‘Chinese medicine and pharmacology are a great treasure-house,’ wrote Chairman Mao, ‘and efforts should be made to explore them and raise them to a higher level.’

Chinese traditional medicine differs from western medicine in that its application is based on years of experience and precedent rather than a strictly scientific approach. In the West it is now seen as either a magical cure-all or the gimmick of a Communist regime. Every pharmacy in China today has a range of both Chinese and western-style drugs. The concept of Chinese versus western medicine only arose in the nineteenth century with the foreign presence, when China was faced with the choice of following w2stern courses of treatment or doing things her own familiar way. The general policy of the new Republic in 1911 was to follow western techniques, and to discard Chinese medicine which represented yet another facet of China’s backwardness. However, some people began to explore Chinese medicine, developing it and linking it to modern techniques in a move to preserve national identity and self-esteem.

In 1921 Yan Xishan, the warlord of Shanxi Province, set up a Society for the Reform of Chinese Medicine, whose chief task was to develop a system of medicine which was both scientific and Chinese. In 1977 the Nationalist government wanted to do away with Chinese traditional methods of medicine altogether; this provoked such an outcry from articulate and involved members of the government and public that a token gesture, the Institute of National Medicine, was set up. Several people took up the cause of establishing a scientific foundation for Chinese medicine, seeking a rationale for the concepts of yin and yang.

As a forward-thinking force the Communists would have been expected to disapprove of Chinese medicine; however they soon recognized that any kind of medical facilities were better than none. In the early ig5os while the methods of medicine used were based on the Russian model, improvement classes were held for traditional-style doctors who would then be able to participate in the new health movements. The concept of Chinese medicine was to be a political weapon as an example of the accumulated wisdom of the masses visavis the elitist medical knowledge of the bourgeois-trained doctors, and as a nationalistic example of China’s rich heritage. After 1954 schools and hospitals specializing in Chinese medicine were opened; hospital wards often had one traditional Chinese doctor attached, and the study of Chinese medicine was included in medical courses.

Major areas of success have been in the field of acupuncture anaesthesia, the treatment of burns, deaf mutes, and a non-invasive alternative to surgery, as for example in the treatment of gallstones. The use of Chinese traditional medicine is also an economic measure: in the countryside, where supply is always a problem, ‘home-grown’ medicine ensures a well-stocked pharmacy, and treatment by acupuncture does not require complex machinery.

Whereas western medical history can be traced somewhat tenuously to Hippo-crates, the sources of Chinese medicine are found in the Yellow Emperor’s Classic of Internal Medicine, a treatise on medicine published in the third century BC. The wisdom it contains is attributed to the mythical ‘Yellow Emperor’, who is said to have lived in the third millennium BC. It is in nature more a philosophical treatise than a practical guide, relating the harmony of the world order, the yin and yang, to the body. The Book of History of the historian Sima Qian, written in the Han dynasty, includes biographies of two famous physicians, Bian Jue and Zang Gong. It records how the former used acupuncture to bring a man out of a coma, and reveals his diagnostic methods, which placed particular emphasis on the pulse, the patient’s environment, face colour, tongue and odours, and on asking the patient questions about himself.

Acupuncture itself is thought to have developed from massage – applying pressure on or near inflamed areas. Massage is one of the oldest forms of therapy in China. Its use ranges from relieving lumbago to relaxing children’s eyes – children at school usually pause for several minutes to massage their eyes during lesson time. The first acupuncture needles were made of stone, and gold and silver needles have been found in Han dynasty tombs dating back to the second century BC. An illness was seen as a temporary imbalance in the relationship between yin and yang by the accumulation or uneven distribution of qi, a kind of life force which flowed along twelve jing or abstract ‘paths’ in the body. Along these abstract lines lay some 360 points, where by applying the acupuncture needle this imbalance could be restored.

Moxibustion is a type of cauterization process whereby moxa wool sticks (moxa is a Chinese wormwood) are slowly burned over an affected area or on acupuncture points; the technique can also be used in conjunction with acupuncture needles. While all the various acupuncture points are still known, the barefoot doctor is usually acquainted with only around seventy points. There are nine different kind sand sizes of needles in three categories – for insertion into the skin, for use on the surface, and for blood letting. The area to be injected is cleaned with alcohol and the needles are inserted rapidly, with slower movement as they penetrate the tissues; the needles may be inserted at different angles and to different depths. Certain points are recognized as being beneficial in the case of different ailments, and the needle is generally twirled or vibrated on the spot for a short period until the pain is alleviated somewhat and the required numbing sensation is experienced in the area where the needle was inserted.

The major development in the use of acupuncture has of course been acupuncture anaesthesia, which was developed in the late 1950s after being used to reduce pain in post-operative cases. Now acupuncture is regularly used for all kinds of operations as an alternative to standard anaesthetics. An important part of the preparation involves gaining the patient’s confidence and selecting the correct sites for insertion of the needles. Usually a light sedative is given beforehand. At the pioneering stage up to eighty needles were inserted and had to be vibrated constantly for a period of twenty minutes at 120 twirls a minute. The art has now been refined with practice and seven needles are usually enough; they are inserted for, twenty minutes or until the patient has the sensation of de qi- a slight soreness, distension, heaviness and numbness at the place where the needle has been inserted- and the acupuncturist has a sensation that his hand is being sucked in. Nowadays the small needles are connected to a small battery of six to nine volts. There are varying interpretations of how acupuncture anaesthesia works, but the many advantages are obvious- the patient does not have to recover from the after-effects of a standard anaesthetic, and the internal organs continue to function during the operation.

The Pharmocopia of Chinese medicine is exotic, and a visit to a Chinese pharmacy is a bewildering experience as one gazes at drawers and piles of strange roots, deer’s tails, snakes and so on. The standard materia medica which is still referred to today was compiled in the Ming dynasty by Li Shizhen (1518-93), and in recent years many folk remedies have been collected from among the people.

Chinese herbal medicine works perhaps more slowly than western medicine, and its main tenet is to cure the cause rather than the symptom, thus avoiding surgery.

Research is being carried out on combining Chinese and western medicine, which can mean compounding herbal medicine into pill or capsule form instead of the traditional infusion; in the case of heart attacks, while strong, western-style drugs or methods of resuscitation may be given, Chinese medicine will be given to stimulation blood circulation. There is evidence that it has been possible to expel gallstones without resorting to surgery, and some progress has been made in reducing the size of malignant tumours and the side-effects of radiotherapy. Serious burn cases have been treated with Ilex chinensis, which helps the burn to heal, reducing shock and loss of fluid. A wealth of work remains to be done on traditional Chinese medicine – from exploring the ancient classics to finding new adaptations of old methods and researching a scientific base to acupuncture.