I took a break from writing about COVID-19 with my last post, and this post will (sort of) be another departure over the unrelenting blogging about COVID-19 I’ve been doing since March. I say “sort of” because the post will be about traditional Chinese medicine (TCM), and it is impossible to escape COVID-19 when you discuss TCM. Why do I say that? Just listen to Edzard Ernst, because, for whatever reason, this is an aspect to the quackery being advocated for COVID-19 is how TCM advocates, including acupuncturists and others, have glommed onto the pandemic as an excuse to peddle useless nostroms. I’ve touched on this a bit, but not nearly enough (perhaps in the future), but for now I want to focus on an article that was sent to me yesterday about TCM. It doesn’t really have anything to do with COVID-19, but it sure does reinforce themes that I’ve been writing about for years when it comes to TCM, particularly how the Chinese government has been relentlessly promoting TCM to the world ever since Chairman Mao. It comes from a website that publishes news and commentary about China in the form of a story, Beijing Seeks to Punish TCM Naysayers. The subtitle? “A new draft regulation would hold those who slander or defame traditional Chinese medicine criminally responsible but does not say how these terms would be defined.” Because of course it would. China is an authoritarian regime. Although the proposed regulation is a local one applying to Beijing, it’s not hard to imagine its wider adoption.
The point of the regulation is this:
Beijing is considering handing out punishments to those who damage the reputation of traditional Chinese medicine, according to a new draft regulation issued Friday.
The document, jointly drafted by several local government departments, including the Beijing Municipal Health Commission and Beijing Administration of Traditional Chinese Medicine, aims to deter individuals and organizations from behaviors that defame or slander TCM in any way.
Those who violate the proposed rules by “picking quarrels, provoking trouble, and disrupting public order” may be subject to punishments by public security organs or even face criminal responsibility. However, the guideline did not say what behaviors might constitute defaming TCM.
The draft regulation — on which the public is invited to submit feedback for one month — also proposes a ban on the false advertising of TCM and its use to harm public interests, while also suggesting requirements about its management.
I’ve written on numerous occasions how the Chinese government promotes TCM, dating back to Chairman Mao. No, seriously, the promotion of TCM to the world dates back to the late 1940s, and the history of TCM has been massively retconned for propaganda purposes. Basically, here’s what happened. After the revolution, there was a shortage of trained medical personnel in China to provide care to Chinese people. So he mobilized “barefoot doctors” (a.k.a. TCM practitioners) to fill the gaps. He also oversaw the creation of a mythology about Chinese folk medicine by retconning the history and science of TCM in order to represent various ancient folk medicines from China based on pseudoscientific, mystical, and/or prescientific beliefs as somehow being co-equal with “Western” or “scientific” medicine through the clever use of language. A whole history was retconned in which the various forms of folk medicines (not medicine) practiced in China magically morphed into a unified whole, renamed “traditional Chinese medicine.” China was remarkably successful in selling TCM to the world.
Let’s recap a bit. Mao actually had a plan to make TCM palatable to the more educated people in China, the people in cities who didn’t necessarily use old Chinese folk medicine, as well as to export it to the world. Mao’s strategy to deal with these criticisms was quite deliberate—and clever. It consisted of two strategies, as reported by Alan Levinovitz, both designed to mythologize TCM as being a scientifically sound and harmonious “whole medical system” (never mind that Mao said that he didn’t use TCM himself) and to provide “evidence” in the form of testimonials that it worked, as Levinovitz relates:
His solution was a two-pronged approach. First, inconsistent texts and idiosyncratic practices had to be standardized. Textbooks were written that portrayed Chinese medicine as a theoretical and practical whole, and they were taught in newly founded academies of so-called “traditional Chinese medicine,” a term that first appeared in English, not Chinese. Needless to say, the academies were anything but traditional, striving valiantly to “scientify” the teachings of classics that often contradicted one another and themselves. Terms such as “holism” (zhengtiguan) and “preventative care” (yufangxing) were used to provide the new system with appealing foundational principles, principles that are now standard fare in arguments about the benefits of alternative medicine.
As I’ve said many times before, this effort to “science-ify” TCM, or, as I now like to call it, to retcon the science, is very much a part of the promotion of TCM and continues this very day. Examples include propaganda published in the media, such as National Geographic, large, glossy advertising sections in real hard core science journals, such as Science and Nature, as well as unrelenting propaganda and even the enactment of laws and regulations (including regulations to lower the scientific bar for TCM use in China) by the Chinese government promoting TCM use. That doesn’t even count the Chinese government’s use of its influence to push the World Health Organization to “integrate” TCM pseudo-diagnoses into the ICD-11 coding system that’s used around the world for classifying and tracking medical diagnoses, leading to its wishy-washy stance on TCM use during the COVID-19 pandemic.
Part of the propaganda for TCM promoted by China also includes the dissemination of spectacular anecdotes to “prove” the efficacy of TCM. The most famous of these was the case of James Reston, a New York Times editor who underwent an emergency appendectomy while visiting China in 1971. Even though the surgeons there used a fairly standard anesthesia technique, described by anesthesiologist Kimball Atwood as sounding like a “standard regional technique, most likely an epidural,” acupuncture was used to treat cramping on second evening after the surgery, which I interpreted as being the evening of postoperative day one. The story is familiar to any general surgeon; about a day and a half after surgery Reston had some cramping, likely due to postoperative ileus that kept the gas from moving through his bowels the way it normally does. It passed after an hour or so. Around that time, the staff at the hospital used acupuncture to treat his discomfort, and the logical fallacy known as post hoc ergo propter hoc fallacy (and a bunch of credulous Westerners, eager to believe that some magical mystical “Eastern” wisdom” could do what “Western medicine” could not) did the rest. Most likely what happened is that Reston finally passed gas spontaneously (which is how postoperative ileus nearly always resolves), letting the built-up gas move through and relieving the cramps and bloating. About a day or two after an uncomplicated appendectomy is about right for that.
Punishment by national or local Chinese governments for criticizing TCM is nothing new, either. For example, a couple of years ago, I wrote about the case of Tan Qindong. Tan Qindong is a Chinese physician who got into trouble for going on social media and criticizing the health claims made by the company manufacturing a TCM remedy called Hongmao liquor, a best selling concoction of over 60 kinds of medicinal herbs and animal products that is registered as a nonprescription medicine, a bottle of which costs around $100. At the time, advertisements for the liquor appeared frequently on Chinese TV and in other media and touted it as a treatment for basically anything that ails you, including painful joints, frail kidneys, spleen ailments, stomach problems, anemia, and basically dozens of ailments. It’s popular, too, and was the second best-selling TCM remedy in China in 2016, when sales of Hongmao liquor reached 1.6 billion yuan. It was approved to be sold in licensed TCM shops and by licensed physicians in 1992 and became over-the-counter in 2003.
So what happened to Dr. Tan? As Dr. Tan was boarding an elevator in his apartment building, two men flashed badges at him and arrested him. They were officers sent from Inner Mongolia, where Hongmao Pharmaceuticals is based, who later, they took him to Liangcheng County. There he was jailed, and remained in prison for over 100 days. The pretext was Article 221 of the Chinese criminal code, a provision that criminalizes to fabricating and and spreading claims that seriously damage a business’s reputation. Dr. Tan was imprisoned under harsh condition, described as having to sleep beside a toilet, “crammed with other suspects, with little but steamed buns to eat.” Ultimately, publicity about the case, including in the New York Times, sufficiently embarrassed the Chinese government to the point where Dr. Tan was finally released, and led to negative publicity directed at Hongmao Pharmaceuticals.
As the article notes, this isn’t the only criticism of TCM:
In recent years, several scandals have raised public concerns over TCM. Last July, a children’s hospital in the eastern Jiangxi province suspended one of its traditional treatments, sanfutie, after dozens of children complained of side effects such as blisters, itchiness, and burns. And in April 2018, medical professionals questioned law enforcement after a doctor was arrested on suspicion of defaming a brand of herbal liquor that was criticized by drug authorities for false advertising.
This brings us back to the new proposed Chinese regulations (original here in Chinese). Google Translate does a pretty good job of converting parts of the draft to English, and the text of the regulations early in the document gives away the game:
The city vigorously develops the cause of traditional Chinese medicine, inherits the essence, keeps innovation, observes the development law of traditional Chinese medicine, establishes a management system that conforms to the characteristics of traditional Chinese medicine, maintains and promotes the characteristics and advantages of traditional Chinese medicine, promotes the construction of healthy Beijing, and improves the health of the people.
This city implements the policy of equal emphasis on Chinese and Western medicine, supports mutual respect, mutual learning, mutual complementation, and coordinated development of Chinese and Western medicine, draws on modern science and technology, and promotes the innovation of traditional Chinese medicine theory and practice.
Yes, it’s all about promoting and protecting TCM. It’s also hilarious. If you read the whole Google Translate version of the document (those who speak Chinese can chime in on how accurate the translation is), you’ll see a whole lot of verbiage about “standardizing” TCM and the education of TCM practitioners, which never ceases to amuse me given that TCM is a prescientific system of medicine based on, more than anything else, many old folk medicine traditions and Taoism, hence all the emphasis on “balancing” things like hot and cold, dry and wet, etc., which to me highly resembles traditional “Western” medicine and its emphasis on disease being caused by an imbalance in the four humors.
Anyway, Article 54 is where the action is, though:
Anyone who violates the provisions of Article 36, Paragraph 2 of these Regulations, defames and defames traditional Chinese medicine, seeks to provoke trouble, disrupts public order, and constitutes a violation of public security management shall be punished by the public security organ according to law; it constitutes a crime , The criminal responsibility shall be investigated according to law.
And, according to Article 36:
The promotion of Chinese medicine culture publicity and knowledge popularization activities shall abide by relevant state regulations and conform to the cultural connotation and development laws of Chinese medicine. No organization or individual may make false or exaggerated propaganda on Chinese medicine; they may not use the name of Chinese medicine to gain illegitimate benefits or harm public interests; they may not defame or slander Chinese medicine in any way or behavior.
Broadcasting, television, newspapers, the Internet, and other media to carry out the promotion of Chinese medicine knowledge should be engaged by Chinese medicine professional and technical personnel to introduce disease prevention, control, treatment and health care and other scientific knowledge as the main content, not to introduce health, health knowledge, etc. Disguised advertisements for traditional Chinese medicine and traditional Chinese medicine.
Clever. Note how Beijing basically includes language outlawing making “exaggerated propaganda” on TCM or “using the name” of TCM to “gain illegitimate benefits or harm public interests,” making it sound as though that this is about public health and preventing the proponents and manufacturers of TCM products from making false claims, but then turning around and criminalizing “defamation” or “slander” of TCM (whatever that means). One wonders if Beijing would consider it “defamation” or “slander” if someone were to suggest that it’s possible that the TCM trade in animal parts had something to do with the jump of SARS-CoV-2 from animals to humans and the beginning of the COVID-19 pandemic or were to harshly criticize the extreme cruelty to animals and the depopulation of endangered species done in the service of making TCM nostrums. Or, more likely, what if someone were to point out that there’s no evidence that anything in TCM can prevent or treat COVID-19, despite this:
It would potentially lead to the criminal prosecution of people who criticise traditional Chinese medicine (TCM) or “cause trouble or disturb public order” by breaching the law.
The move comes amid a broader campaign by China to promote TCM at home and abroad. In March state media said TCM therapies had been playing a “critical role” in the prevention and treatment of Covid-19, and some were sent to other nations as part of China’s international aid.
China’s president Xi Jinping is a fervent supporter of TCM as a pillar of industry, and its potential to grow and develop.
Whatever the outcome, it’s become very clear that Chinese governments, including the national government and local governments like those of Beijing and Inner Mongolia, are very much committed to promoting the TCM industry, both in China and worldwide, as well as to protecting it from even legitimate criticism, as Inner Mongolia did when its police arrested Tan Qindong and Beijing is trying to do now by proposing criminalizing criticism of TCM. After all, China already has a history of viewing scientifically valid criticism of TCM as “slanderous” or “libelous.” Worse, now that President Donald Trump has made the incredibly disastrous decision to withdraw the US from the WHO, China’s power to use the WHO to promote TCM to the world is now basically unchecked. The legitimization of the mystical pseudoscience that is TCM continues apace and will likely accelerate.