Listen instead:
If you grew up in the United States in the late 20th century, it’s statistically unlikely you had much exposure to Chinese medicine. Unless you happened to frequent or live in Chinatown on either of our country’s coasts, you probably didn’t integrate acupuncture, herbalism, martial arts, or Chinese food therapy into your life.
Probably it was more of a Tylenol and Flintstones vitamins experience, shaken (not stirred) over a No Pain, No Gain mentality, and held together by a li’l Pepto-Bismol. No shame. Same here. The smell of Pepto still soothes me.
In recent decades, though, America has seen an increase in access to acupuncture. A 2014 NIH paper about the rise of acupuncture in the US reports that more than 10 million acupuncture treatments are given per year in the States. In the intervening decade, that number has likely risen.
In short, more and more people in the US are beginning to discover the benefits of acupuncture and Chinese medicine. And in the process, people are learning that not all acupuncture is the same.1
Today in the US, acupuncture typically falls under one of two branches: classical Chinese medicine (CCM) and traditional Chinese medicine (TCM). Today’s post aims to disambiguate classical and traditional Chinese medicine, two styles whose dramatically different approaches can yield dramatically different results. Let’s go.
The Question Is — Who Cares?
Before we launch into classical vs. traditional Chinese medicine, I’d like to put forward two quick notes:
Why it matters.You’ve probably noticed that every so often people in any given (and every given) industry can become highly concerned — preoccupied, even — by discrepancies and distinctions that make the rest of us roll our eyes so hard we sprain something. I don’t want to do that to you.
The classical vs. traditional Chinese medicine distinction isn’t simply an academic one. I’m pointing out these styles’ differences because it actually matters for acupuncture clients. It’s worth knowing that not all acupuncture is the same, so you can best choose a practitioner whose training and style meets your needs.
Here’s my bias. At Huwe Acupuncture, we practice classical Chinese medicine, and we do that on purpose. We’re not a traditional Chinese medicine clinic, though we learned TCM differentiation and treatment principles because the national board exams are TCM-based. (The reason for this is deeply political.)
6,000+ Years of Chinese Medicine in a Few Paragraphs?
There are many types and styles of Chinese medicine — so many that it’s laughable to try to enumerate them. After all, Chinese medicine writings date back to 206 BCE, but its practice goes back even further. No one really knows when acupuncture came into being, but we have archaeological evidence that acupuncture existed in China in the Neolithic era,2 which means around, say, 6,500 years ago-ish. Old, in other words.
Not only is it an old medicine, but it’s also a cumulative medicine — meaning that as new discoveries were made, old ones weren’t necessarily discarded as irrelevant. Instead, the new idea was added as another school of thought. Thus a practitioner can learn and practice multiple, wildly different approaches, including — but nowhere near limited to — Attacking & Purging, Warming the Interior, Cold Damage, Pestilent Factors, and Tonifying.3
There’s also the reality that acupuncture is only one part of Chinese medicine. This medicine is vast, wide-ranging, and includes overlapping — but nonetheless distinct — modalities such as moxibustion, cupping, herbalism, tui na, martial arts AKA tai chi AKA qigong AKA daoyin, dietary recommendations, and meditation.
How this medicine was taught and passed down through the millennia is, naturally, a mixture of tradition, drama, intrigue, and political influence. The form we see today is no exception.
Traditional Chinese Medicine’s Short History: Lost in Translation
According to a very fine article by scholar Ian Johnson, the Chinese term for this medicine, zhongyi, translates simply to Chinese medicine.4“Outside China,” Johnson goes on to say, “the unfortunate term ‘traditional Chinese medicine,’ or TCM, has taken hold, even though it doesn’t exist in Chinese.”
Johnson explains that the English language term traditional Chinese medicine originated in the 1950s in Chinese Communist Party publications aimed at the West. The idea here was for China to distance itself from Chinese medicine while cozying up to biomedicine. The Chinese Communist Party (CCP, or the Party) wished to be viewed as both modern and culturally unimpeachable.
The use of the word traditional, at least according to this word nerd,was apt. In English, that’s exactly the word we use to describe medicine that predates biomedicine. Sometimes we know the names of traditional medical systems — Ayurveda in India, for example. Other times, often in the wake of colonization and/or genocidal measures, we know the names of specific traditional medicines. Either way, the term traditional tells us something very specific when modifying medicine.
So while they wanted to distance themselves from Chinese medicine, whose theories were not validated by scientific imaging or studies, the Party couldn’t simply eradicate Chinese medicine. For one thing, they didn’t have enough practitioners of biomedicine to take its place. For another, there was some ambivalence surrounding it — after first renouncing Chinese medicine, Chairman Mao Zedong later endorsed it… ish. That is to say, he announced support of Chinese medicine, but didn’t believe in its efficacy or use it himself. In short, the Communists had to sort of incorporate Chinese medicine… and sort of eschew it.
In the end, the Party renamed and radically altered the practice and teaching of Chinese medicine, so that it became much less like its actual traditional self, despite the “traditional” moniker. Practitioners of Chinese medicine in China were sometimes exiled, sometimes fled the country, and sometimes were taught a bit of biomedicine and sent to far-off reaches of the country. In other cases, to quote this article by classical practitioner Heiner Fruehauf:
“[M]any physicians frantically burned their stitch-bound volumes and other old-fashioned belongings to avoid persecution, and as others died from grief or physical abuse, much of the physical legacy of Chinese medicine perished irretrievably.”
The dissemination of Chinese medicine within the country was overhauled. Learning no longer occurred in an apprenticeship to a practitioner, but became standardized and taught from textbooks. If an aspect of Chinese medicine was deemed superstitious — read “unprovable by modern science” — it was discarded.
Truncated and simplified from its origins and theoretical backbone, TCM takes a prescriptive version of Chinese medicine, or as Johnson describes it, “a sort of handyman approach.” The individualized, comprehensive power of Chinese medicine is watered down in this approach, which amounts more or less to Use this point prescription for this ailment.
Rather like a word-for-word translation, TCM doesn’t encapsulate the full breadth of Chinese medicine’s deep understanding and wide-ranging flexibility. Instead, it seeks to emulate biomedicine in an awkward application of Western thought to Chinese medicine. Its results are, then, as mixed as its components. It is this version of Chinese medicine that began to be practiced in China, and was most broadly released to the West.
Classical Chinese Medicine: The True Traditional Medicine
But what happened to the non-physical parts of Chinese medicine that were removed from favor in the 1900s? What happened to the people who had once practiced those arts and survived? Some lineages are traceable to and alive in the United States today.
Classical Chinese medicine, or CCM, is the practice of Chinese medicine prior to the Party overhaul. This format of the medicine is comprehensive, individualized, and less formulaic than TCM. It gives the practitioner more access points to the client, and pulls fully from the depths of the medicine. For example, the classical acupuncturist treats choosing among 74 channel systems; the TCM practitioner chooses from among 14.5 With a more robust understanding of the ways in which healing works, the CCM practitioner can help guide people more fluently from illness to wellness.
Many professionals seek to revive and reinstate Chinese medicine to its full expression in the West, and some changes are being seen in China as well. Heiner Fruehauf, Ann Cecil-Sterman, Dianne Connolly, and Sabine Wills are all well-known, Western-born practitioners whose work with the classics and the classical approach reach Western practitioners. Many TCM practitioners avail themselves of continuing education to learn more about clinical efficacy and the classics.
At our clinic, we’re lucky to have learned classical Chinese medicine from the start. In fact, it’s why we both (individually) chose the four-year, graduate academic program we did. At that time, it was one of the only classical schools in the country. The classical component of the curriculum was taught by Jeffrey Yuen, an internationally renowned leader in the dissemination of classical Chinese medicine. Master Yuen’s considerable experience is rooted in Daoist philosophy, and is — as far as I can tell — unmatched.
Conclusion
None of this is meant as slanderous toward TCM; it is simply the reality of how Chinese medicine has changed in recent political times, and how it was introduced to the outside world as a result. As clients of acupuncture in our younger years, we Huwes both experienced TCM as a beneficial paradigm for healing.
Our subsequent experience and education have convinced us, though, that the more deeply the practitioner understands the complexity and elegance of Chinese medicine, the more frequent the opportunities for healing. And this is where classical Chinese medicine truly shines.
by Mary Beth Huwe
These writings are an exploration of what it means to be human – to be sick, to be well, and to heal – viewed through the lens of classical Chinese medicine. My words aren’t medical advice, and these essays don’t constitute a practitioner-client relationship. They also aren’t meant to be the final word on… well, anything. Rather, I hope they are the beginning of a conversation you have with someone in your life. Thanks for reading!
Footnotes:
- Acupuncture itself is believed to have originated in China, based on the evidence of classical texts and other historical data. That said, Japanese and Korean cultures also have distinct acupuncture traditions. Our training includes some Japanese and Korean approaches, but mainly focused on Chinese medicine, based on the medical classics. ↩︎
- This is a disputed claim. See a counterargument. ↩︎
- We’ll address terminology directly another time, but if these terms seem jolting, please remember (a) language evolves over time, and these are old terms (b) these old terms are translations out of another culture into our language, and (c) there’s a paradigmatic difference between Chinese medicine and biomedicine. ↩︎
- Johnson, Ian. “Chinese Medicine in the Covid Wards.” ChinaFile, 4 Oct. 2021, https://www.chinafile.com/library/nyrb-china-archive/chinese-medicine-covid-wards. Retrieved 28 Nov. 2023. ↩︎
- CCM uses these channels: primary, extraordinary, luos, sinews, and divergents. TCM typically uses primary channels, plus two extraordinary channels (the Ren and the Du). ↩︎
