On October 5, 2015, the annual Nobel Prize in Physiology or Medicine was awarded jointly to three elderly doctors. William C. Campbell and Satoshi Ōmura received the prize for the discovery of Avermectin, a drug that proved to be very effective at treating parasite-based diseases, such as River Blindness and Lymphatic Filariasis. The third recipient was Chinese medical researcher Tu Youyou, for her discovery of Artemisinin, the most powerful drug against malaria to date.
The success of the latter drug is particularly unique. Artemisinin is an herbal-based substance extracted from the wormwood plant Artemisia annua. While the anti-malarial properties were discovered by Tu in 1971, Artemisia Annua has been used in Chinese herbal medicine as far back as 168 B.C.E. Her award has renewed a debate on Traditional Chinese Medicine (TCM), a field with a controversial history.
Many consider TCM to be a form of pseudoscience, including scientific journals such as Nature. The foundations of acupuncture, a major component of TCM, are based on concepts that are more spiritual than scientific, such as “qi”, an energy that flows throughout the “meridian” channels all over the body. Many studies have been performed to compare the effects of acupuncture treatment to a placebo, also known as “sham” treatment. Some of these trials have concluded that there is strong evidence that acupuncture can alleviate symptoms such as joint pains, nausea, and fatigue, while others have been inconclusive. While many contemporary acupuncturists no longer use concepts such as qi and meridians in their research, TCM as a whole has much less scientific backing, compared to medicine that is practiced in the Western world, which is rooted in a very different set of principles. It seems bizarre, considering that Chinese medicine traces back thousands of years, that it could be completely ineffective. However, others argue that Western standards of scientific testing fail to capture the art of healing the body.
Weidong Lu, an oncologic acupuncturist and researcher at Dana-Farber Cancer Institute, told Frontiers that the fundamental difference between the two medical approaches is that whereas Western medicine has a detail-oriented basis, TCM takes a more holistic approach. It assumes that all parts of the body are invariably connected, even to its environment such as the seasons that pass, food eaten, and the exercise the body receives. “Chinese Medicine looks at relationships among phenomena,” Lu explained, and gave an example of someone who has headaches, painful urination and blistered lips simultaneously. The Western-style approach would be to look at each problem individually, and seek out the root causes to determine proper treatment, whereas in Chinese medicine, this would be “considered as one connected phenomena.”
Lu leads a team of researchers, all of whom were trained in China and have over a decade of experience in Western Medicine, in studying the merit of acupunctural treatment of the cancer treatment side effects. The foundations of TCM, said Lu, are based on personal experiences, tradition, and literature, rather than scientific testing. So how can we accept a form of medicine that is not grounded in scientific testing? If acupuncture and herbal treatments traditionally rely on people’s personal experiences, is there any reason to believe that it could help us?
Ultimately, the search for a root cause of every disease or painful feeling is not always successful. Suppose you went to go down to a health clinic, because you had been experiencing severe headaches, insomnia, or fatigue. These cases often don’t have clear physiological causes. When the doctor comes back to inform you, “We ran some tests, and it looks like there’s nothing wrong with you. You’re free to go,” you would not be happy. You know that something’s wrong with yourself, and yet, with current technology, there is no way of diagnosing the problem. Perhaps, if the source of the illness cannot be detected quantifiably, a more holistic approach would be optimal. Chinese herbs, when used as treatment, contain multiple components, and target multiple areas of the body, which may increase the chances of finding a spot to relieve pain.
Compared to TCM, Western medicine is particularly powerful at dealing with acute conditions, where there is a clear known cause to an infection or disease. “[Western Medicine] has developed tremendous techniques with science,” Lu commented, noting that when dealing with trauma, injuries, and infections, Western approaches win out. But when dealing with chronic illnesses without a clear, known cause, the detailed approach of evidence-based medicine “tends to be linearly thinking … looking for the one source,” Lu said. In fact, multiple sources may be involved in an illness. The experience-based approach of TCM doesn’t fully understand the physiology of diseases, but when dealing with chronic pain, a holistic approach can be a more useful method than conventional Western practices. TCM is more often used for treatment and pain relief that for cures and has applications for addressing both physical diseases and mental conditions, such as anxiety and depression. And given how far back acupuncture and herbal remedies have been documented, people’s experiences, while not necessarily considered as data, can bestow important information.
Despite the contrast in cultural and scientific roots, Western and Eastern Medicines have greatly disseminated into each other’s societies; according to Lu, acupuncture is now, in fact, more prevalent in the United States than it is in China. Meanwhile in China, as of 2015, 1.1 million doctors specialize in Western medicine, while fewer than 200,000 specialize in TCM.
It is not uncommon these days for a cancer patient to receive radiation and chemotherapy, and then be prescribed herbal remedies to speed up recovery and alleviate the side effects of these procedures. Sometimes, patients may receive acupunctural treatment even during surgery to ease the suffering. In research, medical workers are applying Western techniques to measure the potential of acupuncture and herbal remedies. Tu Youyou discovered the anti-malarial powers of artemisinin, by using a Western method to analyze Chinese herbs that have been known to be effective. Integrative medicine has also been growing in the United States as an ideal best-of-both-worlds approach, given the relative advantages of TCM and Western Medicine. “The essence of this integrated medicine is to take the best part of both of them, and combine them together to use on the patient,” said Lu. Although there are very different backgrounds, approaches, and standards for Western and Eastern medicine, they have proven over the years to be very compatible in certain medical treatments.