For the first time, the World Health Organization (WHO) is including a section on traditional Chinese medicine in its upcoming disease diagnosis and classification guide.
Practitioners welcome the update, but in Europe the move is setting off alarm bells among top medical and scientific groups.
“We were quite amazed to see something like this having no scientific support to be included in a document that is so widely used across the world,” said Dan Larhammar, president of the Royal Swedish Academy of Sciences. , who helped draft a statement released this month by a coalition representing Europe’s science and medical academies.
Traditional Chinese Medicine, or TCM, is a complex practice that approaches health through the body’s relationship with nature.
“The terminology, the language is different,” said Song Xuan Ke, a traditional Chinese doctor who has practiced in London for three decades.
Traditional Chinese Medicine is rooted in the ancient principle of Yin and Yang. These opposing forces correspond to different parts of the body and have characteristics like hot and cold, calm versus active.
Health problems are a sign of an imbalance, perhaps kidney Yin deficiency, or a blockage of qi in the meridian line, or energy channel, in the body.
Practitioners seek to restore this balance through various herbal remedies and therapies such as cupping and acupuncture.
It can be more subjective and individualized, Ke told the world, compared to Western medical approaches.
The WHO Diagnostic Manual was created in 1948 and has become an international standard for reporting data on health conditions and causes of death. It has also been revised a lot, as medicine itself evolves. The inclusion of a chapter on TCM in the next edition was approved this spring and takes effect in 2022.
“It shows the world is multi-dimensional, so that’s great,” said Ke, who hopes the move will be a boost for the field worldwide.
This is exactly what the Federation of European Academies of Medicine (FEAM) and the European Academies Scientific Advisory Council (EASAC), a coalition representing the European Academies of Science and Medicine, fear. In November, they released a statement calling on the European Union to do more “to ensure that all medical products and procedures are subject to an appropriate level of quality, safety and efficacy assessment… “
They want to crack down on claims of unregulated herbal drug treatments and interventions.
“If unproven methods are claimed to be helpful, we risk the health of patients,” Larhammar said, adding that the move could legitimize quack claims about panacea for cancer and other diseases and put pressure on health systems. for them to incorporate unproven practices, such as using an ingredient in animal skins to fight cancer.
“No one has been able to define a meridian or an acupuncture point. No one can tell what the diameter of an acupuncture point is, or how deep it is. [the] skin, whether it is the same size on the body. It is still totally unknown – and most likely, [an] the explanation for this is that they probably don’t exist.
In a separate, searing editorial, the journal Nature wrote that the WHO risks promoting an unsubstantiated philosophy and is likely to fuel the sale of largely unproven treatments.
In an emailed statement, WHO spokesman Christian Lindmeier wrote that the inclusion of TCM “is not an endorsement of the scientific validity of any TCM practice or effectiveness of any TCM intervention, but a tool for counting and comparing TCM conditions.The chapter provides the means to do research and evaluation to establish the effectiveness and safety of TCM.
For Dominik Irnich, a doctor at the University of Munich and head of a pain center at the hospital, the warning from European academies is a good thing but “a bit exaggerated”.
“I think it’s not just about regulation, it’s about the acceptance of traditional Chinese medicine and acupuncture in the western world,” he said.
Irnich is also president of the German Acupuncture Association and active in international groups. He has found that some traditional approaches, such as acupuncture for chronic pain, have shown promise in his practice.
“There is scientific evidence, and for example in Germany it is well accepted,” Irnich said. “We have about a third of German doctors who know it very well and use it.”
Still, he said it’s best brought under the umbrella of Western medicine, where practitioners have training in both fields and where scientific research methods can provide more checks. As it stands, he says, policies and regulations surrounding TCM vary from country to country. They often don’t exist.
“There is a need for a call for regulation,” Irnich said, referring to the European Union level. “So that makes sense.”
Elana Gordon is a journalist and producer at The World, specializing in global health and medicine. She is a founding member of WHYY’s Health and Science show, The Pulse, and was a 2018-19 Knight Science Journalism Fellow at MIT.