As Chinese acupuncture gains in popularity in Western countries for its amazing healing ability, it seems to be withering away in China.

A recent survey has found that even among students majoring in Traditional Chinese Medicine (TCM), only 13 per cent would choose the Chinese treatment first if attacked by disease, compared with 48 per cent who would choose Western medicine.

It seems that many Chinese people are losing confidence in their own medicine which for several thousand years was the only therapeutic treatment in China.

Chen Xianshu, a local journalist, said she might choose traditional Chinese medicine for some minor health problems but for any acute disease, she would prefer Western medicine. This attitude is shared by many locals today, although TCM actually originated from the treatment of acute and serious diseases - such as plague.

The bleak outlook for Chinese medicine can be easily seen in the meagre number of TCM hospitals in the city.

"Although both State and regional laws stipulate that each district should have at least one hospital specializing in Chinese medicine, the situation now is that most of them just say they are TCM hospitals, while inside they mainly practise Western medicine," said Yan Shiyun, president of the Shanghai University of Traditional Chinese Medicine and Pharmacology.

Market-oriented confusion

Based on the scientific study of blood and cells, Western medicine is obviously in more accordance with modern cultural attitudes than with the abstract Chinese medical theories of yin and yang.

Under market pressure, Yan's university which specializes in TCM has set more courses on Western medicine for students. The current curriculum is 60 per cent TCM and 40 per cent Western medicine.

"We have to do that. Otherwise the students can't find a job after graduation," Yan said.

However, such a curriculum, in the eyes of old experts, can hardly produce good TCM doctors.

Western medicine and TCM are totally different. The theoretical framework of Chinese medicine goes back nearly 2,500 years. Due to limited technology, the theory is based more on clinical thinking and analysis than on laboratory experiments.

TCM, which is based on yuanqi(primordial qi), looks at people in their social environment. It considers many possible reasons behind the disease, so when treating the patient, it takes the whole body into consideration when prescribing compounds of herbs.

Western medicine is more direct and simply targets a single disease.

"The amazing good effect of Chinese medicine is based on its unique theory and way of thinking," said a professor from Shanghai No 2 Medical University, who refused to be identified.

"The current mixture of learning Chinese and Western medicine together may lead the students into confusion. The students may easily be restricted by the rigid thinking mode in Western medicine, which will badly affect their study of Chinese medicine."

To make matters worse, many students majoring in TCM are spending more time learning about Western medicine than about their major.

"Doctors with Western medicine skills are more needed in the market," said Rita Lin, a local TCM student.

In Shuguang Hospital, one of the city's four major TCM hospitals, doctors with Traditional Chinese Medicine skills only are not accepted. At the same time there is no similar demand that those majoring in Western medicine acquire a certain knowledge of TCM.

But in Hong Kong and some Western countries where TCM is legal, the line between doctors practising Western medicine and Chinese medicine is much clearer. TCM doctors overseas may only give prescriptions for Chinese medicine. "And it would help a lot if doctors made a greater effort to learn Chinese medicine," said Yan Shiyun.

"But here, TCM doctors have to give diagnoses for the same disease in both ways."

Experts have warned that the current situation will lead to a deterioration in the skills and capabilities of TCM doctors.

Raw materials shortage

The crisis facing TCM is not solely to do with education. Another threatening problem has to do with the raw materials used.

Most of the raw materials for Chinese medicine come from animals and plants and this has already aroused complaints from wild life protection organizations. Currently many raw materials are not allowed to be used, such as tiger eyes and tiger bones.

"To solve the problem, a lot of farms have been set up to raise plants and animals for medical use. But that has actually caused many other problems," Yan said.

Chinese medicine pays special attention to the genuineness of the ingredients used to make the medicine. For example, only ginseng from the Changbai Mountain in North China's Jilin Province is regarded as being genuine and fully effective, according to ancient Chinese medical texts. For Chinese goldthread, the genuine variety can only be found in Sichuan Province.

"The quality of the products from the farms is sometimes very low," Yan said.

Not long ago, the market was short of ephedrine. Its high price led many different farms to grow the plant. Now the domestic market has more than 20 different types of ephedrine, with the quality gap between the best and the worst as large as twentyfold.

The use of chemical fertilizers was also becoming more and more serious.

"The quality of the medicinal materials is the biggest problem facing Chinese medicine now. So far, no good solution has been found," Yan said.

(Shanghai Star  January 13, 2004)