Talk:Traditional Chinese medicine

Adding to Article

I think the history section can be fleshed out more. There is also a Historical physicians sub-section that lists the names but not their importance. Jnhkb4 (talk) 18:20, 16 February 2018 (UTC)

Yeah I agree. It's severely lacking. I got a good textbook on Oriental Medicine History, I can use it to add some things. Thorbachev (talk) 12:09, 27 February 2018 (UTC)

"Lead content" image caption

Standard American TCM practice considers lead-containing herbs obsolete.[176]
People keep adding the above sentence to the info box, featuring an image of a piece of lead used in quack medicine.
Tempted to re-revert this diff, but happy to BRD instead.

1. The article isn't about "standard american" TCM - what ever that is
2. The first source mentioned below the image, clearly demonstrates that it is being used in modern TCM
3. Other sources demonstrate that this product is still used.

The addition here hints of white-washing, definitely includes aspects of synth and is at best off-topic for the article, which doesn't specify or limit what kind of TCM it deals with.
can we please have a consensus here. Many thanks Edaham (talk) 04:16, 12 January 2018 (UTC)

Hi there, I'd like to clarify a bit. The article does seek to describe the practice of Chinese Medicine worldwide, for example - the section on regulatory agencies in various countries. Since the 70's, it's been illegal in the USA to use products from endangered animals. Of course, the situation in mainland China is different, so it's worthwhile to describe this huge difference in industry standards, dependent on where in the world the medicine is practiced.

Here's a source from an American TCM company describing what isn't allowed in the USA (including lead). Thank you for the discussion on this.

https://www.mayway.com/pdfs/maywaymailers/Skye-Sturgeon-QM-Restricted-herbs-P1-10-2011.pdf Thorbachev (talk) 09:50, 13 January 2018 (UTC)

WP:3O as requested here 09:08, 15 January 2018 (UTC)

Personally, I'd say that the article does cover TCM in other countries. However, standard american might be a misnomer. I'd say include but reword. Third opinion ∰Bellezzasolo✡ Discuss 21:13, 15 January 2018 (UTC)

I agree with keep but reword. It is significant that practitioners in Western countries practice in different regulatory snd cultural contexts. Herbxue (talk) 21:39, 15 January 2018 (UTC)

It's significant if there's reliable sources (MEDRS) to validate the inclusion. It's not noteworthy if unreliable, low-quality texts are being used by people promoting the subject of this article to assuage the concerns of readers who might be worried about the contents of various kinds of CAM treatments. I think this is worth an RfC as I believe that the term "Standard American TCM" is misleadingly fabricated and the information added is not particularly due in light of the fact that a number of genuinely reliable sources such as health organizations caution people as to the potentially harmful contents of the remedies, including the use of ores.

• While the FDA may have issued a ban on the use of substances it in no way precludes the possibility that these substances are still used or verifies that their use (intentional or otherwise) has been discontinued
• The fact that these standards have been added to the FDA's regulations doesn't constitute a "Standardization" of American TCM in the sense of a regulated medical practice. It merely emphasizes the fact that the people promoting it have been told to stop filling it with hazardous crap. The use of that term is therefore synth. Edaham (talk) 04:49, 16 January 2018 (UTC)

I agreed that the term "standard American TCM" is not an official term, but seems to be an attempt to describe a real phenomenon. Better use of published sources would be to describe the knowledge base required for national certification (NCCAOM) or the standards of accreditation (ACAOM) used in the US. Not sure why you seem to have a bone to pick, its just simple fact that TCM practitioners in the US tend to be more risk averse than in China due to the litigious nature of the culture and an emphasis on safety concerns by the acupuncture colleges (see the Clean Needle Technique Manual published by CCAOM). Sorry if our actual practices don't fit your narrative. Herbxue (talk) 17:05, 16 January 2018 (UTC)

the "picking" going on here by me is regarding a policy our encyclopedia has of not making stuff up and the "bone" in question is a group of editors who, intent on skirting that policy, reinstated made up terms, with flimsy non-MEDRS sources, which I removed from the article. It is neither necessary or due to append disturbing information in this article with, "....but the 'Standard American version' is fine", when some modern aspect of these kinds of medicines differ from their traditional roots. Particularly not when you are a practitioner of whatever this Standard American TCM is. Edaham (talk) 17:30, 16 January 2018 (UTC)

Nothing is being fabricated with this addition. American TCM schools use the Bensky Materia Medica textbook listed for the source under the lead picture. This textbook includes a category called "obsolete herbs", in which lead is included.

• The obsolete herbs category is an FYI section, similar to how psychology textbooks detail outdated therapies such as lobotomies.
• The FDA is not forcing them to write the textbook this way. Bensky is the textbook that USA herbal licensing tests are based on, so it is the current standard. Thorbachev (talk) 10:00, 18 January 2018 (UTC)

Categorization under Alternative and Pseudo-medicine

I think it's inaccurate to place TCM in the same group with "scientific racism" and vaccine conspiracies.

• It would make more sense to group the alternative medicines covered by health insurance, separate from the truly fringe medicine.
• So this would require two groups instead of the current one. There would be an "Alternative Medicine" series, and a "Pseudo-medicine" series. Thorbachev (talk) 10:04, 26 February 2018 (UTC)

Why should we use the health insurance companies' decision to cover something or not as a criterion? At the moment, we use the scientific evidence. Health insurance companies use that too, but they also have financial reasons. We don't. So, why should we follow them? --Hob Gadling (talk) 10:18, 26 February 2018 (UTC)

That's a great question actually. This criterion about insurance coverage makes for a huge distinction among the many different therapies in this series. With this, the different topics split perfectly into two groups: One that appears valid enough to pay for. And the other that is bogus. Most research in medicine is based on trends and patterns over time, that aren't completely understood. Thus, Western Medicine is not a true science. It's an applied science, like engineering. But that's OK because healthcare has to be pragmatic, it's about results, rather than a perfect scientific understanding. So the money goes where the data shows that the healthcare has some validity. So why should Chiropractic be held in the same regard as Orgone? The current series is missing an interpretation of additional relevant information. Thank you. Thorbachev (talk) 07:45, 27 February 2018 (UTC)

You write: "So the money goes where the data shows that the healthcare has some validity." To some degree that's true, but insurance companies also seek to meet the demands made by their policyholders. They are willing to pay for the premiums, so the insurance company makes more money, regardless of true efficacy.

Chiropractic is in a class of its own because of its extremely strong lobbying. They have successfully pressured Congress to pass laws giving them authorization, thus bypassing traditional acceptance by other health care professions. Thus they exist in a parallel universe, and are not really part of mainstream healthcare. Medicare law for chiropractic recognizes a fictive lesion as the basis for billing! See vertebral subluxation. That is the foundation of chiropractic. That happened because of pressure on Congress, not because of scientific efficacy or evidence. Money and politics talk. -- BullRangifer (talk) PingMe 08:04, 27 February 2018 (UTC)

You are trying to replace a clear direct criterion - scientific validity - with a secondary criterion that is related to it but is tainted by other effects beside what really matters. Bad idea. Science is already about "results". If it were true that "the money goes where the data shows", we could use either - except we are not allowed WP:OR. But, as BullRangifer explains above, the money has other forces pulling on it. Therefore, the OR is not just forbidden but also wrong. The direct criterion is the one we will use. --Hob Gadling (talk) 09:13, 27 February 2018 (UTC)

Another issue, it seems these therapies are somewhat arbitrarily decided whether they are pseudo or alternative. So the pseudo-medicine banner shows Chiropractic, but not massage therapy, though it shows NCCIH manipulative therapies. Yet, if we click "manipulative therapies", we see a list of chiropractic and massage therapy together. Then if you click on "massage therapy" it redirects to "massage" with a banner saying it is "complementary and alternative medicine", with no mention of pseudo-medicine. The problem with the "pseudo" label is its inconsistent use. Thorbachev (talk) 11:52, 27 February 2018 (UTC)

Some massage practices are pseudo-medicine, containing bullshit concepts, others are not. The inconsistency is not a problem for the pseudo-medicine label but for the Massage article, because it is a generic term containing various practices, some of which are in the cat and some of which are not. --Hob Gadling (talk) 13:00, 27 February 2018 (UTC)

That's a fair and common understanding of massage. So it would make sense to have some link to massage in the "Alternative and pseudo-medicine" banner. I would suggest adding "aspects of massage" to the "fringe medicine and science" section of the series banner, and then link that to the massage article. Otherwise Wikipedia favors massage over other alternative therapies, while overlooking pseudo-science based massage. Thorbachev (talk) 23:13, 27 February 2018 (UTC)

Misinformation from at least two sources

There are two ways that people can describe that Chinese Medicine has unscientific components.

• One way - the NPOV way, is a statement like "Yin and Yang ideas are unfalsifiable, and as such cannot be considered scientific."
• The biased non-NPOV way, is a statement like "Chinese Medicine has no evidence at all" or "there is no logical mechanism of action."

• I'm identifying these as non-NPOV since they attempt to make a blanket definitive statement, falsely claiming there is nothing to identify or measure in research.
• I'm taking issue, for now, with two sources -
• First, The Nature editorial (which doesn't even have a named author) states "the most obvious reason why it hasn't delivered many cures is that the majority of its treatments have no logical mechanism of action."

• The Nature editorial line is a baseless opinion, ignoring the fact that acupuncture needles cause a measurable neurotransmitter release, which provides the possibility of a logical mechanism of action.

• Second, the Singh 2008 article claims "scientists are still unable to find a shred of evidence."

• The Singh 2008 article ignores the embryologically based theories for meridians. For example, the mesonephric ducts in a 25 day old human embryo fit the pattern of acupuncture points of the urinary bladder channel. So there's your "shred" of evidence.

• The excerpts from the Nature editorial and Singh 2008 are worded as propaganda, rather than prudent scientific analysis. The assumptive statements are presented in the Wikipedia page as if they were fact, causing misinformation, and therefore these statements should be either removed or reworded.
• An NPOV reword would be something like "inconclusive mechanism of action" and "inconclusive evidence for meridians." However the current wordings are essentially verbatim from the sources, so it would be better to remove the statements entirely and replace them with sources that are capable of criticizing Chinese Medicine in proper scientific language.Thorbachev (talk) 08:37, 5 April 2018 (UTC)

You appear to be working from the assumption that TCM is not based upon pseudoscience and fringe theories. --Ronz (talk) 18:16, 19 May 2018 (UTC)

TCM is based on Daoist concepts, which are of course, unscientific, as they are untestable, like with any religion. Personally, I don't think it's accurate to call Daoist ideas, like yin-yang or five elements, pseudoscience, when they are not pretending to be science - they are just metaphors. It's more accurate to call them unscientific. The situation with TCM becomes more complicated when we take into account, that over time (1000's of years) scientifically testable treatments have been added to the knowledge base of TCM - such things like needling to drain cysts, or anesthesia by opium or cannabis, (the list goes on). Other aspects of TCM became more physically outlined, when human dissection was allowed by governments in Greater China. Nowadays within TCM research, there is plenty of room for testing specific treatments, like how acupuncture affects hormone release, blood flow in the brain, etc. But, a lot of good research gets ignored because editorial authors aren't willing to look past the Daoist components of TCM. So, when making final judgments on a specific TCM therapy, saying that yin and yang aren't scientific, is not a good enough reason to discredit a specific therapy. Conclusions should be based on the experiments, and then meta-analyses. I'm aware there is a common complaint of poor-quality research in Asia, but that's a separate issue. I'm just focusing on the trend of editorials saying TCM definitely doesn't work, because of the pseudoscience argument, when the reality is that a lot of the testable parts of TCM, haven't actually been tested yet. Thorbachev (talk) 05:40, 30 May 2018 (UTC)

Capitalize "medicine"

I am a student of TCM, and I feel that in this situation we should capitalize Medicine here, because Traditional Chinese Medicine is a specific field, where Traditional Chinese medicine may be more general (and I would be unsure about capitalizing Traditional in that case). Koabal85 (talk) 02:51, 17 May 2018 (UTC)

Agreed. I'll make the edit. Thorbachev (talk) 04:21, 19 May 2018 (UTC)

Actually, I can't figure out how to change the page title, so I'll just leave it for now. Thorbachev (talk) 04:37, 19 May 2018 (UTC)

The only way to change a page title is to move the page, which might need discussion in this case. See Move a Page.ch (talk) 20:21, 19 May 2018 (UTC)

A small m says: "This is medicine, and it is Traditional Chinese". A capital M says: this is called "TCM", and makes no further assumptions. Since it is doubtful whether it is really medicine, the M should be capitalized. Also, it is "TCM" and not "TCm". --Hob Gadling (talk)

Introduction Improvements

Hello, I've added a source about research into biochemical effects of acupuncture. Personally, I think the source is MEDRS, but I'd like to focus on why I believe it is an appropriate addition. The introduction currently has an unbalanced negative stance on Chinese Medicine. We need to add counterpoints, to make it NPOV. The reality is more nuanced than simply stating "there is no evidence for the existence of meridians." There is a lot of information that would say otherwise. The intro should reflect this. Thorbachev (talk) 02:04, 24 May 2018 (UTC)

Hi Thorbachev, the source you tried to use fails WP:MEDRS on a number of counts. First off, it appears to be a primary source - it's a research paper. MEDRS requires secondary sources - reviews, meta-analyses, etc. Also, it's about a study in rabbits, not people, so you couldn't draw conclusions about people from it. Furthermore, while I haven't looked into the journal itself, I would not be surprised to find that it fails on its reliability. For these reasons, I am very confident that it fails MEDRS.

On the question of NPOV, Wikipedia does not seek to achieve balance by making sure that all sides of an argument are presented; rather, we seek to ensure that we faithfully reflect what mainstream science says about a topic. If mainstream medical science says that there is no evidence for meridians, then that is what Wikipedia must say. If mainstream medical science takes TCM ideas seriously, it should be possible for you to find some discussion of them in mainstream medical science journals - anything you find could certainly be included here.

Finally, when adding material to the lead, remember what the lead is there to do - it summarises the rest of the article. You can't add stuff to the lead that isn't in the body of the text, and you need to remember that it is a summary of the key points. The lead of this article is a few sentences long, and its job is to summarise everything Wikipedia has to say about TCM. A single primary research paper on acupuncture in rabbits, published in a low-impact, fringe journal, just isn't significant enough to discuss in the lead. Girth Summit (talk) 06:31, 24 May 2018 (UTC)

Hello Girth Summit, I can certainly find mainstream journals which take TCM ideas seriously, but these articles tend to require purchase. I'll see if I can eventually gain access to these articles at a library.

I agree that Wikipedia should be reflecting mainstream science. But, currently this article is relying heavily on editorials that are too quick to dismiss the anatomical and physiological data that appear to match up with meridians and acupuncture points. For instance, at the bottom of this article, we have a note stating that there is "not a shred of evidence" for the existence of meridians, even though it's easy to find meridian patterns in embryo-developmental stages of humans. (There's certainly a lot of "shreds") The editorials we are currently citing, are ignoring plausible theories rather than addressing them, because they can't see past the fact that meridians are in ancient texts. The Wikipedia article is asserting that there has been extensive research, resulting in zero evidence, but this verdict is just someone's opinion.

If I find suitable sources in regard to meridians research, where do you suggest I add them? Thanks. Thorbachev (talk) 04:27, 25 May 2018 (UTC)

If you found some good MEDRS sources for the existence of meridians, I expect they would want to be discussed in the section on 'model of the body'. They'd also need to go into the main article on 'TCM model of the body', as well as the main articles on 'Meridians', 'Qi' etc. HOWEVER - I would strongly advise you to bring the articles to the talk page for discussion before inserting them anywhere in order to get a consensus. It would be an extraordinary turn-around in many people's understanding if you were able to unearth any MEDRS-compliant sources evidencing meridians, and you should ensure that we all agree it meets the necessary quality bar before proceeding.Girth Summit (talk) 06:29, 25 May 2018 (UTC)

Ok, thanks! Thorbachev (talk) 16:39, 25 May 2018 (UTC)

Wording on Nature editorial

Let's discuss this: The way the Wikipedia intro words the information in the editorial, makes it sound like the Nature article is talking about TCM as a whole, when it is really talking about herbs. When the source text says "traditional Chinese medicine(s)," the context is clearly Chinese Herbology. It seems the editorial author chose this wording because of how some prefer to say "medicinal", in place of "herb," because a lot of Chinese "herbs" are not plant-based.

Current text in the Wikipedia page:
"Pharmaceutical research has explored the potential for creating new drugs from traditional remedies, with few successful results.[15] A Nature editorial described TCM as "fraught with pseudoscience", and said that the most obvious reason it hasn't delivered many cures is that the majority of its treatments have no logical mechanism of action.[15] Proponents propose that research has so far missed key features of the art of TCM, such as unknown interactions between various ingredients and complex interactive biological systems.[15]"

Why this article is talking about Chinese Herbology, rather than TCM as a whole.

• 2nd paragraph "...the prospect that the nation's traditional medicine might contain a number of potentially profitable compounds hidden somewhere in its arcane array of potions and herbal mixtures."
• 3rd paragraph "Sometimes this has been successful: artemisinin, for example, which is currently the most effective treatment for malaria, was fished out of a herbal treatment for fevers. "
• 5th paragraph "...the US Food and Drug Administration issued new guidelines on botanical drugs that made it much easier to get extracts into clinical trials if there was some history of prior use, and that obviated the need to characterize all compounds in an extract."

The context of the editorial should be made clear in the Wikipedia article, so I changed "TCM" to "Chinese Herbology", but that was reverted. "Chinese Herbology" makes especially more sense, in the third sentence, talking about "various ingredients". I'm open to discussion. Thorbachev (talk) 07:48, 30 May 2018 (UTC)

The Nature reference has "traditional Chinese medicine" in its subheading and uses that term an additional three times; it does not say "Chinese herbology". Interpreting the reference as really being about Chinese herbology is known as original research and is not permitted. Johnuniq (talk) 07:58, 30 May 2018 (UTC)

I reverted the edit concerned, with an informative edsum that shouldn't have to be explained again, but I will anyway. The reference informing that section does not mention "Chinese Herbology" but uses the phrase "Traditional Chinese Medicine" which is, astonishingly, what this article is about. -Roxy, the dog. barcus 10:48, 30 May 2018 (UTC)

We still don't know exactly who wrote that flippant editorial, which we are accepting as MEDRS because the majority of editors like the pejorative "pseudoscience".Herbxue (talk) 15:13, 30 May 2018 (UTC)