A Brief Introduction to Traditional Chinese Medicine (TCM)

Traditional Chinese Medicine (中医 or zhōngyī in pinyin), also called "TCM," is an ancient medical system developed in China over thousands of years. Although seeking TCM treatment is still somewhat uncommon in the West, it's hard to spend much time in China without noticing TCM's booming popularity.

For instance, walk down any street and you're likely to bump into several pharmacies selling traditional Chinese herbal medicines. You'll also hear people reference TCM concepts, like the idea that certain foods are "hot" while others are "cold." In addition, even Western-trained doctors and dentists in mainstream hospitals may make TCM-inspired recommendations, focusing on certain daily living habits to encourage well-being.

Because of TCM's continued prevalence in everyday Chinese life, gaining some familiarity with it benefits any student of Chinese language and culture. Read on to explore the past, present, and future of traditional Chinese medicine!

01 What Is Traditional Chinese Medicine?

Traditional Chinese medicine is a catch-all term for medical treatments and practices developed in China over hundreds — sometimes thousands — of years. Overall, TCM practitioners take a holistic approach to health. Rather than treating specific symptoms in isolation, they examine the body as a whole to identify a disease's underlying causes.

Qi and Meridians

One of the most important concepts in TCM is qi (气 or qì). Essentially, this vital energy circulates throughout the body along pathways called meridians (经络 or jīngluò). In healthy people, qi flows freely. However, health problems can arise if it becomes blocked, too strong, or too weak. As a result, many TCM treatments focus on restoring its normal flow.

Yin and Yang

Furthermore, TCM practitioners view the body's organs and systems as an interconnected, organic whole. Specifically, they describe each part as either yin (阴 or yīn) or yang (阳 or yáng). Blocked qi or stagnant blood can upset this balance. According to TCM, such imbalances lead to health problems, so many therapies aim to restore equilibrium.

Diagnostic Methods

When diagnosing patients, TCM doctors use several methods including inquiry, inspection, palpation, olfaction (smelling) and auscultation (listening). In addition, they commonly take the patient's pulse and examine the tongue before choosing a treatment.

02 Common TCM Treatments

Herbal Medicines

TCM doctors widely prescribe Chinese herbal medicines (中药 or zhōngyào). Typically, they give patients a mixture of herbs to boil in water, creating a tea-like brew. In total, practitioners draw on thousands of plant and animal species.

Acupuncture

Acupuncture (针灸 or zhēnjiǔ) involves inserting thin needles into specific points along the meridians to rebalance qi.

Notably, it is one of the more popular TCM treatments outside China. Practitioners use it to address ailments from chronic pain to infertility. Nevertheless, the debate over its effectiveness continues.

Moxibustion

Practitioners often use moxibustion (艾灸 or àijiǔ) alongside acupuncture. Specifically, the technique involves burning an herbal mixture on an acupuncture needle or directly on the patient's skin. The resulting heat is then thought to help qi flow along the meridians.

Massage (Tuina)

Tuina (推拿 or tuīná) combines massage and acupressure techniques. In particular, practitioners apply strong, deep pressure to specific meridian points to improve the flow of qi.

Cupping

Cupping therapy (拔罐 or báguàn, also called 拔火罐 or báhuǒguàn) places inverted rounded cups onto the skin to enhance qi flow. First, practitioners burn a substance inside the cups to create a vacuum, allowing them to stick tightly to the skin.

Once removed, the cups leave circular dark purple bruises that can last up to three weeks. Practitioners mainly use cupping to treat headaches, nasal congestion, and other ailments.

Guasha

During guasha (刮痧 or guāshā), a practitioner rubs the skin with a specialized tool. The goal is to boost the flow of qi and stagnated blood. In particular, this technique often targets joint and muscle pain.

Similarly to cupping, guasha leaves bruises that take time to heal. For a look at East-West cultural misunderstandings around this practice, check out the movie The Guasha Treatment.

Qigong and Tai Chi

Qigong (气功 or qìgōng) and tai chi (太极 tàijí, also called 太极拳 or tàijíquán) are slow, meditative exercises inspired by martial arts. Both pair a series of movements with controlled breathing. As a result, practitioners believe these routines promote health and help balance qi.

Diet and Nutrition

TCM practitioners also classify foods as either "hot" (阳 yáng) or "cold" (阴 yīn). According to this theory, too much of either yang or yin in the body can trigger disease.

Therefore, dietary changes can correct this imbalance. For example, a practitioner might encourage a patient with excess yang to eat "cold" foods like mung beans. Conversely, someone with too much yin might receive a recommendation for "hot" foods like mutton. Additionally, TCM encourages seasonal dietary shifts between winter and summer.

03 History of Traditional Chinese Medicine

Early Origins

Like most aspects of traditional Chinese culture, Chinese medicine has a long history. Legends credit the Yellow Emperor and Emperor Shennong with inventing it. Moreover, oracle bone evidence points to medical practices dating back to the Shang Dynasty (c. 1600–1046 BC). However, the Shang people had a limited understanding of disease. They attributed illnesses to ancestral curses and consequently used magical treatments.

The Han Dynasty Classics

China's first systematic medical texts appeared during the Han Dynasty (202 BC–220 AD). During this period, authors produced the four great classics of Chinese medicine (中医四大经典 or zhōngyī sìdàjīngdiǎn).

The first of these, The Inner Canon of the Yellow Emperor (黄帝内经 or Huángdì Nèijīng), describes treatments still in use today — acupuncture, drugs and dietary changes. Furthermore, it lays out the anatomical and physiological theories that form TCM's philosophical basis.

Similarly important, The Classic of Herbal Medicine (神农本草经 or Shénnóng Běncǎojīng) draws on earlier oral traditions. This reference book lists 365 medicinal plants.

Famous Han Dynasty Physicians

China's first recognized physician, Bian Que (扁鹊 or Biǎn Què), authored The Emperor's Canon of Eighty-one Difficult Issues (黄帝八十一难经 or Huángdìbāshíyī Nánjīng). Indeed, the Han Dynasty marked a turning point when individual doctors first gained recognition. To this day, legendary stories continue to celebrate Bian Que's skills.

Another famous practitioner, Zhang Zhongjing (张仲景 or Zhāng Zhòngjǐng), earned the nickname "Chinese Hippocrates." He wrote The Treatise on Cold Damage Disorders and Miscellaneous Illnesses (伤寒杂病论 or Shānghánzábìnglùn), a guide to diagnosing illnesses by their symptoms.

From Classical Era to Modern China

After the Han Dynasty, authors continued to expand on these classical works. This process lasted until Chinese medicine encountered Western medical ideas in the 16th century.

Subsequently, as China modernized in the late 19th and early 20th century, reformers called for TCM's abolition. They increasingly viewed it as unscientific. After the communist revolution, however, Mao promoted TCM as a low-cost way to improve rural healthcare.

Later, during the Cultural Revolution, authorities deployed barefoot doctors (赤脚医生 or chìjiǎo yīshēng) to improve rural healthcare. These practitioners blended Western and Chinese medicine — a strategy that China still follows today.

04 TCM in China Today

Today, TCM enjoys strong popular and political support in China. In particular, President Xi Jinping actively promotes it, calling it a national treasure. Since 2017, law has required local governments to expand TCM services. As a result, China's state insurance plan now treats them as equal to Western medicine.

TCM pharmacies line city streets across the country. In addition, most Western-medicine pharmacies devote a section to TCM products. Major hospitals — not just TCM specialists — also offer herbal treatments. Meanwhile, practices such as guasha and cupping remain popular, especially among older people. Practitioners even deployed TCM treatments during the fight against COVID-19.

05 International Reception of TCM

TCM first gained wider American attention in 1971 through an article by James Reston, a New York Times reporter. He received acupuncture for appendicitis while traveling in China with Henry Kissinger. Since then, TCM has enjoyed some popularity as an alternative therapy in the West.

In the early years of the People's Republic (1949–present), the government sent TCM doctors to Africa as part of its foreign aid program. More recently, China has promoted TCM globally to expand its soft power and capture a share of the growing global TCM market.

To that end, Beijing runs training programs for foreign students and supports TCM tourism. It has also opened TCM centers in cities like Dubai and Barcelona. Furthermore, more centers are planned as part of the Belt and Road Initiative. China even sent TCM doctors and medicines to countries affected by COVID-19.

In 2019, China successfully lobbied to include TCM in the WHO's International Statistical Classification of Diseases (ICD). This influential document serves as a standard reference for doctors, epidemiologists, health officials and insurers in over 100 countries. Consequently, its inclusion of TCM is likely to accelerate these practices' global spread.

06 Controversies

Despite its growing popularity, TCM's modern rise has not come without controversy. Most importantly, no one has yet proven the existence of core concepts like qi and meridians.

Moreover, standardization and regulation of TCM products remain lacking. Researchers have found mislabeled medicines that contain dangerous unlisted ingredients. Unfortunately, some herbal medicines also still use parts from protected or endangered animals.

As a result, many Western-trained scientists remain skeptical about TCM's efficacy. Clinical trials have so far failed to support many traditional treatments. In some cases, researchers have yet to conduct trials; in others, completed studies showed no clear benefit.

On the other hand, some TCM practitioners counter that Western-style trials are unsuited to their treatments. They point to the highly individualized nature of TCM therapies and the complex interaction of ingredients in herbal medicines. Nevertheless, many Western-trained experts remain unconvinced.

07 The Future of Traditional Chinese Medicine

With President Xi's strong backing and its inclusion in the WHO's ICD, TCM is likely to grow globally. Above all, its gentle, low-cost, holistic approach appeals to many people inside and outside China. In particular, the practice may hold great potential for chronic conditions like heart disease.

In the short term, however, a lack of scientific evidence may slow widespread acceptance. Therefore, researchers need to standardize treatments and test them using modern methods. Eventually, the field may even need entirely new approaches better suited to TCM therapies.

As evidence accumulates, practitioners will likely discard harmful practices and refine effective ones. Ultimately, methods that prove their worth will enjoy greater acceptance in China and around the world.

08 Chinese Vocabulary Related to Traditional Chinese Medicine