View source for Traditional Chinese medicine

{{Short description|Traditional medicine in China}}
{{Redirect|Chinese Medicine|the practice of medicine in modern China|Medicine in China}}
{{Use dmy dates|date=January 2020}}
{{Infobox Chinese
| title = Traditional Chinese Medicine
| image = [[File:ChineseMedicine-HK.JPG|200px]]
| caption = Traditional Chinese medicines/dried goods shop in Kowloon, Hong Kong
| t = 中醫
| s = 中医
| l = "Chinese medicine"
| p = Zhōngyī
| w = Chung<sup>1</sup>-i<sup>1</sup>
| mi = {{IPAc-cmn|zh|ong|1|-|yi|1}}
| tl = Tiong-i
| j = Zung<sup>1</sup> ji<sup>1</sup>
| y = Jūng yī
| c =
| ci =
| altname =
| order = st
}}
{{Alternative medical systems}}
{{Chinese folk religion}}

'''Traditional Chinese Medicine''' ('''TCM''') is an [[alternative medicine|alternative medical practice]] drawn from [[traditional medicine]] in China. It has been described as "fraught with [[pseudoscience]]", and the majority of its treatments as having no logical [[mechanism of action]].<ref name="Eigenschink Dearing Dablander et al 2020">{{cite journal |last1=Eigenschink |first1=Michael |last2=Dearing |first2=Lukas |last3=Dablander |first3=Tom E. |last4=Maier |first4=Julian |last5=Sitte |first5=Harald H. |title=A critical examination of the main premises of Traditional Chinese Medicine |journal=Wiener klinische Wochenschrift |date=May 2020 |volume=132 |issue=9–10 |pages=260–273 |doi=10.1007/s00508-020-01625-w |pmid=32198544 |pmc=7253514 }}</ref><ref name="swallow" />

Medicine in traditional China encompassed a range of sometimes competing health and healing practices, [[folk beliefs]], [[Scholar-official|literati]] theory and [[Confucianism|Confucian philosophy]], [[Chinese herbology|herbal remedies]], [[Chinese food therapy|food]], diet, and exercise, medical specializations, and schools of thought.{{sfnb|Andrews|2013b|pp=10-17}} In the early twentieth century, Chinese cultural and political modernizers worked to eliminate traditional practices as backward and unscientific. Traditional practitioners then selected elements of philosophy and practice and organized them into what they called "Chinese Medicine" (''Zhongyi'').{{sfnb|Lei|2014|pp= 97-120}} In the 1950s, the Chinese government sponsored the integration of Chinese and Western medicine,{{sfnb|Taylor|2005|pp=30-36}} and in the [[Great Proletarian Cultural Revolution]] of the 1960s, promoted Chinese medicine as inexpensive and popular.<ref name="Gushi 2019" />

After the opening of relations between the United States and China after 1972, there was great interest in the West for what was now called Traditional Chinese Medicine (TCM).{{sfnb|Taylor|2005|pp=138-141}} TCM is said to be based on [[Compendium of Materia Medica]] and [[Huangdi Neijing]] and includes various forms of [[Chinese herbology|herbal medicine]], [[acupuncture]], [[cupping therapy]], [[gua sha]], [[tui na|massage (tui na)]], [[die-da|bonesetter (die-da)]], [[Qigong|exercise (qigong)]], and dietary therapy. TCM is widely used in the [[East Asian cultural sphere|Sinosphere]]. One of the basic tenets is that the body's [[vital energy]] (''ch'i'' or ''[[qi]]'') is circulating through channels called [[Meridian (Chinese medicine)|meridians]] having branches connected to bodily organs and functions.<ref name="Quackwatch" /> The concept of vital energy is pseudoscientific. Concepts of the body and of disease used in TCM reflect its ancient origins and its emphasis on dynamic processes over material structure, similar to the [[humoral theory]] of [[Ancient Greek medicine|Ancient Greece]] and [[Medicine in ancient Rome|Ancient Rome]].<ref name="Novella2012" />

The demand for traditional medicines in China has been a major generator of [[Wildlife smuggling|illegal wildlife smuggling]], linked to the [[poaching|killing and smuggling of endangered animals]].<ref>{{Cite news|date=2019-03-28|title=As China pushes traditional medicine globally, illegal wildlife trade flourishes|language=en|work=Reuters|url=https://www.reuters.com/article/us-china-tcm-idUSKCN1R90D5|access-date=2021-10-20}}</ref>

== History ==
[[File:Compendium of Materia Medica.png|thumb|The Compendium of Materia Medica is a pharmaceutical text written by [[Li Shizhen]] (1518–1593 CE) during the [[Ming dynasty]] of China. This edition was published in 1593.]]
[[File:hua t08.jpg|thumb|Acupuncture chart from Hua Shou ([[floruit|fl.]] 1340s, [[Yuan dynasty]]). This image from ''Shi si jing fa hui (Expression of the Fourteen Meridians).'' (Tokyo: Suharaya Heisuke kanko, Kyoho gan 1716).]]

Scholars in the history of medicine in China distinguish its doctrines and practice from those of present-day TCM. As [[Ian Johnson (writer)|Ian Johnson]] notes, the term "Traditional Chinese Medicine" was coined by "party propagandists" and first appeared in English in 1955.{{sfnb|Johnson|2021}} [[Nathan Sivin]] criticizes attempts to treat medicine and medical practices in traditional China as if they were a single system. Instead, he says, there were 2,000 years of "medical system in turmoil" and speaks of a "myth of an unchanging medical tradition."  He urges that "Traditional medicine translated purely into terms of modern medicine becomes partly nonsensical, partly irrelevant, and partly mistaken; that is also true the other way around, a point easily overlooked."  {{sfnb|Sivin|1987|p=198}} TJ Hinrichs observes that people in modern Western societies divide healing practices into biomedicine for the body, psychology for the mind, and religion for the spirit, but these distinctions are inadequate to describe medical concepts among Chinese historically and to a considerable degree today .{{sfnb|Hinrichs|2005|p=3859 }}

The medical anthropologist [[Charles Miller Leslie|Charles Leslie]] writes that Chinese, Greco-Arabic, and Indian [[traditional medicines]] were all grounded in systems of correspondence that aligned the organization of society, the universe, and the human body and other forms of life into an "all-embracing order of things." Each of these traditional systems was organized with such qualities as heat and cold, wet and dry, light and darkness, qualities that also align the seasons, compass directions, and the human cycle of birth, growth, and death. They provided, Leslie continued, a "comprehensive way of conceiving patterns that ran through all of nature," and  they "served as a classificatory and mnemonic device to observe health problems and to reflect upon, store, and recover empirical knowledge," but they were also "subject to stultifying theoretical elaboration, self-deception, and [[dogma]]tism."<ref>{{cite encyclopedia |first= Charles |last= Leslie|article= Medicine |title=Encyclopedia of Asian History |editor-first=Ainslee|editor-last=Embry|volume=  2|pages= 521–522|ref= none}}</ref>

The doctrines of Chinese medicine are rooted in books such as the ''[[Huangdi Neijing|Yellow Emperor's Inner Canon]]'' and the ''[[Shanghan lun|Treatise on Cold Damage]]'', as well as in cosmological notions such as [[yin and yang|yin–yang]] and the [[Wuxing (Chinese philosophy)|five phases]]. The "Documentation of Chinese materia medica" (CMM) dates back to around 1,100 BCE when only a few dozen drugs were described. By the end of the 16th century, the number of drugs documented had reached close to 1,900. And by the end of the last century, published records of CMM had reached 12,800 drugs."<ref name="ZxukC">{{cite journal | vauthors = Leung AY | title = Traditional toxicity documentation of Chinese Materia Medica--an overview | journal = Toxicologic Pathology | volume = 34 | issue = 4 | pages = 319–26 | year = 2006 | pmid = 16787890 | doi = 10.1080/01926230600773958 | s2cid = 8301501 }}</ref> Starting in the 1950s, these precepts were standardized in the People's Republic of China, including attempts to integrate them with modern notions of [[anatomy]] and [[pathology]]. In the 1950s, the Chinese government promoted a systematized form of TCM.<ref name="Levinovitz 2013" />

=== Shang dynasty ===
Traces of therapeutic activities in China date from the [[Shang dynasty]] (14th–11th centuries BCE).<ref name="Unschuld 1985">{{Cite book| vauthors = Unschuld PU  |title=Medicine in China: A History of Ideas|year=1985|publisher=University of California Press |location=Berkeley |isbn = 978-0-520-05023-5}}</ref> Though the Shang did not have a concept of "medicine" as distinct from other health practices, their [[oracle|oracular]] inscriptions on [[oracle bone|bones]] and tortoise shells refer to illnesses that affected the Shang royal family: eye disorders, toothaches, bloated abdomen, and such.<ref name="1hwgd">{{Cite book | veditors = Peng B, (({{lang|zh|彭邦炯}})) |title = Jiaguwen yixue ziliao: shiwen kaobian yu yanjiu |script-title=zh:甲骨文医学资料: 释文考辨与研究 |trans-title=Medical data in the oracle bones: translations, philological analysis, and research |year=2008 |publisher=Renmin weisheng chubanshe |location=Beijing |isbn = 978-7-117-09270-8}}</ref> Shang elites usually attributed them to curses sent by their ancestors. There is currently no evidence that the Shang nobility used herbal remedies.<ref name="Unschuld 1985" />

Stone and bone needles found in ancient tombs led [[Joseph Needham]] to speculate that acupuncture might have been carried out in the Shang dynasty.<ref name="Needham 2002">{{Cite book | vauthors = Lu GD, Needham J |title=Celestial Lancets: A History and Rationale of Acupuncture and Moxa |year=2002 |publisher=Routledge |isbn = 978-0-700-71458-2}}</ref><ref name="Harper 1998">{{Cite book | vauthors = Harper D |title = Early Chinese Medical Literature: The Mawangdui Medical Manuscripts |year=1998 |publisher=Kegan Paul International|location=London and New York |isbn = 978-0-7103-0582-4}}</ref> This being said, most historians now make a distinction between medical [[lancing (surgical procedure)|lancing]] (or [[bloodletting]]) and acupuncture in the narrower sense of using metal needles to attempt to treat illnesses by stimulating [[Acupuncture points|points]] along [[meridian (Chinese medicine)|circulation channels]] ("meridians") in accordance with beliefs related to the circulation of "Qi".<ref name="Needham 2002" /><ref name="Harper 1998" /><ref name="RN4Yh">{{cite journal | vauthors = Epler DC | title = Bloodletting in early Chinese medicine and its relation to the origin of acupuncture | journal = Bulletin of the History of Medicine | volume = 54 | issue = 3 | pages = 337–67 | year = 1980 | pmid = 6998524 }}</ref> The earliest evidence for acupuncture in this sense dates to the second or first century BCE.<ref name="Unschuld 1985" /><ref name="Needham 2002" /><ref name="Harper 1998" /><ref name="dO7YW">{{Cite journal | vauthors = Liao Y, (({{lang|zh|廖育群}})) |year=1991 |title=Qin Han zhi ji zhenjiu liaofa lilun de jianli |script-title=zh:秦漢之際鍼灸療法理論的建立 |trans-title=The formation of the theory of acumoxa therapy in the Qin and Han periods |journal=Ziran Kexue Yanjiu {{lang|zh|italics=no|自然科學研究}} (Research in the Natural Sciences)|volume=10 |pages=272–79}}</ref>

=== Han dynasty ===
The ''Yellow Emperor's Inner Canon ([[Huangdi Neijing|Huangdi Nei Jing]])'', the oldest received work of Chinese medical theory, was compiled during the [[Han dynasty]] around the first century BCE on the basis of shorter texts from different medical lineages.<ref name="Needham 2002" /><ref name="Harper 1998" /><ref name="Sivin 1993">{{Cite book | vauthors = Sivin N |chapter=Huang-ti nei-ching |script-chapter=zh:黃帝內經 |pages=[https://archive.org/details/earlychinesetext00loew/page/n209 196]–215 |title=Early Chinese Texts: A Bibliographical Guide |url=https://archive.org/details/earlychinesetext00loew |url-access=limited |year=1993|publisher=Institute for East Asian Studies, University of California, Berkeley|location=Los Angeles and Berkeley | veditors = Loewe M |isbn = 978-1-55729-043-4}}</ref> Written in the form of dialogues between the legendary [[Yellow Emperor]] and his ministers, it offers explanations on the relation between humans, their environment, and the [[cosmos]], on the contents of the body, on human vitality and pathology, on the symptoms of illness, and on how to make diagnostic and therapeutic decisions in light of all these factors.<ref name="Sivin 1993" /> Unlike earlier texts like ''[[Wushi'er bingfang|Recipes for Fifty-Two Ailments]]'', which was excavated in the 1970s from the [[Mawangdui|Mawangdui tomb]] that had been sealed in 168 BCE, the ''Inner Canon'' rejected the influence of spirits and the use of magic.<ref name="Harper 1998" /> It was also one of the first books in which the cosmological doctrines of Yinyang and the Five Phases were brought to a mature synthesis.<ref name="Sivin 1993" />

The ''Treatise on Cold Damage Disorders and Miscellaneous Illnesses (Shang Han Lun)'' was collated by [[Zhang Zhongjing]] sometime between 196 and 220 CE; at the end of the Han dynasty.{{sfnb|Liu|2019}} Focusing on drug prescriptions rather than acupuncture,<ref name="Sivin 1987">{{Cite book | vauthors = Sivin N |title=Traditional Medicine in Contemporary China|year=1987|publisher=Center for Chinese Studies, University of Michigan|location=Ann Arbor |isbn = 978-0-89264-074-4}}</ref><ref name="Ergil 2009">{{Cite book | vauthors = Ergil MC, Ergil KV |url=https://books.google.com/books?id=kdZ1rFKW-LEC |title=Pocket Atlas of Chinese Medicine |year=2009 |publisher=Thieme |location=Stuttgart |isbn=978-3-13-141611-7 |access-date=18 February 2016 |archive-url=https://web.archive.org/web/20170320191445/https://books.google.com/books?id=kdZ1rFKW-LEC |archive-date=20 March 2017 |url-status=live}}</ref> it was the first medical work to combine Yinyang and the Five Phases with drug therapy.<ref name="Unschuld 1985" /> This [[Formulary (pharmacy)|formulary]] was also the earliest public Chinese medical text to group symptoms into clinically useful "patterns" (''zheng'' {{lang|zh|證}}) that could serve as targets for therapy. Having gone through numerous changes over time, the formulary now circulates as two distinct books: the ''[[Shang Han Lun|Treatise on Cold Damage Disorders]]'' and the ''[[Jingui Yaolue|Essential Prescriptions of the Golden Casket]]'', which were edited separately in the eleventh century, under the [[Song dynasty]].<ref name="ij1Wl">{{Cite book | vauthors = Goldschmidt A |title = The Evolution of Chinese Medicine: Song Dynasty, 960–1200 |year=2009 |publisher=Routledge |location=London and New York |isbn = 978-0-415-42655-8}}</ref>

[[Nan Jing (Chinese medicine)|Nanjing]] or "Classic of Difficult Issues," originally called "The Yellow Emperor Eighty-one Nan Jing", ascribed to [[Bian Que]] in the [[eastern Han dynasty]]. This book was compiled in the form of question-and-answer explanations. A total of 81 questions have been discussed. Therefore, it is also called "Eighty-One Nan".<ref name="Zhongyibaodian 2019">{{Cite web|url=http://zhongyibaodian.com/archives/198.html|script-title=zh:《难经》在线阅读_【中医宝典】|website=zhongyibaodian.com|access-date=14 July 2019|title=Archived copy|archive-url=https://web.archive.org/web/20190714105158/http://zhongyibaodian.com/archives/198.html|archive-date=14 July 2019|url-status=live}}</ref> The book is based on basic theory and has also analyzed some disease certificates. Questions one to twenty-two is about pulse study, questions twenty-three to twenty-nine is about meridian study, questions thirty to forty-seven is related to urgent illnesses, questions forty-eight to sixty-one is related to serious diseases, questions sixty-two to sixty-eight is related to acupuncture points, and questions sixty-nine to eighty-one is related to the needlepoint methods.<ref name="Zhongyibaodian 2019" />

The book is credited as developing its own path, while also inheriting the theories from Huangdi Neijing. The content includes physiology, pathology, diagnosis, treatment contents, and a more essential and specific discussion of pulse diagnosis.<ref name="Zhongyibaodian 2019" /> It has become one of the four classics for Chinese medicine practitioners to learn from and has impacted the medical development in China.<ref name="Zhongyibaodian 2019" />

''[[Shennong Ben Cao Jing]]'' is one of the earliest written medical books in China. Written during the Eastern Han Dynasty between 200 and 250 CE, it was the combined effort of practitioners in the Qin and Han Dynasties who summarized, collected and compiled the results of pharmacological experience during their time periods. It was the first systematic summary of Chinese herbal medicine.<ref name="Douban 2007">{{Cite book|url=https://book.douban.com/subject/2248401/|script-title=zh:神农本草经|last={{lang|zh|顾观光}}|date=August 2007|publisher={{lang|zh|哈尔滨出版社}}|isbn=9787806999752|title=Archived copy|access-date=14 July 2019|archive-url=https://web.archive.org/web/20190714105158/https://book.douban.com/subject/2248401/|archive-date=14 July 2019|url-status=live}}</ref> Most of the pharmacological theories and compatibility rules and the proposed "seven emotions and harmony" principle have played a role in the practice of medicine for thousands of years.<ref name="Douban 2007" /> Therefore, it has been a textbook for medical workers in modern China.<ref name="Douban 2007" /> The full text of ''Shennong Ben Cao Jing'' in English can be found online.<ref name="ShenNongBenCaoLing">[https://archive.org/stream/ShenNongBenCaoLingTheDivineFarmersMateriaMedica/ShenNong%20Ben%20Cao%20ling%28The%20Divine%20Farmers%20Materia%20Medica%29_djvu.txt Shen Nong Ben Cao Ling (The Divine Farmers Materia Medica)] archive.org</ref>

=== Post-Han dynasty ===
In the centuries that followed, several shorter books tried to summarize or systematize the contents of the  ''Yellow Emperor's Inner Canon''. The ''Canon of Problems'' (probably second century CE) tried to reconcile divergent doctrines from the ''Inner Canon'' and developed a complete medical system centered on needling therapy.<ref name="Sivin 1987" /> The ''AB Canon of Acupuncture and Moxibustion'' (''Zhenjiu jiayi jing'' {{lang|zh|針灸甲乙經}}, compiled by [[Huangfu Mi]] sometime between 256 and 282 CE) assembled a consistent body of doctrines concerning acupuncture;<ref name="Sivin 1987" /> whereas the ''Canon of the Pulse'' (''Maijing'' {{lang|zh|脈經}}; ca. 280) presented itself as a "comprehensive handbook of diagnostics and therapy."<ref name="Sivin 1987" />

Around 900-1000 AD, Chinese were the first to develop a form of vaccination, known as [[variolation]] or [[inoculation]], to prevent [[smallpox]]. Chinese physicians had realised that when healthy people were exposed to smallpox scab tissue, they had a smaller chance of being infected by the disease later on. The common methods of inoculation at the time was through crushing smallpox scabs into powder and breathing it through the nose.<ref>{{Cite web|last=Bushak|first=Lecia|date=2016-03-21|title=A Brief History Of Vaccines: From Medieval Chinese 'Variolation' To Modern Vaccination|url=https://www.medicaldaily.com/history-vaccines-variolation-378738|access-date=2021-04-16|website=Medical Daily|language=en}}</ref>

Prominent medical scholars of the post-Han period included [[Tao Hongjing]] (456-536), [[Sun Simiao]] of the Sui and Tang dynasties,  [[Zhang Jiegu]] (c. 1151–1234), and [[Li Shizhen]] (1518-1593). <!-- [[Ou XiFan|Wu Jian]] a robber known for being dissected -->

===People's Republic ===
In 1950, [[Chinese Communist Party]] (CCP) chairman [[Mao Zedong]] announced support of Traditional Chinese Medicine, but he did not personally believe in and did not use it.<ref name="Levinovitz 2013" /> In 1952, the president of the [[Chinese Medical Association]] said that, "This One Medicine, will possess a basis in modern natural sciences, will have absorbed the ancient and the new, the Chinese and the foreign, all medical achievements—and will be China's New Medicine!"<ref name="Levinovitz 2013">{{cite magazine|url=http://www.slate.com/articles/health_and_science/medical_examiner/2013/10/traditional_chinese_medicine_origins_mao_invented_it_but_didn_t_believe.html|title=Chairman Mao Invented Traditional Chinese Medicine | vauthors = Levinovitz A |magazine=[[Slate (magazine)|Slate]]|date=22 October 2013|access-date=7 March 2014|archive-url=https://web.archive.org/web/20140307114753/http://www.slate.com/articles/health_and_science/medical_examiner/2013/10/traditional_chinese_medicine_origins_mao_invented_it_but_didn_t_believe.html|archive-date=7 March 2014|url-status=live}}</ref>

During the [[Cultural Revolution]] (1966–1976) the CCP and the government emphasized modernity, cultural identity and China's social and economic reconstruction and contrasted them to the colonial and feudal past. The government established a grassroots health care system as a step in the search for a new national identity and tried to revitalize traditional medicine and made large investments in traditional medicine to try to develop affordable medical care and public health facilities.<ref name="Gushi 2019">{{Cite web|url=https://gushi.tw/chinese-medicine-invented/|script-title=zh:中醫的發明和國族認同有關係？文化大革命對「傳統中醫學」的影響 {{!}} 故事|date=7 April 2019|website=gushi.tw|language=zh-TW|access-date=14 July 2019|title=Gushi.tw|archive-url=https://web.archive.org/web/20190714235827/https://gushi.tw/chinese-medicine-invented/|archive-date=14 July 2019|url-status=live}}</ref> The Ministry of Health directed health care throughout China and established primary care units. Chinese physicians trained in Western medicine were required to learn traditional medicine, while traditional healers received training in modern methods. This strategy aimed to integrate modern medical concepts and methods and revitalize appropriate aspects of traditional medicine. Therefore, traditional Chinese medicine was re-created in response to Western medicine.<ref name="Gushi 2019" />

In 1968, the CCP supported a new system of health care delivery for rural areas. Villages were assigned a [[barefoot doctor]] (a medical staff with basic medical skills and knowledge to deal with minor illnesses) responsible for basic medical care. The medical staff combined the values of traditional China with modern methods to provide health and medical care to poor farmers in remote rural areas. The barefoot doctors became a symbol of the Cultural Revolution, for the introduction of modern medicine into villages where traditional Chinese medicine services were used.<ref name="Gushi 2019" />

In the second decade of the twenty-first century, [[Chinese Communist Party]] general secretary [[Xi Jinping]] strongly supported TCM, calling it a "gem." As of May 2011, in order to promote TCM worldwide, China had signed TCM partnership agreements with over 70 countries.<ref name="Cheung 2011">{{cite journal |last1=Cheung |first1=Felix |title=TCM: Made in China |journal=Nature |date=December 2011 |volume=480 |issue=7378 |pages=S82–S83 |doi=10.1038/480S82a |pmid=22190085 |bibcode=2011Natur.480S..82C |s2cid=600909 }}</ref> His government pushed to increase its use and the number of TCM-trained doctors and announced that students of TCM would no longer be required to pass examinations in Western medicine. Chinese scientists and researchers, however, expressed concern that TCM training and therapies would receive equal support with Western medicine. They also criticized a reduction in government testing and regulation of the production of TCMs, some of which were toxic. Government censors have removed Internet posts that question TCM.<ref>{{cite journal |last1=Cyranoski |first1=David |title=China to roll back regulations for traditional medicine despite safety concerns |journal=Nature |date=November 2017 |volume=551 |issue=7682 |pages=552–553 |doi=10.1038/nature.2017.23038 |pmid=29189784 |bibcode=2017Natur.551..552C |s2cid=4464138 |doi-access=free }}</ref>

=== Hong Kong ===
At the beginning of [[Hong Kong]]'s opening up, Western medicine was not yet popular, and Western medicine doctors were mostly foreigners; local residents mostly relied on Chinese medicine practitioners. In 1841, the British government of Hong Kong issued an announcement pledging to govern Hong Kong residents in accordance with all the original rituals, customs and private legal property rights.<ref name="gD1Zl">{{Cite book|script-title=zh:香港與中國: 歷史文獻資料彙編, 第1集|publisher={{lang|zh|廣角鏡出版社}}|year=1981|isbn=978-9622260160|location=Hong Kong|pages=164}}</ref> As traditional Chinese medicine had always been used in China, the use of traditional Chinese medicine was not regulated.<ref name="L06zw">{{cite journal |last1=Ho |first1=Polly L H |title=Agenda-Setting for the Regulation of Traditional Chinese Medicine in Hong Kong |journal=Asian Journal of Public Administration |date=December 2002 |volume=24 |issue=2 |pages=257–286 |doi=10.1080/02598272.2002.10800403 |s2cid=155221420 }}</ref>

The establishment in 1870 of the [[Tung Wah Hospital]] was the first use of Chinese medicine for the treatment in Chinese hospitals providing free medical services.<ref name="RqWjK">{{Cite web|url=http://www.tungwah.org.hk/en/about/about-us/|title=About Us|website=Tung Wah Group of Hospitals|access-date=1 March 2019|archive-url=https://web.archive.org/web/20190304201455/http://www.tungwah.org.hk/en/about/about-us/|archive-date=4 March 2019|url-status=live}}</ref> As the promotion of Western medicine by the British government started from 1940,<ref name="Dudovskiy">{{cite web|url=https://research-methodology.net/historical-evolution-of-chinese-healthcare-system-a-brief-overview/|website=Business Research Methodology|title=Historical evolution of Chinese Healthcare System| vauthors = Dudovskiy J |date=24 March 2014|access-date=July 6, 2020}}</ref> Western medicine started being popular among Hong Kong population. In 1959, Hong Kong had researched the use of traditional Chinese medicine to replace Western medicine.<ref name="x1e9j">{{Cite news|url=https://mmis.hkpl.gov.hk/coverpage/-/coverpage/view?_coverpage_WAR_mmisportalportlet_hsf=%E4%B8%AD%E8%97%A5%E7%94%A8%E9%80%94&p_r_p_-1078056564_c=QF757YsWv5%2FH7zGe%2FKF%2BFOLucU8fZKiu&_coverpage_WAR_mmisportalportlet_o=0&_coverpage_WAR_mmisportalportlet_actual_q=%28%20verbatim_dc.collection%3A%28%22Old%5C%20HK%5C%20Newspapers%22%29%20%29%20AND+%28%20%28%20allTermsMandatory%3A%28true%29%20OR+all_dc.title%3A%28%E4%B8%AD%E8%97%A5%E7%94%A8%E9%80%94%29%20OR+all_dc.creator%3A%28%E4%B8%AD%E8%97%A5%E7%94%A8%E9%80%94%29%20OR+all_dc.contributor%3A%28%E4%B8%AD%E8%97%A5%E7%94%A8%E9%80%94%29%20OR+all_dc.subject%3A%28%E4%B8%AD%E8%97%A5%E7%94%A8%E9%80%94%29%20OR+fulltext%3A%28%E4%B8%AD%E8%97%A5%E7%94%A8%E9%80%94%29%20OR+all_dc.description%3A%28%E4%B8%AD%E8%97%A5%E7%94%A8%E9%80%94%29%20%29%20%29&_coverpage_WAR_mmisportalportlet_sort_order=desc&_coverpage_WAR_mmisportalportlet_sort_field=score&_coverpage_WAR_mmisportalportlet_log=Y&tabs1=FILE_DOWNLOAD|script-title=zh:粵共研究中藥替代西藥用途|date=13 May 1959|work=Wah Kiu Yat Po|access-date=1 March 2019|language=zh|title=Archived copy|archive-url=https://web.archive.org/web/20190306042837/https://mmis.hkpl.gov.hk/coverpage/-/coverpage/view?_coverpage_WAR_mmisportalportlet_hsf=%E4%B8%AD%E8%97%A5%E7%94%A8%E9%80%94&p_r_p_-1078056564_c=QF757YsWv5%2FH7zGe%2FKF%2BFOLucU8fZKiu&_coverpage_WAR_mmisportalportlet_o=0&_coverpage_WAR_mmisportalportlet_actual_q=%28%20verbatim_dc.collection%3A%28%22Old%5C%20HK%5C%20Newspapers%22%29%20%29%20AND+%28%20%28%20allTermsMandatory%3A%28true%29%20OR+all_dc.title%3A%28%E4%B8%AD%E8%97%A5%E7%94%A8%E9%80%94%29%20OR+all_dc.creator%3A%28%E4%B8%AD%E8%97%A5%E7%94%A8%E9%80%94%29%20OR+all_dc.contributor%3A%28%E4%B8%AD%E8%97%A5%E7%94%A8%E9%80%94%29%20OR+all_dc.subject%3A%28%E4%B8%AD%E8%97%A5%E7%94%A8%E9%80%94%29%20OR+fulltext%3A%28%E4%B8%AD%E8%97%A5%E7%94%A8%E9%80%94%29%20OR+all_dc.description%3A%28%E4%B8%AD%E8%97%A5%E7%94%A8%E9%80%94%29%20%29%20%29&_coverpage_WAR_mmisportalportlet_sort_order=desc&_coverpage_WAR_mmisportalportlet_sort_field=score&_coverpage_WAR_mmisportalportlet_log=Y&tabs1=FILE_DOWNLOAD|archive-date=6 March 2019|url-status=live}}</ref>{{Verify source|date=March 2019}}

==Critique==
The effectiveness of Chinese medicine remains poorly researched and supported, and most of its treatments have no logical [[mechanism of action]].<ref name="swallow" /><ref name="Shang-2007" /> A ''[[Nature (journal)|Nature]]'' editorial described TCM as "fraught with [[pseudoscience]]".<ref name="swallow" />   According to standards of [[science-based medicine]], there is no scientific basis for traditional Chinese concepts such as ''qi'', meridians, and acupuncture points.{{efn |name= "SinghErnst2008" |Singh & Ernst (2008) stated, "Scientists are still unable to find a shred of evidence to support the existence of meridians or Ch'i",<ref name="bIPgX">{{harvnb|Singh & Ernst|2008|page = 72}}</ref> "The traditional principles of acupuncture are deeply flawed, as there is no evidence at all to demonstrate the existence of Ch'i or meridians"<ref name="FJS08">{{harvnb|Singh & Ernst|2008|page = 107}}</ref> and "Acupuncture points and meridians are not a reality, but merely the product of an ancient Chinese philosophy".<ref name="5y6YH">{{harvnb|Singh & Ernst|2008|page= 387}}</ref>}} TCM theory and practice have no basis in [[scientific knowledge|modern science]], and there is disagreement among TCM practitioners on what diagnosis and treatments should be used for any given person.<ref name="Quackwatch" />

A 2012 review of [[cost-effectiveness]] research for TCM found that studies had low [[levels of evidence]], with no beneficial outcomes.<ref name="Zhang2012" /> Pharmaceutical research on the potential for creating new drugs from traditional remedies has few successful results.<ref name="swallow" /> Proponents suggest 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.<ref name="swallow" /> One of the basic tenets of TCM is that the body's [[vital energy]] (''ch'i'' or ''[[qi]]'') is circulating through channels called [[Meridian (Chinese medicine)|meridians]] having branches connected to bodily organs and functions.<ref name="Quackwatch" /> The concept of vital energy is pseudoscientific. Concepts of the body and of disease used in TCM reflect its ancient origins and its emphasis on dynamic processes over material structure, similar to [[Mediterranean race|Mediterranean]] [[humoral theory]].<ref name="Novella2012" />

TCM has also been controversial within China. In 2006, the Chinese philosopher [[Zhang Gongyao]] triggered a national debate with an article entitled "Farewell to Traditional Chinese Medicine", arguing that TCM was a pseudoscience that should be abolished in public healthcare and academia. The Chinese government however, took the stance that TCM is a science and continued to encourage its development.<ref name="qiu">{{cite journal | vauthors = Qiu J | title = China plans to modernize traditional medicine | journal = Nature | volume = 446 | issue = 7136 | pages = 590–1 | date = April 2007 | pmid = 17410143 | doi = 10.1038/446590a | quote = Zhang argued that TCM is a pseudoscience and should not be part of public healthcare and research | doi-access = free | bibcode = 2007Natur.446..590Q }}</ref>

There are concerns over a number of potentially toxic plants, animal parts, and mineral Chinese compounds,<ref name="Shaw-2012" /> as well as the facilitation of disease. Trafficked and farm-raised animals used in TCM are a source of several fatal [[Zoonosis|zoonotic diseases]].<ref name="ZVvJo">{{cite journal|vauthors=Liu Q, Cao L, Zhu XQ|date=August 2014|title=Major emerging and re-emerging zoonoses in China: a matter of global health and socioeconomic development for 1.3 billion|journal=International Journal of Infectious Diseases|volume=25|pages=65–72|doi=10.1016/j.ijid.2014.04.003|pmc=7110807|pmid=24858904|doi-access=free}}</ref> The probable bat-to-human [[severe acute respiratory syndrome coronavirus 2|COVID-19]] infection may have been among people processing bat carcasses and [[guano]] in the production of TCM.<ref name="5M8c6">{{cite journal|vauthors=Wassenaar TM, Zou Y|date=May 2020|title=2019_nCoV/SARS-CoV-2: rapid classification of betacoronaviruses and identification of Traditional Chinese Medicine as potential origin of zoonotic coronaviruses|journal=Letters in Applied Microbiology|volume=70|issue=5|pages=342–348|doi=10.1111/lam.13285|pmc=7165814|pmid=32060933}}</ref>

There are additional concerns over the illegal trade and transport of endangered species including rhinoceroses and tigers, and the welfare of specially farmed animals, including bears.<ref name="pHc8M">{{cite encyclopedia|title=Traditional Chinese Medicine and Endangered Animals|encyclopedia=Encyclopædia Britannica|url=http://advocacy.britannica.com/blog/advocacy/2007/10/traditional-chinese-medicine-and-endangered-animals/|access-date=1 October 2016|date=22 October 2007|archive-url=https://web.archive.org/web/20131005052622/http://advocacy.britannica.com/blog/advocacy/2007/10/traditional-chinese-medicine-and-endangered-animals/|archive-date=5 October 2013|url-status=live}}</ref>

In June 2019, the [[World Health Organization]] included Traditional Chinese Medicine in a global diagnostic compendium, drawing criticism from scientists. A WHO spokesman said it was "not an endorsement of the scientific validity of any Traditional Medicine practice or the efficacy of any Traditional Medicine intervention."<ref>{{cite journal |title=The World Health Organization's decision about traditional Chinese medicine could backfire |journal=Nature |date=5 June 2019 |volume=570 |issue=7759 |pages=5 |doi=10.1038/d41586-019-01726-1 |pmid=31165792 |bibcode=2019Natur.570Q...5. |s2cid=174809790 }}</ref><ref>{{Cite web |url=https://www.scientificamerican.com/article/the-world-health-organization-gives-the-nod-to-traditional-chinese-medicine-bad-idea/ |title=Archived copy |access-date=9 January 2022 |archive-date=6 April 2020 |archive-url=https://archive.fo/20200406145913/https://www.scientificamerican.com/article/the-world-health-organization-gives-the-nod-to-traditional-chinese-medicine-bad-idea/ |url-status=dead }}</ref><ref>{{cite news |last1=Hunt |first1=Katie |title=Chinese medicine gains WHO acceptance but it has many critics |url=https://edition.cnn.com/2019/05/24/health/traditional-chinese-medicine-who-controversy-intl/index.html |access-date=21 April 2022 |work=[[CNN]] |date=26 May 2019}}</ref>

==Philosophical background==
Traditional Chinese medicine (TCM) is a broad range of medicine practices sharing common concepts which have been developed in China and are based on a tradition of more than 2,000 years, including various forms of [[Chinese herbology|herbal medicine]], acupuncture, massage ({{lang|zh-Latn|tui na}}), exercise ({{lang|zh-Latn|qigong}}), and dietary therapy.<ref name="TCMNCCIH">Traditional Chinese Medicine, National Center for Complementary and Integrative Health, [http://nccih.nih.gov/health/whatiscam/chinesemed.htm Traditional Chinese Medicine: An Introduction] {{Webarchive|url=https://web.archive.org/web/20150626223845/https://nccih.nih.gov/health/whatiscam/chinesemed.htm |date=26 June 2015}}</ref><ref name="uOuvz">{{cite journal | vauthors = Bannon D |author-link=David "Race" Bannon |title=Balancing the Yang and Yin: Development and Contributions of Chinese Medicine |journal=Asian Pacific Quarterly |volume=26 |issue=2 |year=1994 |pages=22–37}}</ref> It is primarily used as a complementary alternative medicine approach.<ref name="TCMNCCIH" /> TCM is widely used in China and it is also used in the West.<ref name="TCMNCCIH" /> Its philosophy is based on [[School of Yin Yang|Yinyangism]] (i.e., the combination of Five Phases theory with Yin–Yang theory),<ref name="Zou Yan">{{cite encyclopedia|url=http://www.britannica.com/EBchecked/topic/607826/Zou-Yan|title=Zou Yan|encyclopedia=Encyclopædia Britannica|access-date=1 March 2011|archive-url=https://web.archive.org/web/20150426150251/http://www.britannica.com/EBchecked/topic/607826/Zou-Yan|archive-date=26 April 2015|url-status=live}}</ref> which was later absorbed by [[Daoism]].<ref name="IiZhf">Liu, Zheng-Cai (1999): [https://books.google.com/books?id=UNUiHP7MPJMC&pg=PA39&dq=liu+1999+daoism+yin+yang&hl=zh-CN#v=onepage&q&f=false "A Study of Daoist Acupuncture & Moxibustion"] Blue Poppy Press, first edition. {{ISBN|978-1-891845-08-6}}</ref> Philosophical texts influenced TCM, mostly by being grounded in the same theories of ''qi, yin-yang'' and ''wuxing'' and microcosm-macrocosm analogies.<ref name="629O1">{{Citation| vauthors = Raphals L |title=Chinese Philosophy and Chinese Medicine|year=2017|url=https://plato.stanford.edu/archives/fall2017/entries/chinese-phil-medicine/|encyclopedia=The Stanford Encyclopedia of Philosophy| veditors = Zalta EN |edition=Fall 2017|publisher=Metaphysics Research Lab, Stanford University|access-date=17 January 2020 |archive-url= https://web.archive.org/web/20190318040920/https://plato.stanford.edu/archives/fall2017/entries/chinese-phil-medicine/|archive-date=18 March 2019 |url-status=live}}</ref>
[[File:Yin yang.svg|thumb|right|200px|Yin and yang symbol for balance. In traditional Chinese Medicine, good health is believed to be achieved by various balances, including a balance between yin and yang.]]

===Yin and yang===
{{Main|Yin and yang}}

Yin and yang are ancient Chinese concepts which can be traced back to the [[Shang dynasty]]<ref name="Men 2010">Men, J. & Guo, L. (2010) [https://books.google.com/books?id=KxoVAXt09F8C&pg=PA60&dq=tcm+yin+yang&hl=zh-CN#v=onepage&q=tcm%20yin%20yang&f=false "A General Introduction to Traditional Chinese Medicine"] {{Webarchive|url=https://web.archive.org/web/20170320171929/https://books.google.com/books?id=KxoVAXt09F8C&pg=PA60&dq=tcm+yin+yang&hl=zh-CN#v=onepage&q=tcm%20yin%20yang&f=false |date=20 March 2017}} Science Press. {{ISBN|978-1-4200-9173-1}}</ref> (1600–1100&nbsp;BCE). They represent two abstract and complementary aspects that every phenomenon in the universe can be divided into.<ref name="Men 2010" /> Primordial analogies for these aspects are the sun-facing (yang) and the shady (yin) side of a hill.<ref name="Ergil 2009" /> Two other commonly used representational allegories of yin and yang are water and fire.<ref name="Men 2010" /> In the [[Yin and yang|yin–yang theory]], detailed attributions are made regarding the yin or yang character of things:

{| class="wikitable"
! Phenomenon || Yin || Yang
|-
! Celestial bodies<ref name="Ergil 2009" />
| moon || sun
|-
! Gender<ref name="Ergil 2009" />
| female || male
|-
! Location<ref name="Ergil 2009" />
| inside || outside
|-
! Temperature<ref name="Ergil 2009" />
| cold || hot
|-
! Direction<ref name="Wiseman 1996" />
| downward || upward
|-
! Degree of humidity
| damp/moist || dry
|}

The concept of yin and yang is also applicable to the human body; for example, the upper part of the body and the back are assigned to yang, while the lower part of the body is believed to have the yin character.<ref name="Wiseman 1996" /> Yin and yang characterization also extends to the various body functions, and – more importantly – to disease symptoms (e.g., cold and heat sensations are assumed to be yin and yang symptoms, respectively).<ref name="Wiseman 1996">{{harvp|Wiseman|Ellis|1996}}{{page needed|date=October 2019}}</ref> Thus, yin and yang of the body are seen as phenomena whose lack (or over-abundance) comes with characteristic symptom combinations:
* Yin vacuity (also termed "vacuity-heat"): heat sensations, possible sweating at night, insomnia, dry pharynx, dry mouth, dark urine, and a "fine" and rapid pulse.<ref name="Kaptchuck 2000">Kaptchuck, Ted J. (2000): [https://books.google.com/books?id=6BiGl562OgEC&printsec=frontcover&dq=the+web+that+has+no+weaver&hl=zh-CN#v=onepage&q&f=false "The Web That Has No Weaver"] {{Webarchive|url=https://web.archive.org/web/20170320170500/https://books.google.com/books?id=6BiGl562OgEC&printsec=frontcover&dq=the+web+that+has+no+weaver&hl=zh-CN#v=onepage&q&f=false |date=20 March 2017}} 2nd edition. Contemporary Books. {{ISBN|978-0-8092-2840-9}}</ref>
* Yang vacuity ("vacuity-cold"): aversion to cold, cold limbs, bright white complexion, long voidings of clear urine, diarrhea, pale and enlarged tongue, and a slightly weak, slow and fine pulse.<ref name="Wiseman 1996" />

TCM also identifies drugs believed to treat these specific symptom combinations, i.e., to reinforce yin and yang.<ref name="Ergil 2009" />
[[File:Wuxing en.svg|thumb|right|200px|Interactions of Wu Xing]]

{| class="wikitable"
! Phenomenon || Wood || Fire || Earth || Metal || Water
|-
! Direction<ref name="Aung 2007" />
| East || South || Centre || West || North
|-
! Colour<ref name="Deng 1999" />
| green/violet || red/purple || yellow/pink || white || black
|-
! Climate<ref name="Aung 2007" />
| wind || heat || damp || dryness || cold
|-
! Taste<ref name="Ergil 2009" />
| sour || bitter || sweet || acrid || salty
|-
! Zang Organ<ref name="Maciocia 1989">Maciocia, Giovanni, (1989): The Foundations of Chinese Medicine: A Comprehensive Text for Acupuncturists and Herbalists; Churchill Livingstone; {{ISBN|978-0-443-03980-5}}, p. 26</ref>
| Liver || Heart || Spleen || Lung || Kidney
|-
! Fu Organ<ref name="Maciocia 1989" />
| Gallbladder || Small intestine || Stomach || Large intestine || Bladder
|-
! Sense organ<ref name="Deng 1999" />
| eye || tongue || mouth || nose || ears
|-
! Facial part<ref name="Deng 1999" />
| above bridge of nose || between eyes, lower part || bridge of nose || between eyes, middle part || cheeks (below cheekbone)
|-
! Eye part<ref name="Deng 1999">Deng, T. (1999): [https://books.google.com/books?id=wONlwtKkUmcC&pg=PA185&dq=tcm+six+evils&hl=zh-CN#v=onepage&q&f=false "Practical diagnosis in traditional Chinese medicine"]. Elsevier. 5th reprint, 2005. {{ISBN|978-0-443-04582-0}}</ref>
| iris || inner/outer corner of the eye || upper and lower lid || sclera || pupil
|}

Strict rules are identified to apply to the relationships between the Five Phases in terms of sequence, of acting on each other, of counteraction, etc.<ref name="Aung 2007">{{harvp|Aung|Chen|2007}}{{page needed|date=October 2019}}</ref> All these aspects of Five Phases theory constitute the basis of the [[Zang-fu|zàng-fǔ]] concept, and thus have great influence regarding the TCM model of the body.<ref name="Ergil 2009" /> Five Phase theory is also applied in diagnosis and therapy.<ref name="Ergil 2009" />

Correspondences between the body and the universe have historically not only been seen in terms of the Five Elements, but also of the "Great Numbers" ({{zh|labels=no|c=大數 |p=dà shū}})<ref name="Matuk 2006" /> For example, the number of acu-points has at times been seen to be 365, corresponding with the number of days in a year; and the number of main meridians–12–has been seen as corresponding with the number of rivers flowing through the [[History of China|ancient Chinese empire]].<ref name="Matuk 2006">{{cite journal |last1=Matuk |first1=Camillia |title=Seeing the Body: The Divergence of Ancient Chinese and Western Medical Illustration |journal=The Journal of Biocommunication |date=2006 |volume=32 |issue=1 |citeseerx=10.1.1.592.1410 |s2cid=6336033 |url=https://www.sesp.northwestern.edu/docs/publications/6074956944509ac426aaa6.pdf }}</ref><ref name="SDAM">''"There are 365 days in the year, while humans have 365 joints [or acu-points]... There are 12 channel rivers across the land, while humans have 12 channel"'', A Study of Daoist Acupuncture & Moxibustion, Cheng-Tsai Liu, Liu Zheng-Cai, Ka Hua, p. 40, [https://books.google.com/books?id=UNUiHP7MPJMC&pg=PA40&lpg=PA40&dq=%22%22traditional+chinese+medicine%22+%2212+rivers%22+acupuncture+%22365+days%22&source=bl&ots=rsClvQps3o&sig=-DGpUyl70Yd4YtHE87RauAe_Q1U&hl=en&ei=OrJcTcaZOoqcsQO9u5nhCg&sa=X&oi=book_result&ct=result&resnum=4&ved=0CCwQ6AEwAw#v=snippet&q=12%20rivers&f=false] {{Webarchive|url=https://web.archive.org/web/20140930234748/http://books.google.com/books?id=UNUiHP7MPJMC&pg=PA40&lpg=PA40&dq=%22%22traditional+chinese+medicine%22+%2212+rivers%22+acupuncture+%22365+days%22&source=bl&ots=rsClvQps3o&sig=-DGpUyl70Yd4YtHE87RauAe_Q1U&hl=en&ei=OrJcTcaZOoqcsQO9u5nhCg&sa=X&oi=book_result&ct=result&resnum=4&ved=0CCwQ6AEwAw#v=snippet&q=12%20rivers&f=false |date=30 September 2014}}</ref>

==Model of the body==
{{Main|TCM model of the body}}

[[File:ChineseMedecine.JPG|thumb|right|200px|Old Chinese medical chart on acupuncture meridians]]

TCM "holds that the body's [[vital energy]] (''chi'' or ''qi'') circulates through channels, called ''[[Meridian (Chinese medicine)|meridians]]'', that have branches connected to bodily organs and functions."<ref name="Quackwatch" /> Its view of the human body is only marginally concerned with anatomical structures, but focuses primarily on the body's ''functions''<ref name="Matuk 2006"/><ref name="Ross 1984" /> (such as digestion, breathing, temperature maintenance, etc.):

These functions are aggregated and then associated with a primary functional entity – for instance, nourishment of the tissues and maintenance of their moisture are seen as connected functions, and the entity postulated to be responsible for these functions is xuě (blood).<ref name="Ross 1984" /> These functional entities thus constitute ''concepts'' rather than something with biochemical or anatomical properties.<ref name="HxfYB">Ross, Jeremy (1984). [https://books.google.com/books?id=t23zKB1FSVYC&pg=PA6&dq=Chinese+medicine+is+completely+different;+it+emphasizes+function.+Little&hl=zh-CN#v=onepage&q=Chinese%20medicine%20is%20completely%20different%3B%20it%20emphasizes%20function.%20Little&f=false "Zang Fu, the organ systems of traditional Chinese medicine"] Elsevier. First edition 1984. {{ISBN|978-0-443-03482-4}} pp. 12–13. "For example, [the term] Xue is used rather than Blood, since the latter implies the blood of Western medicine, with its precise parameters of biochemistry and histology. Although Xue and blood share some common attributes, fundamentally, Xue is a different concept."</ref>

The primary functional entities used by traditional Chinese medicine are qì, xuě, the five zàng organs, the six fǔ organs, and the meridians which extend through the organ systems.<ref name="Aung, S.K.H. 2007 p. 19">{{harvp|Aung|Chen|2007|p=19}}</ref> These are all theoretically interconnected: each zàng organ is paired with a fǔ organ, which are nourished by the blood and concentrate qi for a particular function, with meridians being extensions of those functional systems throughout the body.

Concepts of the body and of disease used in TCM are pseudoscientific, similar to [[Mediterranean race|Mediterranean]] [[humoral theory]].<ref name="Novella2012">{{cite web|title=What Is Traditional Chinese Medicine?| vauthors = Novella S |work=Science-based Medicine|url=http://www.sciencebasedmedicine.org/what-is-traditional-chinese-medicine/|date=25 January 2012|access-date=14 April 2014|archive-url=https://web.archive.org/web/20140415070141/http://www.sciencebasedmedicine.org/what-is-traditional-chinese-medicine/|archive-date=15 April 2014|url-status=live}}</ref> TCM's model of the body is characterized as full of pseudoscience.<ref name="Jin2005">{{cite book |vauthors = Jin Z |title=Global Technological Change: From Hard Technology to Soft Technology |url=https://books.google.com/books?id=V7SsFqkHaC4C&pg=PT36 |year=2005 |publisher=Intellect Books |isbn=978-1-84150-124-6 |page=36 |quote=The vacuum created by China's failure to adequately support a disciplined scientific approach to traditional Chinese medicine has been filled by pseudoscience |access-date=18 February 2016 |archive-url=https://web.archive.org/web/20170320185919/https://books.google.com/books?id=V7SsFqkHaC4C&pg=PT36 |archive-date=20 March 2017 |url-status=live}}</ref> Some practitioners no longer consider yin and yang and the idea of an energy flow to apply.<ref name="vnonJ">{{cite encyclopedia | vauthors = Williams WF | title = Encyclopedia of Pseudoscience: From Alien Abductions to Zone Therapy | isbn = 978-1135955229 | encyclopedia = [[Encyclopedia of Pseudoscience: From Alien Abductions to Zone Therapy|Encyclopedia of Pseudoscience]] | publisher = [[Routledge]] | year = 2013 | pages = 3–4 | url = https://books.google.com/books?id=vH1EAgAAQBAJ | access-date = 18 February 2016 | archive-url = https://web.archive.org/web/20160821080422/https://books.google.com/books?id=vH1EAgAAQBAJ | archive-date = 21 August 2016 | url-status = live}}</ref> Scientific investigation has not found any [[histology|histological]] or [[physiology|physiological]] evidence for traditional Chinese concepts such as ''qi'', meridians, and acupuncture points.{{efn|name= "SinghErnst2008"}} It is a generally held belief within the acupuncture community that acupuncture points and meridians structures are special conduits for electrical signals but no research has established any consistent anatomical structure or function for either acupuncture points or meridians.{{efn|name="SinghErnst2008"}}<ref name="Ahn2008">{{cite journal |last1=Ahn |first1=Andrew C. |last2=Colbert |first2=Agatha P. |last3=Anderson |first3=Belinda J. |last4=Martinsen |first4=Ørjan G. |last5=Hammerschlag |first5=Richard |last6=Cina |first6=Steve |last7=Wayne |first7=Peter M. |last8=Langevin |first8=Helene M. |title=Electrical properties of acupuncture points and meridians: A systematic review |journal=Bioelectromagnetics |date=May 2008 |volume=29 |issue=4 |pages=245–256 |doi=10.1002/bem.20403 |pmid=18240287 }}</ref> The scientific evidence for the anatomical existence of either meridians or acupuncture points is not compelling.<ref name="JTAsx">{{cite journal | vauthors = Ernst E | title = Acupuncture--a critical analysis | journal = Journal of Internal Medicine | volume = 259 | issue = 2 | pages = 125–37 | date = February 2006 | pmid = 16420542 | doi = 10.1111/j.1365-2796.2005.01584.x | s2cid = 22052509 | doi-access = free }}</ref> [[Stephen Barrett]] of [[Quackwatch]] writes that, "TCM theory and practice are not based upon the body of knowledge related to health, disease, and health care that has been widely accepted by the scientific community. TCM practitioners disagree among themselves about how to diagnose patients and which treatments should go with which diagnoses. Even if they could agree, the TCM theories are so nebulous that no amount of scientific study will enable TCM to offer rational care."<ref name="Quackwatch">{{Cite web |url=http://www.quackwatch.org/01QuackeryRelatedTopics/acu.html | vauthors = Barrett S |author-link=Stephen Barrett |title=Be Wary of Acupuncture, Qigong, and 'Chinese Medicine' | date = 12 January 2011 |access-date=11 December 2013 |archive-url=https://web.archive.org/web/20180602104856/https://www.quackwatch.org/01QuackeryRelatedTopics/acu.html |archive-date=2 June 2018 |url-status=live}}</ref>

===Qi===
{{Main|Qi}}

TCM distinguishes many kinds of qi ({{zh |p = qì |s = 气 |t = 氣|c=|labels=no}}).<ref name="Aung & Chen" /> In a general sense, qi is something that is defined by five "cardinal functions":<ref name="Aung & Chen">{{harvp|Aung|Chen|2007|pp=11–12}}. "{{lang|zh|氣的生理功能...(一)推動作用...(二)溫煦作用...(三)防御作用...(四)固攝作用...(五)氣化作用}}" &#91;Physiological functions of qi: 1.) Function of actuation ... 2.) Function of warming ... 3.) Function of defense ... 4.) Function of containment ... 5.) Function of transformation ...&#93;</ref><ref name="BUJWu">as seen at {{cite web |url = http://www.zgxl.net/sljk/imgbody/zyrt/qi.htm |script-title = zh:氣 |author = 郭卜樂 |date = 24 October 2009 |access-date = 2 December 2010 |language = zh |trans-title = Qi |archive-url = https://web.archive.org/web/20090108191112/http://www.zgxl.net/sljk/imgbody/zyrt/qi.htm |archive-date = 8 January 2009 |url-status = dead}}</ref>
# Actuation ({{zh |t = 推動 |s = 推动 |p = tuīdòng|c=|labels=no}}) – of all physical processes in the body, especially the circulation of all body fluids such as blood in their vessels. This includes actuation of the functions of the zang-fu organs and meridians.
# Warming ({{zh |t = 溫煦 |p = wēnxù|c=|s=温煦|labels=no}}) – the body, especially the limbs.
# Defense ({{zh |c = 防御 |p = fángyù|s=|t=|labels=no}}) – against [[#Six Excesses|Exogenous Pathogenic Factors]]
# Containment ({{zh |t = 固攝 |s = 固摄 |p = gùshè|c=|labels=no}}) – of body fluids, i.e., keeping blood, sweat, urine, semen, etc. from leakage or excessive emission.
# Transformation ({{zh |t = 氣化 |s = 气化 |p = qìhuà|c=|labels=no}}) – of food, drink, and breath into qi, [[#Xue|xue]] (blood), and [[#Bodily fluids (Jinye)|jinye]] ("fluids"), and/or transformation of all of the latter into each other.
Vacuity of qi will be characterized especially by pale complexion, lassitude of spirit, lack of strength, spontaneous sweating, laziness to speak, non-digestion of food, shortness of breath (especially on exertion), and a pale and enlarged tongue.<ref name="Wiseman 1996" />

Qi is believed to be partially generated from food and drink, and partially from air (by breathing). Another considerable part of it is inherited from the parents and will be consumed in the course of life.

TCM uses special terms for qi running inside of the blood vessels and for qi that is distributed in the skin, muscles, and tissues between them. The former is called yíng-qì ({{zh |s = 营气 |t = 營氣|c=|p=|labels=no}}); its function is to complement xuè and its nature has a strong yin aspect (although qi in general is considered to be yang).<ref name="Elizabeth Reninger">{{cite web |url=http://taoism.about.com/od/qi/a/Qi_Forms.htm |title=Qi (Chi): Various Forms Used in Qigong & Chinese Medicine – How Are The Major Forms Of Qi Created Within The Body? | vauthors = Reninger E |access-date=6 December 2010 |archive-url=https://web.archive.org/web/20110707075119/http://taoism.about.com/od/qi/a/Qi_Forms.htm |archive-date=7 July 2011 |url-status=live}}</ref> The latter is called weì-qì ({{zh |t = 衛氣 |s = 卫气|c=|p=|labels=no}}); its main function is defence and it has pronounced yang nature.<ref name="Elizabeth Reninger" />

Qi is said to circulate in the meridians. Just as the qi held by each of the zang-fu organs, this is considered to be part of the 'principal' qi ({{zh |t = 元氣 |s = 元气 |p = yuánqì|c=|labels=no}}) of the body<ref name="HUCB4">"{{lang|zh|...元氣生成後，通過三焦而流行分布於全身，內至髒腑，外達腠理肌膚...}} &#91;After yuan-qi is created, it disperses over the whole body, to the zang-fu in the interior, to the skin and the space beneath it on the exterior...&#93; as seen in {{cite web |url = http://www.zgxl.net/sljk/imgbody/zyrt/qi.htm |script-title = zh:氣 |author = 郭卜樂 |date = 24 October 2009 |access-date = 6 December 2010 |language = zh |trans-title = Qi |archive-url = https://web.archive.org/web/20090108191112/http://www.zgxl.net/sljk/imgbody/zyrt/qi.htm |archive-date = 8 January 2009 |url-status = dead}}</ref> (also called {{zh |s = 真气 |p = zhēn qì|c=|t=真氣|labels=no}}, ''true'' qi, or {{zh |s = 原气 |p = yuán qì|c=|t=原氣|labels=no}}, ''original'' qi).<ref name="0QFSU">"{{lang|zh|1、元氣 元氣又稱為"原氣"、"真氣"，為人體最基本、最重要的氣，...}}" &#91;1. Yuan-qi is also known as "yuan-qi" and "zhēn qì", is the body's most fundamental and most important (kind of) qi ...&#93; as seen at {{cite web |url = http://www.zgxl.net/sljk/imgbody/zyrt/qi.htm |script-title = zh:氣 |author = 郭卜樂 |date = 24 October 2009 |access-date = 6 December 2010 |language = zh |trans-title = Qi |archive-url = https://web.archive.org/web/20090108191112/http://www.zgxl.net/sljk/imgbody/zyrt/qi.htm |archive-date = 8 January 2009 |url-status = dead}}</ref>

===Xue===
In contrast to the majority of other functional entities, xuè ({{lang|zh|血}}, "blood") is correlated with a physical form – the red liquid running in the blood vessels.<ref name="Blood from a TCM Perspective">{{cite web|url=http://www.shen-nong.com/eng/principles/blood.html|title=Blood from a TCM Perspective|publisher=Shen-Nong Limited|access-date=4 April 2011|archive-url=https://web.archive.org/web/20110716053655/http://www.shen-nong.com/eng/principles/blood.html|archive-date=16 July 2011|url-status=live}}</ref> Its concept is, nevertheless, defined by its functions: nourishing all parts and tissues of the body, safeguarding an adequate degree of moisture, and sustaining and soothing both consciousness and sleep.<ref name="Blood from a TCM Perspective" />

Typical symptoms of a lack of xuě (usually termed "blood vacuity" &#91;{{zh|c=血虚 |p=xuě xū|labels=no}}&#93;) are described as: Pale-white or withered-yellow complexion, dizziness, flowery vision, palpitations, insomnia, numbness of the extremities; pale tongue; "fine" pulse.<ref name="cudGr">{{harvp|Wiseman|Ellis|1996|p=147}}</ref>

===Jinye===
Closely related to xuě are the jīnyè ({{lang|zh|津液}}, usually translated as "body fluids"), and just like xuě they are considered to be yin in nature, and defined first and foremost by the functions of nurturing and moisturizing the different structures of the body.<ref name="sacredlotus">{{cite web |url=http://www.sacredlotus.com/theory/substances/jinye.cfm |title=Body Fluids (Yin Ye) |publisher=2001–2010 by Sacred Lotus Arts |access-date=9 December 2010 |archive-url=https://web.archive.org/web/20101127132141/http://sacredlotus.com/theory/substances/jinye.cfm |archive-date=27 November 2010 |url-status=live}}</ref> Their other functions are to harmonize yin and yang, and to help with the secretion of waste products.<ref name="NJxjg">"{{lang|zh|三、津液的功能 ...（三）调节阴阳 ...（四）排泄废物 ..."}} &#91;3.) Functions of the Jinye: ... 3.3.)Harmonizing yin and yang ... 3.4.)Secretion of waste products ...&#93; As seen at: {{cite web |url=http://www.zysj.com.cn/lilunshuji/jichulilun/44-4-4.html |script-title=zh:《中医基础理论》第四章 精、气、血、津液. 第四节 津液 |access-date=9 December 2010 |language=zh |trans-title=Basics of TCM theory. Chapter 4: Essence, qi, blood, jinye. Section 4: jinye |archive-url=https://web.archive.org/web/20101113053828/http://www.zysj.com.cn/lilunshuji/jichulilun/44-4-4.html |archive-date=13 November 2010 |url-status=live}}</ref>

Jīnyè are ultimately extracted from food and drink, and constitute the raw material for the production of xuě; conversely, xuě can also be transformed into jīnyè.<ref name="sacredlotus" /> Their palpable manifestations are all bodily fluids: [[tears]], [[sputum]], [[Salivary gland|saliva]], [[gastric acid]], [[Synovial fluid|joint fluid]], [[Perspiration|sweat]], [[urine]], etc.<ref name="XOqR0">"{{lang|zh|津液包括各脏腑组织的正常体液和正常的分泌物，胃液、肠液、唾液、关节液等。习惯上也包括代谢产物中的尿、汗、泪等。}}" [The (term) jinye comprises all physiological bodily fluids of the zang-fu and tissues, and physiological secretions, gastric juice, intestinal juice, saliva, joint fluid, etc. Customarily, this also includes metabolic products like urine, sweat, tears, etc.] As seen at: {{cite web |url=http://www.zysj.com.cn/lilunshuji/jichulilun/44-4-4.html |script-title=zh:《中医基础理论》第四章 精、气、血、津液. 第四节 津液 |access-date=9 December 2010 |language=zh |trans-title=Basics of TCM theory. Chapter 4: Essence, qi, blood, jinye. Section 4: jinye |archive-url=https://web.archive.org/web/20101113053828/http://www.zysj.com.cn/lilunshuji/jichulilun/44-4-4.html |archive-date=13 November 2010 |url-status=live}}</ref>

===Zang-fu===
{{Main|Zang-fu}}
The '''zàng-fǔ''' ({{zh|labels=no|s=脏腑|t=臟腑}}) constitute the centre piece of TCM's systematization of bodily functions. Bearing the names of organs, they are, however, only secondarily tied to (rudimentary) anatomical assumptions (the fǔ a little more, the zàng much less).<ref name="hJoCV">{{cite web |url=http://kaleidoscope.cultural-china.com/en/118Kaleidoscope4651.html |title=Cultural China–Chinese Medicine–Basic Zang Fu Theory |access-date=8 January 2011 |url-status=dead |archive-url=https://web.archive.org/web/20110314201959/http://kaleidoscope.cultural-china.com/en/118Kaleidoscope4651.html |archive-date=14 March 2011}}</ref> As they are primarily defined by their functions,<ref name="Kaptchuck 2000" /><ref name="Ross 1984" /> they are not equivalent to the anatomical organs–to highlight this fact, their names are usually capitalized.

The term zàng ({{lang|zh|臟}}) refers to the five entities considered to be yin in nature–[[Heart (Chinese medicine)|Heart]], [[Liver (Chinese medicine)|Liver]], [[Spleen (Chinese medicine)|Spleen]], [[Lung (Chinese medicine)|Lung]], [[Kidney (Chinese medicine)|Kidney]]–, while fǔ ({{lang|zh|腑}}) refers to the six yang organs–[[Small intestine (Chinese medicine)|Small Intestine]], [[Large intestine (Chinese medicine)|Large Intestine]], [[Gallbladder (Chinese medicine)|Gallbladder]], [[Urinary bladder (Chinese medicine)|Urinary Bladder]], [[Stomach (Chinese medicine)|Stomach]] and [[San Jiao|Sānjiaō]].<ref name="mUWDG">by citation from the [[Huangdi Neijing]]'s Suwen: "{{lang|zh|言人身臟腑中陰陽，則臟者為陰，腑者為陽。}}" &#91;Within the human body's zang-fu, there's yin and yang; the zang are yin, the fu are yang&#93;. As seen at: {{cite web |url=http://www.yixuesheng.com/lunwen/zhongyi/zyjc/201001/5090.html |script-title=zh:略論臟腑表裏關係 |date=22 January 2010 |access-date=13 December 2010 |language=zh |trans-title=outline on the relationships between the zang-fu |url-status=dead |archive-url=https://web.archive.org/web/20110718141705/http://www.yixuesheng.com/lunwen/zhongyi/zyjc/201001/5090.html |archive-date=18 July 2011}}</ref>

The zàng's essential functions consist in production and storage of qì and xuě; they are said to regulate digestion, breathing, water metabolism, the musculoskeletal system, the skin, the sense organs, aging, emotional processes, and mental activity, among other structures and processes.<ref name="gPrNi">{{cite web |url=http://kaleidoscope.cultural-china.com/en/118Kaleidoscope4651.html |title=Cultural China–Chinese Medicine–Basic Zang Fu Theory |access-date=26 February 2011 |url-status=dead |archive-url=https://web.archive.org/web/20110314201959/http://kaleidoscope.cultural-china.com/en/118Kaleidoscope4651.html |archive-date=14 March 2011}}</ref> The fǔ organs' main purpose is merely to transmit and digest ({{zh|c=傳化 |labels=no|p=chuán-huà}})<ref name="wh23b">"{{lang|zh|六腑：膽、胃、小腸、大腸、膀胱、三焦；"傳化物質"。}} &#91;The Six Fu: gallbladder, stomach, small intestine, large intestine, bladder, sanjiao; "transmit and digest"&#93; as seen at {{cite web |url=http://www.notedyy.com/news/html/?341.html |script-title=zh:中醫基礎理論-髒腑學說 |date=11 June 2010 |access-date=14 December 2010 |language=zh |trans-title=Basics of TCM theory–The zangfu concept |url-status=dead |archive-url=https://web.archive.org/web/20110714200403/http://www.notedyy.com/news/html/?341.html |archive-date=14 July 2011}}</ref> substances such as waste and food.

Since their concept was developed on the basis of Wǔ Xíng philosophy, each zàng is paired with a fǔ, and each zàng-fǔ pair is assigned to one of five elemental qualities (i.e., the Five Elements or Five Phases).<ref name="K2pRO">{{harvp|Aung|Chen|2007|pp= 15–16}}</ref> These correspondences are stipulated as:
* Fire ({{lang|zh|火}}) = Heart ({{zh|c=心|labels=no|p=xīn}}) and Small Intestine ({{zh|c=小腸|labels=no|p=xiaǒcháng}}) (and, secondarily, Sānjiaō &#91;{{lang|zh|三焦}}, "Triple Burner"&#93; and Pericardium [{{zh|c=心包|p=xīnbaò|labels=no}}])
* Earth ({{lang|zh|土}}) = Spleen ({{zh|c=脾 |labels=no|p=pí}}) and Stomach ({{zh|c=胃 |labels=no|p=weì}})
* Metal ({{lang|zh|金}}) = Lung ({{zh|c=肺 |labels=no|p=feì}}) and Large Intestine ({{zh|c=大腸 |labels=no|p=dàcháng}})
* Water ({{lang|zh|水}}) = Kidney ({{zh|c=腎 |labels=no|p=shèn}}) and Bladder ({{zh|c=膀胱|labels=no|p=pángguāng}})
* Wood ({{lang|zh|木}}) = Liver ({{zh|c=肝 |labels=no|p=gān}}) and Gallbladder ({{zh|c=膽|labels=no|p=dān}})

The zàng-fǔ are also connected to the [[Meridian (Chinese medicine)#Twelve standard meridians|twelve standard meridians]]–each yang meridian is attached to a fǔ organ, and five of the yin meridians are attached to a zàng.<ref name="4IoBNy" /> As there are only five zàng but six yin meridians, the sixth is assigned to the [[Pericardium (Chinese medicine)|Pericardium]], a peculiar entity almost similar to the Heart zàng.<ref name="4IoBNy">{{harvp|Aung|Chen|2007|p=16}}</ref>

===Jing-luo===
[[File:Acupuncture chart 300px.jpg|thumb|Acupuncture chart from the [[Ming dynasty]] (c. 1368–1644)|200px]]
{{Main|Meridian (Chinese medicine)}}

The meridians ({{lang|zh|经络}}, {{zh|labels=no|p=jīng-luò}}) are believed to be channels running from the zàng-fǔ in the interior ({{lang|zh|里}}, {{zh|labels=no|p=lǐ}}) of the body to the limbs and joints ("the surface" [{{lang|zh|表}}, {{zh|labels=no|p=biaǒ}}]), transporting qi and xuĕ.<ref name="GLbap">{{lang|zh|"经络是运行全身气血，联络脏腑肢节，沟通表里上下内外，...}}" &#91;The jingluo transport qi and blood through the whole body, connecting the zang-fu with limbs and joints, connecting interior with surface, up with down, inside with outside ...&#93; as seen at {{cite web |url=http://www.diyifanwen.com/kaoshizhuanti/fuxizhidao1/0781614101641980_497.htm |script-title=zh:中医基础理论辅导：经络概念及经络学说的形成: 经络学说的形成 |access-date=13 January 2011 |language=zh |trans-title=guide to basic TCM theory: the jing-luo concept and the emergence of jing-luo theory: the emergence of jing-luo theory |archive-url=https://web.archive.org/web/20110710135054/http://www.diyifanwen.com/kaoshizhuanti/fuxizhidao1/0781614101641980_497.htm |archive-date=10 July 2011 |url-status=live}}</ref><ref name="aFnoX">{{harvp|Aung|Chen|2007|p=20}}</ref> TCM identifies 12 "regular" and 8 "extraordinary" meridians;<ref name="Aung, S.K.H. 2007 p. 19" /> the Chinese terms being {{lang|zh|十二经脉}} ({{zh|labels=no|p=shí-èr jīngmài}}, lit. "the Twelve Vessels") and {{lang|zh|奇经八脉}} ({{zh|labels=no|p=qí jīng bā mài}}) respectively.<ref name="xdLlk">"{{lang|zh|（三）十二经脉 ...（四）奇经八脉 ..."}} &#91;(3.) The Twelve Vessels ... (4.) The Extraordinary Eight Vessels ...&#93; as seen at {{cite web |url=http://www.pharmnet.com.cn/tcm/knowledge/detail/100044.html |script-title=zh:经络学 |access-date=22 February 2011 |language=zh |trans-title=meridian theory |url-status=dead |archive-url=https://web.archive.org/web/20161110121328/http://www.pharmnet.com.cn/tcm/knowledge/detail/100044.html |archive-date=10 November 2016}}</ref> There's also a number of less customary channels branching from the "regular" meridians.<ref name="Aung, S.K.H. 2007 p. 19" />

== Gender in traditional medicine ==
''Fuke ''({{zh |t =婦科 |s =妇科|p = Fuke|c=|labels=no}}) is the Chinese term for women's medicine,  (known as [[gynecology]] and [[obstetrics]] in modern medicine). However, there are few or no ancient works on it except for Fu Qing-zhu's ''Fu Qing Zhu Nu Ke'' (Fu Qing-zhu's ''Gynecology'').<ref name="PyYtM">{{Cite book|title=Fu Qing-zhu's gynecology| vauthors = Fu S |date=1995 |publisher=Blue Poppy Press|isbn=093618535X|oclc=46812372}}</ref> In traditional China, as in many other cultures, the health and medicine of female bodies was less understood than that of male bodies. Women's bodies were often secondary to male bodies, since women were thought of as the weaker, sicklier sex.<ref name="yzdrXFB">Furth, Charlotte. ''A Flourishing Yin: Gender in China's Medical History, 960–1665''. Berkeley: University of California Press, 1999. [http://hdl.handle.net/2027/HEB.04218.0001.001 hdl.handle.net]</ref>

In clinical encounters, women and men were treated differently. Diagnosing women was not as simple as diagnosing men. First, when a woman fell ill, an appropriate adult man was to call the doctor and remain present during the examination, for the woman could not be left alone with the doctor.<ref name="nzFZzH">{{Cite book|title=A flourishing yin: gender in Chinaʼs medical history| vauthors = Furth C |publisher=University of California Press|year=1999|isbn=0520208293|pages=245, 250, 255|oclc=955120174}}</ref> The physician would discuss the female's problems and diagnosis only through the male. However, in certain cases, when a woman dealt with complications of pregnancy or birth, older women assumed the role of the formal authority. Men in these situations would not have much power to interfere.<ref name="54E8O5" />  Second, women were often silent about their issues with doctors due to the societal expectation of female modesty when a male figure was in the room.<ref name="nzFZzH" /> Third, patriarchal society also caused doctors to call women and children patients "the anonymous category of family members (''Jia Ren'') or household (''Ju Jia'')"<ref name="nzFZzH" /> in their journals. This anonymity and lack of conversation between the doctor and woman patient led to the inquiry diagnosis of the Four Diagnostic Methods<ref name="jBODo">{{Cite book|title=Diagnostic of Traditional Chinese Medicine – A newly compiled practical English-Chinese library of Traditional Chinese medicine| vauthors = Wang LF |publisher=Shanghai university of TCM press|year=2002|isbn=7810106805}}</ref> being the most challenging. Doctors used a medical doll known as a [[Doctor's lady]], on which female patients could indicate the location of their symptoms.<ref name="Byouo">{{cite book | url=https://books.google.com/books?id=xtgVBAAAQBAJ&pg=PA66 | title=You and Your Doctor: A Guide to a Healing Relationship, with Physicians' Insights | publisher=McFarland & Company | vauthors = Heller T | year=2012 | pages=66| isbn=9780786462933}}</ref>

Cheng Maoxian (b. 1581), who practiced medicine in Yangzhou, described the difficulties doctors had with the norm of female modesty. One of his case studies was that of Fan Jisuo's teenage daughter, who could not be diagnosed because she was unwilling to speak about her symptoms, since the illness involved discharge from her intimate areas.<ref name="54E8O5">{{cite book|title=A Flourishing Yin: Gender in China's Medical History| vauthors = Furth C |date=March 1999|isbn=9780520208292}}</ref> As Cheng describes, there were four standard methods of diagnosis—looking, asking, listening and smelling and touching (for pulse-taking). To maintain some form of modesty, women would often stay hidden behind curtains and screens. The doctor was allowed to touch enough of her body to complete his examination, often just the pulse taking. This would lead to situations where the symptoms and the doctor's diagnosis did not agree and the doctor would have to ask to view more of the patient.<ref name="VtvP4C">{{cite book|title=A Flourishing Yin: Gender in China's Medical History: 960–1665| vauthors = Furth C |date=March 1999|isbn=9780520208292|page=248}}</ref>

These social and cultural beliefs were often barriers to learning more about female health, with women themselves often being the most formidable barrier. Women were often uncomfortable talking about their illnesses, especially in front of the male chaperones that attended medical examinations.<ref name="yzdrXFB" /> Women would choose to omit certain symptoms as a means of upholding their chastity and honor. One such example is the case in which a teenage girl was unable to be diagnosed because she failed to mention her symptom of vaginal discharge.<ref name="yzdrXFB" /> Silence was their way of maintaining control in these situations, but it often came at the expense of their health and the advancement of female health and medicine. This silence and control were most obviously seen when the health problem was related to the core of Ming ''fuke'', or the sexual body.<ref name="yzdrXFB" /> It was often in these diagnostic settings that women would choose silence. In addition, there would be a conflict between patient and doctor on the probability of her diagnosis. For example, a woman who thought herself to be past the point of child-bearing age, might not believe a doctor who diagnoses her as pregnant.<ref name="yzdrXFB" /> This only resulted in more conflict.

=== Yin Yang and gender ===
Yin and Yang were critical to the understanding of women's bodies, but understood only in conjunction with male bodies.<ref name="uHbrTu">{{cite journal |last1=Farquhar |first1=Judith |title=Objects, Processes, and Female Infertility in Chinese Medicine |journal=Medical Anthropology Quarterly |date=1991 |volume=5 |issue=4 |pages=370–399 |doi=10.1525/maq.1991.5.4.02a00040 |jstor=649292 }}</ref> Yin and yang ruled the body, the body being a microcosm of the universe and the earth. In addition, gender in the body was understood as homologous, the two genders operating in synchronization.<ref name="yzdrXFB" /> Gender was presumed to influence the movement of energy and a well-trained physician would be expected to read the pulse and be able to identify two dozen or more energy flows.<ref name="GFgKi">{{Cite book|title=Canon of the Pulse (Maijing)}}</ref> Yin and yang concepts were applied to the feminine and masculine aspects of all bodies, implying that the differences between men and women begin at the level of this energy flow. According to ''Bequeathed Writings of Master Chu'' the male's yang pulse movement follows an ascending path in "compliance [with cosmic direction] so that the cycle of circulation in the body and the Vital Gate are felt...The female's yin pulse movement follows a defending path against the direction of cosmic influences, so that the nadir and the Gate of Life are felt at the inch position of the left hand".<ref name="Z7q7v">{{Cite book|title=Bequeathed Writings of Master Chu}}</ref> In sum, classical medicine marked yin and yang as high and low on bodies which in turn would be labeled normal or abnormal and gendered either male or female.<ref name="54E8O5" />

Bodily functions could be categorized through systems, not organs. In many drawings and diagrams, the twelve channels and their visceral systems were organized by yin and yang, an organization that was identical in female and male bodies. Female and male bodies were no different on the plane of yin and yang. Their gendered differences were not acknowledged in diagrams of the human body. Medical journals were filled with illustrations of male bodies or androgynous bodies that did not display gendered characteristics.<ref name="dsK5E">Wu, Yi-Li, and {{lang|zh|吳一立}}. "The Gendered Medical Iconography of the Golden Mirror, Yuzuan Yizong Jinjian {{lang|zh|御纂醫宗金鑑}}, 1742." In ''Imagining Chinese Medicine'', edited by Lo Vivienne, {{lang|zh|羅維前}}, Barrett Penelope, Dear David, Di Lu, {{lang|zh|蘆笛}}, Reynolds Lois, Yang Dolly, and {{lang|zh|楊德秀}}, 111–32. LEIDEN; BOSTON: Brill, 2018. {{jstor|10.1163/j.ctvbqs6ph.12}}.</ref>

As in other cultures, fertility and menstruation dominate female health concerns.<ref name="yzdrXFB" />  Since male and female bodies were governed by the same forces, traditional Chinese medicine did not recognize the womb as the place of reproduction. The abdominal cavity presented pathologies that were similar in both men and women, which included tumors, growths, hernias, and swellings of the genitals. The "master system," as Charlotte Furth calls it, is the kidney visceral system, which governed reproductive functions. Therefore, it was not the anatomical structures that allowed for pregnancy, but the difference in processes that allowed for the affliction of pregnancy to occur.<ref name="yzdrXFB" />

=== Pregnancy ===
Traditional Chinese medicine's dealings with pregnancy are documented from at least the seventeenth century. According to Charlotte Furth, "a pregnancy (in the seventeenth century) as a known bodily experience emerged [...] out of the liminality of menstrual irregularity, as uneasy digestion, and a sense of fullness".<ref name="nzFZzH" /> These symptoms were common among other illness as well, so the diagnosis of pregnancy often came late in the term. The ''Canon of the Pulse'', which described the use of pulse in diagnosis, stated that pregnancy was "a condition marked by symptoms of the disorder in one whose pulse is normal" or "where the pulse and symptoms do not agree".<ref name="BddYV">{{Citation|chapter=Diagnosis for Pulse-Taking and Pulse Subtlety|date=March 2019|pages=69–77|publisher=WORLD SCIENTIFIC|isbn=9789813273573|doi=10.1142/9789813273580_0017|title=The Yellow Emperor's Classic of Medicine – Essential Questions|s2cid=241372790}}</ref> Women were often silent about suspected pregnancy, which led to many men not knowing that their wife or daughter was pregnant until complications arrived. Complications through the misdiagnosis and the woman's reluctance to speak often led to medically induced abortions. Dr.Cheng, Furth wrote, "was unapologetic about endangering a fetus when pregnancy risked a mother's well being".<ref name="nzFZzH" /> The method of abortion was the ingestion of certain herbs and foods. Disappointment at the loss of the fetus often led to family discord.<ref name="nzFZzH" />

=== Postpartum ===
If the baby and mother survived the term of the pregnancy, childbirth was then the next step. The tools provided for birth were: towels to catch the blood, a container for the placenta, a pregnancy sash to support the belly, and an infant swaddling wrap.<ref name="BTqQT">{{Cite book|title=Shinzoku kibun.| vauthors = Nakagawa T, Sun B, Muramatsu K |publisher=Tōkyō: Heibonsha.|year=1966}}</ref> With these tools, the baby was born, cleaned, and swaddled; however, the mother was then immediately the focus of the doctor to replenish her ''qi.''<ref name="nzFZzH" /> In his writings, Dr.Cheng places a large amount of emphasis on the Four Diagnostic methods to deal with postpartum issues and instructs all physicians to "not neglect any [of the four methods]".<ref name="nzFZzH" /> The process of birthing was thought to deplete a woman's blood level and ''qi'' so the most common treatments for postpartum were food (commonly garlic and ginseng), medicine, and rest.<ref name="QDRbHW">Cheng Maoxian. ''Yi'an'' (casebook). Dated 1633, but Xue Qinghu (1991) states that the original was printed in 1644</ref> This process was followed up by a month check-in with the physician, a practice known as ''zuo yuezi''.<ref name="aeNQF">{{cite journal |last1=Pillsbury |first1=Barbara L.K. |title='Doing the month': Confinement and convalescence of Chinese women after childbirth |journal=Social Science & Medicine. Part B: Medical Anthropology |date=January 1978 |volume=12 |issue=1B |pages=11–22 |doi=10.1016/0160-7987(78)90003-0 |pmid=565536 }}</ref>

=== Infertility ===
Infertility, not very well understood, posed serious social and cultural repercussions. The seventh-century scholar [[Sun Simiao]] is often quoted: "those who have prescriptions for women's distinctiveness take their differences of pregnancy, childbirth and [internal] bursting injuries as their basis."<ref name="uHbrTu" /> Even in contemporary ''fu ke'' placing emphasis on reproductive functions, rather than the entire health of the woman, suggests that the main function of ''fu ke'' is to produce children.

Once again, the kidney visceral system governs the "source ''Qi,''" which governs the reproductive systems in both sexes. This source ''Qi'' was thought to "be slowly depleted through sexual activity, menstruation and childbirth."<ref name="uHbrTu" /> It was also understood that the depletion of source Qi could result from the movement of an external pathology that moved through the outer visceral systems before causing more permanent damage to the home of source Qi, the kidney system. In addition, the view that only very serious ailments ended in the damage of this system means that those who had trouble with their reproductive systems or fertility were seriously ill.

According to traditional Chinese medical texts, infertility can be summarized into different syndrome types. These were spleen and kidney depletion (yang depletion), liver and kidney depletion (yin depletion), blood depletion, phlegm damp, liver oppression, and damp heat. This is important because, while most other issues were complex in Chinese medical physiology, women's fertility issues were simple. Most syndrome types revolved around menstruation, or lack thereof. The patient was entrusted with recording not only the frequency, but also the "volume, color, consistency, and odor of menstrual flow."<ref name="uHbrTu" /> This placed responsibility of symptom recording on the patient, and was compounded by the earlier discussed issue of female chastity and honor. This meant that diagnosing female infertility was difficult, because the only symptoms that were recorded and monitored by the physician were the pulse and color of the tongue.<ref name="uHbrTu" />

== Concept of disease ==
In general, disease is perceived as a disharmony (or imbalance) in the functions or interactions of yin, yang, qi, xuĕ, zàng-fǔ, meridians etc. and/or of the interaction between the human body and the environment.<ref name="Wiseman 1996" /> Therapy is based on which "pattern of disharmony" can be identified.<ref name="Ergil 2009" /><ref name="Flaws 1996" /> Thus, "pattern discrimination" is the most important step in TCM diagnosis.<ref name="Ergil 2009" /><ref name="Flaws 1996" /> It is also known to be the most difficult aspect of practicing TCM.<ref name="Flaws 1990" />

To determine which pattern is at hand, practitioners will examine things like the color and shape of the tongue, the relative strength of pulse-points, the smell of the breath, the quality of breathing or the sound of the voice.<ref name="xhEsP">"Tongue Diagnosis in Chinese Medicine", Giovanni Maciocia, Eastland Press; Revised edition (June 1995)</ref><ref name="Maciocia">{{Cite book | vauthors = Maciocia G |title=The Foundations of Chinese Medicine|publisher=Churchill Livingstone|year=1989}}</ref> For example, depending on tongue and pulse conditions, a TCM practitioner might diagnose bleeding from the mouth and nose as: "Liver fire rushes upwards and scorches the Lung, injuring the blood vessels and giving rise to reckless pouring of blood from the mouth and nose."<ref name="Deadman">{{cite journal |last1=Deadman |first1=Peter |last2=Al-Khafaji |first2=Mazin |title=Some Acupuncture Points Which Treat Disorders of Blood |journal=Journal of Chinese Medicine |date=September 1994 |issue=46 |pages=21–29 |url=https://www.journalofchinesemedicine.com/some-acupuncture-points-which-treat-disorders-of-blood.html }}</ref> He might then go on to prescribe [[#Traditional categorization|treatments]] designed to clear heat or supplement the Lung.

===Disease entities===
In TCM, a disease has two aspects: "bìng" and "zhèng".<ref name="Clavey 1995">Clavey, Steven (1995): [https://books.google.com/books?id=2RQMLGcFe6kC&pg=PR30&dq=tcm+ba+gang+diagnosis&hl=zh-CN#v=onepage&q=tcm%20ba%20gang%20diagnosis&f=false "Fluid physiology and pathology in traditional Chinese medicine"]. Elsevier. 2nd edition, 2003. {{ISBN|978-0-443-07194-2}}</ref> The former is often translated as "disease entity",<ref name="Ergil 2009" /> "disease category",<ref name="Flaws 1990" /> "illness",<ref name="Clavey 1995" /> or simply "diagnosis".<ref name="Clavey 1995" /> The latter, and more important one, is usually translated as "pattern"<ref name="Ergil 2009" /><ref name="Flaws 1990" /> (or sometimes also as "syndrome"<ref name="Clavey 1995" />). For example, the disease entity of a common cold might present with a pattern of [[#Six Excesses|wind-cold]] in one person, and with the pattern of [[#Six Excesses|wind-heat]] in another.<ref name="Ergil 2009" />

From a scientific point of view, most of the disease entities ({{zh|c=病|labels=no|p=bìng}}) listed by TCM constitute symptoms.<ref name="Ergil 2009" /> Examples include headache, cough, abdominal pain, constipation etc.<ref name="Ergil 2009" /><ref>{{cite journal | vauthors = Vickers AJ, Linde K | title = Acupuncture for chronic pain | journal = JAMA | volume = 311 | issue = 9 | pages = 955–6 | date = March 2014 | pmid = 24595780 | pmc = 4036643 | doi = 10.1001/jama.2013.285478 }}</ref>

Since therapy will not be chosen according to the disease entity but according to the pattern, two people with the same disease entity but different patterns will receive different therapy.<ref name="Flaws 1996" /> Vice versa, people with similar patterns might receive similar therapy even if their disease entities are different. This is called ''yì bìng tóng zhì, tóng bìng yì zhì'' ({{zh|p=|c=异病同治，同病异治|s=|t=|l=different diseases, same treatment; same disease, different treatments|labels=no}}).<ref name="Flaws 1996" />

===Patterns===
In TCM, "pattern" ({{zh|c=证|labels=no|p=zhèng}}) refers to a "pattern of disharmony" or "functional disturbance" within the functional entities of which the TCM model of the body is composed.<ref name="Ergil 2009" /> There are disharmony patterns of qi, xuě, the body fluids, the zàng-fǔ, and the [[#Jing-luo|meridians]].<ref name="Clavey 1995" /> They are ultimately defined by their symptoms and signs (i.e., for example, pulse and tongue findings).<ref name="Flaws 1996" />

In clinical practice, the identified pattern usually involves a combination of affected entities<ref name="Flaws 1990">Flaws, Bob (1990): [https://books.google.com/books?id=hID3SfkAuzUC&pg=PA5&dq=tcm+ba+gang+diagnosis&hl=zh-CN#v=onepage&q=tcm%20ba%20gang%20diagnosis&f=false "Sticking to the Point"] {{Webarchive|url=https://web.archive.org/web/20170320195338/https://books.google.com/books?id=hID3SfkAuzUC&pg=PA5&dq=tcm+ba+gang+diagnosis&hl=zh-CN#v=onepage&q=tcm%20ba%20gang%20diagnosis&f=false |date=20 March 2017}} Blue Poppy Press. 10th Printing, 2007. {{ISBN|978-0-936185-17-0}}</ref> (compare with [[#Typical examples of patterns|typical examples of patterns]]). The concrete pattern identified should account for ''all'' the symptoms a person has.<ref name="Flaws 1996">Flaws, B. & Finney, D. (1996): [https://books.google.com/books?id=iJT3mz20yHoC&pg=PA1&dq=tcm+pattern&hl=zh-CN#v=onepage&q=tcm%20pattern&f=false "A handbook of TCM patterns & their treatments"] {{Webarchive|url=https://web.archive.org/web/20170320165212/https://books.google.com/books?id=iJT3mz20yHoC&pg=PA1&dq=tcm+pattern&hl=zh-CN#v=onepage&q=tcm%20pattern&f=false |date=20 March 2017}} Blue Poppy Press. 6th Printing 2007. {{ISBN|978-0-936185-70-5}}</ref>

====Six Excesses====
The Six Excesses ({{zh|labels=no|c=六淫|p=liù yín}},<ref name="Wiseman 1996" /> sometimes also translated as "Pathogenic Factors",<ref name="1U3dN">{{cite book|url=https://books.google.com/books?id=WbThUt45ZXgC&q=tcm+six&pg=PA159|title=Foundations for integrative musculoskeletal medicine: an east-west approach|author=Marcus & Kuchera|publisher=North Atlantic Books|year=2004|access-date=22 March 2011|isbn=978-1-55643-540-9}} p. 159</ref> or "Six Pernicious Influences";<ref name="Ross 1984" /> with the alternative term of {{zh|c=六邪|labels=no|p=liù xié}}, – "Six Evils" or "Six Devils")<ref name="Ross 1984" /> are allegorical terms used to describe disharmony patterns displaying certain typical symptoms.<ref name="Ergil 2009" /> These symptoms resemble the effects of six climatic factors.<ref name="Ross 1984" /> In the allegory, these symptoms can occur because one or more of those climatic factors (called {{zh|c=六气|labels=no|p=liù qì}}, "the six qi")<ref name="Deng 1999" /> were able to invade the body surface and to proceed to the interior.<ref name="Ergil 2009" /> This is sometimes used to draw causal relationships (i.e., prior exposure to wind/cold/etc. is identified as the cause of a disease),<ref name="Deng 1999" /> while other authors explicitly deny a direct cause-effect relationship between weather conditions and disease,<ref name="Ergil 2009" /><ref name="Ross 1984" /> pointing out that the Six Excesses are primarily descriptions of a certain combination of symptoms<ref name="Ergil 2009" /> translated into a pattern of disharmony.<ref name="Ross 1984" /> It is undisputed, though, that the Six Excesses can manifest inside the body without an external cause.<ref name="Ergil 2009" /><ref name="Wiseman 1996" /> In this case, they might be denoted "internal", e.g., "internal wind"<ref name="Wiseman 1996" /> or "internal fire (or heat)".<ref name="Wiseman 1996" />

The Six Excesses and their characteristic clinical signs are:
# Wind ({{zh|c=风|labels=no|p=fēng}}): rapid onset of symptoms, wandering location of symptoms, itching, nasal congestion, "floating" pulse;<ref name="Deng 1999" /> tremor, paralysis, convulsion.<ref name="Ergil 2009" />
# Cold ({{zh|c=寒|labels=no|p=hán}}): cold sensations, aversion to cold, relief of symptoms by warmth, watery/clear excreta, severe pain, abdominal pain, contracture/hypertonicity of muscles, (slimy) white tongue fur, "deep"/"hidden" or "string-like" pulse,<ref name="jvz68">{{harvp|Wiseman|Ellis|1996|pp=80, 142}}</ref> or slow pulse.<ref name="Ross 1984" />
# Fire/Heat ({{zh|c=火|labels=no|p=huǒ}}): aversion to heat, high fever, thirst, concentrated urine, red face, red tongue, yellow tongue fur, rapid pulse.<ref name="Ergil 2009" /> (Fire and heat are basically seen to be the same)<ref name="Wiseman 1996" />
# Dampness ({{zh|c=湿|labels=no|p=shī}}): sensation of heaviness, sensation of fullness, symptoms of Spleen dysfunction, greasy tongue fur, "slippery" pulse.<ref name="Ross 1984" />
# Dryness ({{zh|c=燥|labels=no|p=zào}}): dry cough, dry mouth, dry throat, dry lips, nosebleeds, dry skin, dry stools.<ref name="Ergil 2009" />
# Summerheat ({{zh|c=暑|labels=no|p=shǔ}}): either heat or mixed damp-heat symptoms.<ref name="Wiseman 1996" />
Six-Excesses-patterns can consist of only one or a combination of Excesses (e.g., wind-cold, wind-damp-heat).<ref name="Deng 1999" /> They can also transform from one into another.<ref name="Deng 1999" />

====Typical examples of patterns====
For each of the functional entities (qi, xuĕ, zàng-fǔ, meridians etc.), typical disharmony patterns are recognized; for example: qi vacuity and qi stagnation in the case of qi;<ref name="Wiseman 1996" /> blood vacuity, blood stasis, and blood heat in the case of xuĕ;<ref name="Wiseman 1996" /> Spleen qi vacuity, Spleen yang vacuity, Spleen qi vacuity with down-bearing qi, Spleen qi vacuity with lack of blood containment, cold-damp invasion of the Spleen, damp-heat invasion of Spleen and Stomach in case of the Spleen zàng;<ref name="Ergil 2009" /> wind/cold/damp invasion in the case of the meridians.<ref name="Flaws 1996" />

TCM gives detailed prescriptions of these patterns regarding their typical symptoms, mostly including characteristic tongue and/or pulse findings.<ref name="Wiseman 1996" /><ref name="Flaws 1996" /> For example:
* "Upflaming Liver fire" ({{zh|c=肝火上炎|labels=no|p=gānhuǒ shàng yán}}): Headache, red face, reddened eyes, dry mouth, nosebleeds, constipation, dry or hard stools, profuse menstruation, sudden [[tinnitus]] or deafness, vomiting of sour or bitter fluids, expectoration of blood, [[irascibility]], impatience; red tongue with dry yellow fur; slippery and string-like pulse.<ref name="Wiseman 1996" />

====Eight principles of diagnosis====
The process of determining which actual pattern is on hand is called {{lang|zh|辩证}} ({{zh|labels=no|p=biàn zhèng}}, usually translated as "pattern diagnosis",<ref name="Ergil 2009" /> "pattern identification"<ref name="Wiseman 1996" /> or "pattern discrimination"<ref name="Flaws 1990" />). Generally, the first and most important step in pattern diagnosis is an evaluation of the present signs and symptoms on the basis of the "Eight Principles" ({{zh|c=八纲 |labels=no|p=bā gāng}}).<ref name="Ergil 2009" /><ref name="Wiseman 1996" /> These eight principles refer to four pairs of fundamental qualities of a disease: exterior/interior, heat/cold, vacuity/repletion, and yin/yang.<ref name="Wiseman 1996" /> Out of these, heat/cold and vacuity/repletion have the biggest clinical importance.<ref name="Wiseman 1996" /> The yin/yang quality, on the other side, has the smallest importance and is somewhat seen aside from the other three pairs, since it merely presents a general and vague conclusion regarding what other qualities are found.<ref name="Wiseman 1996" /> In detail, the Eight Principles refer to the following:
* ''Yin and yang'' are universal aspects all things can be classified under, this includes diseases in general as well as the Eight Principles' first three couples.<ref name="Wiseman 1996" /> For example, cold is identified to be a yin aspect, while heat is attributed to yang.<ref name="Wiseman 1996" /> Since descriptions of patterns in terms of yin and yang lack complexity and clinical practicality, though, patterns are usually not labeled this way anymore.<ref name="Wiseman 1996" /> Exceptions are vacuity-cold and repletion-heat patterns, who are sometimes referred to as "yin patterns" and "yang patterns" respectively.<ref name="Wiseman 1996" />
* ''Exterior'' ({{zh|c=表|labels=no|p=biǎo}}) refers to a disease manifesting in the superficial layers of the body – skin, hair, flesh, and meridians.<ref name="Wiseman 1996" /> It is characterized by aversion to cold and/or wind, headache, muscle ache, mild fever, a "floating" pulse, and a normal tongue appearance.<ref name="Wiseman 1996" />
* ''Interior'' ({{zh|c=里|labels=no|p=lǐ}}) refers to disease manifestation in the zàng-fǔ, or (in a wider sense) to any disease that can not be counted as exterior.<ref name="Deng 1999" /> There are no generalized characteristic symptoms of interior patterns, since they'll be determined by the affected zàng or fǔ entity.<ref name="Wiseman 1996" />
* ''Cold'' ({{zh|c=寒|labels=no|p=hán}}) is generally characterized by aversion to cold, absence of thirst, and a white tongue fur.<ref name="Wiseman 1996" /> More detailed characterization depends on whether cold is coupled with vacuity or repletion.<ref name="Wiseman 1996" />
* ''Heat'' ({{zh|c=热|labels=no|p=rè}}) is characterized by an absence of aversion to cold, a red and painful throat, a dry tongue fur and a rapid and floating pulse if it falls together with an exterior pattern.<ref name="Wiseman 1996" /> In all other cases, symptoms depend on whether heat is coupled with vacuity or repletion.<ref name="Wiseman 1996" />
* ''Deficiency'' ({{zh|c=虚|labels=no|p=xū}}), can be further differentiated into deficiency of [[#Qi|qi]], xuě, [[#Yin and yang|yin and yang]], with all their respective characteristic symptoms.<ref name="Wiseman 1996" /> Yin deficiency can also cause "empty-heat".<ref name="Kaptchuck 2000" />
* ''Excess'' ({{zh|c=实|labels=no|p=shí}}) generally refers to any disease that can't be identified as a deficient pattern, and usually indicates the presence of one of the Six Excesses,<ref name="Deng 1999" /> or a pattern of stagnation (of qi, xuě, etc.).<ref name="hM4aY">Tierra & Tierra 1998, p. 108</ref> In a concurrent exterior pattern, excess is characterized by the absence of sweating.<ref name="Wiseman 1996" />

After the fundamental nature of a disease in terms of the Eight Principles is determined, the investigation focuses on more specific aspects.<ref name="Wiseman 1996" /> By evaluating the present signs and symptoms against the background of typical disharmony patterns of the various entities, evidence is collected whether or how specific entities are affected.<ref name="Wiseman 1996" /> This evaluation can be done
# in respect of the meridians ({{zh|c=经络辩证|labels=no|p=jīngluò biàn zhèng}})<ref name="Flaws 1990" />
# in respect of qi ({{zh|c=气血辩证, |labels=no|p=qì xuè biàn zhèng}})<ref name="Flaws 1990" />
# in respect of xuè ({{zh|c=气血辩证|labels=no|p=qì xuè biàn zhèng}})<ref name="Flaws 1990" />
# in respect of the body fluids ({{zh|c=津液辩证|labels=no|p= jīnyè biàn zhèng}})<ref name="Flaws 1990" />
# in respect of the zàng-fǔ ({{zh|c=脏腑辩证|labels=no|p= zàngfǔ biàn zhèng}})<ref name="Flaws 1990" /> – very similar to this, though less specific, is disharmony pattern description in terms of the Five Elements [{{zh|c=五行辩证|labels=no|p=wǔ xíng biàn zhèng}}]<ref name="Flaws 1996" />)

There are also three special pattern diagnosis systems used in case of febrile and infectious diseases only ("Six Channel system" or "six division pattern" &#91;{{zh|c=六经辩证|labels=no|p=liù jīng biàn zhèng}}&#93;; "Wei Qi Ying Xue system" or "four division pattern" [{{zh|c=卫气营血辩证|labels=no|p=weì qì yíng xuè biàn zhèng}}]; "San Jiao system" or "three burners pattern" &#91;{{zh|c=三焦辩证|labels=no|p=sānjiaō biàn zhèng}}&#93;).<ref name="Flaws 1996" /><ref name="Clavey 1995" />

====Considerations of disease causes====
Although TCM and its concept of disease do not strongly differentiate between cause and effect,<ref name="Ross 1984">Ross, Jeremy (1984) [https://books.google.com/books?id=t23zKB1FSVYC&pg=PA6&dq=Chinese+medicine+is+completely+different;+it+emphasizes+function.+Little&hl=zh-CN#v=onepage&q=Chinese%20medicine%20is%20completely%20different%3B%20it%20emphasizes%20function.%20Little&f=false "Zang Fu, the organ systems of traditional Chinese medicine"] Elsevier. First edition 1984. {{ISBN|978-0-443-03482-4}}</ref> pattern discrimination can include considerations regarding the disease cause; this is called {{lang|zh|病因辩证}} ({{zh|labels=no|p=bìngyīn biàn zhèng}}, "disease-cause pattern discrimination").<ref name="Flaws 1990" />

There are three fundamental categories of disease causes ({{zh|c=三因|labels=no|p=sān yīn}}) recognized:<ref name="Wiseman 1996" />
# external causes: these include the Six Excesses and "Pestilential Qi".<ref name="Wiseman 1996" />
# internal causes: the "Seven Affects" ({{zh|c=七情|labels=no|p=qī qíng}},<ref name="Wiseman 1996" /> sometimes also translated as "Seven Emotions"<ref name="Ross 1984" />) – joy, anger, brooding, sorrow, fear, fright and grief.<ref name="Ross 1984" /> These are believed to be able to cause damage to the functions of the zàng-fú, especially of the Liver.<ref name="Wiseman 1996" />
# non-external-non-internal causes: dietary irregularities (especially: too much raw, cold, spicy, fatty or sweet food; voracious eating; too much alcohol),<ref name="Wiseman 1996" /> fatigue, sexual intemperance, trauma, and parasites ({{zh|c=虫|labels=no|p=chóng}}).<ref name="Wiseman 1996" />

==Diagnostics==
In TCM, there are five major diagnostic methods: inspection, auscultation, olfaction, inquiry, and palpation.<ref name="Cheng 1987">{{cite book | vauthors = Cheng X | title = Chinese Acupuncture and Moxibustion (1st ed.) | year = 1987 | publisher = Foreign Languages Press | isbn = 978-7-119-00378-8}}</ref> These are grouped into what is known as the "Four pillars" of diagnosis, which are Inspection, Auscultation/ Olfaction, Inquiry, and Palpation ({{lang|zh|望，聞，問，切}}).
* Inspection focuses on the face and particularly on the tongue, including analysis of the tongue size, shape, tension, color and coating, and the absence or presence of teeth marks around the edge.
* Auscultation refers to listening for particular sounds (such as wheezing).
* Olfaction refers to attending to body odor.
* Inquiry focuses on the "seven inquiries", which involve asking the person about the regularity, severity, or other characteristics of: chills, fever, perspiration, appetite, thirst, taste, defecation, urination, pain, sleep, [[menses]], [[leukorrhea]].
* Palpation which includes feeling the body for tender [[Acupuncture#Qi, meridians and acupuncture points|A-shi points]], and the palpation of the wrist pulses as well as various other pulses, and palpation of the abdomen.

===Tongue and pulse===
Examination of the tongue and the pulse are among the principal diagnostic methods in TCM. Details of the tongue, including shape, size, color, texture, cracks, teeth marks, as well as tongue coating are all considered as part of [[tongue diagnosis]]. Various regions of the tongue's surface are believed to correspond to the zàng-fŭ organs. For example, redness on the tip of the tongue might indicate heat in the Heart, while redness on the sides of the tongue might indicate heat in the Liver.<ref name="zrxs6">{{cite book | vauthors = Maciocia G |title=Tongue Diagnosis in Chinese Medicine |date=2001}}</ref>

Pulse palpation involves measuring the pulse both at a superficial and at a deep level at three different locations on the [[radial artery]] (''Cun, Guan, Chi'', located two fingerbreadths from the wrist crease, one fingerbreadth from the wrist crease, and right at the wrist crease, respectively, usually palpated with the index, middle and ring finger) of each arm, for a total of twelve pulses, all of which are thought to correspond with certain zàng-fŭ. The pulse is examined for several characteristics including rhythm, strength and volume, and described with qualities like "floating, slippery, bolstering-like, feeble, thready and quick"; each of these qualities indicates certain [[#Patterns|disease patterns]]. Learning TCM pulse diagnosis can take several years.<ref name="qMZOY">{{cite book | vauthors = Wright T, Eisenberg D |title=Encounters with Qi: exploring Chinese medicine |publisher=Norton |location=New York |year=1995 |pages= [https://books.google.com/books?id=DgFA–kVkuZEC&pg=PA53#v=onepage&q&f=false 53–54]|isbn=978-0-393-31213-3 }}</ref>

==Herbal medicine==
{{Main|Chinese herbology}}
{{See also|List of traditional Chinese medicines}}
{{more medical citations needed|section|date=June 2020}}
[[File:Traditional Chinese medicine in Xi'an market.jpg|thumb|Assorted dried plant and animal parts used in traditional Chinese medicines, clockwise from top left corner: dried [[Lingzhi mushroom|Lingzhi]] (lit. "spirit mushrooms"), [[ginseng]], [[Siraitia grosvenorii|Luo Han Guo]], turtle shell underbelly ([[plastron]]), and dried curled snakes.]]
[[File:Red ginseng.JPG|thumb|right|Chinese red ginseng roots]]
[[File:Bile bear.jpg|thumb|left|A [[bile bear]] in a "crush cage" on Huizhou Farm, China.<ref name="c555c">{{cite web | title = ENDANGERED AND ABUSED WILD ANIMALS & The USE OF HERBAL ALTERNATIVES TO REPLACE ANIMAL DERIVATIVES | url = http://aapn.org/article/endangered/#Bile%20Bears | publisher = Asian Animal Protection Network | date = 26 July 2012 | access-date = 29 April 2014 | archive-url = https://web.archive.org/web/20140430013227/http://aapn.org/article/endangered/#Bile%20Bears | archive-date = 30 April 2014 | url-status = live}}</ref>]]
[[File:Seahorse Skeleton Macro 8 - edit.jpg|thumb|left|upright|Dried [[seahorse]]s are extensively used in traditional medicine in China and elsewhere.<ref name="Vincent2011" />]]
The term "herbal medicine" is somewhat misleading in that, while plant elements are by far the most commonly used substances in TCM, other, non-botanic substances are used as well: animal, human, and mineral products are also used.<ref name="QSmNc">{{Cite web|url=http://www.china.org.cn/english/MATERIAL/185685.htm|title=The Essentials of Traditional Chinese Herbal Medicine|website=china.org.cn|access-date=26 January 2017|archive-url=https://web.archive.org/web/20160303202039/http://www.china.org.cn/english/MATERIAL/185685.htm|archive-date=3 March 2016|url-status=live}}</ref> Thus, the term "medicinal" (instead of herb) may be used,<ref name="1zMoF">{{cite book|url= https://books.google.com/books?id=uRdIuISvjo4C&q=wiseman+chinese |title=Introduction to English Terminology of Chinese Medicine | vauthors = Wiseman N, Feng Y |access-date=10 June 2011|isbn= 978-0912111643|date= 2002}}</ref> although there is no scientific evidence that any of these compounds have medicinal effects.<ref name="Eigenschink Dearing Dablander et al 2020"/>

===Raw materials===
There are roughly 13,000 compounds used in China and over 100,000 TCM recipes recorded in the ancient literature.<ref name="Certainprogress">{{cite journal |last1=Chen |first1=K |last2=Yu |first2=B |title=Certain progress of clinical research on Chinese integrative medicine |journal=Chinese Medical Journal |date=1999 |volume=112 |issue=10 |pages=934–937 |pmid=11717980 |url=https://medcentral.net/doi/abs/10.5555/cmj.0366-6999.112.10.p934.01 }}</ref> Plant elements and extracts are by far the most common elements used.<ref name="Foster 1992">Foster, S. & Yue, C. (1992): [https://books.google.com/books?id=y78zzxTN570C&printsec=frontcover&dq=herbal+emissaries&hl=zh-CN#v=onepage&q&f=false "Herbal emissaries: bringing Chinese herbs to the West"] {{Webarchive|url=https://web.archive.org/web/20170320172949/https://books.google.com/books?id=y78zzxTN570C&printsec=frontcover&dq=herbal+emissaries&hl=zh-CN#v=onepage&q&f=false |date=20 March 2017}}. Healing Arts Press. {{ISBN|978-0-89281-349-0}}</ref> In the classic ''Handbook of Traditional Drugs'' from 1941, 517 drugs were listed – out of these, 45 were animal parts, and 30 were minerals.<ref name="Foster 1992" />

====Animal substances====
Some animal parts used can be considered rather strange such as cow gallstones,<ref name="Hesketh1997">{{cite journal | vauthors = Hesketh T, Zhu WX | title = Health in China. Traditional Chinese medicine: one country, two systems | journal = BMJ | volume = 315 | issue = 7100 | pages = 115–7 | date = July 1997 | pmid = 9240055 | pmc = 2127090 | doi = 10.1136/bmj.315.7100.115 }}</ref> hornet nests,<ref name="mnfl6">{{cite web| url = http://tcm.health-info.org/Herbology.Materia.Medica/lufengfangproperties.htm| title = Lu Feng Fang, Materia Metrica| archive-url = https://web.archive.org/web/20180614121358/http://tcm.health-info.org/Herbology.Materia.Medica/lufengfangproperties.htm| archive-date = 14 June 2018}}</ref> [[leech]]es,<ref name="LAT">{{Cite web |url=http://www.acupuncturetoday.com/herbcentral/leech.php |title=Leech, Acupuncture Today |access-date=6 March 2011 |archive-url=https://web.archive.org/web/20110105042335/http://www.acupuncturetoday.com/herbcentral/leech.php |archive-date=5 January 2011 |url-status=live}}</ref> and [[scorpion]].<ref name="SAT">{{Cite web |url=http://www.acupuncturetoday.com/herbcentral/scorpion.php |title=Scorpion, Acupuncture Todady |access-date=6 March 2011 |archive-url=https://web.archive.org/web/20110104235049/http://www.acupuncturetoday.com/herbcentral/scorpion.php |archive-date=4 January 2011 |url-status=live}}</ref> Other examples of animal parts include horn of the antelope or buffalo, deer antlers, testicles and [[penis bone]] of the dog, and snake bile.<ref name="Still 2003" /> Some TCM textbooks still recommend preparations containing animal tissues, but there has been little research to justify the claimed clinical efficacy of many TCM animal products.<ref name="Still 2003">{{cite journal | vauthors = Still J | title = Use of animal products in traditional Chinese medicine: environmental impact and health hazards | journal = Complementary Therapies in Medicine | volume = 11 | issue = 2 | pages = 118–22 | date = June 2003 | pmid = 12801499 | doi = 10.1016/S0965-2299(03)00055-4 }}</ref>

Some compounds can include the parts of endangered species, including tiger bones<ref name="ezyCZ">{{cite book| vauthors = Wiseman N, Feng Y |title=A Practical Dictionary of Chinese Medicine|publisher=Paradigm Publications|edition=2|year=1998|url=https://books.google.com/books?id=_FyGk5QnjhAC&pg=PA904|page=904|isbn=978-0912111544|access-date=18 February 2016|archive-url=https://web.archive.org/web/20170320195430/https://books.google.com/books?id=_FyGk5QnjhAC&pg=PA904#v=onepage&q&f=false|archive-date=20 March 2017|url-status=live}}</ref> and [[rhinoceros horn]]<ref name="FTCMRH">''Facts about traditional Chinese medicine (TCM): rhinoceros horn'', Encyclopædia Britannica, [http://www.britannica.com/facts/5/1035448/traditional-Chinese-medicine-TCM-as-discussed-in-rhinoceros-mammal Facts about traditional Chinese medicine (TCM): rhinoceros horn, as discussed in rhinoceros (mammal): – Britannica Online Encyclopedia] {{Webarchive|url=https://web.archive.org/web/20110629095329/http://www.britannica.com/facts/5/1035448/traditional-Chinese-medicine-TCM-as-discussed-in-rhinoceros-mammal |date=29 June 2011}}</ref>
which is used for many ailments (though not as an aphrodisiac as is commonly misunderstood in the West).<ref name="0luMq">{{cite web|title=Poaching for rhino horn|url=https://www.pbs.org/wnet/nature/rhinoceros-rhino-horn-use-fact-vs-fiction/1178/|website=Save The Rhino|access-date=25 March 2016|date=20 August 2010|archive-url=https://web.archive.org/web/20160321143824/http://www.pbs.org/wnet/nature/rhinoceros-rhino-horn-use-fact-vs-fiction/1178/|archive-date=21 March 2016|url-status=live}}</ref>
The black market in rhinoceros horns (driven not just by TCM but also unrelated status-seeking) has reduced the world's rhino population by more than 90 percent over the past 40 years.<ref name="RH">{{cite news |title=Rhino horn: All myth, no medicine |first1=Rhishja |last1=Larson |date=July 2010 |url=http://voices.nationalgeographic.com/2010/07/07/rhino_horn_and_traditional_chinese_medicine_facts/ |archive-url=https://web.archive.org/web/20150411123924/http://voices.nationalgeographic.com/2010/07/07/rhino_horn_and_traditional_chinese_medicine_facts/ |archive-date=11 April 2015 }}</ref>
Concerns have also arisen over the use of [[pangolin]] scales,<ref name="70aUc">{{cite news|url=https://www.bbc.co.uk/nature/26549963|title='Shocking' scale of pangolin smuggling revealed| vauthors = Davies E | date=13 March 2014|work=Nature News|publisher=BBC|access-date=1 October 2016|archive-url=https://web.archive.org/web/20161018062653/http://www.bbc.co.uk/nature/26549963|archive-date=18 October 2016|url-status=live}}</ref> turtle [[plastron]],<ref name="guiban">{{Cite journal | vauthors = Chen TH, Chang HC, Lue KY |journal= Chelonian Conservation and Biology|volume= 8|issue=1|pages=11–18|year= 2009|doi= 10.2744/CCB-0747.1 |title=Unregulated Trade in Turtle Shells for Chinese Traditional Medicine in East and Southeast Asia: The Case of Taiwan |s2cid= 86821249}}</ref> seahorses,<ref name="Pbs.org">{{cite web |url=https://www.pbs.org/wgbh/nova/seahorse/vincent.html |title=NOVA Online &#124; Amanda Vincent |publisher=PBS |access-date=7 December 2009 |archive-url=https://web.archive.org/web/20091209055422/http://www.pbs.org/wgbh/nova/seahorse/vincent.html |archive-date=9 December 2009 |url-status=live}}</ref> and the [[Gill plate trade|gill plates]] of [[mobula]] and [[manta ray]]s.<ref name="Rc0qN">{{cite news|url=http://www.aljazeera.com/programmes/101east/2013/03/201332715299451455.html|title=Diminishing ray of hope| vauthors = Chou CT |date=2 April 2013|work=101 East|publisher=Al Jazeera|access-date=6 May 2013|archive-url=https://web.archive.org/web/20130502175216/http://www.aljazeera.com/programmes/101east/2013/03/201332715299451455.html|archive-date=2 May 2013|url-status=live}}</ref>

Poachers hunt restricted or endangered species to supply the black market with TCM products.<ref name="Weirum">{{Cite web |vauthors = Weirum BK |url=http://www.sfgate.com/cgi-bin/article.cgi?f=/c/a/2007/11/11/TR10T8RBN.DTL |title=Will traditional Chinese medicine mean the end of the wild tiger? |work=San Francisco Chronicle |date=11 November 2007 |access-date=3 June 2020 |archive-url=https://web.archive.org/web/20090201170930/http://www.sfgate.com/cgi-bin/article.cgi?f=%2Fc%2Fa%2F2007%2F11%2F11%2FTR10T8RBN.DTL |archive-date=1 February 2009 |url-status=live}}</ref><ref name="Newscientist.com">{{Cite web |url=https://www.newscientist.com/channel/life/endangered-species/dn3376 |title=Rhino rescue plan decimates Asian antelopes |work=New Scientist |access-date=17 September 2017 |archive-url=https://web.archive.org/web/20080517124015/http://www.newscientist.com/channel/life/endangered-species/dn3376 |archive-date=17 May 2008 |url-status=live}}</ref> There is no scientific evidence of efficacy for tiger medicines.<ref name="Weirum" /> Concern over China considering to legalize the trade in tiger parts prompted the 171-nation [[Convention on International Trade in Endangered Species]] (CITES) to endorse a decision opposing the resurgence of trade in tigers.<ref name="Weirum" /> Fewer than 30,000 [[saiga antelope]]s remain, which are exported to China for use in traditional fever therapies.<ref name="Newscientist.com" /> Organized gangs illegally export the horn of the antelopes to China.<ref name="Newscientist.com" /> The pressures on [[seahorse]]s (''Hippocampus'' spp.) used in traditional medicine is enormous; tens of millions of animals are unsustainably caught annually.<ref name="Vincent2011" /> Many species of [[syngnathid]] are currently part of the [[IUCN Red List of Threatened Species]] or national equivalents.<ref name="Vincent2011">{{cite journal | vauthors = Vincent AC, Foster SJ, Koldewey HJ | title = Conservation and management of seahorses and other Syngnathidae | journal = Journal of Fish Biology | volume = 78 | issue = 6 | pages = 1681–724 | date = June 2011 | pmid = 21651523 | doi = 10.1111/j.1095-8649.2011.03003.x | s2cid = 37920910 }}</ref>

Since TCM recognizes [[bear bile]] as a treatment compound, more than 12,000 [[asiatic black bears]] are held in bear farms. The bile is extracted through a permanent hole in the abdomen leading to the [[gall bladder]], which can cause severe pain. This can lead to bears trying to kill themselves. As of 2012, approximately 10,000 bears are farmed in China for their bile.<ref name="Xia Sheng" /> This practice has spurred public outcry across the country.<ref name="Xia Sheng" /> The bile is collected from live bears via a surgical procedure.<ref name="Xia Sheng">{{cite journal | vauthors = Sheng X, Zhang H, Weng Q | title = Traditional Chinese medicine: China's bear farms prompt public outcry | journal = Nature | volume = 484 | issue = 7395 | pages = 455 | date = April 2012 | pmid = 22538598 | doi = 10.1038/484455c | doi-access = free | bibcode = 2012Natur.484R.455S }}</ref> As of March 2020 bear bile as ingredient  of ''Tan Re Qing'' injection remains on the list of remedies recommended for treatment of "severe cases" of COVID-19 by National Health Commission of China and the National Administration of Traditional Chinese Medicine.<ref name="7CLiE">{{Cite web|title=We've been accused of peddling 'fake news' – so here are the facts about China's recommended use of bear bile - EIA|url=https://eia-international.org/news/weve-been-accused-of-peddling-fake-news-so-here-are-the-facts-about-chinas-recommended-use-of-bear-bile/|website=eia-international.org|language=en|access-date=2020-05-01|archive-url=https://web.archive.org/web/20200516155613/https://eia-international.org/news/weve-been-accused-of-peddling-fake-news-so-here-are-the-facts-about-chinas-recommended-use-of-bear-bile/|archive-date=16 May 2020|url-status=live}}</ref>

The [[deer penis]] is believed to have therapeutic benefits according to traditional Chinese medicine. Tiger parts from poached animals include [[tiger penis]], believed to improve virility, and tiger eyes.<ref name="Harding">{{cite news | vauthors = Harding A  |url=http://news.bbc.co.uk/1/hi/programmes/from_our_own_correspondent/5371500.stm |title=Beijing's penis emporium |work=BBC News |date=23 September 2006 |access-date=16 March 2009 |archive-url=https://web.archive.org/web/20090420070528/http://news.bbc.co.uk/1/hi/programmes/from_our_own_correspondent/5371500.stm |archive-date=20 April 2009 |url-status=live}}</ref> The illegal trade for tiger parts in China has driven the species to near-extinction because of its popularity in traditional medicine.<ref name="JLrVS">{{cite book | vauthors = van Uhm DP |title=The Illegal Wildlife Trade: Inside the World of Poachers, Smugglers and Traders (Studies of Organized Crime) |series=Studies of Organized Crime |date=2016 |volume=15 |publisher=New York: Springer |doi=10.1007/978-3-319-42129-2 |isbn=978-3-319-42128-5 |url=https://www.springer.com/gp/book/9783319421285}}</ref><ref name="Harding" /> Laws protecting even [[critically endangered]] species such as the [[Sumatran tiger]] fail to stop the display and sale of these items in open markets.<ref name="2008 report from TRAFFIC">{{Cite web |url=http://www.traffic.org/home/2008/2/13/tiger-tiger-future-not-so-bright.html |title=2008 report from TRAFFIC |access-date=16 March 2009 |archive-url=https://web.archive.org/web/20090122105541/http://www.traffic.org/home/2008/2/13/tiger-tiger-future-not-so-bright.html |archive-date=22 January 2009 |url-status=live}}</ref> [[Shark fin soup]] is traditionally regarded in Chinese medicine as beneficial for health in East Asia, and its status as an elite dish has led to huge demand with the increase of affluence in China, devastating shark populations.<ref name="Sfgate.com">{{Cite web |url=http://www.sfgate.com/cgi-bin/article.cgi?file=/g/archive/2003/01/20/urbananimal.DTL |title=Shark Fin Soup: An Eco-Catastrophe? |work=San Francisco Chronicle |date=20 January 2003 |access-date=3 June 2020 |archive-url=https://web.archive.org/web/20120614142217/http://www.sfgate.com/cgi-bin/article.cgi?file=%2Fg%2Farchive%2F2003%2F01%2F20%2Furbananimal.DTL |archive-date=14 June 2012 |url-status=live}}</ref> The shark fins have been a part of traditional Chinese medicine for centuries.<ref name="VBTdV">{{Cite web| vauthors = Radford B |date=9 July 2011|title=Sharks Fin Soup Bans Don't Stop Strong Demand|url=https://www.livescience.com/14964-sharks-fin-soup-bans-stop-strong-demand.html|access-date=2020-09-07|website=livescience.com|language=en}}</ref> Shark finning is banned in many countries, but the trade is thriving in Hong Kong and China, where the fins are part of shark fin soup, a dish considered a delicacy, and used in some types of traditional Chinese medicine.<ref name="NaomiNg2013">{{cite web | url=http://www.cnn.com/2013/12/09/world/asia/china-ban-shark-fin/index.html | title=China bans shark fin dishes at official banquets | website=[[CNN]] | date=9 December 2013 | access-date=27 March 2014 | archive-url=https://web.archive.org/web/20140501103823/http://www.cnn.com/2013/12/09/world/asia/china-ban-shark-fin/index.html | archive-date=1 May 2014 | url-status=live}}</ref>

The [[tortoise]] ([[freshwater turtle]], ''guiban'') and turtle ([[Chinese softshell turtle]], ''biejia'') species used in traditional Chinese medicine are raised on farms, while restrictions are made on the accumulation and export of other endangered species.<ref name="dharma4">{{Cite web|url=http://www.itmonline.org/arts/turtles.htm|title=Endangered Species Issues Affecting Turtles And Tortoises Used in Chinese Medicine| vauthors = Dharmananda S |access-date=10 February 2013|archive-url=https://web.archive.org/web/20121004124346/http://www.itmonline.org/arts/turtles.htm|archive-date=4 October 2012|url-status=live}}</ref> However, issues concerning the [[overexploitation]] of Asian turtles in China have not been completely solved.<ref name="dharma4" /> Australian scientists have developed methods to identify medicines containing DNA traces of endangered species.<ref name="REKkt">[http://www.abc.net.au/news/2012-04-13/dna-may-help-weed-out-toxic-chinese-medicine/3949356 DNA may weed out toxic Chinese medicine] {{Webarchive|url=https://web.archive.org/web/20120413211547/http://www.abc.net.au/news/2012-04-13/dna-may-help-weed-out-toxic-chinese-medicine/3949356 |date=13 April 2012}} – By Carolyn Herbert – Australian Broadcasting Corporation – Retrieved 14 April 2012.</ref> Finally, although not an endangered species, sharp rises in exports of donkeys and donkey hide from Africa to China to make the traditional remedy ''ejiao'' have prompted export restrictions by some African countries.<ref name="0VO1T">{{Cite web |url=https://www.independent.co.uk/news/world/asia/china-donkeys-buying-kill-africa-ejiao-medicine-hide-burkina-faso-niger-donkey-shortage-a7339181.html |title=China's quest to buy up global supply of donkeys halted by African nations |work=The Independent |date=30 September 2016 |access-date=17 September 2017 |archive-url=https://web.archive.org/web/20171003171037/http://www.independent.co.uk/news/world/asia/china-donkeys-buying-kill-africa-ejiao-medicine-hide-burkina-faso-niger-donkey-shortage-a7339181.html |archive-date=3 October 2017 |url-status=live}}</ref>

====Human body parts====
{{Main|Traditional Chinese medicines derived from the human body}}
[[File:Ziheche.jpg|thumb|right|Dried [[Placenta|human placenta]] (Ziheche ({{lang|zh|紫河车}}) is used in traditional Chinese medicine.<ref name="Tierra" />]]
Traditional Chinese medicine also includes some human parts: the classic [[Materia medica]] ([[Bencao Gangmu]]) describes (also criticizes) the use of 35 human body parts and [[excreta]] in medicines, including bones, fingernail, hairs, dandruff, earwax, impurities on the teeth, feces, urine, sweat, organs, but most are no longer in use.<ref name="HDCM">{{cite book |doi=10.1007/0-306-46867-0_7 |chapter='Human Drugs' in Chinese Medicine and the Confucian View: An Interpretive Study |title=Confucian Bioethics |year=1999 |last1=Nie |first1=Jing-Bao |pages=167–206 |isbn=978-0-7923-5723-0 }}</ref><ref name="HBNC">THE HUMAN BODY AS A NEW COMMODITY, Tsuyoshi Awaya, The Review of Tokuyama, June 1999</ref><ref name="CBSH">Commodifying bodies, Nancy Scheper-Hughes, Loïc J. D. Wacquant, 2002</ref>

Human placenta has been used an ingredient in certain traditional Chinese medicines,<ref name="News-Medical.Net">{{Cite news |url=http://www.news-medical.net/print_article.asp?id=1333 |title=Traditional Chinese medicine contains human placenta |publisher=News-Medical.Net |date=8 May 2004 |access-date=29 April 2014 |archive-url=https://web.archive.org/web/20090116073621/http://www.news-medical.net/print_article.asp?id=1333 |archive-date=16 January 2009 |url-status=live}}</ref> including using dried human placenta, known as "Ziheche", to treat infertility, impotence and other conditions.<ref name="Tierra">{{Cite book | vauthors = Tierra L, Tierra M |title=Chinese traditional herbal medicine |publisher=Lotus Light Pub |location=Twin Lakes, WI |year=1998 |isbn=978-0-914955-32-0 | pages = [https://books.google.com/books?id=Zm6QTqNt3JEC&pg=PT225#v=onepage&q&f=false 225]}}</ref> The consumption of the human placenta is a potential source of infection.<ref name="News-Medical.Net" />

===Traditional categorization===
The traditional categorizations and classifications that can still be found today are:
* The classification according to the [[Chinese herbology#Four Natures|Four Natures]] ({{zh|labels=no|c=四气|p=sì qì}}): hot, warm, cool, or cold (or, neutral in terms of temperature)<ref name="Ergil 2009" /> and hot and warm herbs are used to treat [[#Eight principles of diagnosis|cold]] diseases, while cool and cold herbs are used to treat heat diseases.<ref name="Ergil 2009" />
* The classification according to the [[Chinese herbology#The Five Tastes|Five Flavors]], ({{zh|labels=no|c=五味 |p=wǔ wèi}}, sometimes also translated as Five Tastes): acrid, sweet, bitter, sour, and salty.<ref name="Ergil 2009" /> Substances may also have more than one flavor, or none (i.e., a "bland" flavor).<ref name="Ergil 2009" /> Each of the Five Flavors corresponds to one of zàng organs, which in turn corresponds to one of the [[#Five Phases theory|Five Phases]].<ref name="Ergil 2009" /> A flavor implies certain properties and therapeutic actions of a substance; e.g., saltiness drains downward and softens hard masses, while sweetness is supplementing, harmonizing, and moistening.<ref name="Ergil 2009" />
* The classification according to the meridian – more precisely, the zàng-fu organ including its associated meridian – which can be expected to be primarily affected by a given compound.<ref name="Ergil 2009" />
* The categorization according to the specific function mainly include: exterior-releasing<ref name="Xu 2002" /> or exterior-resolving,<ref name="Ergil 2009" /> heat-clearing,<ref name="Ergil 2009" /><ref name="Xu 2002" /> downward-draining,<ref name="Xu 2002" /> or precipitating<ref name="Ergil 2009" /> wind-damp-dispelling,<ref name="Ergil 2009" /><ref name="Xu 2002" /> dampness-transforming,<ref name="Ergil 2009" /><ref name="Xu 2002" /> promoting the movement of water and percolating dampness<ref name="Xu 2002" /> or dampness-percolating,<ref name="Ergil 2009" /> interior-warming,<ref name="Ergil 2009" /><ref name="Xu 2002" /> qi-regulating<ref name="Xu 2002" /> or qi-rectifying,<ref name="Ergil 2009" /> dispersing food accumulation<ref name="Xu 2002" /> or food-dispersing,<ref name="Ergil 2009" /> worm-expelling,<ref name="Ergil 2009" /><ref name="Xu 2002" /> stopping bleeding<ref name="Xu 2002" /> or blood-[[wikt:stanching|stanching]],<ref name="Ergil 2009" /> quickening the Blood and dispelling [[stasis (medicine)|stasis]]<ref name="Xu 2002" /> or blood-quickening,<ref name="Ergil 2009" /> transforming phlegm, stopping coughing and calming wheezing<ref name="Xu 2002" /> or phlegm-transforming and cough- and panting-suppressing,<ref name="Ergil 2009" /> Spirit-quieting,<ref name="Ergil 2009" /><ref name="Xu 2002" /> calming the liver and expelling wind<ref name="Ergil 2009" /> or liver-calming and wind-extinguishing<ref name="Ergil 2009" /> orifice-opening<ref name="Ergil 2009" /><ref name="Xu 2002" /> supplementing<ref name="Ergil 2009" /><ref name="Xu 2002" /> which includes qi-supplementing, blood-nourishing, yin-enriching, and yang-fortifying,<ref name="Ergil 2009" /> astriction-promoting<ref name="Xu 2002" /> or securing and astringing,<ref name="Ergil 2009" /> vomiting-inducing,<ref name="Xu 2002" /> and substances for external application.<ref name="Ergil 2009" /><ref name="Xu 2002">Xu, L. & Wang, W. (2002) [https://books.google.com/books?id=36dhuXGm3OgC&pg=PA1&dq=traditional+chinese+medicine+herb&hl=zh-CN#v=onepage&q=traditional%20chinese%20medicine%20herb&f=false "Chinese materia medica: combinations and applications"] Donica Publishing Ltd. 1st edition. {{ISBN|978-1-901149-02-9}}</ref>

===Efficacy===
{{Asof|2007}} there were not enough good-quality trials of herbal therapies to allow their effectiveness to be determined.<ref name="Shang-2007">{{cite journal | vauthors = Shang A, Huwiler K, Nartey L, Jüni P, Egger M | title = Placebo-controlled trials of Chinese herbal medicine and conventional medicine comparative study | journal = International Journal of Epidemiology | volume = 36 | issue = 5 | pages = 1086–92 | date = October 2007 | pmid = 17602184 | doi = 10.1093/ije/dym119 | doi-access = free }}</ref> A high percentage of relevant studies on traditional Chinese medicine are in Chinese databases. Fifty percent of systematic reviews on TCM did not search Chinese databases, which could lead to a bias in the results.<ref name="DhORr">{{cite journal | vauthors = Wu XY, Tang JL, Mao C, Yuan JQ, Qin Y, Chung VC | title = Systematic reviews and meta-analyses of traditional chinese medicine must search chinese databases to reduce language bias | journal = Evidence-Based Complementary and Alternative Medicine | volume = 2013 | pages = 812179 | year = 2013 | pmid = 24223063 | pmc = 3816048 | doi = 10.1155/2013/812179 | doi-access = free }}</ref> Many systematic reviews of TCM interventions published in Chinese journals are incomplete, some contained errors or were misleading.<ref name="TUZvn">{{cite journal | vauthors = Ma B, Guo J, Qi G, Li H, Peng J, Zhang Y, Ding Y, Yang K | display-authors = 6 | title = Epidemiology, quality and reporting characteristics of systematic reviews of traditional Chinese medicine interventions published in Chinese journals | journal = PLOS ONE | volume = 6 | issue = 5 | pages = e20185 | year = 2011 | pmid = 21633698 | pmc = 3102106 | doi = 10.1371/journal.pone.0020185 | veditors = Hartling L | bibcode = 2011PLoSO...620185M | doi-access = free }}</ref> The herbs recommended by traditional Chinese practitioners in the US are unregulated.<ref name="HumberAlmeder2013">{{cite book| vauthors = Humber JM, Almeder RF |title=Alternative Medicine and Ethics|url=https://books.google.com/books?id=ehWzBwAAQBAJ&pg=PA10|date=9 March 2013|publisher=Springer Science & Business Media|isbn=978-1-4757-2774-6|pages=10–|access-date=18 February 2016|archive-url=https://web.archive.org/web/20160821092847/https://books.google.com/books?id=ehWzBwAAQBAJ&pg=PA10|archive-date=21 August 2016|url-status=live}}</ref>
* A 2013 review found the data too weak to support use of Chinese herbal medicine (CHM) for [[benign prostatic hyperplasia]].<ref name="FyK0S">{{cite journal | vauthors = Ma CH, Lin WL, Lui SL, Cai XY, Wong VT, Ziea E, Zhang ZJ | title = Efficacy and safety of Chinese herbal medicine for benign prostatic hyperplasia: systematic review of randomized controlled trials | journal = Asian Journal of Andrology | volume = 15 | issue = 4 | pages = 471–82 | date = July 2013 | pmid = 23728585 | pmc = 3739225 | doi = 10.1038/aja.2012.173 }}</ref>
* A 2013 review found the research on the benefit and safety of CHM for idiopathic sudden sensorineural hearing loss is of poor quality and cannot be relied upon to support their use.<ref name="ztPPx">{{cite journal | vauthors = Su CX, Yan LJ, Lewith G, Liu JP | title = Chinese herbal medicine for idiopathic sudden sensorineural hearing loss: a systematic review of randomised clinical trials | journal = Clinical Otolaryngology | volume = 38 | issue = 6 | pages = 455–73 | date = December 2013 | pmid = 24209508 | doi = 10.1111/coa.12198 | s2cid = 35688209 }}</ref>
* A 2013 [[Cochrane review]] found inconclusive evidence that CHM reduces the severity of eczema.<ref name="PS71S">{{cite journal | vauthors = Gu S, Yang AW, Xue CC, Li CG, Pang C, Zhang W, Williams HC | title = Chinese herbal medicine for atopic eczema | journal = The Cochrane Database of Systematic Reviews | volume = 9 | issue = 9 | pages = CD008642 | date = September 2013 | pmid = 24018636 | doi = 10.1002/14651858.CD008642.pub2 | url = http://handle.uws.edu.au:8081/1959.7/530887 | veditors = Gu S }}</ref>
* The traditional medicine ginger, which has shown anti-inflammatory properties in laboratory experiments, has been used to treat [[rheumatism]], headache and digestive and respiratory issues, though there is no firm evidence supporting these uses.<ref name="BvceJ">{{cite journal | vauthors = Leonti M, Casu L | title = Traditional medicines and globalization: current and future perspectives in ethnopharmacology | journal = Frontiers in Pharmacology | volume = 4 | pages = 92 | year = 2013 | pmid = 23898296 | pmc = 3722488 | doi = 10.3389/fphar.2013.00092 | doi-access = free }}</ref>
* A 2012 Cochrane review found no difference in [[mortality rate]] among 640 SARS patients when Chinese herbs were used alongside Western medicine versus Western medicine exclusively, although they concluded some herbs may have improved symptoms and decreased corticosteroid doses.<ref name="3ab7r">{{cite journal | vauthors = Liu X, Zhang M, He L, Li Y | title = Chinese herbs combined with Western medicine for severe acute respiratory syndrome (SARS) | journal = The Cochrane Database of Systematic Reviews | volume = 10 | pages = CD004882 | date = October 2012 | pmid = 23076910 | pmc = 6993561 | doi = 10.1002/14651858.CD004882.pub3 | veditors = Li Y  }}</ref>
* A 2012 Cochrane review found insufficient evidence to support the use of TCM for people with adhesive small bowel obstruction.<ref name="BEEp3">{{cite journal | vauthors = Suo T, Gu X, Andersson R, Ma H, Zhang W, Deng W, Zhang B, Cai D, Qin X | display-authors = 6 | title = Oral traditional Chinese medication for adhesive small bowel obstruction | journal = The Cochrane Database of Systematic Reviews | volume = 5 | issue = 5 | pages = CD008836 | date = May 2012 | pmid = 22592734 | doi = 10.1002/14651858.CD008836.pub2 | veditors = Qin X }}</ref>
* A 2011 review found low quality evidence that suggests CHM improves the symptoms of Sjogren's syndrome.<ref name="9SvbV">{{cite journal | vauthors = Luo H, Han M, Liu JP | title = [Systematic review and meta-analysis of randomized controlled trials of Chinese herbal medicine in the treatment of Sjogren's syndrome] | journal = Zhong Xi Yi Jie He Xue Bao = Journal of Chinese Integrative Medicine | volume = 9 | issue = 3 | pages = 257–74 | date = March 2011 | pmid = 21419078 | doi = 10.3736/jcim20110306 }}</ref>
*A 2011 Cochrane review found inconclusive evidence to support the use of TCM herbal medicines for treatment of [[hypercholesterolemia]].<ref name=":1">{{Cite journal|last1=Liu|first1=Zhao Lan|last2=Liu|first2=Jian Ping|last3=Zhang|first3=Anthony Lin|last4=Wu|first4=Qiong|last5=Ruan|first5=Yao|last6=Lewith|first6=George|last7=Visconte|first7=Denise|date=2011-07-05|editor-last=Cochrane Metabolic and Endocrine Disorders Group|title=Chinese herbal medicines for hypercholesterolemia|journal=Cochrane Database of Systematic Reviews|issue=7|pages=CD008305|language=en|doi=10.1002/14651858.CD008305.pub2|pmid=21735427|pmc=3402023}}</ref>
* A 2011 Cochrane review did not find improvement in fasting [[C-peptide]] when compared to [[insulin]] treatment for [[Latent autoimmune diabetes in adults|Latent Autoimmune Diabetes]] in adults after 3 months. It is important to highlight that the studies available to be included in this review presented considerable flaws in quality and design.<ref>{{Cite journal |last=Brophy |first=Sinead |last2=Davies |first2=Helen |last3=Mannan |first3=Sopna |last4=Brunt |first4=Huw |last5=Williams |first5=Rhys |date=2011-09-07 |title=Interventions for latent autoimmune diabetes (LADA) in adults |url=https://doi.org/10.1002/14651858.CD006165.pub3 |journal=Cochrane Database of Systematic Reviews |doi=10.1002/14651858.cd006165.pub3 |issn=1465-1858 |pmc=6486159 |pmid=21901702}}</ref>
* A 2010 review found TCM seems to be effective for the treatment of fibromyalgia but the findings were of insufficient methodological rigor.<ref name="UqEpQ">{{cite journal | vauthors = Cao H, Liu J, Lewith GT | title = Traditional Chinese Medicine for treatment of fibromyalgia: a systematic review of randomized controlled trials | journal = Journal of Alternative and Complementary Medicine | volume = 16 | issue = 4 | pages = 397–409 | date = April 2010 | pmid = 20423209 | pmc = 3110829 | doi = 10.1089/acm.2009.0599 }}</ref>
* A 2008 Cochrane review found promising evidence for the use of Chinese herbal medicine in relieving [[dysmenorrhea|painful menstruation]], but the trials assessed were of such low methodological quality that no conclusion could be drawn about the remedies' suitability as a recommendable treatment option.<ref name="mTlKH">{{cite journal | vauthors = Zhu X, Proctor M, Bensoussan A, Wu E, Smith CA | title = Chinese herbal medicine for primary dysmenorrhoea | journal = The Cochrane Database of Systematic Reviews | issue = 2 | pages = CD005288 | date = April 2008 | pmid = 18425916 | doi = 10.1002/14651858.CD005288.pub3 | veditors = Zhu X }}</ref>
* [[Turmeric]] has been used in traditional Chinese medicine for centuries to treat various conditions.<ref name="Gautam" /> This includes jaundice and hepatic disorders, rheumatism, anorexia, diabetic wounds, and menstrual complications.<ref name="Gautam" /> Most of its effects have been attributed to [[curcumin]].<ref name="Gautam" /> Research that curcumin shows strong anti-inflammatory and antioxidant activities have instigated mechanism of action studies on the possibility for cancer and inflammatory diseases prevention and treatment.<ref name="Gautam" /> It also exhibits [[immunomodulatory]] effects.<ref name="Gautam">{{cite book |doi=10.1007/978-0-387-46401-5_14 |chapter=Immunomodulation by Curcumin |title=The Molecular Targets and Therapeutic Uses of Curcumin in Health and Disease |series=Advances in Experimental Medicine and Biology |year=2007 |last1=Gautam |first1=Subhash C. |last2=Gao |first2=Xiaohua |last3=Dulchavsky |first3=Scott |volume=595 |pages=321–341 |pmid=17569218 |isbn=978-0-387-46400-8 }}</ref>
* A 2005 Cochrane review found insufficient evidence for the use of CHM in HIV-infected people and people with [[HIV/AIDS|AIDS]].<ref name="PNBAI">{{cite journal | vauthors = Liu JP, Manheimer E, Yang M | title = Herbal medicines for treating HIV infection and AIDS | journal = The Cochrane Database of Systematic Reviews | issue = 3 | pages = CD003937 | date = July 2005 | volume = 2010 | pmid = 16034917 | doi = 10.1002/14651858.CD003937.pub2 | pmc = 8759069 | veditors = Liu JP }}</ref>
* A 2010 Cochrane review found insufficient evidence to support the use of Traditional Chinese Herbal Products (THCP) in the treatment of [[angina]].<ref name="vfVTP">{{cite journal | vauthors = Zhuo Q, Yuan Z, Chen H, Wu T | title = Traditional Chinese herbal products for stable angina | journal = The Cochrane Database of Systematic Reviews | issue = 5 | pages = CD004468 | date = May 2010 | pmid = 20464731 | pmc = 6718232 | doi = 10.1002/14651858.cd004468.pub2 }}</ref>
* A 2010 Cochrane review found no evidence supporting the use of TCHM for stopping bleeding from [[Hemorrhoid|haemorrhoids]]. There was some weak evidence of pain relief.<ref name="vkl5u">{{cite journal | vauthors = Gan T, Liu YD, Wang Y, Yang J | title = Traditional Chinese Medicine herbs for stopping bleeding from haemorrhoids | journal = The Cochrane Database of Systematic Reviews | issue = 10 | pages = CD006791 | date = October 2010 | pmid = 20927750 | doi = 10.1002/14651858.cd006791.pub2 }}</ref>

====Drug research====
{{Further|Arsenic trioxide|Artemisinin|Huperzine A|Ephedrine}}
[[File:Artemisia annua(01).jpg|thumb|upright|''[[Artemisia annua]]'', traditionally used to treat fever, has been found to have [[malaria|antimalarial]] properties.<ref name="swallow" />]]
With an eye to the enormous Chinese market, pharmaceutical companies have explored creating new drugs from traditional remedies. The journal ''Nature'' commented that  "claims made on behalf of an uncharted body of knowledge should be treated with the customary skepticism that is the bedrock of both science and medicine."<ref name="swallow">{{cite journal | vauthors =  | title = Hard to swallow | journal = Nature | volume = 448 | issue = 7150 | pages = 105–6 | date = July 2007 | pmid = 17625521 | doi = 10.1038/448106a | quote = Constructive approaches to divining the potential usefulness of traditional therapies are to be welcomed. But it seems problematic to apply a brand new technique, largely untested in the clinic, to test the veracity of traditional Chinese medicine, when the field is so fraught with pseudoscience. In the meantime, claims made on behalf of an uncharted body of knowledge should be treated with the customary skepticism that is the bedrock of both science and medicine. | doi-access = free | bibcode = 2007Natur.448S.105. }}</ref>

There had been success in the 1970s, however, with the development of the antimalarial drug [[artemisinin]], which is a processed extract of ''[[Artemisia annua]]'', a herb traditionally used as a fever treatment.<ref name="swallow" /><ref name="Su 2011">{{cite journal | vauthors = Miller LH, Su X | title = Artemisinin: discovery from the Chinese herbal garden | journal = Cell | volume = 146 | issue = 6 | pages = 855–8 | date = September 2011 | pmid = 21907397 | pmc = 3414217 | doi = 10.1016/j.cell.2011.08.024 }}</ref> ''Artemisia annua'' has been used by Chinese herbalists in traditional Chinese medicines for 2,000 years. In 1596, Li Shizhen recommended tea made from qinghao specifically to treat malaria symptoms in his ''[[Compendium of Materia Medica]]''. Researcher [[Tu Youyou]] discovered that a low-temperature extraction process could isolate an effective antimalarial substance from the plant.<ref name="scimag" /> Tu says she was influenced by a traditional Chinese herbal medicine source, ''The Handbook of Prescriptions for Emergency Treatments'', written in 340 by [[Ge Hong]], which states that this herb should be steeped in cold water.<ref name="scimag">{{cite web |url=http://news.sciencemag.org/asia/2011/09/lasker-award-rekindles-debate-over-artemisinins-discovery |title=Lasker Award Rekindles Debate Over Artemisinin's Discovery &#124; Science/AAAS |publisher=News.sciencemag.org |access-date=7 January 2014 |date=29 September 2011 |archive-url=https://web.archive.org/web/20140104214759/http://news.sciencemag.org/asia/2011/09/lasker-award-rekindles-debate-over-artemisinins-discovery |archive-date=4 January 2014 |url-status=live}}</ref> The extracted substance, once subject to detoxification and purification processes, is a usable antimalarial drug<ref name="Su 2011" /> – a 2012 review found that artemisinin-based remedies were the most effective drugs for the treatment of malaria.<ref name="h0dmr">{{cite journal | vauthors = Fairhurst RM, Nayyar GM, Breman JG, Hallett R, Vennerstrom JL, Duong S, Ringwald P, Wellems TE, Plowe CV, Dondorp AM | display-authors = 6 | title = Artemisinin-resistant malaria: research challenges, opportunities, and public health implications | journal = The American Journal of Tropical Medicine and Hygiene | volume = 87 | issue = 2 | pages = 231–241 | date = August 2012 | pmid = 22855752 | pmc = 3414557 | doi = 10.4269/ajtmh.2012.12-0025 }}</ref> For her work on malaria, Tu received the 2015 [[Nobel Prize in Physiology or Medicine]]. Despite global efforts in combating malaria, it remains a large burden for the population.<ref name="Chrubasik 2010" /> Although [[WHO]] recommends artemisinin-based remedies for treating uncomplicated malaria,  but resistance to the drug can no longer be ignored.<ref name="Chrubasik 2010">{{cite journal | vauthors = Chrubasik C, Jacobson RL | title = The development of artemisinin resistance in malaria: reasons and solutions | journal = Phytotherapy Research | volume = 24 | issue = 7 | pages = 1104–6 | date = July 2010 | pmid = 20578122 | doi = 10.1002/ptr.3133 | s2cid = 37901416 }}</ref><ref name="CtwCp">{{Cite web|title=The Nobel Prize in Physiology or Medicine 2015|url=https://www.nobelprize.org/prizes/medicine/2015/tu/facts/|website=NobelPrize.org|language=en-US|access-date=2020-05-21|archive-url=https://web.archive.org/web/20200422125851/https://www.nobelprize.org/prizes/medicine/2015/tu/facts/|archive-date=22 April 2020|url-status=live}}</ref>

Also in the 1970s Chinese researcher [[Zhang TingDong]] and colleagues investigated the potential use of the traditionally used substance [[arsenic trioxide]] to treat [[acute promyelocytic leukemia]] (APL).<ref name="dfp">{{cite journal | vauthors = Rao Y, Li R, Zhang D | title = A drug from poison: how the therapeutic effect of arsenic trioxide on acute promyelocytic leukemia was discovered | journal = Science China Life Sciences | volume = 56 | issue = 6 | pages = 495–502 | date = June 2013 | pmid = 23645104 | doi = 10.1007/s11427-013-4487-z | doi-access = free }}</ref> Building on his work, research both in China and the West eventually led to the development of the drug [[Trisenox]], which was approved for leukemia treatment by the FDA in 2000.<ref name="VonXd">{{cite journal | vauthors = Bian Z, Chen S, Cheng C, Wang J, Xiao H, Qin H |doi=10.1016/j.apsb.2011.12.007|title=Developing new drugs from annals of Chinese medicine|year=2012 |journal=Acta Pharmaceutica Sinica B|volume=2|pages=1–7|name-list-style=vanc|doi-access=free}}</ref>

[[Huperzine A]], an extract from the herb, ''[[Huperzia serrata]]'', is under preliminary research as a possible therapeutic for Alzheimer's disease, but poor methodological quality of the research restricts conclusions about its effectiveness.<ref name="SfkqU">{{cite journal | vauthors = Yang G, Wang Y, Tian J, Liu JP | title = Huperzine A for Alzheimer's disease: a systematic review and meta-analysis of randomized clinical trials | journal = PLOS ONE | volume = 8 | issue = 9 | pages = e74916 | year = 2013 | pmid = 24086396 | pmc = 3781107 | doi = 10.1371/journal.pone.0074916 | veditors = Scherer RW | bibcode = 2013PLoSO...874916Y | doi-access = free }}</ref>

[[Ephedrine]] in its natural form, known as ''má huáng'' ({{lang|zh|麻黄}}) in TCM, has been documented in China since the [[Han dynasty]] (206 BCE – 220 CE) as an [[Asthma|antiasthmatic]] and stimulant.<ref name="principles">{{cite book| vauthors= Levy WO, Kalidas K, Miller NS |title=Principles of Addictions and the Law: Applications in Forensic, Mental Health, and Medical Practice|date=26 February 2010|publisher=Academic Press|isbn=978-0-12-496736-6|pages=307–08}}</ref> In 1885, the chemical synthesis of ephedrine was first accomplished by Japanese [[organic chemist]] [[Nagai Nagayoshi]] based on his research on [[Japanese traditional medicine|Japanese]] and Chinese traditional herbal medicines<ref name="7Oug3">{{cite book| vauthors = Lock  |title=East Asian Medicine in Urban Japan: Varieties of Medical Experience|year=1984|publisher= University of California Press; Reprint edition|isbn=978-0-520-05231-4}}</ref>

[[Pien tze huang]] was first documented in the [[Ming dynasty]].

====Cost-effectiveness====
A 2012 systematic review found there is a lack of available [[cost-effectiveness]] evidence in TCM.<ref name="Zhang2012">{{cite journal | vauthors = Zhang F, Kong LL, Zhang YY, Li SC | title = Evaluation of impact on health-related quality of life and cost effectiveness of Traditional Chinese Medicine: a systematic review of randomized clinical trials | journal = Journal of Alternative and Complementary Medicine | volume = 18 | issue = 12 | pages = 1108–20 | date = December 2012 | pmid = 22924383 | doi = 10.1089/acm.2011.0315 }}</ref>

===Safety===
[[File:Calcite-Galena-elm56c.jpg|thumb|right|upright|Galena (lead ore) is part of historical TCM.<ref name="galena" />
Standard American TCM practice considers lead-containing herbs obsolete.<ref name="futoV">{{cite book | vauthors = Bensky D | author-link = Dan Bensky | title = Chinese Herbal Medicine Materia Medica | publisher = [[Eastland Press Inc.]] | edition = 3 | location = Seattle | date = 2004 | page = 1042 | isbn = 978-0-939616-4-28}}</ref>]]
From the earliest records regarding the use of compounds to today, the toxicity of certain substances has been described in all Chinese materiae medicae.<ref name="Ergil 2009" /> Since TCM has become more popular in the Western world, there are increasing concerns about the potential toxicity of many traditional Chinese plants, animal parts and minerals.<ref name="Shaw-2012" /> Traditional Chinese herbal remedies are conveniently available from grocery stores in most Chinese neighborhoods; some of these items may contain toxic ingredients, are imported into the U.S. illegally, and are associated with claims of therapeutic benefit without evidence.<ref name="LICHT">{{cite journal | vauthors = Ko RJ, Greenwald MS, Loscutoff SM, Au AM, Appel BR, Kreutzer RA, Haddon WF, Jackson TY, Boo FO, Presicek G | display-authors = 6 | title = Lethal ingestion of Chinese herbal tea containing ch'an su | journal = The Western Journal of Medicine | volume = 164 | issue = 1 | pages = 71–5 | date = January 1996 | pmid = 8779214 | pmc = 1303306 }}</ref> For most compounds, efficacy and toxicity testing are based on traditional knowledge rather than laboratory analysis.<ref name="Shaw-2012">{{cite journal | vauthors = Shaw D | title = Toxicological risks of Chinese herbs | journal = Planta Medica | volume = 76 | issue = 17 | pages = 2012–8 | date = December 2010 | pmid = 21077025 | doi = 10.1055/s-0030-1250533 | doi-access = free }}</ref> The toxicity in some cases could be confirmed by modern research (i.e., in scorpion); in some cases it could not (i.e., in ''[[Curculigo]]'').<ref name="Ergil 2009" /> Traditional herbal medicines can contain extremely toxic chemicals and heavy metals, and naturally occurring toxins, which can cause illness, exacerbate pre-existing poor health or result in death.<ref name="0tADw">{{cite journal | vauthors = Byard RW | title = A review of the potential forensic significance of traditional herbal medicines | journal = Journal of Forensic Sciences | volume = 55 | issue = 1 | pages = 89–92 | date = January 2010 | pmid = 20412155 | doi = 10.1111/j.1556-4029.2009.01252.x | url = http://www.adelaide.edu.au/news/binary5521/Journal.pdf | access-date = 24 October 2017 | url-status = live | s2cid = 205768581 | citeseerx = 10.1.1.627.5612 | archive-url = https://web.archive.org/web/20170809110132/http://www.adelaide.edu.au/news/binary5521/Journal.pdf | archive-date = 9 August 2017 }}</ref> Botanical misidentification of plants can cause toxic reactions in humans.<ref name="Efferth2011" /> The description of some plants used in TCM has changed, leading to unintended poisoning by using the wrong plants.<ref name="Efferth2011" /> A concern is also contaminated herbal medicines with microorganisms and fungal toxins, including [[aflatoxin]].<ref name="Efferth2011">{{cite journal | vauthors = Efferth T, Kaina B | title = Toxicities by herbal medicines with emphasis to traditional Chinese medicine | journal = Current Drug Metabolism | volume = 12 | issue = 10 | pages = 989–96 | date = December 2011 | pmid = 21892916 | doi = 10.2174/138920011798062328 }}</ref> Traditional herbal medicines are sometimes contaminated with toxic heavy metals, including lead, arsenic, mercury and cadmium, which inflict serious health risks to consumers.<ref name="zkc6B">{{cite journal | vauthors = Yuan X, Chapman RL, Wu Z | title = Analytical methods for heavy metals in herbal medicines | journal = Phytochemical Analysis | volume = 22 | issue = 3 | pages = 189–98 | year = 2011 | pmid = 21341339 | doi = 10.1002/pca.1287 }}</ref> Also, adulteration of some herbal medicine preparations with conventional drugs which may cause serious adverse effects, such as [[corticosteroid]]s, [[phenylbutazone]], [[phenytoin]], and [[glibenclamide]], has been reported.<ref name="Efferth2011" /><ref name="Ernst2002">{{cite journal | vauthors = Ernst E | title = Adulteration of Chinese herbal medicines with synthetic drugs: a systematic review | journal = Journal of Internal Medicine | volume = 252 | issue = 2 | pages = 107–13 | date = August 2002 | pmid = 12190885 | doi = 10.1046/j.1365-2796.2002.00999.x | type = Systematic Review | s2cid = 29077682 }}{{open access}}</ref>

Substances known to be potentially dangerous include ''[[Aconitum]]'',<ref name="Ergil 2009" /><ref name="Shaw-2012" /> secretions from the [[Asiatic toad]],<ref name="LICHT"/> powdered centipede,<ref name="CAT">{{cite web |url=http://www.acupuncturetoday.com/herbcentral/centipede.php |title=Centipede, Acupuncture Today |publisher=Acupuncturetoday.com |access-date=17 May 2011 |archive-url=https://web.archive.org/web/20110707082229/http://www.acupuncturetoday.com/herbcentral/centipede.php |archive-date=7 July 2011 |url-status=live}}</ref> the Chinese beetle (''[[Mylabris phalerata]]''),<ref name="IDCD">{{cite journal | vauthors = Namba T, Ma YH, Inagaki K | title = Insect-derived crude drugs in the Chinese Song dynasty | journal = Journal of Ethnopharmacology | volume = 24 | issue = 2–3 | pages = 247–85 | date = December 1988 | pmid = 3075674 | doi = 10.1016/0378-8741(88)90157-2 }}</ref> certain fungi,<ref name="2RQlq">{{cite journal | vauthors = Wang XP, Yang RM | title = Movement disorders possibly induced by traditional chinese herbs | journal = European Neurology | volume = 50 | issue = 3 | pages = 153–9 | year = 2003 | pmid = 14530621 | doi = 10.1159/000073056 | s2cid = 43878555 }}</ref> ''[[Aristolochia]]'',<ref name="Shaw-2012" /> arsenic sulfide ([[realgar]]),<ref name="Genuis2012" /> mercury sulfide,<ref name="AsaNP">{{cite journal |last1=Wong |first1=H.C. George |title=Mercury and Chinese herbal medicine {{!}} British Columbia Medical Journal |journal=BCMJ |date=November 2004 |volume=46 |issue=9 |pages=442 |url=https://bcmj.org/letters/mercury-and-chinese-herbal-medicine }}</ref> and [[cinnabar]].<ref name="F1lej">{{cite journal | vauthors = Huang CF, Hsu CJ, Liu SH, Lin-Shiau SY | title = Exposure to low dose of cinnabar (a naturally occurring mercuric sulfide (HgS)) caused neurotoxicological effects in offspring mice | journal = Journal of Biomedicine & Biotechnology | volume = 2012 | pages = 254582 | year = 2012 | pmid = 22888198 | pmc = 3408718 | doi = 10.1155/2012/254582 | doi-access = free }}</ref> Asbestos ore ([[Actinolite]], Yang Qi Shi, 阳起石) is used to treat impotence in TCM.<ref name="ERTCM">''Encyclopedic Reference of Traditional Chinese Medicine'', Xinrong Yang, p. 8, [https://books.google.com/books?hl=en&lr=&id=mwol-baZYMEC&oi=fnd&pg=PA1&dq=Actinolite+toxic+%22traditional+chinese+medicine%22&ots=l_SDqCIZiJ&sig=lkBNJXF4HINqXZg-GG0Sl5Rc6o0#v=onepage&q=actinolite&f=false] {{Webarchive|url=https://web.archive.org/web/20160302164242/https://books.google.com/books?hl=en&lr=&id=mwol-baZYMEC&oi=fnd&pg=PA1&dq=Actinolite+toxic+%22traditional+chinese+medicine%22&ots=l_SDqCIZiJ&sig=lkBNJXF4HINqXZg-GG0Sl5Rc6o0#v=onepage&q=actinolite&f=false |date=2 March 2016}}</ref> Due to [[galena]]'s ([[litharge]], [[lead(II) oxide]]) high lead content, it is known to be toxic.<ref name="galena">{{Cite web |url=http://www.acupuncturetoday.com/herbcentral/galena.php |title=Galena, Acupuncture Today |access-date=7 March 2011 |archive-url=https://web.archive.org/web/20110312051005/http://www.acupuncturetoday.com/herbcentral/galena.php |archive-date=12 March 2011 |url-status=live}}</ref> Lead, mercury, arsenic, copper, cadmium, and thallium have been detected in TCM products sold in the U.S. and China.<ref name="Genuis2012">{{cite journal | vauthors = Genuis SJ, Schwalfenberg G, Siy AK, Rodushkin I | title = Toxic element contamination of natural health products and pharmaceutical preparations | journal = PLOS ONE | volume = 7 | issue = 11 | pages = e49676 | year = 2012 | pmid = 23185404 | pmc = 3504157 | doi = 10.1371/journal.pone.0049676 | bibcode = 2012PLoSO...749676G | doi-access = free }}</ref>

To avoid its toxic adverse effects ''[[Xanthium sibiricum]]'' must be processed.<ref name="Shaw-2012" /> [[Hepatotoxicity]] has been reported with products containing ''[[Reynoutria multiflora]]'' ([[Synonym (taxonomy)|synonym]] ''Polygonum multiflorum''), [[glycyrrhizin]], ''[[Senecio]]'' and ''[[Symphytum]]''.<ref name="Shaw-2012" /> The herbs indicated as being hepatotoxic included ''[[Dictamnus dasycarpus]]'', ''[[Astragalus membranaceous]]'', and ''[[Paeonia lactiflora]]''.<ref name="Shaw-2012" /> Contrary to popular belief, ''[[Ganoderma lucidum]]'' mushroom extract, as an adjuvant for cancer immunotherapy, appears to have the potential for toxicity.<ref name="LloIl">{{cite journal | vauthors = Gill SK, Rieder MJ | title = Toxicity of a traditional Chinese medicine, Ganoderma lucidum, in children with cancer | journal = The Canadian Journal of Clinical Pharmacology | volume = 15 | issue = 2 | pages = e275-85 | year = 2008 | pmid = 18603664 }}</ref> A 2013 review suggested that although the [[Antimalarial medication|antimalarial]] herb ''[[Artemisia annua]]'' may not cause hepatotoxicity, haematotoxicity, or hyperlipidemia, it should be used cautiously during pregnancy due to a potential risk of embryotoxicity at a high dose.<ref name="oSYtW">{{cite journal | vauthors = Abolaji AO, Eteng MU, Ebong PE, Brisibe EA, Dar A, Kabir N, Choudhary MI | title = A safety assessment of the antimalarial herb Artemisia annua during pregnancy in Wistar rats | journal = Phytotherapy Research | volume = 27 | issue = 5 | pages = 647–54 | date = May 2013 | pmid = 22736625 | doi = 10.1002/ptr.4760 | s2cid = 22650085 }}</ref>

However, many adverse reactions are due to misuse or abuse of Chinese medicine.<ref name="Shaw-2012" /> For example, the misuse of the dietary supplement ''[[Ephedra (plant)|Ephedra]]'' (containing ephedrine) can lead to adverse events including gastrointestinal problems as well as sudden death from [[cardiomyopathy]].<ref name="Shaw-2012" /> Products adulterated with pharmaceuticals for weight loss or erectile dysfunction are one of the main concerns.<ref name="Shaw-2012" /> Chinese herbal medicine has been a major cause of [[acute liver failure]] in China.<ref name="nc1f3">{{cite journal | vauthors = Zhao P, Wang C, Liu W, Chen G, Liu X, Wang X, Wang B, Yu L, Sun Y, Liang X, Yang H, Zhang F | display-authors = 6 | title = Causes and outcomes of acute liver failure in China | journal = PLOS ONE | volume = 8 | issue = 11 | pages = e80991 | year = 2013 | pmid = 24278360 | pmc = 3838343 | doi = 10.1371/journal.pone.0080991 | veditors = Avila MA | bibcode = 2013PLoSO...880991Z | doi-access = free }}</ref>

The harvesting of [[Guano]] from bat caves (''Ye Ming Sha'') brings workers into close contact with these animals, increasing the risk of [[zoonosis]].<ref>{{cite journal |last1=Wassenaar |first1=T.M. |last2=Zou |first2=Y. |title=2019_nCoV/SARS‐CoV‐2: rapid classification of betacoronaviruses and identification of Traditional Chinese Medicine as potential origin of zoonotic coronaviruses |journal=Letters in Applied Microbiology |date=May 2020 |volume=70 |issue=5 |pages=342–348 |doi=10.1111/lam.13285 |pmid=32060933 |pmc=7165814 }}</ref> The Chinese virologist [[Shi Zhengli]] has identified dozens of SARS-like [[coronavirus]]es in samples of bat droppings.<ref>{{cite journal |last1=Li |first1=Wendong |last2=Shi |first2=Zhengli |last3=Yu |first3=Meng |last4=Ren |first4=Wuze |last5=Smith |first5=Craig |last6=Epstein |first6=Jonathan H. |last7=Wang |first7=Hanzhong |last8=Crameri |first8=Gary |last9=Hu |first9=Zhihong |last10=Zhang |first10=Huajun |last11=Zhang |first11=Jianhong |last12=McEachern |first12=Jennifer |last13=Field |first13=Hume |last14=Daszak |first14=Peter |last15=Eaton |first15=Bryan T. |last16=Zhang |first16=Shuyi |last17=Wang |first17=Lin-Fa |title=Bats Are Natural Reservoirs of SARS-Like Coronaviruses |journal=Science |date=28 October 2005 |volume=310 |issue=5748 |pages=676–679 |doi=10.1126/science.1118391 |pmid=16195424 |bibcode=2005Sci...310..676L |s2cid=2971923 }}</ref>

==Acupuncture and moxibustion==
{{Main|Acupuncture|Moxibustion}}
[[File:Acupuncture1-1.jpg|thumb|200px|Needles being inserted into the skin]]
[[File:Ming Bronze Acupuncture Statue.jpg|thumb|300x300px|A bronze acupuncture statue from the Ming Dynasty being displayed inside a museum]]
Acupuncture is the insertion of needles into superficial structures of the body (skin, subcutaneous tissue, muscles) – usually at acupuncture points (acupoints) – and their subsequent manipulation; this aims at influencing the flow of [[qi]].<ref name="Npn8K">{{cite web |url=http://consensus.nih.gov/1997/1997Acupuncture107html.htm |publisher=National Institutes of Health |title=Acupuncture – Consensus Development Conference Statement |date=5 November 1997 |access-date=3 February 2007 |archive-url=https://www.webcitation.org/618ZUP7jI?url=http://consensus.nih.gov/1997/1997Acupuncture107html.htm |archive-date=22 August 2011 |url-status=live}}</ref> According to TCM it relieves [[pain]] and treats (and prevents) various diseases.<ref name="Dorlands">{{cite book | vauthors = Novak PD, Dorland NW, Dorland WA |title=Dorland's Pocket Medical Dictionary |publisher=W.B. Saunders |location=Philadelphia |year=1995 |edition= 25th |isbn=978-0-7216-5738-7 |oclc=33123537 |title-link=Dorland's Pocket Medical Dictionary}}</ref> The US FDA classifies single-use acupuncture needles as Class II medical devices, under CFR 21.<ref name="PwhYY">{{cite web|title=CFR – Code of Federal Regulations Title 21|url=https://www.accessdata.fda.gov/scripts/cdrh/cfdocs/cfcfr/cfrsearch.cfm?fr=880.5580|website=FDA US Food and Drug Administration|publisher=U.S. Department of Health and Human Services|access-date=4 March 2018|archive-url=https://web.archive.org/web/20190327071747/https://www.accessdata.fda.gov/scripts/cdrh/cfdocs/cfcfr/cfrsearch.cfm?fr=880.5580|archive-date=27 March 2019|url-status=live}}</ref>

Acupuncture is often accompanied by moxibustion – the Chinese characters for acupuncture ({{zh|labels=no|s=针灸|t=針灸|p=zhēnjiǔ}}) literally meaning "acupuncture-moxibustion" – which involves burning [[mugwort]] on or near the skin at an acupuncture point.<ref name="MAT">{{cite web |url=http://acupuncturetoday.com/abc/moxibustion.php |title=Moxibustion, Acupuncture Today |publisher=Acupuncturetoday.com |access-date=17 May 2011 |archive-url=https://web.archive.org/web/20110811033311/http://acupuncturetoday.com/abc/moxibustion.php |archive-date=11 August 2011 |url-status=live}}</ref> According to the [[American Cancer Society]], "available scientific evidence does not support claims that moxibustion is effective in preventing or treating cancer or any other disease".<ref name="acs-moxi">{{cite web |title=Moxibustion |url=http://www.cancer.org/treatment/treatmentsandsideeffects/complementaryandalternativemedicine/manualhealingandphysicaltouch/moxibustion |publisher=[[American Cancer Society]] |date=8 March 2011 |access-date=15 August 2013 |archive-url=https://web.archive.org/web/20130809061732/http://www.cancer.org/treatment/treatmentsandsideeffects/complementaryandalternativemedicine/manualhealingandphysicaltouch/moxibustion |archive-date=9 August 2013 |url-status=live}}</ref>

In [[electroacupuncture]], an electric current is applied to the needles once they are inserted, to further stimulate the respective acupuncture points.<ref name="Robertson2006">{{cite book | vauthors = Robertson V, Ward A, Low J, Reed A |title=Electrotherapy explained: principles and practice |publisher=[[Elsevier Health Sciences]] |year=2006 |isbn=978-0-7506-8843-7}}</ref>

A recent historian of Chinese medicine remarked that it is "nicely ironic that the specialty of acupuncture -- arguably the most questionable part of their medical heritage for most Chinese at the start of the twentieth century -- has become the most marketable aspect of Chinese medicine." She found that acupuncture as we know it today has hardly been in existence for sixty years. Moreover, the fine, [[Glossary of botanical terms#filiform|filiform]] needle we think of as the acupuncture needle today was not widely used a century ago. Present day acupuncture was developed in the 1930s and put into wide practice only as late as the 1960s.{{sfnb|Andrews|2013a|pp=237–238}}

===Efficacy===
{{Further|Acupuncture#Efficacy|Acupuncture#Safety}}
A 2013 editorial in the American journal ''[[Anesthesia and Analgesia]]'' stated that acupuncture studies produced inconsistent results, (i.e. acupuncture relieved pain in some conditions but had no effect in other very similar conditions) which suggests the presence of [[Type I and type II errors#Type I error|false positive results]].  These may be caused by factors like biased study design, poor blinding, and the classification of electrified needles (a type of [[Transcutaneous electrical nerve stimulation|TENS]]) as a form of acupuncture. The inability to find consistent results despite more than 3,000 studies, the editorial continued, suggests that the treatment seems to be a [[placebo effect]] and the existing equivocal positive results are the type of  [[statistical noise|noise]] one expects to see after a large number of studies are performed on an inert therapy. The editorial concluded that the best controlled studies showed a clear pattern, in which the outcome does not rely upon needle location or even needle insertion, and since "these variables are those that define acupuncture, the only sensible conclusion is that acupuncture does not work."<ref name="Colquhoun2013">{{cite journal | vauthors = Colquhoun D, Novella SP | title = Acupuncture is theatrical placebo | journal = Anesthesia and Analgesia | volume = 116 | issue = 6 | pages = 1360–3 | date = June 2013 | pmid = 23709076 | doi = 10.1213/ANE.0b013e31828f2d5e | url = http://www.dcscience.net/Colquhoun-Novella-A&A-2013.pdf | access-date = 3 June 2020 | url-status = live | author2-link = Steven Novella | s2cid = 207135491 | archive-url = https://web.archive.org/web/20181120055409/http://www.dcscience.net/Colquhoun-Novella-A%26A-2013.pdf | archive-date = 20 November 2018 | author-link = David Colquhoun }}</ref>

According to the US NIH National Cancer Institute, a review of 17,922 patients reported that real acupuncture relieved muscle and joint pain, caused by aromatase inhibitors, much better than sham acupuncture.<ref name="nihnci">{{cite web|last1=U.S. National Institute of Health|title=Complementary and Alternative Medicine: Questions and Answers About Acupuncture|url=https://www.cancer.gov/about-cancer/treatment/cam/patient/acupuncture-pdq#section/_3|publisher=National Cancer Institute|access-date=4 March 2018|date=11 May 2006|archive-url=https://web.archive.org/web/20180304172443/https://www.cancer.gov/about-cancer/treatment/cam/patient/acupuncture-pdq#section/_3|archive-date=4 March 2018|url-status=live}}</ref> Regarding cancer patients, The review hypothesized that acupuncture may cause physical responses in nerve cells, the pituitary gland, and the brain – releasing proteins, hormones, and chemicals that are proposed to affect blood pressure, body temperature, immune activity, and endorphin release.<ref name="nihnci" />

A 2012 meta-analysis concluded that the mechanisms of acupuncture "are clinically relevant, but that an important part of these total effects is not due to issues considered to be crucial by most acupuncturists, such as the correct location of points and depth of needling ... [but is] ... associated with more potent placebo or context effects".<ref name="XsseQ">{{cite journal | vauthors = Vickers AJ, Cronin AM, Maschino AC, Lewith G, MacPherson H, Foster NE, Sherman KJ, Witt CM, Linde K | display-authors = 6 | title = Acupuncture for chronic pain: individual patient data meta-analysis | journal = Archives of Internal Medicine | volume = 172 | issue = 19 | pages = 1444–53 | date = October 2012 | pmid = 22965186 | pmc = 3658605 | doi = 10.1001/archinternmed.2012.3654 }}</ref> Commenting on this meta-analysis, both [[Edzard Ernst]] and David Colquhoun said the results were of negligible clinical significance.<ref name="Jha">{{cite news | vauthors = Jha A | title = Acupuncture useful, but overall of little benefit, study shows | url = https://www.theguardian.com/science/2012/sep/10/acupuncture-useful-little-benefit-study | newspaper = [[The Guardian]] | date = 10 September 2012 | access-date = 18 December 2016 | archive-url = https://web.archive.org/web/20170104002226/https://www.theguardian.com/science/2012/sep/10/acupuncture-useful-little-benefit-study | archive-date = 4 January 2017 | url-status = live}}</ref><ref name="Colquhoun">{{cite web |last1=Colquhoun |first1=David |title=Re: Risks of acupuncture range from stray needles to pneumothorax, finds study |website=BMJ |url=https://www.bmj.com/content/345/bmj.e6060/rr/603200 |date=17 September 2012 }} Reply to: {{cite journal |last1=Kmietowicz |first1=Z. |title=Risks of acupuncture range from stray needles to pneumothorax, finds study |journal=BMJ |date=7 September 2012 |volume=345 |issue=sep07 2 |pages=e6060 |doi=10.1136/bmj.e6060 |pmid=22960463 |s2cid=32788662 }}</ref>

A 2011 overview of [[Cochrane Collaboration|Cochrane reviews]] found evidence that suggests acupuncture is effective for some but not all kinds of pain.<ref name="pmid21359919">{{cite journal | vauthors = Lee MS, Ernst E | title = Acupuncture for pain: an overview of Cochrane reviews | journal = Chinese Journal of Integrative Medicine | volume = 17 | issue = 3 | pages = 187–9 | date = March 2011 | pmid = 21359919 | doi = 10.1007/s11655-011-0665-7 | s2cid = 21513259 }}</ref> A 2010 systematic review found that there is evidence "that acupuncture provides a short-term clinically relevant effect when compared with a waiting list control or when acupuncture is added to another intervention" in the treatment of chronic low back pain.<ref name="VlCfc">{{cite journal | vauthors = Rubinstein SM, van Middelkoop M, Kuijpers T, Ostelo R, Verhagen AP, de Boer MR, Koes BW, van Tulder MW | display-authors = 6 | title = A systematic review on the effectiveness of complementary and alternative medicine for chronic non-specific low-back pain | journal = European Spine Journal | volume = 19 | issue = 8 | pages = 1213–28 | date = August 2010 | pmid = 20229280 | pmc = 2989199 | doi = 10.1007/s00586-010-1356-3 }}</ref> Two review articles discussing the effectiveness of acupuncture, from 2008 and 2009, have concluded that there is not enough evidence to conclude that it is effective beyond the placebo effect.<ref name="RetractingNeedleStudies">{{cite book | vauthors = Singh S, Ernst EE | author-link1 = Simon Singh  |author-link2=Edzard Ernst | year = 2008 | title =Trick or treatment: The undeniable facts about alternative medicine | isbn = 978-0-393-06661-6 | publisher = [[W. W. Norton & Company]] | pages = 103–06 | chapter = The Truth about Acupuncture | quote="These initial conclusions have generally been disappointing for acupuncturists: They provide no convincing evidence that real acupuncture is significantly more effective than placebo." (p. 104)| title-link = Trick or Treatment}}</ref><ref name="Madsen2009">{{cite journal | vauthors = Madsen MV, Gøtzsche PC, Hróbjartsson A | title = Acupuncture treatment for pain: systematic review of randomised clinical trials with acupuncture, placebo acupuncture, and no acupuncture groups | journal = BMJ | volume = 338 | pages = a3115 | date = January 2009 | pmid = 19174438 | pmc = 2769056 | doi = 10.1136/bmj.a3115 }}</ref>

Acupuncture is generally safe when administered using Clean Needle Technique (CNT).<ref name="Xu S" /> Although serious [[adverse effects]] are rare, acupuncture is not without risk.<ref name="Xu S">{{cite journal | vauthors = Xu S, Wang L, Cooper E, Zhang M, Manheimer E, Berman B, Shen X, Lao L | display-authors = 6 | title = Adverse events of acupuncture: a systematic review of case reports | journal = Evidence-Based Complementary and Alternative Medicine | volume = 2013 | pages = 581203 | year = 2013 | pmid = 23573135 | pmc = 3616356 | doi = 10.1155/2013/581203 | doi-access = free }}</ref> Severe adverse effects, including very rarely death (5 case reports), have been reported.<ref name="Ernst 2011">{{cite journal | vauthors = Ernst E, Lee MS, Choi TY | title = Acupuncture: does it alleviate pain and are there serious risks? A review of reviews | journal = Pain | volume = 152 | issue = 4 | pages = 755–764 | date = April 2011 | pmid = 21440191 | doi = 10.1016/j.pain.2010.11.004 | s2cid = 20205666 }}</ref>

==Tui na==
[[File:Zheng Gu Shui.jpg|thumb|243x243px|An example of a traditional Chinese medicine used in tui na]]
{{Main|Tui na}}
Tui na ({{lang|zh|推拿}}) is a form of massage akin to [[acupressure]] (from which [[shiatsu]] evolved). Asian massage is typically administered with the person fully clothed, without the application of grease or oils.<ref name="tQZf1">{{cite journal| vauthors = Centeno JI |title=Ping Ming Traditional Chinese Medicine|journal=Milliman|date=27 January 2017|volume=520|issue=Stockton|page=23|url=http://www.pingminghealth.com/chinese-medicine/what-is-chinese-medicine/|access-date=1 February 2017|archive-url=https://web.archive.org/web/20170124112537/http://www.pingminghealth.com/chinese-medicine/what-is-chinese-medicine/|archive-date=24 January 2017|url-status=live}}</ref> Techniques employed may include thumb presses, rubbing, percussion, and assisted stretching.

== Qigong ==
{{Main|Qigong}}
Qìgōng ({{zh|labels=no|s=气功|t=氣功}}) is a TCM system of exercise and meditation that combines regulated breathing, slow movement, and focused awareness, purportedly to cultivate and balance qi.<ref name="Holland">{{cite book | vauthors = Holland A |year=2000 |title=Voices of Qi: An Introductory Guide to Traditional Chinese Medicine |publisher= North Atlantic Books |isbn=978-1-55643-326-9}}</ref> One branch of qigong is qigong massage, in which the practitioner combines massage techniques with awareness of the acupuncture channels and points.<ref name="2009Silva">{{cite journal | vauthors = Silva LM, Schalock M, Ayres R, Bunse C, Budden S | title = Qigong massage treatment for sensory and self-regulation problems in young children with autism: a randomized controlled trial | journal = The American Journal of Occupational Therapy | volume = 63 | issue = 4 | pages = 423–32 | year = 2009 | pmid = 19708471 | doi = 10.5014/ajot.63.4.423 | doi-access = free }}</ref><ref name="home">{{cite journal | vauthors = Silva LM, Schalock M, Gabrielsen K | title = Early intervention for autism with a parent-delivered Qigong massage program: a randomized controlled trial | journal = The American Journal of Occupational Therapy | volume = 65 | issue = 5 | pages = 550–9 | year = 2011 | pmid = 22026323 | doi = 10.5014/ajot.2011.000661 | doi-access = free }}</ref>

Qi is air, breath, energy, or primordial life source that is neither matter or spirit. While Gong is a skillful movement, work, or exercise of the qi.<ref name="KjrTcE">{{Cite book|title=Breathing Spaces| vauthors = Chen N |publisher=[[Columbia University Press]]|year=2003|isbn=9780231128056|url-access=registration|url=https://archive.org/details/isbn_9780231128056}}</ref>

===Forms===
* ''Nei gong'': introspective and meditative
* ''Wai gong'': external energy and motion
* ''Dong gong'': dynamic or active
* ''Jing gong'': tranquil or passive<ref name="KjrTcE" />

==Other therapies==
===Cupping===
{{Main|Cupping therapy}}
[[File:Kyutoshin.JPG|thumb|Acupuncture and moxibustion after cupping in Japan]]
Cupping ({{zh|labels=no|c=拔罐|p=báguàn}}) is a type of Chinese massage, consisting of placing several glass "cups" (open spheres) on the body. A match is lit and placed inside the cup and then removed before placing the cup against the skin. As the air in the cup is heated, it expands, and after placing in the skin, cools, creating lower pressure inside the cup that allows the cup to stick to the skin via [[suction]].<ref name="PadyQ">{{cite web | url=http://time.com/4443105/cupping-rio-olympics-michael-phelps/ | title=What is Cupping? Here's What You Need to Know | access-date=7 February 2018 | archive-url=https://web.archive.org/web/20180123162459/http://time.com/4443105/cupping-rio-olympics-michael-phelps/ | archive-date=23 January 2018 | url-status=live}}</ref> When combined with massage oil, the cups can be slid around the back, offering "reverse-pressure massage".

===Gua sha===
{{Main|Gua sha}}
[[File:Gua Sha.jpg|thumb|Gua sha]]
'''Gua sha''' ({{zh|labels=no|c=刮痧|p=guāshā}}) is abrading the skin with pieces of smooth jade, bone, animal tusks or horns or smooth stones; until red spots then bruising cover the area to which it is done. It is believed that this treatment is for almost any ailment. The red spots and bruising take three to ten days to heal, there is often some soreness in the area that has been treated.<ref name="1doyG">{{cite web |url = http://www.tcmwell.com/TCMNaturalTherapy/GuashaCupping/GuaSha-Treatment-of-Disease.html |title = GuaSha Treatment of Disease |publisher = Tcmwell.com |access-date = 17 May 2011 |archive-url = https://web.archive.org/web/20110702102751/http://www.tcmwell.com/TCMNaturalTherapy/GuashaCupping/GuaSha-Treatment-of-Disease.html |archive-date = 2 July 2011 |url-status = live}}</ref>

=== Die-da ===
{{Main|Die-da}}
'''Diē-dá''' ({{lang|zh|跌打}}) or '''Dit Da''', is a traditional Chinese [[bone-setting]] technique, usually practiced by martial artists who know aspects of Chinese medicine that apply to the treatment of [[Physical trauma|trauma]] and injuries such as bone fractures, sprains, and bruises. Some of these specialists may also use or recommend other disciplines of Chinese medical therapies if serious injury is involved. Such practice of bone-setting ({{zh|labels=no|t=整骨|s=正骨}}) is not common in the West.

=== Chinese food therapy ===
{{more citations needed|section|date=July 2021}}
{{Main|Chinese food therapy}}
The concepts ''yin'' and ''yang'' are associated with different classes of foods, and tradition considers it important to consume them in a balanced fashion.

==Regulations==
Many governments have enacted laws to regulate TCM practice.

=== Australia ===
From 1 July 2012 Chinese medicine practitioners must be registered under the national registration and accreditation scheme with the Chinese Medicine Board of Australia and meet the Board's Registration Standards, to practice in Australia.<ref name="dEoSG">{{cite web|url=https://www.chinesemedicineboard.gov.au/Registration.aspx|title=Chinese Medicine Board of Australia – Registration|website=Chinese Medicine Board of Australia|publisher=Chinese Medicine Board of Australia|access-date=15 November 2019|archive-url=https://web.archive.org/web/20191024040943/https://www.chinesemedicineboard.gov.au/Registration.aspx|archive-date=24 October 2019|url-status=live}}</ref>

=== Canada ===
TCM is regulated in five provinces in Canada: Alberta, British Columbia,<ref name="efn1q">{{cite web |url=http://www.ctcma.bc.ca/about.asp |title=CTCMA |publisher=College of Traditional Chinese Medicine Practitioners and Acupuncturists of British Columbia |access-date=25 May 2013 |url-status=dead |archive-url=https://web.archive.org/web/20121014195917/http://www.ctcma.bc.ca/about.asp |archive-date=14 October 2012}}</ref> Ontario,<ref name="LYHr5">{{cite web |url=http://www.e-laws.gov.on.ca/html/statutes/english/elaws_statutes_06t27_e.htm |title=Traditional Chinese Medicine Act, 2006 |work=S.O. 2006, c. 27 |date=24 July 2014 |access-date=4 June 2014 |archive-url=https://web.archive.org/web/20100523091035/http://www.e-laws.gov.on.ca/html/statutes/english/elaws_statutes_06t27_e.htm |archive-date=23 May 2010 |url-status=live}}</ref> Quebec, and Newfoundland & Labrador.

=== China (mainland) ===
The People's Republic of China has supported TCM since its founding in 1949<ref name="L4ZSd">{{cite web | vauthors = Berezow A |title=Is China the World Leader in Biomedical Fraud? |url=https://foreignpolicy.com/2018/02/28/is-china-the-world-leader-in-biomedical-fraud/ |website=Foreign Policy |date=February 28, 2018 |access-date=31 March 2020 |archive-url=https://web.archive.org/web/20200206193208/https://foreignpolicy.com/2018/02/28/is-china-the-world-leader-in-biomedical-fraud/ |archive-date=6 February 2020 |url-status=live}}</ref> The [[National Administration of Traditional Chinese Medicine]] was created in 1949, which then absorbed existing TCM management in 1986 with major changes in 1998.<ref name="IO4NJ">{{cite web |author1=State Council of the People's Republic of China|script-title=zh:国务院关于成立国家中医管理局的通知（国发〔1986〕79号）|trans-title=State Countil notification on establishing the NATCM (SC [1986] 79) |url=http://www.gov.cn/zhengce/content/2012-07/25/content_6480.htm |date=1986-07-20}}</ref><ref name="FwJ6J">{{cite web |author1=General Office of the State Council of the People's Republic of China |script-title=zh:国务院办公厅关于印发国家中医药管理局职能配置内设机构和人员编制规定的通知（国办发〔1998〕95号）|trans-title=State Office notification on provisions for nstitutions and staffing of the NATCM (SO [1998] 95) |url=http://www.gov.cn/zhengce/content/2010-11/18/content_7729.htm |date=1998-06-25}}</ref>

China's National People's Congress Standing Committee passed the country's first law on TCM in 2016, which came into effect on 1 July 2017. The new law standardized TCM certifications by requiring TCM practitioners to (i) pass exams administered by provincial-level TCM authorities, and (ii) obtain recommendations from two certified practitioners. TCM products and services can be advertised only with approval from the local TCM authority.<ref name="WebMD China TCM">{{cite web|title=China passes first law on traditional Chinese medicine (TCM)|url=http://webmd.cn/en/china-passes-first-law-traditional-chinese-medicine-tcm/|publisher=WebMD China|date=28 December 2016|access-date=28 August 2018|archive-url=https://web.archive.org/web/20180828170102/http://webmd.cn/en/china-passes-first-law-traditional-chinese-medicine-tcm/|archive-date=28 August 2018|url-status=live}}</ref>

===Hong Kong===
During [[British Hong Kong|British rule]], Chinese medicine practitioners in Hong Kong were not recognized as "medical doctors", which means they could not issue prescription drugs, give injections, etc. However, TCM practitioners could register and operate TCM as "herbalists".<ref>{{cite news|title=香港执业中医的概况|url=http://www.cntv.cn/program/zhyy/topic/health/C12827/20040824/101533.shtml|publisher=央视国际|date=2004-08-24}}</ref> The Chinese Medicine Council of Hong Kong was established in 1999. It regulates the compounds and professional standards for TCM practitioners. All TCM practitioners in Hong Kong are required to register with the council. The eligibility for registration includes a recognised 5-year university degree of TCM, a 30-week minimum supervised clinical internship, and passing the licensing exam.<ref name="Rfm3C">[http://www.cmchk.org.hk/index_en.html The Chinese Medicine Council of Hong Kong] {{Webarchive|url=https://web.archive.org/web/20140111100346/http://www.cmchk.org.hk/index_en.html |date=11 January 2014}} Hong Kong Registered the Chinese Medicine Practitioner licensure requirements</ref>

===Macau===
The [[Portuguese Macau]] government seldom interfered in the affairs of Chinese society, including with regard to regulations on the practice of TCM. There were a few TCM pharmacies in Macau during the colonial period. In 1994, the Portuguese Macau government published Decree-Law no. 53/94/M that officially started to regulate the TCM market. After the sovereign handover, the Macau S.A.R. government also published regulations on the practice of TCM.{{Clarify|date=January 2022}} In 2000, [[Macau University of Science and Technology]] and [[Nanjing University of Traditional Chinese Medicine]] established the Macau College of Traditional Chinese Medicine to offer a degree course in Chinese medicine.<ref>{{Cite news|title=澳门的高等中医药教育|url=https://eic.tjutcm.edu.cn/info/1005/1140.htm|publisher=世界中医药教育|date=2013-04-19}}</ref>

In Macau, the legitimacy of Chinese medicine is not built upon "miracle making".  Instead, it is achieved through a celebration of cultural tradition rejuvenated with discourses of nationalism and modernity, and through the mutual constructions of medical references between doctors and patients.<ref name="somatosphere">{{cite news |last1=Lou|first1=Loretta|url=http://somatosphere.net/2016/beyond-miracles-how-traditional-chinese-medicine-establishes-professional-legitimacy-in-post-colonial-macau.html/ |title=Beyond Miracles: How Traditional Chinese Medicine Establishes Professional Legitimacy in Post-colonial Macau |work=[[somatosphere]] |date=2016-12-09 |access-date=2016-12-09}}</ref>

In 2022, a new law regulating TCM, Law no. 11/2021, came into effect. The same law also repealed Decree-Law no. 53/94/M.<ref>{{Cite web|title=Lei n.º 11/2021|url=https://bo.io.gov.mo/bo/i/2021/30/lei11.asp|access-date=2022-01-08|website=|language=pt|via=Imprensa Oficial}}</ref><ref>{{Cite web|title=Special Report – Traditional Chinese Medicine – Breathing a new life|url=https://www.macaubusiness.com/special-report-traditional-chinese-medicine-breathing-a-new-life/|access-date=2022-01-08|website=|language=en|via=Macau Business}}</ref>

=== Indonesia ===
[[File:Chinese traditional medicine.jpg|thumb|The Chinese traditional medicine at one of Chinese traditional medicine shop at Jagalan Road, Surabaya, Indonesia.]]
All traditional medicines, including TCM, are regulated by Indonesian Minister of Health Regulation of 2013 on traditional medicine. Traditional medicine license (''Surat Izin Pengobatan Tradisional'' – SIPT) is granted to the practitioners whose methods are recognized as safe and may benefit health.<ref name="men">{{cite web |url=https://dinkes.belitung.go.id/wp-content/uploads/2021/01/kepmenkes-9980d-kepmenkes_1076-pengobatan-tradisional.pdf |title=KEPUTUSAN MENTERI KESEHATAN REPUBLIK INDONESIA }}</ref> The TCM clinics are registered but there is no explicit regulation for it. The only TCM method which is accepted by medical logic and is empirically proofed is acupuncture.<ref name="rgrUG">Cheta Nilawaty dan Rini Kustiati. 13 August 2012. TEMPO, [http://www.tempo.co/read/news/2012/08/13/060423155/Belum-Ada-Aturan-Soal-Klinik-Pengobatan-Cina Belum Ada Aturan Soal Klinik Pengobatan Cina] {{Webarchive|url=https://web.archive.org/web/20140819084547/http://www.tempo.co/read/news/2012/08/13/060423155/Belum-Ada-Aturan-Soal-Klinik-Pengobatan-Cina |date=19 August 2014}}. {{in lang|id}}</ref> The acupuncturists can get SIPT and participate in health care facilities.<ref name="men" />

===Japan===
[[File:Drug Seirogan.png|thumb|''[[Seirogan]]'', a type of antidiarrhoeal drug in Japan developed based on Kanpo medicine theory]]
{{Main|Kampo|Kampo list}}

=== Malaysia ===
The Traditional and Complementary Medicine Bill was passed by parliament in 2012 establishing the Traditional and Complementary Medicine Council to register and regulate traditional and complementary medicine practitioners, including TCM practitioners as well as other traditional and complementary medicine practitioners such as those in traditional Malay medicine and traditional Indian medicine.<ref name="WaKgb">{{cite web|url=https://www.npra.gov.my/images/Announcement/2015/NRC-2015-day2/TMHS08-P-Ms-TehLiYin-31-07-15.pdf|title=Traditional and Complementary Medicine (T&CM) Act [What Should You Know?]|work=Traditional and Complementary Medicine Division|publisher=Ministry of Health, Malaysia|year=2015|access-date=14 May 2019|page=10|archive-url=https://web.archive.org/web/20190514052514/https://www.npra.gov.my/images/Announcement/2015/NRC-2015-day2/TMHS08-P-Ms-TehLiYin-31-07-15.pdf|archive-date=14 May 2019|url-status=dead}}</ref>

=== Netherlands ===
[[File:中 Zhong - Nederlandse Vereniging voor Traditionele Chinese Geneeskunde logo (Big).jpg|thumb|right|The logo of the Dutch Association of Traditional Chinese Medicine (or ''中 Zhong - Nederlandse Vereniging voor Traditionele Chinese Geneeskunde''), the largest of the professional organisations that is recognised by private [[health insurance]] companies in the Netherlands.]]

There are no specific regulations in the Netherlands on TCM;<ref name="CAM-Regulations-Netherlands">{{cite web|url= http://cam-regulation.org/en/traditional-chinese-medicine-tcm-netherlands|title= Traditional Chinese Medicine (TCM) in the Netherlands.|date= 31 December 2012|access-date= 12 March 2020|author= CAM Regulation admin|publisher= Norway's National Research Center in Complementary and Alternative Medicine|language= en|archive-url= https://web.archive.org/web/20200330000727/http://cam-regulation.org/en/traditional-chinese-medicine-tcm-netherlands|archive-date= 30 March 2020|url-status= live}}</ref> TCM is neither prohibited nor recognised by the [[government of the Netherlands]].<ref name="ETCMAZhongNethetlands">{{cite web|url=https://www.etcma.org/find-a-member/the-netherlands/zhong/|title=Nederlandse Vereniging voor Traditionele Chinese Geneeskunde (ZHONG) - Dutch Association of Chinese Traditional Medicine.|date=2020|access-date=12 March 2020|work=European Traditional Chinese Medicine Association (ETCMA)|language=en|archive-url=https://web.archive.org/web/20200330000723/https://www.etcma.org/find-a-member/the-netherlands/zhong/|archive-date=30 March 2020|url-status=live}}</ref> [[Chinese herbology|Chinese herbs as well as Chinese herbal products]] that are used in TCM are classified as foods and [[food supplement]]s, and these Chinese herbs can be imported into the Netherlands as well as marketed as such without any type registration or notification to the government.<ref name="ETCMAZhongNethetlands" />

Despite its status, some private [[health insurance]] companies reimburse a certain amount of annual costs for [[acupuncture]] treatments, this depends on one's insurance policy, as not all insurance policies cover it, and if the acupuncture practitioner is or is not a member of one of the professional organisations that are recognised by private health insurance companies.<ref name="ETCMAZhongNethetlands" />&nbsp;The recognized professional organizations include the Nederlandse Vereniging voor Acupunctuur (NVA), Nederlandse Artsen Acupunctuur Vereniging (NAAV), ZHONG, (Nederlandse Vereniging voor Traditionele Chinese Geneeskunde), Nederlandse Beroepsvereniging Chinese Geneeswijzen Yi (NBCG Yi), and Wetenschappelijke Artsen Vereniging voor Acupunctuur in Nederland (WAVAN).<ref name="ZorgwijzerTraditionalChineseMedicine">{{cite web|url= https://www.zorgwijzer.nl/vergoeding/acupunctuur|title= Acupunctuur (2020).|date= 2020|access-date= 12 March 2020|work= Zorgwijzer|language= nl|archive-url= https://web.archive.org/web/20200312201516/https://www.zorgwijzer.nl/vergoeding/acupunctuur|archive-date= 12 March 2020|url-status= live}}</ref>

=== New Zealand ===
Although there are no regulatory standards for the practice of TCM in New Zealand, in the year 1990, acupuncture was included in the Governmental [[Accident Compensation Corporation]] (ACC) Act. This inclusion granted qualified and professionally registered acupuncturists to provide subsidised care and treatment to citizens, residents, and temporary visitors for work or sports related injuries that occurred within and upon the land of New Zealand. The two bodies for the regulation of acupuncture and attainment of ACC treatment provider status in New Zealand are Acupuncture NZ<ref>{{Cite web|title=Home|url=https://www.acupuncture.org.nz/|access-date=2020-11-13|website=Acupuncture NZ}}</ref> and The New Zealand Acupuncture Standards Authority.<ref>{{Cite web|title=NZASA - Home|url=https://nzasa.org/|access-date=2020-11-13|website=nzasa.org}}</ref><ref>{{Cite web|title=Accident Compensation Act 2001 No 49 (as at 01 August 2020), Public Act Contents – New Zealand Legislation|url=http://www.legislation.govt.nz/act/public/2001/0049/latest/DLM99494.html|access-date=2020-11-13|website=www.legislation.govt.nz}}</ref>

=== Singapore ===
The TCM Practitioners Act was passed by Parliament in 2000 and the TCM Practitioners Board was established in 2001 as a statutory board under the Ministry of Health, to register and regulate TCM practitioners. The requirements for registration include possession of a diploma or degree from a TCM educational institution/university on a gazetted list, either structured TCM clinical training at an approved local TCM educational institution or foreign TCM registration together with supervised TCM clinical attachment/practice at an approved local TCM clinic, and upon meeting these requirements, passing the Singapore TCM Physicians Registration Examination (STRE) conducted by the TCM Practitioners Board.<ref name="pcpTk">{{cite web |title = Registration Requirements for the Registration of TCM Physicians |url = http://www.healthprofessionals.gov.sg/content/hprof/tcmpb/en/leftnav/registration_requirements.html |access-date = 5 April 2013 |archive-url = https://web.archive.org/web/20120730171245/http://www.healthprofessionals.gov.sg/content/hprof/tcmpb/en/leftnav/registration_requirements.html |archive-date = 30 July 2012 |url-status = live}}</ref>

=== United States ===
As of July 2012, only six states lack legislation to regulate the professional practice of TCM: [[Alabama]], [[Kansas]], [[North Dakota]], [[South Dakota]], [[Oklahoma]], and [[Wyoming]]. In 1976, California established an Acupuncture Board and became the first state licensing professional acupuncturists.<ref name="esZx6">{{cite web |url=http://www.acupuncture.ca.gov/pubs_forms/consumer_guide.shtml |title=Archived copy |access-date=8 July 2012 |url-status=dead |archive-url=https://web.archive.org/web/20120522194421/http://www.acupuncture.ca.gov/pubs_forms/consumer_guide.shtml |archive-date=22 May 2012}} California Acupuncture Board</ref>

== See also ==
{{Portal|China|History}}
{{div col|colwidth=22em}}
* [[Compendium of Materia Medica]]
* [[Huangdi Neijing]]
* ''[[American Journal of Chinese Medicine]]''
* [[The body in traditional Chinese medicine]]
* [[Capsicum plaster]]
* [[Chinese classic herbal formula]]
* [[Chinese herbology]]
* [[Chinese Ophthalmology]]
* [[Chinese patent medicine]]
* [[Guizhentang Pharmaceutical company]]
* [[Hallucinogenic plants in Chinese herbals]]
* [[HIV/AIDS and traditional Chinese medicine]]
* ''[[Journal of Traditional Chinese Medicine]]''
* [[Hua Tuo]]
* [[Li Shizhen]]
* [[List of branches of alternative medicine]]
* [[List of topics characterized as pseudoscience]]
* [[List of traditional Chinese medicines]]
* [[Medicinal mushrooms]]
* [[Pharmacognosy]]
* [[Public health in the People's Republic of China]]
* [[Qingdai]]
*  [[Snake farm]]
*  [[Sun Simiao]] 
* [[Tao Hongjing]]
* [[Traditional Korean medicine]]
* [[Traditional Mongolian medicine]]
* [[Traditional Vietnamese medicine]] 
* [[Traditional Tibetan medicine]]
* [[Turtle farm]]
* [[Zhang Jiegu]]
{{div col end}}

==Notes==
{{Notelist}}

== References ==
=== Citations ===
{{Reflist}}

=== Sources ===
{{refbegin}}
* {{cite encyclopedia |last = Andrews |first = Bridie |editor1-last = Hinrichs |editor1-first = T. J. |editor2-first = Linda L. |editor2-last = Barnes |year = 2013a |title = The Republic of China |encyclopedia = Chinese Medicine and Healing: An Illustrated History |publisher = Belknap Press of Harvard University Press |location = Cambridge, MA |url = https://books.google.com/books?id=dtsYe0ZFORcC |isbn = 9780674047372 }}
* {{cite book |last = Andrews |first = Bridie |author-mask=4|url = https://www.google.com/search?tbm=bks&q=isbn:0774824328|year = 2013b |title = The Making of Modern Chinese Medicine |publisher = UBC Press |location = Vancouver, BC |isbn = 978-0774824323}}
* {{cite book |vauthors = Aung SK, Chen WP |year=2007 |title = Clinical introduction to medical acupuncture |publisher = Thieme Mecial Publishers |isbn= 978-1-58890-221-4 }}
* {{cite encyclopedia |editor-last = Borowy |editor-first = Iris |year = 2009 |title = Uneasy Encounters: The Politics of Medicine and Health in China, 1900-1937 |publisher = Peter Lang |location = [[Frankfurt am Maim]]; New York, NY |url = https://books.google.com/books?id=H9D-Z2fjHUEC |isbn = 9783631578032 }}
* {{cite encyclopedia |first = T. J. |last = Hinrichs |pages = 3859–3864 |title = Healing and Medicine |chapter = Healing and Medicine in China |volume = 6 |editor-first = Lindsay |editor-last = Jones |location = Detroit, MI |publisher = Macmillan Reference USA |year = 2005 |isbn = |chapter-url = }}
* {{cite book |editor1-last = Hinrichs |editor1-first = T. J. |editor2-first = Linda L. |editor2-last = Barnes |year = 2013 |title = Chinese Medicine and Healing: An Illustrated History |publisher = Belknap Press of Harvard University Press| location = Cambridge, MA |url = https://books.google.com/books?id=dtsYe0ZFORcC |isbn = 9780674047372 }}
* {{cite journal |last =Johnson |first = Ian|author-link = Ian Johnson|title =Chinese Medicine in the Covid Wards |journal =New York Review of Books |volume =68 |issue = 17 |pages= |publisher = |location = |date =2021 |language = |url = https://www.nybooks.com/articles/2021/11/04/traditional-chinese-medicine-covid-wards/ |jstor = |issn = |doi = |access-date = }} Review of Liu Lihong ''Classical Chinese Medicine'' (below). Also free online at ''China File'' [https://www.chinafile.com/library/nyrb-china-archive/chinese-medicine-covid-wards Chinese Medicine in Covid Wards].
* {{cite book |last = Lei |first= Sean Xianglin |year = 2014 |title = Neither Donkey nor Horse: Medicine in the Struggle over China's Modernity |publisher = University of Chicago |location = Chicago |url = https://books.google.com/books?id=wOU_BAAAQBAJ |isbn = 9780226169880}}
* {{cite web |vauthors = Novella S |author-link=Steve Novella |url = http://www.sciencebasedmedicine.org/what-is-traditional-chinese-medicine/ |title = What Is Traditional Chinese Medicine? |website = Science-Based Medicine |access-date = 14 April 2014 |date = 25 January 2012 }}
* {{cite book |vauthors =  Singh S, Ernst E |author1-link = Simon Singh |author2-link = Edzard Ernst |title = Trick or Treatment: Alternative Medicine on Trial |location = London |publisher= Bantam |year= 2008 |isbn= 978-0593061299 |ref = {{harvid|Singh & Ernst|2008}} }}
* {{cite book |last = Taylor |first = Kim |year = 2005 |title = Chinese Medicine in Early Communist China, 1945-63 A Medicine of Revolution |publisher = RoutledgeCurzon |location = London, England; New York, NY |isbn = 041534512X }}
* {{cite book |last = Watt  |first = John R. |year = 2014 |title = Saving Lives in Wartime China: How Medical Reformers Built Modern Healthcare Systems Amid War and Epidemics, 1928-1945 |publisher =  Brill| location = Boston;Leiden |isbn = 9789004256453}}
* {{cite book |vauthors = Wiseman N, Ellis A |year = 1996 |url = https://books.google.com/books?id=3SOAjUt53UgC&q=summerheat+tcm&pg=PA199 |title = Fundamentals of Chinese medicine |publisher = Paradigm Publications |isbn = 978-0-912111-44-5 }}
{{refend}}

== Further reading ==
* {{cite book |vauthors=Baran GR, Kiana MF, Samuel SP |title=Healthcare and Biomedical Technology in the 21st Century |publisher=Springer |year=2014 |pages=19–57 |chapter=Chapter 2: Science, Pseudoscience, and Not Science: How Do They Differ? |doi=10.1007/978-1-4614-8541-4_2 |isbn=978-1-4614-8540-7}}
* {{cite book |last = Barnes |first= Linda L. |year = 2005 |title = Needles, Herbs, Gods, and Ghosts: China, Healing, and the West to 1848 |publisher = Harvard University Press| location = Cambridge, Mass |isbn = 0674018729}} Shows early use of Chinese medicine not always perceived as "Chinese."
* {{cite journal |last =Baum  |first = Emily|title =Medicine and Public Health in Twentieth‐Century China: Histories of Modernization and Change |journal =History Compass |volume =18 |issue = 7 |pages =|date =2020 |language = |url = |jstor = |issn = |doi = 10.1111/hic3.12616 |s2cid = 225622823|access-date = }}
* {{cite book |last = Liu |first=Lihong |translator=Weiss, Gabriel |translator2=Henry Buchtel |translator3=Sabine Wilms|year = 2019 |title = Classical Chinese Medicine |publisher = Chinese University of Hong Kong Press; distributed by Columbia University Press| location = Shatin, NT Hong Kong |isbn = 9789882370579}}
* {{cite book |last1 = Lloyd |first1= G. E. R. |author1-link=G. E. R. Lloyd|first2= Nathan |last2= Sivin |author2-link= Nathan Sivin|year = 2002 |title = The Way and the Word: Science and Medicine in Early China and Greece |publisher = Yale University Press| location = New Haven |isbn = 0300092970}}
* McGrew, Roderick. ''Encyclopedia of Medical History'' (1985), brief history on pp.&nbsp;56–59
* {{cite book | vauthors = Needham J |author-link=Joseph Needham | veditors = Sivin N |editor-link=Nathan Sivin |series=Science and Civilisation in China |publisher=[[Cambridge University Press]] |year=2000 |url=https://books.google.com/books?id=6bEZ8Hp8h5sC |volume=6, ''Biology and Biological Technology'' |title=Part VI: Medicine |isbn=978-0-521-63262-1 |oclc=163502797}}
* {{citation|author-last = Raphals |author-first=Lisa |author-link= Lisa Raphals|chapter= Chinese Philosophy and Chinese Medicine |title=The Stanford Encyclopedia of Philosophy |editor-first =Edward N. |editor-last=Zalta |chapter-url= https://plato.stanford.edu/archives/win2020/entries/chinese-phil-medicine/ |date=Winter 2020 |publisher = Metaphysics Research Lab, Stanford University}}
* {{cite book |last = Shelton |first= Tamara Venit |year = 2019 |title = Herbs and Roots: A History of Chinese Doctors in the American Medical Marketplace |publisher = Yale University Press| location = New Haven |isbn = 9780300249408}}
*{{cite book |last = Unschuld |first =Paul|author-link=   |translator = |year = 1986 |title = Nan-Ching: The Classic of Difficult Issues |publisher = University of California Press| location = Berkeley |isbn = 9780520053724}}
*{{cite book |last = Unschuld |first= Paul U. |author-mask= 2|translator = |year = 1986a |title = Medicine in China: A History of Pharmaceutics |publisher = University of California Press |location = Berkeley |isbn = 9780520050259}}
*{{cite book |last = Unschuld |first= Paul U. |author-mask= 2|translator = |year = 2000 |title = Medicine in China: Historical Artifacts and Images |publisher = Prestel| location = Munich |isbn = 9783791321493}}
*{{cite book |last = Unschuld |first= Paul U. |author-mask= 2 |translator = Bridie J. Andrews |year = 2018 |title = Traditional Chinese Medicine: Heritage and Adaptation  |publisher = Columbia University Press| location = New York |trans-title= Traditionelle chinesische Medizin (2013)|isbn = 9780231175005}}

== External links ==
{{Commons category}}
{{Wikiquote}}
* [http://libproject.hkbu.edu.hk/was40/search?lang=en&channelid=1288 Medicinal Plant Images Database]—School of Chinese Medicine, Hong Kong Baptist University {{in lang|zh-hant}}
* [http://libproject.hkbu.edu.hk/was40/search?channelid=44273 Chinese Medicine Specimen Database]—School of Chinese Medicine, Hong Kong Baptist University {{in lang|zh-hant}}
* [http://www.association.quebec.aqtn.ca/files/scientific-literary-review-traditional-chinese-medicine-tcm.pdf ''Literary Review Compilation on Traditional Chinese Medicine''], PDF, 133 pages; compiled by the Association Québécoise des Thérapeutes Naturels (AQTN)

{{Traditional Chinese medicine|state=expanded}}
{{Health in the People's Republic of China}}
{{Traditional medicine}}
{{Authority control}}

[[Category:Traditional Chinese medicine| ]]
[[Category:Alternative medicine]]
[[Category:Pharmacy in China]]
[[Category:Pseudoscience]]