“It’s an energy field created by all living things. It surrounds us and penetrates us; it binds the galaxy together.”

That twaddle, of course, was Obi-Wan Kenobi explaining the mystical “Force” to a young Luke Skywalker – but he could equally have been talking about traditional Chinese medicine (TCM). For those unfamiliar with its tenets, TCM is based on concepts of biology and health radically different from modern medicine. Modern medicine – or “Western”, for want of a better word – is built on foundations of evidence and science. TCM is built on the foundationless idea of an unmeasurable energy that permeates everything in the universe – including you and me.

Sound familiar? Use the Force, Luke ...

According to traditional Chinese medicine, we get sick when this energy – chi, as it’s called – falls out of balance in our bodies. In order to rebalance the chi flowing through invisible channels (meridians), TCM practitioners use methods including herbal remedies, acupuncture, massage, diet and my favorite, moxibustion – the burning of dried herbs above the patient’s skin.

Clinical phenomena are “interpreted” by referring to theories of bodily function, while syndromes are differentiated according to four pairs of contradictory principles – negative (yin), positive (yang); exterior, interior; cold, heat; deficiency and excess.

Thus if you have a headache, a doctor – or indeed your mum – might recommend you lay off the fried food and lychees, which are considered “hot air” – or “yit hei” in Cantonese. Or conversely drink more beer, which is considered cooling. Different TCM practitioners will often give different treatments to different patients, saying they need to be “tailor-made.”

So TCM has no scientific rationale, but is based on a concoction of invisible energies running through invisible channels, together with bits and pieces of Buddhist, Confucian, and Taoist philosophy. It’s also a profitable business: according to state figures, it was worth USD115 billion to China’s economy in 2016. It’s used by millions of people every day who firmly believe in its effectiveness.

In a recent letter to the South China Morning Post, Professor George Woo, an eminent optometrist at the Polytechnic University, and Yeung Hin Wing, the former founding director of the Baptist University’s Institute for the Advancement of Chinese Medicine, sang the praises of TCM in treating Covid-19 on the mainland, and questioned why it wasn’t being used to fight the disease here in Hong Kong.

I would question why it’s being used at all.

There is precious little evidence that traditional Chinese medicine is any more effective than a placebo. Yes, hundreds of studies have been conducted on the mainland showing how much patients benefit from herbal remedies and acupuncture, but most are poorly constructed and/or biased. Many do not have a proper control group, meaning you don’t know if patients are really getting better because of the treatment, and not just from the placebo effect. Or indeed if they just got better, as most of us do most of the time.

In a 2008 review, researchers looked at more than 800 Chinese journals of medicine and pharmacy. They found only 77 placebo-controlled trials. This is what they said:

“After reviewing the 77 full-length articles, we found that nearly half of the clinical trials did not pay attention to the physical quality of the testing drug and placebo and whether they were of comparable physical quality. The rest provided very limited placebo information so that blinding assurance could not be assumed. Only 2 articles (2.6%) specifically validated the comparability between the testing drug and the placebo. Researchers in Chinese medicine commonly ignored the quality of the placebo in comparison to the test drug. This may be causing bias in the clinical trials. Quality specifications and evaluation of the placebo should deserve special attention to reduce bias in randomized controlled trials in TCM study.”

To be fair, poor study design and method is not limited to traditional medicine; there’s growing evidence that many, if not most Western medical studies are flawed or biased – but to nowhere near the extent of TCM.

Then there’s the very concepts on which it’s founded: Here’s what the respected journal Nature had to say in an editorial:

“So if traditional Chinese medicine is so great, why hasn’t the qualitative study of its outcomes opened the door to a flood of cures? The most obvious answer is that it actually has little to offer: it is largely just pseudoscience, with no rational mechanism of action for most of its therapies.”

And finally, why traditional Chinese medicine could actually be really, really bad for you: according to recent studies, bat species used in TCM have been found to carry coronaviruses.

(Alex Price is a journalist who has lived and worked in Hong Kong for over 30 years.)

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