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Axel Wright
Axel Wright

Traditional Medicine In Asia BEST



Background and Purpose. Traditional medicine (TM) has been widely used in China (including the Taiwan region), Korea, and Japan. The purposes of this paper are to summarize the basic data on TM systems in these three countries and to compare them in terms of overall policy, education, and insurance. Methods. Government websites, national statistics, and authoritative papers from each country were fully searched. Further data were gathered by TM experts from each country. Results. China and Korea showed similar patterns in TM systems, whereas Japan showed different patterns. In China and Korea, TM was practiced in a dual system with conventional medicine (CM), and TM education was 6-year training programs on average for TM doctors, and acupuncture, moxibustion, and cupping were completely insured. Whereas, CM was dominant in Japan, and TM was practiced by each health care worker who has received different TM education respectively, and main TM therapies were partially insured. Conclusions. TM was developed similarly or somewhat differently based on differences in cultural background and national policies in East Asia. We cautiously propose that this study could contribute to the development of TM and also be used for reference in complementary and alternative medicine systems.




Traditional Medicine in Asia


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East Asian medicine is known to have originated in China about 3,000 years ago [3]. It was introduced to Korea with Buddhism and to Japan with Chinese culture beginning in the 6th century [4, 5]. It has been widely used following a long history, and practices in the three countries strongly influenced each other. Before Western culture was introduced to East Asia in 19th century, TM was the main medical system used to treat all types of diseases [2].


TM doctors, whose activities are defined by law and regulated by the government of each country, have three different specialties in mainland China: TCM, integrative medicine, and other ethnic medicine doctors. Only one kind of doctor, TCM (or TKM) doctors, are found in the Taiwan region and Korea, respectively, in contrast with conventional medicine (CM) doctors (including dental doctors). The percentage of TM doctors in medical facilities (hospitals and clinics) was the highest in Korea, at 15.26%, followed by mainland China, at 12.63%, and the Taiwan region, at 9.69%. For Japan, the percentage of Kampo doctors who are medical doctors and members of a nongovernmental academic society, the Japan Society for Oriental Medicine, was estimated to be 0.65% in 2008.


The Ministry of Health and Welfare of Korea implemented a TKM specialist training system in 1999 that follows the model of the CM specialist system. Medical care is provided in 8 departments: internal medicine, gynecology, pediatrics, neuropsychiatry, acupuncture and moxibustion, ophthalmology-otorhinolaryngology-dermatology, rehabilitation medicine, and Sasang Constitutional medicine. After obtaining a TKM license, a practitioner can become a TKM specialist through 4 years of additional training in a designated TKM hospital (a 1-year internship and a 3-year resident course). These practitioners accounted for 9.1% of all TKM licensed doctors by 2009 [12].


All three countries have insured TM procedures: mainland China since 1951; the Taiwan region since 1995; Korea since 1987; and Japan since 1976, only for Kampo (Table 3). Mainland China had the most reimbursable treatments: acupuncture, moxibustion, cupping, and manual therapies are completely covered, and herbal medicines are partially covered. Acupuncture, moxibustion, and cupping were usually completely covered by medical insurance in mainland China, the Taiwan region, and Korea. Herbal medicines are divided roughly into two types: concentrated herbal extracts provided by a drug company according to GMP and decoctions of raw herbs prepared in medical facilities. In mainland China, herbal extracts are insured if they are accorded to the nominated indication (nominated to be applicable for specific diseases), and most of decoctions of raw herbs are also insured except for very precious medicine, herbal paste, and medicine without the nominated indication; herbal extracts are mostly insured, but decoctions of raw herbs are not in Korea; meanwhile, because only herbal extracts based on GMP are used in Japan, they are completely covered. Coverage of manual therapies was different in each country. Data on the proportion of reimbursement for TM treatments were not available for mainland China and Japan, whereas the Taiwan region showed a reimbursement rate of 5.59%, and Korea 4.04%.


We discovered substantial differences between the TM practices of three East Asian countries, especially TCM (or TKM), and CAM in Western society. First, TCM (or TKM) has been considered as a dual medical system with CM, unlike CAM. Second, the practice of and training in each therapeutic method of TM was combined under TCM (or TKM) theory, whereas in Western society, each therapy is offered individually, either together with or in place of CM [22]. The use of acupuncture has become common in Western society, as there are an estimated 15,000 acupuncturists in Europe [9], but the situation is different for other therapies. We think this difference arises from differences in cultural background. Third, the main therapies of TM were covered, completely or partially, by national health insurance, unlike in Western society, where only a few therapies of TM are covered by private health insurance. Eventually, TM infrastructure, from national licenses and resources, education, and medical insurance coverage to monitoring of herbal medicines, was developed organically, and the TM systems in each of the three countries influenced the others.


Yet a bit of probing revealed what a complex story this is. Not only are big efforts underway to modernize traditional medicine in China and Japan, but Western medicine is adopting some aspects of the Eastern point of view too. In particular, modern medical practitioners are coming around to the idea that certain illnesses cannot be reduced to one isolatable, treatable cause. Rather, a fall from good health often involves many small, subtle effects that create a system-wide imbalance.


Although artemisinin and arsenic trioxide are the archetypal examples of successful modern medicines mined from traditional Asian medicine, they do not represent the ideal convergence of the two systems. There are unique aspects to traditional Asian medicine that could hold great promise if they are artfully investigated. The goal of science should be to rigorously test each claim and sort the medical wheat from the pseudoscientific chaff.


Some psychological and/or physical approaches used in traditional Chinese medicine practices, such as acupuncture and tai chi, may help improve quality of life and certain pain conditions. Studies of Chinese herbal products used in traditional Chinese medicine for a range of medical conditions have had mixed results.


Traditional Chinese medicine (TCM) has evolved over thousands of years. TCM practitioners use various psychological and/or physical approaches (such as acupuncture and tai chi) as well as herbal products to address health problems.


Ethnobotany, as a research field of science, has been widely used for the documentation of indigenous knowledge on the use of plants and for providing an inventory of useful plants from local flora in Asian countries. Plants that are used for traditional herbal medicine in different countries are an important part of these studies. However, in some countries in recent years, ethnobotanical studies have been used for the discovery of new drugs and new drug development. In general, experiences gained from ethnobotanical approaches of traditional medicinal studies in China and Himalayan countries have helped drug production and new drug development. At the same time, in many cases, over-harvesting, degradation of medical plants, and loss of traditional medical knowledge in local communities are common problems in these resource areas. Issues of indigenous knowledge, intellectual property rights, and uncontrolled transboundary trade in medicinal plants occur frequently in the region. This paper discusses ethnobotanical approaches of traditional medicinal studies, in reference to experiences from China and Himalayan countries, with an emphasis on the conservation of traditional medical knowledge and medical plant resources.


According to some estimates, as much as USD $10 billion is spent every year on alternative therapies. Over USDA $650 million is spent on botanical supplements that are used for chronic inflammatory diseases such as chronic obstructive airways disease (COPD), asthma, and rheumatoid arthritis. Botanical supplements have been used for centuries in traditional medicine, including Ayurveda (science of long life), Chinese medicine, Kampo (Japanese medicine), and Egyptian medicine. Several of the medicines that are traditionally used exhibit anti-inflammatory activities (Garodia et al. 2007; Aggarwal et al. 2006). Turmeric is one such herb.


In folk medicine, turmeric has been used in therapeutic preparations over the centuries in different parts of the world. In Ayurvedic practices, turmeric is thought to have many medicinal properties including strengthening the overall energy of the body, relieving gas, dispelling worms, improving digestion, regulating menstruation, dissolving gallstones, and relieving arthritis. Many South Asian countries use it as an antiseptic for cuts, burns, and bruises, and as an antibacterial agent. In Pakistan, it is used as an anti-inflammatory agent, and as a remedy for gastrointestinal discomfort associated with irritable bowel syndrome and other digestive disorders. In Pakistan and Afghanistan, turmeric is used to cleanse wounds and stimulate their recovery by applying it on a piece of burnt cloth that is placed over a wound. Indians use turmeric, in addition to its Ayurvedic applications, to purify blood and remedy skin conditions. Turmeric paste is used by women in some parts of India to remove superfluous hair. Turmeric paste is applied to the skin of the bride and groom before marriage in some parts of India, Bangladesh, and Pakistan, where it is believed to make the skin glow and keep harmful bacteria away from the body. Turmeric is currently used in the formulation of several sunscreens. Several multinational companies are involved in making face creams based on turmeric. 041b061a72


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