China‘s Ancient Solution to the Contemporary Crisis in Medicine
Roger Jahnke, OMD
The Institute of Integral Qigong and Tai Chi (IIQTC)
Santa Barbara, CA
How To Be More Well, Reduce Medical Costs & Help Pay Off the National Debt: Ask the Chinese
Ancient China has been a source of profound treasure for millennia. Marco Polo brought back small portions of this treasure and for centuries traders carried bits of it out along the Silk Road – silk, spices and knowledge. Still today there are more of these treasures that we can freely borrow from China to enhance our world. One key treasure from traditional China that the West has almost completely discounted, until very recently, is the traditional health care system.
Conventional medical science has been so busy creating new technologies for treating disease that we have forgotten about caring for health. In the West we incorrectly believe that health care and medicine are the same thing. While we in the West have a truly fantastic, though very expensive, system based on treating people after they are sick, China has a profoundly remarkable and quite inexpensive system of health care based on keeping people well.
As we enter the new millennium, these two – the Western disease based system focusing on eliminating what is wrong and the Asian wellbeing based system focusing on enhancing what is right – are working together.
- In China, there is equal availability of traditional Chinese medicine and Western medicine in hospitals and clinics.
- This is now truer in the West.
- In China, health self-reliance and self-care (typically in the form of Qigong and Taiji) are prominent aspects of the national health care system.
- Health promotion and wellness programs are now more common in the West.
- In China, universal health care has been free.
- Health self-reliance and universal care are progressing in the West.
What would it be like if medical care based on natural healing methods – including acupuncture, massage, and herbal medicine, along with a strong tradition for self-care-were in place in the North America and Europe? We are seeing more of this integrative approach to health care every day, primarily because citizens (consumers) are demanding it and the emerging research on self-care, wellness, health promotion, stress management, etc is very compelling.
In addition, many companies are self-insuring (becoming their own insurance company and insuring their own employees). Even more exciting, many people are insuring themselves through health savings accounts. According to the Department of Health and Human Services (DHHS, Healthy People 2000 and 2010), 70% of all disease is preventable – that is, it is easier to prevent disease than we thought. This includes heart disease and diabetes, two of the most challenging and expensive disorders. Money spent on disease is wasted if people can stay well for free. The wellness based medicine of China and its inherent health improvement strategies – Qigong and Tai Chi — is a perfect complement to conventional medical strategies.
Collaboration between Chinese Medicine and Western Medicine
In China, Western medicine has been considered a form of alternative medicine for several hundred years. However, until 1919, traditional Chinese medicine, which includes massage, herbal medicine, acupuncture, and self-care practices (Qigong and Taiji), was the primary system of medicine. In the 18th and 19th centuries, some Western medical practices were available, mostly through missionaries. In 1919, when the last emperor stepped down, a number of Western medical schools were established in China, but it took until the 1990s (70 years) for Western medicine to be fully integrated into the overall health care delivery system. Now, the alternative, that is Western conventional medicine, has been almost completely integrated into China’s mainstream system of medical practice, which is still strongly founded in the ancient traditional system of medicine.
Today, there are only a few clinical settings in China where either traditional Chinese medicine or Western methods are delivered alone. For example, in some very rural clinics, acupuncture, herbal medicine, and massage are easy and inexpensive to deliver, but Western medicine is difficult and expensive to provide. A few specialty institutions in large cities exclusively use technological Western diagnostic methods, and follow up with primarily Western intervention procedures. However, most institutions that focus on Western methods typically have acupuncture, massage, and herbal medicine also available to reduce pain, mediate the side effects of medications, and support patients with regulation of sleep, bowel disturbances, pain, anxiety, and nausea.
The extent to which the Chinese have absorbed “alternative medicine”, (conventional Western medicine) into their system, is quite remarkable. It is apparent that the Chinese are proud of this collaborative, complementary, and comprehensive model. They have so completely embraced the alternatives to traditional Chinese medicine – surgical and drug based procedures – that all residents of Chinese cities have complete access to both.
One might wonder whether Chinese traditional physicians and Western physicians cooperate, and are they equally respected and equally compensated. Everyone in China typically makes approximately the same monetary wage: physician, teacher, administrator, bus driver, clerk (of course this is changing with the “market economy”). The public holds equal respect for all physicians, whether Western or traditional. Patients may have a bias based on specific experiences, but both traditional medicine and Western medicine are equally available and are typically paid for through universal access to health care resources.
Physicians who make the professional choice to adopt either traditional Chinese medicine or Western medicine tend to have strong biases. However, many physicians have trained in both areas. These individuals are often quick to express the benefits of both approaches, in spite of their final choice to practice primarily one or the other.
The Chinese Model for Integrating Western medicine with Natural Healing Methods
At the Shanghai Traditional Medicine Hospital, one of the Chinese culture’s most current and comprehensive approaches to medicine is revealed. The hospital merges the very best of traditional Chinese medicine and the best of Western medicine in a beautiful, new, 500-bed facility with an out-patient clinic that serves 1,000 patients per day. The chief administrator was asked, “Why do you combine systems of medicine in this way?” His answer was, “It is the most efficient and cost effective way to serve large numbers of people who have a broad variety of clinical needs.”
The model below, which is from the Shanghai Traditional Medicine Hospital, is typical of the integration of traditional Chinese Medicine and conventional Western medicine throughout China – and provides a provocative model for integrative medicine in the West:
Step 1. Diagnosis: All patients are diagnosed using traditional methods: pulse, tongue, and questioning. This requires no technological equipment and is therefore extremely inexpensive and immediate. This diagnostic strategy is sufficient in over 50% of cases, encompassing both in- and out-patient groups and it is the least costly approach to diagnosis.
Step 2. Diagnosis: Only when necessary, confirmation of diagnosis is provided through Western diagnostic methods. This combination is utilized in less than 50% of all cases. If needed, the latest technology is available: complete laboratory for all currently standard, body chemistry studies, X-ray, CT Scan (computer topography), and MRI (magnetic resonance imagery). The increase in cost is significant.
Step 3. Treatment: In almost all cases, the first layer of treatment uses traditional Chinese natural healing modalities (acupuncture, massage, herbs) and self-care (Qigong and Tai Chi) training. Even individuals who have taken step 2 into Western diagnostic methodologies generally receive traditional medical treatment. The cost is minimal.
Step 4. Treatment: Western medical treatment is given generally when traditional treatment is not sufficient. Because of their recognized value in managing the side effects of drugs and radiological intervention and in mediating symptoms of insomnia, nausea, aches and pains, constipation, anxiety, and depression, the traditional modalities (acupuncture, massage, herbal formulas, and Qigong and Tai Chi practice) are frequently integrated with Western medical treatment programs.
Self-Care in China
In China, the true definition of health care is to care for one’s health – maximize one’s assets. The rationale for self-care is that if citizens can do self-applied health enhancement methods (SAHEM), in the comfort of their own home or in a nearby park for no cost, then the primary aspect of health care – caring for one’s health –is free. An ancient Chinese tradition encourages citizens and physicians to take great pride in healthy longevity. One of the most ancient and revered codes of traditional medicine states, “The superior physician teaches people to sustain their health, rather than treating them after health is lost.” In the health crisis (of cost and quality) in the U.S., what could be more useful and cost effective than “free” health care? In China, this variety of free health care is being utilized by millions of people every day, and it is actively supported by the Chinese government.
In numerous meetings with the ministry of health in numerous provinces, we have asked, “What is the foundation of the public health system”. In all cases the response has been, “Have you been to the parks at dawn?”
Chinese self-care, Qigong and Tai Chi, combines careful regulation of breath, deep states of relaxation, specific regulation of bodily movement and posture, and, in certain forms, self-applied massage to generate a physiological and energetic state termed the Qigong state. This state is unique in its comparison to aerobics, jogging, and muscle-building, because of the simultaneous application of deep states of relaxation and intentful focus on the Qi – energy of life. Qigong requires no special equipment. While aerobics, jogging, and even walking require that the individual be relatively fit, people who are very sick and incapacitated can easily practice Qigong and simple forms of Tai Chi.
There are many varieties of Qigong self-care practice. Some are very mild and aimed at the severely unwell. Taiji (tai chi), with which most Americans are familiar, is a moderate level of Qigong that is both curative and preventative. Certain types of wu shu and gung fu (martial and athletic forms) are very dynamic. However, when breath regulation and deep relaxation accompany the movements, the Qigong state can be attained. The Qigong state is characterized by a balanced coordination of the healing and health-sustaining resources in the body, including immune function, oxygen distribution, lymphatic flow, autonomic balance, and the ample and free-flowing activity of the body vitality – Qi.
The Clinical and Economic Benefits are Compelling
The most obvious economic benefits to an integrated or comprehensive health care model in the U.S. can be summarized as follows: Many disorders respond immediately to acupuncture, massage, and herbal formulas. A series of visits with an acupuncturist and a course of one or two herbal formulas often will clear the case. This is why the Chinese use the four-step model outlined above is so profound. Natural methods that cause no side effects.
Self-care (Qigong and Taiji) are powerful complements to either Chinese or Western treatment. Most importantly, in many cases Qigong and Tai Chi alone can resolve a wise array of health challenges for no cost – that is for free.
The expense of treatment with acupuncture, massage, and herbs is less than with Western medicine. Often the cost of treatment with natural methods is less expensive than even preliminary diagnostic procedures in the West. Massage involves no technology and minimal supplies. Acupuncture requires only minimal technology, if electrical stimulation is used, and minimal supplies. Herbal formulas (also homeopathic remedies-not Chinese) have not historically required FDA approval and are therefore much less expensive than pharmaceutical drugs. These examples suggest that integrative medicine, including the traditional Chinese modalities, will have dramatic economic benefit.
A Renaissance in Health Care and Medicine
In Chinese medical tradition there are two forms:
- Attack the disease – kill or excise the pathogen, fix what is wrong
- Maximize the host – support the righteous, optimize what is right
Until recently we have only done number 1 in the West. The emerging new medicine with more wellness focused health care does both. Qigong and Tai Chi, of course, empower people to health themselves for free.
This a contemporary renaissance!
Use natural, wellbeing based, less expensive strategies whenever possible, only use more expensive disease focused treatment whenever it is absolutely necessary.
By Roger Jahnke, OMD
Director of Institute for Integral Qigong and Tai Chi (IIQTC), Santa Barbara, CA
Dr. Jahnke, a physician of Chinese traditional medicine for 30 years, with eight research trips to China’s universities, institutes and sacred mountains, is the author of The Healer Within (Harper-Collins, 1999) and The Healing Promise Qi (McGraw-Hill, 2002). The Institute of Integral Qigong and Tai Chi provides training for teachers, workshops for the public, cutting edge research and is the originating institution for Tai Chi Easy ™, an approach to Qigong and Tai Chi designed to make the benefits more widely accessible.
For the original version of this article in Qi Journal please see: