by Bob Flaws

In my experience, as recent converts to Chinese medicine, we tend to be starry-eyed and gullible as a group. We are so enamored of this new love of our life that we often fail to ask some really important questions, questions we would normally ask when dealing with more familiar, less romantic areas of our life. Many of us are still infatuated by this medicine, this "brave new world." We've stepped into a new universe. We love it, and we want more and more of it. However, it's well known that converts are often stronger (and more gullible, more fanatical, and more fundamentalist) believers than people who have grown up within a tradition. People who have grown up within a tradition have a greater depth of familiarity with it and are aware of some of the negatives neophytes are ignorant of or willfully blind to. Sometimes our enthusiasm feels a bit naive in retrospect, but ultimately it is just a normal expression of our inherent passion. In some ways, it is a perfectly natural stage of evolution in a person's familiarity with and, therefore, understanding of something new and alluring.

For instance, some readers may gasp at the idea that quackery was and is an on-going problem in Chinese medicine. This is nothing new. If you read the premodern Chinese medical literature (such as Blue Poppy's Great Masters Series), famous Chinese authors frequently bemoaned the prevalence of quacks working within their society. For instance, Zhang Jing-yue created his famous 10 questions in the late Ming dynasty because it was so easy for supposed "experts" to simply feel a patient's wrist and then tell them they needed to buy some very expensive medicine that they or their associates just happened to have on hand. Imperial medical bureaus, colleges, and their examinations existed dynasty after dynasty in Old China, in part, to try to weed out these quacks. Several years ago, the famous German sinologist Paul U. Unschuld wrote about the history and prevalence of quackery in Chinese medicine. Although, to my knowledge, this essay has never been translated into English, I can tell you it caused apoplexy among many "younger" German practitioners I know. Here in N. America, there has been at least one instance of a "famous" doctor of Chinese medicine selling licensing exam answers to those who simply wanted Green Cards, and, in large cities, more than a few "acupuncture clinics" are simply fronts for prostitution. However, more worrisome are those "practitioners" who purposely cheat their naive patients by selling supposed secret formulas at inflated prices based on little or no medical justification. This topic has been explored in the Chinese literature for centuries.

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Unfortunately, just as there may be quacks in day-to-day medical practice, there may also be con artists among our teachers. Such teachers may purport to have marvelous pedigrees, but has anyone actually checked them out? They may teach wonderful esoterica, just the stuff we want and love to hear, but do they ever actually give verifiable citations? Do they give any kind of actual evidence for their wonderful ideas and arcane techniques? How many cases are they talking about over what length of time? "A single swallow does not a summer make," and a single case history is next to worthless as medical evidence. This issue is especially difficult to talk about in public because we are often most easily fooled by people who come from far away, speak a different language, and look different from ourselves. Thus caveats such as mine may be mistaken for supposed racism. However, such people are, in every sense of the word, exotic, and sometimes we mistake language, citizenship, or ethnicity for competency and real credentials. Naturally, these issues cross all cultural and national boundaries, and can be found the world over.

What does all this mean for us as "consumers" of Chinese medicine? In two words, caveat emptor, let the buyer beware. In particular, as students, listeners, and readers, we need to constantly demand evidence from our assumed authorities. When possible, we should actually check out people's credentials, especially if those credentials seem extraordinary. When things seem to be too good to be true, the fact is they usually are. When teachers tell us something clothed in the language of fact, we need to ask for evidence. Who said that, where, when, and in what context? When we know those things, we have the ability to judge the credibility of that supposed fact. Often in Chinese medicine, this means citing a classic or other premodern text that an idea or treatment comes from. In other cases, it may be the citation of a case history, a cohort study, a randomized comparison study, animal experiment, or laboratory analysis. Each of these types of evidence has a different weight in terms of its credibility. If someone has come up with a new idea on their own, then we need to know that that is what it is. If, over time, evidence supports that new idea or technique, then the originator may be hailed as a great innovator. But we won't know that until some evidence supporting that idea or technique accumulates to a sufficient degree.

The less we are a careful and critical consumer of Chinese medicine, the more easily and the more likely it will be to fall prey to unscrupulous quacks and frauds, and, if history is any precedent, they are out there. Be a savvy consumer. It's not all good!

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