The World Health Organization (WHO) has announced their 11th version of the International Statistical Classification of Diseases and Related Health Problems (ICD). In a controversial new chapter they include Traditional European Medicine diagnoses, such as excess bile or stagnant blood.

These diagnoses refer to Galenic medicine, which is almost 2,000 years old and dominated Western medicine for 13 centuries. Treatments frequently include blood letting and purgatives, and are based on traditional examinations, which may include a detailed analysis of the color of one’s urine.

By including Galenic medicine in the latest WHO classification, this will allow researchers to track the use of these methods more accurately. Patients may also find such traditional practices more affordable and accessible, and this will also encourage insurance companies to offer coverage.

Oh, except there is one tiny change – the WHO is endorsing Traditional Chinese Medicine (TCM), not traditional European medicine. But the move is just as unscientific and outrageous.

A Nature article discussing the move is also frustratingly replete with false balance. Absent in the article is the appropriate outrage that anyone who cares about people’s health and having a legitimate healthcare system should feel.

TCM is essentially the equivalent of bloodletting in the East. The Nature article gives a concise definition:

TCM is based on theories about qi, a vital energy, which is said to flow along channels called meridians and help the body to maintain health. In acupuncture, needles puncture the skin to tap into any of the hundreds of points on the meridians where the flow of qi can be redirected to restore health. Treatments, whether acupuncture or herbal remedies, are also said to work by rebalancing forces known as yin and yang.

The obvious problem with basing an entire system of medicine on qi is that qi does not exist. It does not exist anymore than miasms, the four humours, or the goblins diagnosed by Theodoric of York. There is no mysterious “life force” by any name. Such a concept is utterly devoid of any evidence, and there is no reason in our modern understanding of biology to even entertain such a hypothesis. Acupuncture points also do not exist, and there is no even theoretical physiological or anatomical basis for their existence.

None of this should be surprising. The concepts if qi, yin, and yang were developed by long before the methods of science were developed, before any real understanding of the human body or the nature of real disease. For these ideas to persist into the modern era is an affront to all that we have accomplished.

Again, the Nature article blithely tells of the difference between TCM and modern medicine:

For example, ‘wasting thirst syndrome’ is characterized by excessive hunger and increased urination and explained by “factors which deplete yin fluids in the lung, spleen or kidney systems and generate fire and heat in the body”. On the basis of those observations, physicians can work out how to treat them. The patient, who would probably be diagnosed as diabetic by a Western doctor, would probably be prescribed acupuncture, various tonics and moxibustion — in which practitioners burn herbs near the skin of the patient. Spinach tea, celery, soya beans and other ‘cooling’ foods would also be recommended.

Patients with out-of-control diabetes can have such high blood sugar that the glucose cannot be fully reabsorbed by the kidneys, and it starts spilling over into the urine. Glucose in the urine acts as an osmotic, which draws more water into the urine, causing increased urination, dehydration, and thirst. The loss of glucose, which would otherwise be feeding the cells, also causes hunger, and may result in rapid weight loss.

This is an extremely serious medical condition, that if untreated can lead to serious complications and even death. Our modern understanding is sufficient to treat the specific mechanisms of the disease, to reduce the blood glucose levels and avoid these serious outcomes.

The TCM interpretation of these symptoms is not based on any real knowledge, but on superstitious nonsense that has no relationship to reality. TCM treatments are completely ineffective, because they are not addressing anything real.

The WHO is now endorsing and encouraging the spread of nonsensical magical treatments for real and serious medical conditions for which we have effective science-based treatments. They are doing this in the name of universal health coverage. How do they justify this? With the usual dodge:

In response to queries by Nature, the WHO said that its Traditional Medicine Strategy “provides guidance to Member States and other stakeholders for regulation and integration, of safe and quality assured traditional and complementary medicine products, practices, and practitioners”. It emphasized that the goal of the strategy “is to promote the safe and effective use of traditional medicine by regulating, researching and integrating traditional medicine products, practitioners and practice into health systems, where appropriate”.

Regulating pseudoscience does not help – it just legitimizes the pseudoscience. There is no quality assurance without some objective measure of safety and efficacy, which TCM lacks. Effective regulation and quality control are incompatible with an unscientific basis of health care. As the article also notes – the committee assigned to developing the chapter on TCM was basically reduced to different traditions (Korean vs Japanese vs Chinese) arguing with each other over priority. There was no evidence to resolve differences.

Part of the reason for this unfortunate move is touched upon by the article, but the author does not really drive home the implications:

The WHO’s support applies to all traditional medicines, but its relationship with Chinese medicine, and with China, has grown especially close, in particular during the tenure of Margaret Chan, who ran the organization from 2006 to 2017.

China has been making a strong push to promote TCM, to capture a big part of the medical tourism market. Chan essentially spent 11 years as head of the WHO to promote TCM, and this is the culmination of her work.

In my opinion, this is rank exploitation. The WHO is doing a great disservice to the people of the world and are violating their very purpose for existing. The WHO exists to raise the quality and access to care around the world. Promoting pseudoscience and pre-scientific superstition will have the opposite effect. This is an epic failure.

While there are many critics of this move, their voices do not appear to be resonating. This should be a scandal, and there should be outrage at this malfeasance. TCM is now nothing more than a harmful scam hiding behind traditional culture.

What the WHO should be doing is fighting for the proper health care of Chinese citizens, and all people, and protecting them from healthcare exploitation. Instead, they are exporting this exploitation to the world.

I can only hope that a future generation will see this as the shameful failure that it is.


Posted by Steven Novella

Founder and currently Executive Editor of Science-Based Medicine Steven Novella, MD is an academic clinical neurologist at the Yale University School of Medicine. He is also the host and producer of the popular weekly science podcast, The Skeptics’ Guide to the Universe, and the author of the NeuroLogicaBlog, a daily blog that covers news and issues in neuroscience, but also general science, scientific skepticism, philosophy of science, critical thinking, and the intersection of science with the media and society. Dr. Novella also has produced two courses with The Great Courses, and published a book on critical thinking - also called The Skeptics Guide to the Universe.