Written by Daniele Mario Buonomo.
The diffusion and practice of Traditional Chinese medicine (TCM) is an important issue both in the Chinese and Western worlds. In European and Western countries, TCM, and specifically acupuncture, is increasingly popular. In 1979, for the first time, acupuncture and moxibustion received the attention of the World Health Organization. TCM’s importance has even been stressed in 2010 by UNESCO, who inscribed acupuncture and moxibustion on the Representative List of the Intangible Cultural Heritage of Humanity. I became curious to learn more about TCM a few years ago. As a bachelor student, I explored the question of the (re)production and performance of traditional Chinese medicine in Italy, where a certain number of doctors practice it. In that work, I focused on acupuncture as a practice that oscillates between its cultural dimension and therapeutic use by analysing how it penetrated Italian society and culture. That study ended with a question: What does it mean to practice acupuncture in a country where biomedicine plays a key role and thus portrays TCM as marginal? Based on this question, I pushed my reflection further. Answering this implies integrating an essential and ongoing debate about the relationship between modernity and tradition.
From the 16th century, when early Chinese immigrants brought traditional Chinese medicine to Taiwan, to 1966, when for the first time Taiwan’s China Medical College offered a professional traditional Chinese medicine medical degree, Taiwanese practitioners—according to the same tradition practised in China for over 2000 years—learned TCM through apprenticeships and self-study. In 1895, when Japan began to rule in Taiwan, Western medicine were favoured and promoted. The Japanese government replaced Chinese medicine practitioners with physicians trained in modern Western medicine and, in 1899, established the first medical school of modern Western medicine. Since 1945, when the Chinese Nationalist government took over Taiwan, TCM has been allowed to coexist with modern Western medicine, but the government pushed for its modernisation. Although this push toward modernising TCM based on a scientific paradigm continues up to our age, in Taiwan – and everywhere globally – the tradition has not disappeared. The dynamics between tradition and modernity have hybridised. Studying the making, development, and circulation of traditional medical knowledge – from China and Taiwan, to the globalised world – implies identifying how TCM is appropriated, translated and transformed by the Western world. In the age of globalisation, the traditional dichotomy between Western linear epistemology and Chinese circular knowledge-production processes are challenged. Novel points of conjunction and disjunction seem to emerge and point out the importance of studying how knowledge is appropriated, translated and transformed.
Moreover, it is essential to analyse the(re)creation and remodelling of tradition over time. As we saw earlier, regarding the Taiwanese TCM story—even during a period where modernity plays a vital role—tradition persists. Even in an age characterised by globalisation, traditional practices continue. Thus, by exploring the relationship between modernity and tradition and globalised and local cultures, I investigate the differences and similarities in TCM’s ways nowadays, which local practitioners still perform in Milan. To do so, I conducted interviews with ten local doctors and practitioners in Milan, who are all of Italian nationality, except for one coming from Vietnam. I identified them online by visiting their websites. I have also analysed how they appropriated traditional Chinese medicine, scrutinising the different ways TMC mixes and merges with biomedicine and other Western medical disciplines and how it is taking an increasingly hybrid shape. This means that traditional Taiwanese and Chinese medical knowledge – produced in loco – takes an increasingly global form when exported to the Western world. Therefore, it does not lose its original significance in terms of content and practices. However, it mixes and merges with other European and, broadly, Western practices.
In this respect, I have identified the differences and similarities in interpreting such practices in Milan. I have discovered the reasons for choosing to practice TCM instead of Western medicine, making diagnosis and agreeing about the limits and areas of action for acupuncture. I realised that doctors decide to use TCM because “Western medicine is not complete,” “it has a holistic view,” “it goes to the origin of things,” “it does not have a mind and psyche division,” “it works,” “it cures without having to administer medicinal substances” and “it gives importance to the dimension of prevention.”
Regarding these latter two aspects, I discovered that local practitioners in Milan use both Chinese and Western diagnoses, often based on medical tests. They, moreover, consider that acupuncture has its maximum effectiveness when there is no significant anatomical modification. On the other hand, the dissimilarities concern selecting TCM’s techniques, the modality of inserting and choosing needles, the biomedical explanation of acupuncture functionality, and the significance of ancient books, particularly to the I-Jing. Regarding these aspects, I have identified three heterogeneous categories into which traditional Chinese medicine practitioners can be classified: the “Purists,” the “Integrators,” and the “Hybridisers.”
Starting with the “Purists,” I identify subjects who studied TCM with teachers from, or trained in, East-Asia, particularly Vietnam and Taiwan. They perform, following the teachings of their masters, a more “traditional” TCM. This implies that by traditional, they mean a practice that “did not change during the time” or a practice that has been defined as “the real Chinese medicine, as it was performed before its modernisation”. On the other hand, the “Integrators” studied traditional Chinese medicine in or with different masters from Europe, Taiwan, and China. They integrate TCM with biomedicine, both in the diagnosis and the practices, with different assimilation levels. There are those who say, “I refer to the scientific literature that states to prick those points there” to the ones who declare: “When I cannot come to the head of a diagnosis, or it seems to me correct but the therapy does not work, also in order to know if perhaps we need to completely change the therapy, stop doing acupuncture and send the patient to different doctors, then I use the I-Jing”. In short, they practice traditional Chinese medicine stating: “we are first of all Western doctors.”
The last category, the “hybridisers,” comprises doctors who mainly studied traditional Chinese medicine in Italy with Italian masters. Their medical training and studies vary and range between TCM, biomedicine, psychology, homotoxicology and homoeopathy. They have a personal way of practice based on the hybridisation of different disciplines. They perform what is called alternative medicine—as clearly emerged through interviews—for example, when one said, “I integrate homosynergetic medicine with acupuncture. In the end, I also test the acupuncture points to be used with the kinesiological test.”The words of such doctors, along with the data I have collected, illuminate how nowadays, in Milan, TCM—specifically regarding acupuncture—oscillates between modernity and tradition and the extent to which this brings about syncretic, hybrid and localised practices.
Daniele Mario Buonomo is a MA student of Anthropological and Ethnological Sciences at University of Milan Bicocca, in Italy. His dissertation focuses on the ways traditional Chinese medicine is practiced in Milan: a subject that he has studied since his BA final project. He also works as a cultural and linguistic mediator specialized in Chinese, English, and Italian languages.
This article was published as part of a Special Issue EATS 2021: Narrating Taiwan