Two medicines, one medical record
Most countries treat traditional medicine and modern medicine as separate systems. A patient sees a family doctor for a prescription and a private practitioner for acupuncture. The two do not speak to each other, and no single clinician holds both parts of the case.
China is organised differently. A large public hospital in China usually contains a Department of Traditional Chinese Medicine and a Department of Integrated Chinese and Western Medicine. These departments sit in the same building as the surgical wards. They write into the same medical record. They attend the same multidisciplinary meetings. The national qualification system recognises both, and the national health insurance system pays for both.
This article explains three things. First, it explains what Chinese medicine has already contributed to modern drug development, because two well-documented cases are more persuasive than any general claim. Second, it explains how the integrated model works in a Chinese hospital and where it produces measurable advantage. Third, it explains where the limits are, because a patient who plans a trip needs to know those limits before paying for a flight.
What Chinese medicine gave modern pharmacology
Artemisinin: a classical text led to a Nobel Prize
Tu Youyou received the 2015 Nobel Prize in Physiology or Medicine for the discovery of artemisinin. The starting point was a document written in the fourth century by Ge Hong, a physician of the Jin dynasty. The text is titled Zhouhou Beiji Fang, which translates as Handbook of Prescriptions for Emergencies. One line in that text describes soaking a handful of qinghao in water and pressing out the juice for the treatment of fever.
Tu Youyou noticed that previous extraction attempts had used heat, and that heat destroyed the active compound. The classical instruction used cold water. That single detail directed her team toward a low-temperature ether extraction. The result was a drug that has saved several million lives and remains the standard treatment for severe malaria worldwide.
The point of this example is not that all old remedies work. The point is that a written clinical observation, recorded more than sixteen hundred years ago, contained information that modern laboratories had not generated. The knowledge was not replaced. It was tested, refined, and then used by modern medicine.
Arsenic trioxide: a disease that changed from fatal to curable
Acute promyelocytic leukaemia, usually shortened to APL, was once described as the most dangerous form of leukaemia. Most patients died within days or weeks of diagnosis, often from bleeding in the brain.
The treatment of APL changed through work done in China. The change has two independent components. Wang Zhenyi and his group at Shanghai Ruijin Hospital developed differentiation therapy using all-trans retinoic acid, known as ATRA. Zhang Tingdong and his group at Harbin Medical University established the clinical value of arsenic trioxide, which is the active ingredient of arsenic, a substance that Chinese medicine had used under the name pishuang.
The two treatments were then combined, and the mechanism was clarified by Chen Saijuan and colleagues at the Shanghai Institute of Hematology, who identified the specific chromosomal translocation that drives the disease. According to a 2025 review published in the Chinese Journal of Hematology, the combination of ATRA and arsenic trioxide raised five-year overall survival from below 35 percent to above 90 percent.
This result is not a claim made by an interest group. Arsenic trioxide combined with ATRA is now part of the international standard of care for APL. A drug derived from a traditional Chinese mineral, validated in Chinese hospitals, became a standard treatment worldwide.
What the Chinese system actually looks like
The scale is difficult to convey with adjectives, so here are the numbers. The National Health Commission publishes an annual statistical bulletin on health development. The 2024 bulletin reports the following figures for Chinese medicine.
| Indicator | 2024 figure |
|---|---|
| Traditional Chinese medicine institutions | 103,704 |
| Traditional Chinese medicine hospitals | 6,397 |
| Beds in these institutions | 1.823 million |
| Practitioners with a Chinese medicine licence | 971,000 |
| Annual outpatient visits | 1.68 billion |
| Annual discharges | 52.71 million |
Two further figures matter more than the totals. In 2024, 99.7 percent of community health centres in China provided Chinese medicine services. Among township health centres, the figure was 99.8 percent.
This level of coverage does not exist in any other country. It means Chinese medicine in China is not an alternative sector visited by people who have rejected hospitals. It is a routine part of primary care, used by patients who also use surgery, chemotherapy and imaging. A patient does not choose one system and abandon the other. The two run in parallel, inside the same institution.
The World Health Organization added a chapter on traditional medicine to the eleventh revision of the International Classification of Diseases, which came into effect in 2022. China was the main driving force behind that chapter. The purpose is not to endorse every traditional practice. The purpose is to create a common language for recording and researching them.
How integration works in practice
The Chinese term for the integrated approach is Zhongxiyi Jiehe. It is a formal medical specialty with its own training pathway, its own departments, and its own academic journals. It is not a courtesy arrangement.
The pattern that repeats across Chinese tertiary hospitals is a division of labour rather than a competition.
| Stage of care | What modern medicine contributes | What Chinese medicine contributes |
|---|---|---|
| Diagnosis | Imaging, pathology, laboratory tests | Syndrome differentiation to describe the patient's overall pattern |
| Active treatment | Surgery, chemotherapy, radiotherapy, targeted drugs | Support of appetite, sleep, digestion and energy during treatment |
| Side-effect control | Antiemetics, growth factors, dose adjustment | Acupuncture for nausea; herbal formulas for fatigue and dry mouth |
| Recovery | Physiotherapy, rehabilitation medicine | Acupuncture, tuina massage, herbal medicine, exercise therapy |
| Long-term follow-up | Surveillance imaging, laboratory monitoring | Constitutional adjustment, relapse prevention, quality of life |
In a hospital that runs this model, a patient having chemotherapy for lung cancer may receive antiemetic drugs from the oncology department and acupuncture from the Chinese medicine department in the same week. Both treatments appear in one chart. The oncologist knows what the acupuncturist is doing. If the patient develops a new symptom, both clinicians read the same test result.
This coordination is the practical advantage. In most countries, a patient who wants both systems must manage the two providers personally, and neither provider sees the other's notes. The Chinese arrangement removes that burden from the patient.
Where the advantage is measurable
Three areas have evidence strong enough to describe without qualification.
Nausea and vomiting caused by chemotherapy
The strongest evidence for acupuncture in cancer care concerns chemotherapy-induced nausea and vomiting. Multiple systematic reviews and clinical guidelines support acupuncture as an addition to standard antiemetic drugs. The Society for Integrative Oncology includes it in its guidelines, and the American Society of Clinical Oncology has endorsed that guidance. In Chinese hospitals, this is routine practice rather than an experimental option.
Chronic pain
A large individual patient data meta-analysis published by Vickers and colleagues analysed 39 trials with 20,827 patients. Acupuncture produced a statistically significant reduction in chronic pain compared with sham acupuncture, and a larger reduction compared with usual care without acupuncture. The average effect is moderate. It is not a cure, and it does not replace surgery when surgery is indicated. It is, however, a real effect that has been reproduced across many independent trials.
Stroke rehabilitation
The advantage in stroke care comes from the rehabilitation system rather than from the needles. Chinese tertiary hospitals admit stroke patients to a dedicated rehabilitation ward, where physiotherapy, occupational therapy, speech therapy and acupuncture are delivered daily over several weeks. The intensity and the inpatient structure are the active ingredients. A 2020 Cochrane network meta-analysis found that organised inpatient stroke care, delivered by a coordinated team, improves outcomes. China delivers that structure at a cost that most patients from Europe or North America can afford.
How Chinese medicine understands illness
A patient who arrives expecting a single diagnosis may find the consultation unfamiliar. Chinese medicine describes illness through patterns rather than through a single disease label.
A practitioner takes the pulse at three positions on each wrist, examines the tongue, and asks about sleep, appetite, digestion, temperature preference and emotional state. These observations are organised into a pattern, called a zheng. Two patients with the same Western diagnosis may receive different patterns and therefore different formulas. One patient with rheumatoid arthritis may be classified as cold-damp, another as damp-heat. The herbal prescriptions for those two patterns differ substantially.
This individualised approach is the reason that randomised trials of fixed formulas are difficult to design fairly. A trial tests one formula in all participants. A Chinese medicine consultation produces a different formula for each participant and adjusts it at every follow-up visit. When researchers test the fixed version, they are not testing the practice. This is a limitation of the research method, not evidence that the method fails.
Classical formulas that are still in use
Several formulas described in classical texts remain in daily clinical use in Chinese hospitals. Each has a documented source.
- Xiao Chai Hu Tang, described in the Treatise on Cold Damage written by Zhang Zhongjing in the second century, is used for alternating fever and chills, and for digestive disturbance associated with stress.
- Guizhi Fuling Wan, from the same text, is used for gynaecological conditions involving blood stasis.
- Liu Wei Di Huang Wan, first recorded by Qian Yi in the Song dynasty, is used for patterns described as kidney yin deficiency, which include night sweats, dry mouth and lower back weakness.
- Huangqi Guizhi Wuwu Tang, also from the Treatise on Cold Damage, is used for numbness and coldness in the limbs, a pattern common after chemotherapy.
These formulas are not prescribed by name alone. A practitioner adjusts the composition and the dose for the individual patient. Modern research has examined several of them in controlled trials, with mixed results. The formulas remain in use because clinicians observe benefit in specific patterns, and because the classical record of how to use them is detailed enough to be taught and tested.
How to judge a practitioner
A reliable Chinese medicine practitioner in a Chinese hospital will have a medical licence, a hospital appointment, and a record of training in a recognised programme. The following questions are reasonable to ask through an interpreter.
- What pattern do you identify in my case, and what observations support that pattern?
- Which formula or which acupuncture points will you use, and why those rather than others?
- How will you measure whether it is working, and at which visit will we decide?
- What will you not treat, and when would you send me back to the oncologist or the surgeon?
- Are you able to read my hospital records, and will you write your notes into the same record?
A practitioner who answers these questions clearly is working within a system. A practitioner who promises a cure, refuses to coordinate with the treating physician, or asks the patient to stop prescribed medication is not.
Cost and practical arrangements
Chinese hospitals bill each item separately, as they do for surgery. An acupuncture session in a public hospital usually costs between fifteen and fifty US dollars, depending on the city and the seniority of the practitioner. A course of ten to twenty sessions over two to four weeks is typical for a chronic condition. A herbal prescription is billed by the individual ingredients and usually costs between five and thirty US dollars per week.
A course of treatment is therefore a reason to travel rather than an addition to a trip. This is the practical difference between China and a private clinic in another country. The volume of treatment, the coordination with the treating hospital, and the cost per session together make a two to four week stay feasible.
What this article does not claim
Chinese medicine has not been shown to cure cancer, to replace surgery, or to reverse organ damage. A patient who delays effective treatment in order to pursue herbal therapy may lose the window in which that treatment would have worked. This is the most common serious harm in this field, and it is caused by delay rather than by toxicity.
The two case studies at the start of this article illustrate the correct relationship. In both cases, a traditional observation was tested with modern methods, refined into a standardised treatment, and then adopted by modern medicine. The knowledge contributed. It did not replace the method of testing.
This article is information, not medical advice. Clinical decisions belong to the treating physicians who have examined the patient.