Chinese Medicine in Taiwan

The recent history of acupuncture as a part of Chinese medicine in Taiwan differs considerably of what happen in mainland China this past century. In Taiwan, before the Japanese colonization, Chinese medicine was the predominant medical system used. The education of Chinese medicine was assured in the most usual way it has been held under the past centuries:

through apprenticeship and self-study². When the Japanese arrived to Taiwan in 1895 they began to replace Chinese medicine by Western medicine, and established the first school of modern Western medicine, which was also in charge for the training of Chinese medicine practitioners³. During the Japanese colonisation (1885-1945), Western medicine became the leading medical system and even Chinese medicine was still practiced, the Japan’s hostile policy towards Chinese medicine had a devastating effect that lead to a tremendous drop of Chinese medicine physicians⁴. When the Japanese left Taiwan in 1945 only a few dozen of physician remained (from the initial 1903 Chinese medicine physicians recognized by the Japanese7 government in 1901)

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The Chinese nationalist government came to Taiwan in 1945 and pursued the policy held in mainland China. During 1945 to 1954, because of the massive arrival of immigrants from Mainland China, coupled by a loosened governmental regulations and control of Chinese medical practice, the number of licensed Chinese medicine practitioners suddenly increase from two dozen physicians in 1945 to 1545 physicians in 1954. As Chi remarked this was both beneficial and treacherous for the sake on Chinese medicine. In one hand, it allowed the Taiwanese population to have a wider

access to Chinese Medicine. In another hand, because of the poor quality of some practitioners the public trust toward licensed Chinese Medicine physicians was reduced⁶. A licensure system examination was established by the nationalist government in 1946 and was open to anybody without a specific educational background. This licensure is named Chinese Medicine Physician Special Licence Qualifying Examination (referred as special licence qualification) and is still in effect today. It is organized in a more or less regular basis of every one or two years⁷.

In 1958 the China Medical College (named China Medical University CMU until 1999) was establish but it is only in 1966 that the institutionalized education of Chinese medicine really began with the establishment of the department of Chinese medicine, whose aim was to

“develop Chinese Medical science, catch up with modern Western medical sciences, and to combine Chinese and Western medical science in order to establish a new system of medical science”⁴. In this department, the students took a seven years course (the course was extended to eight years until 1996) and study jointly Chinese and Western medicine. At the end of their studies and internship they can take the examinations to have a licence both in Chinese Medicine and in Western Medicine, but they are not allowed to practice under the both licence at the same time. Until 1995 a lot of students issued from this courses chose to be registered as Western medicine physicians principally because of the higher income and the social prestige conferred by this position⁸. In 1975, the university established a graduate school of Chinese medicine (a master degree in 1975 and a doctoral degree in 1987) in order “to combine ancient, current, domestic and foreign medical knowledge, to develop Chinese medicine in general and to train teacher of Chinese medicine”⁴. Ten years later, in 1984, the university created a school of Post baccalaureate Chinese medicine. It offered a five years course to

train graduate students to become Chinese medicine physicians. Then in 1996, Changgung University opened a seven years course in Chinese medicine more or less similar as China Medical University.

The teaching and practice of acupuncture is a part of the whole course of a Chinese medicine physician. It is a therapeutic technique among others and does not require specialised course. Nerveless, it exist a specific course of acupuncture open to Western medicine physicians and dentists that offer them a quick formation (a hundred of hours). From 2005, the China Medical University opened a master degree in acupuncture research whose aim is “to cultivate the qualified acupuncture teachers and specialists for research and development purpose”.

In the beginning of the seventies, political policy engaged to encourage Chinese medicine and particularly acupuncture. The Chinese Acupuncture association (中國針灸學會) was created in 1957 but it is only in 1972 that a centre for acupuncture research was created. Following his creation, the first symposium on acupuncture and moxibustion was held. The international recognition of acupuncture abroad helping this process led, in 1982, to the first international symposium organized by the Department of Health and the China Medical College. This symposium gathered over 1000 experts and the aim of this meeting was to unify the academic theories and concepts and therefore enabling scholars to communicate and to promote the interaction between Chinese and Western medicine⁹.

A. Kleinman has explored the case of Chinese medicine in Taiwan from an anthropological perspective¹⁰. He offered a broad description of the health care system in Taiwan at the end of the seventies. He distinguished three sectors into the health care system: the popular one, the professional one and the folk sector. He explained how popular, professional and folk culture shape illness and therapeutic experiences in distinct ways. He showed that

the professional sector as an institution posses a large power « to create illness and treatment as social phenomena, to legitimate a certain construction of reality, as the only clinical reality »¹¹. From this point of view he showed that Western Medicine control most of the power letting few place to other therapeutic systems, including Chinese medicine.

Some other studies focused more on Chinese Medicine, like C.C. Chi, who offers a condensed description of the education, training and licensure system of Chinese medicine physicians in Taiwan³. L.D. Chen, in his doctoral thesis, explored in detail the characteristics of the Chinese Medicine practitioners linked to different educational backgrounds⁵. Other articles about the uses of Chinese medicine in Taiwan have demonstrated the general increase of use of Chinese Medicine the last decades especially until its inclusion in the heath care system^12,13,14.

All these studies help us to understand the actual trends of Chinese Medicine in Taiwan. Nevertheless very few studies have addressed the case of acupuncture. The few articles related to acupuncture focused on the pattern of acupuncture use and the characteristics of the patients¹².