Traditional Chinese Medicine in the Republic of China: from revolution to renaissance

The history of Traditional Chinese Medicine (TCM) in the twentieth century is inseparably linked to the political and social upheavals China experienced during that period. What began as an attempt at modernization and reform turned into decades of repression, collective violence, and cultural destruction — and ultimately into a cautious yet steady rehabilitation of the ancient healing art. To understand modern TCM, one must know the turbulent history of the Republic of China.

The beginning of a new era: reforms and resistance

With the proclamation of the Republic of China in 1912, a new phase began in Chinese history. The empire, which had endured for millennia, gave way to a modern government oriented toward Western political and scientific ideas. This drive for modernization had direct consequences for medicine. Western physicians and policymakers argued for the abolition of TCM, which they regarded as unscientific and archaic. Concrete attempts were even made to legally prohibit the practice of traditional medicine.

Yet TCM proved resilient. Thanks in part to mass resistance from the population and practicing physicians, traditional medicine remained in use, albeit in a vulnerable position. The tension between Eastern and Western medicine that arose during this period would continue throughout the entire twentieth century.

Mao Zedong and the People's Republic of China: an ambiguous legacy

On October 1, 1949, Mao Zedong proclaimed the People's Republic of China. His rule would leave an unprecedented mark on the country and on medicine. At first, Mao rehabilitated TCM for pragmatic reasons: there were simply too few Western physicians to serve the enormous population. The so-called "barefoot doctors" — semi-trained healthcare workers who applied both Western and traditional methods — were deployed in the countryside to improve basic care.

At the same time, Mao's regime cost millions of people their lives. The number of victims of his regime is estimated at between 40 and 72 million people — a number that is almost impossible to comprehend. Mao's politics also had devastating consequences for the religious and cultural institutions that were closely interwoven with traditional medicine, philosophy, and ways of life.

Land reforms and the destruction of monasteries

Between 1950 and 1952, the communist government implemented far-reaching land reforms. The vast majority of monasteries were expropriated from their lands, causing monks and clergy to lose their source of livelihood. Many were forced to return to ordinary society. Formally, religion was permitted, but only insofar as it did not conflict with the convictions of the Communist Party. In 1953, the Buddhist Association of China was established — not to protect Buddhism, but to spread communist policy among monks and control their activities.

This had far-reaching consequences for TCM. Monasteries and temples had, after all, for centuries been repositories of knowledge about herbs, meditation, Qi Gong, and other healing practices. The loss of these institutions meant a rupture in the transmission of traditional knowledge.

The Great Leap Forward: catastrophe and chaos

In 1959, Mao Zedong launched the Great Leap Forward, an ambitious economic and social five-year plan intended to transform China into an industrial and agricultural great power in one giant step. Agricultural collectivization and mass industrialization stood at its core. Reality, however, proved different: the plan failed dramatically. Crop failures, mismanagement, and political pressure to report successes that did not exist led to one of the greatest human-caused famines in history. The estimated death toll lies between 20 and 43 million people.

In this period of chaos and necessity, traditional physicians once again played an important role. In the absence of sufficient Western medical personnel and resources, communities once more relied on herbal medicine, acupuncture, and other traditional treatment methods. Necessity breeds ingenuity — and in this case also conservatism: TCM survived partly because it was indispensable.

The Cultural Revolution: attack on the old culture

The most devastating phase for TCM began with the Cultural Revolution, which started in 1966. Mao Zedong launched this campaign to strengthen his political position after the debacle of the Great Leap Forward. The revolution called for the destruction of the "Four Olds": old customs, old culture, old habits, and old ideas. This struck TCM at its heart.

Doctors, scholars, and intellectuals were regarded as enemies of the revolution. Many were sent to labor camps, humiliated, or worse. Books on traditional medicine were burned, schools were closed, and the transmission of knowledge from master to student was brutally interrupted. The entire upper layer of the population had to perform physical labor in the countryside in order to learn "solidarity with peasants and workers." Millions of people who did not adhere to the Maoist line were tortured or murdered. It was a systematic attack on everything ancient and culturally valuable.

The death of Mao and the opening toward a new future

In 1976, Mao Zedong died. After a political power struggle, Deng Xiaoping managed to seize control of China. Under his leadership, a cautious liberalization of the economy began. China gradually opened itself to the outside world and started finding its way as a global economic power. Living standards improved noticeably for large parts of the population.

For TCM, this new political climate marked a turning point. The government once again recognized the value of traditional medicine and invested in its institutionalization. Universities were established that offered TCM as a full academic discipline. The integration of TCM and Western medicine was actively encouraged — a model China continues to maintain to this day.

TCM in modern times: global recognition

Although the one-party system in China remains fully in force, TCM has undergone a remarkable rehabilitation. Today, Traditional Chinese Medicine is not only deeply anchored in the Chinese healthcare system, but it also enjoys growing recognition worldwide. In 2019, the World Health Organization (WHO) incorporated traditional medicine patterns into its international classification system — a historic step reflecting decades of effort by TCM practitioners worldwide.

The history of TCM in the Republic of China teaches us that knowledge is resilient. Even under the harshest political repression — land reforms, the Great Leap Forward, and the Cultural Revolution — traditional medicine endured. It did so not only because it was institutionally supported, but because it was rooted in a deeply human desire for healing, harmony, and connection with nature. Those roots are stronger than any revolution.

Conclusion: lessons from a turbulent century

The twentieth century was a period of unprecedented upheaval for China, and TCM was swept along in it like a ship on a stormy sea. From the reform efforts at the beginning of the Republic to the devastations of the Cultural Revolution and the eventual renaissance under Deng Xiaoping — TCM survived it all. It is precisely this power of survival that makes it such a remarkable subject of study. For students and practitioners of TCM, knowing this history is not only academically interesting: it adds depth to practice and connects the present with a rich, sometimes painful, yet always living tradition.