Earlier quoted context omitted.
This is one of the things that makes the contemporary Chinese treatment of TCM as credible so jarring to me. Many people seem to regard it as some unique inheritance of their culture, but in fact it closely resembles many other pre-scientific medical traditions, including in the "West". For me, pseudoscience is like comparative religions: historicizing it and situating it in a context alongside comparable traditions…
I think your contemporary "Western" bias is what is jarring you. In fact, the prevalence of these traditional medicine practices gives them credence in my mind. Most people probably don't have my same view, but I don't see these practices as having 'credibility' in the same way as a pharmaceutical with a phase 3 trial and decades of follow ups. But they DO have credibility in the sense that there's a long history of…
There's also long histories of people following folk medicine advice and being hurt by it. And in the case of TCM, the history isn't really that long; TCM as we know it is synthetic and modern, stitched together from various different and often contradictory or mutually exclusive folk medicine traditions. It reminds me of Enlightenment-era philosophers who tried to "rescue" belief in God by retreating to "natural religion"— they were of course accused of atheism!
> This is similar to my view of religion. Any given doctrine isn't factual, but people long for a way to spiritually understand the world, and they aren't wrong for doing so. Science can't and shouldn't provide that.
Sure, you can espouse a kind of enlightened "separate magisteria" view of science and religion's roles in society. But the flip side of that is something like "religion (or folk medicine, in this case) can't and shouldn't provide factual claims about the world". And that's more or less totally divorced from actual practice of those things.
Of course I agree about the weaknesses of contemporary medicine and even of "actually existing science", so-to-speak.
But what you're describing here ("Any given doctrine isn't factual", "I don't see these practices as having 'credibility' in the same way as a pharmaceutical with a phase 3 trial and decades of follow ups") isn't really "credence" in the usual sense so much as affinity, interest, or a kind of "outsider's respect".
Any medical remedy not too dangerous, expensive, or inconvenient is worth trying even if the evidence to support it is weak. Folk medicine traditions are useful sources from which to do reverse pharmacology or other research.
But there are third-rate TCM "journals" churning out (sometimes deliberately) ill-designed papers. TCM isn't merely an operational framework and it doesn't limit itself to operational or practical guidance. It's chock full of extremely dubious ontological claims. (Mainstream actually-existing-science isn't free of dubious ontological claims about invisible entities either, but these are of a different class.) That's not just a different practice, that's industrialized counterfeit science.
Humans, it turns out, are capable of developing a lot of useful tools and practices even with no methodologies or bad methodologies. That's true, and the fact of it is kind of surprising and fun. But the world didn't outgrow pre-scientific folk medicine traditions like that of the four humors by mere accident or happenstance. And when you are familiar with a couple of such folk medicine traditions, TCM doesn't look like part of an alternate modernity so much as yet another outmoded pre-scientific tradition.