Particularly in the cities, traditional medicine has been largely superseded by Western methods and treatments. However, it is still popular for particular conditions and in rural areas.

Folk remedies
There are many folk ‘remedies’. For example, for stomach ache, some locks of hair must be pulled out, or the spine should be sharply pinched. A poultice of betel juice and tobacco will control acne. A treatment for pimples was to marinate silkworms in alcohol, grill them to ashes, crush them, add some liquid – and then drink the concoction!

The traditional healer
If such remedies failed, a ‘physician’ was called. This would be a person who had learned the skills and knowledge of traditional medicine under a ‘master’ – the teaching of medicine as an academic discipline is a recent innovation. He, for physicians were nearly always men, was also a pharmacist who examined, diagnosed and supplied medication to the patient. A physician was highly respected and unpaid, but earned an income by selling medicine.

What little knowledge the physician had regarding anatomy and physiology was of Chinese origin. Vietnamese traditional medicine draws heavily upon the Taoist beliefs of Yin and Yang and the harmony of natural elements as well as divination and astrology.

The basics of Vietnamese traditional medicine
Vietnamese traditional medecine is based on two natural elements – the ‘duong’ (the male principle, or vital heat, or active fluid) and the ‘am’ (the female principle, or radical humour, or passive fluid). The perfect balance of these two elements will result in good health.

If vital heat is dominant, the system will be in a state of ‘hot essence’. If radical humour is in control, the body suffers from the effects of ‘cold essence’. The focus of Vietnamese traditional medicine is to determine the 'heat' of the patient’s 'essence' because all medicines are deemed to have a hot, cold, or temperate action.

The ‘duong’ is located in the abdomen, and the ‘am’ in the brain and spinal cord – the three ‘heat centres’. The ‘duong’ controls the gall bladder, spleen, small and large intestines, bladder and left kidney, and the ‘am’ controls the heart, liver, lungs, stomach and right kidney.

The three ‘heat centres’ control the flow of blood and the digestion, and communicate with each other via channels that carry the vital heat and the radical humour. There are pulse points on the body's network of channels where the physician can detect 24 different types of pulse, all equally important.

Diagnosis
The diagnosis is made by feeling the pulses, using the left hand for the right side of the body and vice versa and is corroborated by external indications from an examination of the tongue, mouth, eyes, ears, nostrils and skin coloration.

Treatment
Once the diagnosis is complete, the physician would prepare the correct combination of ingredients to bring the ‘duong’ and ‘am’ back into balance, thereby effecting a cure. The ingredients would comprise Chinese herbs, flowers, leaves, roots, barks, and grains, and plants and minerals from the north of Vietnam. Other ingredients included such items as deer horn, tiger bones, bear gall, rhinoceros and elephant skin, snakes, earthworms, silkworms, and so on.

Vietnamese traditional medicine in the 21st century
Nowadays, many of the more exotic ingredients are no longer used, but the diagnosis and treatment is more or less the same. However, the cost of treatment is no longer cheap. Whereas traditional medicine was once the medicine of the poor, it is now more likely to be the middle classes and foreigners who find their way to the traditional physician.

Poor people who can afford to self-medicate using foreign or domestically produced drugs and antibiotics usually rely upon the advice of the pharmacist. Among wealthier groups, acculturation and local doctors with only limited medical knowledge have combined to create a major problem of over-prescribing 'Western' drugs.

Those who don’t have enough money for medicine, or an exemption card from their local authority, use folk remedies and make do the best they can.

There is now increasing interest in using traditional medicine to supplement treatment of chronic illnesses, such as AIDS and cancer. Traditional treatments are benign, and seem to have therapeutic benefits in calming patients and restoring their confidence, perhaps because the methods and medicines are so deeply rooted in the Vietnamese culture.