This medical framing is not simply modern secularisation stripping a once purely religious practice of its original meaning, since Chinese medicine's theoretical vocabulary, qi, yin and yang, the Daoist cosmological concepts underlying meridian theory, has always sat closer to Chinese natural philosophy and cosmology than to devotional religious practice in the narrower sense, historically overlapping with Daoist thought and practice, particularly around cultivation of qi, without tui na itself functioning as temple ritual or worship in the way, for example, wai khru ram muay or lomilomi frame their own bodywork.
The therapy's attested roots reach back centuries within the Chinese medical textual tradition, developing alongside acupuncture and herbal medicine as part of a shared theoretical system, and its status today as a clinically integrated, evidence tested branch of medicine, including recognition and, in various forms, regulation within China's state healthcare system and growing use internationally as a complementary therapy, reflects continuity with that older, always more naturalistic than devotional Chinese medical framework rather than a sharp modern break from an originally more overtly sacred practice. Where individual practitioners bring an explicitly Daoist or otherwise spiritual framing to their own tui na practice, that reflects personal or lineage specific emphasis rather than the discipline's dominant contemporary institutional character.