Chinese Herbal
Medicines:
The Good, the Bad, and the Ugly
Michael H. Dong
MPH, DrPA, PhD
with
Jennifer I. Dong
readings
Learning Objectives
1. To understand how Chinese herbal
medicines (CHM) are used worldwide.
2. To familiarize the students with some
of the negative aspects of CHM.
3. To learn the additional beneficial
effects of CHM.
4. To gain insight into the controversies
surrounding the use of CHM.
Performance Objectives
1. Be able to characterize the basics of
Chinese herbal medicines (CHM).
2. Be able to identify some of the adverse
cases associated with the use of CHM.
3. Know the basic properties of the major
class of Chinese herbs.
4. Know the factors that continue to make
CHM unacceptable to many people.
5. Know how to use some of the resources
for advancing CHM.
Contents of Lecture
1. A brief introduction of how Chinese
herbal medicines (CHM) are used
worldwide.
2. Toxicological or side effects of CHM.
3. Beneficial effects on health prevention
and health maintenance.
4. Controversies over the use of CHM.
5. Resources for advancing CHM.
Traditional Chinese Medicine
• Has been practiced for many centuries.
• Uses holistic concepts and elements of
natural energies to restore body homeostasis and hence to treat the disease.
• Relies principally on acupuncture and
herbal drugs to restore patients’ health.
• Chinese herbs include plant, animal,
and mineral substances.
• Recently has increasingly found its way
into Western medicine.
Use of Chinese Herbal
Medicines (CHM) in the USA
• Use of CHM has soared in the USA
since the passage of a law in 1994.
• Many CHM are now treated as dietary
supplements, thus not subject to any
stringent health regulation.
• Millions of Americans are now taking
Chinese herbal products.
• Not enough Congressional support to
overturn current regulations on CHM.
Use of Chinese Herbs in
Europe and Australia
• Europe takes half of the global market
for herbal medicines (HM) in 1996.
• Use in Europe largely based on rule of
historical use as evidence of herb safety.
• European governments are more proactive in regulating the use of HM.
• Australia requires registration of
practitioners as a means to regulate the
dispensing of Chinese herbs.
Use of Chinese Herbs in
Hong Kong and China
• Hong Kong has enacted an ordinance
and established a council to regulate the
use of Chinese medicines.
• China revised the Pharmaceutical
(Administration) Law requiring drug
manufacturers to obtain good
manufacturing practice certification.
• China’s law exempts Chinese herbs
from following the new standards.
Ways in Which Chinese
Herbs Are Used
• Countless numbers of remedies have
been prepared from a small fraction of
approximately 6,000 Chinese herbs.
• Used to treat the whole body with a
focus on one or more body organs, but
based primarily on holistic concepts.
• Herbal formulas are used to mitigate
the toxic effects of some herbs.
Negative Aspects of
Chinese Herbs (I)
• Poisonings from misuse of Chinese
herbs do occur from time to time.
• Misuse can also lead to acute or longterm adverse effects.
• Chinese herbal products can be
contaminated with heavy metals.
• Extensive clinical trials on (long-term)
side effects are not well documented.
Negative Aspects of
Chinese Herbs (II)
• Drug adulterations or drug interactions
are found in some Chinese herbal
medicines (CHM).
• Misleading labels can also be problems
with CHM sold over the counter.
• Unapproved ingredients and heavy
metals can be introduced during the
formulation or cultivation of herbs.
Negative Aspects of
Chinese Herbs (III)
• More than 50 cases of kidney damage
have been linked to Chinese herbs
added to slimming capsules.
• Several cases of liver problems have
been linked to Chinese herbs used for
skin conditions.
• Acute hepatitis has been linked to some
Chinese herbal products used for
eczema or psoriasis.
Negative Aspects of
Chinese Herbs (IV)
• Some Chinese herbs are found to have
caused cardiac adverse reactions and
pneumonitis.
• At least one herb was considered to be
carcinogenic; another one was reported
to increase risk of bleeding when used
concomitantly with the drug warfarin.
• Some others are known to cause allergic
reactions.
Positive Aspects of
Chinese Herbs (I)
• Many Chinese herbs contain a variety
of vitamins or minerals and hence can
be used as dietary supplements.
• Those herbs that are antioxidants can
alleviate or prevent various disorders.
• Herbs cooked with food are highly
digestible, assimilable, extremely
nutritious, and sometimes delicious.
Positive Aspects of
Chinese Herbs (II)
• A majority of Chinese herbs are famous
for providing body strength and energy.
• These tonic herbs are super-nutrients
with an ability to enhance body
functions.
• They have anti-aging functions with no
known adverse effects when used
properly; and are easily digestible.
Positive Aspects of
Chinese Herbs (III)
• As an example, ginseng is a classic tonic
herb used to enhance endurance.
• The plant contains chemicals capable of
nourishing and regulating the nervous
and endocrine (hormonal) systems.
• Ginseng may arouse sexual desire, even
though long-term use of this plant could
lead to some adverse effects.
Positive Aspects of
Chinese Herbs (IV)
• Tang kuei is another classic tonic herb
used for centuries to build blood.
• The herb can be used to alleviate premenstrual symptoms, muscular aches,
and bowel movements.
• A number of Chinese athletes regularly
consume tonic herbs to supplement
their stringent training regimen.
The Ugly Side of Chinese
Herbs (I)
• Some herbs have an unpleasant smell
and a very bitter taste.
• Stories are rarely reported on positive
experiences with use of Chinese herbal
medicines (CHM).
• Disbelievers of traditional Chinese
medicine are skeptical about the merits
of CHM and have no room for therapy
based on holistic concepts.
The Ugly Side of Chinese
Herbs (II)
• There are controversies over the use of
some Chinese herbs, adding greater
discomfort for disbelievers.
• As an example, ginseng is said to have
many faces regarding its effects.
• Adequate standards and processes are
not in place to guarantee the claimed
effects and quality of Chinese herbs.
Institutes for Advancing
Chinese Herbal Medicine (I)
• Over a hundred of traditional Chinese
medicine (TCM) institutes are located
worldwide, with > 50% in the USA.
• Chinese herbal medicine (CHM) is a key
branch of TCM; students thus may
receive CHM training in these institutes.
• These institutes often take a leadership
role in advancing CHM through joint
programs and scientific conferences.
Institutes for Advancing
Chinese Herbal Medicine (II)
• Institutes located in Asia are fewer than
50, with expectedly the majority in China.
• One institute in Beijing has compiled the
English-Chinese Textbook Series in
traditional Chinese medicine (TCM).
• The university in Shanghai is one of the
leading institutions in the world for TCM.
• The university in Nanjing is known as the
birthplace of the earliest TCM scholars.
Institutes for Advancing
Chinese Herbal Medicine (III)
• In Hong Kong, research into the effects of
Chinese herbs is an ongoing activity at
several local universities.
• Some of these local universities also offer
degree programs in Chinese medicine.
• These educational and research programs
all point to the direction that Chinese
medicine should be used as an alternative
or a supplement to Western medicine.