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Chinese herbology () is the theory of traditional Chinese herbal therapy, which accounts for the majority of treatments in
traditional Chinese medicine Traditional Chinese medicine (TCM) is an alternative medical practice drawn from traditional medicine in China. It has been described as "fraught with pseudoscience", with the majority of its treatments having no logical mechanism of acti ...
(TCM). A ''
Nature Nature, in the broadest sense, is the physical world or universe. "Nature" can refer to the phenomena of the physical world, and also to life in general. The study of nature is a large, if not the only, part of science. Although humans are ...
'' editorial described TCM as "fraught with
pseudoscience Pseudoscience consists of statements, beliefs, or practices that claim to be both scientific and factual but are incompatible with the scientific method. Pseudoscience is often characterized by contradictory, exaggerated or unfalsifiable claim ...
", and said that the most obvious reason why it has not delivered many cures is that the majority of its treatments have no logical
mechanism of action In pharmacology, the term mechanism of action (MOA) refers to the specific biochemical interaction through which a drug substance produces its pharmacological effect. A mechanism of action usually includes mention of the specific molecular targ ...
. The term herbology is misleading in the sense that, while plant elements are by far the most commonly used substances, animal, human, and mineral products are also utilized, among which some are poisonous. In the ''
Huangdi Neijing ''Huangdi Neijing'' (), literally the ''Inner Canon of the Yellow Emperor'' or ''Esoteric Scripture of the Yellow Emperor'', is an ancient Chinese medical text or group of texts that has been treated as a fundamental doctrinal source for Chines ...
'' they are referred to as () which means toxin, poison, or medicine. Paul U. Unschuld points out that this is similar etymology to the Greek '' pharmakon'' and so he uses the term "pharmaceutic". Thus, the term "medicinal" (instead of
herb In general use, herbs are a widely distributed and widespread group of plants, excluding vegetables and other plants consumed for macronutrients, with savory or aromatic properties that are used for flavoring and garnishing food, for medicina ...
) is usually preferred as a translation for (). Research into the effectiveness of traditional Chinese herbal therapy is of poor quality and often tainted by bias, with little or no rigorous evidence of efficacy. There are concerns over a number of potentially toxic Chinese herbs.


History

Chinese herbs have been used for centuries. Among the earliest literature are lists of prescriptions for specific ailments, exemplified by the manuscript "''Recipes for 52 Ailments''", found in the
Mawangdui Mawangdui () is an archaeological site located in Changsha, China. The site consists of two saddle-shaped hills and contained the tombs of three people from the Changsha Kingdom during the western Han dynasty (206 BC – 9 AD): the Chancellor Li ...
which were sealed in 168 BC. The first traditionally recognized herbalist is Shénnóng (, lit. "Divine Farmer"), a mythical god-like figure, who is said to have lived around 2800 BC. He allegedly tasted hundreds of herbs and imparted his knowledge of medicinal and poisonous plants to farmers. His '' Shénnóng Běn Cǎo Jīng'' (, ''Shennong's Materia Medica'') is considered as the oldest book on Chinese herbal medicine. It classifies 365 species of roots, grass, woods, furs, animals and stones into three categories of herbal medicine:Unschuld, Paul Ulrich (1986), ''Medicine in China, A History of Pharmaceutics'', , University of California Press. # The "superior" category, which includes herbs effective for multiple diseases and are mostly responsible for maintaining and restoring the body balance. They have almost no unfavorable side-effects. # A category comprising tonics and boosters, whose consumption must not be prolonged. # A category of substances which must usually be taken in small doses, and for the treatment of specific diseases only. The original text of Shennong's ''Materia Medica'' has been lost; however, there are extant translations. The true date of origin is believed to fall into the late Western Han dynasty (i.e., the first century BC). The '' Treatise on Cold Damage Disorders and Miscellaneous Illnesses'' was collated by
Zhang Zhongjing Zhang Zhongjing (; 150–219), formal name Zhang Ji (), was a Chinese pharmacologist, physician, inventor, and writer of the Eastern Han dynasty and one of the most eminent Chinese physicians during the later years of the Han dynasty. He estab ...
, also sometime at the end of the
Han dynasty The Han dynasty (, ; ) was an Dynasties in Chinese history, imperial dynasty of China (202 BC – 9 AD, 25–220 AD), established by Emperor Gaozu of Han, Liu Bang (Emperor Gao) and ruled by the House of Liu. The dynasty was preceded by th ...
, between 196 and 220 CE. Focusing on drug prescriptions, it was the first medical work to combine Yinyang and the Five Phases with drug therapy. This formulary was also the earliest Chinese medical text to group symptoms into clinically useful "patterns" (''zheng'' ) that could serve as targets for therapy. Having gone through numerous changes over time, it now circulates as two distinct books: the '' Treatise on Cold Damage Disorders'' and the '' Essential Prescriptions of the Golden Casket'', which were edited separately in the eleventh century, under the
Song dynasty The Song dynasty (; ; 960–1279) was an imperial dynasty of China that began in 960 and lasted until 1279. The dynasty was founded by Emperor Taizu of Song following his usurpation of the throne of the Later Zhou. The Song conquered the res ...
. Succeeding generations augmented these works, as in the ''
Yaoxing Lun ''Yaoxing Lun'' (''Yao-hsing Lun''; ), literally ''Treatise on the Nature of Medicinal Herbs'', is a 7th-century Tang Dynasty Chinese treatise on herbal medicine. See also *Chinese herbology *''Compendium of Materia Medica The ''Bencao gangm ...
'' (), a 7th-century
Tang dynasty The Tang dynasty (, ; zh, t= ), or Tang Empire, was an Dynasties in Chinese history, imperial dynasty of China that ruled from 618 to 907 AD, with an Zhou dynasty (690–705), interregnum between 690 and 705. It was preceded by the Sui dyn ...
Chinese treatise on herbal medicine. There was a shift in emphasis in treatment over several centuries. A section of the
Neijing In advanced traditional Chinese kung fu ( martial arts), Neijing (Traditional Chinese: 內 勁; pinyin: nèijìng) refers to the conscious control of the practitioner's qi, or "life energy", to gain advantages in combat. Nèijìng is developed ...
Suwen including Chapter 74 was added by Wang Bing Wáng Bīngin his 765 edition. In which it says: "Ruler of disease it called Sovereign, aid to Sovereign it called Minister, comply with Minister it called Envoy (Assistant), not upper lower three classes (qualities) it called." The last part is interpreted as stating that these three rulers are not the three classes of Shénnóng mentioned previously. This chapter in particular outlines a more forceful approach. Later on Zhang Zihe Zhāng Zĭ-hé, aka Zhang Cong-zhen(1156–1228) is credited with founding the 'Attacking School' which criticized the overuse of tonics. Arguably the most important of these later works is the ''
Compendium of Materia Medica The ''Bencao gangmu'', known in English as the ''Compendium of Materia Medica'' or ''Great Pharmacopoeia'', is an encyclopedic gathering of medicine, natural history, and Chinese herbology compiled and edited by Li Shizhen and published in the ...
'' (''Bencao Gangmu'':) compiled during the
Ming dynasty The Ming dynasty (), officially the Great Ming, was an Dynasties in Chinese history, imperial dynasty of China, ruling from 1368 to 1644 following the collapse of the Mongol Empire, Mongol-led Yuan dynasty. The Ming dynasty was the last ort ...
by
Li Shizhen Li Shizhen (July 3, 1518  – 1593), courtesy name Dongbi, was a Chinese acupuncturist, herbalist, naturalist, pharmacologist, physician, and writer of the Ming dynasty. He is the author of a 27-year work, found in the ''Compendium o ...
, which is still used today for consultation and reference. The use of Chinese herbs was popular during the medieval age in western Asian and Islamic countries. They were traded through the Silk Road from the East to the West.
Cinnamon Cinnamon is a spice obtained from the inner bark of several tree species from the genus '' Cinnamomum''. Cinnamon is used mainly as an aromatic condiment and flavouring additive in a wide variety of cuisines, sweet and savoury dishes, breakf ...
,
ginger Ginger (''Zingiber officinale'') is a flowering plant whose rhizome, ginger root or ginger, is widely used as a spice and a folk medicine. It is a herbaceous perennial which grows annual pseudostems (false stems made of the rolled bases of ...
,
rhubarb Rhubarb is the fleshy, edible stalks ( petioles) of species and hybrids (culinary rhubarb) of '' Rheum'' in the family Polygonaceae, which are cooked and used for food. The whole plant – a herbaceous perennial growing from short, thick rhi ...
,
nutmeg Nutmeg is the seed or ground spice of several species of the genus ''Myristica''. ''Myristica fragrans'' (fragrant nutmeg or true nutmeg) is a dark-leaved evergreen tree cultivated for two spices derived from its fruit: nutmeg, from its seed, an ...
and cubeb are mentioned as Chinese herbs by medieval Islamic medical scholars Such as Rhazes (854– 925 CE), Haly Abbas (930–994 CE) and
Avicenna Ibn Sina ( fa, ابن سینا; 980 – June 1037 CE), commonly known in the West as Avicenna (), was a Persian polymath who is regarded as one of the most significant physicians, astronomers, philosophers, and writers of the Islamic ...
(980–1037 CE). There were also multiple similarities between the clinical uses of these herbs in Chinese and Islamic medicine.


Raw materials

There are roughly 13,000 medicinals used in China and over 100,000 medicinal recipes recorded in the ancient literature. Plant elements and extracts are by far the most common elements used. In the classic ''Handbook of Traditional Drugs'' from 1941, 517 drugs were listed – out of these, only 45 were animal parts, and 30 were minerals. For many plants used as medicinals, detailed instructions have been handed down not only regarding the locations and areas where they grow best, but also regarding the best timing of planting and harvesting them. Some animal parts used as medicinals can be considered rather strange such as cows' gallstones. Furthermore, the classic materia medica '' Bencao Gangmu'' describes the use of 35 traditional Chinese medicines derived from the human body, including bones, fingernail, hairs, dandruff, earwax, impurities on the teeth, feces, urine, sweat, and organs, but most are no longer in use.


Preparation


Decoction

Typically, one batch of medicinals is prepared as a
decoction Decoction is a method of extraction by boiling herbal or plant material (which may include stems, roots, bark and rhizomes) to dissolve the chemicals of the material. It is the most common preparation method in various herbal-medicine systems. Dec ...
of about 9 to 18 substances. Some of these are considered as main herbs, some as ancillary herbs; within the ancillary herbs, up to three categories can be distinguished. Some ingredients are added in order to cancel out toxicity or side-effects of the main ingredients; on top of that, some medicinals require the use of other substances as catalysts.


Chinese patent medicine

Chinese patent medicine () is a kind of
traditional Chinese medicine Traditional Chinese medicine (TCM) is an alternative medical practice drawn from traditional medicine in China. It has been described as "fraught with pseudoscience", with the majority of its treatments having no logical mechanism of acti ...
. They are standardized herbal formulas. From ancient times, pills were formed by combining several herbs and other ingredients, which were dried and ground into a powder. They were then mixed with a binder and formed into pills by hand. The binder was traditionally honey. Modern teapills, however, are extracted in stainless steel extractors to create either a water decoction or water-alcohol decoction, depending on the herbs used. They are extracted at a low temperature (below 100 degrees Celsius) to preserve essential ingredients. The extracted liquid is then further condensed, and some raw herb powder from one of the herbal ingredients is mixed in to form an herbal dough. This dough is then machine cut into tiny pieces, a small amount of excipients are added for a smooth and consistent exterior, and they are spun into pills. These medicines are not
patent A patent is a type of intellectual property that gives its owner the legal right to exclude others from making, using, or selling an invention for a limited period of time in exchange for publishing an enabling disclosure of the invention."A ...
ed in the traditional sense of the word. No one has
exclusive right In Anglo-Saxon law, an exclusive right, or exclusivity, is a de facto, non-tangible prerogative existing in law (that is, the power or, in a wider sense, right) to perform an action or acquire a benefit and to permit or deny others the right t ...
s to the formula. Instead, "patent" refers to the
standardization Standardization or standardisation is the process of implementing and developing technical standards based on the consensus of different parties that include firms, users, interest groups, standards organizations and governments. Standardizatio ...
of the formula. In China, all Chinese patent medicines of the same name will have the same proportions of ingredients, and manufactured in accordance with the PRC Pharmacopoeia, which is mandated by law. However, in western countries there may be variations in the proportions of ingredients in patent medicines of the same name, and even different ingredients altogether. Several producers of Chinese herbal medicines are pursuing FDA clinical trials to market their products as drugs in U.S. and European markets.


Chinese herbal extracts

Chinese herbal extracts are herbal decoctions that have been condensed into a granular or powdered form. Herbal extracts, similar to patent medicines, are easier and more convenient for patients to take. The industry extraction standard is 5:1, meaning for every five pounds of raw materials, one pound of herbal extract is derived.


Categorization

There are several different methods to classify traditional Chinese medicinals: * The Four Natures () * The Five Flavors () * The meridians () * The specific function.


Four Natures

The Four Natures are: hot (), warm (), cool (), cold () or neutral (). Hot and warm herbs are used to treat cold diseases, while cool and cold herbs are used to treat hot diseases.


Five Flavors

The Five Flavors, sometimes also translated as ''Five Tastes'', are: acrid/pungent (), sweet (), bitter (), sour (), and salty (). Substances may also have more than one flavor, or none (i.e., a bland () flavor). Each of the Five Flavors corresponds to one of the zàng organs, which in turn corresponds to one of the Five Phases: A flavor implies certain properties and presumed therapeutic "actions" of a substance: saltiness "drains downward and softens hard masses"; sweetness is "supplementing, harmonizing, and moistening"; pungent substances are thought to induce sweat and act on qi and
blood Blood is a body fluid in the circulatory system of humans and other vertebrates that delivers necessary substances such as nutrients and oxygen to the cells, and transports metabolic waste products away from those same cells. Blood in the cir ...
; sourness tends to be astringent () in nature; bitterness "drains
heat In thermodynamics, heat is defined as the form of energy crossing the boundary of a thermodynamic system by virtue of a temperature difference across the boundary. A thermodynamic system does not ''contain'' heat. Nevertheless, the term is ...
, purges the bowels, and eliminates dampness".


Specific function

These categories mainly include: * exterior-releasingXu & Wang 2002, Summary of Contents or exterior-resolving *
heat In thermodynamics, heat is defined as the form of energy crossing the boundary of a thermodynamic system by virtue of a temperature difference across the boundary. A thermodynamic system does not ''contain'' heat. Nevertheless, the term is ...
-clearing * downward-draining or precipitating * wind-damp-dispelling * dampness-transforming * promoting the movement of water and percolating dampness or dampness-percolating * interior-warming * qi-regulating or qi-rectifying * dispersing food accumulation or food-dispersing * worm-expelling * stopping bleeding or blood-stanching * quickening the
Blood Blood is a body fluid in the circulatory system of humans and other vertebrates that delivers necessary substances such as nutrients and oxygen to the cells, and transports metabolic waste products away from those same cells. Blood in the cir ...
and dispelling stasis or
blood Blood is a body fluid in the circulatory system of humans and other vertebrates that delivers necessary substances such as nutrients and oxygen to the cells, and transports metabolic waste products away from those same cells. Blood in the cir ...
-quickening or Blood-moving. * transforming phlegm, stopping coughing and calming wheezing or phlegm-transforming and cough- and panting-suppressing * Spirit-quieting or Shen-calming. * calming the
Liver The liver is a major organ only found in vertebrates which performs many essential biological functions such as detoxification of the organism, and the synthesis of proteins and biochemicals necessary for digestion and growth. In humans, it i ...
and expelling
wind Wind is the natural movement of air or other gases relative to a planet's surface. Winds occur on a range of scales, from thunderstorm flows lasting tens of minutes, to local breezes generated by heating of land surfaces and lasting a few ...
or Liver-calming and wind-extinguishing * orifice-opening * supplementing or tonifying: this includes qi-supplementing,
blood Blood is a body fluid in the circulatory system of humans and other vertebrates that delivers necessary substances such as nutrients and oxygen to the cells, and transports metabolic waste products away from those same cells. Blood in the cir ...
-nourishing, yin-enriching, and yang-fortifying. * astriction-promoting or securing and astringing * vomiting-inducing * substances for external application


Nomenclature

Many herbs earn their names from their unique physical appearance. Examples of such names include ''Niu Xi'' (Radix cyathulae seu achyranthis), "cow's knees," which has big joints that might look like cow knees; ''Bai Mu Er'' (Fructificatio tremellae fuciformis), white wood ear,' which is white and resembles an ear; ''Gou Ji'' (Rhizoma cibotii), 'dog spine,' which resembles the spine of a dog.


Color

Color is not only a valuable means of identifying herbs, but in many cases also provides information about the therapeutic attributes of the herb. For example, yellow herbs are referred to as ''huang'' (yellow) or ''jin'' (gold). Huang Bai (Cortex Phellodendri) means 'yellow fir," and ''Jin Yin Hua'' (Flos Lonicerae) has the label 'golden silver flower."


Smell and taste

Unique flavors define specific names for some substances. ''Gan'' means 'sweet,' so ''Gan Cao'' (Radix glycyrrhizae) is 'sweet herb," an adequate description for the licorice root. "Ku" means bitter, thus Ku Shen (Sophorae flavescentis) translates as 'bitter herb.'


Geographic location

The locations or provinces in which herbs are grown often figure into herb names. For example, ''Bei Sha Shen'' (Radix glehniae) is grown and harvested in northern China, whereas ''Nan Sha Shen'' (Radix adenophorae) originated in southern China. And the Chinese words for north and south are respectively ''bei'' and ''nan''. ''Chuan Bei Mu'' (Bulbus fritillariae cirrhosae) and ''Chuan Niu Xi'' (Radix cyathulae) are both found in Sichuan province, as the character "chuan" indicates in their names.


Function

Some herbs, like Fang Feng (Radix Saposhnikoviae), literally 'prevent wind," prevents or treats wind-related illnesses. Xu Duan (Radix Dipsaci), literally 'restore the broken,' effectively treats torn soft tissues and broken bones.


Country of origin

Many herbs indigenous to other countries have been incorporated into the Chinese materia medica. ''Xi Yang Shen'' (Radix panacis quinquefolii), imported from North American crops, translates as 'western ginseng," while ''Dong Yang Shen'' (Radix ginseng Japonica), grown in and imported from North Asian countries, is 'eastern ginseng.'


Toxicity

From the earliest records regarding the use of medicinals to today, the toxicity of certain substances has been described in all Chinese materia medica. Since TCM has become more popular in the Western world, there are increasing concerns about the potential toxicity of many traditional Chinese medicinals including plants, animal parts and minerals. For most medicinals, efficacy and toxicity testing are based on traditional knowledge rather than laboratory analysis. The toxicity in some cases could be confirmed by modern research (i.e., in
scorpion Scorpions are predatory arachnids of the order Scorpiones. They have eight legs, and are easily recognized by a pair of grasping pincers and a narrow, segmented tail, often carried in a characteristic forward curve over the back and always en ...
); in some cases it could not (i.e., in ''
Curculigo ''Curculigo'' is a flowering plant genus in the family Hypoxidaceae, first described in 1788. It is widespread across tropical regions of Asia, Africa, Australia, and the Americas. Curculin is a sweet protein that was discovered and isolated in ...
''). Further, ingredients may have different names in different locales or in historical texts, and different preparations may have similar names for the same reason, which can create inconsistencies and confusion in the creation of medicinals, with the possible danger of poisoning. Edzard Ernst "concluded that adverse effects of herbal medicines are an important albeit neglected subject in dermatology, which deserves further systematic investigation." Research suggests that the toxic heavy metals and undeclared drugs found in Chinese herbal medicines might be a serious health issue. Substances known to be potentially dangerous include aconite, secretions from the
Asiatic toad The Asiatic toad or Chusan Island toad (''Bufo gargarizans'') is a species of toad endemic to East Asia. The species was previously classified as ''Bufo bufo gargarizans'', a subspecies of the common toad. Distribution and habitat It is comm ...
, powdered centipede, the Chinese beetle ('' Mylabris phalerata'', Ban mao), and certain fungi. There are health problems associated with ''
Aristolochia ''Aristolochia'' () is a large plant genus with over 500 species that is the type genus of the family Aristolochiaceae. Its members are commonly known as birthwort, pipevine or Dutchman's pipe and are widespread and occur in the most diverse clim ...
''. Toxic effects are also frequent with ''
Aconitum ''Aconitum'' (), also known as aconite, monkshood, wolf's-bane, leopard's bane, mousebane, women's bane, devil's helmet, queen of poisons, or blue rocket, is a genus of over 250 species of flowering plants belonging to the family Ranunculaceae. ...
''. To avoid its toxic adverse effects ''
Xanthium sibiricum ''Xanthium strumarium'' (rough cocklebur, clotbur, common cocklebur, large cocklebur, woolgarie bur) is a species of annual plants of the family Asteraceae. Some sources claim it originates in southern Europe and Asia, but has been extensively na ...
'' must be processed.
Hepatotoxicity Hepatotoxicity (from ''hepatic toxicity'') implies chemical-driven liver damage. Drug-induced liver injury is a cause of acute and chronic liver disease caused specifically by medications and the most common reason for a drug to be withdrawn fr ...
has been reported with products containing '' Reynoutria multiflora'' (
synonym A synonym is a word, morpheme, or phrase that means exactly or nearly the same as another word, morpheme, or phrase in a given language. For example, in the English language, the words ''begin'', ''start'', ''commence'', and ''initiate'' are al ...
''Polygonum multiflorum''),
glycyrrhizin Glycyrrhizin (or glycyrrhizic acid or glycyrrhizinic acid) is the chief sweet-tasting constituent of ''Glycyrrhiza glabra'' ( liquorice) root. Structurally, it is a saponin used as an emulsifier and gel-forming agent in foodstuffs and cosmet ...
, ''
Senecio ''Senecio'' is a genus of flowering plants in the daisy family (Asteraceae) that includes ragworts and groundsels. Variously circumscribed taxonomically, the genus ''Senecio'' is one of the largest genera of flowering plants. Description Mor ...
'' and '' Symphytum''. The evidence suggests that hepatotoxic herbs also include ''
Dictamnus dasycarpus ''Dictamnus dasycarpus'' or chinese dittany is a species of flowering plant in the family Rutaceae, native from southeast Siberia to China and Korea. It was first described by Nikolai Turczaninow in 1842. It has also been treated as only a variet ...
'', '' Astragalus membranaceous'', and ''
Paeonia lactiflora ''Paeonia lactiflora'' (Chinese peony, Chinese herbaceous peony, or common garden peony) is a species of herbaceous perennial flowering plant in the family Paeoniaceae, native to central and eastern Asia from eastern Tibet across northern China t ...
''; although there is no evidence that they cause liver damage. Contrary to popular belief, ''
Ganoderma lucidum ''Ganoderma lucidum'' is a red-colored species of ''Ganoderma'' with a limited distribution in Europe and parts of China, where it grows on decaying hardwood trees. Wild populations have been found in the United States in California and Utah, but ...
'' mushroom extract, as an adjuvant for cancer immunotherapy, appears to have the potential for toxicity. Also, adulteration of some herbal medicine preparations with conventional drugs which may cause serious adverse effects, such as
corticosteroid Corticosteroids are a class of steroid hormones that are produced in the adrenal cortex of vertebrates, as well as the synthetic analogues of these hormones. Two main classes of corticosteroids, glucocorticoids and mineralocorticoids, are inv ...
s, phenylbutazone,
phenytoin Phenytoin (PHT), sold under the brand name Dilantin among others, is an anti-seizure medication. It is useful for the prevention of tonic-clonic seizures (also known as grand mal seizures) and focal seizures, but not absence seizures. The in ...
, and glibenclamide, has been reported. However, many adverse reactions are due to misuse or abuse of Chinese medicine. For example, the misuse of the dietary supplement '' Ephedra'' (containing
ephedrine Ephedrine is a central nervous system (CNS) stimulant that is often used to prevent low blood pressure during anesthesia. It has also been used for asthma, narcolepsy, and obesity but is not the preferred treatment. It is of unclear benefit in ...
) can lead to adverse events including gastrointestinal problems as well as sudden death from
cardiomyopathy Cardiomyopathy is a group of diseases that affect the heart muscle. Early on there may be few or no symptoms. As the disease worsens, shortness of breath, feeling tired, and swelling of the legs may occur, due to the onset of heart failure. ...
. Products adulterated with
pharmaceutical A medication (also called medicament, medicine, pharmaceutical drug, medicinal drug or simply drug) is a drug used to diagnose, cure, treat, or prevent disease. Drug therapy ( pharmacotherapy) is an important part of the medical field and ...
s for weight loss or erectile dysfunction are one of the main concerns. Chinese herbal medicine has been a major cause of
acute liver failure Acute liver failure is the appearance of severe complications rapidly after the first signs (such as jaundice) of liver disease, and indicates that the liver has sustained severe damage (loss of function of 80–90% of liver cells). The complicati ...
in China. Most Chinese herbs are safe but some have shown not to be. Reports have shown products being contaminated with drugs, toxins, or false reporting of ingredients. Some herbs used in TCM may also react with drugs, have side effects, or be dangerous to people with certain medical conditions.


Efficacy

Only a few trials exist that are considered to have adequate methodology by scientific standards. Proof of effectiveness is poorly documented or absent. A 2016
Cochrane review Cochrane (previously known as the Cochrane Collaboration) is a British international charitable organisation formed to organise medical research findings to facilitate evidence-based choices about health interventions involving health professi ...
found "insufficient evidence that Chinese Herbal Medicines were any more or less effective than placebo or Hormonal Therapy" for the relief of menopause related symptoms. A 2012 Cochrane review found no difference in decreased mortality for
SARS Severe acute respiratory syndrome (SARS) is a viral respiratory disease of zoonotic origin caused by the severe acute respiratory syndrome coronavirus (SARS-CoV or SARS-CoV-1), the first identified strain of the SARS coronavirus species, ''seve ...
patients when Chinese herbs were used alongside Western medicine versus Western medicine exclusively. A 2010 Cochrane review found there is not enough robust evidence to support the effectiveness of traditional Chinese medicine herbs to stop the bleeding from
haemorrhoids Hemorrhoids (or haemorrhoids), also known as piles, are vascular structures in the anal canal. In their normal state, they are cushions that help with stool control. They become a disease when swollen or inflamed; the unqualified term ''he ...
. A 2008 Cochrane review found promising evidence for the use of Chinese herbal medicine in relieving painful menstruation, compared to conventional medicine such as
NSAID Non-steroidal anti-inflammatory drugs (NSAID) are members of a therapeutic drug class which reduces pain, decreases inflammation, decreases fever, and prevents blood clots. Side effects depend on the specific drug, its dose and duration of ...
s and the oral contraceptive pill, but the findings are of low methodological quality. A 2012 Cochrane review found weak evidence suggesting that some Chinese medicinal herbs have a similar effect at preventing and treating
influenza Influenza, commonly known as "the flu", is an infectious disease caused by influenza viruses. Symptoms range from mild to severe and often include fever, runny nose, sore throat, muscle pain, headache, coughing, and fatigue. These symptom ...
as
antiviral Antiviral drugs are a class of medication used for treating viral infections. Most antivirals target specific viruses, while a broad-spectrum antiviral is effective against a wide range of viruses. Unlike most antibiotics, antiviral drugs do n ...
medication. Due to the poor quality of these medical studies, there is insufficient evidence to support or dismiss the use of Chinese medicinal herbs for the treatment of influenza. There is a need for larger and higher quality randomized clinical trials to determine how effective Chinese herbal medicine is for treating people with influenza. A 2005 Cochrane review found that although the evidence was weak for the use of any single herb, there was low quality evidence that some Chinese medicinal herbs may be effective for the treatment of acute
pancreatitis Pancreatitis is a condition characterized by inflammation of the pancreas. The pancreas is a large organ behind the stomach that produces digestive enzymes and a number of hormones. There are two main types: acute pancreatitis, and chronic p ...
. Successful results have been scarce:
artemisinin Artemisinin () and its semisynthetic derivatives are a group of drugs used in the treatment of malaria due to '' Plasmodium falciparum''. It was discovered in 1972 by Tu Youyou, who shared the 2015 Nobel Prize in Physiology or Medicine for h ...
is one of few examples. An effective treatment for
malaria Malaria is a mosquito-borne infectious disease that affects humans and other animals. Malaria causes symptoms that typically include fever, tiredness, vomiting, and headaches. In severe cases, it can cause jaundice, seizures, coma, or death. ...
, it was derived from ''
Artemisia annua ''Artemisia annua'', also known as sweet wormwood, sweet annie, sweet sagewort, annual mugwort or annual wormwood (), is a common type of wormwood native to temperate Asia, but naturalized in many countries including scattered parts of North Am ...
'' which is traditionally used to treat fever. Chinese herbology is largely
pseudoscience Pseudoscience consists of statements, beliefs, or practices that claim to be both scientific and factual but are incompatible with the scientific method. Pseudoscience is often characterized by contradictory, exaggerated or unfalsifiable claim ...
, with no valid
mechanism of action In pharmacology, the term mechanism of action (MOA) refers to the specific biochemical interaction through which a drug substance produces its pharmacological effect. A mechanism of action usually includes mention of the specific molecular targ ...
for the majority of its treatments.


Ecological impacts

The traditional practice of using (by now)
endangered species An endangered species is a species that is very likely to become extinct in the near future, either worldwide or in a particular political jurisdiction. Endangered species may be at risk due to factors such as habitat loss, poaching and inv ...
is controversial within TCM. Modern Materia Medicas such as Bensky, Clavey and Stoger's comprehensive Chinese herbal text discuss substances derived from endangered species in an appendix, emphasizing alternatives. Parts of endangered species used as TCM drugs include tiger bones and rhinoceros horn.''Facts about traditional Chinese medicine (TCM): rhinoceros horn'', Encyclopædia Britannica
Facts about traditional Chinese medicine (TCM): rhinoceros horn, as discussed in rhinoceros (mammal): – Britannica Online Encyclopedia
/ref> Poachers supply the
black market A black market, underground economy, or shadow economy is a clandestine market or series of transactions that has some aspect of illegality or is characterized by noncompliance with an institutional set of rules. If the rule defines the ...
with such substances, and the black market in rhinoceros horn, for example, has reduced the world's rhino population by more than 90 percent over the past 40 years.''"Rhino horn: All myth, no medicine"'', ''National Geographic'', Rhishja Larson Concerns have also arisen over the use of
turtle Turtles are an order of reptiles known as Testudines, characterized by a special shell developed mainly from their ribs. Modern turtles are divided into two major groups, the Pleurodira (side necked turtles) and Cryptodira (hidden necked t ...
plastron and
seahorse A seahorse (also written ''sea-horse'' and ''sea horse'') is any of 46 species of small marine fish in the genus ''Hippocampus''. "Hippocampus" comes from the Ancient Greek (), itself from () meaning "horse" and () meaning "sea monster" or ...
s. TCM recognizes
bear bile Bears are carnivoran mammals of the family Ursidae. They are classified as caniforms, or doglike carnivorans. Although only eight species of bears are extant, they are widespread, appearing in a wide variety of habitats throughout the No ...
as a medicinal. In 1988, the Chinese Ministry of Health started controlling bile production, which previously used bears killed before winter. Now bears are fitted with a sort of permanent
catheter In medicine, a catheter (/ˈkæθətər/) is a thin tubing (material), tube made from medical grade materials serving a broad range of functions. Catheters are medical devices that can be inserted in the body to treat diseases or perform a surgi ...
, which is more profitable than killing the bears. November 12, 2002 More than 12,000
asiatic black bears The Asian black bear (''Ursus thibetanus''), also known as the Asiatic black bear, moon bear and white-chested bear, is a medium-sized bear species native to Asia that is largely adapted to an arboreal lifestyle. It lives in the Himalayas, sout ...
are held in "bear farms", where they suffer cruel conditions while being held in tiny cages. The catheter leads through a permanent hole in the abdomen directly to the
gall bladder In vertebrates, the gallbladder, also known as the cholecyst, is a small hollow organ where bile is stored and concentrated before it is released into the small intestine. In humans, the pear-shaped gallbladder lies beneath the liver, although ...
, which can cause severe pain. Increased international attention has mostly stopped the use of bile outside of China; gallbladders from butchered cattle () are recommended as a substitute for this ingredient. Collecting American ginseng to assist the Asian traditional medicine trade has made ginseng the most harvested wild plant in North America for the last two centuries, which eventually led to a listing on CITES Appendix II.


Herbs in use

Chinese herbology is a pseudoscientific practice with potentially unreliable product quality, safety hazards or misleading health advice. There are regulatory bodies, such as China GMP (Good Manufacturing Process) of herbal products. However, there have been notable cases of an absence of
quality control Quality control (QC) is a process by which entities review the quality of all factors involved in production. ISO 9000 defines quality control as "a part of quality management focused on fulfilling quality requirements". This approach place ...
during herbal product preparation. There is a lack of high-quality scientific research on herbology practices and product effectiveness for anti-disease activity. In the herbal sources listed below, there is little or no evidence for efficacy or proof of safety across consumer age groups and disease conditions for which they are intended. There are over 300 herbs in common use. Some of the most commonly used herbs are
Ginseng Ginseng () is the root of plants in the genus '' Panax'', such as Korean ginseng ('' P. ginseng''), South China ginseng ('' P. notoginseng''), and American ginseng ('' P. quinquefolius''), typically characterized by the presence of ginsenosides ...
(), wolfberry ( (''
Angelica sinensis ''Angelica sinensis'', commonly known as ''dong quai'' () or female ginseng, is a herb belonging to the family Apiaceae, indigenous to China. ''Angelica sinensis'' grows in cool high altitude mountains in East Asia. The yellowish brown root of th ...
'', ), astragalus (), atractylodes (), bupleurum (), cinnamon (cinnamon twigs () and cinnamon bark ()), coptis (), ginger (), hoelen (),
licorice Liquorice (British English) or licorice ( American English) ( ; also ) is the common name of ''Glycyrrhiza glabra'', a flowering plant of the bean family Fabaceae, from the root of which a sweet, aromatic flavouring can be extracted. The l ...
(), ''
ephedra sinica ''Ephedra sinica'' (also known as Chinese ephedra or Ma Huang) is a species of '' Ephedra'' native to Mongolia, Russia (Buryatiya, Chita, Primorye), and northeastern China ( Gansu, Hebei, Heilongjiang, Jilin, Liaoning, Nei Mongo ...
'' (),
peony The peony or paeony is a flowering plant in the genus ''Paeonia'' , the only genus in the family Paeoniaceae . Peonies are native to Asia, Europe and Western North America. Scientists differ on the number of species that can be distinguished, ...
(white: and reddish: ), rehmannia (), rhubarb (), and salvia ().


50 fundamental herbs

In Chinese herbology, there are 50 "fundamental" herbs, as given in the reference text, although these herbs are not universally recognized as such in other texts. The herbs are:


Other Chinese herbs

In addition to the above, many other Chinese herbs and other substances are in common use, and these include: * ''
Akebia quinata ''Akebia quinata'', commonly known as chocolate vine, five-leaf chocolate vine, or five-leaf akebia, is a shrub that is native to Japan (known as ), China and Korea, commonly used as an ornamental / edible plant in the United States and Europe ...
'' () * '' Arisaema heterophyllum'' () * '' Chenpi'' (sun-dried tangerine (mandarin) peel) () * ''
Clematis ''Clematis'' is a genus of about 300 species within the buttercup family, Ranunculaceae. Their garden hybrids have been popular among gardeners, beginning with ''Clematis'' × ''jackmanii'', a garden standby since 1862; more hybrid cultivars ...
'' () * '' Concretio silicea bambusae'' () * '' Cordyceps sinensis'' () * '' Curcuma'' () * ''
Dalbergia odorifera ''Dalbergia odorifera'', fragrant rosewood or Chinese rosewood (), is a species of legume in the family Fabaceae. It is a small or medium-sized tree, tall. It is endemic to China and occurs in Fujian, Hainan, Zhejiang, and Guangdong. It is us ...
'' () * ''
Myrrh Myrrh (; from Semitic, but see '' § Etymology'') is a gum-resin extracted from a number of small, thorny tree species of the genus '' Commiphora''. Myrrh resin has been used throughout history as a perfume, incense and medicine. Myrrh m ...
'' () * ''
Frankincense Frankincense (also known as olibanum) is an aromatic resin used in incense and perfumes, obtained from trees of the genus '' Boswellia'' in the family Burseraceae. The word is from Old French ('high-quality incense'). There are several species ...
'' () * '' Persicaria'' () * ''
Patchouli PatchouliAlso spelled ''patchouly'' or ''pachouli''. (; ''Pogostemon cablin'') is a species of flowering plant in the family Lamiaceae, commonly called the mint or deadnettle family. The plant grows as a bushy perennial herb, with erect stems r ...
' () * ''
Polygonum ''Polygonum'' is a genus of about 130 species of flowering plant in the buckwheat and knotweed family Polygonaceae. Common names include knotweed and knotgrass (though the common names may refer more broadly to plants from Polygonaceae). In ...
'' () * '' Sparganium'' () * ''
Zedoary ''Curcuma zedoaria'' (zedoary, white turmeric, or temu putih) is a perennial herb and member of the genus ''Curcuma'', family Zingiberaceae. The plant is native to South Asia and Southeast Asia but is now naturalized in other places including th ...
'' (''Curcuma zedoaria'') ()


See also

*
Chinese classic herbal formula Chinese classic herbal formulas () are combinations of herbs used in Chinese herbology for supposed greater efficiency in comparison to individual herbs. They are the basic herbal formulas that students of Traditional Chinese medicine learn. Later t ...
* Chinese ophthalmology * ''
Compendium of Materia Medica The ''Bencao gangmu'', known in English as the ''Compendium of Materia Medica'' or ''Great Pharmacopoeia'', is an encyclopedic gathering of medicine, natural history, and Chinese herbology compiled and edited by Li Shizhen and published in the ...
'' * Hallucinogenic plants in Chinese herbals *
Herbalism Herbal medicine (also herbalism) is the study of pharmacognosy and the use of medicinal plants, which are a basis of traditional medicine. With worldwide research into pharmacology, some herbal medicines have been translated into modern reme ...
, for the use of medicinal herbs in other traditions. *
Japanese star anise ''Illicium anisatum'', with common names Japanese star anise, Aniseed tree, and sacred Anise tree, known in Japan as , is a tree closely related to the Chinese star anise (''Illicium verum)''. Since it is highly toxic, the fruit is not edible; ...
* '' Jiuhuang Bencao'' * Kampo (traditional Japanese medicine) *
Li Shizhen Li Shizhen (July 3, 1518  – 1593), courtesy name Dongbi, was a Chinese acupuncturist, herbalist, naturalist, pharmacologist, physician, and writer of the Ming dynasty. He is the author of a 27-year work, found in the ''Compendium o ...
*
Pharmacognosy Pharmacognosy is the study of medicinal plants and other natural substances as sources of drugs. The American Society of Pharmacognosy defines pharmacognosy as "the study of the physical, chemical, biochemical, and biological properties of dru ...
*
Star anise ''Illicium verum'' is a medium-sized evergreen tree native to northeast Vietnam and southwest China. A spice commonly called star anise, staranise, star anise seed, star aniseed, star of anise, Chinese star anise, or badian that closely resemb ...
*
Traditional Chinese medicine Traditional Chinese medicine (TCM) is an alternative medical practice drawn from traditional medicine in China. It has been described as "fraught with pseudoscience", with the majority of its treatments having no logical mechanism of acti ...
*
Traditional Korean medicine Traditional Korean medicine (known in North Korea as Koryo medicine) refers to the forms of traditional medicine practiced in Korea. History Korean medicine traditions originated in ancient and prehistoric times and can be traced back as far a ...
*
Traditional Vietnamese medicine Traditional Vietnamese medicine (Y học Cổ truyền Việt Nam), also known as Southern Herbology (Thuốc Nam) is a traditional medicine practiced by Vietnamese people. It is influenced by traditional Chinese medicine. The other traditional ...
* ''
Yaoxing Lun ''Yaoxing Lun'' (''Yao-hsing Lun''; ), literally ''Treatise on the Nature of Medicinal Herbs'', is a 7th-century Tang Dynasty Chinese treatise on herbal medicine. See also *Chinese herbology *''Compendium of Materia Medica The ''Bencao gangm ...
''


References

* * * * * * * * *


External links

* {{DEFAULTSORT:Chinese Herbology Plants used in traditional Chinese medicine Pseudoscience Traditional medicine Traditional Chinese medicine Alternative medicine Herbalism Chinese traditions Pharmacognosy