Chinese Medicine

What is traditional Chinese medicine?

Traditional Chinese herbal medicine (TCHM) is a form of medicine which is made from a mixture of herbal products in differing amounts. Traditional Chinese medicine places a great emphasis on the usage of Chinese herbal medicine as a means of balancing the flow of energy “Qi”, in the body. Practitioners believe that the balance of Qi is the best way to sustain a patient’s health. In this way, traditional Chinese medicine takes a holistic approach to treatments by focusing on the general health of the patient rather than treating one specific condition or disease.

Historical background

Having been used in China for nearly 5000 years,[1] Chinese herbal medicine is one of the most ancient forms of alternative and complementary medicine.[2] Herbal medicine has been documented in the Egyptian Ebers papyrus (ca. 1550BC) where numerous natural products such as coriander, garlic, linseed, figs, fennel, poppy and peppermint were used in prescriptions.[3] In about 200BC, Shen Nong’s Materia Medica was compiled by Chinese which categorises the properties and usages of 365 types of Chinese medicines into three groups.[4] In his work De Materia Medica, Greek physician and botanist Dioscorides (AD 40-90) assembled the first systematic description of 579 plants and their 4700 medicinal uses and modes of action.[5] His work played a critical role in European medicine until the seventeenth century.[6]

Current use of herbal medicine

In China, the use of herbal medicine remains widely common and is often the only form of medicine available.[7]  Its popularity is also prevalent in countries where western medicine is easily accessible including Singapore and Hong Kong.[8] In recent times, there has been a surge in the interest and usage of herbal medicine in the western world, along with the increased demand for other herbal remedies, being readily available in drug stores, food stores and supermarkets.[9] The reasons include various claims supporting the effectiveness of plant medicines, greater interest in alternative medicines with a preference for natural therapies, belief that herbal products are better than manufactured products, belief that herbal medicines may be effective to treat diseases where orthodox pharmaceuticals have been ineffective, high cost of most drugs,[10] greater interest in improving the whole body immune system,[11] a movement towards self-medication,[12] and belief that herbal medicines are safe with minimal side-effects.[13] Overall, it is believed to promote healthier living.[14] The increased practise of self-medication is attributed to several factors including patients feeling uncomfortable about discussing their medical conditions with the treating doctor and fearing that their confidential information may be mishandled, fear of misdiagnosis for non-specific symptoms and the lack of time to see a doctor in their busy, working lives.[15] In addition to these factors, effective marketing strategies have also contributed to the increased awareness and acceptance of herbal medicines.[16] For example, children are encouraged to consume herbs for their healthy growth and development, adolescents for relieving daily stress and the euphoric effects, older persons for anti-aging or rejuvenating benefits[17] and women for weight loss and beauty enhancing effects.[18]

How are traditional Chinese herbal medicine made?

In China, traditional Chinese herbal medicine involves the use of more than 5000 species of plants, animals and minerals.[19] A practitioner who administers Chinese herbal medicine will obtain their herbs from natural plant life.  The herbal medicine is a mixture of several plants containing on average of 10-15 herbs and sometimes may contain up to 50 species.[20] Each herb possesses different substances and may be categorised by their main actions, i.e. tonify Yang, tonify Yin, tonify Blood, tonify Qi, warm and expel cold, warm and transform Phlegm-Cold.[21] The medicine will be formulated based on the characteristics and symptoms of the patient and follows the rules of drug synergism and compatibility, a holistic philosophy of traditional Chinese medicine.[22] There are numerous theories on the causes of diseases and the most effective way to formulate the herbal medicines.[23] One of the most influential school of thought is the principle of jun-chen-zuo-shi[24] which involves the use of four categories of herbs. The principal herbs are aimed at treating the main symptom and associate herbs assist the function of the principal herbs and target other minor symptoms.[25] Adjuvant herbs are used to support the function of the principal herbs and reduce the toxicity and the side-effects of the herbs.[26] Messenger herbs guide the function of all the ingredient herbs into the right pattern and harmonises the function of the formula.[27] Chinese patent medicines (CPMs) are also available which are finished products made from crude herbs, i.e. capsules.[28] Some modern CPMs are a combination of herbal medicines and pharmaceutical drugs to improve its effectiveness and to minimise the risk of its side-effects.[29] The practitioner will use the herbal medicines to treat various bodily symptoms suffered by their patients. But first, the patient is required to have a consultation with the practitioner where they are examined and then diagnosed. The practitioner will discuss symptoms with the patient after observing areas of their body, such as their facial features, tongue and pulse. Based on their findings, the practitioner will write out a prescription for Chinese herbal medicine for the patient to take.

What are the benefits?

Scientific assessment on the effectiveness of traditional Chinese herbal medicine is complex because it is based on abstract philosophy relying on therapeutic benefits passed down through generations.[30] Generally, scientific evidence of TCHM is achieved through examining the efficacy of specific herbs or formulae.[31] However, TCHMs are made from a mixture of ingredients that reflect the patient’s symptoms and characteristics.  The individualised nature of herbal medicines makes it difficult to generalise their effectiveness across all patients of different age, sex and symptoms. In China, there is wide use and acceptance of TCHM as an alternative, therapeutic option due do its historical use and understanding of its working philosophy.[32] Traditional Chinese herbal medicine may assist in balancing the patient’s Qi energy which may have a positive effect on their overall health and mood.

Is it safe?

Chinese herbs are generally considered to be safe but occasionally (as with all health treatments) may be associated with possible adverse reactions in individual cases. The adverse effects may stem from the use of toxic herbs.

How much does it cost?

The price of herbal medicine differs from patient to patient, as it depends on their age, health and symptoms. Please contact the practitioner for more information.
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[1] Chen, Guohua and Mujumdar, Arun, ‘Drying of Herbal Medicines and Tea’ in Arum S. Mujumdar (ed), Handbook of Industrial Drying (Taylor and Francis, 2006) 637.
[2] Wang, Zhen-Gang and Ren, Jun, ‘Current Status and future direction of Chinese herbal medicine’ (2002) 23(8) Trends in Pharmacological Sciences 347. Accessed 15 March 2019 < https://www.sciencedirect.com/journal/trends-in-pharmacological-sciences/vol/23/issue/8>.
[3] Lipp, F.J., ‘Herbalism – The healing power of plant: Regional translations’ in Remedies and Recipes (Duncan Baird Publishers, 1996).
[4] Chen and Mujumdar, above n 1.
[5] Ibid.
[6] Lipp, above n 3.
[7] Kam, P.C.A., Liew S., ‘Traditional Chinese herbal medicine and anaesthesia’ (2002) 57 Anaesthesia. Accessed 12 March 2019 < https://www.ncbi.nlm.nih.gov/pubmed/12392455>.
[8] Ibid.
[9] Ekor, Martins, ‘The growing use of herbal medicines: issues relating to adverse reactions and challenges in monitoring safety’ (2014) 4 Frontiers in Pharmacology 1. Accessed 15 March 2019 < https://www.frontiersin.org/articles/10.3389/fphar.2013.00177/full>.
[10] Ekor, above n 9.
[11] Chen and Mujumdar, above n 1.
[12] Bandaranayake, Wickhramsinghe, ‘Quality Control Screening, Toxicity, and Regulation of Herbal Drugs’ in Ipbal Ahmad, Farrukh Aqil and Mohammad Owais (eds.), Modern Phytomedicine: Turning Medicinal Plants into Drugs (Wiley-VCH Verlag GmbH & Co, 2006).
[13] Kam, above n 7.
[14] Ekor, above n 9.
[15] Ibid.
[16] Ibid.
[17] Ibid.
[18] Parle, Milind and Bansal, Nitin, ‘Herbal Medicines: Are they safe?’ (2006) 5(1) Natural Product Radiance 6 <https://www.researchgate.net/publication/229000125_Herbal_Medicines_Are_they_safe>.
[19] Teng, Lida, Shaw, Debbie and Barnes, Joanne, ‘Traditional Chinese herbal medicine’ (2006) 276 The Pharmaceutical Journal 361. Accessed 19 March 2019 < https://pdfs.semanticscholar.org/9ebf/ac9c05dadd3307a31bd8dd70009567a29412.pdf>.
[20] Marris, Emma, ‘Diabetes drugs under scrutiny in a post-Vioxx world’ (2007) 6(7) Nature Reviews Drug Discovery 505. Accessed 15 March 2019 <https://www.researchgate.net/publication/6125520_Diabetes_drugs_under_scrutiny_in_a_post-Vioxx_world>.
[21] Ried, Karin, ‘Chinese herbal medicine for female infertility: An updated meta-analysis’ (2015) 23(1) Complementary Therapies in Medicine 116. Accessed 21 March 2019 <https://www.restorativeacupuncture.com/uploads/8/1/5/5/8155093/tcmherbalsforfertilitymetaanalysis.pdf>.
[22] Marris, above n 20.
[23] Qiu, Jane, ‘A culture in the balance’ (2007) 448 Nature 126. Accessed 19 March 2019.
[24] Qiu, above n 23.
[25] Teng, Shaw and Barnes, above n 19.
[26] Ibid.
[27] Ibid.
[28] Ibid.
[29] Ibid.
[30] Ibid.
[31] Ibid.
[32] Ibid.
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