Chinese Patent Medicine

In July, 1997, I saw a press release that looked like a news article splashed across the front page of a newspaper announcing in big headlines "DRUG-FREE HEALTH CARE DEBUTS HERE" Included was a photo of a happy looking Caucasian couple, one of whom was described as a native of New Mexico.

Acupuncture and herbal medicine were listed under the treatment modalities offered. The article noted that very often acupuncturists recommend herbs in conjunction with acupuncture adding that herbs are used more extensively than acupuncture in China.

"Drug-free health care" that uses Chinese herbs? I don't think so, and I don't think that the Chinese do either. They always refer to them as "medicinal herbs" and "tradtional medicine".

Presently in the United States medicinal herbs and botanicals drugs are classified as "dietary supplements". That means that they are unregulated by any government agency and can be legally sold as long as manufacturers and salespeople don't make drug claims for them. (Go Here)

According to a front page article in the June 19, 1997, issue of USA TODAY, China is cracking down, requiring prescriptions for herbs that are sold off the shelf in the U.S. They quote Michael Hanna who manufacturers and sells dietary supplements under the name of "Arizona Natural" as saying that, "Unless I make a health claim, the FDA can't even look at it. In Singapore I have to fill out 20 to 30 pages about what's in it."

Testimony presented to the President's Committee on Dietary Supplement Labels shows that people in public health are very disturbed by what is sold as Asian patent medicine in this country.

Deborah Orr, a pharmacist and drug control officer with the State of Florida, submitted a report stating that they have Chinese grocery stores all across her state in which there are shelves full of traditional remedies imported from China. Most of the ingredients listed on the labels are in Latin or Chinese.

"Testis et Penis Canitis", one of the ingredients in Gejie Nourishing Kidney Pills, translates to dog testicle and penis.

Other medicines contain tiger bones, deer placenta and crocodile penises. In addition to being disgusting, there is the risk of an infection being passed from a sick animal to a person consuming it. Both California and Florida have lists of natural toxins such as toad venom which are commonly found in Asian patent medicines.

Orr's report also contains case reports of adverse reactions, including deaths, attributed to these remedies. Before the passage of DSHEA (Go Here), her department purchased and analyzed such products. They discovered that many things sold as traditional medicines contained heavy metals as well as potent western prescription drugs like morphine.

When they found a botanical spiked or adulterated with regulated pharmaceuticals, they removed it from the shelf only to find the same thing surface again somewhere else with a new name. Shopkeepers could not be prosecuted because it was impossible to prove intent to commit a crime.

Unfortunately, Florida's experience is the norm not the exception.

Dr. Richard Ko of the California Department of Health Services writes of similar findings in a letter to The New England Journal of Medicine, Vol. 339 # 12, September 17, 1998, p. 847. Of 260 products analyzed, he found that 82 contained pharmaceuticals or dangerous levels of heavy metals such as lead, arsenic and mercury.

These products are widely available in California being sold in herbal stores and are accepted by many Americans as an "alternative" form of medicine. Dr. Ko concludes his letter by saying that, "The remaining products, which contained no detectable adulterants, cannot be assumed to be safe and free of toxic ingredients, in view of their batch-to- batch inconsistency, as well as limitations in our detection methods."

In "Monitoring the Safety of Herbal Medicines", DRUG SAFETY 1997 Oct. 17 (4) p. 209-15, Thomas Y.K. Chan, a Hong Kong pharmacologist notes that out of about 7000 species of plants used in China as herbal remedies, only 230 of the most common ones have been the subject of "in-depth pharmacological, analytical and clinical studies." Chan adds, "Even these studies cannot provide all the necessary safety information, for several reasons.

Toxicological studies in animals do not necessarily reveal all human hazards. Clinical trials in human volunteers are often small and adverse reactions may be poorly documented. Adverse effects that have a long latency period such as carcinogenicity and teratogenicity will pose special problems." Teratogenicity refers to substances such as thalidomide that cause abnormal growth and development which results in birth defects in the fetuses of pregnant women who consume them.

In "Chinese herbal medicines revisited: a Hong Kong perspective" in the LANCET Vol. 342 Dec. 18/25, 1993 p.1532-4 Thomas Chan notes that while very few "acute medical admissions" in his study were caused by Chinese remedies, there have been reports of severe and fatal poisonings. He says that of 150 species of commonly used plants, 10 are toxic. I think that "known to be toxic" would be a better way to put it.

In an article entitled "Adulteration by Synthetic Therapeutic Substances of Traditional Chinese Medicines in Taiwan" by Weng F. Huang, et. al. that appeared in 1997 (J Clin Pharmacol 1997;37:344-350) the authors report on a study they conducted on 2,609 samples of traditional Chinese medicines collected at eight major hospitals in Taiwan. 23.7% of the samples were found to have been adulterated with synthetic drugs not listed on the labels. Of those 52.8% contained two or more adulterants.

If the Chinese believe that "natural is good and synthetic bad" as western promoters of botanical drugs would have us believe, you have to wonder why they adulterate those fine old traditional remedies with those nasty new synthetics. You also have to worry about the safety of the patients unknowingly consuming them.

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