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'Modernisation' Of Herbal Medicine Is Not 'Pharmaceuticalisation'

Modernising traditional herbal medicine requires vision and sensitivity if it is not to be 'analysed to death' and its long-standing benefits for humankind lost. Albert Y Leung explains

With the recent increased popularity of herbal products, the talk about modernising the practise of traditional herbal medicine (THM) has intensified. In this article, I am making a specific point to separate THM and traditional Chinese medicine (TCM), because the former does not have a whole field of tonic herbs, for example, and is much simpler in application and concept.

The conventional medical and scientific communities want to see modern, controlled studies on the efficacy of herbal medicines and many in the dietary supplements industry echo this call. However, 'modernising' means different things to different people, depending on whether the concept is applied to Western herbal medicine or to Chinese herbal medicine. It also depends on whether a person sees the total picture or is specialised or limited.

Western herbal medicine has traditionally been used mainly for treating specific conditions, such as headache, cough, arthritis, menstrual problems, skin sores, insect bites, colds and sore throat. One aspect of Chinese herbal medicine does the same. However, a major difference is that, in addition to this aspect of disease treatment, Chinese herbal medicine stresses disease prevention and good health maintenance. The concept of disease prevention and health maintenance is a minor aspect, if it exists at all, in the practise of Western herbal medicine.

If a compound is used like a modern drug for a specific indication, it no longer can be called THM. This is not modernisation of THM
Furthermore, the herbs currently used worldwide in the practise of traditional Chinese medicine (TCM) far outnumber those used in Western herbal medicine. In my own literature searches, I've discovered the number of commonly used Chinese herbs ranges between 1,000 and 2,000, including certain foods, spices and tonics that also double as drugs when used in higher doses (in Western disease treatment). There now are 11,470 documented plant species from 369 families used in TCM. Considering that a single plant species (root, leaf, stem, bark or flower) can yield more than one drug, it is a conservative estimate. The actual number of herbal drugs may well be twice the number of plant species documented and possibly more than 22,000. 1 Since herbs in TCM are commonly used in combination, the number of permutations derived from the number of plant drugs listed can be staggering.

Thus, the total recorded number of traditional formulas (prescriptions) from a single recent compilation is 130,000.2 This includes formulas from classical herbals and formularies (the Pu Ji Fang from the 14th century alone describes nearly 62,000 formulas), with a small percentage from the more recently published literature.

Unpublished Formulas
For each formula published in the current Chinese literature, there are possibly hundreds more used by the Chinese population worldwide that have never been published. But that's not all! There are also thousands of formulas used for diet therapy that are not included in Pu Ji Fang. Although these diet formulas are less systematically documented than those for treating disease, I estimate, conservatively, they range between 20 to 40 per cent of those used in disease treatment, whether or not documented.3,4 This suggests that in 'modernising' the practise of herbal medicine as part of Western medicine, one should consider traditional TCM diet therapy and disease prevention because TCM and Chinese herbs are becoming important in the field of dietary supplements in North America.

Modern allopathic medicine does not have a scientific model for evaluating TCM, which involves the interaction of drugs and foods that do not have a single or a single group of active principles for modern science to standardise and analyse.

TCM is a legitimate system of health care that is not going to disappear. Its herbal aspect can resolve many problems that modern drugs cannot adequately handle
'Modernising' the treatment of diarrhoea with berberine from huanglian ( Coptis chinensis and other Coptis spp) is possible because this compound effectively stops diarrhoea caused by bacterial infection. Standardising the amount of berberine in a huanglian extract is progress. However, this standardised extract based on berberine alone may not work for other traditional indications for huanglian, such as fever, insomnia, hematemesis, toothache, nosebleed, conjunctivitis, canker sores, carbuncle, abscess or eczema, for which huanglian is also traditionally used, and the active principal(s) responsible for these effects are not yet characterised.

Herbal Synergy
This situation also applies to Chinese herbs/foods that are used for maintaining good health and preventing disease. This class of botanicals, consisting mostly of tonics, contains more than one or one class of active chemical compounds (flavonoids, lignans, sterols, triterpenes, saponins, alkaloids). Hence, their pharmacological actions are not due to a single compound or even a group of compounds, but rather to a synergistic effect of all the compounds present.

To date, the call for 'modernisation' of traditional herbal medicine, even from the most prominent and the brightest scientists in the field, addresses only the obvious modern drug aspect of this issue. They miss the most important aspect of traditional herbal medicine, which is the fact that herbs have been beneficially used for so many centuries due to their milder nature. They work by interacting with the whole body system rather than targeting a particular organ or tissue, providing a synergy amongst the various active compounds present.

However, once an active compound is isolated and used in its natural or synthesised form, the synergistic nature of the original herb is absent. If this compound is used like a modern drug for a specific indication, it can no longer be called THM. This is not modernisation of THM. It is simply drug discovery using traditional herbs as a raw-materials source. The particular herb, or the practise of using this herb, has not been modernised. Instead, if it is abandoned in favour of the active compound, this herb no longer provides the holistic benefit via its gentler, synergistic and broader-reaching effects. And, our quality of life will suffer because we no longer have a choice. Instead, we are stuck with a new drug that will invariably cause side effects that require the use of yet more drugs and perpetuate the existing problems inherent in modern drugs. Consequently, we must not confuse new drug discovery and advanced chemical analyses with modernisation of the practise of THM.

True modernisation is preserving the practise of THM while making it relevant to modern society. This must be accomplished through a broad vision of both modern medicine and traditional herbal medicine. In the case of TCM, a general misconception about modernisation is doing chemical and/or pharmacological studies on it without regard to where these studies may lead or how relevant they are to TCM or to science.

TCM is a legitimate system of health care that is not going to disappear. Its herbal aspect can resolve many problems that modern drugs cannot adequately handle, especially in the areas of viral infections, aches and pains and illnesses of unknown aetiology (arthritis, rheumatism, eczema, vitiligo). It should be used in conjunction with Western medicine and not simply used as a source of modern drugs; the latter would obliterate TCM, rather than modernise it.

Albert Y Leung, PhD, is president of Phyto-Technologies, Inc, Iowa, USA.


1. Inst. Ch. Materia Medica, Ch Acad THM, Eds, Quanguo Zhongcaoyao Mingjian, 3 vols, People's Health Publications, Beijing, 1996.

2. Nanjing Coll. THM, Eds, Zhongyi Fangji Da Cidian, 11 vols, People's Health Publications, Beijing, 1993-7.

3. LQ Zhang and YZ Guang, Eds, Zhongguo Minzu Yaoshi Daquan. Encyclopaedia of Chinese Ethnic Diet Therapy, Shanxi Scientific and Technical Publications, Taiyuan, 1994.

4. ZY Wang, Ed, Zhongguo Yaoshan Da Cidian. Encyclopaedia of Chinese Diet Therapy, Dalian Publishers, Dalian, 1992.

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