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ISO/TS 17948:2014 health information traditional chinese medicine literature metedata

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Courtesy: ISO/TS 17948:2014 health information traditional chinese medicine literature metedata

The term “herbal medicine” is somewhat misleading in that, while plant elements are by far the most commonly used substances in TCM, other, non-botanic substances are used as well: animal, human, and mineral products are also used. Thus, the term “medicinal” (instead of herb) may be used, although there is no scientific evidence that any of these compounds have medicinal effects.

Raw materials

There are roughly 13,000 compounds used in China and over 100,000 TCM 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, 45 were animal parts, and 30 were minerals.

Animal substances

Some animal parts used can be considered rather strange such as cow gallstones, hornet nests, leeches, and scorpion. Other examples of animal parts include horn of the antelope or buffalo, deer antlers, testicles and penis bone of the dog, and snake bile. Some TCM textbooks still recommend preparations containing animal tissues, but there has been little research to justify the claimed clinical efficacy of many TCM animal products.

Some compounds can include the parts of endangered species, including tiger bones and rhinoceros horn which is used for many ailments (though not as an aphrodisiac as is commonly misunderstood in the West). The black market in rhinoceros horns (driven not just by TCM but also unrelated status-seeking) has reduced the world’s rhino population by more than 90 percent over the past 40 years. Concerns have also arisen over the use of pangolin scales, turtle plastron, seahorses, and the gill plates of mobula and manta ray

Poachers hunt restricted or endangered species to supply the black market with TCM products. There is no scientific evidence of efficacy for tiger medicines. Concern over China considering to legalize the trade in tiger parts prompted the 171-nation Convention on International Trade in Endangered Species (CITES) to endorse a decision opposing the resurgence of trade in tigers. Fewer than 30,000 saiga antelopes remain, which are exported to China for use in traditional fever therapies. Organized gangs illegally export the horn of the antelopes to China. The pressures on seahorses (Hippocampus spp.) used in traditional medicine is enormous; tens of millions of animals are unsustainably caught annually. Many species of syngnathid are currently part of the IUCN Red List of Threatened Species or national equivalents.

Since TCM recognizes bear bile as a treatment compound, more than 12,000 asiatic black bears are held in bear farms. The bile is extracted through a permanent hole in the abdomen leading to the gall bladder, which can cause severe pain. This can lead to bears trying to kill themselves. As of 2012, approximately 10,000 bears are farmed in China for their bile. This practice has spurred public outcry across the country. The bile is collected from live bears via a surgical procedure. As of March 2020 bear bile as ingredient of Tan Re Qing injection remains on the list of remedies recommended for treatment of “severe cases” of COVID-19 by National Health Commission of China and the National Administration of Traditional Chinese Medicine.

The deer penis is believed to have therapeutic benefits according to traditional Chinese medicine. Tiger parts from poached animals include tiger penis, believed to improve virility, and tiger eyes. The illegal trade for tiger parts in China has driven the species to near-extinction because of its popularity in traditional medicine. Laws protecting even critically endangered species such as the Sumatran tiger fail to stop the display and sale of these items in open markets. Shark fin soup is traditionally regarded in Chinese medicine as beneficial for health in East Asia, and its status as an elite dish has led to huge demand with the increase of affluence in China, devastating shark populations. The shark fins have been a part of traditional Chinese medicine for centuries. Shark finning is banned in many countries, but the trade is thriving in Hong Kong and China, where the fins are part of shark fin soup, a dish considered a delicacy, and used in some types of traditional Chinese medicine.

The tortoise (freshwater turtle, guiban) and turtle (Chinese softshell turtle, biejia) species used in traditional Chinese medicine are raised on farms, while restrictions are made on the accumulation and export of other endangered species. However, issues concerning the overexploitation of Asian turtles in China have not been completely solved. Australian scientists have developed methods to identify medicines containing DNA traces of endangered species. Finally, although not an endangered species, sharp rises in exports of donkeys and donkey hide from Africa to China to make the traditional remedy ejiao have prompted export restrictions by some African countries.

Traditional Chinese medicine also includes some human parts: the classic Materia medica (Bencao Gangmu) describes (also criticizes) the use of 35 human body parts and excreta in medicines, including bones, fingernail, hairs, dandruff, earwax, impurities on the teeth, feces, urine, sweat, organs, but most are no longer in use.

Human placenta has been used an ingredient in certain traditional Chinese medicines, including using dried human placenta, known as “Ziheche”, to treat infertility, impotence and other conditions. The consumption of the human placenta is a potential source of infection.

Traditional categorization

The traditional categorizations and classifications that can still be found today are:

Efficacy

As of 2007 there were not enough good-quality trials of herbal therapies to allow their effectiveness to be determined. A high percentage of relevant studies on traditional Chinese medicine are in Chinese databases. Fifty percent of systematic reviews on TCM did not search Chinese databases, which could lead to a bias in the results. Many systematic reviews of TCM interventions published in Chinese journals are incomplete, some contained errors or were misleading. The herbs recommended by traditional Chinese practitioners in the US are unregulated.

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