I remember standing in the pharmacy room of a hospital of traditional Chinese medicine. The slight bitter smell of herbs would rush into my nose and blend into every breath I took. The room was filled with wooden drawers that went almost from wall to ceiling. The pharmacist would take a quick look at the prescription and then just walk to the right drawer without any hesitation. They would pull out drawers and drawers to take out all different kinds of herbs, sometimes they even need to stand on a ladder. They held a little silver scoop in their hands, and took just the right amount and then poured it into a big piece of brown paper. I stood behind a transparent counter in which there were dried seahorse and turtle and some other animal and plants that I could not really identify. After the set of herbs was complete, the pharmacist would wrap it with cotton thread and hand it in with detailed information on how to make it at home. After that day, for about two months, our apartment would be filled with a strong herbal smell. The dark brown liquid would bubble in an ivory round pot on the stove, and Mom would stand by it, putting in and taking out different herbs at a different time to maximize the function of each.
It was a nightly crisis for me to take in these bitter liquids. I would close my eyes tightly and chug it down. Before the bitterness took control over all my tastebuds, I would take a gulp of the honey water mom prepared for me. I never really remembered the reason that I went to the hospital of traditional Chinese medicine or whether the bitter brown herbal liquid actually worked. It just seemed to be a part of life as a Chinese person; people believed and trusted it.
Recently, there has been a debate about the efficiency and usage of herbal medicine on Weibo, the most popular social media platform in China. Much of the debate centers around “Incidence and Etiology of Drug-Induced Liver Injury in Mainland China”, a report published by several doctors from various hospitals in China. The report collected a total of 25,927 confirmed DILI (drug-induced liver injury) cases across from 308 medical centers in mainland China. The researchers collected demographic information, medical history, treatment, laboratory, disease severity, and mortality data from all these cases. According to the report, from 2012 to 2014, among all the drugs that induced liver injury, the leading classes were traditional Chinese medicines or herbal and dietary supplements (26.81%) and anti-tuberculosis medications (21.99%). The report also states that the incidence of DILI of the general population in mainland China is much higher than that of western countries, due to mainly Traditional Chinese medicines, herbal and dietary supplements, and anti-tuberculosis drugs.
Many influential accounts on Weibo and mainstream media have since used this report to argue that Chinese traditional medicine is not based on scientific evidence and they have not done enough clinical trials to identify the specific side effect of different herbs. They also point out that in 2017, China’s State Food and Drug Administration collected 1618 kinds of current market drugs that contain elements of traditional Chinese medicine. 80.2% of these drugs have unclear indications of side effects. They dispute that Chinese Traditional medicine has become a cultural symbol and a huge industry; therefore, it enjoys some privilege on some policies. According to the Chinese Drug Label Regulation, drug description should include clear information on side effects. Nevertheless, in 2016, the China Food and Drug Administration released “Printing and Writing the Requirements for the Formatting of Chinese Medicine and Natural Medicine Prescription Drugs and Writing Guidelines” which suggests that drugs of Chinese Traditional medicine could get around side effects, drug interactions, clinical trials and pharmacokinetics by stating unclear information in the drug descriptions. Nonetheless, the other side of the debate argues that people should not deny the function of Chinese Traditional just because of this one incident. They also state that many hospitals that practice modern medicine would refer their patients to drugs of Chinese Traditional medicine. However, the general public does think there should be more strict regulation on drugs of Chinese Traditional Medicine.
Edited by: Rama Balasubramaniam
Illustrated by: Caroline Cao