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Chinese herbology

Chinese herbology (simplified Chinese: 中药学; traditional Chinese: 中藥學; pinyin: zhōngyào xué) is the theory of traditional Chinese herbal therapy, which accounts for the majority of treatments in traditional Chinese medicine (TCM). A Nature editorial described TCM as "fraught with pseudoscience", and said that the most obvious reason why it has not delivered many cures is that the majority of its treatments have no logical mechanism of action.[1]

Dried herbs and plant portions for Chinese herbology at a Xi'an market

The term herbology is misleading in the sense that, while plant elements are by far the most commonly used substances, animal, human, and mineral products are also utilized, among which some are poisonous. In the Huangdi Neijing they are referred to as 毒藥 (pinyin: dúyào) which means toxin, poison, or medicine. Paul U. Unschuld points out that this is similar etymology to the Greek pharmakon and so he uses the term "pharmaceutic".[2] Thus, the term "medicinal" (instead of herb) is usually preferred as a translation for (pinyin: yào).[3]

Research into the effectiveness of traditional Chinese herbal therapy is of poor quality and often tainted by bias,[4] with little or no rigorous evidence of efficacy.[5] There are concerns over a number of potentially toxic Chinese herbs.[6]

History

 
Chinese pharmacopoeia

Chinese herbs have been used for centuries. Among the earliest literature are lists of prescriptions for specific ailments, exemplified by the manuscript "Recipes for 52 Ailments", found in the Mawangdui which were sealed in 168 BC.

The first traditionally recognized herbalist is Shénnóng (神农, lit. "Divine Farmer"), a mythical god-like figure, who is said to have lived around 2800 BC.[7] He allegedly tasted hundreds of herbs and imparted his knowledge of medicinal and poisonous plants to farmers. His Shénnóng Běn Cǎo Jīng (神农本草经, Shennong's Materia Medica) is considered as the oldest book on Chinese herbal medicine. It classifies 365 species of roots, grass, woods, furs, animals and stones into three categories of herbal medicine:[8]

  1. The "superior" category, which includes herbs effective for multiple diseases and are mostly responsible for maintaining and restoring the body balance. They have almost no unfavorable side-effects.[8]
  2. A category comprising tonics and boosters, whose consumption must not be prolonged.[8]
  3. A category of substances which must usually be taken in small doses, and for the treatment of specific diseases only.[8]

The original text of Shennong's Materia Medica has been lost; however, there are extant translations.[9] The true date of origin is believed to fall into the late Western Han dynasty[7] (i.e., the first century BC).

The Treatise on Cold Damage Disorders and Miscellaneous Illnesses was collated by Zhang Zhongjing, also sometime at the end of the Han dynasty, between 196 and 220 CE. Focusing on drug prescriptions,[10] it was the first medical work to combine Yinyang and the Five Phases with drug therapy.[11] This formulary was also the earliest Chinese medical text to group symptoms into clinically useful "patterns" (zheng ) that could serve as targets for therapy. Having gone through numerous changes over time, it now circulates as two distinct books: the Treatise on Cold Damage Disorders and the Essential Prescriptions of the Golden Casket, which were edited separately in the eleventh century, under the Song dynasty.[12]

Succeeding generations augmented these works, as in the Yaoxing Lun (药性论; 藥性論; 'Treatise on the Nature of Medicinal Herbs'), a 7th-century Tang dynasty Chinese treatise on herbal medicine.

There was a shift in emphasis in treatment over several centuries. A section of the Neijing Suwen including Chapter 74 was added by Wang Bing [王冰 Wáng Bīng] in his 765 edition. In which it says: 主病之謂君,佐君之謂臣,應臣之謂使,非上下三品之謂也。 "Ruler of disease it called Sovereign, aid to Sovereign it called Minister, comply with Minister it called Envoy (Assistant), not upper lower three classes (qualities) it called." The last part is interpreted as stating that these three rulers are not the three classes of Shénnóng mentioned previously. This chapter in particular outlines a more forceful approach. Later on Zhang Zihe [張子和 Zhāng Zĭ-hé, aka Zhang Cong-zhen] (1156–1228) is credited with founding the 'Attacking School' which criticized the overuse of tonics.

Arguably the most important of these later works is the Compendium of Materia Medica (Bencao Gangmu:本草綱目) compiled during the Ming dynasty by Li Shizhen, which is still used today for consultation and reference.

The use of Chinese herbs was popular during the medieval age in western Asian and Islamic countries. They were traded through the Silk Road from the East to the West. Cinnamon, ginger, rhubarb, nutmeg and cubeb are mentioned as Chinese herbs by medieval Islamic medical scholars Such as Rhazes (854– 925 CE), Haly Abbas (930–994 CE) and Avicenna (980–1037 CE). There were also multiple similarities between the clinical uses of these herbs in Chinese and Islamic medicine.[13]

Raw materials

There are roughly 13,000 medicinals used in China and over 100,000 medicinal recipes recorded in the ancient literature.[14] Plant elements and extracts are by far the most common elements used.[15] In the classic Handbook of Traditional Drugs from 1941, 517 drugs were listed – out of these, only 45 were animal parts, and 30 were minerals.[15] For many plants used as medicinals, detailed instructions have been handed down not only regarding the locations and areas where they grow best, but also regarding the best timing of planting and harvesting them.[16]

Some animal parts used as medicinals can be considered rather strange such as cows' gallstones.[17]

Furthermore, the classic materia medica Bencao Gangmu describes the use of 35 traditional Chinese medicines derived from the human body, including bones, fingernail, hairs, dandruff, earwax, impurities on the teeth, feces, urine, sweat, and organs, but most are no longer in use.[18][19][20]

Preparation

Decoction

Typically, one batch of medicinals is prepared as a decoction of about 9 to 18 substances.[21] Some of these are considered as main herbs, some as ancillary herbs; within the ancillary herbs, up to three categories can be distinguished.[22] Some ingredients are added in order to cancel out toxicity or side-effects of the main ingredients; on top of that, some medicinals require the use of other substances as catalysts.

Chinese patent medicine

Chinese patent medicine (中成药; 中成藥; zhōngchéng yào) is a kind of traditional Chinese medicine. They are standardized herbal formulas. From ancient times, pills were formed by combining several herbs and other ingredients, which were dried and ground into a powder. They were then mixed with a binder and formed into pills by hand. The binder was traditionally honey. Modern teapills, however, are extracted in stainless steel extractors to create either a water decoction or water-alcohol decoction, depending on the herbs used. They are extracted at a low temperature (below 100 degrees Celsius) to preserve essential ingredients. The extracted liquid is then further condensed, and some raw herb powder from one of the herbal ingredients is mixed in to form an herbal dough. This dough is then machine cut into tiny pieces, a small amount of excipients are added for a smooth and consistent exterior, and they are spun into pills.[citation needed]

These medicines are not patented in the traditional sense of the word. No one has exclusive rights to the formula. Instead, "patent" refers to the standardization of the formula. In China, all Chinese patent medicines of the same name will have the same proportions of ingredients, and manufactured in accordance with the PRC Pharmacopoeia, which is mandated by law. However, in western countries there may be variations in the proportions of ingredients in patent medicines of the same name, and even different ingredients altogether.[citation needed]

Several producers of Chinese herbal medicines are pursuing FDA clinical trials to market their products as drugs in U.S. and European markets.[23]

Chinese herbal extracts

Chinese herbal extracts are herbal decoctions that have been condensed into a granular or powdered form. Herbal extracts, similar to patent medicines, are easier and more convenient for patients to take. The industry extraction standard is 5:1, meaning for every five pounds of raw materials, one pound of herbal extract is derived.[24][better source needed]

Categorization

There are several different methods to classify traditional Chinese medicinals:

  • The Four Natures (四气; 四氣; sìqì)
  • The Five Flavors (五味; wǔwèi)
  • The meridians (经络; 經絡; jīngluò)
  • The specific function.

Four Natures

The Four Natures are: hot (; ), warm (; ), cool (), cold () or neutral ().[25] Hot and warm herbs are used to treat cold diseases, while cool and cold herbs are used to treat hot diseases.[25]

Five Flavors

 
The Five Phases, which correspond to the Five Flavors

The Five Flavors, sometimes also translated as Five Tastes, are: acrid/pungent (), sweet (), bitter (), sour (), and salty (; ).[25] Substances may also have more than one flavor, or none (i.e., a bland () flavor).[25] Each of the Five Flavors corresponds to one of the zàng organs, which in turn corresponds to one of the Five Phases:[26] A flavor implies certain properties and presumed therapeutic "actions" of a substance: saltiness "drains downward and softens hard masses";[25] sweetness is "supplementing, harmonizing, and moistening";[25] pungent substances are thought to induce sweat and act on qi and blood; sourness tends to be astringent (; ) in nature; bitterness "drains heat, purges the bowels, and eliminates dampness".

Specific function

These categories mainly include:

Nomenclature

Many herbs earn their names from their unique physical appearance. Examples of such names include Niu Xi (Radix cyathulae seu achyranthis), "cow's knees," which has big joints that might look like cow knees; Bai Mu Er (Fructificatio tremellae fuciformis), white wood ear,' which is white and resembles an ear; Gou Ji (Rhizoma cibotii), 'dog spine,' which resembles the spine of a dog.[30]

Color

Color is not only a valuable means of identifying herbs, but in many cases also provides information about the therapeutic attributes of the herb. For example, yellow herbs are referred to as huang (yellow) or jin (gold). Huang Bai (Cortex Phellodendri) means 'yellow fir," and Jin Yin Hua (Flos Lonicerae) has the label 'golden silver flower."[30]

Smell and taste

Unique flavors define specific names for some substances. Gan means 'sweet,' so Gan Cao (Radix glycyrrhizae) is 'sweet herb," an adequate description for the licorice root. "Ku" means bitter, thus Ku Shen (Sophorae flavescentis) translates as 'bitter herb.'[30]

Geographic location

The locations or provinces in which herbs are grown often figure into herb names. For example, Bei Sha Shen (Radix glehniae) is grown and harvested in northern China, whereas Nan Sha Shen (Radix adenophorae) originated in southern China. And the Chinese words for north and south are respectively bei and nan.[30]

Chuan Bei Mu (Bulbus fritillariae cirrhosae) and Chuan Niu Xi (Radix cyathulae) are both found in Sichuan province, as the character "chuan" indicates in their names.[30]

Function

Some herbs, like Fang Feng (Radix Saposhnikoviae), literally 'prevent wind," prevents or treats wind-related illnesses. Xu Duan (Radix Dipsaci), literally 'restore the broken,' effectively treats torn soft tissues and broken bones.[30]

Country of origin

Many herbs indigenous to other countries have been incorporated into the Chinese materia medica. Xi Yang Shen (Radix panacis quinquefolii), imported from North American crops, translates as 'western ginseng," while Dong Yang Shen (Radix ginseng Japonica), grown in and imported from North Asian countries, is 'eastern ginseng.'[30]

Toxicity

From the earliest records regarding the use of medicinals to today, the toxicity of certain substances has been described in all Chinese materia medica.[31] Since TCM has become more popular in the Western world, there are increasing concerns about the potential toxicity of many traditional Chinese medicinals including plants, animal parts and minerals.[6] For most medicinals, efficacy and toxicity testing are based on traditional knowledge rather than laboratory analysis.[6] The toxicity in some cases could be confirmed by modern research (i.e., in scorpion); in some cases it could not (i.e., in Curculigo).[32] Further, ingredients may have different names in different locales or in historical texts, and different preparations may have similar names for the same reason, which can create inconsistencies and confusion in the creation of medicinals,[33] with the possible danger of poisoning.[34][35][36][unreliable source?] Edzard Ernst "concluded that adverse effects of herbal medicines are an important albeit neglected subject in dermatology, which deserves further systematic investigation."[37] Research suggests that the toxic heavy metals and undeclared drugs found in Chinese herbal medicines might be a serious health issue.[38]

Substances known to be potentially dangerous include aconite,[32] secretions from the Asiatic toad,[39] powdered centipede,[40] the Chinese beetle (Mylabris phalerata, Ban mao),[41] and certain fungi.[42] There are health problems associated with Aristolochia.[6] Toxic effects are also frequent with Aconitum.[6] To avoid its toxic adverse effects Xanthium sibiricum must be processed.[6] Hepatotoxicity has been reported with products containing Reynoutria multiflora (synonym Polygonum multiflorum), glycyrrhizin, Senecio and Symphytum.[6] The evidence suggests that hepatotoxic herbs also include Dictamnus dasycarpus, Astragalus membranaceous, and Paeonia lactiflora; although there is no evidence that they cause liver damage.[6][clarification needed] Contrary to popular belief, Ganoderma lucidum mushroom extract, as an adjuvant for cancer immunotherapy, appears to have the potential for toxicity.[43]

Also, adulteration of some herbal medicine preparations with conventional drugs which may cause serious adverse effects, such as corticosteroids, phenylbutazone, phenytoin, and glibenclamide, has been reported.[44][45]

However, many adverse reactions are due to misuse or abuse of Chinese medicine.[6] For example, the misuse of the dietary supplement Ephedra (containing ephedrine) can lead to adverse events including gastrointestinal problems as well as sudden death from cardiomyopathy.[6] Products adulterated with pharmaceuticals for weight loss or erectile dysfunction are one of the main concerns.[6] Chinese herbal medicine has been a major cause of acute liver failure in China.[46]

Most Chinese herbs are safe but some have shown not to be. Reports have shown products being contaminated with drugs, toxins, or false reporting of ingredients. Some herbs used in TCM may also react with drugs, have side effects, or be dangerous to people with certain medical conditions.[47]

Efficacy

Only a few trials exist that are considered to have adequate methodology by scientific standards. Proof of effectiveness is poorly documented or absent.[4] A 2016 Cochrane review found "insufficient evidence that Chinese Herbal Medicines were any more or less effective than placebo or hormonal therapy" for the relief of menopause related symptoms.[48] A 2012 Cochrane review found no difference in decreased mortality for SARS patients when Chinese herbs were used alongside Western medicine versus Western medicine exclusively.[49] A 2010 Cochrane review found there is not enough robust evidence to support the effectiveness of traditional Chinese medicine herbs to stop the bleeding from haemorrhoids.[50] A 2008 Cochrane review found promising evidence for the use of Chinese herbal medicine in relieving painful menstruation, compared to conventional medicine such as NSAIDs and the oral contraceptive pill, but the findings are of low methodological quality.[51] A 2012 Cochrane review found weak evidence suggesting that some Chinese medicinal herbs have a similar effect at preventing and treating influenza as antiviral medication.[52] Due to the poor quality of these medical studies, there is insufficient evidence to support or dismiss the use of Chinese medicinal herbs for the treatment of influenza.[52] There is a need for larger and higher quality randomized clinical trials to determine how effective Chinese herbal medicine is for treating people with influenza.[52] A 2005 Cochrane review found that although the evidence was weak for the use of any single herb, there was low quality evidence that some Chinese medicinal herbs may be effective for the treatment of acute pancreatitis.[53]

Successful results have been scarce: artemisinin is one of few examples, as effective treatment for malaria derived from Artemisia annua, which is traditionally used to treat fever.[1] Chinese herbology is largely pseudoscience, with no valid mechanism of action for the majority of its treatments.[1]

Ecological impacts

 
Dried seahorses like these are extensively used in traditional medicine in China and elsewhere.

The traditional practice of using (by now) endangered species is controversial within TCM. Modern Materia Medicas such as Bensky, Clavey and Stoger's comprehensive Chinese herbal text discuss substances derived from endangered species in an appendix, emphasizing alternatives.[54]

Parts of endangered species used as TCM drugs include tiger bones[55] and rhinoceros horn.[56] Poachers supply the black market with such substances,[57][58] and the black market in rhinoceros horn, for example, has reduced the world's rhino population by more than 90 percent over the past 40 years.[59] Concerns have also arisen over the use of turtle plastron[60] and seahorses.[61]

TCM recognizes bear bile as a medicinal. In 1988, the Chinese Ministry of Health started controlling bile production, which previously used bears killed before winter. Now bears are fitted with a sort of permanent catheter, which is more profitable than killing the bears.[62] More than 12,000 asiatic black bears are held in "bear farms", where they suffer cruel conditions while being held in tiny cages. The catheter leads through a permanent hole in the abdomen directly to the gall bladder, which can cause severe pain. Increased international attention has mostly stopped the use of bile outside of China; gallbladders from butchered cattle (牛胆; 牛膽; niú dǎn) are recommended as a substitute for this ingredient.[citation needed]

Collecting American ginseng to assist the Asian traditional medicine trade has made ginseng the most harvested wild plant in North America for the last two centuries, which eventually led to a listing on CITES Appendix II.[63]

Herbs in use

Chinese herbology is a pseudoscientific practice with potentially unreliable product quality, safety hazards or misleading health advice.[64][65][66] There are regulatory bodies, such as China GMP (Good Manufacturing Process) of herbal products.[67] However, there have been notable cases of an absence of quality control during herbal product preparation.[68] There is a lack of high-quality scientific research on herbology practices and product effectiveness for anti-disease activity.[64][65] In the herbal sources listed below, there is little or no evidence for efficacy or proof of safety across consumer age groups and disease conditions for which they are intended.[64][65]

There are over 300 herbs in common use. Some of the most commonly used herbs are Ginseng (人参; 人參; rénshēn), wolfberry (枸杞子; gǒuqǐzǐ), dong quai (Angelica sinensis, 当归; 當歸; dāngguī), astragalus (黄耆; 黃耆; huángqí), atractylodes (白术; 白朮; báizhú), bupleurum (柴胡; cháihú), cinnamon (cinnamon twigs (桂枝; guìzhī) and cinnamon bark (肉桂; ròuguì)), coptis (黄连; 黃連; huánglián), ginger (; ; jiāng), hoelen (茯苓; fúlíng), licorice (甘草; gāncǎo), ephedra sinica (麻黄; 麻黃; máhuáng), peony (white: 白芍; báisháo and reddish: 赤芍; chìsháo), rehmannia (地黄; 地黃; dìhuáng), rhubarb (大黄; 大黃; dàhuáng), and salvia (丹参; 丹參; dānshēn).

50 fundamental herbs

In Chinese herbology, there are 50 "fundamental" herbs, as given in the reference text,[69] although these herbs are not universally recognized as such in other texts. The herbs are:

Binomial nomenclature Chinese name English common name (when available)
Agastache rugosa, Pogostemon cablin[70] huò xiāng (藿香)[71] Korean mint, Patchouli
Alangium chinense[72] bā jiǎo fēng (八角枫)[73] Chinese Alangium root
Anemone chinensis (syn. Pulsatilla chinensis)[74] bái tóu weng (白头翁)[73][74] Chinese anemone
Anisodus tanguticus shān làng dàng (山莨菪)[75] (trans.) Mountain henbane
Ardisia japonica zǐ jīn niú (紫金牛)[76] Marlberry
Aster tataricus zǐ wǎn (紫菀) Tatar aster, Tartar aster
Astragalus propinquus (syn. Astragalus membranaceus)[77] huáng qí (黄芪)[78] or běi qí (北芪)[78] Mongolian milkvetch
Camellia sinensis chá shù (茶树) or chá yè (茶叶) Tea plant
Cannabis sativa dà má (大麻) Cannabis
Carthamus tinctorius hóng huā (红花) Safflower
Cinnamomum cassia ròu gùi (肉桂) Cassia, Chinese cinnamon
Cissampelos pareira xí shēng téng (锡生藤) or (亞乎奴) Velvet leaf
Coptis chinensis duǎn è huáng lián (短萼黄连) Chinese goldthread
Corydalis yanhusuo yán hú suǒ (延胡索) Chinese poppy of Yan Hu Sou
Croton tiglium bā dòu (巴豆) Purging croton
Daphne genkwa yuán huā (芫花) Lilac daphne
Datura metel yáng jīn huā (洋金花) Devil's trumpet
Datura stramonium[79] zǐ huā màn tuó luó (紫花曼陀萝) Jimson weed
Dendrobium nobile shí hú (石斛) or shí hú lán (石斛兰) Noble dendrobium
Dichroa febrifuga[80] cháng shān (常山) Blue evergreen hydrangea, Chinese quinine
Ephedra sinica cǎo má huáng (草麻黄) Chinese ephedra
Eucommia ulmoides dù zhòng (杜仲) Hardy rubber tree
Euphorbia pekinensis[81] dà jǐ (大戟) Peking spurge
Flueggea suffruticosa (formerly Securinega suffruticosa) yī yè qiū (一叶秋)[82]
Forsythia suspensa liánqiáo[83] (连翘) Weeping forsythia
Gentiana loureiroi dì dīng (地丁)
Gleditsia sinensis zào jiá (皂荚) Chinese honeylocust
Glycyrrhiza uralensis gān cǎo (甘草)[84] Licorice
Hydnocarpus anthelminticus (syn. H. anthelminthica) dà fēng zǐ (大风子) Chaulmoogra tree
Ilex purpurea dōngqīng (冬青) Purple holly
Leonurus japonicus yì mǔ cǎo (益母草) Chinese motherwort
Ligusticum wallichii[85] chuān xiōng (川芎) Szechwan lovage
Lobelia chinensis bàn biān lián (半边莲) Creeping lobelia
Phellodendron amurense huáng bǎi (黄柏) Amur cork tree
Platycladus orientalis (formerly Thuja orientalis) cè bǎi (侧柏) Chinese arborvitae
Pseudolarix amabilis jīn qián sōng (金钱松) Golden larch
Psilopeganum sinense shān má huáng (山麻黄) Naked rue
Pueraria lobata gé gēn (葛根) Kudzu
Rauvolfia serpentina shégēnmù (蛇根木), cóng shégēnmù (從蛇根木) or yìndù shé mù (印度蛇木) Sarpagandha, Indian snakeroot
Rehmannia glutinosa dìhuáng (地黄)[86] Chinese foxglove
Rheum officinale yào yòng dà huáng (药用大黄) Chinese or Eastern rhubarb
Rhododendron qinghaiense Qīng hǎi dù juān (青海杜鹃)
Saussurea costus yún mù xiāng (云木香) Costus root
Schisandra chinensis wǔ wèi zi (五味子) Chinese magnolia vine
Scutellaria baicalensis huáng qín (黄芩) Baikal skullcap
Stemona tuberosa bǎi bù (百部)
Stephania tetrandra fáng jǐ (防己) Stephania root
Styphnolobium japonicum (formerly Sophora japonica) huái (), huái shù (槐树), or huái huā (槐花) Pagoda tree
Trichosanthes kirilowii guā lóu (栝楼) Chinese cucumber
Wikstroemia indica liāo gē wáng (了哥王) Indian stringbush

Other Chinese herbs

In addition to the above, many other Chinese herbs and other substances are in common use, and these include:

See also

References

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  21. ^ "Nach der Erfahrung des Verfassers bewegen sich in der VR China 99% der Rezepturen in einem Bereich zwischen 6 und 20 Kräutern; meist sind es aber zwischen 9 und 18,..."; "According to the experience of the author, 99% of prescriptions in the PR of China range from 6 to 20 herbs; in the majority, however, it is 9 to 12,..." From Kiessler (2005), p. 24.
  22. ^ "Innerhalb einer Rezeptur wird grob zwischen Haupt- und Nebenkräuter unterschieden. Bei klassischen Rezepturen existieren sehr genaue Analysen zur Funktion jeder einzelnen Zutat, die bis zu drei Kategorien (Chen, Zun und Chi) von Nebenkräutern differenzieren."; "Regarding the content of the prescription, one can differentiate between main herbs and ancillary herbs. For classical prescriptions, detailed analyses exist for each single ingredient which discriminate between up to three categories (Chen, Zun, and Chi) of ancillary herbs." From Kiessler (2005), p. 25.
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chinese, herbology, simplified, chinese, 中药学, traditional, chinese, 中藥學, pinyin, zhōngyào, xué, theory, traditional, chinese, herbal, therapy, which, accounts, majority, treatments, traditional, chinese, medicine, nature, editorial, described, fraught, with, p. Chinese herbology simplified Chinese 中药学 traditional Chinese 中藥學 pinyin zhōngyao xue is the theory of traditional Chinese herbal therapy which accounts for the majority of treatments in traditional Chinese medicine TCM A Nature editorial described TCM as fraught with pseudoscience and said that the most obvious reason why it has not delivered many cures is that the majority of its treatments have no logical mechanism of action 1 Dried herbs and plant portions for Chinese herbology at a Xi an market The term herbology is misleading in the sense that while plant elements are by far the most commonly used substances animal human and mineral products are also utilized among which some are poisonous In the Huangdi Neijing they are referred to as 毒藥 pinyin duyao which means toxin poison or medicine Paul U Unschuld points out that this is similar etymology to the Greek pharmakon and so he uses the term pharmaceutic 2 Thus the term medicinal instead of herb is usually preferred as a translation for 药 pinyin yao 3 Research into the effectiveness of traditional Chinese herbal therapy is of poor quality and often tainted by bias 4 with little or no rigorous evidence of efficacy 5 There are concerns over a number of potentially toxic Chinese herbs 6 Contents 1 History 2 Raw materials 3 Preparation 3 1 Decoction 3 2 Chinese patent medicine 3 3 Chinese herbal extracts 4 Categorization 4 1 Four Natures 4 2 Five Flavors 4 3 Specific function 5 Nomenclature 5 1 Color 5 2 Smell and taste 5 3 Geographic location 5 4 Function 5 5 Country of origin 6 Toxicity 7 Efficacy 8 Ecological impacts 9 Herbs in use 10 50 fundamental herbs 11 Other Chinese herbs 12 See also 13 References 14 External linksHistory EditThis section needs additional citations for verification Please help improve this article by adding citations to reliable sources Unsourced material may be challenged and removed October 2013 Learn how and when to remove this template message Chinese pharmacopoeia Chinese herbs have been used for centuries Among the earliest literature are lists of prescriptions for specific ailments exemplified by the manuscript Recipes for 52 Ailments found in the Mawangdui which were sealed in 168 BC The first traditionally recognized herbalist is Shennong 神农 lit Divine Farmer a mythical god like figure who is said to have lived around 2800 BC 7 He allegedly tasted hundreds of herbs and imparted his knowledge of medicinal and poisonous plants to farmers His Shennong Ben Cǎo Jing 神农本草经 Shennong s Materia Medica is considered as the oldest book on Chinese herbal medicine It classifies 365 species of roots grass woods furs animals and stones into three categories of herbal medicine 8 The superior category which includes herbs effective for multiple diseases and are mostly responsible for maintaining and restoring the body balance They have almost no unfavorable side effects 8 A category comprising tonics and boosters whose consumption must not be prolonged 8 A category of substances which must usually be taken in small doses and for the treatment of specific diseases only 8 The original text of Shennong s Materia Medica has been lost however there are extant translations 9 The true date of origin is believed to fall into the late Western Han dynasty 7 i e the first century BC The Treatise on Cold Damage Disorders and Miscellaneous Illnesses was collated by Zhang Zhongjing also sometime at the end of the Han dynasty between 196 and 220 CE Focusing on drug prescriptions 10 it was the first medical work to combine Yinyang and the Five Phases with drug therapy 11 This formulary was also the earliest Chinese medical text to group symptoms into clinically useful patterns zheng 證 that could serve as targets for therapy Having gone through numerous changes over time it now circulates as two distinct books the Treatise on Cold Damage Disorders and the Essential Prescriptions of the Golden Casket which were edited separately in the eleventh century under the Song dynasty 12 Succeeding generations augmented these works as in the Yaoxing Lun 药性论 藥性論 Treatise on the Nature of Medicinal Herbs a 7th century Tang dynasty Chinese treatise on herbal medicine There was a shift in emphasis in treatment over several centuries A section of the Neijing Suwen including Chapter 74 was added by Wang Bing 王冰 Wang Bing in his 765 edition In which it says 主病之謂君 佐君之謂臣 應臣之謂使 非上下三品之謂也 Ruler of disease it called Sovereign aid to Sovereign it called Minister comply with Minister it called Envoy Assistant not upper lower three classes qualities it called The last part is interpreted as stating that these three rulers are not the three classes of Shennong mentioned previously This chapter in particular outlines a more forceful approach Later on Zhang Zihe 張子和 Zhang Zĭ he aka Zhang Cong zhen 1156 1228 is credited with founding the Attacking School which criticized the overuse of tonics Arguably the most important of these later works is the Compendium of Materia Medica Bencao Gangmu 本草綱目 compiled during the Ming dynasty by Li Shizhen which is still used today for consultation and reference The use of Chinese herbs was popular during the medieval age in western Asian and Islamic countries They were traded through the Silk Road from the East to the West Cinnamon ginger rhubarb nutmeg and cubeb are mentioned as Chinese herbs by medieval Islamic medical scholars Such as Rhazes 854 925 CE Haly Abbas 930 994 CE and Avicenna 980 1037 CE There were also multiple similarities between the clinical uses of these herbs in Chinese and Islamic medicine 13 Raw materials EditThere are roughly 13 000 medicinals used in China and over 100 000 medicinal recipes recorded in the ancient literature 14 Plant elements and extracts are by far the most common elements used 15 In the classic Handbook of Traditional Drugs from 1941 517 drugs were listed out of these only 45 were animal parts and 30 were minerals 15 For many plants used as medicinals detailed instructions have been handed down not only regarding the locations and areas where they grow best but also regarding the best timing of planting and harvesting them 16 Some animal parts used as medicinals can be considered rather strange such as cows gallstones 17 Furthermore the classic materia medica Bencao Gangmu describes the use of 35 traditional Chinese medicines derived from the human body including bones fingernail hairs dandruff earwax impurities on the teeth feces urine sweat and organs but most are no longer in use 18 19 20 Preparation EditDecoction Edit Typically one batch of medicinals is prepared as a decoction of about 9 to 18 substances 21 Some of these are considered as main herbs some as ancillary herbs within the ancillary herbs up to three categories can be distinguished 22 Some ingredients are added in order to cancel out toxicity or side effects of the main ingredients on top of that some medicinals require the use of other substances as catalysts Chinese patent medicine Edit Main article Chinese patent medicine Chinese patent medicine 中成药 中成藥 zhōngcheng yao is a kind of traditional Chinese medicine They are standardized herbal formulas From ancient times pills were formed by combining several herbs and other ingredients which were dried and ground into a powder They were then mixed with a binder and formed into pills by hand The binder was traditionally honey Modern teapills however are extracted in stainless steel extractors to create either a water decoction or water alcohol decoction depending on the herbs used They are extracted at a low temperature below 100 degrees Celsius to preserve essential ingredients The extracted liquid is then further condensed and some raw herb powder from one of the herbal ingredients is mixed in to form an herbal dough This dough is then machine cut into tiny pieces a small amount of excipients are added for a smooth and consistent exterior and they are spun into pills citation needed These medicines are not patented in the traditional sense of the word No one has exclusive rights to the formula Instead patent refers to the standardization of the formula In China all Chinese patent medicines of the same name will have the same proportions of ingredients and manufactured in accordance with the PRC Pharmacopoeia which is mandated by law However in western countries there may be variations in the proportions of ingredients in patent medicines of the same name and even different ingredients altogether citation needed Several producers of Chinese herbal medicines are pursuing FDA clinical trials to market their products as drugs in U S and European markets 23 Chinese herbal extracts Edit Chinese herbal extracts are herbal decoctions that have been condensed into a granular or powdered form Herbal extracts similar to patent medicines are easier and more convenient for patients to take The industry extraction standard is 5 1 meaning for every five pounds of raw materials one pound of herbal extract is derived 24 better source needed Categorization EditThere are several different methods to classify traditional Chinese medicinals The Four Natures 四气 四氣 siqi The Five Flavors 五味 wǔwei The meridians 经络 經絡 jingluo The specific function Four Natures Edit The Four Natures are hot 热 熱 warm 温 溫 cool 凉 cold 寒 or neutral 平 25 Hot and warm herbs are used to treat cold diseases while cool and cold herbs are used to treat hot diseases 25 Five Flavors Edit The Five Phases which correspond to the Five Flavors The Five Flavors sometimes also translated as Five Tastes are acrid pungent 辛 sweet 甘 bitter 苦 sour 酸 and salty 咸 鹹 25 Substances may also have more than one flavor or none i e a bland 淡 flavor 25 Each of the Five Flavors corresponds to one of the zang organs which in turn corresponds to one of the Five Phases 26 A flavor implies certain properties and presumed therapeutic actions of a substance saltiness drains downward and softens hard masses 25 sweetness is supplementing harmonizing and moistening 25 pungent substances are thought to induce sweat and act on qi and blood sourness tends to be astringent 涩 澀 in nature bitterness drains heat purges the bowels and eliminates dampness Specific function Edit These categories mainly include exterior releasing 27 or exterior resolving 28 heat clearing 27 28 downward draining 27 or precipitating 28 wind damp dispelling 27 28 dampness transforming 27 28 promoting the movement of water and percolating dampness 27 or dampness percolating 28 interior warming 27 28 qi regulating 27 or qi rectifying 28 dispersing food accumulation 27 or food dispersing 28 worm expelling 27 28 stopping bleeding 27 or blood stanching 28 quickening the Blood and dispelling stasis 27 or blood quickening 28 or Blood moving 29 transforming phlegm stopping coughing and calming wheezing 27 or phlegm transforming and cough and panting suppressing 28 Spirit quieting 27 28 or Shen calming 29 calming the Liver and expelling wind 27 or Liver calming and wind extinguishing 28 orifice opening 27 28 supplementing 27 28 or tonifying 29 this includes qi supplementing blood nourishing yin enriching and yang fortifying 28 astriction promoting 27 or securing and astringing 28 vomiting inducing 27 substances for external application 27 28 Nomenclature EditMany herbs earn their names from their unique physical appearance Examples of such names include Niu Xi Radix cyathulae seu achyranthis cow s knees which has big joints that might look like cow knees Bai Mu Er Fructificatio tremellae fuciformis white wood ear which is white and resembles an ear Gou Ji Rhizoma cibotii dog spine which resembles the spine of a dog 30 Color Edit Color is not only a valuable means of identifying herbs but in many cases also provides information about the therapeutic attributes of the herb For example yellow herbs are referred to as huang yellow or jin gold Huang Bai Cortex Phellodendri means yellow fir and Jin Yin Hua Flos Lonicerae has the label golden silver flower 30 Smell and taste Edit Unique flavors define specific names for some substances Gan means sweet so Gan Cao Radix glycyrrhizae is sweet herb an adequate description for the licorice root Ku means bitter thus Ku Shen Sophorae flavescentis translates as bitter herb 30 Geographic location Edit The locations or provinces in which herbs are grown often figure into herb names For example Bei Sha Shen Radix glehniae is grown and harvested in northern China whereas Nan Sha Shen Radix adenophorae originated in southern China And the Chinese words for north and south are respectively bei and nan 30 Chuan Bei Mu Bulbus fritillariae cirrhosae and Chuan Niu Xi Radix cyathulae are both found in Sichuan province as the character chuan indicates in their names 30 Function Edit Some herbs like Fang Feng Radix Saposhnikoviae literally prevent wind prevents or treats wind related illnesses Xu Duan Radix Dipsaci literally restore the broken effectively treats torn soft tissues and broken bones 30 Country of origin Edit Many herbs indigenous to other countries have been incorporated into the Chinese materia medica Xi Yang Shen Radix panacis quinquefolii imported from North American crops translates as western ginseng while Dong Yang Shen Radix ginseng Japonica grown in and imported from North Asian countries is eastern ginseng 30 Toxicity EditFrom the earliest records regarding the use of medicinals to today the toxicity of certain substances has been described in all Chinese materia medica 31 Since TCM has become more popular in the Western world there are increasing concerns about the potential toxicity of many traditional Chinese medicinals including plants animal parts and minerals 6 For most medicinals efficacy and toxicity testing are based on traditional knowledge rather than laboratory analysis 6 The toxicity in some cases could be confirmed by modern research i e in scorpion in some cases it could not i e in Curculigo 32 Further ingredients may have different names in different locales or in historical texts and different preparations may have similar names for the same reason which can create inconsistencies and confusion in the creation of medicinals 33 with the possible danger of poisoning 34 35 36 unreliable source Edzard Ernst concluded that adverse effects of herbal medicines are an important albeit neglected subject in dermatology which deserves further systematic investigation 37 Research suggests that the toxic heavy metals and undeclared drugs found in Chinese herbal medicines might be a serious health issue 38 Substances known to be potentially dangerous include aconite 32 secretions from the Asiatic toad 39 powdered centipede 40 the Chinese beetle Mylabris phalerata Ban mao 41 and certain fungi 42 There are health problems associated with Aristolochia 6 Toxic effects are also frequent with Aconitum 6 To avoid its toxic adverse effects Xanthium sibiricum must be processed 6 Hepatotoxicity has been reported with products containing Reynoutria multiflora synonym Polygonum multiflorum glycyrrhizin Senecio and Symphytum 6 The evidence suggests that hepatotoxic herbs also include Dictamnus dasycarpus Astragalus membranaceous and Paeonia lactiflora although there is no evidence that they cause liver damage 6 clarification needed Contrary to popular belief Ganoderma lucidum mushroom extract as an adjuvant for cancer immunotherapy appears to have the potential for toxicity 43 Also adulteration of some herbal medicine preparations with conventional drugs which may cause serious adverse effects such as corticosteroids phenylbutazone phenytoin and glibenclamide has been reported 44 45 However many adverse reactions are due to misuse or abuse of Chinese medicine 6 For example the misuse of the dietary supplement Ephedra containing ephedrine can lead to adverse events including gastrointestinal problems as well as sudden death from cardiomyopathy 6 Products adulterated with pharmaceuticals for weight loss or erectile dysfunction are one of the main concerns 6 Chinese herbal medicine has been a major cause of acute liver failure in China 46 Most Chinese herbs are safe but some have shown not to be Reports have shown products being contaminated with drugs toxins or false reporting of ingredients Some herbs used in TCM may also react with drugs have side effects or be dangerous to people with certain medical conditions 47 Efficacy EditFurther information Traditional Chinese medicine Efficacy and Drug research Only a few trials exist that are considered to have adequate methodology by scientific standards Proof of effectiveness is poorly documented or absent 4 A 2016 Cochrane review found insufficient evidence that Chinese Herbal Medicines were any more or less effective than placebo or hormonal therapy for the relief of menopause related symptoms 48 A 2012 Cochrane review found no difference in decreased mortality for SARS patients when Chinese herbs were used alongside Western medicine versus Western medicine exclusively 49 A 2010 Cochrane review found there is not enough robust evidence to support the effectiveness of traditional Chinese medicine herbs to stop the bleeding from haemorrhoids 50 A 2008 Cochrane review found promising evidence for the use of Chinese herbal medicine in relieving painful menstruation compared to conventional medicine such as NSAIDs and the oral contraceptive pill but the findings are of low methodological quality 51 A 2012 Cochrane review found weak evidence suggesting that some Chinese medicinal herbs have a similar effect at preventing and treating influenza as antiviral medication 52 Due to the poor quality of these medical studies there is insufficient evidence to support or dismiss the use of Chinese medicinal herbs for the treatment of influenza 52 There is a need for larger and higher quality randomized clinical trials to determine how effective Chinese herbal medicine is for treating people with influenza 52 A 2005 Cochrane review found that although the evidence was weak for the use of any single herb there was low quality evidence that some Chinese medicinal herbs may be effective for the treatment of acute pancreatitis 53 Successful results have been scarce artemisinin is one of few examples as effective treatment for malaria derived from Artemisia annua which is traditionally used to treat fever 1 Chinese herbology is largely pseudoscience with no valid mechanism of action for the majority of its treatments 1 Ecological impacts Edit Dried seahorses like these are extensively used in traditional medicine in China and elsewhere The traditional practice of using by now endangered species is controversial within TCM Modern Materia Medicas such as Bensky Clavey and Stoger s comprehensive Chinese herbal text discuss substances derived from endangered species in an appendix emphasizing alternatives 54 Parts of endangered species used as TCM drugs include tiger bones 55 and rhinoceros horn 56 Poachers supply the black market with such substances 57 58 and the black market in rhinoceros horn for example has reduced the world s rhino population by more than 90 percent over the past 40 years 59 Concerns have also arisen over the use of turtle plastron 60 and seahorses 61 TCM recognizes bear bile as a medicinal In 1988 the Chinese Ministry of Health started controlling bile production which previously used bears killed before winter Now bears are fitted with a sort of permanent catheter which is more profitable than killing the bears 62 More than 12 000 asiatic black bears are held in bear farms where they suffer cruel conditions while being held in tiny cages The catheter leads through a permanent hole in the abdomen directly to the gall bladder which can cause severe pain Increased international attention has mostly stopped the use of bile outside of China gallbladders from butchered cattle 牛胆 牛膽 niu dǎn are recommended as a substitute for this ingredient citation needed Collecting American ginseng to assist the Asian traditional medicine trade has made ginseng the most harvested wild plant in North America for the last two centuries which eventually led to a listing on CITES Appendix II 63 Herbs in use EditSee also List of medicines in traditional Chinese medicine Chinese herbology is a pseudoscientific practice with potentially unreliable product quality safety hazards or misleading health advice 64 65 66 There are regulatory bodies such as China GMP Good Manufacturing Process of herbal products 67 However there have been notable cases of an absence of quality control during herbal product preparation 68 There is a lack of high quality scientific research on herbology practices and product effectiveness for anti disease activity 64 65 In the herbal sources listed below there is little or no evidence for efficacy or proof of safety across consumer age groups and disease conditions for which they are intended 64 65 There are over 300 herbs in common use Some of the most commonly used herbs are Ginseng 人参 人參 renshen wolfberry 枸杞子 gǒuqǐzǐ dong quai Angelica sinensis 当归 當歸 danggui astragalus 黄耆 黃耆 huangqi atractylodes 白术 白朮 baizhu bupleurum 柴胡 chaihu cinnamon cinnamon twigs 桂枝 guizhi and cinnamon bark 肉桂 rougui coptis 黄连 黃連 huanglian ginger 姜 薑 jiang hoelen 茯苓 fuling licorice 甘草 gancǎo ephedra sinica 麻黄 麻黃 mahuang peony white 白芍 baishao and reddish 赤芍 chishao rehmannia 地黄 地黃 dihuang rhubarb 大黄 大黃 dahuang and salvia 丹参 丹參 danshen 50 fundamental herbs EditIn Chinese herbology there are 50 fundamental herbs as given in the reference text 69 although these herbs are not universally recognized as such in other texts The herbs are Binomial nomenclature Chinese name English common name when available Agastache rugosa Pogostemon cablin 70 huo xiang 藿香 71 Korean mint PatchouliAlangium chinense 72 ba jiǎo feng 八角枫 73 Chinese Alangium rootAnemone chinensis syn Pulsatilla chinensis 74 bai tou weng 白头翁 73 74 Chinese anemoneAnisodus tanguticus shan lang dang 山莨菪 75 trans Mountain henbaneArdisia japonica zǐ jin niu 紫金牛 76 MarlberryAster tataricus zǐ wǎn 紫菀 Tatar aster Tartar asterAstragalus propinquus syn Astragalus membranaceus 77 huang qi 黄芪 78 or bei qi 北芪 78 Mongolian milkvetchCamellia sinensis cha shu 茶树 or cha ye 茶叶 Tea plantCannabis sativa da ma 大麻 CannabisCarthamus tinctorius hong hua 红花 SafflowerCinnamomum cassia rou gui 肉桂 Cassia Chinese cinnamonCissampelos pareira xi sheng teng 锡生藤 or 亞乎奴 Velvet leafCoptis chinensis duǎn e huang lian 短萼黄连 Chinese goldthreadCorydalis yanhusuo yan hu suǒ 延胡索 Chinese poppy of Yan Hu SouCroton tiglium ba dou 巴豆 Purging crotonDaphne genkwa yuan hua 芫花 Lilac daphneDatura metel yang jin hua 洋金花 Devil s trumpetDatura stramonium 79 zǐ hua man tuo luo 紫花曼陀萝 Jimson weedDendrobium nobile shi hu 石斛 or shi hu lan 石斛兰 Noble dendrobiumDichroa febrifuga 80 chang shan 常山 Blue evergreen hydrangea Chinese quinineEphedra sinica cǎo ma huang 草麻黄 Chinese ephedraEucommia ulmoides du zhong 杜仲 Hardy rubber treeEuphorbia pekinensis 81 da jǐ 大戟 Peking spurgeFlueggea suffruticosa formerly Securinega suffruticosa yi ye qiu 一叶秋 82 Forsythia suspensa lianqiao 83 连翘 Weeping forsythiaGentiana loureiroi di ding 地丁 Gleditsia sinensis zao jia 皂荚 Chinese honeylocustGlycyrrhiza uralensis gan cǎo 甘草 84 LicoriceHydnocarpus anthelminticus syn H anthelminthica da feng zǐ 大风子 Chaulmoogra treeIlex purpurea dōngqing 冬青 Purple hollyLeonurus japonicus yi mǔ cǎo 益母草 Chinese motherwortLigusticum wallichii 85 chuan xiōng 川芎 Szechwan lovageLobelia chinensis ban bian lian 半边莲 Creeping lobeliaPhellodendron amurense huang bǎi 黄柏 Amur cork treePlatycladus orientalis formerly Thuja orientalis ce bǎi 侧柏 Chinese arborvitaePseudolarix amabilis jin qian sōng 金钱松 Golden larchPsilopeganum sinense shan ma huang 山麻黄 Naked ruePueraria lobata ge gen 葛根 KudzuRauvolfia serpentina shegenmu 蛇根木 cong shegenmu 從蛇根木 or yindu she mu 印度蛇木 Sarpagandha Indian snakerootRehmannia glutinosa dihuang 地黄 86 Chinese foxgloveRheum officinale yao yong da huang 药用大黄 Chinese or Eastern rhubarbRhododendron qinghaiense Qing hǎi du juan 青海杜鹃 Saussurea costus yun mu xiang 云木香 Costus rootSchisandra chinensis wǔ wei zi 五味子 Chinese magnolia vineScutellaria baicalensis huang qin 黄芩 Baikal skullcapStemona tuberosa bǎi bu 百部 Stephania tetrandra fang jǐ 防己 Stephania rootStyphnolobium japonicum formerly Sophora japonica huai 槐 huai shu 槐树 or huai hua 槐花 Pagoda treeTrichosanthes kirilowii gua lou 栝楼 Chinese cucumberWikstroemia indica liao ge wang 了哥王 Indian stringbushOther Chinese herbs EditThis section does not cite any sources Please help improve this section by adding citations to reliable sources Unsourced material may be challenged and removed April 2017 Learn how and when to remove this template message In addition to the above many other Chinese herbs and other substances are in common use and these include Akebia quinata 木通 Arisaema heterophyllum 87 88 胆南星 Chenpi sun dried tangerine mandarin peel 陳皮 Clematis 威灵仙 Concretio silicea bambusae 天竺黄 Cordyceps sinensis 冬虫夏草 Curcuma 郁金 Dalbergia odorifera 降香 Myrrh 没药 Frankincense 乳香 Persicaria 桃仁 Patchouli 广藿香 Polygonum 虎杖 Sparganium 三棱 Zedoary Curcuma zedoaria 莪朮 See also EditChinese classic herbal formula Chinese ophthalmology Compendium of Materia Medica Hallucinogenic plants in Chinese herbals Herbalism for the use of medicinal herbs in other traditions Japanese star anise Jiuhuang Bencao Kampo traditional Japanese medicine Li Shizhen Pharmacognosy Star anise Traditional Chinese medicine Traditional Korean medicine Traditional Vietnamese medicine Yaoxing LunReferences Edit a b c Hard to swallow Nature 448 7150 105 6 2007 Bibcode 2007Natur 448S 105 doi 10 1038 448106a PMID 17625521 Unschuld Paul U Medicine in China A History of Pharmaceutics University of California Press Berkeley CA 1986 Nigel Wiseman Ye Feng 2002 08 01 Introduction to English Terminology of Chinese Medicine ISBN 9780912111643 Retrieved 10 June 2011 a b Shang A Huwiler K Nartey L Juni P Egger M 2007 Placebo controlled trials of Chinese 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herbal medicines Challenges and solutions Complementary Therapies in Medicine 20 1 2 100 6 doi 10 1016 j ctim 2011 09 004 PMID 22305255 He Tian Tian Lam Ung Carolina Oi Hu Hao Wang Yi Tao February 2015 Good manufacturing practice GMP regulation of herbal medicine in comparative research China GMP cGMP WHO GMP PIC S and EU GMP European Journal of Integrative Medicine 7 1 55 56 doi 10 1016 j eujim 2014 11 007 Newmaster S G Grguric M Shanmughanandhan D Ramalingam S Ragupathy S 2013 DNA barcoding detects contamination and substitution in North American herbal products BMC Medicine 11 222 doi 10 1186 1741 7015 11 222 PMC 3851815 PMID 24120035 Wong Ming 1976 La Medecine chinoise par les plantes Le Corps a Vivre series Editions Tchou Agastache rugosa Plants For A Future database report Archived from the original on April 12 2006 Retrieved 2008 02 14 Agastache rugosa in Flora of China efloras org Retrieved 2008 02 19 Alangium chinense Plants For A Future database report Plants for a Future June 2004 Archived from the original on May 6 2010 Retrieved 2008 02 05 a b Alangium chinense in Flora of China efloras org Retrieved 2008 02 14 a b 2015 Top MBBS Programs in China CUCAS Archived from the original on 2014 11 11 Retrieved 2008 02 05 Anisodus tanguticus in Flora of China efloras org Retrieved 2008 02 05 Flora of China Ardisia japonica Astragalus propinquus ILDIS LegumeWeb International Legume Database amp Information Service 16 June 2018 Retrieved 25 October 2019 a b Huang qi Complementary and Alternative Healing University Retrieved 2008 02 19 Datura stramonium information from NPGS GRIN Retrieved 2008 02 05 dead link Dichroa febrifuga Plants For A Future database report Archived from the original on January 17 2009 Retrieved 2008 02 05 Euphorbia pekinensis Plants For A Future database report Archived from the original on January 16 2009 Retrieved 2008 02 05 Securinega suffruticosa Plants For A Future database report Archived from the original on January 17 2009 Retrieved 2008 02 06 Xiandai Hanyu Cidian Commercial Press fifth Edition p 844 Glycyrrhiza uralensis Plants For A Future database report Archived from the original on January 15 2009 Retrieved 2008 02 08 Ligusticum wallichii Plants For A Future database report Archived from the original on March 3 2008 Retrieved 2008 02 21 Rehmannia glutinosa Retrieved 2012 11 04 Tiannanxing 天南星 Hong Kong Baptist University in Chinese Archived from the original on 2015 10 19 Cap 549 Sched 2 CHINESE HERBAL MEDICINES CHINESE MEDICINE ORDINANCE Legislation gov hk Retrieved 2012 11 04 Chen John K Chen Tina T 2004 Chinese Medical Herbology and Pharmacology ISBN 0 9740635 0 9 Chen John K Chen Tina T 2009 Pocket Atlas of Chinese Medicine ISBN 978 0 9740635 7 7 Ergil M et al 2009 Pocket Atlas of Chinese Medicine Thieme ISBN 978 3 13 141611 7 Foster S Yue C 1992 Herbal emissaries bringing Chinese herbs to the West Healing Arts Press ISBN 978 0 89281 349 0 Kiessler Malte 2005 Traditionelle Chinesische Innere Medizin in German Elsevier Urban amp Fischer ISBN 978 3 437 57220 3 Goldschmidt Asaf 2009 The Evolution of Chinese Medicine Song Dynasty 960 1200 London and New York Routledge ISBN 978 0 415 42655 8 Sivin Nathan 1987 Traditional Medicine in Contemporary China Ann Arbor Center for Chinese Studies University of Michigan ISBN 978 0 89264 074 4 Unschuld Paul U 1985 Medicine in China A History of Ideas Berkeley University of California Press ISBN 978 0 520 05023 5 Xu L Wang W 2002 Chinese materia medica combinations and applications 1st ed Donica Publishing ISBN 978 1 901149 02 9 External links Edit Quotations related to Traditional Chinese medicine at Wikiquote Retrieved from https en wikipedia org w index php title Chinese herbology amp oldid 1134288729, wikipedia, wiki, book, books, library,

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