Radii’s Traditional Chinese Medicine (TCM) commentator Colin Garon launched his column by pointing out a few deeply entrenched misconceptions about TCM held in the West:

Sometimes [TCM] represents what [Western] biomedicine is not but wishes it could be: where biomedicine is artificial, prescribing pills with complex chemical ingredients, TCM is natural, its practitioners mixing herbs into poultices and potions. Biomedicine subdivides the body into organs, tissues, cells, and molecules, sometimes threatening to erase the person that unites them, but TCM adopts a holistic approach to the human body, preserving the patient’s individuality.

Colin’s Radii column aims to dispel some of these false stereotypes among Western audiences, but it’s important to know that many of these ideas also persist here in China. This past weekend, the independent, Hong Kong-based magazine Phoenix Weekly reposted their landmark 2014 exposé (link in Chinese) about the chemical effects of TCM on drug-induced liver disease, citing cultural causes that echo the same misconceptions mentioned above. The repost has racked up more than 100,000 views since being published on Phoenix Weekly‘s WeChat account on July 28, testifying to the subject’s continued relevance as a heated topic of discussion.

Citing over a decade of statistical research, in-depth interviews with Mainland Chinese liver specialists and case studies from 16 major Chinese hospitals, the Phoenix Weekly report paints a stark picture of the unexpected, unacknowledged danger of TCM overdosing. They found that Chinese herbal medicine accounted for 20% of pathogenic causes of liver disease in China, with three large specialist hospitals reporting more than half of their liver disease cases as associated with TCM.

“More and more medical studies have found that a wide range of traditional Chinese herbal medicine is damaging the livers of Chinese people. Long-term, high-dose taking — including proprietary Chinese medicines and herbs — can cause fatal damage,” Phoenix Weekly reported.

The problem is that, unlike with biomedicine, there has been no systematic, in-depth toxicology research into the effect of TCM herbal treatments on long-term liver damage. The chemical composition of biomedical treatments are meticulously researched and objectively measured, and therefore easier to monitor in their effects on the body — over 900 chemicals are known to cause drug-induced liver disease, including anti-tuberculosis drugs, some antibiotics and many chemotherapy drugs. The chemical makeups of TCM remedies are harder to quantify, and the faulty logic that herbal remedies dodge the harmful side effects of Western pharmaceuticals has led to a surge in liver disease in China:

Due to the wide application of traditional Chinese medicine and the lack of toxicological research, China is facing more serious drug problems than [Western patients]… There is an objective reason for the difficulty of linking Traditional Chinese Medicine with liver disease. Some patients take a single herb, but it is more common to take a variety of TCM herbs in various preparations, including as powder, granules and decoctions. Chinese medicine lacks chemical composition analysis, and the related toxicology research is therefore weak. Chinese herbal medicine treatment is often coupled with [self-medication]. Medication types and dosages are complex and variable, which makes it difficult to clearly determine the effects of herbal medicine on liver disease.

Phoenix Weekly‘s piece echoes the voices of several prominent Chinese doctors urging for a more sustained investigation into the chemical properties of TCM treatments, so that their effects on the body can be better understood and potentially harmful side effects of mixing Chinese with Western treatments can be avoided. Demystifying the chemical makeup of Chinese herbal medicine has profound implications not only for improving cross-cultural understanding, but for the very health of its adherents.

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