I recently read the above-referenced article regarding the use of Traditional Chinese Medicine (TCM) and COVID-19. The unfortunate conclusions and one-sidedness of the article have led me to speak out on the ignorance surrounding Chinese Herbal Medicine. The article states that “scientists warn against the use” and that they (Chinese herbs) could be harmful and “pose both direct and indirect risks to patients”, quoted by Dr. Edzard Ernst, a professor emeritus of complementary medicine at the United Kingdom’s University of Exeter. He goes on to state that “TCM mixtures can be toxic, contaminated or adulterated with prescription drugs; they can also interact with prescription drugs,” Ernst said.
First, TCM mixtures should be prescribed only by a licensed TCM practitioner that has spent years learning the medicine. Chinese herbal medicine in granular form is pharmaceutical grade and is tested for adulterants, chemicals, pesticides, and thin-layer chromatography is used to ascertain the correct genus and species of the plant. His argument that Chinese Medicine can be contaminated and or adulterated and that the entire system of medicine should not be used is like saying that because Zantac has recently been pulled off the shelves because it contained NDMA that no one should ever use pharmaceuticals because they can be adulterated.
He also claims that TCM mixtures can be toxic. Yes, a few herbs have some level of toxicity, however, over the 3000-year history of the medicine, the way the herb is prepared and the amount that is given within the formula negates the toxicity and increases the safety of the herb. For example, the herb pinellia (ban xia in pinyin) is toxic when harvested but when prepared with ginger, the toxicity level is negated. Pinellia is sold in the prepared form only, so there is no chance of ever consuming it raw. We have specific guidelines about dosage to ensure safety of the herbs prescribed. Many of our herbs are considered foods, like Reishi mushrooms, goji berries, and longnan fruit. These are incredibly gentle and safe. Anything taken beyond a prescribed dose can be toxic. If you drink too much water, it can actually kill you. If you eat too many carrots, you will turn orange from excess beta-carotene (called carotenemia). In addition, many prescription drugs can be considered toxic, however, they are prescribed because the benefits of the medicine are thought to outweigh the side-effects.
Dr. Ernst goes on to say, “It can also give patients a false sense of security, leading them to neglect proven medications or therapies.” First of all, there are NO proven therapies for COVID-19 right now. If Chinese Medicine can help to bring a fever down, clear some of the glue-like phlegm from the lungs and help the patients recover quicker, than how is this a “false sense of security”? No one is saying to neglect Western Medicine. If a patient is turned away from the hospital saying they aren’t sick enough to be admitted, then what? A telemedicine consult with a licensed practitioner that can prescribe herbal medicine can open up valuable options for many in need. And if TCM can be used in the hospitals (like they are in China) alongside other as of yet unproven therapies, then why wouldn’t we welcome it as another tool in our armory to fight this and save lives? As long as the practitioner is a licensed herbalist (Dipl. OM, or Dipl. CH) they should be working alongside hospitals to prescribe the correct formulas to the individual patients.
The article goes on to quote, “The lack of detail about the remedies contributes to doubts over their efficacy”, Dan Larhammar, a molecular cell biologist and president of the Royal Swedish Academy of Sciences, said in a phone interview. Mr. Larhammar is referencing the pre-packaged herbal pills that are being produced for the masses. TCM practitioners in China developed these specific COVID remedies (such as jinhua qinggan capsules, lianhua qingwen capsules) because there are not enough TCM practitioners around the world to prescribe custom formulas for the swaths of people in need of such medicinals. Also, there is a shortage of specific herbs that seem to be effective against this virus which makes it more difficult for the private TCM practitioners to prescribe on a large scale. Do I agree with the use of a capsule that could be used to treat everyone? Not really. Chinese medicine is based on treating the individual. The Chinese found a formula that would treat the “typical” symptoms of COVID, although true practice does not work that way. And if the ingredients aren’t listed, then I would be hesitant to trust it as well.
The “scientific rigor” that is missing from Chinese herbal medicine treatment is due to a few important factors. One, herbs are combined for specific reasons. The herbs work together within a formula and interact with each other on a molecular level to have a specific therapeutic outcome. By researching each individual component rather than seeking the holistic effect of the formula together is a reductionist view that is typical of the pharmaceutical industry. The complex interactions that occur with combining Chinese medicinals have been studied over thousands of years. Secondly, the lack of “scientific rigor” is due to the inherent nature of our individualized medicine. If there are 20 people that have COVID-19, there would likely be 20 different formulas given to each one of them (with some overlap of specific herbs found to be useful with this virus). This makes it difficult for TCM to be shoe-horned into the Western model of placebo-controlled, double-blinded studies. There are no “one-size fits all” remedies. And to neglect its benefits, even as an augment to Western medicine in treating COVID-19, is short-sighted. Yes, TCM terminology and its “vague terms” are not often understood by Western researchers, however, this is because the ancient medicine used terms from the natural world to describe physiologic events occurring in the body. Just because it does not conform to the standards of modern medicine, it does not mean that it is inferior.
If people improve with or without TCM, this argument is completely illogical. If they have the virus and they get better, they should continue with their quarantine for 14 days like everyone else that has a confirmed case. If TCM helps them, it could prevent them from going into the hospital and decrease the risk of their symptoms getting worse and a potential need for a mechanical ventilator, which is in short supply. Again, let’s compare. If a physician prescribes medicine to fight COVID, and the patient feels better and decides to venture out before the 14-day quarantine, the argument to not treat with physician-prescribed medicine because it will give patients a false sense of security now seems quite laughable.
I hope this writing has cleared up some of the misconceptions surrounding an extraordinary medicine. The hospitals in WuHan and the surrounding areas have been forthright with the global Chinese Medicine community by disseminating information to TCM practitioners in how to best treat COVID-19. The amazing community of TCM herbalists across America stands poised and ready to help those in need by doing telemedicine herbal consults. I personally have offered my services to the state of NJ to fight alongside the doctors and nurses in local hospitals to bring TCM to help those in need. I believe that we should all work together to save as many patients as we can using every single tool available. Join me in the embrace of old and new, traditional and modern, and together we can overcome and heal the globe.
Candace Jania, L.Ac., Dipl. O.M.