(CHINESE) HERB NEWS
Herbs in this issue:
Sichuan lovage (chuanxiong)
Polysaccharides – orphans of standardization
I recently attended a scientific conference in Mississippi organized by colleagues of the American Society of Pharmacognosy. Except for a small handful, most presentations were technical and noncommercial, unlike many other recent conferences put forth by professional conference organizers. It was the only such conference during the past few years that I considered worth attending. With one or two exceptions, there were no company representatives openly touting their products or marketing skills, and you didn’t see the self-professed and self-promoted “experts” who typically adorn speaker rosters of such conferences. All in all, it was a very decent conference. I hope the ASP will continue to organize such meetings on dietary supplements and show the industry what a scientific conference should be! During the conference, after an esteemed colleague made an excellent presentation on a commercial ginseng validation program, I asked him why the ginseng
Dr. Leung is author of the Encyclopedia of Common Natural Ingredients Used in Food, Drugs, and Cosmetics (Wiley-Interscience), which was published in 1980 and revised in 1996. He is also creator of PHYTOMED, a prototype computer database on Chinese herbal medicine developed under contract with the National Cancer Institute.
polysaccharides were not included as part of the standards for ginseng quality. His answer, like those from other colleagues, was that there were no workable analytical methods for ginseng polysaccharides, and he dismissed my question as not being important. I guess he simply didn’t get it.
The importance of polysaccharides is well established both in Western and Asian scientific literature. They are present as active components of ginseng, astragalus, echinacea, eleuthero, and many other important herbs. They are at least as important as ginsenosides, astragalosides, “phenolics”, and eleutherosides (glycosides of sitosterol, oleanolic acid, phenylpropanoids, lignans, etc.), which are generally considered as the active principles of above -mentioned herbs. Yet these polysaccharides have simply been set aside or totally ignored, one main reason being that there are no easy analytical methods to determine their amounts. In short, polysaccharides are “orphans” of standardization. Academic scientists ignore them and industrial scientists don’t know what to do with them when it comes to measuring their concentrations in herbs. The polysaccharides in ginseng are a typical example. Most analysts or scientists only talk about ginsenosides, including Rg1, Rb1, etc., their ratios, their “upper” and “downer” effects, and so forth. Rarely do you hear these experts acknowledge the important role of ginseng polysaccharides that are mostly responsible for ginseng’s immunomodulating effects. But that is not all! I have seen a monograph on the analytical standards for astragalus, written by eminent German and Chinese scientists, recently published, which totally ignores the polysaccharides. That puzzles me. Is it due to laziness on the part of these scientists who should know better or is it a matter of money? With commercial “scientists,” it is understandable that they champion such ridiculous standards as “phenolics” in echinacea, ignoring polysaccharides and other active components (e.g., alkylamides) [Issue 13, p. 2], because they are either mere chemists who don’t understand the intricacies of medicinal herbs or they have close ties to the companies that promote these “standards,” whose echinacea products may not contain other truly important active components. To these individuals, I extend my condolences because their scientific career has basically ended; whatever they profess to do in science is biased and dictated by their financial backers. But to my scientific colleagues who are simply a little bit lazy or complacent, I want to challenge them to be masters of methodology and instrumentation, not slaves to them.
Leung, A.Y., and S. Foster, Encyclopedia of Common Natural Ingredients Used in Food, Drugs and Cosmetics, Wiley-Interscience, New York, 1995, pp. 51-52, 216-218, 225-226, 278-279.
Modernization of traditional herbal medicine – What does it mean?
With the recent increased popularity of herbal products, the talk about modernizing the practice of traditional herbal medicine (THM) has intensified. The conventional medical and scientific communities want to see modern controlled studies on the efficacy of herbal medicines; and many in the dietary supplements industry echo this call. However, “modernizing” means different things to different people, depending on whether the concept is applied to Western herbal medicine or to Chinese herbal medicine. It also depends on whether a person is a scientist who sees the total picture or one whose knowledge is specialized or limited.
Western herbal medicine has traditionally been used mainly for treating specific conditions, such as headache, cough, arthritis, menstrual problems, skin sores, insect bites, colds, sore throat, etc. One aspect of Chinese herbal medicine does the same. However, a major difference is that, in addition to this aspect of disease treatment, Chinese herbal medicine stresses disease prevention and good-health maintenance. This concept of disease prevention and health maintenance is a minor aspect, if existent at all, in the practice of Western herbal medicine. Furthermore, the herbs currently used worldwide in the practice of traditional Chinese medicine (TCM) outnumber those used in Western herbal medicine many fold. This holds true even for North America. From my own literature resources, the number of commonly used Chinese herbs is estimated to be somewhere between 1,000 and 2,000, including certain foods, spices and tonics that also double as drugs (in the Western sense of disease treatment) when used in higher doses. The total number of documented plant species used in TCM has reached 11,470 (from 369 families). Considering that a single plant species generally yields more than 1 drug (e.g., root, leaf, stem, bark, or flower) and sometimes up to 4 or 5, it is conservative to say that the number of actual herbal drugs derived from these plants can easily be twice the number of plant species documented, or over 22,000!1 Since herbs in TCM are commonly used in combinations, the number of permutations derived from the number of plant drugs listed can be astronomical! Thus, the total recorded number of traditional formulas (prescriptions) from a single recent compilation is 130,000.2 This includes formulas from classical herbals and formularies (e.g., the Pu Ji Fang from the 14th century, alone, describes close to 62,000 formulas), with a small proportion from the more recently published literature. For each formula published in the current Chinese literature for treating a particular type of condition, there must be dozens or even hundreds of others that are used by the Chinese population worldwide, which don’t reach any journals or magazines. This is not all! There are also thousands of formulas used for diet therapy, both from classical diet herbals and the modern literature, which are not included in the above publication. Though these diet formulas are less systematically documented than those for disease treatment, I estimate, conservatively, their number to be between 20% to 40% of those used in disease palliation or treatment, whether or not documented.3,4 This all goes to show that when one talks about “modernizing” the practice of herbal medicine, one has to consider not only the simple practice of Western herbal medicine, but also the traditional practice of diet therapy and disease prevention in TCM, because TCM and Chinese herbs are becoming more and more important in the field of dietary supplements in North America. Modern allopathic medicine does not have a scientific model to evaluate TCM which involves holistic interaction of a person with the drugs/foods he ingests, and these foods/drugs usually do not have a single or a single group of active principles for modern science to standardize and analyze. “Modernizing” the treatment of diarrhea with berberine from huanglian (Coptis chinensis and other Coptis spp.) is workable, because this compound is effective in stopping diarrhea due to bacterial infection. And standardizing the amount of berberine in a huanglian extract is modern progress. However, this standardized extract based on berberine alone may not work for other traditional indications for huanglian, such as fever, insomnia, hematemesis, toothache, nosebleed, conjunctivitis, canker sores, carbuncle, abscess, or eczema, for which huanglian is also traditionally used, and the active principle(s) responsible for these effects are not yet characterized. This situation likewise applies to Chinese herbs/foods that are used for maintaining good health and for preventing disease. This class of botanicals, consisting of mostly tonics, contain more than 1 or 1 class of active chemical compounds (flavonoids, lignans, sterols, triterpenes, saponins, alkaloids, etc.). Hence, their pharmacological actions are not due to a single compound or even a group of compounds but rather, to a synergistic effect of all the compounds present. To date, the call for “modernization” of traditional herbal medicine, even from the most prominent and the brightest scientists in the field, has addressed only the obvious modern-drug aspect of this issue. The most important aspect of traditional herbal medicine is missed, which is the fact that herbs have been beneficially used for so many centuries due to their milder nature. They work by interacting with the whole body system and not “target-shooting” any particular organ or tissue, and their effects are a synergy among the various active compounds present. However, once an “active” compound is isolated and used in its pure natural or synthesized form, the synergistic nature of the original herb is no longer there. If this compound is used like a modern drug for a specific indication, it no longer can be called THM. This is NOT modernization of THM. It is simply drug discovery using traditional herbs as a raw-material source. The particular herb, or the practice of using this herb, has not been modernized. Instead, if it is abandoned in favor of the “active” compound, this herb will no longer benefit us by offering its gentler, synergistic, and broader effects. And our quality of life will suffer because now we no longer have a choice, but instead, are stuck with a new drug that will invariably cause side effects that require the use of other drugs to alleviate and thus lead to more of the same existing problems inherent in modern drugs. Consequently, we must not confuse new drug discovery and advanced chemical analyses with modernization of the practice of THM. True modernization is preserving the practice of THM and at the same time making it relevant to our modern society. This must be accomplished by having a broad vision of both modern medicine and traditional herbal medicine.
Let’s consider TCM. A general misconception about modernizing TCM is doing chemical and/or pharmacological studies on it without regard to where these studies may lead or how relevant they are to TCM or to science. TCM is a legitimate system of health care that is not going to disappear. Its herbal aspect can resolve many problems that modern drugs cannot adequately handle, especially in the areas of viral infections (e.g., cold and flu), aches and pains, and illnesses of unknown etiology (e.g., arthritis, rheumatism, eczema, vitiligo, etc.). It should be beneficially employed along with modern medicine and not simply used as a source of modern drugs; the latter would obliterate TCM, rather than modernize it.
(1) Inst. Ch. Materia Medica, Ch. Acad. TCM, Eds., Quanguo Zhongcaoyao Mingjian, 3 vols., People’s Health Publications, Beijing, 1996; (2) Nanjing Coll. TCM, Eds., Zhongyi Fangji Da Cidian, 11 vols., People’s Health Publications, Beijing, 1993-1997; (3) L.Q. Zhang and Y.Z. Guang, Eds., Zhongguo Minzu Yaoshi Daquan (“Encyclopedia of Chinese Ethnic Diet Therapy”), Shanxi Scientific and Technical Publications, Taiyuan, 1994; (4) Z.Y. Wang, Ed., Zhongguo Yaoshan Da Cidian (“Encyclopedia of Chinese Diet Therapy”), Dalian Publishers, Dalian, 1992.
Herb Tips – Herbal Remedies
Jiucai (Allium odorum or Allium tuberosum leaf) for treating ringworm of hand and foot (athlete’s foot). Jiucai is a common Chinese vegetable of the same family as onions and green onions, but with flat leaves, also known as Chinese chive. It is a rather versatile medicinal herb whose uses include the treatment of internal bleeding, dysentery, diabetes, and hemorrhoids, as well as topically for insect bites, skin sores, bruises and swellings due to physical trauma. The seed of this plant (jiucaizi) is used for impotence. I have previously reported on the use of jiucai in the diet therapy of male sterility [Issue 8, p. 2]. Here, I want to relate the information as reported recently in a Chinese medical and pharmaceutical journal in using this herb for treating ringworm.5 Jiucai can be bought in any Chinatown food or vegetable market or stall. Its Cantonese name is “gau choi.” Only use the green leaves by removing any yellow or discolored ones. Wash and drain dry 1kg (2.2lbs) of the vegetable and mash it up using a mortar and pestle. It will probably also work if you chop it up in a blender, unless there are some active components present which are sensitive to metals. Place the mash in a basin or bucket that can hold at least 8L (8qt). Immediately add 5L (5qt) of boiling water to it. Stir well and let it cool to a tolerable temperature, about 50oC (122oF). Then soak the infected feet or hands in the warm/hot liquid for 40 minutes. Do this once daily for 5 days. It is not clear from the report whether the liquid can be saved, reheated, and reused. This is quite common with Chinese reports, many of which I don’t even bother to read further, due to their impreciseness. In the present case, if one had a bad case of athlete’s foot, one might be desperate enough to prepare the liquid fresh daily. According to the report, of 84 patients treated, the ringworm in 63 (75%) was cured after one course of treatment, with no recurrence; and symptoms generally disappeared in 18 patients (21.4%) after two courses of treatment. The remaining 3 patients had long-term infection and their symptoms lightened but did not disappear after 2 courses of treatment.
Athlete’s foot can be nasty and some people have it for years. There are many Chinese herbs and combinations that are effective in treating it. I also used to have it, but I got rid of it with my own tincture of a combination of astragalus root, magnolia bud, and licorice root. This jiucai treatment is actually quite simple. One can buy the jiucai in Chinatown and do this treatment nightly for 5 nights, preferably in a well-ventilated place, unless one doesn’t mind the strong lingering onion odor at bedtime.
Treatment of shingles (herpes zoster) with fig leaf. This is a report from a hospital in Henan Province published in the journal Henan Traditional Chinese Medicine.6 Ninety patients (42 male, 48 female; ages 16-68 yr) with shingles of various types and locations, of 1-10 days in duration, were randomly divided into 2 groups of 45 each. The control group was treated with the antiviral drug ribavirin (0.2g, i.m., b.i.d.), along with vitamin B1 tablets (20mg, t.i.d.), and the analgesic carbamazepine (tablets, 0.1g, t.i.d.). The treatment group was treated topically with fig leaf. Method: Cut and mash a few fresh fig leaves in a suitable vessel. Add a small amount of vinegar to form a paste. Apply this to afflicted areas to cover the lesions and leave on for 30 minutes. Do this twice a day. Do not apply to lesions that have been broken. After 10 days of treatment, the rash and lesions, along with pain, disappeared in 42 patients in the treatment group while only 26 patients in the control group experienced the same results. The remaining 3 patients in the treatment group experienced resolution of the rash and lesions and a reduction in pain, while 18 patients in the control group did the same. Also, the rash in 1 patient in the control group was reduced but the pain persisted.
Shingles is a miserable condition, and currently there is no effective modern treatment. For those who live in warmer climates and have access to fig leaves, they may want to give this remedy a try. If no fig leaves are available, try a strong tea [Issue 14, p. 2].
Treatment of 53 cases of dysmenorrhea (menstrual pain) with danggui, chuanxiong, and chicken egg.7 The ages of the patients ranged from 13 to 45 yr, with history of the condition from 1 to 28 yr. Within 3 days after menses, the patients were treated with a decoction of 30g danggui (Angelica sinensis root), 30g chuanxiong (Sichuan lovage or Ligusticum chuanxiong rhizome), and an egg. The liquid was drunk and the egg eaten. This was done once each month for 3 months. If the pain still persisted, the patients were given the decoction for 3 more months, to a total of 6 doses. After this treatment, all the patients had complete resolution of their symptoms, most of them after 3 doses. For those who are not familiar with what a decoction is, it is simply boiling the herbs (after soaking in cool water for 20-60 min) to concentrate the liquid down to a fraction of the original volume [Issue 18, p. 3].
Although the dosage of the 2 herbs in this formula is 2 to 5 times the amount normally used, this apparently is not a problem, because they are not consumed continuously for extended periods of time, nor used alone. Furthermore, in traditional Chinese medicine, danggui and chuanxiong are frequently used together in alleviating pain and in menstrual problems. Their combination is believed to enhance their therapeutic effects as well as lower their potentially toxic side effects. The latter may be supported by recent toxicity studies using two known active chemical constituents found in these herbs: ferulic acid (in danggui and many other herbs) and tetramethylpyrazine (in chuanxiong). Both compounds have cardiovascular and hematologic activities. When tested individually in mice, their toxicities are quite low [LD50(i.v.) = 866±29mg/kg for ferulic acid; LD50(i.v.) = 416±17mg/kg for tetramethylpyrazine]. But when used together, these toxic effects are even lower [a combination of ½ dose of each of above compounds produced no fatality in mice].8
I think this treatment is remarkable. Like many TCM remedies, its effects are difficult to explain based on our modern drug principles. But do we really need to understand a tradition before accepting it? I’ll let you ponder it.
(5) G.C. Dong and Y.Y. Sun, “Jiucai Juice in the Treatment of Ringworm of Hand and Foot,” Zhongguo Zhongyiyao Keji, 5(2): 72(1998); (6) Y.L. Zhang and W.J. Liu, “Topical Treatment of 45 Cases of Herpes Zoster with Fig Leaf,” Henan Zhongyi, 19(3): 50(1999); (7) H.Q. Lian, “Treatment of 53 Cases of Dysmenorrhea with Chuanxiong, Danggui, and Chicken Egg,” Shizhen Guoyi Guoyao, 9(6): 489(1998); (8) J. Xu et al., “Comparative Studies of the Effects of Tetramethylpyrazine and Ferulic Acid on Blood Vessels, Smooth Muscles, Blood Viscosity, and Acute Toxicity, Singly and in Combination,” Zhongguo Zhongyao Zazhi, 17(11): 680-682(1992); Leung, A.Y., and S. Foster, Encyclopedia of Common Natural Ingredients Used in Food, Drugs and Cosmetics, Wiley-Interscience, New York, 1995, p. 553.