Number 22
September/October 1999

Herbs in this issue:


Asian ginseng

Atractylodes spp.


A Note From Dr. Leung


What’s in a label?


     There are 2 aspects to reading labels of herbal supplements:  (1) At the present time, when you read the herbal ingredients on a label, there is no way to tell whether they are actually present in the product.  And if they are, there is no easy way to know if they are of good quality.  As I have repeatedly stressed in my previous comments [Issue 16, p.2; Issue 19, pp. 2-3], herbs and herbal extracts are not well defined.  Unlike pure chemicals (e.g., vitamins, amino acids, and synthetic drugs), the same herbal ingredient listed on different product labels can mean completely different materials, depending on the manufacturer.  For example, take Siberian ginseng (eleuthero).  In Chinese, it’s known as ciwujia, meaning “spiny wujia.”  For years, a major well-known herbal company was using the wrong herb (Acanthopanax giraldii) in its Siberian ginseng products.  The label listed it as Siberian ginseng, but in fact, it was not.  Acanthopanax giraldii is also spiny and is thus a “spiny” wujia.  But it is NOT the ciwujia (spiny wujia) or Acanthopanax


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.


senticosus (syn. Eleutherococcus senticosus), which is the Siberian ginseng.  Fortunately, not much harm has been done because A. giraldii is closely related to eleuthero and, like eleuthero, is one of the various wujias traditionally used as tonics in Chinese medicine, and it is not toxic when normally used.  On the other hand, the wrong herb could be Periploca sepium, which has in fact attained notoriety in North America as an adulterant of eleuthero.1  You may argue that this type of problem can also occur with vitamin and synthetic drug products. It certainly can, but not as frequently as with herbs.  In drug and vitamin products, there are well-defined standards specified in the United States Pharmacopoeia/National Formulary (USP/NF), Food Chemical Codex (FCC), and other official compendia, which manufacturers of quality products can readily follow.  This is not so with herbal products.  Although there are some rudimentary standards for a minute fraction of the herbs currently being used, standard setting is still in its infancy.  Hence, in most herbs currently being used in supplements, no 2 herbal ingredients bearing the same name on product labels from different companies are alike, unless these companies are buying it from the same supplier.  It is not a good situation.  Until the time when meaningful standards and specifications are established for herbs in such official compendia as the USP/NF, and product labels contain ingredients stated to pass these standards, consumers have nothing on which to judge the quality of an herbal product.  All they can do is trust the marketers and take their chances since, at present, product quality has no direct relationship to the size or name of the company that markets these products.  [Incidentally, for those not familiar with USP/NF, it is a nonprofit organization that sets standards for drugs and vitamins in the United States, and more recently, started setting standards for herbs].  (2) It is not uncommon to encounter herbalists, naturopathic physicians, and other professionals (who should know better), who will look at a label and tell you about the properties and benefits (or toxicities) of a given herbal product, even if the product gives no information on the makeup of its formula.  These professionals are either ignorant about the nature of herbs, herbal extracts, and herbal formulas, or they are careless and negligent in their evaluation of a product based solely on its labeled ingredients.  As I have often said and written, not even 2% of herbs currently used in commercial products have standards that can reasonably guarantee the identity and quality of an herbal ingredient.  One simply can’t tell the properties and uses of an herbal product by reading its label!  Even if all the herbs in a formula had standards like those of pure chemicals (a pure fantasy), without the precise proportions of these herbs, no magician of an herbalist or naturopathic physician would be able to tell you about the product’s properties.  The reason is that an herbal product with ingredient A at 10% and ingredient B at 90% is very different in properties from one with the amounts in reverse.  So, the next time such a professional tries to show off his “knowledge” of herbs without having detailed information on the formula, just take his comments with a grain of salt. 

(1) D.V.C. Awang, “Recalling the Case of the Hairy Baby,” Natural Health Products Report, 18-19(1994).


Preventive medicine – What is it?

        I don’t know how they define “preventive medicine” in medical schools or in schools of public health, but from what I read and hear, here is the message that comes across:  Detect your illness early and treat it with drugs, radiation and/or surgery.  The emphasis is invariably placed on detection and NOT on real prevention.  While we have been spending and wasting tons of money in expensive diagnosis and in surgery and sophisticated drugs to treat diseases that already have occurred, we have spent little in educating the public about the potential true causes of these diseases.  Instead of educating the public about the toxic side effects of drugs (including prescription and OTC drugs) and to avoid taking them unnecessarily, we try our best to hide these data from them in the form of fine prints.  Simultaneously, the public is being told daily by television and printed ads that a new drug around the corner will take care of their current problem.  Little or no effort is made to educate consumers that their diet and lifestyle are often the cause of their problems, which then become even further aggravated by drug treatment.  All these factors contribute to our current state of proliferation of diseases, especially cancer, but they are largely kept under wraps due to self-interest.  Little effort and money are being spent to look into ways to eliminate these potential causative factors.

        There is a rather revealing article on this subject in a recent issue of the Sierra magazine published by the Sierra Club.2  It is titled “Breast Cancer & the Environment.”  Even if only half of the information in this article is true, it does not speak well of the people who monopolize our breast cancer care.  The authors expose and chide some well-known political, government, and self-interest organizations and companies for advocating detection and drug treatment but not true prevention.  According to the article, a cozy alliance exists among the American Cancer Society (ACS), the National Cancer Institute (NCI), and companies that manufacture toxic environmental chemicals (e.g., carcinogenic pesticides) and anticancer drugs, which assures that true cancer prevention gets the silent treatment.  Thus, the primary sponsor of National Breast Cancer Awareness Month (every October) is AstraZeneca (formerly known as Zeneca), a multinational giant that manufactures the cancer drug tamoxifen as well as fungicides and herbicides, including the carcinogen acetochlor.  Referring to AstraZeneca, the article continues:  Its Perry, Ohio, chemical plant is the third-largest source of potential cancer causing pollution in the United States, releasing 53,000 pounds of recognized carcinogens into the air in 1996.  When Zeneca created Breast Cancer Awareness Month in 1985, it was owned by Imperial Chemical Industries, a multibillion-dollar producer of pesticides, paper, and plastics.  State and federal agencies sued ICI in 1990, alleging that it dumped DDT and PCBs - both banned in the United States since the 1970s – in Los Angeles and Long Beach harbors.  Any mention of what role such chemicals may be playing in rising breast cancer rates is missing from Breast Cancer Awareness Month promos.

        After acquiring the Salick chain of cancer treatment centers in 1997, Zeneca merged with the Swedish pharmaceutical company Astra this year to form AstraZeneca, creating the world’s third-largest drug concern, valued at $67 billion.  “This is a conflict of interest unparalleled in the history of American medicine,” says Dr. Samuel Epstein, a professor of occupational and environmental medicine at the University of Illinois of Public Health.  “You’ve got a company that’s a spinoff of one of the world’s biggest manufacturers of carcinogenic chemicals, they’ve got control of breast cancer treatment, they’ve got control of the chemoprevention [studies], and now they have control of cancer treatment in eleven centers – which are clearly going to be prescribing the drugs they manufacture.” 

        Here is more: ….. The primary source of support for cancer research in the United States comes from the federally funded NCI.  Senior executives in both the ACS and NCI routinely move through a revolving door to board and executive posts at companies that make cancer-treatment drugs. 

        Such conflicts of interest extend to the petrochemical industry.  While serving as chairman of National Cancer Advisory Panel (a three-member committee appointed by the president) in 1990, Armand Hammer announced a drive to add a billion dollars to the NCI’s budget “to find a cure for cancer in the next ten years.”  At the time, he was also chairman of Occidental Petroleum, which would later have to pay the federal government $129 million and New York State $98 million to clean up its infamous toxic dump, Love Canal. 

It’s no surprise, then, that reducing exposures to environmental carcinogens gets short shrift in the NCI’s breast cancer prevention efforts, and that the agency embraced a study in “chemoprevention” in 1992.  The Breast Cancer Prevention Trial, involving over 13,000 women throughout North America, was designed to see if the chemotherapy drug tamoxifen would reduce the risk of breast cancer in healthy women.  Zeneca supplied the tamoxifen, and the NCI provided $50 million in funding.

        Space does not allow me to quote more from this article, but it would seem that the folks in charge of our tax dollars and cancer prevention programs might not be looking into true prevention, because they are either totally brainwashed in medical and pharmacy schools or by their drug and chemical company executive colleagues to only think “drugs,” or are financially indebted to drug interests.  That ludicrous “chemoprevention” study with tamoxifen is such an example.  Otherwise, how can anyone justify subjecting normal women to a potentially highly toxic drug?  This is not vitamin E or shark cartilage we are talking about, which, if not effective, will do no harm, except to one’s pocketbook.  But with tamoxifen, people who were involved in approving the funding of the study and those involved in running it should know better, because there are no safe cancer drugs.  Tamoxifen is no exception!  I can see the risk one has to take if one has breast cancer.  But to persuade normal women to take tamoxifen to “prevent” breast cancer that may never come and risk another type of cancer is irresponsible.  There is already evidence linking tamoxifen to an increased incidence of uterine tumors (adenocarcinoma and mixed mullerian tumor) in patients treated with this cancer drug.

        Instead of addressing the real causes of cancer (lifestyles, toxicants in our food, water and air, toxic side effects of drugs, etc.), we are trying our best to protect and promote drug and chemical interests.  With hundreds of millions of our tax dollars already spent over the past 10 years, not to mention investments of a probably equal magnitude by drug and medical industries, dare we hope the cancer situation has improved?  Not unless we are part of the monopoly on cancer care. 

(2) S. Batt and L. Gross, “Breast Cancer and the Environment: Cancer, Inc.,” Sierra, Sept./Oct., 36-41,63 (1999).


Useful herb tips


          Berberine – a drug or dietary supplement?  [See Issue 4, p. 3; Issue 12, p. 3; and Issue 21, p.2].    Berberine is a major active ingredient of huanglian (Coptis spp.), a common Chinese herb long used for treating “toxic” and “heat” conditions, which encompass bacterial and viral infections, fever, bacterial dysentery, pinkeye, inflammations, etc.  For the past few decades, commercial products containing pure berberine (usually as the hydrochloride salt) have been available in China and overseas Chinese communities for treating bacterial dysentery, gastroenteritis, and indigestion.  It is particularly effective against different types of traveler’s diarrhea.  For the past 15 years, I have been recommending it to friends and colleagues who travel to developing countries, especially for the first time, and have received many thankful comments from them.  It is really cheap – about $3-4/bottle of 100 tiny tablets (100mg each), with daily dosage of 3-6 tablets.  One bottle is sufficient to take care of a whole family of 4 or more should they encounter “Montezuma’s revenge” in Mexico.  During my frequent travels to China, I always carry a bottle, not so much for myself, but rather, for colleagues and friends who are not used to taking precautions in drinking local water or eating local food.  I know of no antidiarrheal, whether prescription or over-the-counter, that is as effective as berberine.  And despite its common availability and use in a country of over 1 billion people, there have not been any reports of notable toxic side effects that I know of, even though I routinely screen over 80 Chinese journal titles on herbs, TCM, pharmacology, and drugs, from our library.  Since products containing ephedrine, synephrine, dehydroepiandrosterone (DHEA), melatonin, and huperzine A can be sold as dietary supplements, I expect berberine to join them soon, if it has not already. 

        There is more on berberine.  Over the past 10 to 15 years, the Chinese have found more therapeutic uses for this compound.  The following are a few diseases whose effective treatment by berberine has been fairly well documented:3,4  arrhythmia (especially continuous), type II diabetes, high blood pressure, hyperlipemia, gastritis and digestive ulcer.  I will provide more details in future issues, especially for treating diabetes, hypertension, and hyperlipemia. 

(3) X.Y. Li, “Use of Berberine in Conditions other than Enteritis,” Jiating Yixue, Oct., 28(1999);  (4) M.J. Shi and J.L. Feng, “New Uses of Berberine,” Zhongyiyao Yanjiu, 15(4): 57-58(1999).


         Men beware! - Toxicity of G-115, a proprietary “standardized” ginseng extract.5  I usually don’t bother with reporting on proprietary preparations, because to me, they should only belong in promotional literature and marketing materials.  However, in the present case, the product has been widely advertised, promoted, and sold.  Any favorable data on it, I am sure, will be added to its promotion packet.  On the other hand, I doubt any unfavorable data on it will be given equal press.  So, as a public service, here it is!  This is from a program abstract of the International Ginseng Conference of 1999, held in Hong Kong on July 8 to 11 this year.  The study was conducted at 2 universities in India.  After feeding G-115 (100 mg/kg b.wt.) to rats and rabbits for 30-60 days, the researchers observed testicular dysfunction in both species, leading them to conclude that “long term G-115 feeding may cause gonadal disturbances affecting spermatogenesis and Leydig cell function.  A word of precaution is necessary for those using health care medicine such as Panax ginseng extract (G-115).”  The testicular dysfunction included a 77% decrease of motile sperm production in both species and a testicular histology indicating a reduced number of germ cells together with reduction in protein, sialic acid and glycogen contents. 

        G-115 is a typical proprietary “standardized” extract, whose detailed chemical and pharmacological properties are known only to the company that manufactures it.  While it is standardized to contain 4% ginsenosides and has been widely promoted for its implied therapeutic effects (energizing and increasing male libido), little is known about its other chemical components or their toxicity.  Without revealing these details as well as the method of extraction (including solvents, chemical adjuvants, etc.), one certainly cannot claim it to be a traditional extract.  Hence, it cannot represent Asian ginseng in its traditional properties.  Its use, thus, has no historical basis in terms of the properties and safety of Asian ginseng.  This appears to be the first study revealing the toxic effect of an Asian ginseng extract on testicular function.  I wouldn’t worry about it as far as Asian ginseng and its traditional extracts are concerned.  But I would advise men who are still virile and who use products containing G-115 for energy and sexual effects, to exercise caution.  At the present time, I can’t say this is a case of “I told you so” yet.  But I will keep an open mind and await further data.  What I would like to see is a comparative study of the effects on testicular function of G-115 and a traditional Asian ginseng extract (aqueous or hydro-alcoholic), which, if well designed and conducted, would tell me whether it is only G-115 that has this undesirable effect, if indeed the Indian study is valid. 

(5) K.K. Sharma et al., “Testicular Dysfunction in Rat/Rabbit Following Panax ginseng (G-115 FR.I) Feeding,” Programme & Abstracts, International Ginseng Conference ’99. Ginseng: Its Science and Its Markets. Advances in Biotechnology, Medicinal Applications & Marketing, 8-11 July, 1999, Hong Kong, PRC.


         Hospital sterilization with atractylodes (cangzhu).  There are 2 kinds of atractylodes, baizhu and cangzhuBaizhu is the dried rhizome of Atractylodes macrocephala Koidz. while cangzhu is the dried rhizome of Atractylodes chinensis Koidz. ex Kitam. (known as northern cangzhu) or A. lancea (Thunb.) DC. (southern cangzhu).  While baizhu and cangzhu have some common properties and uses (e.g., Spleen invigorating and diuretic; used in indigestion, diarrhea, and fluid retention), baizhu is a major qi tonic that is now used in counteracting the toxic side effects of chemotherapy and radiotherapy in cancer treatment, while cangzhu is considered a wetness-drying drug, used in treating arthritis and rheumatism as well as the common cold. 

        In addition to above uses, a traditional practice in China during an epidemic was to burn cangzhu to drive off the “evil” (translated: pathogens) that was believed to cause the epidemic.  In recent years, this practice has been adapted for the routine sterilization of operating rooms in some Chinese hospitals.  The method is to burn cangzhu (after being soaked in alcohol) with the room closed for several hours.  Normally, 1 g/m3 of the herb is used.  The fumes are effective in killing bacteria, fungi and viruses, but, unfortunately, have no effect on pests (mosquitoes, etc.).  The effectiveness of this practice was recently tested at the Dongyang Municipal People’s Hospital in Zhejiang Province and results reported earlier this year in a major journal of Chinese materia medica.6  

        The effect of the fumigation was tested, during the months of May and October, in 3 types of hospital rooms – operating room, treatment room, and general ward.  Cangzhu (1 g/m3) was first soaked in 95% alcohol (2 parts to 1 part herb) for 24 hr.  It was then burned until only ashes remained.  The rooms were sealed for 4 hr.  Before and after fumigation, the rooms were plated with common nutrient agar for total plate count.  Each agar plate was exposed in the room for 15 min.  After incubating for 24 hr, results showed that there was an average kill rate of 65.8% with northern cangzhu and 73.7% with southern cangzhu.  There was no seasonal difference in the results obtained.  After fumigation, all the 3 types of hospital rooms met Chinese national standards:  operating room (<200 cfu m-3), treatment room (<500 cfu m-3), and general ward (<500 cfu m-3).

        It is believed that the volatile oil is responsible for the germicidal effects, as evidenced by the higher kill rate of southern cangzhu that contains 5%-9% volatile oil as compared to 3%-5% in northern cangzhu.  The specific active chemical(s) are not yet known. 

(6) Z. Du, “Air Quality of Hospital Rooms after Fumigation with Atractylodes,” Zhongguo Zhongyao Zazhi, 24(9): 569-570(1999);  Leung, A.Y. and S. Foster, Encyclopedia of Common Natural Ingredients Used in Food, Drugs and Cosmetics, 2nd Ed., Wiley-Interscience, New York, 1995, pp. 529-531;  Leung, A.Y., Better Health with (Mostly) Chinese Herbs & Foods, AYSL Corp., Glen Rock, N.J., 1995, pp. 7-8, 10-11.


Addendum:  Issue 21, p. 3.  “Treatment of 53 cases of dysmenorrhea (menstrual pain) with danggui, chuanxiong, and chicken egg.”  After a reader raised a question, I need to add the underlined in order to make it clear when treatment should take place, thus: “Within 3 days after the cessation of menses …”