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Chinese medicine’s great waste of resources

Traditional Chinese medicine employs 400,000 people in China, and is used to treat many more. But, writes Chen Long, a consumer obsession with speed and convenience has made the industry wasteful and inefficient.

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Traditional Chinese medicine is used by 1.3 billion people in China, and many Chinese communities around the world. The country has 3,800 Chinese medical institutions of county level and above, which together employ around 400,000 people. Traditional Chinese pharmacies are common both in cities and the countryside, and sell huge numbers of treatments every day. Millions of hectares of land are used to grow millions of tonnes of raw materials for the production of medicines. There are almost 3,000 enterprises and 2,000 factories that produce Chinese medicine (including some that also manufacture western medicine). It is a huge industry, and the country’s medicinal resources provide many with the healthcare they need.

But China’s twentieth-century population explosion led to a massive increase in the use of these resources. The export of raw materials in exchange for foreign currency left the country's natural resources in a terrible state. Outdated, improperly-used technology in medicine has also resulted in a huge degree of waste. As a result, the supply of raw materials for Chinese medicines has become ever tighter, with the use of some ingredients being banned for their own preservation. It is a hard industry to make sustainable.

Major causes of waste include the failure to harvest medicinal herbs on time, the damage caused by poor transportation conditions and losses due to heat, moisture, pests and mould. Poor manufacturing processes also result in herbs prepared for decoction that are too thick, or crystals that are too large, affecting the absorption of active components and squandering valuable resources.

There has already been much research and debate on the subject; policies have also been introduced on cultivating new sources of Chinese medicine. But still nothing has been done to reduce this staggering loss of resources. If effective measures are not taken soon, the plight of China’s endangered species will continue to worsen and environmental protection will be held back. Consumers’ desire for “convenience”, the improper use of technology and corporate greed means the situation just keeps getting worse.

Pharmaceutical textbooks tell us that to extract active components efficiently; saturated solutions must be removed and replaced with new solutions for a second and third round of steeping. This increases the amount of work involved and the power consumed. It also lengthens the production cycle and increases costs. When faced with a choice between lowering costs and increasing extraction, the majority of enterprises opt to save money. As a result, huge quantities of active components are thrown away with the “dregs” of the production process – and the quality of the medicine is reduced. This is one reason why mass-produced medicines are not as effective as ones made to order.

A lot of waste is caused by preparations that use only one active ingredient or only one type of ingredient. In some cases, a volatile component may be obtained through distillation, while another water-soluble component is discarded. Granulated preparations have been tested and found not to contain the active components of their raw materials, which have in fact been discarded during the manufacturing process.

Many manufacturers also only extract one chemical from their raw materials, which results in a colossal waste of resources. For instance, companies that manufacture for export extract US$13 million worth of ephedrine from 30,000 tonnes of ephedra annually, 10 times the amount that is used in traditional Chinese medicine. And liquorice root is a similar case. It is clear that the environmental damage caused has little to do with the plants’ traditional use in Chinese medicine.

Another Chinese medicine, recommended for anti-malarial treatments by the World Health Organisation, has a huge market. But once the necessary component has been extracted, antibiotic components are thrown out with the “waste”. Over 5,000 tonnes are wasted annually. The use of resources in Chinese medicine needs to be overseen by a central authority.

Instant preparations

Granulated, instant medicinal preparations first appeared in Japan and Korea before spreading to China. Their convenience has lead to widespread popularity, but animal tests have proved that the pharmaceutical effect of these compound preparations does not equal the sum of their individually-prepared parts. The nature and quality of active components change in the preparation of compound medicines. Instant preparations ignore this key characteristic of Chinese medicine and waste valuable resources.

Decocting machines are also wasteful. The pressure of modern lifestyles means that patients prefer to wait an hour or two for their 200 ml of medicine rather than prepare it themselves at home. The decoction ratio is directly related to the number of decoctions and the amount of solvent. Decocting twice usually extracts 70 to 80% of the active component (although even then, 20 to 30% is left unextracted). If that liquid is then concentrated, the volume of the dose is small and the active components are retained. But decocting machines decoct only once, and always produce 200 to 300 ml of medicine, which means 30 to 50% of the active component is lost. Tragically, this is ignored or covered up for the sake of “convenience” and speed in “modern medicine.”

But preparing Chinese medicine in microscopic powders may be a possible solution to the problem. These powders are prepared by drying, mixing and grinding. They can be taken directly with water, or dissolved for several minutes in hot water. Because powders have a far larger surface area, the rates of dispersion, dissolution and absorption are higher, and allow the digestive system to fully absorb the necessary components. This reduces the necessary dosage and conserves resources. Powdered medicines are similar to preparations used historically in times of war or natural disasters, and that experience provides the theoretical and clinical basis for their use. We now need to research dosages, storage methods and shelf-life of powdered medicines, and implement quality control standards for these preparations.

 

Long Chen is a professor of Chinese medicine.

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Default avatar
匿名 | Anonymous

遗漏的翻译

中医学者和医师Rey Tiquia对本文中遗漏的中文到英文的
翻译部分给予了补充。中外对话在此表示感谢。我们在翻译此文中,因考虑到普通外国读者对中医深厚理论和实际操作的认识和理解的难度,我们对部分段落只简明地做了翻译。需了解有关部分的翻译,请参看英文评论。

感谢Rey等专业人士对我们工作的支持和帮助。

中外对话

Translation Omission

Dear Prof. Dong Chen,

There has been an omission in the translation of the article from

the Chinese into the English text.

“便捷”中药

配方颗粒又叫免煎中药,最初源于日、韩等国,再传至中国。这种使用形式很受欢迎的原因是方便调剂配方和“免煎”,但复方中药的药理作用并不等于其组成药味的简单相加,动物实验表明生脉散合煎抗心肌缺血作用明显强于3药单煎后混合的药效,而且有些药物的合煎有减毒增效作用。这是因为在煎煮过程中药物成分间发生吸附、沉淀、增溶、助溶引起成分质和量的改变,有的药单煎的得量远远低于合煎。显然配方颗粒不仅忽略了中药配伍的特点,而且不同程度地存在浪费药材的问题。

Instant preparations

Granulated, instant medicinal preparations first appeared in Japan and Korea before spreading to China. Their convenience has lead to widespread popularity, but animal tests have proved that the pharmaceutical effect of these compound preparations does not equal the sum of their individually-prepared parts. The nature and quality of active components change in the preparation of compound medicines. Instant preparations ignore this key characteristic of Chinese medicine and waste valuable resources.

Hence, I provided the following translation

Instant preparations

Granulated, instant medicinal preparations first appeared in Japan and Korea before spreading to China. Their convenience has led to its widespread popularity.This type of medicinal preparation has been popular because the individually granulated materia medica facilitates their compounding into a formula and then administered to or by the patient. In addition, there is no need for decocting them. However, the pharmacological effect of a number of Chinese materia medica combined in a formula or prescription 复方中药的药理作用 is not equivalent to simply mixing the individual materia medica together . Animal tests have confirmed that the anti-myocardial ischemic effects of of the traditionally formulated or compounded Sheng Mai San (Pulse Activating Powder ) is markedly efficacious than the three (Ginseng,Lush Winter Wheat and Schisandra Fruit) individually decocted materia medica that has been combined or compounded thereafter. In addition, Chinese materia medica which has been compounded and decocted together has the desired effect of reducing toxicity and enhancing effficacy. This is because of the fact that in the course of decocting the Chinese materia medica, the active (chemical ) ingredients go through the process of mutual absorption, sedimentation,solubisation and co-solubisation and thus brings about certain qualitative changes. In some cases, the value or quality or measure achieved by decocting individual materia medica is far to low compared to decocting the compounded materia medica. As a result, granulated instant medicinal preparations ignores the unique features of traditionally compounding Chinese materia medica . At the same time, it contributes to the problem of wasting valuable Chinese materia medica material resources.
The tradition of Chinese medicine(TCM) has its own
evolving technical language in English . In using this language, we have to differentiate it from the
language of biomedical and chemical science.

Dr. Rey Tiquia Ph.D.

Scholar/Practitioner

Tradition of Chinese Medicine

Member: Doctors for the Environment

Australia

Default avatar
匿名 | Anonymous

没想到

这样的浪费太惊人了!生活越便利,越对环境有伤害,怎么办呢?

I never imagined

This kind of waste is too frightening! The more convenient things get in our daily lives, the more harm it will do to the environment. What can we do?

Default avatar
匿名 | Anonymous

地球和人类

地球正在让人类知道我们的浪费和破坏不会再被忍受了。继续为了理想争斗。不管你住在什么地方。Mark - 美国

Earth and mankind

Earth is letting Mankind know that our waste and destruction will not be tolerated any more.

Keep up the the Fight for What is Right.
No Matter where You are located.

Mark - USA

Default avatar
匿名 | Anonymous

中医弊大于利

中医所引起的环境争议太多了,药材浪费是第一次知道,还这么严重。如此看来,在这个年代搞中医,很容易被环境破坏分子所利用,太难控制。如此发展弊大于利,建议限制中医发展。

Disadvantages of Chinese medicine

Traditional Chinese medicine has brought up many environmental arguments: the waste of resources is the first issue we are aware of, and it is serious. In view of this, the making of Traditional Chinese medicine today is too easily exploited by those who will destroy the environment, and it's too difficult to control. Such developments in Traditional Chinese medicine do more harm than good; hence, it is suggested to restrict it.

Default avatar
匿名 | Anonymous

约翰

请你告诉我实验室的麻黄素的合成。

john

may you please give me the synthesis of ephedrine in the lab