title: Understanding the "Toxicity" of Traditional Chinese Medicine
tags:
- Traditional Chinese Medicine
category: Article
index_img: https://tse1-mm.cn.bing.net/th/id/R-C.ea5e06a79f93aafde832601778b1f2ba?rik=Vm%2b20OcwhINQFQ&riu=http%3a%2f%2fimg3.jiemian.com%2f101%2foriginal%2f20160722%2f146917254819742600.jpg&ehk=FsDlY7SSLYPXz%2flByA1F9g7isMqdr4mPCNhppG3i8%2bA%3d&risl=&pid=ImgRaw&r=0
date: 2021-09-26 15:51:23
summary: With the development of the times, people have entered an era of rapid fragmented information browsing. Accompanied by the Belgian traditional Chinese medicine weight loss incident and the aristolochic acid incident, a group of people with biases against traditional Chinese medicine, known as "anti-TCM," has gradually emerged online, raising doubts about the safety of traditional Chinese medicine. This is inevitable. Compared to modern medicine's chemical drugs, the toxicological mechanisms of traditional Chinese medicine are not entirely clear. It is normal for some people who have not systematically studied traditional Chinese medicine to believe that "traditional Chinese medicine is a scam, and taking traditional Chinese medicine will cause problems." Therefore, explaining the meaning of "toxicity" in traditional Chinese medicine is one of the ways to unravel social public opinion.
1. Is the "toxicity" of traditional Chinese medicine really toxic?#
In traditional Chinese medicine theory, all traditional Chinese medicines have a bias, with cold, heat, warmth, and coolness being their biases. Traditional Chinese medicine emphasizes "treating heat with cold, treating cold with heat, blocking leads to purging, dispersing leads to solidifying," etc. The corresponding medicine should be used for the corresponding symptoms. If a warming medicine is used for a heat syndrome, in most cases, it is no different from taking poison; one cannot expect one plus one to equal zero.
The meaning of toxicity in traditional Chinese medicine should be divided into three types: 1. Traditional meaning of toxicity: referring to the severity of the medicinal properties of the drug, thus also classified as "great toxicity," "toxic," "slight toxicity," and "non-toxic"; 2. Toxicity in traditional Chinese medicine theory: referring to the ability of the drug to treat diseases, all drugs with therapeutic significance can be called toxins. The "Jingyue Quanshu" states: "All that can dispel evil and stabilize the body can be called a toxic drug." The famous Ming dynasty physician Zhang Jingyue believed: "Drugs treat diseases, and toxicity is their ability"; 3. Toxicity under modern research: referring to drugs or extracts that have a small safe dosage, and slightly exceeding the usual amount can cause harm to the human body, even leading to death. Traditional Chinese medicine has always advocated the theory of "using poison to attack poison," where the first "poison" should refer to powerful drugs, not narrowly defined harmful substances.
Many toxic components of traditional Chinese medicine are actually effective components for treating diseases. The late renowned national TCM physician Li Keshan used Aconite, which is toxic, as a lifesaving medicine. He believed, "Aconite is the main general for strengthening the heart, and its toxicity is precisely where the life-saving medicine lies." A 65-year-old male patient had an enlarged heart, could not lie flat, had difficulty breathing, a gray complexion, cold hands beyond the elbows, cold feet beyond the knees, sweating profusely, a red tongue with no coating, a floating, weak, and rapid pulse (260 beats/min), and blood pressure that could not be measured, with a breath that was faint, in critical condition. Li Keshan prescribed three doses of medicine: the first dose contained 200 grams of Aconite, and the condition did not improve; in the second dose, Aconite was increased to 400 grams, slightly stabilizing the condition; in the third dose, Aconite was increased to 500 grams, and the condition began to ease, with limbs warming up, the pulse slowing (90 beats/min), and blood pressure at 160/70 mmHg. After a week of adjustment, the patient was discharged.
2. Talking about toxicity without considering dosage is "playing tricks"#
Whether it is modern chemical drugs or traditional Chinese medicine, or modern traditional Chinese medicine, there are guidelines for medication and dosage control in clinical use. For example, in China, the national pharmacopoeia "Chinese Pharmacopoeia" details the medication standards for various drugs. Moreover, toxic traditional Chinese medicines are not used alone but are combined with other medicinal ingredients to ensure that the overall efficacy of the compound medicine is achieved while minimizing the potential toxicity of individual ingredients. When using medicine, reasonable long boiling and detoxification while retaining efficacy are reliable experiences for many physicians using toxic traditional Chinese medicine. After prolonged boiling, toxic components can be volatilized or hydrolyzed, while effective components can still be retained to exert therapeutic effects. For example, after soaking or boiling Aconite, its effective and toxic components, bisbenzylisoquinoline alkaloids, can be hydrolyzed into less toxic monoester alkaloids or hydrolyzed into almost non-toxic amino alcohol alkaloids, thus preserving efficacy while reducing toxicity. Not only boiling, but also processing and combining traditional Chinese medicine can achieve the effect of reducing or eliminating toxicity and increasing efficacy.
Importantly, whether using toxic or non-toxic traditional Chinese medicine, one should start with a small dosage and gradually increase it, stopping when the condition improves, and not overusing it. Most incidents of bodily harm caused by taking traditional Chinese medicine are due to excessive dosages.
3. Facing the "toxicity" of traditional Chinese medicine squarely#
With the rise of modern medicine, pharmacology has gradually gained importance, while traditional Chinese medicine is often based on empirical use, and pharmacological research is a shortcoming. This has led to criticism of traditional Chinese medicine and has become a major attack point for those against it. The toxicity of traditional Chinese medicine can sometimes be ineffective components, but sometimes it is precisely the active components, such as the highly toxic arsenic. Professor Zhang Tingdong from Harbin Medical University became the pioneer in using arsenic (arsenic trioxide) to treat leukemia in China by studying and utilizing its "toxicity," and has received multiple awards for this. A concept of toxicity should be established for traditional Chinese medicine, with an attitude of safe medication. One should not reduce the dosage below the effective amount in pursuit of safety due to the presence of significant toxicity, leading to a worsening of the condition. Emphasizing and vigorously researching the toxicology of traditional Chinese medicine is one of the essential paths for traditional Chinese medicine to move towards safety and internationalization.
> References:
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> 1. Zhao Juning and Ye Zuguang. "The Scientific Connotation of the Traditional Chinese Medicine Toxicity Grading Theory and Suggestions for the Revision of the 'Chinese Pharmacopoeia' (Part One)." (2012).
> 2. Zhang Shuainán, Li Xuzhao, Lu Fang, & Liu Shumin (2015). New Directions in the Study of Traditional Chinese Medicine Toxicity: Discovery of Potential Toxicity in "Non-toxic" Drugs.
> 3. Chen Shikui (2017). The Innovative Research of Integrating Traditional Chinese and Western Medicine in China and Its Enlightenment (Nine) — Research on the Integration of Traditional Chinese Medicine and Arsenic in the Treatment of Acute Promyelocytic Leukemia by Professor Zhang Tingdong et al.