Could Americans Draw a Lesson from the Death of Patients in Japan Because of the Abusive Application of Herbal Formula Xiao Chai Hu Tang

by Kexin Bao, L. Ac.
2712 San Gabreil Boulevard
Rosemead, CA 91770 U.S.A.
Tel.: (626) 288-1199
Fax: (626) 288-4199

In the United States, Traditional Chinese Materia Medica (TCMM, known as herbal medicine) is still officially considered as dietary supplement but not formal medicine. Therefore, no matter whoever is educated in traditional Chinese medicine or not, including someone who was only educated in modern medicine, can practice or prescribe herbal formula. Furthermore, the patients themselves can purchase herbal medicine in the herbs store without any restriction.

About two years ago, the author had a experience in a ginseng store (herbs store). At that time, a customer asked the clerk: do you have herb Xiao Chai Hu Tang for sale. The answer was yes Is this for hepatitis? She asked again. Again the answer was yes. The customer probably purchased several packages of Xiao Chai Hu Tang and left. I am a traditional Chinese medical practitioner. When I heard the conversation, I wanted to explain that the application of traditional Chinese medicine must be performed or directed by a traditional Chinese medical doctor. If the herbal medicine does not fit the disease, not only can the disease not be cured, but may also have harmful side effect, and may even be fatal to the people. However, if I explained it this way at that time, it would possibly have been misunderstood. The customer might consider that I had no business to interfere since the herb was not considered as medicine. The TCMM could be sold, bought and applied without prescription according to the policy of Traditional Chinese Medicine (TCM) in USA. The customer might think that I was wasting my time. As for the seller, he may be unhappy with me because my words might affect his business. It was such a sensitive issue that I could not be involved in them. However, I often take it into my heart and worry about the customer. Nevertheless, I also know that even if I could convince them, I could only do it once. Unless the TCMM policy in the United States can be changed and the practice of traditional Chinese medicine would be restricted in the people who are educated by TCM. Otherwise, it would be useless even I stayed in the store all the time because I could not keep watch over all the herb stores in the United States. I could not change the peoples mind, specially to those who do not believe that there is real a problem or serious side effect if herbal medicine is improperly used. Probably, I was like the man called Qi who was always haunted by the fear that the sky might fall down some day.It is possible to cost a certain price to change this misunderstanding of TCM in the United States.

Just as I expected, the price was paid in Japan instead of in America. In March of 1996, the Ministry of Public Health in Japan released the information that because Xiao Chai Hu Tang was used in the treatment of chronic hepatitis, 88 patients had suffered from interstitial pneumonia, and among them 10 patients died. Over 40 newspapers and televisions in Japan including Asahi Newspaper, Yomiuri Newspaper, Tokyo Newspaper reported this information as the important news. Strong repercussions were evoked in countrywide of Japan.

After this happened, some Japanese scholars wrote to experts in China one after another to discuss this accident. They asked why the Xiao Chai Hu Tang could cause the death of patients, and how to restrict the side effect of Chinese herbal medicine. TCMM experts in China pointed out that the factor causing this accident was because Xiao Chai Hu Tang were prescribed by doctors who had not received formal education and training in TCMM. Those people prescribed the herbal formula based on the advertisements and propaganda material. They did not follow the TCMM theories and methods to apply the Xiao Chai Hu Tang in the treatment. Hepatitis is a term of modern medicine, it has several clinical types based on patients constitution and the stage of hepatitis according to the theories and experience of traditional Chinese medicine. If the clinical type of hepatitis is consistent with the indications of Xiao Chai Hu Tang, it should have no such toxicity or side effect. If the clinical type of hepatitis is not consistent with the indication of Xiao Chai Hu Tang, it could cause a serious problem to the hepatitis patients. Moreover, the type of herbs, the procedure of preparing herbs and the compatibility of the herbal formula should also be taken into consideration. In short, Chinas experts pointed out that TCM is a independent branch of human medicine, it only can be applied by the doctors who have received formal education in TCM. It is just like that if someone who has no modern medical knowledge should not prescribe western materia medica to the patients. Such monstrous absurdity somehow is existing in the United States which has a advanced scientific level. In some areas of the United States, people including modern medical doctors who are not or not properly educated in TCM can legally practice herbal medicine and/or acupuncture, or TCM practitioner and/or acupuncturist can only practice under the supervision of modern medical doctor. It is clear that no good result could be attained by doing this way. However, any negative results caused by this improper way are usually considered as a evidence to doubt the scientific sense of TCM.

This mismanagement of herbs in Japan will probably give a hope that Americans could draw a lesson from the death of patients caused by the abusive application of herbal formula Xiao Chai Hu Tang. If not shed a tear until seeing the coffin, now it is the time to face the problem.

There is no scientific sense that anyone can practice TCM and acupuncture in USA. Also, it is not right that a medical doctor who is not trained in TCM can apply TCM or supervise TCM practitioner and/or acupuncturist. We hope that TCM will be given a proper scientific evaluation and management in very soon future. to Journal of SOTCM General Edition Page