In the realm of traditional Chinese medicine (TCM), a growing concern is the misalignment between medical practice and pharmaceutical application, leading to what many call "waste medical drugs." This issue persists across various fields of TCM, such as when clinicians prescribe proprietary medicines without proper syndrome differentiation. Additionally, in drug development, many researchers come from medicinal chemistry backgrounds rather than TCM, resulting in a lack of deep understanding of traditional principles. Hospital pharmacists often know only the medicines, not the underlying theories, which further contributes to misuse.
The consequences of this "medicine waste" are severe, potentially leading to a loss of both medicine and medical credibility. Experts have raised concerns that this crisis undermines trust in TCM globally, creating barriers for countries competing in the herbal market. For instance, in the early 1990s, the Hong Kong-made "Slim Pills" caused serious adverse reactions abroad, triggering the Aristolochic Acid Incident. The U.S. FDA banned imports of products containing aristolochic acid, followed by several other countries, causing a global health scare.
Similarly, in 2003, an adverse event involving Longdan Xiegan Pill sparked a credibility crisis in China. The incident shattered the perception that TCM was inherently safer, raising doubts about its safety. The formula of Slim Pills included ingredients like amphetamine and belladonna extract, which did not align with TCM principles. Patients used them for extended periods, violating the TCM concept of "stopping the medicine when the condition improves."
A notable example is the Japanese Xiaochaihu Tang incident. In 1994, the Japanese Ministry of Health recognized its efficacy for liver disease, but later reports of interstitial pneumonia led to a ban. This event significantly impacted the production and sales of Hanfang preparations in Japan, highlighting the dangers of neglecting TCM theory in drug use.
Experts like Wang Zhimin emphasize that while pharmacological research is important, it should not overshadow the need for theoretical guidance. Modernizing TCM requires more than just scientific validation—it demands a deeper integration of medical theory. Without this, TCM risks being reduced to mere botanical medicine, losing its unique advantages.
Education also plays a crucial role. Today, doctors and pharmacists often work in silos, unlike in the past when they were unified. Zhang Daning, dean of the Tianjin Institute of Traditional Chinese Medicine, stresses that TCM is a holistic science, where theory and practice must go hand in hand. He suggests reforms in education, such as increasing training in both clinical and theoretical aspects, to bridge this gap.
Ultimately, the future of TCM depends on balancing innovation with tradition, ensuring that modernization does not come at the cost of its foundational principles. Only then can it maintain its place as a respected and effective system of medicine worldwide.
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