The Ben Cao Gang Mu - Compendium of Materia Medica

The Ben Cao Gang Mu - Compendium of Materia Medica


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The Ben Cao Gang Mu is an encyclopaedic compendium written by LI Shi-zhen (1518-1593), a Chinese doctor who lived during the Ming Dynasty (1368-1644). This compendium is said to be the most complete and comprehensive medical book ever written in the history of traditional Chinese medicine. Besides being a book on medicine, it also deals with natural history, giving a classification of mineral, vegetable, and animal products. If this were not enough, this piece of work has chapters on chemical and industrial technology, as well as geographical, historical, dietetic, culinary, cosmological, philosophical, and philological data. This incredible piece of work, which contains 52 volumes, took 27 years to complete.

In 2011, the Ben Cao Gang Mu received global recognition when it was included in UNESCO’s Memory of the World Register. A copy of the compendium that was block-printed in 1593 by Hu Cheng-Long in Jinling (modern Nanjin city in Jiansu Province, China), is kept in the Library of the China Academy of Chinese Medical Sciences. So, why is the Ben Cao Gang Mu so important?

It has been claimed that this piece of work, and the empirical approach employed by Li in his research and fieldwork have profoundly influenced the development and study of modern natural science. For instance, classification standards and the way materia medica should be compiled and formatted were laid down for the first time. This has been crucial in enhancing the credibility, scientific value, and accuracy of the biological classification of both flora and fauna. Its importance is also evident in the fact that it has been translated into all the languages of the Far East, as well as the principal Western languages. Despite being over 400 years old, the Ben Cao Gang Mu is still being used as a monumental reference work. Thus, the longevity of this work and its influence beyond the borders of its land of origin demonstrates that this was an incredible achievement.

Nevertheless, there are some notable factual errors in the Ben Cao Gang Mu . For instance, lead was claimed to be non-toxic, otters are “always male”, and the Moupin langur is ten feet tall, has backwards feet and can be caught when it draws its upper lip over its eyes. These errors, however, may be attributed to the limitations of scientific and technical knowledge of the time. Fortunately, they have been corrected. I suppose this demonstrates the cumulative nature of human knowledge, which one generation builds upon the achievements of its predecessors. It is this process of accumulation that has allowed us to attain the technological progress that we enjoy today.

Taking its name from the original masterpiece, the Ben Cao Gang Mu was performed by the popular Taiwanese singer Jay Chow in his album Still Fantasy . While its lyrics deal with Chinese pride, the aspect of the song I found most amusing was that Jay Chow rapped his way through the references to Chinese herbal medicine!

So, anyone up for rapping Pliny’s Natural History ?

Featured image: The Ben Cao Gang Mu (Compendium of Material Medica). Photo source.

By Ḏḥwty

References

Huard, P. & Wong, M., 1968. Chinese Medicine. London: Weidenfeld and Nicolson.

justsomelyrics.com, 2014. Jay Chou Ben Cao Gang Mu (A Herbalist's Manual) Lyrics. [Online]
Available at: http://www.justsomelyrics.com/949060/jay-chou-ben-cao-gang-mu-(a-herbalist's-manual)-lyrics.html
[Accessed 16 April 2014].

UNESCO, 2014. Ben Cao Gang Mu ( 《本草纲目》 Compendium of Materia Medica). [Online]
Available here.
[Accessed 16 April 2014].

Wikipedia, 2014. Compendium of Materia Medica. [Online]
Available at: http://en.wikipedia.org/wiki/Compendium_of_Materia_Medica
[Accessed 16 April 2014].


Ben Cao Gang Mu English Pdf

Persons and literary sources for ipad 1. This compendium is said to be the most complete and comprehensive medical book ever written in the history of traditional chinese medicine.

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All books are in clear copy here and all files are secure so dont worry about it.

Ben cao gang mu english pdf. The work in 52 juan of text and two juan of illustrations consists of 1892 entries 374 of them added by the author and compiler li shizhen 151893. Printed during the wanli period ben cao gang mu compendium of materia medica is a work on an encyclopedic scale in 52 juan of text with two juan of illustrations in 25 volumes. Download bencao gangmu or read online here in pdf or epub.

The ben cao gang mu compiled in the second half of the sixteenth century by a team led by the physician li shizhen 1518 1593 on the basis of previously published books and contemporary knowledge is the largest encyclopedia of natural history in a long tradition of chinese materia medica works. The compendium of materia medica also known by the romanizations bencao gangmu or pen tsao kang mu is a chinese herbology volume written by li shizhen during the ming dynasty. It is a work epitomizing the materia medica known at the time.

Compiled and written by li shi zhen 15181593 a medical expert of the ming dynasty 1368 1644 over a period of. It was compiled by li shizhen circa 151893 a native of sichuan who was one of the greatest physicians pharmacologists and naturalists in chinese history. Free pdf dictionary of the ben cao gang mu volume 3.

The ben cao gang mu is an encyclopaedic compendium written by li shi zhen 1518 1593 a chinese doctor who lived during the ming dynasty 1368 1644. Persons and literary sources for ipad. This site is like a library you could find million book here by using search box in the widget.

Ben cao gang mu compendium of materia medica is is the most complete and comprehensive medical book ever written in the history of traditional chinese medicine. Theben cao gang mu compiled in the second half of the sixteenth century by a team led by the physician li shizhen 1518 1593 on the basis of previously published books and contemporary knowledge is the largest encyclopedia of natural history in a long tradition of chinese materia medica worksits description of almost 1900 pharmaceutically used natural and man made. Free pdf dictionary of the ben cao gang mu volume 3.

Please click button to get bencao gangmu book now. Ben cao gang mu compendium of materia medica is a systematic encyclopedia of traditional chinese medicine before the 16th century. Its first draft was completed in 1578.

The ben cao gang mu project this is the first volume of a project aimed at providing better access to the ben cao gang mu bcgm chinas great encyclopedia of pharmaceutical lore first published in 1598 and designated a world cultural heritage in 2012.

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Chinese Medical Classics

The Yellow Emperor's Internal Classic

The Yellow Emperor's Internal Classic, or Internal Classic for short, whose author is unknown, is the earliest medical classic in China,and it&rsquos one of the great four traditional medical classics in China, the other three are Nan Jing (Canon On Eighty-One Difficult Issues), Treatise on Febrile Diseases , and Shennong Classic of Materia Medica.

It includes two parts: Plain Question and Acupuncture Classic, each of which comprises 9 volumes. The 18 volumes originally consist of 162 articles, even though some of the chapters have been lost with the lapse of time. In a question-and-answer format, Plain Question recounts the discussion between the Yellow Emperor and his royal physician Qi Bo. It mainly sets forth the basic theories of physiology and pathology of the human body. Acupuncture Classic dwells upon acupuncture and moxibustion, main and collateral channels as well as hygiene and health care.


Traditional Chinese Medicine Book

Internal Classic lays the foundation for the theoretical systems of traditional Chinese medicine, which has long guided the clinical practice of Chinese medicine and played an important role in China&rsquos medical history. It has great significance both inside and outside China. Parts of the book have been translated into Japanese, English, German and French. Many treatises on Internal Classic have been published in Japan.
Compendium of Materia Medica (Ben Cao Gang Mu)

Compendium of Materia Medica is another great medical work in China, created by great doctor Li Shizhen in Ming Dynasty (1368 AD-1644 AD). Recorded in the 1.9-milions-words, 52-chapters, and 16-volumes are 1.897 varieties of medicines grouped under 60 categories. All the recorded medicines were in actual application and have proved effective by the author's time. Besides Chinese herbal medicine, they include animals and minerals for medication. In addition, the book contains 11,096 prescriptions and 1,160 illustrations. Such enormous contents enable the book to be the greatest treatise of material medica in history.


Traditional Cinese Medicine Book

Compendium of Materia Medica is more than a masterpiece of pharmaceutics, as it has also contributed to the human knowledge of biology, mineralogy and chemistry.

Compendium of Materia Medica spread to Japan in 1606, then to Korea and Vietnam, and later to Europe around the 16th and 17th centuries. The book is now available either in whole or in excerpts in Latin, French, German, English, Russian and other languages. The world famous scientist Charles Darwin once consulted the book for historical data on the formation of skin colors of gold fish to demonstrate the artificial selection process of animals and gave high comments on it.
Prescriptions Worth a Thousand Pieces of Gold for Emergencies

Beiji Qianjin Yaofang (Prescriptions Worth a Thousand Pieces of Gold for Emergencies), also called Qianjin Fang (Precious Prescriptions for Emergencies) or Qianjin Yaofang, was edited by Sun Simiao in the year 652. As Sun Simiao said, "Human life is of paramount importance, more precious than a thousand pieces of gold to save it with one prescription is to show your great virtue", thus, 'gold" is used in the name of the book.

From the Tang Dynasty (618-907) to the modern time, Beiji Qianjin Yaofang has had more than 40 versions at home and abroad, which are roughly divided into two categories.


Taditional Chinese Medicine Book

The book is in 30 volumes. Volume 1 is the pandect of medical science, including medical ethics, materia medica, pharmacy and so on Volume 2-4 are on gynecopathy Volume 5 on pediatrics Volume 6 on diseases of the seven orifices Volume 7-8 on dermatophytosis of all kinds Volume 9-10 on febrile diseases caused by cold Volume 11-20 on viscera diseases Volume 21 on diabetes and similar diseases Volume 22 on skin and external diseases Volume 23 on hemorrhoid Volume 24 on disintoxicating and various treatments Volume 25 on techniques for emergencies Volume 26-27 on dietetic therapy and cultivation of mental poise Volume 28 on normal pulse and Volumes 29-30 on acupuncture and moxibustion. There are totally 233 categories, containing more than 5,300 articles. It has set up the format for compilation of prescriptions.

A systematic summing-up of the accomplishments in medical science was concluded in this book before the Tang Dynasty. Its sources are extensive and its contents are abundant, covering all clinical sectors and many aspects such as acupuncture and moxibustion, dietetic therapy, medicament, prevention, hygiene and so on. It is the first comprehensive monumental works of medical science in China, another conclusion of Chinese medicine after Treatise on Febrile Diseases Caused by Cold and Miscellaneous Diseases by Zhang Zhongjing, and is praised as the earliest encyclopedia of clinical medicine in the Chinese history.


The Ben Cao Gang Mu - Compendium of Materia Medica - History

Contact your nearest poison control center in the US or Canada, emergency room, or your physician.
US Poison Control:1-800-222-1222

Promoting, pursuing and advancing the science of mycology

LING ZHI, Ganoderma lucidum,the Chinese Mushroom of Immortality

By Dianna SmithChair of NAMA&rsquos Medicinal Mushroom Committee

The history of classic medicine in pre-modern China is extremely rich and complex. It is intimately associated with long-standing beliefs and hygienic practices 1 of the political elite, scholars, powerful landowners, merchants and the many specialists that catered to the physical and psychological health of the privileged during their lives and afterward. Some were founded on quasi-religious or mystical ideas and superstitions, focused on living a balanced life that incorporated consumption of a wide-variety of health promoting foods in moderation and in accordance with their seasonal and regional availability. Others were based on interpretations of an integrated theory of cosmological change systematized during the Later Han Dynasty that tied the synchronization of political, social and health activities and ideals to the celestial movements and natural observable changes that occurred over the course of the seasons. During the Han Dynastic period (202 BC &ndash 9 AD 25 AD &ndash 220 AD), classical medical theory was developed in a hierarchically defined, authoritarian socio-political culture dependent upon the labor of a rural peasantry to feed many urban centers and maintain infrastructure to ensure the continued existence of the reigning dynastic family. It reflected the ideals of the entitled and the desire of at least some Han Dynasty political advisers to establish control over the whims of tyrannical rulers. It entailed sociopolitical ideals that would become manifest in a world united by compliance to rituals honoring Heaven, Earth and Man, moderation in all activities, and respectful obedience to the ruler, the ancestors, the family elders and particularly the laws of nature. 2 Deviations from the norm, whether from an emperor&rsquos or a commoner&rsquos misbehavior, resulted in social uprisings, political chaos, war, widespread illness and famine. Restoration to order and health required compliance to the laws of nature and the adoption of behavioral and dietary practices as recommended by sagely physicians. If unheeded, irregularities would transform into more virulent disorders from which one would perish before reaching one&rsquos predetermined life-span of one hundred years. (Most Chinese men, it was said, die by age 50. Most Chinese women died by 49). 3 Controlling one&rsquos fate, reputation and legacy required following recommended rituals throughout the year by the emperor and the people. These were designed to maintain order, appease ancestors, show respect for authority, and prolong one&rsquos natural life-span of one hundred years with continued physical and emotional vigor. Failure to do so in an exemplary manner, would invite Heaven&rsquos wrath causing earthquakes, invasions, epidemics, uprisings and famine which resulted in the ruler to losing the Mandate of Heaven.

There were others, especially ardent followers of numerous Taoist sects, who were less interested in being compliant with patterning their lives after behavioral norms proposed by dictates of Confucian-Legalist government authorities. Their numbers grew in times of war, famine and other catastrophes and they were often suspect in being associated with political rebellions. 4 Some sought to make the most of circumstances that threatened survival. They found refuge in uninhabited mountainous regions south of the Yangtze River. There they searched for foods and medicines consisting of its unfamiliar plants, insects, colorful stones, minerals, metals and fungi to sustain and to cultivate themselves physically and spiritually. Cut off from access to grains and rice, the basic foods of the masses, they ate no starches, fish or pungently favored foods, and intentionally fasted for days at a time. They practiced purification rites, and sought to lengthen their lives or better yet, become spiritual beings by creating elixirs of immortality. Quite a few even envisioned sustaining themselves in perpetuity as etherealized god-like spirits. Many methods and recipes were developed over the centuries to achieve these lofty ambitions and they appealed to anyone willing to devote their entire lives to spiritual self-cultivation. Some of these men were at least partly responsible for fostering the adoption and use of many of the drugs employed in China&rsquos corpus of pharmaceutics in the past and in the present. In fact, some attained reputations for living hundreds of years and knowing exactly where these secret immortality substances could be found. Emperors were especially desirous of locating and rewarding shamans, doctors, and other wizardly men and women to find and make the elixirs spoken of in legendary tales in hopes of becoming immortal.


Shennong chewing a branch (1503). The short horns on his head are a consequence of his acquiring a feature of immortal tortoises. Painting by Guo Xu (1456-1529). Shennong is the mythological ancestor of Chinese medicine and is called the Divine Farmer and a Sage King. In addition to inventing the plow, the hoe, the axe and various other items of civilization, he is credited with teaching the people farming practices, irrigation techniques, how to dig wells, and how to preserve and store food. He is also said to have personally tested hundreds herbal drugs for the benefit of the people. The legendary Yellow Emperor, Huang Di, believed to be his son, is known for inventing wheeled chariots, astronomy, the compass, the calendar and is known for promoting the secrets of dietetics, immortality and golden elixirs. He is believed to be an Immortal.

Given the esteem in which fungiphiles especially hold on &lsquomedicinal fungi&rsquo longevity drugs like Ganoderma ling zhi, you may be thinking these immortality substances consisted mainly of fungi and certain herbs. Most popular books and articles &ndash even those by Chinese medical researchers writing about the potential medicinal compounds found in Ganoderma ling zhi - are insistent on convincing us this is a fact. Belief in the antiquity of use is somehow supposed to make this polypore more acceptable as a an empirically verified scientific medicine. This is unfortunate. Certainly, there are numerous fungi used in Chinese cooking, which are also recommended for maintaining health and even enhancing it if not in tip-top shape. However, it is impossible to find supporting evidence that Ganoderma ling zhi has a two to seven-thousand-year history of use in China. Despite the often-repeated passages regarding its antiquity of use, it is not in fact mentioned in any original Chinese medical source prior to recent times, and it certainly was never recommended as a cure for heart disease or cancer!

There are just two references to which scholars and researchers of Chinese medicinals point when they declare that Ganoderma ling zhi had been used from early imperial times onward. The first was recorded during the Han dynasty (206 BC &ndash 9 AD). In a prose poem about the mythical Islands of the Immortals called &ldquoWestern Metropolis Rhapsody&rdquo, Zhang Heng (AD 78-139) wrote:

Precisely what the terms &lsquostone mushrooms&rsquo referred to is seriously open to question. Despite its possible later association with a species of Ganoderma from the late fifteenth century onward, no one can be certain that the characters referred to the polypore in its earliest documented reference. 6 According to Xue Zong, a scholar and high official of the state of Eastern Wu during between 220s to 243, the characters dan zhi referred to drugs of immortality.

Today the character for zhi means fungus or lichen or an iris. Two thousand years ago, however, it referred to a variety of super mundane substances often described as immortality substances. Depending on the historical period in which it was used, the term denoted different substances made from minerals, precious stones, petrified fossils, lichens and fungi. The following passage, however, is the one usually referred to when authors and researchers mention the long use of Ganoderma lucidum in China. It consists of this translated passage the from Huang Di Nei Jing, also known as The Yellow Emperor&rsquos Classic of Health, which is believed to have been compiled during the second half of the Han Dynasty.

The &lsquotiny excrescences&rsquo or zhi referred to above refer to a variety of &lsquoauspicious&rsquo spiritual substances in the earliest dictionaries. In medicine, they have the power to confer immortality. Generally, they refer to substances that have charismatic powers of transcendence. 8 In other words, the square-spoonful of dried substances which conferred on the Taoist at least a thousand years of life, or even immortality definitely was not ground-up Ganoderma!

Might the author have been referring to hallucinogenic mushrooms, such as Gymnopilus junonius, or even hallucinogenic plants, which some groups of Taoist alchemists are known to have used? 9 Joseph Needham mentions an illustrated Liang dynasty (502-587) publication called &ldquoOn the Planting and Cultivation of Magic Mushrooms&rdquo, which unfortunately is no longer extant. 10 So it is possible, but it is difficult to believe that even a hallucinogenic out of body experience would result in the proliferation of so many writings laying out the detailed ritual and material requirements of achieving everlasting immortality by standing over a continuously glowing crucible of metallic liquid.

What were immortality elixirs made of?
The earliest Immortality elixirs were not made with herbs or fungi. Herbs could only provide longevity. After all, they turned to ash when cooked or rotted when allowed to naturally decompose. The ingredients employed for forging a physical compound through metallurgical processes to fashion Pills of Immortality were durable, long-lasting substances not subject to decay. They were a class of supernatural drugs made from metals, minerals, stones and pearls. These could be ground up and melted down and transformed in the caldrons of seekers of immortality. According to Ge Hong (284-363), who wrote a book on emergency medicine, Zhou hou beiji fang (Handbook of Prescriptions for Emergency), the superior medicine is cinnabar, followed by yellow gold, white silver, the various excrescences, the five jades, followed by mica, pearls, realgar, Limonite, Burnet, quartz, and softer metals&hellip.. 11


Cinnabar has been used both in alchemical formulas and in Chinese medicines. Depending on the quantity consumed, the recipient may initially experience a sense of relaxation and mild euphoria. Patients taking medicines made with the mercury ore can live many years before eventually experiencing severe kidney malfunction.

Taoist adherents engaged in ritualized alchemical practices involving the manufacture of a golden elixir out of cinnabar, mercury, realgar (disulphide of arsenic), salts, orpiment and sulphur in crucibles kept going over fires for many years at a time. Some elixirs were said to be so potent that lost teeth would regrow, and white hair would become black again. Immortals could also walk on water, ice or snow, become invisible at will, change form and travel the heavens and earth without being hampered. These powers were known through ancient stories to have been achieved by the mythical adepts who lived in the depths of legendary time. Devotees aimed to become so light that they would dematerialize. 12 They ate so little that they occasionally wrote about seeing ghosts and gods. The metallic compounds and particularly arsenic breathed in while cooking their preparations may have been accompanied by hallucinations. Drinking the elixir over time probably also prevented their bodies from decomposing as they would if they died naturally. 13

The practice of consuming mineral elixirs was mainly carried out by rulers and the well-to-do, who had the ability to procure expensive substances employed to make golden elixirs of immortality. Emperors, like many of the rest of us, were concerned, especially toward the end of their lives with prolonging their existence forever. Like most human beings, emperors preferred to take short-cuts in hopes of getting instant results. Theoretically, all that was required was that while living, the ruler perform the prescribed annual rituals and govern in accordance with the Tao and Confucian principles. 14 After all, why give up all the pleasures of exotic foods, wines and an unlimited number of beautiful concubines too before one reached old age to take magical substances that promised eternal life?

The first emperor of a unified empire was the Chin Dynasty (221 &ndash 206 BC) Emperor Shi Huang (259 - 210 BC), the first of numerous subsequent rulers obsessed with finding and taking an elixir of immortality. According to legend, well before Shi Huang Di declared himself emperor of China&rsquos first unified empire, he allegedly met a thousand-year-old wizard who invited him to come to the mythical Penglai mountain, a mystical island to imbibe on its immortality substances. The Taoist spirits were said to be living there in gold and platinum palaces surrounded by magical fauna, flora and stone-shaped mushrooms as well as ancient trees with branches that dripped with colorful jewels. After trying three times to find it, in 219 BC he sent Xu Fu and an armada of ships out to sea filled with hundreds of young boys and girls to collect the treasured antidote to death. They never returned.

At the virtual end of his life, he was in eastern China on another search for the elixir. He is supposed to have drunk the golden alchemical elixir and died of mercury poisoning. 15 He was buried with a life-sized terracotta army of 2,000 individual soldiers, stone and bronze horses, chariots, weapons, incense burners and mirrors. His tomb also held the sacrificed bodies of his concubines who never bore him a son, so he would have their companionship and heirs in the afterlife. 16 Bodies were often buried with a large amount of mercury in the form of rivers and lakes, a key ingredient of immortality drugs. Mercury served to prevent decomposition. The body of a 2100-year old wife of a Han Dynasty leader represents the best-preserved mummy ever found anywhere in the world. 17

Although there are no historical records in existence of any Chinese emperor managing to actually attain a life of either a hundred years - or - immortality, as we have seen several are infamous for going to extraordinary lengths to procure and create magical substances that promised to protract and even perpetuate their lives forever. Immortality drugs were consumed in preparation for ascending to the celestial firmament as a winged immortal. An ultimate and &lsquoideal&rsquo goal of emperors, theoretically at least, was to rule at the center of an orderly celestial government centered at the pole star. 18 It would be managed by loyal, righteous and ethical spirit-bureaucrats and protected by strong defending celestial armies.

Legendary tales of miraculous elixirs suggested this was a goal that could be attained. Imperial chroniclers reasoned that emperors who consumed these substances were too worldly, too immoderate, too acquisitive, too connected to the here and now to become immortals. They all failed to become spirits and were poisoned instead, presumably because they were unworthy. In fact, of the 66% who were not murdered or who died by suicide, 82 out of 88 emperors who died early in life had a history of overindulgence in drinking or/and sex and died between 31.4 and 38.6 years of age depending on the mode of extravagance. This contrasts with the mere six out of 240 emperors who managed to live an average of 81 years (range: 69-89).

By the ninth and tenth century, many Taoist alchemists started to look for antidotes to elixir poisoning resulting from consuming toxic metals. Others abandoned the attempt to attain physical and/or immaterial immortality altogether and focused instead on internal &lsquoalchemy&rsquo. It supposedly led to longevity, if not immortality. It involved less expense as no materials were required. There were many different &lsquoschools&rsquo, but most involved complex embryonic breathing exercises, gymnastic calisthenics, and sexual techniques requiring retention of semen (primal-quintessential life). The visual and temporal terminology used to describe the processes necessary to achieve longevity through controlled breathing practices were borrowed from that of the metallurgical alchemists. This method also required many years of diligent practice for those who hoped to achieve a long life. There nevertheless continued to be others who persisted in the attempt to live forever by taking dangerous immortality drugs in the Sung Dynasty period (960&ndash1279) and even up through the eighteenth century. Kuo Zongshi, who worked as a minor official as Drug Inspector for the Imperial Medical Service during the Sung, wrote Dilatations on Materia Medica (Bencao yanyi) in which he discussed the functions and traits of what he considered were the most important drugs. He criticized the continued practice of popular healers&rsquo promotion of longevity drugs:

His conservative &mdash more Confucian &mdash and practical philosophy of medicine follows that expressed in earlier classical canonical literature in reminding physicians that they should not treat those already ill, but instead treat them with education on maintaining health before they are sick. &ldquoDispensing drugs in a perfect way is not as good as maintaining health.&rdquo 20

The (1444) Ming Dynasty edition of the Taoist Canon mentions 127 varieties of immortality drugs in the chapter entitled "Classifications of the Most High Divine Treasure Mushroom Plant". A Ming reprint from 1598 includes woodblock pictures of them. Most are herbs that are also employed in many commonly used prescriptions for a variety of diseases. Some of them could elicit hallucinations &ndash including Cannabis sativa, Datura stramonium, Phytolacca acinosa (poke weed) and Gymnopus junonius (The latter may be a different species, but it was known as the &lsquolaughing mushroom&rsquo). I find it interesting that the book illustrates several cap and stem mushrooms - possibly hallucinogenic, as well as edible fungi still widely used and revered in Chinese cooking (Tremella fuciformis, Auricularia sp., and Polyporus umbellatus). However, there is no representation of a strain of any species of Ganoderma, life-extending or not. 21

Li Shizhen&rsquos Ben cao Gang mu (Compendium of Materia Medica) from 1596 discusses the six differently colored immortality excrescences or zhi (green, red, yellow, white, black, and purple) written about in the no longer extant Han medical classic, Shennong ben cao. Again, the term Ling zhi is not listed, but he relates the effects of Chi zhi, the "red mushroom." 22 Li Shizhen reports that early sources say it &ldquoaffects the life-energy (ch&rsquoi) of the heart region, repairing and benefiting those with a knotted and tight chest. Taken over a long period of time, agility of the body will not cease, and the years are lengthened to those of the Immortals.&rdquo 23 Interestingly, the chi zhi or "red mushroom" is also associated in his mind with dan zhi, the Cinnabar immortality substance, which is also called the &ldquostone mushroom&rdquo. 24

The term zhi, interestingly, is often also used with plant names where it means &lsquoseed&rsquo. By the late sixteenth century, the term zhi referred mainly to a variety of plants, fungi, lichens and excrescences. At this point in time, the red fungus currently called Ganoderma ling zhi seems to be suddenly and fairly reliably associated with the polypore in question. But, like most 21 st century authors, Li Shizhen of the late sixteenth and early seventeenth century believed that the red immortality substance that was mentioned in the 2,000-year-old classic is the same as the one the Ming Dynasty emperors accepted as symbolic of their reign.

In any case, the polypore retained all the associations previously assigned to things that are red: the emperor in politics the heart in medicine cinnabar (the # 1 supernatural medicine), the red ore that releases silvery blobs of toxic mercury upon heating and which was still used in royal immortality recipes fire the sun summer noon heat growth expansive energy circulation the planet Mars happiness joy laughter long life vitality money prosperity good luck the south marriage the bridal color cherry blossoms red carnations peaches a musical note mythical flying birds fertility bitter taste and scorching odors among a plethora of similar correspondences. 24

In an effort to convince us of its medicinal efficacy, modern authors are fond of discussing its symbolism as a feature of Chinese imperial art and architecture over many thousands of years:

To be perfectly clear, the decorative art referred to in the preceding passage was not a feature of any imperial period until the Ming Dynasty (1368&ndash1644). Contrary to the impression given by writers of the popular book and movement called Radical Mycology, Beijing was not the capital city of China throughout its imperial history. It first became the capital of the empire after the Mongol ruler Kublai Khan installed himself in the northeastern corner as emperor of the Yuan Dynasty (1279-1368). Following the overthrow of the Yuan, the third Ming dynasty ruler, Zhu Di, moved his capital from Nanking to Beijing in 1420 with the goal of deterring renewed threats of invasion from his foreign predecessors. It was built from 1406-1420 on the ruins of the former Yuan Forbidden City with the aid of Chinese architects, engineers, stone masons, brick-layers and at least a million workers ordered to take down the Phoebe zhennon forests in the southwest to build the capital city from scratch. Incidentally, the first Ming ruler was reported to have sent out envoys into various mountains to find Zhang Sanfeng, a renowned Taoist immortal, to offer him a post in the royal court. It was said he went into hiding until their departure. The third emperor Cheng Zu also tried to find him, but it was rumored he escaped by pretending to be a beggar. Others claimed he ascended to the sky. The emperor honored him by building a Taoist monastery on Wu Dang Mountain in 1420. All the Ming rulers admired him. 26


Mountain-Dragon-Cloud motif represents the emperor and imperial power. The source of frequently repeated assertions that Ganoderma Ling-zhi is prominently depicted in sculpture and buildings of Beijing&rsquos Forbidden City is Terry Willard, Ph.D., a naturopath, herbal healer, founder of the Mind Body Institute&rsquos Wild Rose College of Natural Healing and author of Reishi Mushroom: Herb of Spiritual Potency and Medical Wonder, Sylvan Press Issaquah WA, 1990. In visiting the imperial city and museums in June of 2019, I found it questionable the cloud design was representative of Ganoderma.

Exactly when or if the image of a Ganoderma appeared on buildings and palace furniture during the Ming isn&rsquot clear. But there was a renewed interest in pursuing some of the Daoist longevity practices once the political situation settled. The painting by Chen Hongshou (1598&ndash1652) of a fully realized Taoist adept sitting on a cloud holding a Ganoderma in hand is among the most famous.

This, coincidentally, is also about the time we see first see the polypore represented in Japanese art. As in China, it is treated as a symbol of good luck, health and longevity. The art of 500-600 hundred years ago in China or Japan is definitely not contemporary, but it also isn&rsquot exactly &lsquoancient&rsquo either. In any case, in the fifteenth century the fungus was considered rare and only the emperor was permitted to possess it. It is revealing that Ming emperor, Jia-Jing, who ruled from 1521 to 1567, looking to prolong his life forever, did not take the so-called &lsquoKing of Herbs&rsquo or &lsquoImmortality Drug&rsquo, the Ganoderma mentioned in the Ming Compendium of Materia Medica. Rather, at the recommendation of his physician, he ate and drank from vessels made from alchemical gold and silver and like rulers before him suddenly died of poisoning. 27 The last known emperor to have taken immortality drugs was Yong-cheng of the Ching Dynasty (1636-1912). He ruled from 1722 until his sudden death also from metallic-mineral elixir poisoning in 1735. 28 In other words, Ganoderma lucidum, was not employed as a medicine, or as a longevity drug even for emperors.

Basically, there is a lack of recorded evidence that Ganoderma ling-zhi (or any of the several other species of Ganoderma known to exist in the Chinese empire) was ever employed as a longevity or immortality substance prior to the late twentieth century. By then, the wealthy paid a fortune to procure Ganoderma from all parts of the world. The fact that it had previously been forbidden to commoners, made it especially valuable and a sign of one&rsquos exalted economic and socio-political station in life. Attempts to cultivate Ling-zhi to be used medicinally by the Chinese began in the late 1960&rsquos, but its first successful cultivation in China was in 1992. Thereafter techniques of cultivating the polypore were transmitted all across China and its use has rapidly spread throughout Asia and elsewhere. Thanks to the continued desire to &lsquoself-medicate&rsquo with ancient supplements associated with happiness, wealth and longevity and to the proficient marketing techniques of Chinese pharmacists, nearly everyone today knows of its alleged energizing, health promoting, preventative and curative powers. 29

Despite the frequently mentioned use of Ganoderma lucidum (G. ling-zhi) in &lsquoancient China&rsquo to cure cancer, 30 there is absolutely no evidence to back up this assertion. No pharmaceutical prescription was ever created specifically for cancers! There was not even a word for cancer in the Chinese literature until the late twentieth century. Its absence doesn&rsquot mean cancer didn&rsquot exist. It just was not recognized as a distinct disease. In fact, none of our modern disease concepts match those described in pre-modern Chinese books on medicine, theory or drugs. But had there been a recognized disease condition representing life-threatening cancers or any other debilitating pathogenic process, Ganoderma ling zhi would definitely not have been the drug of choice prescribed to treat or cure it. As a so-called &lsquosuperior&rsquo drug, it would not even have been considered robust enough to fight the effects of a growth that made it difficult for the patient to breathe. A patient diagnosed with potentially terminal illnesses would have been prescribed a combination of militant &ndash even toxic ingredients to fight his condition &ndash or nothing at all. 31


Historical and Contemporary Use in Japan and Korea.

Historically, the traditional medical practices of Japan and Korea were greatly influenced by classical Chinese culture and medicine. Many of the prominent early medical works from China were quickly exported and translated into Japanese and Korean, including the Tang materia medica/ Xin Xiu Ben Cao and the Compendium of Materia Medica. These texts both enriched the medical theories of those countries and positively influenced the health of the populations. Throughout history and into today, the traditional medicines of Japan, North, and South Korea have been heavily influenced by classical and Traditional Chinese medicine.

Similar to China, Pine Pollen has a long history of use in Japan. In early Japan, it was first used as a panacea of sorts, treating many diseases throughout both Japanese royalty and the common classes. Looking back at historical treatment logs, it is clear that Pine Pollen was being prescribed in Japan according to the classic Chinese texts. Additionally, records show that ancient Japanese were consuming it as a food and medicine, aside from prescriptions from the medical text. This is especially true of people from the Japanese Ibaraki Prefecture, who have a long history using Pine Pollen. An ancient saying in Japan translates to &ldquoThe softness of pollen is even superior to rice, cotton, and rabbit fur.&rdquo

Today, Pine Pollen is even more popular in Japan than it was historically. Within the medical field, it has enjoyed positive scientific research. Doctor Saito of the Urology Department Nagasaki University, Japan, specifically has researched the medicinal application of Pine Pollen for treating male urological diseases and illnesses, including as a treatment for prostate disease.

Other Japanese medical research into Pine Pollen has studied its anti-aging effects, including reversal of graying hair and promoting hair regrowth after loss due to age (androgenic alopecia). According to the research, these results are shown after approximately half a year of use. In contemporary Japan, it is also used as a beauty aid for lightening scars and freckles and is referred to as &ldquoThe source of beauty&rdquo.

Pine Pollen is also used as a food in contemporary Japan. Pine Pollen Powder Cold Noodles has been a featured dish at many Japanese, highlighting the importance of Pine Pollen in Japan.

Similar to Japan, Korea (present day North and South Korea) also has both historical and contemporary use of Pine Pollen.

The famous Korean medical work Dongui Bogam was compiled by the royal physician Heo Jun (1539 &ndash 1615, and was first published in 1613 during the Joseon Dynasty of Korea. Historically, South Korea and North Korea were a unified whole under the Joseon Dynasty. The Joseon Dynasty (also known as the Chosun, or Li Dynasty). The Li Dynasty ruled over the Korean peninsula from 1392 to 1910&mdash519 years. And during this period The Dongui Bogam as mentioned, was written during this time period, and was one of the most important medical texts to come out of the Dynasty. The title of the text literally means &ldquoMirror of Eastern Medicine,&rdquo which, to put it lightly, makes reference to the deep, fundamental influence that Chinese medicine had on Korean medicine.

The original Dongui Bogam was written in Chinese and only fragments of it was transcribed into Korean for popular use by common Koreans, as only the elite were fluent and literate Chinese. The value of the Dongui Bogam as an authoritative medical text to the development of Korean medicine is on par with the the influence of the Compendium of Materia Medica was to Chinese medicine.

It is in the Dongui Bogam where we see the first mention of Pine Pollen in Korean medicine (publication 1613). In the text, Pine Pollen is recoded and described as the following:

The Dongui Bogam is regarded as highly influential and important in traditional Korean medicine and it is today considered one of the classics of Oriental medicine. The importance and historical significance of the texts is reflected in its designation (July, 2009) on UNESCO&rsquos Memory of the World Programme.

Koreans during the Joseo Dynasty held Pine Pollen as a food in high regard. The compendium of Korean life under the Joseon Dynasty, known as the Annals of Joseon Dynasty, are the official annual records of life under the Dynasty, and were kept from 1413 to 1865. In this text, the use of Pine Pollen as a food and as a brewed wine in mentioned. Furthermore, speaking to the significance of its harvest, the book details how the yearly harvesting of the pollen was imposed labor for the Korean people. Depending on the harvest and the available work force, monks were also recruited for the harvest. Presentation of the Pine Pollen harvest was a tribute at the Royal Palace. Today, Pine Pollen tea and food from the Royal Palace is still a well-known food in South Korea. In recent years, there has been a proliferation of beauty products from South Korea (considered by many to be the world&rsquos preeminent source of beauty and skin care products) containing Pine Pollen.

* These statements have not been evaluated by the Food and Drug Administration. This product is not intended to diagnose, treat, cure, or prevent any disease. Please view our full Terms and Conditions.


Ben Cao Gang Mu (Compendium of Materia Medica) (2010)

Traditional Chinese Medicine uses a great number of herbs and other natural products with medicinal properties. Identification of these, how they should be used and what diseases they could be used to treat began several thousand years ago. Over time, many books were written on them, but a truly encyclopedic catalogue was needed to put this pharmacopoeia onto a firm basis. Doing this was the lifework of Li Shi-zhen. He started working on it at the age of 31 and completed the task 27 years later in 1578.

The encyclopedia thus produced is called the Ben Cao Gang Mu. It identified 1,892 medicinal drugs and gave 11,096 prescriptions using them. For each drug a full description of its use with observation notes as to its effects is given, and misconceptions as to the drug given by earlier authors are amended. An initial two volumes offer an overview of medical theory. The Ben Cao Gang Mu has been, ever since its first publication, an essential text for all traditional Chinese medical practitioners, and similarly for those in Japan, Korea and Vietnam.

This medical encyclopedia was the first of its kind in the world. It represents a critically important stage in the scientific exploration of medical drugs and its author, Li Shi-zhen, is a figure of immense importance as an early scientist. The work is still regularly printed today. The oldest surviving copy of Ben Cao Gang Mu comprises 54 woodblock printed volumes, including two volumes of 1,109 illustrations, was printed in 1593.

Copyright © 2021 · MOWCAP, The Memory of the World Committee for Asia/Pacific


History

Reishi mushrooms have a long history

They have been used in China and Japan for nearly 4,000 years as a health tonic and as medicine for liver problems, heart conditions, asthma, cancer , high blood pressure, and arthritis.

Lingzhi or Reishi has been recognized as a medicinal mushroom for over 2000 years, and its powerful effects have been documented in ancient scripts (Wasser 2005).

The proliferation of G. lucidum images in art began in 1400 AD, and they are associated with Taoism (McMeekin 2005). However, G. lucidum images extended beyond religion and appeared in paintings, carvings, furniture, and even women&rsquos accessories (Wasser 2005).

The first book wholly devoted to the description of herbs and their medicinal value was Shen Nong Ben Cao Jing, written in the Eastern Han dynasty of China (25-220 AD). This book is also known as &ldquoClassic of the Materia Medica&rdquo or &ldquoShen-nong&rsquos Herbal Classics.&rdquo It describes botanical, zoological, and mineral substances, and was composed in the second century under the pseudonym of Shen-nong (&ldquothe holy farmer&rdquo Zhu, 1998).

The book, which has been continually updated and extended, describes the beneficial effects of several mushrooms with a reference to the medicinal mushroom G. lucidum (Zhu, 1998 Upton 2000 Sanodiya et al. 2009). In the Supplement to Classic of Materia Medica (502-536 AD) and the Ben Cao Gang Mu by Li Shin-Zhen, which is considered to be the first pharmacopoeia in China (1590 AD Ming dynasty), the mushroom was attributed with therapeutic properties, such as tonifying effects, enhancing vital energy, strengthening cardiac function, increasing memory, and antiaging effects.

According to the State Pharmacopoeia of the People&rsquos Republic of China (2000), G. lucidum acts to replenish Qi, ease the mind, and relieve cough and asthma, and it is recommended for dizziness, insomnia, palpitation, and shortness of breath.

Zhongke Wild Lingzhi


The Ben Cao Gang Mu - Compendium of Materia Medica - History

BEIJING &mdash China&rsquos State Council Information Office on Dec 6 issued a white paper on the development of traditional Chinese medicine (TCM) in China.

Following is the full text of the document.

Traditional Chinese Medicine in China

The State Council Information Office of the People&rsquos Republic of China

I. The Historical Development of TCM II. Policies and Measures on TCM Development

III. Carrying Forward the Tradition and Ensuring the Development of TCM

IV. International Exchanges and Cooperation in TCM

Humanity has created a colorful global civilization in the long course of its development, and the civilization of China is an important component of the world civilization harboring great diversity. As a representative feature of Chinese civilization, traditional Chinese medicine (TCM) is a medical science that was formed and developed in the daily life of the people and in the process of their fight against diseases over thousands of years. It has made a great contribution to the nation&rsquos procreation and the country&rsquos prosperity, in addition to producing a positive impact on the progress of human civilization.

TCM has created unique views on life, on fitness, on diseases and on the prevention and treatment of diseases during its long history of absorption and innovation. It represents a combination of natural sciences and humanities, embracing profound philosophical ideas of the Chinese nation. As ideas on fitness and medical models change and evolve, traditional Chinese medicine has come to underline a more and more profound value.

Since the founding of the People&rsquos Republic of China in 1949, the Chinese government has set great store by TCM and rendered vigorous support to its development. TCM and Western medicine have their different strengths. They work together in China to protect people from diseases and improve public health. This has turned out to be one of the important features and notable strengths of medicine with Chinese characteristics.

I. The Historical Development of TCM

In remote antiquity, the ancestors of the Chinese nation chanced to find that some creatures and plants could serve as remedies for certain ailments and pains, and came to gradually master their application. As time went by, people began to actively seek out such remedies and methods for preventing and treating diseases. Sayings like &ldquoShennong (Celestial Farmer) tasting a hundred herbs&rdquo and &ldquofood and medicine coming from the same source&rdquo are characteristic of those years.

The discovery of alcohol in the Xia Dynasty (c. 2070-1600 BC) and the invention of herbal decoction in the Shang Dynasty (1600-1046 BC) rendered medicines more effective.

In the Western Zhou Dynasty (1046-771 BC), doctors began to be classified into four categories &mdash dietician, physician, doctor of decoctions and veterinarian.

During the Spring and Autumn and Warring States Period (770-221 BC), Bian Que drew on the experience of his predecessors and put forward the four diagnostic methods &mdash inspection, auscultation & olfaction, inquiry, and palpation, laying the foundation for TCM diagnosis and treatment.

The Huang Di Nei Jing (Yellow Emperor&rsquos Inner Canon) compiled during the Qin and Han times (221 BC-AD 220) offered systematic discourses on human physiology, on pathology, on the symptoms of illness, on preventative treatment, and on the principles and methods of treatment. This book defined the framework of TCM, thus serving as a landmark in TCM&rsquos development and symbolizing the transformation from the accumulation of clinical experience to the systematic summation of theories. A theoretical framework for TCM had been in place.

The Shang Han Za Bing Lun (Treatise on Febrile Diseases and Miscellaneous Illnesses) collated by Zhang Zhongjing in the Eastern Han Dynasty (25-220) advanced the principles and methods to treat febrile diseases due to exogenous factors (including pestilences). It expounds on the rules and principles of differentiating the patterns of miscellaneous illnesses caused by internal ailments, including their prevention, pathology, symptoms, therapies, and treatment. It establishes the theory and methodology for syndrome pattern diagnosis and treatment differentiation. The Shen Nong Ben Cao Jing (Shennong&rsquos Classic of Materia Medica) &mdash another masterpiece of medical literature appeared during this period &mdash outlines the theory of the compatibility of medicinal ingredients. For example, it holds that a prescription should include at the same time the jun (or sovereign), chen (or minister), zuo (or assistant) and shi (or messenger) ingredient drugs, and should give expression to the harmony of the seven emotions as well as the properties of drugs known as &ldquofour natures&rdquo and &ldquofive flavors.&rdquo All this provides guidance to the production of TCM prescriptions, safe application of TCM drugs and enhancement of the therapeutic effects, thus laying the foundation for the formation and development of TCM pharmaceutical theory. In the late years of the Eastern Han Dynasty, Hua Tuo (c. 140-208) was recorded to be the first person to use anesthetic (mafeisan) during surgery.

The Zhen Jiu Jia Yi Jing (AB Canon of Acupuncture and Moxibustion) by Huangfu Mi during the Western Jin time (265-316) expounded on the concepts of zangfu (internal organs) and jingluo (meridians and collaterals). This was the point when theory of jingluo and acupuncture & moxibustion began to take shape.

Sun Simiao, a great doctor of the Tang Dynasty (618-907), proposed that mastership of medicine lies in proficient medical skills and lofty medical ethics, which eventually became the embodiment of a moral value of the Chinese nation, a core value that has been conscientiously upheld by the TCM circles.

A herbology and nature masterpiece, the Ben Cao Gang Mu (Compendium of Materia Medica) compiled by Li Shizhen in the Ming Dynasty (1368-1644) was the first book in the world that scientifically categorized medicinal herbs. It was a pioneering work that advanced TCM pharmaceutical theory.

The Wen Re Lun (A Treatise on Epidemic Febrile Diseases) by Ye Tianshi during the Qing Dynasty (1644-1911) developed the principles and methods for prevention and treatment of pestilential febrile diseases. It represents the theory and results of the practice of TCM in preventing and treating such diseases.

Following the spread of Western medicine in China from the mid-Qing Dynasty, especially during the period of the Republic of China (1912-1949), some TCM experts began to explore ways to absorb the essence of Western medicine for a combination of TCM with Western medicine.

During its course of development spanning a couple of millennia, TCM has kept drawing and assimilating advanced elements of natural science and humanities. Through many innovations, its theoretical base covered more ground and its remedies against various diseases expanded, displaying unique characteristics.

First, setting great store by the holistic view. TCM deems that the relationship between humans and nature is an interactive and inseparable whole, as are the relationships between humans and the society, and between the internal organs of the human body, so it values the impacts of natural and social environment on health and illness. Moreover, it believes that the mind and body are closely connected, emphasizing the coordination of physical and mental factors and their interactions in the conditions of health and illness.

Second, setting great store by the principle of harmony. TCM lays particular stress on the importance of harmony on health, holding that a person&rsquos physical health depends on harmony in the functions of the various body organs, the moderate status of the emotional expression, and adaption and compliance to different environments, of which the most vital is the dynamic balance between yin and yang. The fundamental reason for illness is that various internal and external factors disturb the dynamic balance. Therefore, maintaining health actually means conserving the dynamic balance of body functions, and curing diseases means restoring chaotic body functions to a state of coordination and harmony.

Third, emphasis on individuality. TCM treats a disease based on full consideration of the individual constitution, climatic and seasonal conditions, and environment. This is embodied in the term &ldquogiving treatment on the basis of syndrome differentiation.&rdquo Syndrome differentiation means diagnosing an illness as a certain syndrome on the basis of analyzing the specific symptoms and physical signs collected by way of inspection, auscultation & olfaction, inquiry, and palpation, while giving treatment means defining the treatment approach in line with the syndrome differentiated. TCM therapies focus on the person who is sick rather than the illness that the patient contracts, i.e., aiming to restore the harmonious state of body functions that is disrupted by pathogenic factors.

Fourth, emphasis on preventative treatment. Preventative treatment is a core belief of TCM, which lays great emphasis on prevention before a disease arises, guarding against pathological changes when falling sick, and protecting recovering patients from relapse. TCM believes that lifestyle is closely related to health, so it advocates health should be preserved in daily life. TCM thinks that a person&rsquos health can be improved through emotional adjustment, balanced labor and rest, a sensible diet, and a regular life, or through appropriate intervention in the lifestyle based on people&rsquos specific physical conditions. By these means, people can cultivate vital energy to protect themselves from harm and keep healthy.

Fifth, simplicity. TCM doctors diagnose patients through inspection, auscultation & olfaction, inquiry, and palpation. In addition to medication, TCM has many non-pharmacological alternative approaches such as acupuncture and moxibustion, tuina (massage), cupping and guasha (spooning). There is no need for complex equipment. TCM tools, for example, the small splints used in Chinese osteopathy, the spoons used in guasha, or the cups used in cupping therapy, can draw from materials close at hand, so that such treatments can spread easily.

TCM is an important component and a characteristic feature of traditional Chinese culture. Applying such principles as &ldquoman should observe the law of the nature and seek for the unity of the heaven and humanity,&rdquo &ldquoyin and yang should be balanced to obtain the golden mean,&rdquo and &ldquopractice of medicine should aim to help people,&rdquo TCM embodies the core value of Chinese civilization. TCM also advocates &ldquofull consideration of the environment, individual constitution, and climatic and seasonal conditions when practicing syndrome differentiation and determining therapies,&rdquo &ldquoreinforcing the fundamental and cultivating the vital energy, and strengthening tendons and bones,&rdquo and &ldquomastership of medicine lying in proficient medical skills and lofty medical ethics,&rdquo all concepts that enrich Chinese culture and provide an enlightened base from which to study and transform the world.

TCM originated in the Chinese culture. It explains health and diseases from a macro, systemic and holistic perspective. It shows how China perceives nature. As a unique form of medicine, TCM exercises a profound influence on the life of the Chinese people. It is a major means to help the Chinese people maintain health, cure diseases, and live a long life. The Chinese nation has survived countless natural disasters, wars and pestilences, and continues to prosper. In this process, TCM has made a great contribution.

Born in China, TCM has also absorbed the essence of other civilizations, evolved, and gradually spread throughout the world. As early as the Qin and Han dynasties (221 BC-AD 220), TCM was popular in many neighboring countries and exerted a major impact on their traditional medicines. The TCM smallpox vaccination technique had already spread outside of China during the Ming and Qing dynasties (1368-1911). The Ben Cao Gang Mu (Compendium of Materia Medica) was translated into various languages and widely read, and Charles Darwin, the British biologist, hailed the book as an &ldquoancient Chinese encyclopedia.&rdquo The remarkable effects of acupuncture and moxibustion have won it popularity throughout the world. The discovery of qinghaosu (artemisinin, an anti-malaria drug) has saved millions of lives, especially in developing countries. Meanwhile, massive imports of medicinal substances such as frankincense and myrrh have enriched TCM therapies.

II. Policies and Measures on TCM Development

China lays great store by the development of TCM. When the People&rsquos Republic was founded in 1949, the government placed emphasis on uniting Chinese and Western medicine as one of its three guidelines for health work, and enshrined the important role of TCM. In 1978, the Communist Party of China (CPC) Central Committee transmitted throughout the country the Ministry of Health&rsquos &ldquoReport on Implementing the Party&rsquos Policies Regarding TCM and Cultivating TCM Practitioners,&rdquo and lent great support in areas of human resources, finance, and supplies, vigorously promoting the development of TCM. It is stipulated in the Constitution of the PRC that the state promotes modern medicine and traditional Chinese medicine to protect the people&rsquos health. In 1986, the State Council set up a relatively independent administration of TCM. All provinces, autonomous regions, and municipalities directly under the central government have established their respective TCM administrations, which has laid an organizational basis for TCM development. At the Fourth Meeting of the Seventh National People&rsquos Congress, equal emphasis was put on Chinese and Western medicine, which was made one of the five guidelines in China&rsquos health work in the new period. In 2003 and 2009, the State Council issued the &ldquoRegulations of the People&rsquos Republic of China on Traditional Chinese Medicine&rdquo and the &ldquoOpinions on Supporting and Promoting the Development of Traditional Chinese Medicine,&rdquo gradually forming a relatively complete policy system on TCM.

Since the CPC&rsquos 18th National Congress in 2012, the Party and the government have granted greater importance to the development of TCM, and made a series of major policy decisions and adopted a number of plans in this regard. At the National Conference on Hygiene and Health held in August 2016, President Xi Jinping emphasized the importance of revitalizing and developing traditional Chinese medicine. The CPC&rsquos 18th National Congress and the Fifth Plenary Session of the 18th CPC Central Committee both reiterated the necessity to pay equal attention to the development of traditional Chinese medicine and Western medicine and lend support to the development of TCM and ethnic minority medicine. In 2015, the executive meeting of the State Council approved the Law on Traditional Chinese Medicine (draft) and submitted it to the Standing Committee of the National People&rsquos Congress for deliberation and approval, intending to provide a sounder policy environment and legal basis for TCM development. In 2016 the CPC Central Committee and the State Council issued the Outline of the Healthy China 2030 Plan, a guide to improving the health of the Chinese people in the coming 15 years. It sets out a series of tasks and measures to implement the program and develop TCM. The State Council issued the Outline of the Strategic Plan on the Development of Traditional Chinese Medicine (2016-2030), which made TCM development a national strategy, with systemic plans for TCM development in the new era. These decisions and plans have mapped out a grand blueprint that focuses on the full revitalization of TCM, accelerated reform of the medical and healthcare system, the building of a medical and healthcare system with Chinese characteristics, and the advancement of the healthy China plan, thus ushering in a new era of development for TCM.

The basic principles and main measures envisioned to develop TCM are:

Putting people first, and making achievements in TCM development accessible to everyone. TCM roots deep among the public, and the philosophies it contains are easy to understand. To meet the people&rsquos demand for healthcare, China endeavors to expand the supply of TCM services, improve community-level TCM health management, advance the integral development of TCM with community service, care of the elderly and tourism, spread knowledge of TCM and advocate healthy ways of life and work, enhance welfare for the public, and ensure that the people can enjoy safe, efficient, and convenient TCM services.

Equal attention to TCM and Western medicine. Equal status shall be accorded to TCM and Western medicine in terms of ideological understanding, legal status, academic development, and practical application. Efforts shall be made to improve system of administration related to TCM, increase financial input, formulate policies, laws and regulations suited to the unique features of TCM, promote coordinated development of TCM and Western medicine, and make sure that they both serve the maintenance and improvement of the people&rsquos health.

Making TCM and Western medicine complementary to each other, and letting each play to its strengths. The state encourages exchanges between TCM and Western medicine, and creates opportunities for Western medical practitioners to learn from their TCM counterparts. Modern medicine courses are offered at TCM colleges and universities to strengthen the cultivation of doctors who have a good knowledge of both TCM and Western medicine. In addition to the general departments, TCM hospitals have been encouraged to open specialized departments for specific diseases. General hospitals and community-level medical care organizations have been encouraged to set up TCM departments, and TCM has been made available to patients in the basic medical care system and efforts have been made to make it play a more important role in basic medical care. A mechanism has been established for TCM to participate in medical relief of public emergencies and the prevention and control of serious infectious diseases.

Upholding the dialectical unity of tradition and innovation, i.e., maintaining TCM&rsquos characteristics while actively applying modern science and technology in TCM development. A system has been established to carry forward the theories and clinical experience of well-known veteran TCM experts, and efforts have been made to rediscover and categorize ancient TCM classics and folk medical experience and practices. A system of technological innovation has been established to advance TCM progress, and efforts have been made to carry out systemic research on the fundamental theories, clinical diagnosis and treatment, and therapeutic evaluation of TCM. Interdisciplinary efforts have been organized in joint research on the treatment and control of major difficult and complicated diseases and major infectious diseases, as well as research on the prevention and treatment of common diseases, frequently occurring diseases, and chronic diseases using TCM. Endeavor has been made in the R&D of new TCM medicines, and medical devices and equipment.

Making overall plans for integrated, coordinated and sustainable development of TCM. The state makes overall plans for the coordinated development of TCM, integrating such areas as TCM clinical practices, healthcare, R&D, education, industry, and culture. Efforts have been made to improve community-level TCM services and the TCM medical care system. A health promotion project featuring preventative treatment of diseases has been launched to enhance TCM medical care. China has built research bases for TCM clinical studies, developed a system of coordination and innovation for the prevention and treatment of major diseases with TCM, and launched programs for training professionals necessary for TCM inheritance and innovation, and improving the quality of the ranks of TCM workers. The state has set out to promote the green development of the entire TCM industrial chain, and vigorous efforts have been made in the development of non-pharmacological therapies. Further efforts have been made to upgrade the TCM industry and develop it into an emerging strategic industry. A nationwide program has been conducted to promote the core values of TCM.

Promoting TCM development by way of government support and multi-party participation. The government has made TCM an important component of economic and social development, and has included it in relevant plans and provided financial support. The state has strengthened the supervision and administration of TCM practices, and initiated a market access system for TCM practitioners, TCM medical institutions, and TCM medicines, and improved the standards for the quality and safety of TCM service. The government has developed preferential policies to let the market play a full and decisive role in allocating resources, and is striving to create a market environment characterized by equal participation and fair play, so as to maximize the potential and vitality of TCM. Encouragement has been given to social capital to support the development of TCM, and to private investors to establish TCM healthcare institutions.

III. Carrying Forward the Tradition and Ensuring the Development of TCM

Establishment of a TCM medical care system covering both urban and rural areas. An urban TCM medical care network, mainly comprising hospitals for TCM (including ethnic minority medicine and integrated Chinese and Western medicine), TCM clinics and general hospitals&rsquo TCM clinical departments, and community health centers, has been formed. A rural TCM medical care network has been established, mainly composed of county-level TCM hospitals, TCM clinical departments of general hospitals (specialized hospitals and maternal & child health centers), TCM departments of township-level health centers, and village health clinics, which provides basic TCM healthcare services.

Statistics collected at the end of 2015 show that there were 3,966 TCM hospitals across the country, including 253 hospitals of ethnic minority medicine and 446 hospitals of integrated Chinese and Western medicine there were 452,000 practitioners and assistant practitioners of TCM (including practitioners of ethnic minority medicine and integrated Chinese and Western medicine) there were 42,528 TCM clinics, including 550 for ethnic minority medicine and 7,706 for integrated medicine there were 910 million visits that year to TCM medical and health service units across the country and 26,915,000 inpatients treated.

In addition to making contribution to the prevention and treatment of common, endemic and difficult diseases, TCM has played an important role in the prevention and treatment of major epidemics and medical relief in public emergencies and natural disasters. The contribution of TCM and integrated Chinese and Western medicine in treating SARS (severe acute respiratory syndrome) has been affirmed by the World Health Organization (WHO). TCM treatment of influenza A virus subtype H1N1 has yielded satisfactory results, arousing widespread attention in the international community. In addition, TCM has made distinctive contributions to the prevention and control of epidemics such as HIV/AIDS (Human Immunodeficiency Virus and Acquired Immune Deficiency Syndrome), HFMD (Hand, Foot and Mouth Disease), and Influenza A virus subtype H7N9 in humans, as well as to medical relief following the Wenchuan earthquake, the Zhouqu mudslide and other public emergencies and natural disasters.

Expedited development of TCM disease prevention and healthcare services. The system of TCM disease prevention and healthcare services has been expedited by establishing preventative healthcare departments at TCM hospitals at/above the second class and providing TCM preventative medical care services at community-level medical and health service institutions, maternal & child health centers and rehabilitation centers. Also seen is rapid growth in the number of privately run TCM healthcare institutions. Endeavor has been made to promote the development of TCM health services and carry out TCM health tourism and TCM integrated treatment and convalesce. TCM health management program has been incorporated as a separate category into the national basic public health service program, gradually releasing the potential and strengths of TCM in public health services, thus fostering a shift from treatment of serious diseases to comprehensive health management in the mode of health development.

Important role played by TCM in the reform of the medical care system. In the course of advancing the reform, TCM&rsquos distinct strengths, such as its clinical effectiveness, its unique role, flexible ways of treatment and relatively low cost in disease prevention and healthcare, have been fully exploited to augment benefits of reform for the people and enriched the connotation of China&rsquos basic medical care system with distinct characteristics. With relatively low cost, TCM has contributed rather a higher share of services in relation to the resources it is entitled to. The medical care services provided by TCM institutions in the national total increased from 14.3 percent to 15.7 percent in the few years from 2009 to 2015. In 2015, out-patient expenses per visit and in-patient expenses per capita at public TCM hospitals were, respectively, 11.5 percent and 24 percent lower than those at general public hospitals.

Building a distinctive system of training for TCM professionals. Training of professionals is essential for the development of TCM. Thus, great efforts have been made to promote development of education in TCM, basically putting in place a system of training for TCM professionals that features an organic link-up between college, graduate and continuing education, and run through master-apprenticeship training. This, together with a mechanism for training of practical TCM professionals geared toward the needs of the urban and rural communities that has also been initially established, forms a multi-dimensional education network covering multiple disciplines at different levels, including TCM, traditional Chinese pharmacology, integrated Chinese and Western medicine, and ethnic minority medicine at secondary and higher vocational schools, colleges, postgraduate and doctoral studies. By the end of 2015, there were throughout the country 42 institutions of higher learning in TCM (including 25 TCM colleges), and more than 200 Western medicine institutions of higher learning or non-medical higher learning institutions offering programs in TCM, enrolling in total as many as 752,000 students.

In the course of implementing the program of training professionals for inheritance and innovation in TCM, efforts have been made to conserve and disseminate the academic ideas and practical experience of the fifth batch of prominent TCM experts. By 2015, 1,016 studios had been set up for carrying forward their expertise 200 studios had been set up for passing on the expertise of prominent TCM experts at the grassroots level 64 studios had been established for promoting various schools of TCM.

TCM training programs targeted at professionals at both grassroots and higher levels have been held, such as training in TCM knowledge and skills for village doctors, training for conserving special traditional pharmacological skills, and advanced training for outstanding TCM clinical practitioners. Together, 124 researchers are finishing postdoctoral studies in TCM inheritance at the Chinese Academy of Chinese Medical Sciences and their work is being evaluated. Exploration has been made in establishing an incentive mechanism for outstanding TCM workers to come to the fore. By 2015, the title of TCM Master had been awarded to a total of 60 experts practicing TCM and ethnic minority medicine.

Positive progress made in TCM scientific research. Sixteen national TCM clinical research bases have been built as part of the clinical research system for preventing and treating infectious diseases and chronic non-infectious diseases with TCM. This, together with a number of key research centers and labs covering all disciplines of TCM and national engineering (technology) research centers and labs in this respect, have brought into being a TCM sci-tech innovation system that is based on independent TCM research institutes, TCM universities, and TCM hospitals at and above the provincial level, and participated by comprehensive universities, general hospitals and TCM enterprises.

In recent years, 45 TCM research achievements have been awarded national sci-tech prizes, of which five were first-prize winners of the National Science and Technology Progress Award. Tu Youyou won the 2011 Lasker Award in clinical medicine and the 2015 Nobel Prize in Physiology or Medicine for discovering qinghaosu (artemisinin). Wang Zhenyi and Chen Zhu were awarded the Seventh Annual Szent-Gyorgyi Prize for Progress in Cancer Research for combining the Western medicine ATRA and the TCM compound arsenic trioxide to treat acute promyelocytic leukemia (APL).

A pilot program for Chinese medicinal resources survey has been implemented, forming a dynamic information and technology system with one central platform, 28 provincial-level centers, and 65 monitoring stations. Sixteen seed and seedling bases for Chinese medicinal plants and two germplasm banks have been established. Organizational work has been done for collation of literature and screening of appropriate skills of ethnic minority medicine, involving 150 works on ethnic minority medicine and 140 appropriate skills. The transformation and application of these research results has provided support for enhancing clinical effectiveness, ensuring the quality of Chinese medicine, and fostering the sound development of the TCM pharmaceutical industry.

Rapid development of the TCM pharmaceutical industry. A number of laws and regulations have been enacted and implemented on strengthening the protection of TCM wild medicinal resources a number of national and local nature reserves have been established research has been conducted on the protection of rare and endangered Chinese medicinal resources and artificial production or wild tending have been carried out for certain scarce and endangered resources.

A registration management system has been basically established for TCM pharmaceuticals under the guidance of theories of traditional Chinese medicine and pharmacology, highlighting the strengths of TCM, setting great store by clinical practice and encouraging innovation. To date, 60,000 TCM and ethnic minority medical drugs have been approved, and 2,088 pharmaceutical enterprises that have been approved by the Good Manufacturing Practice (GMP) of Medical Products are manufacturing Chinese patent medicines. The dosage forms of TCM medicines have increased from a traditionally limited number of forms such as pills, powders, ointments and pellets into more than 40, including dropping pills, tablets, pods and capsules, indicating marked improvement in the technological level of Chinese medicinal drug production, and initial establishment of a modern Chinese medicine industry based on the production of medicinal materials and industrial production and tied together by commerce.

In 2015, the total output value of the TCM pharmaceutical industry was RMB 786.6 billion, accounting for 28.55 percent of the total generated by the country&rsquos pharmaceutical industry, and becoming a new source of growth in China&rsquos economy. Planting Chinese medicinal herbs has become a key means of adjusting the rural industrial structure, improving the eco-environment, and increasing farmers&rsquo incomes. Trade in Chinese medicinal products has maintained rapid growth, and the export value of Chinese medicines amounted to $3.72 billion in 2015, signifying the great potential of Chinese medicines in overseas markets. The TCM pharmaceutical industry has gradually developed into an industry with distinctive strengths and broad market prospects, which is of strategic importance to national economic and social development.

New progress in TCM culture. The Chinese government treasures and protects the cultural value of TCM, and endeavors to build a system for passing on the traditional culture of TCM. In total, 130 TCM elements have been incorporated into the Representative List of National Intangible Cultural Heritage, with TCM acupuncture and moxibustion being included in the Representative List of the Intangible Cultural Heritage of Humanity by UNESCO, and the Huang Di Nei Jing (Yellow Emperor&rsquos Inner Canon) and Ben Cao Gang Mu (Compendium of Materia Medica) are listed in the Memory of the World Register. Efforts have been reinforced to promote public awareness in TCM healthcare, including events under the campaign of Traditional Chinese Medicine Across China. Public talks have been organized through media and TCM education bases popularizing basic knowledge and skills of TCM healthcare and prevention and treatment of illnesses. In this way, public awareness of and ability to practice TCM healthcare has been enhanced, and general public health has improved.

Positive progress in TCM standardization. The Outline of the Medium- and Long-term Development Plan for the Standardization of Traditional Chinese Medicine (2011-2020) has been issued and implemented, putting in place initially a system of TCM standards which amount to 649, showing an average annual growth of 29 percent. Five national technical committees of standardization have been established for, respectively, Chinese medicine, acupuncture and moxibustion, TCM drugs, integrated Chinese and Western medicine, and seeds and seedlings of Chinese medicinal plants, with local standardization technical committees of traditional Chinese medicine and pharmaceuticals being set up in Guangdong, Shanghai, Gansu and some other localities. The building of 42 research and application bases for TCM standardization is proceeding smoothly, and the clinical application of guidelines for TCM diagnosis and treatment of commonly seen diseases and guidelines for acupuncture and moxibustion is proving effective.

Steady progress has also been witnessed in standardization of ethnic minority medicine, so has been orderly advancement in the formulation of guidelines for diagnosis and treatment of commonly seen diseases. In this regard, Uyghur medicine has taken the lead, with the publishing of 14 guidelines for disease diagnosis and treatment, and curative effect evaluation. The first local technical committee for standardization of Tibetan medicine has been established in the Tibet autonomous region. Constant improvement has been observed in the competence and efficiency of institutions and workers in relation to the standardization of ethnic minority medicine and pharmacology.

IV. International Exchanges and Cooperation in TCM

Promoting the globalization of TCM. Traditional Chinese medicine has been spread to 183 countries and regions around the world. According to the World Health Organization, 103 member states have given approval to the practice of acupuncture and moxibustion, 29 have enacted special statutes on traditional medicine, and 18 have included acupuncture and moxibustion treatment in their medical insurance provisions. TCM medicines have gradually entered the international system of medicines, and some of them have been registered in Russia, Cuba, Vietnam, Singapore, United Arab Emirates, and other nations. Some 30 countries and regions have opened a couple of hundred TCM schools to train native TCM workers. The World Federation of Acupuncture-Moxibustion Societies, headquartered in China, has 194 member organizations from 53 countries and regions, and the World Federation of Chinese Medicine Societies has 251 member organizations from 67 countries and regions. Traditional Chinese medicine has become an important area of health and trade cooperation between China and the ASEAN, EU, Africa, and Central and Eastern Europe, a key component in people-to-people exchanges between China and the rest of the world and between Eastern and Western cultures, and an important vehicle for China and other countries to work together in promoting world peace, improving the well-being of humanity, and developing a community of shared future.

Supporting the global development of traditional medicine. The Chinese government is dedicated to promoting the development of traditional medicine throughout the world, and works closely with the WHO to contribute to progress in traditional medicine around the globe. China has summarized its successful TCM practices and offers them to the world. It hosted the first WHO Congress on Traditional Medicine in Beijing in 2008, and played an important role in drafting the Beijing Declaration. In accordance with initiatives of the Chinese government, the 62nd and 67th World Health Assemblies passed two resolutions on traditional medicine, and urged its member states to implement the WHO&rsquos Traditional Medicine Strategy 2014-2023. Currently, the Chinese government has signed 86 TCM cooperation agreements with other countries and international organizations, and has supported the building of 10 TCM centers overseas.

Promoting standard management of TCM internationally. To promote the orderly development of TCM around the globe and ensure its safe, efficient and targeted application, China has facilitated the founding of the ISO/TC249 Traditional Chinese Medicine in the ISO. With its secretariat in Shanghai, it has now issued a series of ISO standards on TCM. Thanks to China&rsquos efforts, the WHO has included traditional medicine, represented by TCM, in the new version of the International Classification of Diseases (ICD-11). China is working actively to promote international exchange and cooperation in the supervision and management of traditional medicine, in an effort to ensure that it is safe and effective.

Providing TCM medical aid overseas. While seeking its own development, within its capacity China has persisted in providing aid and assistance to other developing countries, fulfilling its due international obligations. To date, China has sent medical teams to over 70 countries in Asia, Africa, and Latin America, with TCM professionals in almost every team, accounting for 10 percent of the total number of staff. A project has been launched to build TCM centers in African countries, and specialized TCM stations have opened in Kuwait, Algeria, Tunisia, Morocco, Malta, and Namibia. The Chinese government has sponsored 10 TCM centers overseas. In recent years, China has strengthened work in the prevention and control of AIDS and malaria in developing countries, and in African countries in particular, sending a total of 400 TCM specialists to more than 40 countries including Tanzania, Comoros, and Indonesia. Chinese medical teams have treated complicated and refractory diseases with TCM, acupuncture and moxibustion, medical massage, and methods combining Chinese and Western medicine, saving many lives and winning extensive appreciation from governments and people concerned.

China&rsquos economic development has entered a new historical period. TCM has come to play an increasingly significant role in the socio-economic development it has become a unique resource in terms of healthcare, an economic resource with great potential, a scientific and technological resource with originality advantages, an outstanding cultural resource, and an ecological resource of great importance. The time has come for TCM to experience a renaissance.

China will learn from the achievements of modern civilization, uphold the principle of making the ancient serve the contemporary, and strive to promote the modernization of TCM by making every effort to carry on the good traditions and practices of Chinese medicine, and promote the innovative development of TCM for health preservation, so that TCM will be incorporated into the modern outlook on health to serve the people. By 2020, every Chinese citizen will have access to basic TCM services, and by 2030 TCM services will cover all areas of medical care. Meanwhile, China will also actively introduce TCM to the rest of the world, and promote the integration of TCM and other traditional medicine with modern technology, so as to explore a new model of healthcare to improve the well-being of all people of the world, and make a full contribution to global progress and a brighter future for mankind.


Li Shizhen (李时珍), Jie zi yuan chong ding ben cao gang mu (芥子園重訂本草綱目), 1657

Medium: hard cover, bamboo paper, thread binding, wood engraving

Publisher: Jieziyuan, Qing Dynasty

University of Pennsylvania Libraries Rare Book & Manuscript Library – Rare Book Collection. RS180.C5 L448 1657

This title, Ben cao gang mu (“Compendium of Materia Medica”), is a collection of the great achievements of traditional medicine before the 16th century in China. It is no exaggeration to call it an encyclopedia of pharmacy, and its content not only includes Chinese herbal medicine, but also contributes to biology, chemistry, astronomy, geography, geology, mining and even history and other disciplines. There have been more than 80 editions since it was first published, with new printings appearing every 6-7 years. The many editions fully demonstrate its practical value and impact on human society.

“Jie zi yuan” was the name of the residence of Li Yu (1611-1680), a famous writer and Chinese opera performer in the late Ming and early Qing Dynasty. This impression took an earlier version, known as “Changwei,” and recarved it for this edition. The publication date should be in the Kangxi era of the Qing Dynasty, although the specific date is uncertain here but we known that the Jie zi yuan section is the copy published in the Tongzhi Ren Shen period of the Qing Dynasty (1872). The “Jie zi yuan version” is very famous for its illustrations, and this version includes examples from three prestigious painters. Carvers Wang Gai and his brothers carefully carved the original new images to replace the earlier versions (some of which had errors). Once it was published, the “Jie zi yuan” version of Ben Cao Gang Mu was quickly snapped up, playing an important role in the development and dissemination of the “Compendium of Materia Medica.”

Copies in other collections: There are a number of various editions one of the most famous being the Jinling edition produced in Ming & Qing Dynasty, China

Selected Reading

• Mayanagi Makoto, “Imported Chinese Medical books and their Japanese Reprints in the Course of the Edo Period,” China Historical Materials of Science and Technology, Volume 23 (September 2002), Period 3, page 232-254 ,.


Historical Perspective of Traditional Indigenous Medical Practices: The Current Renaissance and Conservation of Herbal Resources

2 Research Unit for Complementary and Integrative Laser Medicine, Research Unit of Biomedical Engineering in Anesthesia and Intensive Care Medicine and TCM Research Center Graz, Medical University of Graz, Auenbruggerplatz 29, 8036 Graz, Austria

3 School of Basic Medicine, Beijing University of Chinese Medicine, Beijing 100102, China

4 College of Pharmacy, University of South Florida, Tampa, FL 33612, USA

5 School of Chinese Medicine, Hong Kong Baptist University, Hong Kong

6 American Academy of Natural Medicine, Costa Mesa, CA 92627, USA

7 Division of Life Science, Hong Kong University of Science & Technology, Hong Kong

Abstract

In recent years, increasing numbers of people have been choosing herbal medicines or products to improve their health conditions, either alone or in combination with others. Herbs are staging a comeback and herbal “renaissance” occurs all over the world. According to the World Health Organization, 75% of the world’s populations are using herbs for basic healthcare needs. Since the dawn of mankind, in fact, the use of herbs/plants has offered an effective medicine for the treatment of illnesses. Moreover, many conventional/pharmaceutical drugs are derived directly from both nature and traditional remedies distributed around the world. Up to now, the practice of herbal medicine entails the use of more than 53,000 species, and a number of these are facing the threat of extinction due to overexploitation. This paper aims to provide a review of the history and status quo of Chinese, Indian, and Arabic herbal medicines in terms of their significant contribution to the health promotion in present-day over-populated and aging societies. Attention will be focused on the depletion of plant resources on earth in meeting the increasing demand for herbs.

1. Introduction

Herbalism is a traditional medicinal or folk medicine practice based on the use of plants and plant extracts. Herbs/plants, the major component of traditional materia medica in the world, are of the main forms of life on earth. It is estimated that there are about 350,000 species of existing plants (including seed plants, bryophytes, and ferns), among which 287,655 species have been identified as of 2004 [1]. Herbal medicine (HM), also called botanical medicine, phytomedicine, or phytotherapy, refers to herbs, herbal materials, herbal preparations, and finished herbal products that contain parts of plants or other materials as active ingredients [2]. The plant parts used in herbal therapy include seeds, berries, roots, leaves, fruits, bark, flowers, or even the whole plants. Man was mainly dependent on crude botanical material for medical needs to retain vitality and cure diseases [3] prior to the introduction of aspirin derived from Spiraea ulmaria which was already prescribed for fever and swelling in Egyptian papyri and recommended by the Greek Hippocrates for pain and fever.

Although written records about medicinal plants dated back at least 5,000 years to the Sumerians, who described well-established medicinal uses for such plants as laurel, caraway, and thyme [4], archeological studies have shown that the practice of herbal medicine dates as far back as 60,000 years ago in Iraq and 8,000 years ago in China [5, 6]. With the advent of western medicine (or “conventional” medicine) over the past century, herbal medicine has been challenged by practitioners of mainstream medicine because of the lack of scientific evidence in the context of contemporary medicine, despite its long history of effective use. Interestingly, things change with time. In recent years, there has been a resurgence of the use of herbs due to the side effects of chemical drugs, lack of curative modern therapies for several chronic diseases, and microbial resistance, as well as the unprecedented investment in pharmaceutical research and development (R&D) [7]. For example, only about 1,200 new drugs have been approved by the US Food and Drug Administration (FDA) since 1950 [8]. As a result, the use of herbs and herbal products for health purposes has increased in popularity worldwide over the past 40 years, in both the developing and the industrialized countries [9]. Moreover, global pharmaceutical companies armed with modern science/technology and ideas have begun to rediscover herbs as a potential source of new drug candidates and renewed their strategies in favor of natural product drug development and discovery [10–13].

Nowadays, many practitioners of “conventional” medicine do not hesitate to recommend herbs, herbal products, or complementary and alternative medicine (CAM) therapy to their patients for the effective treatment of certain diseases [14, 15]. A survey in 2007 indicated that about 40% of adults and 11% of children used CAM therapy (CAMT), and among the adult users, white and black adults constituted 43.1% and 25.5%, respectively [16]. In addition, CAM and herbal medicines are more commonly used by people with higher levels of education and income [17, 18]. In this context, a 2012 study indicated that the use of CAM significantly correlated with higher education level, with a trend towards greater use in younger patients with breast cancer [19]. Although at present, we do not fully understand the exact facts and mechanisms underlying most traditional remedies and/or how they prevent disease that does not affect the enthusiasm of the public to accept CAM/CAMT [20]. Although there is a wide variety of CAM and CAMT around the world, they can all be divided into two main categories, namely, drug-based CAM/CAMT and non-drug-based CAM/CAMT [21].

Our earlier endeavors, which focused on discussing the current research and development of Chinese herbal medicine (CHM), and the trend in drug discovery, as well as a variety of CAM, aimed to promote the utilization of natural and traditional resources for contemporary health care, including food/diet therapy [7, 21–24]. As a continuing effort, the current paper will give an overview on herbal medicine from China, India, and Arabia, which are the three most influential traditional medicine systems to improve public health problems.

2. Chinese Herbal Medicine (CHM)

In ancient Chinese times “medicine” (traditional Chinese medicine, TCM, e.g., Zhong-Yi in Chinese) and “pharmacy” (CHM, e.g., Zhong-Yao in Chinese) were already described as distinct disciplines. More than 85% of Chinese materia medica (CMM) originates from plants, but animal parts/insects, minerals, and crude synthetic compounds are also prescribed by TCM practitioners. In addition, the term “CHM” also encompasses a number of ethnic herbal medicines and folk medicines in China.

2.1. Literature Overview of CHM

CHM is traditionally one of the most important modalities utilized in TCM. It has an extremely valuable, rich, lengthy, and extensive treatment history. CHM was firstly described by a legendary figure called Shen-Nong, who is said to have lived from 2737 BCE to 2697 BCE, nearly 5,000 years ago [25, 26]. It is said that Shen-Nong, by tasting hundreds of herbs on one day, found more than 70 herbs that had medicinal value, selected those that were suitable as remedies, and described their properties [27]. As a result of his efforts, numerous herbs (“herbal” medicine) became routinely used for health care in ancient China [28]. Shen-Nong-Ben-Cao-Jing, the first known user guide to CHM, was written by authors who lived during the period immediately following the fall of the Han dynasty (202 BCE–220 CE). The compendium documented 365 Chinese herbal preparations, including 252 kinds of plant parts, 67 kinds of animal parts, and 46 kinds of minerals for medication, and it also described their therapeutic effects.

Prior to the time of Shen-Nong-Ben-Cao-Jing, some ancient Chinese scripts, such as Shang-Shu, Shi-Jing (The book of songs), Shan-Hai-Jing, Zhou-Li, Li-Ji (The book of rites), and Zuo-Zhuan, recorded the use of herbal remedies. Shi-Jing, which first recorded the use of herbal remedies, illustrated not only the therapeutic effects of the herbs, but also the places where the herbs were grown and their harvesting season. It recorded 170 kinds of CHMs, including 80 plant species and 90 insect species [29]. Shan-Hai-Jing, the oldest Chinese book dealing with geography, recorded 9 species of plants with food value, 45 species of plants with medicinal value, 6 plants with some kind of efficacy, 6 plants poisonous to animals and pests, 6 species of plants with mood-elevating effects, 6 plants with health-promoting properties, 19 species of plants for the treatment of diseases, and 2 plants that are poisonous for humans [30].

More than 240 herbal drugs and 52 prescriptions were described in the book named 52 Bing-Fang (Recipes for 52 Ailments), which was unearthed in an ancient tomb (Ma-Wang-Dui) in China [31]. Xin-Xiu-Ben-Cao (Newly revised materia medica), which was promulgated in 659 CE and recorded 850 kinds of herbal drugs, was the first pharmacopoeia in China, even in the world [32]. Oracle bone, a form of divination in ancient China, recorded more than 60 kinds of plants and animals, but they were not described as medication.

The epic book of materia medica in TCM history, Ben-Cao-Gang-Mu (Compendium of Materia Medica) written by Li Shi-Zhen (1528–1593), was published in 1596 in China. This book recorded 1,892 kinds of herbal medicines and 11,096 herbal formulae. After Charles Darwin (1809–1882) had read the book, he stated that The Compendium of Materia Medica was the encyclopedia of 16th century in China. This book was later translated into different languages, including Japanese, Korean, English, French, Russian, and Latin, and it has become a major historical reference on CMM.

The founding of China has brought about a hitherto unprecedented development of CHM in Chinese history. The holistic and systematic development of CHM has resulted in an increase in the number of approved CHMs. Zhong-Hua-Ben-Cao, the most authoritative Chinese book with a complete record of CMM issued in 1999, lists 8,980 kinds of CHMs that are divided into 34 volumes and summarizes the contemporary research of Chinese medicine with modern science and technology. Zhong-Yao-Da-Ci-Dian (a dictionary of traditional Chinese medicine), published in 1997, recorded 5,767 CHMs when it was reprinted in 2006, the number of CHMs had increased to 6,008. The Chinese Pharmacopoeia (2010 version) listed 2,165 CHMs and their products. About 300 of them are commonly used in clinical practice, and many others are used locally as folk medicines. In terms of the literature on CHM, the theoretical aspects and practical experiences of several thousand years of usage are documented in more than 8,000 books the total number of ancient literature about both CHM and TCM reached 13,000. Therefore, the documentation of knowledge in CHM is unique in the world (Table 1).

2.2. The Contribution of CHM to the World’s Pharmacy

CHM has been influencing the world since ancient times. The famous Italian traveler Marco Polo (1254–1324) described a scene of merchants shipping Chinese herbs in Aden and Alexandria in his Travel Book. During the sea voyage of Zheng He between 1405 and 1433, China exported a large number of herbs including rhubarb, angelica, velvet, poria, taurine, ginseng, and cinnamon to other Southeast Asian countries. In return, over the past 2,000 years, more than 40 kinds of foreign herbs were imported into China and eventually adopted by TCM they include kelp from Korea, turmeric and styrax from Southeast Asia, and others such as borneol, clove, frankincense, myrrh, benzoin, senna, and saffron [35].

In the 18th century, with reference to Chinese ginseng, Panax quinquefolium (also called American ginseng) was first discovered. It is indigenous to the southern regions of Ontario and Quebec in Canada and the midwestern, southern, and eastern parts of the United States [36]. In recent decades, studies have shown that American ginseng, like the Chinese one, also possesses neuroprotective, cardioprotective, antidiabetic, antioxidant, and anticancer properties, as well as the ability to alleviate symptoms of the common cold [37, 38]. The proven similarities between American ginseng and Chinese ginseng have been instrumental in boosting the market of the American product. From 1960 to 1992, both the demand and the price for American ginseng increased, with the export value being over US $104 million in 1992 in the USA alone. During the period from 1997 to 2007, the average export price of cultivated ginseng from the USA was US $19.30/lb and that of wild ginseng was US $84.50/lb [39]. The Panax family consists of at least nine species, including ginseng, panax quinquefolium, panax notoginseng (Sanqi), and Panax japonicus (Japanese ginseng) [40]. If Chinese ginseng had not served as a reference herb, the Panax family would certainly not have become so popular and might still be treated as ordinary grass. Similarly, if the Chinese had not recognized the medicinal value of bezoars (gallstones from cattle), they would only have been treated as waste. Currently, China imports more than 100,000 kilograms of gallstones each year, about 60% of which comes from Africa, and the total value amounts to US $100 million. A good quality gallstone sells for between US $15 and 20 per gram [41].

In the winter of 753, Jian Zhen (688–763), a famous Chinese master of Buddhism in the Tang Dynasty, arrived in Nara, Japan, after several unsuccessful attempts, and he brought with him a number of CHMs. To date, more than 60 kinds of CHMs are still kept in the Nara Shosoin. According to the official body of Japanese kampo medicine (the practice of CHM in Japan), 36 kinds of CHMs were brought by Jian Zhen for use in Japan they include ephedra, asarum, peony, monkshood, polygalaceae, astragalus, licorice root, angelica, bupleurum, Chuanxiong, scrophulariaceae, scutellaria, platycodon, anemarrhena, pinellia, schisandra, and eucommia [42]. To recognize the contribution of Jian Zhen, he was renowned as the father of kampo medicine by the Japanese. The 14th edition of the Japanese Pharmacopoeia (JP), issued in 1993, listed 165 herbal ingredients, the majority of Chinese origin, that are approved to be used in kampo remedies [43] the 16th Japanese Pharmacopoeia, published in 2012, listed 276 kinds of crude drugs (e.g., herbal medicines and/or their extractions) [44].

All in all, the development of CHM has emerged from thousands of years of Chinese civilization. It is therefore no surprise that CHM is of great worth for mankind.

2.3. Species in China and CHM

Nature has endowed China with a vast landscape with varied geographical features and a resultant wealth of medicinal plants. Geographically, China (from south to north) covers equatorial, tropical, subtropical, warm-temperate, temperate, and cold-temperate zones. Therefore, Chinese climatic conditions are suitable for the growth and reproduction of various animals and plants. In China, there are 499 kinds of mammals, 1,186 kinds of birds, 376 kinds of reptiles, 279 kinds of amphibians, and 2,084 kinds of fish, which account for 12.5, 13.1, 6.0, 7.0, and 12.1% of their respective species in the world [45–50]. China has more than 31,000 higher plants, 256 endemic genera, and 15,000–18,000 endemic species (50–60% of the total on earth), many of which are living fossils, such as dawn redwood (Metasequoia glyptostroboides Hu and Cheng), ginkgo (Ginkgo biloba L.), silver fir (Cathaya argyrophylla Chun and kuang), and tulip tree (Liriodendron chinense (Hemsl.) Sarg.) [51]. The increasing demand for herbal products in the global market is likely to challenge herbal resources in the world. In the China Plant Red Data Book published in 1992, 388 species of plants are listed as threatened, which include 121 as endangered (i.e., first grade national protection), 110 as rare (second grade national protection), and 157 as vulnerable (third grade national protection). Among these plant species, 77 are typical CHMs that account for 19.86% of the total threatened species [52]. Besides, 257 kinds of animal medicine appear in the national key protection name list of wild animals (Figure 1).


In CHM, there are 11,146 different kinds of plants, 1,581 kinds of animals/animal parts and insects, 80 kinds of mineral drugs, and more than 50 kinds of crude chemical preparations, as well as 5,000 (total one million) clinically validated herbal formulations. Unlike other herbal medicines and western medicines, CHMs are often prescribed as formulas under the guidance of TCM’s theories and practice. Each herbal medicine prescription (formula, Fang-Ji in Chinese) is a cocktail of many herbs tailored to the individual patient. It allows us to blend herbs to enhance their positive effects and reduce or eliminate any negative side effects they may have, when they are used each alone (Figure 2).


Because of the differences in geographical and climatic conditions, residents in various geographical regions in China have distinctive lifestyles, customs, and cultures, as well as disease spectra. These variations have brought about the development of a wide variety of traditional medicine practices. China has 56 ethnic groups, meaning that there are 56 kinds of culture, language, and herbal medicine. CHM (also called Han medicine) was developed by the Han ethnic group. Table 2 shows the number of plant-derived herbal medicines in various ethnic medicines as recorded in the database of China plant species. In fact, the number of herbal medicines is far bigger than that recorded in the database. For example, Tibetan herbal drugs have 2,172 rather than 1,085 varieties, not including 214 kinds of animal drugs and 50 kinds of mineral drugs [53]. There is no doubt that CHM, together with other ethnic herbal medicines in China, comprises a gold mine of potential modern medicines and health products.

2.4. Pharmaceutics of CHM

Dosage form, also known as routes of administration, is a mixture of components with medicinal properties and nondrug components (excipient or vehicle). It describes the physical form in which medication will be delivered into the body. Currently, there are more than 40 available dosage forms of CHM products in the market. They include decoction (Tang-Ji, hot water extract), tincture (Ting-Ji, ethanol extract), powders (San-Ji, powder form), bolus/pills (Wan-Ji, boluses or small pills containing herbal ingredients), pastes (Jin-Gao, extracts from organic solvents), granules, tablets, oral liquids, and injection liquids. Liniment, poultices, plasters, and ointments are adopted for external use of CHM. Recently “nanomized” and “aerosol” herbs have emerged as new dosage forms of CHM [54–56].

Unlike synthetic drugs, CHMs are usually subjected to specific treatments (processing, the process of preparing CHM), also known as Pao-Zhi in Chinese, prior to use. Pao-Zhi is a very ancient part of the practice of Chinese medicine, dating back at least 2,000 years. There are more than 30 kinds of procedures involving stir-frying (Chao), calcining (Daun), steaming (Zheng), boiling (Zhu), and so forth. The herbal effects and compositions/ingredient structures are changed after Pao-Zhi, as compared to the unprocessed version. Experience has shown that the effectiveness and security of some CHMs are dependent upon their correct Pao-Zhi before being used in clinic. This is one of the reasons why CHM is different from the plant drug and/or natural drug. Regardless of the primitive processing technology that was used in ancient times, the rationale underlying the traditional processing of CHM has been supported by scientific evidence in modern research. Figure 3 shows the traditional processing methods of CHM, together with their pharmaceutical processing procedures, which are still employed in the pharmaceutical industry of CMM in China [57].


2.5. The Status Quo of CHM

The CHM industry has always been one of China’s traditional competitive industries. In 2010, CHM manufacturing assets in China exceeded 300 billion RMB, an increase of about 18%, nearly 5 percentage points higher than the year before the number of CMM pharmaceutical enterprises amounts to more than 2,300, total investment in fixed assets totaled nearly 500 billion RMB, an increase of about 16% compared to the previous year [58]. As of today, there are 8,000 products related to CHM in the China market. In 2010, China manufactured 2.384 million tons of Chinese herbal products, with sales amounting to 417.875 billion RMB [59].

More than 8,000 varieties of CHMs or related herbal products are now exported from China to more than 130 countries and regions worldwide each year, more than 50 kind of CMMs are exported to the United States, including berberine, angelica, licorice, Fritillaria, turmeric, frankincense, Tianma, rhubarb, Eucommia, cloves, wolfberry, Panax, fresh ginseng, and pinellia [60]. Over the past few years, herbal exports have steadily increased from US $1.09 billion in 2006 to US $1.46 billion in 2009 [61].

More importantly, in recent decades, China has put a great deal of human efforts and financial resources to promote research and development in the area of CHM in a systematic manner, and this enormous effort is unmatched by other traditional medicines around the world. In this context, we have published reviews on the status of CHM research and development as well as drug discovery in China [24]. In China, 3,563 extracts, 64,715 compositions, 5,000 single compounds, and 130 kinds of CHM-related chemical drugs have been developed [22]. From the marketing perspective, currently, four models of application and five types of Chinese herbal products can be adopted in the international arena. The same approach may also be applied to other herbal medicines (Figure 4).


Styles of Chinese herbal medicine (CHM) in the global market (see also [62] of quasi-chemical model and [63–65] of full-chemical model).

3. Indian Herbal Medicine (IHM)

Indian medicine/materia medica/herbal medicine (IM/IMM/IHM), also called Ayurvedic medicine/materia medica (AYM/AYMM), belongs to the traditional health care and longevity systems. Because the belief that “everything can be a drug” is deeply rooted in Indian culture, Ayurvedic physicians made use of an extensive collection of medications, herbs/plants, even the urine of animals, and described their effects meticulously. Currently, 70 percent of Indians still rely on IM for their primary health care [66].

3.1. Literature Overview of IHM

In India, the history of using plant resources for treating diseases can be dated back to 6,000 to 4,000 BCE, the Buddhist period. AYM has a vast literature in Sanskrit and various Indian languages, covering various aspects of diseases, therapeutics, and pharmacy. The earliest references to such plants, minerals, and animal products with their usage for medical purposes are found in the Rig veda, an ancient Indian sacred collection of Vedic Sanskrit hymns, and the Atharvaveda, the fourth and last Veda of Hindu literature [67]. Bhava Prakasha, written by Bhava-Mishra, is the most important text on herbs/plants and is held in high esteem by modern Ayurvedic practitioners [68–70].

The oldest text of AMM, the Rasa Vaisesika of Nagarjuna, who is considered the most important Buddhist philosopher after Buddha’s death [71], was composed during the 5th century CE. In this text the various concepts of drug composition and action were described [72]. The Charaka Samhita is the first recorded treatise fully devoted to the concepts and practice of Ayurveda, with a primary focus on therapeutics [73]. In the Charaka Samhita, plant-derived drugs are divided into 50 groups according to their pharmacologic/therapeutic actions. The next landmark in Ayurvedic literature was the Sushruta Samhita. Although the text places special emphasis on surgery, it also describes 395 medicinal plants, 57 drugs of animal origin, and 64 minerals or metals as therapeutic agents [74] (Figure 5). In ancient times, Ayurvedic texts were very respected in the neighboring countries, and they were also translated into Greek (300 BCE), Tibetan and Chinese (300 CE), Persian and Arabic (700 CE), and so forth [75].


3.2. Plant Species in India and IHM

India possesses almost 8% of the estimated biodiversity of the world with around 126,000 species there are about 400 families of flowering plants in the world, at least 315 of these can be found in India [79]. Currently, about 45,000 species (nearly 20% of the global species) are found in the Indian subcontinent:

3,500 species of plants are of medicinal value 500 medicinal plant species are used by the contemporary Ayurvedic industry

80% of the medicinal plant species are procured from wild areas and 10% of medicinal plants involved in active trade are obtained from cultivation in farms [80]. The western Himalayan region provides about 80% of herbal drugs in Ayurveda, 46% of Unani, and 33% of allopathic systems [81] 50% of drugs recorded in the British Pharmacopoeia are related to medicinal plants growing in this region [82].

In India, approximately 25,000 plant-based formulations are used in traditional and folk medicines [83]. The number of plant species used in various IM is as follows: Ayurveda, 2,000 Siddha (a type of ancient traditional Indian medicine), 1,300 Unani (a system of alternative medicine first developed by the Islamic physician Avicenna in about 1025 CE), 1,000 homeopathy, 800 Tibetan, 500 modern, 200, and folk, 4,500 [84]. More than 7,500 plant species are currently used in IM, including tonics, antimalarials, antipyretics, aphrodisiacs, expectorants, hepatoprotectants, antirheumatics, and diuretics [85, 86], as well as for the therapy of certain central nervous system disorders [87, 88].

The IHMs are derived either from the whole plant or from different organs, like leaves, stem, bark, root, flower, seed, and so forth, but also include animals and minerals. Some drugs are prepared from excretory plant products such as gum, resins, and latex. Commonly used spices, herbs, and herbal formulae are utilized for therapeutic interventions in about 28 kinds of chronic diseases in humans [89]. Special herbal preparations, known as Rasayans, are used for rejuvenation and retarding the aging process, thereby promoting longevity [90].

Of the 700 plant species commonly used in the Indian herbal industry, 90% of them are collected from the wild. About 50% of the tropical forests, the treasure house of plant, and animal diversity have already been destroyed. Many valuable medicinal plants are on the verge of extinction. The Red Data Book of India in 1997 has 427 entries of endangered species of which 28 are considered extinct, 124 endangered, 81 vulnerable, 100 rare, and 34 insufficiently known species [91]. The Red Data Book of India released in 2012 described 3,947 species as “critically endangered”, 5,766 as “endangered”, and more than 10,000 species as “vulnerable” [92] (Figure 6).


3.3. Pharmaceutics of IHM

Compared to those of CMM, AYM possesses very complex formulae consisting of 30 or more ingredients. In the formula, a number of ingredients, which are properly processed for pharmaceutical application, are chosen to balance the three humoral doctrines (“Vata”, “Pitta,” and “Kapha”). Herbs used in AYM include essential oils extracted from plants, fruits, vegetables, and common spices. The crude herbal material may be ground into powders and put into capsules, cooked into teas, used topically, taken raw, and so forth. IMM preparations on the market and/or Ayurvedic medical practice are complex mixtures including plant- and animal-derived products, minerals, and metals, as well as involving several specific preparatory steps or manufacturing processes.

Kasthoushadhies (herbal preparations) and Rasaoushadhies (herbo-bio-mineral-metallic preparations) are the two major groups of IMM preparations [93]. The latter has a metallic base but ordinarily does not contain active metal, since the metal is converted into an ash or oxide and forms an organometallic compound with a number of organic materials used for trituration as Bhavana Dravya [94, 95].

Medicinal principles are present in different parts of the plant such as root, stem, bark, heartwood, leaf, flower, fruit, or plant exudates. Generally, the herbal remedies can be in various crude dosage forms like pills, powders, essential oil, infusions, or poultices. AYM believes that Sandhana kalpana (biomedical fermented formulations), a unique and complex dosage form containing acidic and alcoholic fermented components, is one of the most effective dosage forms of Ayurveda in practice for thousands of years [96]. During the fermentation process of liquid basic drugs, such as juices or decoctions, alcohol is produced by in-source material used in pharmaceutical procedure. Thus, extraction of active principles of the herbal drugs is done through self-generated alcohol. This formulation has longer shelf life, quick absorption and action, and excellent therapeutic efficacy as compared to other preparations [97].

The specific media are usually used in the manufacturing process of IMM products according to the different preparation. This plays a very important role in either breaking down the chemical compound(s) that is not required or forming the novel active ingredient(s) that is of value to the people, for example, Shodhana (purification/potentiation) of particular poisonous herbs, like Gomutra (cow’s urine) for Shodhana of Vatsanabha (Aconitum ferox Wall.) and Godugdha (cow’s milk) for kupeelu (Strychnos nux-vomica Linn.) [98]. On the other hand, Ayurvedic drugs are usually administered orally along with vehicle materials (Anupana) such as honey, sugar, jaggery, ghee, milk, warm water, and juice of some medicinal herbs. These Ayurvedic Anupana (i.e., drug vehicles serving as a medium of administration) can improve acceptability and palatability and help in absorption of the main herbal remedy moreover, they may also act as an early antidote (Figure 7).


3.4. The Status Quo of IHM

The treatment of disease by Ayurveda is highly individualized and depends on the psychophysiologic status of the patient, particularly in relation to the season of the year [101]. Currently, more than 600 herbal formulas and 250 single plant drugs are included in the “Pharmacy” of Ayurvedic treatments [102] about 1,000 single herbal remedies and 3,000 compound herbal formulations are registered in India. More than 600 herbal formulae and 250 single plants are included in the “Pharmacy” of Ayurvedic treatment [103]. The 6th Indian Pharmacopeia released in 2010 recognized 55 crude herbal drugs, 26 extracts, 3 finished formulations, and 2 pharmaceutical aids that are marketed [104].

According to a study commissioned by the Associated Chamber of Commerce and Industry, the Indian herbal industry is projected to double to 150 billion Rs. by 2015, from the current 75 billion business [105]. In the 1990s, the annual sales of the Indian herbal industry were about 23 billion Rs. (as compared to 145 billion Rs. in the pharmaceutical industry), with a growth rate of 15% [106]. By the end of 2012, the domestic market is expected to reach 145 billion Rs. and the export market 90 billion Rs., with compound annual growth rates of 20 and 25%, respectively [105]. The export market for medicinal plants appears to be growing faster than the Indian domestic market.

India not only has a great role to play as a supplier of herbal products for the domestic market, but it can also benefit from the tremendous potential afforded by overseas markets. Currently, the Indian herbal market is valued at 70 billion Rs., and over 36 billion Rs. worth of raw herbal materials and herbal products is exported [106]. The export of crude herbal extracts amounted to US $80 million, and the total sales of herbal products added up to US $1 billion [107]. Among the exported herbal products, 60% are processed plant materials that are unique to India, 30% are plant extracts, and 10% are Ayurvedic preparations [108]. The plant-derived pharmaceuticals exported from India include isabgol, opium alkaloids, senna derivatives, vinca extract, cinchona alkaloids, ipecac root alkaloids, solasodine, diosgenin/16DPA, menthol, gudmar herb, mehdi leaves, papian, rauwolfia guar gum, jasmine oil, agar wood oil, and sandal wood oil [109]. However, the export of 29 medicinal plants, including plant parts and their derivatives/extracts, obtained from wild sources, is prohibited by the Indian government [109]. Indian herbal medicine has now become a rich source of innovative drug discovery [110].

In India, the turnover of IHM industry is estimated to be more than 88 billion Rs the domestic market is of the order of 40 billion Rs with a total consumption of all IMMs to a figure of 177,000 metric tons (MT). India has 9,493 HM manufacturing units, but 8,000 of them are small scale, one having an annual turnover of less than 10 million Rs. Some of the well-known units (with an annual turnover of more than 500 million Rs.) include Dabur, Zandu, Himalaya, Shree Baidyanath, and Arya Vaidya. They consume about 35% of the total raw IHMs [111].

4. Arabic Herbal Medicine (AHM)

It is well known that ancient Hippocratic-Greek medical knowhow was adapted and improved by Arabian herbalists, pharmacologists, chemists, and physicians in the Middle Ages. Furthermore, the majority of Arabs are Muslims, and Arabic culture and Islamic ideology are closely related. As such, Arabic medicine/materia medica/herbal medicine (AM/AMM/AHM) may also be called Greco-Arab or Islamic medicine.

4.1. Achievements of AM

The Arabic world used to be the center of scientific and medical knowledge for many centuries (from 632 to 1258 CE) after the fall of the Roman Empire. The Legacy of Islam (published in 1931 edited by the late Sir Thomas Arnold and Alfred Guillaume) states, “Looking back we may say that Islamic medicine and science reflected the light of the Hellenic sun, when its day had fled, and that they shone like a moon, illuminating the darkest night of the European Middle Ages that some bright stars lent their own light, and that moon and stars alike faded at the dawn of a new day: the Renaissance. Since they had their share in the direction and introduction of that great movement, it may reasonably be claimed that they are with us yet.” [112].

During the middle ages, AM contributed greatly to the development of modern medicine and pharmacy in Europe. For instance, the European pharmacopoeia relied on Muslim writings and information therein until the late 19th century. Despite the scarcity of medical knowledge in the Koran, Arabs adopted the ancient medical practices that originated from Mesopotamia, Greece, Rome, Persia, and India (or even China) [113, 114]. In the early 11th century, Avicenna (980–1037), a great philosopher and physician, incorporated a number of Chinese herbal preparations in his book Pharmacopoeia. Ancient Arabs established their “Pharmacy” on the basis of physicochemical techniques such as evaporation, filtration, distillation, sublimation, and crystallization used in “alchemy” which was invented by the Chinese [115].

Alchemy is the predecessor of chemical discipline that led to the development of natural science in modern times. Therefore, China is regarded as one of the key players in advancing modern civilization, particularly in the area of scientific methodology. It has been stated that if Greece was the theoretical founder of modern civilization, the Qin/Han dynasty in ancient China was the technical founder of modern natural sciences. Alchemy was invented during the period of Warring States in ancient China, but it vanished for no apparent reason in the middle of the Tang Dynasty. Nevertheless, the spirit of exploration of the ancient Chinese is praise-worthy. Several inventions by Taoist alchemists, such as cinnabar (Zhu-Sha), orpiment (Ci-Huang), and realgar (Xiong-Huang) in CHM, particularly gunpowder, have had a far-reaching impact on modern medicine and on the world in general [115].

Although AM was at the forefront of medical knowledge in Renaissance Europe of the 15th century, unlike CM and IM, its herbal medicine was not well developed from the start. The theory of AM is based on the “humours” of Hippocrates and Galen. There were more “modern” than “traditional” elements in AM therefore, it played a pivotal role in the early formation and development of modern medicine. AM mainly integrated various herbal medicines and related technologies that originated from other countries and regions and established the foundation for the development of medicine and pharmacy in modern medicine [116, 117]. Therefore, AM carried on the past heritage and opened up the future in the history of the development of human medicine (Figure 8).


4.2. Past and Present of AHM

During the 8th century, Arabs in the Baghdad region were the first in history to separate medicine from pharmacological science. The world’s first drug stores were established in the Arab world (Baghdad, 754 CE). The forms employed in that period are still used in therapy, and some formulations of drugs can be found in pharmacopoeias even today [120]. The earliest records of herbs, which were written on clay tablets in cuneiform, were from Mesopotamia (dating back to 2600 BCE). The best known Egyptian pharmaceutical record is the Ebers Papyrus (dating back to 1500 BCE), which documented some 700 herbal medicines (mostly from plants), with dosage forms including gargles, snuffs, poultices, infusions, pills, and ointments and vehicles using beer, milk, wine, and honey [121].

Since the 8th century, the practice of AHM has been using natural remedies, both organic (such as camel urine) and inorganic types, for the prevention and treatment of diseases [122]. Interestingly, pharmacological studies have revealed that camel urine treatment caused a significant cytotoxic effect on bone marrow cells in mice [123]. The Middle East region is inhabited by more than 2,600 plant species, of which more than 700 species are noted for their use as medicinal herbs or botanical pesticides however, only 200–250 plant species are still in use in traditional Arab medicine for the treatment of various diseases [124]. Plant species from the western Mediterranean coastal region (from Alexandria to Sallum, Egypt) comprise 230 species belonging to 48 families 89% of the species had medicinal value, 62% of the species were common, approximately 24.9% were occasional, and 13% were rare [118].

Until now, 236 plant species, 30 animal species, 29 organic substances, and 9 materials of other or mixed origins are still being used in treating human diseases and are sold or traded in the Mediterranean region and/or in the global market [124]. A survey of the plant species in the Mediterranean region by ethnopharmacologists indicated that 250–290 plant species are still in use [125, 126]. In Israel, 129 plant species are used in AM for the treatment of various diseases. Among these plants, there are 40 species used for treating skin diseases, 27 species for treating digestive disorders, 22 species for treating liver diseases, 16 species for treating respiratory diseases and coughing, 22 species for treating various forms of cancer, and 9 species for weight loss and lowering cholesterol [127]. However, more than 1,400 kinds of herbal medicines were used by Islamic physicians during the period of the Arab Empire (632–1258).

The dosage forms utilized in AHM include decoction, infusion, oil, juice, syrup, roasted materials, fresh salads or fruits, macerated plant parts, milky sap, poultice, and paste, of which some formulations of herbal drugs are still used today [128]. Although AHM is the first choice for many people in dealing with ailments in the Middle East, most of the herbalists (such as those in Jordan), who acquire the expertise from their predecessors, are not properly trained in herbal medicine [129] (Figure 9).


In contrast to CHM or IHM, the physical characteristics of the herbal size, shape, color, texture, and taste traditionally served as important criteria in their selection for therapeutic purposes. For example, seeds with kidney shape are used for treating kidney stones roots shaped similar to the human body or fruits that resemble human testicles are traditionally used to stimulate sexual desire or treat sexual weakness a yellow decoction or juice obtained from herbal leaves is used for treating jaundice and liver diseases [131, 132].

5. Discussion

In this section, two important issues related to herbal medicine are discussed.

5.1. The Theoretical Advantages of Herbal Medicine

Due to shortage of scientific evidence on the molecular mechanism of herbs, it is often considered as only an alternative choice to conventional drugs. Here, we attempt to describe the feasibility and superiority of herbal medicine containing complex and multicompounds as medication using logical concepts in philosophy.

Currently, multidrug therapy or polypharmacy, also known as multiple drug intake or cocktail treatment, which involves therapeutic interventions using combinations of drugs (herbal versus chemical, herbal versus herbal, and chemical versus chemical) through pharmacokinetic and pharmacodynamic pathways or both [133–136], is commonly practiced in clinical situations. It is believed that multidrug therapy produces beneficial effects that do not occur when using each drug alone. Due to the additive and/or synergistic interactions among the drugs, or the suppression of adverse effects, multidrug therapy appears to be effective in treating diseases such as cancer, AIDS, malaria, diabetes, hypertension, MRSA, and chronic diseases associated with old age. Nevertheless adverse drug reaction (ADR), another important public health problem, may be enhanced after multidrug combination treatment through not only drug-drug interaction, but also herb-herb or drug-herb interaction [137, 138]. For example, as a monotherapy, St John’s wort extract has an encouraging safety profile. However, in some cases, life-threatening interactions were reported when used together with other drugs [139]. Therefore, the possibility of drug-drug interaction (DDI), including both beneficial effects and ADR, has caused the FDA and European Medicines Agency (EMA) to encourage the industry to perform drug interaction studies [140]. In the new postgenomic era DDI can be predicted with the data from pharmacogenetic information which may have an important implication for the development of personalized medicine and drug R&D for clinic and pharmaceutical industry, respectively [141].

More often than not, the pathogenesis of diseases is related to multiple targets rather than a single target. Asai et al. found that nonsteroidal anti-inflammatory drugs, cholesterol-lowering statins, and

-secretase inhibitors can produce additive effects on the reduction of A -amyloid levels in cultured neuronal cells [142]. Combination therapy of PA-824-moxifloxacin and pyrazinamide can kill over 99% of drug-sensitive and multidrug-resistant Mycobacterium tuberculosis in patients with tuberculosis (TB) within 2 weeks. However, at present, the treatment of patients with TB or multidrug-resistant TB using conventional drug therapy requires 6 or 18–24 months, respectively [143]. A polypill containing amlodipine, losartan, hydrochlorothiazide, and simvastatin produces a significant effect in preventing heart attacks and strokes [144]. Liu Wei Di Huang Wan (Rehmannia Six Formula), which is a well-known Chinese herbal formula used for the treatment of 137 kinds of diseases in China, consists of six Chinese herbs: Radix Rehmanniae nourishes kidney Yin and essence (minute substances for supporting life) Fructus Corni nourishes the liver/kidney and restrains the leakage of the essence Rhizoma Dioscoreae tonifies spleen Yin and consolidates the essence Rhizoma Alismatis promotes urination to prevent buildup of significant fluids Poria drains dampness from the spleen Cortex Paeoniae clears liver fire [145–147]. Therefore, the multitarget herbal formula can produce a wide range of therapeutic effects.

Herbal formulations evolved from thousands of years of experience in practicing herbal medicine. While therapeutic interventions using multiple drugs in modern medicine are based on an understanding of disease processes and drug mechanisms, the use of multicomponent herbal formulae (Fu-Fang in Chinese herbal medicine) is based on CM theory and practical experience. Unlike using a single drug in orthodox medicine, raw plant or plant extracts contain an array of bioactive ingredients (a single plant contains 100–1,000 compounds of 20–50 different structure types) that can produce additive and/or synergistic actions [148]. The multi-ingredient herbal drug/formula allows for a multitarget interaction in treating diseases. For instance, the common cold is a viral infectious disease of the upper respiratory system, which primarily affects the nasal cavity. However, cold symptoms typically include coughing, sore throat, runny nose, headache, fever, and discomfort in the entire body. So far, no single chemical entity can simultaneously alleviate all clinical manifestations of common cold. Therefore a typical over-the-counter cold remedy is composed of multiple drugs, such as aspirin (A), phenacetin (P), and caffeine (C), in an APC tablet.

One and one can add up to more than two. Therefore, herbal treatment resembles a cocktail treatment or “magic shrapnel” (multidrugs act on multiple targets) [149]. The chemical compounds residing in an herbal drug or formulation work together within the body to maintain health and/or fight against diseases. The concept of synergism in modern pharmacology encompasses two aspects: (1) pharmacodynamic synergy results from the enhancement of action when multiple biologically active substances are directed at related targets in a physiological system, which are often linked to the pathogenesis of a disease and (2) pharmacokinetic synergy can result from alterations in drug absorption, distribution, metabolism, and/or elimination (Figure 10).


5.2. Resource Conservation in Herbal Medicine

Excessive medical treatment and medication, including the consumption of herbal medications, is a global trend, especially in developed countries. Countless facts have indicated that herbal preparations or formulations can be used for the treatment of many common as well as complex diseases for all ages, with a minimum of adverse side effects compared to conventional drugs. Together with the long history of their use, plant-derived herbs and herbal products are gaining popularity in the global market as registered drugs, dietary supplements, health care products, cosmetics, and so forth. Medicinal plants are highly esteemed as a rich source of new therapeutic agents for the prevention and treatment of diseases. Nowadays, the public acceptance of herbal medicine increases not only in Asian countries (49% in Japan, 45% in Singapore, 70% in China, and 80% in India), but also in western countries [150]. The sales of herbal drugs or related products are expected to increase at an annual rate of 6.4%. In the USA, the use of herbal products by consumers was less than 5% in 1991, but it increased to 50% in 2004, and the amount of botanical remedies constitutes as much as 25% of total medications. According to a WHO report, the global market value of herbal products to date is US $61 billion, but it is predicted to grow to US $5 trillion by 2050 [151]. The market shares in Europe and the USA are 41 and 20%, respectively [152].

Of the 250,000 higher plant species on earth, more than 80,000 are of medicinal value even in the genome era. In Brazil, it is estimated that there are almost 55,000 native species, at least 1,200 documented medicinal plants, and probably many more undocumented species used by various indigenous groups [153]. It can be expected that natural medicines, particularly herbal medicine, will make a growing or even a decisive contribution to human health care again. By 2001, researchers had identified 122 compounds used in modern medicine which were derived from plant/herb sources. Of these, 80% have an ethnic medical use which is identical or related to the current use of the active component(s) of the plant [154]. Some of these compounds include tubocurarine, morphine, codeine, aspirin, atropine, pilocarpine, ephedrine, vinblastine, vincristine, taxol, podophyllotoxin, camptothecin, digitoxigenin, gitoxigenin, digoxigenin, capsaicin, allicin, curcumin, and artemisinin. Unfortunately, many plant species on earth have become endangered as the consumption of herbs and herbal products continues to increase world-wide.

Traditional herbal medicine uses remedies derived from plants, animals, metals, and minerals. If herbal resources are inappropriately exploited, the extinction of many plant species will inevitably occur, with a resulting adverse alteration of the ecological environment. For example, for more than 30 years wild Panax notoginseng has no longer been found in Yunnan province (the origin of the plant) in China [155] the acquisition of one kilogram of wild licorice will destroy 8–10 acres of grasslands [156] digging of one Cordyceps can cause direct damage to about 30 cm 2 of grassland [157]. To treasure and maintain the gifts from mother nature (Hindu philosophy regards the Earth as a living being, i.e., mother nature), governments should install measures to ensure the ethical exploitation of herbal resources in their countries or societies. Therefore, it is high time to formulate strategies to avoid the overexploitation of herbal resources.

6. Concluding Remarks

Since ancient times, disease has been a leading cause of morbidity/mortality, and it is associated with a heavy economic burden among people with diseases. Despite current advances in science and medicine, disease remains a serious threat to public health in both developed and developing countries, urban and rural areas, and all ethnic groups. Ancient and modern people take medicines to fight illness or to feel better when they are sick. Most medicines (conventional drugs) at present are chemically synthesized and some are isolated from naturally occurring plants on the basis of their use in traditional medicine. However, our ancestors took only certain kinds of specific natural remedies to fight or prevent a specific illness. Because modern drug development is a high-risk (and therefore high-failure) commercial endeavor and synthetic drugs have a high rate of adverse events there is a universal trend of using herbal medications or related products.

Based on cultures and geographical regions, various kinds of herbal remedies have evolved. Herbal medicines are therefore an integral part of culture and geographical environment, and various kinds of herbal medicines have their own unique way of understanding and treating a disease. However, the globalization of trade and market has brought about an integration of different kinds of herbal medicines over the world. At present, herbal medications or related products in the global market are derived from Chinese herbs, Indian herbs, Arabic herbs, and Western herbs. Herbal remedies may also be classified into three categories, namely, modern herbs, theoretical herbs, and empirical herbs, in accordance with their nature/characteristics and the nature of current usage [158]. As for the medications derived from herbs, they no longer belong to any herbal series or category and have essentially become equivalent to conventional drugs. In general, most herbal remedies/formulae are considered to be safe and are well tolerated because they have been successfully used for thousands of years as foods to promote health and as medicines to treat diseases. To date, herbal products are widely available to consumers and have become increasingly popular throughout the world. There is no doubt that herbal products will continue to play a crucial role in the health care system of human societies, not to mention that secondary metabolites of plants are economically important as drugs, fragrances, pigments, food additives, and pesticides (Figure 11) [159].


Conflict of Interests

The authors declared no conflict of interests with respect to the authorship and/or publication of this paper.

Authors’ Contribution

Si-Yuan Pan, Gerhard Litscher, Si-Hua Gao, Shu-Feng Zhou, and Zhi-Ling Yu equally contributed to this work.

Acknowledgments

This paper was supported by the National Natural Science Foundation of China (Grant no. 31071989). The work has also been supported by Sino-Austrian Projects (Austrian Federal Ministries of Economy and Science and of Health) and the European Academy of TCM.

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Copyright

Copyright © 2014 Si-Yuan Pan et al. This is an open access article distributed under the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.


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Comments:

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  3. Weylyn

    I must admit, the one who wrote the nishtyak was sprinkled.

  4. Dorran

    This version is deprecated

  5. Tearlach

    the sympathetic thought



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