China's medicine wars

An attack on the traditional healing arts has inflamed adherents and sparked a debate about Western healthcare.

By Mark Magnier, L.A. Times Staff Writer
January 8, 2007

Xikou, China — THE fur is flying, not to mention the acupuncture needles, the firewort and the $15,000-a-pound bull gallstones. China's ancient healing arts, as integral to national identity as the Great Wall or steamed dumplings, have become embroiled in the country's struggle to balance tradition and modernity.

A relatively obscure professor at a regional university kicked off the controversy in October with an online petition calling for traditional medicine to be stripped from the Chinese Constitution. It has a protected status here that, at least in theory, guarantees it equal footing with its Western counterpart.

Professor Zhang Gongyao and fellow critics have blasted Chinese medicine as an often ineffective, even dangerous derivative of witchcraft that relies on untested concoctions and obscure ingredients to trick patients, then employs a host of excuses if the treatment doesn't work.

For adherents of the 3,000-year-old system, this borders on heresy. The Health Ministry labeled Zhang's ideas "ignorant of history," and traditionalists have called the skeptics traitors bent on "murdering" Chinese culture.

Ironically, the firestorm dovetails with a growing embrace of Chinese medicine abroad as an antidote to the perceived soulless, money-obsessed nature of Western healthcare.

On a trip to China in mid-December, U.S. Health and Human Services Secretary Mike Leavitt said the two countries planned to trade lessons on how to integrate Western and Chinese medicine.

"It's an area of interest for China and the U.S.," he said.

Many Australians, Europeans and Americans see the limitations of advanced science, said Rey Tiquia, an expert in Chinese traditional medicine based in Australia, even as more Chinese view their traditions as old-fashioned.

"For Chinese," he said, "it's still the lure of something new and shiny, like riding a car rather than a bicycle."

Since 1949, the number of traditional doctors trained in China has fallen by nearly half to 270,000, while the number of Western-trained doctors has jumped twentyfold to more than 1.7 million.

Criticism that traditional medicine is not scientific dates back centuries. But Zhang's prescriptive remedies — including an end to national insurance coverage for traditional medicine, rigorous scientific standards and obligatory Western training for traditional doctors — have hit a nerve at a time when traditional Chinese medicine is increasingly on the defensive.

At Beijing's prestigious Xiehe Hospital, cardiology, gynecology, internal medicine and other Western specialties are housed in a new six-story building filled with shiny equipment, well-maintained halls and renovated toilets. The traditional medicine department is relegated to eight consulting rooms and a therapeutic facility in an outer building with peeling green paint, water-stained walls and a foul smell emanating from a dimly lighted toilet.

Some blame skewed financial incentives and a government that is forgetting its roots.

"The Health Ministry is actually the Ministry of Western Health," said Lin Zhongpeng, a researcher with the Beijing Tianren Yiyi Traditional Medicine Institute. "It's also shocking that doctors get 15% kickbacks selling Western drugs."

TRADITIONAL remedies tend to be less expensive than Western ones. At the Tongrentang traditional pharmacy and clinic along Dashila alley in Beijing, a dozen people waited for football-sized bags of herbs for a few dollars each.

"Give me some deer sinew," said one customer, asking for a traditional cure for arthritis. "Large or small?" a clerk in a white coat asked, grabbing several from a tray.

But there are some notable, more expensive exceptions. In glass cases, beneath an ad touting an herbal tonic for avian flu, shelves brimmed with dried snakes, sea horses, ground-up pearls and deer horn powder, used for ailments such as rheumatism, paralysis, asthma, epilepsy, gastritis and acute infantile convulsions.

Nearby sat an ornate green box lined with red satin holding a shriveled deer penis and testicles ensemble for $63 — nature's apparent answer to Viagra. "That's to improve male function," an employee explained helpfully.

Deer privates at nearly a month's average wage hardly top the price list.

"The most expensive would be bull gallstones," a clerk said, pointing at a yellowish shrink-wrapped object the size of a nickel, used for fevers and inflammation.

In an adjoining building, third-generation traditional doctor Guan Qingwei examined several patients, prescribing different herbal combinations for insomnia, high-blood pressure and rashes.

Unlike Western medicine, which focuses on the disease, traditional medicine takes a holistic approach, he said. Adherents of "ZangXiang," one of the discipline's fundamental tenets, believe the body gives external clues to the imbalance of internal organs, which can be rectified with herbs and acupuncture. This makes knowledge of anatomy unnecessary, he said.

Both systems have their strengths, Guan said, but judging traditional medicine according to Western scientific theory and using "double blind" tests on herbal remedies is inappropriate.

"Not only is it unfair, it's laughable," he said. "It's like judging hamburgers based on the taste of dumplings."

Although Chinese schools pump out thousands of traditional medicine graduates each year, nearly half never practice — they chose the specialty because other departments were full.

This is in contrast with the United States, where most people who study medicine are mature, highly motivated students.

A Chinese government delegation on a recent visit to California said the U.S. could surpass China soon as the best place to learn traditional medicine, said Lixin Huang, president of the American College of Traditional Chinese Medicine in San Francisco, the nation's oldest such graduate program.

Traditional medicine in China tends to be more popular in rural areas and among older people, in part because of its lower cost.

Each day here in the farm village of Xikou, traditional doctor Liu Huade, 92, sees as many as a dozen patients suffering from ailments such as kidney failure, "women's problems" and liver tumors. Until a few years ago, he picked all of his own herbs in the nearby mountains.

Liu Qiuyao, 59, stopped by to have his pulse checked. Privacy was hardly a concern as a dog wandered in and out of the one-room consultation area accompanied by several villagers eager to chat or buy pills.

Two years ago, Liu, an impoverished farmer, spit up blood and was told to go to a Western medicine hospital, but he couldn't afford it. So he came to the traditional doctor, who cured him with herbs.

"I'd rather come here," he said, his right eye fused shut beneath a shock of unkempt hair. "When a prescription is too expensive, Dr. Liu tells me where to pick the herbs myself."

A common criticism of Chinese medicine involves its often-unregulated ingredients.

"Many herbal medicines considered innocuous are actually very toxic," said Fang Zhouzi, a biochemist, columnist and founder of a website that targets academic fraud. "But practitioners and proponents cover this up using various excuses."

THE U.S. Food and Drug Administration banned products marketed as Chinese herbal medicine during the 1970s and '80s after they were implicated in several deaths. In 2004, the FDA issued a ban on the controversial herb ephedra after it was linked to heart attacks and strokes.

Chinese traditional experts blame misuse. They point to guan mu tong, which has been used for centuries to treat urinary tract infections. Problems surfaced only when Westerners used it incorrectly as part of a weight loss therapy, they say.

Nor are Western drugs free of powerful side effects, others counter.

"Why don't people talk about Western medicines that cause problems?" said Zheng Jinsheng, a professor at the Academy of Chinese Medical Sciences in Beijing, who thinks both disciplines have their place. "Why is traditional medicine always blamed?"

Chinese medicine's use of endangered animal and plant ingredients also has been cause for concern. Officially, China forbids trading in the items, but rising incomes and old habits threaten species worldwide.

Only about 30 Chinese tigers, hunted for their bones and other parts, remain in the wild, experts estimate, compared with tens of thousands a few decades ago. Tiger parts are used for rheumatism and to increase virility.

Substances such as bear gallbladder bile are legal, but the cruel conditions under which they are "farmed" have attracted worldwide criticism.

"People in China need to change their values," said Mang Ping, associate professor at Beijing's Central Institute of Socialism. "And most of the time there are replacements in traditional medicine."

Dog bones, for example, are now recommended in lieu of tiger bones, buffalo horns for rhinoceros horns.

Western medicine was introduced to China by missionaries in the late 16th century, though it remained largely a curiosity for centuries. Starting in the early 19th century, missionary hospitals became more widespread as European nations elbowed for influence in a weakened China.

"There was a proverb that the door that couldn't be opened with a gun could be opened with a single surgery knife," said Zheng, the professor at the Academy of Chinese Medical Sciences.

In 1914 and again in 1929, pro-Western governments tried unsuccessfully to ban traditional medicine as backward and unsafe, spurred by the likes of intellectual Liang Qichao, who had his healthy right kidney accidentally removed by Western-trained doctors but still sung their praises.

Traditional doctors, threatened with the loss of their livelihoods, spread rumors that Western doctors removed Chinese organs and stored them in their churches, using children's hearts in demon rituals.

"We must never forget our roots," said Li Jian, 46, a business consultant, accompanying his father to a traditional doctor for a liver ailment. "Western medicine always tries to judge traditional medicine from its perspective. Maybe if China becomes very powerful one day, we'll return the favor."

mark.magnier@latimes.com

*

Yin Lijin of The Times' Beijing Bureau contributed to this report.

Why is Yosan so popular?

In addition to myself, there are two other people transferring from PCOM-NY and starting at Yosan next semester. None of us know each other! I know there is at least one other person transferring after next semester. Hmmm...

Commute Time

In this week's New Yorker, there's an article about commuting. Did you know that the average commute time in America is 51 minutes? The vast majority of those commuters go by car. According to the article, commuting by car increases social isolation and leads to increased unhappiness (not to mention all the fossil fuels used - google ocean acidification). New Yorkers are supposedly the happiest urban commuters in the U.S.A. - possibly due to our shared sense of community when we're on the train...

I'm so glad I'm in a field where I can pretty much set up anywhere and do business. I plan to live "over the store" as they say - I want my commute to be down a flight of stairs or across a courtyard.

[speaking of courtyards, I've always had the dream of having an interior courtyard. You know, a house with the garden in the middle of it rather than in the front or back. With a packed earth platform for doing martial arts.]

There's a bit in the article about how people trade social goods for material goods. In other words, people trade time with their kids, time with friends, and home cooked meals for bigger houses, more space between them and their neighbors, bigger autos. HOW SAD!

By the way, I am moving to Los Angeles. I've had enough of PCOM. There may be a few more posts but essentially I'm done. Orientation at Yosan is April 27th and I'm going to be there...

A Note To Teachers

If you read out of a book or directly from a handout for the entire class period, please stop. You're embarassing yourself. Is this not a 'masters' degree we're studying for? Come on. Get a grip! Have some pride! Try and think about how to make your class better. Students will love you for it.

World Medicine Institute

Take a look at this school... then contrast the general attitude and feel you get from the website with our school... it'll make you weep.

Imagine, a school where more than a few people actually practice and cultivate their qi on a daily basis!

Comparison of Mission Statements
World Medicine Institute	PCOM*
The College prepares professional acupuncture and Oriental medicine practitioners who, after fulfilling state requirements, which typically require passing National Board examinations, are technically proficient and have a deep understanding, sensitivity, insight, and intuition into a patient's physical, emotional, intellectual, energetic, and spiritual health needs. Professional practitioners are trained within the context of Taoist heritage, philosophy, and traditions rooted in the Six Taoist Arts of the Chou Dynasty, which are an essential component of the College and the Foundation.	Pacific College exists to constantly reinforce the superior effectiveness of Western clinical diagnosis skills over the traditional Chinese signs such as tongue and pulse. Students will learn to trust the judgement of MD's over their own observations and to treat Western disease categories rather than TCM patterns. Following the example of our founder and school CEO, Jack Miller, students will learn how to create a niche market for themselves and become successful entrepreneurs.
*For those without a sense of humor, I feel obliged to point out that the World Medicine Institute's mission statement is REAL, and the one allegedly from PCOM is FAKE, written by me as a JOKE, albeit a BITTER JOKE with a HIGH DOSE OF REALITY. See? I just ruined the joke.

Ho's Trading Inc. Issues Alert on Undeclared Sulfites in Fortune Star Brand Dried Lily Bulb

Contact: Alvin Ho 718-622-2288

FOR IMMEDIATE RELEASE -- Brooklyn, NY -- February 5, 2007 -- Ho's Trading Inc, 1010 Dean Street, Brooklyn, NY 11238 is recalling Fortune Star Brand Dried Lily Bulb, because it contains undeclared sulfites. People who have severe sensitivity to sulfites run the risk of serious or life-threatening allergic reactions if they consume this product.

The recalled Fortune Star Brand Dried Lily Bulb is packed in 10 oz., un-coded plastic bags. The products were sold nationwide.

The recall was initiated after routine sampling by New York State Department of Agriculture and Markets Food Inspectors and subsequent analysis of the product by Food Laboratory personnel revealed the presence of undeclared sulfites in Fortune Star Brand Dried Lily Bulb which did not declare sulfites on the label. The consumption of 10 milligrams of sulfites per serving has been reported to elicit severe reaction in some asthmatics. Anaphylactic shock could occur in certain sulfites sensitive individuals upon ingesting 10 milligrams or more of sulfites.

No illnesses have been reported to date in connection with this problem.

Consumers who have purchased Fortune Star Brand Dried Lily Bulb should return it to the place of purchase. Consumer with any questions may contact the company at 718-622-2288.

The Pitfalls of For-Profit Schools

Very revealing article in the New York Times today about Phoenix University - the nation's largest private university, which happens to be for-profit, much like our beloved Pacific College of Oriental Medicine.

Here's the lede:

The University of Phoenix became the nation’s largest private university by delivering high profits to investors and a solid, albeit low-overhead, education to midcareer workers seeking college degrees.

But its reputation is fraying as prominent educators, students and some of its own former administrators say the relentless pressure for higher profits, at a university that gets more federal student financial aid than any other, has eroded academic quality.

Sound familiar?

Take a look at the full article===>

Beijing Orders Investigation of Health Agency

This article, from today's New York Times, seems to talk only about pharmaceutical drugs - I wonder if TCM products are affected.

See also: pcomstudents.net

SHANGHAI, Feb. 9 — Concerned about a growing number of cases that involve the sale of fraudulent or dangerous medicine, the Chinese government said today that it had ordered a thorough investigation into the agency that is supposed to be the national regulatory watchdog, the state food and drug administration.

The move comes amid a widening investigation into corruption in the country’s fast-growing pharmaceutical industry.

Small Chinese drug makers have long been accused or suspected of producing cheap counterfeit versions of well-known drugs, often using substandard or hazardous substitute ingredients, and selling them to the nation’s hospitals and pharmacies.

Some of those phony drugs have been blamed in recent years for widespread illnesses and scores of deaths.

Now, the government says that corruption in the state food and drug administration, which is based in Beijing, was a major part of the problem.

The government said it had detained Zheng Xiaoyu, the head of the agency from its founding in 1998 until June 2005, when he retired, and that it is investigating whether Mr. Zheng accepted bribes from Chinese pharamaceutical companies in exchange for approving drug production licenses.

The state-run news media said that a high-level government body was recently told that Mr. Zheng had “neglected his duty to supervise the drug market, abused the administration’s drug approval authority, took bribes and turned a blind eye to bad practices by relatives and subordinate officials.”

Two other high-ranking officials of the agency have also been detained. In November, one of them, the director of the division in charge of issuing production licenses, was sentenced to 15 years in prison for corruption.

No western drug companies appear to be involved in the investigation, though some global drug companies have complained about Chinese counterfeiting of their most popular drugs.

Even so, the scandal may have global implications, because experts say that a large percentage of the medicine sold in the developing world is counterfeit, and that China is a main source.

The scandal is almost certain to intensify concerns in the global pharmaceutical industry about China’s regulatory controls and its oversight of a drug industry that has a history of infringing drug patents and trademarks.

The investigation was ordered by senior government leaders, including Premier Wen Jiabao and Vice-Premier Wu Yi, an indication of how serious the problem of fraudulent drugs has become in China.

Reports of illnesses and deaths caused by dangerous foods or fraudulent drugs have been frequent in recent years. Last May, for instance, 11 people died in China after being given injections tainted by a fake chemical.

In July, six people died and 80 people fell ill nationwide after taking an antibiotic that was produced using a “substandard disinfectant.”

An even more sensational case occurred in 2004, when at least 13 babies died and more than 100 other children suffered from severe malnutrition in eastern Anhui Province after being fed fake milk powder.

The authorities here are also trying to crack down on the production of unlicensed generic versions of popular drugs.

Last May, 10 people were arrested here in Shanghai for selling knocked-off Tamiflu, a drug used to prevent and treat influenza.

In a statement posted on the food and drug agency’s web site today, Wu Yi, the vice premier, said the government would severely punish the “wicked activities” that put adulterated food and drugs on the market.

Worried that corruption may have seeped into the top levels of the agency, the government said on Thursday that it would review more than 170,000 production licenses issued over the past decade, particularly those issued between 1999 and 2002.

The inquiry is expected to slow the drug approval process at a time when demand for medicine is soaring in an overburdented health care system.

Zhu Changhao, vice chairman of the China Association of Pharmaceutical Commerce, a Beijing-based trade group, acknowledged today that “corruption certainly exists in the drug administration system.”

But, he added, “I wouldn’t say that the whole drug administration system is corrupt.”

The problems with fake drugs in China have been developing for years. As long ago as 2000, officials were warning about “illegal medicine fairs” and widespread counterfeiting. In 2002, Mr. Zheng, a 20-year veteran of China’s drug industry, told a conference that his agency had uncovered 70,000 instances of fake drugs in the first half of that year alone, and said he was working to crack down on the problem, according to reports in state-run news outlets. The agency was reported to have revoked the business licenses of some 160 manufacturers and retailers in 2006.