🌿 Folk Prescriptions

The TCM community, long attempting to interpret TCM therapeutic functions using modern language, now finds itself adjusting its strategy and approach. This shift stems from changes in the content of the highest legal standard for pharmaceuticals—the "Chinese Pharmacopoeia."
According to the National Pharmacopoeia Commission, the 2005 edition of the "Chinese Pharmacopoeia" will standardize the functional and therapeutic descriptions of over 1,400 Chinese patent medicines. Notably, terms like "lower blood pressure" and "anti-inflammatory" from Western medicine will be replaced by TCM terminology to highlight the characteristic of TCM syndrome differentiation-based medication.
What caused the inconsistency in describing TCM functions? Experts from the National Pharmacopoeia Commission explain it results from historical and academic reasons. What prompted the shift from "Westernized" to TCM "syndrome differentiation" in drug labels? Experts believe it is necessary for guiding clinicians and patients to use medicines correctly, as well as applying TCM theory to TCM production and new drug registration. Some experts argue that whether it was "inconsistent" or returning to "syndrome differentiation," both trends ultimately reflect the ongoing "collision" between TCM and Western medicine cultures.
On September 30, the collection of opinions on standardizing TCM functional descriptions will conclude. Yet, this does not eliminate the cultural clash between TCM and Western medicine.
How difficult is it to articulate one culture through another?
Jianzhen’s journey to Japan brought TCM to Japan, and Zheng He’s voyages introduced TCM to Southeast Asia. In distant eras, TCM overcame geographical barriers and took root abroad. Today, whether striving for global reach or local development, TCM faces a formidable barrier: cultural gap.
Xue Yidequan, Deputy Director of the State Food and Drug Administration, believes TCM, as part of Chinese traditional culture, possesses unique theories and language. Terms like "upper fire," "qi deficiency," and "yin-yang imbalance" are unclear even to most modern Chinese, let alone Westerners. Without understanding, effective communication is impossible.
How to use modern language to "translate" the ancient, profound TCM terminology and achieve "modern" expression of TCM functions? Many see this as the key to TCM’s global outreach.
Dr. Qiao Shan Yi, Associate Researcher at the Academy of Military Medical Sciences and a plant chemist, argues that expressing TCM therapeutic functions using TCM terminology is not unscientific—it’s simply that modern science cannot explain it. He illustrates: What does "nourishing yin and yang" mean? Western medicine cannot explain it, and even Chinese researchers may struggle to express it adequately. He believes holding onto the past prevents acceptance by the world.
How can we achieve this "modern expression"? Qiao Shan Yi cites research on the classic formula "Liuwei Dihuang Wan" initiated by the Academy of Military Medical Sciences since 1995. The study found that the formula’s "nourishing yin and yang" effect resembles the "neuro-endocrine-immune network" regulation studied in Western medicine. He believes using such modern scientific methods provides a powerful "bridge" that convinces people.
Qiao Shan Yi emphasizes that the "bridge" depends on clarifying the material basis of TCM effects and scientifically explaining pharmacology and mechanisms of action.
Meanwhile, Director of the Chinese Association of Traditional Chinese Medicine, member of the National TCM Protection Review Committee, and expert Zhao Shengli believes TCM and TCM theory cannot be separated. Only when applied according to TCM theory can it be truly called TCM. For example, charcoal is used for hemostasis and astringency in Western medicine, and also used for hemostasis in TCM, but the theoretical foundations differ. Western medicine uses charcoal’s strong adsorption property, while TCM uses its black color, associated with "water" in the Five Elements; blood is red, associated with "fire." "Water" controls "fire." He argues that ignoring these differing theoretical foundations and forcing translation leads to dead ends.
Zhao Shengli believes the clash between TCM and Western medicine is actually a cultural clash between Chinese and Western cultures, not a matter of TCM being backward or Western medicine being advanced. He insists that TCM’s concept of Yin-Yang is not superstition but has been validated by over a thousand years of clinical practice. He believes TCM has millennia of historical accumulation and a complete theoretical system, making its theory incomparable to Western medicine’s.
Qiao Shan Yi also notes that due to cultural background and theoretical system differences, combined with the inherent complexity of TCM, modern scientific methods still struggle to explain the essence and rich connotations of TCM. Additionally, long-standing lag in foundational research on TCM applications has led to low technological content in patent medicines, lacking standardized, reliable data and controllable quality standards. Therefore, achieving "modern" expression of TCM will remain a long process.
The "Component Approach" Troubles the TCM Community
Since the "Seventh Five-Year Plan" and "Eighth Five-Year Plan" periods, China has drawn on chemical drug research experience, studying the chemical components of over 200 commonly used single herbs, discovering more than 500 active compounds. Currently, dozens of single herb compounds and active fractions have shown high clinical efficacy, such as artemisinin for malaria and tripterygium glycosides for lupus erythematosus.
Qiao Shan Yi believes starting from chemical analysis, establishing corresponding models to identify active components, then refining and purifying them is crucial. He asserts that active components are vital for determining TCM’s mechanism of action.
Zhao Shengli counters that Western medicine focuses on active components, whereas TCM emphasizes four natures, five flavors, rising-descending-floating-sinking, and meridian tropism. He gives examples: Iron oxides like Fe₂O₃ and Fe₃O₄ are insoluble in water but still exhibit sinking effects in TCM, such as stopping vomiting. Ginseng replenishes vital energy; modern research shows it contains ginsenosides, but the concentration in leaves is over 20 times that in roots. Why do roots yield better clinical results? He argues that TCM’s four natures, five flavors, rising-descending-floating-sinking, and meridian tropism guide clinical formulation, and these principles remain difficult to explain using chemical components and pharmacological effects.
Qiao Shan Yi acknowledges that purification of single-herb extracts has made progress, and significant achievements have been made in formula research. He believes TCM is part of natural medicine, and foreign applications are largely purified. Foreign countries have strong foundations in natural medicine research, allowing mutual advancement.
Zhao Shengli insists that if TCM is extracted solely using Western medicine research methods, it ceases to be TCM. He believes maintaining TCM’s unique characteristics is essential for global acceptance. He notes that purification is only part of TCM—extracting berberine from Coptis only treats diarrhea, whereas whole Coptis can treat acute eye inflammation, mouth ulcers, tongue sores, burns, enteritis, and dysentery. He explains that TCM formulas follow the principle of sovereign, minister, assistant, and envoy, with interactions like mutual enhancement, mutual assistance, mutual inhibition, and mutual antagonism, working synergistically to strengthen the body and expel pathogens. He stresses that the interactions among chemical components in TCM formulas are extremely complex and not merely additive of individual herb components.
What Does "Modernization of TCM" Mean?
Xue Yidequan believes TCM is a science and, as such, evolves and discards outdated elements. He says TCM has endured from the "Inner Canon" to "Shennong Bencao Jing" to "Treatise on Cold Damage" precisely because it adapts to changing times. To flourish today, TCM must modernize; without modernization, it cannot be accepted in modern life.
The National "Ninth Five-Year Plan" research project on "Strategic Development of TCM Modernization" states that TCM modernization involves inheriting and promoting TCM’s advantages and characteristics, fully utilizing modern scientific and technological methods and international pharmaceutical standards, researching and developing TCM products legally marketable internationally, and enhancing TCM’s competitiveness in the global market.
Qiao Shan Yi believes TCM modernization should first be scientific. Scientific modernization has two core aspects: one is industrialization of TCM, and the other is sustained fundamental research. He argues that it’s not about aligning with international standards, but rather about international standards adapting to us.
Zhao Shengli believes that during TCM modernization, industrialization and scaling must pay attention to authentic medicinal materials. TCM efficacy is constrained by sunlight, temperature, soil, moisture, and other geographical conditions. Overemphasis on scale is unscientific. Rarely used medicinal materials cannot achieve large-scale production. He warns of a painful lesson: mass "northward migration of southern herbs" and "southward cultivation of northern herbs" destroyed the authenticity of medicinal materials, making recovery difficult. He notes that clinically common TCM herbs number around 500, with only about 200 suitable for artificial cultivation. The remaining 300 cannot be scaled up. Furthermore, different TCM herbs require different processing methods, with significant regional variations. Thus, TCM modernization means modernizing processing equipment, but TCM dispensing cannot be modernized.
Zhao Shengli emphasizes that when using modern technology for TCM quality control, one must adhere to TCM theory and not overlook the accumulated experience of thousands of years. He notes that fingerprint profiling can monitor a TCM’s components but cannot assess its grade. Talent for grading TCM is severely lacking. Medical colleges increasingly train TCM professionals like Western medicine specialists, losing essential traditions. He believes neither the chemical drug model nor the plant drug model constitutes true TCM modernization. Only a modern TCM model guided by TCM theory is genuine modernization.