Traditional Chinese Medicine : Safety Issues

Acupressure and acupuncture are largely accepted to be safe from results gained through medical studies. Several cases of pneumothorax, nerve damage and infection have been reported as resulting from acupuncture treatments. These adverse events are extremely rare especially when compared to other medical interventions, and were found to be due to practitioner negligence. Dizziness and bruising will sometimes result from acupuncture treatment.

Some governments have decided that Chinese acupuncture and herbal treatments should only be administered by persons who have been educated to apply them safely. “A key finding is that the risk of adverse events is linked to the length of education of the practitioner, with practitioners graduating from extended Traditional Chinese Medicine education programs experiencing about half the adverse event rate of those practitioners who have graduated from short training programs.”

Certain Chinese herbal medicines involve a risk of allergic reaction and in rare cases involve a risk of poisoning. Cases of acute and chronic poisoning due to treatment through ingested Chinese medicines are found in China, Hong Kong, and Taiwan, with a few deaths occurring each year. Many of these deaths do occur however, when patients self prescribe herbs or take unprocessed versions of toxic herbs. The raw and unprocessed form of aconite, or fuzi is the most common cause of poisoning. The use of aconite in Chinese herbal medicine is usually limited to processed aconite, in which the toxicity is denatured by heat treatment.

Furthermore, potentially toxic and carcinogenic compounds such as arsenic and cinnabar are sometimes prescribed as part of a medicinal mixture or used on the basis of “using poison to cure poison”. Unprocessed herbals are sometimes adulterated with chemicals that may alter the intended effect of a herbal preparation or prescription. Much of these are being prevented with more empirical studies of Chinese herbals and tighter regulation regarding the growing, processing, and prescription of various herbals.

In the United States, the Chinese herb má huáng (麻黄; lit. “hemp yellow”) — known commonly in the West by its Latin name Ephedra — was banned in 2004 by the FDA, although, the FDA’s final ruling exempted traditional Asian preparations of Ephedra from the ban. The Ephedra ban was meant to combat the use of this herb in Western weight loss products, a usage that directly conflicts with traditional Asian uses of the herb. There were no cases of Ephedra based fatalities with patients using traditional Asian preparations of the herb for its traditionally intended uses. This ban was ordered lifted in April 2005 by a Utah federal court judge. However, the ruling was appealed and on August 17, 2006, the Appeals Court upheld the FDA’s ban of ephedra, finding that the 133,000-page administrative record compiled by the FDA supported the agency’s finding that ephedra posed an unreasonable risk to consumers.

Many Chinese medicines have different names for the same ingredient depending on location and time, but worse yet, ingredients with vastly different medical properties have shared similar or even same names. For example, there was a report that mirabilite/sodium sulphate decahydrate (芒硝) was misrecognized as sodium nitrite (牙硝), resulting in a poisoned victim. In some Chinese medical texts, both names are interchangeable. Chinese herbal medicine authorities are working towards improved standards in this area.