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December 5, 2023

Chinese Patent Medicine and Over-the-Counter Herbalism

Wooden herbal apothecary drawers, labeled with Chinese script

The phrase “Chinese patent medicine” extends to describe herbal recipes generally composed into pill or tablet form for wider accessibility and streamlined dosing when compared to more traditional raw herb decoctions. Their preparation into prepackaged prescriptions descends from formulations in ancient texts, such as the Shang Han Lun and the Jin Gui Yao Lue, time tested by generations for over 2,000 years. This historical context establishes not only the ingredient herbs, but the preparation required for single herbs before they are mended together, and the harmonizing proportions necessary to bring out the intended effects of the entire composition.

Chinese Traditional Medicine; herbal tea pills

Tea pills are made starting with ground herbs mixed into a paste with a binder – water, honey, or a liquid herbal extract – then rolled or spun into small pearls for individual dosage. Traditionally the honey would act with an additional importance to preserve the medicinal properties. Alternatively, larger balls containing multiple servings would be encased by a wax layer to this potency, then be cut to size and taken by patients at home.

In China today these formulas are proprietary, highly standardized to monographs in the Chinese pharmacopeia and their production standardized by government pharmaceutical factories. This industry regulation sets the quality standard and leaves a minimal risk margin to cause harm or worsen illness, perfect in tone for over-the-counter purchasing.

herbs organized and unwrapped from brown paper sachets

Taking Illness into Account

In colder seasons the cool air brings us an increased susceptibility to viral pathogens. Mucus membranes lining the nose and throat are dried out and weakened, reducing our natural immunity. In TCM, climatic “Wind” can influence both external and internal degeneration and invade our bodies as during its illness. Symptoms associated with wind invasion are often “dry”, and follow a movement pattern of come and go, inconsistent headaches or bodily pain, rashes that move around, even seasonal allergies.

A diagnosis of a “Pathogenic Wind-Cold” translates as a common cold with symptoms like an occasional scratchy or sore throat, sudden fatigue, neck or body stiffness, slight headaches and runny nose/congestion. At the first sign of illness it is commonly advised to take Gan Mao Ling. Gan Mao Ling’s proprietary formula is a blend of Ilex asprella root, Evodia lepta (similar to echinacea), Isatis Indigotica Root, Chrysanthemum flowers, and Honeysuckle. This formula can be taken to treat mild wind-cold and early stages of wind-heat to clear toxic heat and disperse wind while regulating and tonifying (Lung) Qi.

    Gan Mao Ling

  • Ilex asprella root–Gang mei gen: Supports respiratory system
  • Evodia lepta herb– San cha ku: Supports respiratory system
  • Chrysanthemum indicum flower– Ye ju hua: Clear wind heat
  • Vitex negundo herb– Wu zhi gan: Guide to sinuses
  • Isatis indigotica root– Ban lan gen: clear heat, relieve toxicity
  • Lonicera japonica flower–Jin yin hua: clear heat relieve toxicity

Another immune system ally, Yin Qiao San, can be advised for “Wind-Heat” invasions, presenting as an occasional sore throat, red irritated eyes, mild body aches, slight cough, an aversion to wind/cold, with itchy red skin lesions that move around the body. Yin Qiao may be called for, alternative to Gan Mao Ling, when symptoms are more pronounced in deeper stages of illness. Herbs Lonicera japonica flower, Forsythia suspensa fruit, Arctium lappa fruit, Platycodon grandiflorum root, Mentha haplocalyx, Glycine max bean-prep, Glycyrrhiza uralensis root, Schizonepeta tenuifolia, and Lophatherum gracile work to clear toxic heat and disperse wind through releasing the exterior – promoting sweating.

    Yin Qiao San

  • Lonicera japonica flower–Jin yin hua: clear heat relieve toxicity
  • Forsythia suspensa fruit– Lian qiao: clear heat relieve toxicity
  • Arctium lappa fruit– Niu bang zi: clear heat, release exterior
  • Platycodon grandiflorum root– Jie geng: dissolve phlegm
  • Mentha haplocalyx herb– Bo he: release exterior
  • Glycine max bean– Dan dou chi: release exterior
  • Glycyrrhiza uralensis– Gan cao: harmonize, clear heat toxin
  • Schizonepeta tenuifolia– Jing jie: warmth to moderate cold in formula, release exterior
  • Lophatherum gracile herb– Dan zhu ye: strongly clear heat
Plum Flower-brand Yin Qiao and Gan Mao Ling formula bottles held in a basket of herbs

Image Courtesy of MayWay Herbs

It’s worth noting that Gan Mao Ling and Yin Qiao are relatively modern formulas considering the long heritage of Chinese herbal medicine and have origins in the last couple hundred years. Gan Mao Ling was created through contemporary research in Taiwan and then brought to China in 1988. Yin Qiao San, written by Dr. Wu Ju-tong, was published in his Wen Bing Tiao Ban (Systematic Differentiation of Warm Diseases) in 1798.

Both formulations can be taken at the onset of cold-like symptoms, but not earlier as neither should be taken too often as preventative medicine. To help determine which may be most effective, patients that run cold, or first present with malaise or a runny nose – signs of cold – may respond best to Gan Mao Ling. Because the pattern of these symptoms often linger or diminish to reappear this formula may be useful at a reduced dose for milder symptoms at the end of sickness to support extending immunity. Patients that run hot, or first present with redness or a sore throat – signs of heat – may respond quickly to Yin Qiao. Patients should stop use when symptoms disappear.

Asian herbal pharmacist weighing herbs with a manual scale

Trust and Transparency to Build an Herbal Confidence

Alongside the standardization of medicine, local practitioners may still write specific formulas – more intimate to the needs of their clients – or make modifications to these time rested ratios based on what is available in local markets – as is allowed overseas/outside of the PRC. It is important to remember that in consideration of any existing or potential variation, ingredient lists should be readily available. Items sold at your local herb shop should have legible labels or translations of original labels provided. At the AIMC Clinic our supervisors and student clinicians will be able to advise you transparently around any herbal prescriptions and component concerns. Book your appointment today!

About the Author

Wana holding a potted squash

Wana is a second year master’s student at AIMC with groundwork practice in reproductive and public health. They connect to East Asian Medicine through an ancestral root, and believe that land-based indigenous medicines deserve the privilege to supplement or substitute western care practices as conduits of more intimate contemporary healing.

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