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Chinese medicine has a long history in the United States, dating back to its colonial period and extending up to the present. This essay focuses on the earliest generation of practitioners of traditional Chinese medicine in the United States. Although acupuncture is the modality most commonly associated with Chinese medicine in today's medical marketplace, up until the 1970s, Chinese healers in the United States typically specialized in herbalism. Well before mass emigration from China to the United States began, Chinese material medica crossed the oceans, in both directions: Chinese medicinal teas and herbs came west while Appalachian ginseng went east. Beginning in the 1850s, Chinese immigrants came to the United States and transplanted their health practices, sometimes quite literally by propagating medicinal plants in their adopted home. Over time, Chinese doctors learned how to sell their services to non-Chinese patients by presenting herbalism as "nature's remedies.". [ABSTRACT FROM AUTHOR]

Background: Complementary and alternative medicine (CAM), such as acupuncture and herbal medicine, is popular in many countries. Yet, treatment outcomes of CAM are found to vary significantly between medical trials in different social environments. This paper addresses how the social organization of medicine affects medical treatment outcomes. In particular, it examines the extent to which two popular complementary and alternative medicine (CAM) interventions (acupuncture and herbal medicine) are coordinated with biomedicine and how coordination characteristics are related to the treatment outcomes of the two CAM interventions., Methods: This paper conducts an archival analysis of the institutional settings of the CAM interventions in Japan and the U.S. It also conducts a systematic content analysis of the treatment outcomes in 246 acupuncture reports and 528 herbal medicine reports that are conducted in Japan or the U.S. and registered in the Cochrane Library's Central Register of Controlled Trials (CENTRAL), and 716 acupuncture reports and 3,485 herbal medicine reports that are from Japan or the U.S. and listed in MEDLINE. It examines the association between the treatment outcomes of the two interventions and the geographical location of the reports; it also explores how the institutional settings of the interventions are related to the treatment outcomes., Results: Japanese herbal medicine is integrated into the national medical system the most and American herbal medicine the least; American acupuncture and Japanese acupuncture fall in the middle. Treatment outcomes are the most favorable for Japanese herbal medicine and the least favorable for American herbal medicine. The outcomes of American acupuncture and Japanese acupuncture fall in the middle., Conclusions: The co-utilization of CAM with biomedicine can produce difficulties due to tensions between CAM and biomedicine. These difficulties and subsequent CAM treatment outcomes vary, depending on how CAM is institutionalized in relation to biomedicine in the national medical system. Coordinated CAM interventions are more likely to be effective and synergic with biomedicine, when compared to uncoordinated ones.

Herbal-induced liver injury (HILI) continues to increase in prevalence each year due to the ongoing popularity of herbal supplements and complementary and alternative medicines. A detailed literature review of case reports and clinical studies published from March 2021 to March 2023 was performed. We discuss the epidemiology and diagnosis of HILI as well as the current and proposed laws and regulations. The 2021 ACG guidelines and 2022 AASLD practice guidelines for the diagnosis and management of drug and herbal-induced liver injury are discussed. We describe updates to previously reported etiologies of HILI such as ayurveda, ashwagandha, turmeric, kratom, green tea extract, and garcinia cambogia. Newly described supplements resulting in HILI, such as tinospora cordifolia, horse chestnut, alkaline water, and more, are described. We discuss newly and previously identified hepatoprotective herbal supplements as they have been reported in the study of animal models and human liver cells. This review suggests the need for ongoing research on the causes and mechanisms of HILI to ensure its proper diagnosis, prevention, and treatment in the future. The goal of this review is to provide novice and expert readers with knowledge regarding the possible etiologies of HILI and a general overview. [ABSTRACT FROM AUTHOR]

Many Americans, not completely satisfied with traditional western medicine, have turned to alternative and complementary medicine which explains the increasing popularity of the herbal products and the Chinese herbal medicine. The lack of government regulations and the increasing advertisements by the manufactures have created an impression to the common public that the natural herbal remedies are inherently safer and cheaper than conventional medicine. The skyrocketing rise of healthcare cost and the adverse reaction and side effects incurred from the prescribed drugs have both reinforced such an impression. Herbs in the USA and in many European countries have been prepared as capsules, tablets, teas, lozenges, juice extracts, tincture, and ointments. Most of the herbs are administered as a single herb in the USA and Europe. However, the traditional Chinese herbal medicine contains multiple active ingredients from various herbs and is prepared as concoctions by simmering them for hours to produce pharma-therapeutic properties useful for the treatment of a particular disease. Those prepared concoctions are taken gingerly with specific treatment purposes. In the USA and some European counties, herbs are distributed and labeled as dietary supplements and are taken by many individuals for a long period of time creating some medical and dental complex problems among them, especially in terms of anesthesia-surgery complications. This paper provides insight into basic differences in how herbs are prepared before administration to the patients in China versus a single unprepared herb sold in the USA and Europe. Also addressed are the interdisciplinary issues with health professionals, the proper regulations for better quality control of imported herbs, and the proper warning on the labels of the herbs. [ABSTRACT FROM AUTHOR]

A phytomedicine, or phytopharmacutical, is a complex mixture derived from plant sources that is used as a medicine or drug. The Ministry of Health has begun the standardization of the names of all phytopharmaceutical preparations. The development of phytopharmaceutical products, which might partially substitute some of the conventional medications demanding imported raw materials, and which could be produced by pharmaceutical industries based in developing countries through joint projects. Highest demands are made on clinically proven phyto-pharmaceuticals. Their effect and safety have to be verified in randomized, double-blind, (placebo)-controlled clinical trials. They are developed and scientifically evaluated in the same way as conventional medicinal products. Globally, herbal medicine has been considered an important alternative to modern allopathic medicine. While they have become very popular, only select herbs have been scientifically evaluated for their potential in medical treatment. The new drug Veregen (Polyphenon E) Ointment is the first prescription botanical (herbal) drug approved by the U.S. FDA under the "new" drug amendments of 1962 that required drugs to be proven safe and effective prior to being marketed in the U.S. Because of the unique health benefits and relatively low side effects, natural products such as food/dietary supplements, nutraceuticals and herbal medicines have been gaining popularity all over the world The gap between the popularity of these remedies and the frequently weak scientific basis of their use is striking. In reality, the efficacy and true frequency of side effects for most herbal medicine products is not known because the majority have not yet been tested in large clinical trials and because pharmacovigilance systems are much less extensive than those in place for pharmaceutical products. In contrast to the popularity of herbal medicinal products, physicians and consumers often have a very critical view of robust efficacy and safety profiles. Application of pharmaceutical nanotechnology for plant actives and extracts, is gaining a tremendous growth and interest among the scientist. [ABSTRACT FROM AUTHOR]

Background: Acute pharyngitis accounts for an estimated 15 million patient visits in the United States. However, there is no proven effective and safe treatment. Although Chinese herbal medicine is widely used in the treatment of acute pharyngitis, there is a lack of evidence-based data. Despite several clinical trials conducted in this setting, no randomized placebo-controlled trial has been performed to date. This trial aims to investigate the efficacy and safety of Qi-Wei-Qing-Yan aerosol (QWQYA), a Chinese herbal prescription, compared with a placebo aerosol in the treatment of acute pharyngitis with lung-stomach excess-heat syndrome.Methods/design: This is a prospective, multicenter, randomized, double-blinded, parallel-group, placebo-controlled trial. A total of 420 adult patients, of either sex, with acute pharyngitis will be enrolled from seven study sites across China. All patients will be randomly allocated to one of three parallel treatment groups: (1) QWQYA with the current propellant, (2) QWQYA with a previous propellant, and (3) the placebo aerosol with the current propellant. The study medication will be administered into the pharyngeal region in three sprays thrice daily for 5 consecutive days. The primary outcome measures are time to complete resolution of sore throat and relief rate of sore throat. Secondary outcome measures include resolution rate of sore throat, time to relief of sore throat, intensity of sore throat, and change of traditional Chinese medicine syndrome score and clinical signs score from baseline to post-treatment, as well as the occurrence of any adverse events.Discussion: This will be the first clinical trial to investigate the efficacy and safety of QWQYA in the treatment of acute pharyngitis in an adult population in a multicenter, randomized, double-blinded, parallel-group, placebo-controlled manner. Not only might it establish the basis for the efficacy and safety of QWQYA in treating acute pharyngitis, but it might also provide evidence to support the use of Chinese herbal medicine in treating acute pharyngitis and thus support an alternative treatment option for management of acute pharyngitis.Trial Registration: Chinese Clinical Trial Registry ChiCTR-IPR-15005991. [ABSTRACT FROM AUTHOR]

The article discusses the regulatory scrutiny of Chinese medicine and physicians in Progressive-era California and Oregon. The author examines how the American Medical Association (AMA) and U.S. government utilized Orientalist ideology, or interest in Asian exoticism combined with a belief in Asian inferiority, when categorizing Chinese medicinal practices as "irregular" and therefore worthy of eradication. Particular focus is given to representations of Chinese herbal medicine.

Purpose - The purpose of this article is to explore boundaries in marketing and science with respect to labeled claims of herbal products and other dietary supplements. Design/methodology/approach - Supplement manufacturers are allowed to include claims on product labels without meeting an acceptable substantiation standard, as long as such claims are accompanied by an FDA disclaimer statement. While manufacturers are prohibited (though the regulation is often violated) from making specific claims about prevention or treatment of disease, the implied associated health benefits of using dietary supplement products are usually clear from marketed claims. A case example on themes expressed in labeled structure-function claims for ginkgo biloba is presented to illustrate the issues. Findings - Marketing of product claims is controversial due to differing perspectives about the truthfulness of claimed health benefits and quality of information presented to consumers. Although dietary supplements could have pharmaceutical-like properties, they are not required to demonstrate safety and efficacy before market availability. The US Food and Drug Administration (FDA) can take action only if supplements are shown to be unsafe after market introduction. Practical implications - The need for consumer choice, meaningful information and free-market access to dietary supplements must be balanced with the demands for truth-in-advertising and consumer protection from unreliable claims and adverse health events. Marketing and policy implications are described. Originality/value - The outcome would help increase consumer confidence, while continuing to allow free-market forces for the dietary supplement industry, to a large extent. [ABSTRACT FROM AUTHOR]

Background: The use of herbal supplements in the United States has become increasingly popular. The prevalence of herbal use among primary care patients varies in previous studies; the pattern of herbal use among urban racially/ethnically diverse primary care patients has not been widely studied. The primary objectives of this study were to describe the use of herbs by ethnically diverse primary care patients in a large metropolitan area and to examine factors associated with such use. The secondary objective was to investigate perceptions about and patterns of herbal use. Methods: Data for a cross-sectional survey were collected at primary care practices affiliated with the Southern Primary-care Urban Research Network (SPUR-Net) in Houston, Texas, from September 2002 to March 2003. To participate in the study, patients had to be at least 18 years of age and visiting one of the SPUR-Net clinics for routine, nonacute care. Survey questions were available in both English and Spanish. Results: A total of 322 patients who had complete information on race/ethnicity were included in the analysis. Overall, 36% of the surveyed patients (n = 322) indicated use of herbs, with wide variability among ethnic groups: 50% of Hispanics, 50% of Asians, 41% of Whites, and 22% of African-Americans. Significant factors associated with an individual's herbal use were ethnicity other than African-American, having an immigrant family history, and reporting herbal use by other family members. About 40% of survey respondents believed that taking prescription medications and herbal medicines together was more effective than taking either alone. One-third of herbal users reported using herbs on a daily basis. More Whites (67%) disclosed their herbal use to their health-care providers than did African-Americans (45%), Hispanics (31%), or Asians (31%). Conclusions: Racial/ethnic differences in herbal use were apparent among this sample of urban multiethnic adult primary care patients. Associated factors of herbal use were non-African- American ethnicity, immigrant family history, and herbal use among family members. Whereas Hispanics and Asians reported the highest rates of herbal use, they were the least likely to disclose their use to health-care professionals. These findings are important for ensuring medication safety in primary care practices. [ABSTRACT FROM AUTHOR]

The article presents a study which investigated the occurrence of pain among community residents and determined the complementary/alternative medicine (CAM) therapies used for self-treatment of pain. The study also examined the similarities and differences in utilizing CAM therapies and the patterns of pain self-treatment in urban, suburban and rural communities in the U.S. The study revealed that 76% of participants used some form of CAM therapy and 28% of the participants took herbal products/supplements.

Part III. Focuses on the issue of medical services in the United States. Overview of the practices; Criticisms on the management in both medical insurer and hospital billing administration; Integration of herbal medication on cigarette addiction.