MD, PhD, FMedSci, FRSB, FRCP, FRCPEd.

If you thought that Chinese herbal medicine is just for oral use, you were wrong. This article explains it all in some detail: Injections of traditional Chinese herbal medicines are also referred to as TCM injections. This approach has evolved during the last 70 years as a treatment modality that, according to the authors, parallels injections of pharmaceutical products.

The researchers from China try to provide a descriptive analysis of various aspects of TCM injections. They used the the following data sources: (1) information retrieved from website of drug registration system of China, and (2) regulatory documents, annual reports and ADR Information Bulletins issued by drug regulatory authority.

As of December 31, 2017, 134 generic names for TCM injections from 224 manufacturers were approved for sale. Only 5 of the 134 TCM injections are documented in the present version of Ch.P (2015). Most TCM injections are documented in drug standards other than Ch.P. The formulation, ingredients and routes of administration of TCM injections are more complex than conventional chemical injections. Ten TCM injections are covered by national lists of essential medicine and 58 are covered by China’s basic insurance program of 2017. Adverse drug reactions (ADR) reports related to TCM injections account for  over 50% of all ADR reports related to TCMs, and the percentages have been rising annually.

The authors concluded that making traditional medicine injectable might be a promising way to develop traditional medicines. However, many practical challenges need to be overcome by further development before a brighter future for injectable traditional medicines can reasonably be expected.

I have to admit that TCM injections frighten the hell out of me. I feel that before we inject any type of substance into patients, we ought to know as a bare minimum:

  • for what conditions, if any, they have been proven to be efficacious,
  • what adverse effects each active ingredient can cause,
  • with what other drugs they might interact,
  • how reliable the quality control for these injections is.

I somehow doubt that these issues have been fully addressed in China. Therefore, I can only hope the Chinese manufacturers are not planning to export their dubious TCM injections.

8 Responses to TCM by injection? The idea frightens me

  • Alternatively, it could be seen as evolution in progress.

    I don’t want to make too light of this, however, it might be a wake up for some besotted with this nonsense. If one doesn’t want the rigours of medicine (the word ‘real’ is superfluous), the consequences must be tangible and, possibly, deadly.

  • I am as scared as anyone at the prospect of things injected. I wonder, might there be problems in the UK for this – i.e. who is allowed to inject anything into people and if the Medicines Authority might make an outright ban on the use of these, traditional ‘medications’

    I hope anything brought to the UK isd going to require trials, just like any other real drug – a process that would likely kill off ideas of their use in the UK

  • This sounds to me like the most horribly stupid idea in a long time… Traditional Chinese ‘medicines’ for oral and topical use are almost by definition mixtures containing lots of unknown substances in unknown concentrations – and analysis often reveals extremely unhealthy ingredients (e.g. heavy metals and toxic plants such as aristolochia), and/or substances that shouldn’t be there in the first place (real pharmaceuticals).
    The main reason why TCM doesn’t kill more people is because oral ingestion prevents most of these harmful ingredients from entering the body in the first place, or at least routes them through the liver first.
    And now they want to inject stuff like this directly into the system? Oh, no doubt most of the acutely lethal stuff has been weeded out, and no doubt some of the more harmful immunogenic ingredients(*) are left out as well, but really, injecting what is basically soup containing lots of random protein-based and mineral ingredients does NOT sound like a good idea.

    *: An example how injecting ‘natural’ substances directly into the bloodstream can go horribly wrong: https://sciencebasedmedicine.org/naturopathic-death-from-iv-turmeric/

  • All this is part of a worrying trend for China to ignore, fail to comply with and avoid subscribing to internationally accepted mores, laws and regulations – in all fields.
    Vast profits are to be made from flogging these remedies – even in countries where there are regulations designed to protect the public.
    We ain’t seen the last of it.

    • I see your point, Richard, but this stuff is what the Chinese have used for hundreds of years so it’s unlikely that the Chinese population would just stop using it in favour of medicines that work. Mind, I do take the point that the Chinese authorities aren’t acting on this – but then even our own government doesn’t seem to what to stop ‘alternative medicine’ even if it doesn’t work (homeopathy) or could even be dangerous.

      It has to be all about the population realising that only medicine works and that there are no ‘alternatives’ that actually work.

      • Actually, TCM was a hodgepodge of countless different (and for the most part totally ineffective and even harmful(*)) modalities until Mao used it to make the introduction of western medicine in the 1950’s easier to swallow for the Chinese. Unfortunately, this strategy worked a little too well: even though western medicine did most of the ‘heavy lifting’, TCM took most of the credit, and became hugely popular outside China as well.

        And even more unfortunate: the Chinese never even attempted to put TCM in a more proper perspective, but continued to propagate it as effective for reasons of national pride and political expediency.

        *: Thirty Years in Moukden by Scottish physician Dugald Christie paints a good picture of the state of “Traditional Chinese Medicine” around 1900 – and things weren’t much better until Mao came to power.
        Especially the bit about acupuncture (pp.33) is a harrowing read:

        “Chinese doctors own that they know nothing at all of surgery. They cannot tie an artery, amputate a finger or perform the simplest operation. The only mode of treatment in vogue which might be called surgical is acupuncture, practised for all kinds of ailments. The needles are of nine forms, and are frequently used red-hot, and occasionally left in the body for days. Having no practical knowledge of anatomy, the practitioners often pass needles into large blood vessels and important organs, and immediate death has sometimes resulted. A little child was carried to the dispensary presenting a pitiable spectacle. The doctor had told the parents that there was an excess of fire in its body, to let out which he must use cold needles, so he had pierced the abdomen deeply in several places. The poor little sufferer died shortly afterwards. For cholera the needling is in the arms. For some children’s diseases, especially convulsions, the needles are inserted under the nails. For eye diseases they are often driven into the back between the shoulders to a depth of several inches. Patients have come to us with large surfaces on their backs sloughing by reason of excessive treatment of this kind with instruments none too clean.”

  • it seems obvious that these injections can cause an anaphylactic shock
    https://www.ncbi.nlm.nih.gov/pubmed/26000291

  • In “More Harm Than Good”, chapter 4, the discussion of education of, for and by the medical profession is fascinating.
    The cascade of failures evinced by agencies that permit such utter bilge being exposed to customers (Alt Med like to claim they’re patients) is woeful.
    As Prof Ernst identifies in another recent blog, deception is rife in SCAM and Brexit: environs where the consequences of deception are virtually nil except to the deceived.

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