farm to pharmacy - southern california university of...

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Farm to Pharmacy:

Herbal Quality and Natural Resources in Chinese Medicine

By Eric Brand, L.Ac.

The Sourcing and Supply Chain of Chinese Herbs

Production Regions Cultivated vs. Wild Effect of growing region on quality (Xi Yang Shen)

Wholesale Markets Bozhou, Chengdu, Guangzhou, Anguo, etc.

Bozhou is home to 1.3 million people and covers 2,226 square kilometers. Over 6000 tons of herbs arrive every day, and 50,000-60,000 daily visitors come to

shop. Over 6000 merchants, annual trade is estimated at 10 billion Yuan.

Importers Western supply chain is influenced by the Southern trading route through Hong

Kong Best herbs go to Japan, Korea, Hong Kong, Taiwan, Singapore, USA (in descending

order) Subject to errors from the use of Cantonese substitutes

Distributors To practitioners and OTC market

Herbal Wholesale Markets

Dihuajie in Taiwan (left) Qingping in Guangzhou (right)

Production Regions

By species, about 70% of the Chinese herbs in the C.P. are wildcrafted and 30% are cultivated

By weight, about 50% is cultivated Over 1200 different herbal products can be

found on the Chinese domestic market About 150 herbs are primarily obtained from

cultivated sources, with an average combined production of about 300,000-350,000 metric tons.

A Geographical Map of Chinese Medicinal Plants

7 distribution areas (A~G) of medicinal

plant resources

7 distribution areas (A~G) of medicinal

plant resources

Vast territory, diverse landforms, mountain ranges, climates, andabundant medicinal resources.

Over 11,000 botanical species, nearly 1600 zoological species and80 mineral substances are used medicinally in China.

C

B

D

D

E

F

GF

A

BBB

BC

D

DD

E

E

FF

A

A

A

G

Over 1,000 species of medicinal plants,mostly wild, with a relatively rich deposits.

Panax ginseng C. A. Mey

AA

AA

A: Northeastern cold temperate zone

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Dioscorea opposita Thunb.

There are about 1,000-1,500 species ofcultivated and/or wild medicinal plants.

B: Northern warm temperate zone

B

BBB

B

More than 3,000 species of cultivatedand/or wild medicinal plants.

Paeonia lactiflora Pall

C: Central subtropical zone

CC

More than 4,500 species of medicinalplants. This is an area that assemblesmedicinal materials produced insouthern China.

Morinda officinalis How.

D: Southern subtropical zone

D

D

D

DD

Pinellia ternata (Thunb.) Breit

More than 5,000 species. Many reputedfamous medicinal materials produced inSichuan, Yunnan and Guizhou provincesare from this zone.

E: Southwestern subtropical zone

EE

E

More than 2,000 species of medicinalplants with a rich deposit of wildspecies but an uneven distribution.

Lycium barbarum L.

F: Northwestern arid zone F

F

F F More than 1,000 species, mostly wild.

Rheum palmatum L.

G: Qinghai-Tibet plateau zone

GG

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Dao Di Yao CaiAuthentic [region] Medicinals

Premium quality huáng lián (Coptidis Rhizoma), chuan xiong(Chuanxiong Rhizoma), and fù zi (Aconiti Radix Lateralis Praeparata) all come from Sìchuan (in Western China).

Premium quality chén pí (Citri Reticulatae Pericarpium) comes from Guangdong (in the South).

Premium quality rén shen (Ginseng Radix), xì xīn (Asari Radix), and wu wèi zi (Schisandrae Fructus) are from Manchuria (the North-East).

Premium quality fú líng (Poria) is from Yúnnán (the South-West).

Premium quality dì huáng (Rehmanniae Radix) comes from Hénán.

Premium quality e jiao (Asini Corii Colla) comes from Shandong.

Regional Specialties

A few major examples of regional specialties include: Manchuria- Lu Rong, Ren Shen, Xi Xin North- Huang Qi, Dang Gui Henan- Grows over 300 medicinals, famous for Huai

Niu Xi, Huai Shan Yao, Di Huang Guizhou- Tian Ma, Du Zhong, Wu Zhu Yu Silk road- Qin Jiao, Gan Cao, Zi Cao, Rou Cong Rong Tibet- Zang Hong Hua, Dong Chong Xia Cao, Xue

Lian Hua, Hong Jing Tian

Regional Map

This map shows the wild populations and cultivated production volume at the county level.

Illustrated here are Shan Yao and Wu Wei Zi sites

Dioscoreae rhizoma(shan yao)

Medicinal varieties

• Distributed in a relatively northern region• Botanical origin is Dioscorea opposita Thunb.• Items produced from plantation sites at

Wuzhi County and Wen County of Henanprovince are believed to be superior in quality

Medicinal materials (huai shan yao)

Edible varieties

• Distributed in southern provinces• Botanical origins are complicated:

1) Dioscorea japonica Thunb.2) Dioscorea alata L.3) Dioscorea persimilis Prain et Burk4) Dioscorea fordii Prain et Burk.

Medicinal materials (tie gun shan yao)

Food

In the Chinese Pharmacopoeia (2010 edition), 616 medicinal materials are recorded and over 25% of them (157) are derived from two or more sources

Although these medicinal materials share similar Chinese names, they are derived from different plant species

nan wu wei zi (Schisandra sphenanthera Rehd. et Wils.)

bei wu wei zi (Schisandra chinensis (Turcz.) Baill.)

wu wei zi

Wild vs. Cultivated Products

Dong Chong Xia Cao Xi Yang Shen Tian Ma Ren Shen Bai Shao vs. Chi Shao Shi Hu Bai Zhu Huang Qi

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chuan xiong(Ligusticum chuanxiong Hort.)

fu xiong(Ligusticum chuanxiong Hort. cv. Fuxiong)

Sichuan

• has the largest output and the longest history of medicinal use

Jiangxi

• goes a long time withoutflowering and rarely sprouts

• has large and fleshy rhizomesbut contains less volatile oil andligustrazine

撫芎雖然個大肉肥，但其揮發油和川芎嗪的含量卻低於川芎。

Guangxi Tianzhou region

田州

Yunnan’s Wenshan region

文山

Notoginseng radix (san qi)

1 cm

Poria (fu ling)

Hubei Luotian region,羅田

“jiu zi he fu ling”

Yunnan province, “yun ling”

1 cm 1 cm

Natural selection and survival of the fittest have resulted in a number of changes in terms of varieties, growing regions, and natural resources

for some daodi medicinal materials.

Prior to the Song dynasty:•ginseng was found in a wide region that included Shanxi, Hebei, and provinces of north-east China•ginseng plants of the Araliaceae were growing in the Luzhou region in former times (the area is now known as Shanxi’s Changzhi region)•Miscellaneous Records of Famous Physicians (Ming yi bie lu) stated that Ginseng radix (ren shen) produced in Shanxi’s Shangdang region was of high quality

“lu zhou ren shen”

Qing dynasty:•the daodi production region assigned toGinseng radix (ren shen) had already movedto northeastern China

“Great Leap Forward” (1958-1959), people in mainland China attempted to cultivate ginseng on Hainan Island in southern China. However, the roots grown in Hainan were large but almost completely lacking in active constituents, ending up nearly useless beyond the appearance.

overharvesting environmental changes

Codonopsis (Dang Shen)

Dang Shen entered Chinese medicine 1500 years after ginseng, in 1757 CE. It lacks ginseng’s actions of supplementing the heart qi and quieting the spirit, as well as the actions of “yi zhi”- boosting mental faculties, and greatly supplementing original qi.

Dong Chong Xia Cao (cordyceps)

Wild product

Cultivated Cordyceps

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Fake CordycepsCultivation techniques of Rehmannia

• Prior to the Song dynasty, traditional production areas include Shaanxi’sXianyang, Tongzhou (陝西的咸陽、同州), Jiangsu’s Pengcheng and Jiangning (江蘇的彭城、江寧)

• From the Ming dynasty onward, it was generally recognized that cultivated inHuaiqingfu (Henan province) was of particularly high quality. “four famousmedicinal materials of Henan”

• Li Shizhen (Ming Dynasty): “ancient people cultivated [Rehmanniaeradix (di huang)] from seed, contemporary people cultivate it fromroots.古人種子，今為種根” The asexual cultivation method is used up to thepresent day.

large, high-yielding roots with high levels of the active constituent catalpol

Good Agricultural Practice (GAP) for Traditional Chinese Medicinal Materials has been enforced by

the Chinese government since 2002

This has expanded production regions for daodi medicinal materials and allowed new daodi medicinal materials to emerge.

Good agricultural practice for the Chinese medicinal dang gui (Angelicae sinensis radix)

Salviae miltiorrhizae (dan shen) has been cultivated in Sichuan’s Zhongjiang County for over 100years; Sichuan is the largest producer and the daodi production region. Modern herbalcompanies have now established large-scale standardized plantation in Shangluo of Shaanxiprovince陝西商洛市.Corni fructus (shan zhu yu) of the traditional daodi production region Zhejiang province (Lin’anand Chun’an 浙江臨安、淳安) → standardized plantation sites in Henan and Shaanxiprovinces by some herbal companies

Some medicinal substances that come from outside of China are among the daodi medicinal materials used in Chinese medicine.

In some cases, medicinal substances from outside of China that are unused or under-appreciated in their own countries are favored in China, and have been introduced and raised in China to enrich China’s treasure house of daodi medicinal materials.

Naturalization and daodi medicinal material

Aucklandiae radix (mu xiang) originally produced in India and Myanmar historically called guang mu xiang because it

was imported into China via Guangzhou. it was successfully cultivated in China’s

Yunnan province (Lijiang麗江GAP plantation sites) and produced good quality medicinal material known as yun mu xiang.

the total amount of costunolide and dehydrocostuslactone contained in Aucklandiae radix (mu xiang) produced in Yunnan was much higher than that specified in the Chinese Pharmacopoeia.

1 cm1 cm1 cm

Croci stigma (xi hong hua) was originally produced in Southern Europe, historically

imported into China via Tibet

incorporated into Chinese medical practice in the Ming Dynasty, known as Croci stigma (xi hong hua), moves the blood, dissipates blood stasis, cools the blood, and resolves toxicity.

nowadays, it has been successfully cultivated in Shanghai (GAP plantation sites), Jiangsu, and Zhejiang provinces in China

It takes 160,000 flowers to produce a single kilogram of saffron.

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American ginseng (Panax quinquefolius L.) In 1702, a French priest Father Jartoux observed the use of Chinese

ginseng in Manchuria. Fascinated by his information, priest Father Joseph Francis Lafitau in

North America (French Canada) discovered American ginseng near Montreal in 1716

Later on, American ginseng from Canada was brought to China and became a valued item in the imperial court.

American ginseng is now successfully cultivated in China on a large scale. Certified GAP plantation sites have also been established at Jingyu in Jilin province.

Jilin province, China Wisconsin, USA Ontario, Canada

Chinese medicinal processing (paozhi) is a pharmaceutical technique that meets different therapeutic, dispensing, and pharmaceutical requirements based on traditional Chinese medicine (TCM) theory.

Medicinal processing scene and equipment in Concise Addendum to Grandfather Lei's Treatise on Herbal Processing (Bu Yi Lei Gong Pao Zhi Bian Lian) of the Ming dynasty

Traditional Chinese medicinal processing and daodi medicinal material

Traditional Chinese medicinal processing produces special characteristics of the daodi medicinal material

1193 elaborate color illustrations

Processed products of Aconiti lateralis radix praeparata (fu zi)

A. steps of processing Chinese medicinal fu zi in Concise Addendum to Grandfather Lei's Treatise on Herbal Processing (Bu yi lei gong pao zhi bian lan) of the Ming Dynasty

B. processed Chinese medicinal fu zi listed in the Chinese Pharmacopoeia (2010 edition)

Fuzi (aconite lateral root) is processed into various products to reduce the toxicity and meet different therapeutical requirements

Creation of Asini corii colla (e jiao)

In ancient times, Asini corii colla (e jiao)was made from ox hide

Compendium of Materia Medica (Ben cao gang mu) proclaimed e jiao from donkey hide to be a “sacred medicine”

From that point on, the item produced from ox hide became known as huang ming jiao, and that produced from donkey skin became known as e jiao.

Chinese medicinal e jiao produced in Dong’e, Shandong province

An instruction detailing of e jiao in the Daoguang years of the Qing Dynasty (1821-1850 C.E.) describes the entire process of making e jiao

The instruction not only details the water used to make e jiao as well as the raising of the donkey and the selection of the hide, but also outlines a strict sequence of using silver pots and gold shovels

For a thousand years, e jiao was known as “nine dynasties tribute gelatin” because it achieved a great reputation due to its excellent clinical effect.The Chinese medicinal e jiao and its

instruction detailing of the Qing Dynasty

Creation of Asini corii colla (e jiao)

ba dou (Crotonis fructus) 巴豆

ba ji tian (Morindae officinalis radix) 巴戟天

shu jiao (Zanthoxyli pericarpium)蜀椒

qin pi (Fraxini cortex) 秦皮

qin jiao (Gentianae macrophyllae radix)秦椒

wu zhu yu (Evodiae fructus)吳茱萸

Records of daodi medicinal in historical literature

The Divine Husbandman’s Classic of Materia Medica(Shen nong ben cao jing)

“Each medicinal material has laws for its production region, authenticity, and freshness. ”土地所出，真偽新陳，並各有法

The first text to discuss the importance of production regions:

names of regions that were in use before and after the ancient Western Zhou Dynasty (c.1100-771 B.C.E.)

Eastern Han Dynasty (25-220 C.E.)

Northern and Southern Dynasties period (420-589 C.E.)

Tang dynasty(618-907 C.E)

Song Dynasty(960-1279 C.E.)

Ming Dynasty(1368-1644 C.E.) Modern times

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Records of daodi medicinal in historical literatureEastern Han Dynasty

(25-220 C.E.)

Northern and Southern Dynasties period

(420-589 C.E.)




Collection of Commentaries on the Classic of the Materia Medica

(Ben cao jing ji zhu)

“the places where all medicinals come from have specific boundaries”諸藥所生，皆有境界

• started to record specific production regions for medicinals

• began to use terms such as “the best” (zui jia) and “surpasses” (wei sheng) to describe correlations between appearance, production region, and quality


(25-220 C.E.)


(420-589 C.E.)




Newly Revised Materia Medica(Xin xiu ben cao)

Materia medica commissioned by the government:

“if medicinal material is not produced from its native

environment, the effect will be different.”

離其本土，則質同而效異


(25-220 C.E.)


(420-589 C.E.)




Formulas Worth a Thousand Gold Pieces

(Qian jin fang)

began to use “dao” to summarize production regions

contains the original concept that would later become known as “daodi”.

“Ancient doctors depended on medicinals produced from the proper production areas. Therefore, if they treated ten

patients, they achieved results in nine. Although contemporary doctors understand the pulse and

prescriptions, they are not familiar with the proper production regions, harvest time, and quality of medicinal materials. Therefore, they only achieve results in five or

six cases out of ten.” 古之醫者...用藥必依土地，所以治十得九。今之醫者，但知診脈處方，不委采藥時節。至於出處土地，新陳虛實，皆不悉，所以治十不得五六者，實由於此


(25-220 C.E.)


(420-589 C.E.)




Extension of the Materia Medica (Ben cao yan yi)

“All medicinals must be chosen from suitable production

regions”凡用藥必須擇州土所宜者

寇氏曾在收買藥材所擔任專門辨認藥材之職,對於鑒別藥材有豐富的經臉。







Essentials of Materia Medica Distinctions (Ben cao pin hui jing yao)

• 1809 medicinals and featured with 1371 illustrations

• The entry “daodi” was formally listed under the heading of “land” (di) for 268 botanical medicinals specifying their daodiproduction regions

Started to document daodi medicinal material as a professional terminology, and established its scale and basic varieties

《本草品匯精要》將道地藥材作為專業的術語載入史冊，並奠定了道地藥材的規模和基本品種。







• the term “daodi medicinal material” spread far and wide among common people in China.

“好道地藥材”的臺詞，在民間廣為傳唱。

Famous masterpiece opera by Tang Xianzu

“The Peony Pavilion: Exploration of Medicine” (《牡丹亭·詗藥》)

“good daodi medicinal materials”

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Mountain Ginseng

True Wild Ye Shan Shen (野山参)

Half-Wild Yi Shan Shen (移山参)

Transplanted to the wild environment Lin Xia Shen (林下参)

Grown from seed in the wild

Fakes Gong Yi Shen (工艺参)

Differentiating Half-Wild Ginseng

Transplanted roots vs. roots grown from seed

Fake Wild Ginseng

The neck is built from broken heads, whole small roots, and superglue, attached to an average field-grown root

Examples of herbs that are almost exclusively cultivated

Dang Gui- Gansu province is the principle growing region of Dang Gui, producing over 90% of the Chinese domestic supply. The importance of Dang Gui over the history of Chinese medicine is summed up in the phrase “10 formulas, 9 angelicas.” It is estimated that the annual consumption of Dang Gui is about 12 million kilograms.

Ren Shen- With the exception of ginseng grown in Japan, Korea or Russia, Asian ginseng is exclusively produced in China’s three Northeastern provinces: Jilin, Heilongjiang, and Liaoning. Jilin produces about 70% of the total. Ginseng has been cultivated for over 400 years, and the total amount that is consumed annually is estimated at 6-7 million kilograms.

Bai Zhi- Bai Zhi is entirely cultivated, with Sichuan Bai Zhi accounting for about 70% of the total volume. The cultivation of Bai Zhi has been documented for over 600 years.

Huang Lian has also been cultivated for over 600 years, and virtually the entire supply is cultivated at present. About 1.5-1.8 million kilograms are used per year.

Dang Shen- Until the 1950s, nearly all the Dang Shen in use was wild. Now the wild populations are depleted and the cultivated product dominates the market. About 30 million kilograms per year are used.

Rehmannia has been cultivated for over 1000 years, and all the product on the market comes from cultivated sources. About 20 million kilos per year are used.

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Bai Shao vs. Chi Shao

All Bai Shao is cultivated and all Chi Shao is wild-harvested.

The plant Paeonia lactiflora produces both Bai Shao and Chi Shao. When it is cultivated and subjected to Pao Zhi (boiling and

peeling the skin) it is Bai Shao When it is wild and the skin is left intact it is Chi Shao. Bai Shao only comes from cultivated P. lactiflora, but Chi Shao

can come from wild P. lactiflora or P. veitchii. P. veitchii is difficult to cultivate and is only prevalent in the

wild.

Gou Teng GAP site

Gou Teng

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Yu Xing Cao cultivation site

Shi Wei GAP Yin Yang Huo site

GAP Yin Yang Huo

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Wild Nu Zhen Zi

Grading and Quality

Many medicinals are sorted based on size, aroma, luster, and other distinctive characteristics

The same field can produce multiple grades; grading is used to determine price

Common Shi Hu Substitute(You Gua Shi Hu, Ephemerantha fimbriata

(Bl.) P.E. Hunt et Summ)

Genuine Shi Hu Chuan Bei Mu vs. Ping Bei Mu

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Chinese Red Ginseng Differentiated by Grade

Chinese White Ginseng(heavily sulfured)

Commonly Confused Items in Trade

Over the centuries, many different regional substitutes and adulterants have been introduced into the herbal marketplace, and many herbs that have similar names and appearances are easily confused.

To achieve reliable therapeutic results and avoid potentially harmful substitutes, it is essential for Chinese medical practitioners to use correctly identified herbal medicines.

Causes of Confusion

Differences in the plant part used Xi Xin

Similarities in Chinese names San Qi vs. Chuan San Qi, Bai Wei vs. Bai Wei Cao, Chuan

Niu Xi vs. Wei Niu Xi Similarities in appearance

Bai Qian (hollow) vs. Bai Wei (solid) Wei Ling Xian and Long Dan vs. Gui Jiu Ping Bei Mu vs. Chuan Bei Mu Ji Xue Teng vs. Da Xue Teng

Xi Xin (whole herb)

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Xi Xin (root)San Qi (notoginseng) vs. Chuan San Qi (tupistra)

Guang Fang Ji vs. Han Fang Ji Cantonese Fu Ping (Da Fu Ping)

True Fu PingWei Ling Cai (potentilla)

Sold as Bai Tou Weng and Zi Cao

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True Zi Cao True Bai Tou Weng

Cantonese Wang Bu Liu Xing Taiwanese Wang Bu Liu Xing

True Wang Bu Liu XingCantonese He Huan Hua

(Ye He Huan)

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Da Xue Teng vs. Ji Xue Teng Sheng Ma

Wei Niu XiTrue Chuan Niu Xi

Photos from Prof. Zhao Zhongzhen’s Easily Confused Chinese Medicines in Hong Kong

Acceptable Substitutes

Items that share a similar therapeutic effect as the main medicinal but are derived from a species other than the official product listed in the Chinese Pharmacopoeia:

He Huan Hua Cantonese substitute is a magnolia flower with similar TCM action to

quiet the spirit, but lacks the qi-coursing action of the true product. Also more expensive than the official medicinal.

Jin Qian Cao Southern variant is often more common than the main medicinal,

regarded as very effective Ban Lan Gen

Southern variant is often more common than the main medicinal, regarded as very effective

Unacceptable substitutes in terms of TCM action

The following items have substitutes that differ in traditional therapeutic effect from the main medicinal, but the mistaken herbs are generally not regarded as being particularly dangerous.

In many cases, the substitute herb has not been studied extensively from a chemical and clinical perspective.

Fu Ping Chuan Niu Xi Bai Wei/ Bai Qian Ji Xue Teng/ Hong Teng (Da Xue Teng) Zi Cao Bai Tou Weng Sheng Ma Wang Bu Liu Xing

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Dangerous Substitutes

Fang Ji Must use han fang ji, also known as fen fang ji (stephania) Rule out aristolochia root, known as guang fang ji

Mu Tong Safe species is chuan mu tong, Armand’s clematis. Akebia is also safe but is rare on the market. Must rule out guan mu tong, Manchurian aristolochia, which contains aristolochic acid)

Mu Xiang Standard mu xiang or chuan mu xiang are fine, not Qing Mu Xiang

San Qi Rule out Rhizoma Tupisra

Long Dan Cao Dangerous substitute is called gui jiu. Fortunately it is uncommon.

Xi Xin Use roots, not aerial portions

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