The first materia medica to be found in practically all worthy texts on Chinese herbal medicines is Herba ephedrae or Ma Huang. This herb has gotten a bad rep because of misuse and has since been banned in the United States. It has come to the point where many diet pills available in health food stores proudly proclaim on their labels the text “ephedrine free”.
This example serves to debunk a popular yet dangerously inaccurate portrayal of natural medicine by some practitioners. In my practice, where I lean towards Traditional Chinese Medicine yet still maintain my core functions as a western MD, I encounter many patients who have been inadvertently hoodwinked by popular media or by practitioners that natural medicine is “natural and therefore safe.”
Tell that to the folks who developed severe complications due to unintentional abuse of Ma Huang.
So what should be the proper attitude? With ANY medicinal substance, whether processed directly from nature or the product of intense scientific production, caution must be undertaken that the substance is used PROPERLY. Ma Huang in the earlier case was used in conjunction with other diet products, something in violation of it’s traditional uses.
More than just the indications and proper diagnosis, one neglected aspect in Chinese materia medica is the fact that many of the dosages and indications in TCM were written with the climate of northern China in mind. We must remember that as climate changes, so do our reactions to substances around us. Who in their right mind would eat spicy food during summer in the Sahara? (Well I would, but only during night time, and assuming I have an endless supply of water with which to rehydrate myself.)
I believe that a conversation I had with Dr. Du Wei in Beijing illustrates this specific aspect of using Chinese medicines with relation to the weather. He also used Ma Huang as an example.
He began by pointing out that the stated dosage of Ma Huang ranges from 3 to 15 grams. It was explained to me thus: in cold, dry Beijing, it would probably take at least 12 grams to induce perspiration in a patient using Ma Huang. However, in Nanjing (where I had also previously studied), the weather was warmer and more humid. Therefore it would take less stimulation from the herb to promote perspiration. In this case, one must keep this in mind and prescribe lower doses of Ma Huang, perhaps in the 3-6 grams range only.
Finally, he said that in my country, good old tropical Philippines, I would probably never even have to use Ma Huang! The extremes of warmth and humidity would make it overkill.
Upon hearing this, I remember several cases of renal failure occurring in our hospital. These were traceable to the (mis)use of Korean Red Ginseng as a cure all by some poor folks. Now, don’t get me wrong. Korean Red Ginseng is quite useful – in cold Korea.
Here, it probably serves to dehydrate folks more.
There you go, ladies and gentlemen – make sure that we know the proper use of ANY medicinal substance before we go about using them.