Chinese herbology#50 fundamental herbs

{{more citations needed section|date=October 2013}}

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Chinese herbs have been used for centuries. Among the earliest literature are lists of prescriptions for specific ailments, exemplified by the manuscript Recipes for 52 Ailments, found in the Mawangdui which were sealed in 168{{nbsp}}BCE.

The first traditionally recognized herbalist is Shénnóng ({{lang|zh|神農}}, {{lit|Divine Farmer}}), a mythical god-like figure, who is said to have lived around 2800{{nbsp}}BCE.{{cite web|url=http://kaleidoscope.cultural-china.com/en/196Kaleidoscope8524.html|title=Shennong |script-title=zh:神农|publisher=cultural-china.com|access-date=24 February 2011|url-status=dead|archive-url=https://web.archive.org/web/20110129060838/http://kaleidoscope.cultural-china.com/en/196Kaleidoscope8524.html|archive-date=29 January 2011}} He allegedly tasted hundreds of herbs and imparted his knowledge of medicinal and poisonous plants to farmers. His {{transliteration|zh|Shénnóng Běn Cǎo Jīng}} ({{lang|zh|神農本草經}}, Shennong's Materia Medica) is considered as the oldest book on Chinese herbal medicine. It classifies 365 species of roots, grass, woods, furs, animals and stones into three categories of herbal medicine:Unschuld, Paul Ulrich (1986), Medicine in China, A History of Pharmaceutics, 本草, University of California Press.

1. The "superior" category, which includes herbs effective for multiple diseases and are mostly responsible for maintaining and restoring the body balance. They have almost no unfavorable side-effects.
2. A category comprising tonics and boosters, whose consumption must not be prolonged.
3. A category of substances which must usually be taken in small doses, and for the treatment of specific diseases only.

The original text of Shennong's Materia Medica has been lost; however, there are extant translations.Du Halde J-B (1736): Description géographique, historique etc. de la Chine, Paris The true date of origin is believed to fall into the late Western Han dynasty (i.e., the first century BCE).

The Treatise on Cold Damage Disorders and Miscellaneous Illnesses was collated by Zhang Zhongjing, also sometime at the end of the Han dynasty, between 196 and 220 CE. Focusing on drug prescriptions,{{Harvnb|Sivin|1987|p=179}}; {{harvnb|Ergil|2009|p=30}} it was the first medical work to combine Yinyang and the Five Phases with drug therapy.{{Harvnb|Unschuld|1985|p=169}} This formulary was also the earliest Chinese medical text to group symptoms into clinically useful "patterns" ({{transliteration|zh|zheng}}, {{lang|zh|證}}) that could serve as targets for therapy. Having gone through numerous changes over time, it now circulates as two distinct books: the Treatise on Cold Damage Disorders and the Essential Prescriptions of the Golden Casket, which were edited separately in the eleventh century, under the Song dynasty.{{Harvnb|Goldschmidt|2009}}, pp. 100–101.

Succeeding generations augmented these works, as in the {{transliteration|zh|Yaoxing Lun}} ({{zh|labels=no|s=药性论|t=藥性論|first=t|l=Treatise on the Nature of Medicinal Herbs}}), a 7th-century Tang dynasty Chinese treatise on herbal medicine.

There was a shift in emphasis in treatment over several centuries. A section of the Huangdi Neijing Suwen including Chapter 74 was added by Wang Bing in his 765 edition. In which it says: {{lang|zh|主病之謂君，佐君之謂臣，應臣之謂使，非上下三品之謂也。}} "Ruler of disease it called Sovereign, aid to Sovereign it called Minister, comply with Minister it called Envoy (Assistant), not upper lower three classes (qualities) it called." The last part is interpreted as stating that these three rulers are not the three classes of Shénnóng mentioned previously. This chapter in particular outlines a more forceful approach. Later on Zhang Zihe ({{aka}} Zhang Cong-zhen, 1156–1228) is credited with founding the 'Attacking School' which criticized the overuse of tonics.

Arguably the most important of these later works is the Compendium of Materia Medica ({{transliteration|zh|Bencao Gangmu}}, {{lang|zh|本草綱目}}) compiled during the Ming dynasty by Li Shizhen, which is still used today for consultation and reference.

The use of Chinese herbs was popular during the medieval age in western Asian and Islamic countries. They were traded through the Silk Road from the East to the West. Cinnamon, ginger, rhubarb, nutmeg and cubeb are mentioned as Chinese herbs by medieval Islamic medical scholars Such as Rhazes (854–925 CE), Haly Abbas (930–994 CE) and Avicenna (980–1037 CE). There were also multiple similarities between the clinical uses of these herbs in Chinese and Islamic medicine.{{cite journal |title=The use of Chinese herbal drugs in Islamic medicine |journal=Journal of Integrative Medicine |doi=10.1016/S2095-4964(15)60205-9 |pmid=26559361 |url=http://www.jcimjournal.com/jim/showAbstrPage.aspx?articleID=S2095-4964(15)60205-9 |volume=13 |issue=6 |pages=363–367 |url-status=dead |archive-url=https://web.archive.org/web/20150925190817/http://www.jcimjournal.com/jim/showAbstrPage.aspx?articleID=S2095-4964%2815%2960205-9 |archive-date=2015-09-25 |year=2015 |last1=Heyadri |first1=Mojtaba |last2=Hashempur |first2=Mohammad Hashem |last3=Ayati |first3=Mohammad Hosein |last4=Quintern |first4=Detlev |last5=Nimrouzi |first5=Majid |last6=Mosavat |first6=Seyed Hamdollah }}

There are roughly 13,000 medicinals used in China and over 100,000 medicinal recipes recorded in the ancient literature.{{cite journal |pmid=11717980 |url=http://wenku.baidu.com/view/dfc192a0b0717fd5360cdc44.html |year=1999 |last1=Chen |first1=K |last2=Yu |first2=B |title=Certain progress of clinical research on Chinese integrative medicine |volume=112 |issue=10 |pages=934–7 |journal=Chinese Medical Journal |access-date=2011-06-09 |archive-date=2011-07-07 |archive-url=https://web.archive.org/web/20110707204820/http://wenku.baidu.com/view/dfc192a0b0717fd5360cdc44.html |url-status=live }} Plant elements and extracts are by far the most common elements used.{{harvnb|Foster|Yue|1992|p=11}} In the classic Handbook of Traditional Drugs from 1941, 517 drugs were listed – out of these, only 45 were animal parts, and 30 were minerals. For many plants used as medicinals, detailed instructions have been handed down not only regarding the locations and areas where they grow best, but also regarding the best timing of planting and harvesting them.{{cite web|url=http://www.classicalchinesemedicine.org/wp-content/uploads/2010/04/fruehauf_fuziinterview1.pdf |title=The Importance of Aconite (fuzi) |access-date=2011-05-17 |url-status=dead |archive-url=https://web.archive.org/web/20110725175628/http://www.classicalchinesemedicine.org/wp-content/uploads/2010/04/fruehauf_fuziinterview1.pdf |archive-date=2011-07-25 }}

Some animal parts used as medicinals can be considered rather strange such as cows' gallstones.{{cite journal |pmid=9240055 |year=1997 |last1=Hesketh |first1=T |last2=Zhu |first2=WX |title=Health in China. Traditional Chinese medicine: One country, two systems |volume=315 |issue=7100 |pages=115–7 |pmc=2127090 |journal=BMJ (Clinical Research Ed.) |doi=10.1136/bmj.315.7100.115}}

Furthermore, the classic materia medica {{transliteration|zh|Bencao Gangmu}} describes the use of 35 traditional Chinese medicines derived from the human body, including bones, fingernail, hairs, dandruff, earwax, impurities on the teeth, feces, urine, sweat, and organs, but most are no longer in use.{{cite book |doi=10.1007/0-306-46867-0_7 |chapter='Human Drugs' in Chinese Medicine and the Confucian View: An Interpretive Study |title=Confucian Bioethics |series=Philosophy and Medicine |year=2002 |last1=Nie |first1=Jing-Bao |isbn=978-0-7923-5723-0 |volume=61 |pages=167–206|publisher=Springer |location=Dordrecht }}{{cite journal |title=The Human Body as a New Commodity |first1=Tsuyoshi |last1=Awaya |journal=The Review of Tokuyama University |date=June 1999}}{{cite book |editor1-first=Nancy |editor1-last=Scheper-Hughes |editor2-first=Loïc J. D. |editor2-last=Wacquant |year=2002 |title=Commodifying Bodies |publisher=Sage |location=Thousand Oaks |isbn=978-0-7619-4034-0}}{{Page needed|date=October 2011}}

[[File:Chinese herbal decoction (一貫煎) on snow.jpg | thumb | 220x124px | right | alt= An image of decocted Chinese medicine 一貫煎 on snow, taken in the United States. The snow is on the border of a forest near a residential area, with a small lake in the background near trees. |

A traditional Chinese herbal decoction (湯劑/汤剂)]]

Typically, one batch of medicinals is prepared as a decoction of about 9 to 18 substances."According to the experience of the author, 99% of prescriptions in the PR of China range from 6 to 20 herbs; in the majority, however, it is 9 to 12,..." From {{harvp|Kiessler|2005|p=24}}. Some of these are considered as main herbs, some as ancillary herbs; within the ancillary herbs, up to three categories can be distinguished."Regarding the content of the prescription, one can differentiate between main herbs and ancillary herbs. For classical prescriptions, detailed analyses exist for each single ingredient which discriminate between up to three categories (Chen, Zun, and Chi) of ancillary herbs." From {{harvp|Kiessler|2005|p=25}}. Some ingredients are added to cancel out toxicity or side-effects of the main ingredients; on top of that, some medicinals require the use of other substances as catalysts.

{{main|Chinese patent medicine}}

Chinese patent medicine ({{zh|t=中成藥|s=中成药|first=t|p=zhōngchéng yào|labels=no}}) is a kind of traditional Chinese medicine. They are standardized herbal formulas. From ancient times, pills were formed by combining several herbs and other ingredients, which were dried and ground into a powder. They were then mixed with a binder and formed into pills by hand. The binder was traditionally honey. Modern teapills, however, are extracted in stainless steel extractors to create either a water decoction or water-alcohol decoction, depending on the herbs used. They are extracted at a low temperature (below {{convert|100|C}}) to preserve essential ingredients. The extracted liquid is then further condensed, and some raw herb powder from one of the herbal ingredients is mixed in to form a herbal dough. This dough is then machine cut into tiny pieces, a small amount of excipients are added for a smooth and consistent exterior, and they are spun into pills.{{Citation needed|date=October 2011}}

These medicines are not patented in the traditional sense of the word. No one has exclusive rights to the formula. Instead, "patent" refers to the standardization of the formula. In China, all Chinese patent medicines of the same name will have the same proportions of ingredients, and manufactured in accordance with the PRC Pharmacopoeia, which is mandated by law. However, in western countries there may be variations in the proportions of ingredients in patent medicines of the same name, and even different ingredients altogether.{{Citation needed|date=October 2011}}

Several producers of Chinese herbal medicines are pursuing FDA clinical trials to market their products as drugs in U.S. and European markets.Chinese Herbal Medicine Passes FDA Phase II Clinical Trials http://www.suntenglobal.com/news/show.php?ID=218&page= {{Webarchive|url=https://web.archive.org/web/20120402133628/http://www.suntenglobal.com/news/show.php?ID=218&page= |date=2012-04-02 }}

Chinese herbal extracts are herbal decoctions that have been condensed into a granular or powdered form. Herbal extracts, similar to patent medicines, are easier and more convenient for patients to take. The industry extraction standard is 5:1, meaning for every five pounds of raw materials, one pound of herbal extract is derived.Chinese Herbal Extract FAQs https://yinsclinic.com/chinese-herbal-extract-faqs/ {{Webarchive|url=https://web.archive.org/web/20180709153735/https://yinsclinic.com/chinese-herbal-extract-faqs/ |date=2018-07-09 }}{{better source needed|reason= Fringe / spam source with little, if any, scientific backing. |date=July 2018}}

There are several different methods to classify traditional Chinese medicinals:

• The Four Natures ({{zh|labels=no|t=四氣|s=四气|first=t|p=sìqì}})
• The Five Flavors ({{zh|labels=no|t=五味|s=五味|p=wǔwèi}})
• The meridians ({{zh|labels=no|t=經絡|s=经络|first=t|p=jīngluò}})
• The specific function.

The Four Natures are: hot ({{zh|labels=no|t=熱|s=热|first=t}}), warm ({{zh|labels=no|t=溫|s=温|first=t}}), cool ({{lang|zh|涼}}), cold ({{lang|zh|寒}}) or neutral ({{lang|zh|平}}).{{harvnb|Ergil|2009|p=232}} Hot and warm herbs are used to treat cold diseases, while cool and cold herbs are used to treat hot diseases.

{{anchor|Five Tastes}}

File:Wuxing en.svg

The Five Flavors, sometimes also translated as Five Tastes, are: acrid/pungent ({{lang|zh|辛}}), sweet ({{lang|zh|甘}}), bitter ({{lang|zh|苦}}), sour ({{lang|zh|酸}}), and salty ({{zh|labels=no|t=鹹|s=咸|first=t}}). Substances may also have more than one flavor, or none (i.e., a bland ({{lang|zh|淡}}) flavor). Each of the Five Flavors corresponds to one of the zàng organs, which in turn corresponds to one of the Five Phases:{{harvnb|Ergil|2009|p=61}} A flavor implies certain properties and presumed therapeutic "actions" of a substance: saltiness "drains downward and softens hard masses"; sweetness is "supplementing, harmonizing, and moistening"; pungent substances are thought to induce sweat and act on qi and blood; sourness tends to be astringent ({{zh|labels=no|t=澀|s=涩|first=t}}) in nature; bitterness "drains heat, purges the bowels, and eliminates dampness".

These categories mainly include:

• exterior-releasingXu & Wang 2002, Summary of Contents or exterior-resolving{{harvnb|Ergil|2009|p=239}}
• heat-clearing
• downward-draining or precipitating
• wind-damp-dispelling
• dampness-transforming
• promoting the movement of water and percolating dampness or dampness-percolating
• interior-warming
• qi-regulating or qi-rectifying
• dispersing food accumulation or food-dispersing
• worm-expelling
• stopping bleeding or blood-stanching
• quickening the Blood and dispelling stasis or blood-quickening or blood-moving.{{cite book |title=Chinese Herbal Medicine: Materia Medica |publisher=Eastland Press |edition=Third |first1=Dan |last1=Bensky |first2=Steven |last2=Clavey |first3=Erich |last3=Stonger |first4=Andrew |last4=Gamble |year=2004}}{{page needed|date=October 2019}}
• transforming phlegm, stopping coughing and calming wheezing or phlegm-transforming and cough- and panting-suppressing
• Spirit-quieting or Shen-calming.
• calming the Liver and expelling wind or liver-calming and wind-extinguishing
• orifice-opening
• supplementing or tonifying: this includes qi-supplementing, blood-nourishing, yin-enriching, and yang-fortifying
• astriction-promoting or securing and astringing
• vomiting-inducing
• substances for external application

Many herbs earn their names from their unique physical appearance. Examples of such names include {{transliteration|zh|Niu Xi}} (Radix cyathulae seu achyranthis), 'cow's knees,' which has big joints that might look like cow knees; {{transliteration|zh|Bai Mu Er}} (Fructificatio tremellae fuciformis), 'white wood ear', which is white and resembles an ear; {{transliteration|zh|Gou Ji}} (Rhizoma cibotii), 'dog spine,' which resembles the spine of a dog.{{harvp|Chen|Chen|2004|pp=3–6}}

Color is not only a valuable means of identifying herbs, but in many cases also provides information about the therapeutic attributes of the herb. For example, yellow herbs are referred to as {{transliteration|zh|huang}} (yellow) or {{transliteration|zh|jin}} (gold). {{transliteration|zh|Huang Bai}} (Cortex Phellodendri) means 'yellow fir," and {{transliteration|zh|Jin Yin Hua}} (Flos Lonicerae) has the label 'golden silver flower."

Unique flavors define specific names for some substances. {{transliteration|zh|Gan}} means 'sweet,' so {{transliteration|zh|Gan Cao}} (Radix glycyrrhizae) is 'sweet herb,' an adequate description for the licorice root. {{transliteration|zh|Ku}} means 'bitter', thus {{transliteration|zh|Ku Shen}} (Sophorae flavescentis) translates as 'bitter herb.'

The locations or provinces in which herbs are grown often figure into herb names. For example, {{transliteration|zh|Bei Sha Shen}} (Radix glehniae) is grown and harvested in northern China, whereas {{transliteration|zh|Nan Sha Shen}} (Radix adenophorae) originated in southern China. And the Chinese words for north and south are respectively {{transliteration|zh|bei}} and {{transliteration|zh|nan}}.

{{transliteration|zh|Chuan Bei Mu}} (Bulbus fritillariae cirrhosae) and {{transliteration|zh|Chuan Niu Xi}} (Radix cyathulae) are both found in Sichuan province, as the character {{transliteration|zh|chuan}} indicates in their names.

Some herbs, like {{transliteration|zh|Fang Feng}} (Radix Saposhnikoviae), literally 'prevent wind,' preventing or treating wind-related illnesses. {{transliteration|zh|Xu Duan}} (Radix Dipsaci), literally 'restore the broken,' treating torn soft tissues and broken bones.

Many herbs indigenous to other countries have been incorporated into the Chinese materia medica. {{transliteration|zh|Xi Yang Shen}} (Radix panacis quinquefolii), imported from North American crops, translates as 'western ginseng,' while {{transliteration|zh|Dong Yang Shen}} (Radix ginseng Japonica), grown in and imported from North Asian countries, is 'eastern ginseng.'

From the earliest records regarding the use of medicinals to today, the toxicity of certain substances has been described in all Chinese materia medica.{{harvnb|Ergil|2009|pp=234–236}} Since TCM has become more popular in the Western world, there are increasing concerns about the potential toxicity of many traditional Chinese medicinals including plants, animal parts and minerals. For most medicinals, efficacy and toxicity testing are based on traditional knowledge rather than laboratory analysis.{{cite journal|journal=Planta Medica|year=2012|volume=76|issue=17|pages=2012–8|title=Toxicological risks of Chinese herbs|author=Shaw D|pmid=21077025|doi=10.1055/s-0030-1250533|doi-access=free}} The toxicity in some cases could be confirmed by modern research (i.e., in scorpion); in some cases it could not (i.e., in Curculigo).{{harvnb|Ergil|2009|p=236}} Further, ingredients may have different names in different locales or in historical texts, and different preparations may have similar names for the same reason, which can create inconsistencies and confusion in the creation of medicinals,{{cite web|url=http://www.hkcccm.com/main.php?id1=164&id2=165 |script-title=zh:香港容易混淆中藥 |publisher=Hkcccm.com |access-date=2009-12-07|archive-url = https://web.archive.org/web/20080119212113/http://www.hkcccm.com/main.php?id1=164&id2=165 |archive-date=January 19, 2008 |url-status=dead}} with the possible danger of poisoning.{{cite web|url=http://www3.news.gov.hk/ISD/ebulletin/tc/category/healthandcommunity/040503/html/040503tc05003.htm |script-title=zh:「芒硝」與「牙硝」勿混淆使用 |publisher=news.gov.hk |date=2004-05-03 |access-date=2009-12-07|archive-url = https://web.archive.org/web/20090602215609/http://www3.news.gov.hk/ISD/ebulletin/tc/category/healthandcommunity/040503/html/040503tc05003.htm |archive-date = June 2, 2009 |url-status=dead}}{{cite web |url=http://www.info.gov.hk/gia/general/200405/03/0503212.htm |title=Chinese medicine Natrii Sulfas not to be confused with chemical Sodium Nitrite |publisher=Info.gov.hk |date=2004-05-03 |access-date=2009-12-07 |archive-date=2009-08-19 |archive-url=https://web.archive.org/web/20090819154927/http://www.info.gov.hk/gia/general/200405/03/0503212.htm |url-status=live }}{{cite web |url=http://www.100md.com/html/DirDu/2004/07/25/53/75/65.htm |script-title=zh:芒硝图谱-矿物类 |publisher=100md.com |access-date=2009-12-07 |archive-date=2011-07-07 |archive-url=https://web.archive.org/web/20110707054218/http://www.100md.com/html/DirDu/2004/07/25/53/75/65.htm |url-status=live }}{{Unreliable source?|what does this article say???|date=October 2011}} Edzard Ernst "concluded that adverse effects of herbal medicines are an important albeit neglected subject in dermatology, which deserves further systematic investigation."{{cite journal|last1=Ernst|first1=E|title=Adverse effects of herbal drugs in dermatology.|journal=The British Journal of Dermatology|date=November 2000|volume=143|issue=5|pages=923–9|pmid=11069498|doi=10.1046/j.1365-2133.2000.03822.x|s2cid=6036692}} Research suggests that the toxic heavy metals and undeclared drugs found in Chinese herbal medicines might be a serious health issue.{{cite journal|last1=Ernst|first1=E|title=Toxic heavy metals and undeclared drugs in Asian herbal medicines.|journal=Trends in Pharmacological Sciences|date=March 2002|volume=23|issue=3|pages=136–9|pmid=11879681|doi=10.1016/s0165-6147(00)01972-6}}

Substances known to be potentially dangerous include aconite, secretions from the Asiatic toad,{{cite journal |pmid=8779214 |year=1996 |last1=Ko |first1=RJ |last2=Greenwald |first2=MS |last3=Loscutoff |first3=SM |last4=Au |first4=AM |last5=Appel |first5=BR |last6=Kreutzer |first6=RA |last7=Haddon |first7=WF |last8=Jackson |first8=TY |last9=Boo |first9=FO |title=Lethal ingestion of Chinese herbal tea containing ch'an su |volume=164 |issue=1 |pages=71–5 |pmc=1303306 |journal=The Western Journal of Medicine |last10=Presicek |first10=G}} powdered centipede,{{cite web |url=http://www.acupuncturetoday.com/herbcentral/centipede.php |title=Centipede, Acupuncture Today |publisher=Acupuncturetoday.com |access-date=2011-05-17 |archive-date=2011-01-05 |archive-url=https://web.archive.org/web/20110105022326/http://www.acupuncturetoday.com/herbcentral/centipede.php |url-status=live }} the Chinese beetle (Mylabris phalerata, Ban mao),{{cite journal |doi=10.1016/0378-8741(88)90157-2 |title=Insect derived crude drugs in the chinese song dynasty |year=1988 |last1=Tsuneo |first1=N |last2=Ma |first2=M |last3=Inagaki |first3=I |journal=Journal of Ethnopharmacology |volume=24 |issue=2–3 |pages=247–85 |pmid=3075674 }} and certain fungi.{{cite journal |doi=10.1159/000073056 |title=Movement Disorders Possibly Induced by Traditional Chinese Herbs |year=2003 |last1=Wang |first1=X.P. |last2=Yang |first2=R.M. |journal=European Neurology |volume=50 |issue=3 |pages=153–9 |pmid=14530621 |s2cid=43878555 }} There are health problems associated with Aristolochia. Toxic effects are also frequent with Aconitum. To avoid its toxic adverse effects Xanthium sibiricum must be processed. Hepatotoxicity has been reported with products containing Reynoutria multiflora (synonym Polygonum multiflorum), glycyrrhizin, Senecio and Symphytum. The evidence suggests that hepatotoxic herbs also include Dictamnus dasycarpus, Astragalus membranaceus, and Paeonia lactiflora; although there is no evidence that they cause liver damage.{{Clarify|date=June 2019}} Contrary to popular belief, Ganoderma lucidum mushroom extract, as an adjuvant for cancer immunotherapy, appears to have the potential for toxicity.{{Cite journal | last1 = Gill | first1 = S. K. | last2 = Rieder | first2 = M. J. | title = Toxicity of a traditional Chinese medicine, Ganoderma lucidum, in children with cancer | journal = Canadian Journal of Clinical Pharmacology | volume = 15 | issue = 2 | pages = e275–e285 | year = 2008 | pmid = 18603664}}

Also, adulteration of some herbal medicine preparations with conventional drugs which may cause serious adverse effects, such as corticosteroids, phenylbutazone, phenytoin, and glibenclamide, has been reported.{{cite journal| author=Efferth T, Kaina B| title=Toxicities by herbal medicines with emphasis to traditional Chinese medicine | journal=Curr Drug Metab | year= 2011 | volume= 12 | issue= 10 | pages= 989–96 | pmid=21892916 | doi= 10.2174/138920011798062328 | url=https://www.researchgate.net/publication/10657129 | type= Review }}{{open access}}{{cite journal| author=Ernst E| title=Adulteration of Chinese herbal medicines with synthetic drugs: a systematic review. | journal=J Intern Med | year= 2002 | volume= 252 | issue= 2 | pages= 107–13 | pmid=12190885 | doi= 10.1046/j.1365-2796.2002.00999.x | s2cid=29077682 | type= Systematic Review | doi-access= free }}{{open access}}

However, many adverse reactions are due to misuse or abuse of Chinese medicine. For example, the misuse of the dietary supplement Ephedra (containing ephedrine) can lead to adverse events including gastrointestinal problems as well as sudden death from cardiomyopathy. Products adulterated with pharmaceuticals for weight loss or erectile dysfunction are one of the main concerns. Chinese herbal medicine has been a major cause of acute liver failure in China.{{Cite journal | last1 = Zhao | first1 = P. | last2 = Wang | first2 = C. | last3 = Liu | first3 = W. | last4 = Chen | first4 = G. | last5 = Liu | first5 = X. | last6 = Wang | first6 = X. | last7 = Wang | first7 = B. | last8 = Yu | first8 = L. | last9 = Sun | first9 = Y. | last10 = Liang | first10 = X. | last11 = Yang | first11 = H. | last12 = Zhang | first12 = F. | editor1-last = Avila | editor1-first = Matias A | title = Causes and Outcomes of Acute Liver Failure in China | doi = 10.1371/journal.pone.0080991 | journal = PLOS ONE | volume = 8 | issue = 11 | pages = e80991 | year = 2013 | pmid = 24278360 | pmc =3838343 | bibcode = 2013PLoSO...880991Z | doi-access = free }}

Most Chinese herbs are safe but some have shown not to be. Reports have shown products being contaminated with drugs, toxins, or false reporting of ingredients. Some herbs used in TCM may also react with drugs, have side effects, or be dangerous to people with certain medical conditions.{{Cite web |url=https://nccih.nih.gov/health/whatiscam/chinesemed.htm |title=Traditional Chinese Medicine: In Depth |website=National Center for Complementary and Integrative Health |publisher=National Institutes of Health |language=en |access-date=2017-11-27 |date=April 2009 |archive-date=2017-04-04 |archive-url=https://web.archive.org/web/20170404224358/https://nccih.nih.gov/health/whatiscam/chinesemed.htm |url-status=live }}

{{Further|Traditional Chinese medicine#Efficacy|Drug research}}

Only a few trials exist that are considered to have adequate methodology by scientific standards. Proof of effectiveness is poorly documented or absent.{{cite journal |doi=10.1093/ije/dym119 |title=Placebo-controlled trials of Chinese herbal medicine and conventional medicine comparative study |year=2007 |last1=Shang |first1=A. |last2=Huwiler |first2=K. |last3=Nartey |first3=L. |last4=Jüni |first4=P. |last5=Egger |first5=M. |journal=International Journal of Epidemiology |volume=36 |issue=5 |pages=1086–92 |pmid=17602184 |doi-access=free }} A 2016 Cochrane review found "insufficient evidence that Chinese Herbal Medicines were any more or less effective than placebo or hormonal therapy" for the relief of menopause related symptoms.{{cite journal|last1=Zhu|first1=X|last2=Liew|first2=Y|last3=Liu|first3=ZL|title=Chinese herbal medicine for menopausal symptoms|journal=The Cochrane Database of Systematic Reviews|date=15 March 2016|volume=3|issue=5 |pages=CD009023|doi=10.1002/14651858.CD009023.pub2|pmid=26976671|pmc=4951187}} A 2012 Cochrane review found no difference in decreased mortality for SARS patients when Chinese herbs were used alongside Western medicine versus Western medicine exclusively.{{Cite journal | last1 = Liu | first1 = X. | last2 = Zhang | first2 = M. | last3 = He | first3 = L. | last4 = Li | first4 = Y. | editor1-last = Li | editor1-first = Youping | title = Chinese herbs combined with Western medicine for severe acute respiratory syndrome (SARS) | doi = 10.1002/14651858.CD004882.pub3

| journal = The Cochrane Database of Systematic Reviews| volume = 10 | pages = CD004882 | year = 2012 | issue = 10 | pmid = 23076910 | pmc =6993561 }} A 2010 Cochrane review found there is not enough robust evidence to support the effectiveness of traditional Chinese medicine herbs to stop the bleeding from haemorrhoids.{{Cite journal | last1 = Gan | first1 = T. | last2 = Liu | first2 = Y. D. | last3 = Wang | first3 = Y. | last4 = Yang | first4 = J. | editor1-last = Gan | editor1-first = Tao | title = Traditional Chinese Medicine herbs for stopping bleeding from haemorrhoids | doi = 10.1002/14651858.CD006791.pub2

| journal = The Cochrane Database of Systematic Reviews| issue = 10 | pages = CD006791 | year = 2010 | pmid = 20927750 }} A 2008 Cochrane review found promising evidence for the use of Chinese herbal medicine in relieving painful menstruation, compared to conventional medicine such as NSAIDs and the oral contraceptive pill, but the findings are of low methodological quality.{{Cite journal | last1 = Zhu | first1 = X. | last2 = Proctor | first2 = M. | last3 = Bensoussan | first3 = A. | last4 = Wu | first4 = E. | last5 = Smith | first5 = C. A. | editor1-last = Zhu | editor1-first = Xiaoshu | title = Chinese herbal medicine for primary dysmenorrhoea | doi = 10.1002/14651858.CD005288.pub3

| journal = The Cochrane Database of Systematic Reviews| issue = 2 | pages = CD005288 | year = 2008 | pmid = 18425916 }} A 2012 Cochrane review found weak evidence suggesting that some Chinese medicinal herbs have a similar effect at preventing and treating influenza as antiviral medication.{{Cite journal|last1=Jiang|first1=Lanhui|last2=Deng|first2=Linyu|last3=Wu|first3=Taixiang|date=2013-03-28|title=Chinese medicinal herbs for influenza|journal=The Cochrane Database of Systematic Reviews|volume=2013 |issue=3|pages=CD004559|doi=10.1002/14651858.CD004559.pub4|issn=1469-493X|pmid=23543533|pmc=8957659 }} Due to the poor quality of these medical studies, there is insufficient evidence to support or dismiss the use of Chinese medicinal herbs for the treatment of influenza. There is a need for larger and higher quality randomized clinical trials to determine how effective Chinese herbal medicine is for treating people with influenza. A 2005 Cochrane review found that although the evidence was weak for the use of any single herb, there was low quality evidence that some Chinese medicinal herbs may be effective for the treatment of acute pancreatitis.{{Cite journal | last1 = Wang | first1 = Q. | last2 = Yiping | first2 = Z. | last3 = Jinlin | first3 = P. | last4 = Tao | first4 = Y. | last5 = Zhen | first5 = T. | last6 = Pengcheng | first6 = J. | editor1-last = Wang | editor1-first = Qiong | doi = 10.1002/14651858.CD003631.pub2 | title = Chinese herbal medicines for acute pancreatitis

| journal = The Cochrane Database of Systematic Reviews| issue = 1 | pages = CD003631 | year = 2005 | volume = 2009 | pmid = 15674909 | pmc = 8724804 }}

File:Seahorse Skeleton Macro 8 - edit.jpgs like these are extensively used in traditional medicine in China and elsewhere.]]

The traditional practice of using now-endangered species is controversial within TCM. Modern Materia Medicas such as Bensky, Clavey and Stoger's comprehensive Chinese herbal text discuss substances derived from endangered species in an appendix, emphasizing alternatives.{{Cite book|title=Chinese Herbal Medicine Material Medica|last=Bensky, Clavey and Stoger|publisher=Eastland Press|year=2004|edition=3rd}}{{Page needed|date=October 2011}}

Parts of endangered species used as TCM drugs include tiger bones{{cite book|author1=Nigel Wiseman |author2=Ye Feng |title=A Practical Dictionary of Chinese Medicine|publisher=Paradigm Publications|edition=2|year=1998|url=https://books.google.com/books?id=_FyGk5QnjhAC&q=tiger+bone|page=904|isbn=9780912111544}} and rhinoceros horn.Facts about traditional Chinese medicine (TCM): rhinoceros horn, Encyclopædia Britannica, [https://www.britannica.com/facts/5/1035448/traditional-Chinese-medicine-TCM-as-discussed-in-rhinoceros-mammal Facts about traditional Chinese medicine (TCM): rhinoceros horn, as discussed in rhinoceros (mammal): – Britannica Online Encyclopedia] {{Webarchive|url=https://web.archive.org/web/20110629095329/http://www.britannica.com/facts/5/1035448/traditional-Chinese-medicine-TCM-as-discussed-in-rhinoceros-mammal |date=2011-06-29 }} Poachers supply the black market with such substances,{{cite news |author=Brian K. Weirum, Special to the Chronicle |url=http://www.sfgate.com/cgi-bin/article.cgi?f=/c/a/2007/11/11/TR10T8RBN.DTL |title=Will traditional Chinese medicine mean the end of the wild tiger? |publisher=Sfgate.com |date=2007-11-11 |access-date=2009-12-07 |archive-date=2009-02-01 |archive-url=https://web.archive.org/web/20090201170930/http://www.sfgate.com/cgi-bin/article.cgi?f=%2Fc%2Fa%2F2007%2F11%2F11%2FTR10T8RBN.DTL |url-status=live }}{{cite web |url=https://www.newscientist.com/channel/life/endangered-species/dn3376 |title=Rhino rescue plan decimates Asian antelopes |publisher=Newscientist.com |access-date=2009-12-07 |archive-date=2008-05-17 |archive-url=https://web.archive.org/web/20080517124015/http://www.newscientist.com/channel/life/endangered-species/dn3376 |url-status=live }} and the black market in rhinoceros horn, for example, has reduced the world's rhino population by more than 90 percent over the past 40 years."Rhino horn: All myth, no medicine", National Geographic, Rhishja Larson Concerns have also arisen over the use of turtle plastron{{Cite journal |doi=10.2744/CCB-0747.1 |title=Unregulated Trade in Turtle Shells for Chinese Traditional Medicine in East and Southeast Asia: The Case of Taiwan |year=2009 |last1=Chen |first1=Tien-Hsi |last2=Chang |first2=Hsien-Cheh |last3=Lue |first3=Kuang-Yang |journal=Chelonian Conservation and Biology |volume=8 |issue=1 |pages=11–18 |s2cid=86821249 }} and seahorses.{{cite web |url=https://www.pbs.org/wgbh/nova/seahorse/vincent.html |title=NOVA Online | Kingdom of the Seahorse | Amanda Vincent |publisher=Pbs.org |access-date=2009-12-07 |archive-date=2017-10-26 |archive-url=https://web.archive.org/web/20171026235711/http://www.pbs.org/wgbh/nova/seahorse/vincent.html |url-status=live }}

TCM recognizes bear bile as a medicinal. In 1988, the Chinese Ministry of Health started controlling bile production, which previously used bears killed before winter. Now bears are fitted with a sort of permanent catheter, which is more profitable than killing the bears."治人病还是救熊命——对养熊"引流熊胆"的思考"南风窗. November 12, 2002{{Verify source|date=October 2011}} More than 12,000 asiatic black bears are held in "bear farms", where they suffer cruel conditions while being held in tiny cages. The catheter leads through a permanent hole in the abdomen directly to the gall bladder, which can cause severe pain.

Increased international attention has mostly stopped the use of bile outside of China; gallbladders from butchered cattle ({{zh|labels=no|t=牛膽|s=牛胆 |p=niú dǎn}}) are recommended as a substitute for this ingredient.{{Citation needed|date=September 2011}}

Collecting American ginseng to assist the Asian traditional medicine trade has made ginseng the most harvested wild plant in North America for the last two centuries, which eventually led to a listing on CITES Appendix II.{{Cite journal | pmid = 23398402| year = 2013| last1 = McGraw| first1 = J. B.| title = Ecology and conservation of ginseng (Panax quinquefolius) in a changing world| journal = Annals of the New York Academy of Sciences| volume = 1286| issue = 1| pages = 62–91| last2 = Lubbers| first2 = A. E.| last3 = Van Der Voort| first3 = M| last4 = Mooney| first4 = E. H.| last5 = Furedi| first5 = M. A.| last6 = Souther| first6 = S| last7 = Turner| first7 = J. B.| last8 = Chandler| first8 = J| doi = 10.1111/nyas.12032| bibcode = 2013NYASA1286...62M| s2cid = 20938136}}

Chinese medicinal plant materials (CMPMs) release chemicals that attracts the Drugstore beetle, leading to the accumulation of this pest and further infestation and damage to these plants.{{Cite journal |last1=Cao |first1=Yu |last2=Pistillo |first2=Onofrio Marco |last3=Lou |first3=Yibin |last4=D'Isita |first4=Ilaria |last5=Maggi |first5=Filippo |last6=Hu |first6=Qiqi |last7=Germinara |first7=Giacinto Salvatore |last8=Li |first8=Can |date=August 2022 |title=Electrophysiological and behavioural responses of Stegobium paniceum to volatile compounds from Chinese medicinal plant materials |journal=Pest Management Science |language=en |volume=78 |issue=8 |pages=3697–3703 |doi=10.1002/ps.7012 |issn=1526-498X |pmc=9542140 |pmid=35620873}}

{{See also|List of medicines in traditional Chinese medicine}}

Chinese herbology is a pseudoscientific practice with potentially unreliable product quality, safety hazards or misleading health advice.{{cite web|url=https://www.quackwatch.com/01QuackeryRelatedTopics/herbs.html|title=The herbal minefield|author=Barrett, Stephen|publisher=Quackwatch|date=23 November 2013|access-date=1 December 2017|archive-date=18 August 2018|archive-url=https://web.archive.org/web/20180818071259/http://quackwatch.com/01QuackeryRelatedTopics/herbs.html|url-status=dead}}{{cite web|url=http://apps.who.int/iris/bitstream/10665/92455/1/9789241506090_eng.pdf?ua=1|publisher=World Health Organization|title=WHO Traditional Medicine Strategy, 2014–2023; page 41|date=2013|access-date=1 December 2017|archive-date=18 November 2017|archive-url=https://web.archive.org/web/20171118192156/http://apps.who.int/iris/bitstream/10665/92455/1/9789241506090_eng.pdf?ua=1|url-status=live}}{{cite journal|pmid=22305255|year=2012|last1=Zhang|first1=J|title=Quality of herbal medicines: Challenges and solutions|journal=Complementary Therapies in Medicine|volume=20|issue=1–2|pages=100–6|last2=Wider|first2=B|last3=Shang|first3=H|last4=Li|first4=X|last5=Ernst|first5=E|doi=10.1016/j.ctim.2011.09.004}} There are regulatory bodies, such as China GMP (Good Manufacturing Process) of herbal products.{{cite journal|last1=He|first1=Tian-Tian|last2=Lam Ung|first2=Carolina Oi|last3=Hu|first3=Hao|last4=Wang|first4=Yi-Tao|title=Good manufacturing practice (GMP) regulation of herbal medicine in comparative research: China GMP, cGMP, WHO-GMP, PIC/S and EU-GMP|journal=European Journal of Integrative Medicine|date=February 2015|volume=7|issue=1|pages=55–56|doi=10.1016/j.eujim.2014.11.007}} There is a lack of high-quality scientific research on herbology practices and product effectiveness for anti-disease activity. In the herbal sources listed below, there is little or no evidence for efficacy or proof of safety across consumer age groups and disease conditions for which they are intended.

There are over 300 herbs in common use. Some of the most commonly used herbs are Ginseng ({{zh|labels=no|s=人参|t=人參|p=rénshēn}}), wolfberry ({{zh|labels=no|c={{linktext|枸杞子}}|p=gǒuqǐzǐ), dong quai}} (Angelica sinensis, {{zh|labels=no|s=当归|t=當歸|p=dāngguī}}), astragalus ({{zh|labels=no|s=黄耆|t=黃耆|p=huángqí}}), atractylodes ({{zh|labels=no|s=白术|t=白朮|p=báizhú}}), bupleurum ({{zh|labels=no|c=柴胡|p=cháihú}}), cinnamon (cinnamon twigs ({{zh|labels=no|c=桂枝|p=guìzhī}}) and cinnamon bark ({{zh|labels=no|c=肉桂|p=ròuguì}})), coptis ({{zh|labels=no|s=黄连|t=黃連|p=huánglián}}), ginger ({{zh|labels=no|s=姜|t=薑|p=jiāng}}), hoelen ({{zh|labels=no|c=茯苓|p=fúlíng}}), licorice ({{zh|labels=no|c=甘草|p=gāncǎo}}), ephedra sinica ({{zh|labels=no|s=麻黄|t=麻黃|p=máhuáng}}), peony (white: {{zh|labels=no|c=白芍|p=báisháo}} and reddish: {{zh|labels=no|c=赤芍|p=chìsháo}}), rehmannia ({{zh|labels=no|s=地黄|t=地黃|p=dìhuáng}}), rhubarb ({{zh|labels=no|s=大黄|t=大黃|p=dàhuáng}}), and salvia ({{zh|labels=no|s=丹参|t=丹參|p=dānshēn}}).

In Chinese herbology, there are 50 "fundamental" herbs, as given in the reference text,Wong, Ming (1976). La Médecine chinoise par les plantes. Le Corps a Vivre series. Éditions Tchou. although these herbs are not universally recognized as such in other texts. The herbs are:

In addition to the above, many other Chinese herbs and other substances are in common use, and these include:

{{Div col|colwidth=20em}}

• Akebia quinata ({{lang|zh|木通}})
• Arisaema heterophyllum{{cite web |script-title=zh:天南星 |title=Tiannanxing |url=http://libproject.hkbu.edu.hk/was40/detail?channelid=47953&searchword=pid=B00106 |website=Hong Kong Baptist University |language=zh |url-status=dead |archive-url=https://web.archive.org/web/20151019004937/http://libproject.hkbu.edu.hk/was40/detail?channelid=47953&searchword=pid%3DB00106 |archive-date=2015-10-19 }}{{cite web |url=http://www.legislation.gov.hk/blis_ind.nsf/d2769881999f47b3482564840019d2f9/75693bae1ea33cd3482567fa00292a6a?OpenDocument |title=Cap 549 Sched 2 CHINESE HERBAL MEDICINES (CHINESE MEDICINE ORDINANCE) |publisher=Legislation.gov.hk |access-date=2012-11-04 |archive-date=2012-11-23 |archive-url=https://web.archive.org/web/20121123214929/http://www.legislation.gov.hk/blis_ind.nsf/d2769881999f47b3482564840019d2f9/75693bae1ea33cd3482567fa00292a6a?OpenDocument |url-status=live }} ({{lang|zh|胆南星}})
• Chenpi (sun-dried tangerine (mandarin) peel) ({{lang|zh|陳皮}})
• Clematis chinensis ({{lang|zh|威灵仙}})
• Concretio silicea bambusae ({{lang|zh|天竺黄}})
• Cordyceps sinensis ({{lang|zh|冬虫夏草}})
• Curcuma longa, Curcuma aromatica ({{lang|zh|郁金}})
• Dalbergia odorifera ({{lang|zh|降香}})
• Myrrh ({{lang|zh|没药}})
• Frankincense ({{lang|zh|乳香}})
• Prunus persica ({{lang|zh|桃仁}})
• ''Patchouli' ({{lang|zh|广藿香}})
• Polygonum ({{lang|zh|虎杖}})
• Sparganium stoloniferum ({{lang|zh|三棱}})
• Zedoary (Curcuma zedoaria) ({{lang|zh|莪朮}})

{{div col end}}

Traditional Chinese herbs are used either standalone, or in a grouping, jointly with other herbs. When several herbs are used together, this amalgamation is called a 'herbal formula'.{{medical citation needed|date=May 2024}}

There are, generally speaking, three types of herbal formulas used in TCM:

1. Classic Formulas - these are formulas which TCM practitioners believe have withstood the test of time over the centuries, and are mentioned in classical texts, such as the Shanghan Lun.

2. Patent Formulas - these are either classic formulas, or newer commonly-used formulas created in recent decades. The patent formulas stand out in that their usage is common enough, that they are frequently mass-produced by large companies, in China, the United States, and elsewhere.

3. Custom-Made Formulas - these formulas are composed by a TCM Practitioner, to match the specific diagnosis and medical condition of a patient. These formulas are often partially-based on the older, classic formulas.

The prescription of TCM formulas, is based on 4-tier system of hierarchy.{{cite journal | doi=10.1142/S2575900018100018 | title=Philosophical thinking of Chinese Traditional Medicine | date=2018 | last1=Dong | first1=Jingcheng | last2=Lu | first2=Linwei | last3=Le | first3=Jingjing | last4=Yan | first4=Chen | last5=Zhang | first5=Hongying | last6=Li | first6=Lulu | journal=Traditional Medicine and Modern Medicine | volume=01 | issue=1 | pages=1–10 | doi-access=free }} The 4-tiers are: Jun (君), Chen (臣), Zuo (佐) and Shi (使).{{Cite journal |last1=Ye |first1=Xiao-Bin |last2=Jing |first2=Mi |last3=Liu |first3=Qing-Song |date=2023 |title=Exploring the mechanism of Guizhi decoction's "Jun-Chen-Zuo-Shi" in treating plant nervous disorders based on weighted network pharmacology and molecular docking techniques |url=https://www.tmrjournals.com/article.html?J_num=6&a_id=2562 |journal=Drug Combination Therapy |language=en |volume=5 |issue=1 |pages=1 |doi=10.53388/DCT20230001 |issn=2624-3075|doi-access=free }}{{cite journal | doi=10.1186/1749-8546-9-24 | doi-access=free | title=Identifying roles of "Jun-Chen-Zuo-Shi" component herbs of QiShenYiQi formula in treating acute myocardial ischemia by network pharmacology | date=2014 | last1=Wu | first1=Leihong | last2=Wang | first2=Yi | last3=Li | first3=Zheng | last4=Zhang | first4=Boli | last5=Cheng | first5=Yiyu | last6=Fan | first6=Xiaohui | journal=Chinese Medicine | volume=9 | issue=1 | page=24 | pmid=25342960 | pmc=4196468 }} These four tiers are often translated as: Sovereign, Minister, Assistant, Courier; or Monarch, Minister, Assistant, Envoy (also: 'Guide').{{cite journal | url=https://www.humangeneticsjournal.com/articles/a-brief-discussion-on-chinese-medicine-behaviour-and-prescription-compatibility.html | title=A Brief Discussion on Chinese Medicine Behaviour and Prescription Compatibility | journal=Journal of Human and Clinical Genetics | date=11 December 2020 | volume=2 | issue=2 | last1=Steven | first1=Loh Cheng Toa | last2=Yi | first2=Goh Xin }}

File:Envoy Herbs (Guiding Herbs) in Traditional Chinese Medicine.jpg

This feudal-like hierarchy denotes the power and role of each herb in a given formula.{{cite web | url=https://www.rawforestfoods.com/formulation/ | title=Jun-Chen-Zuo-Shi Formulation » RAW Forest Foods }}{{cite journal | url=https://symbiosisonlinepublishing.com/rheumatology-arthritic-diseases/rheumatology-arthritic-diseases23.php | title=Application of "Monarch, Minister, Assistant and Envoy" Principle to Rheumatoid Arthritis Management | journal=Journal of Rheumatology and Arthritic Diseases | date=5 September 2017 | volume=2 | issue=3 | last1=Chen | first1=Yong | last2=Zheng | first2=Ji-nan | last3=Fang | first3=Jun | last4=Li | first4=Shen-Guang | last5=Guan | first5=Jiang-Long | last6=Yang | first6=Peiwei }} The Jun is the herb which is usually of the highest relative dosage, and leads the main action of the formula. In the majority of formulas, there is only one Jun (Monarch) herb. Sometimes, a formula may feature 2-3 Jun herbs, or lack a dominant Jun herb altogether. The Chen support the Jun in its actions, and provide additional uses for the medical purpose of the formula. The Zuo assist the Jun and Chen, but are given at a much lower dosage (relative to themselves), to deemphasize their influence, for various reasons. The Shi's main role is to help guide the formula to the correct bodily areas or organ systems inside of which it is meant to act.{{cite journal | pmc=4846759 | date=2016 | last1=Su | first1=X. | last2=Yao | first2=Z. | last3=Li | first3=S. | last4=Sun | first4=H. | title=Synergism of Chinese Herbal Medicine: Illustrated by Danshen Compound | journal=Evidence-Based Complementary and Alternative Medicine | issue=1 | pages=1–10 | doi=10.1155/2016/7279361 | doi-access=free | pmid=27190537 }}{{cite web | url=https://deeprootswellness.com/services/chinese-herbal-medicine/ | title=Chinese Herbal Medicine | Deep Roots Wellness | date=3 August 2011 }}{{cite web | url=https://albanacupuncture.com/services/chinese-herbs/ | title=Chinese Herbs » Alban Acupuncture | date=31 March 2016 }} The Shi are also sometimes used "to harmonize the properties of other herbs in the formula".{{cite web | url=https://www.usccmbybucm.org/chinese-herbal-medicine | title=Chinese Herbal Medicine }}{{cite web | url=http://www.shanwellness.com/herbal.php | title=Chinese Herbal Medicine | Shan Wellness }}

Most herbs can serve as either Jun (Monarch), Chen (Minister) or Zuo (Assistant) - the first three tiers in the herbal hierarchy. But only certain herbs, are considered fit to serve as Shi. This is because only some herbs are believed to have the ability, to guide other herbs into a given bodily area or organ system.{{cite web | url=https://blog.mountainroseherbs.com/tcm-for-fall | title=Traditional Chinese Medicine (TCM) Formula for Autumn Wellness }}

Within TCM formulas, there are also strict rules about which herbs pair well together (Dui Yao), and which are either contradictory, incompatible, or may cause a reaction amongst themselves, or with Western Medicine Drugs.{{cite web | url=http://www.itmonline.org/arts/herbdrug.htm | title=The Interactions of Herbs and Drugs }} For example: Gan Cao (Licorice) is incompatible with the herbs Yuan hua, Jing Da Ji, Hai Zao and Gan Sui. It may also alter the therapeutic effects of corticosteroids.{{cite web | url=https://www.americandragon.com/Individualherbsupdate/GanCao.html | title=Gan Cao - 甘草 - (Zhi Gan Cao) - 甘草 (炙甘草) - Radix Glycyrrhizae - Chinese Herbs - American Dragon - Dr Joel Penner OMD, LAc }}{{cite web | url=http://alternativehealing.org/gan_cao.htm | title=Gan cao, licorice, Glycyrrhiza glabra L., Complementary and Alternative Healing University }}

{{expand section|date=March 2024}}

• Ji Desheng (1898–1981), Chinese herbalist from Nantong.{{cite book |last= 振林金 |title= 蛇医游侠传 |publisher= 人民文协出版社 |date= January 1984}}
• Li Ching-Yuen (died 1933), Chinese herbalist, martial artist and tactical advisor.{{cite web |url= http://likenews.tw/article.php?no=16151 |title=史上第一長壽！256歲的李青雲 長壽秘訣只有一個字 |publisher= Likenews.tw |access-date= 2015-03-10 |url-status=dead|archive-url= https://web.archive.org/web/20141231023516/http://likenews.tw/article.php?no=16151 |archive-date=2014-12-31 }}
• Aw Chu Kin (died 1908), Burmese Chinese herbalist, inventor of Tiger Balm.
• Ing Hay (1862–1952), migrated to the United States in 1887 and practiced traditional Chinese medicine in Oregon.

{{Div col|colwidth=30em}}

• Chinese classic herbal formula
• Chinese food therapy
• Chinese Ophthalmology
• Compendium of Materia Medica
• Hallucinogenic plants in Chinese herbals
• Herbalism, for the use of medicinal herbs in other traditions.
• Japanese star anise
• Jiuhuang Bencao
• Kampo (traditional Japanese medicine)
• Li Shizhen
• Pharmacognosy
• Star anise
• Traditional Chinese medicine
• Traditional Korean medicine
• Traditional Vietnamese medicine
• Yaoxing Lun

{{Div col end}}

{{reflist|colwidth=30em}}

• {{Cite book |first1=John K. |last1=Chen |first2=Tina T. |last2=Chen |year=2004 |url=http://aompress.com/book_herbology/index.html |title=Chinese Medical Herbology and Pharmacology |publisher=Art of Medicine Press |isbn=0-9740635-0-9 |access-date=2012-02-09 |archive-date=2011-09-04 |archive-url=https://web.archive.org/web/20110904045012/http://www.aompress.com/book_herbology/index.html |url-status=dead }}
• {{Cite book |first1=John K. |last1=Chen |first2=Tina T. |last2=Chen |year=2009 |url=http://aompress.com/book_formulas/index.html |title=Pocket Atlas of Chinese Medicine |publisher=Art of Medicine Press |isbn=978-0-9740635-7-7 |access-date=2012-02-09 |archive-date=2009-07-31 |archive-url=https://web.archive.org/web/20090731233427/http://www.aompress.com/book_formulas/index.html |url-status=dead }}
• {{Cite book |last=Ergil |first=M. |display-authors=etal |year=2009 |url=https://books.google.com/books?id=kdZ1rFKW-LEC&q=tcm+pattern+diagnosis&pg=PA146 |title=Pocket Atlas of Chinese Medicine |publisher=Thieme |isbn=978-3-13-141611-7 }}
• {{Cite book |last1=Foster |first1=S. |last2=Yue |first2=C. |year=1992 |url=https://books.google.com/books?id=y78zzxTN570C&q=herbal+emissaries |title=Herbal emissaries: bringing Chinese herbs to the West |publisher=Healing Arts Press |isbn=978-0-89281-349-0 }}
• {{Cite book |last=Kiessler |first=Malte |year=2005 |url=https://books.google.com/books?id=Mmm-ZlIHrjwC&q=tcim+kiessler&pg=PA14 |title=Traditionelle Chinesische Innere Medizin |publisher=Elsevier, Urban & Fischer |isbn=978-3-437-57220-3 |language=de }}
• {{Cite book|last=Goldschmidt |first=Asaf |title=The Evolution of Chinese Medicine: Song Dynasty, 960-1200 |year=2009 |publisher=Routledge |location=London and New York |isbn=978-0-415-42655-8}}
• {{Cite book|last=Sivin|first=Nathan|title=Traditional Medicine in Contemporary China|year=1987|publisher=Center for Chinese Studies, University of Michigan|location=Ann Arbor|isbn=978-0-89264-074-4}}
• {{Cite book|last=Unschuld|first=Paul U.|title=Medicine in China: A History of Ideas|year=1985|publisher=University of California Press|location=Berkeley|isbn=978-0-520-05023-5}}
• {{Cite book |last1=Xu |first1=L. |last2=Wang |first2=W. |year=2002 |url=https://books.google.com/books?id=36dhuXGm3OgC&q=traditional+chinese+medicine+herb&pg=PA1|title=Chinese materia medica: combinations and applications |publisher=Donica Publishing |edition=1st |isbn=978-1-901149-02-9 }}

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