Written by Bob Quinn, DAOM, LAc
I have a few patients who will not take any Chinese herbs, simply on the basis of safety concerns. Are these safety concerns reasonable? They cite a recent death in the US due to the consumption of unprocessed aconite (a Chinese herb that professionally is always used in the safer “processed” form), concerns over environmental degradation in China, articles in the popular press about Chinese people with financial resources buying much of their food from foreign countries due to perceived corruption in the food safety system in China, earlier articles about hidden drugs in Chinese patent medicines, and so on. For patients who are well informed, there are legitimate concerns to be allayed. And they can be if the time is taken to learn about the natural products industry.
It is true that environmental degradation in China has had an impact on herb quality. There can be no doubt of that. I have many years experience being involved in importing Chinese herb extracts, and the big concern is heavy metals, likely attributable to industrial pollution. Pesticide-herbicide residues were generally not a problem that I encountered—with the exception of fungicide residues on ginseng, but China has mostly dealt with that now. But once the air and water are so polluted, as it is in many Chinese cities, it is impossible to keep the rain from carrying those pollutants down into the herb fields, often many hundreds of miles away.
Believe it or not the main way to deal with this problem in Chinese herb manufacturing plants is by thoroughly washing the plants again and again and again before processing them into extracts. If heavy metals are still a problem after that, there are more costly ways of removing them. Even with all that, in my earlier experience, we would still occasionally have to reject some imported Chinese material because it exceeded US heavy metal limits. This was not often.
Note that our systems on this side of the ocean are completely capable of catching problems before they end up in products sold to the public (our patients). Heavy metal testing is done routinely and effectively in hundreds of labs across the US. These testing protocols are all harmonized and totally trustworthy; luckily this test is quite inexpensive, meaning companies of all sizes can easily absorb the cost of testing. The same is true of testing for pesticide and herbicide residues. A company can test for literally hundreds of these residues for an affordable cost.
The safety record of the professional side of Chinese herbal medicine is an admirable one, especially when compared to the safety of prescribed medications. Iatrogenic disease is after all one of the leading causes of death in the US. No survey of the Chinese medicine field to my knowledge has shown our professional lines to EVER include hidden drugs. Where this practice has been observed, it has always been in non-GMP products, mostly ones sold in Chinatown shops.
GMP refers to “Good Manufacturing Practices.” GMP designation is given to a factory after an auditing visit by an accredited external agency, such as the Australian TGA (Therapeutic Goods Administration) or others based here in the US. These visits are rigorous and look at all stages of manufacture from procurement to preprocessing storage, to manufacture, and post-manufacture handling, packing and storage. Additionally the US FDA has in recent years visited many Chinese manufacturing facilities on official inspections. As a result we can have solid faith in the products that come from these GMP companies—and this means all of our most trusted professional lines available in acupuncture offices across the US.
Many people are unaware that Chinese herb and natural product manufacturers now dominate the world market, and perhaps if so informed it might give them a little more confidence in our products. Many of the ingredients you likely thought would come from Europe or South America, now come primarily from China, e.g., milk thistle, echinacea, many vitamins and so on. Because of all these foreign sales Chinese manufacturers have ample capital to invest in the very best manufacturing equipment. The Chinese government has helped with additional investment. As a result Chinese herb manufacturing plants are among the best in the world. It has been many years now (maybe 20 or so) since the Chinese government drove many small producers out of business, because they were not able to invest in the most modern equipment so as to meet global safety concerns. This was not an easy policy to implement, as it put many companies out of business. Now Chinese manufacturers have been among the best—along with Japanese, German, French, and Italian companies.
This is the conversation that we need to have with our patients. Systems have been put in place for the products sold through the offices of Chinese medicine professionals. Where a patient is at risk is when they go into herb shops where it might be possible to buy non-GMP products (most products in natural food stores are also GMP-certified, but not all)—these products would be the ones likely to have unallowable levels of heavy metals and possibly hidden drugs. It is safest to purchase through the offices of professionals where only GMP products are carried.
Bob Quinn is one of the owner-founders of Onkodo Clinic. He is also a full-time Assistant Professor in the School of Classical Chinese Medicine at NUNM. In the past he was the Marketing Manager for China Herbs and Natural Products International Corp. and co-founder of People’s Herbs, a professional supply company.
Written by Bob Quinn, DAOM, LAc
“If we can really understand the problem, the answer will come out of it, because the answer is not separate from the problem.” J. Krishnamurti
Yesterday I taught an all-day shonishin seminar for the Oregon State Association as a fundraiser. I was helped by Daniel Silver (also of Onkodo Clinic). For those unfamiliar with this term--shonishin—it is a Japanese style of pediatric treatment that does not often use inserted needles. Instead techniques of stroking, tapping, scratching, and vibrating acupuncture points and meridians are used. Various interesting tools are employed to do this work.
How can it be that such minute levels of stimulation as we find in shonishin are often enough to bring about the kinds of change infants and children need? It is difficult, if not impossible, to explain these positive outcomes given our current understanding of the human body. The amount of contact pressure is often only 5 grams or so, and yet this is enough to bring surprising shifts to many conditions commonly encountered.
In this seminar we had three patients come to receive treatment, ranging in age from 2 to 8. All three really enjoyed the work—that much was clear. It is possible to talk kids into needles, and it is possible to needle them painlessly and to have this be very helpful (indeed this gentle needling is part of shonishin training as well), but I have never encountered a child who LOVED being needled. Some rare 6-year olds think it is sort of cool to see a needle in their arm, but none of them think that it feels great—not the way the stroking techniques of shonishin do.
I worked for a famous math educator for a year at the University of Oregon as her grader. She was fascinated by questions, and she infected me with the same curiosity. When I first saw shonishin performed, my assumption was that it would not be enough stimulation to provoke positive change. When it became clear that that was not true, that shonishin treatments actually produce impressive clinical outcomes, then certain questions presented themselves, questions that I could not ignore.
In one old article in the North American Journal of Oriental Medicine Dr. Yoshio Manaka, MD wrote that with every patient we have to ask how much stimulation is needed to get the desired outcome. He maintained that this question never gets easier, even after we have practiced for many years. The patient who looks like an NFL linebacker might best be served with a very gentle treatment style, and the thin 70-year old woman might experience the best results from a much heavier-handed approach. It is a tough question.
It was 18 years ago when I first saw shonishin performed. I started to wonder about how this gentle stuff would work on adults. I started to think about Dr. Manaka’s question. Could it be, I wondered, that many of our treatments offer much more stimulation than is really needed to get the job done? I started to think about this, and it still occupies my thought. With children though the question is easily answered: They universally need the gentlest of the gentle treatment. Strong techniques often make already challenging conditions worse.
Buckminster Fuller’s geodesic domes can enclose the same cubic space as a standard box home with 30% fewer materials used. That is a lot, a big difference. A dome needs no internal supporting walls like our square buildings do. The larger the dome, the more stable it is. This is just one example of how our basic assumptions can be challenged. Of course in our culture a house is supposed to be square. Really? Does it have to be, or is it the case that we are simply used to houses looking like this? How many animals build square nests like our houses? How locked in are we to a certain kind of thinking? In a similar way we believe that of course acupuncture treatments need to include a significant amount of stimulation, whether for adults or children. Really? How would we know the true answer to such a big, big question? All we can say is that we have an opinion about this question based on quite limited experience. No one knows the truth of how much stimulation would be ideal.
My point here, beyond making the point that Onkodo Clinic practitioners love working with children in this shonishin system, is to promote the practice of asking tough questions, ones that get to the heart of our most cherished and basic assumptions. Of course this is no way to make friends, and I feel obligated to let readers know that up front. That University of Oregon professor I worked for was not popular with her students, despite the fact that she was an exceptionally lovely human being. Her questions were difficult, thought-provoking ones, and the students did not welcome such tough work.
In shonishin my initial doubts were long ago banished. Over the years I have seen too much to doubt the power of this gentle pediatric treatment system. I no longer doubt that there is something in the human body that we do not yet understand that would explain how such minute inputs can bring such blessed changes in difficult health conditions. I can’t explain in any modern way how the body does this, but it is possible in shonishin.
In general people do not like their long-held assumptions to be challenged or questioned. This is as true for acupuncturists as it is in any other field. If you become a questioner of this sort in Chinese medicine, you can count on a certain amount of push-back. People defend their ideas and assumptions as if their lives depend on it. But you will benefit in many ways from this sort of questioning, as will your patients. In shonishin it is infants and children who benefit, and this is a great joy for us shonishin practitioners.
Bob Quinn, DAOM, L.Ac. is one of the owner-founders of the Onkodo Clinic. He is also a full-time Assistant Professor in the School of Classical Chinese Medicine at NUNM. He and Lauri Elizabeth and Daniel Silver offer shonishin treatments at the Onkodo Clinic.
p.s. Onkodo will soon offer its own line of one-of-a-kind shonishin tools! Look for more developments on this soon!!