TRADITIONAL CHINESE HERBAL REMEDIES  
As evidenced by a February 18th tweet from China Xinhua News, healthcare practitioners across China are relying on centuries-old remedies to treat the novel coronavirus. In the absence of targeted drugs and vaccines, with continual updates to the national diagnosis and treatment program for novel coronavirus, the role of traditional Chinese medicine (TCM) is on the rise. More COVID-19 patients are being treated with Chinese medicine or integrated Western-Chinese medicine, and the role of TCM herbal prescription formulas is expanding. What formulas are they using? What do the properties of these herbs tell us about TCM approaches to the virus?

USE OF CHINESE HERBS TO TREAT THE CORONAVIRUS
With an array of treatment methods and a wealth of experience in its arsenal, Chinese medicine has been used to fight plagues and epidemics for thousands of years. The focus of TCM is not just the virus itself but also symptoms and changes to the body caused by the invasion of the virus. Treatment starts with the patient as a whole, to identify patterns and then dispel sickness and support health.

HERBAL FORMULA USAGE RATES 80% TO 95%
Reports from throughout China indicate TCM formula usage rates of 80% to 95% in confirmed cases of novel coronavirus. One specialist described isolation wards containing a mix of mild, typical, and severe cases of novel coronavirus. Typical cases are characterized as imaging findings in the lungs but the absence of disease progression to respiratory failure. In hospitals, traditional Chinese medicine plays a significant role in regulating diarrhea, constipation, and other gastrointestinal symptoms; in addition, intervention with Chinese medicine may stop the condition from progressing to the severe and critical stages.

WHAT FORMULAS ARE BEING USED? WHAT FORMULAS HAVE BEEN VALIDATED?
清肺排毒汤
The National Health Commission and the State Administration of Traditional Chinese Medicine recommend Qing Fei Pai Du decoction (清肺排毒汤); clinical observation and data analysis have been performed on the therapeutic efficacy of this classical TCM formula. One formula for Qing Fei Pai Du decoction appearing on multiple sites, including Baidu, listed 21 ingredients. The top ingredients in terms of quantity are calcium sulfate, Radix bupleuri (common name bupleurum, effective in the treatment of alternating chills and fever; may induce headache or nausea), Poria cocos (efficacy in draining dampness and transforming phlegm; concurrent administration of diuretics contraindicated), Radix dioscoreae (Chinese yam, known to tonify qi and yin of the lungs, spleen, and stomach; may have hypoglycemic effects, use with caution in comorbid hepatobiliary disease).

肺炎一号
Pneumonia Formula No. 1 (肺炎一号), developed by the Chinese Medicine Department at Guangzhou Eighth People's Hospital, and its variations Pneumonia Formula No. 2, Pneumonia Formula No. 3, Pneumonia Formula No. 4, and Pneumonia Formula No. 5 are also in use. Formula No. 1 has achieved favorable clinical results in Guangzhou. Formula No. 1 includes two herbs that clear heat and relieve toxicity, Flos lonicerae (honeysuckle flower) and Fructus forsythiae (forsythia fruit), along with 16 other ingredients.

VARIATIONS
In Chinese medicine, the treatment regimen adopted varies by person. If a patient is in poor physical condition, dispelling disease is not enough, treatment must focus on supporting health. For example, in those with poor appetite it is necessary to focus on spleen health; in patients with damp-heavy qi and thick tongue coating it is necessary to improve the flow of urine. Ear needling (acupuncture) may be used to treat the patient’s psychological state and resolve issues of insomnia, in order to restore the patient’s biological clock.

Just as treatment varies by individual patient, the virus varies by region. This too is a factor in treatment selection. It would not be appropriate to select one uniform formula for the entire nation.

NOT ADVOCATED FOR THE HEALTHY
NOT ADVOCATED FOR THE PREVENTION OF CORONAVIRUS
According to the head of a university of traditional Chinese medicine, the entire populace does not need to take this medicine. Healthy people need to improve resistance in order to avoid getting sick. High-risk populations, including healthcare providers, may take herbal remedies as appropriate.

Practitioners emphasized that these are treatment prescriptions and are not recommended as preventive prescriptions. The general public should not self-administer these prescriptions.
 

What's the solution?  Hire an experienced translator to ensure accurate translations. The standard in the translation industry is to translate into one's native language, thus a native English speaker is the best choice for Chinese-to-English translations. Look for a language professional with relevant language training, professional experience, and excellent written English. Grammatical errors and typos are red flags! 
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The January 24, 2020, news update from the Health Emergency Response Office on the Chinese government website reported hundreds of confirmed cases of novel coronavirus nationwide and 25 deaths in Hubei Province and Hebei Province – an additional eight deaths compared to the  January 23rd update, which detailed the anonymized medical histories of these initial 17 deaths. The majority were of advanced age (15 of the 17 over age 60), male (13 of 17), and suffered from such underlying conditions as liver cirrhosis, hypertension, cerebral infarction, diabetes, heart disease, chronic obstructive pulmonary disease, chronic renal insufficiency, Parkinson’s disease, and bronchitis. Most but not all presented with fever. Other symptoms at admission:

• cough
• headache
• systemic chills and body aches
• weakness
• fatigue
• breathing difficulties
• loss of appetite
• chest pain

Novel coronavirus was confirmed through positive nucleic acid testing and monitored by electrocardiogram, lung CT, and blood-gas analysis. Therapies included oxygen, extracorporeal membrane oxygenation, endotracheal intubation (refused in some cases), anti-infectives, antibiotics, antipyretics, analgesics, and sedatives, supplemental fluids, and symptomatic therapies.

Outcomes were intensifying respiratory failure, continuous declines in terminal oxygen saturation, reduced blood pressure, and ultimately death.

​Seven hospitals in Wuhan are offering intake for patients with high fever in order to identify new cases.

CHINESE VS JAPANESE VS KOREAN LANGUAGE  
​Chinese, Japanese, and Korean all use characters, sometimes they use the same characters. While modern Japanese is a mix of kanji (Chinese characters) and the katakana and hiragana syllabaries, most of the time Korean is written in the Hangul alphabet, although I have seen older Korean documents written with Chinese characters.

WHAT DOES CHINESE WRITING LOOK LIKE?
Here are some clues to help you differentiate: Chinese characters are, in general, more complex. They look denser. A written Chinese character, whether traditional (Hong Kong, Taiwan) or simplified (China, Singapore), has more strokes than a Japanese or Korean character.

WHAT DOES JAPANESE WRITING LOOK LIKE?
Look for "no" (の). Look for dots(び). The Japanese language uses Chinese characters (kanji) and it uses two syllabaries (kana) of characters with only a few strokes. A Japanese document will contain multiple occurrences of the character “no” (の) which means “of” or denotes possession. So, glance through the document, do you see の scattered throughout? Then, it’s Japanese. Double dots also appear frequently, e.g., グ and ガ and ド.

WHAT DOES KOREAN WRITING LOOK LIKE?
I look for ovals. The Korean language has its own phonetic writing system, sometimes described as an alphabetic syllabary, and an oval shape appears frequently, for example, 여 and 우 and 으 and 어. You won’t see these oval shapes in Chinese. When you see a oval or circle shape in the Japanese language, it is a small circle パ. 

WHAT ABOUT OTHER LANGUAGES AND OTHER WRITING SYSTEMS? 
​
จิ้งจอกสีน้ำตาลอย่างรวดเร็ว (Thai)
cáo nâu nhanh (Vietnamese)
хурдан бор үнэг (Mongolian)
быстрая коричневая лиса (Russian)
γρήγορη καστανή αλεπού (Greek)
الثعلب البني السريع (Arabic)
שועל חום מהיר (Hebrew)
ፈጣን ቡናማ ቀበሮ (Amharic)​

​Still have questions?
Write me at https://www.integrativetranslations.com/contact.html. I will look at your document and let you know.

ASTRAGALUS  
Originating in northeastern China, central Mongolia, and Manchuria, the root of the herbaceous perennial Astragalus membranaceus or 黃芪 (huangqi) is a staple of traditional Chinese medicine. Mild in strength, with a sweet and slightly warm nature and an affinity for the spleen and lungs, astragalus is used as a general tonic to improve endurance, immune resistance, and energy, and to promote blood flow to the surface. ​Astragalus is useful for viral infections and increases the action of interferon alpha-1. It tonifies the spleen, the qi, and the blood. It is indicated for energy deficiency, fatigue, prolapse of rectum, womb, or other organs, profuse sweating due to external “empty” ailments, stubborn abscesses, facial swelling, and diabetes. ​

The use of astragalus root as a general tonic dates to the 28th century BCE and the mythical Chinese ruler Shennong, the legendary author of the first materia medica. Astragalus root has a long, cylindrical taproot, which is internally yellowish in color, but rootlets should be absent. The constituents of astragalus root include triterpenoid saponins, astragalosides I-VIII, astramembranins I and II, isoglavones including formononetin and kumatakenin, and polysaccharides known as astrogaloglucans. There is anecdotal but little clinical evidence that astragalus alone or in combination aids in the treatment of the common cold or impaired immunity. Clinical studies supported by data from over 1000 patients in China confirm the use of astragalus as an immunostimulant for use in colds and upper respiratory infections. It is also used prophylactically. In general, astragalus is well tolerated but should probably be avoided in autoimmune diseases. 

INGREDIENTS
​
Root herbs astragalus, ginseng, eleuthero
Six cups low-salt soup broth
2 tablespoons olive oil
2 cloves garlic
​4 carrots
1 onion
1-2 pounds chicken (optional - for added immunity)
2 cups of chopped greens (spinach, chard, kale)
4 sprigs of parsley
2-3 sprigs of sage
6 slices of ginger root
 
Step 1: Soak root herbs in large pot with soup broth while preparing Steps 2 and 3. 
Step 2: Mince garlic, chop carrots and onion. Sauté  in olive oil over low heat until onions are translucent.
Step 3: Add chicken to above and brown on both sides.
Step 4: Add sautéed carrots, onions, and garlic, as well as chopped greens, sprigs of parsley and sage, slices of ginger, and chicken to soup broth.
Step 5: Simmer soup 3-4 hours, then remove root herbs, ginger slices, and sprigs of parsley and sage. 
Step 6: Season to taste with salt and pepper or soy sauce/hot oil/sesame oil. 

Tips and advice on where to find a qualified professional translator for your business needs.

A translator works with the written word and an interpreter works with the spoken word.  Do you have a document requiring translation or do you need to schedule an interpreter for a court hearing, business negotiation, or medical appointment? Here's some advice on how to find a professional translator or interpreter.

​RECOMMENDATIONS
​ 
Ask a trusted colleague in your industry for a referral to a translator or interpreter they work with regularly. If you know a qualified Spanish translator but need to have a document translated into French, ask the Spanish translator for a referral. Translators often network with one another and asking for a recommendation is a great place to start when looking for a professional translator.

Here is a partial list of websites with specific links to search for a translator or interpreter. 

• Look for the corresponding link on the association's home page.
• Use menus to select the language of the document requiring translation and the target language, e.g., Spanish to English. Or select two languages for interpretation services.
• Select certification, if required. 
• Select subject matter or specialization, e.g., medical, financial, legal.
• Select city or other geographic region, if applicable. While translators work over the computer across states and across nations, interpreters generally work in person at a specific location.  

National association
American Translators Association  Find a translator or interpreter

Regional and local groups
Association of Translators and Interpreters of Florida  Find a professional
Carolina Association of Translators and Interpreters  Find a translator/interpreter
Colorado Translators Association  Directories > Translators and Interpreters
Michigan Translators/Interpreters Network  Find a Translator/Interpreter
New Mexico Translators and Interpreters Association  The Directory
New York Circle of Translators  Find a Linguist
Northwest Translators & Interpreters Society  Find a language specialist
​Oregon Society of Translators and Interpreters  Find a translator/interpreter

HELPFUL GUIDELINES
​ 

• At its website https://www.atanet.org/, the American Translators Association has a free publication with tips for translation buyers  https://www.atanet.org/publications/Getting_it_right.pdf
• And another publication with tips for buyers of interpreting services https://www.atanet.org/publications/Getting_it_right_int.pdf
• A publication on translation standards called Translation: Buying a Non-Commodity  https://www.atanet.org/docs/translation_buying_guide.pdf
• The ATA Compass: Your Guide to Translation in the Global Market  https://theatacompass.org/

Still have questions? Contact me at https://www.integrativetranslations.com/ and I will do my best to help.

Active ingredients in herbs from traditional Chinese medicine have shown promising efficacy in rehabilitating and protecting the liver after injury from excess acetaminophen. 

Drug-induced liver injury
A significant number of cases of acute liver failure are caused by acetaminophen, also known as paracetamol. Acetaminophen is not toxic to the liver, but its reactive metabolite may cause liver injury. Excess quantities of acetaminophen can deplete the glutathione needed to convert the toxic metabolite NAPQI into a nontoxic metabolic product. Toxins generated during metabolization, mitochondrial dysfunction, inflammatory response, oxidative stress, the release of damage-associated molecular patterns (DAMPs), autophagy, endoplasmic reticulum stress, and microcirculatory dysfunction are among the mechanisms of injury.
 
Limits of pharmacologic drugs 
The chief pharmacologic agent used for the clinical treatment of acetaminophen-induced liver injury is N-acetylcysteine (NAC), but NAC has limited treatment results and its administration is time-sensitive. For optimal results, NAC is administered approximately one hour after oral acetaminophen.
 
Protective effects of traditional Chinese medicine
A number of active ingredients discovered in Chinese herbs suppress liver toxicity. These compounds vary in how they benefit liver injury: they may alleviate liver disease, mitigate damage to liver tissue, reduce the degree of liver injury, and prevent or ameliorate side effects by suppressing the pathways and mechanisms of liver injury. These active ingredients are fast acting, with notable efficacy and few toxic side effects, and include polyphenol compounds, flavonoid compounds, saponins, organic acids, terpenoid compounds, phenylpropanoids, polysaccharides, and alkaloids. 

Polyphenol compounds
Polyphenol compounds are widely present in traditional Chinese herbal remedies. Polyphenols  can affect the production of biomarkers associated with oxidative stress, a major cause of hepatotoxicity induced by acetaminophen overdose. In the research of Hasanein (2017), rosmarinic acid (found in basil, rosemary, and lemon balm) produced remarkable hepatoprotective effects by inhibiting CYP2E1 activity in the liver and lipid peroxidation.
 
Flavonoid compounds 
The protective effects of flavonoid compounds include the effects of ginseng anthocyanins on acetaminophen-induced hepatotoxicity (Qi 2017) and hyperoside which can hinder the formation of toxic intermediates and boost acetaminophen detoxification in the liver (Xie 2016). Fu (2018)  discovered that α-mangostin notably suppressed acetaminophen-induced oxidative stress; α-mangostin, a xanthone derivative found in the pericarp of mangosteen fruit, also reduced  inflammatory response through the anti-inflammatory mechanism mediated by the NF-κB and mitogen-activated protein kinase (MAPK) signaling pathways. Lu (2018) demonstrated that licochalcone A isolated from the root of Glycyrrhiza glabra had a protective effect on acetaminophen-induced liver injury through the Nrf2-mediated oxidative stress defense mechanism.
 
Saponins
Xu (2017) discovered that the antioxidant, anti-apoptotic, and anti-inflammatory actions of saponins (ginsenosides) had a protective effect on acetaminophen-induced liver injury in mice. Hu (2017) found that ginsenoside Rk1 pretreatment of acetaminophen-induced liver injury in mice significantly lowered levels of the lipid peroxidation product MDA. By increasing Bcl-2 and reducing Bax protein expression, ginsenoside Rk1 impeded activation of the apoptosis pathway. In Ning (2018), ginsenoside Rg1 prevented acetaminophen-induced liver injury through in vivo and in vitro activation of the Nrf2 signaling pathway. Leng (2018) proved that Platycodon grandiflorum saponins had pronounced protective effects on acetaminophen-induced liver injury through the NF-κB and AMPK/PI3K/Akt signaling pathways.

Organic acids 
In Heidari (2016), taurine effectively relieved acetaminophen-induced liver injury and its complications in mice. Jiang (2017) established that, by reducing thiobarbituric acid reactive substances (TBARS) which form as a byproduct of lipid peroxidation and reducing iNOS, COX-2, TNF-2, IL-12, and IL-6, the acids from Potentilla chinensis inhibited inflammation and oxidative stress to alleviate acetaminophen-induced liver injury. Cha (2018) discovered that p-coumaric acid (an abundant isomer of hydroxycinnamic acid widely found in fruits and vegetables) suppressed acetaminophen-induced hepatocyte apoptosis by modulating the MAPK signaling axis in a reactive oxygen species (ROS)-dependent manner and by alleviating response and inflammation from ROS-mediated DNA damage . 

Terpenoid compounds  
In Uchida (2017), compounds in the essential oil of Cymbopogon citratus (lemongrass) hindered neutrophil migration and antioxidant activity in mice with acetaminophen-induced liver injury, thus relieving hepatotoxicity. The research of Zhang (2017) proved that by inhibiting the TNF-α-mediated JNK signaling pathway and the phosphorylation ERK and P38 pathways, pretreatment with astaxanthin (natural sources include shrimp, algae, yeast, and salmon) reduced hepatocellular necrosis, blocked the formation of ROS, prevented oxidative stress, and diminished cellular apoptosis, protecting the liver and alleviating drug-induced liver injury. In Yoshioka  (2017), kamebakaurin (isolated from Rabdosia excisa) improved hepatotoxicity from acetaminophen overdose by inhibiting lipid peroxidation and inflammatory response in mice. 

Phenylpropanoids 
Fructus schisandrae (schisandra fruit) is widely used for liver protection in traditional Chinese medicine and the research of Jiang (2015) proved that lignan components in Fructus schisandrae ameliorated acetaminophen-induced liver injury by inhibiting acetaminophen's CYP-mediated biologic and metabolic pathways. Furthermore, in Jiang (2016) schisandrin B increased liver detoxification and antioxidation by activating the Nrf2/ARE pathway and regulating the Nrf2 target gene, reflecting its hepatoprotective effects. Yan (2018) demonstrated that, by activating sustained autophagy, glycycoumarin relieved acetaminophen-induced oxidative stress and thus prevented liver injury. 

Polysaccharides 
Lin (2018) found that polysaccharides of Dendrobium officinale played a hepatoprotective role by lowering oxidative stress and activating the Nrf2-Keap1 signaling pathway. And in Zhao (2018) the anti-inflammatory effects of polysaccharides of Coreopsis tinctoria regulated the expression of apoptosis-related proteins such as Bax and Bcl-2 to prevent acetaminophen-induced hepatotoxicity. Wu (2018) proved that polysaccharides of Poria cocos played a protective role against acetaminophen-induced liver injury in mice and their molecular mechanism was associated with suppression of the hepatocellular inflammatory response and apoptosis. 

Alkaloids
Li (2014) discovered hepatoprotective effects of berberine on liver fibrosis via activation of AMP-activated protein kinase; and Zhao (2018) found that berberine had pronounced prophylactic effects on acetaminophen-induced hepatotoxicity by inhibiting oxidative stress, hepatocellular necrosis, and inflammatory response. In Park (2016), the alkaloids of Aconitum carmichaelii  protected the organism against acetaminophen-induced injury by suppressing mitochondrial dysfunction and defending liver cells, although the herb is toxic when taken in excess. In 2018, a trial by Bian confirmed that ligustrazine (an alkaloid isolated from Ligusticum wallichii) improved acetaminophen-induced liver injury in mice by regulating the NF-κF and MAPK signal transduction pathways. 

Other compounds  
In Wangkheirakpam (2018), Auricularia delicata demonstrated antimicrobial, antioxidant, and protective effects on acetaminophen-induced liver injury in rats. In Guo (2018), Rhizoma pinelliae  extract regulated bile acid transporter protein in mice with acetaminophen-induced liver injury. By activating Nrf2 and inhibiting NF-κB signal transduction, Garcinia cambogia extract played a protective role in acetaminophen-induced liver injury in mice (Ibrahim 2018). The antioxidant, anti-inflammatory, and anti-apoptotic actions of tannic acid demonstrated significant hepatoprotective effects on acetaminophen-induced hepatotoxicity in the work of Zhang (2017).  

Acetaminophen is a leading cause of drug-induced liver injury and recent research findings indicate that the use of active ingredients from traditional Chinese medicinal herbs might ameliorate such injury. Research on mechanisms of liver injury and the means by which such compounds protect against and alleviate injury holds promise for future antidotes to drug-induced liver injury. 

​On November 5, 2019, the FDA updated its 2017 safety communication to remind patients, healthcare professionals, and laboratory technicians that levels of biotin or B-7, a B-complex vitamin and a common component of dietary supplements, higher than the recommended daily allowance may interfere with lab test results.   
​
Many dietary supplements promoted for hair, skin, and nails contain biotin levels up to 650 times the recommended daily intake of biotin. Physicians may also recommend high levels of biotin for patients with certain conditions such as multiple sclerosis. Biotin levels higher than the recommended daily allowance may cause interference with lab tests.
 
In its most recent update, the FDA reminds the public, healthcare providers, lab personnel, and lab test developers that biotin, often found in dietary supplements, can cause clinically significant incorrect lab test results. The FDA has seen an increase in the number of reported adverse events, including one death, related to biotin interference with lab tests. Incorrect test results may lead to inappropriate patient management or misdiagnosis. Biotin in patient samples can cause falsely high or falsely low results, which may lead to inappropriate patient management or misdiagnosis. For example, a falsely low result for troponin, a clinically important biomarker to aid in the diagnosis of heart attacks, may lead to a missed diagnosis and potentially serious clinical implications.
 
Consumers are advised to tell their doctor if they are taking biotin. Healthcare providers should talk to their patients about any biotin supplements they may be taking. Know that biotin is found in multivitamins – including prenatal multivitamins, biotin supplements, and dietary supplements for hair, skin, and nail growth – at levels that may interfere with lab tests. Lab personnel using assays with biotin technology must educate themselves and others about the potential for biotin interference.
 
The recommended daily allowance of biotin is 0.03 mg and biotin is present in small amounts in many foods including whole grains, eggs, walnuts, avocados, egg yolk, liver, and yeast.

Forms for healthcare professionals and patients to report safety information: 
https://www.fda.gov/safety/medwatch-fda-safety-information-and-adverse-event-reporting-program/medical-product-safety-information
FDA Safety Communication:
https://www.fda.gov/medical-devices/safety-communications/update-fda-warns-biotin-may-interfere-lab-tests-fda-safety-communication

WILD STRAWBERRY   
​Wild strawberry runs along the trail. Tea of strawberry leaves and stems is valued for its mild astringent effects, and its antirheumatic, diuretic, antidiarrheal, tonic, and laxative properties. Strawberry is recommended in many traditions for intestinal sluggishness and for pregnancy, convalescence, and chronic stomach sensitivity when stronger herbs are contraindicated.

WORMWOOD 
Known variously as 艾叶 (aiye), artemisia, or mugwort, wormwood is an intense bitter that stimulates underactive digestion and aids anemia. An anti-inflammatory and antidepressant, wormwood can be added as a potentiating factor to other preparations. Its active substances include essential oils, sesquiterpene lactones, azulenes, flavonoids, phenolic acids, and lignans. The whole plant is used as an antimalarial. Wormwood herbal tea is administered as a stomach stimulator and orexigenic.
In Chinese medicine, wormwood warms the channels and stops bleeding. It dispels cold and alleviates pain, calms the fetus, resolves phlegm, and stops cough and asthma. As an aromatic, wormwood is used in sweat baths and saunas. Wormwood-juniper smudge sticks cleanse spaces and purge negativity.

VERBENA 
The constituents of verbena or 马鞭草 (mabiancao, literally, horsewhip herb) include volatile oils, bitters, iridoids, alkaloids, mucilage, and tannins. It is a restorative, helpful for tension and long-term stress and good for convalescence from a long illness. The entire plant has sedative, tonic, diaphoretic, and anti-inflammatory properties and it is used to treat early-stage depression, melancholia, stress, and fever. Chinese medicine employs the bitter and cool properties of verbena to clear heat and remove toxicity, activate blood, disperse nodules, promote diuresis, and resolve swelling. It is indicated for jaundice caused by damp-heat, for fever due to external pathogens, and for dysmenorrhea or amenorrhea from blood stasis and abdominal masses. Its heat-clearing properties are used for severe sore throat and other accumulations of heat toxin including breast abscesses and swollen and painful gums. Extracts of lemon verbena and its major compound acteoside (ACT) have a regulatory effect on abnormal liver lipid metabolism; furthermore, ACT promotes lipolysis and fatty acid oxidation by increasing messenger RNA expression of adipose triglyceride lipase and carnitine palmitoyltransferase. 

OAK TREE
The leaves, acorns, galls, and branches of oak trees contain tannin, quercetin, gallic acid, pectin, calcium, magnesium, and potassium. In various medical traditions, infusion of oak tree bark is administered internally to treat hemorrhoids, diarrhea, chronic dysentery, intestinal bleeding, and uterine bleeding, and, as a tea astringent, oak is applied externally to skin wounds, burns, mouth inflammation, toothaches, sore throats, and earaches.
Oak gall possesses astringent, anti-inflammatory, antiviral, antidiabetic, larvicidal, antibacterial, and gastroprotective effects. Gallnuts have been sourced to produce drug therapies for cancerous diseases in traditional and folk medicine systems through the centuries, and the literature indicates that gallnuts contain a number of bioactive metabolites, accounting for their anticancer effects. Further screening of bioactive compounds is expected to yield valuable anticancer agents.

​JUNIPER
​The medicinal evergreen juniper or 杜松子(dusongzi) is resinous and aromatic. Internally, the leaves or berries have been used as a urinary antiseptic and for cystitis and urethritis, although juniper is contraindicated in people with kidney infection or chronic kidney weakness as the oils may be irritating to kidney inflammations. Juniper berries have diaphoretic and emmenagogue properties and the leaves have diuretic properties. In Chinese medicine, juniper works at the heart, spleen, and lung meridians and its key actions and medicinal uses include promoting digestion, warming the middle burner, expelling phlegm, warming the lungs, and cleansing the kidneys and liver.
Topically, juniper is used to treat chronic skin irritations and as a relaxant. It relaxes the muscles and removes barriers to blood flow and energetic flow. Juniper is prized in many traditions for its ability to dispel tension and stagnation and the aromatic parts of the juniper plant have been employed as a protector against negativity.  Juniper is known to have a stabilizing presence for those in need of safety and protection. ​
Juniper's versatility extends to the culinary world and includes the flavoring of meat and sauerkraut and the distillation of gin.  

 
Please note: The herb information in this blog is presented for educational purposes only. The use of herbal preparations is not recommended without seeking the advice of a healthcare provider. Substances in herbal preparations may interact with prescription drugs to eliminate therapeutic efficacy or induce toxicity.

BEAR CORN
​​Bear corn or 肉苁蓉 (roucongrong) emerges from the soil under the oaks. A root parasite lacking chlorophyll, bear corn searches the dark soil to feed off the root system of the host tree. These New Mexico specimens are yellow and resemble ears of corn. In the words of Culpeper, “The juice or decoction of the young branches or seed, or the powder of the seed taken in drink, purgeth downwards and draweth phlegmatic and watery humors from the joints, whereby it helpeth the dropsy, gout, sciatica, and pains in the hips and joints.” Bear corn serves as an astringent, a poultice, a laxative, and a sedative. It restores strength, muscle tone, and balance after a long illness. In Chinese medicine, bear corn is a tonic to kidney-yang and a demulcent laxative; it tonifies yin as well as yang, lowers blood pressure, and is prized as an aphrodisiac and a uterine hemostatic. Modern research indicates that phenylethanoid glycosides isolated from bear corn may be effective in treating hot flashes and menopausal syndrome.

YARROW
The wet spring has produced a bumper crop of fernlike yarrow. Also known as thousand-leaf, yarrow is an important species in the traditional medicine of many cultures. It is antispasmodic, astringent, bitter, diaphoretic, and anti-inflammatory, and its constituents include coumarins, tannins, alkaloids, flavonoids, lactones, volatile oils, and triterpenes. Internally, yarrow is used to break fevers and to regulate the menstrual cycle, reduce heavy bleeding, and relieve menstrual pain. Externally, a salve or ointment of yarrow heals wounds and eases the pain of varicose veins. Yarrow has been used as a battlefield remedy for its ability to stanch bleeding and its antibacterial properties. Soldiers applied powdered yarrow or fresh yarrow leaves and flowers to stop wounds from bleeding. 

CLEMATIS
Clematis ​or 威灵仙 (weilingxian) grows vertically on rocky roots as a vine with sparse, four-petal, nodding mauve flowers. Clematis has analgesic, anti-inflammatory, diuretic, and antimicrobial properties and its synergistic nature increases the effectiveness of other herbs. Clematis tea both acts as a vasoconstrictor on brain lining and dilates blood vessels -- it is used to treat headaches and migraines. Externally, a poultice of clematis leaves treats rheumatic pain.  
Known as “the holy root of the temple” in Chinese medicine, clematis removes wind and dampness, facilitates passage of meridians, and relieves pain. Experimental studies have demonstrated the antirheumatic and analgesic effects of clematis and saponins isolated from clematis may induce apoptosis in breast cancer cells via the mitochondrial pathway. Triterpene saponins from the roots and rhizomes of Clematis mandshurica show inhibitory activity against human colon cancer cell lines.

VALERIAN
Valerian or 缬草 (xiecao) clings to the rocks nearby. Also known as all-heal, valerian's use as a medicinal herb was documented in ancient Greece. Pliny said that the powder of valerian root given in drink, or the decoction thereof taken, helps all stoppings and stranglings in any part of the body. And Culpeper recommended the root of valerian boiled with licorice, raisins, and aniseed as singularly good for those who are short-winded and for those who are troubled with the cough, to open passages and expectorate phlegm easily.
​We scratch the root and smell the pungent odor of its chemical constituent valerenic acid. Acting at the central nervous system, valerenic acid and its derivatives have soothing, sedative, spasmolytic, digestive, and hypnotic properties. Physiologically active iridoid valepotriates may cause the release of GABA from nerve endings and block its return to nerve cells, and valerenic acid is known to inhibit an enzyme that destroys GABA. Herbal tea from valerian root has been used for anxiety, tension, hysteria, insomnia, and pain. Valerian root is approved in Europe for mild anxiety and to aid sleep. 
In Chinese medicine, valerian possesses pungent, bitter, and warm properties and enters through the liver and heart meridians. It acts to induce tranquilization, stop bleeding, and alleviate pain. Valerian root is indicated for irregular menstruation, traumatic injury, back pain, neurasthenia, and indigestion. ​

CORYDALIS
​Corydalis, also known as golden smoke, scrambled egg, or 延胡索 (yanhusuo), is among the first herbs to flower in spring. An herbal tea of the fumewort corydalis has hypnotic and analgesic properties and is used for stomachache and headache. The Ojibwe people placed the root on coals and inhaled the smoke to clear the head and calm the patient. In Chinese medicine, corydalis invigorates the blood, moves qi, alleviates pain, and reduces masses; thus, it is indicated for pain due to blood stasis and qi stagnation such as epigastric pain and dysmenorrhea. Corydalis contains 20 alkaloids, among them corydaline, tetrahydropalmatine, protopine, and tetrahydrocoptisine, and in laboratory research has exhibited pharmacological action on the central nervous system, including analgesic and sedative effects. Corydalis may block certain receptor sites in the brain, inducing sedation. Its alkaloids may also have cardiovascular effects.

Please note: The herb information in this blog is presented for educational purposes only. The use of herbal preparations is not recommended without the advice of a healthcare provider. Substances in herbal preparations may interact with prescription drugs to eliminate therapeutic efficacy or induce toxicity.

September 2019

The U.S. Food and Drug Administration is advising consumers not to purchase or use LOBO, Love in S, Sheaya Lender, and Mero Macho sold and advertised as dietary supplements. FDA has identified an emerging trend in which over-the-counter products, frequently represented as dietary supplements, contain hidden active ingredients that could be harmful. Consumers may unknowingly take products laced with varying quantities of approved prescription drug ingredients, controlled substances, and untested and unstudied pharmaceutically active ingredients. These deceptive products can harm you!

LOBO

This product promoted for sexual enhancement was identified in an examination of international mail shipments. The red LOBO text and fierce wolf image resemble the mascot of the University of New Mexico, and package copy in Spanish states Maximiza tu potencia sexual – Doble dosis de poder (Maximize your sexual potency – double dose of power). The Food and Drug Administration is advising consumers not to purchase or use LOBO, which contains sildenafil, the active ingredient in the prescription drug Viagra. This undeclared ingredient may interact with nitrates found in some prescription drugs, such as nitroglycerin, and may lower blood pressure to dangerous levels. 

Mero Macho

Mero Macho is sold on the websites fitoterapiausa.com and meromachodrink.com (both sites are currently under construction). FDA laboratory analysis confirmed that Mero Macho contains tadalafil, the active ingredient in the prescription drug Cialis, used to treat erectile dysfunction. Adverse reactions noted in the Cialis prescribing information include headache, indigestion, back pain, myalgia, nasal congestion, flushing, and limb pain. Contraindications are organic nitrates (tadalafil potentiates the hypotensive effect of nitrates), patients with known serious hypersensitivity to tadalafil, and concomitant guanylate cyclase stimulators. People with diabetes, high blood pressure, high cholesterol, or heart disease often take nitrates.

Sheaya Lender

FDA is advising consumers not to purchase or use Sheaya Lender, a product promoted for weight loss. This product was identified during an examination of international mail shipments. FDA laboratory analysis confirmed that Sheaya Lender contains sibutramine and fluoxetine. Sibutramine is a controlled substance that was removed from the market in October 2010 for safety reasons. This product poses a threat to consumers because sibutramine is known to substantially increase blood pressure and/or heart rate in some people and may present a significant risk for people with a history of coronary artery disease, congestive heart failure, arrhythmia, or stroke. This product may also interact, in life-threatening ways, with other medications a consumer may be taking.

Fluoxetine is an FDA-approved drug in a class of drugs called selective serotonin reuptake inhibitors (SSRIs) used for treating depression, bulimia, obsessive-compulsive disorder, panic disorder, and premenstrual dysphoric disorder. The use of SSRIs has been associated with serious side effects including suicidal thinking, abnormal bleeding, and seizures. Ventricular arrhythmia or sudden death can occur when patients are also taking other medications for common conditions (aspirin, ibuprofen, or other drugs for depression, anxiety, bipolar illness, blood clots, chemotherapy, heart conditions, and psychosis).

Love in S

FDA is advising consumers not to purchase or use Love in S, a product promoted and sold for weight loss. The package has the torso of a fit woman, images of fruits and other plants, and the words “love in S lose inches Natrually.” FDA laboratory analysis confirmed that Love in S contains sibutramine and N-desmethylsibutramine. N-desmethylsibutramine is structurally similar to sibutramine (as described above, sibutramine is a controlled substance that has been removed from the market).

“These products are masquerading as dietary supplements — they may look like dietary supplements but they are not legal dietary supplements,” says Michael Levy, director of FDA’s Division of New Drugs and Labeling Compliance. “Some of these products contain hidden prescription ingredients at levels much higher than those found in an approved drug product and are dangerous.” FDA has received numerous reports of harm associated with the use of these products, including stroke, liver injury, kidney failure, heart palpitations, and death.

Dietary Supplements and the FDA 

Dietary supplements, in general, are not FDA-approved. Under the Dietary Supplement Health and Education Act of 1994, dietary supplement firms do not need FDA approval prior to marketing their products. It is the company’s responsibility to make sure its products are safe and that any claims are true.

Just because you see a supplement product on a store shelf does NOT mean it is safe or effective. When safety issues are suspected, FDA must investigate and, when warranted, take steps to have the product removed from the market. However, it is much easier for a firm to get a product on the market than it is for FDA to take a product off the market. FDA has worked with the supplement industry to recall numerous products with potentially harmful ingredients including products marketed for weight loss, products marketed for sexual enhancement, and products marketed for body building. The agency has issued warning letters, seized products, and conducted criminal prosecutions. In December 2010, a woman pleaded guilty to an 18-count indictment charging her with the illegal importation and distribution of more than four million diet pills that contained a controlled substance, unapproved drugs, and a possible cancer-causing agent.

These hidden ingredients pose a risk to consumer health.  Remember, FDA cannot test all products marketed as dietary supplements to identify those containing potentially harmful hidden ingredients. Consumers must be aware of these dangerous products and learn how to identify and avoid them using the warning signs described below.

Advice for Consumers

What can you do? Be an informed consumer. Know the source of the dietary supplements you buy. Read the label information. Subscribe to FDA notifications informing the public of products marketed as dietary supplements or conventional foods with hidden drug ingredients and chemicals. These products are typically promoted for sexual enhancement, weight loss, and body building and are often represented as being “all natural.” Consumers should exercise caution before purchasing any product in the above categories. 

“We need consumers to be aware of these dangerous products and to learn how to identify and avoid them,” says Levy. Consumers should look for potential warning signs of tainted products marketed as dietary supplements, such as products claiming to be alternatives to FDA-approved drugs or to have effects similar to prescription drugs, products claiming to be a legal alternative to anabolic steroids, products marketed primarily in a foreign language, products with typographical errors in the label information, or products marketed through mass emails. Beware of sexual enhancement products promising rapid effects, such as working in minutes to hours, or long-lasting effects, such as working for 24 to 72 hours. Generally, if you are using or considering using any product marketed as a dietary supplement, FDA suggests that you check with your healthcare professional or a registered dietician about any nutrients you may need in addition to your regular diet. Ask your healthcare professional for help distinguishing between reliable and questionable information. Ask yourself if it sounds too good to be true. Be cautious if the claims for the product seem exaggerated or unrealistic. Watch out for extreme claims — “quick and effective,” “cure-all,” “can treat or cure diseases,” or “totally safe.” Be skeptical about anecdotal information from personal “testimonials” about incredible benefits or results obtained from using a product.

Useful Links
​
FDA’s Medication Health Fraud webpage:
https://www.fda.gov/drugs/buying-using-medicine-safely/medication-health-fraud
Forms for healthcare professionals and patients to report adverse events or side effects: https://www.accessdata.fda.gov/scripts/medwatch/
Responsibilities of retailers and distributors regarding tainted dietary supplements and foods: https://www.fda.gov/media/79494/download
​FDA Announcement:
​Mero Macho