Public Perception and Consumption of Herbal Medicine in China

Based on my 15+ years living and working in China

I lived in China for more than 15 years. While there I worked and studied in clinics and hospitals and interacted with industry leaders and, through my time as a graduate student and later as a researcher, spent a lot of time talking to people in academia as well as people on the ground in herb markets and at farms. There’s a lot I could say about people’s perceptions of herbs in China but I wanted to take a little bit of your time to introduce you to how herbal medicine is seen and consumed in China

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In China, herbal medicine holds a revered place, deeply rooted in ancient traditions and integrated into modern healthcare. It is not uncommon to see patients in a modern Chinese hospital drinking herbal decoctions that were prepared in the hospital’s pharmacy. While not all hospitals have a Chinese medicine department, those hospitals that do are far and away in the majority.

The Chinese public generally holds a positive and trusting view of herbal medicine, deeply influenced by centuries-old traditions and cultural beliefs. However, there are significant voids in this way of thinking, particularly for those under 50 years of age. These folks are, generally, the best educated portion of the population but they also suffered from the strain of the government’s “science first” policy with sayings such as, "科技是第一生产力" (Kējì shì dì yī shēngchǎnlì): "Science and technology are the primary productive forces," emphasizing the pivotal role of science and technology in driving economic and societal progress. This, coupled with the Cultural Revolution hangover that still shrouds the country after heavy use of slogans such as, "打破四旧，建设四新" (Dǎpò sì jiù, jiànshè sì xīn), which means "Smash the Four Olds, Establish the Four News," the "Four Olds" are old customs, old culture, old habits, and old ideas. The intent was to eradicate traditional cultural practices and promote new revolutionary values; and "破除迷信，实事求是" (Pòchú míxìn, shíshì qiúshì), which means, "Eliminate superstitions, seek truth from facts," this slogan advocated for rational thinking and rejecting traditional beliefs that were considered irrational or superstitious. As one can imagine, if you and your parents and grandparents had heard and seen slogans like these repeatedly over 2–3 generations, the thought of using Chinese medicine with its core theories based around the concept of qì (氣) and yīn/yáng (陰陽) might seem to be misaligned with these propaganda slogans.

That being said, there is something to be said for the practicality and user-friendly model of Chinese medicine, especially for a society that has used this form of medicine consistently over 2 millennia. It’s very difficult to turn a steaming ship and I think it is reasonable to liken, metaphorically, an ancient society like China to that steaming ship; some habits die hard, as they say.

In my own family, my mother-in-law was an avid user of Chinese herbal medicine but my father-in-law was far more reserved when it came to using Chinese medicine, although I believe I had a strong impact on him and the way he viewed herbal medicine. Being a man of science, it took many discussions about the science of herbal medicine before I was able to turn that ship. But, like so many other older Chinese folks, my father-in-law was an avid tàijí (太極) practitioner, got regular massages, and understood the value of some other methods used in Chinese medicine such as guāshā (刮痧).

Those are the consumers of herbal medicine but what about the producers? These are the growers, traders, academicians, pharmaceutical companies, etc. that help to bring herbal medicine to the people. Here we have a decided mixed bag. On the one hand we have farmers and traders who have been brought into the industry via a family tradition, sometimes spanning 10 or more generations. This group, which is not small, is almost blindly adherent to herbal medicine. They have seen it work and, of course, their livelihood is tied to the success of the industry. On the other hand, we have those in academia and the newer additions to the industry such as drug companies (nearly every drug company in the country either started with Chinese medicine or has come into the industry with its eyes set on the potential for creating the next great drug from a plant in hopes of being the next Tu Youyou (屠呦呦) — the Chinese researcher who discovered artemisinin for the treatment of malaria). People involved in these areas of the industry are often quite skeptical of herbal medicine and whether or not it is a valid therapeutic intervention.

There is one very significant difference between how herbal medicine is consumed in China relative to “the west,” where herbs are purchased. While there are over the counter herbs sold in China, particularly some of the most famous formulas, the vast majority of herbs are prescribed to people by doctors in hospitals and clinics. People going into the “health food store” to get an herbal remedy to treat their child or themselves is rare. This is true for some pretty obvious reasons. First, in spite of some of what I mentioned above, the tradition remains strong and many people have doctors that they have seen since they were kids or that their family has some relationship with and thus trust in as their go-to doctor. Second, and this is particularly important and a stark difference from pretty much every country in “the west,” there is a strong sense that herbs are part of a medical system and to use them requires significant training. Therefore, the majority of people would never consider self-prescribing.

While there is so much more that could be said, I will leave it there. I trust this was an interesting read. I apologize for missing the last couple weeks of writing. We are about to release our new website over at Herb Whisperer and that has consumed more than 24 hours of each of the last 15–20 days. Stay tuned for the launch coming soon. I will be in China for the first half of November, so it is likely that this will be my last article for a couple weeks (I’ll do my best to get another one out before I leave). I hope my time there inspires me to write more. Also, I’m very interested to hear what you would like to read about. The biggest question I always have when writing these articles is “What should I write about?” I’d love to hear from you. And, if I pick your suggestion, I’ll get you a coupon to spend over on the new site once its up and running.

Thanks for dropping by to read this. Stay in touch.

Warmly,
Thomas