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Nature’s Remedies: The Environmental Impact of Chinese Medicine in the Global Medical Marketplace

Tamara Venit Shelton

Nearly three years ago, on January 18, 2017, Chinese President Xi Jinping visited the World Health Organization and presented a traditional bronze statue used to identify acupuncture points on the human body. The gift was part of the Chinese government’s ongoing campaign to promote Traditional Chinese Medicine, not only in community health centers across China but also in expanding markets abroad. Traditional Chinese Medicine—a twentieth-century riff of an ancient set of healing practices—has become integral to Chinese economic and diplomatic efforts around the world. For China, the manufacture of botanical and zoologically-based (or herbal) remedies has become a major export business, with an estimated $50 billion in global sales in 2018. The United States has topped the list of biggest importers outside of Asia. At least part of the market appeal of traditional remedies comes from their popular association with “natural medicine,” but that association obscures the real environmental costs of Chinese herbalism.

Chinese medicine has been part of American medical traditions since its colonial period, when apothecaries and itinerant drug sellers peddled herbal remedies imported via England. The long history of Chinese medicine in the United States unfolded in the context of American foreign relations and Orientalist attitudes, mass immigration from China, and—importantly—the changing significance of “natural medicine” in the American medical marketplace. In American medical history, the notion that some therapeutic practices and principles are closer to “nature” than others has been a persistent and powerful mode of distinguishing irregular (or alternative) from regular (or scientific) medicine. Chinese doctors in the United States capitalized on their presumed closeness to “nature” to compete in the medical marketplace. The promise to prescribe only “nature’s remedies” featured centrally in their English-language advertisements, especially in the Progressive Era.

But the presumed closeness to nature of Chinese remedies has not necessarily led to sustainable relationships with materia medica. In North America, over-foraging of wild ginseng for export to China led to its depletion and disappearance in areas of Canada and the United States where it once grew. In 1865, Minnesota passed the first legislation to restrict the gathering season to May 1 to August 1, with fines up to one hundred dollars for violations. The efforts were for naught; by the end of the century, wild ginseng was vanishing. Beginning in the 1870s, American and Canadian farmers experimented with growing cultivated ginseng, but Chinese buyers deemed it less potent and therefore less valuable. In 1977, in an effort to protect the vestiges of wild ginseng, the Endangered Species Scientific Authority, a division of the United States Fish and Wildlife Service, proposed an export ban. Ultimately, ginseng-producing states reached a compromise with the federal agency that limited diggers to harvesting mature roots five years or older during a restricted season lasting from August to December. Within the last decade, however, soaring international demand for wild ginseng has triggered a surge in illegal “poaching” across Appalachia. Extinction is a real possibility.

Ethnopharmacologists and conservationists have alerted the public to the urgent need to protect biodiversity, but the expanding global market for traditional Chinese medicine still puts wild plants and animals at risk. Over-foraging has imperiled Ophiocordyceps sinensis, a combination of a caterpillar and fungus found in the high altitude mountains of Tibet. Recorded in both classical Chinese and Tibetan pharmacopoeia, cordyceps—or “Himalayan Viagra” as it is known colloquially—flourishes beneath the snowpack and has a variety of traditional medicinal uses, including treating cancers. Locals forage for cordyceps by hand, using trowels to uproot the fungus along with the soil and vegetation that surrounds it. As demand has increased so has collection, which has damaged the vegetative cover that prevents soil erosion. A drought in 2014 exacerbated conditions and diminished the production of cordyceps by 50%. Global climate change has also adversely affected cordyceps by raising the snow line and shrinking the species’s natural habitat. Seemingly oblivious to these changing ecological pressures, local governments have encouraged Tibetan families to increase cordyceps production.

Although some purveyors of zoological medicines have experimented with stock raising animals coveted for their medicinal properties, a customary preference for wild animals persists. Illegal poaching seems to have accelerated in recent years and contributed to the endangerment of several species. The Chinese government has at least indirectly encouraged such behavior as it aims to grow the export market for traditional remedies. Just a year ago, on October 29, 2018, the Chinese government reversed a twenty-five-year ban on the use of rhinoceros horns and tiger bones in traditional remedies.

In today’s American medical marketplace, practitioners of Chinese herbalism continue to assert the value of their remedies through the language of “natural medicine.” But patient-consumers should be attentive to the way that language can conceal the true nature of Chinese medicine and its potentially devastating impact on the environment. 

Tamara Venit Shelton is associate professor of history at Claremont McKenna College and author of A Squatter’s Republic: Land and the Politics of Monopoly in California, 1850–1900.

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