Medicinal cowboys who cash in and put lives at risk

More than one billion people, a quarter of the world's population, rely on traditional Chinese medicines, derived from herbs and other natural products, to treat major and minor ailments.

The efficacy of these herbal remedies, when used appropriately by a skilled practitioner, is not in doubt. Even the most sceptical of orthodox doctors recognise that 4,000 years of experience and a vast store of clinical data is difficult to argue with. Traditional Chinese medicine (TCM) has had success in treating the symptoms of many illnesses, from multiple sclerosis to infertility.

Carol Newall, pharmacist and author of Herbal Medicine: a guide for healthcare practitioners, says the tradition has "a huge amount" to offer Western medical practice - but safeguards are necessary. "In China there are cultural safeguards built into the system," she said.

In Britain, the interest in Chinese herbal medicines can be linked to the publicity surrounding the skill of Dr Ding Hui Luo, a practitioner in Chinatown, in Soho, London, who has been selling her acclaimed remedy for eczema for almost 15 years. Some skin specialists refer patients to her, and her remedy will soon be available as a pill, developed by a "herbiceuticals" manufacturer.

But practitioners of TCM acknowledge that the explosive growth of interest in TCM here and throughout Europe has generated problems.

The TCM market has become extremely lucrative, and cowboy practitioners and irresponsible importers can put at risk the health - even the lives - of consumers. Side-effects due to toxic ingredients or contaminants in Chinese remedies, which prompted the investigation by the Ministry of Agriculture and the National Poisons Unit, are not uncommon.

In addition, the raw herbs may have been exposed to pesticides, heavy metals and other contaminants. Imported, pre-packaged Chinese medicines have also been found to contain traces of conventional drugs, such as steroids, but there is no indication of this on the label.

Every major town and city in Britain now has at least one TCM clinic, surgery or shop. The demand for gentler alternatives to synthetic drugs is phenomenal but the fact that a remedy is derived from herbs does not mean it is safer. In fact, many of the most powerful drugs prescribed by doctors originate from plants, such as the heart drug digoxin which comes from foxgloves.

Ken Lloyd, president of the Register of Chinese Herbal Medicine, said there are 120 practitioners on the voluntary register who have satisfied a minimum requirement of training. This includes two years of training in Western anatomy, physiology, and pathology; three years of diagnosis, and two years of the philosophy and practice of Chinese herbal medicine with a study visit to China or Vietnam if possible.

However, the number of practitioners on the register represents only a quarter of the total number of practitioners, some of whom may have had only the most basic of training or even no training at all.

"People should be warned that if a practitioner spends only five minutes with a patient before selling them something then they are probably not getting the standard of treatment they should," Mr Lloyd said. "An experienced practitioner would not prescribe anything without taking a full history."

Mr Lloyd is also spearheading a campaign to persuade importers to introduce quality control tests on herbs they sell on to practitioners.