It is always interesting to link what the Australian based National Institute of Complementary Medicine (NICM) say or do with international events that seemingly doesn’t have anything to do with them – or at least that is what most people would think. What does the Western Sydney University based NICM have to do with Rhino poaching in South Africa??

First a bit of background, so please bear with me. Recently, the first Traditional Chinese Medicine (TCM) product was registered in the UK by a company called Phynova. It contains a TCM herbal ingredient and it is sold for “Joint and Muscle Relief” – you can read the press releases here and here and a more critical appraisal here. What struck me as odd was that this product was clearly being advertised as the first TCM product to be sold in the UK. This basically means that the UK Medicines and Healthcare products Regulatory Agency (MHRA), has given credibility and legitimacy to the underlying pseudoscientific principles of TCM, for example; the yin/yang, six excesses (wind, cold, fire/heat etc.), five phases (fire, earth, metal etc.), vital energy that flows through meridians etc.

These TCM principles have been relegated to the pseudosciences and even some Chinese scholars promote the abolishment of TCM, and labels it as nothing more than a valuable export product for China! Does this now mean that all herbs used in TCM is pretty much useless? No, there are indeed some herbs, admittedly very few, that have been shown to be quite valuable (e.g. Artemisia annua).

Phynova could have chosen to register and market their new product merely under the name of the herb that it contains. This, at least, might have given their product slightly more scientific credibility – depending on if it contains useful compounds or not. Hence, it was a choice between these two issues; support for the underlying pseudoscientific TCM principles or support for the scientific approach that a specific herb might contain useful compounds. Phynova has chosen the former and hence this product is marketed under the TCM banner for the sake of market size and profits.

This, of course, is great news for TCM practitioners worldwide including Prof Alan Bensoussan the director of the NICM and registered in Australia as a TCM and acupuncture practitioner. They will now claim that the body of evidence and hence the acceptance of TCM in the West is growing, knowing pretty well that it has a lot more to do with lobbying than with science! Alan has been instrumental in lobbying the Australian regulatory agency, the TGA, that a long tradition of use is all you need to register a product – who cares about efficacy!

He has also been chipping away at the resistance that the Australian public might have against these pseudoscientific healthcare systems, such as TCM, by publicly misleading them that TCM principles is based on real science – which it is not! You can read about it here, here and here. He is also planning to expand into the Westmead precinct of Sydney with a new TCM clinic/hospital – thus, Alan has big plans for TCM in Australia and he is a staunch believer and advocate of the TCM principles (maybe the global $170 billion TCM market has something to do with this?).

Enough background; so what does all of this have to do with Rhino horn? (and for that matter other endangered species). Well, Rhino horn “…. is bitter, sour, and salty in flavor and cold in nature. Vital functions are removing heat to cool blood, relieve internal heat, and arresting convulsion.” This is the type of language that you hear from TCM practitioners such as Alan, companies such as Phynova and also the MHRA who has now given credibility and legitimacy to these TCM principles. Where did I get this information regarding Rhino horn? Well, from Phynova – or at least indirectly!

On Phynova’s website there was a link that directed the potential customer to a website providing scientific information regarding the herb in their new product – fair enough (accessed on 13/07/2016 – this link from Phynova’s site has since been removed). Shockingly, and probably also the reason why this link has been removed so quickly, was the information provided in the sidebar under the heading “New Herbs and Remedies.” There you find Rhinoceros horn! Yes, it is listed as a “herb” and yes the accompanying image is that of elephant tusks! Oh Boy!

If Phynova is that sloppy with doing research I have to wonder how much real scientific research has gone into their new product. Did they even read the “scientific” information regarding their herb on this website? Clearly not! Or maybe their research was more focused on the packaging, marketing and sales of this ‘amazing’ new product.

Even though it is claimed on this website that Rhino horn does not have any medicinal value – the fact that it is listed and that they provide recipes of how to prepare and use it tells me a different story (please scroll down to the comments section of the website). For example, they state “Even though now it is not used as a medicine any more. Knowing a bit more about the medical facts about rhinos can be good for you.” Here again we have the familiar issue plaguing the complementary medicine industry – what they say and what they actually mean or do is two different things! You be the judge.

And Alan Bensoussan at the NICM? The following section comes straight from a PhD thesis (on page 45) supervised by the NICM uner the leadership of Alan Bensoussan and approved by Western Sydney University in 2008 (my highlights in bold and explanation of abbreviations in brackets)

“These have not only largely facilitated improved application to patients, but also increased the therapeutic effectiveness and accordingly reduced the therapeutic courses. Following on Table 2.4 lists the most common Chinese herbal medicine injections used for the treatment of VaD (Vascular Dementia).

Table 2.4 Chinese herbal medicine injections for VaD

CHM injection Functions Compositions Xing Nao Jing Injection Clearing heat toxin and opening brain, removing phlegm Gallbaldder stone of Bos taurus domesticus (Niuhuang), Curcuma aromatica (Yujin), Rhinoceros unicornis (Xijiao), Coptis chinensis (Huanglian), Scutellaria baicalensis (Huangqin), Gardenia jasminoides (Shanzhi), Cinnabar (Zhusha), (Xionghuang), Moschus berezovskii (Shexiang), Pteria martensii (Zhenzhu)

Xing Nao Jing Injection

Based on the classic formula “An Gong Niu Huang Wan”, Xing Nao Jing injection has been widely applied in China for stroke and vascular dementia. Wang et al (2000) observed the therapeutic effect of Xing Nao Jing Injection treatment on vascular dementia and the affect on HDL (high-density lipoprotein) and LDL (low-density lipoprotein). 76 cases of VaD in patients were randomly allocated into two groups: Xing Nao Jing Injection treatment group (n=39) and western medicine control group (n=37). MMSE (Mini Mental State Examination) and content of HDL and LDL were assessed or observed before and after treatment. After 1-month treatment intervention, they found the scores of MMSE in the treatment group increased remarkably, as compared with the control group (p<0.05). The HDL elevated and LDL decreased in the treatment group (Wang et al, 2000).”

They only list two endangered species; the Rhino and the Chinese forest musk deer (Moschus berezovskii), but what is worrying is that they don’t even mention the endangered status or at least recommend that the non-endangered substitutes should be used instead. Clearly they are marketing these endangered species as way more effective than western medicine (their control group) for the treatment of vascular dementia! I have to admit that this thesis is rather confusing and that it will need an in-depth investigation – my next blog post will deal with this thesis and any other similar theses I can find from the NICM, dealing with endangered species.

The problem with Rhino horn is relatively simple. The more Rhino’s killed the more expensive the horn becomes which leads to more rhinos being killed – there seems to be no solution! That Rhino horn is claimed, as above, to be highly active against Vascular Dementia is to say the least, deplorable. Statements like this fuels the decimation of this species. But we have to try and do something. A simple step could be that people like Prof Alan Bensoussan publicly denounce the underlying pseudoscientific TCM principles and make the “difficult” switch to real science! Admittedly, he will have to part with a bit of money from the CM industry and his Chinese partners, and maybe not built his new TCM hospital – but whatever he can do to save the Rhino, right?

The NICM have successfully applied a very thin, but beautiful, veneer of political correctness and modernity over the surface of complementary medicine, focusing on TCM, by ticking the box that they are against the use of endangered species, and by using real scientific terminology incorrectly in order to convince the public of the medicinal value of TCM in a “modern” package. Anyone who cares to look underneath this veneer will find the rotten ancient pseudoscientific TCM world – including the use of endangered species. Just look at how active Rhino horn is for vascular dementia!! Read chapter two of the above mentioned thesis and you cannot believe that this is from an Australian University and paid for by the Australian taxpayer! Unfortunately rhino horn is just the tip of the iceberg, they continue to defend and promote almost all complementary medicines such as homeopathy and acupuncture as well by using the same techniques.

Another piece of evidence that the use of Rhino horn in TCM is indeed alive and well comes from poaching statistics. Over the last number of years there has been an exponential rise in poaching in South Africa with 2015 topping out at 1 175 as compared to only 13 rhinos killed in 2007. Not even to mention the hundreds of human lives lost attempting to either poach or protect the rhinos. Maybe theses, such as the ones supervised by the NICM and approved by WSU in 2008, has partly led to this exponential increase in poaching stats?

Companies such as Phynova should register their product as a herb and market it as such based on real scientific results, and not advertise it under the TCM banner. The TCM banner encompasses the whole pseudoscientific TCM healthcare system including the use of Rhino horn and other endangered species.

The regulatory authorities, lobbied endlessly by the CM industry and people like Alan, should refuse to register products under the TCM banner and should only register the specific herb after real evidence of efficacy and safety have been provided – preferably clinical trial results. The Phynova product was registered solely based on a long tradition of use without any clinical trials backing up their claims!

By now, I know that very few people care. I’ve been told many times – this is how the world works, get used to it and move on. I am okay with the idea that apparently most Aussies do not mind being misled by other Aussies – seemingly an Aussie thing as Alan once told me “but everyone is doing it”. If most Aussies want to fall for TCM, and even use their own tax dollars to sponsor it (NICM receives $2 million/annum) – be my guest, but please keep these issues within Australian borders and leave the Rhinos alone. But that is not going to happen – supporting and advocating the TCM principles in Australia by people such as Alan Bensoussan creates a global ripple effect with Rhino poaching being one of the many detrimental results. I give it 5-10 years and that will be the end of Rhinos – which animals will they target then?

Comments received on this post from reddit/r/ChineseMedicine.