The Ethics And Politics Of Clinical Experiments With Changshan

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Chinese doctors had clear reasons to adopt the clinical-experiment-first strategy. First, if clinical experimentation were generally accepted as the first step for studying Chinese drugs, to a certain degree the autonomy of Chinese medicine would be maintained. Since clinical experimentation came first, it would have to be conducted more or less in the traditional fashion. On the other hand, if the research procedure on Chinese drugs followed the received program, then immediately after the first step of chemical analysis, the extracted active component would be tested and this would be totally foreign to Chinese doctors.

Second, as revealed in the study of Changshan, precisely because Chen Guofu's research did not follow the received program but started with a clinical experiment, it had the subversive effect of demonstrating that Japanese and Western scholars had been wrong for decades in assuming that the botanical identity of Chinese Changshan was the root of the O. japonica.

Third, inasmuch as the received program presupposed that the efficacy of Chinese drugs could be traced to one active chemical, a reductionist framework was built into it. As a result, as long as researchers worked within this received program, there was no way that they could empirically prove this reductionist presupposition to be wrong or counterproductive. If the extracted principal component of a Chinese drug turned out not to have traditional curative efficacy, this failure would be taken as a refutation of the traditional belief, just as in the case of Mahuang before 1924. On the contrary, if the curative efficacy of a Chinese drug were clinically verified from the outset, chemists' failure to find the active component would call into question the reductionistic approach.

After clinical experiments on the human body showed D. febrifuga to be active (Chen Fangzhi, 1944), the distinguished Cambridge scholar of Chinese medicine Joseph Needham sent the same local herbal drug to K.K. Chen's research group at Eli Lilly & Company (Henderson et al., 1948) and to another American group for animal experiments (Tonkin and Work, 1945). When these U.S. animal experiments confirmed the antimalarial efficacy of D. febrifuga, some samples of the same herbal drug were sent to the University of London for pharmacognostic research (Fairbairn and Lou, 1950; Lou, 1954). The other Chinese governmental laboratory that pioneered antimalarial drugs also requested an aqueous extract of Changshan from the Research Laboratory of National Drugs. The clinical success of Chen Guofu and his Western-trained colleagues made the local variety of Changshan and its extract the obligatory passage point for further research. In the end, Chen Guofu did not wait for the Western-style doctors to isolate the active agents or to synthesise the chemical component through artificial means. While Western-style doctors were busy conducting experiments and writing papers, which never led to a useful substitute for the extract of Changshan, Chen Guofu worked on the mass cultivation of D. febrifuga on the Jingfo Mountain (Chen Guofu, 1952, p. 267). Lei (1999) gives a more detailed analysis of this history.

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Traditional Chinese Medicine

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