Tackling the Risk of Herbs under the Globalization of Chinese Herbs: Aristolochic Acid Controversy and Response in Taiwan.

• Main Authors: Po-Hsun Chen, 陳柏勳
• Other Authors: Sean Hsiang-Lin Lei
• Format: Others
• Language: zh-TW
• Published: 2018
• Online Access: http://ndltd.ncl.edu.tw/handle/7m99rf

碩士 === 國立陽明大學 === 科技與社會研究所 === 106 === In the late 20th century, the Aristolochic Acid controversies not only changed the concept of herbs in the international but transformed the regulation of herbs in Taiwan. By analyzing the Aristolochic Acid controversy in Taiwan, this thesis will investigate the following questions. How and why were the herbs considered toxic and risky? How did Taiwan government making policies by negotiating between the traditional Chinese medicine and the modern science? How did the multiple actors build the new concepts and new regulations of herbs under the globalization? At last, how did the Aristolochic Acid controversy structurally transform the herb regulation? The Aristolochic Acids are in Aristolochiaceae herbs, which are known for the renal toxicity and carcinogen. It was the Aristolochic Acids that cause the Chinese herb nephropathy in Belgium after the investigation in 1993. Aftermath, there were more and more poisoned cases around the Europe, America, and Asia. Thus, many countries set the bans on the preparations which contained the Aristolochic Acids. The toxicology medicine physician gave a speech about the renal toxicity of aristolochic acid in Chinese Herbal Toxicity Congress in Taipei in 2003. Also, a traditional Chinese medicine doctor made an appearance and claimed that he was the victim of Aristolochic acids. It aroused a great controversy between the modern medicine and the traditional Chinese medicine for prohibiting Aristolochiaceae herbs or not. This controversy, on the one hand, highlighted that it is unable to frame the toxicity and the efficacy of herbs by one type of knowledge. On the other hand, it also raised the public alert to the toxicity of herb. The regulation for the toxicity of herb became the essential issue to Taiwan government for expanding the global market of herb. To adjust the impact of WHO Traditional Medicine Strategy in 2002 and to join WTO in 2005, the Chinese medicine could not uphold the traditional regime to regulate the herb. However, they were not willing to accept the framework of biomedicine. The Chinese medicine integrated the modern technology and the concept of materia medica to build the new knowledge and the new regulations for herbs. There was also the new idea for herbal toxicity. The big data researches, such as the epidemiology and the National Health Insurance Research Databases, turned into the important scientific means to comprehend the efficacy, safety, and risk of herbs. As a result, the new knowledge and the new regulation model of herbs were taken shape. The government took this knowledge and system not only to quell the public doubts but to act as the quality guarantee for herbal preparations in the global market. Even though, there was some room for improvement in this new herbal safety system. In sum, after the Aristolochic Acid controversy, the regulation of herb turned into the regime of risk in Taiwan. Different from following the model of USFDA to prohibit the Aristolochic-Acid contained herbs, the Chinese medicine decided to establish the safety environment and negotiated the risk of herbs. Under the push-pull factors of herbal risk and global market, the Chinese medicine heterogeneously integrated knowledge, system, and actors to construct the safety of herbs by decreasing the risk of herbs. Furthermore, the Chinese medicine made the modern conventions to the quality of herbs in Taiwan.