For around 30 years, ‘Complemedis’ has been enabling medical practitioners and therapists and/or their patients the use of high grade quality ‘TCM’ medication, which is tested for its botanical and pharmaceutical identity, its content of active ingredients and purity, in a Swiss laboratory batch by batch.
Whatever is a prerequisite from the aspect of patients, namely that medication made available in Switzerland is to be of the highest quality, is a matter not to be taken for granted as regards the assortment of the ‘TCM’ products made available. The authorities issue statutory requirements, but the execution is fragmentary, even in Switzerland. The reasons for this are diverse.
‘TCM’ medication is usually prescribed individually. This means, that each patient is prescribed an herbal prescription specifically for his or her healthcare requirements. The prescriptions issued by medical practitioners for each individual situation are known as ‘extemporaneous prescriptions’. The state supervision of such activities is not governed by the ‘Swissmedic’ medication control institution, but by the Swiss cantonal pharmaceutical agencies. The necessary execution is therefore extremely diverse because the 26 Swiss cantons act autonomously of each another. ‘Swissmedic’ only supervises the wholesale pharmaceutical trade (e.g. supervises importers of ‘TCM’ medication for the supply of pharmacies in Switzerland) and specifies a list of approved herbal products.
In China, 30,000 various herbal plants are available, and 12,000 of these are employed for medicinal purposes. Normally, 500 herbal preparations are sufficient for a proper practise of ‘TCM’. The 500 herbal plants were scarcely known in Switzerland before the introduction of ‘TCM’ practices, and for this reason it is not surprising, that only a few possess the requisite knowledge. Trained ‘TCM’ medical practitioners and therapists well know the effective of such herbal substances, but they rely on their suppliers for qualitatively good products.
It all depends on high grade quality
As a rule, the authorities control the machinery and equipment in industry as well as the procedures for hygienic and logistic standards, in accordance with accepted international norms (e.g. ‘GMP’ = good manufacturing practise), ‘PIC/S’ (the Pharmaceutical Inspection Convention) or ‘ISO’ Standards, to exclude any errors in the handling of the goods. But, as regards botanics and the qualification of ‘TCM’ medication, the supervisory agencies of the country are largely ignorant of the requisite specialist knowledge. Responsibility is therefore largely left to the importers and distributors of ‘TCM’ medication, to ensure that good quality is provided. Such responsibilities are addressed differentially among the various suppliers. Even in certain European countries, there exist no supervisory authorities, and in Switzerland, there are considerable differences among the Swiss cantons for the execution of authoritative requirements, where these are prescribed by cantonal, national and international bodies (e.g. the European Pharmacopoeia).
‘Complemedis’ for its part, since the inception of its activities, concentrates on high grade and controlled quality. The key to success is the thorough- and consistent -analysis of each and every batch. For this purpose, ‘Complemedis’ has set up the ‘Phytax’ Analysis Laboratory and required, that methods should be developed to address this task. ‘Phytax’ has now been known for a long time worldwide in specialist circles, and has been instructed by the Swiss authorities such as ‘Swissmedic’ on the basis of its specialist competences, to collaborate in the introduction of international standards (e.g. with ‘EDQM’ in Strasbourg, where the European Pharmacopoeia is managed). The staff members at ‘Complemedis’ and ‘Phytax’ are also involved in the training of medical and pharmaceutical students at the ‘ETH’-Swiss Federal Institute of Technology and at various other Swiss universities, as well as at specialist seminars and congresses.
Chinese medicinal herbs originate from many areas of China, from the subtropical forests of the south, from the high plains of the Himalayas, from the desert areas of the northwest or from the loess plains along the great rivers. It requires great experience to know from where the best qualities originate. But, that in itself is not sufficient because the ecological environment in China has been severely damaged in many parts due to the rapid industrialisation. Reliable suppliers market herbal substances originating from defined ‘uncontaminated’ contractual producers, who act responsibly and do not apply mixed pesticides indiscriminately. The collection of wild herbs requires knowledge of how disadvantageous over-harvesting can become. Attention needs to be paid to proper harvesting, drying and processing. Our staff members travel regularly to the traders and the contractual farmers. They visit the processing factories and inspect these in accordance with international guidelines. These activities are based on experience and knowledge, which enables them to reveal any possible deficiencies unsparingly. Every aspect is rigorously inspected, even the condition of the water for the heating or extraction of the herbal substances. Test certifications are checked and subsequently analysed and the work is conducted by means of the most modern equipment. The botanical and pharmaceutical identities of the herbal products are ascertained. First of all visually and then under the microscope, and finally by means of other methods, such as ‘thin layer chromatographics’, ‘infrared spectroscopics’, high performance ‘liquid chromatographics’, ‘x-ray diffraction’, ‘mass spectrometrics’, ‘gas chromatographics’ or even DNA analyses. Active ingredients are evidenced and qualified, as required. Purity testing includes analyses for heavy metals, pesticides, aflatoxins, microbe contamination and other ecological environmental toxins. The ‘Phytax’ Team has analysed thousands of samples over the past 20 years, and has checked all batches supplied to ‘Complemedis’.
‘Phytax’ is a leading authority in the analysis of ‘TCM’ medication
The result of thorough- and consistent -quality testing is impressive as it stands. ‘Complemedis’ only processes batches, which comply with the requirements of the Swiss and European supervisory authorities. The analysis certifications issued by ‘Phytax’ are recognised by the healthcare authorities in Switzerland, the European Union, and even the by the United States, Canada and Japan, as well as in other countries. Not all distributors seek- or can even afford -a thorough analysis of their products. Certain quality-control loopholes therefore exist, because as previously mentioned, the execution of the testing of ‘TCM’ medicinal products in Switzerland is not yet homogenously organised. It is particularly deplorable, that products are sometimes acquired via postal addresses abroad or through the internet, or goods are directly carried from the Far East in travel baggage. This of course represents a financial benefit for patients, but whether it benefits good healthcare, is quite a different matter. From the medical and ethic aspects, such activities are extremely doubtful. Press reports regularly appear on ‘TCM’ medicinal products where deficient quality is displayed, i.e. concerning products, which are contaminated with heavy metals or pesticides. On one occasion, ‘Phytax’ was confronted with a batch of Chrysanthemum blooms contaminated with 32 different pesticides. Sometimes batches are even mixed with ‘western’ medicinal preparations, such as cortisone and sildenafil (Viagra), or parts of protected plants and animals.
‘TCM’ has now obtained an official status
Right from the very start of its business activities, ‘Complemedis’ pursued the ‘avenue’ of legality, and has thus achieved very much. The combined efforts of ‘Complemedis’ and ‘Phytax’ have thus enabled ‘TCM’ medicinal therapies in Switzerland to obtain official status with the pharmaceutical supervisory authorities such as ‘Swissmedic’ and the regional and cantonal control agencies for healthcare remedies.
‘TCM’ therapies can help patients to a great extent, and in combination with the preparations of recognised ‘western’ ‘academic’ medicine achieve good healthcare results. All practitioners, who work with ‘TCM’ methods and prescribe ‘TCM’ prescriptions, are able to cite many cases of patients where ‘TCM’ methodology has been of benefit, has produced healing effects, or has even enabled savings to be made on often expensive healthcare treatments with conventionally administered ‘academic’ medicine, or sometimes even avoided surgical operations. The potential of ‘TCM’ medicine is enormous, and a good and controlled provision of ‘TCM’ preparations represents the prerequisite, that such can be implemented in this country.