Traditional Chinese medicine (TCM) treats digestion as the work of what its texts call the spleen and stomach, and most of its best-known digestive formulas are built to support that pair. This section explains the system in plain words, says what the trials of its classic formulas show, sets out the safety record, and lists the TCM products the catalog has researched.
TCM is the modern, standardized form of a medical tradition whose core texts, the Huangdi Neijing and Zhang Zhongjing’s Shang Han Lun, date from roughly the second century BCE to the third century CE. It combines herbal medicine, acupuncture, massage (tuina), diet and movement practices. In China it runs alongside biomedicine in the state health system, with its own universities, hospitals and a national pharmacopoeia; the 2019 edition of the WHO’s international disease classification (ICD-11) added a supplementary chapter of traditional medicine diagnoses drawn from it. In the United States acupuncture is licensed in most states; Chinese herbal medicine is not separately licensed and is practiced under acupuncture and “Oriental medicine” licenses in some states, and the herbs and formulas are sold as dietary supplements under the 1994 DSHEA law, with no pre-market approval of safety or effect. Japan’s Kampo tradition, which uses many of the same formulas in fixed, factory-made granules, is covered by Japanese national health insurance, and some of the best-designed formula trials come from there.
How it describes digestion
TCM describes the body in terms of qi (often glossed as vital energy or function), yin and yang, and a set of organ systems whose names overlap with anatomy but whose definitions are functional. Digestion is assigned to the spleen and stomach: the stomach “receives and ripens” food, the spleen “transforms and transports” it. A practitioner sorts a gut complaint into a pattern rather than a disease: spleen qi deficiency (fatigue, loose stools, bloating after meals), food stagnation (fullness and belching after overeating), damp-heat (urgent, foul loose stools), liver qi overacting on the spleen (bowel symptoms that follow stress). Each pattern has classical formulas: Si Jun Zi Tang and Liu Jun Zi Tang for the deficiency patterns, Bao He Wan for food stagnation, Tong Xie Yao Fang for stress-driven loose stools, Ban Xia Xie Xin Tang for mixed patterns with nausea. Formulas are built from a chief herb with deputies, assistants and an envoy, and are sold as decoctions, granules, teapills and tablets. The herb pages in this section give each ingredient’s pinyin name, the tradition’s classification in plain words and the formulas it belongs to.
What the trials show
Most trials in this field test a multi-herb formula, and most are small, short or poorly reported. A 2006 Cochrane review of herbal medicines for IBS found 75 trials, nearly all from China, and judged the methodological quality generally poor while noting that some formulas improved global symptoms. The best-known Western trial, published in JAMA in 1998, randomized 116 people with IBS in Australia to a standard Chinese formula, an individualized one or placebo for 16 weeks; both herbal groups improved more than placebo, and only the individualized group kept the gain at follow-up. Japanese trials of rikkunshito (Liu Jun Zi Tang) in functional dyspepsia are the most rigorous formula trials for the upper gut. Single herbs with human data include berberine from coptis in IBS-D and diarrhea, rhubarb as a stimulant laxative, and ginger for nausea. The guides below go through the formulas and herbs with the numbers.
Safety: aristolochic acid, adulteration and heavy metals
Three findings shape the safety record. Aristolochic acid, present in Aristolochia species that were substituted for other herbs in some products, caused kidney failure and urinary-tract cancers in a Belgian weight-loss clinic’s patients in the 1990s; the FDA issued a nationwide alert in 2001 and screens imports for it, and the herbs in the catalog’s products are checked against the FDA’s list. Adulteration with undeclared pharmaceuticals and heavy metals has been documented in Asian patent medicines: a 1998 survey of 260 patent medicines sold in California found about a third contained undeclared drugs or heavy metals. Product recalls and FDA warning letters for undeclared drugs continue. Finally, several herbs have documented interactions (ginseng and warfarin, licorice and blood-pressure medicines, bupleurum-containing formulas and interstitial lung disease in Japanese case series). A buyer can check for Latin binomials and pinyin names together, a Supplement Facts panel with amounts, a third-party heavy-metal test, GMP certification, and the absence of any Aristolochia, Asarum or mu tong species that lack a botanical name.
How this site handles TCM products: the same three gates as every other entry (a real rating, a readable Supplement Facts panel, a brand-hosted photo), a check of every ingredient against the FDA’s aristolochic-acid list, the same research page, and a tradition line in the facts box that links back here. The quiz treats them as herbal formulas and nudges them up when someone names Chinese medicine in the free-text box and the symptoms fit.
TCM products in the catalog
Each page names the classical formula where the label gives one, states the label as printed, the trials of the formula, the review picture and the price per day. The products are listed by review count.
One page per herb, with its pinyin and Chinese names, the tradition’s classification in plain words, the formulas it belongs to, the human trials, doses and safety. The herb encyclopedia has the full list.
The quiz asks about your symptoms, what you have tried and the medicines you take. Name Chinese medicine in the free-text box and its formulas get a nudge in the ranking when they fit.
Is Chinese herbal medicine regulated in the United States?
The herbs and formulas are dietary supplements under the 1994 DSHEA law, so they need no pre-market approval; the FDA acts after the fact on adulteration, contamination and illegal claims, and holds import alerts for aristolochic acid and for some brands. Practitioners: acupuncture is licensed in most states, and Chinese herbal medicine is practiced under those licenses in some of them; there is no separate herbalist license.
What is the difference between a patent medicine, a teapill and granules?
A patent medicine is a fixed classical or proprietary formula sold ready-made, usually as small pills (teapills) or tablets. Granules are concentrated extracts dried onto a carrier and dissolved in hot water, the form Japanese Kampo and many US practitioners use. A decoction is the raw herbs simmered at home, the traditional form, and the one most classical doses refer to.
Do TCM formulas work for IBS?
The 2006 Cochrane review found that some formulas improved global IBS symptoms across 75 mostly Chinese trials but rated the evidence low in quality. The one Western placebo-controlled trial (116 people, 16 weeks, JAMA 1998) found benefit for both a standard and an individualized formula. That is a reason to call the evidence suggestive, not settled; the guides give the trials.
What is aristolochic acid and should I worry about it?
A kidney toxin and carcinogen in Aristolochia plants, which were substituted for other herbs in some products in the 1990s and caused kidney failure in Belgium and elsewhere. The FDA has screened imports for it since 2001. Products from brands that publish botanical names and testing are the practical safeguard; none of the catalog’s products contains an Aristolochia species.
What does spleen qi deficiency mean?
It is a TCM pattern, not a statement about the anatomical spleen. The texts use it for a cluster of fatigue, poor appetite, bloating after meals and loose stools, and treat it with formulas such as Si Jun Zi Tang and Liu Jun Zi Tang. The key-concepts guide goes through the patterns and their formulas.
How does the quiz treat TCM products?
As herbal formulas scored on the same symptoms, trials, label and review criteria as everything else. If you write Chinese medicine, TCM or a formula name in the free-text box, products carrying the TCM tradition flag get a small boost when they fit your symptoms. Nothing is excluded because of its tradition.
World Health Organization, ICD-11 chapter 26, supplementary chapter on traditional medicine conditions icd.who.int/browse11/l-m/en
Liu JP et al., "Herbal medicines for treatment of irritable bowel syndrome", Cochrane Database Syst Rev 2006;(1):CD004116 pubmed.ncbi.nlm.nih.gov/16437473
Bensoussan A et al., "Treatment of irritable bowel syndrome with Chinese herbal medicine: a randomized controlled trial", JAMA 1998;280:1585 pubmed.ncbi.nlm.nih.gov/9820260
Debelle FD, Vanherweghem JL, Nortier JL, "Aristolochic acid nephropathy: a worldwide problem", Kidney Int 2008;74:158 pubmed.ncbi.nlm.nih.gov/18418355
Ministry of Health, Labour and Welfare of Japan and the Japan Society for Oriental Medicine on Kampo formulas covered by national health insurance www.jsom.or.jp/international