1. The observations summarized in this manuscript were made while the author was a member of the U.S. National Academy of Sciences Pharmacology Delegation to the People's Republic of China, 1–26 June 1974. The Herbal Pharmacology Study Group was sponsored by the Committee on Scholarly Communication with the People's Republic of China and we were guests of the Chinese Medical Association. Grateful acknowledgment is extended to the Chinese Medical Association and members of the various hospitals, institutes and universities we visited for making our mission a most enlightening and pleasant experience.

2. (a) Between 1969 and 1972 the overall study was extended to 7,300,000 people (and since 1971 to 49 million people) in the Taihang Mountains region (covers part of Honan, Shansi and Hopei provinces) and the incidence of oesophageal cancer was found to range from 8 per 100,000 in Peking to 139·8 per 100,000 in a central area of the Taihangs: Han Suyin, Eastern Horizon, Vol. VIII, No. 6, (1974), p. 6; (b) Appreciation is hereby extended to a referee for providing the following important observation: “ Reference to the very high incidence of carcinoma of the oesophagus in northeast China should mention that only 6% of these cases are actually diagnosed by histology, 66% were diagnosed by barium swallow alone without histology or cytology and some were based purely on clinical criteria. I do not think this invalidates the study in any way and since it involved a mass survey of 11,654 people it is a tremendous tribute to the organisational ability of the medical services in Honan Province. I think this ability to mobilise large masses of the population and obtain their co-operation should be made more strongly in the paper.” See also, “ Co-ordinating group for research on the aetiology of esophageal cancer in northern China,” Scientia Sinica; No. 18 (1975), p. 131. (c) Refer, for example, to the excellent articles of C. Djerassi, “ Some observations on current fertility control in China,” The China Quarterly, No. 57 (1974), pp. 40–62; “Studies in family planning,” No. 5 (1974), p. 13, and the New England Journal of Medicine, No. 289 (1974), p. 533. See also, A. J. Smith, British Medical Journal (1974), p. 429.Google Scholar

3. Recently, S. V. Pathre reported isolation of 15-acetoxy-3α, 4β-dihydroxy-12, 13-epoxy-trichothec-9-ene as the toxin of Fusarium roseum, a fungus of mouldy corn: September 1974, American Chemical Society Meeting, Atlantic City, New Jersey.

4. A group at the Hoffman-LaRoche Laboratories in New Jersey are also using vitamin A acid in an attempt to reverse precancerous lesions (sputum test) in uranium miners. So far, experiments in animals with hypoplasia shows that such therapy is effective: private communication from Dr John Burns, Hoffman- LaRoche Company. See also, W. Bollag, Chemotherapy (1975), No. 21, p. 236; and E. Cameron and L. Pauling, Chem. Biol. Interact. (1974), No. 9, p. 273.

5. However, this reviewer did have time to visit with a good friend and former laboratory partner, now a patient in this hospital. The excellent treatment available, combined with efficiency and cleanliness, was quite evident.

6. The Capital Hospital was, originally constructed with Rockefeller funds and began operations in the late 20s with some medical expertise from the United States. Before Liberation the hospital carried about 300 beds. Presently, the hospital has provision for 550 beds and 2,000 out-patients (150 emergency) per day. Prior to 1949, approximately 200 out-patients were handled per day. The Capital Hospital also cares for members of the diplomatic corps and their families from foreign countries and, in addition, serves as a referral centre.

7. This teaching facility was established in 1953 by consolidation of three separate medical colleges and college faculties. Presently the teaching hospital has 750 beds and another 200 beds are devoted to the tumour hospital section. The medical college specializes particularly in cancer, ophthalmology and microsurgery (for joining severed limbs and fingers). The total staff numbers 3,500 of which 800 are teachers in the medical college. As a typical example, the pharmacology faculty numbers 30. Student enrolment totals 1,200 and another 120 students are enrolled in the nursing college.

8. Perhaps the indoor fires common in this part of China are producing the carcinogens leading to the high incidence (in the 30 to 50 age groups) experienced.

9. Of some 35,000 plant species in China, extracts of about 5,000 have found use in traditional Chinese medicine.

10. The hospital was organized in 1956 and has now grown to a staff of approximately 700 with departments for internal medicine, surgery, gynaecology, obstetrics, pediatrics and acupuncture. The main mission of the hospital is preventive medicine, teaching and research. They have trained about 900 barefoot doctors and about 50 western-trained physicians are at the hospital learning traditional medicine. Their overall mission is to combine traditional medicine and pharmacology with western medicine and pharmacology. At present the hospital has 116 beds which will be expanded this year by a 240-bed addition. Presently the staff handles 4–5,000 out-patients per day and the various buildings occupy about one city block.

11. This is the teaching hospital of the Shanghai College of Traditional Medicine and was established in 1960. Presently the staff numbers 400 and includes about 100 physicians and 100 nurses. The hospital has 250 beds and handles 2,000 out-patients per day. Some 40–50 of the personnel are assigned to rural areas or to factories each year.

12. The Institute was established in 1958 during the Great Leap Forward and now employs some 300 scientific and technical personnel. Their mission is development of new drugs, investigation of known drugs and to raise traditional drugs (primarily medicinal plant extracts) to a more systematic and higher level of utility. In general, four broad objectives are under study: (a) the common cold and bronchitis; (b) prevention and treatment of cancer; (c) prevention and treatment of cardiovascular diseases; (d) development of contraceptive agents. The Institute has a medicinal plant farm outside Peking which employs 106 staff members on an approximate 10-hectare site and is involved in the cultivation of some 1,300 medicinal plants. Production is primarily for experimental purposes and developing seed stock (cultivation bank for some species). Many of the well known medicinal plants were represented here, for example, Camptotheca acuminate and Digitalis lanata. The latter plant is being cultivated in other parts of China for large scale production of digitalis glycosides. The Institute's herbarium collection amounts to some 50,000 plant specimens.

13. The Institute has a staff of approximately 470 of whom 370 are technical people. Before Liberation the staff numbered four or five. Presently the Institute's mission is uncovering agents for cancer, CNS problems, chronic bronchitis, hepatitis, liver diseases and contraception. They are approaching these problems by isolation of natural products and synthetic studies as well as pursuing an antibiotic programme.

14. One of the entirely new areas under study in the pharmacology and chemistry departments of this medical college concerns an extract of Ilex pubescena Hook (Aquifollaceae). In the dog, blood pressure begins to fall in 30 minutes and lasts several hours. Even more importantly, the extract is being studied clinically for its useful effects on angina pectoris, hypertension and reduction (50%) of plaque in the aorta.

15. Apparently no animal extracts are known to be widely used in traditional medical treatment of cancer.

16. Over 400 commonly used medicinal plants are under cultivation. None is grown there for production but rather as specimens. The garden covers about 1,000 hectares of land and employs 120 workers. Editorial Note: The 11th International Cancer Congress was held in Florence, Italy, between 20 and 26 October 1974. Dr Li Ping an eminent Chinese cancer specialist was said to have attended and the Chinese Medical Journal, No. 5 (September 1975), pp. 360–68 includes an article entitled “Factors influencing survival after resection for bronchogenic carcinoma” which was reportedly delivered to the 11th Congress.