An Analysis of Ilex 15 (Seven Forests)

In China, there are numerous herb shops where people can stop by and pick up remedies for common ailments, such as cold and flu. A number of these remedies are so widely used and have such a good reputation that Chinese people overseas get their local Chinese groceries to keep them in stock. Westerners have heard of some of them and have sought them out. Among the most popular of the remedies for influenza and common cold are Yin Qiao Jie Du Pian and Gan Mao Ling. The former is named for two of its key ingredients (the Japanese honeysuckle, lonicera, referred to here as yin, and the weeping forsythia, referred to here as qiao) and for its action (to get rid of infection, or, literally, cleanse toxins). The latter is named for the disorder it treats (gan mao, an upper respiratory infection, such as common cold) and the fact that it is considered effective (ling).

Unfortunately, Westerners seeking all natural remedies at these Chinese herb shops sometimes didn't realize that certain brands or varieties of the products contained modern drugs (the sale of herb products with drugs is illegal, but authorities here were also unaware at the time). For example, some of the products included antihistamines and other drugs that helped contribute to their notable symptom-alleviating action. Also, consumers didn't realize that the labels on the products were not necessarily an accurate portrayal of the ingredients in the product. Chinese labeling laws were either non-existent or not enforced.

Several other herbs in the formula were selected for anti-pathogenic effects (e.g., possibly inhibiting bacteria and viruses): mainly forsythia, lonicera, isatis root, chrysanthemum, and ardisia root. These herbs comprise just over 50% of the formula content by weight. The other ingredients of the formula are included primarily for the purpose of alleviating symptoms, such as increased mucus secretions (stuffy nose, cough), sore throat, headache, aching muscles, and feelings of chill and fever.

In the Chinese herbal system, acute respiratory ailments are often classified as being either of hot nature or cold nature. Those ailments that are classified as being of hot nature tend to produce symptoms of fever, thick and discolored mucus, and sore throat; those of cold nature tend to produce symptoms of chills, thin and clear mucus, and aching muscles. Herbs are then chosen, in part, on the basis of their "nature": being cooling or warming. Today, such distinctions are not as critical to the selection of Chinese herb therapies. In our modern situation, where people have easy access to nutritious foods, drugs, and herbal therapies, these considerations are secondary and it is often found that symptoms fall into both hot and cold categories. Instead of relying on these properties, most people want to be assured that the formulation is suited to helping the body fight off acute infections in a balanced way. This is the aim of Ilex 15, and it may be utilized for the initial stage of either the hot type or cold type of ailment (slightly more than half the ingredients by weight have cooling nature and the remainder have warming nature; none of the ingredients have extreme nature in the amounts present). The herbs of this formula are also traditionally used in treatment of skin eruptions. They may be of value in treating acne outbreaks and other skin disorders involving infections.

Method of Use

The time from exposure to the influenza virus until the first symptoms appear is typically 1-3 days. During that time, the number of viral particles is growing from a few dozens to many millions. The first signs of having the infection are often due the immune system's complex response mechanism, which involves release of various signaling substances that then trigger such things as increased secretion of mucus and aching in the muscles (especially of the upper body). Additional symptoms develop as the immune responses intensify and as the viral activity causes some of its own damage. Since the disorder is undetectable prior to these symptoms arriving, the earliest treatment of the disease is undertaken at the first symptoms. This is the point at which herbal therapies might be most efficacious, as they theoretically increase the immune response (directly, without stimulating more symptoms) while inhibiting the virus at a time when neither the immune response or the viral activity has yet peaked on its own. Ilex 15 might be taken in relatively high doses (6 tablets each time, for adults), and frequently (at least three times in a day, up to four times if starting early in the day). Small amounts of the herbs are less likely to produce an adequate response. If the symptoms have already been present for 2-3 days by the time herbal therapy is started, it is less likely to have a significant effect. Some of the herbs have symptom-alleviating properties, so it may still provide that benefit. However, once the symptoms have peaked, inhibiting the virus and stimulating the immune system are probably not going to have a big impact on the remainder of the disease process.

Cautions About Claims

Herbs, such as the ones that are included in Ilex 15, have been subjected to some laboratory and clinical evaluations. The laboratory studies involve applying herbs to viral samples or providing herbs to animals that are exposed to viruses; clinical trials may involve prevention or treatment of influenza or other viral diseases. These studies, mostly conducted in Asia (though some laboratory analyses have been conducted in the U.S., Canada, and Europe), do not prove that the herbs are effective in actual clinical situations. This is because the laboratory studies only confirm that the herbs might have an effect. The clinical trials that have been conducted to date do not meet the rigorous standards that would be required to consider the therapies proven. No clinical trials have been carried out with the specific formula Ilex 15. While these limitations apply to all herbal therapies for influenza, Chinese herb formulas such as this one are routinely recommended by licensed health professionals (e.g., acupuncturists and naturopathic doctors), so it is valuable to understand the theoretical framework in which they are intended to be used. By making this information available, no one should be dissuaded from getting flu vaccinations, nor from visiting a medical doctor as necessary for evaluation of the illness and recommendations for appropriate medical treatments.

The Herbs of Ilex 15

* These are samples of traditional applications of the herbs. Listing them here is not intended to imply that there is evidence for their efficacy. As described in the text, some of the herbs have been subjected to pharmacology experiments supporting some of the applications; results may indicate that the herbs inhibit certain viruses and bacteria, that they disperse mucus, relieve coughing, or reduce inflammation. Such laboratory results do not assure that they will have the same effects in people who consume them. For example, a laboratory analysis of Yin Qiao San, the basic formula of the tableted remedy Yin Qiao Jie Du Pian, was studied to determine its antiviral components. The results, published in the January 2003 issue of the Chinese language Journal of Chinese Traditional Herbs, identified arctiin (from arctium); phillyrin and forsythiaside (from forsythia); liquiritigenin and liquiritin (from licorice); genistein, formononetin, daidzein, glycitrin (from soja); and chlorogenic acid (from lonicera). However, the formula has not been subjected to formal clinical trials (early trials, showing favorable results, were carried out in China during the 1950s and 1960s but are not considered reliable due to poor design of the study protocol).