New York is a city of specialists from foodies to academics, laborers to shopkeepers. Every Wednesday, Niche Market will take a peek inside a different specialty store and showcase the city's purists who have made an art out of selling one commodity. Slideshow below.
There’s a reason 85 percent of the customers at the Kamwo Herbal Pharmacy on Grand Street in Chinatown are non-Chinese. While the shop has been in the area since 1973, it is by no means your typical traditional Chinese medicine emporium.
Thomas Leung, 42, is a fourth generation herbal pharmacist, who runs his family’s traditional Chinese medicine business, taking what his great-grandfather started in the small village Ting Yun in Guangdong Province, and combining it with modern business techniques, some of which he picked up while working at a Walgreens after college.
He strides through the shop pointing out some of the more common items. He points to a glass jar brimming with huang qi (astragalus) sticks that look like a rustic tongue depressor. “When you want to strengthen your Qi, that is the premiere herb for that,” he said.
Pointing at a jar of small yellow, pistachio-looking lian zi (lotus seeds) he notes, they are good to stop bedwetting, “an easy fix.”
Leung, who moved to New York at age 7 from Hong Kong has spent his life in medicine shops, “as a free source of labor,” and has a remedy for any ailment.
Herbal prescriptions being prepared. (Stephen Nessen/WNYC)
He unrolls a flap of du zhong, (rubber tree bark), pulling the taut brown bark and exposing the silk threads. “Good for lower back pain, not because you’re hit by a car, but old age,” he said. (Photo below)
All the herbs are to be used as soup broth, or cooked like tea. Du zhong, Leung notes, is best prepared with pork bone soup.
Generally, though, Chinese medicine is not like a Western drug store, where you find a pill for your specific ailment. “Two patients can come in with a headache, but my formulas can look different than yours based on our constitutions, or presentations, age, everything,” Leung said.
As a child, he dreamed of being a sports broadcaster, but his father squashed that plan. “Drop that dream real fast,” Leung remembers him saying. Instead he became a licensed pharmacist and got a degree from the University of Buffalo.
Working as a supervisor at Walgreens, he liked the way they documented every transaction and conversation with physicians. “These things we take for granted in a western pharmacy, I took that and incorporated into our Chinese herbal pharmacy.”
The Kamwo shop reflects Leung’s diverse experiences. There are floor to ceiling drawers, like a giant card catalog stuffed with bags of fresh herbs, and ancient looking Chinese scales dangling from the ceiling.
Wearing a green smock and rubber gloves, the store’s only non-English speaking staff fills herbal prescriptions, laying out orders on crisp white paper and folding concoctions for ailments like headaches, muscle pain, constipation and even breast milk production. Each paper envelope contains one-day’s worth of herbs. In the basement, there is a clinically clean room for weighing the herbs that have been cooked, dried and crushed into a powder, for customers that don’t like dealing with the earthy, dried herbs.
“It’s not therapeutically superior to raw herbs. I tell people Folgers is never as strong as Starbucks, but then again it’s better to have Folgers than no coffee. Not everyone is willing to brew herbs so this is a modern alternative to that,” Leung said.
It’s one of the modern conventions he’s brought to the shop, which does a brisk business in person and online.
Standing near a rack of herbal face cream, which Leung’s father created, Carolina Devarona, 23, visiting from Miami, made a special trip to Kamwo for some treatment. She’s a nurse and suffers from bad asthma in the winter. “I don’t know how to mix the teas and so I’ll just get the pill form,” she said. She doesn’t like the steroids in western medicine. Unfortunately, she said, she’s not permitted to recommend it to her patients.
Waiting for her prescription to be filled Wendy Wang, 30, thinks she might have chronic bronchitis. Her doctor tells her it’s allergies, but the pills he prescribed haven’t relieved her chest pain. So she’s at Kamwo to pick up a concoction that includes di long (dried earthworms) and the uterus of pig. She saw it on a TV show and is giving it a shot. “Chinese medicine is something you can try with not too much side effects. This is an ongoing course. If it’s doing good, I will keep trying,” Wang said.
Ayla Yavan, 35, is a local acupuncturist and a new mother. She often sends her patients to Kamwo, but today she’s picking up a formula she designed herself, which she hopes will increase her breast milk production. It includes fenugreek and several other herbs, but she admits the origin of the ingredients is of some concern. “Sourcing is an issue, it’s not FDA regulated. So it’s difficult to know and a lot of times we’re not seeing the herbs were prescribing our patients, or they’re in a cooked form or granular form, but that that’s why I like this place, they cater to a Western population.”
Dutifully filling out prescriptions that are emailed in or written by local doctors is Chen Jian. The Chinese-born Chen, 60, has worked in traditional medicine most of his life and says the herb business is more tightly controlled in China than in America. But, he adds, “There is a strict process to select the herbs for export. Normally, the best quality is sent overseas.”
Interview with Thomas Leung, owner of Kamwo Herbal Pharmacy
There are certain herbs you can take to strengthen your Qi. You don’t have enough Qi, your immune system is going to be weak. In Chinese medicine your immune system is described as our defensive Qi. And there are certain herbs to help strengthen our defensive Qi. Something like astragalus root (huang qi), something commonly used in Chinese medicine and Chinese food. You can put it in soup to boost your immune system. Codonopsis, (dang shen), they don’t have much of taste so you can put it in soups and you get the goodness of it. It strengthens the spleen Qi, which helps build blood and give you overall strength.
But it’s not about just taking a particular herb. Tt’s about your lifestyle, too. Getting enough sleep helps with your Qi, also eating right, correctly. After that, if you still need boost, there are certain herbs. But if you’re partying all night, I’m not sure taking astragalus root is going to help you.
There’s some truth to that, but certainly I wouldn’t say that’s true all the time. Emergency medicine, Western medicine is king. In China, if you get hit by a car no one is rushing you to the herbalist. You’re going to the ER. Chinese medicine is a relatively novel concept in the United States, where you almost have to choose to “believe” in Chinese medicine or do you “believe” in Western medicine. In China they view it as medicine and they chose what’s best depending on the situation. Like if you have a serious acute infection you’re going to go to your western physician but for more preventive medicine they will use Chinese medicine and thirdly, often times, both of them can be used together. The people who study Western medicine they know about Chinese medicine and vice versa and they work together. But here in the U.S. because Chinese medicine is still new and novel and doesn’t have the equal footing of Western medicine it seems like it’s either/or, but that’s certainly not the case in Asia.
An herb called cordyceps (dong chong xia cao), which is a fungus that took over the body of a worm. It’s from Tibet and goes for $6,000 a pound or $800 an ounce. And people are actually na?ve enough to think it’s $800 an ounce-good like that would translate in efficacy, but actually it’s not. I tell people when I was nine years old the same herb cost $6.50 cents an ounce. Very few people buy this. We only keep three or four ounces on hand. We have to carry some because certain formulas call for it, we usually call the practitioner and say, ‘hey you sure you really want to use this?’ Often times they back down. One of the most common uses is for asthma. But there are other herbs with comparable effectiveness that are 1/8,000 of the price. It does have this aura of superiority because of its price. If the Bill Gates of China was taking you out to dinner, I’m sure there are cordyceps in the soup.
Most of our customers are not Chinese. Only 15 percent of our customers are Chinese. We’re situated in the outer perimeters of Chinatown, but a lot of our business is mail order. We ship all over the United States and we have a lot of non-Chinese customers. Many certified herbalists in New York State are also acupuncturists and most are not Chinese. When they set up shop in small towns they see non-Chinese patients.
It’s like walking into a pharmacy and asking what’s your best selling item. Most of the formulations are customized, so there isn’t a best selling item.
As he navigates behind the counter at the Kamwo Herb and Tea Company, a bustling Chinese pharmacy on Grand Street in Chinatown, Tom Leung always weighs the freakout factor. ''Here's something that will definitely freak you out,'' he said as he nimbly assembled a prescription for an arthritic woman who was not well acquainted with traditional Chinese medicine. ''Cicadas.''
No debating that. The formula mandated a dosage of the shells of expired flylike serenading insects.
Usually, the prescription is bundled loosely for the patient to boil as tea and then strain. But Mr. Leung funneled these ingredients straight into a mammoth tea bag. ''This is for a non-Chinese customer, and she might not be real happy about seeing a cicada going into her tea,'' he said. ''My theory is you make people as comfortable as possible.''
So goes his weekday world, as Mr. Leung works as a Chinese-style pharmacist sorting through drawers of dried sea horses, magnolia flowers, deer antler and licorice root, dispensing prescriptions from herbalists and acupuncturists.
Then there is the Western Tom Leung. On sporadic weekends, he fills prescriptions behind another counter. This one is at the pharmacy at either the Kmart at Pennsylvania Station or the Kmart at Astor Place, where he apportions pills into small bottles and keeps mum about the benefits of cicadas for the joints.
At a time when alternative medicine is increasingly intersecting with conventional medicine, Tom Leung's professional bifurcation is perhaps an inevitable byproduct. In medicinal outlook, he is part Eastern, part Western, the ultimate hybrid pharmacist. It can make for complicated weeks. Indeed, Mr. Leung admits he sometimes finds himself mildly confused over which white coat he is wearing.
Someone will stop in at Kmart with a headache associated with dizziness and Mr. Leung points them to Tylenol or Motrin. If the same person visits Kamwo, Mr. Leung feels it his duty to recommend some chuan xiong and bai zhi, which happen to be roots. Such is pharmaceutical life when East meets West in the same body and neither yields.
''A customer came into Kmart last week and said he had trouble sleeping and relaxing,'' said Mr. Leung, a chipper, companionable man of 28. ''Knowing the side effects of sleeping pills, I didn't want to just tell them to take Sominex or something. As a Kmart employee that day, I couldn't say, go buy these herbs. So I told the person less coffee in the afternoon and don't eat after 9 at night.''
Chinese medicine makes use of often disagreeable-tasting brews of herbs, grasses, bark, branches, chemicals and animal parts in a tradition that traces back thousands of years. By and large, prescriptions are boiled into a tea or soup and drunk. At Kamwo, a pharmacist wraps the herbs in a square piece of paper. They look like salad preparations, the beginnings of a bird's nest, something the cat dragged in.
Western medicine, of course, is pretty much all pills and liquids in a bottle.
Like a growing number of his customers, Mr. Leung believes in both the herb and the pill. He does not see a clash between Chinese and Western medicine, and thus he keeps a mortar and pestle in both worlds. When he has a minor ailment, he visits an acupuncturist or herbalist; for acute problems, he sees a Western doctor.
''In the past, it has been, you either believe in Chinese medicine or you believe in Western medicine,'' he said. ''Over the last five years especially, I see more of, 'I'll take the best of both worlds.' Personally, I'm right in the middle. I always tell people, if I have a headache, I'll take a Tylenol, no questions asked. But if I have a persistent sore throat, I'll take herbs. Herbs are better at treating the underlying cause. Western medicine is treating the symptom -- the running nose.''
Grand Street was choked with people, a cacophony of noise, and patrons, Chinese and non-Chinese alike, steadily drifted into Kamwo (the word means golden crop), a long, slender expanse crammed with jars and counters and drawers of herbal relief. Dead geckos hung on the wall (yes, they go into prescriptions too). Three employees were busily measuring out formulas.
Since Mr. Leung is by far the most fluent in English, he tackles most of the growing number of non-Chinese customers. In his two years at Kamwo, the non-Chinese business has jumped to nearly 20 percent from less than 5 percent.
A sinewy man wanted something for rheumatism. Mr. Leung said he had something for external use, but the customer did not want that. So Mr. Leung told him he needed a prescription from an acupuncturist.
''We get a lot of, 'Hey, what herbs you got for a migraine?' '' Mr. Leung said as he raked his hair with his fingers. ''But it's not like Western medicine. You have to find out what the internal imbalance in the body is and then treat that imbalance.''
Born in Hong Kong, Mr. Leung moved with his family to New York when he was 6. His great-grandfather was an herbalist, as is his grandfather, as is his father, Shan Leung, who sees patients in the back of the Kamwo store.
The place has been in business since 1973 and is primarily owned by Tom Leung's uncle, Chou Leung, who is also an herbalist.
Growing up in America, Mr. Leung was uncertain whether he could make a living in Chinese medicine. It was appreciably less mainstream in the 1970's and 1980's, and so, with his parents' blessing, he pursued a pharmacy degree. He worked for three years at Walgreen's before getting restless. In 1995, he gravitated to Kamwo, where he is a manager as well as a pharmacist. Three nights a week, he takes classes to become an herbalist and acupuncturist.
Medicine -- of the East and of the West -- runs in the family. His sister is a pediatrician. His future brother-in-law is a Western-style internist in Chinatown. Mr. Leung's father sees him on the sly for serious ailments, for it is apostasy to some Chinese patients for their herbalist to go to a Western doctor.
Mr. Leung filled a woman's prescription ''to clear dampness and break up the phlegm.'' Using a hand-held balance, he measured out some ban xia, a root, and pulverized it with a pestle. He added licorice, ginger, angelica -- a dozen herbs in all.
In his dual world, there is the regulated Mr. Leung and the unregulated Mr. Leung. To be a Western pharmacist, a pharmacy degree and a license are required. Prescriptions must be signed by doctors.
To be an Eastern pharmacist selling herb formulas, you just need someone knowledgeable to show you how. Mr. Leung learned at a young age, mostly from his grandfather. He was putting together formulas when he was 9. There is no licensing requirement.
Prescriptions do not have to come from a doctor. The practice at Kamwo, though, is to fill only prescriptions signed by acupuncturists or herbalists. (Acupuncturists are licensed in New York; herbalists are not.)
At Kmart, he must concern himself with side effects. He must ascertain what other medications the patient is taking to be sure a new prescription does not cause a deadly mix. With herbs, he says, there is less worry.
''A formula may not work, but someone would not drop dead on the floor,'' he said. ''There aren't really many side effects with herbs. There are some external formulas to soak your hands or feet in, and I make sure people know they're not for drinking.''
Many conventional doctors complain that the efficacy and safety of herbs are unproven, but Mr. Leung feels the criticism is unfounded. ''Listen, if honeysuckle was toxic, they would have found out in the last 4,000 years,'' he said.
Last year, New York State banned ephedra, or ma huang, when sold in products aimed at achieving a drug high, for it has been linked to a number of deaths, though it is permitted in medications for asthma and other disorders. Kamwo sells it only by prescription.
There are certain herbs that do not interact well. Licorice root and hai zao, for instance, are not compatible. ''You won't die,'' Mr. Leung said. ''But it will make you pretty ill.''
All told, Kamwo carries 1,500 herbs, and fills about 200 to 300 prescriptions a day, some of which come from around the country. Orders even arrive over the Internet. In September, an acupuncture clinic is due to open next door. Most formulas cost $4 to $5, and tend to consist of 4 to 15 herbs, though Mr. Leung mixed one with 34.
''Is this bad for the liver?'' a man asked, holding up a box of Suan Zao Ren Tang, an over-the-counter product.
''No, that is a formula they use in China to calm your spirit,'' Mr. Leung said, adding, ''It helps you sleep.'' The man took three boxes.
Someone asked about sea horses and Mr. Leung said they strengthened the kidney and the kidney channels. Someone wondered about spotted deer antler and was advised that it gives you more qi, or energy.
A non-Asian couple stared transfixed at a row of antelope horns behind the glass counter.
Mr. Leung was amused. Out of earshot, this translator of Eastern medicine to Westerners and Western medicine to Easterners said, ''Honestly, they're for show. In the past, they used them for convulsions and seizures, manifestations of internal wind. Nobody buys them now. But they create this atmosphere. People come in and say, 'Look at that!' ''
NEW YORK (CNN) -- Deep in the heart of New York's Chinatown, amid the hustle and bustle of the produce markets, sits the Kamwo Trading Company, a Chinatown presence for the last 25 years.
Its goods, including cricket wings and licorice root, are the makings of herbal brews. There are more than 1,500 ingredients, and some are not for the faint of heart.
"It's hard to explain to your patients, 'You really need that lizard in your tea,'" said Thomas Leung of Kamwo Herb & Tea.
Leung, the fourth generation of his family to distribute Chinese herbs, said he sees it as his mission to bring the Chinese herb business -- one he's worked in since he was 9 -- to mainstream America.
"My goal is to have Chinese medicine accessible to everyone, not just to Chinese people," Leung said.
Leung said he has no problem with Western medicine. In fact, he said you can't beat it for treating symptoms. He should know because he worked as a Western pharmacist for three years. "If you're having an asthmatic attack, the spasms, it's a good idea to use your inhaler and not go make your tea," he said.
But to get at the underlying root of some problems, Leung said Chinese medicine should be given a try.
Some Western doctors agree.
"Chinese medicine is good at dealing with some of life's lesser issues like chronic back pain," said Dr. Henry Lodge of Columbia University Hospital.
Since putting aside full-time work as a pharmacist to return to his roots, Leung has found many roadblocks.
"A lot of people have misconceptions," he said. "They think it's hocus pocus.
"And then you have people who know very little about alternative medicine but have a lot of very strong opinions about the field. And you have to go against that."
Then there's the "ickiness quotient." It's a business, after all, that deals in cicada shells and gecko lizard bodies.
Chinese customers tend to boil the herbs loose, but for squeamish Western customers who don't want to know what's in their tea, Leung said he'll bag the bugs, sometimes in one huge tea bag.
Leung's efforts have paid off. Since working in the business full-time, Leung said his Western clientele has picked up.
His non-Chinese business has increased 20 percent in just three years, and Leung has hired other English-speaking herbalists to talk to non-Chinese customers when he's away.
"When a non-Chinese customer comes in, we give them extra instructions," he said. "We print out pamphlets on how to prepare herbal medicine."
The pamphlets give simple instructions: Don't drink the soaks -- they are made just for bathing in -- and don't eat the herbs.
"You strain the herbs -- never eat the herbs," Leung says. "A lot of people think you eat the herbs. You don't eat the herbs, you just drink the tea."
With faxes pouring in from acupuncturists and druggists across the country for 200 prescriptions a day, the company is branching out. It has a new acupuncture studio as well as a tea room in the back of the store.
Leung has been tireless in promoting the medicinal value of Chinese herbs. He said the time is right, and experts in the field agree.
"There's a number of different market and social factors that have created this herbal interest," said Mark Blumenthal, executive director of the American Botanical Council. "First of all, there's the philosophy that natural is better."
However, Leung said no one should limit themselves to either Eastern or Western medicine.
There's nothing like a bout of asthma treated with an inhaler, followed up by a good strong cup of sea horse, to clear the lungs.
The pharmacists of Kamwo Herbal Pharmacy in New York’s Chinatown spend their days weighing and mixing bear gallbladder, deer tail, wild ginger and other traditional Chinese botanical and animal ingredients.
The owner, Tomas Leung, 38, comes from a long line of herbal pharmacists. His great-grandfather had an herbal pharmacy in Hong Kong. Leung’s father and grandfather, he says, opened their store in America in 1973. “It is the oldest continuous herbal pharmacy in New York City,” he said.
In recent years the demand for raw herbal remedies has put Kamwo at the forefront of a booming business. Importation of Chinese botanicals used in traditional medicines soared to $132 million in 2006 from $67 million five years earlier, an increase of 96 percent, according to figures from the U.S. Department of Commerce.
The explanations for the surge vary. For Leung, the North American Free Trade Agreement passed in 1994 forced him to find new customers who may have then helped create a greater demand for herbs across the country. For years Leung’s customers were exclusively Chinese immigrants who worked in the local garment factories. But when NAFTA passed, he said: “The garment factories moved overseas to Mexico and, ironically, to China. The workers found new work in the outer boroughs. We had to forge a new direction and change our business model.”
So he began marketing to licensed acupuncturists and Western practitioners of traditional Oriental medicine. As a result, the composition of his customer base flipped. Today almost 95 percent of his clients are non-Chinese and about 85 percent come from outside Chinatown.
But nationally, the foreign-born Chinese population is on the rise, up 87 percent since 1990. This boom may have created a greater demand in the United States for Chinese herbs, said Caroline Yuen, an agricultural trade specialist at the U.S. Department of Agriculture. In addition, she said, some herbs are becoming easier for consumers to take as they are made into capsules or ready-to-eat supplements.
It is all part of a global trend, said Dr. Edmund Lee, a Hong Kong-based consultant on the development of biotechnology and Chinese medicine. “Chinese medicine, with 4,000 years' worth of literature on the treatment of illnesses, provides a good opportunity for evidence-based research and development of natural products, dietary supplements, botanicals, and medicines by scientific researchers.”
Those researchers have made groundbreaking discoveries; for example, wild ginger and soy have been shown to inhibit cancer. As a result, the Western medical community has become more accepting of herbal remedies, says Mel Drisko, of the University of Colorado’s Center for Integrative Medicine in Denver.
“It's not just word of mouth, or media exposure,” he said. “We have seen over these last few years a pretty dramatic sea change. Some of the most conservative physicians have seen some of their patients improve from the use of traditional Chinese therapies. These physicians have become some of our best sources for patient referrals.”
In San Francisco, Michelle Kuroda’s four-year-old Chinese medical practice is a beneficiary of that trend. She has seen a 50 percent spike in the number of new clients, largely because of referrals by Western doctors. Kuroda also treats patients one day a week at San Francisco’s Metropolitan Medical Group, a primary care practice run by Western doctors, in what is becoming a more common arrangement.
Acupuncturist Jon Simon, 39, works closely with Western doctors in New York. “They focus on specific symptoms, and I look at the whole person,” he said. “It’s best when we work together.”
With a thriving practice at two Manhattan locations, Simon goes through bushels of exotic medical herbs like wild ginger, used to clear blocked nasal passages during colds, and bear gallbladder, an animal-based remedy for gastric and neurological troubles.
But concerns about the effects of herbal medicines still linger. Many outlets no longer carry certain raw botanicals or traditional medicines made with animal products because of increased government regulation, Simon said.
Under federal law, many of herbs and herbal formulas may be sold as dietary supplements if all the ingredients have a history of safe use in the food supply, according to the Division of Dietary Supplement Programs of the U.S. Public Health Service. It is not enough for herb suppliers to say the ingredients already exist as an article of food. They must document that history, identify the source of the raw material, and describe the composition and manufacturing process.
Those regulations help build trust, Simon said. Shopping for traditional products like bear gallbladder, which has been used in China for centuries to treat everything from headaches to parasite infections, requires special care, he said. “Unscrupulous sellers will inject mercury to add weight and jack up the price. To ensure purity, you have to cut open animal products like deer tail." Taken from Sika deer, the tail is used to treat fatigue and impotence.
A medical disaster in Belgium illustrates the concern over improper mixing. One hundred patients who sought weight-loss treatment in a clinic there in the early 1990s came down with renal disease. Seventy of them eventually needed kidney transplants or dialysis, according to the U. S. Food and Drug Administration. Researchers hypothesized that a dangerous herb, Aristolochia Fangchi, which contains a nephrotoxin called aristolochic acid, was mistakenly substituted for the safe herb Stephania tetrandra. The names are very similar in Chinese and may have easily confused an inexperienced practitioner.
But Simon trusts his supplier, Kamwo, based on his personal experience with Leung’s expert knowledge and the high quality of his products. Today, Kamwo sells 30,000 tons of herbs each year, grossing $2.7 million to $3 million, Leung said. His pharmacists still hand-mix herbs and medicines to specific prescriptions and weigh them in large brass and wood precision scales, the same kind used in Bangkok to weigh gold.
Kamwo Herbal Pharmacy is proud to have been featured on Asia's widely broadcasted NTDTV. The segment, which aired on November 5, 2008, focused on the treatment of migraines and headaches with eastern and western medicine. They visited our pharmacy and processing facility to learn about the various ways Chinese herbs can treat these conditions. NTDTV is a non-profit, independent news source focused on building bridges between Eastern and Western society within a global viewing context.