China seeks new markets for ancient medicines
A crowd gathers at a Shanghai hospital, queuing for remedies made with plant mixtures and animal parts including scorpions and freeze-dried millipedes - medicines that China hopes will find an audience overseas.
With a history going back 2,400 years, traditional Chinese medicine (TCM) is deeply rooted in the country and remains popular despite access to Western pharmaceuticals.
Now the authorities are hoping to modernise and export the remedies, but they face major obstacles.
A veritable forest of medicinal plants surrounds patients waiting at Yueyang Hospital's pharmacy.
Some leave with boxes of pills, others take away plastic sachets filled with herbal extracts.
Lin Hongguo, a 76-year-old pensioner, has bought herbal remedies that he will boil to make a tea to treat his "slow beating heart".
"I prefer it to Western medicines. It's not about the cost, it's because it works well," he told AFP.
Another patient, pet fish seller Wang Deyun, 51, is also a believer.
"Two months ago my skin had an allergic reaction to a modern medicine for high blood pressure," she said from her hospital bed.
But after a treatment of face masks and plant infusions, she said she's almost fully healed.
Painting vs photography
Traditional medicine is subsidised in China and is cheaper than Western medicine.
It consistently makes up one quarter of the country's pharmaceuticals market - even as China increasingly opens up to modern medicine.
The World Health Organisation will next year include a chapter on traditional medicine in its "International Classification of Diseases" - a tome of reference for medical trends and global health statistics.
China hopes the WHO inclusion will spur global recognition of its traditional remedies as it seeks to export them.
But Beijing still faces significant hurdles, not least the fact that TCM focuses on tailoring treatment to each individual, which means different people with the same condition can be prescribed different medicines and dosages.
"It's like a painting - it's composed differently each time, while Western medicine is more similar to photography" with its standardised products, said Wang Zhenyi, a proctologist at Yueyang Hospital.
That is the crux of China's challenge in gaining overseas acceptance: its traditional medicine is largely incompatible with modern clinical trials which require an identical product to be tested on a large number of patients.
As these medicines typically contain dozens of ingredients, understanding how they work together and proving their effectiveness is a complex task.
Even within China there have been public skirmishes over the efficacy of TCM, pitting its proponents against doctors who advocate evidence-based, peer-reviewed medicine.
Conservationists also say growing demand for products like rhino horn and pangolin scales - which are used by some practitioners even though they have no proven medical properties - have decimated vulnerable species.