At a pharmaceutical factory in Chengdu, China, an order that Thomas Leung placed from Manhattan in January is sitting on hold.
The shipment includes a variety of concentrated herbal granules used in traditional Chinese medicine. There’s dang gui, also known as angelica root, which is used to treat gynecological ailments; chai hu, or bupleurum root, an herb that is often used to calm nerves; and huang qi, or astragalus root, a tonic herb that promotes immune strength.
It is not clear when the shipment will land at Kamwo Meridian Herbs, a New York City staple for more than half a century that claims to be the largest traditional Chinese medicine dispensary on the East Coast. When it arrives, the herbs will be dispensed to practitioners and patients looking to treat colds, pain and other ailments — but for now, the herbs must sit.
Dr. Leung, Kamwo’s chief executive, put a stop on the order after President Trump placed a minimum tariff of 145 percent on all Chinese goods last month. China responded by raising tariffs on U.S. goods to 125 percent, and the resulting standoff has effectively frozen trade between the two countries.
Traditional Chinese medicine is just one of many industries that has been upended by the tariffs and the uncertainty over when, or whether, they may be lifted. Already, fewer ships are arriving in American ports, and consumers could begin seeing empty shelves by early June.
The trade war has caused paralysis among importers, said Dr. Leung, a fourth-generation herbal pharmacist and the third member of his family to lead Kamwo. Even if he were willing to pay the import duty, he said, he would risk being stuck with prohibitively expensive stock that few people would be willing to buy if the tariffs are reversed.
“No one’s doing anything until we know what the heck is happening,” he said.
Since it opened its doors in 1973, Kamwo has filled prescriptions written by traditional Chinese medicine practitioners and sold herbs by the pound. Recently, however, it stopped advertising bulk sales. With imports effectively paused, there has been a run on herbs and supplies that has already caused prices to jump, Dr. Leung said.
Space and time also limit how much the typical traditional Chinese medicine dispensary can stock up on these supplies. Herbs can go bad or grow stale, and even if it were possible to stockpile a large supply, there is the question of where to store it all.
Before the tariffs were announced, Kamwo had expected to take in $6.5 million in revenue this year, Dr. Leung said. Kamwo is fortunate to be a bigger company that has “maybe eight months worth of herbs” on hand, he said, but “not every smaller company is going to have that luxury.”
Slim Margins, High Stakes
Traditional Chinese medicine, or T.C.M., has boomed over the last 20 years, driven by immigration and a willingness among American consumers to try something new when seeking relief, said Arthur Dong, a teaching professor at the McDonough School of Business at Georgetown University.
It’s unclear exactly how large the T.C.M. industry is in the United States. China exported nearly $5.5 billion in traditional Chinese medicine in 2023, up from $3.6 billion in 2017, according to Statista.
A protracted trade war would harm the T.C.M. industry just as it would other niche but popular sectors that rely largely on imports. Jaya Wen, an assistant professor at Harvard Business School, said T.C.M. “is likely to be highly adversely affected relative to other industries.”
Many dispensaries are small mom-and-pop shops operating on razor-thin margins. Once they run out of stock, they’ll be left with bare shelves, no incoming business and a rent check that’s due every month. The tariffs also could threaten the livelihoods of people all along the supply chain, including the store associates who gather the orders and the truckers who haul these ingredients to their final destinations.
Many of the herbs used in T.C.M. can’t grow outside China, Dr. Leung said, and they are processed by skilled workers, following highly specialized methods that were established generations ago.
“If I make a list of all the things that we need to do to foster that, like a home Chinese herb industry in the United States, it’s impossible,” he said. “It’s literally impossible.”
The disruption to T.C.M. in the United States “will be pretty widespread, and this is just one narrow industry,” Dr. Dong said. “This is one of thousands of industries that are going to be affected.”
Because Mr. Trump changes his mind frequently, Dr. Dong said, it’s hard for companies to plan for the future. That’s why “you’ve seen the gears of commerce come to a grinding halt.”
“No C.E.O. of any company, whether it’s large or small, is willing to make investments or take out loans or increase a trade or commit to anything beyond like the next two months due to this uncertainty,” he said.
Still, despite the economic challenges, G.A. Donovan, a fellow at the Asia Society Policy Institute, said he would “not count this industry out.”
T.C.M. practitioners in China experienced a “very turbulent 20th century,” he said, referring to the violent political upheaval of Mao Zedong’s Cultural Revolution. As a result, he added, they “have the resilience to manage this.”
“You could expect them to respond to this challenge with a great deal of ingenuity,” he said.
Treatments for ‘Everyday People’
Kamwo ships to all 50 states, Canada and Europe, and about 75 percent of its customers are not Chinese, Dr. Leung said.
Among them is Lyn Pierre, 58, who walked into Kamwo on a sunny Friday afternoon looking to fill her prescription. A runner, she has used T.C.M. at various points in her life to stay injury free, but now she worries that the already pricey medicine she takes will cost even more.
“Of course I’m worried,” Ms. Pierre said, sitting on a stool inside the shop, adding, “I think it’s going to be a bit expensive.”
Ms. Pierre said it’s already hard to earn a living, especially in these days of soaring costs. The idea of herbs costing even more than they already do is daunting.
“It’s not easy,” she said. “It’s really a struggle.”
Acupuncture, the ancient Chinese medical technique for pain relief, could also feel the impact of the trade war.
Dr. Beth Nugent, the president of the Acupuncture Society of New York, said that most acupuncture practitioners “operate on very slim margins,” adding that she and her colleagues “tend to not charge people a lot because we just love what we do.”
Herbs, tonics and needles are essential to Dr. Nugent’s practice. While there are other sources for some items, like needles, they “may not be as high quality as the ones we can get from China,” she said.
“If I could charge somebody the minimum amount that they can afford so that they come for acupuncture, that’s what I’m going to do,” she said, “but if it gets to a point where I can’t keep the lights on in my practice, then how do I survive as a practitioner?”
She worries that patients who may not seek her out if she is forced to raise prices, perhaps because they will no longer be able to afford the treatments. She thinks of the hockey player she helped get back on the ice, the couple who finally conceived after fertility struggles and the patient with vertigo who got back on their feet.
“This is not something esoteric or something that’s out of the realm of everyday people,” she said. “It is everyday people that are getting this treatment.”