toxicity of herbs

[Guest guest]

If you read mandarin, there is a book called 中è¯é£Žé™·é€ŸæŸ¥ zhong yao feng

xian su cha (Quick " reference " of herbal hazard) from Liaoning science and

technology publishing house. ISBN : 7-5381-4410-2

In this book both patent medicine and single herbs are discussed for their

hazard in 271 pages.

 

Cheers,

Yandy

[Guest guest]

There is an " essential guide to herbal safety " that was mentioned

recently in a thread on bu zhong yi gi tang. I think it's by Kerry Bone?

Lea.

 

Chinese Medicine , Joyce

Schwartz <joyces wrote:

>

> Tom: In lieu of taking a course in toxicity of herbs, as well as herb-

drug interactions, could you possibly recommend some books that

would be helpful. I have the Chen & Chen Chinese Medical Herbology

and Pharmacology, as well as Bensky, but I would be interested in

reading more about the possibly side-effects, etc. of the formulas that I

am about to write for my patients (I hopefully will be finishing my final

exams within the month and receiving my degree in Israel). Thank you.

> Joyce Schwartz

> -

> Tom Verhaeghe

> Chinese Medicine

> Saturday, July 22, 2006 12:15 PM

> Re: Chinese medicine gave man cancer

>

>

> Chinese Medicine , " Attilio

> D'Alberto " <attiliodalberto@> wrote:

> >

> > I just pulled up Bob's old message, thanks for pointing it out Tom.

> >

> > Yes, Mu Tong is well known as a banned substance. It's been

banned

> for quite

> > a few years. The formula must of been imported directly from

China and

> > evaded customs. It just goes to show the lack of a strict control

on the

> > importing of patents into various western countries.

> >

> > I'll also keep a look out for other herbs that contain aristolochic

> acid.

> >

> Atillio, I was trying to say that as practitioners, we should know

> immediately that aristolochic acids in long dan xie gan tang should

> come from mu tong. You seem to have missed that point. Instead of

> acknodledging that you didn't think of mu tong you reply with " Yes,

Mu

> Tong is well known as a banned substance. It's been banned for

quite a

> few years. "

> Did you study Chinese herbs in your curriculum, Attilio? Every

Chinese

> herbal course should at least mention the dangers of toxicity. Chris

> Dhaenens, a Belgian expert on toxicity laments the fact that only

few

> practitioners show an interest in his courses. He has had a lot of his

> courses cancelled because of low attendance.

> On a European level, food supplements including Chinese herbs are

> being regulated. There is one vacancy to be filled: a pharmacology

> expert on Chinese herbs. There just is nobody to be found in Europe

> who is an expert in both pharmacology and Chinese herbs. Actually

> there is one, a professor emeritus from Germany, but he's too old.

So

> what we have now is that a group of people, including many

> pharmacologists and MDs ( not one herbalist or acupuncturist) are

> making decisions about herb regulation. This could turn out very bad

> for the whole profession. Herbs will be regarded as drugs.

>

> Tom.

 

[Guest guest]

Hi Bob...was not aware of your lectures. Please include me in for next time.

Much obliged and gracias.

th

 

" Bob Linde,AP, Herbalist " <boblindeherbalist wrote:

One of the best books I have found on the subject is Francis Brinker

called Herb Contraindications and drug interactions. He actually goes back and

looks at the research to see whether actions are implied, in vivo or invitro,

oral, or injection and such. Very dense on info, focus is on western herbs but

has many chinese herbs as well. If start to look at latin names you will find

some similar species and can take cautions if needed. He also has a website that

updates the book.

Its interesting....there are about 100 acupuncturists in my area...most practice

some form of herbalism and most went to the same school I did, where we got very

little information on herb safety or interactions. I have worked very hard to

learn this from many sources and 4 times a year offer a free 2 hour lecture with

hand outs on herb/drug interactions. In 3 years of offering this I have had one

acupuncturist, 4 nurses and an MD attend....lots of the general public...but

still one of my poorest tended classes.

go figure....

 

Bob

www.acuherbals.com

 

Joyce Schwartz <joyces wrote:

Tom:

 

Thank you very much for the info. I would appreciate your keeping me (us) more

informed!

 

Joyce

 

-

Tom Verhaeghe

Chinese Medicine

Saturday, July 22, 2006 2:16 PM

Re: toxicity of herbs

 

Chinese Medicine , Joyce Schwartz

<joyces wrote:

>

> Tom: In lieu of taking a course in toxicity of herbs, as well as

herb-drug interactions, could you possibly recommend some books that

would be helpful. I have the Chen & Chen Chinese Medical Herbology

and Pharmacology, as well as Bensky, but I would be interested in

reading more about the possibly side-effects, etc. of the formulas

that I am about to write for my patients (I hopefully will be

finishing my final exams within the month and receiving my degree in

Israel). Thank you.

> Joyce Schwartz

 

Dear Joyce,

 

I'm really no expert on pharmacotoxicology. I have forwarded your

question to Chris Dhaenens.

I for one was very disappointed in the Blue Poppy book on the subject

( " herb toxicities & drug interactions " ). A lot of the information is

repeated like ten or more times in the book, and it is far from

complete. It is just a repetition of the toxicity chapters of some

other books (like Chen & Chen, Bensky & Gamble,..). There is almost no

new information in the book.

 

A good source of herbal pharmacology on the web is the Japanese

magazine " Chemical & Pharmaceutical Bulletin "

http://www.jstage.jst.go.jp/browse/cpb

http://alternativehealing.org/ has some info.

Chinese universities also do a lot of pharmacological research on

herbs, and these are published in professional magazines.

 

However, when it comes to side-effects and drug interactions, a lot is

still unknown. Chinese newspapers often do not report on negative

news items, including related to public health. The PRC is trying to

sell more of Chinese medicine to the west, and they don't really like

negative press.

Follow the publications on pubmed or on this list to find out more

about drug interactions. Two common side-effects are renal damage from

aristolochic acid or hepatitis from herbs like he shou wu, xiao chai

hu tang,... Mazin Al-Khafaji, who only used Chinese herbs in his

dermatology clinic, is aware of the latter and has published an

article called " MONITORING OF LIVER ENZYMES IN PATIENTS

ON CHINESE MEDICINE " in the JOURNAL OF CHINESE MEDICINE NUMBER 62

FEBRUARY 2000. Please send me an email if you would like to read the

article.

 

I will let you know when Chris Dhaenens sends me a reply,

 

regards,

 

Tom.

 

 

[Guest guest]

Dear Joyce and others,

 

Chris Dhaenens answered me by email. He told me that the book AN

INTRODUCTION TO CHINESE HERBAL MEDICINE: with Particular Reference to the

Chinese Umbelliferae by Mark Wright is currently one of the best in its

category. Chris Dhaenens is also writing a review on CHM books for the

Thieme almanac. See http://tinyurl.com/lcr9g (Thieme is an international

medical books publisher; the editors for the almanac are international

lecturers like Elisabeth Rochat-de-la-Vallée, Stephen Birch, Jane Lyttleton,

..)

 

Here's a review of the book taken from http://tinyurl.com/s6ssr :

 

AN INTRODUCTION TO CHINESE HERBAL MEDICINE: with Particular Reference to the

Chinese Umbelliferae

by Mark Wright

Greenbank Publications, hardback, 568 pages

This book is available at a reduced price from The Journal of Chinese

Medicine bookshop

On reading an early draft of this book, then entitled The Umbelliferae of

, I was concerned that Mark Wright might be putting a lot of

effort into writing a text that was just too specialised. After all, Chinese

herbal medicine (CHM) commonly employs only a dozen or so plants from this

family. Already at this stage, though, he had begun to draw on a wide range

of skills including his knowledge of Chinese and his science background. As

well as explaining the ideas of China’s ancient naturalists and physicians

to outsiders journeying into Chinese medicine, he was outlining the

botanist’s outlook and terminology to CHM-trained readers. The project grew

to the point where it was less a book about a handful of plant species, and

rather, a grander project aimed at tying together the hitherto rather

separate disciplines of CHM, pharmacology, phytochemistry, botany, plant

taxonomy and more. Wright states some of his aims in a preface: " … to

provide a rigorous botanical base … To bridge the gap of understanding

between herbalists and botanists … To better acquaint herbalists with

notions of botanical classification and nomenclature … to introduce

botanists to … valuable medical potentials … " .

Even this significantly understates what is actually achieved. Far from

being a fringe text pitched at the most obsessed enthusiast, it rectifies a

key omission in available CHM texts. I would imagine that if Western medical

herbalists were forced to criticise their CHM colleagues, it would be for

our relative weakness in the sciences that Mark illuminates in this book.

Happily for us this book has been written by someone with a clear affection

for China’s culture, language and medical legacy, so the result is an

eminently readable and relevant contribution to our study and practice.

A preliminary notes section offers the reader some useful background,

including an introduction to the basics of the Chinese language and to some

of the inherent translational pitfalls. Wright highlights various tricky

issues such as the problem of proper identification and naming of CHM

medicinals. This preliminary section also includes the best guide to pinyin

pronunciation that I have seen.

 

From here on, the book is divided into three parts; the first consisting of

five introductory sections on basic theory East and West; the second

containing extended monographs on 26 medicinals from the umbelliferae family

and the third consisting of a variety of appendices.

 

The first section in Part One presents a concise and orthodox exposition of

CHM history, focusing especially on the development of bencao (materia

medica) literature, 20th century history and CHM politics, comparisons with

other herbal medical traditions and an overview of Li Shi-zhen’s Ben Cao

Gang Mu. Here the author visits a pet subject – the vexed question of the

hasty (and in Wright’s view risky) inclusion of new medicinals into CHM

practice in recent times. A memorable observation for me in this section was

the author’s suggestion that the early bencao authors maintained a kind of

licence applied for " , or " candidate status " , herb section, which acted as a

holding area for new medicinals, classically called a " named-but-not-used "

category. Wright suggests that herbs might languish here for centuries

awaiting recognition as safe and effective medicines. I was unaware of this

notion.

Section II, The Concepts of offers an introduction to the

core principles of the subject, aimed both at the reader visiting CHM from

other disciplines, and at seasoned practitioners. The main issues are well

covered and some character etymology helps clarify the ideas. On the

toxicity of medicinals, for example, Wright states " The concept of toxicity

has been understood for a long time. It is viewed with constructive respect

rather than negative foreboding " . Especially striking is his detailed

discussion of the " seven relationships " between pairs of herbs – mutual need

mutual dislike, and so on. This is easily the best description I have seen

of this subject and, to my mind, these ten pages are worth a significant

portion of the book’s cost, although the depth here might leave

pharmacologists or botanists a touch bemused.

 

In just 24 pages, the Introduction to Botany section fills an enormous gap

for CHM students and practitioners. It clarifies the way plants are

identified, named and classified in botany, and explains key botanical terms

especially those relevant to Chinese herbalists. Then, in sections IV and V

we move into deeper waters – well over 100 pages covering phytochemistry and

pharmacokinetics respectively. A plethora of biochemist's " stick diagrams "

might scare away some readers at first glance. Wright, however, admits us

into this arcane world gently and skilfully by means of lucid explanations,

and by tying the material into our existing CHM knowledge base – the herbs

we use on a daily basis. Once again the questions dealt with are

wide-ranging, for example how pao zhi might affect herb properties or

toxicity, and how active constituents interact with each other or with the

body. Included too is an excellent summary of the factors affecting

absorption, distribution, metabolism and excretion of ingested substances,

mention of the blood-brain barrier concept, and likely influences on the

foetus. Wright makes a creditable attempt to marry together Chinese herbal

lore " (although personally I find this word a touch disparaging) with

science. Taking the relatively recent example of the potentially fatal

cross-reaction between the antihistamine drug terfenadine and grapefruit, he

extrapolates to the citrus herbs known to contain the same problematic

component, and which therefore have the potential to produce similar

reactions.

 

In Part 2 Wright presents his 26 monographs on the members of the

umbelliferae plant family, mainly derived from his translation of Li

Shi-zhen’s Ben Cao Gang Mu (1596). This includes well-known medicinals such

as dang gui, chuang xiong, fang feng, du huo, she chuang zi, qiang huo and

gao ben, plus some less familiar substances. Added to this are modern

discussions on what is known of each herb’s pharmacology, comments on

growing conditions, and the range of related herbs sometimes used. Again we

are offered many further informational nuggets, for example, " Du Huo means

‘moving alone’. It refers to the fact that it was said not to move when the

wind blew, but to move by itself when it was windless … " . These are the

most detailed descriptions of these herbs available in English.

 

The final part is a group of appendices, including an annotated bibliography

a table of dynasties, and tables of active constituents of the umbelliferae

discussed in the text.

 

This is a considerable and original publication. It is well placed to be the

standard text for Chinese herb students in the West to learn some of the

plant sciences relevant to studying the subject to a professional level, and

perfectly fills a key gap in the market. As a single volume spanning a wide

area, it is an ideal text to help colleges meet university validation panel

requirements for increased pharmacology and plant sciences course content.

At the same time it will help seasoned practitioners get up to speed on

subjects that were generally scantily covered in our student days.

Recommended.

 

Charlie Buck (lecturer at the Northern College of Acupuncture)

 

 

----

 

Joyce Schwartz

07/22/06 15:21:07

Chinese Medicine

Re: Re: toxicity of herbs

 

Tom:

 

Thank you very much for the info. I would appreciate your keeping me (us)

more informed!

 

Joyce

 

-

Tom Verhaeghe

Chinese Medicine

Saturday, July 22, 2006 2:16 PM

Re: toxicity of herbs

 

Chinese Medicine , Joyce Schwartz

<joyces wrote:

>

> Tom: In lieu of taking a course in toxicity of herbs, as well as

herb-drug interactions, could you possibly recommend some books that

would be helpful. I have the Chen & Chen Chinese Medical Herbology

and Pharmacology, as well as Bensky, but I would be interested in

reading more about the possibly side-effects, etc. of the formulas

that I am about to write for my patients (I hopefully will be

finishing my final exams within the month and receiving my degree in

Israel). Thank you.

> Joyce Schwartz

 

Dear Joyce,

 

I'm really no expert on pharmacotoxicology. I have forwarded your

question to Chris Dhaenens.

I for one was very disappointed in the Blue Poppy book on the subject

( " herb toxicities & drug interactions " ). A lot of the information is

repeated like ten or more times in the book, and it is far from

complete. It is just a repetition of the toxicity chapters of some

other books (like Chen & Chen, Bensky & Gamble,..). There is almost no

new information in the book.

 

A good source of herbal pharmacology on the web is the Japanese

magazine " Chemical & Pharmaceutical Bulletin "

http://www.jstage.jst.go.jp/browse/cpb

http://alternativehealing.org/ has some info.

Chinese universities also do a lot of pharmacological research on

herbs, and these are published in professional magazines.

 

However, when it comes to side-effects and drug interactions, a lot is

still unknown. Chinese newspapers often do not report on negative

news items, including related to public health. The PRC is trying to

sell more of Chinese medicine to the west, and they don't really like

negative press.

Follow the publications on pubmed or on this list to find out more

about drug interactions. Two common side-effects are renal damage from

aristolochic acid or hepatitis from herbs like he shou wu, xiao chai

hu tang,... Mazin Al-Khafaji, who only used Chinese herbs in his

dermatology clinic, is aware of the latter and has published an

article called " MONITORING OF LIVER ENZYMES IN PATIENTS

ON CHINESE MEDICINE " in the JOURNAL OF CHINESE MEDICINE NUMBER 62

FEBRUARY 2000. Please send me an email if you would like to read the

article.

 

I will let you know when Chris Dhaenens sends me a reply,

 

regards,

 

Tom.

 

 

[Guest guest]

Hi all! my first post.. Please look at PHARMACOLOGY AND APPLICATIONS

OF CHINESE MATERIA MEDICA edited by Hson-Mou Chang. Published by

World scientific press. It is two volumes and has the chemical

composition, pharmacology,toxicity ( usually LD50 in animals) and

clinical studies of individual chinese herbs. It also lists adverse

effects. The two volumes probably have info on about 200-300 herbs.

Many of the most commonly used herbs.

 

What is most unique about this book is that the index classifies the

herbs according to western medical functions! ie Gastrointestinal

smooth muscle stimulant, histamine releasing agent, diuretic,

coronary vasodilator etc.

 

each herb monograph has extensive references of studies so you can

see exactly where the information came from. I highly recommend it

 

aristolochic acid is unfortunately an old story here in california.

The Department of health services had listed a lot of herbs we

thought we were going to lose because close cousins are toxic.

Berberine, I think is the chemical that gives the huang(yellow) herbs

their color and they even put that on the list. luckily the ferver

died down and most herbs are still available. Better education will

help everyone. -kc

 

 

 

- In Chinese Medicine , Joyce Schwartz

<joyces wrote:

>

> Tom: In lieu of taking a course in toxicity of herbs, as well as

herb-drug interactions, could you possibly recommend some books that

would be helpful. I have the Chen & Chen Chinese Medical Herbology

and Pharmacology, as well as Bensky, but I would be interested in

reading more about the possibly side-effects, etc. of the formulas

that I am about to write for my patients (I hopefully will be

finishing my final exams within the month and receiving my degree in

Israel). Thank you.

> Joyce Schwartz

> -

> Tom Verhaeghe

> Chinese Medicine

> Saturday, July 22, 2006 12:15 PM

> Re: Chinese medicine gave man cancer

>

>

> Chinese Medicine , " Attilio

> D'Alberto " <attiliodalberto@> wrote:

> >

> > I just pulled up Bob's old message, thanks for pointing it out

Tom.

> >

> > Yes, Mu Tong is well known as a banned substance. It's been

banned

> for quite

> > a few years. The formula must of been imported directly from

China and

> > evaded customs. It just goes to show the lack of a strict

control on the

> > importing of patents into various western countries.

> >

> > I'll also keep a look out for other herbs that contain

aristolochic

> acid.

> >

> Atillio, I was trying to say that as practitioners, we should know

> immediately that aristolochic acids in long dan xie gan tang

should

> come from mu tong. You seem to have missed that point. Instead of

> acknodledging that you didn't think of mu tong you reply

with " Yes, Mu

> Tong is well known as a banned substance. It's been banned for

quite a

> few years. "

> Did you study Chinese herbs in your curriculum, Attilio? Every

Chinese

> herbal course should at least mention the dangers of toxicity.

Chris

> Dhaenens, a Belgian expert on toxicity laments the fact that only

few

> practitioners show an interest in his courses. He has had a lot

of his

> courses cancelled because of low attendance.

> On a European level, food supplements including Chinese herbs are

> being regulated. There is one vacancy to be filled: a pharmacology

> expert on Chinese herbs. There just is nobody to be found in

Europe

> who is an expert in both pharmacology and Chinese herbs. Actually

> there is one, a professor emeritus from Germany, but he's too

old. So

> what we have now is that a group of people, including many

> pharmacologists and MDs ( not one herbalist or acupuncturist) are

> making decisions about herb regulation. This could turn out very

bad

> for the whole profession. Herbs will be regarded as drugs.

>

> Tom.

 

[Guest guest]

There are also several books in Chinese that cover Chinese materia medica

pharmacology, but I find them hard to read.

I noticed that the book you mentioned is published by World Scientific

Press. Is it based mainly upon Chinese sources?

 

Tom.

 

 

----

 

asvassah

07/26/06 18:40:05

Chinese Medicine

Re: toxicity of herbs

 

Hi all! my first post.. Please look at PHARMACOLOGY AND APPLICATIONS

OF CHINESE MATERIA MEDICA edited by Hson-Mou Chang. Published by

World scientific press. It is two volumes and has the chemical

composition, pharmacology,toxicity ( usually LD50 in animals) and

clinical studies of individual chinese herbs. It also lists adverse

effects. The two volumes probably have info on about 200-300 herbs.

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