TCM causing hepatotoxicity in patients with chronic hepatitis B infection: a 1-year prospective study

October 6, 2006

If herbs cause serious problems then I'll be the first to decry them. The use of

adulterants

is especially horrendous. But all I read here is that out of the 45 patients

THAT ARE

ALREADY HOSPITALIZED 15 percent had taken TCM herbs. An extensive seach of

Chinese

and English publications reveals some sort of hepatoxicolical effects. One would

have to

look at the percentage of the entire Hong Kong HBV population are taking TCM

herbs.Without that I could read these results that Non-TCM patients are likely

to be

hospitalized at a 6 times the rates of TCM patients. And this is without the

other controls

of chronic alcohol use etc...

Tell me if I am wrong but this looks like a Ray Charles is God arguement.

Patient is

hospitalized, Patient uses TCM, TCM causes hospitalization.

doug

>

> Alon was referring to the following paper, just published:

>

> Yuen MF, Tam S, Fung J, Wong DK, Wong BC, Lai CL. Traditional Chinese

> medicine causing hepatotoxicity in patients with chronic hepatitis B

infection:

> a 1-year prospective study. Aliment Pharmacol Ther. 2006 Oct

> 15;24(8):1179-86. Dept of Medicine, Univ of Hong Kong, Queen Mary

> Hospital, Hong Kong. Background Safety of TCM in patients with chronic

> hepatitis B is unknown. Aim To study the clinical outcome of TCM-induced

> hepatotoxicity in chronic hepatitis B patients. Patients and methods All

> chronic hepatitis B patients in 2004 with liver dysfunction requiring

> hospitalization were screened prospectively for TCM intake. The

> hepatotoxicity of individual TCM elements was determined by extensive

> search of both English and Chinese publications. Results Of 45 chronic

> hepatitis B patients, the liver dysfunction in seven (15.6%) was attributable

> to TCM. All had liver dysfunction pattern resembling those of acute

> exacerbation of chronic hepatitis B. Three patients had adverse outcomes

> (two deaths, one liver transplantation). One patient had accelerated course

> of cirrhosis now awaiting liver transplantation. The identified hepatotoxic

> components were Polygonum multiflorum Thunb, Cassia obtusifolia L, Melia

> toosendan Sieb., Rheum palmatum L., Scolopendra subspinipes mutilans L,

> Alisma orientale Juzepe, Glycyrrhiza uralensis Fisch. and Mentha

> haplocalyx Briq. One TCM formula was adulterated with a highly

> hepatotoxic agent, N-nitrosofenfluramine. Conclusions TCM-related

> hepatotoxicity resulted in high mortality in chronic hepatitis B patients.

> Prospective randomized-controlled trials with the same stringent criteria as

> western medicine clinical trials are required for Chinese medicines, to

> document their efficacies and safety before they can be advocated for the

> treatment of patients. PMID: 17014576 [PubMed - in process]

>

> IMO, this is a body-blow to TCM herbalism in patients with chronic virus-B

> hepatitis. It will be a major reference used by Quackbusters in support of

> their attempts to have TCM banned in the west, pending massive research.

>

> It is doubly damaging because it is reported by a CHINESE TEAM from

> University of Hongkong.

>

> Those who may wish to respond to that paper would need study the full text

> carefully and dig deep to see what other medications were used in the

> patients studied.

>

> They also should examine in detail the rationale WHEREBY the named

> herbs were shortlisted as the " identified hepatotoxic components " , whereas

> other supplements, nutrients or western drugs were eliminated as

> predisposing or triggering causes of hepatotoxicity.

>

> In the past, similar papers, for example on Kava, conveniently neglected to

> put equal blame for morbidity/mortality on alcoholism and a concurrent

> medication with WMs that can hit liver hard.

>

> If FDA and EU Drug Licensing Authorities accept the validity of the

> conclusions, we can expect to see suggestions that warnings against the

> use of the following herbs will be issued, at least for patients with chronic

> liver disease:

>

> Bohe-Mentha haplocalyx

> Chuanlianzi-Melia toosendan

> Dahuang-Rheum palmatum

> Gancao-Glycyrrhiza uralensis

> Heshouwu/Yejiaoteng-Polygonum multiflorum

> Juemingzi-Cassia obtusifolia OR

> Wugong-Scolopendra subspinipes mutilans

> Zexie-Alisma orientale

>

> In TCM, Bohe is used to Course LV & Rectify Qi [

> http://www.itmonline.org/5organs/liver.htm and

> http://www.herbasin.com/database/bohe.htm ] and has LV-protective effects

> [

> http://content.nhiondemand.com/moh/media/TCMH1.asp?objID=100717 & ct

> ype=tcmh ];

>

> Chuanlianzi is used to Course LV & Rectify Qi [

> http://www.itmonline.org/5organs/liver.htm ] but has toxic alkaloid; Caution:

> TOXIC; Effective dose is very close to TOXIC dose; 5-6 pieces of Fr can

> kill; Children taking 0.3-0.4g had TOXIC reactions; 2-4g caused death;

> avoid overdose/prolonged use; CI in KI/LV disease; CI in SJM-SP-ST Xu &

> Cold

>

> Dahuang: Bitter; Cold; LV; SJM-SP-ST; LI; Class: Purge~Drain Down;

> Purge vigorously; Purge~Drain Down; Drain Heat; Clear Heat; Resolve

> Toxin; Purge Fire; Purge SJU/LU Fire (Drain Fire through LI in SJL); Clear

> Damp Heat; Purge Icterus; Clear ST-SI-LI Phlegm Heat; Purge

> Accumulation; Purge Stas; Resolve Stas; Aid Defecation; Quicken Xue~Aid

> Circulation; Disperse Xue Stas; Clear Head; Antivirus; Topical for burns,

> carbuncles, suppurative skin diseases; Used in Heat/ST-SI-LI Heat

> Accumulation w constipation; Xue Heat w bleeding; Fire Uprising w eyes-

> red, headache, pharyngitis, swelling & pain of gums; Xue Stas, incl

> amenorrhoea, abdomen mass/trauma; Damp Heat w icterus & Heat Lin;

> Heat Toxin w sores & carbuncles; burns & scalds; Damp Heat w dysentery,

> abdomen pain; Xue Heat w fever, constipation & abdomen fullness,

> haematemesis & Epistaxis; dysmenorrhoea & amenorrhoea; icterus~acute,

> appendicitis~acute, intestinal obstruction; Large dose/sensitive subjects

> show faeces-loose/abdomen cramp w diarrhoea; long-term use of emodin-

> containing Hbs can cause colon to darken; Caution in Exterior Patterns; Qi

> & Xue Xu; Cold dt SJM-SP-ST Xu; CI in menstruation/postpartum; CI in

> pregnancy

>

> Gancao: sweet, neutral; all 12 Channels & organs, esp HT; LU; SJM-SP-

> ST; Glycyrrhizin & other actives of Gancao influence paeoniflorin activity on

> muscles; Gancao triterpenes are metabolized to molecules that have similar

> structure to adrenal cortex hormones ( used in vitaligo); this may be basis of

> its Antiinflammatory action; Class: Tonic~Tone Qi; Tonic~Tone Qi

> (Zhigancao is stronger); Replenish Qi; Tone SP; Tone & Build SJM-SP-ST

> Qi, esp SP Qi; Moderate Hb Actions; Harmonise/Neutralise strong

> (purgative, TOXIC) Hbs; Moisten LU; demulcent; Ease Cough; Antitussive;

> expectorant; Resolve Damp/Phlegm; Clear Fire; Resolve Toxin; Antipyretic;

> Relax Spasm; Antispasmodic, laxative~mild; Ease Pain; Antiinflammatory;

> Antistress~adrenal agent; Used in Shi Patterns; HT Qi Xu w pulse-knotted;

> cramp discomfort; infertility, colic, bronchial catarrh, bronchitis, gastritis

-

> chronic, peptic ulcer, adrenocortical insufficiency, Addison's disease;

> weakness (Qi Xu), sore throat, boils, asthma, Qi-Xue Xu; peptic ulcer,

> empty SJM-SP-ST, colic acute abdomen pains; Prolonged overuse may

> cause oedema; CI in Damp Shi w chest & abdomen distension & fullness

> /emesis; Gancao counteracts Daji (Peking Spurge Rx), Yuanhua, Gansui &

> Haizao

>

> Heshouwu is used to Moisten LV & Tone Yin [

> http://www.itmonline.org/5organs/liver.htm ]: May cause faeces-loose;

> NOTE: there are two case reports of LV reaction when taking Shouwupian,

> a preparation of this herb; CI in Diarrhoea & Accumulation of Phlegm Damp,

> esp when dt SP Xu

>

> Juemingzi: Sweet; Bitter; salty; Cold-slightly; LV; LI; Class: Calm LV; Calm

> Yang; Calm Wind ~Interior; Purge Fire; Clear Heat; Clear LV Heat; Clear

> Wind Heat; Ease Tremor; Brighten Eyes; laxative - safe natural-acting;

> Moisten LI; Ease Defecation; Aid Defecation; Anticholesterol; Dose: 10-15g;

> Yin Xu w vision weak; LV Heat/Wind Heat w eye congestion, swelling &

> pain, photophobia & lacrimation-profuse; LV Heat/LV Yang Uprising w

> headache, hypertension & dizziness, vision-blurred; eye problems, eye

> soreness & photophobia, eye inflammation~acute & lacrimation; SI-LI Heat

> Accumulation/SI-LI Dryness w constipation; Allergy; Large doses may cause

> diarrhoea; Caution/CI: Diarrhoea; Hypotension

>

> Wugong is used to (1) Calm LV; Calm Wind~Interior; Ease Spasm; Ease

> Convulsion; Antispasm; Dispel Stas; Resolve Toxin; (2) Free Channels &

> Collaterals; Ease Pain, esp headache-stubborn; Dispel Channel Wind

> Phlegm; (3) Resolve Toxin & Disperse Nodules; Disperse concretions;

> TOXIC; Avoid overdose; CI in pregnancy

>

> Zexie: Sweet, Bland (No Taste); Cold; KI; BL; Diuretic; Expel Damp; Drain

> Damp; Release Water; Transform Damp; Aid Water Metabolism; Clear

> Heat; Drain Heat; Purge Fire; Disperse Swelling; Dose: 5-10g; Used in

> Damp w Water Retention, urination-infrequent, oedema, limb-oedema,

> dizziness; Phlegm & Fluids Retention w dizziness, vertigo, palpitation &

> cough; Heat Lin w dysuria, urine~turbid, burning sensation +/- haematuria;

> diarrhoea; Damp Heat in abdomen-lower, like diarrhoea &

> leukorrhoea~profuse; KI Yin Xu w Fire Agitation; thirst, abdomen bloating,

> urinary calculi, diabetic Pattern (Zexie + Fuling, Zhuling & Baizhu in Wuling

> San) ; Prolonged use of large doses can irritate ST & SI-LI; CI in SJL Damp

> /abdomen-lower Patterns dt KI Yang Xu/Damp Cold w

> spermatorrhoea/leukorrhoea

>

> Expect incoming missiles! It is time to grab our helmets and flak-jackets &

> head for the bunker!

>

> Best regards,

>

October 6, 2006

Phil-

In the paper they list those herbal constituents as being " known

hepatotoxins " without any reference. Any idea why they would list them

as such? Is it just that the patients were taking them at the time?

Or is it that they are listed as such in some text that I do not have?

Thanks.

-Steve

On Oct 6, 2006, at 5:31 PM, wrote:

> Hi All, & Alon,

>

> Alon wrote:

> > What are we to make out of this

>

> Alon was referring to the following paper, just published:

>

> Yuen MF, Tam S, Fung J, Wong DK, Wong BC, Lai CL. Traditional Chinese

> medicine causing hepatotoxicity in patients with chronic hepatitis B

> infection:

> a 1-year prospective study. Aliment Pharmacol Ther. 2006 Oct

> 15;24(8):1179-86. Dept of Medicine, Univ of Hong Kong, Queen Mary

> Hospital, Hong Kong. Background Safety of TCM in patients with chronic

> hepatitis B is unknown. Aim To study the clinical outcome of

> TCM-induced

> hepatotoxicity in chronic hepatitis B patients. Patients and methods

> All

> chronic hepatitis B patients in 2004 with liver dysfunction requiring

> hospitalization were screened prospectively for TCM intake. The

> hepatotoxicity of individual TCM elements was determined by extensive

> search of both English and Chinese publications. Results Of 45 chronic

> hepatitis B patients, the liver dysfunction in seven (15.6%) was

> attributable

> to TCM. All had liver dysfunction pattern resembling those of acute

> exacerbation of chronic hepatitis B. Three patients had adverse

> outcomes

> (two deaths, one liver transplantation). One patient had accelerated

> course

> of cirrhosis now awaiting liver transplantation. The identified

> hepatotoxic

> components were Polygonum multiflorum Thunb, Cassia obtusifolia L,

> Melia

> toosendan Sieb., Rheum palmatum L., Scolopendra subspinipes mutilans

> L,

> Alisma orientale Juzepe, Glycyrrhiza uralensis Fisch. and Mentha

> haplocalyx Briq. One TCM formula was adulterated with a highly

> hepatotoxic agent, N-nitrosofenfluramine. Conclusions TCM-related

> hepatotoxicity resulted in high mortality in chronic hepatitis B

> patients.

> Prospective randomized-controlled trials with the same stringent

> criteria as

> western medicine clinical trials are required for Chinese medicines,

> to

> document their efficacies and safety before they can be advocated for

> the

> treatment of patients. PMID: 17014576 [PubMed - in process]

>

> IMO, this is a body-blow to TCM herbalism in patients with chronic

> virus-B

> hepatitis. It will be a major reference used by Quackbusters in

> support of

> their attempts to have TCM banned in the west, pending massive

> research.

>

> It is doubly damaging because it is reported by a CHINESE TEAM from

> University of Hongkong.

>

> Those who may wish to respond to that paper would need study the full

> text

> carefully and dig deep to see what other medications were used in the

> patients studied.

>

> They also should examine in detail the rationale WHEREBY the named

> herbs were shortlisted as the " identified hepatotoxic components " ,

> whereas

> other supplements, nutrients or western drugs were eliminated as

> predisposing or triggering causes of hepatotoxicity.

>

> In the past, similar papers, for example on Kava, conveniently

> neglected to

> put equal blame for morbidity/mortality on alcoholism and a concurrent

> medication with WMs that can hit liver hard.

>

> If FDA and EU Drug Licensing Authorities accept the validity of the

> conclusions, we can expect to see suggestions that warnings against

> the

> use of the following herbs will be issued, at least for patients with

> chronic

> liver disease:

>

> Bohe-Mentha haplocalyx

> Chuanlianzi-Melia toosendan

> Dahuang-Rheum palmatum

> Gancao-Glycyrrhiza uralensis

> Heshouwu/Yejiaoteng-Polygonum multiflorum

> Juemingzi-Cassia obtusifolia OR

> Wugong-Scolopendra subspinipes mutilans

> Zexie-Alisma orientale

>

> In TCM, Bohe is used to Course LV & Rectify Qi [

> http://www.itmonline.org/5organs/liver.htm and

> http://www.herbasin.com/database/bohe.htm ] and has LV-protective

> effects

> [

> http://content.nhiondemand.com/moh/media/TCMH1.asp?objID=100717 & ct

> ype=tcmh ];

>

> Chuanlianzi is used to Course LV & Rectify Qi [

> http://www.itmonline.org/5organs/liver.htm ] but has toxic alkaloid;

> Caution:

> TOXIC; Effective dose is very close to TOXIC dose; 5-6 pieces of Fr

> can

> kill; Children taking 0.3-0.4g had TOXIC reactions; 2-4g caused death;

> avoid overdose/prolonged use; CI in KI/LV disease; CI in SJM-SP-ST Xu

> &

> Cold

>

> Dahuang: Bitter; Cold; LV; SJM-SP-ST; LI; Class: Purge~Drain Down;

> Purge vigorously; Purge~Drain Down; Drain Heat; Clear Heat; Resolve

> Toxin; Purge Fire; Purge SJU/LU Fire (Drain Fire through LI in SJL);

> Clear

> Damp Heat; Purge Icterus; Clear ST-SI-LI Phlegm Heat; Purge

> Accumulation; Purge Stas; Resolve Stas; Aid Defecation; Quicken

> Xue~Aid

> Circulation; Disperse Xue Stas; Clear Head; Antivirus; Topical for

> burns,

> carbuncles, suppurative skin diseases; Used in Heat/ST-SI-LI Heat

> Accumulation w constipation; Xue Heat w bleeding; Fire Uprising w

> eyes-

> red, headache, pharyngitis, swelling & pain of gums; Xue Stas, incl

> amenorrhoea, abdomen mass/trauma; Damp Heat w icterus & Heat Lin;

> Heat Toxin w sores & carbuncles; burns & scalds; Damp Heat w

> dysentery,

> abdomen pain; Xue Heat w fever, constipation & abdomen fullness,

> haematemesis & Epistaxis; dysmenorrhoea & amenorrhoea; icterus~acute,

> appendicitis~acute, intestinal obstruction; Large dose/sensitive

> subjects

> show faeces-loose/abdomen cramp w diarrhoea; long-term use of emodin-

> containing Hbs can cause colon to darken; Caution in Exterior

> Patterns; Qi

> & Xue Xu; Cold dt SJM-SP-ST Xu; CI in menstruation/postpartum; CI in

> pregnancy

>

> Gancao: sweet, neutral; all 12 Channels & organs, esp HT; LU; SJM-SP-

> ST; Glycyrrhizin & other actives of Gancao influence paeoniflorin

> activity on

> muscles; Gancao triterpenes are metabolized to molecules that have

> similar

> structure to adrenal cortex hormones ( used in vitaligo); this may be

> basis of

> its Antiinflammatory action; Class: Tonic~Tone Qi; Tonic~Tone Qi

> (Zhigancao is stronger); Replenish Qi; Tone SP; Tone & Build SJM-SP-ST

> Qi, esp SP Qi; Moderate Hb Actions; Harmonise/Neutralise strong

> (purgative, TOXIC) Hbs; Moisten LU; demulcent; Ease Cough;

> Antitussive;

> expectorant; Resolve Damp/Phlegm; Clear Fire; Resolve Toxin;

> Antipyretic;

> Relax Spasm; Antispasmodic, laxative~mild; Ease Pain;

> Antiinflammatory;

> Antistress~adrenal agent; Used in Shi Patterns; HT Qi Xu w

> pulse-knotted;

> cramp discomfort; infertility, colic, bronchial catarrh, bronchitis,

> gastritis -

> chronic, peptic ulcer, adrenocortical insufficiency, Addison's

> disease;

> weakness (Qi Xu), sore throat, boils, asthma, Qi-Xue Xu; peptic ulcer,

> empty SJM-SP-ST, colic acute abdomen pains; Prolonged overuse may

> cause oedema; CI in Damp Shi w chest & abdomen distension & fullness

> /emesis; Gancao counteracts Daji (Peking Spurge Rx), Yuanhua, Gansui &

> Haizao

>

> Heshouwu is used to Moisten LV & Tone Yin [

> http://www.itmonline.org/5organs/liver.htm ]: May cause faeces-loose;

> NOTE: there are two case reports of LV reaction when taking

> Shouwupian,

> a preparation of this herb; CI in Diarrhoea & Accumulation of Phlegm

> Damp,

> esp when dt SP Xu

>

> Juemingzi: Sweet; Bitter; salty; Cold-slightly; LV; LI; Class: Calm

> LV; Calm

> Yang; Calm Wind ~Interior; Purge Fire; Clear Heat; Clear LV Heat;

> Clear

> Wind Heat; Ease Tremor; Brighten Eyes; laxative - safe natural-acting;

> Moisten LI; Ease Defecation; Aid Defecation; Anticholesterol; Dose:

> 10-15g;

> Yin Xu w vision weak; LV Heat/Wind Heat w eye congestion, swelling &

> pain, photophobia & lacrimation-profuse; LV Heat/LV Yang Uprising w

> headache, hypertension & dizziness, vision-blurred; eye problems, eye

> soreness & photophobia, eye inflammation~acute & lacrimation; SI-LI

> Heat

> Accumulation/SI-LI Dryness w constipation; Allergy; Large doses may

> cause

> diarrhoea; Caution/CI: Diarrhoea; Hypotension

>

> Wugong is used to (1) Calm LV; Calm Wind~Interior; Ease Spasm; Ease

> Convulsion; Antispasm; Dispel Stas; Resolve Toxin; (2) Free Channels &

> Collaterals; Ease Pain, esp headache-stubborn; Dispel Channel Wind

> Phlegm; (3) Resolve Toxin & Disperse Nodules; Disperse concretions;

> TOXIC; Avoid overdose; CI in pregnancy

>

> Zexie: Sweet, Bland (No Taste); Cold; KI; BL; Diuretic; Expel Damp;

> Drain

> Damp; Release Water; Transform Damp; Aid Water Metabolism; Clear

> Heat; Drain Heat; Purge Fire; Disperse Swelling; Dose: 5-10g; Used in

> Damp w Water Retention, urination-infrequent, oedema, limb-oedema,

> dizziness; Phlegm & Fluids Retention w dizziness, vertigo,

> palpitation &

> cough; Heat Lin w dysuria, urine~turbid, burning sensation +/-

> haematuria;

> diarrhoea; Damp Heat in abdomen-lower, like diarrhoea &

> leukorrhoea~profuse; KI Yin Xu w Fire Agitation; thirst, abdomen

> bloating,

> urinary calculi, diabetic Pattern (Zexie + Fuling, Zhuling & Baizhu

> in Wuling

> San) ; Prolonged use of large doses can irritate ST & SI-LI; CI in

> SJL Damp

> /abdomen-lower Patterns dt KI Yang Xu/Damp Cold w

> spermatorrhoea/leukorrhoea

>

> Expect incoming missiles! It is time to grab our helmets and

> flak-jackets &

> head for the bunker!

>

> Best regards,

>

October 6, 2006

Hi All, & Alon,

Alon wrote:

> What are we to make out of this

Alon was referring to the following paper, just published:

Yuen MF, Tam S, Fung J, Wong DK, Wong BC, Lai CL. Traditional Chinese

medicine causing hepatotoxicity in patients with chronic hepatitis B infection:

a 1-year prospective study. Aliment Pharmacol Ther. 2006 Oct

15;24(8):1179-86. Dept of Medicine, Univ of Hong Kong, Queen Mary

Hospital, Hong Kong. Background Safety of TCM in patients with chronic

hepatitis B is unknown. Aim To study the clinical outcome of TCM-induced

hepatotoxicity in chronic hepatitis B patients. Patients and methods All

chronic hepatitis B patients in 2004 with liver dysfunction requiring

hospitalization were screened prospectively for TCM intake. The

hepatotoxicity of individual TCM elements was determined by extensive

search of both English and Chinese publications. Results Of 45 chronic

hepatitis B patients, the liver dysfunction in seven (15.6%) was attributable

to TCM. All had liver dysfunction pattern resembling those of acute

exacerbation of chronic hepatitis B. Three patients had adverse outcomes

(two deaths, one liver transplantation). One patient had accelerated course

of cirrhosis now awaiting liver transplantation. The identified hepatotoxic

components were Polygonum multiflorum Thunb, Cassia obtusifolia L, Melia

toosendan Sieb., Rheum palmatum L., Scolopendra subspinipes mutilans L,

Alisma orientale Juzepe, Glycyrrhiza uralensis Fisch. and Mentha

haplocalyx Briq. One TCM formula was adulterated with a highly

hepatotoxic agent, N-nitrosofenfluramine. Conclusions TCM-related

hepatotoxicity resulted in high mortality in chronic hepatitis B patients.

Prospective randomized-controlled trials with the same stringent criteria as

western medicine clinical trials are required for Chinese medicines, to

document their efficacies and safety before they can be advocated for the

treatment of patients. PMID: 17014576 [PubMed - in process]

IMO, this is a body-blow to TCM herbalism in patients with chronic virus-B

hepatitis. It will be a major reference used by Quackbusters in support of

their attempts to have TCM banned in the west, pending massive research.

It is doubly damaging because it is reported by a CHINESE TEAM from

University of Hongkong.

Those who may wish to respond to that paper would need study the full text

carefully and dig deep to see what other medications were used in the

patients studied.

They also should examine in detail the rationale WHEREBY the named

herbs were shortlisted as the " identified hepatotoxic components " , whereas

other supplements, nutrients or western drugs were eliminated as

predisposing or triggering causes of hepatotoxicity.

In the past, similar papers, for example on Kava, conveniently neglected to

put equal blame for morbidity/mortality on alcoholism and a concurrent

medication with WMs that can hit liver hard.

If FDA and EU Drug Licensing Authorities accept the validity of the

conclusions, we can expect to see suggestions that warnings against the

use of the following herbs will be issued, at least for patients with chronic

liver disease:

Bohe-Mentha haplocalyx

Chuanlianzi-Melia toosendan

Dahuang-Rheum palmatum

Gancao-Glycyrrhiza uralensis

Heshouwu/Yejiaoteng-Polygonum multiflorum

Juemingzi-Cassia obtusifolia OR

Wugong-Scolopendra subspinipes mutilans

Zexie-Alisma orientale

In TCM, Bohe is used to Course LV & Rectify Qi [

http://www.itmonline.org/5organs/liver.htm and

http://www.herbasin.com/database/bohe.htm ] and has LV-protective effects

[

http://content.nhiondemand.com/moh/media/TCMH1.asp?objID=100717 & ct

ype=tcmh ];

Chuanlianzi is used to Course LV & Rectify Qi [

http://www.itmonline.org/5organs/liver.htm ] but has toxic alkaloid; Caution:

TOXIC; Effective dose is very close to TOXIC dose; 5-6 pieces of Fr can

kill; Children taking 0.3-0.4g had TOXIC reactions; 2-4g caused death;

avoid overdose/prolonged use; CI in KI/LV disease; CI in SJM-SP-ST Xu &

Cold

Dahuang: Bitter; Cold; LV; SJM-SP-ST; LI; Class: Purge~Drain Down;

Purge vigorously; Purge~Drain Down; Drain Heat; Clear Heat; Resolve

Toxin; Purge Fire; Purge SJU/LU Fire (Drain Fire through LI in SJL); Clear

Damp Heat; Purge Icterus; Clear ST-SI-LI Phlegm Heat; Purge

Accumulation; Purge Stas; Resolve Stas; Aid Defecation; Quicken Xue~Aid

Circulation; Disperse Xue Stas; Clear Head; Antivirus; Topical for burns,

carbuncles, suppurative skin diseases; Used in Heat/ST-SI-LI Heat

Accumulation w constipation; Xue Heat w bleeding; Fire Uprising w eyes-

red, headache, pharyngitis, swelling & pain of gums; Xue Stas, incl

amenorrhoea, abdomen mass/trauma; Damp Heat w icterus & Heat Lin;

Heat Toxin w sores & carbuncles; burns & scalds; Damp Heat w dysentery,

abdomen pain; Xue Heat w fever, constipation & abdomen fullness,

haematemesis & Epistaxis; dysmenorrhoea & amenorrhoea; icterus~acute,

appendicitis~acute, intestinal obstruction; Large dose/sensitive subjects

show faeces-loose/abdomen cramp w diarrhoea; long-term use of emodin-

containing Hbs can cause colon to darken; Caution in Exterior Patterns; Qi

& Xue Xu; Cold dt SJM-SP-ST Xu; CI in menstruation/postpartum; CI in

pregnancy

Gancao: sweet, neutral; all 12 Channels & organs, esp HT; LU; SJM-SP-

ST; Glycyrrhizin & other actives of Gancao influence paeoniflorin activity on

muscles; Gancao triterpenes are metabolized to molecules that have similar

structure to adrenal cortex hormones ( used in vitaligo); this may be basis of

its Antiinflammatory action; Class: Tonic~Tone Qi; Tonic~Tone Qi

(Zhigancao is stronger); Replenish Qi; Tone SP; Tone & Build SJM-SP-ST

Qi, esp SP Qi; Moderate Hb Actions; Harmonise/Neutralise strong

(purgative, TOXIC) Hbs; Moisten LU; demulcent; Ease Cough; Antitussive;

expectorant; Resolve Damp/Phlegm; Clear Fire; Resolve Toxin; Antipyretic;

Relax Spasm; Antispasmodic, laxative~mild; Ease Pain; Antiinflammatory;

Antistress~adrenal agent; Used in Shi Patterns; HT Qi Xu w pulse-knotted;

cramp discomfort; infertility, colic, bronchial catarrh, bronchitis, gastritis -

chronic, peptic ulcer, adrenocortical insufficiency, Addison's disease;

weakness (Qi Xu), sore throat, boils, asthma, Qi-Xue Xu; peptic ulcer,

empty SJM-SP-ST, colic acute abdomen pains; Prolonged overuse may

cause oedema; CI in Damp Shi w chest & abdomen distension & fullness

/emesis; Gancao counteracts Daji (Peking Spurge Rx), Yuanhua, Gansui &

Haizao

Heshouwu is used to Moisten LV & Tone Yin [

http://www.itmonline.org/5organs/liver.htm ]: May cause faeces-loose;

NOTE: there are two case reports of LV reaction when taking Shouwupian,

a preparation of this herb; CI in Diarrhoea & Accumulation of Phlegm Damp,

esp when dt SP Xu

Juemingzi: Sweet; Bitter; salty; Cold-slightly; LV; LI; Class: Calm LV; Calm

Yang; Calm Wind ~Interior; Purge Fire; Clear Heat; Clear LV Heat; Clear

Wind Heat; Ease Tremor; Brighten Eyes; laxative - safe natural-acting;

Moisten LI; Ease Defecation; Aid Defecation; Anticholesterol; Dose: 10-15g;

Yin Xu w vision weak; LV Heat/Wind Heat w eye congestion, swelling &

pain, photophobia & lacrimation-profuse; LV Heat/LV Yang Uprising w

headache, hypertension & dizziness, vision-blurred; eye problems, eye

soreness & photophobia, eye inflammation~acute & lacrimation; SI-LI Heat

Accumulation/SI-LI Dryness w constipation; Allergy; Large doses may cause

diarrhoea; Caution/CI: Diarrhoea; Hypotension

Wugong is used to (1) Calm LV; Calm Wind~Interior; Ease Spasm; Ease

Convulsion; Antispasm; Dispel Stas; Resolve Toxin; (2) Free Channels &

Collaterals; Ease Pain, esp headache-stubborn; Dispel Channel Wind

Phlegm; (3) Resolve Toxin & Disperse Nodules; Disperse concretions;

TOXIC; Avoid overdose; CI in pregnancy

Zexie: Sweet, Bland (No Taste); Cold; KI; BL; Diuretic; Expel Damp; Drain

Damp; Release Water; Transform Damp; Aid Water Metabolism; Clear

Heat; Drain Heat; Purge Fire; Disperse Swelling; Dose: 5-10g; Used in

Damp w Water Retention, urination-infrequent, oedema, limb-oedema,

dizziness; Phlegm & Fluids Retention w dizziness, vertigo, palpitation &

cough; Heat Lin w dysuria, urine~turbid, burning sensation +/- haematuria;

diarrhoea; Damp Heat in abdomen-lower, like diarrhoea &

leukorrhoea~profuse; KI Yin Xu w Fire Agitation; thirst, abdomen bloating,

urinary calculi, diabetic Pattern (Zexie + Fuling, Zhuling & Baizhu in Wuling

San) ; Prolonged use of large doses can irritate ST & SI-LI; CI in SJL Damp

/abdomen-lower Patterns dt KI Yang Xu/Damp Cold w

spermatorrhoea/leukorrhoea

Expect incoming missiles! It is time to grab our helmets and flak-jackets &

head for the bunker!

Best regards,

October 7, 2006

I would like to read the entire paper but from the abstract I can see a faulty

connect the

dots arguement here. Patients are hospitalized as a result of chronic Hep B.

Some of the

took TCM herbs. The researchers find studies that says some ingredients are

hepatoxic. -

Now, this is up to debate, most of the herbs here are standard in TCM HepB

formulas- the

researchers then say that TCM herbs because they are hepatoxic cause the decline

in

health of these patients. As I pointed out in the CHA list, one could also say

in just as big a

generalization that non-TCM users are hospitalized at a 6 times the number of

TCM users.

Of course, the use of adulterants in formulas - one case- is abhorrant and

should be

investigated.

doug eisenstark

Chinese Medicine , " "

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wrote: