R: BANXIA / Pinellia as an hepatotoxin?

[Guest guest]

Gabriele,

 

Where did you get this information that Ban Xia contains thujone?

 

It definitely contains calcium oxylate, which is a major irritant to mucus

membranes. According to a Chinese study, when it is processed in alum, the

oxylate crystals lose their sharp edges.

 

- Bill Schoenbart

 

 

 

 

Chinese Medicine , " "

<saudelligabriele wrote:

>

> Dear Phil, Ban Xia tosicity is due to Thuyone, one of the components of

> thuya perennis; remember, too, that Sheng Jang, Zingiber rhiz. recens, fresh

> ginger, is the most important antidote to Ban Xia; hence, MTC well knows its

> toxicity; maybe some patient is more sensitive to it.

> My best regards,

>

>

> _____

>

> Da: Chinese Medicine

> Chinese Medicine Per conto di Phil

> Rogers

> Inviato: mercoledì 2 dicembre 2009 7.47

> A: VBMA; traditional_Chinese_Medicine ;

>

> Oggetto: Re: BANXIA / Pinellia as an hepatotoxin?

>

>

>

>

> Hi All, & Aloha Ihor,

>

> Aiba T,* Takahashi T,* Suzuki K,* Okoshi S,* Nomoto M,* Uno K + & Aoyagi

> Y* (2007) CASE REPORT: Liver injury induced by a Japanese herbal

> medicine, Sairei-to (TJ-114, Bupleurum and Hoelen Combination, Chai-Ling-

> Tang). Journal of Gastroenterology and Hepatology 22(5):762-763. *Div of

> Gastroenterology & Hepatology, Graduate School of Med & Dental Sci,

> Niigata Univ, and + Dept of Pharmacy, Suibarago Hospital, Niigata, Japan.

> Contact: Dr Toru Takahashi, Div of Gastroenterology & Hepatology,

> Nagaoka Red Cross Hospital, 297-1, Terashimacho, Nagaoka 940-2085,

> Niigata, Japan. torutoru (AT) nagaoka (DOT) <torutoru%40nagaoka.jrc.or.jp>

> jrc.or.jp A man showed acute hepatitis

> with jaundice after taking a Japanese herbal medicine, Sairei-to (TJ-114,

> Bupleurum and Hoelen Combination, Chai-Ling-Tang). Unusually, the

> component thought to be responsible for the observed drug-induced liver

> injury was identified. Lymphocyte migration inhibition testing indicated

> that

> the tuber of the perennial herbage Pinellia ternate was the causative agent.

>

>

> Apart from that paper, I can find no hits on Medline for BANXIA / Pinellia

> as

> a hepatotoxin.

>

> However, another paper (Hsu et al, below) reported acute hepatitis in 1

> patient taking XIAOCHAIHU TANG (Japanese: Syo-Saiko-To).

>

> Hsu L, Huang Y, Tsay S, Chang F & Lee S (2006) Acute Hepatitis Induced

> by Chinese Hepatoprotective Herb, XIAOCHAIHU TANG. Journal of the

> Chinese Medical Association 69(2): 86-88. XIAOCHAIHU TANG (Japanese:

> Syo-Saiko-To) is a herbal remedy widely used in China to treat respiratory,

> hepatobiliary, and gastrointestinal diseases, particularly among patients w

> chronic liver disease. However, its safety has been challenged recently. We

> report a Chinese patient w acute hepatitis induced by XCT. A 52-year-old

> woman presented w weakness, fatigue, and tea-colored urine after continual

> consumption of XCT for 1.5 months. Lab studies disclosed acute hepatitis

> even though all of the viral hepatitis markers were negative. Liver biopsy

> also revealed acute hepatocellular hepatitis. The symptoms improved after

> discontinuing XCT, and liver biochemical tests normalized 2 months later.

> The case report reminds us of the probable adverse drug reaction of herbs,

> even in some that are claimed to have hepatoprotective effects.

>

> Phil's Notes:

> Note that CHAILING TANG + XIAOCHAIHU TANG contain BANXIA; they

> also contain 6 other Meds in common: Chaihu, Dangshen / Renshen,

> Dazao; Gancao / Zhigancao; Huangqin; Shengjiang.

> IMO, none of the latter Meds would be hepatotoxic at normal doses.

>

> IMO, because BANXIA is used widely in Chinese + Kampo Med, and

> because there are so few reports in medical journals of BANXIA

> hepatotoxicity, we can conclude that it is GRAS (generally regarded as

> safe).

>

> However, we might be wise to omit BANXIA (or reduce its inclusion rate) in

> patients in which we suspect pre-existing LV damage. Also, we should

> ensure that we AVOID using RAW BANXIA (viz, use ONLY the

> PROCESSED form).

>

> TCMAssistant [ www.tcmassistant.com/ ] says:

> CHAILING TANG; Bupleurum + Poria / Hoelen Dec;

> Class: Dispel Damp; Subclass: Diuretic;

>

> Chaihu (Rx Bupleuri) 13.00 %

> BANXIA (Rz Pinelliae Ternatae) 11.00 %

> Shengjiang (Rz Zingiberis Officinalis Recens) 11.00 %

> Zexie (Rz Alismatis Orientalis) 11.00 %

> Fuling (Sclerotium Poriae Cocos) 7.00 %

> Zhuling (Sclerotium Polypori Umbellati) 7.00 %

> Baizhu (Rz Atractylodis Macrocephalae) 7.00 %

> Guizhi (Rml Cinnamomi Cassiae) 7.00 %

> Renshen (Rx Ginseng) 7.00 %

> Huangqin (Rx Scutellariae Baicalensis) 7.00 %

> Dazao (Fr Jujubae) 7.00 %

> Zhigancao (Rx Glycyrrhizae Uralensis) 5.00 %

>

> Dec: 60-70 g/L; simmer down to 400mL; take ??mL TID-QID;

> Actions: Diuretic; Harmonise SJM

> Indications: digestive disorders w injury to Body Fluids dt Exterior

> disorders~

> persistent; SSs: acute gastroenteritis; diarrhoea; BL disorders; dysuria;

> nephritis; oedema; thirst; LV disorders; infectious disease in summer;

>

> Bob Flaws - http://tinyurl. <http://tinyurl.com/yzb9tg8> com/yzb9tg8 - says:

> XIAOCHAIHU TANG (Minor Bupleurum Dec) & Digestive Ulcers: 80 cases

> of digestive ulcers, all diagnosed by gastroscopy + all positive for

> Heliobacter pylori, were studied; patients had digestive ulcers for 0.5-1

> years; main SSs included ST duct tension + pain, distension, oppression +

> discomfort, burping/belching, acid eructation, HT Vexation, dry mouth w

> bitter taste, torpid intake, depression + oppression w predilection to

> sighing;

> Tx method: XIAOCHAIHU TANG:

> Chaihu (Rx Bupleuri) 15g,

> Huangqin (Rx Scutellariae) 12g,

> Shengjiang (raw Rz Zingiberis) 6g,

> BANXIA (Rz Pinelliae) 12g,

> Dangshen (Rx Codonopsis) 12g,

> Dazao (Fr Jujubae) 12g,

> Gancao (Rx Glycyrrhizae) 3g;

> Chaihu + Huangqin: Course + Resolve LV-GB Yu Heat;

> Shengjiang + BANXIA: Harmonise ST + Descend Counterflow;

> Renshen, Gancao + Dazao: Boost SP + Tone Xu;

> Dec 1 packet; divide into 2 parts + take 1 part orally on empty ST, BID, for

>

> 15d / Tx course, for 5 continuous courses;

> Formula acts to Course LV, Free SP + Cholagogue (Free GB), Rectify +

> Harmonise SJM-SP-ST; thus these Meds and the Pattern correspond; thus

> Tx effects are good

>

> Indications: digestive ulcers mostly present as SJM-SP-ST Xu Pattern dt

> enduring disease w emotional stress, oppression + unhappiness. Thus, it

> relates to LV-GB Qiyu + LV Qi Not Coursing; then Wood Yu attacks Earth

> (SJM-SP-ST), SP loses its fortification + movement, while Earth loses its

> harmony + downbearing;

>

> Modifications (Additions + Subtractions):

> for rib-side distension + pain~ bilateral / pain radiating to loin / back~

> upper,

> add Chuanlianzi (Fr Toosendan) 10g + Yanhusuo (Rz Corydalis) 10g;

> for depression + oppression w predilection to sighing, add Xiangfu (Rz

> Cyperi) 12g;

> for bitter taste in mouth, dry throat + HT Vexation, omit BANXIA + add

> Huanglian (Rz Coptidis) 10g;

> for nausea + acid eructation, add Haipiaoxiao (Os Sepiae / Sepiellae) 20g;

> for ST duct distension + oppression, add Houpo (Cx Magnoliae) 10g +

> Sugeng (Caulis Perillae) 10g;

>

> Best regards,

>

>

>