(22 March 2000) -- Chinese herbology, along with acupuncture,
is the best-known and most widely available branch of Chinese
medicine. It is a holistic approach to medicine, meaning that
treatment focuses on restoring balance in the body in a fundamentally
individualized way rather than on the treatment of a specific disease.
Presently, about one-quarter of the world's population uses some form
of Chinese medicine. Of the estimated $14 billion a year that
Americans spend on alternative medicine, Chinese medicine accounts for
$1 billion, 75% of which is spent on acupuncture.
the care of a qualified Chinese herbalist, Chinese medicine has been
used to treat a variety of illnesses, from arthritis to infertility.
However, when practiced by unqualified individuals, Chinese herbal
medicine has been described as a recipe for grief. It is very
difficult, if not impossible, for the average consumer to make an
informed decision when purchasing a Chinese herbal remedy. There is a
bewildering array of herbals complicated by inadequate labeling
information, making it impossible to know for sure what is in the
bottle or tea bag.
problem is compounded by a long history of products containing
undeclared drugs, unlabeled drug/herb combinations
and toxic ingredients. This review is not intended as a condemnation
of Chinese herbal medicine. Rather, it is meant to guide consumers to
carefully select a Chinese herbalist, and to update practitioners of
recent warnings regarding the safety of herbal medicine products.
herbal medicines are not regulated as medicine in a Western sense, and
they tend to be poorly (if at all) labeled with their contents.
According to Adriane Fugh-Berman, M.D., of George Washington
University School of Medicine, "It is not uncommon for
medications prescribed in Asia to contain both herbs and drugs. This
is standard practice. The problem occurs when a patient takes a
preparation without knowing that it contains a potentially hazardous
or addictive drug, or a drug to which the person is allergic."
alarming is the fact that there is a long history of herbs being
imported into the United States that have been contaminated with heavy
metals and pollutants.
and treatment are complex tasks
skills required to accurately assess (or diagnose) the imbalance
between major body systems and then prescribe effective and safe
treatment is a complex task that is best undertaken by a qualified
professional. The process starts with inquiry to obtain a complete
history and hands-on examination. Practitioners who treat only
symptoms should be avoided.
in choosing Chinese herbal medicines
herbal medications have a history of containing prescription drugs. In
1974, there were four cases of agranulocytosis, a blood disorder
resulting from an insult to the production of white blood cells,
resulting in death of one person and extensive hospitalization of
three others. Analysis by the Food and Drug Administration (FDA) of
pills involved in the illnesses found phenylbutazone and
aminopyrine, both of which have been associated with agranulocytosis.
Analyses of other "herbal medications" found methyl testosterone,
prednisolone, diazepam, chlorzoxazone and acetaminophen.
years later, several illnesses and another death were linked to use of
Chinese herbal medications, particularly chuifong toukuwan.
Analysis of chuifong toukuwan from various sources found
indomethacin, hydrochlorothiazide, chlordiazepoxide, lead and cadmium,
a human carcinogen.
recently, in 1998, Californiaís Department of Health Services issued
a warning to consumers not to use a Chinese medicine called An Shu
Ling because it contains levo-tetrahydropalmatine, an ingredient that
can cause chemical- induced hepatitis. An Alameda County woman was
diagnosed with chemical-induced hepatitis in late May 1998 after using
the product for insomnia.
distributors and acupuncturists were also told not to sell or provide
An Shu Ling to their customers. In addition to hepatitis, levo- tetrahydropalmatine
is associated with respiratory depression,
slowing of the heart, sedation and fatigue.
list of products found by the FDA or the National Fish and Wildlife
Service Forensics Laboratory to contain undeclared drug substances is
presented in Table
here to view Table 1
Products identified by
the California Department of Health Services as containing toxic
ingredients, and the reported reactions to these products, are listed
in Table 2.
here to view Table 2
Russo, Jr., PharmD, is senior vice president of medical
communications at Vicus.com. He is a pharmacist and medical writer
with 20 years of experience in medical education.
1. The list is based on a
report issued by the FDA in August 1999.