contain a toxin that can cause nausea, vomiting, diarrhoea and abdominal
pain.^170
There are two species of senecio plants: Senecio scandens(grown in
China) and Senecio vulgaris(grown in Europe). Senecio scandens, used in
TCM, contains eight times less pyrrolizidine alkaloids than Senecio
vulgarisand has little toxicity to the liver, whereas Senecio vulgarisexhibits
significant toxicity.
Hepatotoxicity is a feature of various Chinese herbal preparations.
Between November 2003 and June 2004 four patients developed severe
acute liver injury within 2 months of starting to take a slimming aid
(Shubao), widely available in the West Midlands of England.^171 Three
patients fully recovered on discontinuing the agent; one patient progressed
to fulminant hepatic failure, requiring liver transplantation. Laboratory
analysis showed adulteration with N-nitrosofenfluramine, a recognised
hepatotoxin. Warnings about taking slimming products have been issued by
the MHRA (see below).
Administration during pregnancy
A number of herbs, e.g. pennyroyal (Mentha pulegium, Hedeoma pule-
goides) and valerian (Valerian wallichi) have abortifacient properties and
should be avoided during pregnancy.^172 Their action is thought to be due to
the presence of volatile oils, which can induce uterine contractions.
Administration to children
Infants are at greater risk of possible poisoning from CHM than adults
because of their inadequate biotransformation processes. Chinese infants
are frequently given huang lian(Coptis chinensis) by their mothers to clear
up ‘products of pregnancy’.^173 The main alkaloid of this herb is berberine
and it can displace bilirubin from its serum-binding proteins, causing a rise
in free bilirubin concentration and a risk of brain damage. Yin-chen hao
(Artemisia scoparia) is used for the treatment of neonatal jaundice and has
a similar effect although it does not contain berberine.
Concurrent use with orthodox medicines
There are two problems here: an enhanced activity from the herbal medicine or
the orthodox medicine, or both, and an intrinsic toxicity, real or threatened,
from the allopathic ingredient.
Aristolochia is an example of a herb that not only is toxic in its own right
but also its administration concurrently with allopathic drugs in Chinese
herbal preparations (albeit inadvertently) may potentiate its action, causing
severe adverse reactions (see below).
Traditional Chinese medicine | 165