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15 April 1995 | Volume 122 Issue 8 | Page 636
I agree with Woolf and colleagues [1] that a national surveillance program and quality control of the manufacture of herbal products are required. We need them because herbal products can cause toxic reactions in the liver, kidneys [2], heart [3], and lungs [4]; they can also cause heavy-metal poisoning [5]. The authors should have consulted a pharmacognosist, botanist, or herbalist. They should have also stated that Jin Bu Huan did not cause the herbal poisoning; the poisoning was caused by a highly concentrated alkaloid fraction that was probably derived from some unidentified plant material. Their article does not describe "herbal" poisoning. It shows that a fraudulent and unscrupulous manufacturer mislabeled a plant-derived pharmaceutical as an "herbal product" to take advantage of popular beliefs that the words "plant" and "natural" somehow mean harmless. Jin Bu Huan is not an herb; it is a camouflaged drug. Describing Jin Bu Huan as an herbal product is like describing estrogen as a plant product derived from the Mexican Dioscorea yam.
1. Woolf GM, Petrovic LM, Rojter SE, Wainwright S, Villamil FG, Katkov WN, et al. Acute hepatitis associated with the Chinese herbal product Jin Bu Huan. Ann Intern Med. 1994; 121:729-35.
2. Vanherweghem JL, Depierreux M, Tielemans C, Abramowicz D, Dratwa M, Jodoul M, et al. Rapidly progressive interstitial renal fibrosis in young women: association with slimming regimen including Chinese herbs. Lancet. 1993; 341:388-91.
3. Tai YT, But PP, Young K, Lau CP. Cardiotoxicity after accidental herb-induced aconite poisoning. Lancet. 1992; 340:1254-6.
4. Wilson BJ, Garst JE, Linnabary RD, Channell RB.Perilla ketone: a potent lung toxin from the mint plant, Perilla frutescens Britton. Science. 1977; 197:573-4.
5. Mitchell-Heggs CA, Conway M, Cassar J. Herbal medicine as a cause of combined lead and arsenic poisoning. Hum Exp Toxicol. 1990; 9:195-6. About Letters
The Editors welcome submissions for possible publication in the Letters section. Authors of letters should:
LETTER
Acute Hepatitis Associated with Jin Bu Huan
TO THE EDITOR:
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Beth Israel Hospital, Boston, MA 02215. Cedars-Sinai Medical Center, Los Angeles, CA 91403.
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