AW: Remedies used long-term with unrecognized side effects

[Guest guest]

Emmanuel,

 

What is your opinion on this subject? Should AA-containing medicinals be

used and adminstered to patients? Again, I am not talking about wrong

substitutions but about herbs like Fructus Aristolochia, etc.

Sincerely,

 

Simon Becker

 

-----Ursprungliche Nachricht-----

Von: Emmanuel Segmen [susegmen]

Gesendet: Samstag, 4. Oktober 2003 00:33

An:

Betreff: Re: Remedies used long-term with

unrecognized side effects

 

 

Simon,

 

This issue has been pretty well beaten to death by as early as the summer

of 2001. The beginning was in the 1980s where Chinese researchers coined

the term that the Japanese and German researchers later quoted. CHN,

Chinese herbal nephropathy was noted in Chinese literature in the 1980s and

referenced in the Japanese and German research of recent years. Only two

incidents of CHN have been documented outside of China in Belgium and in

Japan's Kansaii district. In both cases toxic versions of wei ling xiang

and fan ji were used by people on slimming diets on a daily basis for years

in order to achieve any fibrotic development on kidney tubules. I was a

member of the joint committee of AHPA and AAOM that looked in to this in

early 2001. By then there was a clear consensus that CHN is a result of

self-medication and treatment by health care providers untrained in Chinese

medicine. No CHN has been reported with regard to patients under the care

of trained Chinese medical practitioners. This is true both inside and

outside of China. The view from the 1980s investigations in China is that

the aristolochia family of herbs should be limited in their use to trained

practitioners of CM and banned from the open marketplace where people could

engage in self-medication. It was agreed that these herbs should not be

removed from the Chinese pharmacopoeia and should continue to be available

for use by CM practitioners. The consensus in China, of course, differs

from the consensus of Western medical authorities.

 

There is more than enough pressure from the U.S. FDA and British and

Canadian authorities. Some balance needs to come into this scenario from

the CM community.

 

Thanks,

Emmanuel Segmen

-

Simon

Friday, October 03, 2003 5:29 AM

AW: Remedies used long-term with

unrecognized side effects

 

 

Zev,

 

I don't see how and why you want to explain away the fact that ALL

medicinals from the aristolochiacea family should not be used any longer

because they are nephrotoxic. I am also cautious when I see western

scientists screaming and running to ban medicinals because of potential

(not

real-life) toxicities (as is happening in Germany). However, when it

comes

to AA, many people have died from it and it is, in my book, beyond any

doubt

that medicinals containing AA are toxic, regardless what traditional

sources

say.

 

In cases like Ma Dou Ling, Fructus Aristolochia, etc., it is clear. In

other

cases, such as with Fang Ji, it is a problem of substitution. According

to

the Chinese pharmacopoeia (2000 ed.), Stephania should be used, not

Aristolochia. Hence, if a factory adheres to the Pharmacopoeia and

identifies the type of Fang Ji correctly, there is no nephrotoxicity.

The

nephrotoxicity is only there if the Aristolochia species is selected. In

" Ten Lectures " it says: " only the abscence of AA and the positive

identification of of tetrandin can lead to a positive identification. "

Inspection by eye is not a safe method of differentiating the various

types

used. Many granules from Taiwan are not entirely clean, although on the

box

it says Stephania. I have found AA in various batches where I was

assured

from the producer that only Stephania was used. If that were the case,

however, it is impossible to find AA.

 

As a profession, we don't become very credible if we negate such basic

biomedical facts as the toxicity of AA. The people who died in Belgium

did

so because of Aristolochic nephrotoxicity. That other factors also

played a

role (i.e., the kidneys were under a lot of stress because of the

dieting

and other medications, etc.), but the toxic damage did occur because of

a

Chinese herb which contained AA.

 

I would be very interested in knowing how many patients in China have

died

because of AA-toxicity. Just because nobody kept track of it does not

mean

that it was not happening. A famous pharmacologist from Chengdu

University

who was on an herb-hike this summer with a group from Switzerland and

Germany said that he thinks this number is quite high and that

pharmacologists have identified and pointed to this problem quite a long

time ago. " The traditionalists were unwilling to listen, " he said, " and

still believed that the therapeutic use of the aristolochia species

outweighed the toxic effects. "

Simon Becker

 

-----Ursprungliche Nachricht-----

Von: [zrosenbe]

Gesendet: Freitag, 3. Oktober 2003 02:19

An:

Betreff: Re: Remedies used long-term with

unrecognized side effects

 

 

Yes,

But the situation where this was discovered was a non-traditional

use

of fang ji, i.e. in a combination for weight loss with prescription

drugs.

 

The resulting nephrotoxicity may have been from: 1) high dosages

of

the fang ji 2) interactions of fang ji with the other medications.

 

I assume the use of fang ji in this weight loss prescription had

to

be from its ability to cause loss of water through urination.

 

While I agree that this extreme situation led to new knowledge

about

potential toxicity of an herbal medicinal (and I have never opposed

pharmacological studies of herbal medicinals, rather I encourage

them),

neither guang fang ji or han fang ji are major medicinals in the

Chinese materia medica. So the potential for traditional abuse was

probably smaller than with other substances.

 

What you describe are simply newer methods of determining

toxicity.

There are countless descriptions of toxicity of medicinals in the

Chinese medical literature.

 

On Thursday, October 2, 2003, at 03:11 PM, Bob Flaws wrote:

 

> In issue #8, 2003 of Xin Zhong Yi (New ), there is

an

> article on AA, nephrotoxicity, and Fang Ji (Han Fang Ji and Guang

> Fang Ji). The article discusses four methods for preventing toxicity

> from Fang Ji. It ends by stating that the safe use of herbal

medicines

> should be based on a sceintific foundation. This article would never

> have been written and published based on traditional empirical

> experience alone. It essentially took outsiders to see that there

were

> potential problems with Chinese meds containing AA.

>

> Bob