by Eric Brand

Honora alerted me to a very interesting article on BBC News today, located at the following link: http://news.bbc.co.uk/2/hi/uk_news/8520171.stm

The headline of the article is “Guilty plea in Chinese herbal ‘cancer’ case,” and the article reports on a practitioner of Chinese medicine in the UK who pleaded guilty to selling a banned product that contained AA (aristolochic acid). AA-containing products have been banned in the UK since 1999, and while the article doesn’t specify the exact herbal product that was used, an accompanying video shows footage of a product labeled as Guan Mu Tong, a toxic Mu Tong substitute that is also known as Manchurian aristolochia. The video feed is a bit confusing because the article states that the patient took small brown pills while the video shows bulk herbs, so it is impossible to ascertain exactly what the patient ingested other than that it tested positive for AA.

Differentiating safe products such as Chuan Mu Tong (Armand’s clematis) or standard Mu Tong (akebia) from toxic substitutes such as Guan Mu Tong (Manchurian aristolochia) has been a recurring theme on our blog here at Blue Poppy. We strongly feel that education is crucial to the future of Chinese medicine in the West, and as practitioners it is absolutely essential for us to be informed about issues such as medicinal identification and safety concerns such as aristolochic acid.

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The courts essentially concluded that the practitioner meant no harm and did not act maliciously, so they didn’t charge her with the more serious offense of “administering a noxious substance so as to endanger life or inflict grievous bodily harm.” Overall, the tone of the article is relatively balanced, and both the video and the text mention that the problem was related to lack of education and acknowledge that well-trained professionals would not likely make the same mistake. However, the case nonetheless provoked a vigilant call for increased regulations on Chinese herbal medicine.

As we know from experience, increased regulation tends to mean reduced access to important medicinal products (such as Xi Xin, Fu Zi, and Ma Huang), and the widespread lack of adequate training on issues of herbal pharmacy and authentication creates an environment wherein more practitioners are likely to make mistakes. It is only a matter of time before another high-profile mistake hits the media, and each media surge carries an increased risk of further regulations that might limit our access to valuable medicinal herbs. Already the Belgian cases related to AA that are cited in this news article have greatly limited the product liability insurance available to most companies, and the fear of Chinese herbal nephrotoxicity created by these high-profile cases has affected our medicine’s public image (regardless of whether this increased scrutiny is justified or not based on the complex circumstances in Belgium).

As an aside, the main medicinal Mu Tong (akebia) is rather uncommon in the West (and many parts of China), though it is prevalent in Japan. The product that we generally use here is properly known as Chuan Mu Tong (Armand’s clematis), which is a safe medicinal that lacks AA and is interchangeable with akebia in terms of its TCM action. Chuan Mu Tong has irregular edges and it is often characterized by a black spot in the center. This black spot doesn’t look nice but it is actually a good sign, as it is only found in the safe medicinal Chuan Mu Tong.

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