ABSTRACT
Traditional Chinese medicine (TCM) is widely used in Asia, especially in China, and plays an important part in the health care of overseas Chinese worldwide. Their methods, processing, and formulations have been worked out over the last 2000 years (1). TCM prescriptions and preparations are derived from natural sources; about 80% of the total is derived from plants, and the rest includes minerals or animal parts. Even though the effectiveness and safety of TCM have been documented by controlled clinical studies, several cases of severe or even fatal poisoning are reported every year. Most of the poisoning cases are reported after ingestion of Chinese medicine preparations that contain aconitine, anticholinergics, or podophyllin (2-4). The preparations commonly used to treat chronic illnesses such as rheumatism or arthritis, as well as for bruises, fractures, and cardiac complaints, may contain species of Aconitum (A. carmicaelli, A. kusnezofii, A. brachypodum, A. pendulum, A. nagarum, or A. coreanum), which are considered highly toxic (4-6). Species of the genus Datura (D. innoxia, D. metel) are regularly used for treatment of bronchial asthma, chronic bronchitis, pains, and flu symptoms (7). Moreover, there are reports on poisoning caused by adulterants or erroneous substitutes involving species of Podophyllum emodi (7) and by the ingestion of dried venom from Bufo gargarizans or Bufo melanostictus used as an aphrodisiac (8).
