By Giovanni Maciocia
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Additional resources for Safety of Chinese Herbal Medicine
This means that if we are treating a woman for infertility we should advise her to discontinue the remedy as soon as she knows she is pregnant. Since at least two weeks would elapse before a pregnancy can be confirmed, when I treat infertility with decoctions, I usually add one or two herbs to Acalm the foetus@ just in case the patient falls pregnant. Dr Chen Zi Ming of the Song dynasty listed the herbs forbidden in pregnancy as being Shui Zhi Hirudo seu Whitmania, Wu Tou Radix Aconiti carmichaeli, Fu Zi Radix lateralis Aconiti carmichaeli praeparata, Niu Huang Calculus Bovis, She Tui Exuviae Serpentis, Ba Dou Semen Croton tiglii, Wu Gong Scolopendra subspinipes, Niu Xi Radix Achyranthis bidentatae seu Cyathulae, Li Lu Radix et Rhizoma Veratri, Yi Yi Ren Semen Coicis lachryma jobi, Xiong Huang Realgar, Mang Xiao Mirabilitum, Di Bie Chong Eupolyphaga seu Opisthoplatia, She Xiang Secretio Moschus moschiferi, Yan Hu Suo Rhizoma Corydalis Yanhusuo, San Leng Rhizoma Sparganii stoloniferii, Qian Niu Zi Semen Pharbitidis, Zao Jiao Fructus Gleditsiae sinensis, Tao Ren Semen Persicae, Bai Mao Gen Rhizoma Imperatae cylindricae, Ting Li Zi Semen Descurainiae seu Lepidii, Qu Mai Herba Dianthi, Ban Xia Rhizoma Pinelliae ternatae, Tian Nan Xing Rhizoma Arisaemati, Tong Cao Medulla Tetrapanacis papyriferi, Gan Jiang Rhizoma Zingiberis officinalis, Da Suan Bulbus Alli sativi, eggs, mule meat and rabbit meat.
G. Da Huang Radix et Rhizoma Rhei) will speed intestinal transit and thus may interfere with the absorption of almost any intestinally-absorbed drug. In conclusion, Chinese herbs may in general be used in conjunction with Western drugs without unduly worrying about negative interactions (apart from the exceptions mentioned above). However, I tend not to use Chinese herbal remedies if the patient is taking many different drugs (say, over four) or very potent drugs such as Roaccutane, cyclosporin or cytotoxic drugs (although herbs can be used to minimise the side-effects of cytotoxic drugs).
These are reactions that develop slowly and chronically over months in a pharmacologically predictable way. Example: the occurrence of muscular weakness due to hypokalaemia in long-term users of herbal anthranoid laxatives. $ Type D reaction. xxvii To summarize, I would list the conditions for a safe practice of Chinese herbal medicine as follows: $ Good quality control of herbs used $ Good command of Chinese diagnosis and identification of patterns $ Good command of treatment principles and differentiation between Root (Ben) and Manifestation (Biao) and between the need to tonify (Bu Zheng) and the need to expel pathogenic factors (Gong Xie) $ In-depth knowledge of Chinese herbs and formulae $ Careful analysis of the patient=s condition and adjustment of the dosage $ Careful inquiry about any previous liver or kidney disease $ Careful instruction of the patient in reporting any adverse symptoms and signs 26 $ Determination of any possible interaction of herbal remedies with drugs being used concurrently, including over-the-counter medicines or Ahealth foods@ I believe that when all these factors are applied, adverse reactions to Chinese herbs are extremely rare.