Herb Toxicities & Drug Interactions:
A Formula Approach

By Fred Jennes
with

Bob Flaws

Blue Poppy Press

Published by: BLUE POPPY PRESS A Division of Blue Poppy Enterprises, Inc. 5441 Western Ave., Suite 2 Boulder, CO 80301 www.bluepoppy.com First Edition, July 2004 ISBN 1-891845-26-8 LC #2004093399 COPYRIGHT © BLUE POPPY PRESS, 2004. All rights reserved.
No part of this book may be reproduced, stored in a retrieval system, transcribed in any form or by any means, electronic, mechanical, photocopy, recording, or translated into any language without the prior written permission of the publisher.

DISCLAIMER: The information in this book is given in good faith. However, the author and
the publishers cannot be held responsible for any error or omission. The publishers will not accept liabilities for any injuries or damages caused to the reader that may result from the reader’s acting upon or using the content contained in this book. The publishers make this information available to English language readers for research and scholarly purposes only. The publishers do not advocate nor endorse self-medication by laypersons. Chinese medicine is a professional medicine. Laypersons interested in availing themselves of the treatments described in this book should seek out a qualified professional practitioner of Chinese medicine. Cover & Page Design: Eric J. Brearton COMP Designation: Original work

10 9 8 7 6 5 4 3 2 1
Printed at Victor Graphics, Baltimore Maryland

TABLE

OF

CONTENTS

Dedication ……………………………………………………………… Acknowledgements…………………………………………………… Foreword ……………………………………………………………… Introduction…………………………………………………………… Chapter 1 The Potential for Toxicity ……………………………… Chapter 2 Three Important Types of Potential Medicinal Toxicity Chapter 3 How To Use This Book ………………………………… Chapter 4 Toxicities and Drug Interaction ……………………… Appendix 1 American Herbal Products Association (AHPA)……

v vii ix xi 1 13 19 27 357

Appendix 2 Western Drugs ………………………………………… 363 Appendix 3 Possible Herb-Drug Interactions Appendix 4 Annotated Bibliography General Index

………………… 365

…………………………… 367
371

………………………………………………………

Pin Yin Formula Index

………………………………………………… 389

English Formula Index ………………………………………………… 391 Pin Yin Herb Index

…………………………………………………… 397

Latin Herb Index ………………………………………………………… 405

DEDICATION

This book is dedicated to my first herb teachers: George Kitchie, Christine Harrison, Yan Yun, Jian-Shu Chen, Caylor Wadlington, and Shi Cheng. Their enthusiasm in teaching their subject matter inspired me to enter and explore the exciting world of Chinese medicinals and to successfully incorporate these substances into my practice. To this day, I admire their skills and abilities as healers and herbalists and deeply appreciate what they shared with me.

March 2004 . Bob Flaws and Honora Wolfe. Again they permitted me to lock myself away from them for days at a time while I delved through piles of texts and clicked away relentlessly at the keys of my laptop. a valuable and safe addition to the tradition of healing. his was the voice of balance which kept me from becoming an alarmist.ACKNOWLEDGEMENTS This book would not have been possible without a number of people whose belief in its importance and in me brought it to fruition. Fred Jennes. after all. I would also like to acknowledge and thank my friend and mentor. Alex. When I was overwhelmed by the inherent dangers in every medicinal I encountered. and son. I would like to thank my colleagues and publishers. and for this I am truly grateful. They suffered my bouts of fatigue and frustration with their usual grace and love. I would like to acknowledge the support and patience of my wife. Helen. as well as their stellar employees for their support during this project. Their patience and enthusiasm was much appreciated throughout the long process of conception to publication. And finally. Caylor Wadlington. for his timely reminder that our Chinese medicinal pharmacy is.

.

The studies of Oriental medicine that do exist mostly aren’t very well done. I’m more than happy to refer that person to a practitioner who comes at the patient from a totally different perspective than mine. It is built on a different foundation than the Western science that I’ve spent decades learning and practicing. When I run out (and sometimes before I run out) of ideas about how to treat a particular patient. It is extremely expensive and time-consuming to meet the gold-standard of prospective. especially not when it comes to healing. The medical literature is of little help in integrating what I do. I rarely find information that gives a credible objective answer to a question I might have about a diagnosis or treatment that falls outside of the standard medicine that I know. Oriental medicine remains a mystery to me. doubleblind research design that rigorous clinical science demands. having jumped through all of the standard educational and certification hoops and practiced my craft on thousands of patients. compare the physiologic role of the gallbladder in Oriental versus Western medicine. with what the Oriental medicine practitioner does for my patient. there are deep philosophical and methodological debates that question the universal applicability of the tools of modern science to some of the practices of what we call alternative medicine for lack of a better handle. I’m neither so naïve nor so arrogant as to believe that Western science has a corner on whats true and what ’ works. Furthermore. Though I’ve availed myself of Fred Jennes’ s healing skills for several of my own ailments and have also referred a number of my patients to him. as a modern Western physician. . (For one small example.FOREWORD I have been a practitioner of modern Western medicine for nearly 30 years. Still.) I like some of the alternatives to the type of healing that I know how to practice exactly because I don’t understand them. When I check the usual reputable sources.

Common sense is the one thing we all share. Chinese Herbal Toxicities and Drug Interactions is a great resource for such a project. and how we can do it together. it is estimated that only about 30% of what I do as a Western physicianis backed by hard science. patenting. neither will everything we practitioners of Western medicine do ever be backedby rigorous science. fortunately. albeit different ones than Western medicine embraces. what we do. reasoning from basic principles. let’s face it.Foreword x • Herb Toxicities & Drug Interactions: A Formula Approach On the other hand. Marc Ringel. when the computerized medical record is a reality. MD Greeley. celecoxib against Juan Bi Tang (Assuage Impediment Decoction) by simply mining the clear. The business of Oriental me dic ine d oes not ha ve t he huge ly dee p pockets that t he ma nufac ture rs of Wes t er n pharmaceuticals do. So. The rest is based on tradition. We will have the means to measure outcomes side-by side for example. In the meantime. let’s get on with the project of understanding as best we can who we are. and regulation before a new allopathic drug can be brought to market. do Chinese herbs require the hundreds of millions of dollars that must be devoted to research. nor. On the other hand. Chinese Herbal Toxicities and Drug Interactions is rife with common sense. and common sense. we will be able to ascertain more objectively the validity of some Oriental medical practices via concurrent research. Colorado . In the future. Certainly we should strive to get the sorts of objective evidence that the scientific method can offer about what really works and what doesn‘t. most of the Chinese herbs and formulations will never be tested by Western medicine. comprehensive data contained in the medical records of a large population of patients with joint pain. Much of Oriental medicine is likewise based on tradition and basic principles.

including acetazolamide and belladonna extract. the clinicians’ ignorance had been the cause of their patients’suffering. the safety of Chinese medicinal substances has been the focus of many groups. the American Herbal Products Association (AHPA). and the German “E” Commission. An aging population therefore using more medical services and taking more medication 3. Reasons for this increased scrutiny of the safety of Chinese medicinals is due to several factors: 1. and that just as the amateur mushroom-hunter can inadvertently choose the wrong fungus to feed to his unwitting dinner guests. This incident later caught the attention of practitioners and researchers around the world. word came from Europe that a number of women who had attended a weight loss clinic in Belgium suffered kidney failure after consuming Chinese medicinal substances. An increasingly risk averse population 2. the blame was laid on the incorporation of a Chinese medicinal that contained aristolochic acid (AA). and centuries of safe and effective presciption and use of Chinese herbal medicinals suddenly came under suspicion.INTRODUCTION In the mid-1990s.1 Although the formula which these unfortunate women consumed contained other dangerous pharmaceutical agents. Since the Belgian incident. including the Food & Drug Administration (FDA). An increasing dissatisfaction with standard Western medical care . that the herbal product had not been prepared properly. a strongly nephrotoxic substance. Further investigation revealed that the weight loss center clinicians had apparently added the wrong species of herb to their miracle cure.

Two years ago. the difficulty I encountered was that.Introduction x • Herb Toxicities & Drug Interactions: A Formula Approach 4. or researcher. are as safe and are. consisting primarily of Western-trained pharmacologists and physicians. In addition. out of curiosity about the pharmacological safety of the products I have prescribed for years without incident. this work will enable you to more precisely and safely prescribe for your patients. Competition in the health care marketplace Many practitioners of Oriental medicine have made the claim that centuries of careful practice by trained clinicians is proof that these medicinal products. For our colleagues who practice Oriental medicine. both Western and Oriental. But it will be of most use to practitioners of medicine. based on modern pharmacological research. What Bob and I decided was needed was a source that contained this information in a convenient. Bob Flaws. “Prove it!” So now practitioners of Oriental medicine are being forced to take a closer look at their medicinals and. determine their safety. Instead of feeling forced to tell your patients to halt a medication which is benign and appropriate for their condition. the time needed to determine the safety of the formula’s total contents was often long and impractical. I attended a seminar on the topic of “Herbal Toxicities & Drug Interactions” offered by my friend and colleague. it was not in one place. But many watchdog groups. For our Western medical colleagues. As Bob discussed many of the medicinals I commonly prescribed and considered safe. when used appropriately. although the safety information was present and accessible via various publications and on the Internet. An increasing use of complementary and alternative medicine (CAM) 5. you now can prescribe with the knowledge of how your pharmaceutical agent will potentially augment or conflict with the Oriental medical substance your patient is taking. “Will this medicine hurt my baby?” you will be able to answer forthrightly and with certainty instead of guessing and relying solely on your good luck in the past. I was surprised at the number of potential problems that could have arisen from my routine use of these medicinals. . student. This book is intended for anyone interested in the topic of Oriental herbology whether you are a practitioner. This book came out of my own [FJ] closer self-examination of Chinese herbal medicine. As I myself began to perform further research on the medicinal substances in these many formulas. Our hope is that. pharmacologist. easy-to-consult format. safer than the pharmaceutical agents prescribed by Western physicians. And so the idea for this book was born. this book will enable you to better understand the nature of the herbal products that many of your patients take. in most cases. have replied with the scientific retort. when a pregnant woman asks you. since formulas often contain many medicinal substances.

Following this Introduction. commonly used Chinese medicinals. and Western pharmaceuticals that can commonly cause certain adverse reactions. p. Next comes an annotated bibliography followed by a general index. we are to help our patients as much as possible and avoid doing them harm. and.Introduction Herb Toxicities & Drug Interactions: A Formula Approach • xiii This book consists of four chapters. will find this book useful in your study and application of Chinese medicine. In addition. a formula index in English. as result of using this book. Chapter 1 discusses the potential for toxicity in the prescription of Chinese medicinals and the factors that can lead to it. and a companion searchable CD-ROM. “Cases of Herb Toxicity: Adverse Events Involving Certain Chinese Herbal Medicines and the Response of the Profession. ENDNOTE Blackwell. 1 Richard . the suspected drug interactions of certain. Chapter 2 focuses in on three major types of toxicity and lists some of the specific medicinals that have been singled out for their toxicity. notions that we as practitioners must struggle with and understand. The appendices consist of the American Herbal Products Association (AHPA) categorization of Chinese medicinals. if in the Hippocratic ideal. several indexes. you will practice more safely and effectively. Each medicinal ingredient in each formula is accompanied by its potential toxicity to patients and potential interactions with other Chinese herbs and Western pharmaceuticals. Our hope is that you. 1-3.htm. and a Chinese medicinal index in both Pinyin and Latin pharmacological nomenclature. several appendices.com/Herbology/Toxic. a formula index in Pinyin. since the additive effect of all the medicinals in a formula may create a toxic or potentially interactive situation with other formulas or drugs. Chapter 4 lists 100 formulas and their medicinal components. the reader.” http://acupunc ture. 1996. Chapter 3 suggests how practitioners can most effectively use this book. we have included toxicities and interactions of the formulas themselves.

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”2 Although some people erroneously think that herbs. A single peanut or a bite of shrimp may put a susceptible individual into anaphylactic shock. Eastern or Western So. or degree of being poisonous. interaction. quality. toxicity refers to the extent. This . when taken ignorantly or carelessly. this is simply not true.” are somehow inherently safe.3 When administered appropriately according to professional standards of care. For instance.” This can be freely translated as. its ingestion by a susceptible individual may not be only inappropriate and unwise but also potentially lethal. being “natural.CHAPTER CONTENTS Diagnosis Preparation Dosage Interaction Inherent Toxicity Contamination Adulteration Mislabeling Types of Toxic Reactions to Medicinals. the result can be unexpected and potentially lethal. “Ut quod ali cibus est aliis fuat acre venenum. DIAGNOSIS Professionally trained Oriental medical practitioners prescribe on the basis of two diagnoses (liang zhen). and salt.1 and there is an old saying that goes. So what should one be aware of when prescribing these substances to insure that patients will benefit from them? There are five primary areas of concern vis á vis toxicity that need to be considered when prescribing Chinese herbal medicinals safely and effectively. Are Chinese Herbal Medicinals Safe? CHAPTER 1 THE POTENTIAL FOR TOXICITY According to Taber’s Cyclopedic Medical Dictionary. and inherent toxicity. their effect is beneficial. However. These are diagnosis. water. can all be lethally toxic when taken in excess. Such is also the case with Chinese herbal medicinals. While the substance itself may be benign. preparation. Too much of anything taken by the wrong individual under the wrong circumstances can result in illness and death. while the rest of us may gorge on these foods to our heart’s content. The first is a disease diagnosis (bing zhen). while necessary to the maintenance of life. dosage. oxygen. resulting in the elimination of disease and the restoration and preservation of health. “One man’s meat is another man’s poison.

such as Jin Yin Hua (Flos Lonicerae Japonicae) and Lian Qiao (Fructus Forsythiae Suspensae). In this case. it is . Thus these erroneously prescribed medicinals themselves would be toxic to the patient even though. by themselves. It is Oriental medicine’s prescriptive methodology of primarily basing treatment on each patient’s personally presenting pattern that makes this system of medicine generally so safe and effective. inquiry. the trained Oriental medical practitioner is able to identify the pattern of disease the specific patient is currently presenting. it is an axiom of truth in standard professional Chinese medicine that treatment is primarily based on the patient’s pattern discrimination and only secondarily on their disease diagnosis. the treatment principles are to resolve the exterior. While the patient’s disease diagnosis is an upper respiratory tract infection. rapid pulse. For example. if the practitioner makes a faulty pattern discrimination and prescribes a formula that contains interior-warming medicinals. this pattern discrimination (bian zheng) is arrived at using only the so-called four examinations. based on their particular signs and symptoms. listening/smelling. they are not considered toxic. While the disease diagnosis may be made using modern laboratory tests and imagining techniques. slight sweating. Practically. and this is what treatment based on pattern discrimination excels at. The issue is getting the right medicinals to the right patient at the right time. exterior-resolving medicinals. Therefore. yellow fur. the patient’s fever and sore throat may very well worsen and their infection become more severe. Medicines in and of themselves are neither good nor bad. cool. and a floating. Then an effective herbal remedy can be prescribed that precisely matches both the patient’s disease diagnosis and their personal pattern. In fact. they lower the fever and relieve the sore throat. listening to the sound of the patient’s breathing and detecting any odors coming from the patient’s body. From here.Chapter 1 2 • Herb Toxicities & Drug Interactions: A Formula Approach may be either a modern Western medical disease diagnosis or a traditional Chinese medical disease diagnosis. a prominent sore throat. asking the patient to describe his or her symptoms and the course of their disease. These are inspection. and disinhibit the throat. and palpation. the patient is exhibiting a specific pattern of common cold called a wind heat external contraction. Because these medicinals’ therapeutic actions match the patient’s personally presenting pattern. However. clear heat. and by feeling the pulse of the radial arteries at both wrists. this means the use of a Chinese medicinal formula that primarily contains acrid. By observing the patient’s tongue and facial complexion. when prescribing Chinese medicinals. a patient presents with a common cold accompanied by a low fever. the practitioner discriminates the pattern of signs and symptoms which the individual patient is presenting at the time of examination. a red tongue with thin. such as Gan Jiang (dry Rhizoma Zingiberis Officinalis) and Rou Gui (Cortex Cinnamomi Cassiae). a red complexion.

even benign medicinals commonly eaten as foods may have toxic effects on a patient’s condition. These methods of preparation traditionally include soaking. steaming.Chapter 1 The Potential for Toxicity • 3 extremely important that the practitioner’s disease diagnosis and pattern discrimination be precise and take into account all the patient’s signs and symptoms. the issue of preparation is still an important one. a potentially lethal decoction containing one of the most toxic herbs in the Chinese medicinal pharmacy. nevertheless. vinegar. powdered. the preparation of medicinals prior to their final cooking or manufacture for administration is called pao zhi. Practitioners and their patients should ask their suppliers of ready-made Chinese medicines if the medicinals in these products have been prepared correctly to reduce or eliminate potential toxicity. and carbonizing. or made into pills for oral administration. Ban Xia becomes a safe medicinal that can be added to a decoction for the effective treatment of many types of phlegm and damp conditions. After such preparation. alcohol. For more information on the traditional Chinese science of processing medicinals prior to use. Otherwise. but. such as saltwater. Similarly. Even in the case of ready-made medicines. ginger juice. powdered. These methods of preparation are meant to do either of two things: 1) increase their intended therapeutic effect. PREPARATION One of the most common mistakes leading to toxicity in the prescription of Chinese medicinals is improper processing or preparation. dry stir-frying. In Chinese. Ban Xia (Rhizoma Pinelliae Ternatae) is toxic in its unprocessed state. While less and less patients both in China and the West are being given bags of bulk-dispensed Chinese medicinals with instructions for making a waterbased decoction at home. baking. decocted. or pilled. blast-frying. For example. or honey. the medicinals are then either boiled or infused in water. or 2) decrease their toxicity. This is an ancient art with a literature stretching back over 1. when stir-fried with ginger or vinegar. it is important that companies manufacturing these medicines follow the traditional methods of processing in order to reduce potential toxicity. becomes safe and useful for treating cold conditions when cooked in combination for a relatively long time with Gan Cao (Radix Glycyrrhizae Uralensis) and Gan Jiang (dry Rhizoma Zingiberis Officinalis). Many Chinese medicinals need to be prepared in some way before they are infused. calcining. stir-frying in some liquid. Fu Zi (Radix Lateralis Praeparatus Aconiti Carmichaeli). readers are referred to Philippe Sionneau’s Pao Zhi: An .500 years.

Chuan Xiong may cause nausea. Short-term. there is a tendency to prescribe them at higher than standard doses. the standard daily dose in decoction of most commonly used Chinese medicinals is 9-10 grams. a number of them have died. and. However. the dose of Chuan Jiao (Pericarpium Zanthoxyli Bungeani) is only 1. there are well established guidelines for the dosage and administration of individual medicinals. However. In the small dosages characteristic of its use in decoctions or Chinese ready-made medicines. because pain is so uncomfortable. Conversely. there should be little concern about toxicity. such nausea may be acceptable to a patient suffering from really severe body pain. These users ingest dosages many times higher than the amount used in a decoction in order to stimulate cardiopulmonary function. DOSAGE The amount of a medicinal substance prescribed and the duration of its continued administration are important factors in that medicinal’s safe and effective use. For instance. as a result. due to known toxicity.5-6 grams.Chapter 1 4 • Herb Toxicities & Drug Interactions: A Formula Approach Introduction to the Use of Processed Chinese Medicinals also published by Blue Poppy Press (Boulder. These dosage parameters have been established based on the clinical experience of a hundred or more generations of Asian medical practitioners. Ma Huang has been proven to be safe and effective for treating a variety of lung disorders ranging from the common cold to severe asthma. In recent years. but need to make on the basis of sound knowledge. These two medicinals are both powerful pain-stopping herbs. this useful medicinal has come under fire due to its misapplication by athletes in the West who have employed it as a performance-enhancing drug. This is the kind of judgement call practitioners are frequently required to make. These guidelines are presented in such standard materia medica as Bensky and Gamble’s Chinese Herbal Medicine: Materia Medica4 and Hong-yen Hsu’s Oriental Materia Medica: A Concise Guide. at doses exceeding 15 grams per day in decoction. Another example of the importance of proper dosage is in the prescription of Chuan Xiong (Radix Ligustici Wallichii) and Bai Zhi (Radix Angelicae Dahuricae). An example of the importance of dosage is the prescription of the medicinal Ma Huang (Herba Ephedrae). and. 1995). the standard daily dose of Pu Gong Ying (Herba Taraxaci Mongolici Cum Radice) begins at nine grams but goes as high as 30 grams due to its low potential for toxicity and the fact that it achieves better therapeutic effects at higher doses. In standard professional Chinese medicine.5 As long as one stays within these standard acceptable parameters. including several prominent professional athletes. .

Tuber Curcumae) will “antagonize.e.6 Early practitioners found that seemingly innocuous substances like cloves (Ding Xiang. children. The consequences can either be an exaggeration of pharmacological or toxic effects or a diminished efficacy of drug treatment. further enhancing the toxicity of each. it is only through inexperience or ignorance that a modern practitioner would create a toxic Chinese medicinal formula through unanticipated interactions. the elderly. INTERACTION Drug interactions (DI) are phenomena during drug therapy when the pharmacological or therapeutic actions of a drug are altered by the co-administration of other drugs or substances. neutralize. Because of differences in metabolism. However. The effects of overdosage can usually be controlled by reducing dosage and/or increasing intervals between administration.. each other. Bensky and Gamble list many of these potentially toxic interactions in their discussion of the classic 19 antagonisms and 18 incompatibilities. and most Chinese medicinal formulas avoid these antagonisms and incompatibilities. Similarly early practitioners recognized a condition called “mutual incompatibility” which occurs when two toxic substances such as Wu Tou (Radix Aconiti) and Ban Xia (Rhizoma Pinelliae Ternatae) are mixed together. Thus. Every professionally trained practitioner of Oriental medicine prescribing Chinese medicinals is taught the above 18 incompatibilities and 19 antagonisms. thus cancelling out the beneficial effects of either medicinal. similar antagonisms and incompatibilities between Chinese medicinals and modern Western pharmaceuticals are possible and not so easily known. Many practitioners may unwittingly create a similar toxic situation as what occurred in Belgium due to ignorance of what other medicinal substances the patient may be taking. and the debilitated often require smaller than standard daily adult doses of both Western and Chinese medications. whether they be Chinese medicinals or Western pharmaceuticals. infants.Chapter 1 The Potential for Toxicity • 5 Symptoms of overdose are mainly those of an exaggerated response to the medicinal. Flos Caryophylli) and turmeric (Yu Jin. In both cases. such interactions may lead to therapeutic failure and endanger the patient’s condition.” i. The relevance of DIs depends on how clinically significant is the therapeutic outcome. These symptoms may not only be due to true overdose of the medicinal but non-metabolism or non-excretion of or hypersensitivity to the medicinal in particular individuals. Drug interactions are commonly categorized in Western medicine in terms of significance as follows: Early Chinese medical practitioners were well aware of the potential problems their medicinals could cause when mixed together. An example of this is the ubiquitous medicinal .

and microbes. But mushrooms are also touted by the health food industry to help prevent cancer. perhaps unrelated. This means it moderates the harsh. Since the majority of patients in the West using Chinese medicinals do so in the form of ready-made medicines. mushrooms contain hydrazines. While heavy metal contamination potentially . cardiac condition. Again. Potatoes contain solanacia alkaloids which are both hepatotoxins and neurotoxins. Over 2. known carcinogens. tea does not usually cause either cancer or stomach upset. it is important to discuss each of these three sources of potential toxicity. These are contamination. adulteration. For instance. let’s first look at some commonly eaten foods and the toxins they contain. in a large enough dose. but unless one eats way too many potatoes. Thus a well-intended Oriental medical practitioner may unwittingly create a toxic condition in a patient through ignorance of what that patient is taking for a. Licorice root is used in many Chinese medicinal formulas as a “harmonizing” agent. in a patient taking a cardiac glycoside. The potential for toxicity depends on the amount of toxins in a given medicinal and the dosage in which it is administered. pesticides. anything can be toxic. every professionally trained Oriental medical practitioner is taught the dosage ranges. it may increase the toxicity of the digitalis. as long as one does not overdo it. In Chinese medicine. The issue is the amount of potential toxins a substance contains and the amount one ingests. And finally. and.. However. there are three other sources of potential toxicity. as stated above. damaging. and processing methods for using these medicinals safely and effectively. combinations. However. and mislabeling. toxic.e. harmful to human life. licorice is considered a safe herb. the Chinese have become acutely aware of the major medicinals within their materia medica which inherently contain toxins. such as digitalis (Digoxin®). attacking. spinach contains oxalates which can cause hypocalcemia and may act as nephrotoxins and coagulants.. they are harmless to the average individual.000 years of recorded history. one does not have to worry about these toxins.Chapter 1 6 • Herb Toxicities & Drug Interactions: A Formula Approach licorice root (Gan Cao. as long as one eats a moderate amount of spinach. Radix Glycyrrizae Uralensis). Tea contains tannins which are potentially carcinogenic and are gastric irritants. effects of other medicinals in the formula. when it comes to ready-made medicinal preparations. INHERENT TOXICITY As stated above.e. i. CONTAMINATION Contamination of ready-made Chinese medicinals can be due to heavy metals. i. To keep this issue in perspective. especially those that may cause digestive side effects. but.

4 DDD. Dylox®. plants take up heavy metals from the ground in which they are grown and from the water which they “drink. heavy metals can enter a readymade medicine in the manufacturing process itself. and Rubitox®. There are two main types of pesticides which may be harmful to human health. we also recommend that you ask your Chinese herbal suppliers for copies of tests analyzing the concentrations of both organopesticides and chlorinated pesticides in their products. for instance if the factory uses lead solder in its manufacturing equipment or plumbing. and Mavrik®. Microbial contamination describes potential human toxicity due to the presence of unacceptably high numbers of pathogenic organisms in the medicinal. In addition. Phosmet®. However.” Some soils. Captan®. pesticides which are harmful to human health. Therefore. Roneet®. BHC-A. As part of their “feeding” on the soil in which they live. Guthion®. they can be rendered so small (in terms of parts per million) that their impact on the human body is virtually inconsequential. pesticides may be picked up by these herbs. arsenic. Chlordane®. Nemacur®. and mercury. due to the concentration processes by which most ready-made Chinese medicines are made. It is also possible to reduce the amounts of pesticides through “washing” processes during manufacture. Co Ral®. When vegetable crops. Examples of well-known but potentially harmful chlorinated pesticides include 4. 4. lead. BHC-B.4 DDE. both bulk and ready-made. Therefore. Naled®.Chapter 1 The Potential for Toxicity • 7 affects all commercially grown Chinese herbal medicinals. cadmium. certain bodies of water contain higher concentrations of heavy metals due to their proximity to manufacturing facilities which release heavy metals into the air and thence enter the water. including medicinal herbs. These are called organopesticides and chlorinated pesticides. BHC-G. these processes can also concentrate heavy metals in the finished product. Endrin®. BHC-D. The third type of contamination of ready-made Chinese medicinals is microbial. this industry is in its infancy in China and other countries supplying Chinese medicinal herbs. our suggestion is to only buy readymade Chinese medicinals from companies who test their medicines for heavy metal contamination and are willing to share with their customers and the public the results of those tests. Pyrethrum®. due to use of certain pesticides and fertilizers contain more heavy metals than others. Some well-known toxic organopesticides include Dursban®. Testing should be done for approximately 200 pesticides known to be harmful to humans. The heavy metals that are especially of concern in terms of human toxicity are copper. 4. One way to avoid contamination by pesticides is to use organically grown Chinese herbs. through proper manufacturing processes. The two main classes of microbes which may contaminate ready-made . Likewise. are grown commercially.4 DDT. While it is very difficult to completely and absolutely eliminate all traces of these heavy metals from Chinese medicinals.

reputable.S. While the Ministry of Health in the People’s Republic of China have made it illegal to manufacture Chinese herbal medicines adulterated by Western pharmaceuticals. Serratia. it is important to buy ready-made Chinese medicinals only from well-established. Mislabeling here refers to the incomplete disclosure of ingredients. including death. and transparent companies. and/or the misidentification of ingredients. as well as the total of all species of bacteria present in the finished product. chlorzoxazone. ADULTERATION Adulteration in the manufacture of Chinese ready-made medicinals means the addition of Western pharmaceuticals to a traditional Chinese herbal formula in order to make it more powerful and effective. The main pathogenic bacteria that should be routinely tested for by manufacturers of ready-made Chinese medicinals are Salmonella. Stpahylococcus aureus. Customers should feel free to ask their suppliers for certificates of analysis (COA) documenting exactly what is in each and every medicine. Klebsiella. aminopyrine. Escherichia coli.Chapter 1 8 • Herb Toxicities & Drug Interactions: A Formula Approach Chinese medicinals are bacteria and yeast and molds. neither can one make such a determination if the ingredients contained are not the ones that are listed. Without knowing all the ingredients in a product. . This sometimes means that the ingredients are correctly identified in Chinese (in Chinese characters) but incorrectly identified in either Pinyin or Latin. Therefore. It has also been common for Asians to misidentify the ingredients in their products simply through ignorance of either Pinyin or Western pharmacognosy and Latin pharmacological nomenclature. many Asian firms sought to keep their proprietary formulas secret by failing to completely disclose all the ingredients in a product. companies operating outside the PRC are still engaging in this practice. MISLABELING While not as much of a problem as in the past. Some of these are over-thecounter medications in the West and some are by-prescription-only. supposedly herbal medicines: acetaminophen. improper listing of ingredients. The following is a list of some adulterants that have been found in certain Chinese ready-made. The main types of pathogenic yeast and molds which should be tested for are Aspergillus niger and Candida albicans. mislabeling can also cause toxic reactions. Some have been taken off the market in the U. phenacetin. In the past. and Bacillus sp. chlorpheniramine. due to reports of toxicity. and phenylbutazone. Just as it is impossible to rationally judge the probability of a toxic reaction if one does not know all the ingredients. there is no way for a practitioner to rationally assess the probabilities of a toxic reaction in a particular individual.

such allergic reactions may result in rash. These kinds of drug reactions are unpredictable. persistent drowsiness. beginning with the ingredient in largest proportion by weight to the ingredient in smallest proportion by weight. Changes in mental function may include hallucinations. impaired memory. EASTERN OR WESTERN There are several types or classes of toxic reactions to medicinals no matter what their source or provenance. Basically. Parkinson-like symptoms are also referred to as extrapyramidal symptoms. delirium.S. there have been great improvements in the labeling of ready-made Chinese medicinals for sale in the U. they tend to print low-end doses on their labels. or persistent wakefulness and excitability. In terms of systems affected. They are similar to hypersensitivity or allergic reactions. respiratory difficulty. gastrointestinal complaints. There must be a nutritional fact panel as well as a serving size. visual disturbances. the FDA does not allow a dosage range but requires a specific daily dose. We will talk more about the issue of dosages in Chapter 3. Unfortunately. This means that practitioners must commonly increase the stated dosages on the packaging in order for their patients to achieve the expected therapeutic effects in a timely manner. there must also be instructions as to use. urinary tract problems. These include drug poisoning. when it comes to instructions for use. Drug poisoning may lead to collapse or death if the drug is not withdrawn and adequate treatment is not administered. must follow the Food & Drug Administration (FDA)’s food labeling rules. Drug poisoning is due to accidental or intentional overdose. And finally. Idiosyncratic reactions may occur in patients who are genetically predisposed to have a reaction to a particular substance. How To Use This Book. This is an extreme emergency. This means that all ingredients must be disclosed. and/or the arising of any new symptoms. allergic reactions. Parkinson-like symptoms. . or flushing of the skin. and idiosyncratic reactions. types of adverse medicinal reactions can include changes in mental function. all companies selling herbal supplements in the U. TYPES OF TOXIC REACTIONS TO MEDICINALS. impaired thinking. In severe cases. confusion. In mild cases. Because companies are commonly worried about litigation from persons who either accidentally or purposefully take too much.S. edema. it may result in anaphalactic shock characterized by collapse or asphyxia. Hypersensitivity or allergic reactions occur either immediately or as a delayed reaction to the ingestion of a medicinal substance.Chapter 1 The Potential for Toxicity • 9 Over the past several years. itching. It may also occur if a patient is excessively susceptible to the drug or unable to eliminate the drug at the normal rate due to liver or kidney damage.

SO. Is its dosage within standard parameters? 4. Because most medications are orally ingested. and a tendency to falling.” Providing a proper diagnosis (including pattern discrimination) has been made. and skin rashes. the new symptoms that the patient and practitioner should be on the lookout for are fever. often by a layperson taking a medicinal without the supervision of a trained practitioner. shows that there have been very few incidents of poisoning from Chinese medicinals. or C) poor diagnosis and improper prescription.Chapter 1 10 • Herb Toxicities & Drug Interactions: A Formula Approach They consist of uncontrolled movement of the face. and/or legs.8 B) improper administration and preparation of aristolochic acid-containing medicinals9 (a topic to be discussed in more detail in the next chapter). both from Chinese medicinals and Western pharmaceuticals. The few incidents documented are the results of A) abuse. and potential interactions have been taken into consideration. the dosage is correct. Chinese herbal medicinals are safe when takien correctly. FOUR QUESTIONS TO ASK BEFORE TAKING/ ADMINISTERING A CHINESE HERBAL MEDICINAL: 1. the medicinals have been properly prepared. Are there any potential toxic interactions between this medicinal and any other medicinals taken concurrently? . “Yes. abdominal pain. the Chinese medicinal substances included in this reference guide have minimal chance for toxicity. as described in the case of Ma Huang. asthma. vomiting. orthostatic dizziness. Has this herb been prepared and/or manufactured properly? 3. ARE CHINESE HERBAL MEDICINALS SAFE? A search of the FDA 7 databases which document reports of medicinal toxicity. Urinary tract problems mostly consist of difficulty voiding or incontinence.10 Therefore. arms. gastrointestinal complaints are typically the first adverse reactions to a medicinal. Gastrointestinal complaints include nausea. pruritus. I believe the answer to the above question is. Is this herb indicated by both the disease diagnosis and the patient’s personally presenting Chinese medical pattern discrimination? 2. diarrhea. and/or bleeding. headache. and/or cough. In particular. while respiratory reactions mostly include shortness of breath. constipation. The most common visual disturbances as a medicinal reaction are blurred vision or absence of vision in one or both eyes.

A similar caution should be applied to the prescribing of obscure or unusual herbs. Chinese medicinals should only be prescribed by fully trained practitioners of Chinese herbal medicine in accordance with a traditional individualized diagnosis. then careful and thorough clinical research and monitoring must be undertaken. 5.Chapter 1 The Potential for Toxicity • 11 REGISTRY OF CHINESE HERBAL MEDICINE RECOMMENDATIONS FOR THE PRESCRIPTION OF CHINESE MEDICINALS The Register of Chinese Herbal Medicine (RCHM) is a professional association of practitioners of Chinese herbal medicine in the United Kingdom. Professional bodies will increasingly need to be able to guarantee minimum standards of practice and to enforce codes of ethics and practice. 9. Patients should be regularly monitored. for example in the form of chemical extracts or for symptomatic treatment. 1. Proper identification and quality control of medicinals by manufacturers and suppliers is a key ingredient in enabling the safe practice of Chinese herbal medicine. 7. . 3. Practitioners should maintain good communication with patients. The medicinals should be used according to their traditional indications and in established combinations. Suppliers should not make available patent medicines whose ingredients are not certain. 6. Chinese medicinals should be prescribed in the traditional manner. 8. 2. We believe the following guidelines should be adopted in all countries where Chinese herbal medicine is practiced. The RCHM is very concerned about medicinal toxicities and interactions. and practitioners should not prescribe them. Whenever it is proposed to use herbs in novel ways. 4. Training of practitioners should include the ability to monitor for and recognize adverse effects. according to an individualized diagnosis based on the theory and practice of Chinese medicine.

.cfsan. p. ed. p. Therefore. Cautions and Contraindications.pdf 10 http://www. Seattle. 2213 2 Lucretius. A. F. D. Invocation. 3 In fact. 1986 6 Bensky & Gamble. Oriental Healing Arts Institute. by Donald Venes. many come from the animal and mineral realms. Davis Co. Book 1.gov/oc/initiatives/ephedra/february2004/ 9 http://www. Eastland Press. 10-11 7 www. the term “herbal” is at least partially a misnomer. Chinese medicinals are not all herbs.gov 8 http://www. 1993 5 Hsu.. cit. Philadelphia. 4 Bensky.. & Gamble.fda.fda.html 1 .Chapter 1 12 • Herb Toxicities & Drug Interactions: A Formula Approach ENDNOTES Taber’s Cyclopedic Medical Dictionary.fda. CA.gov/~dms/ds-ill.A.fda. Oriental Materia Medica: A Concise Guide. Hong-Yen. While most Chinese medicinals are vegetable or “herbal” in nature. 2001. op.cfsan. 19th edition. Long Beach. De Rerum Natura (On the Nature of Things).gov/~acrobat/lib4212. Chinese Herbal Medicine: Materia Medica.

It may have also been due to the fact that the Chinese medicinals were not prepared in a decoction but ground up raw. Later research suggested that the aristolochic acid intoxication might have come from a different source.CHAPTER CONTENTS Nephrotoxicity Hepatoxicity Fetotoxicity CHAPTER 2 OF THREE IMPORTANT TYPES POTENTIAL MEDICINAL TOXICITY In the past decade. hepatoxicity. These are nephrotoxicity. such as the medicinal Guang Fang Ji (Radix Aristolochia Fangji) which does contain aristolochic acid and may have been included in the capsules due to a purchasing and identification error by the practitioners prescribing it. three types of toxicity have received attention and driven concern over the safety of Chinese medicinal substances. subsequent chromatographic examination of the capsules showed that they did not contain the compound tetandrine which is a major component of Han Fang Ji and is used as a chemical marker for this medicinal. a known nephrotoxin. This concern was driven by the Belgium incident mentioned in the Introduction.2 However. Another possibility is that the toxicity resulted . thus greatly increasing their individual potency. such as the low carbohydrate diet the patients were on which might have accelerated and enhanced the effect of all the pharmaceutical products in the formula. Or else the toxicity originated from a combination of other causes. and fetotoxicity. The medicinal singled out for the nephrotoxicity was Han Fang Ji (Radix Stephaniae Tetandrae) which was alleged to be in the capsules consumed by the women. NEPHROTOXICITY The greatest concern over the toxicity of Chinese medicinal products remains the potential for nephrotoxicity.1 The cause of the nephropathy experienced by the women who took the dangerous “slimming formula” was thought to be aristolochic acid.

and nephrotoxic if not decocted properly with other medicinals. fenfluramine. Just as the combination of acetaminophen (Tylenol®) and alcohol can create a potentially fatal hepatoxicity. or Di Yu (Radix Sanguisorbae Officinialis) create a hepatoxic combination when processed in the liver with isoniazid.” 5 wherein the toxic medicinal’s potentially toxic effects are eliminated by one or more other substances. the FDA branded all Chinese medicinals containing even trace amounts of aristolochic acid before cooking as being toxic and began moving to prohibit their sale and prescription by 2001. most Oriental medical practitioners are either eliminating these medicinals from their formulas or substituting other medicinals with similar actions to take their place. so too can the medicinals He Zi (Fructus Terminalia Chebulae). or erythromycin. the potentially toxic effects of many herbs can be eliminated by appropriate herbal preparation. rafampcin. popular and effective medicinals which appear in many formulas. Another example is the unfortunate result that may occur when some Chinese herbal medicinals interact with orthodox Western drugs in the liver. Fortunately. 6 Patients taking any of these Western pharmaceuticals should be monitored carefully to guard against accidental poisoning due to the combination effects of these substances. when prepared and dosed properly.Chapter 2 14 • Herb Toxicities & Drug Interactions: A Formula Approach from the strange combination of medicinals which included Western appetite inhibitors. can cause nephropathy.3 In addition to Guang Fang Ji and Han Fang Ji. Cang Er Zi (Fructus Xanthii Sibirici). In the meantime. HEPATOXICITY In general. these substances included Mu Tong (Caulis Mutong). a commonly used herb for many nasal symptoms. upon hearing of the reports from Belgium. they remain banned today. Wei Ling Xian (Radix Clematidis). Wu Bei Zi (Galla Rhois Chinensis). can be both hepa. including the now banned pharmaceutical.4 Despite little evidence that these medicinals. and Xi Xin (Herba Asari Cum Radice). As discussed in Chapter 1. the advantage of most Chinese medicinals is that they are quickly processed and passed out of the liver with no hepatoxic effects. a measure that should solve the potential toxicity problem. a number of respected American pharmaceutical companies who manufacture Chinese medicinal formulas have found a way to process these forbidden herbs so that the trace amounts of aristolochic acid they contain are removed prior to decoction. This is an example of “mutual counteraction. A third example of hepatoxicity due to Chinese medicinals came as the result of the liver damage caused by a ready-made medicine called Jin Bu Huan . Regardless of the cause. chlorpromazine. However there are some exceptions which should be noted. tetracyclines.

a once-popular remedy for insomnia and pain. reduction in coloration of the feces Medicinal-induced hepatitis is defined as inflammation of the liver resulting in loss of integrity of the cell membranes causing leakage of cells’ contents into blood plasma. Although the mechanism that caused the hepatitis in this small number of individuals is still unclear. SGOP) and ALT (a. Therefore. At first.7 In either case. were instrumental in focusing attention on the issue of toxicity and Chinese medicinals with subsequent efforts on the part of manufacturers and distributors to substantially increase quality control. it was thought this was perhaps due to a reaction to its supposed primary ingredient.a. the result was that Jin Bu Huan was banned in the United States and the United Kingdom. there is elevation of the liver enzymes AST (a. Stop signs when using herbs include: 1. and pre-existing liver disease. seven adults taking the brand of this formula manufactured by the Kwangsi Pai Se Company developed symptoms of hepatitis consistent with a drug reaction.S. further investigation found that the alkaloids in the remedy did not match those of the Polygala family but rather that of the blood-quickening herb Yan Hu Suo (Rhizoma Corydalis Yanhusuo).k.a.Chapter 2 Three Important Types of Potential Medicinal Toxicity • 15 (More Precious Than Gold). Yuan Zhi (Radix Polygalae Tenuifoliae). these immunoallergic reactions in the U. So it remains uncertain whether the remedy contained the wrong medicinal or was adulterated by some other substance which caused the actual hepatoxicity. Development of a substantial skin rash 2. Risk factors predisposing one to hepatoxicity include previous notable adverse reactions to drugs or herbs or a history of a number of different allergies. Curiously. this is still a popular remedy in Far and Southeast Asia with no reports of hepatoxicity from its use in those regions. SGOT). fatigue. The developing embryo is so vulnerable to damage caused by foreign sub- . and/or aching in the area of the liver. yellowing of the eyes or skin.k. Nausea. investigators at the time concluded that it was due to an immunoallergic reaction because of the eosinophilia found in the liver biopsies of two of the patients. bloating. FETOTOXICITY Perhaps the most difficult type of toxicity facing the practitioner of either Western or Oriental medicinal products is the potential for causing fetotoxicity. a history of chronic skin rashes. In 1993-94. In any case. However.

op. including external conditions such as traumas and internal issues such as hematuria. 72 7 Blackwell. p. cit.fda. L. It is generally decocted with medicinals such as Fu Ling (Sclerotium Poriae Cocos) and Gui Zhi (Ramulus Cinnamomi Cassiae) to treat lower body edema due to fluid accumulation.”(http://acupuncture. and the ancient herbs frankincense and myrrh (Mo Yao. which include herbs such as San Qi (Radix Notoginseng). have the actions of stopping bleeding and/or dispelling blood stasis.htm)....Chapter 2 16 • Herb Toxicities & Drug Interactions: A Formula Approach stances in the mother’s blood stream that many Western and Oriental medicinal products. While it is obvious that highly potent and/or toxic substances. K. op. They are very effective in treating various forms of bleeding. cit. and 2 1 Blackwell.9 ENDNOTES op. cit.gov/~dms/addsbot.com/ Herbology/aristo. It should be noted that Han Fang Ji. such as Ma Huang (Herba Ephedrae) or Fu Zi (Radix Lateralis Praeparatus Aconiti Carmichaeli). Most Oriental medicine practitioners avoid giving this class of herbs to a pregnant patient unless there is a cogent reason. It is believed that they can create problems for patients on Western anticoagulant medications.cfsan. Resina Myrrhae. 3-4 8 In actual point of fact. p. Unfortunately. Dan Shen (Radix Salviae Miltiorrhizae). “Aristolochic Acid and ChineseHerbs. 1-3. Taylor and Francis. 2003. p. http://www.8 One more note on this class of Chinese medicinals. are considered problematic and potentially lethal for the fetus. These medicinals. they can dramatically alter prothrombin times. & Cheung. such as angina due to coronary artery disease. is not commonly used by trained Oriental medicine practitioners for weight loss. either by direct poisoning or by causing spontaneous abortion. while having diuretic qualities. p. they are positively indicated.html 4 Chen. when these medicinals are used inappropriately in pregnant women. p. blood-quickening medicinals are not absolutely forbidden during pregnancy to trained and experienced gynecological specialists. an entire class of Chinese herbs known as blood-quickeners are generally forbidden for prescription during pregnancy. 3 FDAConsumer Advisory. while quite safe for an adult. Interactions Between Chinese Herbal Medicinal Products and Orthodox Drugs. 1-3 5 Bensky & Gamble.. would be harmful to a fetus. They also treat various internal clotting-related symptoms. When blood stasis is one of the causes of threatened abortion. As a result. and Ru Xiang. London. this group of Oriental medicinals are generally not prescribed to patients taking these Western drugs.. they can potentially interfere with uterine blood flow to the fetus and cause it to be expelled as a clot. J. If prescribed to a patient taking a warfarin-based Western pharmaceutical. . 9 6 Chan. Resina Olibanui).

such prohibitions are also not regarded as absolute. this is also a complex situation. In China. However. 9 Unfortunately. when used in such circumstances. . they should be prescribed in the smallest effective dose and their use should be suspended as soon as they are no longer indicated.Chapter 2 Three Important Types of Potential Medicinal Toxicity • 17 failure to prescribe them may result in a failure to forestall the abortion. where integrated ChineseWestern medicine is more advanced and there are senior practitioners specializing in cardiovascular disease with decades of experience.

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The English translation is primarily based on Wiseman’s EnglishChinese Chinese-English Dictionary of Chinese Medicine6 supplemented by Bensky and Barolet’s Chinese Herbal Medicine: Formulas & Strategies and Hong-yen Hsu’s Commonly Used Chinese Herb Formulas with Illustrations7 . each formula listing contains the following information: FORMULA NAME The formula name is given in both Chinese (in Pinyin romanization) and English.1 Bensky and Barolet’s Chinese Herbal Medicine: Formulas & Strategies. it does not contain all the information on these medicinals that either Western or Oriental medical practitioners may be accustomed to or want.3 Similarly. 5 What this book will enable both Western and Oriental medical practitioners to do is to quickly and accurately assess the potential toxicity that a particular formula and its medicinal components can present.CHAPTER CONTENTS Formula Name Category Functions Chinese Medical Indications Contraindications Western Medical Indications Potential Formula Toxicities and Interactions Potential Medicinal Toxicities and Interactions Medicinal Name Standard Daily Dosage Advisories Comments What About Conflicting Information? Looking Up Formulas & Individual Medicinals CHAPTER 3 HOW TO USE THIS BOOK This book has been written as a reference guide specifically on Chinese medicinal toxicity and drug interactions for both Western and Oriental medical practitioners. for Western medical practitioners.2 and/or Flaws’s 260 Essential Chinese Medicinals and 70 Essential Chinese Herbal Formulas.4 a valuable resource that I have utilized throughout this book. this book is not designed to replace the PDR for Herbal Medicines. For more detailed Chinese medical information on the medicinals included in this book. Western medical practitioners who wish to gather more complex pharmacological information about the medicinals listed in this book should either consult the PDR for Herbal Medicines or Huang’s Pharmacology of Chinese Herbs. readers are referred to Bensky and Gamble’s Chinese Herbal Medicine: Materia Medica. As such. To accomplish this.

k. These functions were taken from Bensky and Barolet’s Formulas & Strategies and/or Flaws’s 70 Essential Chinese Herbal Formulas or written by Bob Flaws specifically for this book. FUNCTIONS This section presents the Chinese medical functions of the formula. . Si Jun Zi Tang. CHINESE MEDICAL INDICATIONS In this section. They are primarily based on Bensky and Barolet’s Formulas & Strategies and Flaws’s 70 Essential Chinese Herbal Formulas.8 CONTRAINDICATIONS These are the contraindications for each formula in terms of Chinese medical patterns and traditional Chinese medical disease categories. Four Gentlemen Decoction a. they were primarily included for use by Oriental medical practitioners. Four Major Herb Combination) CATEGORY The formula category is taken from the classifications determined by Bensky and Barolet and Flaws. be that traditional Chinese or modern Western medical disease diagnosis. The use of pulse images is based on the definitions found in Bob Flaws’s The Secret of Chinese Pulse Diagnosis.Chapter 3 20 • Herb Toxicities & Drug Interactions: A Formula Approach (i. While some Western practitioners may find these useful.a.. Many of these contraindications underscore the fact that Chinese medicinal formulas are meant to be prescribed primarily on the basis of Chinese medical pattern discrimination and only secondarily on the basis of disease diagnosis. This will be of more relevance to Oriental medicine practitioners but may prove useful to Western medical practitioners as well in determining the kind of diseases and/or patterns for which the formula may be indicated. These are correlated to the standard treatment principles found as the intermediary step between the disease and patterns diagnoses and the treatment plan in the patient’s Oriental medical chart. In a few cases. Bob Flaws has written Chinese medical contraindications specifically for this book.e. we present the main pattern and traditional Chinese medical disease indications for the formula along with a precis of the defining signs and symptoms of that pattern. including in most cases tongue and pulse signs.

2) standard daily dosage. the rationale for the use of the formula is primarily based on the patient’s presenting pattern(s) which does/do conform to the formula’s standard pattern indications. POTENTIAL MEDICINAL TOXICITIES AND INTERACTIONS This section comprises the bulk of each formula’s listing. the author presents several case histories of using this formula for the treatment of new Western medical diseases previously not considered within the standard scope of that formula. this section is primarily for Western medical practitioners. may list additional concerns. in some cases. . Because Chinese medicinal formulas are prescribed primarily on the basis of pattern discrimination. It is divided into three parts: 1) each medicinal’s name.” In that case. Occasionally. the sources I employed may disagree or. Thereafter. just because neither work listed a formula caution.Chapter 3 How To Use This Book • 21 WESTERN MEDICAL INDICATIONS Just as the previous sections were provided for primarily Oriental medicine practitioners. one should then consult the next section to determine the relative safety of the formula. POTENTIAL FORMULA TOXICITIES AND INTERACTIONS This section is a listing of cautions taken from Bensky and Barolet’s Formulas & Strategies and Flaws’s 70 Essential Chinese Herbal Formulas. the listing for this section is “None listed. The cautions apply to the formula as a whole. In these cases. if no cautions are listed. These cautions are often due to some of the individual medicinals in the formula. The indications were taken from Bensky and Barolet’s Formulas & Strategies and Flaws’s 70 Essential Chinese Herbal Formulas and include the most common Western disease applications for each formula. A popular genre in the contemporary Chinese medical literature is the so-called New Uses article. Indeed. these Western medical disease indications are only indicative of a formulas scope of application and are not necessarily categorically complete. well-known formula’s name. the formula is entirely safe. and 3) the advisories associated with each medicinal based on the sources used. I have used an abbreviated coding system. These articles begin with the words “New Uses of” followed by a standard. In many cases. “FL” or “B&B” by itself means that the information came solely from the single work. the reader should not assume that. To clarify the agreements and disagreements. “B&B/FL” indicates that both works agree on the stated cautions.

Because the Chinese often use different names for the same medicinal as well as different species under the same Chinese name. If there is a common. powdered extracts. any other method of administration is specified.” That being said. such as “in pills and powders.Chapter 3 22 • Herb Toxicities & Drug Interactions: A Formula Approach MEDICINAL NAME Each medicinal is listed by its most common Chinese names (in Pinyin romanization) followed by its Latin pharmacological name in parentheses. then that follows the pharmacological name in parentheses. a 10:1 extract ratio means that 10 pounds of herbs were used to make one pound of finished product. or tinctures. If one then wants to know the approximate daily dose of a single ingredient in a ready-made extract for- . If one knows the extract ratio of a Chinese medicinal formula. The higher the first number. If it takes eight pounds (or kilos) to make one pound (or kilo) of finished product. For instance. therefore. if one name is ambiguous or unclear. it is necessary to say something about the conversion of these standards when looking at the use of some sort of ready-made extract. while three grams of a 10:1 extract powder equal 30 grams of bulk-dispensed herbs. that the Chinese name of a medicinal be crossreferenced by a pharm-acological name. These daily doses are the standards for the prescription and administration of bulk-dispensed Chinese medicinals made into water decoctions for oral administration. For example. most Westerners availing themselves of the benefits of Chinese medicinals are taking their medications in the form of ready-made pills. well-known English name. Similarly. that is a 5:1 extract ratio. then one can figure out roughly how much of that ready-made medicine equals how much of bulk-dispensed herbs. When this is not the case. The easiest way to determine the relative strengths of extracts is to know their extract ratio. That way. three grams of a 5:1 extract powder equal 15 grams of bulk-dispensed herbs. STANDARD DAILY DOSAGE This is the standard daily dosage as taught at government sponsored and endorsed Chinese medical colleges in the People’s Republic of China and found in such standard English language texts as Bensky and Gamble’s Chinese Herbal Medicine: Materia Medica and Hong-yen Hsu’s Oriental Materia Medica: A Concise Guide. it is extremely important. Therefore. the more highly concentrated is the extract and. the other name should clarify the medicinal’s identity for all concerned. if it takes five pounds (or kilos) of a medicinal or medicinal formula to make one pound (or kilo) of finished product. then this is an 8:1 extract ratio. the more potent it is.

1 part This means that there are a total of 13 parts to this formula (4 + 4 + 4 + 1 = 13). At this point in time. and anecdotal evidence in humans based on a very few incidents. Therefore. in Si Jun Zi Tang (Four Gentlemen Decoction a. such as Ma Huang (Herba Ephedrae). in no way. if the Ren Shen had been taken as part of a bulk-dispensed. Then one multiplies 4/13 times 15 (4/13 x 15 = 4. we simply do not yet have enough experience and information to make simple. Each source is coded. one then multiples 4/13 times 15. the answer is 4.615 grams). one first multiplies three grams times five (3g x 5 [the extract ratio multiplier] = 15). and a key is listed at the bottom of each page for your convenience. The truth of the matter is that.615 grams of Ren Shen. Since the standard daily dosage range for Ren Shen runs from 1-30 grams. In other words. However. one can figure the proportion of that ingredient in the standard form of that prescription and then divide accordingly. when it comes to a Chinese medicinal’s interactions with every single Western medical drug. Four Major Herb Combination). For instance.615 grams. If one wants to know how much Ren Shen is in three grams of this formula in a 5:1 extract form.10 In some cases. this is well within and towards the low end of Ren Shen’s standard dosage range. animal studies. 4 parts Fu Ling (Sclerotium Poriae Cocos). definitive and categorically complete. . 4 parts Bai Zhu (Rhizoma Atractylodis Macrocephalae). the proportions given by Hong-yen Hsu for the individual ingredients are as follows: Ren Shen (Radix Panacis Ginseng). we have included a summary statement with the most important warnings about the medicinal. categorically complete. It should be strongly noted that most of these advisories are couched in terms of theoretical possibility. where there is general agreement among all sources about its potential toxicity. water-based decoction in the same proportions as the above formula. “AH” stands for the American Herbal Products Association (AHPA)’s Botanical Safety Handbook. in vitro experiments. these advisories are based on theoretical speculation. This means that. the patient would have received 4. For example.Chapter 3 How To Use This Book • 23 mula. and definitive statements.a. these advisories are.k. ADVISORIES The advisories for each medicinal come from six potential sources. 4 parts Gan Cao (Radix Glycyrrhizae Uralensis). A certain medicinal could do such and such or may result in such and such based on its chemical constituents or pharmacodynamic actions.

Having this additional information allows the practitioner to make a determination as to whether this medicinal is appropriate for the patient. either expanding on its use or other useful information for practitioners. If the patient is nursing. COMMENTS Comments are our concluding comments about the formula. potential adverse reactions are forestalled or mitigated by other ingredients in a formula. This may seem confusing at first. and dosage are correct. many medicinals are considered by AHPA to be “safe when used appropriately. it is to be expected and may. “Not recommended for nursing mothers as it may inhibit lactation. WHAT ABOUT CONFLICTING INFORMATION? In many cases. it may be wiser to either leave it out of the formula or find a substitute formula for treating the problem.Chapter 3 24 • Herb Toxicities & Drug Interactions: A Formula Approach In addition. a particular formula. in the larger context. this additional information helps one make an informed choice about a particular medicinal and. in the end. actually. In some cases. Bensky and Gamble offer the caution. In part.” This means that. medicinal advisories from different sources may conflict. standard professional Oriental medicine does not use singles (with a few notable exceptions). if the diagnosis. However. For example. practitioners of Western medicine are especially advised not to read too much into these individual advisories in terms of catastrophic potential. In other cases. Therefore.” This simply means that these authors discovered a source or found a study that indicated some potential for this medicinal’s inhibiting lactation. many of these advisories are not very meaningful when read and judged by trained and experienced Oriental medical practitioners. . It uses formulas made up of multiple ingredients according to well-established. has had a history of scanty or difficult lactation and Bo He is a primary ingredient in the formula under consideration. the role that a medicinal plays in a particular formula may call for such a low dose as to render it innocuous. but. the medicinal will generally have no potential toxicity. these advisories all deal with the use of individual medicinals used as “singles. in the case of common field mint (Bo He. such as common substitutions. preparation. Herba Menthae Haplocalycis). these principles and rules are meant to avoid the creation of adverse interactions and to minimize the potential for toxicity. In other words. be quite useful. time-tested principles and rules.” However. Therefore.

70 Essential Chinese Herbal Formulas.. Chinese Herbal Medicine: Formulas and Strategies. Eastland Press. Eastland Press. N. 1993 2 Bensky. And finally.Chapter 3 How To Use This Book • 25 LOOKING UP FORMULAS & INDIVIDUAL MEDICINALS This book has several comprehensive indexes to make finding information within quick and relatively easy. American Herbal Products Association’s Botanical Safety Handbook. CRC Press. there is a Chinese medicinal index in Pinyin romanization as well as in Latin pharmacological nomenclature. 2003 5 Huang.C. Chinese Herbal Medicine: Materia Medica. English-Chinese Chinese-English Dictionary of Chinese Medicine. 1990 3 Flaws. & Barolet. Hunan Science & Technology Press.. Oriental Healing Arts Institute. CO. Seattle. 1999. Next. 2nd ed. Seattle. signs and symptoms. If you have not been trained sufficiently in either. 1980 8 Flaws. This is followed by a formula index in Pinyin as well as a formula index in English. The Secret of Chinese Pulse Diagnosis. D. Boulder.. either Western or Oriental. & Gamble. al. A. Neither the authors of this book or the source books utilized to research and generate this work should be held liable for injuries to patients due to the information contained herein. The Pharmacology of Chinese Herbs. 1995 9 Hsu. CO. and Western medical terms and medications. 2001 4 Tyler Varro E. Thomson Medical Economics. There is a general index which mainly consists of diseases. Blue Poppy Press.... this book is accompanied by a CD-ROM which is searchable by any term in any of these indexes. 1999 6Wiseman. Blue Poppy Press. Hong-yen. 1997. 260 Essential Chinese Medicinals. ed. 264 10M. B.. 1 . K. LA. Changsha. CRC Press. N. p. McGuffin. B... cit.. NJ. D... Montvale. ed’s. ENDNOTES Bensky. R. Physicians’Desk Reference for Herbal Medicines. Commonly Used Chinese Herb Formulas with Illustrations. et. DISCLAIMER This book is not intended to be a substitute for good medical training and practice. 1996 7 Hsu. op. you should not be using this book as a prescription tool for treating patients. Boulder. NY.

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uremia. cattle gallstone. formula should not be heated.15-1g used only in pills and powders B&G: Contraindicated during pregnancy. hepatic coma.a. acute encephalitis. C&C= CHAN & CHEUNG.k. easy anger.CHAPTER 4 TOXICITIES & DRUG INTERACTION AN GONG NIU HUANG WAN (Quiet the Palace Bezoar Pills. restlessness. POTENTIAL MEDICINAL TOXICITIES & I NTERACTIONS: Niu Huang (Calculus Bovis. sweeps away phlegm and resolves toxins Chinese medical indications: Heat evils falling into the pericardium with high fever. infantile convulsions. B&B= BENSKY & BAROLET. a crimson red tongue. pneumonia. bezoar) Standard daily dosage: 0. F L= FLAWS. acute hepatitis. deranged speech. Bos & Curcuma Formula) Category: Orifice-opening Functions: Clears heat and opens the orifices. dysentery. BR= BRINKER. and a rapid pulse Contraindications: Pregnancy Western medical indications: Total or partial loss of consciousness due to cerebral vascular accident. spirit clouding. acute meningitis. Large overdosage in mice led AH= AHPA. and schizophrenia Potential formula toxicities & interactions: FL/B&B: Do not use in high doses or long-term due to the possibility of mercury toxicity from Zhu Sha (Cinnabaris). For best results. PDR= P HYSICIANS’ DESK REFERENCE . a. B&G= B ENSKY & GAMBLE. GLW= GAO LU WEN.

Could possibly reduce the absorption and therapeutic effect of potassium and sodium iodides. Cao Wu (Radix Aconiti Kusnezoffii). and death. Because Xi Jiao is from an endangered species. and AH= AHPA. Could possibly cause hyperkalemia when used with potassium-sparing diuretics. sodium bicarbonate. Jiang Can (Bombyx Batryticatus).5-9g.(This medicinal is commonly used during pregnancy in China when indicated by disease and pattern discrimination. According to traditional sources. According to some traditional sources. Standard daily dosage of this ingredient in decoction is 4.016-0. it is now commonly substituted by Shui Niu Jiao (Cornu Bubali. Huang Lian (Rhizoma Coptidis Chinensis) Standard daily dosage: 1.Chapter 4 28 • Herb Toxicities & Drug Interactions: A Formula Approach to diarrhea. antagonizes Long Gu (Os Draconis). quercetin.15g in pills and powders B&G: Contraindicated during pregnancy. FDA has banned the inclusion of this medicinal in all dietary supplements. PDR= PHYSICIANS’ DESK REFERENCE .5-9g. Long-term use may damage the digestive system.S. water buffalo horn).) B&G: Contains berberine. AH: Do not use during pregnancy. coma. According to some traditional sources. musk) Standard daily dosage: 0. B&B= BENSKY & BAROLET. Xi Jiao (Cornu Rhinocerotis. B&G= B ENSKY & GAMBLE. GLW= GAO LU WEN . may antagonize Chuan Wu (Radix Aconiti Carmichaeli). C&C= CHAN & CHEUNG. The U. and Long Dan Cao (Radix Gentianae Longdancao) and counteracts Niu Xi (Radix Achyranthis Bidentatae). Bai Xian Pi (Cortex Radicis Dictamni Dasycarpi). She Xiang (Secretio Moschi Moschiferi. calcium gluconate. carbonate. and Lei Wan (Sclerotium Omphaliae Lapidescentis). antagonizes Ju Hua (Flos Chrysanthemi Morifolii). and potassium. BR= BRINKER. Some traditional sources say it should not be taken with pork. Use with caution in cases of hypertension. Sheng Di (uncooked Radix Rehmanniae Glutinosae). rhinoceros horn) Standard daily dosage: 1-2g as a powder B&G: Use with great caution during pregnancy and only in the presence of high fever. Xuan Shen (Radix Scrophulariae Ningpoensis). F L= FLAWS. According to some traditional sources counteracts Kuan Dong Hua (Flos Tussilaginis Farfarae) and Niu Xi (Radix Achyranthis Bidentatae). C&C: Contains alkaloids.

Tiao Qin (Radix Scutellariae Baicalensis) Standard daily dosage: 6-15g AH: Safe when used appropriately B&G: According to some traditional sources. Huang Qin. nicotinic acid.Chapter 4 Toxicities & Drug Interaction • 29 lactate. nicotinic acid. Vitamin C. counteracts Dan Pi (Cortex Radicis Moutan) and Li Lu (Rhizoma Et Radix Veratri). and other highly acidic substances could possibly reduce the therapeutic effect of this medicinal. C&C= CHAN & CHEUNG. Could possibly cause hyperkalemia when used with potassium-sparing diuretics. Shan Zhi. aluminum hydroxide. Do not expose to heat. magnesium and ferrous sulfates. Xiong Huang (Realgar.15-0. F L= FLAWS. GLW= GAO LU WEN .5-9g AH= AHPA. arsenic sulfide) Standard daily dosage: 0. Shan Zhi Zi (Fructus Gardeniae Jasminoidis. and bismuth subcarbonate. PDR= PHYSICIANS’ DESK REFERENCE . C&C: Contains potassium and glycosides. Zhi Zi. glutamic acid. and other highly acidic substances could possibly reduce the therapeutic effect of this medicinal. glutamic acid. BR= BRINKER.3-0. hydrochloric acid. Could possibly cause hyperkalemia when used with potassium-sparing diuretics.9g in pills and powders B&G: Use with caution during pregnancy. B&B= BENSKY & BAROLET. C&C: Contains potassium and glycosides. Yu Jin (Tuber Curcumae) Standard daily dosage: 4. dried gardenia fruit pod) Standard daily dosage: 3-12g AH: Safe when used appropriately B&G: Contains geniposide which caused diarrhea in mice. B&G= BENSKY & GAMBLE. hydrochloric acid.6 in pills and powders B&G: Contraindicated during pregnancy Bing Pian (Borneol) Standard daily dosage: 0. Vitamin C.

COMMENTS This powerful formula is designed to treat strokes. and trembling.7g in pills and powders B&G: Contains mercuric sulfide which is highly toxic. do not heat. and eventual respiratory failure. vomiting. swelling and distention of the mucosa. ulceration. clenched teeth. GLW= GAO L U WEN . AH= AHPA. shock. fright reversal. B&G= BENSKY & GAMBLE. mucus in the stools or hemafecia. PDR= PHYSICIANS’ DESK REFERENCE . Should not be used in large amounts or long-term. C&C: Contains potassium. If severe. If the kidneys are poisoned. pearl) Standard daily dosage: 0. there is edema. C&C= CHAN & CHEUNG. Zhen Zhu (Margarita. It has several toxic substances in it and should only be prescribed by a skilled practitioner. Some traditional sources discourage use with Ding Xiang (Flos Caryophylli). It is typically administered as a ready-made medicine. bleeding. and a metallic taste in the mouth. diarrhea. Could possibly reduce the effect of most antibiotics and levadopa.9g in pills and powders C&C: Contains calcium.Chapter 4 30 • Herb Toxicities & Drug Interactions: A Formula Approach B&G: Use with caution during pregnancy. hinder the absorption of isoniazid. BR= BRINKER. albuminuria. Zhu Sha (Cinnabaris. cinnabar) Standard daily dosage: 0. Could possibly cause hyperkalemia when used with potassium-sparing diuretics. GLW: Symptoms of adverse reaction include burning pain in the oral cavity and throat. and other neurological symptoms.2-2. scanty urination. nausea. F L= FLAWS. PDR: This medicinal should not be used by people with obstructed biliary ducts. and acute kidney failure. B&B= BENSKY & BAROLET. there is hemorrhagic enteritis. epilepsy. low blood pressure. syncope. abdominal pain. Stomach complaints can occur following extended use or in the case of overdose. cause digitalis intoxication and heart arrhythmias. Those with gallstones should take it only under the supervision of a physician. To prevent mercury poisoning. convulsions.3-0.

glomerulonephritis. B&B= BENSKY & BAROLET.k. acute nephritis. acute prostatitis. PDR: Do not administer during pregnancy. acute pyelonephritis. and acute gonorrhea Potential formula toxicities & interactions: FL/B&B: Long-term use may cause weakness. light-headedness. Some patients present oily stools. such as upper abdominal discomfort. heart palpitations. rapid pulse Contraindications: Cold Western medical indications: Acute urinary tract infection. urinary calculi. unclear consciousness. This medicinal is often substituted with Caulis Aristolochiae AH= AHPA. B&G= BENSKY & GAMBLE. scanty. and diminished appetite. uremia leads to death. chest oppression. intestinal colic. GLW= GAO LU WEN . yellow tongue fur. Use with care during pregnancy. GLW: Symptoms of adverse reaction include early stage symptoms of poisoning. urgent urination. In those with acute kidney failure. C&C: Contains potassium. cystitis. inability to lie down. Dianthus Formula) Category: Dampness-dispelling Functions: Clears heat and drains fire. urethritis. BR= BRINKER.a. Could possibly cause hyperkalemia when used with potassium-sparing diuretics. PDR= PHYSICIANS’ DESK REFERENCE . and diarrhea. turbid.Chapter 4 Toxicities & Drug Interaction • 31 BA ZHENG SAN (Eight Correcting [Ingredients] Powder. disinhibits water and frees the flow of strangury Chinese medical indications: Heat and/or bloody strangury due to damp heat in the lower burner with dark. F L= FLAWS. Could possibly cause dehydration and renal failure in large doses. abdominal pain. C&C= CHAN & CHEUNG. difficult. Secondarily. slimy. there is frequent urination. and increased blood pressure. scanty urination or blocked urination. facial edema which gradually spreads to the entire body. Large doses of the medicinal may lead to gastroenteritis. and diarrhea due to saponin content. and painful urination. a. vomiting. POTENTIAL MEDICINAL TOXICITIES & I NTERACTIONS: Mu Tong (Caulis Akebiae) Standard daily dosage: 3-9g B&G: Contraindicated during pregnancy. and a slippery. a dry mouth and parched throat.

Could possibly reduce the effect of most antibiotics.5-9g B&G: Contraindicated during pregnancy C&C: Contains glycosides. AH= AHPA. B&B= BENSKY & BAROLET. Bian Xu Cao (Herba Polygoni Avicularis) Standard daily dosage: 9-15g B&G: Could possibly cause dermatitis or gastrointestinal disturbance in horses or sheep. Vitamin C. C&C: Contains glycosides. reserpine. glutamic acid. Che Qian Ren (Semen Plantaginis. and other highly acidic substances could possibly reduce the therapeutic effect of this medicinal. and prednisolone. and hinder the absorption of isoniazid. many antibiotics (especially aminoglycosides and sulfas). and berbamin. BR= BRINKER. C&C: Contains calcium and magnesium. C&C= CHAN & CHEUNG. Could possibly cause crystalluria and hematuria. scopolamine. F L= FLAWS. PDR= P HYSICIANS’ DESK REFERENCE . nicotinic acid. Can stimulate the growth of granulomas in the colon and vagina. aluminum hydroxide. Qu Mai (Herba Dianthi. caffeine. cause digitalis intoxication and heart arrhythmias. plantain seeds) Standard daily dosage: 4. B&G= B ENSKY & GAMBLE. hydrochloric acid. Therefore. GLW= GAO LU WEN. Hua Shi (Talcum) Standard daily dosage: 9-18g AH: Safe when used appropriately B&G: Use with caution during pregnancy. and other highly acidic substances could possibly reduce the therapeutic effect of this medicinal. reduce the therapeutic effect of sodium bicarbonate. Highly acidic. glutamic acid. levadopa. dianthus) Standard daily dosage: 6-24g B&G: According to traditional sources. opiates. may antagonize Sang Piao Xiao (Ootheca Mantidis).Chapter 4 32 • Herb Toxicities & Drug Interactions: A Formula Approach Manchuriensis which contains aristolochic acid. it is important that this medicinal only be prescribed in the form of Caulis Akebiae Trifoliatae or Akebiae Quinatae. nicotinic acid. hydrochloric acid. Che Qian Zi. Bian Xu. Vitamin C.

Shan Zhi Zi (Fructus Gardeniae Jasminoidis. Vitamin C. dried gardenia fruit pod) Standard daily dosage: 3-12g AH: Safe when used appropriately B&G: Contains geniposide which caused diarrhea in mice. and other highly acidic substances could possibly reduce the therapeutic effect of this medicinal. Chuan Jun. Zhi Zi. Deng Xin.5g No toxicity or interaction information listed in the sources AH= AHPA. hydrochloric acid.Chapter 4 Toxicities & Drug Interaction • 33 C&C: Contains potassium. juncus) Standard daily dosage: 1. Vitamin C. Jun (Radix Et Rhizoma Rhei. PDR= PHYSICIANS’ DESK REFERENCE . Deng Cao (Medulla Junci Effusi. Contraindicated in cases of intestinal obstruction. Contraindicated for nursing mothers since active ingredients enter the milk. PDR: No health risks or side effects are known in conjunction with the proper administration of designated therapeutic dosages. Contraindicated in intestinal obstruction. rhubard root) Standard daily dosage: 3-12g AH: Not to be used during pregnancy. hydrochloric acid. Could possibly cause hyperkalemia when used with potassium-sparing diuretics. glutamic acid. abdominal pain of unknown origin. B&G= B ENSKY & GAMBLE. Overuse may cause hypokalemia and increased toxicity of cardiac glycosides. or any inflammatory condition of the intestines. PDR: Consult a physician before using this medicinal during pregnancy or while nursing. BR: Reduces absorption of oral drugs. nicotinic acid. Could possibly cause hyperkalemia when used with potassium-sparing diuretics. glutamic acid. potassium.5-4. FL= FLAWS. or postpartum. nicotinic acid. B&B= BENSKY & BAROLET. May aggravate potassium loss from diuretics. acute inflammatory intestinal disease. and abdominal pain of unknown origin. B&G: Use with extreme caution during pregnancy. Dai Huang. Deng Xin Cao. menstruation. Could possibly cause hyperkalemia when used in large doses with potassium-sparing diuretics. Da Huang. tannic acid. and glycosides. C&C: Contains alkaloids. appendicitis. B R= BRINKER. GLW= GAO LU WEN. Shan Zhi. and other highly acidic substances could possibly reduce the therapeutic effect of this medicinal. C&C= CHAN & CHEUNG. C&C: Contains potassium and glycosides. Not to be used while nursing.

licorice root) AH: Not to be used during pregnancy. caution should be exercised to guard against potential toxicity and drug interaction. It should not be taken long-term or as a single herb during pregnancy. BR= BRINKER. Contains glycyrrhetinic acid which could possibly cause a reduction in thyroid activity and basal metabolic rate. AH= AHPA. Da Huang can commonly be deleted from this formula. it may cause hypertension and/or edema. and liver disorders. B&B= BENSKY & BAROLET. Possible additive effect to corticosteroids. B&G: According to some traditional sources. it is contraindicated in diabetes. and Yuan Zhi (Radix Polygalae Tenuifoliae). When damp heat is a result of a liver-spleen disharmony.Chapter 4 34 • Herb Toxicities & Drug Interactions: A Formula Approach Gan Cao (Radix Glycyrrhizae Uralensis. this formula needs to be modified or a selection of its ingredients added to some other harmonizing formula. As a single herb in high doses. incompatible with Gan Sui (Radix Euphorbiae Kansui). Yuan Hua (Flos Daphnes Genkwae). as it commonly is in Western patients. GLW= GAO LU WEN. COMMENTS If there is no accompanying constipation. C&C= CHAN & CHEUNG. May be synergistic with insulin in causing hypokalemia and sodium retention. The research on Gan Cao concurs that this medicinal is generally safe when used in small amounts as a harmonizing agent. B&G= B ENSKY & GAMBLE. If taken long-term. PDR= P HYSICIANS’ DESK REFERENCE . When used as a single medicinal or in patients taking other potent Western pharmaceuticals. F L= FLAWS. BR: May increase toxicity of cardiac glycosides. May increase potassium loss due to diuretics and laxatives. Not for long-term use. hypertension.

a. and diarrhea due to saponin content. may counteract Li Lu (Rhizoma Et Radix Veratri). AH= AHPA. high fever. Qian Hu (Radix Peucedani) Standard daily dosage: 4. and a floating. slimy. no sweating. cold. acute cellulitis.Chapter 4 Toxicities & Drug Interaction • 35 BAI DU SAN (Vanquishing Toxins Powder.5-9g B&G: According to traditional sources. In that case. PDR= PHYSICIANS’ DESK REFERENCE . Ginseng Vanquishing Toxins Powder. glutamic acid. C&C: Vitamin C. and other highly acidic substances could possibly reduce the therapeutic effect of this medicinal. Ginseng & Gypsum Combination) Category: Exterior-resolving Functions: Effuses sweat and resolves the exterior. nicotinic acid. intestinal colic.) Overdose may lead to gastroenteritis. severe chills. Ren Shen Bai Du San. B&B= BENSKY & BAROLET. cough with profuse phlegm. pain and stiffness of the head and nape of the neck. Vanquishing Toxins Plus Ginseng Powder.k. upper respiratory tract infections. soreness and pain of the extremities. (This medicinal is routinely used in Chinese medical gynecology during pregnancy as part of formulas appropriately prescribed on the basis of pattern discrimination. PDR: Not to be administered during pregnancy. flu. early stage dysentery. early stage measles. B&G= B ENSKY & GAMBLE. a. soggy pulse Contraindications: Heat Western medical indications: Common cold. scatters wind and eliminates dampness while simultaneously boosting the qi Chinese medical indications: External contraction of wind. malaria. nasal congestion. F L= FLAWS. BR= BRINKER. white tongue fur. and dampness with concomitant righteous qi vacuity. chest and ductal glomus and fullness. emphysema. C&C= CHAN & CHEUNG. sores Potential formula toxicities & interactions: None listed POTENTIAL MEDICINAL TOXICITIES & I NTERACTIONS: Chai Hu (Radix Bupleuri) Standard daily dosage: 3-12g AH: Safe when used appropriately B&G: May occasionally cause nausea and vomiting. GLW= GAO LU WEN . hydrochloric acid. the dose should be reduced significantly. Bai Du Jia Ren Shen San.

Otherwise. F L= FLAWS. PDR: May cause UV-sensitivity in light-skinned individuals. Could possibly reduce the absorption and biologic effect of most antibiotics. Chuan Xiong (Radix Ligustici Wallichii) Standard daily dosage: 3-9g(In China today. ephedrine. quinine. chlorpromazine. digitalis. trypsine. aluminum hydroxide. digitalis.) AH: Do not use during pregnancy. GLW= GAO L U WEN . quinine. antagonizes Shan Zhu Yu (Fructus Corni Officinalis) and Huang Qi (Radix Astragali Membranacei). Could possibly cause hyperkalemia when used with potassium-sparing diuretics. Could possibly reduce the absorption and biologic effect of most antibiotics. reserpine. isoniazid. C&C: Contains tannic acid. BR= BRINKER. calcium carbonate and gluconate. vitamin B1. Could possibly cause crystalluria and hematuria. caffeine. scopolamine. and berbamin. According to some traditional texts. aluminum hydroxide. sodium bicarbonate. amylase. B&G= BENSKY & GAMBLE. vitamin B1. trypsine. no health hazards are known in conjunction with the proper administration of designated therapeutic dosages. and is incompatible with Li Lu (Rhizoma Et Radix Veratri). and magnesium sulfate. C&C: Contains alkaloids and potassium. Overdosage causes vomiting and dizziness. chlorpromazine. Highly acidic. reserpine. isoniazid. sodium bicarbonate. Zhi Ke. C&C= C HAN & CHEUNG.Chapter 4 36 • Herb Toxicities & Drug Interactions: A Formula Approach C&C: Contains tannic acid. atropine. amylase. (This medicinal is routinely used in Chinese medical gynecology during pregnancy as part of formulas appropriately prescribed on the basis of pattern discrimination. ephedrine. and pepsin. PDR= PHYSICIANS’ DESK REFERENCE . counteracts Hua Shi (Talcum) and Huang Lian (Rhizoma Coptidis Chinensis). Zhi Qiao (Fructus Citri Aurantii) Standard daily dose: 3-9g AH: Safe when used appropriately B&G: Use with caution during pregnancy. B&B= BENSKY & BAROLET. Could possibly reduce the absorption and therapeutic effect of potassium and sodium iodides. and pepsin. it is not uncommon for this medicinal to be prescribed up to 15 grams per day in decoction. calcium carbonate and gluconate. opiates.) B&G: Not for patients with migraine headache or excessive menstrual bleeding. Qiang Huo (Radix Et Rhizoma Notopterygii) Standard daily dosage: 6-15g AH: Safe when used appropriately AH= AHPA. atropine.

hinder the absorption of isoniazid. and Bie Jia (Carapax Amydae Sinensis). Qin Jiao (Radix Gentianae Qinjiao). Yun Ling (Sclerotium Poriae Cocos) Standard daily dosage: 9-15g B&G: Large doses or long-term use is discouraged. bellflower root) Standard daily dosage: 3-9g AH: Contraindicated in hemoptysis. Jie Geng (Radix Platycodi Grandiflori. Bai Fu Ling. According to traditional sources. May reduce the anticoagulative effect of warfarin (Coumadin). B&G= B ENSKY & GAMBLE. C&C: Contains calcium and glycosides. AH= AHPA. nicotinic acid. Fu Ling. especially in cases of tuberculosis. Could possibly reduce the effect of most antibiotics. and reduce the biological effect of levadopa.Chapter 4 Toxicities & Drug Interaction • 37 Du Huo (Radix Angelicae Pubescentis) Standard daily dosage: 3-9g AH: Patients should avoid prolonged exposure to sunlight. GLW= GAO LU WEN. Possible additive effects to insulin. ginseng) Standard daily dosage: 1-30g AH: Contraindicated in hypertension BR: May cause manic episodes in patients on MAO-inhibitors. hydrochloric acid. may counteract Di Yu (Radix Sanguisorbae Officinalis). copious urination. C&C: Contains potassium. PDR= PHYSICIANS’ DESK REFERENCE . According to some traditional sources. Could possibly cause hyperkalemia when used with potassium-sparing diuretics. Vitamin C. B&B= BENSKY & BAROLET. Ren Shen (Radix Panacis Ginseng. C&C= CHAN & CHEUNG. Use with caution in bleeding peptic ulcer. cause digitalis intoxication and heart arrhythmias. glutamic acid. FL= FLAWS. B&G: Contraindicated in patients with hemoptysis. B R= BRINKER. Contraindicated in patients with frequent. and other highly acidic substances could possibly reduce the therapeutic effect of this medicinal. counteracts Long Dan Cao (Radix Gentianae Longdancao) and Long Yan Rou (Arillus Euphoriae Longanae). May cause hypertension if consumed with caffeine.

it may cause hypertension and/or edema.Chapter 4 38 • Herb Toxicities & Drug Interactions: A Formula Approach B&G: Contraindicated for hypertensive patients. glutamic acid. nicotinic acid. BR: May increase toxicity of cardiac glycosides. FL= FLAWS. Contains glycyrrhetinic acid which could possibly cause a reduction in thyroid activity and basal metabolic rate. field mint) Standard daily dose: 1.) As a single herb in high doses. and manias. (This medicinal is routinely used in China during pregnancy when its use is indicated by pattern discrimination. GLW= GAO LU WEN. insomnia. A traditional antidote is mung bean soup. C&C: Vitamin C. and liver disorders. May increase potassium loss due to diuretics and laxatives. is incompatible with Gan Sui (Radix Euphorbiae Kansui). Bo He (Herba Menthae Haplocalycis. Gan Cao (Radix Glycyrrhizae Uralensis. B&G= B ENSKY & GAMBLE . caution should be exercised to guard against potential toxicity and drug interaction. Overdose can lead to headache. PDR: Contraindicated in patients with hypertension. It should not be taken longterm or as a single herb during pregnancy. heart palpitations. AH= AHPA. licorice root) Standard daily dosage: 2-12g AH: Do not use during pregnancy. and a rise in blood pressure. and other highly acidic substances could possibly reduce the therapeutic effect of this medicinal. hydrochloric acid. Possible additive effect to corticosteroids. If taken long-term. it is contraindicated in diabetes. tremors. B&B= BENSKY & BAROLET. Use with MAO-inhibitors may cause headaches. The research on Gan Cao concurs that this medicinal is generally safe when used in small amounts as an envoy. BR= BRINKER.5-6g AH: Safe when used appropriately B&G: Not recommended for nursing mothers as it may inhibit lactation. Yuan Hua (Flos Daphnes Genkwae). and Yuan Zhi (Radix Polygalae Tenuifoliae). May be synergistic with insulin in causing hypokalemia and sodium retention. B&G: According to some traditional sources. PDR= P HYSICIANS’ DESK REFERENCE . Not for long-term use. When used as a single medicinal or in patients taking other potent Western pharmaceuticals. Enhances the effect of insulin and other antidiabetic agents. Not recommended in large doses during pregnancy or lactation due to potential neonatal androgenization. C&C= CHAN & CHEUNG. hypertension.

C&C= CHAN & CHEUNG. This formula deserves to be more commonly prescribed than it is in the West where Ma Huang Tang (Ephedra Decoction) or Ge Gen Tang (Pueraria Decoction) are often erroneously prescribed in its stead based on the main symptoms of fever with upper back and nape of the neck stiffness. Avoid larger doses if being used to treat morning sickness or if used in patients taking anticoagulants. GLW= GAO L U WEN. fresh ginger) Standard daily dose: 3-9g AH: Safe when used appropriately BR: Reduces vomiting caused by chemotherapeutic drugs. PDR: Recommended safe dosage limit is six grams (6g). B&G= B ENSKY & GAMBLE. AH= AHPA. COMMENTS Dang Shen (Radix Codonopsitis Pilosulae) is commonly substituted for Ren Shen in this formula.Chapter 4 Toxicities & Drug Interaction • 39 Sheng Jiang (uncooked Rhizoma Zingiberis Officinalis. therefore. Increases the absorption of oral drugs. B&B= BENSKY & BAROLET. supports and attacks at the same time in a balanced manner. Such patients commonly suffer from a root vacuity and only a tip or branch repletion and. PDR= P HYSICIANS’ DESK REFERENCE . F L= FLAWS. BR= BRINKER. need a formula which supplements and drains.

Sheng Di Huang (uncooked Radix Rehmanniae Glutinosae) Standard daily dosage: 9-30g AH: Contraindicated in patients with diarrhea or lack of appetite B&G: Contraindicated in pregnant women with anemias or digestive weakness C&C: Contains potassium. lily bulb) Standard daily dosage: 9-30g AH: Safe when used appropriately C&C: Contains alkaloids. wheezing. a dry. a red tongue with scanty fur. BR= BRINKER. Lily Combination) Category: Dryness-treating Functions: Nourishes yin and moistens the lungs. chronic pharyngitis. heat in the centers of the palms and soles. B&B= BENSKY & BAROLET. bronchiectasis. GLW= GAO L U WEN . spontaneous pneumothorax. and pulmonary tuberculosis Potential formula toxicities & interactions: None listed POTENTIAL MEDICINAL TOXICITIES & I NTERACTIONS: Bai He (Bulbus Lilii. and a fine. hemoptysis. sore throat. C&C= CHAN & CHEUNG. and magnesium sulfate.Chapter 4 40 • Herb Toxicities & Drug Interactions: A Formula Approach BAI HE GU JIN TANG (Lily Secure the Lungs Decoction.a. Could possibly reduce the absorption and therapeutic effect of potassium and sodium iodides. Could possibly cause hyperkalemia when used with potassium-sparing diuretics. and stops cough Chinese medical indications: Coughing and panting due to a lung-kidney yin vacuity with blood-streaked phlegm. PDR= PHYSICIANS’ DESK REFERENCE . transforms phlegm.k. carcinoma of the larynx. Sheng Di. PDR: No health risks or side effects are known in conjunction with the proper administration of designated therapeutic dosages. aluminum hydroxide. night sweats. B&G= BENSKY & GAMBLE. AH= AHPA. rapid pulse Contraindications: Spleen vacuity and/or food stagnation Western medical indications: Chronic bronchitis. F L= FLAWS. sodium bicarbonate. polyps on the vocal cords. a. laryngitis. cor pulmonale. silicosis.

Vitamin C. incompatible with Wu Tou AH= AHPA. Shu Di Huang (cooked Radix Rehmanniae Glutinosae) Standard daily dosage: 9-30g AH: Contraindicated in patients with diarrhea or indigestion B&G: Overuse can lead to abdominal distention and loose stools. Could possibly reduce the absorption and therapeutic effect of potassium and sodium iodides. glutamic acid. Chuan Bei Mu (Bulbus Fritillariae Cirrhosae) Standard daily dosage: 3-12g AH: Not to be used during pregnancy. Vitamin C. and other highly acidic substances could possibly reduce the therapeutic effect of this medicinal. and heart palpitations which often disappear upon continued administration of the medicinal. nicotinic acid.Chapter 4 Toxicities & Drug Interaction • 41 Shu Di. B&B= BENSKY & BAROLET. and magnesium sulfate. hydrochloric acid.) B&G: According to traditional sources. aluminum hydroxide. F L= FLAWS. lethargy. C&C: Contains glycosides. dizziness. (This medicinal is commonly used in China during pregnancy to treat coughing and panting when indicated by pattern discrimination. B&G= B ENSKY & GAMBLE. C&C= CHAN & CHEUNG. and other highly acidic substances could possibly reduce the therapeutic effect of this medicinal. Could possibly cause hyperkalemia when used with potassium-sparing diuretics. Mai Men Dong. GLW= GAO LU WEN . sodium bicarbonate. antagonizes Kuan Dong Hua (Flos Tussilaginis Farfarae) and counteracts Ku Shen (Radix Sophorae Flavescentis) and Bai Mu Er (Fructificatio Tremellae Fuciformis). Xuan Shen. Mai Dong (Tuber Ophiopogoni Japonici) Standard daily dosage: 6-15g AH: Safe when used appropriately B&G: According to some traditional sources. glutamic acid. nicotinic acid. and glycosides. Side effects include diarrhea. hydrochloric acid. abdominal pain. Yuan Shen (Radix Scrophulariae Ningpoensis) Standard daily dosage: 9-30g C&C: Contains alkaloids. PDR= PHYSICIANS’ DESK REFERENCE . BR= BRINKER. PDR: No health risks or side effects are known in conjunction with the proper administration of designated therapeutic dosages. potassium.

Use with caution in bleeding peptic ulcer. B&G: Contraindicated in patients with hemoptysis. Bai Shao. Jie Geng (Radix Platycodi Grandiflori. (This medicinal is routinely used in Chinese medical gynecology during pregnancy as part of formulas appropriately prescribed on the basis of pattern discrimination. C&C: Contains potassium. B R= BRINKER. especially in cases of tuberculosis. counteracts Bie Jia (Carapax Amydae Sinensis) and Xiao Ji (Herba Cephalanoploris Segeti). tannic acid. glutamic acid. PDR= PHYSICIANS’ DESK REFERENCE . and other highly acidic substances could possibly reduce the therapeutic effect of this medicinal. bellflower root) Standard daily dosage: 3-9g AH: Contraindicated in hemoptysis.) B&G: Use with caution in patients with diarrhea or abdominal distention. and glycosides. FL= FLAWS.Chapter 4 42 • Herb Toxicities & Drug Interactions: A Formula Approach (Radix Aconiti) and counteracts Qin Jiao (Radix Gentianae Qinjiao). aluminum hydroxide. antagonizes Shi Hu (Herba Dendrobii) and Mang Xiao (Mirabilitum). According to some traditional sources. Shao Yao (Radix Albus Paeoniae Lactiflorae. GLW= GAO LU WEN. hinder the absorption of isoniazid. potassium. Vitamin C. Could possibly cause hyperkalemia when used with potassium-sparing diuretAH= AHPA. and magnesium sulfate. nicotinic acid. C&C: Contains alkaloids. hydrochloric acid. C&C: Contains calcium and glycosides. May exaggerate the anticoagulative effect of warfarin (Coumadin). C&C: Contains calcium. and reduce the biological effect of levadopa. and is incompatible with Li Lu (Rhizoma Et Radix Veratri). C&C= CHAN & CHEUNG. sodium bicarbonate. Dang Gui (Radix Angelicae Sinensis) Standard daily dosage: 3-15g AH: Do not use during pregnancy. B&G= B ENSKY & GAMBLE. Could possibly reduce the absorption and therapeutic effect of potassium and sodium iodides. Could possibly cause hyperkalemia when used with potassium-sparing diuretics. Could possibly reduce the effect of most antibiotics. counteracts Long Dan Cao (Radix Gentianae Longdancao) and Long Yan Rou (Arillus Euphoriae Longanae). cause digitalis intoxication and heart arrhythmias. white peony root) Standard daily dosage: 6-30g AH: Safe when used appropriately B&G: Use with caution in debilitated patients with diarrhea. B&B= BENSKY & BAROLET. According to some traditional sources.

could possibly reduce the absorption and therapeutic effect of levadopa. hypertension. and other highly acidic substances could possibly reduce the therapeutic effect of this medicinal. May be synergistic with insulin in causing hypokalemia and sodium retention. trypsine. B&B= BENSKY & BAROLET. licorice) Standard daily dosage: 2-12g AH: Do not use during pregnancy. cause digitalis intoxication and heart arrhythmias. quinine. If taken long-term. When used as a single medicinal or in patients taking other potent Western pharmaceuticals. AH= AHPA. B&G: According to some traditional sources. calcium carbonate and gluconate. and liver disorders. The research on Gan Cao concurs that this medicinal is generally safe when used in small amounts as an envoy. C&C= CHAN & CHEUNG. glutamic acid. PDR= P HYSICIANS’ DESK REFERENCE . BR= BRINKER. and pepsin. Not for long-term use. atropine. Contains glycyrrhetinic acid which could possibly cause a reduction in thyroid activity and basal metabolic rate. caution should be exercised to guard against potential toxicity and drug interaction. amylase. It should not be taken long-term or as a single herb during pregnancy. Could possibly reduce the effect of most antibiotics. nicotinic acid.) As a single herb in high doses. it may cause hypertension and/or edema. is incompatible with Gan Sui (Radix Euphorbiae Kansui). reserpine. Gan Cao (Radix Glycyrrhizae Uralensis. Vitamin C. ephedrine. isoniazid. hydrochloric acid. May increase potassium loss due to diuretics and laxatives. B&G= B ENSKY & GAMBLE .Chapter 4 Toxicities & Drug Interaction • 43 ics. Possible additive effect to corticosteroids. and Yuan Zhi (Radix Polygalae Tenuifoliae). it is contraindicated in diabetes. F L= FLAWS. Yuan Hua (Flos Daphnes Genkwae). GLW= GAO LU WEN. BR: May increase toxicity of cardiac glycosides. vitamin B1. (This medicinal is routinely used in Chinese medical gynecology during pregnancy as part of formulas appropriately prescribed on the basis of pattern discrimination. chlorpromazine.

scarlatina. severe thirst. GLW= GAO LU WEN. Vitamin C. C&C: Contains calcium. profuse sweating. and some anxiety and emotional disorders. C&C: Contains potassium and glycosides. B&B= BENSKY & BAROLET. Also useful in treating diabetes mellitus. FL= FLAWS.e. common cold.a. nicotinic acid. PDR: No health hazards are known in conjunction with the proper administration of designated therapeutic dosages. pruritus. C&C= CHAN & CHEUNG. and a flooding.Chapter 4 44 • Herb Toxicities & Drug Interactions: A Formula Approach BAI HU TANG (White Tiger Decoction. and hinder the absorption of isoniazid. hydrochloric acid. heat evils entering the qi aspect) with high fever. BR= BRINKER. a. rapid pulse Contraindications: Spleen qi vacuity fever or true cold and false heat Western medical indications: High fever due to infectious illnesses such as gingivitis. Gypsum Combination) Category: Qi aspect heat-clearing Functions: Clears heat and engenders fluids Chinese medical indications: Yang ming blazing heat (i. B&G= B ENSKY & GAMBLE . measles. and other highly acidic substances could possibly reduce the therapeutic effect of this medicinal. lobar pneumonia. a red facial complexion. aversion to heat.. epidemic meningitis. erysipelas. cause digitalis intoxication and heart arrhythmias. Could possibly reduce the effect of most antibiotics and levadopa. eczema. flus. easy anger. Potential formula toxicities & interactions: None listed POTENTIAL MEDICINAL TOXICITIES & I NTERACTIONS: Shi Gao (Gypsum Fibrosum) Standard daily dosage: 9-30g B&G: Could possibly cause gastric upset in some patients. encephalitis B. PDR= P HYSICIANS’ DESK REFERENCE . AH= AHPA.k. glutamic acid. Zhi Mu (Rhizoma Anemarrhenae Aspheloidis) Standard daily dosage: 6-12g AH: Safe when used appropriately B&G: May cause diarrhea in some patients. Could possibly cause hyperkalemia when used with potassium-sparing diuretics.

Yuan Hua (Flos Daphnes Genkwae). it may cause hypertension and/or edema. May increase potassium loss due to diuretics and laxatives. BR= BRINKER. it is contraindicated in diabetes. If taken long-term. Geng Mi (Semen Oryzae Sativae. When used as a single medicinal or in patients taking other potent Western pharmaceuticals. polished rice) Standard daily dosage: 15-30g No toxicity or interaction information listed in the sources AH= AHPA.Chapter 4 Toxicities & Drug Interaction • 45 Gan Cao (Radix Glycyrrhizae Uralensis.) As a single herb in high doses. B&B= BENSKY & BAROLET. May be synergistic with insulin in causing hypokalemia and sodium retention. It should not be taken longterm or as a single herb during pregnancy. BR: May increase toxicity of cardiac glycosides. is incompatible with Gan Sui (Radix Euphorbiae Kansui). Not for long-term use. (This medicinal is routinely used in Chinese medical gynecology during pregnancy as part of formulas appropriately prescribed on the basis of pattern discrimination. and liver disorders. and Yuan Zhi (Radix Polygalae Tenuifoliae). The research on Gan Cao concurs that this medicinal is generally safe when used in small amounts as an envoy. GLW= GAO LU WEN . F L= FLAWS. C&C= CHAN & CHEUNG. licorice) Standard daily dosage: 2-12g AH: Do not use during pregnancy. B&G= B ENSKY & GAMBLE. Possible additive effect to corticosteroids. B&G: According to some traditional sources. hypertension. caution should be exercised to guard against potential toxicity and drug interaction. Contains glycyrrhetinic acid which could possibly cause a reduction in thyroid activity and basal metabolic rate. PDR= PHYSICIANS’ DESK REFERENCE .

5-9g AH: Not to be used during pregnancy (This medicinal is commonly used during pregnancy in China when indicated by disease and pattern discrimination. diarrhea with the expulsion of black. nicotinic acid. C&C= CHAN & CHEUNG. Huang Lian (Rhizoma Coptidis Chinensis) Standard daily dosage: 1. heart arrhythmia and weakness. PDR= P HYSICIANS’ DESK REFERENCE . acute conjunctivitis Potential formula toxicities & interactions: FL/B&B: Not to be used for long periods of time in patients with digestive weakness. urinary tract infections. Death typically occurs within 10 hours of ingestion in severe cases. GLW= GAO LU WEN. hydrochloric acid. C&C: Contains glycosides. rapid pulse Contraindications: Spleen qi vacuity weakness Western medical indications: Acute enteritis. perianal burning.a.k. diarrhea with pus and blood (but more blood than pus).) AH= AHPA. cools the blood and stops dysentery Chinese medical indications: Heat toxins burning and damaging the stomach and intestines with abdominal pain. thirst. acute bacillary dysentery. glutamic acid.Chapter 4 46 • Herb Toxicities & Drug Interactions: A Formula Approach BAI TOU WENG TANG (Pulsatilla Decoction. putrid stools which may contain threads of blood. abnormal vaginal discharge. circulatory failure. ulcerative colitis. difficulty breathing. and a slippery. low blood pressure. BR= BRINKER. Vitamin C. F L= FLAWS. This is followed by severe abdominal pain. amoebic dysentery. Anemone Combination) Category: Heat-clearing Functions: Clears heat and resolves toxins. B&B= BENSKY & BAROLET. and dilation of the pupils. a red tongue with yellow fur. POTENTIAL MEDICINAL TOXICITIES & I NTERACTIONS: Bai Tou Weng (Radix Pulsatillae Chinensis) Standard daily dosage: 6-15g B&G: Contraindicated in patients with chronic dysenteric disorders with damaged or weak digestive systems. postpartum enteritis. and other highly acidic substances could possibly reduce the therapeutic effect of this medicinal. bowstring. a. tenesmus. B&G= B ENSKY & GAMBLE. GLW: The first symptom of internal poisoning by this medicinal is a burning sensation in the mouth along with swelling of the oral cavity.

sodium bicarbonate. calcium gluconate. and bismuth subcarbonate. aluminum hydroxide. and bismuth subcarbonate. and for accompanying qi and/or yin vacuity. C&C: Contains alkaloids. carbonate. FL= FLAWS. sodium bicarbonate. B&B= BENSKY & BAROLET.) B&G: Chinese literature reports one case of a patient who developed a skin rash after ingestion. glutamic acid. and lactate. it is rarely prescribed in this simple. B R= BRINKER. magnesium and ferrous sulfates. C&C: Contains glycosides. Bai Xian Pi (Cortex Radicis Dictamni Dasycarpi). Xuan Shen (Radix Scrophulariae Ningpoensis). AH= AHPA. antagonizes Ju Hua (Flos Chrysanthemi Morifolii). PDR= PHYSICIANS’ DESK REFERENCE . C&C= CHAN & CHEUNG. it is commonly modified for either predominant heat or predominant dampness.Chapter 4 Toxicities & Drug Interaction • 47 B&G: Contains berberine. According to some traditional sources counteracts Kuan Dong Hua (Flos Tussilaginis Farfarae) and Niu Xi (Radix Achyranthis Bidentatae). Could possibly cause hyperkalemia when used with potassium-sparing diuretics. hydrochloric acid. and other highly acidic substances could possibly reduce the therapeutic effect of this medicinal. Qin Pi (Cortex Fraxini) Standard daily dosage: 4. quercetin. Long-term use may damage the digestive system. carbonate. Some traditional sources say it should not be taken with pork.5-15g B&G: According to some traditional sources. According to some traditional sources. COMMENTS While this formula is a very famous one for the treatment of damp heat diarrhea and dysentery. antagonizes Wu Zhu Yu (Fructus Evodiae Rutecarpae). discrete form. C&C: Contains alkaloids and quercetin. For instance. Huang Bo (Cortex Phellodendri) Standard daily dosage: 3-12g AH: Not to be used during pregnancy (This medicinal is commonly used during pregnancy in China. and potassium. nicotinic acid. Vitamin C. GLW= GAO LU WEN. accompanying qi stagnation and/or blood stasis. and Jiang Can (Bombyx Batryticatus). Huang Bai. B&G= B ENSKY & GAMBLE. Could possibly reduce the absorption and therapeutic effect of potassium and sodium iodides. aluminum hydroxide. calcium gluconate. and lactate. Could possibly reduce the absorption and therapeutic effect of potassium and sodium iodides. magnesium and ferrous sulfates.

slimy. GLW: Poisoning occurs within 15 minutes to three hours after ingestion AH= AHPA. According to some traditional sources. and a bowstring.Chapter 4 48 • Herb Toxicities & Drug Interactions: A Formula Approach BAN XIA HOU PO TANG (Pinellia & Magnolia Decoction) Category: Qi-rectifying Functions: Moves the qi and downbears counterflow. and edema Potential formula toxicities & interactions: None listed POTENTIAL MEDICINAL TOXICITIES & INTERACTIONS: Ban Xia (Rhizoma Pinelliae Ternatae) Standard daily dosage: 4. sodium bicarbonate. asthma. Vitamin C. white tongue fur. bronchitis. Use with caution in patients with fever. chest and abdominal oppression and fullness. B&G= B ENSKY & GAMBLE . BR= BRINKER. possible nausea and vomiting. (This medicinal is routinely used during pregnancy in China when indicated by disease and pattern discrimination. and a feeling of pressure in the chest. C&C= CHAN & CHEUNG. neurosis. transforms phlegm and dissipates binding Chinese medical indications: Phlegm dampness with upward counterflow of the lung and/or stomach qi manifesting as plum pit qi. nicotinic acid.5-12g AH: Do not use during pregnancy. and magnesium sulfate. Antidote is oral administration of raw ginger. FL= FLAWS. morning sickness. B&B= BENSKY & BAROLET. Toxic effects due to improper preparation or dosage include burning and numbness in throat and lips. pertussis. slippery pulse Contraindications: Depressive or vacuity heat Western medical indications: Neurotic esophageal stenosis. neurasthenia. recurrent palpitations. incompatible with Wu Tou (Radix Aconiti). Must be decocted with other herbs and not taken alone or uncooked. GLW= GAO LU WEN. glutamic acid. possible cough with profuse phlegm. hydrochloric acid. aluminum hydroxide. B&G: Safe as long as it is properly prepared.) Contraindicated in all hemorrhagic disorders. chronic laryngitis. C&C: Contains alkaloids and glycosides. PDR= P HYSICIANS’ DESK REFERENCE . nausea. gastrointestinal neurosis. hysteria. and other highly acidic substances could possibly reduce the therapeutic effect of this medicinal. tracheitis. toxemia during pregnancy. Could possibly reduce the absorption and therapeutic effect of potassium and sodium iodides.

B&G= B ENSKY & GAMBLE. B&B= BENSKY & BAROLET. Qin Jiao (Radix Gentianae Qinjiao). C&C= CHAN & CHEUNG. amylase. and throat. ephedrine. Could possibly reduce the absorption and biologic effect of most antibiotics. and pepsin. According to some traditional sources. Fu Ling. Bai Fu Ling. Could possibly cause hyperkalemia when used with potassium-sparing diuretics. This is then followed by drooling. may counteract Di Yu (Radix Sanguisorbae Officinalis). copious urination. calcium carbonate and gluconate. atropine. C&C: Contains tannic acid and potassium. heart palpitations. forceless pulse. chlorpromazine. isoniazid. PDR= P HYSICIANS’ DESK REFERENCE .) B&G: Use with caution during pregnancy. a somber white facial complexion. and a weak. fresh ginger) Standard daily dose: 3-9g BR: Reduces vomiting caused by chemotherapeutic drugs. PDR: No health risks or side effects are known in conjunction with the proper administration of designated therapeutic dosages. Sheng Jiang (uncooked Rhizoma Zingiberis Officinalis. low-grade fever. Yun Ling (Sclerotium Poriae Cocos) Standard daily dosage: 9-15g B&G: Large doses or long-term use is discouraged. difficulty swallowing. antagonizes Ze Xie (Rhizoma Alismatis Orientalis) and Han Shui Shi (Calcitum). Contraindicated in patients with frequent. According to traditional sources. reserpine. numbness of the extremities. Chuan Po (Cortex Magnoliae Officinalis) Standard daily dosage: 3-9g AH: Do not use during pregnancy. C&C: Contains potassium. trypsine. Hou Po. If severe. BR= BRINKER. dizziness. especially for the treatment of nausea and vomiting. and enlargement of the tongue. tongue. GLW= GAO LU WEN. ulceration of the oral mucosa. AH= AHPA. quinine. Increases absorption of oral drugs. there may be convulsions and respiratory failure leading to death. vitamin B1. and Bie Jia (Carapax Amydae Sinensis). Could possibly cause hyperkalemia when used with potassium-sparing diuretics. digitalis. (This medicinal is commonly used in China during pregnancy. Initially. there is burning pain in the mouth. F L= FLAWS.Chapter 4 Toxicities & Drug Interaction • 49 of a suitable amount. unclear speech.

Zi Su (Folium Perillae Frutescentis. B&G= B ENSKY & GAMBLE.Chapter 4 50 • Herb Toxicities & Drug Interactions: A Formula Approach PDR: Recommended safe dosage limit is six grams (6g). PDR= PHYSICIANS’ DESK REFERENCE . AH= AHPA. FL= FLAWS. Zi Su Ye. Su Ye. beefsteak leaves) Standard daily dosage: 3-9g PDR: Use during pregnancy is contraindicated because perillaldehyde has been demonstrated to have a mutagenic effect in some in vitro studies. GLW= GAO LU WEN. B&B= BENSKY & BAROLET. B R= BRINKER. Studies showed that large doses can trigger pulmonary edema. C&C= CHAN & CHEUNG. Avoid larger doses if being used to treat morning sickness or if used in patients taking anticoagulants.

Toxic effects due to improper preparation or dosage include burning and numbness in throat and lips. hydrochloric acid.5-12g AH: Do not use during pregnancy. and gastric ulcers Potential formula toxicities & interactions: None listed POTENTIAL MEDICINAL TOXICITIES & INTERACTIONS: Ban Xia (Rhizoma Pinelliae Ternatae) Standard daily dosage: 4. early stage cirrhosis. B&B= BENSKY & BAROLET. Could possibly reduce the absorption and therapeutic effect of potassium and sodium iodides. and throat. GLW= GAO LU WEN. magnesium sulfate.Chapter 4 Toxicities & Drug Interaction • 51 BAN XIA XIE XIN TANG (Pinellia Drain the Heart Decoction. heart palpitations. sodium bicarbonate. aluminum hydroxide. According to some traditional sources. This is then followed by drooling. fortifies the spleen and eliminates glomus Chinese medical indications: Spleen vacuity and stomach and intestinal damp heat with stomach duct glomus and distention. ulceration of the oral mucosa. PDR= P HYSICIANS’ DESK REFERENCE . Vitamin C. torpid intake. and a bowstring. dizziness. B&G= B ENSKY & GAMBLE . a. borborygmus.) Contraindicated in all hemorrhagic disorders. there is burning pain in the mouth. and a feeling of pressure in the chest. and enlargement of the tongue.a. Must be decocted with other herbs and not taken alone or uncooked. unclear speech. (This medicinal is routinely used during pregnancy in China when indicated by disease and pattern discrimination. yellow. tongue. nausea. Antidote is oral administration of raw ginger. slippery. numbness of AH= AHPA. Use with caution in patients with fever. C&C= CHAN & CHEUNG. enteritis. and other highly acidic substances could possibly reduce the therapeutic effect of this medicinal.k. BR= BRINKER. low-grade fever. slimy tongue fur. B&G: Safe as long as it is properly prepared. nausea and vomiting. indigestion. FL= FLAWS. chronic hepatitis. C&C: Contains alkaloids and glycosides. Initially. Pinellia Combination) Category: Harmonizing Functions: Harmonizes the stomach and downbears counterflow. diarrhea. thin. GLW: Poisoning occurs within 15 minutes to three hours after ingestion of a suitable amount. rapid pulse Contraindications: None listed Western medical indications: Acute and chronic gastritis. glutamic acid. pediatric vomiting and diarrhea. difficulty swallowing. incompatible with Wu Tou (Radix Aconiti). nicotinic acid.

and other highly acidic substances could possibly reduce the therapeutic effect of this medicinal. May reduce the anticoagulative effect of warfarin (Coumadin). tremors. If severe. B&G: Contraindicated for hypertensive patients. Overdose can lead to headache. and manias. F L= FLAWS. AH= AHPA. Enhances the effect of insulin and other antidiabetic agents. PDR= PHYSICIAN’S DESK REFERENCE . Huang Qin. there may be convulsions and respiratory failure leading to death. GLW= GAO L U WEN . B&G: Use with caution during pregnancy. A traditional antidote is mung bean soup. C&C= CHAN & CHEUNG. BR= BRINKER. C&C: Vitamin C. heart palpitations. B&G= BENSKY & GAMBLE. Use with MAO-inhibitors may cause headaches. and other highly acidic substances could possibly reduce the therapeutic effect of this medicinal. C&C: Contains potassium and glycosides. nicotinic acid. insomnia. dry ginger) Standard daily dosage: 3-12g AH: Do not use during pregnancy. Vitamin C.Chapter 4 52 • Herb Toxicities & Drug Interactions: A Formula Approach the extremities. ginseng) Standard daily dosage: 1-30g BR: May cause manic episodes in patients on MAO-inhibitors. Tiao Qin (Radix Scutellariae Baicalensis) Standard daily dosage: 6-15g AH: Safe when used appropriately B&G: According to some traditional sources. and a rise in blood pressure. hydrochloric acid. glutamic acid. counteracts Dan Pi (Cortex Radicis Moutan) and Li Lu (Rhizoma Et Radix Veratri). Possible additive effects to insulin. Ren Shen (Radix Panacis Ginseng. Not recommended in large doses during pregnancy or lactation due to potential neonatal androgenization. Could possibly cause hyperkalemia when used with potassium-sparing diuretics. Gan Jiang (dry Rhizoma Zingiberis Officinalis. nicotinic acid. a somber white facial complexion. May cause hypertension if consumed with caffeine. B&B= BENSKY & BAROLET. and a weak. forceless pulse. glutamic acid. PDR: Contraindicated in patients with hypertension. Patients with gallstones should consult a practitioner prior to use. hydrochloric acid.

it may cause hypertension and/or edema. BR= BRINKER.) As a single herb in high doses. PDR= PHYSICIAN’S DESK REFERENCE . The research on Gan Cao concurs that this medicinal is generally safe when used in small amounts as an envoy. Could possibly reduce the absorption and therapeutic effect of potassium and sodium iodides. sodium bicarbonate. Long-term use may damage the digestive system. carbonate. and lactate. If taken long-term. BR: May increase toxicity of cardiac glycosides. and Jiang Can (Bombyx Batryticatus). GLW= GAO L U WEN . and potassium. quercetin. hypertension. B&G= BENSKY & GAMBLE.5-9g AH: Not to be used during pregnancy. Could possibly cause hyperkalemia when used with potassium-sparing diuretics. AH= AHPA. May increase potassium loss due to diuretics and laxatives. magnesium and ferrous sulfates. F L= FLAWS.Chapter 4 Toxicities & Drug Interaction • 53 Gan Cao (Radix Glycyrrhizae Uralensis. Huang Lian (Rhizoma Coptidis Chinensis) Standard daily dosage: 1. When used as a single medicinal or in patients taking other potent Western pharmaceuticals. According to some traditional sources counteracts Kuan Dong Hua (Flos Tussilaginis Farfarae) and Niu Xi (Radix Achyranthis Bidentatae). (This medicinal is commonly used during pregnancy in China when indicated by disease and pattern discrimination. Yuan Hua (Flos Daphnes Genkwae). and bismuth subcarbonate. and liver disorders. licorice) Standard daily dosage: 2-12g AH: Do not use during pregnancy. Not for long-term use. caution should be exercised to guard against potential toxicity and drug interaction. antagonizes Ju Hua (Flos Chrysanthemi Morifolii). It should not be taken long-term or as a single herb during pregnancy. Xuan Shen (Radix Scrophulariae Ningpoensis). B&B= BENSKY & BAROLET. B&G: According to some traditional sources. (This medicinal is routinely used in Chinese medical gynecology during pregnancy as part of formulas appropriately prescribed on the basis of pattern discrimination. C&C: Contains alkaloids. Contains glycyrrhetinic acid which could possibly cause a reduction in thyroid activity and basal metabolic rate. Possible additive effect to corticosteroids.) B&G: Contains berberine. According to some traditional sources. May be synergistic with insulin in causing hypokalemia and sodium retention. it is contraindicated in diabetes. Some traditional sources say it should not be taken with pork. C&C= CHAN & CHEUNG. calcium gluconate. aluminum hydroxide. and Yuan Zhi (Radix Polygalae Tenuifoliae). is incompatible with Gan Sui (Radix Euphorbiae Kansui). Bai Xian Pi (Cortex Radicis Dictamni Dasycarpi).

PDR= PHYSICIAN’S DESK REFERENCE . F L= FLAWS. Two variations of this formula are Gan Cao Xie Xin Tang (Licorice Drain the Heart Decoction) and Sheng Jiang Xie Xin Tang (Uncooked Ginger Drain the Heart Decoction). BR= BRINKER. AH= AHPA.Chapter 4 54 • Herb Toxicities & Drug Interactions: A Formula Approach Da Zao. The former is used for a spleen-stomach-intestinal disharmony in which spleen vacuity has resulted in heart qi vacuity. Gan Cao may be either uncooked or mix-fried depending on whether it is being primarily used for clearing heat or fortifying the spleen. C&C= CHAN & CHEUNG. Hong Zao (Fructus Zizyphi Jujubae. The latter is used when there is a spleenstomach-intestinal disharmony with less vacuity cold and more pronounced dampness. red dates) Standard daily dosage: 10-30g (3-12 pieces) AH: Safe when used appropriately PDR: No health risks or side effects are known in conjunction with the proper administration of designated therapeutic dosages. COMMENTS Dang Shen (Radix Codonopsitis Pilosulae) is commonly substituted for Ren Shen in this formula. B&G= BENSKY & GAMBLE. GLW= GAO L U WEN . B&B= BENSKY & BAROLET.

and sedation in susceptible patients. yellow. C&C= CHAN & CHEUNG. gastrointestinal flu. glutamic acid. hydrochloric acid. High doses can produce hypotension. aversion to food. and other highly acidic substances could possibly reduce the therapeutic effect of this medicinal. putrid-smelling belching and burping.Chapter 4 Toxicities & Drug Interaction • 55 BAO HE WAN (Protecting Harmony Pills. hawthorne berries) Standard daily dosage: 9-15g AH: Safe when used appropriately BR: Possible additive effect to digitalis. B&G= BENSKY & GAMBLE. PDR= PHYSICIAN’S DESK REFERENCE . belching. and a slippery pulse Contraindications: Spleen vacuity Western medical indications: Indigestion. cardiac arrhythmia. slimy tongue fur. B&B= BENSKY & BAROLET. PDR: Contraindicated in the first trimester of pregnancy and for children under 12 years of age. C&C: Contains amylase. heart rate and blood pressure should be monitored on a regular basis. abdominal pain. In patients with a history of cardiac problems. acute pancreatitis. diarrhea.a. nicotinic acid. hepatitis. acid regurgitation. Citrus & Crataegus Formula) Category: Food-dispersing. nausea and vomiting. a. Vitamin C. acute exacerbation of chronic gastritis. Could possibly cause digitalis intoxication and heart arrhythmias. Shen Qu (Massa Medica Fermentata) Standard daily dosage: 6-15g B&G: Use with caution during pregnancy. and cardiac glycosides C&C: Contains glycosides. GLW= GAO L U WEN .k. digoxin. AH= AHPA. sulphanomides. F L= FLAWS. and aspirin could possibly reduce the therapeutic effect of this medicinal. Tetracyclines. and acute and chronic cholecystitis Potential formula toxicities & interactions: None listed POTENTIAL MEDICINAL TOXICITIES AND INTERACTIONS: Shan Zha (Fructus Crataegi. stagnation-abducting Functions: Disperses food and harmonizes the stomach Chinese medical indications: Food stagnation with chest and abdominal glomus and fullness. BR= BRINKER.

and a weak. glutamic acid. Use with caution in patients with fever. nausea. magnesium sulfate. AH= AHPA. If severe. Could possibly reduce the absorption and therapeutic effect of potassium and sodium iodides. incompatible with Wu Tou (Radix Aconiti).5-12g AH: Do not use during pregnancy. Chen Pi. B&B= BENSKY & BAROLET. and enlargement of the tongue.) Contraindicated in all hemorrhagic disorders. numbness of the extremities. heart palpitations. Could possibly cause hyperkalemia when used with potassium-sparing diuretics. Ju Pi. B&G: Safe as long as it is properly prepared. low-grade fever. This is then followed by drooling. aluminum hydroxide. difficulty swallowing. According to some traditional sources. Must be decocted with other herbs and not taken alone or uncooked. Ju Hong (Pericarpium Citri Reticulatae. hydrochloric acid. there is burning pain in the mouth. Antidote is oral administration of raw ginger. forceless pulse. and other highly acidic substances could possibly reduce the therapeutic effect of this medicinal. GLW: Poisoning occurs within 15 minutes to three hours after ingestion of a suitable amount. nicotinic acid. unclear speech. there may be convulsions and respiratory failure leading to death. Ban Xia (Rhizoma Pinelliae Ternatae) Standard daily dosage: 4. and a feeling of pressure in the chest. dizziness. (This medicinal is routinely used during pregnancy in China when indicated by disease and pattern discrimination.Chapter 4 56 • Herb Toxicities & Drug Interactions: A Formula Approach Lai Fu Zi (Semen Raphani Sativi. tangerine peel) Standard daily dosage: 3-9g C&C: Contains potassium. C&C= CHAN & CHEUNG. sodium bicarbonate. GLW= GAO LU WEN. Initially. ulceration of the oral mucosa. BR= BRINKER. B&G= B ENSKY & GAMBLE . and throat. PDR= P HYSICIAN’ S DESK REFERENCE . Toxic effects due to improper preparation or dosage include burning and numbness in throat and lips. Vitamin C. C&C: Contains alkaloids and glycosides. radish seeds) Standard daily dosage: 6-15g PDR: No health risks or side effects are known in conjunction with the proper administration of designated therapeutic dosages. tongue. FL= FLAWS. a somber white facial complexion.

(This medicinal is commonly used in China during pregnancy for the treatment of wind heat external contractions and heat toxins. PDR= PHYSICIAN’S DESK REFERENCE . B&G: According to one traditional source. B&B= BENSKY & BAROLET. and Bie Jia (Carapax Amydae Sinensis). nicotinic acid. B&G= BENSKY & GAMBLE. and aspirin could possibly reduce the therapeutic effect of this medicinal. BR= BRINKER. C&C: Contains potassium. copious urination. may counteract Di Yu (Radix Sanguisorbae Officinalis). long-term use may damage the kidneys. According to traditional sources. Lian Qiao (Fructus Forsythiae Suspensae. Mai Ya (Fructus Germinatus Hordei Vulgaris. malted barley) Standard daily dosage: 12-30g AH: Not to be used during pregnancy. F L= FLAWS. hydrochloric acid. Vitamin C. Contraindicated in patients with frequent.) B&G: Contraindicated in patients with diarrhea. sulphanomides. C&C: Contains amylase. and skin ulcers. Bai Fu Ling. Tetracyclines. GLW= GAO L U WEN .Chapter 4 Toxicities & Drug Interaction • 57 Fu Ling. and other highly acidic substances could possibly reduce the therapeutic effect of this medicinal. C&C: Contains potassium and glycosides. Qin Jiao (Radix Gentianae Qinjiao). C&C= C HAN & CHEUNG. AH= AHPA. glutamic acid. dried forsythia fruit pods) Standard daily dosage: 6-15g AH: Not to be used during pregnancy. Could possibly cause hyperkalemia when used with potassium-sparing diuretics. carbuncles that have already ulcerated. Yun Ling (Sclerotium Poriae Cocos) Standard daily dosage: 9-15g B&G: Large doses or long-term use is discouraged. Could possibly cause hyperkalemia when used with potassium-sparing diuretics.

) B&G: According to traditional sources. Vitamin C. Symptoms of toxicity include reduced breathing. and other highly acidic substances could possibly reduce the therapeutic effect of this medicinal. aluminum hydroxide. incompatible with Wu Tou (Radix Aconiti).Chapter 4 58 • Herb Toxicities & Drug Interactions: A Formula Approach BEI MU GUA LOU SAN (Fritillaria & Trichosanthes Powder) Category: Phlegm-transforming. rapid. Gua Lou. B&G= B ENSKY & GAMBLE . and a fine. lung abscess. sodium bicarbonate. breast abscess Potential formula toxicities & interactions: None listed POTENTIAL MEDICINAL TOXICITIES & I NTERACTIONS: Chuan Bei Mu (Bulbus Fritillariae Cirrhosae) Standard daily dosage: 3-12g AH: Not to be used during pregnancy. Quan Gua Lou (Fructus Trichosanthis Kirlowii) Standard daily dosage: 9-30g AH: Safe when used appropriately B&G: According to traditional sources. glutamic acid. sodium bicarbonate. Contains peimine. hydrochloric acid. AH= AHPA. nicotinic acid. Could possibly reduce the absorption and therapeutic effect of potassium and sodium iodides. red tongue with scanty fur. C&C: Contains alkaloids and glycosides. PDR= P HYSICIAN’ S DESK REFERENCE . and magnesium sulfate. (This medicinal is commonly used in China during pregnancy to treat coughing and panting when indicated by pattern discrimination. and magnesium sulfate. B&B= BENSKY & BAROLET. sore throat. a dry. which is fatal in animals at doses of nine milligram per kilogram of body weight (9mg/kg). FL= FLAWS. and coma. C&C= CHAN & CHEUNG. possible wheezing. BR= BRINKER. a dry. aluminum hydroxide. C&C: Contains alkaloids. GLW= GAO LU WEN. Could possibly reduce the absorption and therapeutic effect of potassium and sodium iodides. rectifies the qi and transforms phlegm Chinese medical indications: Lung dryness cough with difficultto-expectorate phlegm. incompatible with Wu Tou (Radix Aconiti) and counteracts Qin Jiao (Radix Gentianae Qinjiao). dryness-moistening Functions: Moistens the lungs and clears heat. mydriasis. tremors. forceful pulse Contraindications: Yin vacuity cough Western medical indications: Chronic bronchitis.

and other highly acidic substances could possibly reduce the therapeutic effect of this medicinal. FL= FLAWS. tangerine peel) Standard daily dosage: 3-9g C&C: Contains potassium. Could possibly cause hyperkalemia when used with potassium-sparing diuretics. Bai Fu Ling. especially in cases of tuberculosis. nicotinic acid. B&B= BENSKY & BAROLET. Ju Pi. Hua Fen (Radix Trichosanthis Kirlowii) Standard daily dosage: 9-15g AH: Not to be used during pregnancy. copious urination. glutamic acid. AH= AHPA. Chen Pi. Jie Geng (Radix Platycodi Grandiflori. Yun Ling (Sclerotium Poriae Cocos) Standard daily dosage: 9-15g B&G: Large doses or long-term use is discouraged. BR= BRINKER. bellflower root) Standard daily dosage: 3-9g AH: Contraindicated in hemoptysis. According to traditional sources. Fu Ling. B&G= B ENSKY & GAMBLE. Could possibly cause hyperkalemia when used with potassium-sparing diuretics. Could possibly cause hyperkalemia when used with potassium-sparing diuretics.Chapter 4 Toxicities & Drug Interaction • 59 Tian Hua Fen. Qin Jiao (Radix Gentianae Qinjiao). C&C: Contains potassium. Use with caution in bleeding peptic ulcer. C&C: Contains potassium and glycosides. Contraindicated in patients with frequent. and Bie Jia (Carapax Amydae Sinensis). may counteract Di Yu (Radix Sanguisorbae Officinalis). C&C= CHAN & CHEUNG. GLW= GAO LU WEN. Ju Hong (Pericarpium Citri Reticulatae. hydrochloric acid. Vitamin C. B&G: Contraindicated in pregnant patients and in patients with diarrhea. counteracts Long Dan Cao (Radix Gentianae Longdancao) and Long Yan Rou (Arillus Euphoriae Longanae). PDR= PHYSICIAN’S DESK REFERENCE . According to some traditional sources. B&G: Contraindicated in patients with hemoptysis.

Could possibly reduce the effect of most antibiotics. AH= AHPA. and other highly acidic substances could possibly reduce the therapeutic effect of this medicinal. BR= BRINKER. glutamic acid. F L= FLAWS. hinder the absorption of isoniazid. hydrochloric acid. B&B= BENSKY & BAROLET. nicotinic acid. B&G= BENSKY & GAMBLE. Vitamin C. GLW= GAO L U WEN . PDR= PHYSICIAN’S DESK REFERENCE . cause digitalis intoxication and heart arrhythmias.Chapter 4 60 • Herb Toxicities & Drug Interactions: A Formula Approach C&C: Contains calcium and glycosides. and reduce the biological effect of levadopa. C&C= CHAN & CHEUNG.

agalactia). PDR= PHYSICIAN’S DESK REFERENCE . corneal ulcers. habitual miscarriage. PDR: Caution should be taken with patients receiving immunosuppressive therapy. impotence.a. BR= BRINKER. an enlarged. chronic bronchitis. Ginseng & Astragalus Combination) Category: Qi-supplementing Functions: Supplements the center and boosts the qi. myasthenia gravis. white fur. Could possibly reduce the absorption and therapeutic effect of potassium and sodium iodides. chronic hemorrhoids. B&G= B ENSKY & GAMBLE. aluminum hydroxide. lochioschesis. Could possibly cause hyperkalemia when used with potassium-sparing diuretics. cerebral arteriosclerosis. loose stools. leukopenia. GLW= GAO LU WEN . a somber white facial complexion. functional uterine bleeding. such as transplant patients or patients with autoimmune AH= AHPA. Bei Qi (Radix Astragali Membranacei. chronic hepatitis. faint voice. C&C= CHAN & CHEUNG. neurasthenia. loss of strength. sodium bicarbonate. shortness of breath.Chapter 4 Toxicities & Drug Interaction • 61 BU ZHONG YI QI TANG (Supplement the Center & Boost the Qi Decoction. chronic diarrhea. disinclination to speak and/or a weak. possible recurrent or enduring low-grade fever. B&B= BENSKY & BAROLET. fat tongue with teeth-marks on its edges and thin.k. F L= FLAWS. a. possibly weak or short pulse Contraindications: Fever due to yin vacuity Western medical indications: Debility after prolonged illness. pernicious anemia. astragalus) Standard daily dosage: 9-60g AH: Safe when used appropriately C&C: Contains alkaloids and potassium. and magnesium sulfate. possible spontaneous perspiration. and forceless. hernia. prolapsed uterus or rectum. upbears yang and lifts the fallen Chinese medical indications: Spleen qi vacuity or central qi falling downward with fatigue. gastroptosis. various postpartum problems (including urinary incontinence. tuberculosis. torpid intake. chronic nephritis Potential formula toxicities & interactions: None listed POTENTIAL MEDICINAL TOXICITIES & I NTERACTIONS: Huang Qi.

ginseng) Standard daily dosage: 1-30g AH: Contraindicated in hypertension BR: May cause manic episodes in patients on MAO-inhibitors. (This medicinal is routinely used in Chinese medical gynecology during pregnancy as part of formulas appropriately prescribed on the basis of pattern discrimination. May cause hypertension if consumed with caffeine. hydrochloric acid.5-9g AH: Safe when used appropriately B&G: When rats were fed 0. C&C= CHAN & CHEUNG. Use with MAO-inhibitors may cause headaches. Not recommended in large doses during pregnancy or lactation due to potential neonatal androgenization. heart. BR: May increase toxicity of cardiac glycosides. Bai Zhu (Rhizoma Atractylodis Macrocephalae) Standard daily dosage: 4. they developed a mild lymphopenia and anemia but suffered no damage to the brain. Not for long-term use. Ren Shen (Radix Panacis Ginseng.Chapter 4 62 • Herb Toxicities & Drug Interactions: A Formula Approach disorders. glutamic acid. May potentiate the risk of bleeding when used concomitantly with anticoagulants. and other highly acidic substances could possibly reduce the therapeutic effect of this medicinal. and liver disorders. GLW= GAO LU WEN . B&G: Contraindicated for hypertensive patients. B&G= B ENSKY & GAMBLE. heart palpitations. tremors. Possible additive effects to insulin. F L= FLAWS. antiplatelets. May cause neurological dysfunction in high doses.5g/kg of this medicinal for two months. or liver. A traditional antidote is mung bean soup. C&C: Vitamin C. Overdose can lead to headache. Enhances the effect of insulin and other antidiabetic agents. insomnia. B&B= BENSKY & BAROLET. May reduce the anticoagulative effect of warfarin (Coumadin). Possible additive effect to cortiAH= AHPA. BR= BRINKER. or antithrombotic agents.) As a single herb in high doses. licorice) Standard daily dosage: 2-12g AH: Do not use during pregnancy. and manias. hypertension. PDR: Contraindicated in patients with hypertension. nicotinic acid. it is contraindicated in diabetes. May increase potassium loss due to diuretics and laxatives. PDR= PHYSICIAN’S DESK REFERENCE . and a rise in blood pressure. Gan Cao (Radix Glycyrrhizae Uralensis.

caution should be exercised to guard against potential toxicity and drug interaction. tangerine peel) Standard daily dosage: 3-9g AH: Safe when used appropriately C&C: Contains potassium. When used as a single medicinal or in patients taking other potent Western pharmaceuticals.) B&G: Use with caution in patients with diarrhea or abdominal distention. B&G: Contraindicated in cases of fully erupted measles and in patients with breathing difficulties. PDR= PHYSICIAN’S DESK REFERENCE . F L= FLAWS. incompatible with Gan Sui (Radix Euphorbiae Kansui). C&C: Vitamin C. May exaggerate the anticoagulative effect of warfarin (Coumadin). Dang Gui (Radix Angelicae Sinensis) Standard daily dosage: 3-15g AH: Do not use during pregnancy. (This medicinal is commonly used during pregnancy in China. May be synergistic with insulin in causing hypokalemia and sodium retention. Sheng Ma (Rhizoma Cimicifugae. it may cause hypertension and/or edema. Ju Hong (Pericarpium Citri Reticulatae. gastroenteritis. Ju Pi. B&G= B ENSKY & GAMBLE. C&C: Contains potassium. tremors. hydrochloric acid. The research on Gan Cao concurs that this medicinal is generally safe when used in small amounts as an envoy. Could possibly cause hyperkalemia when used with potassium-sparing diuretics.) Not to be used while nursing. Overdose causes headaches. and Yuan Zhi (Radix Polygalae Tenuifoliae). B&B= BENSKY & BAROLET. B&G: According to some traditional sources. nicotinic acid. It should not be taken long-term or as a single herb during pregnancy. BR= BRINKER. C&C= CHAN & CHEUNG.Chapter 4 Toxicities & Drug Interaction • 63 costeroids. Yuan Hua (Flos Daphnes Genkwae). and AH= AHPA. vomiting. Contains glycyrrhetinic acid which could possibly cause a reduction in thyroid activity and basal metabolic rate. glutamic acid. If taken long-term. GLW= GAO LU WEN. Could possibly cause hyperkalemia when used with potassium-sparing diuretics. and pathologic erections. dizziness. (This medicinal is routinely used in Chinese medical gynecology during pregnancy as part of formulas appropriately prescribed on the basis of pattern discrimination. Chen Pi. black cohosh) Standard daily dosage: 1.5-9g AH: Do not use during pregnancy.

This formula has a wider scope of application than simply downward falling of the central qi. Chai Hu (Radix Bupleuri) Standard daily dosage: 3-12g AH: Safe when used appropriately B&G: May occasionally cause nausea and vomiting. this contraindication is not absolute.Chapter 4 64 • Herb Toxicities & Drug Interactions: A Formula Approach other highly acidic substances could possibly reduce the therapeutic effect of this medicinal. AH= AHPA. BR= BRINKER. Therefore. It may also be used for liver-spleen disharmonies where spleen qi vacuity is marked. and diarrhea due to saponin content. (However. the amount of Chai Hu may be increased so that it more forcefully courses the liver and rectifies the qi. In that case. in which case the dose should then be reduced significantly. C&C: Vitamin C. this medicinal is routinely used as part of this formula in Chinese medical gynecology for the treatment of threatened abortion due to spleen qi vacuity not containing the fetus. B&G= B ENSKY & GAMBLE. intestinal colic. Because a liver-spleen disharmony is such a commonly seen pattern. hydrochloric acid. glutamic acid.) Contains glycosides which may potentiate the effect of antihypertensive medications and result in hypotension. GLW= GAO LU WEN. C&C= CHAN & CHEUNG. COMMENTS Dang Shen (Radix Codonopsitis Pilosulae) is commonly substituted for Ren Shen in this formula. PDR: Not to be administered during pregnancy. (This medicinal is routinely used in Chinese medical gynecology during pregnancy as part of formulas appropriately prescribed on the basis of pattern discrimination. this formula is very commonly used when modified with appropriate additions and subtractions to treat a large variety of conditions. and other highly acidic substances could possibly reduce the therapeutic effect of this medicinal. B&B= BENSKY & BAROLET. F L= FLAWS.) Overdose may lead to gastroenteritis. nicotinic acid. PDR: Not for use during pregnancy due to an increased risk of spontaneous abortion. PDR= PHYSICIAN’S DESK REFERENCE .

fever. there is vexation. and frees the flow of the nose Chinese medical indications: Deep source nasal congestion with profuse. thin. nicotinic acid. F L= FLAWS. white or yellow tongue fur. headache. GLW= GAO LU WEN. C&C= CHAN & CHEUNG. The initial symptoms include dizziness. agitation. jaundice. nausea. and other highly acidic substances could possibly reduce the therapeutic effect of this medicinal. and allergic rhinitis Potential formula toxicities & interactions: None listed POTENTIAL MEDICINAL TOXICITIES & INTERACTIONS: Cang Er Zi (Fructus Xanthii Sibirici) Standard daily dosage: 3-9g B&G: Safe as long as it is properly prepared. glutamic acid. stops pain. hydrochloric acid. sodium bicarbonate. acute. fatigue. diarrhea. dizziness. purulent. C&C: Contains alkaloids and glycosides. B&B= BENSKY & BAROLET. this formula can be used to treat either hot or cold patterns of nasal congestion simply based on the treatment principles of aromatically and penetratingly free the flow of the nose. foul-smelling nasal discharge. liver enlargement. liver area pain. and restlessness or somnolence. BR= BRINKER. malar flushing. Must be decocted properly with other medicinals and should not be taken alone or uncooked. Toxic effects due to improper preparation or dosage include CNS deficits as well as nephro. vomiting. chronic. In more serious cases. nasal congestion. GLW: There is a latency period of 1-7 days after poisoning. frontal headache. B&G= B ENSKY & GAMBLE.Chapter 4 Toxicities & Drug Interaction • 65 CANG ER ZI SAN (Xanthium Powder) Category: Exterior-resolving Functions: Dispels wind. and magnesium sulfate. and conjunctival hyperemia. aluminum hydroxide. Could possibly reduce the absorption and therapeutic effect of potassium and sodium iodides.and hepatoxicity which can lead to coma and death. This is followed by dimming of consciousAH= AHPA. abdominal pain. and gastrointestinal tract bleeding. Vitamin C. PDR= P HYSICIAN’S DESK REFERENCE . and a floating pulse Note: While deep source nasal discharge typically involves lung heat. Contraindications: None listed Western medical indications: Acute or chronic sinusitis.

discrete form. angelica root) Standard daily dosage: 3-9g AH: Safe when used appropriately Bo He (Herba Menthae Haplocalycis. B&B= BENSKY & BAROLET. C&C= CHAN & CHEUNG. Xin Yi Hua (Flos Magnoliae Liliflorae) Standard daily dosage: 3-9g AH: Safe when used appropriately B&G: Overdose may cause dizziness or redness of the eyes. Therefore. More commonly. fright reversal. F L= FLAWS. shock. B&G= B ENSKY & GAMBLE. unless used in ready-made form for symptomatic relief only.5-6g B&G: Not recommended for nursing mothers as it may inhibit lactation. Bai Zhi (Radix Angelicae Dahuricae. Either kidney or respiratory failure may lead to death. field mint) Standard daily dose: 1. COMMENTS This formula only treats the tip or branch symptom of nasal congestion. it is rarely used by itself in this simple.Chapter 4 66 • Herb Toxicities & Drug Interactions: A Formula Approach ness. and urinary block. BR= BRINKER. AH= AHPA. GLW= GAO LU WEN . heart arrhythmia. PDR= PHYSICIAN’S DESK REFERENCE . these ingredients are added to another formula to treat the root of nasal congestion.

Bupleurum & Dragon Bone Combination) Category: Heavy. B&G= B ENSKY & GAMBLE. yellow fur. first or second degree A-V block. hydrochloric acid. BR= BRINKER. a. insomnia. nicotinic acid. schizophrenia. and postconcussion syndrome Potential formula toxicities & interactions: B&B: The original recipe for this formula called for the inclusion of Qian Dan (Minium). B&B= BENSKY & BAROLET. menopausal syndrome. PDR= P HYSICIAN’S DESK REFERENCE . hysteria. intestinal colic. C&C= CHAN & CHEUNG. rapid pulse Contraindications: None listed Western medical indications: Neurosis. and other highly acidic substances could possibly reduce the therapeutic effect of this medicinal. POTENTIAL MEDICINAL TOXICITIES & INTERACTIONS: Chai Hu (Radix Bupleuri) Standard daily dosage: 3-12g AH: Safe when used appropriately B&G: May occasionally cause nausea and vomiting.k. slimy. hypertension. epilepsy. Meniere’s disease. and a bowstring. GLW= GAO LU WEN. and diarrhea due to saponin content. easy anger. glutamic acid.25 Overdose may lead to gastroenteritis. F L= FLAWS. hyperthyroidism.a. C&C: Vitamin C. spasm of the sternocleidomastoid muscle. restlessness. a red tongue with thick. Modern day formulations substitute either uncooked Tie Luo (Frusta Ferri) or Dai Zhe Shi (Haemititum) or simply omit this medicinal altogether. deranged speech. in which case the dose should then be reduced significantly. gastritis. settling. PDR: Not to be administered during pregnancy. a form of lead which is toxic. heart palpitations. spirit-quieting Functions: Frees the flow of the three yang aspects and quiets the spirit Chinese medical indications: Replete heat harassing the heart spirit with chest oppression.Chapter 4 Toxicities & Drug Interaction • 67 CHAI HU JIA LONG GU MU LI TANG (Bupleurum Plus Dragon Bone & Oyster Shell Decoction. AH= AHPA. possibly slippery.

difficulty swallowing. hydrochloric acid. B&G= B ENSKY & GAMBLE. unclear speech. Toxic effects due to improper preparation or dosage include burning and numbness in throat and lips. sodium bicarbonate. This is then followed by drooling. a somber white facial complexion. Initially. Must be decocted with other herbs and not taken alone or uncooked. and a weak. BR= BRINKER. PDR= P HYSICIAN’S DESK REFERENCE . dizziness. If severe. AH= AHPA. glutamic acid. aluminum hydroxide. nicotinic acid. GLW: Poisoning occurs within 15 minutes to three hours after ingestion of a suitable amount.Chapter 4 68 • Herb Toxicities & Drug Interactions: A Formula Approach Huang Qin. tongue. incompatible with Wu Tou (Radix Aconiti). Use with caution in patients with fever. and other highly acidic substances could possibly reduce the therapeutic effect of this medicinal. GLW= GAO LU WEN. counteracts Dan Pi (Cortex Radicis Moutan) and Li Lu (Rhizoma Et Radix Veratri). heart palpitations. B&B= BENSKY & BAROLET. forceless pulse. Antidote is oral administration of raw ginger. F L= FLAWS. and enlargement of the tongue.5-12g AH: Do not use during pregnancy. B&G: Safe as long as it is properly prepared. glutamic acid. and throat. (This medicinal is routinely used during pregnancy in China when indicated by disease and pattern discrimination. Could possibly cause hyperkalemia when used with potassium-sparing diuretics. According to some traditional sources. nicotinic acid. Tiao Qin (Radix Scutellariae Baicalensis) Standard daily dosage: 6-15g AH: Safe when used appropriately B&G: According to some traditional sources. there may be convulsions and respiratory failure leading to death. Could possibly reduce the absorption and therapeutic effect of potassium and sodium iodides. numbness of the extremities. low-grade fever. C&C= CHAN & CHEUNG. and magnesium sulfate. and a feeling of pressure in the chest. Vitamin C. there is burning pain in the mouth. nausea. and other highly acidic substances could possibly reduce the therapeutic effect of this medicinal. C&C: Contains alkaloids and glycosides. Ban Xia (Rhizoma Pinelliae Ternatae) Standard daily dosage: 4. C&C: Contains potassium and glycosides. hydrochloric acid.) Contraindicated in all hemorrhagic disorders. ulceration of the oral mucosa. Vitamin C.

PDR: Contraindicated during pregnancy. Sheng Jiang (uncooked Rhizoma Zingiberis Officinalis. A traditional antidote is mung bean soup. B&G= BENSKY & GAMBLE. GLW= GAO L U WEN . Overdose can lead to headache. PDR= PHYSICIAN’S DESK REFERENCE . and a rise in blood pressure. Use with MAO-inhibitors may cause headaches. hydrochloric acid. Enhances the effect of insulin and other antidiabetic agents. AH= AHPA. C&C: Vitamin C. Gui Zhi (Ramulus Cinnamomi Cassiae. PDR: Contraindicated in patients with hypertension. Increases absorption of oral drugs. May reduce the anticoagulative effect of warfarin (Coumadin). and manias. BR= BRINKER. tremors. fresh ginger) Standard daily dose: 3-9g AH: Safe when used appropriately BR: Reduces vomiting caused by chemotherapeutic drugs. and other highly acidic substances could possibly reduce the therapeutic effect of this medicinal. nicotinic acid. C&C= CHAN & CHEUNG. May cause hypertension if consumed with caffeine. Not recommended in large doses during pregnancy or lactation due to potential neonatal androgenization. ginseng) Standard daily dosage: 1-30g AH: Safe when used appropriately BR: May cause manic episodes in patients on MAO-inhibitors. B&G: Contraindicated for hypertensive patients. Avoid larger doses if being used to treat morning sickness or if used in patients taking anticoagulants. F L= FLAWS. B&B= BENSKY & BAROLET. Possible additive effects to insulin. glutamic acid. PDR: Recommended safe dosage limit is six grams (6g). insomnia. or during excessive menstruation.Chapter 4 Toxicities & Drug Interaction • 69 Ren Shen (Radix Panacis Ginseng. during pregnancy. cinnamon twigs) Standard daily dosage: 3-15g AH: Safe when used appropriately B&G: Use with caution in the presence of fever. heart palpitations.

S. FDA has banned the inclusion of this medicinal in all dietary supplements. Wu Zhu Yu (Fructus Evodiae Rutecarpae). C&C= CHAN & CHEUNG. and hinder the absorption of isoniazid. AH= AHPA. C&C: Contains calcium. PDR= PHYSICIAN’S DESK REFERENCE . Mu Li (Concha Ostreae. copious urination. and prednisolone.Chapter 4 70 • Herb Toxicities & Drug Interactions: A Formula Approach Fu Ling. C&C: Contains potassium. Niu Xi (Radix Achyranthis Bidentatae). magnesium. Long Gu (Os Draconis. Could possibly reduce the effects of most antibiotics. Overdose may lead to indigestion or constipation. C&C: Contains calcium. B&G= B ENSKY & GAMBLE. iron. and Bie Jia (Carapax Amydae Sinensis). Could possibly cause hyperkalemia when used with potassium-sparing diuretics. fossilized bone) Standard daily dosage: 15-30g B&G: According to some traditional sources. and Yuan Zhi (Radix Polygalae Tenuifoliae) and has adverse effects when combined with Ma Huang (Herba Ephedrae). B&B= BENSKY & BAROLET. F L= FLAWS. levadopa. According to traditional sources. Qin Jiao (Radix Gentianae Qinjiao). cause digitalis intoxication and heart arrhythmias. oyster shell) Standard daily dosage: 15-30g B&G: Contraindicated when the patient has high fever without sweating. and potassium. Could possibly reduce the effect of most antibiotics. aluminum. and Xi Xin (Herba Asari Cum Radice). GLW= GAO LU WEN . The U. and aluminum. Yun Ling (Sclerotium Poriae Cocos) Standard daily dosage: 9-15g B&G: Large doses or long-term use is discouraged. magnesium. Bai Fu Ling. BR= BRINKER. and prednisolone. levadopa. works synergistically with Bei Mu (Bulbus Fritillariae). iron. According to some traditional sources. counteracts Shi Gao (Gypsum Fibrosum) and should not be mixed with fish. Could possibly cause hyperkalemia when used with potassium-sparing diuretics. may counteract Di Yu (Radix Sanguisorbae Officinalis). Contraindicated in patients with frequent. cause digitalis intoxication and heart arrhythmias. Gan Cao (Radix Glycyrrizae Uralensis). and hinder the absorption of isoniazid.

hematite) Standard daily dosage: 9-30g B&G: Use with caution during pregnancy. Contraindicated for nursing mothers since active ingredients enter the milk. May aggravate potassium loss from diuretics. Hong Zao (Fructus Zizyphi Jujubae. potassium. or any inflammatory condition of the intestines. B&G= B ENSKY & GAMBLE. BR= BRINKER. C&C: Contains iron. Overuse may cause hypokalemia and increased toxicity of cardiac glycosides. abdominal pain of unknown origin. B&G: Use with extreme caution during pregnancy. Dai Huang. Chuan Jun. counteracts Fu Zi (Radix Lateralis Praeparatus Aconiti Carmichaeli).Chapter 4 Toxicities & Drug Interaction • 71 Da Huang. PDR= PHYSICIAN’S DESK REFERENCE . Not to be used while nursing. C&C: Contains alkaloids. C&C= CHAN & CHEUNG. glutamic acid. Contraindicated in intestinal obstruction. B&B= BENSKY & BAROLET. nicotinic acid. rhubarb root) Standard daily dosage: 3-12g AH: Do not use during pregnancy. Signs of toxicity include weakness. and other highly acidic substances could possibly reduce the therapeutic effect of this medicinal. Two grams daily for seven days caused death in mice. acute inflammatory intestinal disease. appendicitis and abdominal pain of unknown origin. Vitamin C. and paroxysmal spasms leading to paralysis and death. and glycosides. Could possibly cause hyperkalemia when used with potassium-sparing diuretics. Researchers have found small amounts of arsenic salts in some samples accounting for its toxicity. menstruation. Da Zao. red dates) Standard daily dosage: 10-30g (3-12 pieces) AH: Safe when used appropriately PDR: No health risks or side effects are known in conjunction with the proper administration of designated therapeutic dosages. According to some traditional sources. Jun (Radix Et Rhizoma Rhei. Contraindicated in cases of intestinal obstruction. Dai Zhe Shi (Haemititum. F L= FLAWS. Could possibly reduce the effect of most antibiAH= AHPA. BR: Reduces absorption of oral drugs. or postpartum. slowness of movement. PDR: Consult a physician before using this medicinal during pregnancy or while nursing. GLW= GAO LU WEN . tannic acid. hydrochloric acid.

B&B= BENSKY & BAROLET. BR= BRINKER. F L= FLAWS. AH= AHPA. while depressive heat has counterflowed upward to also harass the spirit. and prednisolone and hinder the absorption of isoniazid. Dai Zhe Shi is usually substituted or the ingredient is left out altogether. C&C= CHAN & CHEUNG. Da Huang is typically omitted if there is no concomitant constipation. the spleen disharmony has resulted in lack of construction and nourishment of the heart spirit. this one treats a liver-spleen disharmony with depressive heat. this formula contained Huang Dan (Minium. a form of lead). In this case. Nowadays. PDR= P HYSICIAN’S DESK REFERENCE . GLW= GAO LU WEN. Like many other famous formulas. B&G= B ENSKY & GAMBLE.Chapter 4 72 • Herb Toxicities & Drug Interactions: A Formula Approach otics. levadopa. Originally. COMMENTS Dang Shen (Radix Codonopsitis Pilosulae) is commonly substituted for Ren Shen in this formula.

counteracts Hua Shi (Talcum) and Huang Lian (Rhizoma Coptidis Chinensis). and a floating pulse Contraindications: Ascendant liver yang hyperactivity with liver blood-kidney yin vacuity or qi and blood dual vacuity headache Western medical indications: Headache from common cold or flu. B&B= BENSKY & BAROLET. Cnidium & Tea Formula) Category: Exterior-resolving Functions: Courses wind and stops pain Chinese medical indications: External contraction wind evil headache accompanied by fever. migraine. aversion to wind. BR= BRINKER. white tongue fur. and is incompatible with Li Lu (Rhizoma Et Radix Veratri). neurogenic headache. According to some traditional texts. C&C: Contains alkaloids and potassium.Chapter 4 Toxicities & Drug Interaction • 73 CHUAN XIONG CHA TIAO SAN (Ligusticum Mixed with Tea Powder. nasal congestion. acute and chronic rhinitis and sinusitis. antagonizes Shan Zhu Yu (Fructus Corni Officinalis) and Huang Qi (Radix Astragali Membranacei). field mint) Standard daily dose: 1. GLW= GAO LU WEN . Chuan Xiong (Radix Ligustici Wallichii) Standard daily dosage: 3-9g(In China today.k. B&G= B ENSKY & GAMBLE.) B&G: Not for patients with migraine headache or excessive menstrual bleeding. tension headache.5-6g AH: Safe when used appropriately B&G: Not recommended for nursing mothers as it may inhibit lactation. a.) AH: Do not use during pregnancy. PDR= PHYSICIAN’S DESK REFERENCE . and vertigo Potential formula toxicities & interactions: None listed POTENTIAL MEDICINAL TOXICITIES & I NTERACTIONS: Bo He (Herba Menthae Haplocalycis. thin.a. C&C= CHAN & CHEUNG. Could possibly cause hyperkalemia when used with potassium-sparing diuretics. (This medicinal is routinely used in Chinese medical gynecology during pregnancy as part of formulas appropriately prescribed on the basis of pattern discrimination. Could possibly reduce the absorption and therapeutic effect of potassium and sodium AH= AHPA. F L= FLAWS. Overdosage causes vomiting and dizziness. dizziness. it is not uncommon for this medicinal to be prescribed up to 15 grams per day in decoction.

According to some traditional sources. twitching muscles. Use with caution in patients with renal problems. slightly dilated pupils. increased body temperature and blood pressure. As of this writing. GLW= GAO LU WEN . BR= BRINKER. other species of Asarum are sometimes substituted. B&G: Nephrotoxic. F L= FLAWS. B&B= BENSKY & BAROLET. stiffness of the neck. Xi Xin is harvested in China mostly from Asarum sieboldi and Asarum heteropoides. angelica root) Standard daily dosage: 3-9g AH: Safe when used appropriately Qiang Huo (Radix Et Rhizoma Notopterygii) Standard daily dosage: 6-15g No toxicity or interaction information listed in the sources Xi Xin (Herba Asari Cum Radice) Standard daily dosage: 1-3g AH: Do not use during pregnancy. sweating. vomiting. may antagonize Shan Zhu Yu (Fructus Corni Officinalis) and Huang Qi (Radix Astragali Membranacei). GLW: Symptoms of adverse reaction include headache. urinary block. C&C= CHAN & CHEUNG. aluminum hydroxide. dimming of consciousness. PDR: Not to be used during pregnancy. Xi Xin is on the FDA’s “B List” of herbs which may potentially contain aristolochic acid (AA).Chapter 4 74 • Herb Toxicities & Drug Interactions: A Formula Approach iodides. Do not exceed recommended dose. AH= AHPA. eventually. sodium bicarbonate. oral thirst. and these may contain AA. death due to respiratory paralysis. arched-back rigidity. a rapid pulse. B&G= B ENSKY & GAMBLE. Bai Zhi (Radix Angelicae Dahuricae. unclear thinking. clenched teeth. cramping of the four limbs. and. vexation and agitation. However. Contains aristolochic acid (AA). generalized tension which may become convulsions. a red flushed face. PDR= PHYSICIAN’S DESK REFERENCE . the FDA has set no acceptable limit to AA consumption by humans. neither of which have conclusively been shown to contain AA. and magnesium sulfate.

hypertension. When used as a single medicinal or in patients taking other potent Western pharmaceuticals. F L= FLAWS. it may cause hypertension and/or edema. Li Lu (Rhizoma Et Radix Veratri) and counteracts Bei Xie (Rhizoma Dioscoreae Hypoglaucae). Vitamin C. May increase potassium loss due to diuretics and laxatives. nicotinic acid. The research on Gan Cao concurs that this medicinal is generally safe when used in small amounts as an envoy. glutamic acid. and liver disorders. BR: May increase toxicity of cardiac glycosides. C&C: Contains glycosides. incompatible with Gan Sui (Radix Euphorbiae Kansui). B&B= BENSKY & BAROLET. AH= AHPA. C&C= CHAN & CHEUNG. If taken long-term. (This medicinal is routinely used in Chinese medical gynecology during pregnancy as part of formulas appropriately prescribed on the basis of pattern discrimination. and Yuan Zhi (Radix Polygalae Tenuifoliae). caution should be exercised to guard against potential toxicity and drug interaction. Possible additive effect to corticosteroids. Contains glycyrrhetinic acid which could possibly cause a reduction in thyroid activity and basal metabolic rate. may antagonize Gan Jiang (dry Rhizoma Zingiberis Officinalis). it is contraindicated in diabetes. and other highly acidic substances could possibly reduce the therapeutic effect of this medicinal. Not for long-term use. Jing Jie (Herba Seu Flos Schizonepetae Tenuifoliae) Standard daily dosage: 3-9g No toxicity or interaction information listed in the sources Fang Feng (Radix Ledebouriellae Divaricatae) Standard daily dosage: 3-9g AH: Safe when used appropriately B&G: According to some traditional sources.) As a single herb in high doses. Gan Cao (Radix Glycyrrhizae Uralensis. BR= BRINKER. Yuan Hua (Flos Daphnes Genkwae). It should not be taken long-term or as a single herb during pregnancy. PDR= P HYSICIAN’S DESK REFERENCE . B&G: According to some traditional sources. May be synergistic with insulin in causing hypokalemia and sodium retention.Chapter 4 Toxicities & Drug Interaction • 75 Jing Jie Sui. licorice) Standard daily dosage: 2-12g AH: Do not use during pregnancy. hydrochloric acid. B&G= B ENSKY & GAMBLE. GLW= GAO LU WEN.

B&B= BENSKY & BAROLET. it is inappropriate for treating vacuity pattern headaches. front. back. FL= FLAWS. AH= AHPA. GLW= GAO LU WEN. and top. Its ingredients free the flow of the qi and blood in all portions of the head. sides. PDR= P HYSICIAN’ S DESK REFERENCE .Chapter 4 76 • Herb Toxicities & Drug Interactions: A Formula Approach COMMENTS This formula is commonly used for the firstaid relief of various types of repletion pattern headaches. Unless combined with supplementing formulas. B&G= B ENSKY & GAMBLE . C&C= CHAN & CHEUNG. BR= BRINKER.

especially in debilitated patients. C&C: Contains alkaloids. GLW= GAO L U WEN . Vitamin C. potassium. appendicitis. C&C= CHAN & CHEUNG. If inappropriately prescribed. rhubard root) Standard daily dosage: 3-12g AH: Do not use during pregnancy. habitual constipation. B&G: Use with extreme caution during pregnancy. Major Rhubarb Combination) Category: Draining & precipitating Functions: Harshly or sternly precipitates heat binding Chinese medical indications: Internal heat accumulation with constipation. and other highly acidic substances could possibly reduce the therapeutic effect of this medicinal. tannic acid. PDR= PHYSICIAN’S DESK REFERENCE . abdominal pain which refuses pressure. neurosis. or postpartum. AH= AHPA. hydrochloric acid. POTENTIAL MEDICINAL TOXICITIES & INTERACTIONS: Da Huang. F L= FLAWS. yellow or dry. typhoid. Chuan Jun. Contraindicated for nursing mothers since active ingredients enter the milk. dysentery. abdominal pain of unknown origin. dry. firm abdomen. intestinal obstruction. glutamic acid. food poisoning. May aggravate potassium loss from diuretics. beriberi. flu. Could possibly cause hyperkalemia when used with potassium-sparing diuretics. replete pulse Contraindications: Vacuity weakness Western medical indications: Acute pneumonia. hypertension. tetanus. BR: Reduces absorption of oral drugs. nicotinic acid. BR= BRINKER. B&B= BENSKY & BAROLET. obesity. hemorrhoids Potential formula toxicities & interactions: FL/B&B: Prohibited during pregnancy. Contraindicated in intestinal obstruction. Overuse may cause hypokalemia and increased toxicity of cardiac glycosides. B&G= BENSKY & GAMBLE.a.Chapter 4 Toxicities & Drug Interaction • 77 DA CHENG QI TANG (Major Order the Qi Decoction. or any inflammatory condition of the intestines. flatulence. Dai Huang. measles.k. Not to be used while nursing. acute abdominal pain. a. Jun (Radix Et Rhizoma Rhei. black tongue fur with prickles. and glycosides. meningitis. and a confined. menstruation. a tense. abdominal glomus and fullness. may cause vomiting and severe diarrhea.

B&B= BENSKY & BAROLET. digitalis. immature bitter orange) Standard daily dosage: 3-9 B&G: Use with caution during pregnancy or in debilitated patients. Contraindicated in cases of intestinal obstruction. and during menstruation. C&C: Contains tannic acid. caffeine. trypsine. PDR= P HYSICIAN’ S DESK REFERENCE . AH= AHPA. Use with caution when fever is present and in the elderly. Chuan Po (Cortex Magnoliae Officinalis) Standard daily dosage: 3-9g AH: Not to be used during pregnancy (This medicinal is commonly used in China during pregnancy. amylase. acute inflammatory intestinal disease. COMMENTS Although a famous classical formula. appendicitis and abdominal pain of unknown origin. and pepsin. antagonizes Ze Xie (Rhizoma Alismatis Orientalis) and Han Shui Shi (Calcitum). BR= BRINKER. digitalis. According to some traditional sources. isoniazid. F L= FLAWS. Mang Xiao (Mirabilitum. reserpine. Glauber’s salt) Standard daily dosage: 3-9g B&G: Contraindicated during pregnancy. quinine. C&C: Contains tannic acid and potassium. B&G= B ENSKY & GAMBLE . amylase. ephedrine. GLW= GAO LU WEN. vitamin B1. quinine. Could possibly cause crystalluria and hematuria and reduce the absorption and biologic effect of most antibiotics. PDR: No health risks or side effects are known in conjunction with the proper administration of designated therapeutic dosages. especially for the treatment of nausea and vomiting. isoniazid. aluminum hydroxide. opiates. Could possibly cause hyperkalemia when used with potassium-sparing diuretics and reduce the absorption and biologic effect of most antibiotics. calcium carbonate and gluconate.) B&G: Use with caution during pregnancy. chlorpromazine. and berbamin. calcium carbonate and gluconate. scopolamine. C&C= CHAN & CHEUNG. reserpine. Highly acidic. vitamin B 1. Hou Po. Zhi Shi (Fructus Immaturus Citri Aurantii. and pepsin. reserpine. atropine. chlorpromazine. atropine. ephedrine. this formula is not commonly indicated in the West where most users of Chinese medicine manifest vacuity and repletion at the same time. sodium bicarbonate. postpartum. trypsine.Chapter 4 78 • Herb Toxicities & Drug Interactions: A Formula Approach PDR: Consult a physician before using this medicinal during pregnancy or while nursing.

hydrochloric acid. C&C: Contains alkaloids. BR: Reduces absorption of oral drugs. B&G: Use with extreme caution during pregnancy. Could possibly cause hyperkalemia when used with potassium-sparing diuretics. Not to be used while nursing. B&G= B ENSKY & GAMBLE. constipation. tight or bowstring pulse Contraindications: Heat Western medical indications: Stomach and intestinal spasms. C&C= CHAN & CHEUNG. gallstones. slimy tongue fur. Rhubarb & Aconite Combination) Category: Attacking & precipitating Functions: Warms yang and dissipates cold. Chuan Jun. PDR= PHYSICIAN’S DESK REFERENCE . migraines. chronic pelvic inflammation Potential formula toxicities & interactions: None listed POTENTIAL MEDICINAL TOXICITIES & INTERACTIONS: Da Huang. May aggravate potassium loss from diuretics. and glycosides. appendicitis and abdominal pain of unknown origin. cold hands and feet. chronic colitis. aversion to cold. GLW= GAO LU WEN . drains binding and moves stagnation Chinese medical indications: Internal cold accumulation with abdominal pain. pancreatitis. white. F L= FLAWS. B&B= BENSKY & BAROLET. potassium. acute inflammatory intestinal disease. a. Dai Huang. AH= AHPA. menstruation. rhubarb root) Standard daily dosage: 3-12g AH: Do not use during pregnancy. Overuse may cause hypokalemia and increased toxicity of cardiac glycosides. pyelonephritis. glutamic acid. low-grade fever. BR= BRINKER.Chapter 4 Toxicities & Drug Interaction • 79 DA HUANG FU ZI TANG (Rhubarb & Aconite Decoction. tannic acid.k. nicotinic acid. or postpartum. hernia pain. Jun (Radix Et Rhizoma Rhei. intestinal colic. PDR: Consult a physician before using this medicinal during pregnancy or while nursing. kidney stones. intercostal neuralgia. and other highly acidic substances could possibly reduce the therapeutic effect of this medicinal.a. sciatica. Vitamin C. Contraindicated in cases of intestinal obstruction. Contraindicated in intestinal obstruction. abdominal pain of unknown origin. Contraindicated for nursing mothers since active ingredients enter the milk. or any inflammatory condition of the intestines. and a confined. rib-side pain.

It is generally combined with Gan Cao (Radix Glycyrhizae Uralensis) and Gan Jiang (dry Rhizoma Zingiberis Officinalis) in decoctions to reduce its toxicity. and circulatory collapse leading to death. Symptoms of toxicity include drooling. vexation. GLW: If mild poisoning. a somber white facial complexion. including aconitine. there may be generalized sweating.5-15g AH: To be used only under the supervision of an expert qualified in the appropriate use of this substance B&G: Contraindicated during pregnancy. numbness. GLW: Symptoms of adverse reaction include headache. dizziness. monkshood) Standard daily dosage: 1. rapid breathing. Could possibly reduce the absorption and therapeutic effect of potassium and sodium iodides. B&G= B ENSKY & GAMBLE. GLW= GAO LU WEN. B&G: Nephrotoxic. paralysis. light-headedness. Contains aristolochic acid (AA). vomiting. and numbness and tingling of the extremities. lowered body temperature. Emergency measures include the administration of atropine. BR= BRINKER. urinary incontinence. sodium bicarbonate. vomiting. According to some traditional sources. dilated pupils. and pain which gradually spreads to the four limbs and then to the whole body. Xi Xin (Herba Asari Cum Radice) Standard daily dosage: 1-3g AH: Do not use during pregnancy. slowed reaction to light. there is a burning hot sensation in the mouth and on the tongue. low blood pressure. dyspnea. B&B= BENSKY & BAROLET. If more severe poisoning. heart palpitations.Chapter 4 80 • Herb Toxicities & Drug Interactions: A Formula Approach Fu Zi. aluminum hydroxide. reversal chilling of the four limbs. PDR: Not to be used during pregnancy. More severe symptoms include premature atrial contractions. and magnesium sulfate. vexaAH= AHPA. arrhythmia. Highly toxic. agitation. Shu Fu Zi. F L= FLAWS. gastric upset. C&C: Contains alkaloids. blurred vision. wolfsbane. and reduced temperature and blood pressure. convulsions. drooling. Use with caution in patients with renal problems. PDR= P HYSICIAN’S DESK REFERENCE . restlessness. A very toxic medicinal which can be fatal if ingested in its uncooked form or in an inappropriate dose. nausea. Do not exceed recommended dose. slow heartbeat. PDR: Contains nor-diterpene alkaloids. C&C= CHAN & CHEUNG. small doses can be fatal. may antagonize Shan Zhu Yu (Fructus Corni Officinalis) and Huang Qi (Radix Astragali Membranacei). Fu Pian (Radix Lateralis Praeparatus Aconiti Carmichaeli.

AH= AHPA. F L= FLAWS. cramping of the four limbs. a rapid pulse. and. and these may contain AA. B&B= BENSKY & BAROLET. C&C= CHAN & CHEUNG. arched-back rigidity. a red flushed face. clenched teeth. unclear thinking. GLW= GAO LU WEN.Chapter 4 Toxicities & Drug Interaction • 81 tion and agitation. urinary block. stiffness of the neck. As of this writing. other species of Asarum are sometimes substituted. neither of which have conclusively been shown to contain AA. slightly dilated pupils. generalized tension which may become convulsions. However. BR= BRINKER. death due to respiratory paralysis. Xi Xin is on the FDA’s “B List” of herbs which may potentially contain aristolochic acid (AA). sweating. B&G= B ENSKY & GAMBLE. eventually. twitching muscles. oral thirst. Xi Xin is harvested in China mostly from Asarum sieboldi and Asarum heteropoides. increased body temperature and blood pressure. the FDA has set no acceptable limit to AA consumption by humans. PDR= P HYSICIAN’S DESK REFERENCE . dimming of consciousness.

a pale.k. slight edema of the lower extremities. a. BR= BRINKER.Chapter 4 82 • Herb Toxicities & Drug Interactions: A Formula Approach DANG GUI SHAO YAO SAN (Dang Gui & Peony Powder. C&C= CHAN & CHEUNG. bowstring or soggy.) B&G: Use with caution in patients with diarrhea or abdominal distention. GLW= GAO LU WEN. C&C: Contains potassium. B&B= BENSKY & BAROLET. Shao Yao (Radix Albus Paeoniae Lactiflorae. F L= FLAWS. counteracts Bie Jia (Carapax Amydae Sinensis) and Xiao Ji (Herba Cephalanopoloris Segeti). white fur. Could possibly cause hyperkalemia when used with potassium-sparing diuretics.a. AH= AHPA. and beriberi Potential formula toxicities & interactions: None listed POTENTIAL MEDICINAL TOXICITIES & INTERACTIONS: Dang Gui (Radix Angelicae Sinensis) Standard daily dosage: 3-15g AH: Do not use during pregnancy. nourishes the blood and percolates dampness Chinese medical indications: Liver-spleen disharmony with blood vacuity and dampness manifesting as continuous but not particularly severe abdominal cramping. and is incompatible with Li Lu (Rhizoma Et Radix Veratri). (This medicinal is routinely used in Chinese medical gynecology during pregnancy as part of formulas appropriately prescribed on the basis of pattern discrimination. chronic nephritis. pelvic inflammatory disease. Bai Shao. possibly enlarged tongue with thin. Tang-kuei & Peony Formula) Category: Blood-supplementing Functions: Harmonizes the liver and spleen. antagonizes Shi Hu (Herba Dendrobii) and Mang Xiao (Mirabilitum). bowstring pulse Contraindications: None listed Western medical indications: Habitual or threatened miscarriage. According to some traditional sources. white peony root) Standard daily dosage: 6-30g AH: Safe when used appropriately B&G: Use with caution in debilitated patients with diarrhea. possible difficulty urinating (especially during pregnancy). primary dysmenorrhea. B&G= B ENSKY & GAMBLE. and a fine. PDR= P HYSICIAN’S DESK REFERENCE . May exaggerate the anticoagulative effect of warfarin (Coumadin).

or liver. copious urination. flavone sulfate. Bai Fu Ling. chlorpromazine.5-9g B&G: When rats were fed 0. glutamic acid. and magnesium sulfate. tannic acid. C&C: Contains alkaloids and potassium. Could possibly cause hyperkalemia when used with potassium-sparing diuretics. B&G= B ENSKY & GAMBLE. Bai Zhu (Rhizoma Atractylodis Macrocephalae) Standard daily dosage: 4. reserpine. Contraindicated in patients with frequent. hydrochloric acid. and glycosides.5g/kg of this medicinal for two months. According to traditional sources. GLW= GAO LU WEN. atropine. heart. aluminum hydroxide. calcium carbonate and gluconate. Could possibly cause hyperkalemia when used with potassium-sparing diuretics and reduce the absorption and therapeutic effect of potassium and sodium iodides. PDR: Contains triterpenes. F L= FLAWS. sodium bicarbonate. B&G: Although considered safe. Vitamin C.Chapter 4 Toxicities & Drug Interaction • 83 C&C: Contains calcium. they developed a mild lymphopenia and anemia but suffered no damage to the brain. prolonged usage may irritate the intestinal tract and could possibly cause gastroenteritis. PDR= P HYSICIAN’S DESK REFERENCE . and pepsin. isoniazid. ephedrine. B&B= BENSKY & BAROLET. Ze Xie (Rhizoma Alismatis Orientalis) Standard daily dosage: 6-15g AH: Prolonged use may cause gastrointestinal irritation. and other highly acidic substances could possibly reduce the therapeutic effect of this medicinal. and Could possibly reduce the absorption and therapeutic effect of levadopa. Fu Ling. amylase. vitamin B1. may counteract Di Yu (Radix Sanguisorbae Officinalis). C&C: Contains potassium. cause digitalis intoxication and heart arrhythmias. and caffeic acid derivatives. No health hazards or side effects with proper administration of designated therapeutic dosages. Could possibly reduce the effect of most antibiotics. quinine. potassium. and Bie Jia (Carapax Amydae Sinensis). BR= BRINKER. trypsine. Yun Ling (Sclerotium Poriae Cocos) Standard daily dosage: 9-15g B&G: Large doses or long-term use is discouraged. Could possibly cause hyperkalemia when used with potassium-sparing diuretics. C&C= CHAN & CHEUNG. Qin Jiao (Radix Gentianae Qinjiao). AH= AHPA. nicotinic acid. sesquiterpenes.

C&C= CHAN & CHEUNG.Chapter 4 84 • Herb Toxicities & Drug Interactions: A Formula Approach Chuan Xiong (Radix Ligustici Wallichii) Standard daily dosage: 3-9g(In China today. Could possibly reduce the absorption and therapeutic effect of potassium and sodium iodides. counteracts Hua Shi (Talcum) and Huang Lian (Rhizoma Coptidis Chinensis). Could possibly cause hyperkalemia when used with potassium-sparing diuretics. and magnesium sulfate. antagonizes Shan Zhu Yu (Fructus Corni Officinalis) and Huang Qi (Radix Astragali Membranacei). Overdosage causes vomiting and dizziness. B&G= BENSKY & GAMBLE.) B&G: Not for patients with migraine headache or excessive menstrual bleeding.) AH: Do not use during pregnancy. (This medicinal is routinely used in Chinese medical gynecology during pregnancy as part of formulas appropriately prescribed on the basis of pattern discrimination. F L= FLAWS. aluminum hydroxide. and is incompatible with Li Lu (Rhizoma Et Radix Veratri). BR= BRINKER. it is not uncommon for this medicinal to be prescribed up to 15 grams per day in decoction. GLW= GAO L U WEN. B&B= BENSKY & BAROLET. PDR= P HYSICIAN’S DESK REFERENCE . C&C: Contains alkaloids and potassium. AH= AHPA. According to some traditional texts. sodium bicarbonate.

peptic ulcer. calcium carbonate. Administration of tinctures of this herb can lead to pruritus. PDR: No health risks or side effects are known in conjunction with the proper administration of designated therapeutic dosages. B&B= BENSKY & BAROLET. BR= BRINKER. and aluminum hydroxide. sandlewood) Standard daily dosage: 3-9g AH: Contraindicated in kidney diseases involving the parenchyma of AH= AHPA. cholecystitis. Could possibly cause hyperkalemia when used with potassium-sparing diuretics. chronic gastritis. since this medicinal can hinder their therapeutic effect and promote tumor metastasis. C&C: Contains potassium. F L= FLAWS. Bai Tan Xiang (Lignum Santali Albi. incompatible with Li Lu (Rhizoma Et Radix Veratri). GLW= GAO LU WEN . Increases the absorption and decreases the clearance of warfarin (Coumadin) which can adversely affect prothrombin time. POTENTIAL MEDICINAL TOXICITIES & INTERACTIONS: Dan Shen (Radix Salviae Miltiorrhizae) Standard daily dosage: 6-60g AH: Safe when used appropriately BR: Possible additive effect to warfarin (Coumadin) B&G: According to traditional texts. Tan Xiang. moves the qi and stops pain Chinese medical indications: Blood stasis & qi stagnation with chest and stomach duct aching and pain Contraindications: Yin vacuity Western medical indications: Angina pectoris. Should not be used in cancer patients taking antineoplastic drugs. or reduced appetite. hepatitis. and primary or secondary dysmenorrhea Potential formula toxicities & interactions: B&B: Contraindicated in pregnancy and in patients with any active hemorrhagic disorder. PDR= PHYSICIAN’S DESK REFERENCE . B&G= B ENSKY & GAMBLE. C&C= CHAN & CHEUNG.Chapter 4 Toxicities & Drug Interaction • 85 DAN SHEN YIN (Salvia Beverage) Category: Blood-quickening Functions: Quickens the blood and dispels stasis. Hinders the absorption of magnesium oxide. stomachache. pancreatitis.

It is not commonly prescribed in decoction unless the ingredients in it are added to another. COMMENTS This formula is primarily used as a ready-made medicine. Sha Ren (Fructus Amomi) Standard daily dosage: 1.5-6g AH: Safe when used appropriately PDR: Use with caution in patients with gallstones since it can trigger colic due to its motility-enhancing effect. larger formula. F L= FLAWS. Do not use for more than six weeks without consultation with a physician. BR= BRINKER.Chapter 4 86 • Herb Toxicities & Drug Interactions: A Formula Approach the kidney. AH= AHPA. GLW= GAO LU WEN . PDR= PHYSICIAN’S DESK REFERENCE . C&C= CHAN & CHEUNG. PDR: Contraindicated in patients with kidney disease. B&B= BENSKY & BAROLET. B&G= B ENSKY & GAMBLE.

Raynaud’s phenomenon or disease. Bai Shao. nourishes the blood and frees the flow of the vessels Chinese medical indications: Cold in the channels in a patient with blood vacuity manifesting as enduring cold hands and feet. midline pain. GLW= GAO L U WEN. C&C: Contains potassium. May exaggerate the anticoagulative effect of warfarin (Coumadin). tannic acid. and is incompatible with Li Lu (Rhizoma Et Radix Veratri). frostbite. C&C= CHAN & CHEUNG. calluses and corns. varicose veins. colicky testalgia. Potential formula toxicities & interactions: None listed POTENTIAL MEDICINAL TOXICITIES & I NTERACTIONS: Dang Gui (Radix Angelicae Sinensis) Standard daily dosage: 3-15g AH: Do not use during pregnancy.k. and glycosides. BR= BRINKER. deep pulse Contraindications: Effulgent fire due to yin vacuity Western medical indications: Thromboangiitis obliterans. dysmenorrhea. Could possibly cause hyperkalemia when used with potassium-sparing diuretics. F L= FLAWS. According to some traditional sources.a. sciatica. hernia.Chapter 4 Toxicities & Drug Interaction • 87 DANG GUI SI NI TANG (Dang Gui Four Counterflows Decoction. a.) B&G: Use with caution in patients with diarrhea or abdominal distention. B&G= B ENSKY & GAMBLE. chronic rheumatoid arthritis. potassium. and gangrene. counteracts Bie Jia (Carapax Amydae Sinensis) and Xiao Ji (Herba Cephalanopoloris Segeti). fibromyalgia. chilblains. and a fine. antagonizes Shi Hu (Herba Dendrobii) and Mang Xiao (Mirabilitum). (This medicinal is routinely used in Chinese medical gynecology during pregnancy as part of formulas appropriately prescribed on the basis of pattern discrimination. Tang-kuei & Jujube Combination) Category: Interior-warming Functions: Warms the channels and dissipates cold. chronic urticaria. a pale tongue with white fur. peptic ulcer. Could AH= AHPA. Shao Yao (Radix Albus Paeoniae Lactiflorae. PDR= P HYSICIAN’S DESK REFERENCE . B&B= BENSKY & BAROLET. white peony root) Standard daily dosage: 6-30g AH: Safe when used appropriately B&G: Use with caution in debilitated patients with diarrhea. C&C: Contains calcium.

F L= FLAWS. slightly dilated pupils. GLW= GAO LU WEN . vexation and agitation. Could possibly reduce the effect of most antibiotics. other species of Asarum are sometimes substituted. a rapid pulse. sweating. PDR: Medicinal preparations are contraindicated during pregnancy. glutamic acid. However. cinnamon twigs) Standard daily dosage: 3-15g AH: Safe when used appropriately B&G: Use with caution in the presence of fever. generalized tension which may become convulsions. vomiting. clenched teeth. arched-back rigidity. PDR: Not to be used during pregnancy. trypsine. AH= AHPA. B&G= B ENSKY & GAMBLE. neither of which have conclusively been shown to contain AA. may antagonize Shan Zhu Yu (Fructus Corni Officinalis) and Huang Qi (Radix Astragali Membranacei). urinary block. ephedrine. Gui Zhi (Ramulus Cinnamomi Cassiae. and these may contain AA. or during excessive menstruation. nicotinic acid. oral thirst. and could possibly reduce the absorption and therapeutic effect of levadopa. Contains aristolochic acid (AA). Use with caution in patients with renal problems. a red flushed face. BR= BRINKER. quinine.Chapter 4 88 • Herb Toxicities & Drug Interactions: A Formula Approach possibly cause hyperkalemia when used with potassium-sparing diuretics. As of this writing. C&C= CHAN & CHEUNG. hydrochloric acid. calcium carbonate and gluconate. eventually. atropine. during pregnancy. the FDA has set no acceptable limit to AA consumption by humans. and. amylase. increased body temperature and blood pressure. PDR= PHYSICIAN’S DESK REFERENCE . Do not exceed recommended dose. death due to respiratory paralysis. and other highly acidic substances could possibly reduce the therapeutic effect of this medicinal. chlorpromazine. stiffness of the neck. unclear thinking. According to some traditional sources. twitching muscles. cause digitalis intoxication and heart arrhythmias. cramping of the four limbs. B&G: Nephrotoxic. Xi Xin is harvested in China mostly from Asarum sieboldi and Asarum heteropoides. GLW: Symptoms of adverse reaction include headache. reserpine. Vitamin C. vitamin B1. Xi Xin (Herba Asari Cum Radice) Standard daily dosage: 1-3g AH: Do not use during pregnancy. Xi Xin is on the FDA’s “B List” of herbs which may potentially contain aristolochic acid (AA). dimming of consciousness. B&B= BENSKY & BAROLET. isoniazid. and pepsin.

When used as a single medicinal or in patients taking other potent Western pharmaceuticals. intestinal colic. and liver disorders. B&G= B ENSKY & GAMBLE. it may cause hypertension and/or edema. caution should be exercised to guard against potential toxicity and drug interaction. May be synergistic with insulin in causing hypokalemia and sodium retention. Da Zao. GLW: Early stage symptoms of poisoning include upper abdominal disAH= AHPA. F L= FLAWS. C&C: Contains potassium. It should not be taken long-term or as a single herb during pregnancy. PDR: Not to be administered during pregnancy. Possible additive effect to corticosteroids. C&C= CHAN & CHEUNG. Not for long-term use. Large doses of the medicinal may lead to gastroenteritis. May increase potassium loss due to diuretics and laxatives. If taken long-term. GLW= GAO LU WEN .) As a single herb in high doses. and Yuan Zhi (Radix Polygalae Tenuifoliae). BR= BRINKER. Could possibly cause dehydration and renal failure in large doses. PDR= PHYSICIAN’S DESK REFERENCE . red dates) Standard daily dosage: 10-30g (3-12 pieces) AH: Safe when used appropriately PDR: No health risks or side effects are known in conjunction with the proper administration of designated therapeutic dosages.Chapter 4 Toxicities & Drug Interaction • 89 Gan Cao (Radix Glycyrrhizae Uralensis. B&B= BENSKY & BAROLET. Mu Tong (Caulis Akebiae) Standard daily dosage: 3-9g B&G: Contraindicated during pregnancy. The research on Gan Cao concurs that this medicinal is generally safe when used in small amounts as an envoy. Hong Zao (Fructus Zizyphi Jujubae. (This medicinal is routinely used in Chinese medical gynecology during pregnancy as part of formulas appropriately prescribed on the basis of pattern discrimination. BR: May increase toxicity of cardiac glycosides. Yuan Hua (Flos Daphnes Genkwae). Contains glycyrrhetinic acid which could possibly cause a reduction in thyroid activity and basal metabolic rate. incompatible with Gan Sui (Radix Euphorbiae Kansui). hypertension. it is contraindicated in diabetes. and diarrhea due to saponin content. B&G: According to some traditional sources. Could possibly cause hyperkalemia when used with potassium-sparing diuretics. licorice) Standard daily dosage: 2-12g AH: Do not use during pregnancy.

C&C= CHAN & CHEUNG. scanty urination or blocked urination. uremia leads to death. chest oppression. GLW= GAO LU WEN. PDR= P HYSICIAN’S DESK REFERENCE . This medicinal is often substituted with Caulis Aristolochiae Manchuriensis which contains aristolochic acid. Secondarily. and increased blood pressure. AH= AHPA. there is frequent urination. F L= FLAWS. Some patients present oily stools. it is important that this medicinal only be prescribed in the form of Caulis Akebiae Trifoliatae or Akebiae Quinatae. B&B= BENSKY & BAROLET. urgent urination. and diarrhea. facial edema which gradually spreads to the entire body. BR= BRINKER. abdominal pain. Therefore. unclear consciousness. In those with acute kidney failure. inability to lie down.Chapter 4 90 • Herb Toxicities & Drug Interactions: A Formula Approach comfort. vomiting. B&G= B ENSKY & GAMBLE.

B&G= B ENSKY & GAMBLE . oral ulceration. AH= AHPA. urethritis. BR= BRINKER. a. Could possibly cause hyperkalemia when used with potassium-sparing diuretics. C&C: Contains potassium. Sheng Di Huang (uncooked Radix Rehmanniae Glutinosae) Standard daily dosage: 9-30g AH: Contraindicated in patients with diarrhea or lack of appetite B&G: Contraindicated in pregnant women with anemias or digestive weakness C&C: Contains potassium. Rehmannia & Akebia Formula) Category: Heat-clearing Functions: Clears the heart and nourishes yin. possible hematuria. scanty. Mu Tong (Caulis Akebiae) Standard daily dosage: 3-9g B&G: Contraindicated during pregnancy. a red facial complexion. and painful urination. and a rapid pulse Contraindications: Spleen vacuity Western medical indications: Acute cystitis. vexatious heat in the chest.Chapter 4 Toxicities & Drug Interaction • 91 DAO CHI SAN (Abduct the Red Powder. disinhibits water and frees the flow of strangury Chinese medical indications: Heat in the heart & small intestine channels with easy anger. dark. PDR: No health risks or side effects are known in conjunction with the proper administration of designated therapeutic dosages. glomerulonephritis. B&B= BENSKY & BAROLET. glossitis. and nightmares Potential formula toxicities & interactions: FL/B&B: Do not use in patients with diarrhea POTENTIAL MEDICINAL TOXICITIES & I NTERACTIONS: Sheng Di. Lead Out the Red Powder. a red tongue. thirst with a desire for cold drinks. sores on the tip of the tongue.a. PDR= P HYSICIAN’ S DESK REFERENCE . difficult urination.k. GLW= GAO LU WEN. C&C= CHAN & CHEUNG. Could possibly cause dehydration and renal failure in large doses. FL= FLAWS. Could possibly cause hyperkalemia when used with potassium-sparing diuretics. astringent.

BR= BRINKER. Some patients present oily stools. Dan Zhu Ye (Herba Lophatheri Gracilis) Standard daily dosage: 6-9g B&G: Use with caution in pregnancy. GLW= GAO LU WEN. Therefore. In those with acute kidney failure. This medicinal is often substituted with Caulis Aristolochiae Manchuriensis which contains aristolochic acid. unclear consciousness. it may cause hypertension and/or edema. May increase potassium loss due to diuretics and laxatives. The research on Gan Cao concurs that this medicinal is generally safe when used in small amounts as an envoy. abdominal pain. vomiting. and diarrhea. urgent urination. GLW: Early stage symptoms of poisoning include upper abdominal discomfort. B&B= BENSKY & BAROLET. there is frequent urination. intestinal colic. scanty urination or blocked urination. If taken long-term. C&C: Contains potassium.Chapter 4 92 • Herb Toxicities & Drug Interactions: A Formula Approach PDR: Not to be administered during pregnancy. Large doses of the medicinal may lead to gastroenteritis. and liver disorders. Possible additive effect to corticosteroids. uremia leads to death. It should not be taken long-term AH= AHPA. licorice) Standard daily dosage: 2-12g AH: Do not use during pregnancy. Yuan Hua (Flos Daphnes Genkwae). incompatible with Gan Sui (Radix Euphorbiae Kansui). C&C= CHAN & CHEUNG. Contains glycyrrhetinic acid which could possibly cause a reduction in thyroid activity and basal metabolic rate. it is important that this medicinal only be prescribed in the form of Caulis Akebiae Trifoliatae or Akebiae Quinatae. Could possibly cause hyperkalemia when used with potassium-sparing diuretics. and diarrhea due to saponin content. and increased blood pressure. it is contraindicated in diabetes. B&G: According to some traditional sources. Not for long-term use. PDR= P HYSICIAN’ S DESK REFERENCE . chest oppression. Secondarily. BR: May increase toxicity of cardiac glycosides. FL= FLAWS. facial edema which gradually spreads to the entire body. Gan Cao (Radix Glycyrrhizae Uralensis. hypertension. (This medicinal is routinely used in Chinese medical gynecology during pregnancy as part of formulas appropriately prescribed on the basis of pattern discrimination. May be synergistic with insulin in causing hypokalemia and sodium retention. and Yuan Zhi (Radix Polygalae Tenuifoliae).) As a single herb in high doses. B&G= B ENSKY & GAMBLE . inability to lie down.

FL= FLAWS. caution should be exercised to guard against potential toxicity and drug interaction. this formula is typically only prescribed for a few days at a time. As soon as the heat has been cleared from the heart. in this case. Since heart fire shifted to the bladder tends to be an acute exacerbation of depressive heat. One of the keys to identifying and discriminating this pattern is the especially red tongue tip with possible/probable tongue sores. AH= AHPA. C&C= CHAN & CHEUNG. B&G= B ENSKY & GAMBLE . BR= BRINKER. PDR= P HYSICIAN’ S DESK REFERENCE .Chapter 4 Toxicities & Drug Interaction • 93 or as a single herb during pregnancy. COMMENTS Although this formula. When used as a single medicinal or in patients taking other potent Western pharmaceuticals. GLW= GAO LU WEN. like Ba Zheng San (Eight [Ingredients] Correcting Powder) treats damp heat in the lower burner resulting in heat strangury difficult and/or painful urination. B&B= BENSKY & BAROLET. the heat has been transferred from the heart to the small intestine to the bladder. one should switch to another formula to treat the underlying root.

slow. Shan Zhu Rou (Fructus Corni Officinalis) Standard daily dosage: 3-60g AH: Contraindicated in patients with difficult or painful urination AH= AHPA. PDR= P HYSICIAN’ S DESK REFERENCE . BR= BRINKER. If taken for several weeks. PDR: No health risks or side effects are known in conjunction with the proper administration of designated therapeutic dosages. FL= FLAWS. C&C= CHAN & CHEUNG. opens the orifices and transforms phlegm Chinese medical indications: Yin and yang dual vacuity with stiffness of the tongue and inability to speak. B&B= BENSKY & BAROLET. B&G= B ENSKY & GAMBLE . yellow tongue fur. GLW= GAO LU WEN. paralysis of the lower extremities. slimy. acute transverse myelitis. Side effects include diarrhea. abdominal pain. fine. a dry mouth but no particular thirst. Xian Mao (Rhizoma Curculiginis Orchioidis) and Yin Yang Huo (Herba Epimedii) should be substituted for Fu Zi (Radix Lateralis Praeparatus Aconiti Carmichaeli) and Rou Gui (Cortex Cinnamomi Cassiae). and heart palpitations which often disappear upon continued administration of the herb. forceless pulse Contraindications: Repletion disorders Western medical indications: Amyotrophic lateral sclerosis. and secondary hypertension associated with glomerulonephritis and pyelonephritis Potential formula toxicities & interactions: B&B: Should not be taken long-term. sequelae of cerebrovascular accident. dizziness. and a deep. Shu Di Huang (cooked Radix Rehmanniae Glutinosae) Standard daily dosage: 9-30g AH: Contraindicated in patients with diarrhea or indigestion B&G: Overuse can lead to abdominal distention and loose stools. supplements and invigorates kidney yang.Chapter 4 94 • Herb Toxicities & Drug Interactions: A Formula Approach DI HUANG YIN ZI (Rehmannia Beverage) Category: Wind-treating Functions: Supplements and enriches kidney yin. Shan Zhu Yu. lethargy. POTENTIAL MEDICINAL TOXICITIES & INTERACTIONS: Shu Di. hypertensive encephalopathy. cerebral arteriorsclerosis.

B&G= B ENSKY & GAMBLE. PDR: No health hazards are known in conjunction with proper administration of designated therapeutic dosages. ephedrine. hydrochloric acid.Chapter 4 Toxicities & Drug Interaction • 95 B&G: Contraindicated in patients with difficult or painful urination. Bai Ji (Radix Morindae Officinalis) Standard daily dosage: 6-15g AH: Safe when used appropriately B&G: According to some traditional sources. aluminum hydroxide. C&C= CHAN & CHEUNG. According to some traditional sources. B&B= BENSKY & BAROLET. atropine. amylase. PDR= P HYSICIAN’S DESK REFERENCE . antagonizes Jie Geng (Radix Platycodi Grandiflori). Ba Ji Rou. BR= BRINKER. Shu Fu Zi. caffeine. Could possibly reduce the therapeutic effect of sodium bicarbonate. A very toxic medicinal which can be fatal if ingested in its uncooked form or in an inappropriate dose. reserpine. digitalis. chlorpromazine. Could possibly cause crystalluria and hematuria. quinine. Fu Zi. scopolamine. GLW= GAO LU WEN. Could possibly reduce the absorption and biologic effect of most antibiotics. many antibiotics (especially aminoglycosides and sulfas). glutamic acid. C&C: Highly acidic. opiates. Cong Rong (Herba Cistanchis Deserticolae Seu Salsae) Standard daily dosage: 9-21g AH: Safe when used appropriately Ba Ji Tian. isoniazid. It is generally combined with Gan Cao (Radix Glycyrhizae Uralensis) and Gan Jiang (dry Rhizoma Zingiberis Officinalis) in decoctions to AH= AHPA. Fang Feng (Radix Ledebouriellae Divaricatae). nicotinic acid. C&C: Contains tannic acid and glycosides. antagonizes Dan Shen (Radix Salviae Miltiorrhizae). reserpine. and other highly acidic substances could possibly reduce the therapeutic effect of this medicinal. calcium carbonate and gluconate. trypsine. vitamin B 1. and Fang Ji (Radix Aristolochiae Fangchi). F L= FLAWS. wolfsbane. Fu Pian (Radix Lateralis Praeparatus Aconiti Carmichaeli. Vitamin C.5-15g AH: To be used only under the supervision of an expert qualified in the appropriate use of this substance B&G: Contraindicated during pregnancy. and pepsin. Rou Cong Rong. and berbamin. monkshood) Standard daily dosage: 1.

dilated pupils. paralysis. and magnesium sulfate. Shi Hu (Herba Dendrobii) Standard daily dosage: 6-15g AH: Safe when used appropriately B&G: Retains and preserves disease evils and should not be used in patients with early stages of a warm disease. GLW: If mild poisoning. C&C= CHAN & CHEUNG. B&G= BENSKY & GAMBLE. PDR= PHYSICIAN’S DESK REFERENCE . and circulatory collapse leading to death. BR= BRINKER. If more severe poisoning. reversal chilling of the four limbs. Emergency measures include the administration of atropine. nausea. numbness. and reduced temperature and blood pressure. and other highly acidic substances Could possibly reduce the therapeutic effect of this medicinal. More severe symptoms include premature atrial contractions. vexation. arrhythmia. Mai Dong (Tuber Ophiopogoni Japonici) Standard daily dosage: 6-15g AH: Safe when used appropriately B&G: According to some traditional sources. PDR: Contains nor-diterpene alkaloids. Large doses had an inhibitory effect on the heart and lungs of experimental animals. slowed reaction to light. dizziness. drooling. low blood pressure. lowered body temperature. a somber white facial complexion. hydrochloric acid. there may be generalized sweating. glutamic acid. C&C: Contains alkaloids. gastric upset. nicotinic acid. slow heartbeat. C&C: Contains glycosides. Mai Men Dong. convulsions. Could possibly reduce the absorption and therapeutic effect of potassium and sodium iodides. including aconitine. Highly toxic. Vitamin C. F L= FLAWS. aluminum hydroxide. urinary incontinence. Overdoses caused convulsions. vomiting. small doses can be fatal. sodium bicarbonate. B&B= BENSKY & BAROLET. dyspnea. and numbness and tingling of the extremities. Symptoms of toxicity include drooling. heart palpitations. slimy tongue fur. light-headedness. and pain which gradually spreads to the four limbs and then to the whole body. agitation. antagonizes Kuan Dong Hua (Flos Tussilaginis Farfarae) and counteracts Ku Shen (Radix Sophorae Flavescentis) and Bai Mu Er (Fructificatio Tremellae Fuciformis). Also causes dampness and should not be used in patients with abdominal distention and thick. blurred vision.Chapter 4 96 • Herb Toxicities & Drug Interactions: A Formula Approach reduce its toxicity. AH= AHPA. GLW= GAO L U WEN . restlessness. there is a burning hot sensation in the mouth and on the tongue. rapid breathing.

a red flushed face. hydrochloric acid. C&C: Contains glycosides. a rapid pulse. dimming of consciousness. clenched teeth. counteracts Zhen Zhu (Margarita) and Li Lu (Rhizoma Et Radix Veratri). and. unclear thinking. sweetflag rhizome) Standard daily dosage: 3-9g AH: Do not use during pregnancy. C&C: Contains potassium. arched-back rigidity. may counteract Di Yu (Radix Sanguisorbae Officinalis). and other highly acidic substances could possibly reduce the therapeutic effect of this medicinal. Qin Jiao (Radix Gentianae Qinjiao). Could possibly cause hyperkalemia when used with potassium-sparing diuretics. vomiting. urinary block. stiffness of the neck. copious urination. Massive overdose in mice led to convulsions. generalized tension which may become convulsions. eventually death due to respiratory paralysis. slightly dilated pupils. Yun Ling (Sclerotium Poriae Cocos) Standard daily dosage: 9-15g B&G: Large doses or long-term use is discouraged. vexation and agitation. B&G= B ENSKY & GAMBLE . Chang Pu (Rhizoma Acori Graminei. PDR= P HYSICIAN’ S DESK REFERENCE . sweating. glutamic acid. oral thirst. increased body temperature and blood pressure.5-9g AH= AHPA. C&C= CHAN & CHEUNG. B&G: Contraindicated in gastritis or when gastric ulcers are present. GLW= GAO LU WEN. schisandra) Standard daily dosage: 1. antagonizes Ma Huang (Herba Ephedrae). twitching muscles. cramping of the four limbs. B&B= BENSKY & BAROLET. nicotinic acid. According to some traditional sources. Fu Ling. Yuan Zhi (Radix Polygalae Tenuifoliae) Standard daily dosage: 3-9g AH: Contraindicated in gastritis or when gastric ulcers are present. and Bie Jia (Carapax Amydae Sinensis). and death caused by stimulation of the spinal cord. According to traditional sources. Wu Wei Zi (Fructus Schisandrae Chinensis. hypersensitivity to external stimuli. Contraindicated in patients with frequent. FL= FLAWS.Chapter 4 Toxicities & Drug Interaction • 97 Shi Chang Pu. Bai Fu Ling. B&G: According to some traditional sources. Vitamin C. BR= BRINKER. GLW: Symptoms of adverse reaction include headache.

cinnamon bark) Standard daily dosage: 1. toxic doses were 1015g/kg. reserpine. Highly acidic. PDR: Recommended safe dosage limit is six grams (6g). B&B= BENSKY & BAROLET. red dates) Standard daily dosage: 10-30g (3-12 pieces) AH: Safe when used appropriately PDR: No health risks or side effects are known in conjunction with the proper administration of designated therapeutic dosages. Bo He (Herba Menthae Haplocalycis. Gui Xin. BR= BRINKER. scopolamine. aluminum hydroxide. or dyspnea. Increases absorption of oral drugs. B&G= B ENSKY & GAMBLE. and berbamin. Avoid larger doses if being used to treat morning sickness or if used in patients taking anticoagulants. Rou Gui. C&C: Contains potassium.5-6g AH: Safe when used appropriately B&G: Not recommended for nursing mothers as it may inhibit lactation. caffeine. insomnia. Da Zao. fresh ginger) Standard daily dose: 3-9g AH: Safe when used appropriately BR: Reduces vomiting caused by chemotherapeutic drugs. PDR: No health risks or side effects are known in conjunction with the proper administration of designated therapeutic dosages. opiates. Could possibly reduce the therapeutic effect of sodium bicarbonate. Guan Gui (Cortex Cinnamomi Cassiae. GLW= GAO LU WEN. Symptoms of overdose included restlessness.Chapter 4 98 • Herb Toxicities & Drug Interactions: A Formula Approach AH: Safe when used appropriately B&G: Occasionally causes heartburn.5-4. In mice. many antibiotics (especially aminoglycosides and sulfas). C&C= CHAN & CHEUNG. Hong Zao (Fructus Zizyphi Jujubae. F L= FLAWS.5g AH= AHPA. Sheng Jiang (uncooked Rhizoma Zingiberis Officinalis. field mint) Standard daily dose: 1. PDR= PHYSICIAN’S DESK REFERENCE . Could possibly cause crystalluria and hematuria. Could possibly cause hyperkalemia when used in large doses with potassium-sparing diuretics.

trypsine. amylase. vitamin B1. PDR= PHYSICIAN’S DESK REFERENCE . F L= FLAWS. calcium carbonate and gluconate. B&B= BENSKY & BAROLET. ephedrine. and pepsin. Could possibly reduce the absorption and biologic effect of most antibiotics. GLW= GAO LU WEN . isoniazid. atropine.Chapter 4 Toxicities & Drug Interaction • 99 AH: Not to be used during pregnancy BR: Reduces absorption of tetracyclines B&G: Use with caution during pregnancy C&C: Contains tannic acid and potassium. C&C= CHAN & CHEUNG. BR= BRINKER. quinine. digitalis. B&G= B ENSKY & GAMBLE. Could possibly cause hyperkalemia when used with potassium-sparing diuretics. AH= AHPA. reserpine. chlorpromazine.

Chapter 4 100 • Herb Toxicities & Drug Interactions: A Formula Approach

DIE DA WAN (Knock & Fall Pills)
Category: Blood-quickening Functions: Quickens the blood and transforms stasis, harmonizes the constructive, disperses swelling, and stops pain Chinese medical indications: Blood stasis after traumatic injury with bruising, swelling, distention, aching, and pain at a fixed location Contraindications: Pregnancy Western medical indications: Traumatic injury due to falls, fractures, contusions, and strains Potential formula toxicities & interactions: None listed

POTENTIAL MEDICINAL TOXICITIES & INTERACTIONS:
Dang Gui
(Radix Angelicae Sinensis) Standard daily dosage: 3-15g AH: Do not use during pregnancy. (This medicinal is routinely used in Chinese medical gynecology during pregnancy as part of formulas appropriately prescribed on the basis of pattern discrimination.) B&G: Use with caution in patients with diarrhea or abdominal distention. C&C: Contains potassium. Could possibly cause hyperkalemia when used with potassium-sparing diuretics. May exaggerate the anticoagulative effect of warfarin (Coumadin).

Chuan Xiong
(Radix Ligustici Wallichii) Standard daily dosage: 3-9g(In China today, it is not uncommon for this medicinal to be prescribed up to 15 grams per day in decoction.) AH: Do not use during pregnancy. (This medicinal is routinely used in Chinese medical gynecology during pregnancy as part of formulas appropriately prescribed on the basis of pattern discrimination.) B&G: Not for patients with migraine headache or excessive menstrual bleeding. Overdosage causes vomiting and dizziness. According to some traditional texts, antagonizes Shan Zhu Yu (Fructus Corni Officinalis) and Huang Qi (Radix Astragali Membranacei), counteracts Hua Shi (Talcum) and Huang Lian (Rhizoma Coptidis Chinensis), and is incompatible with Li Lu (Rhizoma Et Radix Veratri). C&C: Contains alkaloids and potassium. Could possibly cause hyperkalemia when used with potassium-sparing diuretics. Could possibly
AH= AHPA, B&B= BENSKY & BAROLET, B&G= B ENSKY & GAMBLE, BR= BRINKER, C&C= CHAN & CHEUNG, F L= FLAWS, GLW= GAO LU WEN , PDR= PHYSICIAN’S DESK REFERENCE

Chapter 4 Toxicities & Drug Interaction • 101

reduce the absorption and therapeutic effect of potassium and sodium iodides, sodium bicarbonate, aluminum hydroxide, and magnesium sulfate.

Ru Xiang
(Resina Olibani, frankincense) Standard daily dosage: 3-9g B&G: Contraindicated during pregnancy.

Mo Yao
(Resina Myrrhae, myrrh) Standard daily dosage: 3-12g B&G: Contraindicated during pregnancy and in patients with excessive uterine bleeding. PDR: Not for use during pregnancy.

Xue Jie
(Sanguis Draconis) Standard daily dosage: 0.3-1.5g as a powder or in a pill AH: Safe when used appropriately B&G: Contraindicated during pregnancy. Internal ingestion has been associated with one case of angioedema due to a hypersensitivity which was later reversed.

Tu Bie Chong, Di Bie Chong, Zhe Chong
(Eupolyphaga Seu Opisthoplatia) Standard daily dosage: 3-6g B&G: Contraindicated during pregnancy.

Ma Huang
(Herba Ephedrae, ephedra) Standard daily dosage: 3-9g AH: Not to be used during pregnancy. Contraindicated in anorexia, bulimia, and glaucoma. Not for long-term use. BR: Increases thermogenesis when combined with methylxanthines in theophylline and caffeine. May induce toxicity with MAO-inhibitors. May reduce the effect of dexamethazone. Amytriptiline blocks its hypertensive effect. Antagonized by reserpine. B&G: May raise blood pressure and cause tremors. As little as 15ml in
AH= AHPA, B&B= BENSKY & BAROLET, B&G= B ENSKY & GAMBLE , BR= BRINKER, C&C= CHAN & CHEUNG, FL= FLAWS, GLW= GAO LU WEN, PDR= PHYSICIAN’ S DESK REFERENCE

Chapter 4 102 • Herb Toxicities & Drug Interactions: A Formula Approach

a 1% solution may be toxic to some individuals. May cause arrhythmias if used in conjunction with cardiac glycosides. Antidote for poisoning is atropine. All research sources concur that Ma Huang is a very powerful herb with many potential side effects and interactions and, therefore, must be administered with care. It enhances digitalis, antagonizes barbiturates, and increases the effects of adrenergic agonists. It should only be prescribed by a properly trained practitioner and should not be given longterm or during pregnancy. GLW: Initially after poisoning, there are central nervous and sympathetic nervous system symptoms, such as vexation, agitation, and restlessness, extreme nerve reactivity, headache, dizziness, tinnitus, insomnia, nausea, vomiting, upper abdominal discomfort, dry mouth, sweating, increased blood pressure, dilated pupils, heart palpitations, shortness of breath, and precordial pain. Graver reactions include difficulty urinating, unclear vision, shock, syncope, difficulty breathing, fright reversal. If critical, there may be respiratory failure and death. The U.S. FDA has banned the inclusion of this medicinal in all dietary supplements.

Zi Ran Tong
(Pyritum, native copper) Standard daily dosage: 3-9g No toxicity or interaction information listed in the sources

COMMENTS
This formula is usually administered in the form of a ready-made medicine.

AH= AHPA, B&B= BENSKY & BAROLET, B&G= B ENSKY & GAMBLE, BR= BRINKER, C&C= CHAN & CHEUNG, F L= FLAWS, GLW= GAO LU WEN , PDR= PHYSICIAN’S DESK REFERENCE

Chapter 4 Toxicities & Drug Interaction • 103

DING CHUAN TANG (Stabilize Panting Decoction, a.k.a. Arrest Wheezing Decoction, Ma Huang & Ginkgo Combination)
Category: Qi-rectifying & counterflow-downbearing Functions: Diffuses the lungs and downbears the qi, clears heat, transforms phlegm, and levels panting Chinese medical indications: Wind cold depressed in the exterior and phlegm heat smoldering in the interior with coughing, panting, wheezing, profuse, thick, yellow phlegm, difficulty breathing, slimy, yellow tongue fur, and a slippery, rapid pulse Contraindications: Wind cold external contraction without internal heat Western medical indications: Chronic bronchitis, bronchial asthma, and bronchiolitis Potential formula toxicities & interactions: None listed

POTENTIAL MEDICINAL TOXICITIES & I NTERACTIONS:
Bai Guo, Yin Guo, Yin Xing
(Semen Ginkgo Bilobae, ginkgo seeds) Standard daily dosage: 4.5-9g AH: May potentiate MAO-inhibitors. B&G: Slightly toxic and should not be taken long-term or in large quantities. Symptoms of overdose include headache, fever, tremors, irritability, and dyspnea. In serious cases, there is an increase in shedding of the mucus membranes. Antidote is 60 grams of boiled uncooked Gan Cao (Radix Glycyrrizae Uralensis) or 30 grams of boiled ginkgo shells. C&C: Contains cyanophoric and other glycosides. If taken in large doses with codeine, morphine, or other opiates, hydrocyanic acid is produced which might lead to respiratory failure and death. Vitamin C, nicotinic acid, glutamic acid, hydrochloric acid, and other highly acidic substances could possibly reduce the therapeutic effect of this medicinal. PDR: May cause cerebral hemorrhage in sensitive individuals. Avoid administering to patients on anticoagulant therapy. May cause infertility due to its adverse effect on oocytes.

AH= AHPA, B&B= BENSKY & BAROLET, B&G= B ENSKY & GAMBLE, BR= BRINKER, C&C= CHAN & CHEUNG, F L= FLAWS, GLW= GAO LU WEN , PDR= PHYSICIAN’S DESK REFERENCE

Chapter 4 104 • Herb Toxicities & Drug Interactions: A Formula Approach

Ma Huang
(Herba Ephedrae, ephedra) Standard daily dosage: 3-9g AH: Not to be used during pregnancy. Contraindicated in anorexia, bulimia, and glaucoma. Not for long-term use. BR: Increases thermogenesis when combined with methylxanthines in theophylline and caffeine. May induce toxicity with MAO-inhibitors. May reduce the effect of dexamethazone. Amytriptiline blocks its hypertensive effect. Antagonized by reserpine. B&G: May raise blood pressure and cause tremors. As little as 15ml in a 1% solution may be toxic to some individuals. May cause arrhythmias if used in conjunction with cardiac glycosides. Antidote for poisoning is atropine. All research sources concur that Ma Huang is a very powerful herb with many potential side effects and interactions and, therefore, must be administered with care. It enhances digitalis, antagonizes barbiturates, and increases the effects of adrenergic agonists. It should only be prescribed by a properly trained practitioner and should not be given longterm or during pregnancy. GLW: Initially after poisoning, there are central nervous and sympathetic nervous system symptoms, such as vexation, agitation, and restlessness, extreme nerve reactivity, headache, dizziness, tinnitus, insomnia, nausea, vomiting, upper abdominal discomfort, dry mouth, sweating, increased blood pressure, dilated pupils, heart palpitations, shortness of breath, and precordial pain. Graver reactions include difficulty urinating, unclear vision, shock, syncope, difficulty breathing, fright reversal. If critical, there may be respiratory failure and death. The U.S. FDA has banned the inclusion of this medicinal in all dietary supplements.

Zi Su Zi, Su Zi
(Fructus Perillae Frutescentis) Standard daily dosage: 4.5-9g B&G: Contraindicated in cases of chronic diarrhea.

Gan Cao
(Radix Glycyrrhizae Uralensis, licorice) Standard daily dosage: 2-12g
AH= AHPA, B&B= BENSKY & BAROLET, B&G= B ENSKY & GAMBLE, BR= BRINKER, C&C= CHAN & CHEUNG, F L= FLAWS, GLW= GAO LU WEN, PDR= P HYSICIAN’S DESK REFERENCE

Chapter 4 Toxicities & Drug Interaction • 105

AH: Do not use during pregnancy. (This medicinal is routinely used in Chinese medical gynecology during pregnancy as part of formulas appropriately prescribed on the basis of pattern discrimination.) As a single herb in high doses, it is contraindicated in diabetes, hypertension, and liver disorders. Not for long-term use. BR: May increase toxicity of cardiac glycosides. May increase potassium loss due to diuretics and laxatives. Possible additive effect to corticosteroids. May be synergistic with insulin in causing hypokalemia and sodium retention. B&G: According to some traditional sources, incompatible with Gan Sui (Radix Euphorbiae Kansui), Yuan Hua (Flos Daphnes Genkwae), and Yuan Zhi (Radix Polygalae Tenuifoliae). If taken long-term, it may cause hypertension and/or edema. Contains glycyrrhetinic acid which could possibly cause a reduction in thyroid activity and basal metabolic rate. The research on Gan Cao concurs that this medicinal is generally safe when used in small amounts as an envoy. It should not be taken longterm or as a single herb during pregnancy. When used as a single medicinal or in patients taking other potent Western pharmaceuticals, caution should be exercised to guard against potential toxicity and drug interaction.

Kuan Dong Hua
(Flos Tussilaginis Farfarae, coltsfoot flower) Standard daily dosage: 1.5-9g AH: Not to be used during pregnancy. Not for long-term use. B&G: Large doses can lead to syncope and apnea. According to some traditional sources, antagonizes Xuan Shen (Radix Scrophulariae Ningpoensis) and counteracts Bei Mu (Bulbus Frittilariae), Xin Yi Hua (Flos Magnoliae), Ma Huang (Herba Ephedrae), Huang Qin (Radix Scutellariae Baicalensis), Huang Lian (Rhizoma Coptidis Chinensis), and Huang Qi (Radix Astragali Membranacei). C&C: Vitamin C, nicotinic acid, glutamic acid, hydrochloric acid, and other highly acidic substances could possibly reduce the therapeutic effect of this medicinal. PDR: Not for use during pregnancy or while nursing.

Xing Ren, Ku Xing Ren
(Semen Pruni Armenicae, apricot kernel) Standard daily dosage: 3-9g AH: To be used only under the supervision of an expert qualified in the appropriate use of this substance
AH= AHPA, B&B= BENSKY & BAROLET, B&G= B ENSKY & GAMBLE, BR= BRINKER, C&C= CHAN & CHEUNG, F L= FLAWS, GLW= GAO LU WEN , PDR= PHYSICIAN’S DESK REFERENCE

Chapter 4 106 • Herb Toxicities & Drug Interactions: A Formula Approach

B&G: Use with caution when treating infants or patients with diarrhea. Contains amygdalin and amygdalase which break down to hydrocyanic acid in the digestive tract. Lethal dosage in adults is 50-60 uncooked kernels, children 10 kernels. Eating this medicinal uncooked or in large quantities could possibly cause dizziness, nausea, vomiting, and headache, which can progress to dyspnea, spasms, dilated pupils, arrhythmias, and coma. In the advent of overdose, activated charcoal and syrup of ipacec should be administered orally. C&C: Contains potassium and glycosides (including cyanophoric glycoside). If taken with codeine, morphine, or other opiates, hydrocyanic acid is produced, which can lead to respiratory failure and death. Could possibly cause hyperkalemia when used with potassium-sparing diuretics. Vitamin C, nicotinic acid, glutamic acid, hydrochloric acid, and other highly acidic substances will reduce the therapeutic effect of this medicinal. GLW: Typically, 1-2 hours after ingestion of a poisonous amount, there is a bitter taste and astringent feeling within the mouth, drooling, headache, dizziness, nausea, vomiting accompanied by watery diarrhea, heart palpitations, and lack of strength. In more serious cases, there is difficulty breathing. Sometimes one can smell cyanide on the person’s breath. Eventually, breathing becomes weak, consciousness becomes unclear, and the pupils of the eye dilate widely with loss of reactivity to light. The teeth become clenched, blood pressure drops, there are generalized convulsions, and respiratory paralysis leads to death. The maximum concentration of toxins in this medicinal are in the skin and the tip. When used in Chinese medicine, the kernels are blanched to remove the skin and the tips are broken off.

Sang Bai Pi, Sang Gen Bai Pi
(Cortex Radicis Mori Albi, mulberry root bark) Standard daily dosage: 6-15g AH: Safe when used appropriately B&G: Contraindicated in cases of excessive urination and for patients with cough due to the common cold.

Huang Qin, Tiao Qin
(Radix Scutellariae Baicalensis) Standard daily dosage: 6-15g AH: Safe when used appropriately B&G: According to some traditional sources, counteracts Dan Pi (Cortex Radicis Moutan) and Li Lu (Rhizoma Et Radix Veratri).
AH= AHPA, B&B= BENSKY & BAROLET, B&G= B ENSKY & GAMBLE, BR= BRINKER, C&C= CHAN & CHEUNG, F L= FLAWS, GLW= GAO LU WEN, PDR= P HYSICIAN’S DESK REFERENCE

Chapter 4 Toxicities & Drug Interaction • 107

C&C: Contains potassium and glycosides. Could possibly cause hyperkalemia when used with potassium-sparing diuretics. Vitamin C, nicotinic acid, glutamic acid, hydrochloric acid, and other highly acidic substances could possibly reduce the therapeutic effect of this medicinal.

Ban Xia
(Rhizoma Pinelliae Ternatae) Standard daily dosage: 4.5-12g AH: Do not use during pregnancy. (This medicinal is routinely used during pregnancy in China when indicated by disease and pattern discrimination.) Contraindicated in all hemorrhagic disorders. B&G: Safe as long as it is properly prepared. Must be decocted with other herbs and not taken alone or uncooked. Toxic effects due to improper preparation or dosage include burning and numbness in throat and lips, nausea, and a feeling of pressure in the chest. Antidote is oral administration of raw ginger. Use with caution in patients with fever. According to some traditional sources, incompatible with Wu Tou (Radix Aconiti). C&C: Contains alkaloids and glycosides. Could possibly reduce the absorption and therapeutic effect of potassium and sodium iodides, sodium bicarbonate, aluminum hydroxide, and magnesium sulfate. Vitamin C, nicotinic acid, glutamic acid, hydrochloric acid, and other highly acidic substances could possibly reduce the therapeutic effect of this medicinal. GLW: Poisoning occurs within 15 minutes to three hours after ingestion of a suitable amount. Initially, there is burning pain in the mouth, tongue, and throat, and enlargement of the tongue. This is then followed by drooling, ulceration of the oral mucosa, unclear speech, difficulty swallowing, dizziness, low-grade fever, heart palpitations, numbness of the extremities, a somber white facial complexion, and a weak, forceless pulse. If severe, there may be convulsions and respiratory failure leading to death.

COMMENTS
The treatment of asthma in Chinese medicine is typically divided into two phases – acute attack phase and remission phase. During the acute attack phase, the pattern discrimination is basically divided between hot and cold patterns. This formula is for the hot pattern of acute, paroxysmal asthma. As soon as the acute attack is eliminated (meaning no more panting, wheezing, and coughing), this formula should be discontinued and the patient should be prescribed some other formula to treat the underlying roots of their condition. Therefore, this formula is not for long-term use.
AH= AHPA, B&B= BENSKY & BAROLET, B&G= B ENSKY & GAMBLE, BR= BRINKER, C&C= CHAN & CHEUNG, F L= FLAWS, GLW= GAO LU WEN , PDR= PHYSICIAN’S DESK REFERENCE

a pale tongue with white fur. Contains aristolochic acid (AA). lack of strength. Do not exceed recommended dose. hemiplegia due to stroke.(The authors have never seen this reaction when this medicinal is used in the dosage ranges commonly employed in Chinese medicine. According to some traditional sources. PDR= P HYSICIAN’S DESK REFERENCE . aversion to cold and a liking for warmth. B&G= B ENSKY & GAMBLE. rheumatic sciatica. may antagonize Shan Zhu Yu (Fructus Corni Officinalis) and Huang Qi (Radix Astragali Membranacei). osteoarthritis. a. F L= FLAWS. lumbar intervertebral disc herniation. possibly slow pulse Contraindications: Wind damp heat impediment Western medical indications: Chronic rheumatoid arthritis. and a fine. C&C= CHAN & CHEUNG. supplements the qi and blood Chinese medical indications: Wind.) Xi Xin (Herba Asari Cum Radice) Standard daily dosage: 1-3g AH: Do not use during pregnancy. PDR: Not to be used during pregnancy. B&G: Nephrotoxic. AH= AHPA. lumbar strain.a. B&B= BENSKY & BAROLET. damp. and the sequelae of poliomyelitis Potential formula toxicities & interactions: None listed POTENTIAL MEDICINAL TOXICITIES & INTERACTIONS: Du Huo (Radix Angelicae Pubescentis) Standard daily dosage: 3-9g AH: Patients should avoid prolonged exposure to sunlight.Chapter 4 108 • Herb Toxicities & Drug Interactions: A Formula Approach DU HUO JI SHENG TANG (Angelica Pubescens & Loranthus Decoction. Tuhuo & Vaeicum Combination) Category: Dampness-dispelling Functions: Dispels wind and eliminates dampness. GLW= GAO L U WEN. Use with caution in patients with renal problems. BR= BRINKER.k. frees the flow of impediment and stops pain. cold impediment with liver-kidney vacuity manifesting as heaviness and pain at fixed locations in the lower back and lower extremities accompanied stiffness. pain in the midline and back during pregnancy. forceless. boosts the liver and kidneys. fatigue.

Sang Ji (Ramulus Loranthi Seu Visci. Vitamin C. B&G= B ENSKY & GAMBLE. glutamic acid. potassium. C&C: Contains glycosides. and. and death in experimental animals. Fang Feng (Radix Ledebouriellae Divaricatae) Standard daily dosage: 3-9g AH: Safe when used appropriately B&G: According to some traditional sources. mulberry mistletoe) Standard daily dosage: 9-30g B&G: Contains avicularin. C&C: Contains quercetin. Overdose has been shown to cause vomiting. urinary block. neither of which have conclusively been shown to contain AA. Xi Xin is harvested in China mostly from Asarum sieboldi and Asarum heteropoides. the FDA has set no acceptable limit to AA consumption by humans. eventually. sweating. clenched teeth. C&C= CHAN & CHEUNG. As of this writing. other species of Asarum are sometimes substituted. slightly dilated pupils.Chapter 4 Toxicities & Drug Interaction • 109 GLW: Symptoms of adverse reaction include headache. FL= FLAWS. arched-back rigidity. GLW= GAO LU WEN. a red flushed face. PDR= PHYSICIAN’ S DESK REFERENCE . increased body temperature and blood pressure. Lethal dose in fifty percent of subjects (LD50) in mice is 480mg/kg. and these may contain AA. However. twitching muscles. diarrhea. a rapid pulse. BR= BRINKER. generalized tension which may become convulsions. may antagonize Gan Jiang (dry Rhizoma Zingiberis Officinalis). unclear thinking. and other highly acidic substances could possibly reduce the therapeutic effect of this medicinal. Could possibly AH= AHPA. Qin Jiao (Radix Gentianae Qinjiao) Standard daily dosage: 4. death due to respiratory paralysis. dimming of consciousness. B&B= BENSKY & BAROLET. cramping of the four limbs. High dosages may cause nausea and vomiting. Sang Ji Sheng. and glycosides. Li Lu (Rhizoma Et Radix Veratri) and counteracts Bei Xie (Rhizoma Dioscoreae Hypoglaucae). nicotinic acid. Xi Xin is on the FDA’s “B List” of herbs which may potentially contain aristolochic acid (AA). oral thirst. vexation and agitation. hydrochloric acid.5-12g AH: Contraindicated in patients with diarrhea or lack of appetite B&G: Contraindicated in cases with frequent urination or chronic pain with emaciation or diarrhea. stiffness of the neck. vomiting.

Therefore. C&C: Contains tannic acid. antagonizes Xuan Shen (Radix Scrophulariae Ningpoensis). and in patients with excessive menstruation. aluminum hydroxide. and other highly acidic substances could possibly reduce the therapeutic effect of this medicinal. digitalis. Vitamin C. sodium bicarbonate. magnesium and ferrous sulfates. calcium carbonate and gluconate. BR= BRINKER. potassium. C&C= CHAN & CHEUNG. Niu Xi. Tu Niu Xi (Radix Achyranthis Bidentatae) Standard daily dosage: 9-15g AH: Not to be used during pregnancy. B&G: Contraindicated during pregnancy. Contraindicated in menorrhagia. Vitamin C. F L= FLAWS. in debilitated patients with diarrhea. Could possibly cause hyperkalemia when used with potassium-sparing diuretics. hydrochloric acid. This medicinal contains latex. nicotinic acid. and lactate. isoniazid. B&B= BENSKY & BAROLET. Huai Niu Xi. Could possibly reduce the absorption of calcium gluconate. C&C: Contains alkaloids. According to some traditional sources. and magnesium sulfate. Could possibly reduce the absorption and therapeutic effect of potassium and sodium iodides. aluminum hydroxide. trypsine. should not be used with Bai Qian (Radix Et Rhizoma Cynanchi Baiqian). glutamic acid. According to some traditional sources. ephedrine. Could possibly reduce the absorption and biologic effect of most antibiotics. glutamic acid. PDR= PHYSICIAN’S DESK REFERENCE . B&G= B ENSKY & GAMBLE. GLW= GAO LU WEN . and glycosides. amylase. hydrochloric acid. nicotinic acid. and pepsin. quinine. chlorpromazine. vitamin B 1. and bismuth subcarbonate. carbonate.Chapter 4 110 • Herb Toxicities & Drug Interactions: A Formula Approach cause hyperkalemia when used with potassium-sparing diuretics. some patients taking this medicinal may have an allergic reaction if they are allergic to latex. Du Zhong (Cortex Eucommiae Ulmoidis) Standard daily dosage: 6-15g AH: Safe when used appropriately B&G: Has a mild sedative effect in large doses. AH= AHPA. and other highly acidic substances will reduce the therapeutic effect of this medicinal. atropine. reserpine.

(This medicinal is routinely used in Chinese medical gynecology during pregnancy as part of formulas appropriately prescribed on the basis of pattern discrimination. reserpine. and is incompatible with Li Lu (Rhizoma Et Radix Veratri). Chuan Xiong (Radix Ligustici Wallichii) Standard daily dosage: 3-9g(In China today. chlorpromazine. cinnamon bark) Standard daily dosage: 1. Could possibly reduce the absorption and biologic effect of most antibiotics. Overdosage causes vomiting and dizziness. Could possibly cause hyperkalemia when used with potassium-sparing diuretics. B&G= B ENSKY & GAMBLE . Could possibly cause hyperkalemia when used with potassium-sparing diuretics. antagonizes Shan Zhu Yu (Fructus Corni Officinalis) and Huang Qi (Radix Astragali Membranacei). digitalis. C&C= CHAN & CHEUNG. atropine. Could possibly cause hyperkalemia when used with potassium-sparing diuretics. Could possibly reduce the absorption and therapeutic effect of potassium and sodium iodides.) B&G: Not for patients with migraine headache or excessive menstrual bleeding. May exaggerate the anticoagulative effect of warfarin (Coumadin). C&C: Contains alkaloids and potassium. GLW= GAO LU WEN. sodium bicarbonate. Gui Xin. Dang Gui (Radix Angelicae Sinensis) Standard daily dosage: 3-15g AH: Do not use during pregnancy.) AH: Do not use during pregnancy. PDR= P HYSICIAN’ S DESK REFERENCE .) B&G: Use with caution in patients with diarrhea or abdominal distention. quinine. it is not uncommon for this medicinal to be prescribed up to 15 grams per day in decoction. According to some traditional texts. FL= FLAWS. (This medicinal is routinely used in Chinese medical gynecology during pregnancy as part of formulas appropriately prescribed on the basis of pattern discrimination. AH= AHPA. trypsine.5-4. C&C: Contains potassium. vitamin B1. B&B= BENSKY & BAROLET. calcium carbonate and gluconate. aluminum hydroxide. and pepsin. and magnesium sulfate.Chapter 4 Toxicities & Drug Interaction • 111 Rou Gui. amylase. BR= BRINKER. ephedrine.5g AH: Not to be used during pregnancy BR: Reduces absorption of tetracyclines B&G: Use with caution during pregnancy C&C: Contains tannic acid and potassium. Guan Gui (Cortex Cinnamomi Cassiae. counteracts Hua Shi (Talcum) and Huang Lian (Rhizoma Coptidis Chinensis). isoniazid.

antagonizes Shi Hu (Herba Dendrobii) and Mang Xiao (Mirabilitum). C&C= CHAN & CHEUNG. B&B= BENSKY & BAROLET. BR= BRINKER. B&G= BENSKY & GAMBLE.Chapter 4 112 • Herb Toxicities & Drug Interactions: A Formula Approach Sheng Di. Shao Yao (Radix Albus Paeoniae Lactiflorae. isoniazid. Could possibly reduce the effect of most antibiotics. hydrochloric acid. potassium. glutamic acid. nicotinic acid. ginseng) Standard daily dosage: 1-30g AH: Contraindicated in hypertension BR: May cause manic episodes in patients on MAO-inhibitors. Overdose can lead to headache. amylase. white peony root) Standard daily dosage: 6-30g AH: Safe when used appropriately B&G: Use with caution in debilitated patients with diarrhea. and a rise in blood pressure. Sheng Di Huang (uncooked Radix Rehmanniae Glutinosae) Standard daily dosage: 9-30g AH: Contraindicated in patients with diarrhea or lack of appetite B&G: Contraindicated in pregnant women with anemias or digestive weakness C&C: Contains potassium. Possible additive effects to insulin. and other highly acidic substances could possibly reduce the therapeutic effect of this medicinal. Vitamin C. nicotinic acid. calcium carbonate and gluconate. Could possibly cause hyperkalemia when used with potassium-sparing diuretics. F L= FLAWS. hydrochloric acid. B&G: Contraindicated for hypertensive patients. quinine. Ren Shen (Radix Panacis Ginseng. ephedrine. PDR: No health risks or side effects are known in conjunction with the proper administration of designated therapeutic dosages. C&C: Contains calcium. May reduce the anticoagulative effect of warfarin (Coumadin). tannic acid. heart palpitations. May cause hypertension if consumed with caffeine. PDR= PHYSICIAN’S DESK REFERENCE . chlorpromazine. According to some traditional sources. GLW= GAO L U WEN . trypsine. insomnia. and glycosides. atropine. A traditional antidote is mung bean soup. reserpine. cause digitalis intoxication and heart arrhythmias. vitamin B 1. counteracts Bie Jia (Carapax Amydae Sinensis) and Xiao Ji (Herba Cephalanopoloris Segeti). C&C: Vitamin C. and AH= AHPA. Could possibly cause hyperkalemia when used with potassium-sparing diuretics. glutamic acid. Bai Shao. and is incompatible with Li Lu (Rhizoma Et Radix Veratri). and pepsin. and could possibly reduce the absorption and therapeutic effect of levadopa.

The research on Gan Cao concurs that this medicinal is generally safe when used in small amounts as an envoy. When used as a single medicinal or in patients taking other potent Western pharmaceuticals. C&C= CHAN & CHEUNG. tremors. and manias. and liver disorders. AH= AHPA. and Yuan Zhi (Radix Polygalae Tenuifoliae). Not for long-term use. copious urination. May increase potassium loss due to diuretics and laxatives. Fu Ling. it is contraindicated in diabetes. may counteract Di Yu (Radix Sanguisorbae Officinalis). BR: May increase toxicity of cardiac glycosides. B&G= B ENSKY & GAMBLE. Not recommended in large doses during pregnancy or lactation due to potential neonatal androgenization. B&B= BENSKY & BAROLET. Gan Cao (Radix Glycyrrhizae Uralensis. If taken long-term. B&G: According to some traditional sources. Yuan Hua (Flos Daphnes Genkwae). Enhances the effect of insulin and other antidiabetic agents. caution should be exercised to guard against potential toxicity and drug interaction. May be synergistic with insulin in causing hypokalemia and sodium retention. GLW= GAO LU WEN. BR= BRINKER. Could possibly cause hyperkalemia when used with potassium-sparing diuretics.) As a single herb in high doses. incompatible with Gan Sui (Radix Euphorbiae Kansui). it may cause hypertension and/or edema. According to traditional sources. hypertension. It should not be taken longterm or as a single herb during pregnancy. Contraindicated in patients with frequent. C&C: Contains potassium. PDR: Contraindicated in patients with hypertension. Qin Jiao (Radix Gentianae Qinjiao). PDR= P HYSICIAN’S DESK REFERENCE . and Bie Jia (Carapax Amydae Sinensis). F L= FLAWS. Contains glycyrrhetinic acid which could possibly cause a reduction in thyroid activity and basal metabolic rate. licorice) Standard daily dosage: 2-12g AH: Do not use during pregnancy. Yun Ling (Sclerotium Poriae Cocos) Standard daily dosage: 9-15g B&G: Large doses or long-term use is discouraged. Use with MAO-inhibitors may cause headaches. (This medicinal is routinely used in Chinese medical gynecology during pregnancy as part of formulas appropriately prescribed on the basis of pattern discrimination. Possible additive effect to corticosteroids.Chapter 4 Toxicities & Drug Interaction • 113 other highly acidic substances could possibly reduce the therapeutic effect of this medicinal. Bai Fu Ling.

Use with caution in patients with fever. hydrochloric acid. emphysema. rectifies the qi and harmonizes the center Chinese medical indications: Phlegm dampness with cough with profuse. peptic ulcer. incompatible with Wu Tou (Radix Aconiti). (This medicinal is routinely used during pregnancy in China when indicated by disease and pattern discrimination. BR= BRINKER. Vitamin C. nicotinic acid. According to some traditional sources. B&B= BENSKY & BAROLET. Must be decocted with other herbs and not taken alone or uncooked. eclampsia. and neurosis Potential formula toxicities & interactions: B&B: Improper use of this formula can lead to excessive thirst and a dry throat. F L= FLAWS. nausea and vomiting. abdominal glomus. hangover. and magnesium sulfate. C&C: Contains alkaloids and glycosides. fat tongue with teeth-marks on its edges and. Toxic effects due to improper preparation or dosage include burning and numbness in throat and lips. aluminum hydroxide. GLW= GAO LU WEN. and other highly acidic substances could possibly reduce the therapeutic effect of this medicinal.) Contraindicated in all hemorrhagic disorders. a. PDR= P HYSICIAN’S DESK REFERENCE . Could possibly reduce the absorption and therapeutic effect of potassium and sodium iodides. and a slippery pulse Contraindications: Lung yin vacuity cough Western medical indications: Meniere’s disease.Chapter 4 114 • Herb Toxicities & Drug Interactions: A Formula Approach ER CHEN TANG (Two Aged [Ingredients] Decoction. slimy fur. chest oppression. chronic gastritis. POTENTIAL MEDICINAL TOXICITIES & INTERACTIONS: Ban Xia (Rhizoma Pinelliae Ternatae) Standard daily dosage: 4. chronic tracheitis. C&C= CHAN & CHEUNG. nausea. AH= AHPA. Citrus & Pinellia Combination) Category: Phlegm-transforming & dampness-drying Functions: Dries dampness and transforms phlegm. an enlarged. sodium bicarbonate. B&G= B ENSKY & GAMBLE. Two-Cured Decoction.a. heart palpitations. glutamic acid. and a feeling of pressure in the chest. chronic bronchitis. Antidote is oral administration of raw ginger. goiter. white phlegm.5-12g AH: Do not use during pregnancy. gastroptis. thick.k. dizziness. white. B&G: Safe as long as it is properly prepared.

licorice) Standard daily dosage: 2-12g AH: Do not use during pregnancy. unclear speech. it may AH= AHPA. GLW= GAO LU WEN . B&G= B ENSKY & GAMBLE. C&C= CHAN & CHEUNG. Qin Jiao (Radix Gentianae Qinjiao). Chen Pi. If taken long-term. Initially. Could possibly cause hyperkalemia when used with potassium-sparing diuretics. Yuan Hua (Flos Daphnes Genkwae). Not for long-term use. incompatible with Gan Sui (Radix Euphorbiae Kansui). BR: May increase toxicity of cardiac glycosides. Ju Pi. Gan Cao (Radix Glycyrrhizae Uralensis. Could possibly cause hyperkalemia when used with potassium-sparing diuretics. C&C: Contains potassium. Ju Hong (Pericarpium Citri Reticulatae) Standard daily dosage: 3-9g AH: Safe when used appropriately C&C: Contains potassium. Contraindicated in patients with frequent. dizziness. copious urination. F L= FLAWS. B&B= BENSKY & BAROLET. Possible additive effect to corticosteroids. there may be convulsions and respiratory failure leading to death. May increase potassium loss due to diuretics and laxatives. a somber white facial complexion. According to traditional sources. forceless pulse. it is contraindicated in diabetes.) As a single herb in high doses. PDR= PHYSICIAN’S DESK REFERENCE . and enlargement of the tongue. BR= BRINKER. and a weak. there is burning pain in the mouth. numbness of the extremities. hypertension. tongue. low-grade fever.Chapter 4 Toxicities & Drug Interaction • 115 GLW: Poisoning occurs within 15 minutes to three hours after ingestion of a suitable amount. and Bie Jia (Carapax Amydae Sinensis). Yun Ling (Sclerotium Poriae Cocos) Standard daily dosage: 9-15g B&G: Large doses or long-term use is discouraged. may counteract Di Yu (Radix Sanguisorbae Officinalis). and liver disorders. difficulty swallowing. This is then followed by drooling. Bai Fu Ling. May be synergistic with insulin in causing hypokalemia and sodium retention. heart palpitations. ulceration of the oral mucosa. Fu Ling. and throat. and Yuan Zhi (Radix Polygalae Tenuifoliae). If severe. B&G: According to some traditional sources. (This medicinal is routinely used in Chinese medical gynecology during pregnancy as part of formulas appropriately prescribed on the basis of pattern discrimination.

It should not be taken longterm or as a single herb during pregnancy. COMMENTS Wu Mei is often omitted from this formula. caffeine. BR= BRINKER. Wu Mei (Frcutus Pruni Mume) Standard daily dosage: 3-9g AH: Safe when used appropriately C&C: Highly acidic. scopolamine. B&G= B ENSKY & GAMBLE. GLW= GAO LU WEN . C&C= CHAN & CHEUNG. B&B= BENSKY & BAROLET. Increases absorption of oral drugs. caution should be exercised to guard against potential toxicity and drug interaction. and Fu Ling) are also often added to other formulas whenever there is the need to transform phlegm and eliminate dampness. Sheng Jiang (uncooked Rhizoma Zingiberis Officinalis.Chapter 4 116 • Herb Toxicities & Drug Interactions: A Formula Approach cause hypertension and/or edema. reserpine. opiates. The research on Gan Cao concurs that this medicinal is generally safe when used in small amounts as an envoy. fresh ginger) Standard daily dose: 3-9g AH: Safe when used appropriately BR: Reduces vomiting caused by chemotherapeutic drugs. Chen Pi. aluminum hydroxide. AH= AHPA. F L= FLAWS. PDR= PHYSICIAN’S DESK REFERENCE . and berbamin. Avoid larger doses if being used to treat morning sickness or if used in patients taking anticoagulants. PDR: Recommended safe dosage limit is six grams (6g). Could possibly reduce the therapeutic effect of sodium bicarbonate. Could possibly cause crystalluria and hematuria. many antibiotics (especially aminoglycosides and sulfas). Contains glycyrrhetinic acid which could possibly cause a reduction in thyroid activity and basal metabolic rate. When used as a single medicinal or in patients taking other potent Western pharmaceuticals. The three main ingredients in this formula (Ban Xia.

nervousness. chlorpromazine. regulates the chong and ren Chinese medical indications: Liver blood-kidney yin & yang vacuity with internal heat manifesting as amenorrhea. AH= AHPA. Toxic reactions. calcium carbonate and gluconate. Symptoms of overdose or toxicity from this medicinal commonly include the eruption of mouth and tongue sores. and pepsin. hypertension. most antibiotics. Huang Lian (Rhizoma Coptidis Chinensis). B&G= B ENSKY & GAMBLE. PDR= PHYSICIAN’ S DESK REFERENCE . can occur. it should not be taken long-term. Antidote is a decoction of Da Huang (Radix Et Rhizoma Rhei). ephedrine. amenorrhea. atropine. GLW= GAO LU WEN. insomnia. renal vascular disease. hot flashes. such as swelling of the tongue. C&C: Contains alkaloids & tannic acid. and Huang Qin (Radix Scutellariae Baicalensis). sodium bicarbonate. B R= BRINKER. heart palpitations. nephritis. urinary tract infection. warms yang but drains fire. trypsine. FL= FLAWS. vitamin B1. amylase. chronic glomerulonephritis.Chapter 4 Toxicities & Drug Interaction • 117 ER XIAN TANG (Two Immortals Decoction) Category: Yang-supplementing Functions: Enriches and supplements the liver and kidneys. dizziness. B&B= BENSKY & BAROLET. POTENTIAL MEDICINAL TOXICITIES & I NTERACTIONS: Xian Mao (Rhizoma Curculiginis Orchioidis) Standard daily dosage: 3-9g B&G: Not recommended for long-term use. Could possibly reduce the absorption and therapeutic effect of potassium and sodium iodides. digitalis. night sweats. polycystic kidneys. isoniazid. and hypofunction of the anterior pituitary Potential formula toxicities & interactions: FL: Because this formula contains Xian Mao (Rhizoma Curculiginis Orchioidis) which is toxic. quinine. magnesium sulfate. fatigue. chronic pyelonephritis. and urinary frequency Contraindications: None listed Western medical indications: Menopausal complaints. C&C= CHAN & CHEUNG. reserpine. aluminum hydroxide.

many antibiotics (especially aminoglycosides and sulfas). carbonate. FL= FLAWS. nicotinic acid. chlorpromazine. Ba Ji Tian. Xian Ling Pi (Herba Epimedii) Standard daily dosage: 6-15g AH: Not for long-term use B&G: Not for long-term use. sodium bicarbonate. quinine. B&B= BENSKY & BAROLET. Japanese forms of this herb have caused hyper reflexia and spasms in mice. and lactate. vitamin B1. antagonizes Dan Shen (Radix Salviae Miltiorrhizae). and other highly acidic substances could possibly reduce the therapeutic effect of this medicinal.) B&G: Chinese literature reports one case of a patient who developed a skin rash after ingestion. C&C: Contains tannic acid. calcium carbonate and gluconate. and bismuth subcarbonate. BR= BRINKER. ephedrine. Large doses could possibly cause respiratory arrest. Ba Ji Rou. atropine. opiates. magnesium and ferrous sulfates. C&C: Contains alkaloids & quercetin. and pepsin. (This medicinal is commonly used during pregnancy in China. Could possibly reduce the absorption and biologic effect of most antibiotics. B&G= B ENSKY & GAMBLE .Chapter 4 118 • Herb Toxicities & Drug Interactions: A Formula Approach Yin Yang Huo. aluminum hydroxide. Could possibly cause hyperkalemia when used with potassium-sparing diuretics. Could possibly reduce the absorption and therapeutic effect of potassium and sodium iodides. isoniazid. trypsine. Vitamin C. hydrochloric acid. Could possibly cause crystalluria and hematuria. digitalis. reserpine. reserpine. Ba Ji (Radix Morindae Officinalis) Standard daily dosage: 6-15g AH: Safe when used appropriately B&G: According to some traditional sources. Huang Bai. GLW= GAO LU WEN. amylase. and glycosides. scopolamine. calcium gluconate. glutamic acid. C&C: Highly acidic. Huang Bo (Cortex Phellodendri) Standard daily dosage: 3-12g AH: Do not use during pregnancy. AH= AHPA. potassium. and berbamin. Could possibly reduce the therapeutic effect of sodium bicarbonate. C&C= CHAN & CHEUNG. PDR= P HYSICIAN’ S DESK REFERENCE . aluminum hydroxide. caffeine.

it is rarely prescribed in its simple. GLW= GAO LU WEN. nicotinic acid. Often Yin Yang Huo is deleted from this formula for fear of its toxicity resulting in the engenderment of internal heat. PDR= PHYSICIAN’ S DESK REFERENCE . B&G= B ENSKY & GAMBLE. hydrochloric acid.Chapter 4 Toxicities & Drug Interaction • 119 Zhi Mu (Rhizoma Anemarrhenae Aspheloidis) Standard daily dosage: 6-12g AH: Safe when used appropriately. May exaggerate the anticoagulative effect of warfarin (Coumadin). C&C: Contains potassium and glycosides. AH= AHPA. B R= BRINKER. FL= FLAWS. discrete form. it has become a very popular one for treating perimenopausal syndrome in general.) B&G: Use with caution in patients with diarrhea or abdominal distention. glutamic acid. Vitamin C. B&B= BENSKY & BAROLET. Could possibly cause hyperkalemia when used with potassium-sparing diuretics. Could possibly cause hyperkalemia when used with potassium-sparing diuretics. C&C= CHAN & CHEUNG. COMMENTS While this formula was originally created to treat perimenopausal hypertension. C&C: Contains potassium. and other highly acidic substances could possibly reduce the therapeutic effect of this medicinal. (This medicinal is routinely used in Chinese medical gynecology during pregnancy as part of formulas appropriately prescribed on the basis of pattern discrimination. PDR: No health hazards are known in conjunction with the proper administration of designated therapeutic dosages. B&G: May cause diarrhea in some patients. Dang Gui (Radix Angelicae Sinensis) Standard daily dosage: 3-15g AH: Do not use during pregnancy. However.

hypertension. calms the spirit. frequent yawning. B&B= BENSKY & BAROLET. Yuan Hua (Flos Daphnes Genkwae). (This medicinal is routinely used in Chinese medical gynecology during pregnancy as part of formulas appropriately prescribed on the basis of pattern discrimination.) As a single herb in high doses. and a fine. The research on Gan Cao concurs that this medicinal is generally safe when used in small amounts as an envoy. and liver disorders.Chapter 4 120 • Herb Toxicities & Drug Interactions: A Formula Approach GAN MAI DA ZAO TANG (Licorice. neurosis. and harmonizes the middle burner Chinese medical indications: Visceral agitation due to malnourishment of the heart spirit with loss of constancy of crying and laughing. May be synergistic with insulin in causing hypokalemia and sodium retention. May increase potassium loss due to diuretics and laxatives. it is contraindicated in diabetes.a. Licorice & Jujube Combination) Category: Spirit-quieting Functions: Nourishes the heart. a red tongue with scanty fur. enuresis. incompatible with Gan Sui (Radix Euphorbiae Kansui). Possible additive effect to corticosteroids. PDR= P HYSICIAN’S DESK REFERENCE . a. it may cause hypertension and/or edema. GLW= GAO LU WEN. It should not be taken long-term or as a single herb during pregnancy. menopausal syndrome. B&G: According to some traditional sources. If taken long-term. Wheat & Red Date Decoction. Not for long-term use. Contains glycyrrhetinic acid which could possibly cause a reduction in thyroid activity and basal metabolic rate. When used as a single medicinal or AH= AHPA. and fever of unknown etiology Potential formula toxicities & interactions: None listed POTENTIAL MEDICINAL TOXICITIES & I NTERACTIONS: Gan Cao (Radix Glycyrrhizae Uralensis. B&G= B ENSKY & GAMBLE. BR: May increase toxicity of cardiac glycosides. commonly bowstring pulse Contraindications: None listed Western medical indications: Hysteria. insomnia. licorice) Standard daily dosage: 2-12g AH: Do not use during pregnancy.k. F L= FLAWS. BR= BRINKER. rapid. inability to control oneself. and Yuan Zhi (Radix Polygalae Tenuifoliae). C&C= CHAN & CHEUNG. autonomic dystonia.

Chapter 4 Toxicities & Drug Interaction • 121

in patients taking other potent Western pharmaceuticals, caution should be exercised to guard against potential toxicity and drug interaction.

Xiao Mai, Huai Xiao Mai, Fu Xiao Mai
(Fu Xiao Mai is the blighted form of this seed. It is used especially when there are spontaneous perspiration and/or night sweats. A portion of this seed floats when thrown into water.) (Semen Tritici Aestivi, wheat) Standard daily dosage: 9-15g(It is common for this medicinal to be prescribed in China in doses of up to 60 grams per day.) PDR: No health risks or side effects are known in conjunction with the proper administration of designated therapeutic dosages.

Da Zao, Hong Zao
(Fructus Zizyphi Jujubae, red dates) Standard daily dosage: 10-30g (3-12 pieces) AH: Safe when used appropriately PDR: No health risks or side effects are known in conjunction with the proper administration of designated therapeutic dosages.

COMMENTS
Unless administered in some ready-made form, this formula is rarely prescribed in its simple, discrete form. More commonly, these three ingredients are added to other formulas when there is spirit disquietude due to lack of nourishment and construction.

AH= AHPA, B&B= BENSKY & BAROLET, B&G= B ENSKY & GAMBLE , BR= BRINKER, C&C= CHAN & CHEUNG, FL= FLAWS, GLW= GAO LU WEN, PDR= PHYSICIAN’ S DESK REFERENCE

Chapter 4 122 • Herb Toxicities & Drug Interactions: A Formula Approach

GE GEN TANG (Pueraria Decoction, a.k.a. Pueraria Combination)
Category: Exterior-resolving Functions: Resolves the exterior, resolves the muscles, and engenders fluids Chinese medical indications: External contraction of wind cold accompanied by fever, aversion to wind, no sweating, a sore, stiff neck and upper back, thin, white tongue fur, and a floating, tight or bowstring pulse Contraindications: Wind heat external contraction Western medical indications: Upper respiratory tract infection, influenza, stomach flu, acute cervical myositis, tendinitis, or bursitis of the shoulder, urticaria, allergic rhinitis, and early stage poliomyelitis or encephalitis, chronic pediatric diarrhea Potential formula toxicities & interactions: None listed

POTENTIAL MEDICINAL TOXICITIES & INTERACTIONS:
Ge Gen
(Radix Puerariae, kudzu root) Standard daily dosage: 6-12g(For the treatment of upper back and nape of the neck stiffness and tension, this medicinal is commonly prescribed up to 18 grams per day.) AH: Safe when used appropriately

Ma Huang
(Herba Ephedrae, ephedra) Standard daily dosage: 3-9g AH: Not to be used during pregnancy. Contraindicated in anorexia, bulimia, and glaucoma. Not for long-term use. BR: Increases thermogenesis when combined with methylxanthines in theophylline and caffeine. May induce toxicity with MAO-inhibitors. May reduce the effect of dexamethazone. Amytriptiline blocks its hypertensive effect. Antagonized by reserpine. B&G: May raise blood pressure and cause tremors. As little as 15ml in a 1% solution may be toxic to some individuals. May cause arrhythmias if used in conjunction with cardiac glycosides. Antidote for poisoning is atropine. All research sources concurs that Ma Huang is a very powerful herb with many potential side effects and interactions and, therefore, must be adminisAH= AHPA, B&B= BENSKY & BAROLET, B&G= B ENSKY & GAMBLE, BR= BRINKER, C&C= CHAN & CHEUNG, F L= FLAWS, GLW= GAO LU WEN, PDR= P HYSICIAN’S DESK REFERENCE

Chapter 4 Toxicities & Drug Interaction • 123

tered with care. It enhances digitalis, antagonizes barbiturates, and increases the effects of adrenergic agonists. It should only be prescribed by a properly trained practitioner and should not be given long-term or during pregnancy. GLW: Initially after poisoning, there are central nervous and sympathetic nervous system symptoms, such as vexation, agitation, and restlessness, extreme nerve reactivity, headache, dizziness, tinnitus, insomnia, nausea, vomiting, upper abdominal discomfort, dry mouth, sweating, increased blood pressure, dilated pupils, heart palpitations, shortness of breath, and precordial pain. Graver reactions include difficulty urinating, unclear vision, shock, syncope, difficulty breathing, fright reversal. If critical, there may be respiratory failure and death. The U.S. FDA has banned the inclusion of this medicinal in all dietary supplements.

Gui Zhi
(Ramulus Cinnamomi Cassiae, cinnamon twigs) Standard daily dosage: 3-15g AH: Safe when used appropriately B&G: Use with caution in the presence of fever, during pregnancy, or during excessive menstruation. PDR: Contraindicated during pregnancy.

Bai Shao, Shao Yao
(Radix Albus Paeoniae Lactiflorae, white peony root) Standard daily dosage: 6-30g AH: Safe when used appropriately B&G: Use with caution in debilitated patients with diarrhea. According to some traditional sources, antagonizes Shi Hu (Herba Dendrobii) and Mang Xiao (Mirabilitum), counteracts Bie Jia (Carapax Amydae Sinensis) and Xiao Ji (Herba Cephalanopoloris Segeti), and is incompatible with Li Lu (Rhizoma Et Radix Veratri). C&C: Contains calcium, tannic acid, potassium, and glycosides. Could possibly cause hyperkalemia when used with potassium-sparing diuretics. Could possibly reduce the effect of most antibiotics, cause digitalis intoxication and heart arrhythmias, and could possibly reduce the absorption and therapeutic effect of levadopa, isoniazid, chlorpromazine, calcium carbonate and gluconate, atropine, ephedrine, quinine, reserpine, vitamin B1, trypsine, amylase, and pepsin. Vitamin C, nicotinic acid, glutamic acid, hydrochloric acid, and other highly acidic substances could possibly reduce the therapeutic effect of this medicinal.
AH= AHPA, B&B= BENSKY & BAROLET, B&G= B ENSKY & GAMBLE, BR= BRINKER, C&C= CHAN & CHEUNG, F L= FLAWS, GLW= GAO LU WEN, PDR= P HYSICIAN’S DESK REFERENCE

Chapter 4 124 • Herb Toxicities & Drug Interactions: A Formula Approach

Sheng Jiang
(uncooked Rhizoma Zingiberis Officinalis, fresh ginger) Standard daily dose: 3-9g AH: Safe when used appropriately BR: Reduces vomiting caused by chemotherapeutic drugs. Increases absorption of oral drugs. PDR: Recommended safe dosage limit is six grams (6g). Avoid larger doses if being used to treat morning sickness or if used in patients taking anticoagulants.

Da Zao, Hong Zao
(Fructus Zizyphi Jujubae, red dates) Standard daily dosage: 10-30g (3-12 pieces) AH: Safe when used appropriately PDR: No health risks or side effects are known in conjunction with the proper administration of designated therapeutic dosages.

Gan Cao
(Radix Glycyrrhizae Uralensis, licorice) Standard daily dosage: 2-12g AH: Do not use during pregnancy. (This medicinal is routinely used in Chinese medical gynecology during pregnancy as part of formulas appropriately prescribed on the basis of pattern discrimination.) As a single herb in high doses, it is contraindicated in diabetes, hypertension, and liver disorders. Not for long-term use. BR: May increase toxicity of cardiac glycosides. May increase potassium loss due to diuretics and laxatives. Possible additive effect to corticosteroids. May be synergistic with insulin in causing hypokalemia and sodium retention. B&G: According to some traditional sources, incompatible with Gan Sui (Radix Euphorbiae Kansui), Yuan Hua (Flos Daphnes Genkwae), and Yuan Zhi (Radix Polygalae Tenuifoliae). If taken long-term, it may cause hypertension and/or edema. Contains glycyrrhetinic acid which Could possibly cause a reduction in thyroid activity and basal metabolic rate. The research on Gan Cao concurs that this medicinal is generally safe when used in small amounts as an envoy. It should not be taken long-term or as a single herb during pregnancy. When used as a single medicinal or in patients taking other potent Western pharmaceuticals, caution should be exercised to guard against potential toxicity and drug interaction.
AH= AHPA, B&B= BENSKY & BAROLET, B&G= BENSKY & GAMBLE, BR= BRINKER, C&C= CHAN & CHEUNG, F L= FLAWS, GLW= GAO L U WEN , PDR= PHYSICIAN’S DESK REFERENCE

Chapter 4 Toxicities & Drug Interaction • 125

GU CHONG TANG
(Secure the Chong Decoction) Category: Securing & astringing Functions: Boosts the qi and fortifies the spleen, secures the chong and stops bleeding Chinese medical indications: Uterine bleeding or menorrhagia due to spleen-kidney qi vacuity with either profuse, pale, thin blood or a continuous trickle, heart palpitations, shortness of breath, a pale tongue, and fine, forceless pulse Contraindications: Blood heat bleeding or vacuity desertion Western medical indications: Functional uterine bleeding, excessive lochiorrhea, bleeding peptic ulcers Potential formula toxicities & interactions: FL/B&B: Not for patients with severe bleeding accompanied by profuse sweating, cold limbs, and a faint pulse.

POTENTIAL MEDICINAL TOXICITIES & I NTERACTIONS:
Bai Zhu
(Rhizoma Atractylodis Macrocephalae) Standard daily dosage: 4.5-9g AH: Safe when used appropriately B&G: When rats were fed 0.5g/kg of this medicinal for two months, they developed a mild lymphopenia and anemia but suffered no damage to the brain, heart, or liver.

Huang Qi, Bei Qi
(Radix Astragali Membranacei, astragalus) Standard daily dosage: 9-60g AH: Safe when used appropriately C&C: Contains alkaloids and potassium. Could possibly cause hyperkalemia when used with potassium-sparing diuretics. Could possibly reduce the absorption and therapeutic effect of potassium and sodium iodides, sodium bicarbonate, aluminum hydroxide, and magnesium sulfate. PDR: Caution should be taken with patients receiving immunosuppressive therapy, such as transplant patients or patients with autoimmune disorders. May cause neurological dysfunction in high doses. May potentiate the risk of bleeding when used concomitantly with anticoagulants, antiplatelets, or antithrombotic agents.
AH= AHPA, B&B= BENSKY & BAROLET, B&G= BENSKY & GAMBLE, BR= BRINKER, C&C= CHAN & CHEUNG, F L= FLAWS, GLW= GAO L U WEN , PDR= PHYSICIAN’S DESK REFERENCE

Chapter 4 126 • Herb Toxicities & Drug Interactions: A Formula Approach

Shan Zhu Yu, Shan Zhu Rou
(Fructus Corni Officinalis) Standard daily dosage: 3-60g AH: Contraindicated in patients with difficult or painful urination B&G: Contraindicated in patients with difficult or painful urination. According to some traditional sources, antagonizes Jie Geng (Radix Platycodi Grandiflori), Fang Feng (Radix Ledebouriellae Divaricatae), and Fang Ji (Radix Aristolochiae Fangchi). C&C: Contains tannic acid and glycosides. Could possibly reduce the absorption and biologic effect of most antibiotics, isoniazid, chlorpromazine, calcium carbonate and gluconate, atropine, ephedrine, quinine, reserpine, digitalis, vitamin B1, trypsine, amylase, and pepsin. Vitamin C, nicotinic acid, glutamic acid, hydrochloric acid, and other highly acidic substances could possibly reduce the therapeutic effect of this medicinal. PDR: No health hazards are known in conjunction with proper administration of designated therapeutic dosages.

Bai Shao, Shao Yao
(Radix Albus Paeoniae Lactiflorae, white peony root) Standard daily dosage: 6-30g AH: Safe when used appropriately B&G: Use with caution in debilitated patients with diarrhea. According to some traditional sources, antagonizes Shi Hu (Herba Dendrobii) and Mang Xiao (Mirabilitum), counteracts Bie Jia (Carapax Amydae Sinensis) and Xiao Ji (Herba Cephalanopoloris Segeti), and is incompatible with Li Lu (Rhizoma Et Radix Veratri). C&C: Contains calcium, tannic acid, potassium, and glycosides. Could possibly cause hyperkalemia when used with potassium-sparing diuretics. Could possibly reduce the effect of most antibiotics, cause digitalis intoxication and heart arrhythmias, and could possibly reduce the absorption and therapeutic effect of levadopa, isoniazid, chlorpromazine, calcium carbonate and gluconate, atropine, ephedrine, quinine, reserpine, vitamin B 1, trypsine, amylase, and pepsin. Vitamin C, nicotinic acid, glutamic acid, hydrochloric acid, and other highly acidic substances could possibly reduce the therapeutic effect of this medicinal.

Long Gu
(Os Draconis, fossilized bone) Standard daily dosage: 15-30g B&G: According to some traditional sources, counteracts Shi Gao (Gypsum Fibrosum) and should not be mixed with fish.
AH= AHPA, B&B= BENSKY & BAROLET, B&G= B ENSKY & GAMBLE, BR= BRINKER, C&C= CHAN & CHEUNG, F L= FLAWS, GLW= GAO LU WEN , PDR= PHYSICIAN’S DESK REFERENCE

Chapter 4 Toxicities & Drug Interaction • 127

C&C: Contains calcium, iron, magnesium, aluminum, and potassium. Could possibly cause hyperkalemia when used with potassium-sparing diuretics. Could possibly reduce the effect of most antibiotics, levadopa, and prednisolone, cause digitalis intoxication and heart arrhythmias, and hinder the absorption of isoniazid.

Mu Li
(Concha Ostreae, oyster shell) Standard daily dosage: 15-30g B&G: Contraindicated when the patient has high fever without sweating. Overdose may lead to indigestion or constipation. According to some traditional sources, works synergistically with Bei Mu (Bulbus Fritillariae), Gan Cao (Radix Glycyrrizae Uralensis), Niu Xi (Radix Achyranthis Bidentatae), and Yuan Zhi (Radix Polygalae Tenuifoliae), and has adverse effects when combined with Ma Huang (Herba Ephedrae), Wu Zhu Yu (Fructus Evodiae Rutecarpae), and Xi Xin (Herba Asari Cum Radice). C&C: Contains calcium, iron, magnesium, and aluminum. Could possibly reduce the effects of most antibiotics, levadopa, and prednisolone, cause digitalis intoxication and heart arrhythmias, and hinder the absorption of isoniazid.

Hai Piao Xiao, Wu Zei Gu
(Os Sepiae Seu Sepiellae, cuttlefish bone) Standard daily dosage: 4.5-12g B&G: If used too long, may lead to constipation. According to some traditional sources, antagonizes Fu Zi (Radix Lateralis Praeparatus Aconiti Carmichaeli) and Bai Ji (Rhizoma Bletillae Striatae). C&C: Contains calcium and magnesium. Could possibly reduce the effect of most antibiotics, levadopa, and prednisolone, cause digitalis intoxication and heart arrhythmias, and hinder the absorption of isoniazid.

Lu Zong Tan
(carbonized Fibra Stipulae Trachycarpi) Standard daily dosage: 9-15g No toxicity or interaction information listed in the sources

Wu Bei Zi
(Galla Rhois Chinensis, sumac nutgall) Standard daily dosage: 1.5-6g
AH= AHPA, B&B= BENSKY & BAROLET, B&G= B ENSKY & GAMBLE, BR= BRINKER, C&C= CHAN & CHEUNG, F L= FLAWS, GLW= GAO LU WEN , PDR= PHYSICIAN’S DESK REFERENCE

Chapter 4 128 • Herb Toxicities & Drug Interactions: A Formula Approach

No toxicity or interaction information listed in the sources

Qian Cao, Qian Cao Gen
(Radix Rubiae Cordifoliae) Standard daily dosage: 6-9g No toxicity or interaction information listed in the sources

COMMENTS
The spleen, as the latter heaven root, and the kidneys, as the former heaven root, are mutually rooted. Therefore, enduring spleen disease may eventually reach the kidneys resulting in kidney qi not securing. This is exactly the type of uterine bleeding this formula addresses, a spleen-kidney qi vacuity. In its unmodified form, it is not for the treatment of blood heat bleeding nor does it address the common complication of blood stasis.

AH= AHPA, B&B= BENSKY & BAROLET, B&G= B ENSKY & GAMBLE, BR= BRINKER, C&C= CHAN & CHEUNG, FL= FLAWS, GLW= GAO LU WEN, PDR= PHYSICIAN’ S DESK REFERENCE

Chapter 4 Toxicities & Drug Interaction • 129

GUI PI TANG (Return the Spleen Decoction, a.k.a. Ginseng & Longan Combination)
Category: Qi & blood supplementing Functions: Boosts the qi and supplements the blood, fortifies the spleen and nourishes the heart Chinese medical indications: Heart-spleen dual vacuity with impaired memory, heart palpitations, insomnia, profuse dreams, anxiety and worry, fatigue, lack of strength, poor appetite, a sallow yellow facial complexion, pale lips and nails, a pale, enlarged tongue with teeth-marks on its edges and thin, white fur, and a fine, forceless pulse Contraindications: None listed Western medical indications: Insomnia, sleep disturbances, mood and personality disorders, functional uterine bleeding, thrombocytic or allergic purpura, superventricular tachycardia, congestive heart disease, postconcussion syndrome, and myasthenia gravis Potential formula toxicities & interactions: None listed

POTENTIAL MEDICINAL TOXICITIES & INTERACTIONS:
Ren Shen
(Radix Panacis Ginseng, ginseng) Standard daily dosage: 1-30g AH: Contraindicated in hypertension BR: May cause manic episodes in patients on MAO-inhibitors. May cause hypertension if consumed with caffeine. Possible additive effects to insulin. May reduce the anticoagulative effect of warfarin (Coumadin). B&G: Contraindicated for hypertensive patients. Overdose can lead to headache, insomnia, heart palpitations, and a rise in blood pressure. A traditional antidote is mung bean soup. C&C: Vitamin C, nicotinic acid, glutamic acid, hydrochloric acid, and other highly acidic substances could possibly reduce the therapeutic effect of this medicinal. PDR: Contraindicated in patients with hypertension. Not recommended in large doses during pregnancy or lactation due to potential neonatal andro-

AH= AHPA, B&B= BENSKY & BAROLET, B&G= B ENSKY & GAMBLE, BR= BRINKER, C&C= CHAN & CHEUNG, F L= FLAWS, GLW= GAO LU WEN, PDR= P HYSICIAN’S DESK REFERENCE

Chapter 4 130 • Herb Toxicities & Drug Interactions: A Formula Approach

genization. Enhances the effect of insulin and other antidiabetic agents. Use with MAO-inhibitors may cause headaches, tremors, and manias.

Huang Qi, Bei Qi
(Radix Astragali Membranacei, astragalus) Standard daily dosage: 9-60g AH: Safe when used appropriately C&C: Contains alkaloids and potassium. Could possibly cause hyperkalemia when used with potassium-sparing diuretics. Could possibly reduce the absorption and therapeutic effect of potassium and sodium iodides, sodium bicarbonate, aluminum hydroxide, magnesium sulfate. PDR: Caution should be taken with patients receiving immunosuppressive therapy, such as transplant patients or patients with autoimmune disorders. May cause neurological dysfunction in high doses. May potentiate the risk of bleeding when used concomitantly with anticoagulants, antiplatelets, or antithrombotic agents.

Bai Zhu
(Rhizoma Atractylodis Macrocephalae) Standard daily dosage: 4.5-9g AH: Safe when used appropriately B&G: When rats were fed 0.5g/kg of this medicinal for two months, they developed a mild lymphopenia and anemia but suffered no damage to the brain, heart, or liver.

Fu Ling, Bai Fu Ling, Yun Ling
(Sclerotium Poriae Cocos) Standard daily dosage: 9-15g B&G: Large doses or long-term use is discouraged. Contraindicated in patients with frequent, copious urination. According to traditional sources, may counteract Di Yu (Radix Sanguisorbae Officinalis), Qin Jiao (Radix Gentianae Qinjiao), and Bie Jia (Carapax Amydae Sinensis). C&C: Contains potassium. Could possibly cause hyperkalemia when used with potassium-sparing diuretics.

Suan Zao Ren
(Semen Zizyphi Spinosae) Standard daily dosage: 9-18g AH: Not to be used during pregnancy. (No such prohibition exists for this medicinal in traditional Chinese medicine.)
AH= AHPA, B&B= BENSKY & BAROLET, B&G= BENSKY & GAMBLE, BR= BRINKER, C&C= CHAN & CHEUNG, F L= FLAWS, GLW= GAO L U WEN , PDR= PHYSICIAN’S DESK REFERENCE

Chapter 4 Toxicities & Drug Interaction • 131

Long Yan Rou, Yuan Rou
(Arillus Euphoriae Longanae, longan fruit) Standard daily dosage: 6-30g No toxicity or interaction information listed in the sources

Mu Xiang
(Radix Aucklandiae Lappae) Standard daily dosage: 1.5-9g AH: Safe when used appropriately PDR: No health risks or side effects are known in conjunction with the proper administration of designated therapeutic dosages.

Gan Cao
(Radix Glycyrrhizae Uralensis, licorice root) Standard daily dosage: 2-12g AH: Do not use during pregnancy. (This medicinal is routinely used in Chinese medical gynecology during pregnancy as part of formulas appropriately prescribed on the basis of pattern discrimination.) As a single herb in high doses, it is contraindicated in diabetes, hypertension, and liver disorders. Not for long-term use. BR: May increase toxicity of cardiac glycosides. May increase potassium loss due to diuretics and laxatives. Possible additive effect to corticosteroids. May be synergistic with insulin in causing hypokalemia and sodium retention. B&G: According to some traditional sources, incompatible with Gan Sui (Radix Euphorbiae Kansui), Yuan Hua (Flos Daphnes Genkwae), and Yuan Zhi (Radix Polygalae Tenuifoliae). If taken long-term, it may cause hypertension and/or edema. Contains glycyrrhetinic acid which could possibly cause a reduction in thyroid activity and basal metabolic rate. The research on Gan Cao concurs that this medicinal is generally safe when used in small amounts as an envoy. It should not be taken long-term or as a single herb during pregnancy. When used as a single medicinal or in patients taking other potent Western pharmaceuticals, caution should be exercised to guard against potential toxicity and drug interaction.

Dang Gui
(Radix Angelicae Sinensis) Standard daily dosage: 3-15g AH: Do not use during pregnancy. (This medicinal is routinely used in Chinese medical gynecology during pregnancy as part of formulas
AH= AHPA, B&B= BENSKY & BAROLET, B&G= B ENSKY & GAMBLE, BR= BRINKER, C&C= CHAN & CHEUNG, F L= FLAWS, GLW= GAO LU WEN, PDR= P HYSICIAN’S DESK REFERENCE

Chapter 4 132• Herb Toxicities & Drug Interactions: A Formula Approach

appropriately prescribed on the basis of pattern discrimination.) B&G: Use with caution in patients with diarrhea or abdominal distention. C&C: Contains potassium. Could possibly cause hyperkalemia when used with potassium-sparing diuretics. May exaggerate the anticoagulative effect of warfarin (Coumadin).

Yuan Zhi
(Radix Polygalae Tenuifoliae) Standard daily dosage: 3-9g AH: Contraindicated in gastritis or when gastric ulcers are present. B&G: Contraindicated in gastritis or when gastric ulcers are present. According to some traditional sources, counteracts Zhen Zhu (Margarita) and Li Lu (Rhizoma Et Radix Veratri). C&C: Contains glycosides. Vitamin C, nicotinic acid, glutamic acid, hydrochloric acid, and other highly acidic substances could possibly reduce the therapeutic effect of this medicinal.

Sheng Jiang
(uncooked Rhizoma Zingiberis Officinalis, fresh ginger) Standard daily dose: 3-9g AH: Safe when used appropriately BR: Reduces vomiting caused by chemotherapeutic drugs. Increases absorption of oral drugs. PDR: Recommended safe dosage limit is six grams (6g). Avoid larger doses if being used to treat morning sickness or if used in patients taking anticoagulants.

Da Zao, Hong Zao
(Fructus Zizyphi Jujubae, red dates) Standard daily dosage: 10-30g (3-12 pieces) AH: Safe when used appropriately PDR: No health risks or side effects are known in conjunction with the proper administration of designated therapeutic dosages.

COMMENTS
This formula does address an element of liver depression which commonly complicates a heart-spleen dual vacuity. In case of even more pronounced liver depression, one or more other qi-rectifying agents may be added.
AH= AHPA, B&B= BENSKY & BAROLET, B&G= B ENSKY & GAMBLE, BR= BRINKER, C&C= CHAN & CHEUNG, F L= FLAWS, GLW= GAO LU WEN, PDR= P HYSICIAN’S DESK REFERENCE

Chapter 4 Toxicities & Drug Interaction • 133

GUI ZHI FU LING WAN (Cinnamon Twig & Poria Pills, a.k.a. Cinnamon & Hoelen Formula)
Category: Blood-quickening Functions: Quickens the blood and transforms stasis, disperses concretions and gatherings Chinese medical indications: Uterine blood stasis with mild, ceaseless uterine bleeding during pregnancy which is dark and purplish, abdominal pain that refuses pressure, blocked menstruation with distention and pain, painful menstruation, nonprecipitation of the lochia, a dark, purplish tongue or possible static macules and/or speckles, and a choppy pulse Contraindications: Use with caution during pregnancy and postpartum and only if there is the confirmed presence of blood stasis. Western medical indications: Primary dysmenorrhea, uterine fibroids, endometriosis, ovarian cysts, chronic salpingitis, chronic pelvic inflammatory disease, lochioschesis, and cervical erosion Potential formula toxicities & interactions: B&B: Although this formula is designed to treat patients with uterine bleeding during pregnancy, it should be used with great caution due to the potential harming of the fetus.

POTENTIAL MEDICINAL TOXICITIES & I NTERACTIONS:
Gui Zhi
(Ramulus Cinnamomi Cassiae, cinnamon twigs) Standard daily dosage: 3-15g AH: Safe when used appropriately B&G: Use with caution in the presence of fever, during pregnancy, or during excessive menstruation. PDR: Contraindicated during pregnancy.

Fu Ling, Bai Fu Ling, Yun Ling
(Sclerotium Poriae Cocos) Standard daily dosage: 9-15g B&G: Large doses or long-term use is discouraged. Contraindicated in patients with frequent, copious urination. According to traditional
AH= AHPA, B&B= BENSKY & BAROLET, B&G= BENSKY & GAMBLE, BR= BRINKER, C&C= CHAN & CHEUNG, F L= FLAWS, GLW= GAO L U WEN, PDR= P HYSICIAN’S DESK REFERENCE

Chapter 4 134 • Herb Toxicities & Drug Interactions: A Formula Approach

sources, may counteract Di Yu (Radix Sanguisorbae Officinalis), Qin Jiao (Radix Gentianae Qinjiao), and Bie Jia (Carapax Amydae Sinensis). C&C: Contains potassium. Could possibly cause hyperkalemia when used with potassium-sparing diuretics.

Bai Shao, Shao Yao
(Radix Albus Paeoniae Lactiflorae, white peony root) Standard daily dosage: 6-30g AH: Safe when used appropriately B&G: Use with caution in debilitated patients with diarrhea. According to some traditional sources, antagonizes Shi Hu (Herba Dendrobii) and Mang Xiao (Mirabilitum), counteracts Bie Jia (Carapax Amydae Sinensis) and Xiao Ji (Herba Cephalanopoloris Segeti), and is incompatible with Li Lu (Rhizoma Et Radix Veratri). C&C: Contains calcium, tannic acid, potassium, and glycosides. Could possibly cause hyperkalemia when used with potassium-sparing diuretics. Could possibly reduce the effect of most antibiotics, cause digitalis intoxication and heart arrhythmias, and could possibly reduce the absorption and therapeutic effect of levadopa, isoniazid, chlorpromazine, calcium carbonate and gluconate, atropine, ephedrine, quinine, reserpine, vitamin B 1, trypsine, amylase, and pepsin. Vitamin C, nicotinic acid, glutamic acid, hydrochloric acid, and other highly acidic substances could possibly reduce the therapeutic effect of this medicinal.

Dan Pi, Mu Dan Pi
(Cortex Radicis Moutan, tree peony root bark) Standard daily dosage: 6-12g AH: Not to be used during pregnancy.(This ingredient is commonly used in China during pregnancy to treat heat in the blood and/or blood stasis.) B&G: Should not be used during pregnancy or in patients with excessive sweating or profuse menstruation. Avoid using with garlic. According to some traditional sources, may counteract the effect of Tu Si Zi (Semen Cuscutae Chinensis), Bei Mu (Bulbus Fritillariae), and Da Huang (Radix Et Rhizoma Rhei). C&C: Contains tannic acid, potassium, and glycosides. Could possibly cause hyperkalemia when used with potassium-sparing diuretics. Could possibly reduce the absorption and biologic effect of most antibiotics, isoniazid, chlorpromazine, calcium carbonate and gluconate, atropine, ephedrine, quinine, reserpine, digitalis, vitamin B1, trypsine, amylase, and pepsin. Vitamin C, nicotinic acid, glutamic acid, hydrochloric acid, and other highly acidic substances could possibly reduce the therapeutic effect of this medicinal.
AH= AHPA, B&B= BENSKY & BAROLET, B&G= BENSKY & GAMBLE, BR= BRINKER, C&C= C HAN & CHEUNG, F L= FLAWS, GLW= GAO L U WEN , PDR= PHYSICIAN’S DESK REFERENCE

B&G= B ENSKY & GAMBLE. hydrocyanic acid is produced which can lead to respiratory failure and death. COMMENTS This formula is only appropriate for the treatment of uterine fibroids when there are clear signs and symptoms of blood stasis. and lack of strength. typically. and respiratory paralysis leads to death. there is difficulty breathing. this medicinal is blanched before using and its tip is broken off in order to make it less or non-toxic. there is a bitter taste and astringent feeling within the mouth. Therefore. GLW: If use has caused poisioning. B&B= BENSKY & BAROLET. drooling. In such cases. BR= BRINKER. there is usually a pronounced element of spleen vacuity and there may also be an element of kidney vacuity as well. nausea. and the pupils of the eye dilate widely with loss of reactivity to light. peach kernel) Standard daily dosage: 4. F L= FLAWS. heart palpitations. GLW= GAO LU WEN. headache. 1-2 hours after ingestion. hydrochloric acid. blood pressure drops. or other opiates. PDR= P HYSICIAN’S DESK REFERENCE . The teeth become clenched. If taken with codeine. and such is not always the case. Because uterine fibroids tend to occur in women between 35-55 years of age. breathing becomes weak. In more serious cases. dizziness. nicotinic acid. there are generalized convulsions. Eventually. C&C= CHAN & CHEUNG. glutamic acid. vomiting accompanied by watery diarrhea.5-9g AH: Not to be used during pregnancy B&G: Contraindicated during pregnancy C&C: Contains potassium and glycosides (including cyanophoric glycosides). Most of the toxins in this medicinal reside in the skin and tip. and other highly acidic substances could possibly reduce the therapeutic effect of this medicinal. morphine.Chapter 4 Toxicities & Drug Interaction • 135 Tao Ren (Semen Pruni Persicae. Sometimes one can smell cyanide on the person’s breath. this formula would need to be modified with spleen and kidney supplements or another formula chosen altogether. AH= AHPA. Could possibly cause hyperkalemia when used with potassium-sparing diuretics. consciousness becomes unclear. Vitamin C.

counteracts Bie Jia (Carapax Amydae Sinensis) and Xiao Ji (Herba Cephalanopoloris Segeti). and irritability. According to some traditional sources. BR= BRINKER. heart palpitations. neuralgia. Shao Yao (Radix Albus Paeoniae Lactiflorae. C&C= CHAN & CHEUNG. forceless pulse Contraindications: Exterior cold and interior heat Western medical indications: Common cold. F L= FLAWS. white. stiff neck. and is incompatible with Li Lu (Rhizoma Et Radix Veratri). headache. Bai Shao. thin.k. severe thirst. high fever. GLW= GAO LU WEN . a. and a floating. regulates and harmonizes the constructive and defensive Chinese medical indications: Externally contracted wind cold with an exterior cold and vacuous condition manifesting fever and aversion to wind unrelieved by sweating. C&C: Contains calcium. PDR: Contraindicated during pregnancy. B&G= B ENSKY & GAMBLE. antagonizes Shi Hu (Herba Dendrobii) and Mang Xiao (Mirabilitum). cinnamon twigs) Standard daily dosage: 3-15g AH: Safe when used appropriately B&G: Use with caution in the presence of fever. and glycosides. Could AH= AHPA. nasal congestion. potassium. white peony root) Standard daily dosage: 6-30g AH: Safe when used appropriately B&G: Use with caution in debilitated patients with diarrhea. B&B= BENSKY & BAROLET. during pregnancy. eclampsia. Antidote is Bai Hu Jia Ren Shen Tang (White Tiger Plus Ginseng Decoction). and neurasthenia Potential formula toxicities & interactions: FL: Contraindicated in hemorrhagic conditions. PDR= PHYSICIAN’S DESK REFERENCE . POTENTIAL MEDICINAL TOXICITIES & I NTERACTIONS: Gui Zhi (Ramulus Cinnamomi Cassiae. B&B: Large doses may cause profuse sweating. or during excessive menstruation. Cinnamon Combination) Category: Exterior-resolving Functions: Resolves the muscles and effuses the exterior. tannic acid.Chapter 4 136 • Herb Toxicities & Drug Interactions: A Formula Approach GUI ZHI TANG (Cinnamon Twig Decoction. abdominal pain due to chills. moist tongue fur.a. bodily weakness and vacuity.

Not for long-term use. BR= BRINKER. amylase.Chapter 4 Toxicities & Drug Interaction • 137 possibly cause hyperkalemia when used with potassium-sparing diuretics. it may cause hypertension and/or edema. fresh ginger) Standard daily dose: 3-9g AH: Safe when used appropriately BR: Reduces vomiting caused by chemotherapeutic drugs. incompatible with Gan Sui (Radix Euphorbiae Kansui). Avoid larger doses if being used to treat morning sickness or if used in patients taking anticoagulants. Could possibly reduce the effect of most antibiotics. atropine.) As a single herb in high doses. and liver disorders. and other highly acidic substances could possibly reduce the therapeutic effect of this medicinal. nicotinic acid. FL= FLAWS. glutamic acid. Possible additive effect to corticosteroids. May be synergistic with insulin in causing hypokalemia and sodium retention. Yuan Hua (Flos Daphnes Genkwae). reserpine. quinine. ephedrine. trypsine. Sheng Jiang (uncooked Rhizoma Zingiberis Officinalis. Da Zao. vitamin B 1. Contains glycyrrhetinic acid which AH= AHPA. B&B= BENSKY & BAROLET. red dates) Standard daily dosage: 10-30g (3-12 pieces) AH: Safe when used appropriately PDR: No health risks or side effects are known in conjunction with the proper administration of designated therapeutic dosages. hypertension. calcium carbonate and gluconate. GLW= GAO LU WEN. B&G= B ENSKY & GAMBLE . and pepsin. Gan Cao (Radix Glycyrrhizae Uralensis. Increases absorption of oral drugs. PDR= P HYSICIAN’ S DESK REFERENCE . and Yuan Zhi (Radix Polygalae Tenuifoliae). (This medicinal is routinely used in Chinese medical gynecology during pregnancy as part of formulas appropriately prescribed on the basis of pattern discrimination. Hong Zao (Fructus Zizyphi Jujubae. cause digitalis intoxication and heart arrhythmias. it is contraindicated in diabetes. chlorpromazine. May increase potassium loss due to diuretics and laxatives. isoniazid. and could possibly reduce the absorption and therapeutic effect of levadopa. C&C= CHAN & CHEUNG. hydrochloric acid. If taken long-term. BR: May increase toxicity of cardiac glycosides. PDR: Recommended safe dosage limit is six grams (6g). B&G: According to some traditional sources. Vitamin C. licorice root) Standard daily dosage: 2-12g AH: Do not use during pregnancy.

GLW= GAO LU WEN. caution should be exercised to guard against potential toxicity and drug interaction.Chapter 4 138 • Herb Toxicities & Drug Interactions: A Formula Approach could possibly cause a reduction in thyroid activity and basal metabolic rate. B&G= B ENSKY & GAMBLE . BR= BRINKER. COMMENTS This is another classic formula which is rarely prescribed in its textbook standard form today. It should not be taken long-term or as a single herb during pregnancy. FL= FLAWS. B&B= BENSKY & BAROLET. AH= AHPA. The research on Gan Cao concurs that this medicinal is generally safe when used in small amounts as an envoy. PDR= P HYSICIAN’ S DESK REFERENCE . When used as a single medicinal or in patients taking other potent Western pharmaceuticals. C&C= CHAN & CHEUNG.

chest oppression and ductal glomus. B&B= BENSKY & BAROLET.k. acute bronchitis. potassium. menstruation. rapid. B&G= B ENSKY & GAMBLE. Overuse may cause hypokalemia and increased toxicity of cardiac glycosides. rhubarb root) Standard daily dosage: 3-12g AH: Do not use during pregnancy. Vitamin C.a. BR= BRINKER. mica schist) Standard daily dosage: 9-15g in decoction. postpartum. seizure disorder. GLW= GAO LU WEN . B&G: Use with extreme caution during pregnancy. May aggravate potassium loss from diuretics. and chronic obstructive pulmonary disease Potential formula toxicities & interactions: None listed POTENTIAL MEDICINAL TOXICITIES & I NTERACTIONS: Meng Shi (Lapis Micae Seu Chloriti. forceful pulse Contraindications: Pregnancy. coughing and wheezing with thick. or any inflammatory condition of the intestines. Not to be used while nursing. schizophrenia.Chapter 4 Toxicities & Drug Interaction • 139 GUN TAN WAN (Phlegm-rolling Pills. BR: Reduces absorption of oral drugs. Vaporize Phlegm Pills) Category: Orifice-opening Functions: Drains fire. C&C: Contains alkaloids. abdominal pain of unknown origin. and opens the orifices Chinese medical indications: Phlegm fire resulting in mania and withdrawal. dizziness. a. Da Huang. transforms phlegm. and glycosides. Could possibly cause hyperkalemia when used with potassium-sparing diuretics. Contraindicated for nursing mothers since active ingredients enter the milk. benign positional vertigo. or postpartum. tinnitus. nicotinic acid. Chuan Jun. manic-depression. insomnia. sticky phlegm. F L= FLAWS. and vacuity weakness Western medical indications: Hysteria. 1. heart palpitations. thick. Contraindicated in intestinal obstruction.5-3g in pills and powders B&G: Contraindicated in pregnancy and for the debilitated. PDR= PHYSICIAN’S DESK REFERENCE . tannic acid. hydrochloric acid. glutamic acid. yellow tongue fur. bronchial asthma. and AH= AHPA. Dai Huang. Meniere’s disease. anxiety neurosis. Jun (Radix Et Rhizoma Rhei. slimy. C&C= CHAN & CHEUNG. and a slippery.

PDR: Consult a physician before using this medicinal during pregnancy or while nursing.5-3g as a powder No toxicity or interaction information listed in the sources COMMENTS The main ingredients in this formula are often used for the treatment of phlegm heat associated with mental-emotional problems. glutamic acid. F L= FLAWS. hydrochloric acid. and other highly acidic substances could possibly reduce the therapeutic effect of this medicinal. B&G= B ENSKY & GAMBLE. Huang Qin. C&C= CHAN & CHEUNG. aloeswood) Standard daily dosage: 1. C&C: Contains potassium and glycosides. Tiao Qin (Radix Scutellariae Baicalensis) Standard daily dosage: 6-15g AH: Safe when used appropriately B&G: According to some traditional sources. B&B= BENSKY & BAROLET. Vitamin C.Chapter 4 140 • Herb Toxicities & Drug Interactions: A Formula Approach other highly acidic substances could possibly reduce the therapeutic effect of this medicinal. GLW= GAO LU WEN . This formula is not commonly used as the base prescription for phlegm heat respiratory problems. counteracts Dan Pi (Cortex Radicis Moutan) and Li Lu (Rhizoma Et Radix Veratri). Could possibly cause hyperkalemia when used with potassium-sparing diuretics. appendicitis and abdominal pain of unknown origin. PDR= PHYSICIAN’S DESK REFERENCE . AH= AHPA. BR= BRINKER. nicotinic acid. acute inflammatory intestinal disease. Contraindicated in cases of intestinal obstruction. Chen Xiang (Lignum Aquilariae.

5-15g C&C: Contains potassium. slimy tongue fur. C&C: Contains potassium. slippery pulse Contraindications: None listed Western medical indications: Goiter. fixed masses in the center of the neck which do not change the color of the overlying skin and do not ulcerate. Kun Bu (Thallus Algae) Standard daily dosage: 4. and a bowstring. C&C= CHAN & CHEUNG. and hyperthyroidism Potential formula toxicities & interactions: B&B: Must be taken for 3-6 months to be effective. Could possibly cause hyperkalemia when used with potassium-sparing diuretics. Could possibly cause hyperkalemia when used with potassium-sparing diuretics.Chapter 4 Toxicities & Drug Interaction • 141 HAI ZAO YU HU TANG (Sargassium Jade Flask Decoction) Category: Phlegm-transforming Functions: Tranforms phlegm and softens the hard. POTENTIAL MEDICINAL TOXICITIES & INTERACTIONS: Hai Zao (Herba Sargassii) Standard daily dosage: 4. thin. dampness. B&G= B ENSKY & GAMBLE.5-15g B&G: According to traditional sources. dissipates binding and disperses goiter Chinese medical indications: Qi goiter due to stagnation and binding of the qi. B&B= BENSKY & BAROLET. thyroid adenoma. phlegm. PDR= PHYSICIAN’ S DESK REFERENCE . GLW= GAO LU WEN. B R= BRINKER. Hai Dai (Thallus Laminariae) Standard daily dosage: 6-9g AH= AHPA. incompatible with Gan Cao (Radix Glycerrhizae Uralensis). FL= FLAWS. and blood between the skin and flesh of the neck with hard.

) Contraindicated in all hemorrhagic disorders. aluminum hydroxide. sodium bicarbonate. a somber white facial complexion. incompatible with Wu Tou (Radix Aconiti). PDR= PHYSICIAN’S DESK REFERENCE . If severe. forceless pulse. there may be convulsions and respiratory failure leading to death. This is then followed by drooling. heart palpitations. Could possibly reduce the absorption and therapeutic effect of potassium and sodium iodides. ulceration of the oral mucosa. Use with caution in patients with fever. B&G= B ENSKY & GAMBLE. GLW= GAO LU WEN . B&B= BENSKY & BAROLET. aluminum hydroxide.5-12g AH: Do not use during pregnancy. and magnesium sulfate.Chapter 4 142 • Herb Toxicities & Drug Interactions: A Formula Approach PDR: No health risks or side effects are known in conjunction with the proper administration of designated therapeutic dosages. low-grade fever. Vitamin C. (This medicinal is routinely used during pregnancy in China when indicated by disease and pattern discrimination. difficulty swallowing. According to some traditional sources. AH= AHPA. C&C: Contains alkaloids and glycosides. Antidote is oral administration of raw ginger. tongue. nausea. and magnesium sulfate. nicotinic acid. Could possibly reduce the absorption and therapeutic effect of potassium and sodium iodides. numbness of the extremities. and throat. Toxic effects due to improper preparation or dosage include burning and numbness in throat and lips. sodium bicarbonate. and a feeling of pressure in the chest. there is burning pain in the mouth. BR= BRINKER. glutamic acid. Ban Xia (Rhizoma Pinelliae Ternatae) Standard daily dosage: 4. dizziness. Zhe Bei Mu (Bulbus Fritillariae Thunbergii) Standard daily dosage: 3-9g AH: Not to be used during pregnancy C&C: Contains alkaloids. hydrochloric acid. B&G: Safe as long as it is properly prepared. unclear speech. Initially. and a weak. and other highly acidic substances could possibly reduce the therapeutic effect of this medicinal. Must be decocted with other herbs and not taken alone or uncooked. This medicinal should never be used internally uncooked since it is very toxic when uncooked. C&C= CHAN & CHEUNG. F L= FLAWS. and enlargement of the tongue. GLW: Poisoning occurs within 15 minutes to three hours after ingestion of a suitable amount.

) B&G: Not for patients with migraine headache or excessive menstrual bleeding.Chapter 4 Toxicities & Drug Interaction • 143 Du Huo (Radix Angelicae Pubescentis) Standard daily dosage: 3-9g AH: Patients should avoid prolonged exposure to sunlight. (This medicinal is routinely used in Chinese medical gynecology during pregnancy as part of formulas appropriately prescribed on the basis of pattern discrimination. According to some traditional texts. May exaggerate the anticoagulative effect of warfarin (Coumadin). B&B= BENSKY & BAROLET. Could possibly reduce the absorption and therapeutic effect of potassium and sodium iodides. Dang Gui (Radix Angelicae Sinensis) Standard daily dosage: 3-15g AH: Do not use during pregnancy. PDR= P HYSICIAN’S DESK REFERENCE . and magnesium sulfate. BR= BRINKER. C&C: Contains potassium.) Chuan Xiong (Radix Ligustici Wallichii) Standard daily dosage: 3-9g(In China today. Qing Pi (Pericarpium Citri Reticulatae Viride) Standard daily dosage: 3-6g AH: Safe when used appropriately Chen Pi.) B&G: Use with caution in patients with diarrhea or abdominal distention. B&G= B ENSKY & GAMBLE. GLW= GAO L U WEN. and is incompatible with Li Lu (Rhizoma Et Radix Veratri). Ju Hong (Pericarpium Citri Reticulatae. antagonizes Shan Zhu Yu (Fructus Corni Officinalis) and Huang Qi (Radix Astragali Membranacei). (This medicinal is routinely used in Chinese medical gynecology during pregnancy as part of formulas appropriately prescribed on the basis of pattern discrimination.(The authors have never seen this reaction when this medicinal is used in the dosage ranges commonly employed in Chinese medicine.) AH: Do not use during pregnancy. Could possibly cause hyperkalemia when used with potassium-sparing diuretics. tangerine peel) Standard daily dosage: 3-9g AH= AHPA. counteracts Hua Shi (Talcum) and Huang Lian (Rhizoma Coptidis Chinensis). aluminum hydroxide. sodium bicarbonate. Could possibly cause hyperkalemia when used with potassium-sparing diuretics. Ju Pi. it is not uncommon for this medicinal to be prescribed up to 15 grams per day in decoction. Overdosage causes vomiting and dizziness. C&C= CHAN & CHEUNG. F L= FLAWS. C&C: Contains alkaloids and potassium.

carbuncles that have already ulcerated.) As a single herb in high doses. hypertension. B&G= B ENSKY & GAMBLE.Chapter 4 144 • Herb Toxicities & Drug Interactions: A Formula Approach AH: Safe when used appropriately C&C: Contains potassium. PDR= PHYSICIAN’ S DESK REFERENCE . nicotinic acid. (This medicinal is routinely used in Chinese medical gynecology during pregnancy as part of formulas appropriately prescribed on the basis of pattern discrimination. it is contraindicated in diabetes. COMMENTS The first five ingredients in this formula plus Chen Pi are commonly used to treat many different types of phlegm binding or nodulation. BR= BRINKER. BR: May increase toxicity of cardiac glycosides. caution should be exercised to guard against potential toxicity and drug interaction. and liver disorders. The research on Gan Cao concurs that this medicinal is generally safe when used in small amounts as an envoy. May increase potassium loss due to diuretics and laxatives. Gan Cao (Radix Glycyrrhizae Uralensis. C&C: Contains potassium and glycosides. When used as a single medicinal or in patients taking other potent Western pharmaceuticals. AH= AHPA. Possible additive effect to corticosteroids. these ingredients are combined with various other Chinese medicinals. and Yuan Zhi (Radix Polygalae Tenuifoliae). it may cause hypertension and/or edema. B&B= BENSKY & BAROLET. C&C= CHAN & CHEUNG. licorice root) Standard daily dosage: 2-12g AH: Do not use during pregnancy. It should not be taken long-term or as a single herb during pregnancy. Could possibly cause hyperkalemia when used with potassium-sparing diuretics. hydrochloric acid. FL= FLAWS. If taken long-term. Not for long-term use. dried forsythia fruit pods) Standard daily dosage: 6-15g AH: Not to be used during pregnancy (This medicinal is commonly used in China during pregnancy to treat wind heat external contractions and heat toxins. May be synergistic with insulin in causing hypokalemia and sodium retention. glutamic acid. B&G: According to some traditional sources. and skin ulcers. Depending on complicating patterns and where the phlegm bindings are located. Yuan Hua (Flos Daphnes Genkwae). Contains glycyrrhetinic acid which could possibly cause a reduction in thyroid activity and basal metabolic rate. incompatible with Gan Sui (Radix Euphorbiae Kansui). Could possibly cause hyperkalemia when used with potassium-sparing diuretics. Lian Qiao (Fructus Forsythiae Suspensae. GLW= GAO LU WEN. and other highly acidic substances could possibly reduce the therapeutic effect of this medicinal. Vitamin C.) B&G: Contraindicated in patients with diarrhea.

tannic acid. magnesium and ferrous sulfates. reserpine. bleeding hemorrhoids. sodium bicarbonate. most antibiotics. dispels wind and moves the qi Chinese medical indications: Wind heat or damp heat in the intestines and stomach with bright red bleeding from the anus during or before defecation. digitalis. C&C= CHAN & CHEUNG. POTENTIAL MEDICINAL TOXICITIES & I NTERACTIONS: Huai Hua. ulcerative colitis. quercetin. isoniazid. Ce Bai Ye (Cacumen Biotae Orientalis) Standard daily dosage: 6-15g B&G: Long-term use or a large dose may cause dizziness and gastric upset. quinine. GLW= GAO L U WEN . gluconate and lactate. glutamic acid. and a bowstring. calcium carbonate. B&B= BENSKY & BAROLET. and pepsin. B&G= BENSKY & GAMBLE. aluminum hydroxide. chlorpromazine. rapid pulse Contraindications: Bleeding due to qi vacuity Western medical indications: Hemorrhoids. rapid or soggy. Huai Hua Mi (Flos Immaturus Sophorae Japonicae) Standard daily dosage: 6-15g B&G: Research notes one case of anaphylatic reaction in a child. nicotinic acid. atropine. and bismuth subcarbonate. rectal prolapse. AH= AHPA. Could possibly reduce the absorption and therapeutic effect of potassium and sodium iodides. C&C: Contains alkaloids. hydrochloric acid. amoebic dysentery Potential formula toxicities & interactions: B&B: Not for long-term use. trypsine. vitamin B1. ephedrine. and other highly acidic substances could possibly reduce the therapeutic effect of this medicinal. F L= FLAWS. a red tongue. Vitamin C. PDR= PHYSICIAN’S DESK REFERENCE .Chapter 4 Toxicities & Drug Interaction • 145 HUAI HUA SAN (Sophora Flower Powder) Category: Bleeding-stopping Functions: Cools the intestines and stops bleeding. BR= BRINKER. and glycosides. amylase. anal fissure.

sodium bicarbonate. C&C= CHAN & CHEUNG. bitter orange) Standard daily dose: 3-9g B&G: Use with caution during pregnancy. AH= AHPA. calcium carbonate and gluconate. digitalis. aluminum hydroxide. BR= BRINKER. vitamin B1. PDR= P HYSICIAN’S DESK REFERENCE . COMMENTS This formula is specifically for the treatment of heat pattern bleeding hemorrhoids for which it is extremely effective.Chapter 4 146 • Herb Toxicities & Drug Interactions: A Formula Approach Jing Jie Sui. isoniazid. Otherwise no health hazards are known in conjunction with the proper administration of designated therapeutic dosages. reserpine. Could possibly cause crystalluria and hematuria. opiates. quinine. caffeine. trypsine. chlorpromazine. Zhi Qiao (Fructus Citri Aurantii. Could possibly reduce the absorption and biologic effect of most antibiotics. B&B= BENSKY & BAROLET. GLW= GAO LU WEN. Zhi Ke. C&C: Contains tannic acid. and pepsin. scopolamine. B&G= B ENSKY & GAMBLE. reserpine. amylase. ephedrine. PDR: May cause UV-sensitivity in light-skinned individuals. and berbamin. Jing Jie (Herba Seu Flos Schizonepetae Tenuifoliae) Standard daily dosage: 3-9g AH: No toxicity information listed in current sources. F L= FLAWS. atropine. Highly acidic.

apthous ulcers. C&C: Contains alkaloids. carbonate. Long-term use may damage the digestive system. and a fine. BR= BRINKER. PDR= PHYSICIAN’S DESK REFERENCE . a red tongue with dry. easy anger.Chapter 4 Toxicities & Drug Interaction • 147 HUANG LIAN E JIAO TANG (Coptis & Donkey Skin Glue Decoction.a. According to some traditional sources. and potassium. C&C= CHAN & CHEUNG. eliminates vexation and quiets the spirit Chinese medical indications: Noninteraction of the heart and kidneys due to yin vacuity and fire blazing with vexatious heat in the chest.k. calcium gluconate. AH= AHPA. Xuan Shen (Radix Scrophulariae Ningpoensis). F L= FLAWS. magnesium and ferrous sulfates. insomnia. and Jiang Can (Bombyx Batryticatus). Some traditional sources say it should not be taken with pork. and lactate. yellow fur. sodium bicarbonate. and bismuth subcarbonate. antagonizes Ju Hua (Flos Chrysanthemi Morifolii). counteracts Kuan Dong Hua (Flos Tussilaginis Farfarae) and Niu Xi (Radix Achyranthis Bidentatae). According to some traditional sources.) B&G: Contains berberine. Coptis & Gelatin Combination) Category: Spirit-quieting Functions: Enriches the yin and descends fire. a. rapid pulse Contraindications: Noninteraction of the heart and kidneys with kidney yang vacuity below Western medical indications: Mood and anxiety disorders. quercetin. Bai Xian Pi (Cortex Radicis Dictamni Dasycarpi). and dysentery Potential formula toxicities & interactions: None listed POTENTIAL MEDICINAL TOXICITIES & I NTERACTIONS: Huang Lian (Rhizoma Coptidis Chinensis) Standard daily dosage: 1. heart palpitations. aluminum hydroxide. B&B= BENSKY & BAROLET.5-9g AH: Not to be used during pregnancy (This medicinal is commonly used during pregnancy in China when indicated by disease and pattern discrimination. Could possibly reduce the absorption and therapeutic effect of potassium and sodium iodides. GLW= GAO LU WEN . the recuperative stage of an infectious disease. Could possibly cause hyperkalemia when used with potassium-sparing diuretics. B&G= B ENSKY & GAMBLE.

reserpine. chlorpromazine. glutamic acid. GLW= GAO L U WEN . trypsine. tannic acid. hydrochloric acid. atropine. and other highly acidic substances could possibly reduce the therapeutic effect of this medicinal. PDR= PHYSICIAN’S DESK REFERENCE . Tiao Qin (Radix Scutellariae Baicalensis) Standard daily dosage: 6-15g AH: Safe when used appropriately B&G: According to some traditional sources. B&B= BENSKY & BAROLET. calcium carbonate and gluconate. quinine. and Could possibly reduce the absorption and therapeutic effect of levadopa. Could possibly cause hyperkalemia when used with potassium-sparing diuretics. E Jiao (Gelatinum Corii Asini. F L= FLAWS. Could possibly reduce the effect of most antibiotics. donkey skin glue) Standard daily dosage: 3-15g B&G: According to some traditional sources counteracts Da Huang (Radix Et Rhizoma Rhei). C&C: Contains calcium. potassium. and is incompatible with Li Lu (Rhizoma Et Radix Veratri). nicotinic acid. Bai Shao. Shao Yao (Radix Albus Paeoniae Lactiflorae. Vitamin C. Ji Zi Huang (Egg yolk) Standard daily dosage: No standard daily dose No toxicity or interaction information listed in the sources AH= AHPA. isoniazid. cause digitalis intoxication and heart arrhythmias. and Xiao Ji (Herba Cephalanopoloris Segeti). hydrochloric acid. ephedrine.Chapter 4 148 • Herb Toxicities & Drug Interactions: A Formula Approach Huang Qin. amylase. white peony root) Standard daily dosage: 6-30g B&G: Use with caution in debilitated patients with diarrhea. vitamin B1. C&C: Contains potassium and glycosides. counteracts Dan Pi (Cortex Radicis Moutan) and Li Lu (Rhizoma Et Radix Veratri). and glycosides. C&C= CHAN & CHEUNG. glutamic acid. According to some traditional sources. and pepsin. nicotinic acid. BR= BRINKER. Could possibly cause hyperkalemia when used with potassium-sparing diuretics. B&G= BENSKY & GAMBLE. and other highly acidic substances could possibly reduce the therapeutic effect of this medicinal. counteracts Bie Jia (Carapax Amydae Sinensis). Vitamin C. antagonizes Shi Hu (Herba Dendrobii) and Mang Xiao (Mirabilitum).

carbonate. C&C= CHAN & CHEUNG. acute pelvic inflammatory diseases. forceful pulse Contraindications: Vacuity weakness Western medical indications: Serious infections including septicemia. Coptis & Scute Combination) Category: Heat-clearing & toxin-resolving Functions: Drains fire and resolves toxins Chinese medical indications: Fire toxins in the three burners with high fever. GLW= GAO LU WEN. epistaxis. calcium gluconate. B&B= BENSKY & BAROLET. Bai Xian Pi (Cortex Radicis Dictamni Dasycarpi). and Jiang Can (Bombyx Batryticatus). acute cholecystitis. POTENTIAL MEDICINAL TOXICITIES & I NTERACTIONS: Huang Lian (Rhizoma Coptidis Chinensis) Standard daily dosage: 1. dark urine. urticaria. According to some traditional sources. acute enteritis. pruritus.(This medicinal is commonly used during pregnancy in China when indicated by disease and pattern discrimination. Some traditional sources say it should not be taken with pork. C&C: Contains alkaloids. cerebral hemorrhage. pneumonia. carbuncles. erysipelas. acute icteric hepatitis. Also useful in treating skin ulcers. BR= BRINKER. PDR= P HYSICIAN’S DESK REFERENCE . urinary tract infections. a red tongue with yellow fur. and a variety of neurological and emotional disorders including anxiety. and potassium. antagonizes Ju Hua (Flos Chrysanthemi Morifolii). hemoptysis. a.) B&G: Contains berberine. furuncles.5-9g AH: Not to be used during pregnancy. sodium bicarbonate. hypertension. encephalitis. Long-term use may damage the digestive system. heart palpitations. B&G= B ENSKY & GAMBLE.a.k. quercetin. Could possibly reduce the absorption and therapeutic effect of potassium and sodium iodides.Chapter 4 Toxicities & Drug Interaction • 149 HUANG LIAN JIE DU TANG (Coptis Resolve Toxins Decoction. According to some traditional sources. cellulitis. counteracts Kuan Dong Hua (Flos Tussilaginis Farfarae) and Niu Xi (Radix Achyranthis Bidentatae). acute conjunctivitis. and neurasthenia. hysteria. insomnia. F L= FLAWS. a dry mouth and parched throat. Could possibly cause hyperkalemia when used with potassium-sparing diuretics. deranged speech. easy anger. and AH= AHPA. and a rapid. Potential formula toxicities & interactions: FL/B&B: Not for prolonged use or with weakened patients. dysentery. boils. insomnia. Xuan Shen (Radix Scrophulariae Ningpoensis).

Huang Bo (Cortex Phellodendri) Standard daily dosage: 3-12g AH: Not to be used during pregnancy. In a robust patient with a replete constitution. and lactate. and other highly acidic substances could possibly reduce the therapeutic effect of this medicinal. this side effect is considered acceptable for a while if the medicinals result in speedy eradication of the heat and toxins. B&B= BENSKY & BAROLET. Tiao Qin (Radix Scutellariae Baicalensis) Standard daily dosage: 6-15g AH: Safe when used appropriately B&G: According to some traditional sources. GLW= GAO L U WEN .) B&G: Chinese literature reports one case of a patient who developed a skin rash after ingestion. (This medicinal is commonly used during pregnancy in China. Vitamin C. attacking. PDR= PHYSICIAN’S DESK REFERENCE . carbonate. hydrochloric acid. aluminum hydroxide. magnesium and ferrous sulfates. F L= FLAWS. Huang Bai. sodium bicarbonate. calcium gluconate. aluminum hydroxide. dried gardenia fruit pod) Standard daily dosage: 3-12g B&G: Contains geniposide which caused diarrhea in mice. Huang Qin. hydrochloric acid. Because its ingredients are so bitter. B&G= BENSKY & GAMBLE. AH= AHPA. C&C: Contains alkaloids and quercetin. it may cause diarrhea. BR= BRINKER. and draining. Shan Zhi Zi (Fructus Gardeniae Jasminoidis. counteracts Dan Pi (Cortex Radicis Moutan) and Li Lu (Rhizoma Et Radix Veratri). C&C= CHAN & CHEUNG. and bismuth subcarbonate. glutamic acid. nicotinic acid. C&C: Contains potassium and glycosides. Could possibly reduce the absorption and therapeutic effect of potassium and sodium iodides. nicotinic acid. Zhi Zi. Could possibly cause hyperkalemia when used with potassium-sparing diuretics. Shan Zhi. Vitamin C. cold. COMMENTS This formula is for the treatment of acute heat toxins.Chapter 4 150 • Herb Toxicities & Drug Interactions: A Formula Approach lactate. Could possibly cause hyperkalemia when used with potassium-sparing diuretics. glutamic acid. and bismuth subcarbonate. magnesium and ferrous sulfates. and other highly acidic substances could possibly reduce the therapeutic effect of this medicinal. C&C: Contains potassium and glycosides.

PDR= P HYSICIAN’S DESK REFERENCE . BR= BRINKER. functional uterine bleeding Potential formula toxicities & interactions: None listed POTENTIAL MEDICINAL TOXICITIES & INTERACTIONS: Fu Long Gan.Chapter 4 Toxicities & Drug Interaction • 151 HUANG TU TANG (Yellow Earth Decoction) Category: Bleeding-stopping Functions: Warms yang and fortifies the spleen. AH= AHPA. bleeding peptic ulcer. or abnormal uterine bleeding with pale red blood. GLW= GAO LU WEN. donkey skin glue) Standard daily dosage: 3-15g B&G: According to some traditional sources. a pale tongue with white fur. Zao Xin Tu (Terra Flava Usta) Standard daily dosage: 15-60g No toxicity or interaction information listed in the sources Sheng Di. hematemesis. fine. C&C= CHAN & CHEUNG. epistaxis. cold extremities. E Jiao (Gelatinum Corii Asini. a sallow yellow or somber white facial complexion. PDR: No health risks or side effects are known in conjunction with the proper administration of designated therapeutic dosages. Sheng Di Huang (uncooked Radix Rehmanniae Glutinosae) Standard daily dosage: 9-30g AH: Contraindicated in patients with diarrhea or lack of appetite B&G: Contraindicated in pregnant women with anemias or digestive weakness C&C: Contains potassium. and a deep. counteracts Da Huang (Radix Et Rhizoma Rhei). hemoptysis. B&B= BENSKY & BAROLET. nourishes the blood and stops bleeding Chinese medical indications: Spleen yang vacuity with spleen qi not containing the blood resulting in hemafecia. Could possibly cause hyperkalemia when used with potassium-sparing diuretics. forceless pulse Contraindications: Bleeding due to heat Western medical indications: Chronic hemorrhagic gastritis. B&G= B ENSKY & GAMBLE. F L= FLAWS.

(This medicinal is routinely used in Chinese medical gynecology during pregnancy as part of formulas appropriately prescribed on the basis of pattern discrimination. PDR= P HYSICIAN’S DESK REFERENCE . licorice root) Standard daily dosage: 2-12g AH: Do not use during pregnancy. When used as a single medicinal or in patients taking other potent Western pharmaceuticals.5-9g B&G: When rats were fed 0. Fu Pian (Radix Lateralis Praeparatus Aconiti Carmichaeli. Gan Cao (Radix Glycyrrhizae Uralensis. BR: May increase toxicity of cardiac glycosides. B&G= B ENSKY & GAMBLE. B&B= BENSKY & BAROLET.5g/kg of this medicinal for two months. Yuan Hua (Flos Daphnes Genkwae). The research on Gan Cao concurs that this medicinal is generally safe when used in small amounts as an envoy.Chapter 4 152 • Herb Toxicities & Drug Interactions: A Formula Approach Bai Zhu (Rhizoma Atractylodis Macrocephalae) Standard daily dosage: 4. and liver disorders. Fu Zi. AH= AHPA. wolfsbane. Not for long-term use. incompatible with Gan Sui (Radix Euphorbiae Kansui). heart. May increase potassium loss due to diuretics and laxatives. they developed a mild lymphopenia and anemia but suffered no damage to the brain. BR= BRINKER. caution should be exercised to guard against potential toxicity and drug interaction. and Yuan Zhi (Radix Polygalae Tenuifoliae). Symptoms of toxicity include drooling. It is generally combined with Gan Cao (Radix Glycyrhizae Uralensis) and Gan Jiang (dry Rhizoma Zingiberis Officinalis) in decoctions to reduce its toxicity. If taken long-term. C&C= CHAN & CHEUNG. monkshood) Standard daily dosage: 1. or liver.) As a single herb in high doses. hypertension. B&G: According to some traditional sources. Shu Fu Zi. GLW= GAO LU WEN. B&G: Contraindicated during pregnancy. it is contraindicated in diabetes. Possible additive effect to corticosteroids. A very toxic medicinal which can be fatal if ingested in its uncooked form or in an inappropriate dose. It should not be taken long-term or as a single herb during pregnancy. gastric upset.5-15g AH: To be used only under the supervision of an expert qualified in the appropriate use of this substance. F L= FLAWS. Contains glycyrrhetinic acid which could possibly cause a reduction in thyroid activity and basal metabolic rate. it may cause hypertension and/or edema. May be synergistic with insulin in causing hypokalemia and sodium retention.

low blood pressure. including aconitine. GLW= GAO LU WEN . lowered body temperature. and magnesium sulfate. PDR= PHYSICIAN’S DESK REFERENCE . drooling. small doses can be fatal. nausea. and numbness and tingling of the extremities. urinary incontinence. glutamic acid. Tiao Qin (Radix Scutellariae Baicalensis) Standard daily dosage: 6-15g AH: Safe when used appropriately B&G: According to some traditional sources. there may be generalized sweating. Huang Qin is acting as a harmonizing agent to moderate the warmth and acridity of the other ingredients. Highly toxic. Emergency measures include the administration of atropine. reversal chilling of the four limbs. Today. paralysis. C&C= CHAN & CHEUNG. and other highly acidic substances could possibly reduce the therapeutic effect of this medicinal. dilated pupils. counteracts Dan Pi (Cortex Radicis Moutan) and Li Lu (Rhizoma Et Radix Veratri). numbness. sodium bicarbonate. Could possibly reduce the absorption and therapeutic effect of potassium and sodium iodides. More severe symptoms include premature atrial contractions. Huang Qin. there is a burning hot sensation in the mouth and on the tongue. heart palpitations. slowed reaction to light. vomiting. If more severe poisoning. arrhythmia. slow heartbeat.Chapter 4 Toxicities & Drug Interaction • 153 light-headedness. B&G= B ENSKY & GAMBLE. COMMENTS Although this formula includes Huang Qin. agitation. Could possibly cause hyperkalemia when used with potassium-sparing diuretics. AH= AHPA. Chi Shi Zhi (Hallyositum Rubrum) is commonly substituted for Fu Long Gan. C&C: Contains alkaloids. convulsions. and pain which gradually spreads to the four limbs and then to the whole body. blurred vision. nicotinic acid. GLW: If mild poisoning. rapid breathing. especially Fu Zi. BR= BRINKER. F L= FLAWS. restlessness. PDR: Contains nor-diterpene alkaloids. Vitamin C. hydrochloric acid. it is not indicated for the treatment of heat pattern bleeding. and reduced temperature and blood pressure. aluminum hydroxide. dizziness. B&B= BENSKY & BAROLET. vexation. C&C: Contains potassium and glycosides. and circulatory collapse leading to death. a somber white facial complexion. dyspnea. In this case.

GLW= GAO LU WEN. back. PDR= P HYSICIAN’ S DESK REFERENCE . and glycosides. C&C= CHAN & CHEUNG. FL= FLAWS. and a bowstring pulse Contraindications: Pregnancy Western medical indications: Angina pectoris. C&C: Contains alkaloids. magnesium AH= AHPA. and ectopic pregnancy Potential formula toxicities & interactions: B&B: Not for use during pregnancy POTENTIAL MEDICINAL TOXICITIES & INTERACTIONS: Dang Gui (Radix Angelicae Sinensis) Standard daily dosage: 3-15g AH: Do not use during pregnancy. May exaggerate the anticoagulative effect of warfarin (Coumadin). frees the flow of the network vessels and stops pain Chinese medical indications: Qi stagnation and blood stasis in the network vessels causing pain in various locations. B&G= B ENSKY & GAMBLE . incompatible with Li Lu (Rhizoma Et Radix Veratri). potassium. Dang Shen (Radix Codonopsitis Pilosulae) Standard daily dosage: 9-30g AH: Safe when used appropriately B&G: According to some traditional sources. B&B= BENSKY & BAROLET. aluminum hydroxide. abdomen. cerebral thrombosis. such as the heart. sciatica. stomach. C&C: Contains potassium. purplish tongue or possible static macules or speckles. Could possibly cause hyperkalemia when used with potassium-sparing diuretics. pelvic inflammatory disease. BR= BRINKER. Could possibly reduce the absorption and therapeutic effect of potassium and sodium iodides.) B&G: Use with caution in patients with diarrhea or abdominal distention. bruising and swelling due to traumatic injury. a dark. arthritis. Could possibly cause hyperkalemia when used with potassium-sparing diuretics.Chapter 4 154 • Herb Toxicities & Drug Interactions: A Formula Approach HUO LUO XIAO LING DAN (Network Vessel Quickening Miraculously Effective Elixir) Category: Blood-quickening Functions: Quickens the blood and dispels stasis. sodium bicarbonate. or arms and legs. traumatic injury. (This medicinal is routinely used in Chinese medical gynecology during pregnancy as part of formulas appropriately prescribed on the basis of pattern discrimination.

C&C= CHAN & CHEUNG. glutamic acid. Vitamin C. hydrochloric acid. F L= FLAWS. B&B= BENSKY & BAROLET. When taken in decoction.Chapter 4 Toxicities & Drug Interaction • 155 sulfate. Ru Xiang and Mo Yao often cause indigestion. frankincense) Standard daily dosage: 3-9g B&G: Contraindicated during pregnancy Mo Yao (Resina Myrrhae. In that case. GLW= GAO LU WEN . myrrh) Standard daily dose: 3-12g B&G: Contraindicated during pregnancy and in patients with excessive uterine bleeding. AH= AHPA. COMMENTS This formula is most commonly administered as a ready-made medicine. Ru Xiang (Resina Olibani. B&G= B ENSKY & GAMBLE. and other highly acidic substances could possibly reduce the therapeutic effect of this medicinal. it is often administered with other formulas designed to treat the root. This side effect is commonly avoided when these medicinals are taken in pill form and the pills are taken with meals. PDR= PHYSICIAN’S DESK REFERENCE . BR= BRINKER. PDR: Not for use during pregnancy. while this formula treats the tip or branch of blood stasis having entered the network vessels. nicotinic acid.

B&G: Contraindicated during pregnancy. B&G= BENSKY & GAMBLE. PDR= PHYSICIAN’S DESK REFERENCE . in debilitated patients with diarrhea. qi. a.Chapter 4 156 • Herb Toxicities & Drug Interactions: A Formula Approach JI CHUAN JIAN (Flow of the River Brew. and blood vacuity complicated by qi stagnation Contraindication: Replete heat constipation Western medical indications: Atonic constipation. Could possibly cause hyperkalemia when used with potassium-sparing diuretics.a. degenerative joint disease. F L= FLAWS. C&C: Contains potassium. and in patients with excessive menstruation. May exaggerate the anticoagulative effect of warfarin (Coumadin). B&B= BENSKY & BAROLET. Contraindicated in menorrhagia. and glycosides. Niu Xi. C&C: Contains alkaloids. According to some traditional sources. moistens the intestines.) B&G: Use with caution in patients with diarrhea or abdominal distention. should not be used with Bai Qian (Radix Et Rhizoma Cynanchi Baiqian). GLW= GAO L U WEN . chronic arthritis Potential formula toxicities & interactions: None listed POTENTIAL MEDICINAL TOXICITIES & INTERACTIONS: Rou Cong Rong. Could possibly cause AH= AHPA. potassium. and frees the flow of the stools Chinese medical indications: Chronic constipation due to yang. C&C= CHAN & CHEUNG.k. BR= BRINKER. Huai Niu Xi. Cong Rong (Herba Cistanchis Deserticolae Seu Salsae) Standard daily dosage: 9-21g AH: Safe when used appropriately Dang Gui (Radix Angelicae Sinensis) Standard daily dosage: 3-15g AH: Do not use during pregnancy. (This medicinal is routinely used in Chinese medical gynecology during pregnancy as part of formulas appropriately prescribed on the basis of pattern discrimination. Tu Niu Xi (Radix Achyranthis Bidentatae) Standard daily dosage: 9-15g AH: Not to be used during pregnancy. Ferry Brew. Benefit the River [Flow] Decoction) Category: Draining and precipitating Functions: Warms the kidneys.

Chapter 4 Toxicities & Drug Interaction • 157

hyperkalemia when used with potassium-sparing diuretics. Could possibly reduce the absorption and therapeutic effect of potassium and sodium iodides, sodium bicarbonate, aluminum hydroxide, and magnesium sulfate. Vitamin C, nicotinic acid, glutamic acid, hydrochloric acid, and other highly acidic substances will reduce the therapeutic effect of this medicinal.

Ze Xie
(Rhizoma Alismatis Orientalis) Standard daily dosage: 6-15g AH: Prolonged use may cause gastrointestinal irritation. B&G: Although considered safe, prolonged usage may irritate the intestinal tract and could possibly cause gastroenteritis. C&C: Contains alkaloids and potassium. Could possibly cause hyperkalemia when used with potassium-sparing diuretics and reduce the absorption and therapeutic effect of potassium and sodium iodides, sodium bicarbonate, aluminum hydroxide, magnesium sulfate. PDR: Contains triterpenes, sesquiterpenes, flavone sulfate, and caffeic acid derivatives. No health hazards or side effects with proper administration of designated therapeutic dosages.

Zhi Ke, Zhi Qiao
(Fructus Citri Aurantii, bitter orange) Standard daily dose: 3-9g AH: Safe when used appropriately B&G: Use with caution during pregnancy. C&C: Contains tannic acid. Highly acidic. Could possibly cause crystalluria and hematuria. Could possibly reduce the absorption and biologic effect of most antibiotics, isoniazid, chlorpromazine, calcium carbonate and gluconate, atropine, ephedrine, quinine, reserpine, digitalis, vitamin B1, trypsine, amylase, and pepsin, sodium bicarbonate, aluminum hydroxide, caffeine, opiates, scopolamine, and berbamin. PDR: May cause UV-sensitivity in light-skinned individuals. Otherwise no health hazards are known in conjunction with the proper administration of designated therapeutic dosages.

Sheng Ma
(Rhizoma Cimicifugae, black cohosh) Standard daily dosage: 1.5-9g AH: Not to be used during pregnancy. (This medicinal is commonly used during pregnancy in China.) Not to be used while nursing. B&G: Contraindicated in cases of fully erupted measles and in patients
AH= AHPA, B&B= BENSKY & BAROLET, B&G= BENSKY & GAMBLE, BR= BRINKER, C&C= CHAN & CHEUNG, F L= FLAWS, GLW= GAO L U WEN , PDR= PHYSICIAN’S DESK REFERENCE

Chapter 4 158 • Herb Toxicities & Drug Interactions: A Formula Approach

with breathing difficulties. Overdose causes headaches, dizziness, vomiting, tremors, gastroenteritis, and pathogenic erections. C&C: Vitamin C, nicotinic acid, glutamic acid, hydrochloric acid, and other highly acidic substances could possibly reduce the therapeutic effect of this medicinal. PDR: Not for use during pregnancy due to an increased risk of spontaneous abortion. Contains glycosides which may potentiate the effect of antihypertensive medications and result in hypotension.

COMMENTS
While this formula does nourish the blood and moisten the intestines, it also frees the flow of the stools by rectifying the qi and invigorating yang. Only if the intestines are steamed and warmed by lifegate fire can their qi function correctly. Therefore, this formula is quite different from Run Chang Wan (Moisten the Intestines Pills) and Ma Zi Ren Wan (Cannabis Seed Pills) which also moisten the intestines.

AH= AHPA, B&B= BENSKY & BAROLET, B&G= B ENSKY & GAMBLE, BR= BRINKER, C&C= CHAN & CHEUNG, F L= FLAWS, GLW= GAO LU WEN , PDR= PHYSICIAN’S DESK REFERENCE

Chapter 4 Toxicities & Drug Interaction • 159

JIN GUI SHEN QI WAN (Golden Cabinet Kidney Qi Pills, a.k.a. Ba Wei Wan, Eight Flavors Pills)
Category: Yang-supplementing Functions: Warms and supplements kidney yang Chinese medical indications: Kidney yang vacuity with low back and knee soreness and limpness, tinnitus, dizziness, deafness, possible edema, a cold sensation in the lower half of the body, lower abdominal tension, polyuria, nocturia, a pale, swollen tongue with thin, white, moist fur, and a deep, weak pulse Contraindications: Yin vacuity without yang vacuity Western medical indications: Nephritis, nephrosclerosis, kidney stones, renal tuberculosis, pyelitis, albuminuria, edema, cystitis, chronic urethritis, prostatic hypertrophy, urinary inconti nence, primary hyperaldosteronism, Addison’s disease, hypothyroidism, postpartum urinary retention, arthritis, diabetes, cerebral hemorrhage, hyper/hypotension, spermatorrhea, impotence, lumbago, sciatica, glaucoma, keratitis, senile pruritus, vaginal itching, urticaria, chronic gonorrhea, rectal prolapse, menopausal complaints, and chronic bronchial asthma Potential formula toxicities & interactions: FL: Do not use in patients with chronic gastrointestinal weakness and diarrhea.

POTENTIAL MEDICINAL TOXICITIES & I NTERACTIONS:
Shu Di, Shu Di Huang
(cooked Radix Rehmanniae Glutinosae) Standard daily dosage: 9-30g AH: Contraindicated in patients with diarrhea or indigestion B&G: Overuse can lead to abdominal distention and loose stools. Side effects include diarrhea, abdominal pain, dizziness, lethargy, and heart palpitations which often disappear upon continued administration of the herb. PDR: No health risks or side effects are known in conjunction with the proper administration of designated therapeutic dosages.

AH= AHPA, B&B= BENSKY & BAROLET, B&G= B ENSKY & GAMBLE, BR= BRINKER, C&C= CHAN & CHEUNG, F L= FLAWS, GLW= GAO LU WEN , PDR= PHYSICIAN’S DESK REFERENCE

Chapter 4 160 • Herb Toxicities & Drug Interactions: A Formula Approach

Shan Zhu Yu, Shan Zhu Rou
(Fructus Corni Officinalis) Standard daily dosage: 3-60g AH: Contraindicated in patients with difficult or painful urination B&G: Contraindicated in patients with difficult or painful urination. According to some traditional sources, antagonizes Jie Geng (Radix Platycodi Grandiflori), Fang Feng (Radix Ledebouriellae Divaricatae), and Fang Ji (Radix Aristolochiae Fangchi). C&C: Contains tannic acid and glycosides. Could possibly reduce the absorption and biologic effect of most antibiotics, isoniazid, chlorpromazine, calcium carbonate and gluconate, atropine, ephedrine, quinine, reserpine, digitalis, vitamin B1, trypsine, amylase, and pepsin. Vitamin C, nicotinic acid, glutamic acid, hydrochloric acid, and other highly acidic substances could possibly reduce the therapeutic effect of this medicinal. PDR: No health hazards are known in conjunction with proper administration of designated therapeutic dosages.

Shan Yao
(Radix Dioscoreae Oppositae) Standard daily dosage: 9-30g AH: Safe when used appropriately B&G: According to some traditional sources, antagonizes Gan Sui (Radix Euphorbiae Kansui). C&C: Contains alkaloids, potassium, amylase, and glycosides. Could possibly cause hyperkalemia when used with potassium-sparing diuretics. Could possibly reduce the absorption and therapeutic effect of potassium and sodium iodides, sodium bicarbonate, aluminum hydroxide, magnesium sulfate, tetracyclines, sulphanomides, and aspirin. Vitamin C, nicotinic acid, glutamic acid, hydrochloric acid, and other highly acidic substances could possibly reduce the therapeutic effect of this medicinal. PDR: Use of this medicinal may reduce the antiinflammatory effect of indomethacin. May have an additive estrogenic effect when administered with estrogen-containing drugs. Poisoning in overdosages may occur from the picrotoxin-like effect of dioscorin.

Fu Zi, Shu Fu Zi, Fu Pian
(Radix Lateralis Praeparatus Aconiti Carmichaeli, wolfsbane, monkshood) Standard daily dosage: 1.5-15g AH: To be used only under the supervision of an expert qualified in the appropriate use of this substance
AH= AHPA, B&B= BENSKY & BAROLET, B&G= B ENSKY & GAMBLE, BR= BRINKER, C&C= CHAN & CHEUNG, F L= FLAWS, GLW= GAO LU WEN , PDR= PHYSICIAN’S DESK REFERENCE

Chapter 4 Toxicities & Drug Interaction • 161

B&G: Contraindicated during pregnancy. A very toxic medicinal which can be fatal if ingested in its uncooked form or in an inappropriate dose. It is generally combined with Gan Cao (Radix Glycyrhizae Uralensis) and Gan Jiang (dry Rhizoma Zingiberis Officinalis) in decoctions to reduce its toxicity. Symptoms of toxicity include drooling, gastric upset, light-headedness, blurred vision, and numbness and tingling of the extremities. More severe symptoms include premature atrial contractions, dyspnea, and reduced temperature and blood pressure. Emergency measures include the administration of atropine. C&C: Contains alkaloids. Could possibly reduce the absorption and therapeutic effect of potassium and sodium iodides, sodium bicarbonate, aluminum hydroxide, and magnesium sulfate. PDR: Contains nor-diterpene alkaloids, including aconitine. Highly toxic; small doses can be fatal. GLW: If mild poisoning, there is a burning hot sensation in the mouth and on the tongue, numbness, and pain which gradually spreads to the four limbs and then to the whole body, nausea, vomiting, dizziness, heart palpitations, rapid breathing, vexation, agitation, restlessness, drooling. If more severe poisoning, there may be generalized sweating, paralysis, convulsions, urinary incontinence, dilated pupils, slowed reaction to light, slow heartbeat, arrhythmia, low blood pressure, a somber white facial complexion, reversal chilling of the four limbs, lowered body temperature, and circulatory collapse leading to death.

Gui Zhi
(Ramulus Cinnamomi Cassiae, cinnamon twigs) Standard daily dosage: 3-15g AH: Safe when used appropriately B&G: Use with caution in the presence of fever, during pregnancy, or during excessive menstruation. PDR: Contraindicated during pregnancy.

Ze Xie
(Rhizoma Alismatis Orientalis) Standard daily dosage: 6-15g AH: Prolonged use may cause gastrointestinal irritation. B&G: Although considered safe, prolonged usage may irritate the intestinal tract and Could possibly cause gastroenteritis. C&C: Contains alkaloids and potassium. Could possibly cause hyperkalemia when used with potassium-sparing diuretics and reduce the absorption and therapeutic effect of potassium and sodium iodides, sodium bicarbonate, aluminum hydroxide, magnesium sulfate.
AH= AHPA, B&B= BENSKY & BAROLET, B&G= B ENSKY & GAMBLE, BR= BRINKER, C&C= CHAN & CHEUNG, F L= FLAWS, GLW= GAO LU WEN, PDR= PHYSICIAN’S DESK REFERENCE

Chapter 4 162 • Herb Toxicities & Drug Interactions: A Formula Approach

PDR: Contains triterpenes, sesquiterpenes, flavone sulfate, and caffeic acid derivatives. No health hazards or side effects with proper administration of designated therapeutic dosages.

Fu Ling, Bai Fu Ling, Yun Ling
(Sclerotium Poriae Cocos) Standard daily dosage: 9-15g B&G: Large doses or long-term use is discouraged. Contraindicated in patients with frequent, copious urination. According to traditional sources, may counteract Di Yu (Radix Sanguisorbae Officinalis), Qin Jiao (Radix Gentianae Qinjiao), and Bie Jia (Carapax Amydae Sinensis). C&C: Contains potassium. Could possibly cause hyperkalemia when used with potassium-sparing diuretics.

Dan Pi, Mu Dan Pi
(Cortex Radicis Moutan, tree peony root bark) Standard daily dosage: 6-12g AH: Not to be used during pregnancy.(This ingredient is commonly used in China during pregnancy to treat heat in the blood and/or blood stasis.) B&G: Should not be used during pregnancy or in patients with excessive sweating or menstruation. Avoid using with garlic. According to some traditional sources, may counteract the effect of Tu Si Zi (Semen Cuscutae Chinensis), Bei Mu (Bulbus Fritillariae), and Da Huang (Radix Et Rhizoma Rhei). C&C: Contains tannic acid, potassium, and glycosides. Could possibly cause hyperkalemia when used with potassium-sparing diuretics. Could possibly reduce the absorption and biologic effect of most antibiotics, isoniazid, chlorpromazine, calcium carbonate and gluconate, atropine, ephedrine, quinine, reserpine, digitalis, vitamin B1, trypsine, amylase, and pepsin. Vitamin C, nicotinic acid, glutamic acid, hydrochloric acid, and other highly acidic substances could possibly reduce the therapeutic effect of this medicinal.

COMMENTS
This is the form of this formula found originally in the Jin Gui Yao Lue (Essentials [W rth] A Thousand [Pieces of] Gold). Today, the more como mon version substitutes Rou Gui (Cortex Cinnamomi Cassiae) for Gui Zhi. Because of the interdependence of the spleen and kidneys, this formula must commonly be modified by the addition of more spleen-supplements or this formula combined with a spleen-supplementing one.
AH= AHPA, B&B= BENSKY & BAROLET, B&G= B ENSKY & GAMBLE, BR= BRINKER, C&C= CHAN & CHEUNG, F L= FLAWS, GLW= GAO LU WEN , PDR= PHYSICIAN’S DESK REFERENCE

Chapter 4 Toxicities & Drug Interaction • 163

JU HE WAN (Tangerine Seed Pills)
Category: Qi-rectifying Functions: Moves the qi and stops pain, softens the hard and dissipates binding Chinese medical indications: Damp cold invading the liver channel with unilateral testicular swelling, colicky pain possibly reaching to the umbilicus, rock-like hardness and swelling of the scrotum, oozing of yellow fluid from the scrotum Contraindications: None listed Western medical indications: Hydrocoele, orchitis, epididymitis Potential formula toxicities & interactions: None listed

POTENTIAL MEDICINAL TOXICITIES & I NTERACTIONS:
Ju He
(Semen Citri Reticulate) Standard daily dosage: 3-9g No toxicity or interaction information listed in the sources

Chuan Lian Zi, Jin Ling Zi
(Fructus Meliae Toosendan) Standard daily dosage: 3-9g AH: Safe when used appropriately GLW: Symptoms of adverse reaction include abdominal distention, abdominal pain, vomiting, diarrhea, poor appetite, dizziness, headache, a red facial complexion, blurred vision, inhibited speech, uneasy respiration, epistaxis, hemorrhage of the liver, kidney, and/or intestines, mania and agitation, convulsions, numbness of the four extremities, heart arrhythmia, shrunken pupils. Poisoning can lead to toxic hepatitis and red blood cells in the urine. In grave conditions, there may be atrial fibrillation, frequent premature beats, and atrioventricular conduction block, low blood pressure, syncope, shock, and even death.

Mu Xiang
(Radix Aucklandiae Lappae) Standard daily dosage: 1.5-9g
AH= AHPA, B&B= BENSKY & BAROLET, B&G= BENSKY & GAMBLE, BR= BRINKER, C&C= CHAN & CHEUNG, F L= FLAWS, GLW= GAO L U WEN , PDR= PHYSICIAN’S DESK REFERENCE

Chapter 4 164 • Herb Toxicities & Drug Interactions: A Formula Approach

AH: Safe when used appropriately PDR: No health risks or side effects are known in conjunction with the proper administration of designated therapeutic dosages.

Tao Ren
(Semen Pruni Persicae, peach kernel) Standard daily dosage: 4.5-9g B&G: Contraindicated during pregnancy. C&C: Contains potassium and glycosides (including cyanophoric glycosides). If taken with codeine, morphine, or other opiates, hydrocyanic acid is produced which can lead to respiratory failure and death. Could possibly cause hyperkalemia when used with potassium-sparing diuretics. Vitamin C, nicotinic acid, glutamic acid, hydrochloric acid, and other highly acidic substances could possibly reduce the therapeutic effect of this medicinal. GLW: In case of poisoning, typically, 1-2 hours after ingestion, there is a bitter taste and astringent feeling within the mouth, drooling, headache, dizziness, nausea, vomiting accompanied by watery diarrhea, heart palpitations, and lack of strength. In more serious cases, there is difficulty breathing. Sometimes one can smell cyanide on the person’s breath. Eventually, breathing becomes weak, consciousness becomes unclear, and the pupils of the eye dilate widely with loss of reactivity to light. The teeth become clenched, blood pressure drops, there are generalized convulsions, and respiratory paralysis leads to death. Most of the toxins in this medicinal reside in the skin and tip. Therefore, this medicinal is blanched before using and its tip is broken off in order to make it less or non-toxic.

Yan Hu Suo, Yan Hu, Yuan Hu, Yuan Hu Suo, Xuan Hu, Xuan Hu Suo
(Rhizoma Corydalis Yanhusuo) Standard daily dosage: 4.5-12g AH: Not to be used during pregnancy. B&G: Contraindicated during pregnancy. LD50 in mice varies from 125.3g/kg to 36.6g/kg depending upon preparation and purity. C&C: Contains alkaloids. Highly alkaline. Toxic when taken with some antibiotics (aminoglycosides) and quinidine. Could possibly cause hyperkalemia when taken with potassium-sparing diuretics and reduce the absorption and therapeutic effect of most antibiotics, potassium and sodium iodides, sodium bicarbonate, aluminum hydroxide, and magnesium sulfate.
AH= AHPA, B&B= BENSKY & BAROLET, B&G= BENSKY & GAMBLE, BR= BRINKER, C&C= CHAN & CHEUNG, F L= FLAWS, GLW= GAO L U WEN , PDR= PHYSICIAN’S DESK REFERENCE

Rou Gui. abdominal distention.5g AH: Not to be used during pregnancy. it is important that this medicinal only be prescribed in the form of Caulis Akebiae Trifoliatae or Akebiae Quinatae. abdominal pain. FL= FLAWS. Gui Xin. In those with acute kidney failure. amylase.Chapter 4 Toxicities & Drug Interaction • 165 PDR: Overdose may result in clonic spasms with muscle tremor. Could possibly cause dehydration and renal failure in large doses. Mu Tong (Caulis Akebiae) Standard daily dosage: 3-9g B&G: Contraindicated during pregnancy. difficulty breathing. Could possibly reduce the absorption and biologic effect of most antibiotics. fright reversal. C&C= CHAN & CHEUNG. BR: Reduces absorption of tetracyclines B&G: Use with caution during pregnancy. digitalis. isoniazid.5-4. PDR= PHYSICIAN’ S DESK REFERENCE . C&C: Contains tannic acid and potassium. B&G= B ENSKY & GAMBLE. scanty urination or blocked urination. B&B= BENSKY & BAROLET. calcium carbonate and gluconate. vitamin B1. atropine. AH= AHPA. Therefore. and diarrhea. lack of strength in the four limbs. BR= BRINKER. ephedrine. This medicinal is often substituted with Caulis Aristolochiae Manchuriensis which contains aristolochic acid. Could possibly cause hyperkalemia when used with potassium-sparing diuretics. and increased blood pressure. Prolonged ingestion may cause elevations in SGPT and drug-induced fever. Ingestion of 60-120g per time may cause a somber white facial complexion. inability to lie down. Some patients present oily stools. convulsions. GLW: Symptoms of adverse reaction include dizziness. unclear consciousness. and respiratory failure. due to saponin content. somnolence. shock. there is frequent urination. Large doses of the medicinal may lead to gastroenteritis. uremia leads to death. chest oppression. PDR: Not to be administered during pregnancy. Secondarily. GLW: Early stage symptoms of poisoning include upper abdominal discomfort. vomiting. trypsine. quinine. if severe. Guan Gui (Cortex Cinnamomi Cassiae. cinnamon bark) Standard daily dosage: 1. urgent urination. C&C: Contains potassium. and. reserpine. decreased heart strength. chlorpromazine. Could possibly cause hyperkalemia when used with potassium-sparing diuretics. GLW= GAO LU WEN. facial edema which gradually spreads to the entire body. intestinal colic and diarrhea. low blood pressure. and pepsin.

trypsine.5-15g C&C: Contains potassium. and pepsin. PDR: No health risks or side effects are known in conjunction with the proper administration of designated therapeutic dosages. isoniazid. especially for the treatment of nausea and vomiting. trypsine. scopolamine. and pepsin. antagonizes Ze Xie (Rhizoma Alismatis Orientalis) and Han Shui Shi (Calcitum).Chapter 4 166 • Herb Toxicities & Drug Interactions: A Formula Approach Hou Po. atropine. atropine. C&C: Contains tannic acid and potassium. calcium carbonate and gluconate. opiates. Chuan Po (Cortex Magnoliae Officinalis) Standard daily dosage: 3-9g AH: Not to be used during pregnancy (This medicinal is commonly used in China during pregnancy. Could possibly cause hyperkalemia when used with potassium-sparing diuretics.5-15g B&G: According to traditional sources. vitamin B 1.) B&G: Use with caution during pregnancy. amylase. isoniazid. reserpine. According to some traditional sources. Could possibly cause hyperkalemia when used with potassium-sparing diuretics. B&G= B ENSKY & GAMBLE. aluminum hydroxide. C&C= CHAN & CHEUNG. Zhi Shi (Fructus Immaturus Citri Aurantii. F L= FLAWS. digitalis. B&B= BENSKY & BAROLET. quinine. BR= BRINKER. amylase. ephedrine. reserpine. Could possibly cause hyperkalemia when used with potassium-sparing diuretics and reduce the absorption and biologic effect of most antibiotics. caffeine. Highly acidic. chlorpromazine. Hai Zao (Herba Sargassii) Standard daily dosage: 4. PDR= P HYSICIAN’S DESK REFERENCE . quinine. ephedrine. vitamin B1. incompatible with Gan Cao (Radix Glycerrhizae Uralensis). C&C: Contains potassium. calcium carbonate and gluconate. Could possibly cause crystalluria and hematuria and reduce the absorption and biologic effect of most antibiotics. digitalis. reserpine. sodium bicarbonate. Kun Bu (Thallus Algae) Standard daily dosage: 4. and berbamin. GLW= GAO LU WEN. AH= AHPA. chlorpromazine. C&C: Contains tannic acid. immature bitter orange) Standard daily dosage: 3-9 B&G: Use with caution during pregnancy or in debilitated patients.

BR= BRINKER. Chinese or otherwise. PDR= PHYSICIAN’S DESK REFERENCE . this is a surgical condition which cannot be cured by the internal administration of medicinals. B&G= BENSKY & GAMBLE. AH= AHPA.Chapter 4 Toxicities & Drug Interaction • 167 Hai Dai (Thallus Laminariae) Standard daily dosage: 6-9g PDR: No health risks or side effects are known in conjunction with the proper administration of designated therapeutic dosages. F L= FLAWS. GLW= GAO L U WEN . B&B= BENSKY & BAROLET. COMMENTS Although this formula can eliminate the discomfort of inguinal hernia and may arrest the progression of this disorder. C&C= CHAN & CHEUNG.

nausea. dry heaves.k. a.5-9g C&C: Contains potassium. B&B= BENSKY & BAROLET. C&C= CHAN & CHEUNG. Overdose can lead to AH= AHPA. Aurantium & Bamboo Combination) Category: Qi-rectifying Functions: Downbears counterflow and stops hiccup. Could possibly cause hyperkalemia when used with potassium-sparing diuretics. May cause hypertension if consumed with caffeine. Possible additive effects to insulin. Ju Pi. Ren Shen (Radix Panacis Ginseng. Could possibly cause hyperkalemia when used with potassium-sparing diuretics. morning sickness. F L= FLAWS.a. red tongue and a rapid. B&G= B ENSKY & GAMBLE. chronic gastric diseases. nausea and vomiting. B&G: Contraindicated for hypertensive patients.Chapter 4 168• Herb Toxicities & Drug Interactions: A Formula Approach JU PI ZHU RU TANG (Tangerine Peel & Bamboo Shavings Decoction. Zhu Rhu (Caulis Bambusae In Taeniis. BR= BRINKER. or retching accompanied by a tender. forceless pulse Contraindications: Replete heat or vacuity cold Western medical indications: Hiccup. tangerine peel) Standard daily dosage: 3-9g AH: Safe when used appropriately C&C: Contains potassium. Ju Hong (Pericarpium Citri Reticulatae. postsurgical persistent hiccup. boosts the qi and clears heat Chinese medical indications: Stomach heat and disharmony resulting in hiccup. bamboo shavings) Standard daily dosage: 4. GLW= GAO LU WEN . ginseng) Standard daily dosage: 1-30g AH: Contraindicated in hypertension BR: May cause manic episodes in patients on MAO-inhibitors. May reduce the anticoagulative effect of warfarin (Coumadin). and incomplete pyloric obstruction Potential formula toxicities & interactions: None listed POTENTIAL MEDICINAL TOXICITIES & INTERACTIONS: Chen Pi. PDR= PHYSICIAN’S DESK REFERENCE .

Possible additive effect to corticosteroids.Chapter 4 Toxicities & Drug Interaction • 169 headache. Not for long-term use. tremors. A traditional antidote is mung bean soup. B&G: According to some traditional sources. it may cause hypertension and/or edema. Gan Cao (Radix Glycyrrhizae Uralensis. GLW= GAO L U WEN. and manias. incompatible with Gan Sui (Radix Euphorbiae Kansui). C&C: Vitamin C. Use with MAO-inhibitors may cause headaches. insomnia. BR: May increase toxicity of cardiac glycosides. PDR: Contraindicated in patients with hypertension. and liver disorders. PDR= P HYSICIAN’S DESK REFERENCE . hydrochloric acid. B&G= BENSKY & GAMBLE. Yuan Hua (Flos Daphnes Genkwae). heart palpitations. glutamic acid. (This medicinal is routinely used in Chinese medical gynecology during pregnancy as part of formulas appropriately prescribed on the basis of pattern discrimination. C&C= CHAN & CHEUNG. May be synergistic with insulin in causing hypokalemia and sodium retention. Increases absorption of oral drugs. and Yuan Zhi (Radix Polygalae Tenuifoliae). Avoid larger doses if being used to treat morning sickness or if used in patients taking anticoagulants. F L= FLAWS. BR= BRINKER. The research on Gan Cao concurs that this medicinal is generally safe when used in small amounts as an envoy. It should not be taken long-term or as a single herb during pregnancy. When used as a single medicinal or AH= AHPA. fresh ginger) Standard daily dose: 3-9g AH: Safe when used appropriately BR: Reduces vomiting caused by chemotherapeutic drugs. Contains glycyrrhetinic acid which could possibly cause a reduction in thyroid activity and basal metabolic rate.) As a single herb in high doses. nicotinic acid. Sheng Jiang (uncooked Rhizoma Zingiberis Officinalis. PDR: Recommended safe dosage limit is six grams (6g). Enhances the effect of insulin and other antidiabetic agents. licorice root) Standard daily dosage: 2-12g AH: Do not use during pregnancy. Not recommended in large doses during pregnancy or lactation due to potential neonatal androgenization. May increase potassium loss due to diuretics and laxatives. it is contraindicated in diabetes. If taken long-term. hypertension. and other highly acidic substances could possibly reduce the therapeutic effect of this medicinal. and a rise in blood pressure. B&B= BENSKY & BAROLET.

GLW= GAO LU WEN.Chapter 4 170 • Herb Toxicities & Drug Interactions: A Formula Approach in patients taking other potent Western pharmaceuticals. COMMENTS This formula is commonly used for the treatment of nausea and vomiting during pregnancy when there is a combination of liver-spleen-stomach disharmony with some depressive heat. BR= BRINKER. C&C= CHAN & CHEUNG. caution should be exercised to guard against potential toxicity and drug interaction. Da Zao. B&G= B ENSKY & GAMBLE. B&B= BENSKY & BAROLET. F L= FLAWS. PDR= P HYSICIAN’S DESK REFERENCE . AH= AHPA. red dates) Standard daily dosage: 10-30g (3-12 pieces) AH: Safe when used appropriately PDR: No health risks or side effects are known in conjunction with the proper administration of designated therapeutic dosages. Hong Zao (Fructus Zizyphi Jujubae.

B&B= BENSKY & BAROLET. and a soggy. BR= BRINKER.Chapter 4 Toxicities & Drug Interaction • 171 JUAN BI TANG (Assuage Impediment Decoction. AH= AHPA. High dosages may cause nausea and vomiting. and upper back. numbness in the extremities. white tongue fur. shoulder. B&G= B ENSKY & GAMBLE . C&C= CHAN & CHEUNG.5-12g AH: Safe when used appropriately. or diarrhea. LD50 in mice is 480mg/kg. gouty arthritis. The authors have never seen this reaction when this medicinal is used in the dosage ranges commonly employed in Chinese medicine.k. difficulty moving. a. B&G: Contraindicated in cases with frequent urination. stiff neck. and bursitis Potential formula toxicities & interactions: None listed POTENTIAL MEDICINAL TOXICITIES & I NTERACTIONS: Qiang Huo (Rhizoma Seu Radix Notopterygii) Standard daily dosage: 6-15g AH: Safe when used appropriately Du Huo (Radix Angelicae Pubescentis) Standard daily dosage: 3-9g AH: Patients should avoid prolonged exposure to sunlight. Impediment-alleviating Decoction. GLW= GAO LU WEN. F L= FLAWS. assuages impediment Chinese medical indications: Wind damp cold impediment complicated by qi and blood vacuity with generalized heaviness of the body. supplements the qi and nourishes the blood. PDR= P HYSICIAN’S DESK REFERENCE . Chianghuo & Turmeric Combination) Category: Dampness-dispelling Functions: Dispels wind and eliminates dampness.a. rheumatoid arthritis. moderate pulse Contraindications: Wind damp heat impediment Western medical indications: Osteoarthritis. chronic pain with emaciation.) Qin Jiao (Radix Gentianae Qinjiao) Standard daily dosage: 4. High doses may cause nausea and vomiting.

hypertension. C&C: Contains potassium. antagonizes Shan Zhu Yu (Fructus Corni Officinalis) and Huang Qi (Radix Astragali Membranacei). B&G= B ENSKY & GAMBLE. sodium bicarbonate. Could possibly cause hyperkalemia when used with potassium-sparing diuretics. it is not uncommon for this medicinal to be prescribed up to 15 grams per day in decoction. FL= FLAWS.) AH: Do not use during pregnancy.Chapter 4 172 • Herb Toxicities & Drug Interactions: A Formula Approach Sang Zhi (Ramulus Mori Albi. (This medicinal is routinely used in Chinese medical gynecology during pregnancy as part of formulas appropriately prescribed on the basis of pattern discrimination. According to some traditional texts.) B&G: Not for patients with migraine headache or excessive menstrual bleeding. B&B= BENSKY & BAROLET. BR= BRINKER. Not for long-term use. Hai Feng Teng (Caulis Piperis Futokadsurae) Standard daily dosage: 6-15g No toxicity or interaction information listed in the sources Dang Gui (Radix Angelicae Sinensis) Standard daily dosage: 3-15g AH: Do not use during pregnancy. AH= AHPA. Could possibly cause hyperkalemia when used with potassium-sparing diuretics. C&C: Contains alkaloids and potassium. PDR= PHYSICIAN’ S DESK REFERENCE . and magnesium sulfate. and liver disorders. Could possibly reduce the absorption and therapeutic effect of potassium and sodium iodides. and is incompatible with Li Lu (Rhizoma Et Radix Veratri). As a single herb in high doses. counteracts Hua Shi (Talcum) and Huang Lian (Rhizoma Coptidis Chinensis). Chuan Xiong (Radix Ligustici Wallichii) Standard daily dosage: 3-9g(In China today.) B&G: Use with caution in patients with diarrhea or abdominal distention. aluminum hydroxide. C&C= CHAN & CHEUNG. GLW= GAO LU WEN. mulberry twigs) Standard daily dosage: 10-30g AH: Not to be used during pregnancy. it is contraindicated in diabetes. May exaggerate the anticoagulative effect of warfarin (Coumadin). Overdosage causes vomiting and dizziness. (This medicinal is routinely used in Chinese medical gynecology during pregnancy as part of formulas appropriately prescribed on the basis of pattern discrimination.

May increase potassium loss due to diuretics and laxatives. reserpine.) As a single herb in high doses. Could possibly cause hyperkalemia when used with potassium-sparing diuretics. F L= FLAWS. BR= BRINKER. GLW= GAO L U WEN . it may cause hypertension and/or edema.5g AH: Not to be used during pregnancy BR: Reduces absorption of tetracyclines B&G: Use with caution during pregnancy C&C: Contains tannic acid and potassium. quinine. frankincense) Standard daily dosage: 3-9g B&G: Contraindicated during pregnancy Mu Xiang (Radix Aucklandiae Lappae) Standard daily dosage: 1. isoniazid. Not for long-term use. ephedrine. B&G= BENSKY & GAMBLE. Contains glycyrrhetinic acid which AH= AHPA. calcium carbonate and gluconate. Gui Xin. Possible additive effect to corticosteroids. May be synergistic with insulin in causing hypokalemia and sodium retention.5-4. and Yuan Zhi (Radix Polygalae Tenuifoliae).Chapter 4 Toxicities & Drug Interaction • 173 Ru Xiang (Resina Olibani.5-9g AH: Safe when used appropriately PDR: No health risks or side effects are known in conjunction with the proper administration of designated therapeutic dosages. (This medicinal is routinely used in Chinese medical gynecology during pregnancy as part of formulas appropriately prescribed on the basis of pattern discrimination. and liver disorders. digitalis. cinnamon bark) Standard daily dosage: 1. trypsine. amylase. B&B= BENSKY & BAROLET. it is contraindicated in diabetes. Rou Gui. Yuan Hua (Flos Daphnes Genkwae). hypertension. vitamin B1. atropine. incompatible with Gan Sui (Radix Euphorbiae Kansui). C&C= CHAN & CHEUNG. Could possibly reduce the absorption and biologic effect of most antibiotics. B&G: According to some traditional sources. BR: May increase toxicity of cardiac glycosides. and pepsin. If taken long-term. chlorpromazine. PDR= PHYSICIAN’S DESK REFERENCE . Guan Gui (Cortex Cinnamomi Cassiae. Gan Cao (Radix Glycyrrhizae Uralensis. licorice root) Standard daily dosage: 2-12g AH: Do not use during pregnancy.

B&G= B ENSKY & GAMBLE. However. B&B= BENSKY & BAROLET. it does address concomitant blood stasis in the network vessels. When used as a single medicinal or in patients taking other potent Western pharmaceuticals. FL= FLAWS. PDR= PHYSICIAN’ S DESK REFERENCE .Chapter 4 174 • Herb Toxicities & Drug Interactions: A Formula Approach could possibly cause a reduction in thyroid activity and basal metabolic rate. GLW= GAO LU WEN. COMMENTS Unlike Du Huo Ji Sheng Wan (Angelica Pubescens & Loranthus Pills). C&C= CHAN & CHEUNG. B R= BRINKER. AH= AHPA. It should not be taken longterm or as a single herb during pregnancy. The research on Gan Cao concurs that this medicinal is generally safe when used in small amounts as an envoy. this formula does not address a concomitant liver-kidney vacuity nor a spleen qi vacuity. caution should be exercised to guard against potential toxicity and drug interaction.

Patients with gallstones should consult a practitioner prior to use. F L= FLAWS.Chapter 4 Toxicities & Drug Interaction • 175 LI ZHONG WAN (Rectify the Center Pills) Category: Interior-warming Functions: Warms the center and dispels cold. irritable bowel syndrome. and anemia Potential formula toxicities & interactions: None listed POTENTIAL MEDICINAL TOXICITIES & INTERACTIONS: Gan Jiang (dry Rhizoma Zingiberis Officinalis. angina pectoris. chronic colitis. torpid intake. insomnia. glutamic acid. a pale tongue with white fur. heart palpitations. insidious abdominal pain and discomfort. ginseng) Standard daily dosage: 1-30g AH: Contraindicated in hypertension BR: May cause manic episodes in patients on MAO-inhibitors. functional uterine bleeding. Possible additive effects to insulin. nausea and vomiting. GLW= GAO LU WEN. bloody stools due to gastroduodenal ulcer. and AH= AHPA. nicotinic acid. BR= BRINKER. May cause hypertension if consumed with caffeine. oral herpes. fine pulse Contraindications: Externally contracted conditions with fever or yin vacuity Western medical indications: Acute and chronic gastritis. hydrochloric acid. chronic bronchitis. C&C: Vitamin C. C&C= CHAN & CHEUNG. and a rise in blood pressure. and a deep. cholera-like disorders. May reduce the anticoagulative effect of warfarin (Coumadin). watery stools. A traditional antidote is mung bean soup. B&B= BENSKY & BAROLET. B&G= B ENSKY & GAMBLE . dry ginger) Standard daily dosage: 3-12g AH: Not to be used during pregnancy. fortifies the spleen and supplements the qi Chinese medical indications: Spleen-stomach yang vacuity with diarrhea. gastric or duodenal ulcers. PDR= P HYSICIAN’S DESK REFERENCE . Ren Shen (Radix Panacis Ginseng. Overdose can lead to headache. B&G: Use with caution during pregnancy. B&G: Contraindicated for hypertensive patients.

PDR: Contraindicated in patients with hypertension. Enhances the effect of insulin and other antidiabetic agents. incompatible with Gan Sui (Radix Euphorbiae Kansui). Not recommended in large doses during pregnancy or lactation due to potential neonatal androgenization. The research on Gan Cao concurs that this medicinal is generally safe when used in small amounts as an envoy. it is contraindicated in diabetes. or liver. B&G= B ENSKY & GAMBLE. However. It should not be taken long-term or as a single herb during pregnancy. BR: May increase toxicity of cardiac glycosides. If taken long-term. F L= FLAWS. B&B= BENSKY & BAROLET. AH= AHPA. Bai Zhu (Rhizoma Atractylodis Macrocephalae) Standard daily dosage: 4. Use with MAO-inhibitors may cause headaches. they developed a mild lymphopenia and anemia but suffered no damage to the brain. and liver disorders. it is not that commonly used in Western clinical practice. hypertension.5g/kg of this medicinal for two months.5-9g AH: Safe when used appropriately B&G: When rats were fed 0. Yuan Hua (Flos Daphnes Genkwae). heart. and manias. Not for long-term use. PDR= PHYSICIAN’S DESK REFERENCE .) As a single herb in high doses. caution should be exercised to guard against potential toxicity and drug interaction. it may cause hypertension and/or edema. B&G: According to some traditional sources. COMMENTS Dang Shen (Radix Codonopsitis Pilosulae) is commonly substituted for Ren Shen in this formula. May increase potassium loss due to diuretics and laxatives. (This medicinal is routinely used in Chinese medical gynecology during pregnancy as part of formulas appropriately prescribed on the basis of pattern discrimination.Chapter 4 176 • Herb Toxicities & Drug Interactions: A Formula Approach other highly acidic substances could possibly reduce the therapeutic effect of this medicinal. When used as a single medicinal or in patients taking other potent Western pharmaceuticals. except in pill form and when combined with other formulas. licorice root) Standard daily dosage: 2-12g AH: Do not use during pregnancy. Contains glycyrrhetinic acid which could possibly cause a reduction in thyroid activity and basal metabolic rate. tremors. C&C= CHAN & CHEUNG. Possible additive effect to corticosteroids. Gan Cao (Radix Glycyrrhizae Uralensis. and Yuan Zhi (Radix Polygalae Tenuifoliae). May be synergistic with insulin in causing hypokalemia and sodium retention. GLW= GAO LU WEN . BR= BRINKER.

dizziness. and a fine. According to some traditional sources. urinary tract infection. failure to thrive. rapid pulse Contraindications: Spleen qi vacuity with dampness Western medical indications: Neurasthenia. PDR= P HYSICIAN’ S DESK REFERENCE . and heart palpitations which often disappear upon continued administration of the herb. diabetes mellitus.Chapter 4 Toxicities & Drug Interaction • 177 LIU WEI DI HUANG WAN (Six Flavors Rehmannia Pills. nocturia. FL= FLAWS. Shu Di Huang (cooked Radix Rehmanniae Glutinosae) Standard daily dosage: 9-30g AH: Contraindicated in patients with diarrhea or indigestion B&G: Overuse can lead to abdominal distention and loose stools. night sweats. hypertension. Side effects include diarrhea. a.a. antagonizes Jie Geng (Radix Platycodi Grandiflori). low back and knee soreness and limpness. chronic nephritis. chronic glomerulonephritis. Shan Zhu Rou (Fructus Corni Officinalis) Standard daily dosage: 3-60g AH: Contraindicated in patients with difficult or painful urination B&G: Contraindicated in patients with difficult or painful urination. abdominal pain. functional uterine bleeding. optic nerve atrophy. GLW= GAO LU WEN. Rehmannia Six Formula) Category: Yin-supplementing Functions: Enriches the yin and nourishes the kidneys Chinese medical indications: Kidney yin vacuity with dizziness. B&B= BENSKY & BAROLET. Shan Zhu Yu. and central retinitis Potential formula toxicities & interactions: FL/B&B: This formula should be used with caution in patients with indigestion or diarrhea. POTENTIAL MEDICINAL TOXICITIES & I NTERACTIONS: Shu Di.k. hyperthyroidism. AH= AHPA. B&G= B ENSKY & GAMBLE . tinnitus. Fang Feng (Radix Ledebouriellae Divaricatae). lethargy. BR= BRINKER. C&C= CHAN & CHEUNG. a red tongue with scanty fur. PDR: No health risks or side effects are known in conjunction with the proper administration of designated therapeutic dosages. decrease in auditory acuity. optic neuritis. pulmonary tuberculosis. and Fang Ji (Radix Aristolochiae Fangchi).

aluminum hydroxide. copious urination. Shan Yao (Radix Dioscoreae Oppositae) Standard daily dosage: 9-30g AH: Safe when used appropriately B&G: According to some traditional sources. AH= AHPA. antagonizes Gan Sui (Radix Euphorbiae Kansui). digitalis. According to traditional sources. Qin Jiao (Radix Gentianae Qinjiao). hydrochloric acid. sodium bicarbonate. amylase. Could possibly cause hyperkalemia when used with potassium-sparing diuretics. ephedrine. chlorpromazine. atropine. vitamin B 1. and Bie Jia (Carapax Amydae Sinensis). potassium. and aspirin. Could possibly reduce the absorption and therapeutic effect of potassium and sodium iodides. Vitamin C. Contraindicated in patients with frequent. C&C: Contains alkaloids. magnesium sulfate. and other highly acidic substances could possibly reduce the therapeutic effect of this medicinal. PDR: No health hazards are known in conjunction with proper administration of designated therapeutic dosages. F L= FLAWS. PDR: Use of this medicinal may reduce the antiinflammatory effect of indomethacin. Could possibly reduce the absorption and biologic effect of most antibiotics. Vitamin C. nicotinic acid. Poisoning in overdosages may occur from the picrotoxin-like effect of dioscorin. tetracyclines. quinine. May have an additive estrogenic effect when administered with estrogen-containing drugs. and glycosides. B&G= B ENSKY & GAMBLE. C&C: Contains potassium. BR= BRINKER. Fu Ling. Bai Fu Ling. sulphanomides. hydrochloric acid. may counteract Di Yu (Radix Sanguisorbae Officinalis). and pepsin. nicotinic acid. trypsine. isoniazid. Yun Ling (Sclerotium Poriae Cocos) Standard daily dosage: 9-15g B&G: Large doses or long-term use is discouraged. PDR= P HYSICIAN’S DESK REFERENCE . Could possibly cause hyperkalemia when used with potassium-sparing diuretics. GLW= GAO LU WEN. C&C= CHAN & CHEUNG. B&B= BENSKY & BAROLET. glutamic acid. amylase. calcium carbonate and gluconate. glutamic acid. reserpine.Chapter 4 178 • Herb Toxicities & Drug Interactions: A Formula Approach C&C: Contains tannic acid and glycosides. and other highly acidic substances could possibly reduce the therapeutic effect of this medicinal.

B&B= BENSKY & BAROLET. chlorpromazine. sodium bicarbonate. when taken in pill form. C&C: Contains alkaloids and potassium. and Da Huang (Radix Et Rhizoma Rhei). aluminum hydroxide. digitalis.(This ingredient is commonly used in China during pregnancy to treat heat in the blood and/or blood stasis. glutamic acid. may counteract the effect of Tu Si Zi (Semen Cuscutae Chinensis). and pepsin. it is commonly combined with other formulas. and other highly acidic substances could possibly reduce the therapeutic effect of this medicinal. C&C: Contains tannic acid. AH= AHPA. and it is often modified extensively when taken in decoction. amylase. atropine. this formula is not commonly indicated in its simple. Vitamin C. Mu Dan Pi (Cortex Radicis Moutan. COMMENTS As with many other famous formulas. magnesium sulfate. However. and Shan Yao. B&G: Although considered safe. prolonged usage may irritate the intestinal tract and could possibly cause gastroenteritis. Could possibly reduce the absorption and biologic effect of most antibiotics. flavone sulfate. Shan Zhu Yu. Could possibly cause hyperkalemia when used with potassium-sparing diuretics. Chinese doctors still say the patient is taking the base of this formula as long as their prescription contains as few of its ingredients as Shu Di. isoniazid.) B&G: Should not be used during pregnancy or in patients with excessive sweating or profuse menstruation. Ze Xie (Rhizoma Alismatis Orientalis) Standard daily dosage: 6-15g AH: Prolonged use may cause gastrointestinal irritation. nicotinic acid. Could possibly cause hyperkalemia when used with potassium-sparing diuretics and reduce the absorption and therapeutic effect of potassium and sodium iodides. potassium. hydrochloric acid. GLW= GAO LU WEN . sesquiterpenes. Bei Mu (Bulbus Fritillariae). vitamin B1. textbook form. In fact. PDR= PHYSICIAN’S DESK REFERENCE . BR= BRINKER. reserpine. Avoid using with garlic. B&G= BENSKY & GAMBLE. quinine. C&C= CHAN & CHEUNG. and caffeic acid derivatives. tree peony root bark) Standard daily dosage: 6-12g AH: Not to be used during pregnancy. calcium carbonate and gluconate.Chapter 4 Toxicities & Drug Interaction • 179 Dan Pi. No health hazards or side effects with proper administration of designated therapeutic dosages. PDR: Contains triterpenes. ephedrine. F L= FLAWS. and glycosides. According to some traditional sources. trypsine.

Huang Qin. Tiao Qin (Radix Scutellariae Baicalensis) Standard daily dosage: 6-15g AH: Safe when used appropriately B&G: According to some traditional sources. B&B= BENSKY & BAROLET. painful eyes. BR= BRINKER. a. headache. and other highly acidic substances could possibly reduce the therapeutic effect of this medicinal. a bitter taste in the mouth. ear infections. PDR= PHYSICIAN’S DESK REFERENCE . forceful pulse Contraindications: Spleen vacuity or damaged fluids Western medical indications: Acute cholecystitis. hydrochloric acid. GLW= GAO LU WEN .a. and a bowstring. male and female genital infections (prostatitis.Chapter 4 180 • Herb Toxicities & Drug Interactions: A Formula Approach LONG DAN XIE GAN TANG (Gentiana Drain the Liver Decoction. epididymitis. acute icteric hepatitis. vaginitis. herpes infections. Vitamin C. pain and swelling in the ears. acute cystitis and urethritis. a red tongue with yellow fur. B&G= B ENSKY & GAMBLE. glutamic acid. hypertension. migraine headache. vaginal itching. easy anger. C&C= CHAN & CHEUNG. clears lower burner damp heat Chinese medical indications: Replete heat in the liver and gallbladder channels with rib-side pain. pyelonephritis. POTENTIAL MEDICINAL TOXICITIES & I NTERACTIONS: Long Dan Cao (Radix Gentianae Longdancao) Standard daily dosage: 3-9g AH: Safe when used appropriately B&G: Contraindicated in patients with diarrhea C&C: Contains glycosides. rapid. and intercostal neuralgia Potential formula toxicities & interactions: FL/B&B: Not to be used in large doses or for long periods of time in patients with digestive weakness. eczema. nicotinic acid. red. pelvic inflammatory disease). F L= FLAWS. AH= AHPA. dizziness. hearing loss. counteracts Dan Pi (Cortex Radicis Moutan) and Li Lu (Rhizoma Et Radix Veratri). eye infections. Gentiana Combination) Category: Heat-clearing and dampness-eliminating Functions: Drains liver-gallbladder replete heat. orchitis.k.

unclear consciousness. and increased blood pressure. Mu Tong (Caulis Akebiae) Standard daily dosage: 3-9g B&G: Contraindicated during pregnancy. C&C= CHAN & CHEUNG. scanty urination or blocked urination. Vitamin C. Zhi Zi. Large doses of the medicinal may lead to gastroenteritis. C&C: Contains potassium. Some patients present oily stools. nicotinic acid. and other highly acidic substances could possibly reduce the therapeutic effect of this medicinal. dried gardenia fruit pod) Standard daily dosage: 3-12g AH: Safe when used appropriately B&G: Contains geniposide which caused diarrhea in mice. and diarrhea due to saponin content. GLW: Early stage symptoms of poisoning include upper abdominal discomfort. Therefore. facial edema which gradually spreads to the entire body. hydrochloric acid. uremia leads to death. Che Qian Zi. glutamic acid. Shan Zhi Zi (Fructus Gardeniae Jasminoidis.Chapter 4 Toxicities & Drug Interaction • 181 C&C: Contains potassium and glycosides. In those with acute kidney failure. inability to lie down. nicotinic acid. Secondarily. Could possibly cause hyperkalemia when used with potassium-sparing diuretics. Vitamin C. there is frequent urination. and other highly acidic substances could possibly reduce the therapeutic effect of this medicinal. hydrochloric acid. This medicinal is often substituted with Caulis Aristolochiae Manchuriensis which contains aristolochic acid. BR= BRINKER. B&B= BENSKY & BAROLET. urgent urination. GLW= GAO L U WEN . chest oppression. abdominal pain. it is important that this medicinal only be prescribed in the form of Caulis Akebiae Trifoliatae or Akebiae Quinatae. C&C: Contains potassium and glycosides. PDR: Not to be administered during pregnancy. glutamic acid. intestinal colic. Could possibly cause dehydration and renal failure in large doses. Could possibly cause hyperkalemia when used with potassium-sparing diuretics. PDR= PHYSICIAN’S DESK REFERENCE . plantain seeds) Standard daily dosage: 4. and diarrhea. vomiting.5-9g B&G: Contraindicated during pregnancy AH= AHPA. Could possibly cause hyperkalemia when used with potassium-sparing diuretics. Shan Zhi. F L= FLAWS. Che Qian Ren (Semen Plantaginis. B&G= BENSKY & GAMBLE.

Highly acidic. caffeic acid derivatives. GLW= GAO LU WEN . hydrochloric acid. and magnesium sulfate. hydrochloric acid. PDR= PHYSICIAN’S DESK REFERENCE . BR= BRINKER. Could possibly cause crystalluria and hematuria and reduce the therapeutic effect of sodium bicarbonate. in which case the dose should then be reduced significantly. Could possibly cause hyperkalemia when used with potassium-sparing diuretics and reduce the absorption and therapeutic effect of potassium and sodium iodides. flavone sulfate. F L= FLAWS. B&G: Although considered safe. PDR: Not to be administered during pregnancy. prolonged usage may irritate the intestinal tract and could possibly cause gastroenteritis. sodium bicarbonate. aluminum hydroxide. glutamic acid. scopolamine. intestinal colic. B&B= BENSKY & BAROLET.Chapter 4 182 • Herb Toxicities & Drug Interactions: A Formula Approach C&C: Contains glycosides. and berbamin. B&G= B ENSKY & GAMBLE. reserpine. (This medicinal is routinely used in Chinese medical gynecology during pregnancy as part of formulas appropriately prescribed on the basis of pattern discrimination. glutamic acid. sesquiterpenes. caffeine. PDR: Contains triterpenes. and diarrhea due to saponin content. C&C: Contains alkaloids and potassium. and other highly acidic substances could possibly reduce the therapeutic effect of this medicinal. opiates. No health hazards or side effects with proper administration of designated therapeutic dosages. Sheng Di Huang (uncooked Radix Rehmanniae Glutinosae) Standard daily dosage: 9-30g AH: Contraindicated in patients with diarrhea or lack of appetite B&G: Contraindicated in pregnant women with anemias or digestive weakness AH= AHPA.) Overdose may lead to gastroenteritis. and other highly acidic substances could possibly reduce the therapeutic effect of this medicinal. nicotinic acid. many antibiotics (especially aminoglycosides and sulfas). nicotinic acid. C&C= CHAN & CHEUNG. Sheng Di. C&C: Vitamin C. Vitamin C. aluminum hydroxide. Chai Hu (Radix Bupleuri) Standard daily dosage: 3-12g AH: Safe when used appropriately B&G: May occasionally cause nausea and vomiting. Ze Xie (Rhizoma Alismatis Orientalis) Standard daily dosage: 6-15g AH: Prolonged use may cause gastrointestinal irritation.

Dang Gui (Radix Angelicae Sinensis) Standard daily dosage: 3-15g AH: Do not use during pregnancy. Gan Cao (Radix Glycyrrhizae Uralensis. and Yuan Zhi (Radix Polygalae Tenuifoliae). BR: May increase toxicity of cardiac glycosides. Contains glycyrrhetinic acid which Could possibly cause a reduction in thyroid activity and basal metabolic rate. B&G: According to some traditional sources.Chapter 4 Toxicities & Drug Interaction • 183 C&C: Contains potassium. F L= FLAWS. Yuan Hua (Flos Daphnes Genkwae). GLW= GAO LU WEN. C&C= CHAN & CHEUNG. and few Western patients are solely replete. The research on Gan Cao concurs that this medicinal is generally safe when used in small amounts as an envoy.) As a single herb in high doses. BR= BRINKER. incompatible with Gan Sui (Radix Euphorbiae Kansui). AH= AHPA. When used as a single medicinal or in patients taking other potent Western pharmaceuticals. B&G= B ENSKY & GAMBLE. PDR= PHYSICIAN’S DESK REFERENCE . Not for long-term use. (This medicinal is routinely used in Chinese medical gynecology during pregnancy as part of formulas appropriately prescribed on the basis of pattern discrimination. hypertension. May increase potassium loss due to diuretics and laxatives. COMMENTS This formula tends to be overprescribed in the West. licorice root) Standard daily dosage: 2-12g AH: Do not use during pregnancy. C&C: Contains potassium.) B&G: Use with caution in patients with diarrhea or abdominal distention. It is indicated for solely replete conditions. Possible additive effect to corticosteroids. PDR: No health risks or side effects are known in conjunction with the proper administration of designated therapeutic dosages. If taken long-term. it may cause hypertension and/or edema. B&B= BENSKY & BAROLET. It should not be taken long-term or as a single herb during pregnancy. caution should be exercised to guard against potential toxicity and drug interaction. (This medicinal is routinely used in Chinese medical gynecology during pregnancy as part of formulas appropriately prescribed on the basis of pattern discrimination. and liver disorders. Could possibly cause hyperkalemia when used with potassium-sparing diuretics. it is contraindicated in diabetes. Could possibly cause hyperkalemia when used with potassium-sparing diuretics. May be synergistic with insulin in causing hypokalemia and sodium retention. May exaggerate the anticoagulative effect of warfarin (Coumadin).

Chapter 4 184 • Herb Toxicities & Drug Interactions: A Formula Approach Some practitioners employ this formula nevertheless on the basis of “in acute [conditions]. B&B= BENSKY & BAROLET. PDR= PHYSICIAN’ S DESK REFERENCE . B&G= B ENSKY & GAMBLE. treat the tip [or branch]. BR= BRINKER. C&C= CHAN & CHEUNG. FL= FLAWS. AH= AHPA.” administering this formula for only a couple of days or so until the heat evils have been cleared. this formula may cause diarrhea due to its bitter. Even so. GLW= GAO LU WEN. cold nature.

GLW= GAO LU WEN . wheezing and panting. pneumonia. thin. May cause arrhythmias if used in conjunction with cardiac glycosides. Antagonized by reserpine. It enhances digitalis. tight or bowstring pulse Contraindications: Vacuity weakness Western medical indications: Common cold. F L= FLAWS. POTENTIAL MEDICINAL TOXICITIES & INTERACTIONS: Ma Huang (Herba Ephedrae. cough. no sweating. white tongue fur. stuffy nose Potential formula toxicities & interactions: B&B: Contraindicated in patients with copious urination and those prone to nosebleeds. typhoid fever. ephedra) Standard daily dosage: 3-9g AH: Not to be used during pregnancy. B&B= BENSKY & BAROLET. bronchitis. It should only be prescribed by a properly trained practitioner and should not be given longterm or during pregnancy. rhinitis. Use with caution in patients with hypertension. AH= AHPA. a. generalized body aches. asthma. antagonizes barbiturates. and increases the effects of adrenergic agonists. therefore. BR: Increases thermogenesis when combined with methylxanthines in theophylline and caffeine.a. must be administered with care.Chapter 4 Toxicities & Drug Interaction • 185 MA HUANG TANG (Ephedra Decoction. aversion to wind. Contraindicated in anorexia. As little as 15ml in a 1% solution may be toxic to some individuals. May induce toxicity with MAO-inhibitors. Antidote for poisoning is atropine. and glaucoma. All research sources concur that Ma Huang is a very powerful herb with many potential side effects and interactions and. Ma-huang Combination) Standard daily dosage: 3-9g Category: Exterior-resolving Functions: Out-thrusts sweat and resolves the exterior. B&G: May raise blood pressure and cause tremors. May reduce the effect of dexamethasone. measles. headache. C&C= CHAN & CHEUNG.k. Amytriptiline blocks its hypertensive effect. Not for long-term use. and a floating. bulimia. B&G= B ENSKY & GAMBLE. BR= BRINKER. diffuses the lungs and levels panting Chinese medical indications: Wind cold external contraction with fever. PDR= PHYSICIAN’S DESK REFERENCE .

If critical. cinnamon twigs) Standard daily dosage: 3-15g AH: Safe when used appropriately B&G: Use with caution in the presence of fever. tinnitus. hydrochloric acid. Ku Xing Ren (Semen Pruni Armenicae. upper abdominal discomfort. Xing Ren. there may be respiratory failure and death. syncope. glutamic acid. PDR= P HYSICIAN’S DESK REFERENCE . GLW: In the case of poisoning. sweating. nausea. vomiting. and precordial pain. Graver reactions include difficulty urinating. C&C: Contains potassium and glycosides (including cyanophoric glycoside). C&C= CHAN & CHEUNG. agitation. B&G= B ENSKY & GAMBLE. 1-2 hours after ingestion there is a bitter taste and astringent feeling within the mouth. dilated pupils. Could possibly cause hyperkalemia when used with potassium-sparing diuretics. such as vexation. dizziness. The U. increased blood pressure. morphine.S. insomnia. Contains amygdalin and amygdalase which break down to hydrocyanic acid in the digestive tract. and headache which can progress to dyspnea. Eating this medicinal uncooked or in large quantities could possibly cause dizziness. FDA has banned the inclusion of this medicinal in all dietary supplements. during pregnancy. typically. B&B= BENSKY & BAROLET. there are central nervous and sympathetic nervous system symptoms. unclear vision. shock. and coma.Chapter 4 186 • Herb Toxicities & Drug Interactions: A Formula Approach GLW: Initially after poisoning. hydrocyanic acid is produced which can lead to respiratory failure and death. drooling. nausea. GLW= GAO L U WEN. If taken with codeine. difficulty breathing. shortness of breath. Vitamin C. extreme nerve reactivity. spasms. apricot kernel) Standard daily dosage: 3-9g AH: To be used only under the supervision of an expert qualified in the appropriate use of this substance B&G: Use with caution when treating infants or patients with diarrhea. children 10 kernels. AH= AHPA. Lethal dosage in adults is 50-60 uncooked kernels. arrhythmias. or other opiates. fright reversal. and other highly acidic substances will reduce the therapeutic effect of this medicinal. F L= FLAWS. activated charcoal and syrup of ipecac should be administered orally. vomiting. BR= BRINKER. headache. In the event of overdosage. PDR: Contraindicated during pregnancy. or during excessive menstruation. and restlessness. heart palpitations. dry mouth. nicotinic acid. dilated pupils. Gui Zhi (Ramulus Cinnamomi Cassiae.

licorice root) Standard daily dosage: 2-12g AH: Do not use during pregnancy. nausea. breathing becomes weak. B&B= BENSKY & BAROLET. The research on Gan Cao concurs that this medicinal is generally safe when used in small amounts as an envoy. and Yuan Zhi (Radix Polygalae Tenuifoliae). (This medicinal is routinely used in Chinese medical gynecology during pregnancy as part of formulas appropriately prescribed on the basis of pattern discrimination. Yuan Hua (Flos Daphnes Genkwae). consciousness becomes unclear. and respiratory paralysis leads to death. incompatible with Gan Sui (Radix Euphorbiae Kansui). When used in Chinese medicine. Possible additive effect to corticosteroids. F L= FLAWS. B&G: According to some traditional sources. Contains glycyrrhetinic acid which could possibly cause a reduction in thyroid activity and basal metabolic rate. In more serious cases. BR: May increase toxicity of cardiac glycosides. there are generalized convulsions. Not for long-term use. caution should be exercised to guard against potential toxicity and drug interaction. there is difficulty breathing. this formula is rarely appropriate for Western patients. it is contraindicated in diabetes. blood pressure drops. and liver disorders. The teeth become clenched. the kernels are blanched to remove the skin and the tips are broken off. dizziness. vomiting accompanied by watery diarrhea. B&G= BENSKY & GAMBLE. and lack of strength. PDR= PHYSICIAN’S DESK REFERENCE . COMMENTS Except for the treatment of acute wind cold asthma. Eventually. When used as a single medicinal or in patients taking other potent Western pharmaceuticals. and the pupils of the eye dilate widely with loss of reactivity to light. Gan Cao (Radix Glycyrrhizae Uralensis.) As a single herb in high doses. AH= AHPA. May increase potassium loss due to diuretics and laxatives. C&C= CHAN & CHEUNG. Sometimes one can smell cyanide on the person’s breath. it may cause hypertension and/or edema. May be synergistic with insulin in causing hypokalemia and sodium retention. hypertension. GLW= GAO L U WEN . The maximum concentration of toxins in this medicinal are in the skin and the tip. heart palpitations. It should not be taken long-term or as a single herb during pregnancy. If taken long-term.Chapter 4 Toxicities & Drug Interaction • 187 headache. BR= BRINKER.

It enhances digitalis. thirst. bronchiolitis. Amytriptiline blocks its hypertensive effect. measlescaused pneumonitis. difficulty breathing. must be administered with care. GLW= GAO LU WEN . BR= BRINKER. Contraindicated in anorexia. Gypsum & Licorice Decoction. B&G= B ENSKY & GAMBLE. C&C= CHAN & CHEUNG. yellow tongue fur. bulimia. As little as 15ml in a 1% solution may be toxic to some individuals. May reduce the effect of dexamethazone. Antagonized by reserpine. there are central nervous and sympathetAH= AHPA. rapid pulse Contraindications: Cold panting or qi vacuity enduring cough Western medical indications: Respiratory tract infection. a. Ma-huang & Apricot Seed Combination) Category: Heat-clearing Functions: Clears heat and diffuses the lungs. panting and wheezing. and a slippery. B&G: May raise blood pressure and cause tremors. F L= FLAWS. downbears counterflow and levels panting Chinese medical indications: Lung heat with fever with or without sweating. antagonizes barbiturates. Apricot Kernel. PDR= PHYSICIAN’S DESK REFERENCE . and diphtheria Potential formula toxicities & interactions: None listed POTENTIAL MEDICINAL TOXICITIES & I NTERACTIONS: Ma Huang (Herba Ephedrae. GLW: Initially after poisoning. bronchial pneumonia. cough.Chapter 4 188 • Herb Toxicities & Drug Interactions: A Formula Approach MA XING SHI GAN TANG (Ephedra. It should only be prescribed by a properly trained practitioner and should not be given longterm or during pregnancy. ephedra) Standard daily dosage: 3-9g AH: Not to be used during pregnancy. pertussis. BR: Increases thermogenesis when combined with methylxanthines in theophylline and caffeine. and increases the effects of adrenergic agonists. nasal flaring with breathing. Antidote for poisoning is atropine. B&B= BENSKY & BAROLET. All research sources concur that Ma Huang is a very powerful herb with many potential side effects and interactions and. bronchial asthma. lobar pneumonia. therefore.a. May cause arrhythmias if used in conjunction with cardiac glycosides.k. and glaucoma. May induce toxicity with MAO-inhibitors. Not for long-term use.

C&C: Contains calcium.S. The U. syncope. there may be respiratory failure and death. dilated pupils. B&G: Use with caution when treating infants or patients with diarrhea. and restlessness. Ku Xing Ren (Semen Pruni Armenicae. heart palpitations. AH= AHPA. unclear vision. Xing Ren. hydrocyanic acid is produced which can lead to respiratory failure and death. BR= BRINKER. shortness of breath. C&C= CHAN & CHEUNG. nicotinic acid. shock. If taken with codeine. Eating this medicinal uncooked or in large quantities Could possibly cause dizziness. dilated pupils. sweating. Shi Gao (Gypsum Fibrosum) Standard daily dosage: 9-30g B&G: Could possibly cause gastric upset in some patients. dizziness. Lethal dosage in adults is 50-60 uncooked kernels. vomiting. nausea. B&G= B ENSKY & GAMBLE . and headache. fright reversal. GLW: In case of poisoning. glutamic acid. upper abdominal discomfort. children 10 kernels. nausea. headache. morphine. arrhythmias. and precordial pain. drooling. increased blood pressure. Could possibly reduce the effect of most antibiotics and levadopa. Vitamin C. C&C: Contains potassium and glycosides (including cyanophoric glycoside).Chapter 4 Toxicities & Drug Interaction • 189 ic nervous system symptoms. extreme nerve reactivity. FDA has banned the inclusion of this medicinal in all dietary supplements. agitation. GLW= GAO LU WEN. dry mouth. In the event of overdosage. tinnitus. apricot kernel) Standard daily dosage: 3-9g AH: To be used only under the supervision of an expert qualified in the appropriate use of this substance. or other opiates. activated charcoal and syrup of ipecac should be administered orally. difficulty breathing. and coma. spasms. Graver reactions include difficulty urinating. insomnia. B&B= BENSKY & BAROLET. and hinder the absorption of isoniazid. FL= FLAWS. such as vexation. typically. hydrochloric acid. cause digitalis intoxication and heart arrhythmias. Could possibly cause hyperkalemia when used with potassium-sparing diuretics. and other highly acidic substances could possibly reduce the therapeutic effect of this medicinal. PDR= P HYSICIAN’ S DESK REFERENCE . 1-2 hours after ingestion there is a bitter taste and astringent feeling within the mouth. which can progress to dyspnea. vomiting. Contains amygdalin and amygdalase which break down to hydrocyanic acid in the digestive tract. If critical.

PDR= PHYSICIAN’S DESK REFERENCE . Eventually. COMMENTS Unlike the preceding formula. consciousness becomes unclear. AH= AHPA. and liver disorders. caution should be exercised to guard against potential toxicity and drug interaction. heart palpitations. B&B= BENSKY & BAROLET.Chapter 4 190 • Herb Toxicities & Drug Interactions: A Formula Approach headache. and Yuan Zhi (Radix Polygalae Tenuifoliae). and the pupils of the eye dilate widely with loss of reactivity to light. In more serious cases. The research on Gan Cao concurs that this medicinal is generally safe when used in small amounts as an envoy. Yuan Hua (Flos Daphnes Genkwae). B&G: According to some traditional sources. Not for long-term use. GLW= GAO L U WEN . The maximum concentration of toxins in this medicinal are in the skin and the tip. May increase potassium loss due to diuretics and laxatives. The teeth become clenched. nausea. F L= FLAWS. licorice root) Standard daily dosage: 2-12g AH: Do not use during pregnancy. Gan Cao (Radix Glycyrrhizae Uralensis. breathing becomes weak. When used in Chinese medicine. When used as a single medicinal or in patients taking other potent Western pharmaceuticals. C&C= CHAN & CHEUNG. blood pressure drops. there is difficulty breathing. Contains glycyrrhetinic acid which could possibly cause a reduction in thyroid activity and basal metabolic rate. dizziness. If taken long-term. the kernels are blanched to remove the skin and the tips are broken off. incompatible with Gan Sui (Radix Euphorbiae Kansui). there are generalized convulsions. B&G= BENSKY & GAMBLE. BR= BRINKER. Besides wind heat asthma. and respiratory paralysis leads to death.) As a single herb in high doses. May be synergistic with insulin in causing hypokalemia and sodium retention. vomiting accompanied by watery diarrhea. it may cause hypertension and/or edema. it is contraindicated in diabetes. hypertension. and lack of strength. (This medicinal is routinely used in Chinese medical gynecology during pregnancy as part of formulas appropriately prescribed on the basis of pattern discrimination. Sometimes one can smell cyanide on the person’s breath. it also treats heat pattern pneumonia and bronchitis. BR: May increase toxicity of cardiac glycosides. Possible additive effect to corticosteroids. this one is more useful in clinical practice. It should not be taken long-term or as a single herb during pregnancy.

PDR: No health risks or side effects are known in conjunction with the proper administration of designated therapeutic dosages. numbness of the extremities. choppy pulse Contraindications: Blood vacuity constipation. profound vacuity weakness. and symptomatic therapy. hard. Could possibly reduce the absorption and therapeutic effect of potassium and sodium iodides. Apricot Seed & Linum Formula) Category: Draining and precipitating Functions: Moistens the intestines and discharges heat. C&C= CHAN & CHEUNG. frequent urination. Bai Shao. B&B= BENSKY & BAROLET.Chapter 4 Toxicities & Drug Interaction • 191 MA ZI REN WAN (Cannabis Seed Pills. GLW= GAO LU WEN. aluminum hydroxide. moves the qi and frees the flow of the stools Chinese medical indications: Heat-induced fluid damage of the intestines and stomach with constipation. or pregnancy Western medical indications: Constipation in the elderly or the weak.a. miosis. According AH= AHPA. cannabis seeds. Shao Yao (Radix Albus Paeoniae Lactiflorae. a. and in severe cases coma and death. diarrhea. FL= FLAWS. rapid or floating. BR= BRINKER.k. chorea. chronic colitis. C&C: Contains alkaloids. PDR= P HYSICIAN’ S DESK REFERENCE . yellow tongue fur. dry. white peony root) Standard daily dosage: 6-30g AH: Safe when used appropriately B&G: Use with caution in debilitated patients with diarrhea. vomiting. and a deep. fluids. habitual constipation. marijuana seeds) Standard daily dosage: 9-45g B&G: Symptoms of overdose may include nausea. Treatment is based on gastric lavage. dry stools. irritability. sodium bicarbonate. hemorrhoids Potential formula toxicities & interactions: FL/B&B: Prohibited during pregnancy B&B: Use caution when treating weak or debilitated patients POTENTIAL MEDICINAL TOXICITIES & INTERACTIONS: Huo Ma Ren (Semen Cannabis Sativae. B&G= B ENSKY & GAMBLE . postpartum or postsurgical constipation. and magnesium sulfate.

atropine. Could possibly cause hyperkalemia when used with potassium-sparing diuretics. opiates. menstruation. trypsine. vitamin B1. Dai Huang. isoniazid. C&C= CHAN & CHEUNG. vitamin B 1. quinine. trypsine. tannic acid. abdominal pain of unknown origin. glutamic acid. AH= AHPA. potassium. nicotinic acid. BR: Reduces absorption of oral drugs. and other highly acidic substances could possibly reduce the therapeutic effect of this medicinal. Could possibly cause crystalluria and hematuria and reduce the absorption and biologic effect of most antibiotics. cause digitalis intoxication and heart arrhythmias.Chapter 4 192 • Herb Toxicities & Drug Interactions: A Formula Approach to some traditional sources. quinine. atropine. GLW= GAO L U WEN . immature bitter orange) Standard daily dosage: 3-9g B&G: Use with caution during pregnancy or in debilitated patients. chlorpromazine. tannic acid. ephedrine. calcium carbonate and gluconate. amylase. counteracts Bie Jia (Carapax Amydae Sinensis) and Xiao Ji (Herba Cephalanopoloris Segeti). Could possibly cause hyperkalemia when used with potassium-sparing diuretics. C&C: Contains tannic acid. reserpine. Not to be used while nursing. B&B= BENSKY & BAROLET. potassium. C&C: Contains calcium. and pepsin. reserpine. or any inflammatory condition of the intestines. and other highly acidic substances could possibly reduce the therapeutic effect of this medicinal. and glycosides. or postpartum. antagonizes Shi Hu (Herba Dendrobii) and Mang Xiao (Mirabilitum). Contraindicated for nursing mothers since active ingredients enter the milk. and pepsin. chlorpromazine. B&G: Use with extreme caution during pregnancy. F L= FLAWS. caffeine. hydrochloric acid. May aggravate potassium loss from diuretics. amylase. glutamic acid. and could possibly reduce the absorption and therapeutic effect of levadopa. ephedrine. Overuse may cause hypokalemia and increased toxicity of cardiac glycosides. BR= BRINKER. B&G= BENSKY & GAMBLE. Chuan Jun. Could possibly reduce the effect of most antibiotics. digitalis. Zhi Shi (Fructus Immaturus Citri Aurantii. scopolamine. Contraindicated in intestinal obstruction. rhubarb root) Standard daily dosage: 3-12g AH: Do not use during pregnancy. aluminum hydroxide. Da Huang. sodium bicarbonate. Vitamin C. and glycosides. isoniazid. and is incompatible with Li Lu (Rhizoma Et Radix Veratri). hydrochloric acid. and berbamin. Vitamin C. PDR= PHYSICIAN’S DESK REFERENCE . Jun (Radix Et Rhizoma Rhei. C&C: Contains alkaloids. calcium carbonate and gluconate. nicotinic acid. Highly acidic.

acute inflammatory intestinal disease. If taken with codeine. nausea. FL= FLAWS. calcium carbonate and gluconate. PDR= PHYSICIAN’ S DESK REFERENCE . Contraindicated in cases of intestinal obstruction. nicotinic acid. C&C: Contains tannic acid and potassium. hydrocyanic acid is produced which can lead to respiratory failure and death. and headache. digitalis. Hou Po. spasms. hydrochloric acid. Ku Xing Ren (Semen Pruni Armenicae.) B&G: Use with caution during pregnancy. C&C= CHAN & CHEUNG. and pepsin. isoniazid. or other opiates. Could possibly cause hyperkalemia when used with potassium-sparing diuretics. antagonizes Ze Xie (Rhizoma Alismatis Orientalis) and Han Shui Shi (Calcitum). BR= BRINKER. B&G: Use with caution when treating infants or patients with diarrhea. and other highly acidic substances will reduce the therapeutic effect of this medicinal. vitamin B 1. Lethal dosage in adults is 50-60 uncooked kernels. In the advent of overdosage activated charcoal and syrup of ipacec should be administered orally. glutamic acid. apricot kernel) Standard daily dosage: 3-9g AH: To be used only under the supervision of an expert qualified in the appropriate use of this substance. Xing Ren. B&G= B ENSKY & GAMBLE . trypsine. which can progress to dyspnea. morphine. vomiting. Contains amygdalin and amygdalase which break down to hydrocyanic acid in the digestive tract. atropine.Chapter 4 Toxicities & Drug Interaction • 193 PDR: Consult a physician before using this medicinal during pregnancy or while nursing. dilated pupils. ephedrine. C&C: contains potassium and glycosides (including cyanophoric glycoside). appendicitis and abdominal pain of unknown origin. Eating this medicinal uncooked or in large quantities Could possibly cause dizziness. Could possibly cause hyperkalemia when used with potassium-sparing diuretics and reduce the absorption and biologic effect of most antibiotics. GLW= GAO LU WEN. B&B= BENSKY & BAROLET. chlorpromazine. and coma. AH= AHPA. According to some traditional sources. arrhythmias. reserpine. Chuan Po (Cortex Magnoliae Officinalis) Standard daily dosage: 3-9g AH: Not to be used during pregnancy (This medicinal is commonly used in China during pregnancy. children 10 kernels. quinine. PDR: No health risks or side effects are known in conjunction with the proper administration of designated therapeutic dosages. especially for the treatment of nausea and vomiting. Vitamin C. amylase.

typically. GLW= GAO LU WEN . Because Da Huang can cause melanosis coli. and respiratory paralysis leads to death. For chronic. a precancerous condition of the bowel. flaxseed) can be substituted for Huo Ma Ren. COMMENTS Hu Ma Ren (Semen Lini Usitatissimi. PDR= PHYSICIAN’S DESK REFERENCE . nausea. 1-2 hours after ingestion there is a bitter taste and astringent feeling within the mouth. there is difficulty breathing.Chapter 4 194 • Herb Toxicities & Drug Interactions: A Formula Approach GLW: In case of poisoning. drooling. B&G= B ENSKY & GAMBLE. there are generalized convulsions. it should not be used long-term. and lack of strength. dizziness. Run Chang Wan (Moisten the Intestines Pills) or Ji Chuan Jian (Flow the River Brew) are safer choices. C&C= CHAN & CHEUNG. blood pressure drops. breathing becomes weak. B&B= BENSKY & BAROLET. The teeth become clenched. and the pupils of the eye dilate widely with loss of reactivity to light. vomiting accompanied by watery diarrhea. When used in Chinese medicine. F L= FLAWS. BR= BRINKER. heart palpitations. consciousness becomes unclear. Sometimes one can smell cyanide on the person’s breath. Eventually. headache. In more serious cases. recalcitrant constipation. the kernels are blanched to remove the skin and the tips are broken off. The maximum concentration of toxins in this medicinal are in the skin and the tip. AH= AHPA.

acute or chronic pharyngitis. panting. BR= BRINKER. glutamic acid. C&C= CHAN & CHEUNG.k. May cause hypertension if consumed with caffeine. Ophiopogon Combination) Standard daily dosage: 6-15g Category: Dryness-treating Functions: Boosts the stomach and engenders fluids. hydrochloric acid. ginseng) Standard daily dosage: 1-30g AH: Contraindicated in hypertension BR: May cause manic episodes in patients on MAO-inhibitors. F L= FLAWS. and a vacuous. chronic bronchitis. downbears counterflow and stops coughing Chinese medical indications: Lung wilting due to damaged lung yin manifesting in coughing. Ren Shen (Radix Panacis Ginseng. Mai Dong (Tuber Ophiopogoni Japonici) Standard daily dosage: 6-15g AH: Safe when used appropriately B&G: According to some traditional sources. B&G= BENSKY & GAMBLE. PDR= PHYSICIAN’S DESK REFERENCE . a dry. Possible additive effects AH= AHPA.Chapter 4 Toxicities & Drug Interaction • 195 MAI MEN DONG TANG (Ophiopogon Decoction. GLW= GAO L U WEN . gastroesophageal reflux disorder (GERD). wheezing. shortness of breath. peptic ulcer. B&B= BENSKY & BAROLET. a dry mouth. and other highly acidic substances could possibly reduce the therapeutic effect of this medicinal. uncomfortable sensation in the throat. rapid pulse Contraindications: Evils retained in the exterior and absence of qi and yin vacuity Western medical indications: Gastritis. a dry. nicotinic acid. a. C&C: Contains glycosides. Vitamin C.a. antagonizes Kuan Dong Hua (Flos Tussilaginis Farfarae) and counteracts Ku Shen (Radix Sophorae Flavescentis) and Bai Mu Er (Fructificatio Tremellae Fuciformis). and pulmonary tuberculosis Potential formula toxicities & interactions: None listed POTENTIAL MEDICINAL TOXICITIES & INTERACTIONS: Mai Men Dong. red tongue with scanty fur.

F L= FLAWS.Chapter 4 196 • Herb Toxicities & Drug Interactions: A Formula Approach to insulin. May be synergistic with insulin in causing hypokalemia and sodium retention. B&G: Contraindicated for hypertensive patients. C&C: Vitamin C. Not recommended in large doses during pregnancy or lactation due to potential neonatal androgenization. hypertension. PDR= P HYSICIAN’S DESK REFERENCE . red dates) Standard daily dosage: 10-30g (3-12 pieces) AH: Safe when used appropriately PDR: No health risks or side effects are known in conjunction with the proper administration of designated therapeutic dosages. Geng Mi (Semen Oryzae Sativae. May reduce the anticoagulative effect of warfarin (Coumadin). and a rise in blood pressure. Not for long-term use. GLW= GAO LU WEN. incompatible with Gan Sui (Radix Euphorbiae Kansui). BR: May increase toxicity of cardiac glycosides. Contains glycyrrhetinic acid which could possibly cause a reduction in thyroid activity and basal metabolic rate. PDR: Contraindicated in patients with hypertension. (This medicinal is routinely used in Chinese medical gynecology during pregnancy as part of formulas appropriately prescribed on the basis of pattern discrimination. Use with MAO-inhibitors may cause headaches. tremors. Enhances the effect of insulin and other antidiabetic agents. A traditional antidote is mung bean soup. C&C= CHAN & CHEUNG. Overdose can lead to headache. nicotinic acid. BR= BRINKER. and other highly acidic substances could possibly reduce the therapeutic effect of this medicinal. and Yuan Zhi (Radix Polygalae Tenuifoliae). B&G: According to some traditional sources. insomnia. AH= AHPA. it may cause hypertension and/or edema. licorice root) Standard daily dosage: 2-12g AH: Do not use during pregnancy. Hong Zao (Fructus Zizyphi Jujubae. heart palpitations. and liver disorders. glutamic acid.) As a single herb in high doses. Gan Cao (Radix Glycyrrhizae Uralensis. polished rice) Standard daily dosage: 15-30g No toxicity or interaction information listed in the sources Da Zao. B&B= BENSKY & BAROLET. May increase potassium loss due to diuretics and laxatives. hydrochloric acid. If taken long-term. Possible additive effect to corticosteroids. and manias. it is contraindicated in diabetes. Yuan Hua (Flos Daphnes Genkwae). B&G= B ENSKY & GAMBLE.

COMMENTS Dang Shen (Radix Codonopsitis Pilosulae) or Tai Zi Shen (Radix Pseudostellariae Heterophyllae) is commonly substituted for Ren Shen in this formula. difficulty swallowing. Ban Xia (Rhizoma Pinelliae Ternatae) Standard daily dosage: 4. FL= FLAWS. B&G: Safe as long as it is properly prepared. low-grade fever. aluminum hydroxide. forceless pulse.Chapter 4 Toxicities & Drug Interaction • 197 The research on Gan Cao concurs that this medicinal is generally safe when used in small amounts as an envoy. nausea. According to some traditional sources. AH= AHPA. and a feeling of pressure in the chest. Toxic effects due to improper preparation or dosage include burning and numbness in throat and lips. heart palpitations. B&B= BENSKY & BAROLET.or radiation therapy. BR= BRINKER. When used as a single medicinal or in patients taking other potent Western pharmaceuticals. It should not be taken long-term or as a single herb during pregnancy. nicotinic acid. Vitamin C. (This medicinal is routinely used during pregnancy in China when indicated by disease and pattern discrimination. glutamic acid. B&G= B ENSKY & GAMBLE . GLW: Poisoning occurs within 15 minutes to three hours after ingestion of a suitable amount. mix-fried Gan Cao is the form of that medicinal used. If severe. This is then followed by drooling. and magnesium sulfate. C&C: Contains alkaloids and glycosides. there may be convulsions and respiratory failure leading to death. incompatible with Wu Tou (Radix Aconiti). tongue. C&C= CHAN & CHEUNG. PDR= P HYSICIAN’ S DESK REFERENCE . Could possibly reduce the absorption and therapeutic effect of potassium and sodium iodides. dizziness. sodium bicarbonate. and usually. ulceration of the oral mucosa. This formula may be used to treat yin damage nausea and vomiting due to chemo. Initially. and throat. Must be decocted with other herbs and not taken alone or uncooked. and other highly acidic substances could possibly reduce the therapeutic effect of this medicinal. a somber white facial complexion. hydrochloric acid. caution should be exercised to guard against potential toxicity and drug interaction. and enlargement of the tongue. Use with caution in patients with fever.) Contraindicated in all hemorrhagic disorders. GLW= GAO LU WEN. there is burning pain in the mouth. Antidote is oral administration of raw ginger.5-12g AH: Do not use during pregnancy. numbness of the extremities. unclear speech. and a weak.

F L= FLAWS. astragalus) Standard daily dosage: 9-60g AH: Safe when used appropriately C&C: Contains alkaloids and potassium. Wu Zhu Yu (Fructus Evodiae Rutecarpae). BR= BRINKER. B&G= B ENSKY & GAMBLE. cause digitalis intoxication and heart arrhythmias. B&B= BENSKY & BAROLET. a pale red tongue with thin. and Yuan Zhi (Radix Polygalae Tenuifoliae) and has adverse effects when combined with Ma Huang (Herba Ephedrae). C&C= CHAN & CHEUNG.Chapter 4 198 • Herb Toxicities & Drug Interactions: A Formula Approach MU LI SAN (Oyster Shell Powder) Category: Securing and astringing Functions: Secures the exterior and stops sweating Chinese medical indications: Qi vacuity spontaneous sweating with heart palpitations. levadopa. and Xi Xin (Herba Asari Cum Radice). Niu Xi (Radix Achyranthis Bidentatae). Could possibly reduce the absorption and therapeutic effect of potassium and sodium iodides. and hinder the absorption of isoniazid. and a faint pulse Contraindications: Yin or yang desertion sweating Western medical indications: Spontaneous sweating caused by weakness or debility Potential formula toxicities & interactions: None listed POTENTIAL MEDICINAL TOXICITIES & I NTERACTIONS: Mu Li (Concha Ostreae. sodium bicarbonate. Bei Qi (Radix Astragali Membranacei. According to some traditional sources. Huang Qi. and prednisolone. aluminum hydroxide. shortness of breath. PDR= PHYSICIAN’S DESK REFERENCE . Could possibly reduce the effects of most antibiotics. oyster shell) Standard daily dosage: 15-30g B&G: Contraindicated when the patient has high fever without sweating. works synergistically with Bei Mu (Bulbus Frittilariae). magnesium. fatigue. Could possibly cause hyperkalemia when used with potassium-sparing diuretics. C&C: Contains calcium. lack of strength. GLW= GAO LU WEN . iron. white fur. Gan Cao (Radix Glycyrrizae Uralensis). AH= AHPA. and aluminum. and magnesium sulfate. Overdose may lead to indigestion or constipation.

or antithrombotic agents. F L= FLAWS. AH= AHPA. BR= BRINKER. antiplatelets. such as transplant patients or patients with autoimmune disorders. ephedra root) Standard daily dosage: 3-9g No toxicity or interaction information listed in the sources The U.Chapter 4 Toxicities & Drug Interaction • 199 PDR: Caution should be taken with patients receiving immunosuppressive therapy. Ma Huang Gen (Radix Ephedrae. FDA has banned the inclusion of this medicinal in all dietary supplements. C&C= CHAN & CHEUNG. PDR= PHYSICIAN’S DESK REFERENCE . B&B= BENSKY & BAROLET. May potentiate the risk of bleeding when used concomitantly with anticoagulants. B&G= B ENSKY & GAMBLE. GLW= GAO LU WEN . May cause neurological dysfunction in high doses.S. COMMENTS These four ingredients may be added to other formulas or combined with other Chinese medicines for the treatment of the specific symptom of qi-vacuity spontaneous perspiration. Fu Xiao Mai (Fructus Levis Tritici Aestivi) Standard daily dosage: 9-15g PDR: No health risks or side effects are known in conjunction with the proper administration of designated therapeutic dosages.

Chapter 4 200 • Herb Toxicities & Drug Interactions: A Formula Approach NUAN GAN JIAN (Warm the Liver Brew) Category: Qi-rectifying Functions: Warms the liver and kidneys. reserpine. B&G= B ENSKY & GAMBLE. May exaggerate the anticoagulative effect of warfarin (Coumadin). C&C= CHAN & CHEUNG. varicocele. Could possibly cause hyperkalemia when used with potassium-sparing diuretics. (This medicinal is routinely used in Chinese medical gynecology during pregnancy as part of formulas appropriately prescribed on the basis of pattern discrimination.) C&C: Contains tannic acid and potassium. digitalis. PDR: Not for use during pregnancy. amylase. isoniazid. chlorpromazine. GLW= GAO LU WEN. Could possibly reduce the absorption and biologic effect of most antibiotics. tight or bowstring pulse Contraindications: Heat or damp heat Western medical indications: Inguinal hernia. FL= FLAWS. and hydrocele Potential formula toxicities & interactions: None listed POTENTIAL MEDICINAL TOXICITIES & I NTERACTIONS: Dang Gui (Radix Angelicae Sinensis) Standard daily dosage: 3-15g AH: Do not use during pregnancy. lycium berries) Standard daily dosage: 6-18g AH: Not to be used during pregnancy.) B&G: Use with caution in patients with diarrhea or abdominal distention. and accompanied by a pale tongue and a deep. vitamin B1. Gou Qi Zi. ephedrine. calcium carbonate and gluconate. AH= AHPA. moves the qi and stops pain Chinese medical indications: Cold mounting due to a liverkidney yang vacuity and qi stagnation with lower abdominal pain which is sharp. Could possibly cause hyperkalemia when used with potassium-sparing diuretics. C&C: Contains potassium. and pepsin. B R= BRINKER. quinine. trypsine. (No such prohibition exists in traditional Chinese medicine regarding this medicinal. atropine. fixed. aggravated by cold. PDR= PHYSICIAN’ S DESK REFERENCE . Qi Zi (Fructus Lycii Chinensis. B&B= BENSKY & BAROLET.

Guan Gui (Cortex Cinnamomi Cassiae. and Bie Jia (Carapax Amydae Sinensis).5-4. atropine. B&G: Use with caution during pregnancy. amylase. calcium carbonate and gluconate. B&B= BENSKY & BAROLET. quinine. may counteract Di Yu (Radix Sanguisorbae Officinalis). Gui Xin. Yun Ling (Sclerotium Poriae Cocos) Standard daily dosage: 9-15g B&G: Large doses or long-term use is discouraged. C&C: Contains potassium. Could possibly cause hyperkalemia when used with potassium-sparing diuretics. Qin Jiao (Radix Gentianae Qinjiao). aloeswood) Standard daily dosage: 1. According to traditional sources. Wu Yao. PDR= PHYSICIAN’S DESK REFERENCE . chlorpromazine. Bai Fu Ling. C&C= CHAN & CHEUNG. BR= BRINKER. Rou Gui. AH= AHPA. Contraindicated in patients with frequent. Could possibly cause hyperkalemia when used with potassium-sparing diuretics. GLW= GAO LU WEN . ephedrine. F L= FLAWS. digitalis.5-3g as a powder No toxicity or interaction information listed in the sources Fu Ling. reserpine. B&G= B ENSKY & GAMBLE. C&C: Contains tannic acid and potassium.5g BR: Reduces absorption of tetracyclines.Chapter 4 Toxicities & Drug Interaction • 201 Xiao Hui Xiang (Fructus Foeniculi Vulgaris. fennel) Standard daily dosage: 3-9g AH: Safe when used appropriately PDR: Not for use during pregnancy or by small children. vitamin B1. and pepsin. Could possibly reduce the absorption and biologic effect of most antibiotics. copious urination. isoniazid. Tai Wu (Radix Linderae Strychnifoliae) Standard daily dosage: 3-9g No toxicity or interaction information listed in the sources Chen Xiang (Lignum Aquilariae. trypsine. cinnamon bark) Standard daily dosage: 1.

B&B= BENSKY & BAROLET. fresh ginger) Standard daily dose: 3-9g AH: Safe when used appropriately BR: Reduces vomiting caused by chemotherapeutic drugs. C&C= CHAN & CHEUNG. COMMENTS It is important for practitioners to rule out testicular cancer in patients complaining of cold-natured testicular pain. Increases absorption of oral drugs. B R= BRINKER. PDR: Recommended safe dosage limit is six grams (6g). Avoid larger doses if being used to treat morning sickness or if used in patients taking anticoagulants. This formula is not capable of curing inguinal hernia but can reduce its discomfort and halt its progression. FL= FLAWS. PDR= PHYSICIAN’ S DESK REFERENCE . B&G= B ENSKY & GAMBLE. AH= AHPA.Chapter 4 202 • Herb Toxicities & Drug Interactions: A Formula Approach Sheng Jiang (uncooked Rhizoma Zingiberis Officinalis. GLW= GAO LU WEN.

loss of taste. indigestion (especially pediatric indigestion). moves the qi and harmonizes the stomach Chinese medical indications: Dampness and cold stagnating in the spleen and stomach with stomach duct and abdominal distention and fullness. and parasitic diseases Potential formula toxicities & interactions: FL/B&B: Use with caution during pregnancy POTENTIAL MEDICINAL TOXICITIES & I NTERACTIONS: Cang Zhu (Rhizoma Atractylodis) Standard daily dosage: 4. PDR= P HYSICIAN’S DESK REFERENCE . somnolence. (This medicinal is commonly used in China during pregnancy. especially for the treatment of nausea and vomiting. Chuan Po (Cortex Magnoliae Officinalis) Standard daily dosage: 3-9g AH: Not to be used during pregnancy. Magnolia & Ginger Formula) Category: Dampness-dispelling. and a moderate (i. chronic pancreatitis. fatigue.e.k. C&C: Contains tannic acid and potassium. obesity. acid regurgitation. F L= FLAWS.5-9g AH: Safe when used appropriately B&G: Use with caution in patients with loose. According to some traditional sources. slightly slow) or soggy pulse Contraindications: Yin-blood vacuity Western medical indications: Acute and chronic gastritis. torpid intake.Chapter 4 Toxicities & Drug Interaction • 203 PING WEI SAN (Level the Stomach Powder. a. peptic ulcer. Could possibly cause hyperAH= AHPA. gastric ulcer.a. watery stools. C&C= CHAN & CHEUNG. belching/burping. Calm the Stomach Powder. loose stools or diarrhea. heaviness of the limbs.) B&G: Use with caution during pregnancy. a swollen.. GLW= GAO L U WEN. gastrectasis. gastric neurosis. PDR: No health risks or side effects are known in conjunction with the proper administration of designated therapeutic dosages. Hou Po. slimy fur. antagonizes Ze Xie (Rhizoma Alismatis Orientalis) and Han Shui Shi (Calcitum). turbidity-transforming Functions: Dries dampness and transports the spleen. BR= BRINKER. fat tongue with thick. B&B= BENSKY & BAROLET. B&G= BENSKY & GAMBLE. nausea and vomiting. white.

Yuan Hua (Flos Daphnes Genkwae). fresh ginger) Standard daily dose: 3-9g AH: Safe when used appropriately AH= AHPA. calcium carbonate and gluconate. B&G= B ENSKY & GAMBLE. reserpine. and pepsin. amylase. (This medicinal is routinely used in Chinese medical gynecology during pregnancy as part of formulas appropriately prescribed on the basis of pattern discrimination. caution should be exercised to guard against potential toxicity and drug interaction. trypsine. vitamin B 1. If taken long-term. BR: May increase toxicity of cardiac glycosides. Chen Pi. chlorpromazine.) As a single herb in high doses. digitalis. May be synergistic with insulin in causing hypokalemia and sodium retention. isoniazid. hypertension. and Yuan Zhi (Radix Polygalae Tenuifoliae). PDR: No health risks or side effects are known in conjunction with the proper administration of designated therapeutic dosages. B&G: According to some traditional sources. F L= FLAWS. Contains glycyrrhetinic acid which could possibly cause a reduction in thyroid activity and basal metabolic rate. PDR= P HYSICIAN’S DESK REFERENCE . B&B= BENSKY & BAROLET. C&C= CHAN & CHEUNG. It should not be taken long-term or as a single herb during pregnancy. and liver disorders. Ju Pi. May increase potassium loss due to diuretics and laxatives. Not for long-term use. Sheng Jiang (uncooked Rhizoma Zingiberis Officinalis. it may cause hypertension and/or edema. tangerine peel) Standard daily dosage: 3-9g AH: Safe when used appropriately C&C: Contains potassium. Gan Cao (Radix Glycyrrhizae Uralensis. Ju Hong (Pericarpium Citri Reticulatae. When used as a single medicinal or in patients taking other potent Western pharmaceuticals. ephedrine. GLW= GAO LU WEN. Could possibly cause hyperkalemia when used with potassium-sparing diuretics. The research on Gan Cao concurs that this medicinal is generally safe when used in small amounts as an envoy. quinine. it is contraindicated in diabetes. licorice root) Standard daily dosage: 2-12g AH: Do not use during pregnancy. BR= BRINKER. Possible additive effect to corticosteroids. incompatible with Gan Sui (Radix Euphorbiae Kansui). atropine.Chapter 4 204 • Herb Toxicities & Drug Interactions: A Formula Approach kalemia when used with potassium-sparing diuretics and reduce the absorption and biologic effect of most antibiotics.

F L= FLAWS. Hong Zao (Fructus Zizyphi Jujubae. B&B= BENSKY & BAROLET.Chapter 4 Toxicities & Drug Interaction • 205 BR: Reduces vomiting caused by chemotherapeutic drugs. Avoid larger doses if being used to treat morning sickness or if used in patients taking anticoagulants. BR= BRINKER. red dates) Standard daily dosage: 10-30g (3-12 pieces) AH: Safe when used appropriately PDR: No health risks or side effects are known in conjunction with the proper administration of designated therapeutic dosages. Da Zao. GLW= GAO LU WEN. PDR= P HYSICIAN’S DESK REFERENCE . B&G= B ENSKY & GAMBLE. AH= AHPA. PDR: Recommended safe dosage limit is six grams (6g). C&C= CHAN & CHEUNG. Increases absorption of oral drugs.

FL= FLAWS. and pepsin. trypsine. POTENTIAL MEDICINAL TOXICITIES & INTERACTIONS: Bie Jia (Carapax Amydae Sinensis) Standard daily dosage: 9-30g B&G: Contraindicated in pregnancy and in patients who have not fully gotten over a cold. emaciation but no loss of appetite. chlorpromazine. Not for use in patients with spasms or convulsions. quinine. antagonizes Ming Fan (Alumen). rapid pulse Contraindications: Early stage warm disease when evils are still in the qi aspect Western medical indications: Advanced stages of various infectious diseases especially pulmonary and renal tuberculosis. Qing Hao (Herba Artemisiae Annuae Seu Apiaceae) Standard daily dosage: 3-24g AH: Not to be used during pregnancy. no sweating as the fever recedes. GLW= GAO LU WEN. amylase. and a fine. Use with caution in cases of impotence. Also useful for chronic nephritis. and postsurgical fever. C&C= CHAN & CHEUNG. atropine. ephedrine. isoniazid. C&C: Contains tannic acid and potassium. According to traditional sources. PDR= P HYSICIAN’ S DESK REFERENCE . typhoid fever convalescence. According to some traditional sources. Potential formula toxicities & interactions: FL/B&B: Not for fever from common cold or simple infections. Could possibly reduce the absorption and biologic effect of most antibiotics. BR= BRINKER. B&B= BENSKY & BAROLET. B&G: Contraindicated in postpartum women with anemia. reserpine. a red tongue with scanty fur. AH= AHPA. fevers of unknown etiology. should not be used with Sheng Di (uncooked Radix Rehmanniae Glutinosae) or Dang Gui (Radix Angelicae Sinensis).Chapter 4 206 • Herb Toxicities & Drug Interactions: A Formula Approach QING HAO BIE JIA TANG (Artemisia Annua & Carapax Amydae Decoction) Category: Vacuity heat-clearing Functions: Nourishes yin and clears heat Chinese medical indications: Yin vacuity heat in the later stages of a warm disease with night-time fever and morning coolness. calcium carbonate and gluconate. digitalis. B&G= B ENSKY & GAMBLE . Could possibly cause hyperkalemia when used with potassium-sparing diuretics. vitamin B1.

C&C: Contains tannic acid. Avoid using with garlic. chlorpromazine. nicotinic acid. may counteract the effect of Tu Si Zi (Semen Cuscutae Chinensis). tree peony root bark) Standard daily dosage: 6-12g AH: Not to be used during pregnancy. ephedrine. Vitamin C. amylase. GLW= GAO LU WEN. glutamic acid. and pepsin. Mu Dan Pi (Cortex Radicis Moutan. quinine. vitamin B1. B&G= B ENSKY & GAMBLE. and Da Huang (Radix Et Rhizoma Rhei). Zhi Mu (Rhizoma Anemarrhenae Aspheloidis) Standard daily dosage: 6-12g B&G: May cause diarrhea in some patients. atropine. digitalis. AH= AHPA. potassium. C&C: Contains potassium and glycosides. and other highly acidic substances could possibly reduce the therapeutic effect of this medicinal. According to some traditional sources. Vitamin C. C&C= CHAN & CHEUNG. PDR: No health risks or side effects are known in conjunction with the proper administration of designated therapeutic dosages. PDR: No health hazards are known in conjunction with the proper administration of designated therapeutic dosages. reserpine. hydrochloric acid. Sheng Di Huang (uncooked Radix Rehmanniae Glutinosae) Standard daily dosage: 9-30g AH: Contraindicated in patients with diarrhea or lack of appetite B&G: Contraindicated in pregnant women with anemias or digestive weakness C&C: Contains potassium.) B&G: Should not be used during pregnancy or in patients with excessive sweating or profuse menstruation. Bei Mu (Bulbus Fritillariae). isoniazid. hydrochloric acid.Chapter 4 Toxicities & Drug Interaction • 207 Sheng Di . Could possibly cause hyperkalemia when used with potassium-sparing diuretics. BR= BRINKER. Could possibly cause hyperkalemia when used with potassium-sparing diuretics. and other highly acidic substances could possibly reduce the therapeutic effect of this medicinal. B&B= BENSKY & BAROLET.(This ingredient is commonly used in China during pregnancy to treat heat in the blood and/or blood stasis. PDR= P HYSICIAN’S DESK REFERENCE . F L= FLAWS. nicotinic acid. calcium carbonate and gluconate. and glycosides. glutamic acid. Dan Pi. Could possibly cause hyperkalemia when used with potassium-sparing diuretics. trypsine. Could possibly reduce the absorption and biologic effect of most antibiotics.

) Contraindicated in all hemorrhagic disorders. nausea.Chapter 4 208 • Herb Toxicities & Drug Interactions: A Formula Approach QING QI HUA TAN TANG (Clear the Qi & Transform Phlegm Pills) Category: Phlegm-transforming and heat-clearing Functions: Clears heat and transforms phlegm. BR= BRINKER. chronic rhinitis. a red tongue with slimy. sticky phlegm which is difficult to expectorate. Must be decocted with other herbs and not taken alone or uncooked. chronic tracheitis. bronchiectasis. may counteract Fu Zi (Radix Lateralis Praeparatus Aconiti Carmichaeli). yellow fur. C&C= CHAN & CHEUNG. and voice problems. Ban Xia (Rhizoma Pinelliae Ternatae) Standard daily dosage: 4. nasosinusitis. F L= FLAWS. PDR= PHYSICIAN’S DESK REFERENCE . Antidote is oral administration of raw ginger. and a slippery. rapid pulse Contraindications: None listed Western medical indications: Acute and chronic bronchitis. nausea. increase in saliva production. According to traditional sources. Toxic effects due to improper preparation or dosage include irritation of the mouth and throat. B&G: Safe as long as it is properly prepared. B&B= BENSKY & BAROLET. and pneumonia Potential formula toxicities & interactions: None listed POTENTIAL MEDICINAL TOXICITIES & I NTERACTIONS: Dan Nan Xing (bile-processed Rhizoma Arisaematis) Standard daily dosage: 4.5-9g B&G: Safe as long as it is properly prepared. Use with caution in patients with fever. chest and diaphragmatic glomus and fullness. GLW= GAO LU WEN . AH= AHPA. Gan Jiang (dry Rhizoma Zingiberis Officinalis). and a feeling of pressure in the chest. rectifies the qi and stops coughing Chinese medical indications: Phlegm heat with cough and yellow. B&G= B ENSKY & GAMBLE. Toxic effects due to improper preparation or dosage include burning and numbness in throat and lips.5-12g AH: Do not use during pregnancy. and Sheng Jiang (uncooked Rhizoma Zingiberis Officinalis). edema and numbness of the lips. (This medicinal is routinely used during pregnancy in China when indicated by disease and pattern discrimination. Must be decocted properly with other medicinals and not taken alone or uncooked.

incompatible with Wu Tou (Radix Aconiti). dizziness. and other highly acidic substances could possibly reduce the therapeutic effect of this medicinal. difficulty swallowing. GLW: Poisoning occurs within 15 minutes to three hours after ingestion of a suitable amount. there may be convulsions and respiratory failure leading to death. incompatible with Wu Tou (Radix Aconiti). C&C= CHAN & CHEUNG. B&B= BENSKY & BAROLET. there is burning pain in the mouth. unclear speech. C&C: Contains alkaloids and glycosides. and magnesium sulfate. hydrochloric acid. glutamic acid. Vitamin C. tremors. C&C: Contains potassium and glycosides. nicotinic acid. Symptoms of toxicity include reduced breathing. hydrochloric acid. C&C: Contains alkaloids and glycosides. tongue.Chapter 4 Toxicities & Drug Interaction • 209 According to some traditional sources. Gua Lou Ren. a somber white facial complexion. aluminum hydroxide. aluminum hydroxide. glutamic acid. and enlargement of the tongue. Initially. and other highly acidic substances could possibly reduce the therapeutic effect of this medicinal. and other highly acidic substances could possibly reduce the therapeutic effect of this medicinal. This is then followed by drooling. B&G= B ENSKY & GAMBLE. ulceration of the oral mucosa. and magnesium sulfate. forceless pulse. nicotinic acid. glutamic acid. Vitamin C. PDR= P HYSICIAN’S DESK REFERENCE . Could possibly reduce the absorption and therapeutic effect of potassium and sodium iodides. Tiao Qin (Radix Scutellariae Baicalensis) Standard daily dosage: 6-15g AH: Safe when used appropriately B&G: According to some traditional sources. low-grade fever. Vitamin C. mydriasis. Could possibly cause hyperkalemia when used with potassium-sparing diuretics. If severe. AH= AHPA. and coma. hydrochloric acid. F L= FLAWS. Contains peimine which is fatal in animals at doses of 9mg/kg. nicotinic acid. sodium bicarbonate. heart palpitations. numbness of the extremities. and throat. Gua Lou Zi (Semen Trichosanthis Kirlowii) Standard daily dosage: 9-12g AH: Safe when used appropriately B&G: According to traditional sources. Could possibly reduce the absorption and therapeutic effect of potassium and sodium iodides. Huang Qin. sodium bicarbonate. counteracts Dan Pi (Cortex Radicis Moutan) and Li Lu (Rhizoma Et Radix Veratri). BR= BRINKER. and a weak. GLW= GAO LU WEN.

headache. In more serious cases. 1-2 hours after ingestion there is a bitter taste and astringent feeling within the mouth. and coma. or other opiates. The maximum concentration of toxins in this medicinal are in the skin and the tip. C&C: Contains potassium and glycosides (including cyanophoric glycoside). nausea. Vitamin C. vomiting. blood pressure drops. hydrocyanic acid is produced which can lead to respiratory failure and death. In the advent of overdose. Ju Pi. When used in Chinese medicine. nausea. Eventually. the kernels are blanched to remove the skin and the tips are broken off. and lack of strength. activated charcoal and syrup of ipecac should be administered orally. F L= FLAWS. breathing becomes weak. PDR= PHYSICIAN’S DESK REFERENCE . Could possibly cause hyperkalemia when used with potassium-sparing diuretics. GLW= GAO LU WEN . and the pupils of the eye dilate widely with loss of reactivity to light. typically. vomiting accompanied by watery diarrhea. arrhythmias. which can progress to dyspnea. and headache. Ju Hong (Pericarpium Citri Reticulatae. dizziness. there is difficulty breathing. B&G: Use with caution when treating infants or patients with diarrhea. AH= AHPA. children 10 kernels. Xing Ren. apricot kernel) Standard daily dosage: 3-12g AH: To be used only under the supervision of an expert qualified in the appropriate use of this substance. Sometimes one can smell cyanide on the person’s breath. glutamic acid. Ku Xing Ren (Semen Pruni Armenicae. If taken with codeine. B&B= BENSKY & BAROLET. there are generalized convulsions. Could possibly cause hyperkalemia when used with potassium-sparing diuretics. The teeth become clenched. drooling. tangerine peel) Standard daily dosage: 3-9g AH: Safe when used appropriately C&C: Contains potassium. BR= BRINKER. nicotinic acid. consciousness becomes unclear. Lethal dosage in adults is 50-60 uncooked kernels. GLW: In case of poisoning.Chapter 4 210 • Herb Toxicities & Drug Interactions: A Formula Approach Chen Pi. hydrochloric acid. heart palpitations. Eating this medicinal uncooked or in large quantities could possibly cause dizziness. and other highly acidic substances will reduce the therapeutic effect of this medicinal. morphine. C&C= CHAN & CHEUNG. spasms. B&G= B ENSKY & GAMBLE. and respiratory paralysis leads to death. Contains amygdalin and amygdalase which break down to hydrocyanic acid in the digestive tract. dilated pupils.

GLW= GAO LU WEN. immature bitter orange) Standard daily dosage: 3-9g B&G: Use with caution during pregnancy or in debilitated patients. may counteract Di Yu (Radix Sanguisorbae Officinalis).Chapter 4 Toxicities & Drug Interaction • 211 Zhi Shi (Fructus Immaturus Citri Aurantii. Qin Jiao (Radix Gentianae Qinjiao). digitalis. atropine. trypsine. Highly acidic. scopolamine. Contraindicated in patients with frequent. BR= BRINKER. caffeine. Could possibly cause hyperkalemia when used with potassium-sparing diuretics. ephedrine. According to traditional sources. C&C= CHAN & CHEUNG. calcium carbonate and gluconate. Yun Ling (Sclerotium Poriae Cocos) Standard daily dosage: 9-15g B&G: Large doses or long-term use is discouraged. quinine. and Bie Jia (Carapax Amydae Sinensis). PDR= PHYSICIAN’ S DESK REFERENCE . C&C: Contains potassium. copious urination. amylase. isoniazid. B&B= BENSKY & BAROLET. Fu Ling. and pepsin. Bai Fu Ling. and berbamin. reserpine. aluminum hydroxide. sodium bicarbonate. B&G= B ENSKY & GAMBLE. vitamin B1. AH= AHPA. C&C: Contains tannic acid. opiates. FL= FLAWS. Could possibly cause crystalluria and hematuria and reduce the absorption and biologic effect of most antibiotics. chlorpromazine.

glossitis. Long-term use may damage the digestive system. black cohosh) Standard daily dosage: 1. According to some traditional sources. and lactate. Coptis & Rehmannia Formula) Category: Heat-clearing Functions: Drains stomach fire. cools the blood.k.) Not to be used while nursing. magnesium and ferrous sulfates. periodontal disease. and bismuth subcarbonate. a. B R= BRINKER. a dry mouth. C&C= CHAN & CHEUNG.5-9g AH: Not to be used during pregnancy. trigeminal neuralgia. FL= FLAWS. B&G= B ENSKY & GAMBLE. B&B= BENSKY & BAROLET.) B&G: Contains berberine. bad breath. (This medicinal is commonly used during pregnancy in China. According to some traditional sources. and potassium. Some traditional sources say it should not be taken with pork. carbonate. calcium gluconate. slippery. B&G: Contraindicated in cases of fully erupted measles and in patients AH= AHPA. counteracts Kuan Dong Hua (Flos Tussilaginis Farfarae) and Niu Xi (Radix Achyranthis Bidentatae). gingivitis. Sheng Ma (Rhizoma Cimicifugae. and a surging.Chapter 4 212 • Herb Toxicities & Drug Interactions: A Formula Approach QING WEI SAN (Clear the Stomach Powder. Bai Xian Pi (Cortex Radicis Dictamni Dasycarpi). aluminum hydroxide. C&C: Contains alkaloids.(This medicinal is commonly used during pregnancy in China when indicated by disease and pattern discrimination.5-9g AH: Not to be used during pregnancy. rapid pulse Contraindications: Wind cold toothache or kidney vacuity tooth and gum disorders Western medical indications: Stomatitis. and nourishes yin Chinese medical indications: Stomach heat manifesting as toothache. antagonizes Ju Hua (Flos Chrysanthemi Morifolii). PDR= PHYSICIAN’ S DESK REFERENCE . sodium bicarbonate. a red tongue with scanty fur. fever.a. quercetin. Chuan Lian (Rhizoma Coptidis Chinensis) Standard daily dosage: 1. facial swelling. Could possibly cause hyperkalemia when used with potassium-sparing diuretics. GLW= GAO LU WEN. and idiopathic halitosis Potential formula toxicities & interactions: None listed POTENTIAL MEDICINAL TOXICITIES & INTERACTIONS: Huang Lian. Could possibly reduce the absorption and therapeutic effect of potassium and sodium iodides. Xuan Shen (Radix Scrophulariae Ningpoensis). and Jiang Can (Bombyx Batryticatus).

Bei Mu (Bulbus Fritillariae). PDR: Not for use during pregnancy due to an increased risk of spontaneous abortion. and Da Huang (Radix Et Rhizoma Rhei). potassium. Vitamin C. tree peony root bark) Standard daily dosage: 6-12g AH: Not to be used during pregnancy.Chapter 4 Toxicities & Drug Interaction • 213 with breathing difficulties. and other highly acidic substances could possibly reduce the therapeutic effect of this medicinal. ephedrine. According to some traditional sources. Mu Dan Pi (Cortex Radicis Moutan. Overdose causes headaches. C&C: Vitamin C. and other highly acidic substances could possibly reduce the therapeutic effect of this medicinal. C&C= CHAN & CHEUNG. isoniazid. Sheng Di Huang (uncooked Radix Rehmanniae Glutinosae) Standard daily dosage: 9-30g AH: Contraindicated in patients with diarrhea or lack of appetite B&G: Contraindicated in pregnant women with anemias or digestive weakness C&C: Contains potassium. trypsine. Sheng Di. glutamic acid. chlorpromazine. reserpine. C&C: Contains tannic acid. amylase. PDR= P HYSICIAN’S DESK REFERENCE . Dang Gui (Radix Angelicae Sinensis) Standard daily dosage: 3-15g AH= AHPA.(This ingredient is commonly used in China during pregnancy to treat heat in the blood and/or blood stasis. F L= FLAWS. may counteract the effect of Tu Si Zi (Semen Cuscutae Chinensis). GLW= GAO LU WEN. PDR: No health risks or side effects are known in conjunction with the proper administration of designated therapeutic dosages. and pathogenic erections. nicotinic acid. hydrochloric acid. and pepsin. atropine. Could possibly cause hyperkalemia when used with potassium-sparing diuretics. hydrochloric acid. B&B= BENSKY & BAROLET. Contains glycosides which may potentiate the effect of antihypertensive medications and result in hypotension. nicotinic acid. Could possibly cause hyperkalemia when used with potassium-sparing diuretics. Dan Pi. glutamic acid. Could possibly reduce the absorption and biologic effect of most antibiotics. Avoid using with garlic. vitamin B1. and glycosides. tremors. dizziness. B&G: Should not be used during pregnancy or in patients with excessive sweating or profuse menstruation. calcium carbonate and gluconate. gastroenteritis. quinine. B&G= B ENSKY & GAMBLE. BR= BRINKER. digitalis. vomiting.

FL= FLAWS. B&B= BENSKY & BAROLET.Chapter 4 214 • Herb Toxicities & Drug Interactions: A Formula Approach AH: Do not use during pregnancy.) B&G: Use with caution in patients with diarrhea or abdominal distention. Could possibly cause hyperkalemia when used with potassium-sparing diuretics. BR= BRINKER. C&C= CHAN & CHEUNG. B&G= B ENSKY & GAMBLE . PDR= P HYSICIAN’ S DESK REFERENCE . GLW= GAO LU WEN. (This medicinal is routinely used in Chinese medical gynecology during pregnancy as part of formulas appropriately prescribed on the basis of pattern discrimination. AH= AHPA. May exaggerate the anticoagulative effect of warfarin (Coumadin). C&C: Contains potassium. COMMENTS This formula is commonly used to treat dental caries and toothache due to stomach heat.

Could possibly cause hyperkalemia when used with potassium-sparing diuretics. and AH= AHPA. or other opiates. PDR: No health risks or side effects are known in conjunction with the proper administration of designated therapeutic dosages. irritability. miosis. diarrhea. hydrocyanic acid is produced which can lead to respiratory failure and death.5-9g AH: Not to be used during pregnancy. and. aluminum hydroxide. in severe cases. Linum & Rhubarb Combination) Category: Draining and precipitating Functions: Moistens the intestines and frees the flow of the stools Chinese medical indications: Intestinal dryness constipation with lusterless skin. B&B= BENSKY & BAROLET. GLW= GAO L U WEN . nicotinic acid. BR= BRINKER. dry mouth and unquenchable thirst. Treatment is based on gastric lavage.k. Tao Ren (Semen Pruni Persicae. B&G= BENSKY & GAMBLE. coma and death. especially in postpartum women and the elderly Potential formula toxicities & interactions: None listed POTENTIAL MEDICINAL TOXICITIES & I NTERACTIONS: Huo Ma Ren (Semen Cannabis Sativae.a. a dry tongue. B&G: Contraindicated during pregnancy. and a fine pulse Contraindications: None listed Western medical indications: Constipation. chorea. peach kernel) Standard daily dosage: 4. numbness of the extremities. PDR= PHYSICIAN’S DESK REFERENCE . If taken with codeine. sodium bicarbonate. a. C&C= CHAN & CHEUNG. and symptomatic therapy. hydrochloric acid. fluids. cannabis seeds. glutamic acid. and magnesium sulfate. Vitamin C. marijuana seeds) Standard daily dosage: 9-45g B&G: Symptoms of overdose may include nausea. vomiting. F L= FLAWS. C&C: Contains alkaloids.Chapter 4 Toxicities & Drug Interaction • 215 RUN CHANG WAN (Moisten the Intestines Pills. Could possibly reduce the absorption and therapeutic effect of potassium and sodium iodides. morphine. C&C: Contains potassium and glycosides (including cyanophoric glycosides).

drooling. headache. Could possibly cause hyperkalemia when used with potassium-sparing diuretics. heart palpitations. Sometimes one can smell cyanide on the person’s breath. Dang Gui (Radix Angelicae Sinensis) Standard daily dosage: 3-15g AH: Do not use during pregnancy. there is difficulty breathing. and the pupils of the eye dilate widely with loss of reactivity to light.) B&G: Use with caution in patients with diarrhea or abdominal distention. 1-2 hours after ingestion there is a bitter taste and astringent feeling within the mouth.Chapter 4 216 • Herb Toxicities & Drug Interactions: A Formula Approach other highly acidic substances could possibly reduce the therapeutic effect of this medicinal. typically. B&B= BENSKY & BAROLET. there are generalized convulsions. and respiratory paralysis leads to death. May exaggerate the anticoagulative effect of warfarin (Coumadin). Most of the toxins in this medicinal reside in the skin and tip. B&G= BENSKY & GAMBLE. GLW= GAO L U WEN . (This medicinal is routinely used in Chinese medical gynecology during pregnancy as part of formulas appropriately prescribed on the basis of pattern discrimination. and lack of strength. Zhi Qiao (Fructus Citri Aurantii. C&C= C HAN & CHEUNG. vomiting accompanied by watery diarrhea. The teeth become clenched. F L= FLAWS. nausea. Zhi Ke. consciousness becomes unclear. blood pressure drops. this medicinal is blanched before using and its tip is broken off in order to make it less or non-toxic. Could possibly cause hyperkalemia when used with potassium-sparing diuretics. Therefore. breathing becomes weak. BR= BRINKER. dizziness. In more serious cases. PDR: No health risks or side effects are known in conjunction with the proper administration of designated therapeutic dosages. GLW: In case of poisoning. PDR= PHYSICIAN’S DESK REFERENCE . C&C: Contains potassium. bitter orange) Standard daily dose: 3-9g AH= AHPA. Eventually. Sheng Di Huang (uncooked Radix Rehmanniae Glutinosae) Standard daily dosage: 9-30g AH: Contraindicated in patients with diarrhea or lack of appetite B&G: Contraindicated in pregnant women with anemias or digestive weakness C&C: Contains potassium. Sheng Di.

PDR= PHYSICIAN’S DESK REFERENCE . GLW= GAO LU WEN . quinine. trypsine. Could possibly cause crystalluria and hematuria. sodium bicarbonate. caffeine. flaxseed). BR= BRINKER. isoniazid. scopolamine. B&G= B ENSKY & GAMBLE. vitamin B1. Highly acidic. Otherwise. COMMENTS Huo Ma Ren can be substituted by Hu Ma Ren (Semen Lini Usitatissimi. chlorpromazine. no health hazards are known in conjunction with the proper administration of designated therapeutic dosages. atropine. PDR: May cause UV-sensitivity in light-skinned individuals. and berbamin. AH= AHPA. opiates. B&B= BENSKY & BAROLET. and pepsin. calcium carbonate and gluconate. aluminum hydroxide. amylase.Chapter 4 Toxicities & Drug Interaction • 217 AH: Safe when used appropriately B&G: Use with caution during pregnancy C&C: Contains tannic acid. Could possibly reduce the absorption and biologic effect of most antibiotics. F L= FLAWS. ephedrine. digitalis. C&C= CHAN & CHEUNG. reserpine.

amylase. isoniazid. vertigo. quinine. digitalis. Therefore. headache. aluminum hydroxide. C&C= CHAN & CHEUNG. atropine. Gan Ju Hua. Ku Xing Ren (Semen Pruni Armenicae. cough. flu. chlorpromazine. magnesium and ferrous sulfates. mulberry leaves) Standard daily dose: 4. gluconate. calcium carbonate. and pepsin.5-15g AH: Safe when used appropriately B&G: Long-term use in high dosages caused liver and kidney damage in mice. Hang Ju Hua (Flos Chrysanthemi Morifolii. B&B= BENSKY & BAROLET. & lactate. and bismuth subcarbonate. could conceivably reduce absorption and biologic effect of most antibiotics. Morus & Chrysanthemum Combination) Category: Exterior-resolving Functions: Courses wind and clears heat.Chapter 4 218 • Herb Toxicities & Drug Interactions: A Formula Approach SANG JU YIN (Mulberry Leaf & Chrysanthemum Beverage. epidemic conjunctivitis. thin. trypsine. slight thirst. chrysanthemum flowers) Standard daily dosage: 4. apricot kernel) Standard daily dosage: 3-9g AH= AHPA. C&C: Contains tannic acid and quercetin. a. ephedrine. rapid pulse Contraindications: Wind cold external contraction Western medical indications: Common cold. BR= BRINKER. Ju Hua. reserpine.5-15g B&G: Use with caution in patients with diarrhea and/or poor appetite. acute tonsillitis. diffuses the lungs and stops cough Chinese medical indications: Defensive aspect warm disease with slight fever.k. B&G= B ENSKY & GAMBLE. GLW= GAO LU WEN . and a floating. white tongue fur. F L= FLAWS. acute bronchitis. and acute tracheitis Potential formula toxicities & interactions: None listed POTENTIAL MEDICINAL TOXICITIES & I NTERACTIONS: Sang Ye (Folium Mori Albi.a. PDR= PHYSICIAN’S DESK REFERENCE . vitamin B1. Xing Ren.

nicotinic acid. breathing becomes weak. The teeth become clenched. hydrochloric acid. nausea. nausea. F L= FLAWS. activated charcoal and syrup of ipecac should be administered orally. vomiting. children 10 kernels. GLW= GAO LU WEN . drooling. hydrocyanic acid is produced which can lead to respiratory failure and death. and skin ulcers. and other highly acidic substances may reduce the therapeutic effect of this medicinal. carbuncles that have already ulcerated. and the pupils of the eye dilate widely with loss of reactivity to light. typically. dilated pupils. arrhythmias. Sometimes one can smell cyanide on the person’s breath. glutamic acid. AH= AHPA. there is difficulty breathing. PDR= PHYSICIAN’S DESK REFERENCE . Could possibly cause hyperkalemia when used with potassium-sparing diuretics. Eventually. C&C= CHAN & CHEUNG.) B&G: Contraindicated in patients with diarrhea. The maximum concentration of toxins in this medicinal are in the skin and the tip. BR= BRINKER. C&C: Contains potassium and glycosides. Vitamin C. morphine. C&C: Contains potassium and glycosides (including cyanophoric glycoside). B&G= B ENSKY & GAMBLE. In more serious cases. blood pressure drops. Lian Qiao (Fructus Forsythiae Suspensae. and respiratory paralysis leads to death. hydrochloric acid. heart palpitations. Lethal dosage in adults is 50-60 uncooked kernels. headache. Vitamin C. and other highly acidic substances could possibly reduce the therapeutic effect of this medicinal. spasms. nicotinic acid. When used in Chinese medicine. GLW: In case of poisoning. and coma. Eating this medicinal uncooked or in large quantities could possibly cause dizziness. B&B= BENSKY & BAROLET. vomiting accompanied by watery diarrhea. (This medicinal is commonly used in China during pregnancy to treat wind heat external contractions and heat toxins.Chapter 4 Toxicities & Drug Interaction • 219 AH: To be used only under the supervision of an expert qualified in the appropriate use of this substance. and headache which can progress to dyspnea. the kernels are blanched to remove the skin and the tips are broken off. If taken with codeine. dizziness. In the advent of overdose. or other opiates. 1-2 hours after ingestion there is a bitter taste and astringent feeling within the mouth. Contains amygdalin and amygdalase which break down to hydrocyanic acid in the digestive tract. Could possibly cause hyperkalemia when used with potassium-sparing diuretics. glutamic acid. dried forsythia fruit pods) Standard daily dosage: 6-15g AH: Not to be used during pregnancy. consciousness becomes unclear. B&G: Use with caution when treating infants or patients with diarrhea. there are generalized convulsions. and lack of strength.

C&C: Contains calcium and glycosides. B&G: According to some traditional sources. F L= FLAWS. C&C= CHAN & CHEUNG. nicotinic acid. bellflower root) Standard daily dosage: 3-9g AH: Contraindicated in hemoptysis. B&G= B ENSKY & GAMBLE. May increase potassium loss due to diuretics and laxatives. Contains glycyrrhetinic acid which could possibly cause a reduction in thyroid activity and basal metabolic rate. Possible additive effect to corticosteroids. glutamic acid. GLW= GAO LU WEN. hypertension. According to some traditional sources. incompatible with Gan Sui (Radix Euphorbiae Kansui). cause digitalis intoxication and heart arrhythmias. When used as a single medicinal or AH= AHPA. field mint) Standard daily dose: 1. The research on Gan Cao concurs that this medicinal is generally safe when used in small amounts as an envoy. Could possibly reduce the effect of most antibiotics. BR: May increase toxicity of cardiac glycosides. and other highly acidic substances could possibly reduce the therapeutic effect of this medicinal. B&B= BENSKY & BAROLET. Vitamin C. It should not be taken long-term or as a single herb during pregnancy. licorice root) Standard daily dosage: 2-12g AH: Do not use during pregnancy. Jie Geng (Radix Platycodi Grandiflori. May be synergistic with insulin in causing hypokalemia and sodium retention. (This medicinal is routinely used in Chinese medical gynecology during pregnancy as part of formulas appropriately prescribed on the basis of pattern discrimination. If taken long-term. it is contraindicated in diabetes. PDR= P HYSICIAN’S DESK REFERENCE . hydrochloric acid. Use with caution in bleeding peptic ulcer. and liver disorders. B&G: Contraindicated in patients with hemoptysis. and reduce the biological effect of levadopa. Not for long-term use. BR= BRINKER. it may cause hypertension and/or edema. and Yuan Zhi (Radix Polygalae Tenuifoliae). hinder the absorption of isoniazid. counteracts Long Dan Cao (Radix Gentiana Longdancao) and Long Yan Rou (Arillus Euphoriae Longanae).Chapter 4 220 • Herb Toxicities & Drug Interactions: A Formula Approach Bo He (Herba Menthae Haplocalycis. Gan Cao (Radix Glycyrrhizae Uralensis.) As a single herb in high doses.5-6g AH: Safe when used appropriately B&G: Not recommended for nursing mothers as it may inhibit lactation. especially in cases of tuberculosis. Yuan Hua (Flos Daphnes Genkwae).

caution should be exercised to guard against potential toxicity and drug interaction. FL= FLAWS. AH= AHPA.Chapter 4 Toxicities & Drug Interaction • 221 in patients taking other potent Western pharmaceuticals. Wei Jing. Lu Gen. Wei Gen (Rhizoma Phragmitis Communis) Standard daily dosage: 15-60g PDR: No health risks or side effects are known in conjunction with the proper administration of designated therapeutic dosages. BR= BRINKER. GLW= GAO LU WEN. B&G= B ENSKY & GAMBLE . PDR= P HYSICIAN’ S DESK REFERENCE . B&B= BENSKY & BAROLET. C&C= CHAN & CHEUNG.

astringes the essence and stops loss Chinese medical indications: Polyuria and incontinence due to heart-kidney qi vacuity with turbid urine. and potassium. impaired memory. PDR= PHYSICIAN’ S DESK REFERENCE . GLW= GAO LU WEN. and a fine. Long Gu (Os Draconis. turbid urine. C&C: Contains calcium. and potassium. counteracts Shi Gao (Gypsum Fibrosum) and should not be mixed with fish. Could possibly reduce the effect of most antibiotics. tubular acidosis. and prednisolone. B&B= BENSKY & BAROLET. diabetes mellitus. iron. levadopa. levadopa.Chapter 4 222 • Herb Toxicities & Drug Interactions: A Formula Approach SANG PIAO XIAO SAN (Mantis Egg-case Powder) Category: Securing and astringing Functions: Regulates and supplements the heart and kidneys. forceless pulse Contraindications: Damp heat or vigorous fire in the lower burner Western medical indications: Polyuria. FL= FLAWS. primary aldosteronism. fossilized bone) Standard daily dosage: 15-30g B&G: According to some traditional sources. neurosis. and autonomic dystonia Potential formula toxicities & interactions: None listed POTENTIAL MEDICINAL TOXICITIES & INTERACTIONS: Sang Piao Xiao (Ootheca Mantidis. a pale tongue with white fur. counteracts Xuan Fu Hua (Flos Inulae Racemosae). mantis egg-case) Standard daily dosage: 3-9g B&G: According to some traditional sources. chronic nephritis. cause digitalis intoxication and heart arrhythmias. C&C= CHAN & CHEUNG. and hinder the absorption of isoniazid. magnesium. aluminum. impaired memory due to nervous exhaustion. spermatorrhea. iron. prolapsed uterus. Could possibly reduce the effect of most antibiotics. B&G= B ENSKY & GAMBLE. Could possibly cause hyperkalemia when used with potassium-sparing diuretics. hyperparathyroidism. nocturnal emissions. Could possibly cause hyperkalemia when used with potassium-sparing diuretics. AH= AHPA. slow. C&C: Contains calcium. B R= BRINKER.

insomnia. According to traditional sources. C&C: Contains potassium. hydrochloric acid. PDR: Contraindicated in patients with hypertension. and Bie Jia (Carapax Amydae Sinensis). nicotinic acid. May reduce the anticoagulative effect of warfarin (Coumadin). May cause hypertension if consumed with caffeine. and manias. Qin Jiao (Radix Gentianae Qinjiao). Not recommended in large doses during pregnancy or lactation due to potential neonatal androgenization. B&G: Contraindicated in gastritis or when gastric ulcers are present. C&C= CHAN & CHEUNG. AH= AHPA. According to some traditional sources. may counteract Di Yu (Radix Sanguisorbae Officinalis). PDR= P HYSICIAN’S DESK REFERENCE .Chapter 4 Toxicities & Drug Interaction • 223 and prednisolone. C&C: Vitamin C. BR= BRINKER. heart palpitations. copious urination. Yuan Zhi (Radix Polygalae Tenuifoliae) Standard daily dosage: 3-9g AH: Contraindicated in gastritis or when gastric ulcers are present. B&G: Contraindicated for hypertensive patients. Contraindicated in patients with frequent. GLW= GAO L U WEN. Overdose can lead to headache. Enhances the effect of insulin and other antidiabetic agents. cause digitalis intoxication and heart arrhythmias. Possible additive effects to insulin. Use with MAO-inhibitors may cause headaches. counteracts Zhen Zhu (Margarita) and Li Lu (Rhizoma Et Radix Veratri). Ren Shen (Radix Panacis Ginseng. F L= FLAWS. Fu Shen (Sclerotium Pararadicis Poriae Cocos) Standard daily dosage: 9-60g B&G: Large doses or long-term use is discouraged. Could possibly cause hyperkalemia when used with potassium-sparing diuretics. and hinder the absorption of isoniazid. B&G= BENSKY & GAMBLE. A traditional antidote is mung bean soup. and other highly acidic substances could possibly reduce the therapeutic effect of this medicinal. and a rise in blood pressure. ginseng) Standard daily dosage: 1-30g AH: Contraindicated in hypertension BR: May cause manic episodes in patients on MAO-inhibitors. glutamic acid. B&B= BENSKY & BAROLET. tremors.

Vitamin C. urinary block. hypersensitivity to external stimuli. Shi Chang Pu. clenched teeth. May exaggerate the anticoagulative effect of warfarin (Coumadin). antagonizes Ma Huang (Herba Ephedrae). unclear thinking.Chapter 4 224 • Herb Toxicities & Drug Interactions: A Formula Approach C&C: Contains glycosides. B&G= BENSKY & GAMBLE. COMMENTS Dang Shen (Radix Codonopsitis Pilosulae) may be substituted for Ren Shen in this formula. sweating. B&B= BENSKY & BAROLET. BR= BRINKER. nicotinic acid. Gui Ban (Plastrum Testudinis. dimming of consciousness. GLW: Symptoms of adverse reaction include headache. Dang Gui (Radix Angelicae Sinensis) Standard daily dosage: 3-15g AH: Do not use during pregnancy. sweetflag rhizome) Standard daily dosage: 3-9g AH: Do not use during pregnancy. AH= AHPA. and death caused by stimulation of the spinal cord. and other highly acidic substances could possibly reduce the therapeutic effect of this medicinal. generalized tension which may become convulsions. vomiting. a rapid pulse. stiffness of the neck.) B&G: Use with caution in patients with diarrhea or abdominal distention. arched-back rigidity. oral thirst. glutamic acid. cramping of the four limbs. C&C: Contains potassium. and. (This medicinal is routinely used in Chinese medical gynecology during pregnancy as part of formulas appropriately prescribed on the basis of pattern discrimination. hydrochloric acid. slightly dilated pupils. Massive overdosage in mice led to convulsions. C&C= C HAN & CHEUNG. a red flushed face. antagonizes Sha Shen (Radix Glehniae Littoralis) and Ren Shen (Radix Panacis Ginseng). eventually death due to respiratory paralysis. tortoise plastron) Standard daily dosage: 9-30g B&G: Contraindicated in pregnancy. F L= FLAWS. According to some traditional sources. Chang Pu (Rhizoma Acori Graminei. B&G: According to some traditional sources. twitching muscles. vexation and agitation. increased body temperature and blood pressure. Could possibly cause hyperkalemia when used with potassium-sparing diuretics. PDR= PHYSICIAN’S DESK REFERENCE . GLW= GAO L U WEN .

and a rise in blood pressure. F L= FLAWS. glutamic acid. and a faint pulse on the verge of expiry Contraindications: Not for long-term use. and other highly acidic substances could possibly reduce the therapeutic effect of this medicinal. B&B= BENSKY & BAROLET. nicotinic acid. Enhances the effect of insulin and other antidiabetic agents. and manias. B&G: Contraindicated for hypertensive patients. a pale tongue. AH= AHPA. ginseng) Standard daily dosage: 1-30g AH: Contraindicated in hypertension BR: May cause manic episodes in patients on MAO-inhibitors. and stems the desertion of qi due to yang detriment Chinese medical indications: Yang qi desertion with cold extremities. Overdose can lead to headache. May reduce the anticoagulative effect of warfarin (Coumadin). tremors. POTENTIAL MEDICINAL TOXICITIES & INTERACTIONS: Ren Shen (Radix Panacis Ginseng. cardiogenic shock. for emergency use only Western medical indications: Cardiac failure. insomnia. Possible additive effects to insulin. Extended use will damage the yin and consume blood. postpartum hemorrhage. hydrochloric acid. heart palpitations. and other causes of hypovolemic shock Potential formula toxicities & interactions: B&B: A very strong formula that should only be administered in acute conditions. Use with MAO-inhibitors may cause headaches. GLW= GAO L U WEN . shortness of breath. C&C: Vitamin C. May cause hypertension if consumed with caffeine. B&G= BENSKY & GAMBLE. C&C= CHAN & CHEUNG. BR= BRINKER. PDR= PHYSICIAN’S DESK REFERENCE . strongly supplements source qi. sweating. myocardial infarction. uterine bleeding. A traditional antidote is mung bean soup. PDR: Contraindicated in patients with hypertension.Chapter 4 Toxicities & Drug Interaction • 225 SHEN FU TANG (Ginseng & Aconite Decoction) Category: Interior-warming Functions: Rescues yang. weak breathing. Not recommended in large doses during pregnancy or lactation due to potential neonatal androgenization. an extremely pale facial complexion. dizziness.

Could possibly reduce the absorption and therapeutic effect of potassium and sodium iodides. vomiting. rapid breathing. Emergency measures include the administration of atropine. dyspnea. Sheng Jiang (uncooked Rhizoma Zingiberis Officinalis. dilated pupils. PDR: Recommended safe dosage limit is six grams (6g). monkshood) Standard daily dosage: 1. slowed reaction to light. small doses can be fatal. a somber white facial complexion. convulsions. there is a burning hot sensation in the mouth and on the tongue. and reduced temperature and blood pressure. Shu Fu Zi. vexation. BR= BRINKER. PDR= PHYSICIAN’S DESK REFERENCE . B&G= BENSKY & GAMBLE. C&C= CHAN & CHEUNG. and circulatory collapse leading to death. there may be generalized sweating. and magnesium sulfate. PDR: Contains nor-diterpene alkaloids. GLW= GAO L U WEN . numbness. Highly toxic. Fu Pian (Radix Lateralis Praeparatus Aconiti Carmichaeli. B&B= BENSKY & BAROLET.Chapter 4 226 • Herb Toxicities & Drug Interactions: A Formula Approach Fu Zi. A very toxic medicinal which can be fatal if ingested in its uncooked form or in an inappropriate dose. restlessness. slow heartbeat. It is generally combined with Gan Cao (Radix Glycyrhizae Uralensis) and Gan Jiang (dry Rhizoma Zingiberis Officinalis) in decoctions to reduce its toxicity. AH= AHPA. paralysis. nausea. If more severe poisoning. More severe symptoms include premature atrial contractions. C&C: Contains alkaloids. and numbness and tingling of the extremities. aluminum hydroxide. low blood pressure. including aconitine. drooling. blurred vision. Symptoms of toxicity include drooling. heart palpitations. light-headedness. gastric upset. and pain which gradually spreads to the four limbs and then to the whole body. agitation. urinary incontinence. F L= FLAWS. dizziness. lowered body temperature. reversal chilling of the four limbs. Avoid larger doses if being used to treat morning sickness or if used in patients taking anticoagulants. fresh ginger) Standard daily dose: 3-9g AH: Safe when used appropriately BR: Reduces vomiting caused by chemotherapeutic drugs. GLW: If mild poisoning. Increases absorption of oral drugs. wolfsbane. sodium bicarbonate.5-15g AH: To be used only under the supervision of an expert qualified in the appropriate use of this substance B&G: Contraindicated during pregnancy. arrhythmia.

AH= AHPA. BR= BRINKER.Chapter 4 Toxicities & Drug Interaction • 227 Da Zao. B&G= B ENSKY & GAMBLE. Hong Zao (Fructus Zizyphi Jujubae. PDR= P HYSICIAN’S DESK REFERENCE . F L= FLAWS. it is one where Dang Shen (Radix Codonopsitis Pilosulae) is not substituted for Ren Shen. C&C= CHAN & CHEUNG. B&B= BENSKY & BAROLET. COMMENTS Because this formula is meant for emergency use. red dates) Standard daily dosage: 10-30g (3-12 pieces) AH: Safe when used appropriately PDR: No health risks or side effects are known in conjunction with the proper administration of designated therapeutic dosages. GLW= GAO LU WEN.

ginseng) Standard daily dosage: 1-30g AH: Contraindicated in hypertension. and a rise in blood pressure. chest and stomach duct oppression and distention. diabetes mellitus. FL= FLAWS. heart palpitations. slightly slow) or forceless.k. Enhances the effect of insulin and other antidiabetic agents. eliminates dampness and stops diarrhea Chinese medical indications: Spleen vacuity with internally engendered dampness resulting in loose stools. and other highly acidic substances could possibly reduce the therapeutic effect of this medicinal. Poria & Atractylodes Powder. Ginseng & Atractylodes Formula) Category: Qi-supplementing Functions: Fortifies the spleen and supplements the qi. B&B= BENSKY & BAROLET. moderate (i. Use with MAO-inhibitors may cause headaches. and manias. chronic bronchitis. insomnia.Chapter 4 228 • Herb Toxicities & Drug Interactions: A Formula Approach SHEN LING BAI ZHU SAN (Ginseng. PDR: Contraindicated in patients with hypertension. and malnutrition in children Potential formula toxicities & interactions: None listed POTENTIAL MEDICINAL TOXICITIES & I NTERACTIONS: Ren Shen (Radix Panacis Ginseng.e. C&C= CHAN & CHEUNG. Possible additive effects to insulin. malabsorption symdromes. chronic nephritis. fatigue. BR: May cause manic episodes in patients on MAO-inhibitors. Overdose can lead to headache. A traditional antidote is mung bean soup.a. and a fine. nicotinic acid. GLW= GAO LU WEN. torpid intake. lack of strength. May cause hypertension if consumed with caffeine. B&G: Contraindicated for hypertensive patients. hydrochloric acid. chronic hepatitis. C&C: Vitamin C. B&G= B ENSKY & GAMBLE . diarrhea. a. tremors.. Not recommended in large doses during pregnancy or lactation due to potential neonatal androgenization. May reduce the anticoagulative effect of warfarin (Coumadin). AH= AHPA. a pale tongue with white fur. a pale white or sallow yellow facial complexion. PDR= P HYSICIAN’ S DESK REFERENCE . moderate pulse Contraindications: Yin vacuity heat Western medical indications: Diarrhea from chronic gastritis. glutamic acid. BR= BRINKER.

may counteract Di Yu (Radix Sanguisorbae Officinalis). PDR= P HYSICIAN’S DESK REFERENCE . B&G= B ENSKY & GAMBLE.5g/kg of this medicinal for two months.Chapter 4 Toxicities & Drug Interaction • 229 Bai Zhu (Rhizoma Atractylodis Macrocephalae) Standard daily dosage: 4. or liver. Qin Jiao (Radix Gentianae Qinjiao). GLW= GAO LU WEN. Not for long-term use. BR: May increase toxicity of cardiac glycosides. hypertension. they developed a mild lymphopenia and anemia but suffered no damage to the brain. caution should be exercised to guard against potential toxicity and drug interaction. and liver disorders. (This medicinal is routinely used in Chinese medical gynecology during pregnancy as part of formulas appropriately prescribed on the basis of pattern discrimination. Could possibly cause hyperkalemia when used with potassium-sparing diuretics. AH= AHPA.5-9g AH: Safe when used appropriately B&G: When rats were fed 0. Yun Ling (Sclerotium Poriae Cocos) Standard daily dosage: 9-15g B&G: Large doses or long-term use is discouraged. B&B= BENSKY & BAROLET. licorice root) Standard daily dosage: 2-12g AH: Do not use during pregnancy. Yuan Hua (Flos Daphnes Genkwae). it may cause hypertension and/or edema. Possible additive effect to corticosteroids. When used as a single medicinal or in patients taking other potent Western pharmaceuticals. It should not be taken longterm or as a single herb during pregnancy.) As a single herb in high doses. If taken long-term. it is contraindicated in diabetes. May increase potassium loss due to diuretics and laxatives. BR= BRINKER. According to traditional sources. and Yuan Zhi (Radix Polygalae Tenuifoliae). copious urination. and Bie Jia (Carapax Amydae Sinensis). Contains glycyrrhetinic acid which could possibly cause a reduction in thyroid activity and basal metabolic rate. The research on Gan Cao concurs that this medicinal is generally safe when used in small amounts as an envoy. B&G: According to some traditional sources. heart. C&C: Contains potassium. C&C= CHAN & CHEUNG. Fu Ling. Contraindicated in patients with frequent. Gan Cao (Radix Glycyrrhizae Uralensis. May be synergistic with insulin in causing hypokalemia and sodium retention. F L= FLAWS. Bai Fu Ling. incompatible with Gan Sui (Radix Euphorbiae Kansui).

and other highly acidic substances could possibly reduce the therapeutic effect of this medicinal. Yi Mi Ren.Chapter 4 230 • Herb Toxicities & Drug Interactions: A Formula Approach Shan Yao (Radix Dioscoreae Oppositae) Standard daily dosage: 9-30g AH: Safe when used appropriately B&G: According to some traditional sources. BR= BRINKER. PDR: No health risks or side effects are known in conjunction with the proper administration of designated therapeutic dosages. Vitamin C. FL= FLAWS. amylase. potassium. and magnesium sulfate. Job’s tears barley) Standard daily dosage: 9-30g AH: Not to be used during pregnancy. hyacinth bean) Standard daily dosage: 9-21g B&G: Contraindicated in patients with intermittent chills and fevers. Lian Ren (Semen Nelumbinis Nuciferae) Standard daily dosage: 6-15g AH: Contraindicated in constipation and stomach distention. PDR: Use of this medicinal may reduce the antiinflammatory effect of indomethacin. Bian Dou (Semen Dolichoris Lablab. and glycosides. tetracyclines. Yi Yi Ren. C&C= CHAN & CHEUNG. B&G: Contraindicated in constipation and stomach distention. hydrochloric acid. nicotinic acid. Could possibly reduce the absorption and therapeutic effect of potassium and sodium iodides. C&C: Contains alkaloids. AH= AHPA. Could possibly cause hyperkalemia when used with potassium-sparing diuretics. Lian Zi. Yi Ren. Yi Mi. May have an additive estrogenic effect when administered with estrogen-containing drugs. sulphanomides. C&C: Contains alkaloids. aluminum hydroxide. Could possibly reduce the absorption and therapeutic effect of potassium and sodium iodides. glutamic acid. B&B= BENSKY & BAROLET. and aspirin. B&G= B ENSKY & GAMBLE . Lian Rou. magnesium sulfate. sodium bicarbonate. Bai Bian Dou. Lian Zi Rou. antagonizes Gan Sui (Radix Euphorbiae Kansui). Yi Ren Mi (Semen Coicis Lachryma-jobi. sodium bicarbonate. Poisoning in overdoses may occur from the picrotoxin-like effect of dioscorin. aluminum hydroxide. PDR= P HYSICIAN’ S DESK REFERENCE . GLW= GAO LU WEN.

cause digitalis intoxication and heart arrhythmias. and reduce the biological effect of levadopa. Sha Ren (Fructus Amomi) Standard daily dosage: 1.Chapter 4 Toxicities & Drug Interaction • 231 B&G: Use with caution during pregnancy. Could possibly reduce the effect of most antibiotics. bellflower root) Standard daily dosage: 3-9g AH: Contraindicated in hemoptysis. Jie Geng (Radix Platycodi Grandiflori. B&B= BENSKY & BAROLET. nicotinic acid. GLW= GAO LU WEN. B&G= B ENSKY & GAMBLE. Use with caution in bleeding peptic ulcer. hydrochloric acid. C&C= CHAN & CHEUNG. especially in cases of tuberculosis. C&C: Contains calcium and glycosides. AH= AHPA. PDR= P HYSICIAN’S DESK REFERENCE . glutamic acid. Could possibly cause hyperkalemia when used with potassium-sparing diuretics. B&G: Contraindicated in patients with hemoptysis. COMMENTS Dang Shen (Radix Codonopsitis Pilosulae) is commonly substituted for Ren Shen in this formula. and other highly acidic substances could possibly reduce the therapeutic effect of this medicinal. hinder the absorption of isoniazid. counteracts Long Dan Cao (Radix Gentiana Longdancao) and Long Yan Rou (Arillus Euphoriae Longanae). Vitamin C. According to some traditional sources. C&C: Contains potassium. F L= FLAWS. BR= BRINKER.5-6g AH: Safe when used appropriately PDR: Use with caution in patients with gallstones since it can trigger colic due to its motility-enhancing effect.

B&G= B ENSKY & GAMBLE . Use with care in postpartum disorders since this formula may be too harsh. GLW= GAO LU WEN.) B&G: Use with caution in patients with diarrhea or abdominal distention. a pale but purplish tongue or possible static macules or speckles. B&B= BENSKY & BAROLET. May exaggerate the anticoagulative effect of warfarin (Coumadin). BR= BRINKER. (This medicinal is routinely used in Chinese medical gynecology during pregnancy as part of formulas appropriately prescribed on the basis of pattern discrimination.) AH: Do not use during pregnancy. it is not uncommon for this medicinal to be prescribed up to 15 grams per day in decoction. chronic endometritis. deep. C&C: Contains potassium. and trichomonas vaginitis Potential formula toxicities & interactions: FL/B&B: Contraindicated during pregnancy and with most hemorrhagic disorders. puerperal infection. According to some AH= AHPA. C&C= CHAN & CHEUNG. and warms the channels Chinese medical indications: Uterine cold as a result of qi and blood vacuity postpartum manifesting as nonprecipitation of the lochia. Chuan Xiong (Radix Ligustici Wallichii) Standard daily dosage: 3-9g(In China today. choppy pulse Contraindications: Heat stasis or postpartum bleeding due to heat causing the blood to move frenetically outside its vessels Western medical indications: Retention of lochia.) B&G: Not for patients with migraine headache or excessive menstrual bleeding. PDR= P HYSICIAN’ S DESK REFERENCE . and a fine. Overdosage causes vomiting and dizziness. FL= FLAWS. retention of placental fragments and other postpartum complaints associated with stale blood retained in the lower abdomen. (This medicinal is routinely used in Chinese medical gynecology during pregnancy as part of formulas appropriately prescribed on the basis of pattern discrimination. POTENTIAL MEDICINAL TOXICITIES & INTERACTIONS: Dang Gui (Radix Angelicae Sinensis) Standard daily dosage: 3-15g AH: Do not use during pregnancy. transforms stasis. chilly pain in the lower abdomen.Chapter 4 232 • Herb Toxicities & Drug Interactions: A Formula Approach SHENG HUA TANG (Engendering & Transforming Decoction) Category: Blood-quickening Functions: Quickens the blood. Could possibly cause hyperkalemia when used with potassium-sparing diuretics.

hypertension. May be synergistic with insulin in causing hypokalemia and sodium retention. and liver disorders. BR: May increase toxicity of cardiac glycosides. it may cause hypertension and/or edema.) Standard daily dosage: 3-12g AH: Not to be used during pregnancy. sodium bicarbonate. GLW= GAO LU WEN . PDR: Recommended safe dosage limit is six grams (6g). it is contraindicated in diabetes. B&G: Use with caution during pregnancy. Pao Jiang (blast-fried Rhizoma Zingiberis Officinalis)(Toxicity and usage information not specific to Pao Jiang or blast-fried Rhizoma Zingiberis Officinalis. aluminum hydroxide. Not for long-term use. If taken long-term. incompatible with Gan Sui (Radix Euphorbiae Kansui). Contains glycyrrhetinic acid which could possibly cause a reduction in thyroid activity and basal metabolic rate. B&G: According to some traditional sources. Patients with gallstones must consult a practitioner prior to use. May increase potassium loss due to diuretics and laxatives. BR= BRINKER. The research on Gan Cao concurs that this medicinal is generally safe AH= AHPA. Avoid larger doses if being used to treat morning sickness or if used in patients taking anticoagulants. B&G= B ENSKY & GAMBLE.) As a single herb in high doses. Yuan Hua (Flos Daphnes Genkwae). blast-frying does change the chemotherapeutic actions of this medicinal. (This medicinal is routinely used in Chinese medical gynecology during pregnancy as part of formulas appropriately prescribed on the basis of pattern discrimination. Assumedly.Chapter 4 Toxicities & Drug Interaction • 233 traditional texts. Gan Cao (Radix Glycyrrhizae Uralensis. C&C= CHAN & CHEUNG. Increases absorption of oral drugs. and is incompatible with Li Lu (Rhizoma Et Radix Veratri). PDR= PHYSICIAN’S DESK REFERENCE . Possible additive effect to corticosteroids. counteracts Hua Shi (Talcum) and Huang Lian (Rhizoma Coptidis Chinensis). BR: Reduces vomiting caused by chemotherapeutic drugs. antagonizes Shan Zhu Yu (Fructus Corni Officinalis) and Huang Qi (Radix Astragali Membranacei). C&C: Contains alkaloids and potassium. F L= FLAWS. licorice root) Standard daily dosage: 2-12g AH: Do not use during pregnancy. B&B= BENSKY & BAROLET. and Yuan Zhi (Radix Polygalae Tenuifoliae). Could possibly cause hyperkalemia when used with potassium-sparing diuretics. and magnesium sulfate. Could possibly reduce the absorption and therapeutic effect of potassium and sodium iodides.

vomiting accompanied by watery diarrhea. consciousness becomes unclear. and respiratory paralysis leads to death. and other highly acidic substances could possibly reduce the therapeutic effect of this medicinal. GLW= GAO LU WEN. nausea. Eventually. drooling. C&C: Contains potassium and glycosides (including cyanophoric glycosides). this medicinal is blanched before using and its tip is broken off in order to make it less or non-toxic. Most of the toxins in this medicinal reside in the skin and tip. When used as a single medicinal or in patients taking other potent Western pharmaceuticals. C&C= CHAN & CHEUNG. It should not be taken long-term or as a single herb during pregnancy. Tao Ren (Semen Pruni Persicae.5-9g AH: Not to be used during pregnancy. GLW: In case of poisoning. B&G= B ENSKY & GAMBLE . heart palpitations. 1-2 hours after ingestion there is a bitter taste and astringent feeling within the mouth.Chapter 4 234 • Herb Toxicities & Drug Interactions: A Formula Approach when used in small amounts as an envoy. and the pupils of the eye dilate widely with loss of reactivity to light. hydrocyanic acid is produced which can lead to respiratory failure and death. B&B= BENSKY & BAROLET. whether spontaneous or artificial. blood pressure drops. PDR= P HYSICIAN’ S DESK REFERENCE . Vitamin C. dizziness. COMMENTS Some Chinese doctors administer this formula prophylactically postpartum and postabortion. B&G: Contraindicated during pregnancy. breathing becomes weak. The teeth become clenched. BR= BRINKER. In more serious cases. nicotinic acid. glutamic acid. Sometimes one can smell cyanide on the person’s breath. there are generalized convulsions. Could possibly cause hyperkalemia when used with potassium-sparing diuretics. typically. or other opiates. peach kernel) Standard daily dosage: 4. headache. Therefore. hydrochloric acid. AH= AHPA. FL= FLAWS. and lack of strength. If taken with codeine. there is difficulty breathing. caution should be exercised to guard against potential toxicity and drug interaction. morphine.

A traditional antidote is mung bean soup. Not recommended in large doses during pregnancy or lactation due to potential neonatal androgenization. such as a cold or flu. F L= FLAWS. Use with MAO-inhibitors may cause headaches. insomnia. heart palpitations. preserves the yin and stops excessive sweating Chinese medical indications: Lung qi and yin dual vacuity with chronic cough and scanty phlegm which is difficult to expectorate. and pulmonary tuberculosis Potential formula toxicities & interactions: B&B: Using this formula in patients with an externally contracted illness. coronary artery disease. AH= AHPA. C&C= C HAN & CHEUNG. chronic bronchitis. nicotinic acid. glutamic acid. Overdose can lead to headache. post-bypass debility. tremors. Enhances the effect of insulin and other antidiabetic agents. PDR= PHYSICIAN’S DESK REFERENCE . shortness of breath. Possible additive effects to insulin. and a vacuous. and manias. B&G= BENSKY & GAMBLE. spontaneous perspiration. may prolong the infection. May cause hypertension if consumed with caffeine. B&B= BENSKY & BAROLET. ginseng) Standard daily dosage: 1-30g AH: Contraindicated in hypertension. and a rise in blood pressure. POTENTIAL MEDICINAL TOXICITIES & INTERACTIONS: Ren Shen (Radix Panacis Ginseng. BR: May cause manic episodes in patients on MAO-inhibitors. rapid pulse Contraindications: Unresolved evils and/or undamaged fluids Western medical indications: Superventricular arrhythmias. and other highly acidic substances could possibly reduce the therapeutic effect of this medicinal.Chapter 4 Toxicities & Drug Interaction • 235 SHENG MAI SAN (Engender the Pulse Powder) Category: Qi-supplementing Functions: Supplements the qi and engenders fluids. rapid or fine. BR= BRINKER. GLW= GAO L U WEN . rheumatic heart disease. hydrochloric acid. PDR: Contraindicated in patients with hypertension. a dry mouth and tongue. C&C: Vitamin C. a pale red tongue with scanty fur. B&G: Contraindicated for hypertensive patients. May reduce the anticoagulative effect of warfarin (Coumadin).

GLW= GAO LU WEN. PDR: No health risks or side effects are known in conjunction with the proper administration of designated therapeutic dosages. aluminum hydroxide. C&C: Contains potassium. toxic doses were 1015g/kg. B&G= B ENSKY & GAMBLE. antagonizes Kuan Dong Hua (Flos Tussilaginis Farfarae) and counteracts Ku Shen (Radix Sophorae Flavescentis) and Bai Mu Er (Fructificatio Tremellae Fuciformis). insomnia. many antibiotics (especially aminoglycosides and sulfas). hydrochloric acid. Vitamin C. C&C: Contains glycosides. nicotinic acid. In mice.5-9g AH: Safe when used appropriately B&G: Occasionally causes heartburn. C&C= CHAN & CHEUNG. glutamic acid.Chapter 4 236 • Herb Toxicities & Drug Interactions: A Formula Approach Mai Men Dong. FL= FLAWS. B&B= BENSKY & BAROLET. reserpine. BR= BRINKER. Wu Wei Zi (Fructus Schisandrae Chinensis. Could possibly cause hyperkalemia when used in large doses with potassium-sparing diuretics. especially when this formula is combined with another formula or heavily modified. and other highly acidic substances could possibly reduce the therapeutic effect of this medicinal. scopolamine. PDR= PHYSICIAN’ S DESK REFERENCE . Could possibly reduce the therapeutic effect of sodium bicarbonate. COMMENTS Dang Shen (Radix Codonopsitis Pilosulae) or Tai Zi Shen (Radix Pseudostellariae Heterophyllae) are commonly substituted for Ren Shen in this formula. Could possibly cause crystalluria and hematuria. AH= AHPA. caffeine. or dyspnea. and berbamin. opiates. schisandra) Standard daily dosage: 1. Mai Dong (Tuber Ophiopogoni Japonici) Standard daily dosage: 6-15g AH: Safe when used appropriately B&G: According to some traditional sources. Symptoms of overdose included restlessness. Highly acidic.

aluminum hydroxide. He Ye (Folium Nelumbinis Nuciferae. B&G= BENSKY & GAMBLE. sodium bicarbonate.a. epistaxis.5-60g No toxicity or interaction information listed in sources Xiao Ji (Herba Cephalanoploris Segeti) Standard daily dosage: 4. bleeding peptic ulcer. Vitamin C. acute hemorrhagic esophagitis or gastritis. PDR= PHYSICIAN’S DESK REFERENCE . and magnesium sulfate. functional uterine bleeding. hemoptysis. a. B&B= BENSKY & BAROLET. and pulmonary tuberculosis Potential formula toxicities & interactions: None listed POTENTIAL MEDICINAL TOXICITIES & INTERACTIONS: Da Ji (Herba Seu Radix Cirsii Japonici) Standard daily dosage: 4.5-60g C&C: Contains alkaloids. yin.k. BR= BRINKER. lotus leaves) Standard daily dosage: 9-30g AH: Safe when used appropriately AH= AHPA. glutamic acid. hydrochloric acid. C&C= CHAN & CHEUNG. hemorrhagic febrile diseases. and/or yang vacuity bleeding Western medical indications: Hematemesis. potassium. and glycosides. F L= FLAWS. nicotinic acid. Could possibly cause hyperkalemia when used with potassium-sparing diuretics and reduce the absorption and therapeutic effect of potassium and sodium iodides. and other highly acidic substances could possibly reduce the therapeutic effect of this medicinal. Ten Partially Charred Substances Powder) Category: Bleeding-stopping Functions: Cools the blood and stops bleeding Chinese medical indications: Fire blazing in the upper and middle burners damaging the blood vessels and resulting in hematemesis or hemoptysis Contraindications: Qi. GLW= GAO L U WEN .Chapter 4 Toxicities & Drug Interaction • 237 SHI HUI SAN (Ten Ashes Powder.

may counteract Fu Ling (Sclerotium Poria Cocos). AH= AHPA. Ce Bai Ye (Cacumen Biotae Orientalis) Standard daily dosage: 6-15g B&G: Long-term use or a large dose may cause dizziness and gastric upset. PDR: No health risks or side effects are known in conjunction with the proper administration of designated therapeutic dosages. glutamic acid. Vitamin C. many antibiotics (especially aminoglycosides and sulfas). Could possibly cause crystalluria and hematuria. PDR= PHYSICIAN’S DESK REFERENCE . Could possibly cause hyperkalemia when used with potassium-sparing diuretics. caffeine. opiates. Bai Mao Gen. GLW= GAO LU WEN . scopolamine. B&B= BENSKY & BAROLET. Shan Zhi Zi (Fructus Gardeniae Jasminoidis. Qian Cao Gen. C&C: Contains potassium and glycosides. Mao Gen (Rhizoma Imperatae Cylindricae) Standard daily dosage: 9-60g AH: Safe when used appropriately C&C: Contains potassium. B&G= B ENSKY & GAMBLE. aluminum hydroxide. and berbamin. nicotinic acid. F L= FLAWS. Could possibly cause hyperkalemia when used with potassium-sparing diuretics and could possibly reduce the therapeutic effect of sodium bicarbonate. dried gardenia fruit pod) Standard daily dosage: 3-12g AH: Safe when used appropriately B&G: Contains geniposide which caused diarrhea in mice. Qian Cao (Radix Rubiae Cordifoliae) Standard daily dosage: 6-9g No toxicity or interaction information listed in the sources Zhi Zi. and other highly acidic substances could possibly reduce the therapeutic effect of this medicinal. reserpine. hydrochloric acid. Shan Zhi. C&C= CHAN & CHEUNG. BR= BRINKER. Highly acidic.Chapter 4 238 • Herb Toxicities & Drug Interactions: A Formula Approach B&G: According to traditional sources.

trypsine. and other highly acidic substances could possibly reduce the therapeutic effect of this medicinal. abdominal pain of unknown origin. Mu Dan Pi (Cortex Radicis Moutan. C&C: Contains tannic acid. Contraindicated in cases of intestinal obstruction. Contraindicated for nursing mothers since active ingredients enter the milk. FL= FLAWS. potassium. and glycosides. atropine. C&C: Contains alkaloids. or any inflammatory condition of the intestines. (This ingredient is commonly used in China during pregnancy to treat heat in the blood and/or blood stasis. Chuan Jun. ephedrine. vitamin B1. B&G= B ENSKY & GAMBLE .) B&G: Should not be used during pregnancy or in patients with excessive sweating or profuse menstruation. hydrochloric acid. and other highly acidic substances could possibly reduce the therapeutic effect of this medicinal. May aggravate potassium loss from diuretics. Could possibly reduce the absorption and biologic effect of most antibiotics. reserpine. AH= AHPA. Not to be used while nursing. Avoid using with garlic. rhubarb root) Standard daily dosage: 3-12g AH: Do not use during pregnancy. According to some traditional sources. quinine. BR= BRINKER. and glycosides. Contraindicated in intestinal obstruction. or postpartum. and pepsin. B&G: Use with extreme caution during pregnancy. C&C= CHAN & CHEUNG. potassium. PDR= P HYSICIAN’ S DESK REFERENCE . nicotinic acid. tree peony root bark) Standard daily dosage: 6-12g AH: Not to be used during pregnancy. and Da Huang (Radix Et Rhizoma Rhei). glutamic acid. tannic acid. Dan Pi. isoniazid. GLW= GAO LU WEN. calcium carbonate and gluconate. Could possibly cause hyperkalemia when used with potassium-sparing diuretics. nicotinic acid. appendicitis and abdominal pain of unknown origin. hydrochloric acid. BR: Reduces absorption of oral drugs. digitalis. glutamic acid. chlorpromazine. Vitamin C. Could possibly cause hyperkalemia when used with potassium-sparing diuretics. PDR: Consult a physician before using this medicinal during pregnancy or while nursing. Overuse may cause hypokalemia and increased toxicity of cardiac glycosides. Bei Mu (Bulbus Fritillariae). Vitamin C. may counteract the effect of Tu Si Zi (Semen Cuscutae Chinensis). amylase. acute inflammatory intestinal disease. B&B= BENSKY & BAROLET. menstruation. Jun (Radix Et Rhizoma Rhei.Chapter 4 Toxicities & Drug Interaction • 239 Da Huang. Dai Huang.

PDR= PHYSICIAN’S DESK REFERENCE . BR= BRINKER. B&B= BENSKY & BAROLET. AH= AHPA. C&C= CHAN & CHEUNG. and 3) treat the root. this formula is employed to first stop the bleeding by any means possible. F L= FLAWS. B&G= B ENSKY & GAMBLE. This is based on Ye Tian-shi’s three principles of treating bleeding: 1) First stop the bleeding. 2) treat the cause. some Chinese doctors use this formula in ready-made form as an all-purpose first aid styptic.Chapter 4 240 • Herb Toxicities & Drug Interactions: A Formula Approach Zong Lu Tan (carbonized Fibra Stipulae Trachycarpi) Standard daily dosage: 9-15g No toxicity or interaction information listed in the sources COMMENTS Although specifically for blood heat bleeding. In that case. GLW= GAO LU WEN .

irregular menstruation.k. discrete form. F L= FLAWS. endometriosis. B&G= BENSKY & GAMBLE. postpartum abdominal pain. and postpartum abdominal pain Contraindications: Spleen-stomach qi vacuity and pregnancy Western medical indications: Retention of lochia. flying squirrel feces) Standard daily dosage: 3-9g B&G: Use with caution during pregnancy. PDR= PHYSICIAN’S DESK REFERENCE . Traditionally considered to be antagonized by Ren Shen (Radix Panacis Ginseng). Could possibly cause hyperkalemia when used with potassium-sparing diuretics.a. Sudden Smile Powder) Category: Blood-quickening Functions: Quickens the blood and dispels stasis. dissipates binding and stops pain Chinese medical indications: Static blood resulting in menstrual irregularities. cat-tail pollen) Standard daily dosage: 4. C&C: Contains potassium. COMMENTS This formula is seldom used in this simple. AH= AHPA. a. Instead. and angina pectoris Potential formula toxicities & interactions: FL/B&B: Contraindicated during pregnancy because Pu Huang (Pollen Typhae) may cause uterine contractions POTENTIAL MEDICINAL TOXICITIES & INTERACTIONS: Wu Ling Zhi (Excrementum Trogopterori Seu Pteromi. more commonly. Pu Huang (Pollen Typhae.5-12g B&G: Use with caution during pregnancy.Chapter 4 Toxicities & Drug Interaction • 241 SHI XIAO SAN (Loose a Smile Powder. nonprecipitation of the lochia. painful menstruation. B&B= BENSKY & BAROLET. amenorrhea. GLW= GAO L U WEN . BR= BRINKER. the ingredients in this formula are added to other formulas when the ability to stop pain is wanted. dysmenorrhea. C&C= C HAN & CHEUNG.

B&G= BENSKY & GAMBLE. a faint. C&C= CHAN & CHEUNG. B&B= BENSKY & BAROLET. irritable bowel syndrome. uterine fibroids.k. POTENTIAL MEDICINAL TOXICITIES & I NTERACTIONS: Ren Shen (Radix Panacis Ginseng. hydrochloric acid. constipation. vomiting. low voice and/or disinclination to speak due to fatigue. heart palpitations. Possible additive effects to insulin. extreme thirst. loose stools. and a fine. agitation. F L= FLAWS. fatigue. gastric and duodenal ulcer. a. PDR= PHYSICIAN’S DESK REFERENCE . AH= AHPA. anemia. Enhances the effect of insulin and other antidiabetic agents. A traditional antidote is mung bean soup. PDR: Contraindicated in patients with hypertension. May reduce the anticoagulative effect of warfarin (Coumadin). tremors. nicotinic acid.Chapter 4 242 • Herb Toxicities & Drug Interactions: A Formula Approach SI JUN ZI TANG (Four Gentlemen Decoction. Overdose can lead to headache. forceless pulse Contraindications: Vacuity heat.a. diabetes mellitus. and diarrhea Potential formula toxicities & interactions: FL/B&B: Prolonged use may result in a dry mouth. glutamic acid. BR= BRINKER. or constipation. Four Major Herb Combination) Category: Qi-supplementing Functions: Fortifies the spleen and supplements the qi Chinese medical indications: Spleen qi vacuity with a pale facial complexion. a pale tongue. and other highly acidic substances could possibly reduce the therapeutic effect of this medicinal. Use with MAO-inhibitors may cause headaches. gastrointestinal weakness and dysfunction. insomnia. B&G: Contraindicated for hypertensive patients. Not recommended in large doses during pregnancy or lactation due to potential neonatal androgenization. GLW= GAO L U WEN . May cause hypertension if consumed with caffeine. high fever Western medical indications: Chronic gastritis. and a rise in blood pressure. C&C: Vitamin C. and manias. lack of strength. ginseng) Standard daily dosage: 1-30g AH: Contraindicated in hypertension BR: May cause manic episodes in patients on MAO-inhibitors. gastroptysis. irritability.

they developed a mild lymphopenia and anemia but suffered no damage to the brain. B&G= B ENSKY & GAMBLE. caution AH= AHPA.) As a single herb in high doses. If taken long-term. Contains glycyrrhetinic acid which could possibly cause a reduction in thyroid activity and basal metabolic rate. Yun Ling (Sclerotium Poriae Cocos) Standard daily dosage: 9-15g B&G: Large doses or long-term use is discouraged. and liver disorders. Bai Fu Ling. incompatible with Gan Sui (Radix Euphorbiae Kansui). C&C: Contains potassium. licorice root) Standard daily dosage: 2-12g AH: Do not use during pregnancy. it may cause hypertension and/or edema. it is contraindicated in diabetes. May be synergistic with insulin in causing hypokalemia and sodium retention.Chapter 4 Toxicities & Drug Interaction • 243 Bai Zhu (Rhizoma Atractylodis Macrocephalae) Standard daily dosage: 4. Possible additive effect to corticosteroids. PDR= PHYSICIAN’S DESK REFERENCE . Could possibly cause hyperkalemia when used with potassium-sparing diuretics. or liver.5-9g AH: Safe when used appropriately B&G: When rats were fed 0.5g/kg of this medicinal for two months. (This medicinal is routinely used in Chinese medical gynecology during pregnancy as part of formulas appropriately prescribed on the basis of pattern discrimination. hypertension. It should not be taken longterm or as a single herb during pregnancy. Contraindicated in patients with frequent. and Yuan Zhi (Radix Polygalae Tenuifoliae). Yuan Hua (Flos Daphnes Genkwae). Gan Cao (Radix Glycyrrhizae Uralensis. F L= FLAWS. May increase potassium loss due to diuretics and laxatives. Fu Ling. may counteract Di Yu (Radix Sanguisorbae Officinalis). and Bie Jia (Carapax Amydae Sinensis). According to traditional sources. copious urination. C&C= CHAN & CHEUNG. heart. BR= BRINKER. B&B= BENSKY & BAROLET. BR: May increase toxicity of cardiac glycosides. Qin Jiao (Radix Gentianae Qinjiao). B&G: According to some traditional sources. Not for long-term use. The research on Gan Cao concurs that this medicinal is generally safe when used in small amounts as an envoy. When used as a single medicinal or in patients taking other potent Western pharmaceuticals. GLW= GAO LU WEN .

either some or all of the ingredients in this formula are often added to other formulas to fortify the spleen and supplement the qi. BR= BRINKER. Typically. C&C= CHAN & CHEUNG. Dang Shen (Radix Codonopsitis Pilosulae) is substituted for Ren Shen in this formula. AH= AHPA. it is rarely prescribed in this simple form since real-life patients rarely present simple spleen qi vacuity. PDR= P HYSICIAN’S DESK REFERENCE .Chapter 4 244 • Herb Toxicities & Drug Interactions: A Formula Approach should be exercised to guard against potential toxicity and drug interaction. F L= FLAWS. especially if the symptom of spleen qi vacuity is loose stools. GLW= GAO LU WEN. However. B&G= B ENSKY & GAMBLE. COMMENTS Although this formula is one of the most famous in Chinese medicine. B&B= BENSKY & BAROLET.

it is contraindicated in diabetes. mastitis.Chapter 4 Toxicities & Drug Interaction • 245 SI NI SAN (Four Counterflows Powder. BR= BRINKER. peptic ulcer. and liver disorders. cholecystitis. B&G= B ENSKY & GAMBLE. AH= AHPA. courses the liver and fortifies the spleen Chinese medical indications: Yang reversal due to a combination of liver depression and spleen vacuity with cold hands and feet caused primarily by psychoemotional stress. intercostal neuralgia. B&B= BENSKY & BAROLET. Not for long-term use. licorice root) Standard daily dosage: 2-12g AH: Do not use during pregnancy. Yuan Hua (Flos Daphnes Genkwae). Raynaud’s phenomenon or disease. hypertension. psychogenic diarrhea.) As a single herb in high doses. hernia. POTENTIAL MEDICINAL TOXICITIES & I NTERACTIONS: Gan Cao (Radix Glycyrrhizae Uralensis. intestinal obstruction. incompatible with Gan Sui (Radix Euphorbiae Kansui). If so. hepatitis. F L= FLAWS. it may cause hypertension and/or edema. easy anger. and a bowstring pulse Contraindications: None listed Western medical indications: Gastritis. If taken long-term. May increase potassium loss due to diuretics and laxatives. Contains glycyrrhetinic acid which could possibly cause a reduction in thyroid activity and basal metabolic rate. PDR= PHYSICIAN’S DESK REFERENCE . possible chest oppression. C&C= CHAN & CHEUNG. reduce the amount of Gan Cao (Radix Glycyrrhizae Uralensis). a. GLW= GAO LU WEN . Possible additive effect to corticosteroids. acute appendicitis. (This medicinal is routinely used in Chinese medical gynecology during pregnancy as part of formulas appropriately prescribed on the basis of pattern discrimination. a red tongue with yellow fur. and fibrocystic breast disease Potential formula toxicities & interactions: FL: May cause abdominal distention in some patients.a. allergic colitis. Bupleurum & Chih-shih Formula) Category: Harmonizing Functions: Out-thrusts the exterior and resolves depression. May be synergistic with insulin in causing hypokalemia and sodium retention. and Yuan Zhi (Radix Polygalae Tenuifoliae). BR: May increase toxicity of cardiac glycosides. gallstones. B&G: According to some traditional sources. biliary acariasis. pancreatitis.k.

Could possibly cause crystalluria and hematuria and reduce the absorption and biologic effect of most antibiotics. trypsine. C&C: Contains tannic acid. PDR= P HYSICIAN’S DESK REFERENCE . calcium carbonate and gluconate. Could possibly cause hyperkalemia when used with potassium-sparing diuretAH= AHPA.Chapter 4 246 • Herb Toxicities & Drug Interactions: A Formula Approach The research on Gan Cao concurs that this medicinal is generally safe when used in small amounts as an envoy. B&G= B ENSKY & GAMBLE. atropine. isoniazid. nicotinic acid. and diarrhea due to saponin content. chlorpromazine. F L= FLAWS. reserpine. Chai Hu (Radix Bupleuri) Standard daily dosage: 3-12g AH: Safe when used appropriately B&G: May occasionally cause nausea and vomiting. sodium bicarbonate. According to some traditional sources. C&C: Vitamin C. and glycosides. C&C: Contains calcium. ephedrine. Highly acidic. When used as a single medicinal or in patients taking other potent Western pharmaceuticals. and pepsin. caution should be exercised to guard against potential toxicity and drug interaction. and is incompatible with Li Lu (Rhizoma Et Radix Veratri). It should not be taken long-term or as a single herb during pregnancy. Bai Shao.) Overdose may lead to gastroenteritis. Shao Yao (Radix Albus Paeoniae Lactiflorae. digitalis. counteracts Bie Jia (Carapax Amydae Sinensis) and Xiao Ji (Herba Cephalanopoloris Segeti). PDR: Not to be administered during pregnancy. scopolamine. potassium. Zhi Shi (Fructus Immaturus Citri Aurantii. and berbamin. vitamin B1. opiates. intestinal colic. caffeine. immature bitter orange) Standard daily dosage: 3-9g B&G: Use with caution during pregnancy or in debilitated patients. tannic acid. amylase. C&C= CHAN & CHEUNG. B&B= BENSKY & BAROLET. quinine. aluminum hydroxide. in which case the dose should then be reduced significantly. hydrochloric acid. white peony root) Standard daily dosage: 6-30g AH: Safe when used appropriately B&G: Use with caution in debilitated patients with diarrhea. glutamic acid. antagonizes Shi Hu (Herba Dendrobii) and Mang Xiao (Mirabilitum). and other highly acidic substances could possibly reduce the therapeutic effect of this medicinal. BR= BRINKER.(This medicinal is routinely used in Chinese medical gynecology during pregnancy as part of formulas appropriately prescribed on the basis of pattern discrimination. GLW= GAO LU WEN.

chlorpromazine. trypsine. Vitamin C. Could possibly reduce the effect of most antibiotics. PDR= PHYSICIAN’S DESK REFERENCE . B&G= B ENSKY & GAMBLE. this formula is considered the model for all qi and blood harmonizing formulas. atropine. and could possibly reduce the absorption and therapeutic effect of levadopa. and other highly acidic substances could possibly reduce the therapeutic effect of this medicinal. reserpine. BR= BRINKER. nicotinic acid. glutamic acid. discrete form. hydrochloric acid. COMMENTS Although this formula is rarely prescribed in this simple. C&C= CHAN & CHEUNG. B&B= BENSKY & BAROLET. quinine. ephedrine. vitamin B1. and pepsin. GLW= GAO LU WEN . amylase. F L= FLAWS. cause digitalis intoxication and heart arrhythmias. AH= AHPA. calcium carbonate and gluconate. isoniazid.Chapter 4 Toxicities & Drug Interaction • 247 ics.

and magnesium sulfate. heart failure. and reduced temperature and blood pressure. indigestion. Aconite & G. GLW= GAO LU WEN. More severe symptoms include premature atrial contractions. including aconitine. C&C: Contains alkaloids. B&G= B ENSKY & GAMBLE. light-headedness. PDR: Contains nor-diterpene alkaloids. FL= FLAWS. Emergency measures include the administration of atropine. Could possibly reduce the absorption and therapeutic effect of potassium and sodium iodides. blurred vision. fatigue. somnolence. dyspnea. forceless pulse Contraindications: True heat and false cold Western medical indications: Influenza. C&C= CHAN & CHEUNG. Shu Fu Zi. B&G: Contraindicated during pregnancy. monkshood) Standard daily dosage: 1. Small doses can be fatal. prostration. and a deep. BR= BRINKER. aluminum hydroxide. jaundice.L. Avery toxic medicinal which can be fatal if ingested in its uncooked form or in an inappropriate dose. there is a burning hot sensation in the mouth and on AH= AHPA. intestinal fever. and coma Potential formula toxicities & interactions: None listed POTENTIAL MEDICINAL TOXICITIES & I NTERACTIONS: Fu Zi. diarrhea. sodium bicarbonate. a pale tongue with slimy. GLW: If mild poisoning. PDR= PHYSICIAN’S DESK REFERENCE . cardiac insufficiency.k. It is generally combined with Gan Cao (Radix Glycyrhizae Uralensis) and Gan Jiang (dry Rhizoma Zingiberis Officinalis) in decoctions to reduce its toxicity. intractable arthritis.a. chilly abdominal pain. fine or deep. adrenal insufficiency. Highly toxic. Symptoms of toxicity include drooling. hypothyroidism. hypopituitarism. white fur. B&B= BENSKY & BAROLET. neurotic vomiting. aversion to cold. edema. wolfsbane. Combination) Category: Interior-warming Functions: Returns or rescues yang and stems counterflow Chinese medical indications: Kidney yang vacuity/vacuity cold resulting in extremely cold extremities. a. gastric upset. Fu Pian (Radix Lateralis Praeparatus Aconiti Carmichaeli. and numbness and tingling of the extremities. vomiting. sleeping with the knees drawn up. cholera.Chapter 4 248 • Herb Toxicities & Drug Interactions: A Formula Approach SI NI TANG (Four Counterflows Decoction. diarrhea with undigested food.5-15g AH: To be used only under the supervision of an expert qualified in the appropriate use of this substance.

a somber white facial complexion. there may be even depressive heat internally. and Yuan Zhi (Radix Polygalae Tenuifoliae). licorice root) Standard daily dosage: 2-12g AH: Do not use during pregnancy.) As a single herb in high doses. and liver disorders. Gan Cao (Radix Glycyrrhizae Uralensis. hypertension. BR= BRINKER. urinary incontinence. restlessness. dry ginger) Standard daily dosage: 3-12g AH: Not to be used during pregnancy. COMMENTS It is extremely important to differentiate this formula from the preceding one. there is only seeming cold. In the case of this formula. vexation.Chapter 4 Toxicities & Drug Interaction • 249 the tongue. Gan Jiang (dry Rhizoma Zingiberis Officinalis. Not for long-term use. slowed reaction to light. it may cause hypertension and/or edema. in actuality. May be synergistic with insulin in causing hypokalemia and sodium retention. B&G: Use with caution during pregnancy. slow heartbeat. reversal chilling of the four limbs. dilated pupils. B&G= B ENSKY & GAMBLE. B&B= BENSKY & BAROLET. agitation. there is true internal cold. Yuan Hua (Flos Daphnes Genkwae). F L= FLAWS. and pain which gradually spreads to the four limbs and then to the whole body. If taken long-term. May increase potassium loss due to diuretics and laxatives. Possible additive effect to corticosteroids. It should not be taken long-term or as a single herb during pregnancy. incompatible with Gan Sui (Radix Euphorbiae Kansui). there may be generalized sweating. In the case of Si Ni San (Four Counterflows Powder). vomiting. The research on Gan Cao concurs that this medicinal is generally safe when used in small amounts as an envoy. B&G: According to some traditional sources. it is contraindicated in diabetes. convulsions. drooling. C&C= CHAN & CHEUNG. PDR= P HYSICIAN’S DESK REFERENCE . BR: May increase toxicity of cardiac glycosides. arrhythmia. lowered body temperature and circulatory collapse leading to death. Patients with gallstones should consult a practitioner prior to use. AH= AHPA. heart palpitations.(This medicinal is routinely used in Chinese medical gynecology during pregnancy as part of formulas appropriately prescribed on the basis of pattern discrimination. while. caution should be exercised to guard against potential toxicity and drug interaction. nausea. paralysis. GLW= GAO LU WEN. Contains glycyrrhetinic acid which could possibly cause a reduction in thyroid activity and basal metabolic rate. rapid breathing. numbness. If more severe. low blood pressure. dizziness. When used as a single medicinal or in patients taking other potent Western pharmaceuticals.

and a deep. a. According to some traditional sources. autonomic dystonia of the intestinal tract. C&C: Contains alkaloids and quercetin. white fur. sodiAH= AHPA. Extremely large doses have had some teratogenic effects when given to rats and guinea pigs. fatigue. B&B= BENSKY & BAROLET. FL= FLAWS. Po Gu Zhi (Fructus Psoraleae Corylifoliae) Standard daily dosage: 3-9g B&G: Contraindicated in patients with fever or constipation. tabes dorsalis. Should not be used long-term. and pancreatic dysfunction Potential formula toxicities & interactions: None listed POTENTIAL MEDICINAL TOXICITIES & INTERACTIONS: Bu Gu Zhi. astringes the intestines and stops diarrhea Chinese medical indications: Daybreak or cockcrow diarrhea due to spleen-kidney yang vacuity with torpid intake. Large doses stimulate the central nervous system and can lead to visual disturbances and hallucinations. Dioscorea Combination) Category: Securing and astringing Functions: Warms and supplements the kidneys. Overdose may cause the throat to become extremely dry. antagonizes Dan Shen (Radix Salviae Miltiorrhizae) and counteracts Zi Shi Ying (Flouritum). antagonizes Gan Cao (Radix Glycyrrhizae Uralensis). Could possibly reduce the absorption and therapeutic effect of potassium and sodium iodides. PDR= PHYSICIAN’ S DESK REFERENCE . allergic colitis.k. C&C= CHAN & CHEUNG. forceless pulse Contraindications: Intestinal and stomach accumulation and stagnation Western medical indications: Chronic colitis. a pale tongue with thin. Wu Zhu Yu (Fructus Evodiae Rutecarpae) Standard daily dosage: 3-9g AH: Do not exceed recommended dose. somnolence. B&G= B ENSKY & GAMBLE. intestinal tuberculosis. Can be hard to digest. low back soreness and cold lower limbs. indigestion. BR= BRINKER. GLW= GAO LU WEN. B&G: Very drying. chronic dysentery. According to some traditional sources. slow.Chapter 4 250 • Herb Toxicities & Drug Interactions: A Formula Approach Si Shen Wan (Four Spirits Pills.a.

abdominal pain.5-9g B&G: Occasionally causes heartburn. BR: May potentiate psychoactive drugs. PDR= PHYSICIAN’S DESK REFERENCE . B&G: Contains myristicin. B&B= BENSKY & BAROLET. GLW= GAO LU WEN. diarrhea. scopolamine. AH= AHPA. and bismuth subcarbonate. especially MAO-inhibitors. aluminum hydroxide. calcium gluconate. and lactate. Could possibly reduce the therapeutic effect of sodium bicarbonate. C&C: Contains potassium. aluminum hydroxide. Doses of 1. BR= BRINKER. reserpine. Deaths from large overdoses have been reported in humans. Rou Guo. or dyspnea.9g/kg were fatal in cats with liver damage found on autopsy. and berbamin. Highly acidic. In humans. B&G= B ENSKY & GAMBLE. COMMENTS A couple or all four ingredients in this formula are often added to other formulas when diarrhea or dysentery is complicated by kidney qi not securing. Rou Kou (Semen Myristicae Fragantis. GLW: Symptoms of adverse reaction include vomiting. Could possibly cause hyperkalemia when used in large doses with potassium-sparing diuretics. visual disturbances. increased body temperature. PDR: No health risks or side effects are known in conjunction with the proper administration of designated therapeutic dosages. In pregnant women. many antibiotics (especially aminoglycosides and sulfas). opiates. toxicity may cause abortion. schisandra) Standard daily dosage: 1. and falling hair. a hallucinogen. In mice. Rou Dou Kou. C&C= CHAN & CHEUNG. F L= FLAWS. visual hallucinations. ingestion of 7. toxic doses were 10-15g/kg. carbonate.5g of the powdered herb can lead to dizziness or stupor. Could possibly cause crystalluria and hematuria.Chapter 4 Toxicities & Drug Interaction • 251 um bicarbonate. nutmeg) Standard daily dosage: 1. Symptoms of overdose included restlessness. magnesium and ferrous sulfates.5-9g AH: Not to be used during pregnancy. Wu Wei Zi (Fructus Schisandrae Chinensis. caffeine. insomnia.

a. Shu Di Huang (cooked Radix Rehmanniae Glutinosae) Standard daily dosage: 9-30g AH: Contraindicated in patients with diarrhea or indigestion B&G: Overuse can lead to abdominal distention and loose stools. uterine bleeding. and a fine. hemafecia. B&G= B ENSKY & GAMBLE. menstrual irregularities. B&B= BENSKY & BAROLET. PDR= P HYSICIAN’S DESK REFERENCE . irregular menstruation. F L= FLAWS. PDR: No health risks or side effects are known in conjunction with the proper administration of designated therapeutic dosages. lethargy. generalized muscle tension and cramps. bowstring or fine. Bai Shao. anemia due to various causes. counteracts Bie Jia (Carapax Amydae Sinensis) and Xiao Ji (Herba Cephalanopoloris Segeti). abdominal pain during pregnancy. and is incompatible with Li Lu (Rhizoma Et Radix Veratri). threatened miscarriage. Tang-kuei Four Combination) Category: Blood-supplementing Functions: Supplements and harmonizes the blood Chinese medical indications: Blood vacuity resulting in dizziness. dry skin.a. Side effects include diarrhea. pale lips and nails. constipation. C&C= CHAN & CHEUNG. abdominal pain. and heart palpitations which often disappear upon continued administration of the herb. scanty menstruation. antagonizes Shi Hu (Herba Dendrobii) and Mang Xiao (Mirabilitum). Shao Yao (Radix Albus Paeoniae Lactiflorae. postpartum weakness. scanty lactation. BR= BRINKER. GLW= GAO LU WEN. a pale tongue. blocked menstruation.k. and neurgenic headache Potential formula toxicities & interactions: None listed POTENTIAL MEDICINAL TOXICITIES & INTERACTIONS: Shu Di. dizziness. choppy pulse Contraindications: Severe blood loss leading to qi desertion or spleen vacuity with poor appetite and loose stools Western medical indications: Dysmenorrhea. white peony root) Standard daily dosage: 6-30g AH: Safe when used appropriately B&G: Use with caution in debilitated patients with diarrhea. According to some traditional sources. a lusterless facial complexion.Chapter 4 252 • Herb Toxicities & Drug Interactions: A Formula Approach SI WU TANG (Four Materials Decoction. AH= AHPA. blurred vision.

Nevertheless. and pepsin. hydrochloric acid. glutamic acid.) B&G: Use with caution in patients with diarrhea or abdominal distention. C&C: Contains potassium. could possibly reduce the effect of most antibiotics. it is not uncommon for this medicinal to be prescribed up to 15 grams per day in decoction. and magnesium sulfate. reserpine. e C&C: Contains alkaloids and potassium. Could possibly cause hyperkalemia when used with potassium-sparing diuretics. quinine. potassium. Vitamin C. B&G= BENSKY & GAMBLE. trypsine. PDR= PHYSICIAN’S DESK REFERENCE . and other highly acidic substances could possibly reduce the therapeutic effect of this medicinal. this formula is an important teaching model. BR= BRINKER. C&C= CHAN & CHEUNG. (This medicinal is routinely used in Chinese medical gynecology during pregnancy as part of formulas appropriately prescribed on the basis of pattern discrimination. and glycosides. Chuan Xiong (Radix Ligustici Wallichii) Standard daily dosage: 3-9g(In China today. this formula is hardly ever indicated in its pure form. ephedrine. could possibly cause digitalis intoxication and heart arrhythmias. Could possibly cause hyperkalemia when used with potassium-sparing diuretics. atropine. discrete pattern. Could possibly cause hyperkalemia when used with potassium-sparing diuretics. sodium bicarbonate. (This medicinal is routinely used in Chinese medical gynecology during pregnancy as part of formulas appropriately prescribed on the basis of pattern discrimination.Chapter 4 Toxicities & Drug Interaction • 253 C&C: Contains calcium. Dang Gui (Radix Angelicae Sinensis) Standard daily dosage: 3-15g AH: Do not use during pregnancy. F L= FLAWS. tannic acid. COMMENTS Since blood vacuity rarely manifests as a single. antagonizes Shan Zhu Yu (Fructus Corni Officinalis) and HuangQi (Radix Astragali Membranacei).) B&G: Not for patients with migraine headache or excessive menstrual bleeding. nicotinic acid. GLW= GAO L U WEN . May exaggerate the anticoagulative effect of warfarin (Coumadin). chlorpromazine. counteracts Hua Shi(Talcum) and Huang Lian (Rhizoma Coptidis Chinensis). isoniazid. calcium carbonate and gluconate. B&B= BENSKY & BAROLET. Could possibly reduce the absorption and therapeutic effect of potassium and sodium iodides.) AH: Do not use during pregnancy. aluminum hydroxide. Overdosage causes vomiting and dizziness. vitamin B1. According to some traditional texts. and is incompatible with Li Lu (Rhizoma Et Radix V ratri). AH= AHPA. if not such a clinically useful one. amylase. and could possibly reduce the absorption and therapeutic effect of levadopa.

psychosis. BR= BRINKER. PDR: No health risks or side effects are known in conjunction with the proper administration of designated therapeutic dosages.3-1g in pills and powders B&G: Use with caution during pregnancy. B&B= BENSKY & BAROLET. and stops pain Chinese medical indications: Acute damp cold and phlegm turbidity obstruction disorders with sudden collapse. postconcussion syndrome. angina pectoris. hysteria. pain. POTENTIAL MEDICINAL TOXICITIES & INTERACTIONS: Su He Xiang (Styrax Liquidis) Standard daily dosage: 0. schizophrenia. AH= AHPA. She Xiang (Secretio Moschi Moschiferi. Use with caution in cases of hypertension. a pale facial complexion. B&G= B ENSKY & GAMBLE. glossy fur. C&C= CHAN & CHEUNG. Contraindicated in patients with high fever. clenched jaw. and a deep. To help prevent mercury poisoning. coma. and collapse. cholera-like illness. chest and abdominal fullness. F L= FLAWS. musk) Standard daily dosage: 0. spontaneous sweating. profuse phlegm and saliva. loss of consciousness. slippery pulse Contraindications: Pregnancy Western medical indications: Partial or total loss of consciousness due to cerebralvascular accident. and coronary artery disease Potential formula toxicities & interactions: FL/B&B: Do not use in high doses or long-term due to the possibility of mercury toxicity from Zhu Sha (Cinnabaris). purple lips. the formula should not be heated. GLW= GAO LU WEN .15g in pills and powders B&G: Contraindicated during pregnancy. a pale tongue with slimy. encephalitis.Chapter 4 254 • Herb Toxicities & Drug Interactions: A Formula Approach SU HE XIANG WAN (Liquid Styrax Pills) Category: Orifice-opening Functions: Aromatically opens the orifices. seizure disorder. uremic or hepatic coma. PDR= PHYSICIAN’S DESK REFERENCE . and cold.016-0. moves the qi. am urge to vomit or defecate without doing either. cold extremities.

frankincense) Standard daily dosage: 3-9g B&G: Contraindicated during pregnancy AH= AHPA.5-3g as a powder No toxicity or interaction information listed in the sources Ru Xiang (Resina Olibani. F L= FLAWS. GLW= GAO LU WEN. Not for use beyond six weeks without consultation with a physician. Tan Xiang. B&G= B ENSKY & GAMBLE.9g in pills and powders B&G: Use with caution during pregnancy. B&B= BENSKY & BAROLET. Do not expose to heat. PDR= P HYSICIAN’S DESK REFERENCE . aloeswood) Standard daily dosage: 1. Bai Tan Xiang (Lignum Santali Albi. C&C= CHAN & CHEUNG.Chapter 4 Toxicities & Drug Interaction • 255 Bing Pian (Borneol) Standard daily dosage: 0. PDR: Contraindicated in patients with kidney disease.5-9g AH: Safe when used appropriately PDR: No health risks or side effects are known in conjunction with the proper administration of designated therapeutic dosages. BR= BRINKER. sandlewood) Standard daily dosage: 3-9g AH: Contraindicated in kidney diseases involving the parenchyma of the kidney.3-1.3-0. Chen Xiang (Lignum Aquilariae. An Xi Xiang (Benzoinum) Standard daily dosage: 0.5g in pills and powders PDR: No health risks or side effects are known in conjunction with the proper administration of designated therapeutic dosages. Mu Xiang (Radix Aucklandiae Lappae) Standard daily dosage: 1.

Cao Wu (Radix Aconiti Kusnezoffii). Zhu Sha (Cinnabaris. Xi Jiao (Cornu Rhinocerotis. Should not be used in large amounts or long-term. cloves) Standard daily dosage: 0. GLW= GAO L U WEN . BR= BRINKER. may antagonize Chuan Wu (Radix Aconiti Carmichaeli). B&G= BENSKY & GAMBLE. According to traditional sources.5-9g. it is now commonly substituted by Shui Niu Jiao (Cornu Bubali. AH= AHPA. Should only be used in the presence of high fever. F L= FLAWS. do not heat.5g in decoction AH: Safe when used appropriately B&G: Contraindicated in the presence of fever. To prevent mercury poisoning. water buffalo horn. Xiang Fu (Rhizoma Cyperi Rotundi) Standard daily dosage: 4. and Lei Wan (Sclerotium Omphaliae Lapidescentis).5g B&G: Contraindicated in patients with fever. Could possibly reduce the absorption of calcium gluconate. aluminum hydroxide. PDR= PHYSICIAN’S DESK REFERENCE .5-1g as a powder. Because Xi Jiao is from an endangered species. and lactate. Standard daily dosage of this ingredient in decoction is 4. B&B= BENSKY & BAROLET.2-2.5-4. 1. cinnabar) Standard daily dosage: 0. carbonate.5-4.6-5g/kg in animals. Do not combine with Yu Jin (Tuber Curcumae). LD50 of oral preparations varied from 1.7g in pills and powders B&G: Contains mercuric sulfide which is highly toxic. and bismuth subcarbonate.Chapter 4 256 • Herb Toxicities & Drug Interactions: A Formula Approach Ding Xiang (Flos Caryophylli. C&C: Contains quercetin. rhinoceros horn) Standard daily dosage: 1-2g as a powder B&G: Use with great caution during pregnancy. C&C= CHAN & CHEUNG. magnesium and ferrous sulfates.5-12g AH: Safe when used appropriately Bi Ba (Fructus Piperis Longi) Standard daily dosage: 1.

and eventual respiratory failure. nausea. Bai Zhu (Rhizoma Atractylodis Macrocephalae) Standard daily dosage: 4. clenched teeth. diarrhea.5-9g AH: Safe when used appropriately B&G: When rats were fed 0. and early stage dysentery. or liver. C&C: Contains tannic acid and alkalis. syncope. bleeding. and trembling. F L= FLAWS. Overdosages could possibly cause liver and kidney damage. scanty urination. vomiting. shock. COMMENTS This formula is given as a ready-made medicinal. When combined with isoniazid. or erythromycin may cause hepatoxicity. If severe.5g/kg of this medicinal for two months. PDR: Contains large amounts of tannin. Large doses may lead to constipation. B&G= B ENSKY & GAMBLE. B&B= BENSKY & BAROLET. rifampin. In China. C&C= CHAN & CHEUNG. there is edema. acute diarrhea. and acute kidney failure. chlorpromazine. He Zi (Fructus Terminaliae Chebulae) Standard daily dosage: 3-9g AH: Contraindicated in acute cough. it is sold in little vials meant to be carried around by the patient the same way one might carry nitroglycerine tablets.Chapter 4 Toxicities & Drug Interaction • 257 GLW: Symptoms of adverse reaction include burning pain in the oral cavity and throat. low blood pressure. May hinder the absorption and reduce the therapeutic effect of most antibiotics. AH= AHPA. BR= BRINKER. ulceration. abdominal pain. they developed a mild lymphopenia and anemia but suffered no damage to the brain. B&G: May inhibit digestive function in some patients. convulsions. mucus in the stools or hemafecia. If the kidneys are poisoned. heart. GLW= GAO LU WEN. and a metallic taste in the mouth. there is hemorrhagic enteritis. albuminuria. tetracyclines. PDR= P HYSICIAN’S DESK REFERENCE . fright reversal. swelling and distention of the mucosa.

C&C: Contains potassium and glycosides. nervous exhaustion. night sweats.a. and schizophrenia Potential formula toxicities & interactions: None listed POTENTIAL MEDICINAL TOXICITIES & INTERACTIONS: Suan Zao Ren (Semen Zizyphi Spinosae) Standard daily dosage: 9-18g AH: Not to be used during pregnancy. Vitamin C. BR= BRINKER. impaired memory. Zhi Mu (Rhizoma Anemarrhenae Aspheloidis) Standard daily dosage: 6-12g AH: Safe when used appropriately B&G: May cause diarrhea in some patients. Bai Fu Ling. Could possibly cause hyperkalemia when used with potassium-sparing diuretics. heart palpitations. dizziness.) Fu Ling.k. B&G= B ENSKY & GAMBLE.Chapter 4 258 • Herb Toxicities & Drug Interactions: A Formula Approach SUAN ZAO REN TANG (Zizyphus Spinosa Decoction. Qin Jiao (Radix Gentianae Qinjiao). nicoAH= AHPA. C&C= CHAN & CHEUNG. copious urination. Contraindicated in patients with frequent. Sour Jujube Decoction. a dry mouth and parched throat. and Bie Jia (Carapax Amydae Sinensis). night sweats. fine. C&C: Contains potassium. may counteract Di Yu (Radix Sanguisorbae Officinalis). nightmares. According to traditional sources. fearful crying and irritability in teething infants. neurasthenia. PDR= PHYSICIAN’S DESK REFERENCE . rapid pulse Contraindications: None listed Western medical indications: Insomnia. F L= FLAWS. a. clears heat and eliminates vexation Chinese medical indications: Liver-heart blood vacuity with vacuity heat and easy anger. insomnia. B&B= BENSKY & BAROLET. Zizyphus Combination) Category: Spirit-quieting Functions: Nourishes the blood and quiets the spirit. Yun Ling (Sclerotium Poriae Cocos) Standard daily dosage: 9-15g B&G: Large doses or long-term use is discouraged. Could possibly cause hyperkalemia when used with potassium-sparing diuretics. GLW= GAO LU WEN . a dry. red tongue. (No such prohibition exists for this medicinal in traditional Chinese medicine. and bowstring.

Could possibly cause hyperkalemia when used with potassium-sparing diuretics. The research on Gan Cao concurs that this medicinal is generally safe when used in small amounts as an envoy. BR: May increase toxicity of cardiac glycosides. If taken long-term. it is not uncommon for this medicinal to be prescribed up to 15 grams per day in decoction. licorice root) Standard daily dosage: 2-12g AH: Do not use during pregnancy. B&G: According to some traditional sources.) AH: Do not use during pregnancy. hypertension. Could possibly reduce the absorption and therapeutic effect of potassium and sodium iodides. incompatible with Gan Sui (Radix Euphorbiae Kansui). Yuan Hua (Flos Daphnes Genkwae). B&B= BENSKY & BAROLET. and liver disorders. it may cause hypertension and/or edema. hydrochloric acid. C&C= CHAN & CHEUNG. AH= AHPA. Chuan Xiong (Radix Ligustici Wallichii) Standard daily dosage: 3-9g(In China today. (This medicinal is routinely used in Chinese medical gynecology during pregnancy as part of formulas appropriately prescribed on the basis of pattern discrimination. PDR: No health hazards are known in conjunction with the proper administration of designated therapeutic dosages. counteracts Hua Shi (Talcum) and Huang Lian (Rhizoma Coptidis Chinensis). it is contraindicated in diabetes. Contains glycyrrhetinic acid which could possibly cause a reduction in thyroid activity and basal metabolic rate. May be synergistic with insulin in causing hypokalemia and sodium retention. Gan Cao (Radix Glycyrrhizae Uralensis. sodium bicarbonate.) As a single herb in high doses.(This medicinal is routinely used in Chinese medical gynecology during pregnancy as part of formulas appropriately prescribed on the basis of pattern discrimination. and Yuan Zhi (Radix Polygalae Tenuifoliae). FL= FLAWS. glutamic acid. PDR= P HYSICIAN’ S DESK REFERENCE . caution should be exercised to guard against potential toxicity and drug interaction. aluminum hydroxide.Chapter 4 Toxicities & Drug Interaction • 259 tinic acid. and is incompatible with Li Lu (Rhizoma Et Radix Veratri). May increase potassium loss due to diuretics and laxatives. and other highly acidic substances could possibly reduce the therapeutic effect of this medicinal. Possible additive effect to corticosteroids. antagonizes Shan Zhu Yu (Fructus Corni Officinalis) and HuangQi (Radix Astragali Membranacei). GLW= GAO LU WEN. C&C: Contains alkaloids and potassium. When used as a single medicinal or in patients taking other potent Western pharmaceuticals. and magnesium sulfate. According to some traditional texts. B&G= B ENSKY & GAMBLE . It should not be taken long-term or as a single herb during pregnancy. Not for long-term use. BR= BRINKER. Overdosage causes vomiting and dizziness.) B&G: Not for patients with migraine headache or excessive menstrual bleeding.

C&C: Contains alkaloids and potassium. glutamic acid.Chapter 4 260 • Herb Toxicities & Drug Interactions: A Formula Approach TIAN MA GOU TENG YIN (Gastrodia & Uncaria Beverage) Category: Wind-treating Functions: Levels the liver and extinguishes wind. tachycardia. GLW= GAO LU WEN . transitory ischemic attacks. C&C: Contains glycosides. Gou Teng (Ramulus Uncariae Cum Uncis) Standard daily dosage: 6-15g AH: Safe when used appropriately B&G: LD50 in mice for one dose in a decoction is 29g/kg. and slow waves on the EEG. BR= BRINKER. loss of appetite. hypertensive encephalopathy. nicotinic acid. B&G: LD50 in mice via intraperitoneal injection is 51g/kg. PDR= PHYSICIAN’S DESK REFERENCE . and neurosis Potential formula toxicities & interactions: None listed POTENTIAL MEDICINAL TOXICITIES & I NTERACTIONS: Tian Ma (Rhizoma Gastrodiae Elatae) Standard daily dosage: 3-9g AH: Safe when used appropriately. clears heat and quickens the blood. in rabbits 12g/kg. renal hypertension. B&B= BENSKY & BAROLET. aphasia. tinnitus. trigeminal neuralgia. F L= FLAWS. essential hypertension. Many of the rabbits died within 48 hours. puerperal eclampsia. Vitamin C. B&G= B ENSKY & GAMBLE. and other highly acidic substances could possibly reduce the therapeutic effect of this medicinal. blurred vision. epilepsy. Signs of toxicity in rabbits included lethargy. a sensation of heat rushing up to the head. rapid pulse Contraindications: None listed Western medical indications: Cerebrovascular disease. hydrochloric acid. insomnia. hemiplegia. C&C= CHAN & CHEUNG. dizziness. Could possibly cause hyperAH= AHPA. a red tongue. and a bowstring. profuse dreams. supplements and boosts the liver and kidneys Chinese medical indications: Ascendant liver yang hyperactivity with internal stirring of the liver wind resulting in headache. reduced deep tendon reflexes. apraxia.

counteracts Xuan Fu Hua (Flos Inulae Racemosae). Shi Jue Ming (Concha Haliotidis. glutamic acid. Could possibly cause hyperkalemia when used with potassium-sparing diuretics. BR= BRINKER. aluminum hydroxide. sodium bicarbonate. nicotinic acid. hydrochloric acid. hydrochloric acid. B&B= BENSKY & BAROLET. C&C: Highly alkaline. Could possibly cause digitalis intoxication and heart arrhythmias. nicotinic acid. F L= FLAWS. Shan Zhi. Toxic when taken with some antibiotics (aminoglycosides) and quinidine. PDR= P HYSICIAN’S DESK REFERENCE . Could possibly reduce the therapeutic effect of most antibiotics. Vitamin C. and other highly acidic substances could possibly reduce the therapeutic effect of this medicinal. levadopa. Could possibly cause hyperkalemia when taken with potassium-sparing diuretics.Chapter 4 Toxicities & Drug Interaction • 261 kalemia when used with potassium-sparing diuretics. Vitamin C. Zhi Zi. B&G= B ENSKY & GAMBLE. C&C: Contains potassium and glycosides. counteracts Dan Pi (Cortex Radicis Moutan) and Li Lu (Rhizoma Et Radix Veratri). C&C= CHAN & CHEUNG. Contains calcium. glutamic acid. AH= AHPA. Could possibly cause hyperkalemia when used with potassium-sparing diuretics. Could possibly reduce the absorption and therapeutic effect of potassium and sodium iodides. Tiao Qin (Radix Scutellariae Baicalensis) Standard daily dosage: 6-15g AH: Safe when used appropriately B&G: According to some traditional sources. isoniazid. C&C: Contains potassium and glycosides. Shan Zhi Zi (Fructus Gardeniae Jasminoidis) Standard daily dosage: 3-12g B&G: Contains geniposide which caused diarrhea in mice. and other highly acidic substances could possibly reduce the therapeutic effect of this medicinal. Huang Qin. and magnesium sulfate. PDR: No health risks or side effects are known in conjunction with the proper administration of designated therapeutic dosages. abalone shell) Standard daily dosage: 9-30g B&G: According to some traditional sources. GLW= GAO LU WEN.

digitalis. C&C: Contains alkaloids and potassium. amylase. sodium bicarbonate. BR= BRINKER. the mind and speech remain clear. GLW: Symptoms of adverse reaction include generalized lack of strength. Oral administration in pregnant rabbits resulted in miscarriages. B&B= BENSKY & BAROLET. AH= AHPA. sweating. some patients taking this medicinal may have an allergic reaction if they are allergic to latex. and pepsin. Could possibly reduce the absorption and biologic effect of most antibiotics. B&G= B ENSKY & GAMBLE. According to some traditional sources. quinine. calcium carbonate and gluconate. PDR: Not for use during pregnancy. aluminum hydroxide. and weak respiration. vitamin B 1. paralysis. However. and magnesium sulfate. PDR= PHYSICIAN’ S DESK REFERENCE . antagonizes Xuan Shen (Radix Scrophulariae Ningpoensis). GLW= GAO LU WEN. Therefore. Chuan Niu Xi (Radix Cyathulae) Standard daily dosage: 9-15g AH: Not to be used during pregnancy B&G: Contraindicated during pregnancy or in patients with excessive menstruation. C&C: Contains tannic acid. Could possibly cause hyperkalemia when used with potassium-sparing diuretics. LD50 for intravenous injection in mice was 572mg/kg. Could possibly reduce the absorption and therapeutic effect of potassium and sodium iodides. chlorpromazine. and pain. This medicinal contains latex. ephedrine. Du Zhong (Cortex Eucommiae Ulmoidis) Standard daily dosage: 6-15g AH: Safe when used appropriately B&G: Has a mild sedative effect in large doses. numbness. low blood pressure. motherwort) Standard daily dosage: 9-60g AH: Not to be used during pregnancy B&G: Contraindicated during pregnancy. Kun Cao (Herba Leonuri Heterophylli. chest oppression. atropine. isoniazid. reserpine. inability to move the lower limbs. trypsine. generalized soreness.Chapter 4 262 • Herb Toxicities & Drug Interactions: A Formula Approach Yi Mu Cao. C&C= CHAN & CHEUNG. FL= FLAWS.

GLW= GAO L U WEN . Could possibly reduce the absorption of calcium gluconate. and glycosides. may counteract Di Yu (Radix Sanguisorbae Officinalis). and bismuth subcarbonate. Yun Ling (Sclerotium Poriae Cocos) Standard daily dosage: 9-15g B&G: Large doses or long-term use is discouraged. Could possibly cause hyperkalemia when used with potassium-sparing diuretics. and Bie Jia (Carapax Amydae Sinensis). and other highly acidic substances could possibly reduce the therapeutic effect of this medicinal. Contraindicated in patients with frequent. and lactate. C&C: Contains quercetin. potassium. Bai Fu Ling. hydrochloric acid. AH= AHPA. F L= FLAWS. and death in experimental animals. B&G= BENSKY & GAMBLE. Vitamin C. Overdose has been shown to cause vomiting. glutamic acid. carbonate. nicotinic acid. diarrhea. Qin Jiao (Radix Gentianae Qinjiao). copious urination. C&C= CHAN & CHEUNG. According to traditional sources. PDR= PHYSICIAN’S DESK REFERENCE .Chapter 4 Toxicities & Drug Interaction • 263 Sang Ji Sheng. BR= BRINKER. aluminum hydroxide. magnesium and ferrous sulfates. C&C: Contains potassium. Could possibly cause hyperkalemia when used with potassium-sparing diuretics. B&B= BENSKY & BAROLET. Sang Ji (Ramulus Loranthi Seu Visci. mulberry mistletoe) Standard daily dosage: 9-30g B&G: Contains avicularin. Ye Jiao Teng (Caulis Polygoni Multiflori) Standard daily dosage: 9-30g No toxicity or interaction information listed in the sources Fu Ling.

PDR: No health risks or side effects are known in conjunction with the proper administration of designated therapeutic dosages. Sheng Di Huang (uncooked Radix Rehmanniae Glutinosae) Standard daily dosage: 9-30g AH: Contraindicated in patients with diarrhea or lack of appetite B&G: Contraindicated in pregnant women with anemias or digestive weakness C&C: Contains potassium. a red tongue with scanty fur. GLW= GAO LU WEN. and a fine. Could possibly cause hyperkalemia when used with potassium-sparing diuretics. rapid pulse Contraindications: Not for long-term use Western medical indications: Drug dependency (especially tranquillizers or sleeping pills). menopausal syndrome. inability to concentrate. and apthous ulcers Potential formula toxicities & interactions: FL/B&BZhu Sha (Cinnabaris) is a toxic substance that should not be taken long-term. FL= FLAWS. neurasthenia. May reduce the anticoagulative effect of warfarin (Coumadin). possible night sweats. heart palpitations. fatigue. Ginseng & Zizyphus Formula) Category: Spirit-quieting Functions: Enriches the yin and nourishes the blood. C&C= CHAN & CHEUNG. AH= AHPA. insomnia. Ren Shen (Radix Panacis Ginseng. PDR= PHYSICIAN’ S DESK REFERENCE .k. B&B= BENSKY & BAROLET. heart disease. B R= BRINKER. Possible additive effects to insulin. a. ginseng) Standard daily dosage: 1-30g AH: Contraindicated in hypertension BR: May cause manic episodes in patients on MAO-inhibitors. impaired memory. supplements the heart and quiets the spirit Chinese medical indications: Heart-kidney qi and yin vacuity with easy anger. anxiety.Chapter 4 264 • Herb Toxicities & Drug Interactions: A Formula Approach TIAN WANG BU XIN DAN (Heavenly Emperor Supplement the Heart Elixir. chronic urticaria. POTENTIAL MEDICINAL TOXICITIES & INTERACTIONS: Sheng Di. B&G= B ENSKY & GAMBLE.a. May cause hypertension if consumed with caffeine.

Mai Men Dong. B&B= BENSKY & BAROLET. Mai Dong (Tuber Ophiopogoni Japonici) Standard daily dosage: 6-15g AH: Safe when used appropriately B&G: According to some traditional sources. hydrochloric acid. GLW= GAO LU WEN. Use with MAO-inhibitors may cause headaches. and other highly acidic substances could possibly reduce the therapeutic effect of this medicinal. nicotinic acid. Otherwise considered safe with the proper administration of designated therapeutic dosages. Not recommended in large doses during pregnancy or lactation due to potential neonatal androgenization. heart palpitations. nicotinic acid. insomnia. PDR= P HYSICIAN’ S DESK REFERENCE . BR= BRINKER. and glycosides. A traditional antidote is mung bean soup. hydrochloric acid. C&C: Contains glycosides. PDR: Contains steroid saponins and flavinoids. Tian Dong (Tuber Asparagi Cochinensis) AH: Safe when used appropriately B&G: Contraindicated in patients with loss of appetite and diarrhea or cough from the common cold. Enhances the effect of insulin and other antidiabetic agents. PDR: Contraindicated in patients with hypertension. B&G= B ENSKY & GAMBLE .Chapter 4 Toxicities & Drug Interaction • 265 B&G: Contraindicated for hypertensive patients. and other highly acidic substances could possibly reduce the therapeutic effect of this medicinal. Tian Men Dong. glutamic acid. antagonizes Kuan Dong Hua (Flos Tussilaginis Farfarae) and counteracts Ku Shen (Radix Sophorae Flavescentis) and Bai Mu Er (Fructificatio Tremellae Fuciformis). Yuan Shen (Radix Scrophulariae Ningpoensis) Standard daily dosage: 9-30g C&C: Contains alkaloids. Overdose can lead to headache. FL= FLAWS. and manias. C&C= CHAN & CHEUNG. C&C: Vitamin C. potassium. Vitamin C. Xuan Shen. and a rise in blood pressure. Could possibly reduce the absorption and therapeutic effect of potassium and AH= AHPA. Could possibly cause hyperkalemia when used with potassium-sparing diuretics. Should not be administered in the presence of kidney diseases due to the irritating effect of the saponins. glutamic acid. tremors.

Qin Jiao (Radix Gentianae Qinjiao). Increases the absorption and decreases the clearance of warfarin (Coumadin) which can adversely affect prothrombin time. C&C: Contains glycosides. hydrochloric acid. nicotinic acid. According to some traditional sources. F L= FLAWS. B&B= BENSKY & BAROLET. C&C: Contains potassium. or reduced appetite. glutamic acid. Could possibly cause hyperkalemia when used with potassium-sparing diuretics. Vitamin C. C&C: Contains potassium. B&G: Contraindicated in gastritis or when gastric ulcers are present. glutamic acid. incompatible with Li Lu (Rhizoma Et Radix Veratri). Fu Ling. Contraindicated in patients with frequent. sodium bicarbonate. Yuan Zhi (Radix Polygalae Tenuifoliae) Standard daily dosage: 3-9g AH: Contraindicated in gastritis or when gastric ulcers are present. and magnesium sulfate. C&C= CHAN & CHEUNG. PDR: No health risks or side effects are known in conjunction with the proper administration of designated therapeutic dosages. Should not be used in cancer patients taking antineoplastic drugs since this medicinal can hinder their therapeutic effect and promote tumor metastasis. counteracts Zhen Zhu (Margarita) and Li Lu (Rhizoma Et Radix Veratri). copious urination. Hinders the absorption of magnesium oxide. and aluminum hydroxide. Could possibly cause hyperkalemia when used with potassium-sparing diuretics. PDR= P HYSICIAN’S DESK REFERENCE . nicotinic acid. Bai Fu Ling. According to traditional sources. and other highly acidic substances Could possibly reduce the therapeutic effect of this medicinal. AH= AHPA. Administration of tinctures of this herb can lead to pruritus. and Bie Jia (Carapax Amydae Sinensis). may counteract Di Yu (Radix Sanguisorbae Officinalis). Vitamin C. stomach ache. aluminum hydroxide. Yun Ling (Sclerotium Poriae Cocos) Standard daily dosage: 9-15g B&G: Large doses or long-term use is discouraged. Dan Shen (Radix Salviae Miltiorrhizae) Standard daily dosage: 6-60g AH: Safe when used appropriately BR: Possible additive effect to warfarin (Coumadin) B&G: According to traditional texts. calcium carbonate. BR= BRINKER. GLW= GAO L U WEN. B&G= B ENSKY & GAMBLE.Chapter 4 266 • Herb Toxicities & Drug Interactions: A Formula Approach sodium iodides.

Could possibly reduce the therapeutic effect of sodium bicarbonate. C&C: Contains potassium. toxic doses were 10-15g/kg. C&C= CHAN & CHEUNG. and other highly acidic substances could possibly reduce the therapeutic effect of this medicinal. antagonizes Ju Hua (Flos Chrysanthemum Morifolii). F L= FLAWS. PDR: No health risks or side effects are known in conjunction with the proper administration of designated therapeutic dosages. insomnia. caffeine. B&G= B ENSKY & GAMBLE. reserpine. opiates. Suan Zao Ren (Semen Zizyphi Spinosae) Standard daily dosage: 9-18g AH= AHPA. GLW= GAO LU WEN. B&B= BENSKY & BAROLET. schisandra) Standard daily dosage: 1. PDR= P HYSICIAN’S DESK REFERENCE . Vitamin C. In mice. or dyspnea. C&C: Contains potassium. BR= BRINKER. Dang Gui (Radix Angelicae Sinensis) Standard daily dosage: 3-15g AH: Do not use during pregnancy. Could possibly cause hyperkalemia when used in large doses with potassium-sparing diuretics. aluminum hydroxide. Highly acidic. (This medicinal is routinely used in Chinese medical gynecology during pregnancy as part of formulas appropriately prescribed on the basis of pattern discrimination. hydrochloric acid.Chapter 4 Toxicities & Drug Interaction • 267 hydrochloric acid.5-9g AH: Safe when used appropriately B&G: Occasionally causes heartburn. Bai Zi Ren (Semen Biotae Orientalis) Standard daily dosage: 6-18g B&G: Contraindicated in patients with loose stools or phlegm disorders. Could possibly cause crystalluria and hematuria. glutamic acid. Wu Wei Zi (Fructus Schisandrae Chinensis.) B&G: Use with caution in patients with diarrhea or abdominal distention. C&C: Contains glycosides. Could possibly cause hyperkalemia when used with potassium-sparing diuretics. May exaggerate the anticoagulative effect of warfarin (Coumadin). Symptoms of overdose include restlessness. and other highly acidic substances could possibly reduce the therapeutic effect of this medicinal. and berbamin. nicotinic acid. many antibiotics (especially aminoglycosides and sulfas). scopolamine. According to some traditional sources.

Could possibly reduce the effect of most antibiotics. there is edema. hydrochloric acid. Long Yan Rou. mucus in the stools or hemafecia. and a metallic taste in the mouth. do not heat. If the kidneys are poisoned.7g in pills and powders B&G: Contains mercuric sulfide which is highly toxic. and acute kidney failure. (No such prohibition exists for this medicinal in traditional Chinese medicine. albuminuria. low blood pressure. bellflower root) Standard daily dosage: 3-9g AH: Contraindicated in hemoptysis. glutamic acid. bleeding. hinder the absorption of isoniazid. ulceration. PDR= P HYSICIAN’S DESK REFERENCE . C&C= CHAN & CHEUNG. and eventual respiratory failure. especially in cases of tuberculosis. B&B= BENSKY & BAROLET. AH= AHPA. GLW: Symptoms of adverse reaction include burning pain in the oral cavity and throat. Vitamin C. Yuan Rou (Arillus Euphoriae Longanae. C&C: Contains calcium and glycosides. clenched teeth. Hu Po (Succinum) or Long Gu (Os Draconis) is commonly substituted for Zhu Sha. Use with caution in bleeding peptic ulcer. abdominal pain. and other highly acidic substances could possibly reduce the therapeutic effect of this medicinal.Chapter 4 268 • Herb Toxicities & Drug Interactions: A Formula Approach AH: Not to be used during pregnancy. and trembling. counteracts Long Dan Cao (Gentiana Longdancao) and Long Yan Rou (Arillus Euphoriae Longanae). According to some traditional sources. F L= FLAWS. nausea. syncope. cause digitalis intoxication and heart arrhythmias. convulsions. vomiting. Zhu Sha (Cinnabaris. cinnabar) Standard daily dosage: 0. GLW= GAO LU WEN. diarrhea. longan fruit) Standard daily dosage: 6-30g No toxicity or interaction information listed in the sources COMMENTS Dang Shen (Radix Codonopsitis Pilosulae) is commonly substituted for Ren Shen in this formula. shock. BR= BRINKER.) Jie Geng (Radix Platycodi Grandiflori. swelling and distention of the mucosa. Should not be used in large amounts or long-term. and reduce the biological effect of levadopa. fright reversal. B&G: Contraindicated in patients with hemoptysis.2-2. To prevent mercury poisoning. nicotinic acid. there is hemorrhagic enteritis. If severe. scanty urination. B&G= B ENSKY & GAMBLE.

PDR= PHYSICIAN’S DESK REFERENCE . F L= FLAWS.5-9g AH: Safe when used appropriately B&G: When rats were fed 0. Bai Shao. C&C= C HAN & CHEUNG. counteracts Bie Jia (Carapax Amydae Sinensis) and Xiao Ji (Herba Cephalanopoloris Segeti). reserAH= AHPA. isoniazid. and could possibly reduce the absorption and therapeutic effect of levadopa. fortifies the spleen and supplements the qi Chinese medical indications: Liver-spleen disharmony resulting in colicky abdominal and diarrhea associated with psychoemotional stress. heart. C&C: Contains calcium. B&G= BENSKY & GAMBLE. or liver. borborygmus. ephedrine.Chapter 4 Toxicities & Drug Interaction • 269 TONG XIE YAO FANG (Painful Diarrhea Essential Formula) Category: Harmonizing Functions: Courses the liver and rectifies the qi. Shao Yao (Radix Albus Paeoniae Lactiflorae. colitis. Could possibly cause hyperkalemia when used with potassium-sparing diuretics. chlorpromazine. acute gastroenteritis.5g/kg of this medicinal for two months. and glycosides. quinine. potassium. cause digitalis intoxication and heart arrhythmias. and a bowstring pulse Contraindications: None listed Western medical indications: Irritable bowel syndrome. GLW= GAO L U WEN . Could possibly reduce the effect of most antibiotics. B&B= BENSKY & BAROLET. atropine. thin. antagonizes Shi Hu (Herba Dendrobii) and Mang Xiao (Mirabilitum). calcium carbonate and gluconate. tannic acid. and hyperthyroidism Potential formula toxicities & interactions: None listed POTENTIAL MEDICINAL TOXICITIES & I NTERACTIONS: Bai Zhu (Rhizoma Atractylodis Macrocephalae) Standard daily dosage: 4. white tongue fur. they developed a mild lymphopenia and anemia but suffered no damage to the brain. BR= BRINKER. bacillary dysentery. and is incompatible with Li Lu (Rhizoma Et Radix Veratri). According to some traditional sources. white peony root) Standard daily dosage: 6-30g AH: Safe when used appropriately B&G: Use with caution in debilitated patients with diarrhea.

C&C= CHAN & CHEUNG. and pepsin. vitamin B 1. may antagonize Gan Jiang (dry Rhizoma Zingiberis Officinalis). nicotinic acid. B&G= B ENSKY & GAMBLE. glutamic acid. and other highly acidic substances could possibly reduce the therapeutic effect of this medicinal.Chapter 4 270 • Herb Toxicities & Drug Interactions: A Formula Approach pine. nicotinic acid. AH= AHPA. tangerine peel) Standard daily dosage: 3-9g AH: Safe when used appropriately C&C: Contains potassium. COMMENTS The ingredients in this formula commonly form the basis of prescriptions for the treatment of all types of diarrhea manifesting as a liverspleen disharmony. hydrochloric acid. GLW= GAO LU WEN. Ju Pi. BR= BRINKER. and other highly acidic substances could possibly reduce the therapeutic effect of this medicinal. Fang Feng (Radix Ledebouriellae Divaricatae) Standard daily dosage: 3-9g AH: Safe when used appropriately B&G: According to some traditional sources. Chen Pi. glutamic acid. Ju Hong (Pericarpium Citri Reticulatae. Li Lu (Rhizoma Et Radix Veratri) and counteracts Bei Xie (Rhizoma Dioscoreae Hypoglaucae). PDR= P HYSICIAN’S DESK REFERENCE . F L= FLAWS. trypsine. Vitamin C. C&C: Contains glycosides. Could possibly cause hyperkalemia when used with potassium-sparing diuretics. amylase. B&B= BENSKY & BAROLET. Vitamin C. hydrochloric acid.

fatigue. slightly slow) pulse Contraindications: Depressive or damp heat Western medical indications: Abnormal vaginal discharge. white or pale yellow.5g/kg of this medicinal for two months. hemophilus vaginitis. loose stools. bowstring. a pale tongue with white fur. and headache Potential formula toxicities & interactions: FL/B&B: Should not be used if discharge is dark yellow. contains blood. F L= FLAWS.5-9g AH: Safe when used appropriately B&G: When rats were fed 0. sticky. a pale facial complexion.e. B&G= BENSKY & GAMBLE. heart. C&C= CHAN & CHEUNG. transforms dampness and stops vaginal discharge Chinese medical indications: Liver-spleen disharmony resulting in profuse. and foul-smelling. edema during menstruation. cervical inflammation. Shan Yao (Radix Dioscoreae Oppositae) Standard daily dosage: 9-30g AH: Safe when used appropriately B&G: According to some traditional sources. uterus-stabilizing Functions: Fortifies the spleen and supplements the center. and not foul-smelling. potassium. Could possibly cause hyperkalemia when used with potassium-sparing diuretics. or liver.. GLW= GAO L U WEN . and a soggy. abnormal vaginal discharge which is thin in consistency. diarrhea. B&B= BENSKY & BAROLET. possibly moderate (i. antagonizes Gan Sui (Radix Euphorbiae Kansui). amylase. edema during pregnancy. AH= AHPA. and glycosides. vulvitis. POTENTIAL MEDICINAL TOXICITIES & I NTERACTIONS: Bai Zhu (Rhizoma Atractylodis Macrocephalae) Standard daily dosage: 4. they developed a mild lymphopenia and anemia but suffered no damage to the brain. C&C: Contains alkaloids.Chapter 4 Toxicities & Drug Interaction • 271 WAN DAI TANG (End [Abnormal] Vaginal Discharge Decoction) Category: Securing and astringing. BR= BRINKER. PDR= PHYSICIAN’S DESK REFERENCE . Use of this formula under these conditions will exacerbate the condition. and is thick. continuous.

Poisoning in overdoses may occur from the picrotoxin-like effect of dioscorin. sulphanomides. sodium bicarbonate. May have an additive estrogenic effect when administered with estrogen-containing drugs. GLW= GAO L U WEN .5-9g B&G: Use with caution in patients with loose. Ju Pi. Overdose can lead to headache. magnesium sulfate. tetracyclines. PDR: No health risks or side effects are known in conjunction with the proper administration of designated therapeutic dosages. insomnia. May cause hypertension if consumed with caffeine. aluminum hydroxide.Chapter 4 272 • Herb Toxicities & Drug Interactions: A Formula Approach Could possibly reduce the absorption and therapeutic effect of potassium and sodium iodides. C&C: Vitamin C. heart palpitations. May reduce the anticoagulative effect of warfarin (Coumadin). Not recommended in large doses during pregnancy or lactation due to potential neonatal androgenization. Enhances the effect of insulin and other antidiabetic agents. BR= BRINKER. B&G: Contraindicated for hypertensive patients. AH= AHPA. and a rise in blood pressure. Vitamin C. and other highly acidic substances could possibly reduce the therapeutic effect of this medicinal. Ren Shen (Radix Panacis Ginseng. F L= FLAWS. hydrochloric acid. and aspirin. hydrochloric acid. glutamic acid. B&B= BENSKY & BAROLET. Chen Pi. Could possibly cause hyperkalemia when used with potassium-sparing diuretics. PDR= PHYSICIAN’S DESK REFERENCE . PDR: Use of this medicinal may reduce the antiinflammatory effect of indomethacin. nicotinic acid. tremors. and manias. B&G= BENSKY & GAMBLE. ginseng) Standard daily dosage: 1-30g AH: Contraindicated in hypertension BR: May cause manic episodes in patients on MAO-inhibitors. Possible additive effects to insulin. A traditional antidote is mung bean soup. and other highly acidic substances could possibly reduce the therapeutic effect of this medicinal. watery stools. glutamic acid. Use with MAO-inhibitors may cause headaches. Cang Zhu (Rhizoma Atractylodis) Standard daily dosage: 4. nicotinic acid. Ju Hong (Pericarpium Citri Reticulatae. PDR: Contraindicated in patients with hypertension. tangerine peel) Standard daily dosage: 3-9g AH: Safe when used appropriately C&C: Contains potassium. C&C= CHAN & CHEUNG.

Not for long-term use. intestinal colic. C&C: Contains glycosides.5-9g B&G: Contraindicated during pregnancy. and other highly acidic substances could possibly reduce the therapeutic effect of this medicinal. opiates. BR: May increase toxicity of cardiac glycosides. scopolamine. FL= FLAWS. and berbamin.Chapter 4 Toxicities & Drug Interaction • 273 Che Qian Zi. hydrochloric acid. caffeine. and diarrhea due to saponin content. and liver disorders. Che Qian Ren (Semen Plantaginis. licorice root) Standard daily dosage: 2-12g AH: Do not use during pregnancy. glutamic acid. many antibiotics (especially aminoglycosides and sulfas). aluminum hydroxide. PDR= P HYSICIAN’ S DESK REFERENCE . Possible additive effect to corticosteroids. B&B= BENSKY & BAROLET.) Overdose may lead to gastroenteritis. May increase potassium loss due to diuretics and laxatives.(This medicinal is routinely used in Chinese medical gynecology during pregnancy as part of formulas appropriately prescribed on the basis of pattern discrimination. reserpine. AH= AHPA. glutamic acid. Could possibly cause crystalluria and hematuria and reduce the therapeutic effect of sodium bicarbonate. Jing Jie (Herba Seu Flos Schizonepetae Tenuifoliae) Standard daily dosage: 3-9g No toxicity or interaction information listed in the sources Gan Cao (Radix Glycyrrhizae Uralensis. May be synergistic with insulin in causing hypokalemia and sodium retention. hydrochloric acid. PDR: Not to be administered during pregnancy. in which case the dose should then be reduced significantly. plantain seeds) Standard daily dosage: 4. GLW= GAO LU WEN. Highly acidic. Vitamin C.) As a single herb in high doses. Chai Hu (Radix Bupleuri) Standard daily dosage: 3-12g AH: Safe when used appropriately B&G: May occasionally cause nausea and vomiting. B&G= B ENSKY & GAMBLE . C&C: Vitamin C. and other highly acidic substances could possibly reduce the therapeutic effect of this medicinal.(This medicinal is routinely used in Chinese medical gynecology during pregnancy as part of formulas appropriately prescribed on the basis of pattern discrimination. nicotinic acid. BR= BRINKER. hypertension. it is contraindicated in diabetes. nicotinic acid. C&C= CHAN & CHEUNG. Jing Jie Sui.

B&B= BENSKY & BAROLET. BR= BRINKER. caution should be exercised to guard against potential toxicity and drug interaction. B&G= B ENSKY & GAMBLE.Chapter 4 274 • Herb Toxicities & Drug Interactions: A Formula Approach B&G: According to some traditional sources. PDR= PHYSICIAN’ S DESK REFERENCE . incompatible with Gan Sui (Radix Euphorbiae Kansui). GLW= GAO LU WEN. AH= AHPA. and Yuan Zhi (Radix Polygalae Tenuifoliae). FL= FLAWS. If taken long-term. COMMENTS Dang Shen (Radix Codonopsitis Pilosulae) is commonly substituted for Ren Shen in this formula. Yuan Hua (Flos Daphnes Genkwae). C&C= CHAN & CHEUNG. Contains glycyrrhetinic acid which could possibly cause a reduction in thyroid activity and basal metabolic rate. it may cause hypertension and/or edema. When used as a single medicinal or in patients taking other potent Western pharmaceuticals. The research on Gan Cao concurs that this medicinal is generally safe when used in small amounts as an envoy. It should not be taken long-term or as a single herb during pregnancy.

5-9g C&C: Contains potassium. a. atropine. heart palpitations. Zhi Shi (Fructus Immaturus Citri Aurantii. trypsine. chlorpromazine. immature bitter orange) Standard daily dosage: 3-9g B&G: Use with caution during pregnancy or in debilitated patients. opiates. B&B= BENSKY & BAROLET. Bamboo & Hoelen Combination) Category: Phlegm-transforming Functions: Rectifies the qi and transforms phlegm. and chronic bronchitis Potential formula toxicities & interactions: None listed POTENTIAL MEDICINAL TOXICITIES & I NTERACTIONS: Zhu Rhu (Caulis Bambusae In Taeniis. AH= AHPA. and pepsin. chronic hepatitis. early stages of schizophrenia. aluminum hydroxide. BR= BRINKER.Chapter 4 Toxicities & Drug Interaction • 275 WEN DAN TANG (Warm the Gallbladder Decoction. a bitter taste in the mouth. yellow tongue fur. such as depression and anxiety. amylase. and a slippery. slight thirst.k. easy fright. F L= FLAWS. bamboo shavings) Standard daily dosage: 4. chest oppression. and berbamin. insomnia.a. obessesive compulsive disorder. nausea and vomiting. isoniazid. liver-stomach disharmony) with phlegm heat resulting in dizziness. B&G= B ENSKY & GAMBLE. Meniere’s disease. clears the gallbladder and harmonizes the stomach Chinese medical indications: Gallbladder-stomach disharmony (a. C&C= CHAN & CHEUNG. ephedrine. slimy. digitalis. reserpine. Could possibly cause hyperkalemia when used with potassium-sparing diuretics. chronic gastritis. caffeine. sodium bicarbonate. PDR= PHYSICIAN’S DESK REFERENCE . scopolamine.k. peptic ulcer. calcium carbonate and gluconate. C&C: Contains tannic acid.a. quinine. Highly acidic. bowstring pulse Contraindications: None listed Western medical indications: Mood disorders. vitamin B1. Could possibly cause crystalluria and hematuria and reduce the absorption and biologic effect of most antibiotics. GLW= GAO LU WEN .

unclear speech. PDR= PHYSICIAN’S DESK REFERENCE . B&G: Safe as long as it is properly prepared. C&C= CHAN & CHEUNG. sodium bicarbonate. there may be convulsions and respiratory failure leading to death. may counteract Di Yu (Radix Sanguisorbae Officinalis). (This medicinal is routinely used during pregnancy in China when indicated by disease and pattern discrimination. nausea.Chapter 4 276 • Herb Toxicities & Drug Interactions: A Formula Approach Ban Xia (Rhizoma Pinelliae Ternatae) Standard daily dosage: 4. AH= AHPA. Antidote is oral administration of raw ginger. Bai Fu Ling. Must be decocted with other herbs and not taken alone or uncooked. Chen Pi. and magnesium sulfate. dizziness. Ju Pi. incompatible with Wu Tou (Radix Aconiti). tongue. Vitamin C. aluminum hydroxide. Initially. Contraindicated in patients with frequent. F L= FLAWS. tangerine peel) Standard daily dosage: 3-9g AH: Safe when used appropriately C&C: Contains potassium. and enlargement of the tongue. nicotinic acid. and throat. and a feeling of pressure in the chest.) Contraindicated in all hemorrhagic disorders. hydrochloric acid. and Bie Jia (Carapax Amydae Sinensis). According to traditional sources. forceless pulse. C&C: Contains potassium. BR= BRINKER. ulceration of the oral mucosa. a somber white facial complexion. difficulty swallowing. GLW: Poisoning occurs within 15 minutes to three hours after ingestion of a suitable amount. If severe. and other highly acidic substances could possibly reduce the therapeutic effect of this medicinal. Yun Ling (Sclerotium Poriae Cocos) Standard daily dosage: 9-15g B&G: Large doses or long-term use is discouraged. there is burning pain in the mouth. and a weak. Fu Ling. Could possibly cause hyperkalemia when used with potassium-sparing diuretics. Use with caution in patients with fever. heart palpitations. Could possibly cause hyperkalemia when used with potassium-sparing diuretics. Qin Jiao (Radix Gentianae Qinjiao). This is then followed by drooling. glutamic acid. low-grade fever. Could possibly reduce the absorption and therapeutic effect of potassium and sodium iodides. copious urination. According to some traditional sources.5-12g AH: Do not use during pregnancy. Toxic effects due to improper preparation or dosage include burning and numbness in throat and lips. B&B= BENSKY & BAROLET. GLW= GAO LU WEN . numbness of the extremities. C&C: Contains alkaloids and glycosides. B&G= B ENSKY & GAMBLE. Ju Hong (Pericarpium Citri Reticulatae.

May be synergistic with insulin in causing hypokalemia and sodium retention. it may cause hypertension and/or edema. The most famous of these is Huang Lian Wen Dan Tang (Coptis Warm the Gallbladder Decoction) and Shi Wei Wen Dan Tang (Ten Flavors Warm the Gallbladder Decoction).(This medicinal is routinely used in Chinese medical gynecology during pregnancy as part of formulas appropriately prescribed on the basis of pattern discrimination. hypertension. it is contraindicated in diabetes. AH= AHPA. When used as a single medicinal or in patients taking other potent Western pharmaceuticals.Chapter 4 Toxicities & Drug Interaction • 277 Gan Cao (Radix Glycyrrhizae Uralensis. It should not be taken long-term or as a single herb during pregnancy. incompatible with Gan Sui (Radix Euphorbiae Kansui). If taken long-term. B&G: According to some traditional sources. Avoid larger doses if being used to treat morning sickness or if used in patients taking anticoagulants. Increases absorption of oral drugs. caution should be exercised to guard against potential toxicity and drug interaction. The research on Gan Cao concurs that this medicinal is generally safe when used in small amounts as an envoy. and liver disorders. BR: May increase toxicity of cardiac glycosides. Yuan Hua (Flos Daphnes Genkwae). Hong Zao (Fructus Zizyphi Jujubae. Sheng Jiang (uncooked Rhizoma Zingiberis Officinalis. and Yuan Zhi (Radix Polygalae Tenuifoliae). B&G= B ENSKY & GAMBLE. Not for long-term use. COMMENTS This formula forms the base for a whole family of related formulas. PDR= PHYSICIAN’ S DESK REFERENCE . licorice root) Standard daily dosage: 2-12g AH: Do not use during pregnancy.) As a single herb in high doses. B R= BRINKER. B&B= BENSKY & BAROLET. Contains glycyrrhetinic acid which could possibly cause a reduction in thyroid activity and basal metabolic rate. FL= FLAWS. Possible additive effect to corticosteroids. PDR: Recommended safe dosage limit is six grams (6g). GLW= GAO LU WEN. red dates) Standard daily dosage: 10-30g (3-12 pieces) AH: Safe when used appropriately PDR: No health risks or side effects are known in conjunction with the proper administration of designated therapeutic dosages. May increase potassium loss due to diuretics and laxatives. C&C= CHAN & CHEUNG. Da Zao. fresh ginger) Standard daily dose: 3-9g AH: Safe when used appropriately BR: Reduces vomiting caused by chemotherapeutic drugs.

purple tongue or possible static macules or speckles. According to some traditional sources. B R= BRINKER. GLW= GAO LU WEN. AH= AHPA. polycystic ovarian syndrome.a. Overdose may cause the throat to become extremely dry. toxicity may cause abortion. abdominal pain.Chapter 4 278 • Herb Toxicities & Drug Interactions: A Formula Approach WEN JING TANG (Warm the Menses Decoction. diarrhea. visual disturbances. B&B= BENSKY & BAROLET. calcium gluconate. deep. C&C= CHAN & CHEUNG. carbonate. a pale. low-grade fever at dusk. GLW: Symptoms of adverse reaction include vomiting. irregular menstruation. aluminum hydroxide. increased body temperature. slow. menstrual irregularity. midcycle bleeding. primary dysmenorrhea. infertility. and a fine. C&C: Contains alkaloids and quercetin. chronic pelvic inflammatory disease. visual hallucinations. In pregnant women. Should not be used long-term. continuous leaking. enduring uterine bleeding. infertility. FL= FLAWS. Large doses stimulate the central nervous system and can lead to visual disturbances and hallucinations. dry lips and mouth. and bowstring pulse Contraindications: Concretions and conglomerations due to blood stasis and replete evils Western medical indications: Functional uterine bleeding. and perimenopausal syndrome Potential formula toxicities & interactions: None listed POTENTIAL MEDICINAL TOXICITIES & INTERACTIONS: Wu Zhu Yu (Fructus Evodiae Rutecarpae) Standard daily dosage: 3-9g AH: Do not exceed recommended dose. Tang-kuei & Evodia Combination) Category: Blood-quickening Functions: Warms the menses and dispels cold. B&G: Very drying.k. nourishes the blood and dispels stasis Chinese medical indications: Vacuity cold of the chong and ren with blood stasis resulting in mild. magnesium and ferrous sulfates. and bismuth subcarbonate. and falling hair. and lactate. PDR= PHYSICIAN’ S DESK REFERENCE . Could possibly reduce the absorption and therapeutic effect of potassium and sodium iodides. sodium bicarbonate. B&G= B ENSKY & GAMBLE. warm palms and soles. a. chilly pain and distention in the lower abdomen. antagonizes Dan Shen (Radix Salviae Miltiorrhizae) and counteracts Zi Shi Ying (Fluoritum).

sodium bicarbonate. and is incompatible with Li Lu (Rhizoma Et Radix Veratri). PDR= P HYSICIAN’S DESK REFERENCE . According to some traditional sources. C&C: Contains alkaloids and potassium. antagonizes Shan Zhu Yu (Fructus Corni Officinalis) and HuangQi (Radix Astragali Membranacei). C&C: Contains potassium. or during excessive menstruation.) B&G: Use with caution in patients with diarrhea or abdominal distention. white peony root) Standard daily dosage: 6-30g AH: Safe when used appropriately B&G: Use with caution in debilitated patients with diarrhea. Dang Gui (Radix Angelicae Sinensis) Standard daily dosage: 3-15g AH: Do not use during pregnancy. (This medicinal is routinely used in Chinese medical gynecology during pregnancy as part of formulas appropriately prescribed on the basis of pattern discrimination. Could possibly reduce the absorption and therapeutic effect of potassium and sodium iodides. BR= BRINKER. Could possibly cause hyperkalemia when used with potassium-sparing diuretics. during pregnancy.) AH: Do not use during pregnancy. Could possibly cause hyperkalemia when used with potassium-sparing diuretics.Chapter 4 Toxicities & Drug Interaction • 279 Gui Zhi (Ramulus Cinnamomi Cassiae. and magnesium sulfate. PDR: Contraindicated during pregnancy. Bai Shao. counteracts Hua Shi (Talcum) and Huang Lian (Rhizoma Coptidis Chinensis).) B&G: Not for patients with migraine headache or excessive menstrual bleeding. B&G= B ENSKY & GAMBLE. aluminum hydroxide. According to some traditional texts. Chuan Xiong (Radix Ligustici Wallichii) Standard daily dosage: 3-9g(In China today. C&C= CHAN & CHEUNG. (This medicinal is routinely used in Chinese medical gynecology during pregnancy as part of formulas appropriately prescribed on the basis of pattern discrimination. GLW= GAO LU WEN. it is not uncommon for this medicinal to be prescribed up to 15 grams per day in decoction. antagonizes Shi Hu (Herba Dendrobii) and AH= AHPA. F L= FLAWS. May exaggerate the anticoagulative effect of warfarin (Coumadin). Overdosage causes vomiting and dizziness. cinnamon twigs) Standard daily dosage: 3-15g AH: Safe when used appropriately B&G: Use with caution in the presence of fever. Shao Yao (Radix Albus Paeoniae Lactiflorae. B&B= BENSKY & BAROLET.

quinine. and other highly acidic substances could possibly reduce the therapeutic effect of this medicinal. Vitamin C. glutamic acid. Could possibly reduce the absorption and biologic effect of most antibiotics. E Jiao (Gelatinum Corii Asini. counteracts Bie Jia (Carapax Amydae Sinensis) and Xiao Ji (Herba Cephalanopoloris Segeti). PDR= P HYSICIAN’ S DESK REFERENCE . cause digitalis intoxication and heart arrhythmias. may counteract the effect of Tu Si Zi (Semen Cuscutae Chinensis). According to some traditional sources. Mai Dong (Tuber Ophiopogoni Japonici) Standard daily dosage: 6-15g AH: Safe when used appropriately B&G: According to some traditional sources. FL= FLAWS. isoniazid. C&C: Contains tannic acid. atropine. reserpine. Vitamin C. glutamic acid. potassium.) B&G: Should not be used during pregnancy or in patients with excessive sweating or profuse menstruation. C&C: Contains glycosides. Dan Pi. Mai Men Dong. Avoid using with garlic. C&C: Contains calcium. antagonizes Kuan Dong Hua (Flos Tussilaginis Farfarae) and counteracts Ku Shen (Radix Sophorae Flavescentis) and Bai Mu Er (Fructificatio Tremellae Fuciformis). Mu Dan Pi (Cortex Radicis Moutan. B&B= BENSKY & BAROLET. Bei Mu (Bulbus Fritillariae). isoniazid. tree peony root bark) Standard daily dosage: 6-12g AH: Not to be used during pregnancy. and could possibly reduce the absorption and therapeutic effect of levadopa. C&C= CHAN & CHEUNG. (This ingredient is commonly used in China during pregnancy to treat heat in the blood and/or blood stasis. hydrochloric acid. and glycosides. and pepsin. calcium carbonate and gluconate. Could possibly cause hyperkalemia when used with potassium-sparing diuretics. GLW= GAO LU WEN. amylase. trypsine. counteracts Da Huang (Radix Et Rhizoma Rhei). AH= AHPA. vitamin B1. tannic acid. and glycosides.Chapter 4 280 • Herb Toxicities & Drug Interactions: A Formula Approach Mang Xiao (Mirabilitum). potassium. chlorpromazine. ephedrine. Could possibly reduce the effect of most antibiotics. nicotinic acid. donkey skin glue) Standard daily dosage: 3-15g B&G: According to some traditional sources. and Da Huang (Radix Et Rhizoma Rhei). and is incompatible with Li Lu (Rhizoma Et Radix Veratri). BR= BRINKER. Could possibly cause hyperkalemia when used with potassium-sparing diuretics. and other highly acidic substances could possibly reduce the therapeutic effect of this medicinal. B&G= B ENSKY & GAMBLE . hydrochloric acid. nicotinic acid.

(This medicinal is routinely used in Chinese medical gynecology during pregnancy as part of formulas appropriately prescribed on the basis of pattern discrimination. quinine. nicotinic acid. digitalis. tremors. F L= FLAWS. and liver disorders. B&G: According to some traditional sources. B&G: Contraindicated for hypertensive patients. hydrochloric acid. May reduce the anticoagulative effect of warfarin (Coumadin).Chapter 4 Toxicities & Drug Interaction • 281 chlorpromazine. BR= BRINKER. heart palpitations. it may cause hypertension and/or edema. calcium carbonate and gluconate. BR: May increase toxicity of cardiac glycosides. licorice root) Standard daily dosage: 2-12g AH: Do not use during pregnancy. The research on Gan Cao concurs that this medicinal is generally safe when used in small amounts as an envoy. Not for long-term use. and Yuan Zhi (Radix Polygalae Tenuifoliae). Vitamin C. Enhances the effect of insulin and other antidiabetic agents. reserpine. Contains glycyrrhetinic acid which could possibly cause a reduction in thyroid activity and basal metabolic rate. B&B= BENSKY & BAROLET. insomnia. A traditional antidote is mung bean soup. and a rise in blood pressure. hypertension. glutamic acid. PDR= PHYSICIAN’S DESK REFERENCE . It should not be taken long-term or as a single herb during pregnancy. ephedrine. and pepsin. GLW= GAO LU WEN . C&C: Vitamin C. amylase. glutamic acid. nicotinic acid. B&G= B ENSKY & GAMBLE. vitamin B1. Yuan Hua (Flos Daphnes Genkwae). it is contraindicated in diabetes. trypsine. C&C= CHAN & CHEUNG. Possible additive effect to corticosteroids. Ren Shen (Radix Panacis Ginseng. and other highly acidic substances could possibly reduce the therapeutic effect of this medicinal. May cause hypertension if consumed with caffeine. incompatible with Gan Sui (Radix Euphorbiae Kansui). May increase potassium loss due to diuretics and laxatives. Possible additive effects to insulin. Not recommended in large doses during pregnancy or lactation due to potential neonatal androgenization. ginseng) Standard daily dosage: 1-30g AH: Contraindicated in hypertension BR: May cause manic episodes in patients on MAO-inhibitors. PDR: Contraindicated in patients with hypertension. hydrochloric acid. May be synergistic with insulin in causing hypokalemia and sodium retention. and manias. If taken long-term. Gan Cao (Radix Glycyrrhizae Uralensis. When used as a single medicinal or AH= AHPA. Overdose can lead to headache. atropine. Use with MAO-inhibitors may cause headaches.) As a single herb in high doses. and other highly acidic substances could possibly reduce the therapeutic effect of this medicinal.

Ban Xia (Rhizoma Pinelliae Ternatae) Standard daily dosage: 4. Avoid larger doses if being used to treat morning sickness or if used in patients taking anticoagulants. PDR= P HYSICIAN’ S DESK REFERENCE . nausea. and enlargement of the tongue. incompatible with Wu Tou (Radix Aconiti). If severe. Use with caution in patients with fever. According to some traditional sources.5-12g AH: Do not use during pregnancy. Sheng Jiang (uncooked Rhizoma Zingiberis Officinalis. hydrochloric acid. Increases absorption of oral drugs. and throat. numbness of the extremities. ulceration of the oral mucosa. tongue. B&G= B ENSKY & GAMBLE .) Contraindicated in all hemorrhagic disorders. Initially. Antidote is oral administration of raw ginger. there may be convulsions and respiratory failure leading to death. and a feeling of pressure in the chest. unclear speech. difficulty swallowing. AH= AHPA. Could possibly reduce the absorption and therapeutic effect of potassium and sodium iodides. FL= FLAWS. B&G: Safe as long as it is properly prepared. PDR: Recommended safe dosage limit is six grams (6g). nicotinic acid. C&C= CHAN & CHEUNG. there is burning pain in the mouth. Toxic effects due to improper preparation or dosage include burning and numbness in throat and lips. GLW: Poisoning occurs within 15 minutes to three hours after ingestion of a suitable amount. GLW= GAO LU WEN. a somber white facial complexion. forceless pulse. fresh ginger) Standard daily dose: 3-9g AH: Safe when used appropriately BR: Reduces vomiting caused by chemotherapeutic drugs. sodium bicarbonate. B&B= BENSKY & BAROLET. BR= BRINKER. low-grade fever. Must be decocted with other herbs and not taken alone or uncooked. aluminum hydroxide. glutamic acid. heart palpitations. dizziness. Vitamin C. COMMENTS Dang Shen (Radix Codonopsitis Pilosulae) is commonly substituted for Ren Shen in this formula. (This medicinal is routinely used during pregnancy in China when indicated by disease and pattern discrimination. This is then followed by drooling. and magnesium sulfate. and a weak.Chapter 4 282 • Herb Toxicities & Drug Interactions: A Formula Approach in patients taking other potent Western pharmaceuticals. caution should be exercised to guard against potential toxicity and drug interaction. and other highly acidic substances could possibly reduce the therapeutic effect of this medicinal. C&C: Contains alkaloids and glycosides.

F L= FLAWS. strangury Contraindications: Long-term use in cases of spleen and/or kidney vacuity Western medical indications: Chronic nephritis edema. B&G: Although considered safe. infectious hepatitis. scrotal hydrocele. and reduced appetite POTENTIAL MEDICINAL TOXICITIES & I NTERACTIONS: Ze Xie (Rhizoma Alismatis Orientalis) Standard daily dosage: 6-15g AH: Prolonged use may cause gastrointestinal irritation. vertigo. genitourinary infections. BR= BRINKER. PDR= PHYSICIAN’S DESK REFERENCE . acute gastritis. warms yang and transforms the qi Chinese medical indications: Spleen vacuity failing to transport water with edema. aluminum hydroxide.k. B&G= BENSKY & GAMBLE. Meniere’s disease. ascites due to liver cirrhosis. neurogenic bladder syndrome Potential formula toxicities & interactions: FL: Do not use for prolonged period of time B&B: Symptoms of overdose may include dizziness. C&C: Contains alkaloids and potassium. magnesium sulfate. a bland taste in the mouth. acute and chronic nephritis. Could possibly cause hyperkalemia when used with potassium-sparing diuretics and reduce the absorption and therapeutic effect of potassium and sodium iodides. acute gastroenteritis with diarrhea. sesquiterpenes. No health hazards or side effects with proper administration of designated therapeutic dosages. Hoelen Five Herb Formula) Category: Dampness-dispelling Functions: Disinhibits water and seeps dampness. gastroptosis. gastrectasis. chronic renal failure. cardiac edema from congestive heart failure. C&C= CHAN & CHEUNG.a. prolonged usage may irritate the intestinal tract and could possibly cause gastroenteritis. a. AH= AHPA.Chapter 4 Toxicities & Drug Interaction • 283 WU LING SAN (Five [Ingredients] Poria Powder. and caffeic acid derivatives. GLW= GAO L U WEN . urinary retention. sodium bicarbonate. diarrhea. B&B= BENSKY & BAROLET. PDR: Contains triterpenes. flavone sulfate. generalized bodily heaviness.

during pregnancy. BR= BRINKER. B&B= BENSKY & BAROLET. Contraindicated in patients with frequent. may counteract Di Yu (Radix Sanguisorbae Officinalis). they developed a mild lymphopenia and anemia but suffered no damage to the brain. F L= FLAWS. cinnamon twigs) Standard daily dosage: 3-15g AH: Safe when used appropriately B&G: Use with caution in the presence of fever. PDR= PHYSICIAN’S DESK REFERENCE . Bai Fu Ling. Zhu Ling (Sclerotium Polypori Umbellati) Standard daily dosage: 6-15g AH: Safe when used appropriately Bai Zhu (Rhizoma Atractylodis Macrocephalae) Standard daily dosage: 4. Yun Ling (Sclerotium Poriae Cocos) Standard daily dosage: 9-15g B&G: Large doses or long-term use is discouraged. According to traditional sources.5g/kg of this medicinal for two months. Gui Zhi (Ramulus Cinnamomi Cassiae. or liver. PDR: Contraindicated during pregnancy. and Bie Jia (Carapax Amydae Sinensis). GLW= GAO L U WEN . heart. or during excessive menstruation. B&G= BENSKY & GAMBLE. Qin Jiao (Radix Gentianae Qinjiao). copious urination. AH= AHPA.5-9g B&G: When rats were fed 0. C&C= C HAN & CHEUNG.Chapter 4 284 • Herb Toxicities & Drug Interactions: A Formula Approach Fu Ling.

chest oppression. Sichuan peppercorn husk) Standard daily dosage: 1.Chapter 4 Toxicities & Drug Interaction • 285 WU MEI WAN (Mume Pills. insomnia.a. and berbamin. chronic dysentery. Could possibly reduce the therapeutic effect of sodium bicarbonate. and damp heat.k. BR= BRINKER. PDR= PHYSICIAN’S DESK REFERENCE . Chuan Jiao (Pericarpium Zanthoxyli Bungeani. and Fang Feng AH= AHPA. Classic symptamology includes intermittent attacks of abdominal pain. and uterine complaints associated with candidiasis Potential formula toxicities & interactions: None listed POTENTIAL MEDICINAL TOXICITIES & INTERACTIONS: Wu Mei (Fructus Pruni Mume) Standard daily dosage: 3-9g AH: Safe when used appropriately C&C: Highly acidic. scopolamine. Contraindications: Damp heat dysentery Western medical indications: Ascariasis (including biliary). caffeine. and cold hands and feet. C&C= CHAN & CHEUNG. many antibiotics (especially aminoglycosides and sulfas). qi and blood stagnation and stasis. However. According to some traditional sources. there is a red tongue with geographically peeled fur. vexatious heat in the chest and stomach duct region accompanied by vomiting after eating. neurosis. easy anger. gastric ulcer. GLW= GAO LU WEN . postgastrectomy syndrome. B&B= BENSKY & BAROLET.5-6g AH: Not to be used during pregnancy. Commonly. reserpine. can also be used to treat complex combinations of qi and blood vacuity due to spleen vacuity. Fu Zi (Radix Lateralis Praeparatus Aconiti Carmichaeli). counteracts Kuan Dong Hua (Flos Tussilaginis Farfarae). B&G: Use with caution during pregnancy. aluminum hydroxide. Mume Formula) Category: Worm-killing Functions: Warms the viscera and quiets roundworms Chinese medical indications: Roundworm reversal with heat in the stomach and cold in the intestines. F L= FLAWS. B&G= B ENSKY & GAMBLE. a. chronic gastritis. Could possibly cause crystalluria and hematuria. opiates.

As of this writing. slightly dilated pupils. twitching muscles. and. Some traditional sources say it should not be taken with pork. Xi Xin is harvested in China mostly from Asarum sieboldi and Asarum heteropoides. generalized tension which may become convulsions. vomiting. According to some traditional sources. Use with caution in patients with renal problems. eventually. and these may contain AA. Xi Xin is on the FDA’s “B List” of herbs which may potentially contain aristolochic acid (AA). B&G= B ENSKY & GAMBLE. antagonizes Ju Hua (Flos Chrysanthemi Morifolii). sweating.) B&G: Contains berberine. B&G: Nephrotoxic. increased body temperature and blood pressure. oral thirst. PDR= PHYSICIAN’S DESK REFERENCE . According to some traditional sources.Chapter 4 286 • Herb Toxicities & Drug Interactions: A Formula Approach (Radix Ledebouriellae Divaricatae) and antagonizes Gua Lou (Fructus Trichosanthis Kirlowii). F L= FLAWS. However. unclear thinking. BR= BRINKER. clenched teeth. Can inhibit lactation. arched-back rigidity. may antagonize Shan Zhu Yu (Fructus Corni Officinalis) and Huang Qi (Radix Astragali Membranacei). urinary block. neither of which have conclusively been shown to contain AA. cramping of the four limbs. dimming of consciousness. counteracts Kuan Dong Hua (Flos Tussilaginis Farfarae) and Niu Xi (Radix Achyranthis Bidentatae). a rapid pulse. Xuan Shen (Radix Scrophulariae Ningpoensis). vexation and agitation. GLW: Symptoms of adverse reaction include headache. a red flushed face. Huang Lian (Rhizoma Coptidis Chinensis) Standard daily dosage: 1. GLW= GAO LU WEN . death due to respiratory paralysis. Jiang Can (Bombyx Batryticatus). the FDA has set no acceptable limit to AA consumption by humans. According to some traditional sources. C&C= CHAN & CHEUNG. other species of Asarum are sometimes substituted. Bai Xian Pi (Cortex Radicis Dictamni Dasycarpi). B&B= BENSKY & BAROLET. Do not exceed recommended dose. stiffness of the neck. PDR: Not to be used during pregnancy. Xi Xin (Herba Asari Cum Radice) Standard daily dosage: 1-3g AH: Do not use during pregnancy.5-9g AH: Do not use during pregnancy. Long-term use may damage the digestive system. (This medicinal is commonly used during pregnancy in China when indicated by disease and pattern discrimination. Contains aristolochic acid (AA). AH= AHPA.

Could possibly reduce the absorption and therapeutic effect of potassium and sodium iodides. B&G= BENSKY & GAMBLE. wolfsbane. carbonate. C&C= CHAN & CHEUNG. monkshood) Standard daily dosage: 1.) B&G: Chinese literature reports one case of a patient who developed a skin rash after ingestion. GLW= GAO L U WEN . Huang Bai. and numbness and tingling of the extremities. and bismuth subcarbonate. Could possibly reduce the absorption and AH= AHPA. A very toxic medicinal which can be fatal if ingested in its uncooked form or in an inappropriate dose. light-headedness. Fu Zi. It is generally combined with Gan Cao (Radix Glycyrhizae Uralensis) and Gan Jiang (dry Rhizoma Zingiberis Officinalis) in decoctions to reduce its toxicity. aluminum hydroxide. calcium gluconate. quercetin. BR= BRINKER. F L= FLAWS. C&C: Contains alkaloids & quercetin. (This medicinal is commonly used during pregnancy in China. Emergency measures include the administration of atropine. Could possibly reduce the absorption and therapeutic effect of potassium and sodium iodides. Fu Pian (Radix Lateralis Praeparatus Aconiti Carmichaeli. Gan Jiang (dry Rhizoma Zingiberis Officinalis. and potassium. Huang Bo (Cortex Phellodendri) Standard daily dosage: 3-12g AH: Not to be used during pregnancy. dry ginger) Standard daily dosage: 3-12g AH: Not to be used during pregnancy. dyspnea. C&C: Contains alkaloids. B&G: Use with caution during pregnancy. B&B= BENSKY & BAROLET. and lactate.Chapter 4 Toxicities & Drug Interaction • 287 C&C: Contains alkaloids.5-15g AH: To be used only under the supervision of an expert qualified in the appropriate use of this substance B&G: Contraindicated during pregnancy. PDR= PHYSICIAN’S DESK REFERENCE . and reduced temperature and blood pressure. Symptoms of toxicity include drooling. magnesium and ferrous sulfates. aluminum hydroxide. Patients with gallstones should consult a practitioner prior to use. Could possibly cause hyperkalemia when used with potassium-sparing diuretics. Shu Fu Zi. More severe symptoms include premature atrial contractions. sodium bicarbonate. and bismuth subcarbonate. carbonate. blurred vision. calcium gluconate. magnesium and ferrous sulfates. and lactate. gastric upset. sodium bicarbonate.

cinnamon twigs) Standard daily dosage: 3-15g AH: Safe when used appropriately B&G: Use with caution in the presence of fever. PDR: Contraindicated during pregnancy. PDR: Contains nor-diterpene alkaloids. nausea. heart palpitations. heart palpitations. slowed reaction to light. C&C= CHAN & CHEUNG. B&B= BENSKY & BAROLET. vomiting. a somber white facial complexion. AH= AHPA. and magnesium sulfate. low blood pressure. and circulatory collapse leading to death. nicotinic acid. lowered body temperature. reversal chilling of the four limbs. tremors. paralysis. May reduce the anticoagulative effect of warfarin (Coumadin). rapid breathing. vexation. Not recommended in large doses during pregnancy or lactation due to potential neonatal androgenization.Chapter 4 288 • Herb Toxicities & Drug Interactions: A Formula Approach therapeutic effect of potassium and sodium iodides. B&G= B ENSKY & GAMBLE. insomnia. slow heartbeat. B&G: Contraindicated for hypertensive patients. A traditional antidote is mung bean soup. urinary incontinence. and pain which gradually spreads to the four limbs and then to the whole body. Gui Zhi (Ramulus Cinnamomi Cassiae. Possible additive effects to insulin. PDR= PHYSICIAN’ S DESK REFERENCE . agitation. and manias. and other highly acidic substances could possibly reduce the therapeutic effect of this medicinal. GLW: If mild poisoning. Use with MAO-inhibitors may cause headaches. aluminum hydroxide. drooling. If more severe poisoning. numbness. convulsions. GLW= GAO LU WEN. there is a burning hot sensation in the mouth and on the tongue. dilated pupils. small doses can be fatal. FL= FLAWS. restlessness. dizziness. BR= BRINKER. C&C: Vitamin C. arrhythmia. and a rise in blood pressure. May cause hypertension if consumed with caffeine. glutamic acid. sodium bicarbonate. or during excessive menstruation. Overdose can lead to headache. PDR: Contraindicated in patients with hypertension. there may be generalized sweating. Enhances the effect of insulin and other antidiabetic agents. during pregnancy. including aconitine. Highly toxic. ginseng) Standard daily dosage: 1-30g AH: Contraindicated in hypertension BR: May cause manic episodes in patients on MAO-inhibitors. hydrochloric acid. Ren Shen (Radix Panacis Ginseng.

Chinese doctors speak of a vacuity and repletion. AH= AHPA. In that case. F L= FLAWS.Chapter 4 Toxicities & Drug Interaction • 289 Dang Gui (Radix Angelicae Sinensis) Standard daily dosage: 3-15g AH: Do not use during pregnancy. PDR= PHYSICIAN’S DESK REFERENCE . C&C= CHAN & CHEUNG. B&G= B ENSKY & GAMBLE. qi stagnation. COMMENTS While this formula is the main one for killing or dispelling worms in Chinese medicine. it actually has a rather broad scope of indications. BR= BRINKER. and damp heat. B&B= BENSKY & BAROLET. hot and cold condition. blood stasis.) B&G: Use with caution in patients with diarrhea or abdominal distention. C&C: Contains potassium. Dang Shen (Radix Codonopsitis Pilosulae) is commonly substituted for Ren Shen in this formula. (This medicinal is routinely used in Chinese medical gynecology during pregnancy as part of formulas appropriately prescribed on the basis of pattern discrimination. GLW= GAO LU WEN . May exaggerate the anticoagulative effect of warfarin (Coumadin). blood vacuity. It can be used whenever there is a complex combination of spleen qi and/or yang vacuity. Could possibly cause hyperkalemia when used with potassium-sparing diuretics.

white tongue fur. and a fine. slimy. and bismuth subcarbonate. the decoction should be taken cool to insure that it will not be regurgitated. sodium bicarbonate. B&B= BENSKY & BAROLET. and a worsening of headache. abdominal pain. cold hands and feet. According to some traditional sources. migraine headache. dizziness. GLW: Symptoms of adverse reaction include vomiting. spitting of clear fluids. acid regurgitation. cholecystitis. GLW= GAO LU WEN. or fine. magnesium and ferrous sulfates. Should not be used long-term. F L= FLAWS. C&C= CHAN & CHEUNG. POTENTIAL MEDICINAL TOXICITIES & INTERACTIONS: Wu Zhu Yu (Fructus Evodiae Rutecarpae) Standard daily dosage: 3-9g AH: Do not exceed recommended dose. B&G= B ENSKY & GAMBLE . Could possibly reduce the absorption and therapeutic effect of potassium and sodium iodides. BR= BRINKER. Overdose may cause the throat to become extremely dry. and Meniere’s disease Potential formula toxicities & interactions: B&B: For severe nausea. trigeminal neuralgia. dry heaves. aluminum hydroxide. diarrhea. downbears counterflow and stops vomiting Chinese medical indications: Vacuity cold of the stomach and/or liver with vomiting immediately after eating. slow pulse Contraindications: Vomiting and acid regurgitation due to heat Western medical indications: Chronic gastritis. In pregnant women. visual disturbances. These symptoms generally resolve within 30 minutes of taking the decoction. AH= AHPA. Evodia Combination) Category: Interior-warming Functions: Warms and supplements the liver and stomach.a. diarrhea. toxicity may cause abortion. headache at the vertex. neurogenic headache. carbonate. visual hallucinations. calcium gluconate. clamoring stomach. antagonizes Dan Shen (Radix Salviae Miltiorrhizae) and counteracts Zi Shi Ying (Fluoritum). bowstring. and falling hair.k. a. C&C: Contains alkaloids and quercetin. Occasional side effects include chest discomfort.Chapter 4 290 • Herb Toxicities & Drug Interactions: A Formula Approach WU ZHU YU TANG (Evodia Decoction. morning sickness. PDR= P HYSICIAN’S DESK REFERENCE . and lactate. Large doses stimulate the central nervous system and can lead to visual disturbances and hallucinations. B&G: Very drying. hypertension. abdominal migraine. acute gastroenteritis. increased body temperature.

However. Overdose can lead to headache. C&C: Vitamin C. fresh ginger) Standard daily dose: 3-9g AH: Safe when used appropriately BR: Reduces vomiting caused by chemotherapeutic drugs. May reduce the anticoagulative effect of warfarin (Coumadin). glutamic acid. and manias. B&B= BENSKY & BAROLET. PDR: Recommended safe dosage limit is six grams (6g). GLW= GAO LU WEN . this formula may actually provoke vomiting. COMMENTS When used for the first aid treatment of migraine headache with nausea. heart palpitations. F L= FLAWS. PDR= PHYSICIAN’S DESK REFERENCE . Hong Zao (Fructus Zizyphi Jujubae. PDR: Contraindicated in patients with hypertension. insomnia. May cause hypertension if consumed with caffeine.Chapter 4 Toxicities & Drug Interaction • 291 Sheng Jiang (uncooked Rhizoma Zingiberis Officinalis. Ren Shen (Radix Panacis Ginseng. and other highly acidic substances could possibly reduce the therapeutic effect of this medicinal. Avoid larger doses if being used to treat morning sickness or if used in patients taking anticoagulants. ginseng) Standard daily dosage: 1-30g AH: Contraindicated in hypertension BR: May cause manic episodes in patients on MAO-inhibitors. if it does. Not recommended in large doses during pregnancy or lactation due to potential neonatal androgenization. AH= AHPA. the migraine pain will abate after the vomiting as will the nausea. Enhances the effect of insulin and other antidiabetic agents. BR= BRINKER. Increases absorption of oral drugs. Possible additive effects to insulin. C&C= CHAN & CHEUNG. hydrochloric acid. Use with MAO-inhibitors may cause headaches. nicotinic acid. red dates) Standard daily dosage: 10-30g (3-12 pieces) AH: Safe when used appropriately PDR: No health risks or side effects are known in conjunction with the proper administration of designated therapeutic dosages. and a rise in blood pressure. A traditional antidote is mung bean soup. B&G= B ENSKY & GAMBLE. Da Zao. tremors. B&G: Contraindicated for hypertensive patients.

BR= BRINKER. Sheng Di. mental illness. hepatic coma. glaucoma. red skin macules. toxemia. various types of hemorrhagic conditions. bleeding and pus in the anterior chamber of the eye. B&B= BENSKY & BAROLET. Because Xi Jiao is from an endangered species. uremia. iridocyclitis. Should only be used in the presence of high fever. F L= FLAWS. thirst with an inability to swallow. acute leukemia. and Lei Wan (Sclerotium Omphaliae Lapidescentis). AH= AHPA. meningitis. B&G= B ENSKY & GAMBLE. and a fine. water buffalo horn). black. GLW= GAO LU WEN. Standard daily dosage of this ingredient in decoction is 4. rapid pulse Contraindications: Bleeding due to yang vacuity or spleenstomach vacuity Western medical indications: Various sorts of hemorrhage including infectious febrile diseases with hemorrhage. rhinoceros horn) Standard daily dosage: 1-2g as a powder B&G: Use with great caution during pregnancy. a crimson tongue with thornlike papillae.5-9g. abdominal distention and fullness. measles. tarry stools. thrombocytopenic purpura. it is now commonly substituted by Shui Niu Jiao (Cornu Bubali. According to traditional sources. C&C= CHAN & CHEUNG. Sheng Di Huang (uncooked Radix Rehmanniae Glutinosae) Standard daily dosage: 9-30g AH: Contraindicated in patients with diarrhea or lack of appetite B&G: Contraindicated in pregnant women with anemias or digestive weakness C&C: Contains potassium.Chapter 4 292 • Herb Toxicities & Drug Interactions: A Formula Approach XI JIAO DI HUANG TANG (Rhinoceros Horn & Rehmannia Decoction) Category: Heat-clearing. may antagonize Chuan Wu (Radix Aconiti Carmichaeli). Cao Wu (Radix Aconiti Kusnezoffii). blood-cooling Functions: Drains fire and resolves toxins Chinese medical indications: Heat evils in the blood aspect with fever. Could possibly cause hyperkalemia when used with potassium-sparing diuretics. PDR= P HYSICIAN’S DESK REFERENCE . and burns Potential formula toxicities & interactions: None listed POTENTIAL MEDICINAL TOXICITIES & I NTERACTIONS: Xi Jiao (Cornu Rhinocerotis. encephalitis. septicemia.

isoniazid. potassium. Could possibly reduce the absorption and biologic effect of most antibiotics. F L= FLAWS. and could possibly reduce the absorption and therapeutic effect of levadopa. and pepsin. digitalis. and other highly acidic substances could possibly reduce the therapeutic effect of this medicinal. Bei Mu (Bulbus Fritillariae). Vitamin C. B&B= BENSKY & BAROLET. C&C: Contains calcium. quinine.Chapter 4 Toxicities & Drug Interaction • 293 PDR: No health risks or side effects are known in conjunction with the proper administration of designated therapeutic dosages. Shao Yao (Radix Albus Paeoniae Lactiflorae. C&C: Contains tannic acid. nicotinic acid. COMMENTS Shui Niu Jiao (Cornu Bubali) and Chi Shao (Radix Rubrus Paeoniae Lactiflorae) are commonly substituted for Xi Jiao and Bai Shao respectively. hydrochloric acid. vitamin B1. may counteract the effect of Tu Si Zi (Semen Cuscutae Chinensis).(This ingredient is commonly used in China during pregnancy to treat heat in the blood and/or blood stasis. GLW= GAO LU WEN . Could possibly reduce the effect of most antibiotics. AH= AHPA. Mu Dan Pi (Cortex Radicis Moutan. ephedrine. trypsine. chlorpromazine. According to some traditional sources. and glycosides. tannic acid. quinine. tree peony root bark) Standard daily dosage: 6-12g AH: Not to be used during pregnancy. cause digitalis intoxication and heart arrhythmias.) B&G: Should not be used during pregnancy or in patients with excessive sweating or profuse menstruation. According to some traditional sources. nicotinic acid. and Da Huang (Radix Et Rhizoma Rhei). counteracts Bie Jia (Carapax Amydae Sinensis) and Xiao Ji (Herba Cephalanopoloris Segeti). BR= BRINKER. Vitamin C. Dan Pi. antagonizes Shi Hu (Herba Dendrobii) and Mang Xiao (Mirabilitum). glutamic acid. potassium. and other highly acidic substances could possibly reduce the therapeutic effect of this medicinal. and glycosides. reserpine. atropine. Bai Shao. calcium carbonate and gluconate. amylase. reserpine. white peony root) Standard daily dosage: 6-30g AH: Safe when used appropriately B&G: Use with caution in debilitated patients with diarrhea. chlorpromazine. atropine. vitamin B1. Could possibly cause hyperkalemia when used with potassium-sparing diuretics. trypsine. and pepsin. Avoid using with garlic. ephedrine. B&G= B ENSKY & GAMBLE. and is incompatible with Li Lu (Rhizoma Et Radix Veratri). amylase. isoniazid. Could possibly cause hyperkalemia when used with potassium-sparing diuretics. glutamic acid. PDR= PHYSICIAN’S DESK REFERENCE . calcium carbonate and gluconate. C&C= CHAN & CHEUNG. hydrochloric acid.

diarrhea. especially for the treatment of nausea and vomiting. Adding Huang Qin (Radix Scutellariae Baicalensis) and Huang Lian (Rhizoma Coptidis Chinensis) reduces this effect. and a floating pulse Contraindications: Summerheat conditions Western medical indications: Upper respiratory infection (especially in the summertime). bacillary dysentery.a. Bian Dou (Semen Dolichoris Lablab. PDR= PHYSICIAN’S DESK REFERENCE . gastroenteritis. and cholera Potential formula toxicities & interactions: None listed POTENTIAL MEDICINAL TOXICITIES & INTERACTIONS: Xiang Ru (Herba Elsholtziae Seu Moslae) Standard daily dosage: 3-9g AH: Safe when used appropriately B&G: May cause vomiting if taken in a hot decoction. fatigue. C&C: Contains alkaloids. GLW= GAO L U WEN . BR= BRINKER. a.) AH= AHPA. aluminum hydroxide. Could possibly reduce the absorption and therapeutic effect of potassium and sodium iodides. hyacinth beans) Standard daily dosage: 9-21g B&G: Contraindicated in patients with intermittent chills and fevers. B&B= BENSKY & BAROLET. abdominal pain. vomiting. transforms dampness and harmonizes the middle Chinese medical indications: Exterior cold with interior dampness contracted in the summer manifesting as aversion to cold with skin that is warm to the touch. Hou Po. sodium bicarbonate. Chuan Po (Cortex Magnoliae Officinalis) Standard daily dosage: 3-9g AH: Do not use during pregnancy. headache. heaviness of the head. chest oppression. C&C= CHAN & CHEUNG. Elsholtzia Combination) Category: Exterior-resolving Functions: Resolves the exterior and dissipates cold.k. slimy. Bai Bian Dou.(This medicinal is commonly used in China during pregnancy. and magnesium sulfate. B&G= BENSKY & GAMBLE. white tongue fur. F L= FLAWS. no sweating.Chapter 4 294 • Herb Toxicities & Drug Interactions: A Formula Approach XIANG RU SAN (Elsholtzia Powder.

calcium carbonate and gluconate. and pepsin. BR= BRINKER.Chapter 4 Toxicities & Drug Interaction • 295 B&G: Use with caution during pregnancy. quinine. Could possibly cause hyperkalemia when used with potassium-sparing diuretics. According to some traditional sources. C&C= CHAN & CHEUNG. chlorpromazine. digitalis. GLW= GAO LU WEN. amylase. isoniazid. vitamin B1. trypsine. reserpine. ephedrine. PDR= P HYSICIAN’S DESK REFERENCE . atropine. AH= AHPA. PDR: No health risks or side effects are known in conjunction with the proper administration of designated therapeutic dosages. F L= FLAWS. Could possibly reduce the absorption and biologic effect of most antibiotics. B&G= B ENSKY & GAMBLE. C&C: Contains tannic acid and potassium. antagonizes Ze Xie (Rhizoma Alismatis Orientalis) and Han Shui Shi (Calcitum). B&B= BENSKY & BAROLET.

and intestines. POTENTIAL MEDICINAL TOXICITIES & INTERACTIONS: Chai Hu (Radix Bupleuri) Standard daily dosage: 3-12g AH: Safe when used appropriately B&G: May occasionally cause nausea and vomiting. dizziness. and a bowstring. dizziness. ascendant liver yang hyperactivity. sinusitis. 2) fatigue. possible cough with yellow phlegm. malaria. B&G= B ENSKY & GAMBLE. cholecystitis. B R= BRINKER. PDR= PHYSICIAN’ S DESK REFERENCE . mumps. and bleeding of the gums in some patients. hydrochloric acid. pneumonia. possibly slippery and/or rapid pulse Contraindications: Repletion above and vacuity below. AH= AHPA. a bitter or sour taste in the mouth. heartburn. reduced appetite. and a bowstring. chest and rib-side oppression and fullness. diarrhea. and liver fire flaming upward Western medical indications: Common cold with lingering fever. 2) harmonizes the liver. a possible bitter taste in the mouth. nausea and vomiting. burping/belching. nausea and vomiting. could possibly cause headache. puerperal fever. C&C= CHAN & CHEUNG. easy anger. pleuritis. heartburn. FL= FLAWS. spleen. dry throat. GLW= GAO LU WEN. white or yellow tongue fur. otitis media. B&B= BENSKY & BAROLET. jaundice. lymphadenitis. nicotinic acid. gastric ulcer. possibly rapid and/or slippery pulse. stomach. pulmonary tuberculosis. and other highly acidic substances could possibly reduce the therapeutic effect of this medicinal. acute or chronic viral hepatitis. half white and half yellow tongue fur. acute and chronic bronchitis. easy anger. Some patients may experience fever and chills due to the out-thrusting action of this formula. in which case the dose should then be reduced significantly. mastitis. and tonsillitis Potential formula toxicities & interactions: B&B: If taken long-term. C&C: Vitamin C. clears heat and transforms phlegm Chinese medical indications: 1) Intermittent fever and chills.Chapter 4 296 • Herb Toxicities & Drug Interactions: A Formula Approach XIAO CHAI HU TANG (Minor Bupleurum Decoction) Category: Harmonizing Functions: 1) Harmonizes and resolves the shao yang aspect. glutamic acid. stomach ache. Use with caution in patients with hypertension.

counteracts Dan Pi (Cortex Radicis Moutan) and Li Lu (Rhizoma Et Radix Veratri). C&C= CHAN & CHEUNG. Ren Shen (Radix Panacis Ginseng. Use with MAO-inhibitors may cause headaches. B&G: Contraindicated for hypertensive patients. and other highly acidic substances could possibly reduce the therapeutic effect of this medicinal. Must be decocted with other herbs and not taken alone or uncooked.5-12g AH: Do not use during pregnancy. tremors. Could possibly cause hyperkalemia when used with potassium-sparing diuretics. and a rise in blood pressure. PDR: Contraindicated in patients with hypertension.) Contraindicated in all hemorrhagic disorders. C&C: Contains potassium and glycosides. nicotinic acid. A traditional antidote is mung bean soup. Not recommended in large doses during pregnancy or lactation due to potential neonatal androgenization.) Overdose may lead to gastroenteritis. GLW= GAO L U WEN. Vitamin C. B&G= B ENSKY & GAMBLE. nicotinic acid.Chapter 4 Toxicities & Drug Interaction • 297 PDR: Not to be administered during pregnancy. May reduce the anticoagulative effect of warfarin (Coumadin). hydrochloric acid. PDR= P HYSICIAN’S DESK REFERENCE . B&G: Safe as long as it is properly prepared. ginseng) Standard daily dosage: 1-30g AH: Contraindicated in hypertension BR: May cause manic episodes in patients on MAO-inhibitors. and manias. insomnia. intestinal colic. F L= FLAWS. and diarrhea due to saponin content. May cause hypertension if consumed with caffeine. heart palpitations. Possible additive effects to insulin. B&B= BENSKY & BAROLET. glutamic acid. glutamic acid. AH= AHPA. C&C: Vitamin C. Overdose can lead to headache. Tiao Qin (Radix Scutellariae Baicalensis) Standard daily dosage: 6-15g AH: Safe when used appropriately B&G: According to some traditional sources. and other highly acidic substances could possibly reduce the therapeutic effect of this medicinal.(This medicinal is routinely used in Chinese medical gynecology during pregnancy as part of formulas appropriately prescribed on the basis of pattern discrimination. hydrochloric acid. Toxic effects due to improper preparation or dosage include burning and numbness in throat and lips. Enhances the effect of insulin and other antidiabetic agents. Huang Qin. Ban Xia (Rhizoma Pinelliae Ternatae) Standard daily dosage: 4. (This medicinal is routinely used during pregnancy in China when indicated by disease and pattern discrimination. BR= BRINKER.

tongue. F L= FLAWS. Contains glycyrrhetinic acid which could possibly cause a reduction in thyroid activity and basal metabolic rate. aluminum hydroxide. B&G: According to some traditional sources. dizziness. Sheng Jiang (uncooked Rhizoma Zingiberis Officinalis. heart palpitations. incompatible with Gan Sui (Radix Euphorbiae Kansui). C&C: Contains alkaloids and glycosides. May be synergistic with insulin in causing hypokalemia and sodium retention. Possible additive effect to corticosteroids. B&G= B ENSKY & GAMBLE. Could possibly reduce the absorption and therapeutic effect of potassium and sodium iodides. Gan Cao (Radix Glycyrrhizae Uralensis. hydrochloric acid. (This medicinal is routinely used in Chinese medical gynecology during pregnancy as part of formulas appropriately prescribed on the basis of pattern discrimination. GLW= GAO LU WEN . there may be convulsions and respiratory failure leading to death.) As a single herb in high doses. ulceration of the oral mucosa.Chapter 4 298 • Herb Toxicities & Drug Interactions: A Formula Approach nausea. and Yuan Zhi (Radix Polygalae Tenuifoliae). The research on Gan Cao concurs that this medicinal is generally safe when used in small amounts as an envoy. C&C= CHAN & CHEUNG. According to some traditional sources. there is burning pain in the mouth. incompatible with Wu Tou (Radix Aconiti). caution should be exercised to guard against potential toxicity and drug interaction. This is then followed by drooling. Yuan Hua (Flos Daphnes Genkwae). If severe. hypertension. and a feeling of pressure in the chest. B&B= BENSKY & BAROLET. and a weak. BR: May increase toxicity of cardiac glycosides. fresh ginger) Standard daily dose: 3-9g AH= AHPA. Initially. licorice root) Standard daily dosage: 2-12g AH: Do not use during pregnancy. May increase potassium loss due to diuretics and laxatives. GLW: Poisoning occurs within 15 minutes to three hours after ingestion of a suitable amount. forceless pulse. nicotinic acid. When used as a single medicinal or in patients taking other potent Western pharmaceuticals. and liver disorders. unclear speech. difficulty swallowing. it may cause hypertension and/or edema. Vitamin C. glutamic acid. Use with caution in patients with fever. PDR= PHYSICIAN’S DESK REFERENCE . numbness of the extremities. and magnesium sulfate. and other highly acidic substances could possibly reduce the therapeutic effect of this medicinal. If taken long-term. a somber white facial complexion. sodium bicarbonate. and throat. Antidote is oral administration of raw ginger. Not for long-term use. It should not be taken long-term or as a single herb during pregnancy. it is contraindicated in diabetes. and enlargement of the tongue. low-grade fever. BR= BRINKER.

PDR: Recommended safe dosage limit is six grams (6g). B&G= B ENSKY & GAMBLE. COMMENTS This is one of the most commonly prescribed Chinese medicinal formulas in Chinese medicine. PDR= PHYSICIAN’S DESK REFERENCE . GLW= GAO LU WEN . It’s scope of indication goes far beyond harmonizing the shao yang. Da Zao. It can be used in any situation where there is a liver-spleen disharmony with heat. Hong Zao (Fructus Zizyphi Jujubae. Commonly. B&B= BENSKY & BAROLET. Dang Shen (Radix Codonopsitis Pilosulae) is substituted for Ren Shen (Radix Panacis Ginseng). F L= FLAWS. and the form of Gan Cao (Radix Glycyrrhizae Uralensis) used is typically mix-fried. Increases absorption of oral drugs. Avoid larger doses if being used to treat morning sickness or if used in patients taking anticoagulants. red dates) Standard daily dosage: 10-30g (3-12 pieces) AH: Safe when used appropriately PDR: No health risks or side effects are known in conjunction with the proper administration of designated therapeutic dosages.Chapter 4 Toxicities & Drug Interaction • 299 AH: Safe when used appropriately BR: Reduces vomiting caused by chemotherapeutic drugs. and/or phlegm. BR= BRINKER. dampness. C&C= CHAN & CHEUNG. AH= AHPA.

bulimia. profuse. bronchial asthma.Chapter 4 300 • Herb Toxicities & Drug Interactions: A Formula Approach XIAO QING LONG TANG (Minor Blue-green Dragon Decoction. PDR= P HYSICIAN’S DESK REFERENCE . As little as 15ml in a 1% solution may be toxic to some individuals. generalized bodily heaviness and body aches. Use with caution in hypertensive patients. F L= FLAWS.k. Antidote for poisoning is atropine. May cause arrhythmias if used in conjunction with cardiac glycosides. GLW= GAO LU WEN. antagonizes barbiturates. Minor Blue Dragon Combination) Category: Exterior-resolving Functions: Resolves the exterior and transforms fluids. moist. Not for long-term use. C&C= CHAN & CHEUNG. May reduce the effect of dexamethazone. tight or bowstring pulse Contraindications: Heat and/or yin vacuity Western medical indications: Common cold. BR: Increases thermogenesis when combined with methylxanthines in theophylline and caffeine. chest oppression. therefore. possible superficial edema and/or difficulty breathing lying down. ephedra) Standard daily dosage: 3-9g AH: Not to be used during pregnancy. white phlegm. B&B= BENSKY & BAROLET. acute bronchitis. warms the lungs and downbears counterflow Chinese medical indications: Wind cold external contraction in a person with enduring lung-spleen vacuity and internal gathering of water fluids with fever and chills. coughing. no sweating. and influenza Potential formula toxicities & interactions: B&B: Should not be used long-term. B&G: May raise blood pressure and cause tremors. B&G= B ENSKY & GAMBLE. Antagonized by reserpine. It enhances digitalis. BR= BRINKER. although chills predominate. and glaucoma. Amytriptiline blocks its hypertensive effect. must be administered with care. May induce toxicity with MAO-inhibitors. POTENTIAL MEDICINAL TOXICITIES & INTERACTIONS: Ma Huang (Herba Ephedrae. All research sources concur that Ma Huang is a very powerful herb with many potential side effects and interactions and. panting and wheezing. white tongue fur. and a floating. a.a. Contraindicated in anorexia. AH= AHPA.

C&C= CHAN & CHEUNG. cinnamon twigs) Standard daily dosage: 3-15g AH: Safe when used appropriately B&G: Use with caution in the presence of fever. upper abdominal discomfort. difficulty breathing. GLW: Initially after poisoning. BR= BRINKER. If critical. According to some traditional sources. there are central nervous and sympathetic nervous system symptoms. agitation. shock. and precordial pain. FDA has banned the inclusion of this medicinal in all dietary supplements. Gui Zhi (Ramulus Cinnamomi Cassiae. syncope. nausea. and restlessness. GLW= GAO LU WEN. headache.Chapter 4 Toxicities & Drug Interaction • 301 and increases the effects of adrenergic agonists. fright reversal. Contains aristolochic acid (AA). insomnia. may antagonize Shan Zhu Yu (Fructus Corni Officinalis) and Huang Qi (Radix Astragali Membranacei). during pregnancy. F L= FLAWS. B&G: Use with caution during pregnancy. B&G: Nephrotoxic. Xi Xin (Herba Asari Cum Radice) Standard daily dosage: 1-3g AH: Do not use during pregnancy. Gan Jiang (dry Rhizoma Zingiberis Officinalis. PDR: Not to be used during pregnancy. AH= AHPA. there may be respiratory failure and death. shortness of breath. Graver reactions include difficulty urinating. extreme nerve reactivity. dry ginger) Standard daily dosage: 3-12g AH: Not to be used during pregnancy. Do not exceed recommended dose. or during excessive menstruation.S. Patients with gallstones should consult a practitioner prior to use. dry mouth. heart palpitations. vomiting. dizziness. increased blood pressure. B&B= BENSKY & BAROLET. PDR= P HYSICIAN’S DESK REFERENCE . unclear vision. PDR: Contraindicated during pregnancy. The U. Use with caution in patients with renal problems. such as vexation. B&G= B ENSKY & GAMBLE. dilated pupils. tinnitus. sweating. It should only be prescribed by a properly trained practitioner and should not be given longterm or during pregnancy.

C&C: Contains calcium. vexation and agitation. slightly dilated pupils. death due to respiratory paralysis. urinary block.5-9g AH: Safe when used appropriately B&G: Occasionally causes heartburn. Xi Xin is harvested in China mostly from Asarum sieboldi and Asarum heteropoides. counteracts Bie Jia (Carapax Amydae Sinensis) and Xiao Ji (Herba Cephalanopoloris Segeti). B&B= BENSKY & BAROLET. C&C: Contains potassium. F L= FLAWS. and. In mice. vomiting. Could possibly cause hyperkalemia when used with potassium-sparing diuretAH= AHPA. Symptoms of overdose included restlessness. other species of Asarum are sometimes substituted. and berbamin. However. a rapid pulse. opiates. Could possibly reduce the therapeutic effect of sodium bicarbonate. and glycosides. C&C= CHAN & CHEUNG. neither of which have conclusively been shown to contain AA. twitching muscles. unclear thinking.Chapter 4 302 • Herb Toxicities & Drug Interactions: A Formula Approach GLW: Symptoms of adverse reaction include headache. B&G= B ENSKY & GAMBLE. oral thirst. Could possibly cause crystalluria and hematuria. Shao Yao (Radix Albus Paeoniae Lactiflorae. eventually. Could possibly cause hyperkalemia when used in large doses with potassium-sparing diuretics. aluminum hydroxide. clenched teeth. potassium. Xi Xin is on the FDA’s “B List” of herbs which may potentially contain aristolochic acid (AA). toxic doses were 10-15g/kg. arched-back rigidity. schisandra) Standard daily dosage: 1. stiffness of the neck. insomnia. or dyspnea. reserpine. dimming of consciousness. cramping of the four limbs. many antibiotics (especially aminoglycosides and sulfas). Highly acidic. GLW= GAO LU WEN. BR= BRINKER. the FDA has set no acceptable limit to AA consumption by humans. Wu Wei Zi (Fructus Schisandrae Chinensis. tannic acid. increased body temperature and blood pressure. antagonizes Shi Hu (Herba Dendrobii) and Mang Xiao (Mirabilitum). scopolamine. PDR= P HYSICIAN’S DESK REFERENCE . Bai Shao. caffeine. a red flushed face. As of this writing. sweating. white peony root) Standard daily dosage: 6-30g AH: Safe when used appropriately B&G: Use with caution in debilitated patients with diarrhea. PDR: No health risks or side effects are known in conjunction with the proper administration of designated therapeutic dosages. and is incompatible with Li Lu (Rhizoma Et Radix Veratri). According to some traditional sources. generalized tension which may become convulsions. and these may contain AA.

and a feeling of pressure in the chest. tongue. heart palpitations. chlorpromazine. May increase potassiAH= AHPA. Antidote is oral administration of raw ginger. Could possibly reduce the effect of most antibiotics. hypertension. and Could possibly reduce the absorption and therapeutic effect of levadopa. nicotinic acid. amylase. unclear speech. Must be decocted with other herbs and not taken alone or uncooked. and other highly acidic substances could possibly reduce the therapeutic effect of this medicinal. Could possibly reduce the absorption and therapeutic effect of potassium and sodium iodides. BR: May increase toxicity of cardiac glycosides. isoniazid. (This medicinal is routinely used during pregnancy in China when indicated by disease and pattern discrimination. ephedrine. it is contraindicated in diabetes. and throat. and other highly acidic substances could possibly reduce the therapeutic effect of this medicinal. Gan Cao (Radix Glycyrrhizae Uralensis. trypsine. atropine. Initially. calcium carbonate and gluconate.) Contraindicated in all hemorrhagic disorders. Ban Xia (Rhizoma Pinelliae Ternatae) Standard daily dosage: 4. hydrochloric acid. glutamic acid. hydrochloric acid. and a weak. This is then followed by drooling. Not for long-term use. licorice root) Standard daily dosage: 2-12g AH: Do not use during pregnancy. o C&C: Contains alkaloids and glycosides. forceless pulse. sodium bicarbonate. low-grade fever. BR= BRINKER. quinine. there may be convulsions and respiratory failure leading to death.) As a single herb in high doses. vitamin B1. Toxic effects due to improper preparation or dosage include burning and numbness in throat and lips. and magnesium sulfate. If severe. PDR= PHYSICIAN’S DESK REFERENCE . a somber white facial complexion. nausea.Chapter 4 Toxicities & Drug Interaction • 303 ics. Use with caution in patients with fever. cause digitalis intoxication and heart arrhythmias.5-12g AH: Do not use during pregnancy. and pepsin. difficulty swallowing. GLW= GAO L U WEN . Vitamin C. According to some traditional sources. glutamic acid. F L= FLAWS. B&G= BENSKY & GAMBLE. there is burning pain in the mouth. incompatible with Wu T u (Radix Aconiti). aluminum hydroxide. nicotinic acid. (This medicinal is routinely used in Chinese medical gynecology during pregnancy as part of formulas appropriately prescribed on the basis of pattern discrimination. and enlargement of the tongue. ulceration of the oral mucosa. reserpine. B&G: Safe as long as it is properly prepared. GLW: Poisoning occurs within 15 minutes to three hours after ingestion of a suitable amount. Vitamin C. C&C= C HAN & CHEUNG. numbness of the extremities. dizziness. and liver disorders. B&B= BENSKY & BAROLET.

Contains glycyrrhetinic acid which could possibly cause a reduction in thyroid activity and basal metabolic rate. PDR= P HYSICIAN’S DESK REFERENCE . B&B= BENSKY & BAROLET. it may cause hypertension and/or edema. The research on Gan Cao concurs that this medicinal is generally safe when used in small amounts as an envoy. AH= AHPA. GLW= GAO LU WEN. caution should be exercised to guard against potential toxicity and drug interaction. incompatible with Gan Sui (Radix Euphorbiae Kansui). If taken long-term. Possible additive effect to corticosteroids. B&G= B ENSKY & GAMBLE. Yuan Hua (Flos Daphnes Genkwae). C&C= CHAN & CHEUNG. When used as a single medicinal or in patients taking other potent Western pharmaceuticals. B&G: According to some traditional sources. and Yuan Zhi (Radix Polygalae Tenuifoliae). BR= BRINKER. F L= FLAWS. May be synergistic with insulin in causing hypokalemia and sodium retention.Chapter 4 304 • Herb Toxicities & Drug Interactions: A Formula Approach um loss due to diuretics and laxatives. It should not be taken long-term or as a single herb during pregnancy.

peptic ulcer. dizziness. PDR: Not to be administered during pregnancy.a. BR= BRINKER.Chapter 4 Toxicities & Drug Interaction • 305 XIAO YAO SAN (Rambling Powder.(This medicinal is routinely used in Chinese medical gynecology during pregnancy as part of formulas appropriately prescribed on the basis of pattern discrimination. climacteric disorders.) Overdose may lead to gastroenteritis. C&C: Vitamin C. B&G= B ENSKY & GAMBLE. anemia. C&C= CHAN & CHEUNG. headache. in which case the dose should then be reduced significantly. central retinitis Potential formula toxicities & interactions: None listed POTENTIAL MEDICINAL TOXICITIES & I NTERACTIONS: Chai Hu (Radix Bupleuri) Standard daily dosage: 3-12g AH: Safe when used appropriately B&G: May occasionally cause nausea and vomiting. and/or rib-side distention and pain. uterine bleeding. and a bowstring pulse Contraindications: None listed Western medical indications: Depression. abdominal.) AH= AHPA. a. fatigue. menstrual irregularities. neurosis. intestinal colic. Bupleurum & Tang-kuei Formula) Category: Harmonizing Functions: Courses the liver and resolves depression. PDR= PHYSICIAN’S DESK REFERENCE . F L= FLAWS. a pale red tongue. B&B= BENSKY & BAROLET. chronic hepatitis. hydrochloric acid. fortifies the spleen and harmonizes the constructive Chinese medical indications: Liver-spleen disharmony complicated by blood vacuity and possible dampness with chest. nicotinic acid. (This medicinal is routinely used in Chinese medical gynecology during pregnancy as part of formulas appropriately prescribed on the basis of pattern discrimination. irregular menstruation. breast. and diarrhea due to saponin content. and other highly acidic substances could possibly reduce the therapeutic effect of this medicinal. abnormal vaginal discharge. chronic gastritis. Dang Gui (Radix Angelicae Sinensis) Standard daily dosage: 3-15g AH: Do not use during pregnancy. pleurisy. insomnia. premenstrual tension. breast distention. glutamic acid. reduced appetite.k. optic nerve atrophy. GLW= GAO LU WEN .

Bai Shao. glutamic acid. According to some traditional sources. ephedrine. C&C: Contains potassium. they developed a mild lymphopenia and anemia but suffered no damage to the brain. Bai Zhu (Rhizoma Atractylodis Macrocephalae) Standard daily dosage: 4. white peony root) Standard daily dosage: 6-30g AH: Safe when used appropriately B&G: Use with caution in debilitated patients with diarrhea. potassium. Qin Jiao (Radix Gentianae Qinjiao). GLW= GAO LU WEN. C&C= CHAN & CHEUNG.5g/kg of this medicinal for two months. and other highly acidic substances could possibly reduce the therapeutic effect of this medicinal. Yun Ling (Sclerotium Poriae Cocos) Standard daily dosage: 9-15g B&G: Large doses or long-term use is discouraged. Vitamin C. tannic acid.5-9g B&G: When rats were fed 0. quinine. calcium carbonate and gluconate. trypsine. F L= FLAWS. May exaggerate the anticoagulative effect of warfarin (Coumadin). Bai Fu Ling. chlorpromazine. atropine. heart. Could possibly cause hyperkalemia when used with potassium-sparing diuretics. copious urination. isoniazid. hydrochloric acid. and glycosides. B&B= BENSKY & BAROLET. and could possibly reduce the absorption and therapeutic effect of levadopa. nicotinic acid. and Bie Jia (Carapax Amydae Sinensis). may counteract Di Yu (Radix Sanguisorbae Officinalis). PDR= P HYSICIAN’S DESK REFERENCE . reserpine. vitamin B1. Could possibly cause hyperkalemia when used with potassium-sparing diuretics. BR= BRINKER. antagonizes Shi Hu (Herba Dendrobii) and Mang Xiao (Mirabilitum). B&G= B ENSKY & GAMBLE. Shao Yao (Radix Albus Paeoniae Lactiflorae. counteracts Bie Jia (Carapax Amydae Sinensis) and Xiao Ji (Herba Cephalanopoloris Segeti). C&C: Contains calcium. Could possibly cause hyperkalemia when used with potassium-sparing diuretics.Chapter 4 306 • Herb Toxicities & Drug Interactions: A Formula Approach B&G: Use with caution in patients with diarrhea or abdominal distention. amylase. Fu Ling. or liver. AH= AHPA. cause digitalis intoxication and heart arrhythmias. Could possibly reduce the effect of most antibiotics. and pepsin. Contraindicated in patients with frequent. C&C: Contains potassium. and is incompatible with Li Lu (Rhizoma Et Radix Veratri). According to traditional sources.

fresh ginger) Standard daily dose: 3-9g AH: Safe when used appropriately BR: Reduces vomiting caused by chemotherapeutic drugs. B&G: According to some traditional sources. BR: May increase toxicity of cardiac glycosides. When used as a single medicinal or in patients taking other potent Western pharmaceuticals. hypertension. Bo He (Herba Menthae Haplocalycis. Contains glycyrrhetinic acid which could possibly cause a reduction in thyroid activity and basal metabolic rate. it may cause hypertension and/or edema. incompatible with Gan Sui (Radix Euphorbiae Kansui). May increase potassium loss due to diuretics and laxatives. PDR: Recommended safe dosage limit is six grams (6g). May be synergistic with insulin in causing hypokalemia and sodium retention. C&C= C HAN & CHEUNG. Avoid larger doses if being used to treat morning sickness or if used in patients taking anticoagulants. Yuan Hua (Flos Daphnes Genkwae). and liver disorders. If taken long-term. and Yuan Zhi (Radix Polygalae Tenuifoliae). BR= BRINKER. (This medicinal is routinely used in Chinese medical gynecology during pregnancy as part of formulas appropriately prescribed on the basis of pattern discrimination. Sheng Jiang (uncooked Rhizoma Zingiberis Officinalis. caution should be exercised to guard against potential toxicity and drug interaction. it is contraindicated in diabetes. B&B= BENSKY & BAROLET.) As a single herb in high doses. The research on Gan Cao concurs that this medicinal is generally safe when used in small amounts as an envoy.Chapter 4 Toxicities & Drug Interaction • 307 Gan Cao (Radix Glycyrrhizae Uralensis.5-6g AH: Safe when used appropriately B&G: Not recommended for nursing mothers as it may inhibit lactation. PDR= PHYSICIAN’S DESK REFERENCE . AH= AHPA. It should not be taken longterm or as a single herb during pregnancy. Increases absorption of oral drugs. F L= FLAWS. Not for long-term use. field mint) Standard daily dose: 1. GLW= GAO L U WEN . B&G= BENSKY & GAMBLE. Possible additive effect to corticosteroids. licorice root) Standard daily dosage: 2-12g AH: Do not use during pregnancy.

GLW= GAO L U WEN . the form of Gan Cao (Radix Glycyrrhizae Uralensis) used in this formula is mix-fried. PDR= PHYSICIAN’S DESK REFERENCE . C&C= CHAN & CHEUNG. AH= AHPA. B&G= BENSKY & GAMBLE. BR= BRINKER.Chapter 4 308 • Herb Toxicities & Drug Interactions: A Formula Approach COMMENTS When Dan Pi (Cortex Radicis Moutan) and Zhi Zi (Fructus Gardeniae Jasminoidis) are added to this formula. it is called either Jia Wei Xiao Yao San (Added Flavors Rambling Powder) or Dan Zhi Xiao Yao San (Moutan & Gardenia Rambling Powder). F L= FLAWS. Most of the time. B&B= BENSKY & BAROLET. This modification treats a liver-spleen disharmony with depressive heat. especially depressive heat causing the blood to move frenetically outside its vessels.

C&C= CHAN & CHEUNG. and a floating bowstring pulse Contraindications: None listed Western medical indications: Common cold. B&G= B ENSKY & GAMBLE. and pulmonary edema Potential formula toxicities & interactions: None listed POTENTIAL MEDICINAL TOXICITIES & I NTERACTIONS: Zi Su Ye. nasal congestion. calcium carbonate and gluconate. Apricot Seed & Perilla Formula) Category: Dryness-treating Functions: Gently diffuses and cools dryness. chills but no sweating. Xing Ren. B&B= BENSKY & BAROLET. acute and chronic bronchitis. bronchiectasis. isoniazid. may counteract Li Lu (Rhizoma Et Radix Veratri).k. trypsine. quinine. Ku Xing Ren (Semen Pruni Armeniacae. Could possibly reduce the absorption and biologic effect of most antibiotics. beefsteak leaves) Standard daily dosage: 3-9g PDR: Use during pregnancy is contraindicated because perillaldehyde was demonstrated to have a mutagenic effect in some in vitro studies. Studies showed that large doses can trigger pulmonary edema.Chapter 4 Toxicities & Drug Interaction • 309 XING SU SAN (Armeniaca & Perilla Powder. C&C: Contains tannic acid. diffuses the lungs and transforms phlegm Chinese medical indications: Externally contracted cool dryness with slight headache. chlorpromazine. F L= FLAWS. Qian Hu (Radix Peucedani) Standard daily dosage: 4. chronic tracheitis. digitalis. Su Ye (Folium Perillae Frutescentis. white tongue fur. BR= BRINKER. amylase.a. reserpine. Zi Su.5-9g B&G: According to traditional sources. apricot kernel) Standard daily dosage: 3-9g AH= AHPA. and pepsin. atropine. ephedrine. GLW= GAO LU WEN . PDR= PHYSICIAN’S DESK REFERENCE . vitamin B 1. dry throat. cough with watery phlegm. a. dry.

hydrocyanic acid is produced which can lead to respiratory failure and death. The maximum concentration of toxins in this medicinal are in the skin and the tip. drooling. B&G: Contraindicated in patients with hemoptysis. spasms. B&G= B ENSKY & GAMBLE . Jie Geng (Radix Platycodi Grandiflori. nausea. B&B= BENSKY & BAROLET. GLW: In case of poisoning. and the pupils of the eye dilate widely with loss of reactivity to light. consciousness becomes unclear. GLW= GAO LU WEN. glutamic acid. dilated pupils. and other highly acidic substances will reduce the therapeutic effect of this medicinal. and headache. According to some traditional sources. counteracts Long Dan Cao (Radix Gentianae Longdancao) and Long Yan Rou (Arillus Euphoriae Longanae). and lack of strength. nicotinic acid. typically. there is difficulty breathing. Could possibly cause hyperkalemia when used with potassium-sparing diuretics. vomiting. PDR= P HYSICIAN’ S DESK REFERENCE . hypertension. dizziness. and respiratory paralysis leads to death. 1-2 hours after ingestion there is a bitter taste and astringent feeling within the mouth. When used in Chinese medicine. In the advent of overdosage activated charcoal and syrup of ipacec should be administered orally. Sometimes one can smell cyanide on the person’s breath. which can progress to dyspnea. vomiting accompanied by watery diarrhea. and coma. Could possibly reduce the effect of most antibiotics. Lethal dosage in adults is 50-60 uncooked kernels. there are generalized convulsions. cause digitalis intoxication and heart arrhythAH= AHPA. heart palpitations. C&C= CHAN & CHEUNG. As a single herb in high doses. If taken with codeine. B&G: Use with caution when treating infants or patients with diarrhea. BR= BRINKER. Contains amygdalin and amygdalase which break down to hydrocyanic acid in the digestive tract. Not for long-term use. Eating this medicinal uncooked or in large quantities could possibly cause dizziness. it is contraindicated in diabetes. children 10 kernels. Vitamin C. arrhythmias. morphine. nausea. In more serious cases. and liver disorders. headache. the kernels are blanched to remove the skin and the tips are broken off. Eventually. FL= FLAWS. breathing becomes weak. C&C: Contains potassium and glycosides (including cyanophoric glycoside). C&C: Contains calcium and glycosides. bellflower root) Standard daily dosage: 3-9g AH: Not to be used during pregnancy. The teeth become clenched. blood pressure drops. or other opiates. hydrochloric acid.Chapter 4 310 • Herb Toxicities & Drug Interactions: A Formula Approach AH: To be used only under the supervision of an expert qualified in the appropriate use of this substance.

amylase. Bai Fu Ling. B&G= BENSKY & GAMBLE. scopolamine. Could possibly cause hyperkalemia when used with potassium-sparing diuretics. Highly acidic. Chen Pi. Vitamin C. bitter orange) Standard daily dose: 3-9g AH: Safe when used appropriately B&G: Use with caution during pregnancy C&C: Contains tannic acid. calcium carbonate and gluconate. digitalis. and pepsin. caffeine. PDR: May cause UV-sensitivity in light-skinned individuals. sodium bicarbonate. nicotinic acid. chlorpromazine. B&B= BENSKY & BAROLET. Could possibly cause hyperkalemia when used with potassium-sparing diuretics. BR= BRINKER. Ju Pi. hinder the absorption of isoniazid. C&C: Contains potassium. ephedrine. atropine. quinine. glutamic acid. isoniazid. C&C= CHAN & CHEUNG. Zhi Ke. Qin Jiao (Radix Gentianae Qinjiao). Contraindicated in patients with frequent. Ju Hong (Pericarpium Citri Reticulatae. and other highly acidic substances could possibly reduce the therapeutic effect of this medicinal. F L= FLAWS. Otherwise no health hazards are known in conjunction with the proper administration of designated therapeutic dosages. GLW= GAO L U WEN . copious urination. According to traditional sources.Chapter 4 Toxicities & Drug Interaction • 311 mias.5-12g AH= AHPA. Could possibly reduce the absorption and biologic effect of most antibiotics. and reduce the biological effect of levadopa. vitamin B1. hydrochloric acid. aluminum hydroxide. trypsine. Zhi Qiao (Fructus Citri Aurantii. opiates. and Bie Jia (Carapax Amydae Sinensis). reserpine. Could possibly cause crystalluria and hematuria. may counteract Di Yu (Radix Sanguisorbae Officinalis). and berbamin. tangerine peel) Standard daily dosage: 3-9g AH: Safe when used appropriately C&C: Contains potassium. Fu Ling. PDR= PHYSICIAN’S DESK REFERENCE . Ban Xia (Rhizoma Pinelliae Ternatae) Standard daily dosage: 4. Yun Ling (Sclerotium Poriae Cocos) Standard daily dosage: 9-15g B&G: Large doses or long-term use is discouraged.

difficulty swallowing. BR= BRINKER. If severe. B&B= BENSKY & BAROLET. hydrochloric acid. Vitamin C. incompatible with Wu Tou (Radix Aconiti). GLW= GAO LU WEN . F L= FLAWS. there may be convulsions and respiratory failure leading to death. Must be decocted with other herbs and not taken alone or uncooked. red dates) Standard daily dosage: 10-30g (3-12 pieces) AH: Safe when used appropriately PDR: No health risks or side effects are known in conjunction with the proper administration of designated therapeutic dosages. Avoid larger doses if being used to treat morning sickness or if used in patients taking anticoagulants. This is then followed by drooling. PDR: Recommended safe dosage limit is six grams (6g). heart palpitations. Use with caution in patients with fever. tongue. nicotinic acid. unclear speech. a somber white facial complexion. and a feeling of pressure in the chest. aluminum hydroxide. numbness of the extremities. B&G: Safe as long as it is properly prepared. ulceration of the oral mucosa. Increases absorption of oral drugs. C&C: Contains alkaloids and glycosides. PDR= PHYSICIAN’S DESK REFERENCE . Initially. Could possibly reduce the absorption and therapeutic effect of potassium and sodium iodides. (This medicinal is routinely used during pregnancy in China when indicated by disease and pattern discrimination. fresh ginger) Standard daily dose: 3-9g AH: Safe when used appropriately BR: Reduces vomiting caused by chemotherapeutic drugs. and a weak. Toxic effects due to improper preparation or dosage include burning and numbness in throat and lips. Hong Zao (Fructus Zizyphi Jujubae. glutamic acid. C&C= CHAN & CHEUNG.) Contraindicated in all hemorrhagic disorders. AH= AHPA. and throat. Sheng Jiang (uncooked Rhizoma Zingiberis Officinalis. and magnesium sulfate. Da Zao. Antidote is oral administration of raw ginger. and enlargement of the tongue. GLW: Poisoning occurs within 15 minutes to three hours after ingestion of a suitable amount. there is burning pain in the mouth. forceless pulse. sodium bicarbonate. low-grade fever.Chapter 4 312 • Herb Toxicities & Drug Interactions: A Formula Approach AH: Do not use during pregnancy. According to some traditional sources. dizziness. B&G= B ENSKY & GAMBLE. and other highly acidic substances could possibly reduce the therapeutic effect of this medicinal. nausea.

When used as a single medicinal or in patients taking other potent Western pharmaceuticals. hypertension. B&B= BENSKY & BAROLET. B&G: According to some traditional sources. Possible additive effect to corticosteroids. May be synergistic with insulin in causing hypokalemia and sodium retention. May increase potassium loss due to diuretics and laxatives. It should not be taken long-term or as a single herb during pregnancy.Chapter 4 Toxicities & Drug Interaction • 313 Gan Cao (Radix Glycyrrhizae Uralensis. it is contraindicated in diabetes. BR= BRINKER. (This medicinal is routinely used in Chinese medical gynecology during pregnancy as part of formulas appropriately prescribed on the basis of pattern discrimination. AH= AHPA. and Yuan Zhi (Radix Polygalae Tenuifoliae). The research on Gan Cao concurs that this medicinal is generally safe when used in small amounts as an envoy. and liver disorders. incompatible with Gan Sui (Radix Euphorbiae Kansui). F L= FLAWS. caution should be exercised to guard against potential toxicity and drug interaction. it may cause hypertension and/or edema. Contains glycyrrhetinic acid which could possibly cause a reduction in thyroid activity and basal metabolic rate. licorice root) Standard daily dosage: 2-12g AH: Do not use during pregnancy. Not for long-term use. Yuan Hua (Flos Daphnes Genkwae). B&G= BENSKY & GAMBLE. GLW= GAO L U WEN .) As a single herb in high doses. BR: May increase toxicity of cardiac glycosides. If taken long-term. PDR= PHYSICIAN’S DESK REFERENCE . C&C= CHAN & CHEUNG.

migraine. AH= AHPA. external injury to chest. hydrocyanic acid is produced which can lead to respiratory failure and death. morphine. cerebral hemorrhage. purple lips. costochondritis. heart palpitations. glutamic acid. vomiting accompanied by watery diarrhea. irregular menstruation.Chapter 4 314 • Herb Toxicities & Drug Interactions: A Formula Approach XUE FU ZHU YU TANG (Blood Mansion Dispel Stasis Decoction) Category: Blood-quickening Functions: Quickens the blood and dispels stasis. If taken with codeine. B&G= B ENSKY & GAMBLE. or intermittent pulse Contraindications: Bleeding conditions or pregnancy Western medical indications: Coronary artery disease. typically. F L= FLAWS. 1-2 hours after ingestion there is a bitter taste and astringent feeling within the mouth. nicotinic acid. angina pectoris. easy anger. piercing pain. tight. headache. In more serious cases. recalcitrant headache with fixed. Could possibly cause hyperkalemia when used with potassium-sparing diuretics. C&C: Contains potassium and glycosides (including cyanophoric glycosides). C&C= CHAN & CHEUNG. and urticaria Potential formula toxicities & interactions: None listed POTENTIAL MEDICINAL TOXICITIES & INTERACTIONS: Tao Ren (Semen Pruni Persicae. evening tidal fever. enduring. GLW= GAO L U WEN. GLW: In case of poisoning. choppy. BR= BRINKER. intercostal neuralgia. moves the qi and stops pain Chinese medical indications: Blood stasis in the chest with pain in the chest and rib-side. Sometimes one can smell cyanide on the person’s breath. postconcussion syndrome. hydrochloric acid. heart palpitations. a dark red or purple tongue or possible static macules or speckles. menopausal syndrome. peach kernel) Standard daily dosage: 4. cor pulmonale. drooling. a sooty facial complexion. B&G: Contraindicated during pregnancy. a choking sensation when drinking. and a bowstring. dizziness. and lack of strength. insomnia. PDR= P HYSICIAN’S DESK REFERENCE . and other highly acidic substances could possibly reduce the therapeutic effect of this medicinal. incessant hiccup. deep. depression accompanied by vexatious heat in the chest. trigeminal neuralgia. B&B= BENSKY & BAROLET. Vitamin C. enduring. dry heaves. nausea. there is difficulty breathing.5-9g AH: Not to be used during pregnancy. rheumatic heart disease. or other opiates. dysmenorrhea. functional neurosis.

(This medicinal is routinely used in Chinese medical gynecology during pregnancy as part of formulas appropriately prescribed on the basis of pattern discrimination. Vitamin C. Dang Gui (Radix Angelicae Sinensis) Standard daily dosage: 3-15g AH: Do not use during pregnancy. safflower flowers) Standard daily dosage: 3-9g AH: Not to be used during pregnancy. blood pressure drops. (This medicinal is routinely used in Chinese medical gynecology during pregnancy as part of formulas appropriately prescribed on the basis of pattern discrimination.) AH: Do not use during pregnancy. B&G: Contraindicated during pregnancy. The teeth become clenched. animals fed the medicinal often experienced weight loss. Could possibly cause hyperkalemia when used with potassium-sparing diuretics. this medicinal is blanched before using and its tip is broken off in order to make it less or non-toxic. Hong Hua (Flos Carthami Tinctorii. hydrochloric acid. PDR: Not for use during pregnancy. consciousness becomes unclear. C&C= CHAN & CHEUNG. F L= FLAWS. and respiratory paralysis leads to death. C&C: Contains potassium. According to some AH= AHPA. Chuan Xiong (Radix Ligustici Wallichii) Standard daily dosage: 3-9g(In China today. In several studies. Could possibly cause hyperkalemia when used with potassium-sparing diuretics. B&B= BENSKY & BAROLET. it is not uncommon for this medicinal to be prescribed up to 15 grams per day in decoction. glutamic acid.) B&G: Not for patients with migraine headache or excessive menstrual bleeding. Most of the toxins in this medicinal reside in the skin and tip. B&G= BENSKY & GAMBLE. C&C: Contains potassium and glycosides. and other highly acidic substances could possibly reduce the therapeutic effect of this medicinal. breathing becomes weak. there are generalized convulsions. Overdosage causes vomiting and dizziness. Therefore.Chapter 4 Toxicities & Drug Interaction • 315 Eventually. and the pupils of the eye dilate widely with loss of reactivity to light. Contraindicated in hemorrhagic diseases or patients with peptic ulcers. BR= BRINKER. GLW= GAO L U WEN. May exaggerate the anticoagulative effect of warfarin (Coumadin). PDR= P HYSICIAN’S DESK REFERENCE .) B&G: Use with caution in patients with diarrhea or abdominal distention. nicotinic acid.

red peony root) Standard daily dosage: 4. glutamic acid. B&G: Contraindicated during pregnancy. B&B= BENSKY & BAROLET. quinine. antagonizes Shan Zhu Yu (Fructus Corni Officinalis) and Huang Qi (Radix Astragali Membranacei). ephedrine. and is incompatible with Li Lu (Rhizoma Et Radix Veratri). PDR= P HYSICIAN’S DESK REFERENCE . and in patients with excessive menstruation. and glycosides. vitamin B1. Could possibly reduce the absorption and biologic effect of most antibiotics. in debilitated patients with diarrhea. C&C: Contains alkaloids. chlorpromazine. AH= AHPA. BR= BRINKER. Chai Hu (Radix Bupleuri) Standard daily dosage: 3-12g AH: Safe when used appropriately B&G: May occasionally cause nausea and vomiting. hydrochloric acid. nicotinic acid. Could possibly cause hyperkalemia when used with potassium-sparing diuretics. aluminum hydroxide. aluminum hydroxide. GLW= GAO LU WEN. Chi Shao (Radix Rubrus Paeoniae Lactiflorae. atropine. potassium. sodium bicarbonate. nicotinic acid. Contraindicated in menorrhagia. Could possibly reduce the absorption and therapeutic effect of potassium and sodium iodides. sodium bicarbonate. isoniazid. Vitamin C. According to some traditional sources. B&G= B ENSKY & GAMBLE .Chapter 4 316 • Herb Toxicities & Drug Interactions: A Formula Approach traditional texts. and magnesium sulfate. reserpine. digitalis. and other highly acidic substances could possibly reduce the therapeutic effect of this medicinal. and pepsin. Vitamin C. glutamic acid. Could possibly cause hyperkalemia when used with potassium-sparing diuretics. calcium carbonate and gluconate. trypsine. Chuan Niu Xi (Radix Cyathulae) Standard daily dosage: 9-15g AH: Not to be used during pregnancy. hydrochloric acid.5-9g C&C: Contains tannic acid. in which case the dose should then be reduced significantly. Could possibly reduce the absorption and therapeutic effect of potassium and sodium iodides. and glycosides. C&C: Contains alkaloids and potassium. should not be used with Bai Qian (Radix Et Rhizoma Cynanchi Baiqian). Could possibly cause hyperkalemia when used with potassium-sparing diuretics. potassium. amylase. and other highly acidic substances could possibly reduce the therapeutic effect of this medicinal. F L= FLAWS. C&C= CHAN & CHEUNG. counteracts Hua Shi (Talcum) and Huang Lian (Rhizoma Coptidis Chinensis). and magnesium sulfate.

intestinal colic. Highly acidic. Zhi Qiao (Fructus Citri Aurantii. B&B= BENSKY & BAROLET. isoniazid. and berbamin. digitalis. PDR= PHYSICIAN’S DESK REFERENCE . Could possibly cause crystalluria and hematuria. Sheng Di. quinine. trypsine. vitamin B1. sodium bicarbonate. Jie Geng (Radix Platycodi Grandiflori. According to some traditional sources. reserpine. (This medicinal is routinely used in Chinese medical gynecology during pregnancy as part of formulas appropriately prescribed on the basis of pattern discrimination. Sheng Di Huang (uncooked Radix Rehmanniae Glutinosae) Standard daily dosage: 9-30g AH: Contraindicated in patients with diarrhea or lack of appetite AH= AHPA. Vitamin C. counteracts Long Dan Cao (Gentiana Longdancao) and Long Yan Rou (Arillus Euphoriae Longanae). Zhi Ke. B&G: Contraindicated in patients with hemoptysis. nicotinic acid. and reduce the biological effect of levadopa. hinder the absorption of isoniazid. glutamic acid. and other highly acidic substances could possibly reduce the therapeutic effect of this medicinal. Could possibly reduce the effect of most antibiotics. bitter orange) Standard daily dose: 3-9g AH: Safe when used appropriately B&G: Use with caution during pregnancy C&C: Contains tannic acid. BR= BRINKER. calcium carbonate and gluconate. aluminum hydroxide. and pepsin. C&C: Contains calcium and glycosides. Could possibly reduce the absorption and biologic effect of most antibiotics. atropine. hydrochloric acid. PDR: May cause UV-sensitivity in light-skinned individuals. caffeine.Chapter 4 Toxicities & Drug Interaction • 317 C&C: Vitamin C. nicotinic acid. C&C= CHAN & CHEUNG. Use with caution in bleeding peptic ulcer. F L= FLAWS. B&G= B ENSKY & GAMBLE. especially in cases of tuberculosis. GLW= GAO LU WEN . cause digitalis intoxication and heart arrhythmias. glutamic acid. chlorpromazine. Otherwise no health hazards are known in conjunction with the proper administration of designated therapeutic dosages. PDR: Not to be administered during pregnancy. scopolamine. ephedrine. opiates. bellflower root) Standard daily dosage: 3-9g AH: Contraindicated in hemoptysis.) Overdose may lead to gastroenteritis. amylase. and other highly acidic substances could possibly reduce the therapeutic effect of this medicinal. and diarrhea due to saponin content. hydrochloric acid.

The research on Gan Cao concurs that this medicinal is generally safe when used in small amounts as an envoy. B&G: According to some traditional sources. F L= FLAWS. Not for long-term use. hypertension. Therefore. BR= BRINKER. licorice root) Standard daily dosage: 2-12g AH: Do not use during pregnancy. this formula is particularly indicated for blood stasis in the chest. May increase potassium loss due to diuretics and laxatives. it may cause hypertension and/or edema. and liver disorders. However. C&C= CHAN & CHEUNG. B&G= B ENSKY & GAMBLE . and Yuan Zhi (Radix Polygalae Tenuifoliae). In this case. COMMENTS Xue Fu Zhu Yu Tang is part of a family of Zhu Yu Tang (Dispel Stasis Decoction) formulas created by Wang Qing-ren for the treatment of blood stasis in various parts of the body. AH= AHPA. incompatible with Gan Sui (Radix Euphorbiae Kansui). (This medicinal is routinely used in Chinese medical gynecology during pregnancy as part of formulas appropriately prescribed on the basis of pattern discrimination. caution should be exercised to guard against potential toxicity and drug interaction. the xue fu or blood mansion is the chest. Gan Cao (Radix Glycyrrhizae Uralensis. Could possibly cause hyperkalemia when used with potassium-sparing diuretics. Possible additive effect to corticosteroids. Contains glycyrrhetinic acid which could possibly cause a reduction in thyroid activity and basal metabolic rate. It should not be taken long-term or as a single herb during pregnancy.Chapter 4 318 • Herb Toxicities & Drug Interactions: A Formula Approach B&G: Contraindicated in pregnant women with anemias or digestive weakness C&C: Contains potassium. Yuan Hua (Flos Daphnes Genkwae). B&B= BENSKY & BAROLET. PDR: No health risks or side effects are known in conjunction with the proper administration of designated therapeutic dosages. GLW= GAO LU WEN. BR: May increase toxicity of cardiac glycosides. When used as a single medicinal or in patients taking other potent Western pharmaceuticals. May be synergistic with insulin in causing hypokalemia and sodium retention. it has also come to be used for mental-emotional problems due to blood stasis based on the Chinese medical fact that the spirit resides in the heart which is located in the center of the chest. PDR= P HYSICIAN’S DESK REFERENCE . If taken long-term. it is contraindicated in diabetes.) As a single herb in high doses.

cirrhosis. stomach duct distention. GLW= GAO LU WEN . PDR= PHYSICIAN’S DESK REFERENCE . isoniazid.) C&C: Contains tannic acid and potassium. BR= BRINKER. Could possibly cause hyperkalemia when used with potassium-sparing diuretics. and neurasthenia Potential formula toxicities & interactions: None listed POTENTIAL MEDICINAL TOXICITIES & I NTERACTIONS: Sheng Di. PDR: No health risks or side effects are known in conjunction with the proper administration of designated therapeutic dosages. Could possibly cause hyperkalemia when used with potassium-sparing diuretics. Addison’s disease. Linking Decoction) Category: Yin-supplementing Functions: Nourishes and enriches the liver and kidneys. essential hypertension. a. Sheng Di Huang (uncooked Radix Rehmanniae Glutinosae) Standard daily dosage: 9-30g AH: Contraindicated in patients with diarrhea or lack of appetite B&G: Contraindicated in pregnant women with anemias or digestive weakness C&C: Contains potassium. peptic ulcer. lycium berries) Standard daily dosage: 6-18g AH: Not to be used during pregnancy.a. courses the liver and rectifies the qi Chinese medical indications: Liver blood-kidney yin vacuity with liver depression qi stagnation manifesting as chest and rib-side pain. bowstring pulse Contraindications: Pain due to phlegm and/or dampness Western medical indications: Chronic active hepatitis. chronic orchiditis. F L= FLAWS. B&G= BENSKY & GAMBLE. All-The-Way-Through Brew. Could possibly reduce the absorption and biologic effect of most antibiotics. B&B= BENSKY & BAROLET. a dry. thrombocytopenic purpura.k.Chapter 4 Toxicities & Drug Interaction • 319 YI GUAN JIAN (One Link Brew. (No such prohibition exists with traditional Chinese medicine regarding this medicinal. dry mouth and parched throat. C&C= CHAN & CHEUNG. red tongue. costochondritis. Qi Zi (Fructus Lycii Chinensis. acid regurgitation. AH= AHPA. hypertension during pregnancy. Gou Qi Zi. pulmonary tuberculosis. and a fine. diabetes mellitus.

vomiting. diarrhea. C&C= CHAN & CHEUNG. May exaggerate the anticoagulative effect of warfarin (Coumadin). Sha Shen (Radix Glehniae Littoralis) Standard daily dosage: 9-15g AH: Safe when used appropriately B&G: According to some traditional sources. Vitamin C. B&G= B ENSKY & GAMBLE . ephedrine. abdominal pain. headache. and pepsin. (This medicinal is routinely used in Chinese medical gynecology during pregnancy as part of formulas appropriately prescribed on the basis of pattern discrimination. Mai Men Dong.Chapter 4 320 • Herb Toxicities & Drug Interactions: A Formula Approach chlorpromazine. digitalis. PDR= P HYSICIAN’ S DESK REFERENCE . glutamic acid. C&C: Contains potassium. reserpine. and other highly acidic substances could possibly reduce the therapeutic effect of this medicinal. quinine. a AH= AHPA. amylase. atropine. Mai Dong (Tuber Ophiopogoni Japonici) Standard daily dosage: 6-15g AH: Safe when used appropriately B&G: According to some traditional sources. C&C: Contains glycosides. B&B= BENSKY & BAROLET. antagonizes Kuan Dong Hua (Flos Tussilaginis Farfarae) and counteracts Ku Shen (Radix Sophorae Flavescentis) and Bai Mu Er (Fructificatio Tremellae Fuciformis). BR= BRINKER. dizziness. Chuan Lian Zi. Dang Gui (Radix Angelicae Sinensis) Standard daily dosage: 3-15g AH: Do not use during pregnancy. FL= FLAWS. trypsine. Could possibly cause hyperkalemia when used with potassium-sparing diuretics. nicotinic acid. GLW= GAO LU WEN. poor appetite. hydrochloric acid. calcium carbonate and gluconate. PDR: Not for use during pregnancy. vitamin B1. Jin Ling Zi (Fructus Meliae Toosendan) Standard daily dosage: 3-9g AH: Safe when used appropriately GLW: Symptoms of adverse reaction include abdominal distention.) B&G: Use with caution in patients with diarrhea or abdominal distention. antagonizes Fang Ji (Radix Aristolochiae Fangchi) and is incompatible with Li Lu (Rhizoma Et Radix Veratri).

blurred vision. convulsions. and even death. shrunken pupils. syncope. low blood pressure. GLW= GAO LU WEN . and/or intestines. BR= BRINKER. In grave conditions. uneasy respiration. F L= FLAWS. B&B= BENSKY & BAROLET. B&G= B ENSKY & GAMBLE. there may be atrial fibrillation. heart arrhythmia. hemorrhage of the liver. kidney. C&C= CHAN & CHEUNG. numbness of the four extremities. inhibited speech. PDR= PHYSICIAN’S DESK REFERENCE . and atrioventricular conduction block. epistaxis. AH= AHPA. Poisoning can lead to toxic hepatitis and red blood cells in the urine. shock. frequent premature beats. mania and agitation.Chapter 4 Toxicities & Drug Interaction • 321 red facial complexion.

and recedes yellowing (i. GLW= GAO L U WEN . and a slippery. pruritis. and uterine bleeding Potential formula toxicities & interactions: FL/B&B: Use with caution during pregnancy due to the inclusion of Da Huang (Radix Et Rhizoma Rhei). Zhi Zi. B&B= BENSKY & BAROLET. leukemia.k. Shan Zhi. PDR= PHYSICIAN’S DESK REFERENCE . F L= FLAWS. C&C: Contains potassium. possibly bowstring pulse Contraindications: Yang jaundice Western medical indications: Acute hepatitis. yellow tongue fur. malarial diseases. Shan Zhi Zi (Fructus Gardeniae Jasminoidis. urticaria. cholecystitis. Could possibly cause hyperAH= AHPA. C&C: Contains potassium and glycosides. edema. typhoid fever. a bitter taste in the mouth. thirst but the ability to only take sips. eye diseases. cirrhosis. stomatitis. rapid. cholelithiasis. jaundice) Chinese medical indications: Liver-gallbladder damp heat jaundice with abdominal distention. C&C= CHAN & CHEUNG.Chapter 4 322 • Herb Toxicities & Drug Interactions: A Formula Approach YIN CHEN HAO TANG (Artemisia Yinchenhao Decoction. leptospirosis. POTENTIAL MEDICINAL TOXICITIES & INTERACTIONS: Yin Chen Hao (Herba Artemisiae Yinchenhao) Standard daily dosage: 9-30g AH: Not to be used during pregnancy.a. dried gardenia fruit pods) Standard daily dosage: 3-12g AH: Safe when used appropriately B&G: Contains geniposide which caused diarrhea in mice. beriberi. a. nephritis.e. Could possibly cause hyperkalemia when used with potassium-sparing diuretics. gingivitis. BR= BRINKER. B&G= BENSKY & GAMBLE. difficult urination. Capillaris Combination) Category: Dampness-dispelling Functions: Clears heat. hepatic necrosis. slimy. B&G: One study showed that using this medicinal along with Da Zao (Fructus Zizyphi Jujubae) to treat infectious hepatitis caused heart block in two patients. favism.. disinhibits dampness.

F L= FLAWS. appendicitis and abdominal pain of unknown origin. and other highly acidic substances could possibly reduce the therapeutic effect of this medicinal. and glycosides. glutamic acid. Vitamin C. acute inflammatory intestinal disease. Yin jaundice is due to spleen vacuity resulting in damp heat. Dai Huang. rhubarb root) Standard daily dosage: 3-12g AH: Do not use during pregnancy. GLW= GAO LU WEN . Overuse may cause hypokalemia and increased toxicity of cardiac glycosides. abdominal pain of unknown origin. Contraindicated for nursing mothers since active ingredients enter the milk. B&G= B ENSKY & GAMBLE. nicotinic acid. PDR= PHYSICIAN’S DESK REFERENCE . Not to be used while nursing. hydrochloric acid. C&C: Contains alkaloids. B&B= BENSKY & BAROLET. and other highly acidic substances could possibly reduce the therapeutic effect of this medicinal. or any inflammatory condition of the intestines. B&G: Use with extreme caution during pregnancy. jaundice (due to any underlying reason) is divided into two types. This formula is specifically for the treatment of yin jaundice. Vitamin C. BR= BRINKER. Contraindicated in intestinal obstruction. May aggravate potassium loss from diuretics. AH= AHPA.Chapter 4 Toxicities & Drug Interaction • 323 kalemia when used with potassium-sparing diuretics. C&C= CHAN & CHEUNG. glutamic acid. tannic acid. Chuan Jun. Yin jaundice and yang jaundice. or postpartum. PDR: Consult a physician before using this medicinal during pregnancy or while nursing. whereas yang jaundice is due to replete damp heat evils. nicotinic acid. Could possibly cause hyperkalemia when used with potassium-sparing diuretics. COMMENTS In Chinese medicine. Contraindicated in cases of intestinal obstruction. Da Huang. menstruation. hydrochloric acid. BR: Reduces absorption of oral drugs. Jun (Radix Et Rhizoma Rhei. potassium.

Vitamin C. mumps. glutamic acid. epidemic meningitis. Lonicera & Forsythia Formula) Category: Exterior-resolving Functions: Acridly and cooly penetrates the exterior. BR= BRINKER. nicoAH= AHPA. honeysuckle flowers) Standard daily dosage: 9-15g AH: Safe when used appropriately C&C: Contains potassium and glycosides. hydrochloric acid. a. thirst. and early stage sores Potential formula toxicities & interactions: None listed POTENTIAL MEDICINAL TOXICITIES & I NTERACTIONS: Jin Yin Hua (Flos Lonicerae Japonicae. PDR: No health risks or side effects are known in conjunction with the proper administration of designated therapeutic dosages. PDR= P HYSICIAN’ S DESK REFERENCE .k. scarlet fever. headache. flu. (This medicinal is commonly used in China during pregnancy for the treatment of wind heat external contractions and heat toxins. nicotinic acid. dried forsythia fruit pods) Standard daily dosage: 6-15g AH: Not to be used during pregnancy. B&G= B ENSKY & GAMBLE . white or thin.Chapter 4 324 • Herb Toxicities & Drug Interactions: A Formula Approach YIN QIAO SAN (Lonicera & Forsythia Powder. acute tonsillitis. and skin ulcers. slight or no chills. and other highly acidic substances could possibly reduce the therapeutic effect of this medicinal. acute suppurative infections. C&C: Contains potassium and glycosides. a red-tipped tongue with thin. measles. B&B= BENSKY & BAROLET.) B&G: Contraindicated in patients with diarrhea. and a floating. cough. encephalitis B. Vitamin C. FL= FLAWS. rapid pulse Contraindications: Externally contracted wind dampness Western medical indications: Common cold. Could possibly cause hyperkalemia when used with potassium-sparing diuretics. yellow fur. GLW= GAO LU WEN. carbuncles that have already ulcerated. C&C= CHAN & CHEUNG. sore throat. Lian Qiao (Fructus Forsythiae Suspensae. clears heat and resolves toxins Chinese medical indications: Externally contracted wind heat evils resulting in fever. Could possibly cause hyperkalemia when used with potassium-sparing diuretics.a.

especially in cases of tuberculosis. PDR= PHYSICIAN’S DESK REFERENCE . bellflower root) Standard daily dosage: 3-9g AH: Contraindicated in hemoptysis. sulphanomides. hydrochloric acid. GLW= GAO LU WEN . and other highly acidic substances could possibly reduce the therapeutic effect of this medicinal. Use with caution in bleeding peptic ulcer. F L= FLAWS. Jie Geng (Radix Platycodi Grandiflori. B&G= B ENSKY & GAMBLE. C&C: Contains amylase. Vitamin C. prepared soybeans) Standard daily dosage: 6-15g B&G: Not for nursing mothers. glutamic acid. Niu Bang Zi. glutamic acid. Dan Dou Chi (Semen Praeparatum Sojae. C&C: Contains calcium and glycosides. AH= AHPA. According to some traditional sources. Inhibits lactation. and aspirin could possibly reduce the therapeutic effect of this medicinal. Niu Zi (Fructus Arctii Lappae. glutamic acid. Niu Bang.5-6g AH: Safe when used appropriately B&G: Not recommended for nursing mothers as it may inhibit lactation. Bo He (Herba Menthae Haplocalycis. and reduce the biological effect of levadopa. Tetracyclines. hydrochloric acid. nicotinic acid. burdock seeds) Standard daily dosage: 3-9g C&C: Vitamin C. B&G: Contraindicated in patients with hemoptysis. hydrochloric acid. and other highly acidic substances could possibly reduce the therapeutic effect of this medicinal. BR= BRINKER. PDR: No health hazards are known in conjunction with the proper administration of designated therapeutic dosages. counteracts Long Dan Cao (Radix Gentianae Longdancao) and Long Yan Rou (Arillus Euphoriae Longanae). B&B= BENSKY & BAROLET. C&C= CHAN & CHEUNG.Chapter 4 Toxicities & Drug Interaction • 325 tinic acid. cause digitalis intoxication and heart arrhythmias. nicotinic acid. and other highly acidic substances could possibly reduce the therapeutic effect of this medicinal. hinder the absorption of isoniazid. field mint) Standard daily dose: 1. Could possibly reduce the effect of most antibiotics.

hypertension. Not for long-term use.) As a single herb in high doses. B&G= BENSKY & GAMBLE. B&G: According to some traditional sources. GLW= GAO LU WEN . Gan Cao (Radix Glycyrrhizae Uralensis. loose stools. If taken long-term. and diarrhea. (This medicinal is routinely used in Chinese medical gynecology during pregnancy as part of formulas appropriately prescribed on the basis of pattern discrimination. Possible additive effect to corticosteroids. Lu Gen (Rhizoma Phragmitis Communis) Standard daily dosage: 15-30g PDR: No health risks or side effects are known in conjunction with the proper administration of designated therapeutic dosages. BR= BRINKER. May be synergistic with insulin in causing hypokalemia and sodium retention. BR: May increase toxicity of cardiac glycosides. F L= FLAWS. Yuan Hua (Flos Daphnes Genkwae). incompatible with Gan Sui (Radix Euphorbiae Kansui). and liver disorders. such as stomach pain.Chapter 4 326 • Herb Toxicities & Drug Interactions: A Formula Approach PDR: Minor side effects include occasional gastrointestinal effects. it is contraindicated in diabetes. C&C= CHAN & CHEUNG. May increase potassium loss due to diuretics and laxatives. Jing Jie Sui. B&B= BENSKY & BAROLET. Jing Jie (Herba Seu Flos Schizonepetae Tenuifoliae) Standard daily dosage: 3-9g No toxicity or interaction information listed in the sources Dan Zhu Ye (Herba Lophatheri Gracilis) Standard daily dosage: 6-9g B&G: Use with caution in pregnancy. PDR= PHYSICIAN’S DESK REFERENCE . The research on Gan Cao concurs that this medicinal is generally safe AH= AHPA. C&C: Contains potassium. Contains glycyrrhetinic acid which could possibly cause a reduction in thyroid activity and basal metabolic rate. and Yuan Zhi (Radix Polygalae Tenuifoliae). licorice root) Standard daily dosage: 2-12g AH: Do not use during pregnancy. Could possibly cause hyperkalemia when used with potassium-sparing diuretics. it may cause hypertension and/or edema.

the cold may immediately return. F L= FLAWS. COMMENTS This is the most commonly prescribed formula for the treatment of common colds associated primarily with sore throat and fever. It should not be taken long-term or as a single herb during pregnancy. if one discontinues this medication as soon as the symptoms abate. PDR= PHYSICIAN’S DESK REFERENCE . B&G= BENSKY & GAMBLE. GLW= GAO L U WEN . C&C= CHAN & CHEUNG. However. these ready-made versions typically need to be taken at several times the dose recommended on the packaging. In addition. to be effective. AH= AHPA. B&B= BENSKY & BAROLET. caution should be exercised to guard against potential toxicity and drug interaction. and many ready-made versions of it exist in the marketplace. When used as a single medicinal or in patients taking other potent Western pharmaceuticals.Chapter 4 Toxicities & Drug Interaction • 327 when used in small amounts as an envoy. BR= BRINKER.

loose teeth.k. vacuous pulse Contraindications: Diarrhea Western medical indications: Toothache. easy anger. B&B= BENSKY & BAROLET. Side effects include diarrhea. a dry. frontal headache. PDR: No health risks or side effects are known in conjunction with the proper administration of designated therapeutic dosages. abdominal pain. cause digitalis intoxication and heart arrhythmias. C&C: Contains calcium. AH= AHPA. bleeding gums.a. GLW= GAO LU WEN. and glossitis Potential formula toxicities & interactions: None listed POTENTIAL MEDICINAL TOXICITIES & INTERACTIONS: Shi Gao (Gypsum Fibrosum) Standard daily dosage: 9-30g B&G: Can cause gastric upset in some patients. FL= FLAWS. Rehmannia & Gypsum Combination) Category: Heat-clearing Functions: Drains heat from the stomach and nourishes yin Chinese medical indications: Stomach heat with yin vacuity due to vigorous stomach fire damaging kidney yin manifesting as toothache. Jade Woman Decoction. and hinder the absorption of isoniazid. Could possibly reduce the effect of most antibiotics and levadopa. Shu Di Huang (cooked Radix Rehmanniae Glutinosae) Standard daily dosage: 9-30g AH: Contraindicated in patients with diarrhea or indigestion B&G: Overuse can lead to abdominal distention and loose stools. and heart palpitations which often disappear upon continued administration of the herb. B&G= B ENSKY & GAMBLE. thirst with a liking for chilled drinks. possible fever. red tongue with yellow fur. BR= BRINKER.Chapter 4 328 • Herb Toxicities & Drug Interactions: A Formula Approach YU NU JIAN (Jade Lady Brew. stomatitis. lethargy. a. C&C= CHAN & CHEUNG. PDR= PHYSICIAN’ S DESK REFERENCE . dizziness. gingivitis. Shu Di. and a slippery.

Contraindicated in menorrhagia. glutamic acid. should not be used with Bai Qian (Radix Et Rhizoma Cynanchi Baiqian). B&G= BENSKY & GAMBLE. and other highly acidic substances could possibly reduce the therapeutic effect of this medicinal. Niu Xi. Mai Dong (Tuber Ophiopogoni Japonici) Standard daily dosage: 6-15g AH: Safe when used appropriately B&G: According to some traditional sources. C&C: Contains potassium and glycosides. Tu Niu Xi (Radix Achyranthis Bidentatae) Standard daily dosage: 9-15g AH: Not to be used during pregnancy. nicotinic acid. PDR: No health hazards are known in conjunction with the proper administration of designated therapeutic dosages.Chapter 4 Toxicities & Drug Interaction • 329 Zhi Mu (Rhizoma Anemarrhenae Aspheloidis) Standard daily dosage: 6-12g AH: Safe when used appropriately B&G: May cause diarrhea in some patients. glutamic acid. aluminum hydroxide. Vitamin C. nicotinic acid. in debilitated patients with diarrhea. C&C= CHAN & CHEUNG. sodium bicarbonate. and glycosides. hydrochloric acid. According to some traditional sources. F L= FLAWS. hydrochloric acid. Vitamin C. Could possibly cause hyperkalemia when used with potassium-sparing diuretics. PDR= PHYSICIAN’S DESK REFERENCE . BR= BRINKER. potassium. glutamic acid. Mai Men Dong. Could possibly reduce the absorption and therapeutic effect of potassium and sodium iodides. Could possibly cause hyperkalemia when used with potassium-sparing diuretics. Vitamin C. and in patients with excessive menstruation. B&G: Contraindicated during pregnancy. C&C: Contains alkaloids. and other highly acidic substances could possibly reduce the therapeutic effect of this medicinal. and magnesium sulfate. AH= AHPA. and other highly acidic substances could possibly reduce the therapeutic effect of this medicinal. C&C: Contains glycosides. nicotinic acid. Huai Niu Xi. B&B= BENSKY & BAROLET. hydrochloric acid. antagonizes Kuan Dong Hua (Flos Tussilaginis Farfarae) and counteracts Ku Shen (Radix Sophorae Flavescentis) and Bai Mu Er (Fructificatio Tremellae Fuciformis). GLW= GAO L U WEN .

such as transplant patients or patients with autoimmune disorders. they developed a mild lymphopenia and anemia but suffered no damage to the brain. aluminum hydroxide. and magnesium sulfate. F L= FLAWS. exacerbation of chronic bronchitis. heart. or antithrombotic agents. sweating due to autonomic dystonia. and a vacuous or soggy pulse Contraindications: None listed Western medical indications: Allergic rhinitis. B&B= BENSKY & BAROLET.5-9g AH: Safe when used appropriately B&G: When rats were fed 0. AH= AHPA. secures the exterior. and stops sweating Chinese medical indications: External defensive insecurity resulting in easy contraction of external evils. Bai Zhu (Rhizoma Atractylodis Macrocephalae) Standard daily dosage: 4. May potentiate the risk of bleeding when used concomitantly with anticoagulants.5g/kg of this medicinal for two months. mild bronchitis. Could possibly reduce the absorption and therapeutic effect of potassium and sodium iodides. upper respiratory infection. B&G= B ENSKY & GAMBLE. spontaneous perspiration. aversion to wind.Chapter 4 330 • Herb Toxicities & Drug Interactions: A Formula Approach YU PING FENG SAN (Jade Windscreen Powder) Category: Securing and astringing Functions: Boosts the qi. PDR= PHYSICIAN’S DESK REFERENCE . Could possibly cause hyperkalemia when used with potassium-sparing diuretics. PDR: Caution should be taken with patients receiving immunosuppressive therapy. or liver. Bei Qi (Radix Astragali Membranacei. C&C= CHAN & CHEUNG. a pale tongue with white fur. May cause neurological dysfunction in high doses. sodium bicarbonate. astragalus root) Standard daily dosage: 9-60g AH: Safe when used appropriately C&C: Contains alkaloids and potassium. a pale facial complexion. and hyperthyroid condition Potential formula toxicities & interactions: None listed POTENTIAL MEDICINAL TOXICITIES & I NTERACTIONS: Huang Qi. antiplatelets. GLW= GAO LU WEN . BR= BRINKER.

COMMENTS The ingredients in this formula are commonly added to other formulas whenever an element of defensive qi vacuity complicates a patient’s overall condition. PDR= P HYSICIAN’S DESK REFERENCE . B&B= BENSKY & BAROLET. Sheng Jiang (uncooked Rhizoma Zingiberis Officinalis. may antagonize Gan Jiang (dry Rhizoma Zingiberis Officinalis).Chapter 4 Toxicities & Drug Interaction • 331 Fang Feng (Radix Ledebouriellae Divaricatae) Standard daily dosage: 3-9g AH: Safe when used appropriately B&G: According to some traditional sources. AH= AHPA. Increases absorption of oral drugs. F L= FLAWS. C&C: Contains glycosides. PDR: Recommended safe dosage limit is six grams (6g). hydrochloric acid. Avoid larger doses if being used to treat morning sickness or if used in patients taking anticoagulants. fresh ginger) Standard daily dose: 3-9g AH: Safe when used appropriately BR: Reduces vomiting caused by chemotherapeutic drugs. C&C= CHAN & CHEUNG. GLW= GAO LU WEN. and other highly acidic substances could possibly reduce the therapeutic effect of this medicinal. nicotinic acid. Li Lu (Rhizoma Et Radix Veratri) and counteracts Bei Xie (Rhizoma Dioscoreae Hypoglaucae). B&G= B ENSKY & GAMBLE. Vitamin C. BR= BRINKER. glutamic acid.

acid regurgitation.) B&G: Not for patients with migraine headache or excessive menstrual bleeding. C&C= CHAN & CHEUNG. B&G= B ENSKY & GAMBLE . infectious hepatitis. blood. watery stools. and heat depressions manifesting as chest oppression. and is incompatible with Li Lu (Rhizoma Et Radix Veratri). B&B= BENSKY & BAROLET. FL= FLAWS. mild cough with profuse phlegm. PDR: No health risks or side effects are known in conjunction with the proper administration of designated therapeutic dosages. scanty appetite. rib-side pain.5-9g AH: Safe when used appropriately B&G: Use with caution in patients with loose. According to some traditional texts. it is not uncommon for this medicinal to be prescribed up to 15 grams per day in decoction. PDR= P HYSICIAN’ S DESK REFERENCE . food. dampness. counteracts Hua Shi (Talcum) and Huang Lian (Rhizoma Coptidis Chinensis). (This medicinal is routinely used in Chinese medical gynecology during pregnancy as part of formulas appropriately prescribed on the basis of pattern discrimination.Chapter 4 332 • Herb Toxicities & Drug Interactions: A Formula Approach YUE JU WAN (Escape Restraint Pills) Category: Qi-rectifying Functions: Moves the qi and resolves depression Chinese medical indications: Qi.) AH: Do not use during pregnancy. phlegm. and indigestion Contraindications: Stasis and stagnation due to vacuity Western medical indications: Gastrointestinal neurosis. C&C: Contains alkaloids and potassium. chronic cholecystitis. irregular menstruation. intercostal neuralgia. abdominal glomus. GLW= GAO LU WEN. vomiting. chronic gastritis. BR= BRINKER. Overdosage causes vomiting and dizziness. Could possibly cause hyperkalemia when used with potassium-sparing diuretics. burping/belching. Chuan Xiong (Radix Ligustici Wallichii) Standard daily dosage: 3-9g(In China today. antagonizes Shan Zhu Yu (Fructus Corni Officinalis) and Huang Qi (Radix Astragali Membranacei). Could possibly reduce the absorption and therapeutic effect of potassium and sodium AH= AHPA. cholelithiasis. and dysmenorrhea Potential formula toxicities & interactions: None listed POTENTIAL MEDICINAL TOXICITIES & I NTERACTIONS: Cang Zhu (Rhizoma Atractylodis) Standard daily dosage: 4. gastric or duodenal ulcer.

Shan Zhi. hydrochloric acid. sulphanomides. C&C= CHAN & CHEUNG. and magnesium sulfate. B&B= BENSKY & BAROLET. glutamic acid. B&G= B ENSKY & GAMBLE. BR= BRINKER. sodium bicarbonate. AH= AHPA. Could possibly cause hyperkalemia when used with potassium-sparing diuretics. nicotinic acid.5-12g AH: Safe when used appropriately Zhi Zi. GLW= GAO LU WEN. Shan Zhi Zi (Fructus Gardeniae Jasminoidis. C&C: Contains potassium and glycosides. and aspirin could possibly reduce the therapeutic effect of this medicinal. COMMENTS This formula is not commonly used in clinical practice.Chapter 4 Toxicities & Drug Interaction • 333 iodides. Xiang Fu (Rhizoma Cyperi Rotundi) Standard daily dosage: 4. Tetracyclines. It is important more as a theoretical model for teaching purposes than as a clinically useful formula. Vitamin C. F L= FLAWS. and other highly acidic substances could possibly reduce the therapeutic effect of this medicinal. Shen Qu (Massa Medica Fermentata) Standard daily dosage: 6-15g B&G: Use with caution during pregnancy. PDR= PHYSICIAN’S DESK REFERENCE . C&C: Contains amylase. aluminum hydroxide. dried gardenia fruit pods) Standard daily dosage: 3-12g B&G: Contains geniposide which caused diarrhea in mice.

Chapter 4 334 • Herb Toxicities & Drug Interactions: A Formula Approach ZHEN GAN XI FENG TANG (Settle the Liver & Extinguish Wind Decoction) Category: Wind-treating Functions: Settles the liver and extinguishes wind. and glycosides. Could possibly cause hyperkalemia when used with potassium-sparing diuretics. potassium. and in patients with excessive menstruation. and magnesium sulfate. AH= AHPA. a flushed face as if intoxicated. and other highly acidic substances will reduce the therapeutic effect of this medicinal. C&C= CHAN & CHEUNG. GLW= GAO LU WEN . arteriorsclerotic heart disease. convulsion. in debilitated patients with diarrhea. hyperthyroidism. should not be used with Bai Qian (Radix Et Rhizoma Cynanchi Baiqian). According to some traditional sources. apraxia. cerebrovascular accident. Contraindicated in menorrhagia. enriches yin and subdues yang Chinese medical indications: Liver-kidney yin vacuity with ascendant liver yang hyperactivity or internal stirring of liver wind manifesting as dizziness. epilepsy. distended eyes. tinnitus. forceful pulse Contraindications: Spleen qi or yang vacuity Western medical indications: Wind stroke. Huai Niu Xi. BR= BRINKER. a feverish sensation in the head. nicotinic acid. postpartum fever with spasms and convulsions Potential formula toxicities & interactions: None listed POTENTIAL MEDICINAL TOXICITIES & INTERACTIONS: Niu Xi. F L= FLAWS. renal hypertension. B&G= B ENSKY & GAMBLE. Could possibly reduce the absorption and therapeutic effect of potassium and sodium iodides. and a bowstring. cerebral arteriorsclerosis. Vitamin C. premenstrual tension. aluminum hydroxide. essential hypertension. Tu Niu Xi (Radix Achyranthis Bidentatae) Standard daily dosage: 9-15g AH: Not to be used during pregnancy. hypertensive encephelopathy. glutamic acid. headache. B&G: Contraindicated during pregnancy. C&C: Contains alkaloids. sodium bicarbonate. hydrochloric acid. aphasia. easy anger. PDR= PHYSICIAN’S DESK REFERENCE . vertigo. B&B= BENSKY & BAROLET.

and Yuan Zhi (Radix Polygalae Tenuifoliae) and has adverse effects when combined with Ma Huang (Herba Ephedrae). Could possibly reduce the effects of most antibiotics. cause digitalis intoxication and heart arrhythmias. BR= BRINKER. levadopa. and hinder the absorption of isoniazid. counteracts Shi Gao (Gypsum Fibrosum) and should not be mixed with fish. oyster shell) Standard daily dosage: 15-30g AH: Not to be used during pregnancy. Niu Xi (Radix Achyranthis Bidentatae). B&G= BENSKY & GAMBLE.Chapter 4 Toxicities & Drug Interaction • 335 Dai Zhe Shi (Haemititum. and prednisolone. and aluminum. According to some traditional sources. Long Gu (Os Draconis. Two grams per day for seven days caused death in mice. According to some traditional sources. counteracts Fu Zi (Radix Lateralis Praeparatus Aconiti Carmichaeli). Could possibly reduce the effect of most antibiotics. Wu Zhu Yu (Fructus Evodiae Rutecarpae). hematite) Standard daily dosage: 9-30g B&G: Use with caution during pregnancy. cause digitalis intoxication and heart arrhythmias. Researchers have found small amounts of arsenic salts in some samples. and potassium. B&G: Contraindicated when the patient has high fever without sweating. slowness of movement. fossilized bone) Standard daily dosage: 15-30g B&G: According to some traditional sources. thus accounting for its toxicity. GLW= GAO L U WEN . C&C= CHAN & CHEUNG. Signs of toxicity include weakness. levadopa. and prednisolone and hinder the absorption of isoniazid. magnesium. Mu Li (Concha Ostreae. levadopa. Could possibly reduce the effect of most antibiotics. and paroxysmal spasms leading to paralysis and death. aluminum. and Xi Xin (Herba Asari Cum Radice). AH= AHPA. and prednisolone. C&C: Contains calcium. C&C: Contains iron. B&B= BENSKY & BAROLET. Could possibly cause hyperkalemia when used with potassium-sparing diuretics. PDR= PHYSICIAN’S DESK REFERENCE . works synergistically with Bei Mu (Bulbus Fritillariae). C&C: Contains calcium. and hinder the absorption of isoniazid. F L= FLAWS. Gan Cao (Radix Glycyrrizae Uralensis). Overdose may lead to indigestion or constipation. iron. magnesium. iron.

Yuan Shen (Radix Scrophulariae Ningpoensis) Standard daily dosage: 9-30g C&C: Contains alkaloids. Could possibly reduce the absorption and therapeutic effect of potassium and sodium iodides. and glycosides. and magnesium sulfate. BR= BRINKER. According to some traditional sources. aluminum hydroxide. and flavinoids. Otherwise considered safe with the proper administration of designated therapeutic dosages. Tian Dong (Tuber Asparagi Cochinensis) Standard daily dosage: 6-15g AH: Safe when used appropriately B&G: Contraindicated in patients with loss of appetite and diarrhea or cough from the common cold. antagonizes Sha Shen (Radix Glehniae Littoralis) and Ren Shen (Radix Panacis Ginseng). nicotinic acid. counteracts Bie Jia (Carapax Amydae Sinensis) and Xiao Ji (Herba Cephalanopoloris Segeti). GLW= GAO L U WEN . hydrochloric acid. and glycosides. According to some traditional sources. and other highly acidic substances could possibly reduce the therapeutic effect of this medicinal. glutamic acid. antagonizes Shi Hu (Herba Dendrobii) and Mang Xiao (Mirabilitum). tannic acid.Chapter 4 336 • Herb Toxicities & Drug Interactions: A Formula Approach Gui Ban (Plastrum Testudinis. potassium. C&C: Contains calcium. white peony root) Standard daily dosage: 6-30g AH: Safe when used appropriately B&G: Use with caution in debilitated patients with diarrhea. C&C= CHAN & CHEUNG. potassium. tortoise plastron) Standard daily dosage: 9-30g B&G: Contraindicated in pregnancy. and is incompatible with Li Lu (Rhizoma Et Radix Veratri). PDR= PHYSICIAN’S DESK REFERENCE . F L= FLAWS. Could possibly cause hyperkalemia when used with potassium-sparing diuretics. Tian Men Dong. Could AH= AHPA. Xuan Shen. Shao Yao (Radix Albus Paeoniae Lactiflorae. Vitamin C. sodium bicarbonate. Should not be administered in the presence of kidney diseases due to the irritating effect of the saponins. PDR: Contains steroid saponins. B&G= BENSKY & GAMBLE. B&B= BENSKY & BAROLET. Bai Shao.

Tetracyclines. long-term use may damage the kidneys. PDR= P HYSICIAN’ S DESK REFERENCE . dizziness. GLW= GAO LU WEN. hydrochloric acid. quinine. ephedrine. In grave conditions. vomiting. convulsions. numbness of the four extremities. a red facial complexion. Could possibly cause hyperkalemia when used with potassium-sparing diuretics. sulphanomides. amylase. B&G: According to one traditional source. FL= FLAWS. Poisoning can lead to toxic hepatitis and red blood cells in the urine. frequent premature beats. glutamic acid. chlorpromazine. BR= BRINKER. kidney. C&C: Contains potassium. and could possibly reduce the absorption and therapeutic effect of levadopa. B&B= BENSKY & BAROLET. shock. trypsine. diarrhea. heart arrhythmia. there may be atrial fibrillation. AH= AHPA. C&C: Contains amylase. cause digitalis intoxication and heart arrhythmias. B&G: One study showed that using this medicinal along with Da Zao (Fructus Zizyphi Jujubae) to treat infectious hepatitis caused heart block in two patients. poor appetite. Vitamin C. blurred vision. and other highly acidic substances could possibly reduce the therapeutic effect of this medicinal. C&C= CHAN & CHEUNG. abdominal pain. Yin Chen Hao (Herba Artemisiae Yinchenhao) Standard daily dosage: 9-30g AH: Not to be used during pregnancy. B&G= B ENSKY & GAMBLE .Chapter 4 Toxicities & Drug Interaction • 337 possibly cause hyperkalemia when used with potassium-sparing diuretics. low blood pressure. malted barley) Standard daily dosage: 12-30g AH: Not to be used during pregnancy. syncope. mania and agitation. and aspirin could possibly reduce the therapeutic effect of this medicinal. vitamin B 1. isoniazid. and even death. and atrioventricular conduction block. inhibited speech. and/or intestines. and pepsin. headache. Could possibly reduce the effect of most antibiotics. Jin Ling Zi (Fructus Meliae Toosendan) Standard daily dosage: 3-9g AH: Safe when used appropriately GLW: Symptoms of adverse reaction include abdominal distention. hemorrhage of the liver. Mai Ya (Fructus Germinatus Hordei Vulgaris. reserpine. calcium carbonate and gluconate. uneasy respiration. nicotinic acid. epistaxis. atropine. shrunken pupils. Chuan Lian Zi.

C&C= CHAN & CHEUNG. GLW= GAO LU WEN. May increase potassium loss due to diuretics and laxatives. it is contraindicated in diabetes. May be synergistic with insulin in causing hypokalemia and sodium retention. caution should be exercised to guard against potential toxicity and drug interaction.) As a single herb in high doses. B&G: According to some traditional sources. Possible additive effect to corticosteroids. B&B= BENSKY & BAROLET. BR: May increase toxicity of cardiac glycosides. FL= FLAWS. When used as a single medicinal or in patients taking other potent Western pharmaceuticals. Yuan Hua (Flos Daphnes Genkwae). Contains glycyrrhetinic acid which could possibly cause a reduction in thyroid activity and basal metabolic rate. It should not be taken long-term or as a single herb during pregnancy. licorice root) Standard daily dosage: 2-12g AH: Do not use during pregnancy. If taken long-term. (This medicinal is routinely used in Chinese medical gynecology during pregnancy as part of formulas appropriately prescribed on the basis of pattern discrimination. it may cause hypertension and/or edema. and liver disorders.Chapter 4 338 • Herb Toxicities & Drug Interactions: A Formula Approach Gan Cao (Radix Glycyrrhizae Uralensis. hypertension. Not for long-term use. incompatible with Gan Sui (Radix Euphorbiae Kansui). BR= BRINKER. AH= AHPA. PDR= P HYSICIAN’ S DESK REFERENCE . The research on Gan Cao concurs that this medicinal is generally safe when used in small amounts as an envoy. B&G= B ENSKY & GAMBLE . and Yuan Zhi (Radix Polygalae Tenuifoliae).

PDR= P HYSICIAN’S DESK REFERENCE . forceless pulse Contraindications: None listed Western medical indications: Chronic nephritis. Shu Fu Zi. swollen tongue with teeth-marks on its edges and white. sodium bicarbonate. a pale or dry. heart palpitations. BR= BRINKER. and magnesium sulfate. and reduced temperature and blood pressure. blurred vision. light-headedness. coughing. F L= FLAWS. rheumatoid arthritis. wolfsbane. B&G= B ENSKY & GAMBLE.Chapter 4 Toxicities & Drug Interaction • 339 ZHEN WU TANG (True Warrior Decoction. rheumatic valvular heart disease. A very toxic medicinal which can be fatal if ingested in its uncooked form or in an inappropriate dose. Vitality Combination) Category: Dampness-dispelling Functions: Warms the yang and disinhibits urination Chinese medical indications: Spleen-kidney yang vacuity with internal gathering of water evils manifesting as abdominal pain which is aggravated by cold. Symptoms of toxicity include drooling. hypothyroidism. More severe symptoms include premature atrial contractions. Meniere’s disease. Fu Pian (Radix Lateralis Praeparatus Aconiti Carmichaeli.5-15g AH: To be used only under the supervision of an expert qualified in the appropriate use of this substance. liver cirrhosis and other hepatic disorders leading to edema and ascites. AH= AHPA. gastric upset. chronic diarrhea. primary hypertension. Emergency measures include the administration of atropine. and chronic bronchitis Potential formula toxicities & interactions: None listed POTENTIAL MEDICINAL TOXICITIES & INTERACTIONS: Fu Zi. vomiting. C&C= CHAN & CHEUNG. dizziness. heavy head. B&G: Contraindicated during pregnancy. GLW= GAO LU WEN. monkshood) Standard daily dosage: 1. B&B= BENSKY & BAROLET. It is generally combined with Gan Cao (Radix Glycyrhizae Uralensis) and Gan Jiang (dry Rhizoma Zingiberis Officinalis) in decoctions to reduce its toxicity. fine. Could possibly reduce the absorption and therapeutic effect of potassium and sodium iodides. loose stools.k. C&C: Contains alkaloids. generalized edema. and numbness and tingling of the extremities. primary hyperaldosteronism. chronic enteritis. dyspnea.a. aluminum hydroxide. congestive heart failure. deep aching and heaviness of the extremities. a. and a deep. difficult urination. slimy fur.

slow heartbeat.5-9g AH: Safe when used appropriately B&G: When rats were fed 0. Fu Ling.5g/kg of this medicinal for two months. F L= FLAWS.Chapter 4 340 • Herb Toxicities & Drug Interactions: A Formula Approach PDR: Contains nor-diterpene alkaloids. Bai Zhu (Rhizoma Atractylodis Macrocephalae) Standard daily dosage: 4. small doses can be fatal. and Bie Jia (Carapax Amydae Sinensis). may counteract Di Yu (Radix Sanguisorbae Officinalis). dilated pupils. there may be generalized sweating. Increases absorption of oral drugs. reversal chilling of the four limbs. Could possibly cause hyperkalemia when used with potassium-sparing diuretics. there is a burning hot sensation in the mouth and on the tongue. lowered body temperature. nausea. and pain which gradually spreads to the four limbs and then to the whole body. Highly toxic. vexation. C&C: Contains potassium. PDR= P HYSICIAN’S DESK REFERENCE . a somber white facial complexion. vomiting. B&B= BENSKY & BAROLET. or liver. GLW= GAO LU WEN. copious urination. dizziness. According to traditional sources. B&G= B ENSKY & GAMBLE. urinary incontinence. BR= BRINKER. Bai Fu Ling. agitation. heart palpitations. rapid breathing. restlessness. arrhythmia. C&C= CHAN & CHEUNG. convulsions. Sheng Jiang (uncooked Rhizoma Zingiberis Officinalis. low blood pressure. slowed reaction to light. fresh ginger) Standard daily dose: 3-9g AH: Safe when used appropriately BR: Reduces vomiting caused by chemotherapeutic drugs. AH= AHPA. and circulatory collapse leading to death. they developed a mild lymphopenia and anemia but suffered no damage to to the brain. including aconitine. Yun Ling (Sclerotium Poriae Cocos) Standard daily dosage: 9-15g B&G: Large doses or long-term use is discouraged. Avoid larger doses if being used to treat morning sickness or if used in patients taking anticoagulants. Qin Jiao (Radix Gentianae Qinjiao). heart. PDR: Recommended safe dosage limit is six grams (6g). GLW: If mild poisoning. If more severe poisoning. Contraindicated in patients with frequent. numbness. drooling. paralysis.

It is not meant for long-term administration. According to some traditional sources. AH= AHPA. Vitamin C. calcium carbonate and gluconate. C&C: Contains calcium. B&G= B ENSKY & GAMBLE. glutamic acid. potassium. and glycosides. chlorpromazine. and could possibly reduce the absorption and therapeutic effect of levadopa. Could possibly reduce the effect of most antibiotics. hydrochloric acid. and pepsin. Shao Yao (Radix Albus Paeoniae Lactiflorae. atropine. vitamin B 1. PDR= PHYSICIAN’S DESK REFERENCE . F L= FLAWS. white peony root) Standard daily dosage: 6-30g AH: Safe when used appropriately B&G: Use with caution in debilitated patients with diarrhea. and is incompatible with Li Lu (Rhizoma Et Radix Veratri). quinine. amylase. cause digitalis intoxication and heart arrhythmias. trypsine. and other highly acidic substances could possibly reduce the therapeutic effect of this medicinal. isoniazid. antagonizes Shi Hu (Herba Dendrobii) and Mang Xiao (Mirabilitum). reserpine. ephedrine. BR= BRINKER. B&B= BENSKY & BAROLET. counteracts Bie Jia (Carapax Amydae Sinensis) and Xiao Ji (Herba Cephalanopoloris Segeti).Chapter 4 Toxicities & Drug Interaction • 341 Bai Shao. C&C= CHAN & CHEUNG. GLW= GAO LU WEN . COMMENTS This formula is a first aid formula meant to rescue seriously ill patients. nicotinic acid. Could possibly cause hyperkalemia when used with potassium-sparing diuretics. tannic acid.

pulmonary tuberculosis. BR= BRINKER. and heart palpitations which often disappear upon continued administration of the herb. hot flashes. rapid. a red tongue with either scanty. yellow or slimy. slippery. hyperthyroidism. B&G= BENSKY & GAMBLE. Shu Di Huang (cooked Radix Rehmanniae Glutinosae) Standard daily dosage: 9-30g AH: Contraindicated in patients with diarrhea or indigestion B&G: Overuse can lead to abdominal distention and loose stools. hypertension. According to some traditional sources.Chapter 4 342 • Herb Toxicities & Drug Interactions: A Formula Approach ZHI BAI DI HUANG WAN (Anemarrhena & Phellodendron Rehmannia Pills) Category: Yin-supplementing Functions: Supplements the kidneys and enriches yin. rapid. night sweats. chronic glomerulonephritis. strangury. and perimenopausal syndrome Potential formula toxicities & interactions: None listed POTENTIAL MEDICINAL TOXICITIES & I NTERACTIONS: Shu Di. benign prostatic hypertrophy. surging. dizziness. abdominal pain. chronic nephritis. senile vaginitis. drains fire as well as clears and eliminates dampness and heat Chinese medical indications: Kidney yin vacuity with either fire flaming internally or damp heat manifesting as dizziness. PDR: No health risks or side effects are known in conjunction with the proper administration of designated therapeutic dosages. nocturia. antagonizes Jie Geng (Radix AH= AHPA. a dry mouth and tongue. GLW= GAO L U WEN . Side effects include diarrhea. tidal heat. low back and knee soreness and limpness. B&B= BENSKY & BAROLET. F L= FLAWS. lethargy. Shan Zhu Yu. yellow fur at the root. C&C= CHAN & CHEUNG. tinnitus. and rapid pulse Contraindications: Absence of fire flaring or damp heat Western medical indications: Chronic prostatitis. functional uterine bleeding. B&G: Contraindicated in patients with difficult or painful urination. or fine. steaming bones. Shan Zhu Rou (Fructus Corni Officinalis) Standard daily dosage: 3-60g AH: Contraindicated in patients with difficult or painful urination. and a fine. PDR= PHYSICIAN’S DESK REFERENCE .

reserpine. May have an additive estrogenic effect when administered with estrogen-containing drugs. magnesium sulfate. sodium bicarbonate. BR= BRINKER. glutamic acid. AH= AHPA. quinine. nicotinic acid. Poisoning in overdosages may occur from the picrotoxin-like effect of dioscorin. hydrochloric acid. Could possibly cause hyperkalemia when used with potassium-sparing diuretics. Yun Ling (Sclerotium Poriae Cocos) Standard daily dosage: 9-15g B&G: Large doses or long-term use is discouraged. PDR: Use of this medicinal may reduce the antiinflammatory effect of indomethacin. amylase. ephedrine. Could possibly reduce the absorption and biologic effect of most antibiotics. According to traditional sources. and other highly acidic substances could possibly reduce the therapeutic effect of this medicinal. digitalis. Vitamin C. C&C: Contains potassium. hydrochloric acid. Qin Jiao (Radix Gentianae Qinjiao). potassium. and glycosides. F L= FLAWS. and Fang Ji (Radix Aristolochiae Fangchi). Contraindicated in patients with frequent. and other highly acidic substances could possibly reduce the therapeutic effect of this medicinal. Could possibly cause hyperkalemia when used with potassium-sparing diuretics. C&C= CHAN & CHEUNG. GLW= GAO LU WEN . tetracyclines. sulphanomides. Fu Ling. glutamic acid. calcium carbonate and gluconate. aluminum hydroxide. atropine. PDR= PHYSICIAN’S DESK REFERENCE . isoniazid. Bai Fu Ling. and aspirin. antagonizes Gan Sui (Radix Euphorbiae Kansui). PDR: No health hazards are known in conjunction with proper administration of designated therapeutic dosages.Chapter 4 Toxicities & Drug Interaction • 343 Platycodi Grandiflori). vitamin B1. B&G= B ENSKY & GAMBLE. copious urination. chlorpromazine. may counteract Di Yu (Radix Sanguisorbae Officinalis). and Bie Jia (Carapax Amydae Sinensis). C&C: Contains alkaloids. nicotinic acid. Vitamin C. C&C: Contains tannic acid and glycosides. trypsine. Could possibly reduce the absorption and therapeutic effect of potassium and sodium iodides. Shan Yao (Radix Dioscoreae Oppositae) Standard daily dosage: 9-30g AH: Safe when used appropriately B&G: According to some traditional sources. Fang Feng (Radix Lebouriellae Divaricatae). B&B= BENSKY & BAROLET. amylase. and pepsin.

) B&G: Should not be used during pregnancy or in patients with excessive sweating or profuse menstruation. According to some traditional sources. C&C: Contains tannic acid. Zhi Mu (Rhizoma Anemarrhenae Aspheloidis) Standard daily dosage: 6-12g AH: Safe when used appropriately B&G: May cause diarrhea in some patients. Ze Xie (Rhizoma Alismatis Orientalis) Standard daily dosage: 6-15g AH: Prolonged use may cause gastrointestinal irritation. aluminum hydroxide. tree peony root bark) Standard daily dosage: 6-12g AH: Not to be used during pregnancy (This ingredient is commonly used in China during pregnancy to treat heat in the blood and/or blood stasis. atropine. reserpine. flavone sulfate. and glycosides. B&G: Although considered safe. BR= BRINKER. F L= FLAWS. prolonged usage may irritate the intestinal tract and could possibly cause gastroenteritis. C&C= CHAN & CHEUNG. chlorpromazine. ephedrine. No health hazards or side effects with proper administration of designated therapeutic dosages. magnesium sulfate. Vitamin C. Could possibly cause hyperkalemia when used with potassium-sparing diuretics and reduce the absorption and therapeutic effect of potassium and sodium iodides. C&C: Contains alkaloids and potassium. hydrochloric acid. and caffeic acid derivatives. Avoid using with garlic. nicoAH= AHPA. and pepsin. and other highly acidic substances could possibly reduce the therapeutic effect of this medicinal. quinine. B&B= BENSKY & BAROLET. and Da Huang (Radix Et Rhizoma Rhei). nicotinic acid. Could possibly cause hyperkalemia when used with potassium-sparing diuretics. Vitamin C. trypsine. vitamin B1B1. Could possibly reduce the absorption and biologic effect of most antibiotics. GLW= GAO LU WEN . Bei Mu (Bulbus Fritillariae). Could possibly cause hyperkalemia when used with potassium-sparing diuretics. B&G= B ENSKY & GAMBLE. digitalis. sodium bicarbonate. PDR: Contains triterpenes. glutamic acid. isoniazid. amylase. may counteract the effect of Tu Si Zi (Semen Cuscutae Chinensis). potassium. sesquiterpenes. C&C: Contains potassium and glycosides. calcium carbonate and gluconate.Chapter 4 344 • Herb Toxicities & Drug Interactions: A Formula Approach Dan Pi. Mu Dan Pi (Cortex Radicis Moutan. PDR= PHYSICIAN’S DESK REFERENCE .

BR= BRINKER. calcium gluconate. B&G= BENSKY & GAMBLE. sodium bicarbonate.) B&G: Chinese literature reports one case of a patient who developed a skin rash after ingestion. and other highly acidic substances could possibly reduce the therapeutic effect of this medicinal. AH= AHPA. Huang Bai. Huang Bo (Cortex Phellodendri) Standard daily dosage: 3-12g AH: Not to be used during pregnancy (This medicinal is commonly used during pregnancy in China. hydrochloric acid. PDR: No health hazards are known in conjunction with the proper administration of designated therapeutic dosages. Could possibly reduce the absorption and therapeutic effect of potassium and sodium iodides. C&C: Contains alkaloids and quercetin. F L= FLAWS. carbonate. glutamic acid. B&B= BENSKY & BAROLET. magnesium and ferrous sulfates. and bismuth subcarbonate. PDR= PHYSICIAN’S DESK REFERENCE .Chapter 4 Toxicities & Drug Interaction • 345 tinic acid. C&C= CHAN & CHEUNG. aluminum hydroxide. GLW= GAO L U WEN . and lactate.

caution should be exercised to guard against potential toxicity and drug interaction. Possible additive effect to corticosteroids. FL= FLAWS.Chapter 4 346 • Herb Toxicities & Drug Interactions: A Formula Approach ZHI GAN CAO TANG (Mix-fried Licorice Decoction) Category: Qi and blood supplementing Functions: Supplements the qi and nourishes the blood. pulmonary tuberculosis. shiny tongue. mitral stenosis. a pale. Contains glycyrrhetinic acid which could possibly cause a reduction in thyroid activity and basal metabolic rate. hyperthyroidism. BR: May increase toxicity of cardiac glycosides. emaciation. PDR= P HYSICIAN’ S DESK REFERENCE . May increase potassium loss due to diuretics and laxatives. mitral valve prolapse. incompatible with Gan Sui (Radix Euphorbiae Kansui). POTENTIAL MEDICINAL TOXICITIES & INTERACTIONS: Gan Cao (Radix Glycyrrhizae Uralensis. It should not be taken long-term or as a single herb during pregnancy.) As a single herb in high doses. insomnia. B&G: According to some traditional sources. enriches the yin and restores the pulse Chinese medical indications: Heart qi and blood vacuity resulting in heart palpitations. C&C= CHAN & CHEUNG. and neurasthenia Potential formula toxicities & interactions: B&B: Use with caution in patients with severe diarrhea. and liver disorders. it may cause hypertension and/or edema. a dry mouth and parched throat. B&G= B ENSKY & GAMBLE . emphysema. When used as a single medicinal or in patients taking other potent Western pharmaceuticals. and a bound and/or faint pulse Contraindications: Yin vacuity heat Western medical indications: Superventricular arrythmia. GLW= GAO LU WEN. shortness of breath. B&B= BENSKY & BAROLET. If taken long-term. constipation. (This medicinal is routinely used in Chinese medical gynecology during pregnancy as part of formulas appropriately prescribed on the basis of pattern discrimination. hypertension. The research on Gan Cao concurs that this medicinal is generally safe when used in small amounts as an envoy. it is contraindicated in diabetes. Yuan Hua (Flos Daphnes Genkwae). BR= BRINKER. easy anger. AH= AHPA. and Yuan Zhi (Radix Polygalae Tenuifoliae). May be synergistic with insulin in causing hypokalemia and sodium retention. rheumatic heart disease. Not for long-term use. licorice root) Standard daily dosage: 2-12g AH: Do not use during pregnancy.

PDR: Contraindicated during pregnancy. Mai Dong (Tuber Ophiopogoni Japonici) Standard daily dosage: 6-15g AH= AHPA. during pregnancy. Sheng Di Huang (uncooked Radix Rehmanniae Glutinosae) Standard daily dosage: 9-30g AH: Contraindicated in patients with diarrhea or lack of appetite B&G: Contraindicated in pregnant women with anemias or digestive weakness C&C: Contains potassium. Mai Men Dong. GLW= GAO LU WEN . heart palpitations. or during excessive menstruation. PDR= PHYSICIAN’S DESK REFERENCE . cinnamon twigs) Standard daily dosage: 3-15g AH: Safe when used appropriately B&G: Use with caution in the presence of fever. C&C: Vitamin C. B&G: Contraindicated for hypertensive patients. B&B= BENSKY & BAROLET. Use with MAO-inhibitors may cause headaches. F L= FLAWS. insomnia. PDR: Contraindicated in patients with hypertension. B&G= B ENSKY & GAMBLE. and a rise in blood pressure. Not recommended in large doses during pregnancy or lactation due to potential neonatal androgenization. PDR: No health risks or side effects are known in conjunction with the proper administration of designated therapeutic dosages. May reduce the anticoagulative effect of warfarin (Coumadin). A traditional antidote is mung bean soup. and other highly acidic substances could possibly reduce the therapeutic effect of this medicinal. Enhances the effect of insulin and other antidiabetic agents. hydrochloric acid. Could possibly cause hyperkalemia when used with potassium-sparing diuretics. May cause hypertension if consumed with caffeine. glutamic acid. Sheng Di. Overdose can lead to headache. C&C= CHAN & CHEUNG. ginseng) Standard daily dosage: 1-30g AH: Contraindicated in hypertension BR: May cause manic episodes in patients on MAO-inhibitors. nicotinic acid. Possible additive effects to insulin.Chapter 4 Toxicities & Drug Interaction • 347 Ren Shen (Radix Panacis Ginseng. BR= BRINKER. Gui Zhi (Ramulus Cinnamomi Cassiae. tremors. and manias.

E Jiao (Gelatinum Corii Asini. aluminum hydroxide. irritability. and other highly acidic substances could possibly reduce the therapeutic effect of this medicinal. numbness of the extremities. glutamic acid. B&B= BENSKY & BAROLET. donkey skin glue) Standard daily dosage: 3-15g B&G: According to some traditional sources. counteracts Da Huang (Radix Et Rhizoma Rhei). and magnesium sulfate. Vitamin C. Avoid larger doses if being used to treat morning sickness or if used in patients taking anticoagulants. PDR: Recommended safe dosage limit is six grams (6g). PDR: No health risks or side effects are known in conjunction with the proper administration of designated therapeutic dosages. C&C: Contains alkaloids. GLW= GAO LU WEN . miosis. PDR= PHYSICIAN’S DESK REFERENCE . BR= BRINKER. Sheng Jiang (uncooked Rhizoma Zingiberis Officinalis. Huo Ma Ren (Semen Cannabis Sativae. B&G= B ENSKY & GAMBLE. sodium bicarbonate. Increases absorption of oral drugs. marijuana seeds) Standard daily dosage: 9-45g B&G: Symptoms of overdose may include nausea. F L= FLAWS. vomiting. chorea. cannabis seeds. fresh ginger) Standard daily dose: 3-9g AH: Safe when used appropriately BR: Reduces vomiting caused by chemotherapeutic drugs. diarrhea. antagonizes Kuan Dong Hua (Flos Tussilaginis Farfarae) and counteracts Ku Shen (Radix Sophorae Flavescentis) and Bai Mu Er (Fructificatio Tremellae Fuciformis). AH= AHPA. fluids. and symptomatic therapy. and in severe cases coma and death. nicotinic acid. Could possibly reduce the absorption and therapeutic effect of potassium and sodium iodides. Treatment is based on gastric lavage. C&C: Contains glycosides. hydrochloric acid.Chapter 4 348 • Herb Toxicities & Drug Interactions: A Formula Approach AH: Safe when used appropriately B&G: According to some traditional sources. C&C= CHAN & CHEUNG.

red dates) Standard daily dosage: 10-30g (3-12 pieces) AH: Safe when used appropriately PDR: No health risks or side effects are known in conjunction with the proper administration of designated therapeutic dosages. F L= FLAWS. PDR= P HYSICIAN’S DESK REFERENCE . B&B= BENSKY & BAROLET. AH= AHPA. BR= BRINKER. Hong Zao (Fructus Zizyphi Jujubae.Chapter 4 Toxicities & Drug Interaction • 349 Da Zao. GLW= GAO LU WEN. C&C= CHAN & CHEUNG. B&G= B ENSKY & GAMBLE.

. hydrochloric acid. nicotinic acid. PDR= P HYSICIAN’ S DESK REFERENCE . B&B= BENSKY & BAROLET. hinder the absorption of isoniazid. Could possibly reduce the effect of most antibiotics.k. pertussis. Vitamin C. resolves the exterior and diffuses the lungs Chinese medical indications: Retained wind evils in the lungs causing cough with or without slight chills and fever. thin. Jing Jie Sui. a. BR= BRINKER. GLW= GAO LU WEN.e. and other highly acidic substances could possibly reduce the therapeutic effect of this medicinal.a.Chapter 4 350 • Herb Toxicities & Drug Interactions: A Formula Approach ZHI SOU SAN (Stop Coughing Powder. B&G: Contraindicated in patients with hemoptysis. slightly slow) pulse Contraindications: Yin vacuity or lung heat coughs Western medical indications: Coughing due to respiratory tract infection. and reduce the biological effect of levadopa. counteracts Long Dan Cao (Radix Gentianae Longdancao) and Long Yan Rou (Arillus Euphoriae Longanae). Use with caution in bleeding peptic ulcer. white tongue fur. Platycodon & Schizonpeta Formula) Category: Phlegm-transforming Functions: Stops cough and transform phlegm. especially in cases of tuberculosis. C&C: Contains calcium and glycosides. C&C= CHAN & CHEUNG. and a floating. According to some traditional sources. and early stages of viral or mycoplasm pneumonia Potential formula toxicities & interactions: None listed POTENTIAL MEDICINAL TOXICITIES & I NTERACTIONS: Jie Geng (Radix Platycodi Grandiflori. acute bronchitis. B&G= B ENSKY & GAMBLE . glutamic acid. cause digitalis intoxication and heart arrhythmias. FL= FLAWS. an itchy throat. Jing Jie (Herba Seu Flos Schizonepetae Tenuifoliae) Standard daily dosage: 3-9g No toxicity or interaction information listed in the sources AH= AHPA. bellflower root) Standard daily dosage: 3-9g AH: Contraindicated in hemoptysis. moderate (i.

hydrochloric acid. Vitamin C. (This medicinal is routinely used in Chinese medical gynecology during pregnancy as part of formulas appropriately prescribed on the basis of pattern discrimination. magnesium and ferrous sulfates. chest oppression. BR= BRINKER. Not for long-term use. rapid breathing. Could possibly reduce the absorption of calcium gluconate. Bai Bu (Radix Stemonae) Standard daily dosage: 3-9g C&C: Contains alkaloids. counteracts Yin Chen Hao (Herba Artemesiae Capillaris).) As a single herb in high doses. May increase potassium loss due to diuretics and laxatives. hypertension. GLW: Symptoms of adverse reaction. sodium bicarbonate. aluminum hydroxide. and magnesium sulfate. GLW= GAO LU WEN. According to traditional sources. glutamic acid. and epistaxis. carbonate. dizziness. and liver disorders. indigestion. aluminum hydroxide. More rarely. B&G= B ENSKY & GAMBLE. and convulsions. include a burning hot. and bismuth subcarbonate. diarrhea. licorice root) Standard daily dosage: 2-12g AH: Do not use during pregnancy. Possible additive effect to cortiAH= AHPA. BR: May increase toxicity of cardiac glycosides. syncope. if mild. there is abdominal pain. and lactate. Extreme overdose leading to poisoning can result in respiratory paralysis. and other highly acidic substances could possibly reduce the therapeutic effect of this medicinal. B&B= BENSKY & BAROLET.Chapter 4 Toxicities & Drug Interaction • 351 Zi Wan (Radix Asteris Tatarici) Standard daily dosage: 3-9g B&G: Large dosages and long-term usage not recommended. nicotinic acid. PDR= P HYSICIAN’S DESK REFERENCE . F L= FLAWS. Could possibly reduce the absorption and therapeutic effect of potassium and sodium iodides. it is contraindicated in diabetes. C&C= CHAN & CHEUNG. Bai Qian (Radix Et Rhizoma Cynanchii Baiqian) Standard daily dosage: 3-9g No toxicity or interaction information listed in the sources Gan Cao (Radix Glycyrrhizae Uralensis. C&C: Contains quercetin and glycosides. dry sensation in the mouth and nose reaching the throat.

C&C= CHAN & CHEUNG. caution should be exercised to guard against potential toxicity and drug interaction. it may cause hypertension and/or edema. It should not be taken longterm or as a single herb during pregnancy. and Yuan Zhi (Radix Polygalae Tenuifoliae). incompatible with Gan Sui (Radix Euphorbiae Kansui). AH= AHPA. Could possibly cause hyperkalemia when used with potassium-sparing diuretics. When used as a single medicinal or in patients taking other potent Western pharmaceuticals. The research on Gan Cao concurs that this medicinal is generally safe when used in small amounts as an envoy. Chen Pi. B&G= B ENSKY & GAMBLE. If taken long-term. Ju Hong (Pericarpium Citri Reticulatae. May be synergistic with insulin in causing hypokalemia and sodium retention. Ju Pi.Chapter 4 352 • Herb Toxicities & Drug Interactions: A Formula Approach costeroids. BR= BRINKER. B&G: According to some traditional sources. GLW= GAO LU WEN . Contains glycyrrhetinic acid which could possibly cause a reduction in thyroid activity and basal metabolic rate. Yuan Hua (Flos Daphnes Genkwae). B&B= BENSKY & BAROLET. F L= FLAWS. PDR= PHYSICIAN’S DESK REFERENCE . tangerine peel) Standard daily dosage: 3-9g AH: Safe when used appropriately C&C: Contains potassium.

a desire to vomit with inability to do so. syncope. convulsions. especially the tip. psychosis. GLW= GAO L U WEN . spirit-quieting Functions: Settles the heart and quiets the spirit. F L= FLAWS. and acute kidney failure. Should not be used in large amounts or long-term. there is edema. and a fine. POTENTIAL MEDICINAL TOXICITIES & I NTERACTIONS: Zhu Sha (Cinnabaris. a. scanty urination. nausea.a. vexatious heat in the chest. depression.5-9g AH: Not to be used during pregnancy. clenched teeth. settling.) AH= AHPA. there is hemorrhagic enteritis. BR= BRINKER. GLW: Symptoms of adverse reaction include burning pain in the oral cavity and throat. vomiting. fright reversal. B&B= BENSKY & BAROLET. low blood pressure.k. To prevent mercury poisoning. B&G= BENSKY & GAMBLE. profuse dreams. mucus in the stools or hemafecia. If the kidneys are poisoned. swelling and distention of the mucosa. palpitations. C&C= CHAN & CHEUNG. bleeding. continuous heart palpitations. (This medicinal is commonly used during pregnancy in China when indicated by disease and pattern discrimination. diarrhea. PDR= PHYSICIAN’S DESK REFERENCE . albuminuria. and mitral valve prolapse syndrome Potential formula toxicities & interactions: FL/B&B: To avoid mercury poisoning. anxiety disorders. and eventual respiratory failure. insomnia. and a metallic taste in the mouth. Huang Lian (Rhizoma Coptidis Chinensis) Standard daily dosage: 1. do not heat. drains fire and nourishes yin Chinese medical indications: Heart fire harassing the spirit and damaging the blood and yin resulting in insomnia. and trembling. ulceration. a red tongue. rapid pulse Contraindications: None listed Western medical indications: Mood disorders. Cinnabar Formula) Category: Heavy. Zhu Sha (Cinnabaris) should not be taken in large doses or long-term. abdominal pain.7g in pills and powders B&G: Contains mercuric sulfide which is highly toxic.Chapter 4 Toxicities & Drug Interaction • 353 ZHU SHA AN SHEN WAN (Cinnabar Quiet the Spirit Pills. If severe. shock. cinnabar) Standard daily dosage: 0.2-2.

Could possibly cause hyperkalemia when used with potassium-sparing diuretics. PDR= P HYSICIAN’ S DESK REFERENCE . counteracts Kuan Dong Hua (Flos Tussilaginis Farfarae) and Niu Xi (Radix Achyranthis Bidentatae). May exaggerate the anticoagulative effect of warfarin (Coumadin). antagonizes Ju Hua (Flos Chrysanthemi Morifolii). B&B= BENSKY & BAROLET. B&G= B ENSKY & GAMBLE . licorice root) Standard daily dosage: 2-12g AH: Do not use during pregnancy. Could possibly cause hyperkalemia when used with potassium-sparing diuretics. Long-term use may damage the digestive system. and lactate. C&C: Contains alkaloids. C&C= CHAN & CHEUNG.Chapter 4 354 • Herb Toxicities & Drug Interactions: A Formula Approach B&G: Contains berberine. hypertension. Sheng Di. Not for long-term use. Xuan Shen (Radix Scrophulariae Ningpoensis). Sheng Di Huang (uncooked Radix Rehmanniae Glutinosae) Standard daily dosage: 9-30g AH: Contraindicated in patients with diarrhea or lack of appetite B&G: Contraindicated in pregnant women with anemias or digestive weakness C&C: Contains potassium. (This medicinal is routinely used in Chinese medical gynecology during pregnancy as part of formulas appropriately prescribed on the basis of pattern discrimination. it is contraindicated in diabetes. aluminum hydroxide. Could possibly cause hyperkalemia when used with potassium-sparing diuretics. According to some traditional sources. and Jiang Can (Bombyx Batryticatus). Bai Xian Pi (Cortex Radicis Dictamni Dasycarpi). sodium bicarbonate. FL= FLAWS. Some traditional sources say it should not be taken with pork. Could possibly reduce the absorption and therapeutic effect of potassium and sodium iodides. magnesium and ferrous sulfates. calcium gluconate. quercetin. PDR: No health risks or side effects are known in conjunction with the proper administration of designated therapeutic dosages.) B&G: Use with caution in patients with diarrhea or abdominal distention. AH= AHPA. and bismuth subcarbonate. C&C: Contains potassium. (This medicinal is routinely used in Chinese medical gynecology during pregnancy as part of formulas appropriately prescribed on the basis of pattern discrimination. and liver disorders. According to some traditional sources. Dang Gui (Radix Angelicae Sinensis) Standard daily dosage: 3-15g AH: Do not use during pregnancy. Gan Cao (Radix Glycyrrhizae Uralensis. and potassium. BR= BRINKER. GLW= GAO LU WEN.) As a single herb in high doses. carbonate.

When used as a single medicinal or in patients taking other potent Western pharmaceuticals. caution should be exercised to guard against potential toxicity and drug interaction. it may cause hypertension and/or edema. AH= AHPA. COMMENTS Hu Po (Succinum) is commonly substituted for Zhu Sha in this formula due to Zhu Sha’s toxicity. It should not be taken long-term or as a single herb during pregnancy. The research on Gan Cao concurs that this medicinal is generally safe when used in small amounts as an envoy. B&G= B ENSKY & GAMBLE . PDR= PHYSICIAN’ S DESK REFERENCE . B&G: According to some traditional sources. Possible additive effect to corticosteroids. B&B= BENSKY & BAROLET.Chapter 4 Toxicities & Drug Interaction • 355 BR: May increase toxicity of cardiac glycosides. FL= FLAWS. and Yuan Zhi (Radix Polygalae Tenuifoliae). May be synergistic with insulin in causing hypokalemia and sodium retention. Yuan Hua (Flos Daphnes Genkwae). May increase potassium loss due to diuretics and laxatives. If taken long-term. Contains glycyrrhetinic acid which could possibly cause a reduction in thyroid activity and basal metabolic rate. incompatible with Gan Sui (Radix Euphorbiae Kansui). BR= BRINKER. C&C= CHAN & CHEUNG. GLW= GAO LU WEN.

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CONTENTS Herbal Classification System Class 1 Chinese Medicinals Class 2 Chinese Medicinals Class 3 Chinese Medicinals Class 4 Chinese Medicinals APPENDIX 1 AMERICAN HERBAL PRODUCTS ASSOCIATION (AHPA) HERBAL CLASSIFICATION SYSTEM Class 1 Herbs which can be safely consumed when used appropriately Herbs for which restrictions apply unless directed by a qualified exper t For external use only Not to be used during pregnancy Not to be used while nursing Other specific use restrictions Herbs which require the following labeling. “To be used only under the supervision of an expert qualified in the appropriate use of this substance” Herbs for which insufficient data are avail able for classification Class 2 2a 2b 2c 2d Class 3 Class 4 .

Appendix 1 358 • Herb Toxicities & Drug Interactions: A Formula Approach ACCORDING TO CLASS 1 CHINESE MEDICINALS BOTANICAL SAFETY HANDBOOK Class 1 Herbs which can be safely consumed when used appropriately Nan Sha Shen (Radix Adenophorae Strictae) Huo Xiang (Herba Agastachis Seu Pogostemi) He Huan Hua (Flos Albizziae Julibrissinis) Gao Liang Jiang (Rhizoma Alpiniae Officinari) Cao Guo (Fructus Amomi Tsao-kuo) Zhi Mu (Rhizoma Anemarrhenae Aspheloidis) Bai Zhi (Radix Angelicae Dahuricae) Niu Bang Zi (Fructus Arctii Lappae) Tian Men Dong (Tuber Asparagi Cochinensis) Huang Qi (Radix Astragali Membranacei) Cang Zhu (Rhizoma Atractylodis) Bai Zhu (Rhizoma Atractylodis Macrocephalae) Mu Xiang (Radix Auklandiae Lappae) Dong Gua Pi (Pericarpium Benincasae Hispidae) Chai Hu (Radix Bupleuri) Mu Gua (Fructus Chaenomelis Lagenariae) Gou Ji (Rhizoma Cibotii Barometsis) Gui Zhi (Ramulus Cinnamomi Cassiae) Rou Cong Rong (Herba Cistanchis Deserticolae Seu Salsae) Zhi Ke (Fructus Citri Aurantii) Chen Pi (Pericarpium Citri Reticulatae) Qing Pi (Fructus Citri Reticulatae Viride) Wei Ling Xian (Radix Clematidis Chinensis) She Chuang Zi (Fructus Cnidii Monnieri) Dang Shen (Radix Codonopsitis Pilosulae) Dong Chong Xia Cao (Cordyceps Sinensis) Shan Zha (Fructus Crataegi) Tu Si Zi (Semen Cuscutae Chinensis) Bai Wei (Radix Cynanchi Atrati) Xiang Fu (Rhizoma Cyperi Rotundi) Xue Jie (Sanguis Draconis) Shi Hu (Herba Dendrobii) Shan Yao (Radix Dioscoreae Oppositae) Xu Duan (Radix Dipsaci) Gu Sui Bu (Rhizoma Drynariae) Han Lian Cao (Herba Ecliptae Prostratae) Bai Dou Kou (Fructus Cardamomi) Da Qing Ye (Folium Daqingye) Ci Wu Jia (Radix Eleuthrococci Senticosi) Hai Tong Pi (Cortex Erythiniae) Du Zhong (Cortex Eucommiae Ulmoidis) Qian Shi (Semen Euryalis Ferocis) .

Appendix 1 American Herbal Products Association (AHPA) • 359 Xiao Hui Xiang (Fructus Foeniculi Vulgaris) Ling Zhi (Fructificatio Ganodermae Lucidi) Zhi Zi (Fructus Gardeniae Jasminoidis) Tian Ma (Rhizoma Gastrodiae Elatae) Qin Jiao (Radix Gentianae Qinjiao) Long Dan Cao (Radix Gentianae Longdancao) Sha Shen (Radix Glehniae Littoralis) Bai Mao Gen (Rhizoma Imperatae Cylindricae) Xuan Fu Hua (Flos Inulae Racemosae) Ban Lan Gen (Radix Isatidis Seu Baphicacanthi) Fang Feng (Radix Ledebouriellae Divaricatae) Gao Ben (Radix Et Rhizoma Ligustici Chinensis) Nu Zhen Zi (Fructus Ligustri Lucidi) Bai He (Bulbus Lilii) Ren Dong Teng (Caulis Lonicerae Japonicae) Jin Yin Hua (Flos Lonicerae Japonicae) Xin Yi Hua (Flos Magnoliae Liliflorae) Chuan Lian Zi (Fructus Meliae Toosendan) Bo He (Herba Menthae Haplocalycis) Ba Ji Tian (Radix Morindae Officinalis) Sang Bai Pi (Cortex Radicis Mori Albi) Sang Ye (Folium Mori Albi) Sang Shen (Fructus Mori Albi) Sang Zhi (Ramulus Mori Albi) Lian Zi Xin (Embryo Nelumbinis Nuciferae) He Ye (Folium Nelumbinis Nuciferae) Ou Jie (Nodus Rhizomatis Nelumbinis Nuciferae) Lian Xu (Stamen Nelumbinis Nuciferae) Qiang Huo (Radix Et Rhizoma Notopterygii) Ru Xiang (Resina Olibani) Mai Men Dong (Tuber Ophiopogonis Japonici) Bai Shao (Radix Albus Paeoniae Lactiflorae) Xi Yang Shen (Radix Panacis Quinquefolii) Ying Su Ke (Pericarpium Papaveris Somniferi) Yu Zhu (Rhizoma Polygoni Odorati) Huang Jing (Rhizoma Polygonati) Zhu Ling (Sclerotium Polypori Umbellati) Xia Ku Cao (Spica Prunellae Vulgaris) Wu Mei (Fructus Pruni Mume) Ge Gen (Radix Puerariae Lobatae) Mei Gui Hua (Flos Rosae Rugosae) Dan Shen (Radix Salviae Miltiorrhizae) Wu Wei Zi (Fructus Schisandrae Chinensis) Huang Qin (Radix Scutellariae Baicalensis) Hei Zhi Ma (Semen Sesami Indici) Bai Jie Zi (Semen Sinapis Albae) Ku Shen (Radix Sophorae Flavescentis) Fang Ji (Radix Stephania Tetrandrae) .

prolonged use may cause gastrointestinal irritation Da Suan (Bulbus Allii Sativi). avoid prolonged exposure to sunlight Dang Gui (Radix Angelicae Sinensis). contraindicated in intestinal obstruction. 2d. 2c Lu Hui (Herba Aloes). 2d. 2b Jiang Huang (Rhizoma Curcumae Longae). 2d. 2b Ze Xie (Rhizoma Alismatis). 2b Yi Yi Ren (Semen Coicis Lachryma-jobi). 2b Huang Lian (Rhizoma Coptidis Chinensis). 2d. colitis. 2b Du Huo (Radix Angelicae Pubescentis). hemorrhoids.Appendix 1 360 • Herb Toxicities & Drug Interactions: A Formula Approach Ding Xiang (Flos Caryophylli) Pu Gong Ying (Herba Taraxaci Mongolici) Gua Lou (Fructus Trichosanthis Kirlowii) Gua Lou Ren (Semen Trichosanthis Kirlowii) Gou Teng (Ramulus Uncariae Cum Uncis) Yu Mi Xu (Stigma Zeae Maydis) Sheng Jiang (uncooked Rhizoma Zingiberis Officinalis) Da Zao (Fructus Zizyphi Jujubae) ACCORDING Class 2 2a 2b 2c 2d TO CLASS 2 CHINESE MEDICINALS BOTANICAL SAFETY HANDBOOK Herbs for which restrictions apply unless directed by a qualified expert For external use only Not to be used during pregnancy Not to be used while nursing Other specific use restrictions Niu Xi (Radix Achyranthis Bidentatae). 2b Shan Zhu Yu (Fructus Corni Officinalis). 2b He Huan Pi (Cortex Albizziae Julibrissinis). 2d. during menstruation Chuan Xin Lian (Herba Andrographidis Paniculatae). 2b Qing Hao (Herba Artemisiae Annuae Seu Apiaceae). contraindicated in difficult or painful urination Yan Hu Suo (Rhizoma Corydalis Yanhusuo). 2d. 2b Tian Nan Xing (Rhizoma Arisaematis). contraindicated in bile duct obstruction . 2b. 2b Yin Chen Hao (Herba Artemisiae Yinchenhao). 2b. 2b. 2b Ai Ye (Folium Artemisiae Argyi). 2d. 2b. 2b. contraindicated in menorrhagia Shi Chang Pu (Rhizoma Acori Graminei). 2b. 2c Zhang Nao (Camphora). not for long-term use Rou Gui (Cortex Cinnamomi Cassiae). 2d. 2d. 2b. 2b Xi Xin (Herba Asari Cum Radice). contraindicated in hemorrhagic diseases Sheng Ma (Rhizoma Cimicifugae). not for long-term use Hong Hua (Flos Carthami Tinctorii).

2b Zhe Bei Mu (Bulbus Fritillariae Thunbergii). 2b Yi Mu Cao (Herba Leonuri Heterophylli). not for long-term use Wu Zhu Yu (Fructus Evodiae Rutecarpae). 2d. 2b Pi Pa Ye (Folium Eriobotryae Japonicae). 2b Chuan Bei Mu (Bulbus Fritillariae Cirrhosae). 2d. etc. contraindicated in hypertension Huang Bai (Cortex Phellodendri). 2b Bai Guo Ye (Folium Ginkgonis Bilobae). 2d. 2d. 2b. 2d. 2d. contraindicated in diarrhea Ma Huang (Radix Ephedrae). 2b Suo Yang (Herba Cynomorii Songarici). 2d. 2d. not for long-term use Yin Yang Huo (Herba Epimedii). contraindicated in anorexia. 2d. 2b Rou Dou Kou (Fructus Myristicae Fragrantis). 2d. 2d. 2b Mo Yao (Resina Myrrhae). 2d. 2d. Mai Ya (Fructus Germinatus Hordei Vulgaris). 2b. contraindicated in difficult urination Tan Xiang (Lignum Santali Albi). contraindicated in all hemorrhagic disorders Jie Geng (Radix Platycodi Grandiflori). 2b San Qi (Radix Notoginseng). 2b Gou Qi Zi (Fructus Lycii Chinensis). 2b. contraindicated in excessive uterine bleeding Song Qi (Rhizoma Nardostachydis). 2b. bulimia. 2b Chuan Xiong (Radix Ligustici Wallichii). liver disorders. contraindicated in intestinal obstruction.Appendix 1 Three Important Types of Potential Medicinal Toxicity • 361 E Zhu (Rhizoma Curcumae Zedoariae). 2b Ban Xia (Rhizoma Pinelliae Ternatae). do not exceed dose Lian Qiao (Fructus Forsythiae Suspensae). Fu Pen Zi (Fructus Rubi Chingii). contraindicated in constipation & stomach distention Ren Shen (Radix Panacis Ginseng). contraindicated in ulcers & gastritis He Shou Wu (Radix Polygoni Multiflori). contraindicated in diseases involving the parenchyma of the kidney . may potentiate MAOinhibitors Gan Cao (Radix Glycyrrhizae Uralensis). 2b. 2d. glaucoma. 2b Dan Pi (Cortex Radicis Moutan). 2b Di Gu Pi (Cortex Radicis Lycii Chinensis). hypertension. not for prolonged use. etc. 2d. 2d. 2d. 2b Chuan Niu Xi (Radix Cyathulae). contraindicated in spitting blood & TB Yuan Zhi (Radix Polygalae Tenuifoliae). contraindicated in diarrhea Tao Ren (Semen Pruni Persicae). 2b Sheng Di (uncooked Radix Rehmanniae Glutinosae). 2b Hou Po (Cortex Magnoliae Officinalis). 2b Lian Zi (Semen Nelumbinis Nuciferae). 2d. not for long-term use Mu Zei Cao (Herba Equiseti Hiemalis). contraindicated in diarrhea Shu Di (cooked Radix Rehmanniae Glutinosae). 2d. contraindicated in diarrhea Da Huang (Radix Et Rhizoma Rhei). contraindicated in diabetes.

contraindicated in blockage of the bile duct. not for long-term use Chuan Jiao (Pericarpium Zanthoxyli Bungeani). 2b Suan Zao Ren (Semen Zizyphi Spinosae). 2b ACCORDING TO CLASS 3 CHINESE MEDICINALS BOTANICAL SAFETY HANDBOOK Class 3 Herbs which require the following labeling. 2d. 2b Hu Lu Ba (Semen Trigonellae Foeni-graeci). 2b Kuan Dong Hua (Flos Tussilaginis Farfarae). 2b. acute diarrhea. “To be used only under the supervision of an expert qualified in the appropriate use of this substance” Fu Zi (Radix Lateralis Praeparatus Aconiti Carmichaeli) Ku Lian Pi (Cortex Radicis Meliae Azerdachis) Xing Ren (Semen Pruni Armeniacae) Shi Liu Pi (Pericarpium Punicae Granati) ACCORDING TO CLASS 4 CHINESE MEDICINALS BOTANICAL SAFETY HANDBOOK Class 4 Herbs for which insufficient data are available for classification Jin Qian Cao (Herba Desmodii Seu Lysimachiae) . early stage dysentery Tian Hua Fen (Radix Trichosanthis Kirlowii). He Zi (Fructus Terminaliae Chebulae). 2d. 2d. etc. contraindicated in acute cough.Appendix 1 362 • Herb Toxicities & Drug Interactions: A Formula Approach Pu Gong Ying (Radix Taraxaci Mongolici Cum Radice).

CONTENTS Nephrotoxic Drugs Drugs Known to Cause Cholestasis Drugs Known to Cause Hepatocellular Damage Drugs That Have Caused Aplastic Anemia APPENDIX 2 WESTERN DRUGS thiazides vancomycin zoxazolamine NEPHROTOXIC DRUGS acetazolamide aminoglycosides aminopyrine aminosalicylate amphotericin ampicillin cephalothin cisplatin colistin cotrimoxazole cyclophosphamide dextran (LMW) erythromycin fenoprofen furosemide ibuprofen indomethacin mannitol methicillin methoxyflurane mithramycin naproxen oxacillin penicillamine pentamide phenacetin phenindione phenylbutazone polymixin B quinine rifampin salicylates sulfonamides tetracyclines DRUGS KNOWN TO CAUSE CHOLESTASIS aminosalicylic acid androgens azathioprine benzodiazepines carbamazepine carbarsone chlorpropamide propoxyphene estrogens penicillin imipramine meprobamate methimazole nicotinic acid progestins penicillin phenothiazines oral contraceptives sulfonamides sulfones erythromycin estolate DRUGS KNOWN TO CAUSE HEPATOCELLULAR DAMAGE acetaminophen allopurinol aminosalicylic acid .

Appendix 2 364 • Herb Toxicities & Drug Interactions: A Formula Approach amitriptyline androgens asparaginase aspirin azathioprine carbamazepine chlorambucil chloramphenicol chlorpropamide dantrolene disulfiram estrogens ethanol ethionamide halothane ibuprofen indomethacin iron salts isoniazid MAO-inhibitors mercaptopurine methotrexate methoxyflurane methyldopa mithramycin nicotinic acid nitrofurantoin oral contraceptives papaverine paramethadione penicillin phenobarbital phenazopyridine phenylbutazone phenytoin probenecid procainamide propylthiouracil pyrazinamide quinidine sulfonamides tetracyclines trimethadione valproic acid DRUGS THAT HAVE CAUSED APLASTIC ANEMIA acetazolamide amphotericin arsenicals aspirin bismuth carbamazepine carbimazole carbutamide chloramphenicol chlordiazepoxide chlorothiazide chlorpheniramine chlorpromazine chlorpropamide colchicine dinitrophenol indomethacin mephenytoin meprobamate methimazole oxyphenbutazone penicillin perchlorate phenacetin phenylbutazone phenytoin primidone promazine pyrimethamine quinacrine ristocetin streptomycin sulfonamides tetracycline thiocyanate thiouracil tolbutamide trifluoperazine trimethadione tripelennamine .

APPENDIX 3 POSSIBLE HERB-DRUG INTERACTIONS Medicinal Sheng Ma (Rhizoma Cimicifugae) May interact with Estrogens OCs Antihyperlipidemics Potential effects May decrease response to estrogen Possible additive effect Possible additive effect Dang Gui (Radix Angelicae Sinensis) Anticoagulants Antiplatelet agents Estrogens May result in estrogen excess Possible additive effect Sheng Jiang (uncooked Rhizoma Zingiberis Officinalis) Ren Shen (Radix Panacis Ginseng) Anticoagulants Antiplatelet agents Hypoglycemic drugs Furosemide Digoxin Possible additive effect Decreased diuretic effect Increased serum concentration Headache. visual hallucinations. tremor. manic episodes Decreased warfarin effect MAO-inhibitors Anticoagulants Antiplatelet agents .

CNS stimulation Kun Bu (Thallus Algae) Gan Cao (Radix Glycyrrhizae Uralensis) Thyroid hormones Spironolactone Cardiac glycosides Thiazide diuretics Corticosteroids Cyclosporine MAO-inhibitors Ma Huang (Herba Ephedrae) Oxytocin Methyldopa Beta-blockers MAO-inhibitors Theophylline Cardiac glycosides Antihyperlipidemics Anticoagulants Che Qian Zi (Semen Plantaginis) Possible additive effects May interfere with anticoagulant therapy May interfere with drug level assay Ci Wu Jia (Radix Eleuthrococci Senticosi) Jiang Huang (Tuber Curcumae Longae) Digitalis Antiplatelet agents Possible additive effects .Appendix 3 366 • Herb Toxicities & Drug Interactions: A Formula Approach Medicinal May interact with Estrogens Corticosteroids Potential effects Possible additive effect Shan Zha (Fructus Crataegi) Antihypertensives Digoxin Increased risk of bleeding Possible additive effect May interfere with thyroid hormone replacement Decreased diuretic effect Possible digoxin toxicity May cause hypokalemia May decrease response to these drugs May increase risk of hypertensive crisis May cause hypertension.

Based on many German “E” Commission findings. 2003. Seattle: Eastland Press The most widely used English language reference for Chinese herbal medicinals. but contains many Oriental medicinals along with actions and pharmacology. Andrew. Bensky. 1996. Physicians’Desk Reference for Herbal Medicines. 1993. popular combinations with other medicinals. 2 nd ed.” http://acupuncture. & Gamble. Well-researched and clearly written. Chinese Herbal Medicine: Formulas and Strategies. Montvale. dosages. where it is grown and harvested. Dan. Blackwell. Almost 300 primary formulas are listed along with their ingredients. Bensky. Each entry contains illustrations of the medicinal’s wild appearance. Seattle: Eastland Press Currently the “gold standard” reference for Chinese medicinal formula prescriptions. indications for their use. and cautions and contraindications. Dan.com/Herbology/Toxic. analysis of their medicinals. and literature references. Chinese Herbal Medicine: Materia Medica. & Barolet. “Cases of Herb Toxicity: Adverse Events Involving Certain Chinese Herbal Medicines and the Response of the Profession. as well as cautions and contraindications. E. information on its proper preparation and prescription. Richard. contraindications. A must for the library of any serious herbalist.APPENDIX 4 ANNOTATED BIBLIOGRAPHY Tyler.. Varro.htm . 1990. precautions and adverse reactions. Randall. NJ: Thomson Medical Economics A recent addition to the PDR family. Used in many colleges of Oriental medicine for training herbal practitioners. Mostly Western in focus.

Kelvin. 2003. Herb Contraindications and Drug Interactions. Contains an extensive bibliography with links to many Websites related to herbal medicinals. 2 nd ed. Undated.Appendix 4 368 • Herb Toxicities & Drug Interactions: A Formula Approach A very concise and well-documented discussion of the most well-known cases of Chinese medicinal toxicity and interaction.. 2001. 2003.htm A brief but informative article written shortly after the FDA sent out its advisory letter. Many tables showing the interactions and their consequences. Ph. Lily. Chen.itmonline. Bob. Lu-wen.” http://acupuncture. “Safety Issues Affecting Chinese Herbs: The Case of Asarum. Sandy: Eclectic Medical Publications An easy-to-consult listing of both Western and Oriental medicinal herbs written by a naturopathic physician. Chan. Subhuti. Highlights and thoroughly analyzes the core formulas comprising the Chinese herbal medicinal pharmacy. Flaws. Dharmananda. Gao.com/Herbology/aristo. “Aristolochic Acid and Chinese Herbs. 2001.htm An excellent on-line discussion of Xi Xin (Herba Asari Cum Radice) in particular and toxicity issues in Chinese medicine in general. 1998. Brinker. Uses Wiseman and Ye’s Chinese medical terminology throughout. Beijing: Study Center Press A Chinese language text on the toxicity of many Chinese medicinals. You Du Zhong Yao Lin Chuang Jing Yao (Essentials of the Clinical Use of Toxic Chinese Medicinals). Boulder: Blue Poppy Press An excellent reference or textbook for both the beginning and advanced herbalist. A must for the pharmacology scholar interested in this topic. Good list of references plus links to several Websites. Contains many useful footnotes for finding further information on these issues. John..D. London: Taylor & Francis A very readable and informative guide to interactions between Eastern and Western medicinal substances. 2nd ed. Francis. Interactions Between Chinese Herbal Medicinal Products and Orthodox Drugs. Underscores that many of the current concerns about Chinese medicinal toxicity are overblown. If this .” www. Appendix section lists medicinal advisories by condition and Western orthodox drug interactions. 70 Essential Chinese Herbal Formulas. Also lists many ready-made medicine interactions. & Cheung.org/arts/asarum.

1997. English-Chinese Chinese-English Dictionary of Chinese Medicine. 1996. LAc. Herbs are classed in four categories with conditions for their safe prescription and consumption.’s excellent standard translational terminology.” Mayo Clinic Proceedings. John S. and therapeutic uses are all covered for individual medicinals. A Practical Dictionary of Chinese Medicine. eds. an Herbal Source of Ephedrine. M. Chemistry. 2nd ed. 1998.pdf An on-line essay about toxicity in Chinese medicine. An excellent compendium of research from the FDA and other sources. . Another must for all serious English language speaking practitioners of Chinese medicine. Brookline: Paradigm Publications A relatively complete Chinese medical dictionary using Wiseman et al. In general. Samenuk. Kee Chang. ed. Muddy Water. The first choice for herbalists worldwide. it would be a useful reference for poison control centers and Western physicians who treat toxicology cases. McGuffin.. http://mayo. Feng. actions. Wiseman. Undated.. New York: CRC Press A must for the pharmacologist who is studying this subject.” http://www. Wiseman. adverse effects. 2002. Michael et al. “Adverse Cardiovascular Events Temporally Associated With Ma Huang. 1999.Appendix 4 Annotated Bibliography • 369 were available in English. et al. Many molecular diagrams. #77 One of the better articles highlighting the dangers of Ma Huang (Herba Ephedrae) intoxication. David. pharmacokinetics. Nigel & Ye.D. New York: CRC Press A relatively complete guide supported and endorsed by AHPA which lists and categorizes the safety of both Western and Oriental individual medicinals. Huang.edu/proceedings/2002/jan/7701a1 Varner. Nigel. “Green Medicine.com/PDFs/GreenMedicine2. cautions that the current concern is largely overblown and based on false assumptions and concerns. American Herbal Products Association’s Botanical Safety Handbook. The Pharmacology of Chinese Herbs. Changhsa: Hunan Science & Technology Press The standard for precise terminology in Chinese medicine.craneherb.

.

55 acute prostatitis. 237 acute hepatitis. 129 allergic rhinitis. 324 acute tonsillitis. 46. 271. 180 acute enteritis. 67 abdominal migraine. 324 acute transverse myelitis. 257.GENERAL INDEX A A-V block. 350 acute cervical myositis. 94 Addison’s disease. 268. 31 acute suppurative infections. 122. 29 acute nephritis. 305 acute abdominal pain. 27. 180 acute leukemia. 31 acute pyelonephritis. 30. 46. 149. 91. 149 acute hemorrhagic esophagitis. 218. 353 allergic colitis. 46. 290 abnormal vaginal discharge. 312 acute pancreatitis. 122 acute conjunctivitis. 149 acute cystitis. 61 AHPA. 375 albuminuria. 319 adrenal insufficiency. 361. 365. 159. 46 acute bronchitis. 27. 218. 322 acute icteric hepatitis. 330 . 250 allergic purpura. 363. 245. 300. 248 agalactia. 139. 159. 77 acute bacillary dysentery. 23-24. 65.

261-263. 248. 211-212. 354 amenorrhea. 130. 130. 238-239. 204. 199. 303. 74. 83. 265. 148. 295. 104. 16. 270. 337. 246-247. 312. 88. 152. 126. 145-146. 185. 103. 260. 204. 293. 293. 190. 46. 251. 36. 193. 78. 198. 122123. 134. 43. 137. 178179. 192-193. 58. 287. 29. 192-193. 116-118. 70. 47-48. 160-162. 220. 341. 162. 235. 301-302. 55. 286. 94 amytriptiline. 302-303. 95-96. 272-273. 61. 191-192. 32. 80. 165-166. 262. 211. 60. 71. 68. 173. 173. 200-201. 126. 88. 281. 269. 272. 145-146. 222-223. 33. 306. 155. 211. 306. 99. 78. 101. 125. 328. 298. 264. 81. 95. 229. 160. 57. 206-207. 230. 351. 10. 124. 56. 246. 200-201. 233. 330 anxiety. 140. 316-317. 126-127. 181. 277. 110-112. 325. 285. 209. 160-162. 39. 122. 264 arched-back rigidity. 228. 280-281. 62. 253. 204. 40-42. 83. 262. 236-238. 137. 147. 242-243. 55. 375 amoebic dysentery. 116. 253. 49. 291. 236. 217-218. 36. 288. 182. 353 anxiety neurosis. 343. 370 asthma. 305-306. 139 aphasia. 130. 223. 343-344. 340. 374 ascites. 157. 333.145147. 335. 271. 188. 4. 69. 189. 300. 272. 316-317. 256. 275. 365. 273. 150. 252. 300 atonic constipation. 107. 10. 36. 157. 110-112. 125. 169. 145-146. 320. 267-269. 254. 36-37. 299. 192-193. 215. 126. 42-44. 160. 348. 139. 226. 343-345. 159. 337. 196. 225. 53. 316-317. 213. 270. 95-96. 78. 153. 117-118. 303. 95. 50. 69. 259. 213. 88. 275-276. 287288. 230. 211. 117. 130. 80-81. 74. 226. 97. 239. 202. 134. 142-143. 126. 83-85. 241 American Herbal Products Association. 185. 88. 78. 217-218. 98-99. 114. 307. 49. 333-334. 261-262. 320. 178-179. 57. 88. 347 antithrombotic agents. 108-109. 325. 239. 134. 329-330. 233. 32. 348. 286. 176. 113. 284. 226. 239. 369-370 angina pectoris. 148. 323 apraxia. 337. 246248. 116118. 197. 339. 343-344 amyotrophic lateral sclerosis. 246-247. 241. 32. 117-118. 293. 341. 175. 83. 217-218. 51. 175-176. 339 aspirin. 253. 123. 123. 334 apthous ulcers. 363. 160. 109.General Index 372 • Herb Toxicities & Drug Interactions: A Formula Approach aluminum hydroxide. 266-267. 178-179. 302 aristolochic acid. 295. 30. 165-166. 74. 282-283. 333. 178-179. 101. 297. 153. 306. 110-111. 200-201. 137. 230. 205. 166. 217-218. 102. 80. 61-62. 98. 169. 275. 83. 165-166. 52. 311. 275. 231. 172. 92. 145 anemia. 48. 257. 148. 104. 173. 199. 90. 137. 77-78. 85. 302-303. 43. 98. 309. 285. 295. 325. 185. 207. 283. 188. 314 antibiotics. 178. 80. 282. 275. 311. 245. 147. 157. 309-311. 132. 330. 99. 280281. 156 atropine. 330-331. 278-279. 206-207. 149. 290. 316- . 62. 334 appendicitis. 139. 257. 224. 154. 340. 65. 165-166. 187-188. 242. 294. 291. 130. 110-112. 107. 309. 213. 49. 62. 251. 129. 38. 145 amylase. 44. 311-312. 13-14. 272. 162. 336. 182. 260. 206. 253. 280. 371-372 antidiabetic agents. 157. 300 anal fissure. 350 anticoagulants. 199.

51. 125. 165. 209. 146. 82. 45. 251. 116. 176. 47. 89. 263. 110. 228. 47. 48. 305 bronchial asthma. 36-37. 162. 157. 313. 204. 134. 147. 55. 78. 79. 120. 223. 296. 185. 220. 124. 147. 318. 300. 228. 185. 350 burning pain in the mouth. 85. 274. 298. 187. 248. 58 breast distention. 275. 117-118. 296. 309 bronchiolitis. 46 bleeding peptic ulcers. 192. 181 bloody stools. 49. 92. 235-236. 101. 338. 309. 269. 203. 208. 307. 190. 130. 300 bronchial pneumonia. 42-44. 330 aversion to cold. 188. 218. 243. 278. 195. 320. 40. 212. 122.General Index Herb Toxicities & Drug Interactions: A Formula Approach • 373 317. 83. 150. 332 bursitis. 110. 174. 107. 28. 47. 131. 29. 249. 304. 281. 139 beriberi. 190. 287. 339. 104. 288. 118. 217. 149 breast abscess. 291. 347 calcium gluconate. 43. 144. 282. 259. 13-14. 256. 197. 103. 115. 312 burns. 110112. 292 burping. 116. 354 black putrid stools. 343-344 autoimmune disorders. 34. 30. 345. 52. 317. 211. 152. 290. 95. 196. 90. 55. 175. 354 calcium. 351. 136. 322 bismuth subcarbonate. 122. 208. 138. 166. 53. 61. 73. 229. 168. 183. 330 B bacillary dysentery. 203. 129. 355 belching. 125 blocked urination. 197. 256. 251. 108. 32. 88. 68. 105. 339. 276. 199. 58. 245. 75. 188. 188 bronchitis. 171 C caffeine. 95. 142. 53. 150. 62. 212. 69. 112. 302. 298. 169. 294 basal metabolic rate. 53. 120. 233. 222. 345. 77. 113. 5. 159. 70. 330. 126-127. 46. 98. 272-273. 251. 341. 99. 165- . 287. 22 benign positional vertigo. 136 boils. 40. 56. 275. 150. 326. 145-148. 297. 145. 38. 36-37. 290. 264. 332 Belgium. 32. 242. 31. 246. 330 autonomic dystonia. 60. 337. 123. 92. 188 bronchiectasis. 103. 352. 136. 281. 296. 118. 311. 157. 303. 225. 175. 182. 78. 285. 28. 263. 122. 238. 139. 103. 53. 160. 294 aversion to wind. 351. 139. 218. 250. 185. 63. 267. 175 bodily weakness. 300. 118. 235. 49. 114. 346. 277. 278.

346. 253. 43. 139. 246-247. 256. 266. 206-207. 31. 177. 296. 257. 303. 196. 45. 320. 211. 99. 137. 300. 123. 246-247. 137. 165. 285. 148. 316-317. 132. 251. 87 candidiasis. 343-344 calluses. 122. 110-112. 62. 173. 169. 309. 175. 228. 253. 191. 71. 337. 178-179. 178-179. 175. 117-118. 303. 220. 88. 55. 233. 185. 134. 211. 36. 275. 261-263. 192. 90. 217-218. 61. 103. 290. 231. 332 chronic gonorrhea. 137. 248. 269. 33-34. 126. 178-179. 225 cardiac glycosides. 205. 102. 159 . 249. 157. 49. 245. 305 cerebral arteriosclerosis. 126. 40 cardiac failure. 187-188. 202. 293. 204. 242. 372 cardiac insufficiency. 275. 180. 338. 332 cholera. 40. 114. 39. 341. 246-247. 14. 318. 57. 295. 322. 145-146. 330. 343-344. 83. 92. 323. 95. 165-166. 200-201. 296. 290. 160. 309-311. 311. 77. 294 cholera-like disorders. 225 cellulitis. 262. 114. 262. 165-166. 294. 79. 115. 285. 198. 280-281. 175 chronic arthritis. 145-146. 85. 339 chronic colitis. 113. 149. 83. 306. 320. 312. 144. 149. 309. 192-193. 300. 306. 275. 351. 298. 61 cerebral hemorrhage. 208. 157. 245. 295. 110-112. 316-317. 245. 27. 304. 291. 355. 78. 337. 268270. 290. 239. 324 carcinoma of the larynx. 124. 87 chlorpromazine. 243. 58. 226. 328. 370 cholecystitis. 200-201. 204. 222. 173. 211-213. 232 chronic gastritis. 229. 250 chronic endometritis. 85. 160. 176. 277. 51. 282. 183. 79. 213. 192-193. 78. 348 chest oppression. 123. 307. 299. 341. 275. 217-218. 293. 35. 154 cerebrovascular accident. 239. 169. 320. 343-345. 305. 69. 124. 144. 278. 235. 85. 306. 248 cardiogenic shock. 55.General Index 374 • Herb Toxicities & Drug Interactions: A Formula Approach 166. 314 cerebral thrombosis. 281. 189. 228. 332. 303. 285 carbuncles. 49. 262. 334 cerebrovascular disease. 260 cervical erosion. 341. 206-207. 137. 53. 99. 277. 156 chronic bronchitis. 287. 95. 259. 49. 220. 114. 173. 266. 43. 148. 190. 293. 149. 331. 217-218. 219. 239. 200201. 36. 354 calcium carbonate. 313. 195. 175. 139. 326. 351 chilblains. 75. 116. 206-207. 88. 152. 67. 38. 55. 253. 89. 103. 233. 280-281. 181. 316-317. 162. 162. 43. 311. 332 cholelithiasis. 133 cervical inflammation. 271 chemotherapeutic drugs. 203. 117-118. 275. 131. 350-351. 274. 204. 173. 192-193. 325. 280281. 98. 307. 94. 275. 295. 92. 134. 159. 104105. 239. 270. 120. 204. 340. 335-337. 213. 309. 149 central retinitis. 322.

151 chronic hepatitis. 88. 215. 302. 206. 114. 314 corticosteroids. 224. 340. 52. 31. 116. 264 chronic viral hepatitis. 166. 133 chronic sinusitis. 115. 300. 200. 282. 273. 74. 78. 339 clenched teeth. 109. 322. 34. 135. 163-165. 32. 226. 186. 56. 257. 181. 251. 156. 27. 139 chronic pediatric diarrhea. 319. 292. 272. 217. 209-210. 236. 118. 347. 209-210. 249. 97. 279. 198. 267. 208. 250. 219. 73. 311. 275. 283. 291. 324. 265. 309. 80-81. 351. 30. 339. 315. 185. 106. 234. 85. 348 common cold. 49. 219. 254. 367 convulsions. 2. 146. 156. 90. 187. 276. 242. 87. 98. 215. 190. 257. 27-28. 127. 249. 153. 226. 73. 230. 65-66. 297. 62-63. 65. 87 coronary artery disease. 216. 346. 51. 209-210. 283 chronic rhinitis. 268. 31. 122 chronic pelvic inflammation. 310. 106-107. 286. 296 circulatory failure. 215-216. 106-107. 278 chronic pharyngitis. 74. 214. 100. 42. 218. 153. 306. 353 climacteric disorders. 30. 228. 96-97. 106. 208 chronic salpingitis. 252. 52. 309 chronic urticaria. 232. 87. 136. 206. 40. 143. 320. 183. 191. 68. 281. 312. 317 cystitis. 51. 129 conjunctival hyperemia. 223-225. 111-112. 253. 197. 337. 235. 36. 268. 154. 242. 246. 88. 61. 58. 193. 245. 88. 159. 180 D death. 56. 74. 354 crystalluria. 16. 195 chronic renal failure. 157. 298. 193-194. 91. 197. 70. 206. 161. 342 chronic obstructive pulmonary disease. 132. 142. 186-187. 194. 310. 177. 109. 314 corneal ulcers. 296. 82. 191. 79. 175. 142. 65 chronic tracheitis. 288-289. 302-303. 288. 68. 305 chronic nephritis. 115. 228. 65 constipation. 80-81. 44. 46. 222. 4. 40. 334. 224. 172. 133. 189. 189-191. 321. 35. 286. 135. 37. 109. 234. 8-9. 285. 305 coma. 10. 275. 77. 1. 257. 79 chronic pelvic inflammatory disease. 238. 95. 119. 168. 192. 248. 129. 224. 302. 315. 28.General Index Herb Toxicities & Drug Interactions: A Formula Approach • 375 chronic hemorrhagic gastritis. 182. 216. 123. 102-104. 81. 161. 96-97. 283. 71. 69. 194. 49. 336 congestive heart disease. 335. 61 corns. 228. 46 cirrhosis. 82. 211. 163-165. . 61. 219. 265-267. 372 Coumadin. 72. 353 cor pulmonale. 196. 235. 254. 52. 92.

55. 298. 224. 287-288. 188. 245-246. 310. 172. 82-85. 200-201. 35. 171-172. 55. 312. 122. 193-194. 75. 186-187. 161. 189-194. 238. 156 depression. 261. 46-47. 10. 253. 148. 109. 306. 219. 326. 341. 88. 288. 172-173. 337. 33-34. 209-210. 106. 303. 164. 305. 197. 153. 219-220. 100. 109. 104. 339. 226. 213. 149. 322-324. 123. 104. 215. 134-135. 300-301. 180-184.General Index 376 • Herb Toxicities & Drug Interactions: A Formula Approach 263. 94. 51. 42-44. 204. 112. 332. 106-107. 210. 77-79. 290. 222-223. 198. 56. 97. 28-31. 207. 143-144. 150-151. 337. 49. 368 difficulty breathing. 252 . 348 degenerative joint disease. 335. 147-154. 94. 289. 143144. 216. 346-348. 351352. 88. 70. 296. 70-71. 104. 40-42. 222. 160. 130-132. 91-92. 276. 228. 163-165. 350 dilated pupils. 249. 340 dimming of consciousness. 102. 106. 36-38. 288. 106. 139. 123. 49. 111. 168. 137. 326. 114-115. 126. 267271. 245. 110-113. 137. 66. 65-66. 28-31. 163-165. 209-210. 61-63. 123. 268-269. 101. 314-322. 286. 247. 336-337. 298. 107. 324. 104. 57. 321. 231. 353-354. 219. 242. 36. 340. 194. 334. 192. 88. 279. 351. 126-127. 77. 305. 164-165. 282. 51. 96. 293. 310. 196. 100. 282-283. 56. 87-89. 73. 293. 40-45. 115. 186. 109-112. 175. 68. 322. 232. 198. 276. 59. 317. 332-338. 310. 319. 302. 339-340 drug dependency. 44. 233-234. 102-104. 162. 186187. 186-187. 97-100. 248-249. 195. 314 dry mouth. 102. 228. 153. 297-298. 310. 209. 33. 250-253. 178-179. 318-320. 91. 142-143. 94. 314. 275. 181-183. 253. 154. 261-267. 135. 46. 224. 68. 303. 123. 189-190. 117. 242. 283. 342. 52-53. 87. 74. 340-341. 47. 115. 288. 123. 314-315. 203. 148. 187. 59. 258. 49. 139-141. 51. 333-334. 321. 313-316. 346 dry skin. 161. 258-260. 372 dizziness. 224. 275-276. 104. 32. 118-120. 213-216. 142. 296-297. 225-226. 189. 67. 156-157. 319 diarrhea. 312 digitalis intoxication. 335. 319. 269-270. 49. 176. 189. 219. 96-97. 210. 353 dexamethazone. 341-342. 332. 310. 312. 31. 343-344. 159. 301. 218-219. 301-303. 63. 185. 272-277. 197. 142. 295. 278-279. 257-258. 229-234. 310. 180. 328. 328-329. 249. 46. 243. 74. 44. 177. 135. 30. 303. 245. 238. 153. 286. 222-224. 189-190. 115. 303. 134. 89-92. 249. 186-190. 283. 210. 177. 287. 367-368 difficult urination. 161. 298. 234. 132. 305-306. 68. 51. 220. 312. 145. 209-216. 226. 123-127. 234. 219. 206-207. 306-307. 63-65. 80. 80-81. 241. 329-330. 156. 68. 282. 60. 80. 301. 351 drooling. 10. 56-57. 301-302. 135. 290. 280. 186. 216. 264 dry heaves. 310. 302 diuretics. 106-107. 132. 315 difficulty swallowing. 298. 282. 61. 339. 212. 258-259. 342. 96. 84. 276. 37. 164-169. 73. 242. 325. 354-355. 158-159. 192-193. 41. 56. 134-136. 102. 261. 328. 302-304. 200. 251. 273. 337. 83. 344. 251-253. 300 diabetes mellitus. 236239. 235. 122-123. 263-265. 314-315. 105-107. 119. 194. 339-340. 234. 286. 314. 310-311. 81. 216. 279281. 289-294. 177. 346-347. 189. 193. 190. 197. 248. 82.

56. 73. 250-251. 188. 27-28. 49. 88. 77. 29. 27. 245 flu. 61. 77 Food & Drug Administration. 126. 303. 271 edema during pregnancy. 278. 175 dysentery. 302. 354 fetotoxicity. 324 endometriosis. 145. 248.General Index Herb Toxicities & Drug Interactions: A Formula Approach • 377 duodenal ulcers. 10. 250. 251. 324. 39. 293. 67. 134. 284. 118. 320. 324 food poisoning. 350 fever of unknown etiology. 150. 341. 288. 316-317. 303. 197. 49. 298. 136. 78. 165. 254. 241 enlargement of the tongue. 142. 47. 346 encephalitis. 374-375 fearful crying. 133. 147. 271 emotional disorders. 107. 334 erysipelas. 185-186. 211. 95. 345. 292. 275. 181 failure to thrive. 180 edema during menstruation. 99. 253. 312. 51. 319. 292. 276. 103. 334 eye infections. 296. 312 ephedrine. 204. 347. 306. 56. 100 . 285. 30. 343-344 epidemic conjunctivitis. 120. 298. 154 eczema. 239. 149. 148. 309. 218. 206-207. 114. 278-279. 256. 368 E ear infections. 173. 15 fever. 55. 36. 122. 327-328. 260. 218. 311. 254. 107. 217-218. 256. 178-179. 65. 9 fractures. 109. 142. 180 eclampsia. 149. 35. 122-123. 280-281. 78-79. 127. 197-198. 276. 147. 31. 2. 35. 120 fibrocystic breast disease. 68-70. 212. 145. 235. 209. 14. 16. 73. 43. 35. 180 epilepsy. 149 essential hypertension. 53. 282. 260. 295. 263. 351. 218 epididymitis. 114. 68. 212. 175. 303. 337. 9. 165-166. 12. 117-118. 149. 180 F facial edema. 44. 123. 290. 262. 145-146. 260 ectopic pregnancy. 157. 46-47. 218. 294. 160. 137. 286. 162. 269. 44. 163. 92. 44. 206. 114-115. 314. 90. 300-301. 88. 200-201. 161. 192-193. 44. 246-247. 322. 165. 88. 258 ferrous sulfates. 83. 133. 270. 51. 177 FDA. 74. 136. 27. 77. 334-335. 44. 242. 110. 287. 209. 213. 122. 81. 13. 115. 282. 35. 48-49. 110-112. 149 emphysema. 257.

212. 66. 192-193. 142. 291. 219-220. 129. 159 gouty arthritis. 134-135. 175. 353 frostbite. 140. 88. 195 German. 60. 70. 195-197. 35. 341. 237. 297. 317. 344 gastroesophageal reflux disorder. 283. 213. 117. 234-239. 293. 104. 322. 81. 215. 109. 333. 87 functional uterine bleeding. 283 generalized lack of strength. 259-261. 79. 283 gastric neurosis. 245. 314-317. 178-182. 336-337. 62-65. 97. 213. 331. 253. 191 fright reversal. 90. 179. 112. 310-312. 29. 61 hangover. 92. 30. 114. 203. 77. 342 glossitis. 30. 189. 77. 203 gastric ulcer. 102. 46-48. 283 GERD. 83. 296-298. 287. 157-158. 109. 305. 272-273. 88. 191 habitual miscarriage. 242. 302 generalized soreness. 104. 95-97. 288. 373 gingivitis. 92. 246. 61. 262 genital infections. 257. 278. 122. 320. 329. 67. 137. 101. 273. 151. 75. 112. 185. 89. 350-351 goiter. 231.General Index 378 • Herb Toxicities & Drug Interactions: A Formula Approach frequent urination. 79. 37-38. 126-127. 171 H habitual constipation. 164. 105-107. 71. 161. 118-119. 91. 212. 347-348. 55. 181. 41-44. 233. 125. 114. 188. 175. 160. 155. 52. 31. 181-182. 37. 263. 32-33. 230-231. 87 gastrectasis. 94. 74. 270. 134. and pain. 31. 103. 123. 169. 129. 285. 171. 48. 203. 224. 207. 149 G gallstones. 63-64. 153. 109-110. 228. numbness. 159. 296 gastroenteritis. 162. 32. 186. 342 furuncles. 300. 83. 86. 44. 165. 35. 294. 292. 280-282. 61. 165. 177. 195 gastrointestinal flu. 276. 223-225. 305-306. 83. 31. 55-60. 157-158. 328 glaucoma. 303. 132. 126. 268. 262 generalized tension. 148. 55 gastrointestinal neurosis. 67-69. 123. 249. 141 gonorrhea. 367 glomerulonephritis. 186. 165. 175. 144-145. 301 gangrene. 114 heart arrhythmias. 328 glutamic acid. 246-247. 343-344. 323-325. 189. 51-52. 265-268. 269. 30. . 88. 180 genitourinary infections. 150. 301.334. 42-44. 290. 31. 286. 332 gastroptosis. 209-210.

180 hiccup. 149. 136. 192193. 51-52. 293. 27. 115. 332. 191. 333-334. 350 heart disease. 238. 61. 96. 28-31. 7071. 270. 326. 341. 236.General Index Herb Toxicities & Drug Interactions: A Formula Approach • 379 137. 37-38. 142. 215. 263. 223-225. 178-182. 280-282. 42. 343-344. 264. 192-193. 62-63. 189. 144-145. 209-210. 334. 77. 253. 335 hydrocele. 222-224. 350 hemorrhagic enteritis. 249. 200. 297. 335. 114. 314. 247. 159. 116. 353 hematuria. 228. 137. 82-85. 162. 310-312. 78. 33. 305. 134-135. 234-239. 45. 189. 127. 106-107. 49. 331. 71. 104. 343-344. 258. 149. 206-207. 202. 265-268. 67. 271 hemoptysis. 137. 51. 295. 178-179. 283. 36. 220. 47. 329. 52-53. 94. 279-280. 257. 35. 61. 339 heart palpitations. 151. 306. 109-110. 77-79. 303. 245. 248. 311. 51-52. 276. 302-303. 106107. 258-267. 260 hemophilus vaginitis. 305-306. 56. 275-276. 219. 229-234. 28. 123. 236239. 317. 288. 325. 15. 151. 322324. 88. 346-347. 289. 325. 175. 186. 132. 310. 44. 275-276. 285. 283. 32-33. 342. 336-337. 242. 62. 181-183. 283. 257 hernia. 40-42. 189. 124. 317. 40. 317 hemiplegia. 125-127. 139. 231. 337. 135-136. 157. 231. 225-226. 164. 160. 200. 87. 246. 16. 245 hernia pain. 129. 268-269. 223. 314-316. 314-317. 168. 117. 147-151. 46-48. 219-220. 149. 161. 149. 134-135. 146. 108. 328. 292-293. 163. 318-320. 95. 69. 79. 80. 118-119. 312. 62-65. 168. 213. 139-141. 246. 157-158. 340-341. 61. 198. 339. 314. 182. 41-44. 129. 243. 153. . 118. 49. 272-273. 281282. 272. 209-210. 321-322. 293. 195-197. 192. 67-69. 186-187. 148. 38. 75. 114-115. 70. 254. 297-298. 189-190. 251. 198. 56-57. 354 hyperparathyroidism. 275. 288. 123. 83. 291. 347-348. 207. 148. 61. 92. 98. 269-272. 126. 200-201. 77. 305-306. 63. 217. 59. 275. 147. 27. 13. 254. 314 high fever. 142. 347. 29. 97-100. 94. 194. 156-157. 341. 259261. 30. 291. 132. 220. 353 hemorrhoids. 67-69. 339-340. 32. 167. 130. 353 hemafecia. 292 hepatic necrosis. 59. 320. 283 hydrochloric acid. 95-97. 68. 31. 153-154. 65. 350-351 hyperkalemia. 230-231. 143-144. 180. 310-311. 153. 44. 140. 267. 268. 91. 301. 105. 175. 164-166. 172-173. 192. 37-38. 34. 164. 253. 242. 166. 169. 303. 234-235. 322 hepatitis. 112. 75. 246-247. 27-28. 112. 337 hepatoxicity. 346 heart failure. 222-223. 55-60. 211. 52-53. 296. 253. 329-330. 235. 323-325. 222 hypertension. 352. 328. 87-89. 209-216. 30. 296-298. 186. 150. 219. 110-113. 41. 261. 35. 228. 264-265. 36-37. 302. 79 herpes infections. 242. 14-15. 310. 43. 332-337. 177. 169. 85. 55. 91-92. 273. 303. 251. 37. 79. 77. 196-198. 287. 256. 103. 257. 241. 118-119. 268. 237. 145-146. 319. 366 hepatic coma. 155. 129. 252. 73. 252. 203-204. 292. 198. 125. 160-162. 105-107. 228. 268. 89. 102. 216. 280.

293. 113. 32. 229. 169. 338-339. 185. 313. 272-274. 67. 183. 231. 316-317. 265. 71. 245. 288. 183. 341. 261-262. 318. 335. 137. 115. 43. 177. 48. 69. 124. 239. 259-260. 202 insulin. 248. 246-247. 137. 200. 144. 110-112. 79. 325. 346-347. 346 hypofunction of the anterior pituitary. 144. 303. 368 intestinal tuberculosis. 172-173. 198. 228-229. 243. 75. 94. 296-298. 117118. 9. 332 intestinal colic. 277. 145-146. 198. 33. 173. 309. 204. 335. 253. 139. 89. 129-131. 281. 254 I idiopathic halitosis. 204. 49. 129. 283. 330 impaired memory. 92. 342. 159. 235. 351-352. 168-169. 264-265. 259. 200-201. 75. 311. 248 iron. 64. 225 hysteria. 269. 120. 334. 370 irritable bowel syndrome. 264 impotence. 159. 239. 204. 300 inguinal hernia. 178179. 61. 328. 35. 248 intestinal obstruction. 370 . 83. 152. 119-120. 198. 239. 155. 78. 248. 274. 124. 217-218. 220. 126-127. 157. 127. 352. 346-347. 79. 53. 233. 105. 248 hypothyroidism. 291. 225. 213. 257. 223. 272. 281. 139. 335. 30. 70. 366. 277. 355. 33-34. 67. 307. 125. 323. 297-298. 41. 34. 269 isoniazid. 242-243. 342. 355. 45. 52-53. 152. 149. 79. 187. 71. 322. 31. 372 hypopituitarism. 141. 323. 149. 51. 278 influenza. 258. 268-269. 95. 252. 43. 70. 342. 148. 165. 307. 120. 235. 337 infertility. 112-113. 105. 242. 372 hypertensive encephalopathy. 199. 352. 175-176. 190. 273. 159. 297. 92. 250. 249. 177. 192. 222. 206-207. 61. 260 hyperthyroidism. 181-182. 317 intestinal fever. 165-166. 206 incomplete pyloric obstruction. 338. 123. 280-281. 343-344. 305. 332. 115-117. 183. 180. 212 immunosuppressive therapy. 304. 134. 318-319. 204. 274. 37-38. 180. 120. 190. 313. 168-169. 334. 168 indigestion. 72. 350. 351 infantile convulsions. 245. 248 hypovolemic shock. 137-138. 60. 14. 42-44. 225. 89. 290-291. 245. 63. 355 intercostal neuralgia. 196. 160. 131. 144. 304. 223. 67. 88. 222223. 122. 137. 62-63. 190. 192-193. 89. 277. 176. 130.General Index 380 • Herb Toxicities & Drug Interactions: A Formula Approach 112-113. 70-71. 326. 55. 99. 173. 245. 275. 326. 332. 192-193. 320. 196. 220. 187. 259. 117 hypokalemia. 367. 27 infectious hepatitis. 77-79. 38. 338. 131. 45. 303-304. 288. 246. 173. 249. 175. 346. 129. 328. 318. 245. 242-243. 162. 127. 115. 250 intractable arthritis. 281. 254. 36-37. 220. 124. 306. 175-177. 77. 314. 139-140. 152. 189. 313. 233. 228229. 295. 211. 187. 310. 203. 94. 220. 222. 233. 249. 307. 337. 195-197. 103. 326. 298. 92. 167.

137. 61 levadopa. 197. 51. 253. 114. 47-48. 196. 243. 150. 124. 159 lumbar intervertebral disc herniation. 65 liver enlargement. 257. 65. 61. 125. 347. 131. 112. 259. 83-85. 58 lymphadenitis. 328. 58. 153. 280. 226. 159. 220. 142. 337. 155. 42-44. 190. 40-42. 292. 45. 115. 80. 353 low-grade fever. 328. 226. 53. 249. 108 lung abscess. 92. 92. 187. 32. 245. 346. 293. 68. 338. 109. 176. 88. 292. 268. 142-143. 257. 339 lobar pneumonia. 165. 182. 38. 209. 130. 44. 91. 159 L lack of appetite. 62. 296 liver area pain. 105. 161. 56. 80. 75. 298. 120. 197-199. 322 leukopenia. 281. 151. 188 lochioschesis. 209. 312 lumbago. 74. 220. 144. 183. 339 lingering fever. 31. 213. 264. 204. 61. 322-323 K keratitis. 110-111. 296 M magnesium. 283. 65 liver cirrhosis. 298. 60. 36. 222-223. 178-179. 318-319. 160-162. 145. 107. 215. 79. 112. 233. 117-118. . 137. 165. 48 laxatives. 306. 70. 49. 123. 108 lumbar strain. 247. 169. 335. 101. 40. 307. 177. 198. 153. 134. 212. 157. 304. 248. 353 kidney stones. 350 light-headedness. 80. 229. 83. 282. 317. 94. 56. 303. 341.General Index Herb Toxicities & Drug Interactions: A Formula Approach • 381 J jaundice. 318. 51. 189. 27. 89. 231. 30. 254 low blood pressure. 192. 43. 287. 68. 65. 41. 191. 326. 274. 163. 37. 152. 30. 216. 126-127. 260. 321. 30-31. 148. 354 laryngitis. 278. 303. 34. 252. 288. 181. 355 leptospirosis. 248. 173. 113. 268-269. 322 lethargy. 276. 313. 165. 127. 159 kidney failure. 153. 29. 262. 53. 147. 72. 96. 107. 261. 90. 337. 207. 268. 277. 325. 96. 115. 61 loss of consciousness. 296. 172. 183. 311. 161. 351. 32. 340. 342 leukemia. 79. 96. 70. 40. 46. 249.

132. 123. 343-345. 249. 298. 242. 278-279. 222. 272. 36. 292. 305. 106-107. 273. 324 myasthenia gravis. 163. 296 malnutrition in children. 50. 122. 264-265. 282. 109. 13 nervous exhaustion. 226. 202. 116. 316. 172. 77. 350 myocardial infarction. 196. 261-263. 353. 329-330. 258 neuralgia. 69. 296. 300 midline pain. 135. 340. 348 mumps. 226. 101. 175. 44. 168. 222. 114. 30. 195-196. 87 migraine. 61. 225 N nasosinusitis. 353 morning sickness. 169. 223. 203. 297. 225. 259. 258. 228 mania. 283. 348. 281. 84. 355-356. 242. 251. 69. 264. 225. 266. 290 . 283 neurogenic headache. 215-216. 290. 35. 117. 339 meningitis. 348. 139. 48. 282. 310. 67. 193-194. 292. 337 manic-depression. 77. 111. 290. 161. 104. 137. 281. 38. 317. 228. 113. 234. 294. 333-336. 189191. 27. 235. 180. 346 neurogenic bladder. 188 Meniere’s disease. 275. 219. 80. 159 nephrotoxicity. 314 mental illness. 303. 52. 237. 276. 346 mitral valve prolapse. 248. 296. 96. 257. 69. 233. 287-288. 235. 61. 197. 292 methylxanthines. 251. 324 menopausal complaints. 112-113. 51. 290-291.General Index 382 • Herb Toxicities & Drug Interactions: A Formula Approach 218. 319. 346. 55-56. 62. 170-171. 52. 73. 65 malaria. 139 MAO-inhibitors. 291. 307. 102. 159 menopausal syndrome. 103-104. 79. 314. 230. 245 measles. 136. 188. 64-65. 354 malar flushing. 168-169. 136. 331. 223. 139. 205. 124. 164. 208 nausea. 188. 277. 4. 177. 114. 264. 260. 35. 265. 351. 186-187. 226. 246. 15. 301. 185. 272. 314. 142. 312. 340. 288. 63. 245. 291. 324 measles-caused pneumonitis. 37-38. 253. 332 mitral stenosis. 339. 314-315. 129 mycoplasm pneumonia. 48. 332 neurasthenia. 259. 347 nephrosclerosis. 48. 290-291. 122. 35. 312. 299. 312. 129-130. 297. 272. 73. 288. 347. 208. 180. 176. 62. 268. 44. 100. 232. 168-169. 185. 233. 358. 67-68. 10. 158. 303. 185. 213. 288. 101. 120. 371-372 mastitis. 279. 67. 228. 143. 212. 282-283. 290-291. 130. 98. 149. 256. 253. 275-276. 104. 39. 210. 360 neonatal androgenization. 321. 175-176. 298. 182. 153. 300.

75. 36. 48. 43. 288. 217. 270. 340. 350-351. 335. 276. 175 oral ulceration. 95. 275. 123. 236. 194. 41-44. 49. 190. 178-179. 139. 157. 32-33. 276. 187. 164. 209-210. 178-182. 343-344 . 219. 343344. 273. 222. 253. 114. 341. 195-197. 173. 74. 232. 203 pediatric vomiting and diarrhea. 164. 263. 180 otitis media. 133 P pancreatic dysfunction. 197. 88. 103. 329. 99. 109-110. 78. 333-334. 302. 162. 91. 48 neurotic vomiting. 177. 166. 137. 154. 311. 56. 310. 336-337. 213. 91 orchitis. 285. 134-135. 142. 62-65. 62. 200-201. 94. 40. 134-135. 272-273. 285. 175. 157-158. 296-298. 348 O obesity. 109. 316-317. 51 pelvic inflammatory disease. 189. 223-225. 140. 293. 204. 115. 234. 51-52. 219-220. 288. 250 pancreatitis. 103. 126. 357 nightmares. 342. 144-145. 88. 234-239. 203. 282. 118-119. 160. 293. 95-97. 310-311. 246. 20 pediatric indigestion. 286. 114. 245 pao zhi. 265-268. 226. 248 nicotinic acid. 182. 280-281. 309. 238. 129. 239. 347-348. 177 oral herpes. 186. 219. 207. 267. 213. 49. 77. 67-69. 369-370 night sweats. 133. 117-118. 296 ovarian cysts. 242. 192-193. 36. 161. 130. 125. 224. 209. 68. 95. 98. 341. 246-247. 207. 251. 117. 107. 230-231. 215. 270. 83. 71. 150. 320. 246-247. 310-312. 280-282. 241 numbness of the extremities. 35. 215. 298. 3 paralysis. 249. 303. 210-211. 320. 351 parasitic diseases. 258 nitroglycerine. 305. 278 pepsin. 186. 262. 146. 79. 155. 165-166. 55. 189. 180. 291. 120. 234. 126. 145-146. 330 neurosis. 106. 78. 215. 257 nonprecipitation of the lochia. 148. 135. 112. 306. 153. 137. 216. 88. 77. 132. 295. 303. 123. 118.General Index Herb Toxicities & Drug Interactions: A Formula Approach • 383 neurological dysfunction. 262. 79. 302. 317 optic nerve atrophy. 260. 315. 116. 32. 210. 162. 203. 253. 135. 332 neurotic esophageal stenosis. 148. 80-81. 37-38. 153. 303. 337. 203 opiates. 67. 217-218. 110-112. 163. 164. 264. 96-97. 305306. 177. 133. 314. 258. 199. 211. 192-193. 29. 305 optic neuritis. 85. 259-261. 106. 157. 323-325. 228. 83. 314-317. 71. 275. 331. 105-107. 169. 160. 142. 82. 55-60. 77. 191. 192-193. 46-48. 312. 314.

261-267. 351-352. 306. 33-34. 134-135. 285 postpartum abdominal pain. 296. 190. 297. 82-85. 192. 65. 70-71. 61. 36-38. 189. 209-216. 117 polyps on the vocal cords. 130. 243. 91-92. 310-316. 332-341. 314 postgastrectomy syndrome. 62. 82. 105-107. 129 pertussis. 70-71. 72. 200-201. 222-223. 208. 89. 178-179. 97-100. 350 poliomyelitis. 354-355 potassium loss. 220. 68. 253. 186. 302-303. 134-135. 68. 123. 147-154. 168 potassium. 63. 40-45. 326. 222-224. 77-79. 33-34. 75. 51-53. 156-157. 354 precordial pain. 305 pleuritis. 251. 274. 110-115. 37. 318. 278. 181-183. 236239. 124. 206-207. 159 postsurgical persistent hiccup. 127. 87-89. 79. 198. 123.343-344. 139-145. 53. 181-183. 275. 56-57. 287. 173. 323. 33. 350 perillaldehyde. 346. 28-31. 329-330.239. 241. 313. 229-234. 326. 243. 71. 160. 283. 269-270. 322-324. 222 post-bypass debility. 269-270. 340-341. 334 primary dysmenorrhea. 42. 137.General Index 384 • Herb Toxicities & Drug Interactions: A Formula Approach peptic ulcer. 91-92. 104. 117-120. 164-168. 188. 206-207. 190. 108. 293295. 77-80. 160-162. 209-216. 248-249. 153-154. 245246. 32. 119. 305. 169. 309 perimenopausal syndrome. 289. 70. 187. 139. 50. 355 potassium-sparing diuretics. 245. 318-320. 131. 259. 196-198. 164-169. 298. 133. 27. 106-107. 350 pleurisy. 249. 295. 59. 172-173. 186. 305. 258-259. 40-44. 314-316. 159. 254. 136. 272-273. 77. 226. 129. 162. 189. 281. 92. 301 prednisolone. 251. 143-144. 151. 48. 73. 77. 222-224. 28-31. 326. 261-267. 237. 229-234. 293. 204. 75. 186-187. 172-173. 115. 87. 229. 144. 47-49. 123127. 130-132. 132. 235 postconcussion syndrome. 275-276. 203. 195. 343-348. 36-37. 319. 56-59. 67. 243. 241. 125-127. 200-201. 317. 241 postpartum fever. 49. 38. 304. 287-290. 231. 73. 52-53. 329-330. 96-101. 61. 185. 222 . 113. 189-193. 325. 178-179. 61 personality disorders. 268. 297-298. 149. 120. 204. 310-311. 253. 118-119. 307. 137. 279280. 252 postpartum urinary retention. 258-259. 176. 87-89. 204. 352. 277. 44. 61-63. 45. 347. 156-157. 183. 272-283. 152. 296 pneumonia. 147-151. 102. 114. 176. 245. 342 periodontal disease. 85. 338. 351. 236. 192-193. 82-85. 40 polyuria. 115. 220. 219. 212 pernicious anemia. 278 prolapsed uterus. 110-113. 43. 318-320. 322-324. 334 postpartum weakness. 188. 140-141. 59. 302-307. 198. 239. 335 premenstrual tension. 219-220. 105. 332-337. 196. 233. 47. 122 polycystic kidneys.

154. 81. 337. 115. 145-146. 122. 188. 293. 209-210. 312. 102-104. 160. 270. 316-317. 117-118. 245 psychosis. 216. 257. 159. 95. 83. 253. 68. 65. 254. 148. 95. 204. 210. 319. 235. 123. 302. 192-193. 306. 314. 159 scrotal hydrocele. 251. 285. 49. 106. 36. 137. 343-344 respiratory failure. 275. 246247. 295. 110-112. 177. 165-166. 282. 134. 43. 213. 73. 238-239. 49. 276. 89. 56. 190. 337. 134. 275 sciatica. 280-281. 257. 50.General Index Herb Toxicities & Drug Interactions: A Formula Approach • 385 prostatic hypertrophy. 173. 135. 239. 305. 342 prostration. 98-99. 219. 273. 142. 311. 217-218. 49. 44. 346 rheumatic valvular heart disease. 207. 353 scarlatina. 286. 237. 324 schizophrenia. 88. 165. 137. 159. 311. 97. 109. 99. 162. 300. 283 seizure disorder. 303. 213. 78. 369 R renal tuberculosis. 10. 353 respiratory paralysis. 350 rheumatic heart disease. 302-303. 234. 341. 309. 66. 315. 219. 268. 189. 85. 342. 267. 280-281. 185. 195. 215. 52. 79. 320. 78. 35. 40. 273. 319. 116-118. 126. 43. 200-201. 149. 314. 309 pulmonary tuberculosis. 139. 235. 88. 208. 266 psychogenic diarrhea. 330 rib-side pain. 148. 192-193. 187. 188. 79. 92. 160. 157. 32. 178-179. 252 scanty urination. 268. 180. 110-112. 117 reserpine. 30-31. 234. 145146. 309. 246. 182. 260 puerperal infection. 193. 270. 232 pulmonary edema. 306. 206 renal vascular disease. 211. 36. 194. 258. 126. 197. 303. 122123. 104. 224. 135. 123. 88. 236. 139. 298. 353 puerperal eclampsia. 164-165. 339 rhinitis. 310. 185. 165. 67. 2. 164. 346 Q quinine. 181. 254 . 173. 262. 295. 301. 343-344. 341. 90. 296. 83. 253. 207. 157. 27. 101. 200-201. 108. 181-182. 30. 92. 31. 64. 316-317. 262. 122. 254. 186. 74. 317 scanty lactation. 293. 44 scarlet fever. 275. 165-166. 87. 204. 351 respiratory tract infection. 211. 178-179. 67. 106-107. 162. 248 pruritus. 246-247. 217-218. 332 S saponin. 320. 310. 297. 159.

145147. 96-97. 213. 51. 206-207. 40-42. 102. 65. 159. 123. 298. 333-334. 136. 277. 73. 153. 276. 57. 282-283. 276. 224. 249. 34. 51. 56. 337. 303. 107. 74. 339. 290. 80. 235. 40 sinusitis. 195. 219. 235 superventricular tachycardia. 330. 209. 309. 178. 230. 113. 236-238. 58. 220. 226. 129 sweating. 243. 261-262. 292 shock. 101. 185-186. 65. 160. 130. 40-42. 335. 10. 107. 345 skin ulcers. 80. 88. 142-143. 104. 188-189. 285. 324 sleeping pills. 355 somber white facial complexion. 125. 104. 1. 253. 67 spermatorrhea. 115. 226. 312. 179. 165. 83-84. 326. 287. 266. 102. 286. 163. 116-118. 337. 47-48. 336. 47. 199. 249. 352. 78. 147. 348. 53. 318. 172. 330. 335 sodium bicarbonate. 68. 55. 338. 212. 191-192. 204. 264 slowness of movement. 149. 316-317. 104. 83-84. 328 strains. 92. 96. 215. 88. 266. 286. 109. 251. 35. 348. 160-162. 71. 36. 155. 114. 61. 302-303. 274. 298. 340 spasm of the sternocleidomastoid muscle. 115. 107. 282. 160-162. 185 sulphanomides. 165. 233. 344 . 237. 15. 351. 122-123. 288. 150. 70. 272-273. 351. 28. 253. 65. 137. 110-111. 301. 159 septicemia. 97. 333-334. 89. 101. 225. 63. 110-111. 311-312. 131. 47-48. 233. 152. 118. 102. 278-279. 36. 53. 142. 293-294. 75. 211-212. 272. 321. 354 sodium iodides. 281. 282-283. 43. 266-267. 325. 329-330. 239. 191. 74. 251. 199. 120. 117-118. 44. 28. 187. 229. 182. 149. 215. 198. 222 spontaneous perspiration. 226. 209. 178-179. 98. 53. 259. 100 stroke. 197. 125. 334 stuffy nose. 197. 322. 56. 287-288. 61. 81. 161. 290. 68. 144. 257. 302 stomachache. 294. 186. 217. 189. 303. 346 silicosis. 235. 165. 74. 80. 287-288. 186. 123. 235. 57. 329-330. 339. 45. 272. 176. 304. 178-179. 182. 130. 153. 298. 61. 230. 3 skin rash. 294. 2. 38. 56. 275-276. 157. 298. 316. 68. 153. 230. Philippe. 108. 196. 189. 296 stomach flu. 124. 307. 245. 122 stomatitis. 333. 125. 96. 353 shortness of breath. 125. 225. 173. 198. 354 sodium retention. 109. 127.General Index 386 • Herb Toxicities & Drug Interactions: A Formula Approach senile pruritus. 61. 151. 259. 153. 224-226. 346. 248. 212. 114. 261-262. 155. 95-96. 357 spontaneous pneumothorax. 134. 142-143. 150. 343-345. 300-302. 288. 233. 248. 336. 49. 80-81. 246. 312. 343-345. 278-279. 144. 157. 259. 145. 150. 161-162. 105. 254. 9. 296 Sionneau. 301. 190. 249. 52. 262. 340. 30. 343 superventricular arrhythmias. 172. 268. 280. 40 stiffness of the neck. 165-166. 313. 169. 85. 32. 197. 58. 183. 209. 66. 61.

176. 43. 293. 117-118. 296. 113. 100. 300. 301. 218. 200-201. 185. 352. 372 tinnitus. 88. 77-79. 48. 341. 211. 68. 311. 117-118. 134. 49. 134. 130. 353 tremors. 115. 114. 178-179. 259. 292 tracheitis. 292. 115. 192-193. 200-201. 281. 270. 206-207. 320. 110-112. 51. 160. 282. 291. 224. 298. 95. 145 unclear consciousness. 30. 312 . 38. 372 threatened miscarriage. 152. 178-179. 120. 300. 222 turbid urine. 92. 228. 188. 33. 77. 343-344 tubular acidosis. 276. 157. 346. 328 toxemia. 323. 187. 204. 334. 282. 88. 206. 295. 303.General Index Herb Toxicities & Drug Interactions: A Formula Approach • 387 T tabes dorsalis. 158. 209. 104. 280. 302 typhoid. 122. 141. 342 tonsillitis. 249. 185. 213. 223. 341. 83. 123. 123. 265. 297. 126. 319. 306. 36. 242. 142. 212. 213. 88. 99. 309. 176. 293. 69. 160. 197. 141 thyroid. 213. 144. 45. 174. 260. 145-146. 105. 222 twitching muscles. 51. 169. 49. 276. 260 traumatic injury. 122. 204. 208. 145146. 281. 257. 53. 303. 36. 107. 343-344 teething. 218. 277. 206. 239. 303. 209. 190. 148. 337. 245. 81. 318. 268. 214. 197. 290. 347 trichomonas vaginitis. 257. 104. 322 U ulceration of the oral mucosa. 192-193. 102. 338. 92. 196. 177. 123. 324 toothache. 136. 157. 75. 275. 197. 38. 243. 274. 253. 211. 165-166. 43. 49. 314 trypsine. 116. 162. 298. 83. 316-317. 260. 62-63. 204. 56. 110-112. 286. 316-317. 288. 82. 280-281. 326. 58. 46. 207. 212. 169. 298. 229. 95. 295. 56. 71. 90. 181 unclear speech. 165-166. 185. 188. 31. 217-218. 313. 49. 250 tannic acid. 162. 131. 78. 77 theophylline. 154 trembling. 89. 113. 63. 34. 186. 304. 139. 97. 336. 173. 73 tetanus. 235. 322 typhoid fever. 239. 109. 185. 232 trigeminal neuralgia. 306. 252 thromboangitis obliterans. 102-104. 246-247. 272. 217-218. 52. 220. 233. 74. 139. 225. 209. 68. 107. 159. 262. 355. 138. 48. 312 ulcerative colitis. 309 transitory ischemic attacks. 311. 87 thrombocytopenic purpura. 137. 142. 126. 173. 275. 101. 319 thyroid adenoma. 309. 189. 262. 246. 303. 307. 124. 99. 43. 183. 148. 165. 269. 253. 258 tension headache.

213. 153. 265-267. 151. 67. 292 urethritis. 286. 100. 320. 337. 156. 264. 296-298. 116. 341. 31 urinary incontinence. 92. 165-166. 216. 162. 200 varicose veins. 62-63. 189. 207. 186. 230-231. 226. 305-306. 262 wind stroke.129. 314-315. 137. 97. 306. 343-344 vitamin C. 51-52. 104. 294. 283 urinary tract infection. 321. 235. 263. 90. 111. 198. 262. 114. 318-319. 148. 224. 144-145. 84. 217-218. 10. 213. 340 urinary retention. 181-182. 123. 193-194. 119. 291. 329. 215. 242. 310. 36. 280-281. 73-74. 162. 160. 79. 41-44. 200-201. 112. 49. 31. 271 W warfarin. 234-239. 228. 273. 272. 145-146. 42. 218. 183. 112. 161. 253. 259-261. 159. 275. 216. 219-220. 149. 181. 315. 109. 248-249. 317. 103. 302 vitamin B 1. 178-179. 253. 354 weak respiration. 82. 342 varicocele.General Index 388 • Herb Toxicities & Drug Interactions: A Formula Approach upper abdominal discomfort. 97.334. 165. 95. 185. 354. 180. 99. 358. 100. 126. 242. 323-325. 259. 153. 51. 80. 211. 168-172. 52. 281. 186-187. 92. 299. 263. 334 vexation and agitation. 143. 77. 37. 320. 204. 288. 106. 88. 55-60. 164. 215-216. 296. 311. 265-268. 232. 175. 279. 154. 61. 46-48. 169. 78. 172. 88. 302 urinary calculi. 132. 270. 136. 159. 109. 341. 180. 92. 137. 173. 353. 347. 71. 126. 96. 337. 31. 83. 91. 88. 305. 252. 268. 334 . 139. 224. 48-49. 153. 31. 192-193. 228. 92. 348. 168. 312. 123-124. 96-98. 150. 73. 24 V vaginal itching. 165. 331-332. 210. 242. 223-225. 111-112. 46. 37-38. 43. 129. 226. 219. 133. 132. 355-356. 288. 290-291. 249. 253. 191. 109. 253. 91. 331. 75. 110-112. 189-191. 270. 181 urinary block. 283. 239. 109-110. 288-289. 333. 31. 280-282. 142. 117-118. 347-348. 31. 242. 197. 132. 83. 200. 202-203. 148. 232. 271. 40. 275. 35-36. 224. 371 weakness. 160. 159. 102. 183. 213. 39. 186. 195-197. 118-119. 66. 214. 307. 309. 67-69. 163-165. 69. 303. 88. 303. 117. 155. 140. 291. 31. 282. 286. 285-286. 85. 90. 223-225. 175. 77. 30-31. 295. 335. 292. 87. 95-97. 123. 177 uterine fibroids. 137. 87 vertigo. 293. 35. 297. 88. 69. 143. 257. 90. 293. 158. 276. 246. 178-182. 314-317. 233-234. 175. 339-340. 62-65. 320. 135. 114. 77. 316-317. 288. 213. 343-344. 301 uremia. 74. 189. 134-135. 29. 165. 180 vaginitis. 161. 71. 181. 207. 205. 209-210. 310-312. 105-107. 347. 336-337. 157-158. 246-247. 123. 104. 27. 102. 159. 180 urgent urination. 135. 246-247. 159. 157. 301-302. 277-279. 32-33. 80-81. 63-65. 196. 207. 306. 251. 350-351 vomiting. 81. 134. 90. 192-193. 55. 139. 74. 272-273. 81. 360 vulvitis.

159 Bai He Gu Jin Tang. 147 Huo Luo Xiao Ling Dan. 44 Bai Du Jia Ren Shen San. 168 . 91 Di Huang Yin Zi. 125 Gui Zhi Tang. 151 Huang Lian Jie Du Tang. 114 G Gan Cao Xie Xin Tang. 122 Gu Chong Tang. 136 Gui Zhi Fu Ling Wan. 40 Bai Hu Tang.P IN YIN FORMULA INDEX A An Gong Niu Huang Wan. 46 Ban Xia Hou Po Tang. 159 Ju Pi Zhu Ru Tang. 93 Ba Wei Wan. 55 Bei Mu Gua Lou San. 65 Chai Hu Jia Long Gu Mu Li Tang. 139 C Cang Er Zi San. 87 Dang Gui Shao Yao San. 35 Bai Du San. 73 H Hai Zao Yu Hu Tang. 117 Er Chen Tang. 145 Huang Tu Tang. 133 Gui Pi Tang. 141 Huai Hua San. 149 Huang Lian E Jiao Tang. 129 Gun Tan Wan. 100 Ding Chuan Tang. 51 Bao He Wan. 82 Dao Chi San. 79 Dan Shen Yin. 194 Jin Gui Shen Qi Wan. 48 Ban Xia Xie Xin Tang. 54 Gan Mai Da Zao Tang. 154 D Da Cheng Qi Tang. 39. 31. 85 Dang Gui Si Ni Tang. 120 Ge Gen Tang. 156. 103 Du Huo Ji Sheng Tang. 58 Bu Zhong Yi Qi Tang. 35 Bai Tou Weng Tang. 77 Da Huang Fu Zi Tang. 27 Die Da Wan. 94 J Ji Chuan Jian. 10 B Ba Zheng San. 67 Chuan Xiong Cha Tiao San. 61 E Er Xian Tang.

175 Liu Wei Di Huang Wan. 54 Sheng Mai San. 242 Su He Xiang Wan. 342 Zhu Sha An Shen Wan. 20. 163 Juan Bi Tang. 314. 328 Yue Ju Wan. 232 Sheng Jiang Xie Xin Tang. 158. 203 X Xi Jiao Di Huang Tang. 283 N Nuan Gan Jian. 245. 218 Sang Piao Xiao San. 275. 215 Y Yi Guan Jian. 250 Z Zhen Wu Tang. 241 Shi Hui San. 264 Tian Ma Gou Teng Yin. 292 Xiang Ru San. 35 Run Chang Wan. 158. 334 Zhi Sou San. 339 Zhen Gan Xi Feng Tang. 252 Si Ni San. 258 L Li Zhong Wan. 285 Wu Ling San. 212 Qing Hao Bie Jia Tang. 277 Wu Zhu Yu Tang. 188 Ma Huang Tang. 305. 208 Qing Wei San. 225 Sheng Hua Tang. 278 Wen Dan Tang. 200 P Ping Wei San. 254 Suan Zao Ren Tang. 248 Si Shen Wan. 177 Long Dan Xie Gan Tang. 308 Xiao Chai Hu Tang. 318 Q Qing Qi Hua Tan Tang. 228 Shen Fu Tang. 294 Xiao Yao San. 290 Wu Mei Wan. 39. 296 Xiao Qing Long Tang. 319 Yin Qiao San. 195 Mu Li San. 237 Si Ni Tang. 350 Zhi Gan Cao Tang. 194. 324 Yin Chen Hao Tang. 260 Tong Xie Yao Fang.Pin Yin Formula Index 390 • Herb Toxicities & Drug Interactions: A Formula Approach Ju He Wan. 346 Zhi Bai Di Huang Wan. 353 . 300 Xing Su San. 222 Shen Ling Bai Zhu San. 180 T Tian Wang Bu Xin Dan. 330 Yu Nu Jian. 206 R Ren Shen Bai Du San. 322 Yu Ping Feng San. 171 Si Wu Tang. 235 Shi Xiao San. 269 M Ma Xing Shi Gan Tang. 271 Wen Jing Tang. 185 Ma Zi Ren Wan. 309 Xue Fu Zhu Yu Tang. 87. 249 Si Jun Zi Tang. 23. 198 W Wan Dai Tang. 191 Mai Men Dong Tang. 332 S Sang Ju Yin.

108 Apricot Seed & Linum Formula. 191 . 168 B Bamboo & Hoelen Combination. 275 Benefit the River [Flow] Decoction. 191 Apricot Seed & Perilla Formula. 46 Angelica Pubescens & Loranthus Decoction. 309 Arrest Wheezing Decoction. 171 Aurantium & Bamboo Combination. 309 Armeniaca & Perilla Powder. 91 Aconite & G. Combination. 206 Artemisia Yinchenhao Decoction. 67 Bupleurum & Tang-kuei Formula. 319 Anemarrhena & Phellodendron Rehmannia Pills. 248 All-The-Way-Through Brew. 156 Blood Mansion Dispel Stasis Decoction. 203 Cannabis Seed Pills. 103 Artemisia Annua & Carapax Amydae Decoction. 245 Bupleurum & Dragon Bone Combination. 342 Anemone Combination. 322 Assuage Impediment Decoction. 305 C Calm the Stomach Powder. 67 Bupleurum Plus Dragon Bone & Oyster Shell Decoction.ENGLISH FORMULA INDEX A Abduct the Red Powder.L. 158. 314 Bupleurum & Chih-shih Formula.

208 Cnidium & Tea Formula. 39. 232 Ephedra. 55 Citrus & Pinellia Combination. 332 Evodia Combination. 133 Citrus & Crataegus Formula. 250 E Eight Correcting [Ingredients] Powder. 136 Cinnamon Twig & Poria Pills. 87 Dang Gui & Peony Powder.English Formula Index 392 • Herb Toxicities & Drug Interactions: A Formula Approach Capillaris Combination. 23. 245. 82 Dianthus Formula. 242 . 147 Coptis & Rehmannia Formula. 156 Four Counterflows Decoction. Gypsum & Licorice Decoction. 159 End [Abnormal] Vaginal Discharge Decoction. 20. 23. 87. 278. Apricot Kernel. 290 Evodia Decoction. 185 Escape Restraint Pills. 248 Four Counterflows Powder. 283 Flow of the River Brew. 171 Cinnabar Formula. 31 Eight Flavors Pills. 20. 73 Coptis & Donkey Skin Glue Decoction. 242 Four Major Herb Combination. 188 Ephedra Decoction. 212 Coptis & Scute Combination. 149 Coptis Resolve Toxins Decoction. 353 Cinnabar Quiet the Spirit Pills. 147 Coptis & Donkey Skin Glue Decoction. 290 F Ferry Brew. 322 Chianghuo & Turmeric Combination. 156 Five [Ingredients] Poria Powder. 114 Clear the Stomach Powder. 149 D Dang Gui Four Counterflows Decoction. 353 Cinnamon Combination. 235 Engendering & Transforming Decoction. 212 Clear the Qi & Transform Phlegm Pills. 249 Four Gentlemen Decoction. 133 Cinnamon Twig Decoction. 31 Dioscorea Combination. 136 Cinnamon & Hoelen Formula. 271 Engender the Pulse Powder.

44. Wheat & Red Date Decoction. 264 Hoelen Five Herb Formula. 40 Linking Decoction. 328 H Heavenly Emperor Supplement the Heart Elixir. 35. 159 Gypsum Combination. 250 Fritillaria & Trichosanthes Powder. 100 L Lead Out the Red Powder. 129 Ginseng. 228 Ginseng Vanquishing Toxins Powder. 40 Lily Secure the Lungs Decoction. 260 Gentiana Combination. 120 Licorice. 264 Golden Cabinet Kidney Qi Pills. 120 Ligusticum Mixed with Tea Powder. 328 K Knock & Fall Pills. 252 Four Spirits Pills. 91 Level the Stomach Powder. 215 Liquid Styrax Pills. 319 Linum & Rhubarb Combination. 54 Licorice & Jujube Combination. 35 Ginseng & Longan Combination.English Formula Index Herb Toxicities & Drug Interactions: A Formula Approach • 393 Four Materials Decoction. Poria & Atractylodes Powder. 73 Lily Combination. 180 Gentiana Drain the Liver Decoction. 180 Ginseng & Aconite Decoction. 61 Ginseng & Atractylodes Formula. 228 Ginseng & Gypsum Combination. 328 Jade Windscreen Powder. 203 Licorice Drain the Heart Decoction. 330 Jade Woman Decoction. 35 Ginseng & Zizyphus Formula. 225 Ginseng & Astragalus Combination. 254 . 58 G Gastrodia & Uncaria Beverage. 283 J Jade Lady Brew.

285 Mume Pills. 285 N Network Vessel Quickening Miraculously Effective Elixir. 188 Ma-huang Combination. 77 Major Rhubarb Combination. 122 Pueraria Decoction. 194. 198 P Painful Diarrhea Essential Formula. 324 Loose a Smile Powder. 324 Lonicera & Forsythia Powder. 218 Mume Formula. 46 . 39. 48 Platycodon & Schizonpeta Formula.English Formula Index 394 • Herb Toxicities & Drug Interactions: A Formula Approach Lonicera & Forsythia Formula. 296 Mix-fried Licorice Decoction. 103 Magnolia & Ginger Formula. 300 Minor Bupleurum Decoction. 158. 51 Pinellia Combination. 139 Pinellia Drain the Heart Decoction. 154 O One Link Brew. 222 Minor Blue Dragon Combination. 51. 195 Oyster Shell Powder. 300 Minor Blue-green Dragon Decoction. 185 Ma Huang & Ginkgo Combination. 77 Mantis Egg-case Powder. 55 Pueraria Combination. 350 Protecting Harmony Pills. 218 Mulberry Leaf & Chrysanthemum Beverage. 195 Ophiopogon Combination. 215 Morus & Chrysanthemum Combination. 346 Moisten the Intestines Pills. 203 Major Order the Qi Decoction. 122 Pulsatilla Decoction. 319 Ophiopogon Decoction. 269 Phlegm-rolling Pills. 114 Pinellia & Magnolia Decoction. 241 M Ma-huang & Apricot Seed Combination.

307-308 Rectify the Center Pills. 108 Two Aged [Ingredients] Decoction. 177 Return the Spleen Decoction. 168 Tangerine Seed Pills. 258 Stabilize Panting Decoction. 114 . 237 Ten Partially Charred Substances Powder. 61 T Tangerine Peel & Bamboo Shavings Decoction. 129 Rhinoceros Horn & Rehmannia Decoction. 305. 350 Sudden Smile Powder. 252 Tang-kuei & Jujube Combination. 334 Six Flavors Rehmannia Pills. 85 Sargassium Jade Flask Decoction. 117 Two-cured Decoction. 241 Supplement the Center & Boost the Qi Decoction. 177 Sophora Flower Powder. 328 Rehmannia Six Formula. 163 Tang-kuei & Evodia Combination. 94 Rehmannia & Gypsum Combination. 292 Rhubarb & Aconite Combination. 339 Tuhuo & Vaeicum Combination. 125 Settle the Liver & Extinguish Wind Decoction. 79 Rhubarb & Aconite Decoction. 237 True Warrior Decoction.English Formula Index Herb Toxicities & Drug Interactions: A Formula Approach • 395 Q Quiet the Palace Bezoar Pills. 91 Rehmannia Beverage. 175 Rehmannia & Akebia Formula. 79 S Salvia Beverage. 278 Tang-kuei Four Combination. 87 Tang-kuei & Peony Formula. 145 Sour Jujube Decoction. 27 R Rambling Powder. 82 Ten Ashes Powder. 103 Stop Coughing Powder. 141 Secure the Chong Decoction. 114 Two Immortals Decoction.

277 Warm the Liver Brew. 44 X Xanthium Powder. 139 Vitality Combination. 275. 278 White Tiger Decoction. 258 Zizyphus Spinosa Decoction. 35 Vanquishing Toxins Powder. 151 Z Zizyphus Combination.English Formula Index 396 • Herb Toxicities & Drug Interactions: A Formula Approach U Uncooked Ginger Drain the Heart Decoction. 200 Warm the Menses Decoction. 339 W Warm the Gallbladder Decoction. 258 . 35 Vaporize Phlegm Pills. 65 Y Yellow Earth Decoction. 54 V Vanquishing Toxins Plus Ginseng Powder.

112. 126. 293. 367 Bai Guo Ye. 107. 364 Bai Guo. 95. 341. 123. 284. 243. 367 Bi Ba. 228-229. 366 An Xi Xiang. 42. 302. 294 Bai Bu. 114. 271. 306. 303. 23. 37. 269. 142. 97. 103. 365 Bai Jie Zi. 311. 329. 87. 62. 40. 297. 191. 365 Bai Bian Dou. 365 Bai Tou Weng. 56. 334. 115. 279. 367 Bai He. 365 Bai Qian. 351 Bai Dou Kou. 110. 255 B Ba Ji Tian. 208. 83. 364 Bai Zhu. 3. 130. 257. 87. 42. 82. 57. 366 Bai Mao Gen. 82-83. 125. 364 Bai Zi Ren. 276. 123. 118. 51. 330. 282. 112-113. 246. 176. 230. 130.P IN YIN HERB INDEX A Ai Ye. 116. 5. 340. 68. 134. 351 Bai Shao. 74. 269. 152. 136. 66. 48. 59. 49. 4. 156. 364 Bai Zhi. 256 Bian Xu. 306. 32 Bie Jia. 252. . 46 Bai Wei. 267 Ban Lan Gen. 70. 148. 238. 316. 365 Ban Xia. 134. 336. 197. 126.

337. 306. 352. 366. 194. 322. 293. 98. 181. 315. 98. 84. 285. 266. 284. 131. 232. 119. 332. 368 Da Ji. 211. 266. 71-72. 24. 292 Chuan Xin Lian. 366 Dang Gui. 307. 315. 259. 307. 364 Chen Pi. 263. 367 Dan Shen. 68. 229. 366 Dai Zhe Shi. 282. 372 D Da Huang. 332. 250. 366 Chuan Xiong. 364 Deng Xin Cao. 71. 340-341. 64. 154. 4. 207. 316. 118. 320. 100. 71-72. 216. 305. 168. 223. 38. 348. 224. 354. 139. 206.Pin Yin Herb Index 398 • Herb Toxicities & Drug Interactions: A Formula Approach 136. 280. 272. 253. 337. 227. 364. 33-34. 279. 210. 272. 162. 197. 290. 89. 322-323. 371 Dang Shen. 176. 111. 236. 201. 82. 16. 246. 153. 178. 134. 364 Cao Guo. 325 Dan Nan Xing. 237 Da Qing Ye. 196. 179. 256. 66. 124. 213. 239. 39. 206. 73. 364 Cao Wu. 269. 311. 115-116. 297. 56. 344. 52. 132. 262. 162. 343 Bing Pian. 148. 154. 253. 367 Chuan Jiao. 349. 54. 231. 312. 293. 213. 182. 220. 134. 273. 255 Bo He. 150. 179. 170. 137. 316. 270. 299. 255 Chi Shao. 250 C Cang Er Zi. 238 Chai Hu. 64. 299. 67. 273. 316 Chi Shi Zhi. 143. 311. 95. 63. 29. 145. 296. 261. 28. 100. 120-121. 172. 32. 54. 205. 42. 274. 277. 192. 172. 368 Chuan Lian Zi. 367 Ci Wu Jia. 59. 335 Dan Dou Chi. 239. 224. 293. 292 Ce Bai Ye. 14. 207. 267. 29. 73. 152. 256. 87. 162. 344. 148. 279. 201. 243. 33 . 65 Cang Zhu. 214. 182. 35. 364 Che Qian Zi. 253. 209. 258. 289. 246. 325. 365 Chuan Niu Xi. 85. 336. 276. 268. 280. 293. 72. 67. 163. 117. 364 Da Suan. 280. 79. 41. 305. 153 Chuan Bei Mu. 302. 276. 63. 143. 183. 140. 36. 291. 111. 372 Chen Xiang. 77. 289. 227. 367 Chuan Wu. 365 Bu Gu Zhi. 106. 148. 58. 28. 140. 204. 4. 244. 156. 192. 208 Dan Pi. 366 Da Zao. 200. 232. 143-144. 278. 320. 203.

152-153. 304. 364 Dong Gua Pi. 226. 49. 147-148. 45. 284. 131. 37. 365. 38. 336 . 326. 160. 229. 280. 367 F Fang Feng. 281. 343. 366 Dong Chong Xia Cao. 124. 92. 307-308. 263. 259. 365 Geng Mi. 178. 53. 266. 152. 354-355. 16. 204. 176. 38. 352. 364 Gou Qi Zi. 187. 226. 122. 115-116. 109. 43. 173. 366 Fu Ling. 58. 45. 70. 339 Gan Sui. 127. 238. 153. 162. 223 Fu Xiao Mai. 245. 298. 248-249. 286.Pin Yin Herb Index Herb Toxicities & Drug Interactions: A Formula Approach • 399 Di Bie Chong. 196 Gou Ji. 318. 335. 338-339. 105. 169. 338. 95. 113. 249. 108. 89. 75. 209. 357 Fu Zi. 5. 226. 171. 320. 368 Fu Shen. 343 Fu Pen Zi. 141. 144. 133. 89. 52. 335. 303-304. 70. 346. 3. 94-95. 346. 34. 196-198. 43. 53-54. 97. 190. 343. 287. 92-93. 331. 364 Ge Gen. 259. 366 Gui Ban. 3. 120. 200. 248. 311. 351-352. 313. 339. 16. 39. 287. 367 Ding Xiang. 96. 319. 127. 276. 151. 137-138. 208. 372 Gan Jiang. 220. 16. 79-80. 56. 220. 95. 161. 113. 59. 177. 30. 287. 173-174. 348 E Zhu. 366 Du Zhong. 34. 365 Gao Liang Jiang. 233. 161. 306. 199. 152-153. 285. 343. 367 Gou Teng. 160. 307. 313. 101 Di Gu Pi. 71. 260. 318. 208. 120. 23. 229. 187. 75. 301. 340. 62-63. 233. 374 E E Jiao. 245-246. 183. 169. 63. 103-105. 45. 277. 262. 331. 126. 124. 298-299. 80. 256. 274. 109. 177. 131. 176. 174. 326. 224. 80. 113. 13-14. 196. 277. 243. 160. 75. 270. 211. 248-250. 110. 355 Gao Ben. 175. 75. 365 Fang Ji. 229-230. 126. 366 Gua Lou Ren. 366 Gu Sui Bu. 23. 201. 271. 2-3. 209. 6. 83. 258. 57. 144. 364 Gua Lou. 273-274. 37. 130. 367. 270. 115-116. 190. 204. 183. 364 Du Huo. 281. 166. 243. 368 G Gan Cao. 143. 178. 160. 285. 243. 95.

332. 28. 367 Huang Qi. 186. 166. 130. 147. 326. 265. 280. 280. 301. 141. 284. 42. 315. 73. 143. 143. 100. 68. 259. 84. 46. 141. 80. 167 Hai Feng Teng. 279. 236. 105. 203. 367 Huang Jing. 161-162. 285- . 231. 117. 343. 177. 297. 364 Han Shui Shi. 73-74. 364 H Hai Dai. 195. 287. 37. 172. 294. 257. 147. 218. 286. 111. 53. 28. 366 Hou Po. 105-106. 153. 286. 133. 108. 259. 36. 105. 41. 117. 166. 316. 279. 372 Jie Geng. 198. 368 Hu Po. 253. 294. 105. 29. 353. 325. 348. 350 Ju Hua. 267. 84. 367. 47. 364 J Jiang Huang. 310. 317. 150. 253. 316. 53.Pin Yin Herb Index 400 • Herb Toxicities & Drug Interactions: A Formula Approach Gui Zhi. 172 Hai Piao Xiao. 160. 150. 125. 355 Hua Shi. 203. 364 Huang Qin. 347. 345. 143. 41. 166 Han Lian Cao. 265. 368 Ku Shen. 268. 100. 118. 136. 193. 32. 366 Kuan Dong Hua. 53. 367 He Ye. 73. 368 Hei Zhi Ma. 367 Hu Lu Ba. 279. 146. 36. 100. 140. 365 Huang Lian. 316. 147. 96. 69. 149. 49. 288. 367 Jin Qian Cao. 88. 172. 16. 95. 220. 277. 261. 96. 180. 126. 365 He Zi. 111. 273. 111. 84. 48-49. 172. 193. 233. 145 Huang Bai. 294. 52. 2. 295 He Huan Hua. 368 Jin Yin Hua. 233. 366 He Shou Wu. 148. 320. 330. 127 Hai Tong Pi. 149. 366 Huo Xiang. 279. 88. 212. 36. 332. 268. 47. 237. 14. 259. 364 He Huan Pi. 365 Jing Jie Sui. 195. 212. 75. 253. 286. 236. 324. 78. 332 Huai Hua Mi. 47. 301. 364 Hai Zao. 28. 61. 233. 123. 149. 354 K Ku Lian Pi. 209. 329. 78. 212. 350. 59. 366 Hong Hua.

325. 198-199. 87. 96. 231. 324. 280. 112. 255. 67. 134. 131. 280. 89. 144. 78. 220. 70. 350 Lu Gen. 317. 156. 220. 365 Ling Zhi. 320. 253. 185. 222. 47. 367 N Nan Sha Shen.Pin Yin Herb Index Herb Toxicities & Drug Interactions: A Formula Approach • 401 286. 192. 354. 365 Long Gu. 127. 167. 347. 364 Niu Bang Zi. 268. 241. 354. 126. 221. 127. 28. 365 . 334335. 316. 367 Mu Gua. 70. 262. 219. 198. 82. 310. 42. 317. 195. 302. 320. 325. 320. 365 O Ou Jie. 163. 14. 59. 224. 4. 127. 365 Long Dan Cao. 236. 31. 367 Lian Xu. 131. 110. 39. 56 Lian Qiao. 348. 199 Mai Men Dong. 97. 41. 149. 28. 70. 364 Mu Li. 306. 329. 53. 16. 101-105. 326 Lu Hui. 148. 268. 364 Mu Zei Cao. 37. 265. 122. 365. 206 Mo Yao. 10. 372. 350. 366-367 Nu Zhen Zi. 123. 231. 367. 37 L Lai Fu Zi. 57. 329. 300. 27 Niu Xi. 366 M Ma Huang. 165. 269. 101. 329. 368 Kun Bu. 367 Mang Xiao. 16. 198. 365 Ming Fan. 188. 23. 246. 268. 335. 335 Long Yan Rou. 181 Mu Xiang. 155. 367 Lian Zi Xin. 293. 136. 59. 67. 335 Mu Tong. 336. 37. 42. 164. 173. 325. 375 Ma Huang Gen. 42. 230. 337. 28. 70. 365 Mai Ya. 2. 91. 364 Niu Huang. 147. 180. 57. 337. 310. 127. 286. 365 Lian Zi. 212. 141. 341 Mei Gui Hua. 58.

109. 108. 35. 372 Shan Zhu Yu. 366 Ru Xiang. 251. 223-225. 274. 365 Sang Ye. 211. 69. 195. 35. 317. 134. 206. 197. 32. 91. 126. 264. 100. 230. 306. 80. 271. 165. 343. 83. 39. 32 R Ren Dong Teng. 258. 365 Sha Shen. 55. 364. 266. 47 Qing Hao. 178-179. 143. 333 Sheng Di. 365 S San Qi. 235-236. 229. 316. 332. 320. 4. 371 Rou Cong Rong. 281282. 109. 178. 354. 367 Pu Gong Ying. 347. 173. 129. 162. 37. 364 Shen Qu. 340. 286. 259. 151. 36. 299. 244. 57-59. 366 Qing Pi. 171. 263 Sang Piao Xiao. 62. 99. 201. 42. 309 Qian Shi. 112. 94. 155. 279. 241-242. 172. 37. 183. 111. 364 Rou Dou Kou. 243. 95. 175-176. 367. 64. 136. 16. 233.Pin Yin Herb Index 402 • Herb Toxicities & Drug Interactions: A Formula Approach P Pi Pa Ye. 216. 206-207. 201. 49. 70. 238 Qian Hu. 284. 74. 115. 347. 291. 364-365 Shan Yao. 16. 255. 177. 253. 365 Qiang Huo. 292. 288-289. 231. 365 Sang Zhi. 28. 162. 264. 173. 40. 365 Ren Shen. 342. 179. 130. 364 Shan Zha. 55. 160. 73-74. 23. 364 Qu Mai. 367 Rou Gui. 72. 97. 367 She Chuang Zi. 218. 343. 36. 336. 311. 106. 223. 172. 365 Sang Ji Sheng. 301. 111. 94. 112. 84. 160. 156. 224. 272. 368 Sang Bai Pi. 54. 365 Qin Jiao. 88. 365 Qin Pi. 263. 52. 336. 297. 366. 113. 171. 168. 319. 368 Q Qian Cao Gen. 101. 2. 368 . 143. 268. 213. 227-228. 128. 222 Sang Shen. 276.

101 Tu Si Zi. 365 Wu Tou. . 48. 364 Tian Nan Xing. 107. 371 Sheng Ma. 250. 68. 114. 307. 82. 366 Tu Bie Chong. 268. 112. 198. 59. 116. 137. 202. 252. 241 Wu Mei. 124. 127. 365 Xiao Ji. 256. 162. 336. 54. 280. 148. 365 Xian Ling Pi. 258. 58. 134. 69. 265. 328. 344. 236. 335. 254 Suan Zao Ren. 333. 293. 226. 267. 368 Suo Yang. 253. 204. 348. 98. 364 W Wei Ling Xian. 5. 49. 215. 56. 192. 44. 366 Shi Gao. 282. 286. 198. 207. 169. 293. 367 Su He Xiang. 70. 70. 246. 278. 341. 328. 42. 98. 123. 127. 280. 130. 366. 137. 314. 335 Shi Hu. 365 Tian Men Dong. 177. 342. 368 Shu Di. 290. 126. 374 Xia Ku Cao. 260. 298. 127. 197. 269. 234. 261 Shi Liu Pi. 179. 298. 292-293 Song Qi. 366. 246. 222. 208. 157. 256. 282. 179. 306. 277. 74. 367 T Tai Zi Shen. 366. 94. 331. 213. 118 Xiang Fu. 340. 39. 291. 192. 197. 364 Shi Jue Ming. 42. 164. 134. 303. 136. 97. 364 Wu Ling Zhi. 365 Xi Xin. 237. 28. 123. 134. 88. 108-109. 276. 47. 302. 209. 269. 201 Wu Zhu Yu. 112. 279. 253. 368 Tian Ma. 85. 312 Wu Wei Zi. 371 Shi Chang Pu. 135. 142. 293. 301-302. 116. 41. 212. 87. 70. 256. 368 Tao Ren. 63. 82.Pin Yin Herb Index Herb Toxicities & Drug Interactions: A Formula Approach • 403 Sheng Jiang. 201. 251. 159. 285. 366 Wu Yao. 312. 126. 255. 80-81. 14. 14. 96. 87. 132. 367 X Xi Jiao. 302. 28. 364 Xiao Hui Xiang. 239. 42. 189. 236 Tan Xiang. 336. 148. 224. 335. 368 Shui Niu Jiao. 292-293 Xi Yang Shen. 368 Tian Hua Fen. 51.

38. 355 Yuan Zhi. 351. 41. 28. 344. 146. 309. 365 Yin Yang Huo. 119. 186. 338. 352. 264. 43. 307. 233. 367 Z Ze Xie. 313. 36. 192. 243. 176. 304. 78. 190. 197-198. 364 Zhi Mu. 164. 346. 150. 157. 116. 149. 113. 45. 45. 207. 265. 131-132. 102 Zi Shi Ying. 92. 367 Zhen Zhu. 193. 336. 233. 298. 344. 38. 104 Zi Wan. 364 Xuan Fu Hua. 223. 295. 166. 75. 341 Xiao Mai. 258. 161. 44. 138. 89. 366 Zhang Nao. 199. 366 Zhe Bei Mu. 306. 169. 326. 254. 365 Zhu Ru. 229. 311. 365 Xing Ren. 15. 222. 121. 351 Zong Lu Tan. 152. 283. 179. 75. 196. 169. 142. 223. 116. 278. 368 Xu Duan. 173. 173. 218. 144. 230. 281. 47. 131. 322. 193. 357 Xin Yi Hua. 364 Zhi Shi. 322. 318. 43. 364 Y Yan Hu Suo. 352. 127. 147. 78. 262. 338. 70. 317. 298. 138. 366 Yu Zhu. 307. 355 Zi Ran Tong. 33. 124. 92. 144. 365 Yuan Hua. 176. 132. 290 Zi Su Ye. 245. 326. 120. 29. 157. 113. 30. 53. 249. 34. 250. 336. 105. 313. 240 . 267 Zhi Ke. 63. 259. 229. 329. 367 Yi Yi Ren. 105. 183. 27. 367 Yi Mu Cao. 120. 284. 83. 124. 275 Zhi Zi. 15. 259. 281. 220. 346. 274. 309 Zi Su Zi.Pin Yin Herb Index 404 • Herb Toxicities & Drug Interactions: A Formula Approach 302. 110. 183. 203. 53. 101. 266. 30. 355. 245. 212. 118-119. 97. 204. 277. 353. 89. 307. 365 Zhu Ling. 354 Xue Jie. 261. 243. 286. 249. 181. 337. 220. 261. 50. 66. 182. 246. 94. 262. 34. 211. 333. 366 Ying Su Ke. 49. 277. 97. 53. 365 Xuan Shen. 204. 268. 166. 256. 367 Yu Mi Xu. 366 Yin Chen Hao. 318. 105. 168 Zhu Sha. 238. 187. 304. 189. 210. 216. 274. 63. 152. 335. 187. 105. 190. 105.

252. 211. 293. 365 Cinnabaris. 340-341. 350 B Benzoinum. 203. 238 Calcitum. 57.LATIN HERB INDEX A Alumen. 310. 343 Caulis Lonicerae Japonicae. 255 bile-processed Rhizoma Arisaematis. 49. 328. 41. 280. 177. 115. 264. 30. 268. 229. 295 Calculus Bovis. 145. 311. 166. 317. 364 Cornu Bubali. 254. 82-83. 268. 126. 220. 261 Concha Ostreae. 223. 49. 112-113. 28. 123. 42. 269. 94. 263. 27. 134. 246. 256. 336. 206 Arillus Euphoriae Longanae. 256. 292-293 Cornu Rhinocerotis. 97. 276. 256. 284. 266. 198. 27 Camphora. 78. 366 Carapax Amydae Sinensis. 325. 130. 159. 70. 258. 368 Cordyceps Sinensis. 342. 59. 353 Concha Haliotidis. 367 Bulbus Lilii. 192. 302. 28. 37. 127. 335 cooked Radix Rehmanniae Glutinosae. 367 Bulbus Fritillariae Thunbergii. 208 Bulbus Allii Sativi. 365 C Cacumen Biotae Orientalis. 243. 58. 206. 292 . 42. 37. 59. 162. 70. 41. 306. 193. 253. 148. 201. 87. 366 Bulbus Fritillariae Cirrhosae. 178. 231. 131.

190. 368 Folium Artemisiae Argyii. 92. 364 Flos Carthami Tinctorii. 236. 280. 366 Flos Caryophylli. 367 Folium Ginkgonis Bilobae. 43. 318. 352. 181. 47 Cortex Phellodendri. 105. 365 Folium Perillae Frutescentis. 307. 367 D dry Rhizoma Zingiberis Officinalis. 204. 366 Cortex Erythiniae. 285-286. 28. 212. 277. 78. 329. 249. 152. 29. 293. 320. 346. 140. 162. 364 Fructus Arctii Lappae. 96. 166. 281. 148. 145 Flos Inulae Racemosae. 218. 209. 5. 366 Cortex Cinnamomi Cassiae. 355 Flos Immaturus Sophorae Japonicae. 218. 259. 47. 105. 153. 53. 68. 256. 344. 134. 49. 365 Cortex Fraxini. 120. 212. 338. 243. 109. 2. 367 Folium Mori Albi. 287. 213. 365 Flos Rosae Rugosae. 331 E Embryo Nelumbinis Nuciferae. 196. 28.Latin Herb Index 406 • Herb Toxicities & Drug Interactions: A Formula Approach Cortex Albizziae Julibrissinis. 138. 66. 113. 309 Fructificatio Ganodermae Lucidi. 116. 63. 364 . 34. 280. 50. 220. 162. 176. 144. 239. 240 Flos Albizziae Julibrissinis. 365 Flos Magnoliae Liliflorae. 297. 131. 53. 245. 274. 173. 2. 345. 149. 45. 179. 354 Flos Daphnes Genkwae. 52. 195. 270. 367 Cortex Radicis Meliae Azardachis. 222. 261. 207. 364 Folium Eriobotryae Japonicae. 286. 30. 366 Folium Daqingye. 149. 106. 324. 147. 169. 325. 294. 298. 110. 229. 118. 233. 38. 261. 354. 365 F Fibra Stipulae Trachycarpi. 187. 52. 304. 365 Fructus Amomi Tsao-kuo. 89. 106. 307. 127. 326. 47. 193. 367 Cortex Radicis Lycii Chinensis. 80. 367 Cortex Magnoliae Officinalis. 313. 124. 265. 75. 147. 364 Cortex Eucommiae Ulmoidis. 203. 47. 53. 75. 365 Cortex Radicis Moutan. 348. 315. 368 Cortex Radicis Mori Albi. 150. 365 Folium Nelumbinis Nuciferae. 183. 365 Flos Tussilaginis Farfarae. 366 Flos Chrysanthemi Morifolii. 150. 365 Flos Lonicerae Japonicae. 262.

302. 286. 335. 337. 365 Fructus Lycii Chinensis. 366. 277.Latin Herb Index Herb Toxicities & Drug Interactions: A Formula Approach • 407 Fructus Cardamomi. 55. 181. 33. 57. 236. 286. 364 Fructus Corni Officinalis. 251. 342. 364. 322. 256 Fructus Pruni Mume. 366 Herba Artemisiae Annuae Seu Apiaceae. 317. 216. 189. 322. 367 Fructus Gardeniae Jasminoidis. 70. 123. 127. 127. 246. 58. 365 Fructus Germinatus Hordei Vulgaris. 364 Fructus Chaenomelis Lagenariae. 112. 36. 98. 319. 134. 337. 261. 299. 146. 367 Fructus Perillae Frutescentis. 82. 71. 14. 337. 368 Fructus Trichosanthis Kirlowii. 366 Fructus Xanthii Sibirici. 364 Fructus Citri Aurantii. 328. 269. 302. 367 Herba Dendrobii. 367 Fructus Foeniculi Vulgaris. 126. 253. 368 Fructus Schisandrae Chinensis. 124. 267. 121. 96. 336. 199 Fructus Ligustri Lucidi. 366 Fructus Terminaliae Chebulae. 275 Fructus Levis Tritici Aestivi. 364 . 65 Fructus Zizyphi Jujubae. 98. 163. 312. 366 Herba Artemisiae Yinchenhao. 316. 89. 153 Herba Agastachis Seu Pogostemmi. 366 Herba Asari Cum Radice. 367 Fructus Crataegi. 166. 160. 170. 192. 74. 87. 95. 157. 364 Fructus Cnidii Monnieri. 341. 238. 335 H Hallyositum Rubrum. 136. 211. 201. 257. 366 G Gelatinum Corii Asini. 14. 148. 192. 132. 88. 137. 320. 42. 227. 366 Herba Andrographidis Paniculatae. 374 Herba Cistanchis Deserticolae Seu Salsae. 349. 337. 29. 205. 156. 365 Fructus Psoraleae Corylifoliae. 148. 365 Fructus Mori Albi. 293. 364 Herba Aloes. 222. 198. 311. 126. 291. 324. 367 Fructus Meliae Toosendan. 177. 80. 279. 322. 364 Herba Cynomorii Songarici. 54. 151. 246. 348 Gypsum Fibrosum. 367 Fructus Immaturus Citri Aurantii. 44. 280. 108. 307. 365 Fructus Myristicae Fragrantis. 333. 78. 219. 250 Fructus Rubi Chingii. 70. 200. 144. 364 Fructus Citri Reticulatae Viride. 306. 57. 150. 285. 94. 196. 301. 372Fructus Evodiae Rutecarpae. 2. 206. 365 Fructus Forsythiae Suspensae. 104 Fructus Piperis Longi.

32 Herba Sargassii. 253. 336 Pollen Typhae. 94. 118. 204. 102 . 210. 222 Os Draconis. 224. 185. 136. 224. 85. 341 N Nodus Rhizomatis Nelumbinis Nuciferae. 335. 280. 98. 255 Lignum Santali Albi. 220. 3267 Herba Menthae Haplocalycis. 269. 333 Medulla Junci Effusi. 336. 276. 365 Pericarpium Punicae Granati. 246. 368 Herba Dianthi. 192. 268. 134. 97. 123. 16. 82. 364 Pericarpium Papaveris Somniferi. 368 M Margarita. 166 Herba Taraxaci Mongolici. 132. 302. 255. 366 L Lignum Aquilariae. 36 Herba Lophatheri Gracilis. 112. 201. 307. 97. 33 Mirabilitum. 367 Herba Equiseti Hiemalis. 140. 143. 306. 55. 30. 368 Plastrum Testudinis. 38. 28. 42. 92. 4. 4. 56. 368 Pericarpium Zanthoxyli Bungeani. 127 P Pericarpium Benincasae Hispidae. 23. 270. 24. 63. 365 O Ootheca Mantidis. 141. 325. 127. 32. 188. 267 Massa Medica Fermentata. 335 Os Sepiae Seu Sepiellae. 32 Herba Ecliptae Prostratae. 311. 115. 4. 285. 367 Herba Leonuri Heterophylli. 272.Latin Herb Index 408 • Herb Toxicities & Drug Interactions: A Formula Approach Herba Desmodii Seu Lysmachiae. 66. 73. 70. 364 Pericarpium Citri Reticulatae. 59. 300. 365 Herba Polygoni Avicularis. 127. 224. 241 Pyritum. 293. 352. 222. 148. 122. 262. 198. 168. 104-105. 101. 70. 78. 126. 375 Herba Epimedii. 87. 364 Herba Ephedrae.

227. 249. 213. 176. 372 Radix Ephedrae. 124. 87. 229. 253. 253. 239. 79. 206. 108. 156. 364. 72. 271. 313. 302. 148. 35. 87. 97. 224. 343. 190. 355 Radix Gentianae Longdancao. 243. 34. 307. 365 Radix Glehniae Littoralis. 144. 116. 152. 187. 258. 266. 64. 67. 154. 293. 58. 115. 198. 343. 233. 298-299. 42. 212. 127. 147. 74. 365 Radix Glycyrrhizae Uralensis. 190. 315. 271. 104. 329. 289. 338. 341. 364 Radix Dipsaci. 70. 306. 364 Radix Asteris Tatarici. 169. 233. 28. 63. 220. 183. 37. 111. 23. 364 Radix Cyathulae. 75. 130. 216. 368 Radix Euphorbiae Kansui. 45. 354. 119. 292 Radix Adenophorae Strictae. 318. 131. 268. 279. 178. 305. 244. 77. 246. 56. 191. 37. 38. 233. 162. 282. 176. 307-308. 364 Radix Eleuthrococci Senticosi. 143. 100. 277. 316. 100. 117. 125. 109. 284. 263. 330. 152. 306. 126. 28. 63. 298. 171. 136. 75. 351. 243. 39. 42. 279. 340. 246. 236. 367. 243. 298. 5. 276. 372 . 169. 34. 367 Radix Dioscoreae Oppositae. 45. 351 Radix Auklandiae Lappae. 364 Radix Codonopsitis Pilosulae. 224. 182. 311. 303. 28. 139. 220. 293. 312 Radix Aconiti Carmichaeli. 113. 110. 296. 192. 348. 160. 259. 82. 53. 178. 346. 256. 371 Radix Astragali Membranacei. 197. 354. 273. 274. 259. 54. 113. 173. 354. 92. 43. 292. 229. 276. 286. 303.Latin Herb Index Herb Toxicities & Drug Interactions: A Formula Approach • 409 R Radix Achyranthis Bidentatae. 112. 28. 364 Radix Bupleuri. 148. 320. 130. 37. 245. 365 Radix Angelicae Dahuricae. 183. 154. 42. 320. 365 Radix Et Rhizoma Rhei. 332. 134. 273. 364 Radix Clematidis Chinensis. 304. 42. 325. 142. 173. 152. 178. 84. 107. 183. 38. 137. 61. 89. 33. 313. 134. 57-59. 289. 282. 256. 160. 113. 156. 196. 259. 280. 143. 36. 366. 322-323. 51. 350. 59. 92. 326. 231. 230. 68. 53. 176. 120. 367 Radix Et Rhizoma Ligustici Chinensis. 346. 366 Radix Aconiti. 42. 256. 224. 143. 365 Radix Gentianae Qinjiao. 277. 214. 366 Radix Angelicae Sinensis. 262. 64. 71. 36. 53. 209. 343. 326. 49. 316. 338. 364 Radix Cynanchi Atrati. 105. 89. 124. 172. 318. 47. 134. 223. 3. 200. 364 Radix Angelicae Pubescentis. 352. 74. 197. 111. 274. 180. 138. 365 Radix Et Rhizoma Notopterygii. 334-335. 196. 299. 279. 4. 204. 48. 131. 171. 281. 211. 120. 229-230. 267. 172. 198. 204. 201. 344. 286. 292 Radix Aconiti Kusnezoffii. 232. 73. 245. 336. 131. 28. 336. 364 Radix Albus Paeoniae Lactiflorae. 62. 252. 281. 114. 82. 43. 162. 83. 66. 305. 199. 105. 179. 316. 149. 249-250. 123. 207. 187. 269. 310. 70. 144. 115.

366 Resina Myrrhae. 364 Rhizoma Anemarrhenae Aspheloidis. 41. 317. 95. 364 Ramulus Loranthi Seu Visci. 125. 62. 257. 226. 126. 287. 160. 209. 347. 155. 339. 160. 243. 220. 97. 105. 265. 23. 310. 182. 255. 365 Rhizoma Acori Graminei. 340. 152. 306. 365 Radix Pulsatillae Chinensis. 143. 4. 365 Radix Lateralis Praeparatus Aconiti Carmichaeli. 128. 269. 367 Radix Panacis Quinquefolii. 73. 266. 368 Ramulus Cinnamomi Cassiae. 197. 83. 232. 83. 129. 343. 367 Resina Olibani. 96. 208. 258. 23. 236 Radix Puerariae Lobatae. 152. 316 Radix Salviae Miltiorrhizae. 344 Rhizoma Alpiniae Officinari. 16. 366 Radix Sophorae Flavescentis. 95. 157. 207. 182. 330. 168. 280. 83. 295. 288. 59. 36. 166. 71. 297. 320. 365 Radix Ligustici Wallichii. 161. 95. 118. 336. 37. 315. 160. 159. 248. 285. 271. 231. 229. 84. 366 Radix Stemonae. 367 Radix Linderae Strychnifoliae. 172. 238 Radix Rubrus Paeoniae Lactiflorae. 344. 213. 366 Radix Scrophulariae Ningpoensis. 348. 325. 206-207. 110. 269. 193. 140. 229. 335. 16. 264. 260. 364 . 293. 100. 253. 201 Radix Morindae Officinalis. 350. 283. 109. 130. 95. 28. 243. 366 Rhizoma Alismatis Orientalis. 306. 177. 49. 271272. 42. 367 Radix Pseudostellariae Heterophyllae. 69. 195. 46 Radix Rehmanniae Glutinosae. 176. 44. 40-41. 208. 368 Radix Ledebouriellae Divaricatae. 150. 37. 354. 177. 241-242. 94-95. 365 Radix Platycodi Grandiflori. 105-106. 52. 235. 252. 112. 91. 68. 177. 109. 16. 284. 347. 328. 3. 175. 278. 368 Radix Trichosanthis Kirlowii. 224. 319. 336 Radix Scutellariae Baicalensis. 281.Latin Herb Index 410 • Herb Toxicities & Drug Interactions: A Formula Approach Radix Isatidis Seu Baphicacanthi. 367 Radix Polygoni Multiflori. 292. 284. 366 Rhizoma Atractylodis. 16. 270. 80. 264. 299. 132. 148. 364 Rhizoma Arisaematis. 257. 111. 101. 29. 262. 151. 101. 97. 332. 297. 152. 367 Radix Polygalae Tenuifoliae. 351 Radix Stephania Tetrandrae. 203. 331. 119. 62. 75. 118. 279. 366 Radix Taraxaci Mongolici Cum Radice. 294. 52. 153. 223. 286. 329. 117. 172. 112. 223-225. 78. 176. 126. 330. 250. 125. 329. 272. 228. 130. 179. 266. 268. 203. 216. 365 Ramulus Uncariae Cum Uncis. 195. 342. 332. 85. 364 Rhizoma Atractylodis Macrocephalae. 265. 180. 340. 367 Radix Rubiae Cordifoliae. 263 Ramulus Mori Albi. 290. 236. 261. 127. 173. 365 Radix Notoginseng. 62. 155. 23. 291. 94. 368 Radix Panacis Ginseng. 317. 41. 259.

303. 365 Rhizoma Imperatae Cylindricae. 353. 368 Semen Raphani Sativi. 284. 215. 68. 314. 229. 197. 344. 366 Semen Sinapis Albae. 365 Rhizoma Nardostachydis. 267 Semen Coicis Lachryma-jobi. 101. 276. 260. 367 Rhizoma Polygonati. 111. 63. 367 Rhizoma Cyperi Rotundi. 212. 56. 297. 182. 343 Semen Biotae Orientalis. 306. 230. 16. 258. 282. 75. 114. 276. 115. 135. 162. 366 Semen Trigonellae Foeni-graeci. 366. 162. 293. 371 Rhizoma Coptidis Chinensis. 221. 332. 149. 172. 243.Latin Herb Index Herb Toxicities & Drug Interactions: A Formula Approach • 411 Rhizoma Cibotii Barometsis. 316. 46. 164. 294. 367 Rhizoma Curcumae Zedoariae. 178. 142. 340. 179. 280. 365 Stamen Nelumbinis Nuciferae. 270. 238. 355 . 266. 196 Semen Plantaginis. 164. 234. 48. 263. 213. 239. 130. 365 S Sanguis Draconis. 230. 53. 207. 147. 117. 157. 209. 258. 56 Semen Sesami Indici. 23. 259. 368 Semen Zizyphi Spinosae. 109. 32. 367 Semen Oryzae Sativae. 134. 311. 367 Rhizoma Phragmitis Communis. 201. 211. 5. 73. 364 Rhizoma Gastrodiae Elatae. 256. 113. 367 Rhizoma Corydalis Yanhusuo. 49. 364 Semen Dolichoris Lablab. 364 Rhizoma Dioscoreae Hypoglaucae. 366 Semen Cuscutae Chinensis. 133. 107. 83. 365 Rhizoma Polygoni Odorati. 368 Spica Prunellae Vulgaris. 325 Semen Pruni Armeniacae. 365 Stigma Zeae Maydis. 51. 208. 366 Semen Trichosanthis Kirlowii. 59. 294 Semen Euryalis Ferocis. 326 Rhizoma Pinelliae Ternatae. 311. 331 Rhizoma Drynariae. 28. 364 Sclerotium Pararadicis Poriae Cocos. 3. 268. 372 Semen Praeparatum Sojae. 366 Succinum. 364 Rhizoma Cimicifugae. 273. 57. 230. 105. 130. 365 Semen Nelumbinis Nuciferae. 70. 212. 45. 36. 223 Sclerotium Polypori Umbellati. 143. 84. 253. 100. 367 Rhizoma Curcumae Longae. 233. 286. 97. 37. 365 Sclerotium Poriae Cocos. 368 Semen Pruni Persicae. 284. 333. 279. 268. 15.

226. 143. 332 Thallus Algae. 371 . 137. 372 Tuber Asparagi Cochinensis. 124. 206. 141. 277. 172. 32. 233. 112. 167 Tuber Curcumae. 259. 204. 312. 73.Latin Herb Index 412 • Herb Toxicities & Drug Interactions: A Formula Approach T Talcum. 29. 372 Thallus Laminariae. 291. 36. 348. 49. 111. 39. 331. 253. 368 uncooked Rhizoma Zingiberis Officinalis. 84. 282. 298. 116. 316. 340. 365 U uncooked Radix Rehmanniae Glutinosae. 256. 100. 366. 364 Tuber Ophiopogonis Japonici. 307. 141. 132. 167. 28. 5. 98. 169. 279. 69. 202.

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