Recent visits to local Chinese herbal shops revealed the following complementary and alternative medicine (CAM) and Chinese herbal medicines available for sale:

•  “Jin Kui Sen Wan (Pill)” containing aconiti tuber lateralis (10%) and seven other Chinese herbs used for “relieving cough.”

•  “Ching Wan Hung” ointment containing myrrha (1.35%) with seven other ingredients and Chinese herbs.

•  “Authentic Red Flower Oil” containing methyl salicylate (28%) and cinnamon oil (24%), used for “relief of rheumatism lumbago, sciatica, sprains, bruises, and others.”

•  “Chin So Ku Ching (sperm) Wan (Pill)” containing six Chinese herbs with a label of “No poison,” used for “spermatorrhea.”

There are potential side effects in these CAM/Chinese herbal medicines. Aconiti tuber lateralis has cardiac side effects.[1] Allergic contact dermatitis occurs with myrrha.[2] There is possible bleeding or coagulation problems with methyl salicylate. It is not clear if the label of “No poison” means this Chinese patent medicine of herbal origin contains no impurities, including heavy metals, e.g., lead[3] or mercury.[4]
The issues of potential adverse and allergic reactions from CAM and dietary supplements,[5] and regulation[6] have been raised. Prescription drugs[7] and pharmaceutical products[8] contained in CAM purchased in local Chinese herbal shops have been reported.
Our history-taking should include patient’s use of CAM. Patients should be asked to bring in all products or pill bottles to their visits. Careful examination of all of them, including CAM, should be carried out.

--H.C. George Wong, MD
Vancouver

References

1. Wong HCG. Cardiac adverse reaction associated with Fu Zi--A case of mild aconite poisoning from Chinese herbal medicine. Ann R Coll Physicians Surg Can 2001;34:358-361.
2. Wong HCG. Allergic contact dermatitis from topical Chinese herbal medicine and generalized urticaria and angioedema with dietary supplementation : A case report. BC Med J 2002;44:184-187.
3. Wong HCG. Generalized allergic maculopapular eruption associated with Prostate Gland Pills, a Chinese proprietary medicine of herbal origin. Ann R Coll Physicians Surg Can 2000;33:104-106.
4. Wong HCG. Mercury and Chinese herbal medicine. BC Med J 2004;46:442.
5. Wong HCG. Potential adverse and allergic reactions from complementary and alternative medicine (CAM) and other dietary supplements (DS). Allergy Asthma Clin Immunol 2006;2:68-73.
6. Wong HCG. Potential adverse reactions from the use of complementary and alternative medicine and other dietary supplements with warning from Canada and US health authorities. (abstract 450) J Allergy Clin Immunol 2002;109:S153.
7. Wong HCG. Potential adverse and allergic reactions to patent medicines containing prescription drugs. Allergy Clin Immunol Int: J World Allergy Org 2003;15:114-118.
8. Wong HCG. Potential adverse reaction from complementary and alternative medicines (CAM) containing pharmaceutical products (PP). (abstract 1150) J Allergy Clin Immunol 2004;113;S313.