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Human & Experimental Toxicology
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Podophyllotoxin Intoxication: Toxic Effect of Bajiaolian in Herbal Therapeutics

Wei-Fong Kao

Department of Emergency Medicine, Veterans General Hoosputal, Taipei, Taiwan, Department of Medicine, Veterans General Hosputal, Taipei, Taiwan

Dong-Zong Hung

Department of Emergency Medicine, Veterans General Hoosputal, Taipei, Taiwan, Department of Medicine, Veterans General Hosputal, Taipei, Taiwan

Wei-Jen Tsai

Department of Emergency Medicine, Veterans General Hoosputal, Taipei, Taiwan, Department of Medicine, Veterans General Hosputal, Taipei, Taiwan

Kon-Ping Lin

Institute of Neurology, Veterans General Hospital, Taipei, Taiwan

Jou-Fang Deng

Department of Emergency Medicine, Veterans General Hoosputal, Taipei, Taiwan, Department of Medicine, Veterans General Hosputal, Taipei, Taiwan

Bajiaolian (Dysosma pleianthum), one species in the Mayapple family, has been widely used as a general remedy and for the treatment of snake bite, weakness, condyloma accuminata, lymphadenopathy and tumours in China for thousands of years. However, the textbooks of traditional Chinese medicine mention little about the toxicity of Bajiaolian. Within 1 year, the authors saw five people who manifested nausea, vomiting, diarrhoea, abdominal pain, thrombocytopenia, leucopenia, abnormal liver function tests, sensory ataxia, altered consciousness and persistant peripheral tingling or numbness after drinking infusions made with Bajiaolian. The herb was recommended by either traditional Chinese medical doctors or herbal pharmacies for postpartum recovery and treatment of a neck mass, hepatoma, lumbago and dysmenorrhoea. Podophyllotoxin is one of the main ingredients of the Bajiaolian root. The clinical manifestations observed in our patients were consistent with podophyllum intoxication. Podophyllotoxin intoxication usually results from the accidental ingestion or topical application of podophyllum resin. However, these cases of Bajiaolian intoxication were iatrogenic and results from 'therapeutic doses' of Bajiaolian cited in the textbooks of traditional Chinese medicine.

Human & Experimental Toxicology, Vol. 11, No. 6, 480-487 (1992)
DOI: 10.1177/096032719201100607
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