Herbalism safety: working with plants that harm and heal

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SAN FRANCISCO –Last week, officials announced that a woman here had died after ingesting a toxic herbal tea, and a man who also drank a brew prepared from herbs sold at the same shop, was hospitalized in critical condition before recovering.

According to local news coverage, the culprit was the herb aconite, which has a variety of common names including wolf’s bane and fuzi. While this plant can be highly toxic without processing, with proper care it is a staple of Chinese herbal medicine.

Aconitum napellus [Wikimedia Commons].

The two victims in San Francisco purchased different tea blends that were mixed at Sun Wing Wo Trading Company, each of which included unprocessed aconite. Tests of both the herbal blends and the victims’ blood confirmed aconite as the toxic agent. It’s a poison for which there is no antidote.

The toxicity of aconite is not news. Ancient Greeks speculated the plant came from the mouth of Cerberus, and their Chinese contemporaries also wrote about how its sap could be simmered down into a very deadly poison. The herbs healing properties were not studied in Europe until the 18th century, but it’s been referred to as the “king of all herbs” in Chinese lore for 2,000 years.

Rev. Kirk White has been a licensed practicing acupuncturist and Chinese herbalist in Vermont since 1994, and has been an instructor at the Green Mountain Institute of Acupuncture and Oriental Medicine. He regularly prescribes aconite, which he refers to by the Chinese name fuzi, as part of his practice.

“It shouldn’t be something someone can pick up for themselves nor self-diagnose the need for,” he said, but “it is in one of the flagship formulas used regularly as a standalone formula, or the base of a customized formula.”

One common formula that includes aconite is the “kidney qi pill,” which is part of the “golden cabinet” of oriental formulas.

The alkaloids in aconite, particularly aconitine, can cause heart palpitations and other symptoms, according to a Heiner Fruehauf:

These alkaloids activate voltage-sensitive sodium channels in the heart and other nervous tissues which then become refractory to further stimulation. Onset of symptoms such as numbness of the mouth and tingling of the hands and feet is rapid, usually within 10 minutes of ingestion. Other symptoms include nausea, vomiting, dizziness, hypotension, ventricular tachycardia, torsades de pointes and heart block which can lead to death. The lethal dose is estimated to be approximately 2 mg of aconitine.

Despite that danger, aconite also has valuable healing properties, such that a second-century B.C.E. Daoist text stresses that “a good physician collects it and stores it away to be used for medicinal purposes.” The names used for the plant “have become synonymous with the concept of ‘medicine’ itself,” according to Fruehauf.

[Photo Credit: PoYang_博仰 ]

[Photo Credit: PoYang_博仰 ]

Those ancient Chinese herbalists used a variety of techniques to detoxify the plant, including cultivating it in specified locations using traditional methods, removing the skin from the roots and applying heat, often in the form of steam, which breaks down the alkaloids.

Aconite is stored in brine to preserve it from harvest until it is processed, and all the salt must also be removed during processing. How the herbs are combined is also intended to reduce toxicity and increase efficacy.

Increased demand for oriental herbs has led to the abandonment of some of the traditional processing steps, including the transplanting of young plants to appropriate locations just after the winter solstice. That has contributed to widely varying quality of the processed herb, and that in turn has resulted in more stringent adherence to the labor-intensive old ways, resulting in both higher prices and higher quality.

White said that if this was a case of aconite poisoning, it was likely either a diagnostic error that resulted in these two victims receiving an incorrect formula, or a dosing error that resulted in too high a concentration of fuzi.

However, he added, “The toxin might be something entirely different and authorities are blaming the easy target because of their (wrong) assumption that no dosage of aconite is safe.”

Despite it being referred to as “leaves” by local authorities, White said that it’s the root of the plant that is used in Chinese medicine. “In unground-up form it is fairly distinctive in appearance, so the preparer either put in too much or didn’t know their herbs well enough.”

Incidents like this can push health consumers away from alternative modalities out of a concern that the treatments will do more harm than good. As many Pagans and polytheists are drawn to these healing formulas, that could have a disproportionate effect on health choices made by members of these communities.

White said that he understands those worries, and counsels education as the best preventative.

“As we see all the time in mainstream medicine, incompetence, mistakes, and malpractice happen all the time. All you can ever do is minimize your risk whether it is Western or Eastern medicine. Do that by checking training, licensure, and credentials, getting references, meeting and asking providers about their backgrounds, training, and healing philosophy, and then listen to your instincts.”

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The work of journalist Terence P. Ward was made possible by the generous underwriting donation from Hecate Demeter, writer, ecofeminist, witch and Priestess of the Great Mother Earth.