I’ve written about the harm arising from the aristolochic acid found in Aristolochia clematitis, birthwort, and other species within the genus several times. As well as an extensive discussion on the plant page in the A to Z section, I’ve blogged about it on 25th November and June 25th 2011.
Monday saw the online publication of the latest paper on the subject from Prof Arthur Grollman and his colleagues. Happily, after Monday’s blog, the full paper is available online. It has some pretty complex chemistry in it but the discussion and conclusions are clear enough.
A summary is available from this Stony Brook University press release and there is an article in the Los Angeles Times. As the work was conducted in Taiwan and involved Taiwanese colleagues, it is not surprising that the local media reported on it. I may be revealing my prejudice about the UK press but I was struck by the headline. In the UK, you would expect them to make as big as crisis about this as possible. The online story from the Focus News Channel (run by the official news agency) however is headlined 'Certain Chinese herbal medicines linked to types of cancer: study'.
It's that 'certain' I find interesting. I don't know if that is just the result of a more restrained style of reporting or if Focus News is anxious to avoid any suggestion that all herbal medicine should be viewed with suspicion.
By looking at the DNA structures and comparing rates of urothelial cancer in Taiwan and elsewhere, especially gender differences, the paper shows unequivocally that herbal remedies containing aristolochic acid are killing people and will, quite probably, kill a lot more people before their use is completely stamped out and the long-term effects of the poisoning work their way through the at risk populations.
So, you would think, job done, problem identified, everybody stops using Aristolochia plants in herbal remedies and health services seek to identify those at risk and offer what treatment they can.
Unfortunately, it is not that easy. I blogged, yesterday, about homeopathy where all the scientific evidence in the world hasn’t stopped people promoting it and successfully duping people into using it. And so it seems with aristolochic acid. It’s not using it that is the problem; it is using it wrongly. Or so you would think if you accepted what the Shijiazhuang Kidney Disease Hospital has to say about adding other substances, like liquorice, to counteract the harmful action of AA.
Though still a communist country, China has taken to the capitalist system in a big way and has even adopted some of the marketing by fear that characterises the worst of commercial medicine. Thus the hospital says ‘Therefore, the persons should be not buy Chinese medicine without prescription by professional doctors’.
I know that Arthur Grollman understands the cultural sensitivity of demonstrating that Traditional Chinese Medicine (TCM) can be lethal to patients. It also seems, however, that commercial self-interest will be a barrier to getting universal acceptance of his work.