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Patients warned of dangers of Chinese medicines

BMJ 2001; 323 doi: http://dx.doi.org/10.1136/bmj.323.7316.770e (Published 06 October 2001) Cite this as: BMJ 2001;323:770

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  1. Mark Gould
  1. London

    Practitioners of traditional Chinese medicine have agreed to cooperate with the Department of Health to improve the safety of traditional medicines after concerns that they may contain potentially toxic or carcinogenic ingredients.

    Last week the Committee on Safety of Medicines said that random tests were still finding banned substances such as mercury and arsenic in traditional Chinese medicines sold in the United Kingdom, despite previous warnings. Some medicines also contained steroids, even though the label did not declare it.

    Banned products containing the herb aristolochia, which has been associated with two cases of kidney disease in the United Kingdom in 1999, are also still being offered for sale. Other Chinese medicines that the committee examined contained parts from endangered animal species.

    A spokesman for the committee said that a 58 year old woman went into a hypoglycaemic coma after she took an oral hypoglycaemic agent containing glibenclamide, a drug that is normally available only on prescription.

    Last week the Medicines Control Agency published guidance on these potentially harmful medicines. Professor Alastair Breckenridge, the chairman of the Committee on Safety of Medicines, which advises the agency, said: “We have informed ministers that we can provide no assurance that traditional Chinese medicines on the UK market are safe.”

    Professor Breckenridge said that it is not possible for consumers to be sure that they are getting a safe product even when the contents are listed and labelled in English. Products labelled as being free of mercury compounds or aristolochia were in some instances found on analysis to contain these substances. He advised people taking traditional Chinese medicines to tell their doctor or pharmacist.

    Over one million people in the United Kingdom use traditional Chinese medicines every year. There are over 3000 clinics and shops in Britain. The Chinese Medical Academy UK plans to establish an internet clinic of Chinese medicine that would allow patients to contact a doctor of Chinese medicine, who would make a diagnosis, give advice, or send traditional Chinese medicines by post. The four main groups representing traditional Chinese medicine in the United Kingdom say they are committed to complying with the law and protecting patients.

    Professor Man Fong Mei, the director of one of the four groups, the Chinese Medical Institute and Register in London, said doctors should advise patients interested in using Chinese medicine to consult practitioners who, like him, were dually qualified in western and Chinese medicine.

    “There are a lot of what I would call ‘herbal takeaways’ in high streets and shopping centres that do not have qualified staff and that sell unlicensed drugs that they bring into the country themselves, and this causes problems for genuine practitioners.”

    Professor Mei felt that the Committee on Safety of Medicines' statement “tarnished” the reputation of responsible groups but that as a result many reputable practitioners had decided they should become better organised.

    However, Devon GP Michael Dixon, chair of the NHS Alliance and an advocate of complementary medicine, said that because of the committees' concerns he would be reluctant to tell a patient that traditional Chinese medicine was safe.

    The guidance for practitioners is available at http://www.mca.gov.uk/