Chapter 1: Current status of research on adverse reactions of Chinese medicines and their causes Chapter 2: Diagnosis of poisoning by Chinese medicines I. History taking II. physical examination III. laboratory examination Chapter 3: Rescue of poisoning by Chinese medicines I. Exclusion of unabsorbed poisons II. 3. Anise 4. Ginseng 5. Jiu Li Xiang 6. 25, Asparagus 26, Mucuna pruriens 27, Corrugated seeds 28, Wu Mu Zi 29, Mao Dong Qing 30, Burdock 31, Salvia 32, Moonflower 33, Croton 34, Mercury 35, Leech V. 36, Mugwort 37, Licorice 38, Acorus calamus 39, Dendrobium 40, North bean root 41, Four seasons 42, Cordyceps 43, Whitehead 44, White flowered snake’s tongue 45, Gua Ti 46, Gua Pao skin 47, Radix Panax notoginseng VI 48, Di Long 49, Di Gua Zi 50, Di Shen Zi 51, Di Bone Pi 52, Di Jin Cao 53, Xiyang Ginseng 54, Bai Bei 55, Ziziphi 56, Cinnamon 57, Zhu Li 58, Zhu Sha 59, Huashan Ginseng 60, Yan Hu Suo 61, Blood Yu Tan 62, Blood Dried 63, All Scorpion 64, Dang Jie Xin 65, Bing Qi 66, Guan Mu Tong 67, Fang Feng 68, Safflower 69, Red Fennel 70, Red powder Seven paintings 71, Yuan Zhi 72, Coriander 73, Mustard seed 74, Cang Er Zi 75, Gorgonian 76, Red peony 77, Lian Qian Cao 78, Forsythia 79, Wu Ju Ju 80, Oyster 81, He Shou Wu 82, Saponaria 83, Xin Yi 84, Myrrh 85, Shen Xiang 86, Boneset 87, Ling Zhi 88, He Gao 89, Chen Pi 90, Radix et Rhizoma Eight paintings 91, Qing Feng Vine 92, Qing Cai 93. Artemisia annua 94, Qing Dai 95, Bitter Almond 96, Neem Bark 97, Kun Bu 98, Kunming Mountain Begonia 99, Pendula 100, Jun Junzi 101, Jin Guo Lan 102, Qian Qian Cao 103, Jin Zhen Zi 104, Jin Tang 105, Swollen Wind 106, Fishy Herb 107, Nightshade Vine 108, Hossein IX 109, Lycium barbarum 110, Fenugreek 111, Thornbush 112, Cao Wu 113 114, Poria cocos 115, Sandy sesame 116, Arsenicum arsenicum 117, Petunia caryophyllum 118, Ligustrum wilfordii 119, Light powder 120, Crow’s bile 121, Douhu 122, Fat sea 123, Cyperus rotundus 124, Qian Hu 125, Andrographis paniculata 126, Andrographis paniculata X 127, Peach kernel 128, Xia Kuo Cao 129, Chai Hu 130, Dou Shu Cao 131, Stinky wutong leaf 132, Wolfsbane 133, Seahorse 134, Seaweed 135, Yi Mu Cao 136, Mulberry 137, Mulberry Eleventh painting 138, Cuscuta 139, Chrysanthemum 140, Scutellaria 141, Astragalus 142, Phellodendron 143, Huang Yao Zi 144, Artemisia spp. 145, Serpent’s gall bladder 146, Rhizoma 147, Shang Lu 148, Wang Jiang Nan Zi 149, Mitra Sinensis 150, Sequoia Twelfth painting 151. 152, Bo Lu Hui 153, Scapularia scabra 154, Xiong Huang 155, Gooseberry 156, Senna leaves 13 paintings 157, Castor seed 158, Tribulus terrestris 159, Dandelion 160, Lei Gong Vine 161, Centipede 162, Honey 163, Mangshan Hong 14 paintings 164, Sour date palm 165, Cicada molasses 166, Poppy shell 15 paintings 167, Camphor 168, Silkworm 169. Ligusticum 170, Toadstool 171, Turtle nail 172, Musk Appendix Appendix I Management of toxic drugs for medical use Appendix II Half lethal dose of commonly used herbs Appendix III Index of Chinese Pinyin Appendix IV Index of Latin names Appendix V Index of Latin scientific names Appendix VI Index of therapeutic classification General Introduction All substances with medical, diagnostic, disease prevention and health care effects are collectively referred to as drugs. The sources of drugs include natural products and their products, synthetic chemicals and biochemical products. Chinese medicine is a medicine of natural origin applied for medical treatment and health care based on the theory and clinical experience of Chinese medicine, and it is an important part of the treasury of medicine of our motherland. It has made significant contributions to the reproduction and prosperity of the Chinese nation, and has brought about extremely far-reaching effects on the development of medicine around the world. “Water can carry a boat, but it can also overturn it.” In the same way, “medicine can cure disease, but also cause disease.” The correct use of Chinese herbal medicine can save the dying body and bring back to life; if used improperly, it can destroy the body and put people to death. Numerous facts prove that there is no clear boundary between drugs and poisons. Under certain conditions, the two can be transformed into each other. The World Health Organization (WHO) refers to any harmful and unwelcome reactions that occur during the use of drugs as adverse drug reaction (ADR). Modern pharmacology often classifies drug-induced adverse reactions into side effect, toxic reactions, after effeet, and unusual reactions due to physical factors. In Chinese herbal medicine, adverse reactions are generally referred to as toxic reactions. For a long time, people pay great attention to the adverse reactions of western medicine, but ignore the adverse reactions of Chinese medicine, and even think that “Chinese medicine is not toxic, no side effects”, and Chinese medicine “can cure disease, no disease is fitness”, which is extremely wrong. With the development of Chinese medicine, the widespread use of Chinese medicine, and the improvement of people’s understanding of pharmacogenic diseases, the adverse reactions in the application of Chinese medicine have gradually attracted people’s attention. From 1960 to 1993, there were 780 reports on ADRs of proprietary Chinese medicines, Chinese herbal injections and Chinese herbal medicines published in 123 domestic medical and pharmacy journals and medical school journals, with 3009 cases. Among them, 0.3% were reported before 1970, 3% from 1971 to 1979, 82.3% from 1980 to 1989, and 14.4% after 1990. Among the 780 reports, there were 389 ADRs of Chinese herbal medicines, accounting for 2071 cases, of which 135 cases caused death, accounting for 6.5%. In conclusion, the adverse reactions of Chinese herbal medicines are the summary of previous clinical experience and practice, and have paid a heavy price. It is a common concern of doctors and patients to master the adverse reactions of commonly used herbal medicines and their prevention and treatment methods. There is a large amount of literature on this subject, but there is a lack of systematic organization, and so far there is no tool book on the adverse reactions of commonly used herbal medicines and their prevention and treatment. This book collects relevant information from a large amount of literature (before 1994), and focuses on the adverse reactions of 172 commonly used herbal medicines and their prevention and treatment in each treatise, and arranges them in the order of strokes into one volume, so as to facilitate the readers’ access, and at the same time, to provide information for future supplementation for perfection. Since ancient times, people have been using plants and animals as food, and while searching for food, they have discovered many biologically active plants and animals that can be used to prevent and treat diseases through repeated attempts, thus there is the saying of “medical food has the same origin”. Shennong (2700 B.C.) tasted a hundred herbs to cure diseases, and encountered seventy poisons in one day. This is a good example of how our ancestors relied on human intuition to understand natural medicines. Over a long period of time, people have developed adaptations to herbal medicines. Meanwhile, the sugars and vitamins contained in herbal medicines may be converted into glucose and glucuronic acid in the human body, thus helping to detoxify the body; some herbal medicines contain proteins and gums, which can protect the gastric mucosa, moderate irritation, hinder the absorption of toxic ingredients, and can combine with certain toxic ingredients, such as alkaloids, and be excreted, so as to eliminate drug toxicity and side effects The purpose of the drug is to eliminate toxicity and side effects. Therefore, the adverse reactions of traditional Chinese medicine are far less than those of synthetic drugs. This has made Chinese medicine more popular in the domestic and international medical community. With the vigorous development of Chinese medicine in China, the application of Chinese herbal medicine and its preparations has become more and more widespread, and thus the number of adverse reactions in the population has also increased. According to the literature, the occurrence of adverse reactions in Chinese medicine has been on the rise year by year, with only 26 cases in the 1950s and before, 147 cases in the 1960s, 398 cases in the 1970s, and up to 2217 cases in the 1980s. In terms of the variety and number of drugs causing adverse reactions, there are 460 varieties of Chinese medicine, of which 239 are single-flavored drugs. According to modern diagnostic classification, adverse reactions of Chinese medicine often cause poisoning of respiratory, circulatory, digestive, urinary and nervous systems, and in serious cases, toxic shock. The concept of “poison” in Chinese medicine is not the same in ancient and modern understanding, but has the following meanings in general: ①Poison refers to drugs in general, as described in the Rites of Zhou: “The physician is in charge of the political order of the doctor, and gathers poison for the medical service”. Zhang Zihe said: “All medicines are poisonous, not only big poison, small poison is called poison”. ② medicine poison refers to the bias of the drug, such as Zhang Jinyue said: “medicine can cure diseases, because the poison for the ability, the so-called poison, is to smell the bias also. (3) Drug toxicity means toxic side effects, such as “Huainanzi” records: “Shennong tasted the taste of a hundred herbs, the sweetness and bitterness of water and springs, so that the people know what to avoid, and encountered seventy poisons in one day”. The correct understanding of the adverse reactions of Chinese medicine is conducive to improving the efficacy and protecting human health. Causes of adverse reactions to Chinese medicine: 1. Prescription overdose According to literature statistics, of the 295 cases of adverse reactions to Chinese herbal medicine, 224 cases are overdoses, accounting for 75,9%. For example, the overdose of Guati and Changshan caused death by poisoning, and the large dose of Astragalus caused severe limb pain, etc. 2, misuse, misuse of wide bean root as northern bean root for the prevention of colds and poisoning, white atractylodes misuse and harm, misuse of sweet gourd tip to death, etc.. 3, improper preparation and serving method such as aconite drugs, due to the greater solubility of aconitine in ethanol, so no matter soaking wine, wine decoction or served with wine, will enhance its toxicity. According to statistics, in the past 30 years, our country aconite poisoning 635 cases, of which 93 cases are served with wine, so that the symptoms of poisoning appear quickly, serious illness, rapid development, and there are 7 people caused by death, can not be cautioned. 4, inappropriate combination such as licorice is a very common Chinese antidote. Traditional Chinese medicine is used to detoxify the toxicity of the herbs. Modern science verifies that licorice has a strong detoxifying effect on diphtheria toxin and tetanus toxin, but if improperly combined, it will increase the toxicity of the combined drugs, such as epinephrine and ephedrine poisoning, the use of licorice will increase the toxicity; licorice and gansui combined, a small dose can reduce its toxicity, a large dose will enhance its toxicity. 5, allergic body According to reports, can cause allergic reactions to more than 150 kinds of herbs, and anaphylaxis accounts for 25, 6% of the total number of allergic reactions. Such as stiff silkworm cause rash, oral decoction of turtle nail can cause serious allergies. The list goes on and on. 6, blind medication think that eating Chinese medicine is safe, there is a disease cure, no disease fitness, do not follow medical advice, abuse of Chinese medicine, superstition, single prescription, secret recipe, etc.. Such as the use of ginseng royal jelly or ginseng tonic and not allopathic, resulting in cases of poisoning are common. According to incomplete statistics, since the liberation, there have been more than 1,000 reports of poisoning cases of Chinese herbs and proprietary Chinese medicines across the country, and there are hundreds of herbs that cause poisoning. A large number of practices have proved that certain herbal medicines, even if not written in the recent pharmacopoeia as toxic, should not be taken lightly in clinical application to avoid adverse consequences. Chapter 2: Diagnosis of poisoning by Chinese herbs Acute poisoning by Chinese herbs is characterized by sudden onset, ferocity, rapid development, and seriousness. In order to turn the poisoned patient into a safe one as soon as possible, it is necessary to make a correct diagnosis as soon as possible and be good at identifying the special clinical manifestations of individual Chinese herbs. The early and late treatment time has a great relationship with the patient’s prognosis. Through interrogation of medical history and physical examination, it can be roughly determined whether the patient is poisoned and the type and degree of poisoning, and combined with laboratory examination, a comprehensive analysis can be made, which is conducive to a clear diagnosis and time for effective treatment. Patients with acute poisoning also have mild and severe symptoms. Generally, early symptoms such as nausea and vomiting, abdominal pain and diarrhea in the digestive tract, as well as changes in respiratory rate and heart rate, and in severe cases, symptoms such as agitation, delirium, coma and shock. A patient with acute poisoning can be told by himself or the person accompanying him. He should be asked when he took what kind of Chinese medicine, the dose and the initial onset of symptoms, etc. He should understand the original health condition of the patient and ask for toxicological analysis of the remaining Chinese medicine and provide the scene to confirm the diagnosis of acute or chronic poisoning. It is necessary to prevent both omission or misdiagnosis and intentional falsification of medical history. II. Physical examination In mild cases, a comprehensive examination can be performed to make an accurate diagnosis. Of course, it is also necessary to avoid delaying treatment due to physical examination. For critical patients, the typical symptoms and signs should be observed to buy time for effective resuscitation. For example, in the case of poisoning with atropine-containing Chinese medicine, there are often dilated pupils, flushing, dry mouth, rapid heartbeat, etc. The key examinations are: (1) color and damage of the skin and face, skin elasticity, body temperature, and whether the muscles are twitching and spasming. (2) pupil size, reaction to light, and whether the conjunctiva is congested (3) Whether the demeanor is awake, comatose or delirious. (4) Respiratory rate, rhythm amplitude, exhalation with or without peculiar odor, and presence of lung (5) Heart rate, rhythm and blood pressure. (6) Whether there is pressure pain in the abdomen, and whether there is diarrhea. (7) The smell and color of vomit and excrement. Third, laboratory tests This is the basis for correct diagnosis or confirmation of diagnosis. First, arrange general routine laboratory tests, or biochemical bacterial examination, if necessary, liver, kidney function, basal metabolism, electrocardiogram and other tests. If conditions permit, the patient’s urine and stool, vomit, gastric lavage, blood, etc. should be collected for qualitative or quantitative examination of suspected toxic substances. In case of poisoning with toxic herbs, the same specimens can be collected for identification by relevant units and experts. The main symptoms of herbal poisoning are identified in the table of identification of the main symptoms of herbal poisoning Skin (including face) Symptoms Toxic substance name Cherry red Cyanide Flushed red Atropine class, ephedrine, scopolamine, mercury, hookah Grey earth color (lead capacity) Lead and its compounds Jaundice Arsenic Cyanide, opioid class, white fruit, hookah, drunken pulp grass Dermatitis Belladonna, opioid, arsenic spot Contact dermatitis Bambusa, croton Symptoms Toxic substance name Skin (including face) purpura arsenic, lead erythema atropine, ephedrine, opioid, cyanide, zebra, arsenic urticaria opioid, arsenic scarlet fever-like rash belladonna, ephedrine, stilbene, opioid, mercury shingles arsenical peeling arsenic dry skin belladonna moist skin opioid, aconite, etc. excessive sweating arsenic, mercury, morphine, etc. sweat green copper, etc. blisters opioid five senses dilated pupils belladonna, lead, cyanide, scopolamine, colchicine, hookwort Aconite, aconite, poisonous celery, ephedra, infusional cornucopia Pupil narrowing Mandragora, tretinoin, opioids, hemiplegia, poisonous lentils, mullein leaves, samphire Pupil fixation Aconite, cyanide Chromatic vision Quinoa, cannabis (yellow vision), digitalis leaves (yellow or green vision) East) Myanma (yellow vision or transient blindness Chromatic vision disorder Cyanhydrin, lead, mercury Diplopia Lead, mercury, arsenic, morphine, scopolamine, aconite, tretinoin, hookah, bittersweet Blurred vision Belladonna Classes Visual deficits Lead Arsenic, mercury, mianmar Epileptic hallucinations Atropine Classes Tinnitus Scopolamine, morphine, codeine, arsenic Deafness Cyanide, atropine, aconite Hearing hypersensitivity Stannins, etc. Oral mucosa Lead (yellow) Gingival color Lead, mercury, arsenic can cause blue-black tooth-eye line Breath or vomit Odor Bitter almond odor Cyanide Classes Garlic odor Arsenic Metallic odor Various metals Continued Table Digestive system Salivation, vomiting Toxic lentils Lead, arsenic, cyanide, aconite, pimenta, mercury, dry mouth Belladonna, ephedrine, morphine, aconite, groundnut, multi-spike golden corn blue Nausea, vomiting Arsenic, mercury, cyanide, colchicine, atropine, quinoa, croton, aconite, ricinus communis, ricinus communis, bilberry, bilberry, bilberry, bilberry, bilberry, bilberry, bilberry, bilberry, bilberry, bilberry, bilberry, bilberry, bilberry, bilberry, bilberry, bilberry. Castor seeds, white fruits, hemp, oleander, spotted cucumber, mint, red maidenhair, toadstool, coriander, garlic, thunderclap, red insect, crow’s nest Abdominal pain, diarrhea Lead, arsenic, oleander, colchicine, cyanide, aloe, spotted cucumber, castor seeds, white fruits, croton, aconite, aconite, tetrahymena, sheep’s feet, shangluo, mullein, mullein, gansui, oleander, wolfsbane, hooksbane, poisonous celery, garcinia constipation Lead (chronic poisoning) Lead (late stage), morphine, opioids, codeine Blood in stool Wolfsbane, Euphorbia, Cyperus, Shangluo, Tulip roots Salivary hypersecretion Zoster, mercury, mullein, toxic lentil base Toxic hepatitis Lead, arsenic, Cyperus, cottonseed, yellow dock, red fennel, big maple, Liver damage Lead, arsenic, mercury, cyanide, poppy bases, ricin Nervous system tremors Lead, mercury, arsenic, ephedrine, opioids, stilbene, delirium Narcissus, aconite, Tobacco, belladonna, lead, mercury, arsenic, ephedrine, codeine, marijuana, quinoa, pseudostellaria, pallidum, puffer fish, lead, mercury, arsenic, aconite, hookah, arrow poison, poison ivy, drunken fishweed, cyanide Spasms (paroxysmal) Atropine, stilbene (early), bilberry, mulberry, mangifera, red aromatic, pseudostellaria, almond, bilberry, fish vine, edelweiss, tennant, rambutan, shangluo, bilberry, bittersweet Staphylococcus, lithospermum, lily of the valley, crocus, tianzenzi, mandrake Spasms (tonic) Stannin, tobacco, thunderbolt, nandina, cyanide Lightning-like fainting Cyanogenic kernels, cyanide, tobacco, etc. Dizziness, lethargy, coma Drunken fishweed, gansui, lily of the valley, tulip tree, Shangluo, king of the song, vanilla, opioids, atropine, scopoletin, scopolamine, white fruit, Shangluo, sanseviera, cannabis, lily of the valley, aconite Aconitum, lead, cyanide Perceptual numbness Aconitum, aristolochia, drunken fishweed Muscle numbness Hookwort, anisele, poison ivy Speech difficulties Aconitum, shanglu, heliotrope Ataxia thunderclap, hookwort, bitter ginseng Mental ambiguity Belladonna, quinoa, snake venom, aconite Polyneuritis Lead, mercury, arsenic, opioids, morphine Cardiovascular system Tachycardia Atropine, belladonna, ephedrine, mandrake, enthesopathy Bradycardia enthesopathy Arrhythmias Aconite, Artemisia, toadstool, quinoa, Mannheimia, shangluo, digitalis, nandinaceae Arrhythmias Aconite, Artemisia, toadstool, oleander Cardiac arrest Bradycardia, lead, scopolamine Continued Table Cardiovascular system Cardiovascular syndrome Oleander, anise, toadstool, aconite, borrelia, Mannheimia Angina-like pain Tobacco, ephedra Toxic myocarditis Arsenic Elevated blood pressure Ephedra, tobacco, wheatgrass Arsenic, mercury, quinoa, almond, castor, horsetail pine, ocimum sanctum, tannin, coriander Toxic encephalopathy Lead, mercury, belladonna, ocimum sanctum Headache Lead, cyanide Leukopenia or granulocytosis Arsenic, colchicine Erythrocytosis Lead, arsenic, mercury Thrombocytopenia Lead, arsenic, colchicine Aplastic anemia Arsenic, colchicine Hemolytic anemia Lead, arsenic Degenerative hemoglobinemia Cyanide Respiratory system Upper respiratory tract irritation Morphine Hyperventilation, hyperventilation Opioids, rosemary, hookah, cyanide, opium, octopamine Hyperventilation, hyperventilation Belladonna, stilbene, horsetail pine, drunken fishweed, shangluo, mandrake Respiratory distress or failure Arsenic, mercury, stilbene, caryophyllum, helianthus, aristolochia, castor bean, tennant, bupleurum, hyssop, hyssop almonds, celandine, pistachio nuts, fish vine, bitter ginseng, pomegranate root bark thunderclap respiratory paralysis mullein, cyanide, castor, opioids, snake venom, bicucullus, foxglove, haematoxylin, lily of the valley, croton, poisonous celery asthma castor bean urinary system renal damage lead, mercury, arsenic, arsenicals, sheep’s mantle, castor bean, aloe vera, zebra toxic nephropathy zebra, lead, daidze, celandine, thunderclap, thunderclap, thunderclap, mullein, castor Hematuria Lead, mercury, arsenic, zebra, sea onion, saffron, red maidenhair, thundercloth, colchicine Proteinuria Arsenic, zebra, mercury Diabetes Atropine, mian horse Porphyrinuria Lead, colchicine, etc. Dark black urine Cannabis, senna, reddish-brown urine (beer color) Chronic lead poisoning or mercury poisoning Pink urine Aloe vera, etc. Yellowish-brown urine (acidic) Rhubarb, aloe vera, senna, etc. Light red with yellow (when alkaline) Rhubarb, aloe vera, senna, etc. Yellow or brown urine Mercury, etc. Difficulty in urination Mercury, Aloe vera, Aconite, Red maidenhair, etc. Difficulty in urination Aconite, Aconite, Red maidenhair, etc. Table of regulating functions Increased body temperature or chills Atropine, Ephedrine, Stannin, Lead Decreased body temperature Morphine, Aconite Reproductive system Uterine bleeding or premature labor Mercury, arsenic, lead, pungent, Aloe vera, Aconite, Cyanide Painful uterine contractions, Eryngium, Shanglu, Saffron, Aconite, Red maidenhair Miscarriage Green Turnip