When it comes to hepatotoxicity of herbal medicines, many people like to talk about herbal medicines, thinking that herbal medicines based on “grass roots and bark” are unscientific and toxic, and even some Western medical practitioners state in their medical prescriptions that “herbal medicines are forbidden or used with caution to regulate”. The article “Investigation of liver damage from Chinese herbal medicines in mainland China” in the Phoenix Weekly is even more rampant, arguing that Chinese herbal medicines are the culprit of acute drug-related liver damage. For thousands of years, Chinese medicine has been used mainly to prevent and treat diseases, with remarkable efficacy, but the hepatotoxicity of herbs has been controversial in recent years. 1, how serious liver damage of Chinese herbal medicine? It is a medicine with three points of toxicity, and the “Zhouli” says that “physicians gather poisonous medicines to common medical affairs”, Chinese medicine never denies the existence of toxicity of herbal medicines. However, is herbal medicine the first cause of acute liver failure as a result of drug-related liver damage? The author begs to differ. First, as experts say, China has not yet established a sound monitoring system of drug-related liver damage, part of the survey and sporadic reporting of data is not yet known whether comprehensive and reliable. Second, China’s drugs are divided into three categories: chemical drugs, biological drugs and traditional Chinese medicine, and the analysis of anti-tuberculosis drugs, cardiovascular drugs and traditional Chinese medicine among chemical drugs is inappropriate for the classification level. Thirdly, many reported hepatotoxicity of proprietary Chinese medicines or health products are caused by their western pharmaceutical ingredients, such as metformin and phenobarbital, rather than the Chinese herbal medicines themselves. Fourthly, not all natural plants are herbal medicines, and some plants used by folk are not listed in the national pharmacopoeia, such as Maoyan and Tuzanqi, or they have the same name, but the species is misused, so these toxic natural plants, which are not used in medicine, cannot be counted as herbal medicines. 2. Why do herbal medicines produce hepatotoxicity? The reasons are complex, including at least four major factors such as the nature of the drug itself, the pathophysiological state of the body, the dosage and course of treatment, etc. Irrational abuse is the main reason. Chinese medicine is concerned about the diagnosis and treatment, according to the person, that is to say, different people, different conditions with different drugs; also pay attention to the rational combination of drugs, make each other, in order to reduce toxicity and increase effectiveness; more importantly, “no amount does not become a formula, the secret of Chinese medicine is not passed down in the amount”, there is a certain amount and course of treatment, earnestly admonished “in the disease that is to stop Even tonic medicine should not be used in large doses for a long period of time blindly and indiscriminately. Zhang Jinyue’s “Young Children Integration” says: “If you have a disease and use the right medicine, the disease will suffer; no disease and use the right medicine, the vital energy will suffer.” If the medicine is not right, the good medicine can be changed into poison. For example, ginseng is a common tonic, which can greatly replenish the vital energy and tranquilize the mind, but when it is used for people with Yang heat and warmth, there can be bleeding from the mouth and nose, increased blood pressure and even death. 3. Are the toxic side effects of Chinese medicine all bad things? The therapeutic effects and adverse reactions of drugs are dialectically unified, and drugs with obvious effects often have obvious toxic side effects, which can be a flood for some people and a good medicine for others. Chinese medicine is also the same, “there is sickness and sickness suffer, no patient suffer”. As mentioned before, if misused, good medicine becomes poison. Conversely, when used properly, poison can also become good medicine. As we all know, arsenic (arsenic trioxide) is very toxic, but it is a good medicine for leukemia. As we can see, toxic side effects are not all bad things, and herbal medicines with certain toxic side effects can be put to use by taking advantage of the situation and correcting the bias. In addition, Chinese herbs can also detoxify, such as polyphenolic acid contained in Salvia, flavonoids contained in Scutellaria, polysaccharides contained in Cordyceps, etc. can prevent hepatotoxicity and even anti-liver fibrosis; licorice preparations, Wu Wei Zi preparations, etc. have anti-inflammatory and choleretic effects and protect liver cell damage, which are widely used clinically. Chinese medicine is a unique and original discipline in China, and has made great contributions to the prosperity of the Chinese nation. Of course, there are many problems and shortcomings that need to be developed and improved. However, it is not advisable to exaggerate the hepatotoxicity and other side effects by hearsay, or to exaggerate them by preconceptions, but to investigate them comprehensively, analyze them rationally, and regulate their use in an objective and impartial manner, so as to remove the crudeness and the falsity, thus promoting the modernization and development of TCM and the improvement of people’s health.