Panax pseudoginseng, also known as Panax ginseng, Panax ginseng and Panax pseudoginseng, has been cultivated in China for more than 400 years, mainly in Yunnan, Guangxi and Sichuan, etc. As a valuable Chinese medicine, it has the effects of resolving blood stasis, stopping bleeding, relieving swelling and pain, and tonifying deficiency. In Li Shizhen’s “Compendium of Materia Medica” and Chen Shiduo’s “New Compilation of Materia Medica”, its efficacy has been mentioned: stopping bleeding, dispersing blood and fixing pain, chewing and applying it to gold blade and arrow wounds, bruises and sores, or mixing it with powder, the blood will stop. It is also used for vomiting and epistaxis, bleeding and dysentery, menstrual flow in collapse, postpartum malignant blood, blood pain, canker sores of the red eyes, and tiger bite and snake wound. However, Panax ginseng poisoning is rare. Panax pseudoginseng (Chrysanthemum pseudoginseng) is also a common Chinese herb, except that it belongs to the Asteraceae family and is mainly produced in Zhejiang, Jiangsu and Hunan. It has similar effects as Panax pseudoginseng but also has great toxicity! Panax notoginseng contains pyrrolizidine alkaloids that reduce the RNA enzyme activity of liver cells, resulting in reduced RNA synthesis and lateral DNA breakage, leading to liver cell necrosis! In layman’s terms, it can cause the blood in the liver to be “in and out”, thus causing increased portal vein pressure, ascites, jaundice and other symptoms. Once the patient is poisoned, the disease progresses quickly and the damage to the organs, especially the liver, is often difficult to reverse! Life-threatening systemic multi-organ failure occurs. The cause of the disease is most likely due to small hepatic vein occlusive disease! Occlusive disease of the small hepatic veins is a non-thrombotic occlusion of the small hepatic veins, with jaundice, hepatomegaly, ascites and other major clinical manifestations. The disease was first reported by Mcfarlane in 1945 and the name hepatic small vein occlusive disease was first adopted by Bras and Jellife when they reported it in 1954. Of course there are many causes that can lead to hepatic small vein occlusive disease, such as hematopoietic stem cell transplantation, chemotherapy, radiation therapy, liver transplantation, etc. But there is another more important cause for our herbal country: the consumption of wild plants or herbs containing pyrrolizidine alkaloids, such as Panax notoginseng! Because the concept of “activating blood circulation and removing blood stasis” is so popular and because it is so easy to obtain herbs, many people prefer to use brewed herbal liquor or simply make their own! In addition to the role of these medicinal wines, the main ingredients of these so-called “blood circulation and blood stasis” effects are a confusing account! Many people who suffer from Panax pseudoginseng poisoning cannot tell the difference between Panax pseudoginseng and Panax pseudoginseng, and even many herbal practitioners cannot tell the difference either! Of course, every year, there are reported cases of poisoning with Panax pseudoginseng for various reasons. Even many western countries such as the United States, the United Kingdom, and other countries have reported cases of hepatic small vein occlusive disease or liver damage associated with plants or herbs containing pyrrolizidine bases. There are about 6000 species of plants containing pyrrolizidine alkaloids in the world, mainly in 4 families and some genera, namely: 1) Asteraceae, Zelenia, Chrysanthemum, and Beechnut; 2) All genera of Compositae; 3) Leguminosae; 4) Orchidaceae. In our country, there are 38 kinds of herbs containing pyrrolizidine alkaloids, and 12 kinds are commonly used: Chrysanthemum, Dog’s Tongue, Chrysanthemum, Zanthoxylum, Pellitory, Zelenia, Aster, Compositae, Celestial Mustard, Wild Lily, Pig’s Poop Bean, and Sheep’s Ear Garlic.