Weary of worrying about what's in Chinese products?1 What about when Chinese products are made in America?2 Do we drop our concerns then? Perhaps we are heading to a future where Chinese and American manufacturing standards become one and the same. In mid-2013, a Chinese company purchased Smithfield Foods Inc., one of the largest pork producers in the United States3. If approved, this deal will mark the "largest takeover of a U.S. company by a Chinese firm." Eat up, America. Enjoy your pork. Never mind that "In recent weeks, China's news media have reported sales of pork adulterated with the drug clenbuterol, which can cause heart palpitations." The list goes on, and includes "pork sold as beef after it was soaked in borax; rice contaminated with cadmium; arsenic-laced soy sauce; popcorn and mushrooms treated with fluorescent bleach; bean sprouts tainted with a animal antibiotic"4 and so on. Chinese herbal products pose problems as well, saddled with a long history of adulteration and contamination. An investigation by Harvard researchers showed that 100 percent of the raw Chinese herbal medicines analyzed contained at least one heavy metal, with a third showing the presence of every metal they tested for, including cadmium, arsenic, chromium, lead and mercury.5 They also found up to nine pesticides in some samples. Other Concerns Ethical and environmental concerns perpetually plague the industry, too. Chinese folkloric herbal prescribing has traditionally involved heavy metals, toxins and certain animal and plant species now considered endangered. Traditional Chinese Veterinary Medicine (TCVM) "herbal" products from the U.S. have required an "adjustment" in contents before being sold in Europe because they violated the Convention on International Trade in Endangered Species6 (CITES) rules designed to prevent threats to the survival of wild species of animals and plants. One would think that these considerations would worry holistic veterinarians, but TCVM folkloric practices have become big business in the U.S. and Europe. What's worse, TCVM veterinarians learn to sell proprietary products, i.e., mixtures with secret ingredients, despite having little information about safety, mechanisms of action, interactions, side effects, manufacturing standards, ecological risks, or public health concerns.7 Considering the scrutiny that compounding pharmacies have undergone of late, why is it that anyone in the U.S. can compound and sell pharmacologically active, even toxic, mixtures, not disclose their contents, and base the recipe on whatever plants, mammals, worms, insects or toxins he or she sees fit? How is it that veterinarians consider this practice ethical or wise?8 But wait, it gets worse. Considerations Let's say that a Chinese herb company CEO/course instructor decided to place undisclosed amounts of herbal strychnine in his secret mixtures. What if he and his cohorts taught that this remedy was "the primary herbal medicine" for intervertebral disk disease9 and "can be used as long as the gut is able to tolerate it"? Even a veterinary neurology professor and TCVM instructor advises students to administer the strychnine-containing mixture "until paralysis is resolved."10 The fact that some state veterinary boards have approved TCVM courses11 may lull attendees into assuming that course content is prudent, justified and free of commercial self-interest. They may mistakenly assume that herbs are natural and therefore safe. They may have developed unquestioning faith in a charismatic teacher. Or they may think that because a number of veterinary colleges have graciously accepted gifts12-15 from TCVM proponents and are now integrating TCVM pseudoscience practices that its products and methods of diagnosis are proven, reliable and safe. And maybe a subset of veterinarians thinks that selling consumers secret substances with strychnine makes good sense. So, what's the problem? If the pretty little bottle containing the strychnine fails to list the amount or risks of the strychnine on the label, does that mean they're of no concern? How might veterinarians obtain informed consent from consumers who purchase the product when they themselves have insufficient knowledge about its toxicity? Lacking independent oversight and enforcement of manufacturing standards, strychnine levels can vary widely in TCVM herbs. Already, research has shown wide variability from batch to batch.16 In addition, veterinary researchers have recommended testing for "other potentially toxic elements, such as selenium, arsenic, fluoride and mercury, and additional classes of contaminants such as pesticides, mycotoxins, herbicides and micro-organisms." What Is It? According to the U.S. Environmental Protection Agency, strychnine in its chemical form falls in the Toxicity Category I, "indicating the greatest degree of acute toxicity."17 Labeling standards require notification that it is a "restricted-use pesticide" with "acute oral toxicity." The Centers for Disease Control and Prevention consider strychnine a "strong poison." Their website states "only a small amount is needed to produce severe effects in people."18 Some countries have banned Strychnos nux-vomica (the plant-based strychnine source) from herbal products.19 Strychnine poisoning from Chinese herbs is not uncommon, even with ordinary doses, as prescribed levels fall near toxic ranges.20 Long-term administration of Strychnos nux–vomica can cause epileptic seizures, as can other Chinese herbs. With Strychnos nux–vomica, "poisoning cases are reported frequently"21 and strychnine readily crosses intact skin, making even transdermal application dangerous.22 No animal or human should be subjected to strychnine poisoning, whether intentionally as a pesticide, an act of terrorism23 or an unintended consequence of Chinese herbs.24 Who's watching out for veterinary patients, the public health and consumers when it comes to herbal strychnine? Hello? What if a patient or toddler consumes 10, 20 or 50 pills? Would such an individual survive or die seizing? How can an emergency veterinarian or physician determine appropriate treatment from "trade secret" amounts of strychnine? And we thought that China was at fault for making us sick.25, 26 Now, U.S. veterinary medicine has its own home-grown problems. When will we wake up? Dr. Robinson, Dipl. ABMA, FAAMA, oversees complementary veterinary education at Colorado State University.
