Western drugs can be highly toxic. Asian medicine, derived from herbs, can do no harm. That’s a widespread belief, which Japan found to be untrue with shosaikoto, a once immensely popular liver treatment. Shosaikoto is a mixture of seven herbs, including Chinese date, ginger root and licorice root, that liver specialists regard as effective in preventing C-type hepatitis from turning into liver cancer. It’s one of the oldest herbal prescriptions in the kampo, or traditional medicine, chest. After shosaikoto was approved for coverage by Japan’s national health insurance program in 1976, usage skyrocketed, with sales hitting a peak of more than $400 million in 1992. An economical, potent solution to a real health problem, shosaikoto seemed the perfect example of a blissful marriage between traditional medicine and modern health-care techniques.
Then came the bad news. In 1990, four patients developed worsening liver problems after being prescribed shosaikoto. In 1993 a wave of cases of interstitial pneumonia linked to shosaikotouse began appearing among liver patients, many of whom were using it simultaneously with the new liver drug interferon—a practice banned later that year. An investigation in 1996 by Japan’s Health Ministry revealed that over the previous two years 10 people had died while using the herb mixture. Sales of shosaikoto have since fallen to an eighth of their 1992 high. The number of victims is now pegged at 26.
“There was a myth that kampo had no side effects,” says Yukio Ogihara, a professor of phytochemistry at Meijo University. That myth has clearly been shattered. The lesson: just because traditional remedies are natural doesn’t necessarily save them from the same risks of side effects and dangerous drug interactions that come with Western medicines. But kampo believers argue that the herb mixture isn’t the problem. They blame Western-trained doctors who don’t understand traditional cures, and who carelessly prescribe or combine it with interferon. “As long as it is used correctly, kampo is absolutely a good medicine,” says Ogihara. The Hippocratic oath applies to traditional medicine too.