Critics of traditional Chinese medicine (TCM) are pouncing on the damning findings of a medical report published in PLOS ONE - an open access, peer reviewed scientific journal from the non-profit organization, the Public Library of Science - which indicated that TCM is a major cause of acute liver failure in China.

The article said that of the 177 patients included in the study, 17 percent of the patients who developed acute liver failure had received herbal remedies, and it was believed to be a more frequent cause than any other factor.

Published on November 22, 2013, the article has stirred a fierce debate within China. Critics cite instances of harmful side effects, while backers say that TCM remains a legacy of Chinese history, and has had beneficial outcomes.

Despite the fact that links between the potential toxicity of TCM on liver and kidney functions have been outlined in previous reports, acknowledgment of the risks remains rare, even within the Chinese medical community, and research is still lacking.

Liver failures

The article said that of all the patients diagnosed with acute liver failure after January 2007 in the study, 77 (43.5 percent) developed the condition due to drug toxicity, 52 (29.38 percent) due to indeterminate causes, 20 (11.3 percent) had acute viral hepatitis and 28 (15.82 percent) due to other causes.

Of the patients with acute liver failure induced by drugs, 30 had received herbal remedies, occupying 16.95 percent of all the patients. This represented the highest percentage of instances of liver failure caused by drugs, including acetaminophen, which takes up roughly 12 percent and is one of the main causes of acute liver failure in Western countries. The study aimed to investigate the causes and outcomes of acute liver failure in China to better plan medical treatments in future, since no extensive investigation has been performed regarding the disease, said the article. The findings on TCM take up a small portion of the article and do not touch upon its toxicity.

Even though the article is the first to provide data regarding TCM's function specifically in relation to acute liver failure, there have been many findings on how TCM can cause other diseases.

Liver damage caused by TCM took up 4.8 percent to 32.6 percent of all drug-induced liver damage, according to a result released by a national liver disease academic conference in 2005, while Practical Preventive Medicine published an article in September 2013, pointing out that among the 12,527 drug-induced liver damage cases mentioned in more than 200 academic articles published from 2003 to 2007, 2,026 were caused by TCM, taking up 16.17 percent, just to name a few academic findings.

Occasionally, a specific TCM drug will gain public attention for all the wrong reasons. In July 2013, heshouwu, (polygonum multiflorum), a drug used to treat baldness, was revealed by a research paper to be a potential cause of liver damage.

Reports surfaced of people's baldness getting worse, and even being killed by taking the drug.

Zhao Pan, from Therapy and Research Center under the, 302 Military Hospital of China, one of the authors of the article published on PLOS ONE, told the Beijing-based Life Times that the quantity of TCM dosages should be delicately controlled so that the harmful effects can be reduced as much as possible, and patients should not fall for folk prescriptions, and instead should only visit qualified doctors and hospitals.