May compliance with accepted scientific standards be dispensed with in risk assessment of Chinese Medicine?

The outstanding German hepatologist, Rolf Teschke has contributed considerably to the elucidation of hepatotoxicity of herbal remedies. Recently he and several co-authors published an article in Alimentary Pharmacology and Therapeutics on the hepatotoxicity of TCM preparations as indicated by international publications between 2011 and March 2014. However, the promising approach does not conform to expectations. Most of the reported liver injuries miss Chinese Medicine but rather apply to local folkloristic practices in China and Korea, the Kampo medicine, dietary supplements from USA containing one or two Chinese herbal ingredients, and a western herb misleadingly attributed to Chinese Medicine. The included sources mostly fail to provide standardized causality assessments as well as authentication of herbal ingredients, testing for contamination and adulteration, which otherwise are considered basic prerequisites for a valid causality statement by the first author. The article exhibits many mistakes pointing to insufficient expertise in Chinese Herbal Medicine (CHT). A letter to the journal addressed the deficiencies and flaws of the paper. Replying, the authors fail to respond to any of the objections, instead they took to a personal affront, which is an uncommon measure. TCM therapists will do without any compilation of unchecked and extraneous case reports instead of reliable information on potential hepatotoxicity of the common Chinese herbal medicines. Without expertise in TCM no sustainable results will be achieved. In Germany, the Center for Safety of Chinese Herbal Therapy (CTCA) is best positioned to address these issues.