Traditional Chinese He Shou Wu Processing: Toxicity-Reduction Method and Modern Hepatotoxicity Evidence

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Polygonum multiflorum is one of the medicinal materials that appears most frequently in the prescription of "taking food to prolong life", and it is also the most controversial species in the toxicology of modern traditional Chinese medicine. The difference between raw and processed products is clear: Raw Polygonum multiflorum contains conjugated anthraquinone (emodin, chrysophanol glycosides) and lecithin, which directly stimulates the gastrointestinal tract; after being mixed with black bean juice and steamed (soaked in bean juice and then steamed for 6-8 hours, repeated three times), the conjugated anthraquinone is partially hydrolyzed into the free form, which weakens the purgative effect and produces new stilbene glycosides. Modern research: There have been many reports of drug-induced liver injury from Polygonum multiflorum (especially raw products and excessive and long-term users). The causative components tend to be anthraquinones and weak allergens, which are manifested by sudden increases in transaminases, jaundice, and fatigue. The 2020 edition of the "Chinese Pharmacopoeia" has included Polygonum multiflorum and its preparations in the list of hepatotoxic traditional Chinese medicines that need to be used with caution, and the prescription must be marked with "Follow the doctor's advice, do not exceed the dosage, and do not use it for a long time." Safe usage: Use for short-term diet (2-4 weeks), the daily dose does not exceed the upper limit of the pharmacopoeia (3- …

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