Apiaceae
Bupleurum chinense
Chai hu · Chinese thorowax
- Part used
- root
- Native range
- China, Korea and Mongolia
- Morphology
- A slender perennial to about a metre with narrow grass-like leaves and small umbels of yellow flowers, over a fine woody root.
What is in it
Evidence
No adequate controlled evidence for the herb. It appears in the Japanese kampo formula sho-saiko-to, which has been studied in liver disease and is the source of its safety record.
Safety
Sho-saiko-to, the Japanese formulation in which bupleurum is the lead herb, caused a cluster of interstitial pneumonia cases in Japan in the 1990s, including deaths, particularly in patients also receiving interferon. Japanese regulators issued warnings and the combination is contraindicated. Hepatotoxicity is also reported.
Interactions: Contraindicated with interferon; Additive liver risk
Regulatory: Permitted as a listed medicine ingredient in Australia; the combination with interferon carries formal warnings in Japan.
How the traditions classify it
Three systems, rating the same plant. Where they disagree, none of them is correcting the others — they are separate frameworks that arrived at their categories independently.
Historical use
In the Shennong Bencao Jing, and central to the formula tradition from Zhang Zhongjing onward.
Recorded as history and attributed where possible. Long use establishes that a plant was widely used, not that it worked, and not that it was safe.
Worth knowing
The sho-saiko-to episode is the most instructive adverse event in the modern history of Chinese and Japanese herbal medicine, because it happened in a well-regulated system that was watching.
Japan integrates kampo formulas into its national health insurance, they are manufactured to pharmaceutical standards, and prescriptions are recorded. That infrastructure is why the interstitial pneumonia cluster was detected, characterised and acted on at all — and why the interferon contraindication is known.
The same signal in an unregulated retail market would almost certainly have been invisible. It is an argument for regulating herbal medicine rather than against using it.
Nomenclature verified against GBIF backbone taxonomy.