Animal products

Ban Mao

See also Spanish fly below.

Ban mao is a toxic Chinese medicine derived from an insect ( Mylabris phalerata Pallas, Miloidae ) that contains cantharidin (see also Spanish fly below), which is thought to inhibit DNA synthesis in blood cells, resulting in acute hemopoietic disorders.

Topical application of formulations that contain mylabris been associated with an acute hemopoietic disorder characterized by a reduced complete blood count (pancytopenia) and abnormal bleeding [ ].

• A 32-year-old man developed epistaxis, tar-like stools, and a pale complexion after applying a topical paste containing ban mao for psoriasis. Hematological investigations suggested pancytopenia. He was instructed to stop using ban mao and the hematological values normalized 25 days later.

• A 9-year-old boy developed epistaxis and a pale complexion after repeated topical application of a vinegar extract of ban mao for alopecia areata for about 4 months. Hematological investigations suggested pancytopenia. Ban mao was stopped immediately and he made a full recovery about 50 days later.

• A 24-year-old woman developed palpitation, shortness of breath, and hematuria after using suppositories containing ban mao for 10 days. Hematological investigations suggested pancytopenia. She made a complete recovery 37 days later after having stopped using the product.

A report from Hong Kong described a fatal case due to the ingestion of a decoction of more than 200 dried Mylabris beetles as an abortifacient [ ].

Bear bile

Bear bile contains bile acids, cholesterol, and phospholipids (phosphatidylcholine, phosphatidylethanolamine, and phosphatidylinositol). It has been used for centuries in traditional Chinese medicine to treat liver and eye complaints and convulsions, and, in combination with curcuma and capillaris, gallstones and cholecystitis. More recently it has been touted as a treatment for stroke on the basis of animal experiments. It has few or no adverse effects, but by the same token probably has little or no efficacy, although it does contain ursodeoxycholic acid [ ], which in purified form is effective in managing gallstones.

Bee products

Carp bile and gallbladder

In Asia, the raw bile of the grass carp ( Ctenopharyngodom idellus ) is believed by some to be health promoting. However, eating it can result in hepatic dysfunction and nephrotoxicity [ ]. The former usually resolves within a few days, but the latter is more serious, culminating in acute renal insufficiency within 2–3 days after ingestion [ ]. Experiments in rats have shown that the bile of the grass carp loses its lethality when treated with colestyramine, which forms insoluble complexes with bile acids [ ].

The consumption of carp gallbladder has been linked to acute renal insufficiency [ ].

• A 67-year-old woman developed nausea and epigastric pain 2 hours after taking grass carp gallbladder stewed with honey. She also had raised alanine aminotransferase activity after 8 hours. On day 3 she developed oliguria, and hemodialysis was performed on day 5, following which she gradually recovered and was discharged on day 26.

Fish oils

Fish oil supplements [ , ], rich in long-chain polyunsaturated ω-3 fatty acids (eicosapentaenoic acid, docosahexaenoic acid), can reduce plasma concentrations of triglycerides and VLDL cholesterol, reduce platelet aggregation, prolong bleeding time, reduce blood pressure, increase the fluidity of the blood, and affect leukotriene production. Reported adverse effects include fullness and epigastric discomfort, diarrhea, and a fishy taste after belching. In addition to these mild symptoms, certain areas have been identified in which problems of a more serious nature could arise:

• a potential risk that the favorable changes in plasma lipids could be offset by a deleterious increase in LDL cholesterol or LDL apoprotein B;

• the possible adverse consequence of the capacity to increase bleeding time and to reduce platelet aggregation, especially in patients with pre-existing bleeding and platelet abnormalities and in those taking other antithrombotic agents;

• preliminary evidence that a detrimental effect on patients with aspirin-sensitive asthma is possible;

• an adverse effect on the metabolic control of patients with non-insulin-dependent diabetes mellitus, when these patients are not being treated with a sulfonylurea derivative [ ];

• prothrombotic effects through changes on clotting factor concentration [ ];

• possible contamination.