Deadly Chinese "aphrodisiac" smuggled into U.S.

[SteveGrenard]

The Chinese have exported a deadly over the counter Chinese drug into the U.S. labeled as an aphrodisiac. This drug has appeared before in the U.S., over a decade ago, under the name Chan Su. The NYC Health Department seems to have forgotten this salient fact although they are aware it is not FDA approved.

It killed people then and was banned by the FDA but it has now showed up here AGAIN under a variety of new names. The Chinese who make and export this drug know it is highly poisonous and that it is banned in the U.S. but that apparently hasn’t stopped them from smuggling it in once again.

http://ap.google.com/article/ALeqM5hMp52-da7KtQoqx3bq4Y7qnwGLpgD90RK1980

BY DAVID B. CARUSO – 41 minutes ago

NEW YORK (AP) — Health officials are warning New Yorkers to stay away from an illegal aphrodisiac made from toad venom after the product apparently killed a man.

The city's poison control center issued the warning Friday after receiving a hospital report that a 35-year-old man who ingested the hard, brown substance died earlier this month.
The product is sold under names including Piedra, Love Stone, Jamaican Stone, Black Stone and Chinese Rock at sex shops and neighborhood stores. It is banned by the Food and Drug Administration.

City health officials said the victim, whose identity was not released, was admitted to the hospital complaining of chest and abdominal pain. He died two days later.

Health officials said the hardened resin, made with venom from toads of the Bufo genus, contains chemicals that can disrupt heart rhythms.

Here is the abstract of the case(s) which previously occurred. Dr. Hoffman was an author of this paper and is a signer, as Director of Poison COntrol, warning of the new incident.

Chest. 1996 Nov;110(5):1139-41.
Treatment of toad venom poisoning with digoxin-specific Fab fragments.
Brubacher JR, Ravikumar PR, Bania T, Heller MB, Hoffman RS.
New York City Poison Control Center, New York, USA.

Toxicity from toad venom poisoning is similar to digoxin toxicity and carries a high mortality rate. We report on six previously healthy men who developed vomiting and bradycardia after ingesting a purported topical aphrodisiac. Each patient had positive apparent digoxin levels and the first four patients died of cardiac dysrhythmias. The last two patients recovered following treatment with digoxin Fab fragments. We analyzed samples of the purported aphrodisiac and found that it was identical to Chan Su, a Chinese medication made from toad venom. To our knowledge, this is the first reported use of digoxin Fab fragments to treat toad venom poisoning.

I received the following letter yesterday from the NYC HealthDepartment; here's what they have to say about this new incident. The news is this is the same drug described in the abstract cited above:

Dear Provider: (poster is a member of the NYCHD Medical Reserve Corps):

The New York City (NYC) Poison Control Center (PCC) notified the NYC Department of Health and Mental Hygiene (DOHMH) that a 35-year-old man died after ingesting an aphrodisiac called Piedra, which was purchased in a neighborhood store. The product is also known as Stone, Rock Hard, Hard Rock, Love Stone, Black Stone or Chinese Rock and is illegal for sale in New York City.

The patient presented to the emergency department within 12 hours after ingesting the product with complaints of chest and abdominal pain. He w as noted to have bradycardia, heart block, a potassium of 7.0 mEq/L and a digoxin level of 2.9 ng/mL. PCC suspected that the patient ingested a product containing ingredients derived from toad venom intended for topical use. The patient was treated with a total of 35 vials of digoxin-specific Fab over the next 12-16 hours. He initially showed signs of improvement, but about 36 hours after ingestion he once again developed heart block and rapidly degenerated into ventricular tachycardia and ventricular fibrillation. Standard resuscitation combined with additional doses of digoxin-specific Fab was unsuccessful and the patient died.
The findings in this patient are highly suggestive of cardiotoxicity from ingestion of a purported aphrodisiac containing bufadienolides and bufotenine and intended for topical use. Ingestion and dermal absorption of such a product can cause symptoms of digitalis poisoning including dysrhythmias, heart block, hypotension, and vomiting. Ca rdioactive steroids, including bufadienolides, have a narrow therapeutic index, and unintentional therapeutic intoxication is well documented. These steroids can adversely affect the myocardium, and the most life-threatening manifestations of toxicity include arrhythmias, ventricular ectopy, sinus bradycardia, atrial arrhythmias, and hyperkalemia.
Be highly suspicious if a patient presents with a clinical picture resembling digoxin overdose and reports the use of aphrodisiacs or OTC male-enhancement products. If you or your patients suspect a poisoning, call the NYC Poison Control Center 24 hours a day at (212) POISONS (764-7667) or 1-800-222-1222; Spanish- speaking callers, call (212) VENENOS (836-3667).

Piedra (Stone, Rock Hard, Hard Rock, Love Stone, Black Stone or Chinese Rock) is a hard, dark brown square and measures less than a square inch. It may be packaged in a clear plastic bag with incomplete labeling. The product is not approved by the U.S. Food and Drug Administration and is currently listed on an FDA import alert for Chinese Herbal Medicines. The product may also contain bufotenin, a controlled substance.




Nancy Clark, MA, CIH
Assistant Commissioner
Bureau of Environmental Disease Prevention

Robert Hoffman, MD
Director NYC Poison Control Center

Nathan Graber, MD, MPH Director
Environmental and Occupational Disease Epidemiology

 

[Wolfman]

I'm sorry, Steve...but exactly where in any of these articles does it say that it is Chinese who are A) actually making it or B) smuggling it into the U.S.? I read all of the articles, and apparently I'm blind, because I couldn't find where it said that.

It says it is a kind of traditional Chinese medicine, that is true. And one of the names for it is Chinese Rock, that is also true.

But so far as I'm aware, there is no "ancient Chinese secret" that prevents others from making it. And there certainly is nothing that prevents non-Chinese from trying to import and/or sell it. I note that one of the articles does say that the products are often labeled in "foreign languages"; since it doesn't specify only Chinese, and indicates several different languages are involved, that is another indication that it could have non-Chinese origins.

I'm not saying that it isn't being made by Chinese, or imported by Chinese...only that, based on the info you give here, you have (as is usual for anything you post that seems to have a Chinese connection) leaped to hugely unwarranted conclusions.

Your claims -- it is being made by Chinese. It is being imported by Chinese. It is being sold by Chinese.

Evidence, please?

 

[mrbaracuda]

You and your anti-China-threads, Steve!
/me shakes fist

Dr. Hoffman was an author of this paper and is a signer, as Director of Poison COntrol, warning of the new incident.

The LSD guy?

 

[casebro]

Do you think the guys who use frog venom topically on their units call their penis's-

Tad Poles?

 

[SteveGrenard]

I'm sorry, Steve...but exactly where in any of these articles does it say that it is Chinese who are A) actually making it or B) smuggling it into the U.S.? I read all of the articles, and apparently I'm blind, because I couldn't find where it said that.

There are now over 250 news articles on this subject and I agree none of them point to any evidence that the latest incarnation of Chan Su, which appears in traditional Chinese pharmacopeias, was made in China and/or exported from China. In fact there seems to be some amnesia connected to the fact that this latest version is the same as the Chan Su that hit the U.S. over a decade ago as I proved in the abstract from the Journal CHEST of the American College of Chest Physicians.

It says it is a kind of traditional Chinese medicine, that is true. And one of the names for it is Chinese Rock, that is also true.

I agree that a traditional Chinese medicine does not necessarily have to be made in China or by any Chinese. If the FDA gets on the stick they could analyze this "new" old stuff and determine its origin. Bufo toads are found worldwide and I don't know if native Chinese bufonid toad skin can be distinguished from others. (ETA: acc to NYT see next post it can):

But so far as I'm aware, there is no "ancient Chinese secret" that prevents others from making it. And there certainly is nothing that prevents non-Chinese from trying to import and/or sell it. I note that one of the articles does say that the products are often labeled in "foreign languages"; since it doesn't specify only Chinese, and indicates several different languages are involved, that is another indication that it could have non-Chinese origins.

This remains to be seen once investigated.

I'm not saying that it isn't being made by Chinese, or imported by Chinese...only that, based on the info you give here, you have (as is usual for anything you post that seems to have a Chinese connection) leaped to hugely unwarranted conclusions.

It's early yet. Any conclusions are your own and these are welcome. I based mine on the prior incident which everyone seems to have forgotten including Dr. Hoffman who co-authored the 1996 paper and then co-signed the 2008 warning letter. The Chan Su at the time was definitely traced to China, was sold in Chinese herbalist shops, etc etc. The FDA banned the import of Chan Su (from China) into the United States.

Your claims -- it is being made by Chinese. It is being imported by Chinese. It is being sold by Chinese.

Evidence, please?

As indicated it is early. I will keep you up to date as progress is made. Thank you for pointing out the absence of evidence, which of course, as I have learned here, is not evidence of absence.

 

[SteveGrenard]

Here is a snippet from a news account regarding Chan Su in the previous incident FYI:

The Federal Food and Drug Administration banned the product's importation in April, said Herman Janiger of the agency's New York district office. Domestic production would be difficult, he said, because one ingredient is the dried skin secretions of a toad not found in the United States. The product also contains a poisonous extract of the foxglove plant, Ms. Balluz said.

An analysis found that the purported aphrodisiac contained an ingredient similar to digoxin, a prescription heart drug, and bufadienolides, steroids that disrupt the heart's natural rhythm. Bufadienolides are also found in a traditional Chinese medication called chan su, used as a topical anesthetic and cardiac medication.

The F.D.A.'s move against the product and its manufacturer, the Tsang Fook Tkee Medicine Company of Hong Kong, was the first Federal action against an alleged aphrodisiac, Mr. Janiger said.

The F.D.A. has classified it as a drug with harmful effects, as opposed to an herbal remedy, which could be allowed if the manufacturer made no health claim, Mr. Janiger said

Full story here:

http://query.nytimes.com/gst/fullpage.html?res=9A03E1DF1039F936A15752C1A963958260

If the skin of this new version can be traced to Chinese Toads such as Bufo sinensis than it is evidence the product is made in China and smuggled out. Clearly if this is the case we are either talking about criminals doing this or people who are too dumb to realize how dangerous this "drug" is. Once again the Chinese government needs to jump on this, find these perps, shut them down and prosecute ... not necessarily sit around and say "show me the evidence."

 

[Damien Evans]

Bufo, isn't that the genus the Cane Toad is in?

If that is the case, I can see why it's banned, they're an extremely poisonous genus.

 

[SteveGrenard]

Bufo, isn't that the genus the Cane Toad is in?

If that is the case, I can see why it's banned, they're an extremely poisonous genus.

Yes it is. The Cane Toad is Bufo marinus, aka the Marine Toad. Australians are only too familiar with the toxicity of this genus/species which was introduced into Oz from Hawaii where it was also introduced from Latin America. There are over 200 species of Bufonid toads in the genus Bufo, all of which have poisonous glandular material embedded in their skin in addition to larger poison glands just to the rear of their eyes. They are running amok in Australia and killing any native wildlife that picks one up and tries to eat it.

Bufonid toads are found virtually all over the world ... but are not normally found in Australia so the native wildlife there have not adapted to its presence the way wildlife has in other areas where they've been round for hundreds of thousands or even millions of years.

The use of Bufo skin in this Chinese so-called traditional or herbal remedy (it isn't herbal at all, it's animal based) and its presence in the traditional Chinese materia medica is one of the best reasons why nobody should trust such unregulated remedies. And even when
a western country bans these drugs for safety reasons idiots still smuggle
them so that other idiots can make themselves sick or kill themselves with them. This is
clearly the case with Chan Su and other drugs exactly the same but with names to
disguise their origin.

The drug was originally meant to use externally but since the instructions are either
absent or in a foreign language such as Chinese people think they should bite off a piece
and swallow it. Others think that if rubbing it on is good ,swallowing would be
better. Who knows what goes through people's minds when it comes to setting out to use a
substance purported to be an aphrodisiac.

My problem is why can't the folks, whether Chinese or others, realize it is bad business to
kill their customers and that they should make their aphrodisiac out of something other than Bufo skin. Chocolate sounds good.