Rumex japonicus 羊蹄

POISONOUS PARTS

Roots, stems and leaves.²

TOXICITY

• Toxic Constituents

  Anthraquinones such as emodin, physcion and chrysophanol; oxalate.^2-7

• Mechanism

  Anthraquinones have purgative effect. Formation of calcium oxalate crystals in renal tubules occurs with excessive consumption of oxalate, resulting in acute tubular necrosis.^2,7,8

• Poisoning Features

  Vomiting, diarrhoea and abdominal bloating. Renal failure in severe cases.^3,7

• Poisoning Events

  A 7-year-old boy in China developed repeated vomiting after accidental ingestion of large amount (>100 g) of R. japonicus leaves. He developed multi-organ failure despite treatment and finally succumbed.⁹

CLINICAL MANAGEMENT

Supportive treatment. Correction of fluid and electrolyte disturbances.

IDENTIFICATION FEATURES

Perennial herbs, 50–100 cm tall. Stems erect, furrowed; with thick root-stock. Petioles 2–4 cm long; radical leaves 8–20(–25) × 4–8(–10) cm, margin undulate, abaxially papillose on veins. Panicles terminal, flowers in many whorls. Perianth segments light green, margin irregularly denticulate, with tubercles. Achenes about 2.5 mm long, broadly ovoid, sharply 3-angled, dark brown.¹⁰

MEDICINAL USES

Uses in TCM—roots: clear heat and remove toxin, relieve constipation, induce diuresis, stanch bleeding, kill parasites; fruits: cool blood and stanch bleeding, relieve constipation; leaves: cool blood and stanch bleeding, relieve constipation, remove toxin and disperse swelling, kill parasites. Recommended dose: roots 9–15 g, fruits 3–6 g, leaves 10–15 g.^2,11,12

LABORATORY ANALYSIS

Anthraquinones can be detected by HPLC-DAD, GC-MS and LC-MS/MS. Oxalate can be detected by HPLC-DAD and GC-MS.^13–17