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September 20, 1995

Chaparral and Liver Toxicity

Author Affiliations

Norfolk, Va

JAMA. 1995;274(11):871. doi:10.1001/jama.1995.03530110033020

To the Editor.  —Regarding the article by Dr Gordon and colleagues,1 chaparral is technically not an herb, it is a woody, perennial shrub. An herb is specifically a flowering plant whose stems above ground are not woody.2,3 This is a subtle but important distinction.The common usage of the term "herbal" as it is applied to all manner of natural plant-derived medicines is misleading and is not supported by the botanic taxonomic literature.3 We propose that this term be avoided in scientific discourse on the subject. A more appropriate subtitle would have been the following: "Liver injury caused by alternative medicines derived from plants."The importance of determining the safety and efficacy of nontraditional supplements and medications appears clear. Despite our fervor to assert this and our unfamiliarity with alternative treatments, organized medicine must resist the urge to combine all of these agents into one category, and

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