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September 20, 1995

Chaparral and Liver Toxicity-Reply

Author Affiliations

University of Chicago Chicago, Ill
West Suburban Hospital Oak Park, Ill

JAMA. 1995;274(11):871-872. doi:10.1001/jama.1995.03530110033023

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In Reply.  —We appreciate the comments generated by our report of a patient with chaparral-induced hepatotoxicity who required treatment with liver and kidney transplantation. All of the respondents called for increased precision in the use of terms referring to medications prepared from plants. We agree. Dr Stashower and Mr Torres correctly point out that plants generally referred to as chaparral are not true herbs. It would have been more correct if we had referred to the tablets our patient ingested as coming from botanical or plant sources. Although physicians often refer to medications and other treatments derived from plants as herbal preparations, more careful attention to plant taxonomy is appropriate because of the growing use of alternative remedies.We used the term chaparral to refer to the medication our patient ingested, and we suspect that most preparations are composed mainly of L tridentata species. As Dr Ippen notes, NDGA, one

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