The Cola spp cited in one of the case studies was indeed packaged and sold as "gotu kola" and represents fourteen such mislabeled packages of "gotu kola" we have examined. The table in the article confusingly groups kola nut with "gotu kola," which is actually Hydrocotyle asiatica. We have encountered no clinical problems associated with the use of H asiatica, although chronic users claim dizziness and diarrhea. A related species, H vulgaris, is a wellknown livestock poison and is commonly termed "sheep's bane."The author of the letter is correct in noting widespread mislabeling of herbal preparations. These practices confound the scientific study of folk medicines. Perhaps the most commonly misrepresented substance is ginseng (Panax spp). Due to its substantial economic importance, as well as remarkable medicinal claims,1 ginseng is often in limited and expensive supply. Alternatively, several companies package as ginseng a wide variety of substances
Siegel RK. Kola, Ginseng, and Mislabeled Herbs-Reply. JAMA. 1977;237(1):25. doi:10.1001/jama.1977.03270280026008
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