The Deadly Pills

Most of the Asiatic folk medicines sold in San Francisco's Chinatown are harmless. Sliced deer horn and powdered tiger penis, which believers in mystical medicine take to increase virility, are unlikely to hurt anything but the buyer's pocketbook. Neither are any of the 58 listed ingredients of another Chinatown favorite for aches and pains: ginseng rejuvenating pills, which are made in Hong Kong and contain such exotica as male mouse droppings, silkworm, rhinoceros horn, amber, turtle shell and myrrh. But this ancient Oriental panacea also contains an unlisted substance: the powerful Western painkiller phenylbutazone, a drug that has been linked with at least five cases of a rare and frequently fatal blood disease among users of ginseng pills.

Doctors first became aware of the problem when Lee Strom, 60, a cook in a Walnut Creek, Calif., restaurant, was admitted to the University of California Medical Center with what Dr. Curt Ries diagnosed as agranulocytosis. The condition, characterized by the body's inability to produce white blood cells, had left Strom weak and feverish and with so severe an infection in his rectal area that doctors were forced to perform a colostomy, bypassing his lower bowel.

An investigation soon revealed the source of his trouble. Strom, suffering from severe back pain, had visited an acupuncturist who prescribed the pills. Analysis showed the pills, which are packaged under different names, to contain phenylbutazone, which both doctors and U.S. Food and Drug Administration officials believe was added so that the pills would have a physiological discernible effect.

Some arthritis victims swear that the foul-smelling pills have relieved their pains quickly. They should; ginseng pills, taken as directed, give users a larger dose of phenylbutazone than is normally prescribed. Even a normal dose can have a serious side effect: from one to ten out of every 1,000 people who take phenylbutazone come down with agranulocytosis. The disease can be lethal. Four of the five persons hospitalized thus far for ginseng-related agranulocytosis (three in San Francisco and one in Minneapolis) came close to death; another San Franciscan died.

Because of the publicity, ginseng rejuvenating pills have now disappeared from stores in the Bay Area's Chinese communities. If they reappear, prospective consumers should steer clear of them. The ingredients listed on their labels may or may not help cure illness; the unlisted items can kill.

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