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According to the Merck Index, aristolochic acids are “a group of 14 . . . substituted 1-phenanthrenecarboxylic acids . . . that occur in [the flowering plant family] Aristolochiaceae and in butterflies feeding on these plants.� Aristolochic acid I, shown here, is the most abundant of the group.

In 1953, H. Gänshirt at the Karlsruhe Institute of Technology (Germany) isolated aristolochic acids from several plants in the genus Aristolochia and determined their concentrations. In the following years, other researchers also isolated the acids, including M. Pailer and co-workers at the University of Vienna, who determined the chemical structures of several of the acids.

As shown in the hazard information table, aristolochic acids are highly toxic. They are suspected of (BEN) that is widespread in the Balkan Peninsula of Europe. A plant called birthwort (Aristolochia clematitis) is abundant in this region. It grows in wheatfields, where its contents enter the soil and groundwater and contaminate the crop. Epidemiologists estimate that �100,000 people are affected by BEN in the region.

But this is only a small part of the problem. As many as hundreds of millions or even billions of people may suffer from BEN worldwide. This is because Aristolochiaceae plants (genera Aristolochia and Asarum) have been used in traditional medicines for millennia, especially in Asia. In addition to BEN, individuals who consume these medicines can also develop aristolochic acid–induced liver cancer.Ìý