Pharmacology & Pharmacy, 2013, 4, 1-3
http://dx.doi.org/10.4236/pp.2013.47A1001 Published Online October 2013 (http://www.scirp.org/journal/pp) 1
Torsadogenic Index: Its Chinese Medical Origin
Adrián Ángel Inchauspe1,2,3,4,5*
1Scientific Department, Argentina Acupuncture Society, Buenos Aires, Argentina; 2Argentina Resuscitation Council, Buenos Aires,
Argentina; 3Investigation Department, HINEA y C. “Dr. Alejandro Korn”, Melchor Romero, La Plata, Argentina; 4Medical Sciences
Faculty of La Plata University, La Plata, Argentina; 5Chronic and Acute Care Neuropsychiatric Hospital Interzonal “Dr. Alejandro
Korn”, Melchor Romero, La Plata, Argentina.
Received July 20th, 2013; revised August 21st, 2013; accepted September 8th, 2013
Copyright © 2013 Adrián Ángel Inchauspe. This is an open access article distributed under the Creative Commons Attribution Li-
cense, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.
ABSTRACT
The foundational chronology of Torsadogenic Index is introduced to explain the relationship between impending death
situations and drug prescription, combination, self-indication, or abuse of torsadogenic pharmacological products. The
pathophysiological basis of Torsade de Pointes is presented with the most frequent causes of Long QT syndrome. Tradi-
tional Chinese Medical principles are exposed in order to help people to understand its par a-logical sequ ence, prov iding
another view of medical explanations upon scientific evidence. Development of Torsadogenic Risk Management
Project and Torsadogenic Traceability concepts derived from these Chinese Medical perpetual axioms are presented
in this paper.
Keywords: T. Index; TCM Principles; Scientific Evidence
1. Background
Invited by the Chinese Government to the 8th BIT’s In-
ternational Congress of Drug Development, Science and
Technology, I assisted to the Overture Ceremony in the
Beijing International Convention Center [1].
In Expert’s Presentation, I met Dr. Jufeng Wang, for
that times Chief of the Exploratory Office of Toxicology
in Harvard. During his interesting dissertation [2], he
announced several medications that derive into sudden
death for electrocardiographic QT interval prolongation.
Deeply impressed, I returned to Argentina wondering
how many impending death situations could be referred
to patients that had previously taken drug s.
Back at work, I asked Dr. Wang for a complete list in
order to prevent its dangerous consequences. With great
surprise, 80 pharmacological products of common use
appeared as potentially cardiac arrest threatening risk [3].
All of them lead to death for the same reason: the devel-
opment of a menacing arrhythmia called Torsade de
Pointes (TdP) [4,5].
2. Introduction
Torsade de Pointes is a potentially tachyarrhythmia ca-
pable to progress into ventricular fibrillation, a major
cause of heart arrest [4].
Long QT syndrome appears due to genetic mutation
(Congenital LQTS) or secondary causes (Acquired
LQTS) as [5]:
- Bradyarrhythmias: sinusal arrhythmia—sinus brady-
cardia—AV block;
- Metabolic abnormalities;
- Drugs;
- Central Nervous System’s injuries: thalamic hema-
toma—subarachnoid hemorrhage;
- Hidroelectrolitical disturbances;
- Malnutrition—anorexia nervosa—liquid protein ele-
mental diets.
3. Physiopathology
*National Delegate for the 5th International Conference on Drug Dis-
covery and Therapy 2013, Dubai, United Arab Emirates; National
Delegate from Argentina in Ninth International Brain Injury Associa-
tion Congress, Edinburgh, UK; Editorial Highlight Member of the
World Journal of Critical Care Medicine, Ed. Baishideng, Beijing,
China; Editorial Guest Member of Frontiers of Clinical Pharmacology
Research and Outcomes Journal, Basilea, Switzerland.
This TdP condition is caused by an ionic channel dys-
function in cardiac cells membranes [5].
It occurs due to blocking potassium efflux or excessive
sodium entry in cardiac cells, causing intracellular posi-
tive ion’s overload that delays ventricular repolarization,

Torsadogenic Index: Its Chinese Medical Origin 2
facilitating early depolarization [6].
4. Material
After obtaining the suspicious drug list, I began spread-
ing this knowledge in order to mitigate risks. First con-
ference took place in La Plata Children’s Hospital; and
its personnel kept in touch with me, consulting about
pharmacological indications over quoted drugs.
From this group of patients was extracted the case pre-
sented in Torsadogenic Index: a proposal to improve sur-
vival rates in cardiac arrest due to prescribed drugs [7].
From the beginning, this impending death situation
was analyzed under Traditiona l Chinese Medicine (TCM)
principles, founding its reasons in its ancient intricate
relationships [8,9].
Quoted case in Frontiers of Medical Pharmacology
Research and Outcomes was a one-year-old infant with
acute lymphocytic leukemia under oncological treatment
with vincristine, daunorubicin and pegylated asparagi-
nase—MARMA Interfant 05 IB protocol—prescribed in
a particular season and in a specific hour of the day [7].
These facts, almost irrelevant for Western medical
science, are crucial to understand the following conse-
quences that finished in the cardiac arrest of this child
[8].
5. Method
A chronological sequence shows quoted cases charac-
teristics that lead to conclusions according to TCM view.
First of all, TCM developed the Five Movements
Theory for explaining a Cosmological order; the har-
mony in human nature and—in our bodies—their organs
and viscus relationships. This Five Elements’ Principles
remind me the Euclidian Geometry’s Axioms. It’s not
by chance that Euclid explained Universe’s structure
based upon its Five Regular Polyhedrons, naming them
in the same way as Chinese masters did.
In particular, reference to Wood element, it’s com-
pound by Liver—as its organ; and Gallblader—as its
viscus. Unlike in Water, where patient condition “falls
down” as it gets worse—like in a cascade, Wood patho-
logies behave like flames: as condition get in progress,
the “burning state” is more serious over the patient; “and
the flames grow up”.
Oncological drugs—vincristine, pegylated asparagi-
nase and daunorubicin—even administrated in correct
prescription and doses—have notorious hepatotoxic ad-
verse effects.
This condition is called “Toxic Heat”; and over the
Liver—a Wood zhang—may provoke an “ignition” that
puts this organ in serious functional danger.
Furthermore, medication was administrated in Sum-
mer—a Fire season; another reason that make Liver—as
a Wood organ—vulnerable to flames [10].
Finally, treatment was accomplished at 12:30 a.m.:
very near the most Yang hour, and sun plenum clarity
and heat.
Synthetically, under Traditional Chinese Medicine’s
view, this child received its hepatotoxic medicines (“To-
xic Heat”); in Summer (“Fire station”); and at mid-day
(“Fire hour”).
Quoted deductions about this summary of conditions
that affected Heart—the next organ in TCM’s “Mother
and Son Rule”—is based upon Cheng Generation Cy-
cle that allows a creative sequence between the Five Ele-
ments in Chinese Medicine.
Heart is the “Son” of Wood; so that “Toxic Heat”
damaged it so seriously, that cardiac arrest was the cor-
ollary of this accursed ex ample.
6. Results
As quoted in Frontiers journal, oncological drug plan
was scheduled with a week-interval between drugs; and
this kid had a successful treatment and kept alive [7].
Downloaded by more than 500 subscriber experts;
Frontiers editorial considered Torsadogenic Index’s Im-
pact Factor as one of the most impressive of this prestig-
ious journal.
Invited as speaker to 5th Drug Discovery and Therapy
Dubai conference and last 5th World Drug Discovery
Congress in Boston, made me possible to introduce new
Drug Risk Management Project [11] and Torsadogenic
Traceability Concept [12] for reducing death rate due to
drug prescription, combination and self-indication [13-
15].
The most enthusiastic sponsor of this work was Dr.
Wang, cu rrent Presiden t of F.D.A. China and Dir ector of
the Chinese National Drug Evaluation Center. His sup-
port has been fundamental for this success.
7. Conclusions
Still in 21th century, Traditional Chinese Medicine con-
tributing to Western science can be useful for taking de-
cisions through its ancient and perpetual principles.
Originated from TCM parameters [16], Torsadogenic
Index Management Project and Torsadogenic Tracea-
bility [11,12] will be main subject for discussion into
next Washington F.D.A. Meeting agenda.
Turning results into evidence will convince Western
Medicine [17,18] to convoke these alternative ways for
improvin g pat i e nt s’ heal t h [19-22].
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