The administration of herbal medicines made from Callilepis laureola is common among the Black population in Natal. This practice can and does cause poisoning, which has only been diagnosed with any confidence at postmortem examination, where the characteristic hepatic and renal tubular necrosis is obvious. Necropsy records of 50 children in whom these typical histological changes were noted were analysed retrospectively in order to determine the clinical picture. Results show that the disease can be recognized in young Black children when there is hypoglycaemia and an alteration in the level of consciousness, together with evidence of hepatic and renal dysfunction. This syndrome can easily be distinguished from viral hepatitis and fulminant hepatic failure, but less readily from Reye's syndrome.