Acute hepatomyoencephalopathy (HME) syndrome is the name given to a multi-system disease affecting the liver, muscle and brain which is now known to be caused by phytotoxins.[1] After extensive investigation the culprit has been found to be the beans of a common herb in India, Cassia occidentalis. In many districts of western Uttar Pradesh, Uttarakhand, Odisha and Haryana, India, outbreaks of an acute “encephalopathy” syndrome, dubbed as a “mysterious disease”, have been an annual feature for many years.