Don't forget pharmacognosy.

摘要

In today's Lancet, we present a patient with bladder cancer and end-stage renal failure after taking a Chinese herbal remedy. This case highlights the toxicity of the active ingredient, aristolochic acid. Such cases provide ammunition to doctors who abhor alternative or complementary medicine while promulgating orthodox practice. But that position is not an open-minded one.All complementary medicines, like any medicine, have the potential for side-effects, drug-drug interactions, and contamination (especially if a herbal product). They all need regulation as drugs. And practitioners in this field need reminding, again, that they need to produce high-quality evidence of efficacy: fully powered double-blind randomised trials with relevant endpoints and sufficient follow-up, and systematic reviews. We do not accept the view that individualisation of complementary treatments precludes proper studies.