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. Despite those caveats, western medicine would do well
to embrace the herbal pharmacopoieas from countries such as