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GUEST,Doc Help: Tylenol and kids danger (31) RE: Help: Tylenol and kids danger 29 Aug 01


Yes, Peg, I learned the wrong spelling for Edward Bach's name and have wrongly always thought it was spelled differently from the family of composers.

Redarding some of your other points I fear we are just going to have to agree to disagree. I do realize, as Mark has pointed out, that there has been some relatively small amount of credible scientific research on "herbal" cures in recent years, mostly, as you mentioned, in Europe. I am aware of some work done in Germany on St Johns' Wort which indicated it may have efficacy as an antidepressant. However I have often been offered references to self-serving, incompetent,anecdotal or apocryphal "research", usually appearing in Prevention Magazine or in advertizing for some herbal product. This I do not count as credible.

I hasten to add that I am also quite skeptical of much of pharmacologic research paid for by drug companies or done by drug company hacks, or university physicians so arrogant they believe they will be impervious to corruption by even an enormous conflict of interest. The fact that such research is often reported in big-name, "refereed" medical journals doesn't impress me much if the paper is, upon careful scrutiny, clearly bad science, which it often is. Hence, again I agree with Mark, in that I don't rush out and try every new medication. My rule of thumb is to wait between one and two years to see how they shake out.

But I believe the reason little "herbal" research is done in the US is not as sinister as some might choose to see it. In the US the FDA assumes a protective role which the public of most other countries does not enjoy. In order for a product (and many, many pharmaceuticals are herbal, you know), to be marketed and sold for a particular purpose, a carefully controlled formal series of clinical tests and trials must demonstrate, to a degree that is found to be statistically significant and not due to chance, that the product is efficacious and that it's undesired effects are well defined. Both the efficacy and the "side-efects" are usually well quantified by the time the product is on the market, so that prescribing physicians can include estimates that the medication will work and estimates of the risk of harmful side effects into the complex and artful process of diagnosing and treating illness.

In addition to the fact that there is little incentive for a pharmaceutical company to underwrite such an expensive undertaking (because the herbs are not patentable) it is also true that even if they were willing to pay for the research on crude herbal products containing thousands of known and unknown ingredients, it is often impossible to demonstrate efficacy once the placebo effect is ruled out; or safety when the witches' brew of organic compounds in the raw herb is considered.

I am, by the way, not seeking here to convince or convert you or anyone who shares your point of view. More I think I am speaking to all the other folks out there who don't really understand much about medicine (as someone put it) and to whom your approach might otherwise sound quite plausible. I spent my first 17 years as a Family Physician, mostly explaining to my patients in plain English what those other doctors were talking about: being sure that they DID have enough information upon which to base the decisions they needed to make. I guess it's a hard habit to break.

Wisdom, I suppose, might be defined partly by knowing when to accept and when to decline any particular form of treatment, whether herbalist or allopathic, or any of the other several hundred theories and methods of treatment of which the planet boasts.

Denis


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