Walter A. Brown's Opinion piece, "Alternative Medicine: It's Time to Get Smart," (The Scientist, 12[24]:13, Dec. 7, 1998) is timely and balanced. It is wishful thinking to argue that no placebo-controlled clinical studies are needed because herbs and the like have been used for hundreds of years. Those of us who have worked in pharmaceutical R&D for decades have seen too many compounds that were sworn efficacious by both physicians and patients, but could not be shown superior to a placebo. All claims made by the purveyors of "alternative" medicines should have to be proven in controlled studies.

A second area that should be seriously addressed is safety. If nobody carefully follows up on the use of a medication in the population, side effects will not likely be detected unless they are serious and have high incidence. Plant products, if they are active, owe their efficacy to...

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