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We designed a randomized double-blind randomized trial to examine the short and long-term effects of alternative approaches commonly used to manage menopause symptoms. Women were randomly assigned to: (1) black cohosh 160 mg daily; (2) multibotanical (50 mg black cohosh, alfalfa, chaste tree, dong quai, false unicorn, licorice, oats, pomegranate, Siberian ginseng, boron) four capsules daily; (3) multibotanical plus telephone counseling to increase dietary soy; (4) conjugated equine estrogen 0.625 mg +/- 2.5 mg medroxyprogesterone acetate; or (5) placebo. Working with a skilled CAM provider helped us choose interventions that reflected naturopathic practices worthy of study. Mass mailing, with careful tracking and rapid responses to recruitment rates, was an effective and cost-effective recruitment strategy. Creativity was necessary to construct methods for blinding capsules and the dietary soy intervention. Independent testing of herbal products was vital to confirming their constituents. The Data and Safety and Monitoring Committee, and project officers at the funding agency, were critical partners in designing responses to unanticipated Women's Health Initiative findings published during the HALT trial. Careful monitoring of adverse events may provide much needed information about side effects of herbal products and supplements. Despite inherent challenges, the study of alternative therapies for menopause symptoms is a rewarding and important area deserving of further inquiry.

An integrative approach to the therapeutic management of dyspepsia and ulcers may offer patients the best opportunity for resolution of disease and symptoms. Although antibiotics play a key role in the eradication of H Pylori infections, adding supplements appears to offer an edge in supporting overall gastric health. In addition to the aforementioned prescriptive antibiotic regimens, the use of supplements in the treatment of ulcers can improve healing rates and decrease the rate of recurrence. Effective digestion must strike a balance between the secretion of caustic acids and the maintenance of the mucosal epithelium. Much of the literature on this topic is limited to small studies and animal studies, but it indicates that a complementary approach to dyspepsia may help to preserve our natural gastric environments and prevent significant morbidity and mortality.

Botanical supplements for health enhancement are being increasingly used in the United States, but no safeguards are formally in place to ensure that they are not contaminated with non-efficacious or potentially harmful plant material. A molecular approach, which allows the authentication of botanical ingredients and detection of contaminating plant material by analyzing the ITS-1 region by PCR-RFLP and subsequent sequencing, is described. When using starting material from which DNA can be obtained, this method has the potential for identifying both primary and contaminating plant material in botanical dietary supplements.

Purpose: To define complementary and alternative medicine (CAM); describe one type of CAM, garlic (Allium sativum L); and discuss its effects on blood pressure as a treatment for hypertension., Data Sources: Literature review from professional journals, abstracts, natural therapy books, and the World Wide Web (Internet). Information from the following professional organizations and agencies: The World Health Organization, Agency of Healthcare Research and Quality, National Cancer Institute, National Center for Complementary and Alternative Medicine, American Botanical Council, and Joint National Committee on Prevention, Detection, Evaluation and Treatment of High Blood Pressure., Conclusion: Garlic is widely used throughout the world as a CAM. It is one of the most popular herbal products sold in the United States. However, while some studies have shown small positive effects in reducing blood pressure, there are insufficient scientific data to draw conclusions regarding its efficacy on clinical blood pressure outcomes. Thus, healthcare providers should be cautious in recommending this herbal product as an antihypertensive CAM., Implications for Practice: CAMs may be used by clients for a variety of conditions including hypertension. Healthcare providers must be cognizant of the use, efficacy, adverse affects, and scientific evidence concerning CAM in order to provide safe and effective practice as well as appropriate and accurate information to their clients.

Herbal dietary supplements are taken by many individuals, often without the knowledge of their clinicians. Herbals have many pharmacologic and medicinal properties but are unregulated with respect to manufacturing purity, safety, and efficacy. Although clinicians often dismiss the utility of herbal therapy, many randomized controlled trials of herbal use in gastrointestinal and liver diseases have been conducted. There is no evidence for benefit from herbal supplements in the treatment of liver disease, but sufficient evidence exists for their use in functional gastrointestinal symptoms to warrant further investigation.

Garlic has long been used medicinally, most recently for its cardiovascular, antineoplastic, and antimicrobial properties. Sulfur compounds, including allicin, appear to be the active components in the root bulb of the garlic plant. Studies show significant but modest lipid-lowering effects and antiplatelet activity. Significant blood pressure reduction is not consistently noted. There is some evidence for antineoplastic activity and insufficient evidence for clinical antimicrobial activity. Side effects generally are mild and uncommon. Garlic appears to have no effect on drug metabolism, but patients taking anticoagulants should be cautious. It seems prudent to stop taking high dosages of garlic seven to 10 days before surgery because garlic can prolong bleeding time.

Background: Green tea is widely used by women for the prevention and treatment of breast cancer. The authors aimed to determine the efficacy of green tea ingestion on the risk of breast cancer development and the risk of breast cancer recurrence., Methods: The authors conducted a systematic review and meta-analyses of observational studies from systematic searches of 8 electronic data sources and contact with authors. They included studies assessing breast cancer incidence and recurrence., Results: Results: The pooled relative risk (RR) of developing breast cancer for the highest levels of green tea consumption in cohort studies was 0.89 (95% confidence interval [CI], 0.71-1.1; P= .28; I(2)= 0%), and in case control studies, the odds ratio was 0.44 (95% CI, 0.14-1.31; P= .14; I(2)= 47%). The pooled RR of cohort studies for breast cancer recurrence in all stages was 0.75 (95% CI, 0.47-1.19; P= .22; I(2)= 37%). A subgroup analysis of recurrence in stage I and II disease showed a pooled RR in cohort studies of 0.56 (95% CI, 0.38-0.83; P= .004; I2= 0%). Dose-response relationships were evident in only 3 of the 7 studies., Conclusion: To date, the epidemiological data indicates that consumption of 5 or more cups of green tea a day shows a non-statistically significant trend towards the prevention of breast cancer development. Evidence indicates that green tea consumption may possibly help prevent breast cancer recurrence in early stage (I and II) cancers. However, conclusions as to the potential therapeutic application of green tea are currently impossible to make due to the small number of studies conducted, the lack of any clinical trial evidence, the lack of a consistent dose-response relationship, and the potential for interaction with standard care.

During the last decade, there has been a dramatic rise in the availability and use of medicinal herbal preparations. Childbearing women are among those who are asking nurses about herbal use, and therefore nurses need to learn more about this topic. One of the most important points to understand is that in the United States herbs are classified as dietary supplements (not drugs), and manufacturers are therefore not required to provide proof of efficacy or safety before selling these substances. Few studies about effects of herbs have been conducted in the general population, and fewer still have been published about pregnancy use. Because the perinatal nurse has two patients to consider when caring for a pregnant woman, he or she has two equally important mandates: to help the mother without harming the fetus. This article provides an overview of key concepts underlying herbal use in general and also safety in pregnancy. Common herbs that can be safely be used in pregnancy are presented in detail to enable the nurse to better care for the pregnant woman who is considering herbal use.

Herbal supplements are among the most popular complementary and alternative therapies used in the US, yet many healthcare providers report having inadequate knowledge about herbs. It also has been reported that many healthcare providers want to have a better understanding of herbs so that they may recommend or discourage their use. In this report, we attempt to determine whether a significant body of research has been indexed in PubMed on the most widely used herbs in the US. These data also prove useful in determining whether the scientific community in the US is focusing investigations on herbs that are widely used domestically. In addition, many clinicians in the US use data from clinical trials performed in the US to inform their practice, so we wanted to determine whether significant clinical data on these herbs were available.

There is continuing emphasis by many professionals and organizations on the importance of breastfeeding as optimal infant nutrition. Pediatricians are frequently asked about the safety of medications taken by the nursing mother and the risk to the infant. Most drugs and many chemicals will be transferred into milk. For a vast majority of these compounds, there is no risk to the infant. It is almost always possible for the mother to continue nursing while taking the necessary medication. This article presents an introduction to the pharmacology of the transfer of drugs into milk, discusses the importance of the infant's age in assessing safety and presents a number of maternal conditions for which drugs need to be used.

We report here a negative ionization nanoelectrospray ionization mass spectrometry (nanoESI-MS) technique that simultaneously detects active components, terpenes and intact flavonol glycosides, and toxic ginkgolic acids in ginkgo products. Unlike the conventional methods that hydrolyze flavonol glycosides to flavonoids for analysis, this technique directly detects intact flavonol glycosides, enabling differentiation of these natural glycosides from the synthetic flavonoids. Thus, it allows the detection of fortification of ginkgo products, alleviating a common problem encountered by the conventional methods. Analysis of 14 commercial ginkgo products using this technique demonstrates large variations and deviation from the well-accepted standardized ginkgo extract. Four products showed evidence of fortification with synthetic surrogates. Two products were found to have toxic ginkgolic acids that exceed the 5 microg g(-1) limit by as much as 60000 fold. These results emphasize the importance of appropriate monitoring of ginkgo product quality.

Even though plants have been used as therapeutic remedies since men have inhabited the Earth, only with advances in pharmaceutical science and the development of analytical methods have professionals been able to guarantee the necessary control procedures, thereby overcoming many of the inconveniences incurred by the traditional use of plants and improving their efficiency. Today, phyto-therapy is based on research and experience. The contents of this article deal with the quality, efficiency and security of phyto-therapeutic preparations.

Botanicals such as herbal products (HPs) and nutraceuticals (NCs) are often regarded as low risk because of their long history of human use. Anecdotal and literature reports of adverse drug events (ADEs) and clinical studies with HPs are increasing, but many of the reports are incomplete and contradictory. These reports need to identify confounding factors and explain contradictory findings if they are to help health care professionals or patients understand what risks are involved. HPs are complex botanicals, not single-active ingredient (SAI) products. Studies can be confounded by different manufacturing processes and formulations, including cosmetics and food supplements; environment; chemotypes; misidentification or adulteration; and factors associated with the patient or user population such as use, total drug load, and genetics. Future studies need to be conducted with characterized product that includes all commercially available related products. Clinical trials should be relevant to the user population and take into account the confounding factors that may influence the interpretation of the findings.

In every country traditional medicines find foundation in magical or religious beliefs, or popular experience. The World Health Organization is engaged to establish guidelines for methodology of clinical research and the appraisal of effectiveness of traditional medicine. In Italy it has been adopted the term non-conventional medicines in order to group one series of therapies and medicines which are radically different one from the other. Phytotherapy uses medicinal plants prepared by means of adapted extractive technologies and proper pharmacological preparations, purified and standardized in their chemical principles. As for any shape of therapy there are possible side effects, contraindications, pharmacological interactions. It is deemed necessary that a basic knowledge of the pharmacological aspects of phytotherapy be included in the regular Course of Medicine.

Herbal preparations have been used for centuries as the main therapeutic means. In Italy there is an ancient tradition of using herbal remedies, which became extremely important from the 16th to the 18th century. Nowadays multinational companies invest great resources on herbal drugs and preparations. This article focuses on herbal medicines, herbal products, and food supplements. Moreover the European legislation on traditional medicinal plants and food supplements is analysed and discussed.

Herbal therapies are used by more than 12% of the U.S. population each year, resulting in annual out-of-pocket expenses above $5 billion. Utilization rates are particularly high among patients with chronic diseases, and in patients frequently seen in clinic by physicians and nurse practitioners. Most physicians do not receive formal education regarding the safety of these therapies, and there is growing concern in the medical community about the potential risks to patients and the paucity of reliable information. Numerous adverse effects and interactions have been attributed to dietary supplements, based on variable levels of evidence ranging from historical use or anecdotes to pre-clinical research or high-quality clinical trials. Significant potential morbidity and costs have been indirectly associated with herb/supplement-drug interactions, including increased emergency room visits, outpatient clinic visits, and perioperative complications. However, most research has focused on efficacy rather than safety. Post-market surveillance is complicated by the uneven standardization of products between manufacturers, and in some cases between batches produced by the same manufacturer. To assure public safety around the use of dietary supplements within the framework of existing legislation and market realities, schema must evolve to more systematically monitor the safety of agents in the post-market environment; identify potentially dangerous supplements (and/or constituents); study the mechanism and potential hazards of these identified products; and clarify the process by which products may be considered for removal from the market. We discuss research and educational paradigms within this context which make use of existing surveillance mechanisms to more efficiently identify agents of particular concern. Specific examples are given.

The use of herbals/botanicals has been gaining wide popularity in recent years in the United States as well as in other parts of the world. The mechanism of action of most of these herbals/botanicals has not been subjected to thorough scientific investigations. St. John's wort (Hypericum perforatum) represents a useful case study in this sense. Traditionally, it is used as a natural treatment for depression; however, in recent years its molecular mechanism of action has been elucidated by a number of laboratories across the world. Such studies have helped understand potential interactions of St. John's wort with drugs and other xenobiotics. St. John's wort activates a nuclear receptor called pregnane X receptor (PXR). PXR is a ligand-activated transcription factor that induces a number of xenobiotic-metabolizing enzymes and transporters including cytochrome P4503A4 (CYP3A4) in humans. Because CYP3A4 alone metabolizes about 60% of all clinically relevant drugs, induction of CYP3A4 may result in the rapid elimination of these drugs and a consequent reduction in drug efficacy. Ironically, such enzyme-inducing effects may not produce any immediate adverse symptomatology in the person taking St. John's wort. Therefore, the case of St. John's wort should serve as a good example of the usefulness and importance of studies on the mechanism of action of the herbals/botanicals, particularly those with widespread use. Scientists, physicians, and other health professionals can make use of the knowledge from such studies as an additional risk management tool., (Copyright 2005 Wiley Periodicals, Inc.)

Objectives: The use of complementary and alternative medicines (CAM) appears increasingly prevalent in children and adolescents. Individuals with chronic illness may have patterns of greater usage. This questionnaire-based study aimed to ascertain the frequency of use by a group of children with proven inflammatory bowel disease (IBD) and to consider the reasons for their use., Methods: A questionnaire was sent by mail to the parents of patients currently attending a paediatric IBD clinic. Parents were asked to describe their child's usage of alternative and probiotic therapies and to comment on a number of aspects of such therapies., Results: Forty-six (77%) of 60 mailed questionnaires were returned. The mean age of the children was 10.9 (+/- 4.1) years and they were taking an average of 1.7 (+/- 0.8) prescribed medications. Thirty-three (72%) of the children were said by their parents to be having CAM, with four having five or more such therapies (average 2.4 +/- 1.3 agents per child). The most commonly used agents were probiotics (78%) and fish oils (56%). A minority (12%) of respondents reported that their child's CAM was very effective, although many (50%) noted partial benefits. The 13 children who had never used any CAM therapies ('non-users') did not differ from the 'users' in terms of gender, age, disease or duration of disease. As expected, non-users expressed greater concerns about use of CAM and described different attitudes towards such therapies., Conclusion: Complementary and alternative medicines, especially probiotic therapies, frequently are administered to children and adolescents with inflammatory bowel disease. Often this appears to be due to parental frustration with managing their child's chronic illness. Practitioners caring for children and adolescents with IBD need to be aware that their patients may be using alternative therapies and adopt an open attitude in this situation.

Background: Ginseng is a commonly used nutraceutical. Intriguingly, existing literature reports both wound-healing and antitumor effects of ginseng extract through opposing activities on the vascular system. To elucidate this perplexity, we merged a chemical fingerprinting approach with a deconstructional study of the effects of pure molecules from ginseng extract on angiogenesis., Methods and Results: A mass spectrometric compositional analysis of American, Chinese and Korean, and Sanqi ginseng revealed distinct "sterol ginsenoside" fingerprints, especially in the ratio between a triol, Rg1, and a diol, Rb1, the 2 most prevalent constituents. Using a Matrigel implant model and reconstituting the extracts using distinct ratios of the 2 ginsenosides, we demonstrate that the dominance of Rg1 leads to angiogenesis, whereas Rb1 exerts an opposing effect. Rg1 also promoted functional neovascularization into a polymer scaffold in vivo and the proliferation of, chemoinvasion of, and tubulogenesis by endothelial cells in vitro, an effect mediated through the expression of nitric oxide synthase and the phosphatidylinositol-3 kinase-->Akt pathway. In contrast, Rb1 inhibited the earliest step in angiogenesis, the chemoinvasion of endothelial cells., Conclusions: The present study explains, for the first time, the ambiguity about the effects of ginseng in vascular pathophysiology based on the existence of opposing active principles in the extract. We also unraveled a speciogeographic variation impinging on the compositional fingerprint that may modulate the final phenotype. This emphasizes the need for regulations standardizing herbal therapy, currently under the Dietary Supplement and Health Education Act. Furthermore, we propose that Rg1 could be a prototype for a novel group of nonpeptide molecules that can induce therapeutic angiogenesis, such as in wound healing.

There are more than 20 completed Cochrane systematic reviews on botanical medicine presently published in the Cochrane Library. There are more than 40 that are planned or in progress. It is an opportune time to explore the information needs of readers of botanical systematic reviews and how those needs can be met better by Cochrane systematic reviews. It is proposed that Cochrane systematic reviews focus not only on efficacy but also on expanded safety and quality. Expanded safety refers not only to the occurrence of adverse events but also the contraindications for use such as drug-herb interactions or allergies to products. Quality pertains to whether or not there was a method of standardizing active ingredients in trials and methods for minimizing risks of contamination. Because there are no package inserts to accompany herbal products as there are for drugs, Cochrane systematic reviews offer the ideal forum to present this much-needed information on expanded safety and quality.

Medicinal plant knowledge of two groups of traditional healers was thoroughly studied during a 2-year ethnobotanical survey in the Bolivian Andes (Quechua farmers from Apillapampa) and Amazon rainforest (Yuracaré-Trinitario slash-and-burn cultivators from Isiboro-Sécure National Park), respectively. Both areas represent ecologically and culturally diverse zones, differing in floristic diversity, physical accessibility to health care and degree of modernization, the latter evidenced by presence or intensity in use of modern services such as electricity, water distribution, and materials for house construction. It is generally believed that indigenous people have an impressive knowledge of useful plant species and that this knowledge reflects the plant wealth of their living environment. However, the present study shows that healers' knowledge of collected medicinal plants (expressed as percentage of plants known by name and use by the majority of healers) is higher in the Andean area characterised by a long history of anthropogenic activity, than in the biodiversity-rich rainforest (protected since 1965). Therefore, medicinal plant knowledge does not seem to depend on the level of plant diversity, degree of modernization or absence of Western health care infrastructure. Indeed, although Andean healers live in a floristically poorer environment, have adopted more modern services and have easier access to primary health care facilities, they are more knowledgeable about medicinal plants than rainforest healers who live isolated in an environment with considerable floristic/ecological variation and lack of Western health care. It is hypothesised that social factors underlying traditional medical practices (background of extensive family in traditional medicine) play an important role in transmission--and hence survival of knowledge on medicinal plants.

This article is a description of how I have integrated Complementary Medicine into the practice of dermatology over the past 2 decades. It emphasizes observing the principles of the system being used, such as the herbal concept of the synergy of the entire plant extract. Examples discussed include the use of flavonoids to protect the liver and capillaries. Herbs and techniques for reducing the inflammatory response, as well as for enhancing immunity, are given. The concept of homeopathy and a few remedies to use in office practice are discussed. Finally, a few methods to complement the treatment of melanoma are presented.

Background and Aims: Owing to the global trend towards improved 'quality of life', there is considerable evidence of an increase in demand for medicinal plants. The WHO guidelines define basic criteria for the standardization of herbal medicines. The present work is an effort in this direction to prove the safety and efficacy of Hemidesmus indicus Linn. in the management of nephrotoxicity induced by aminoglycosides such as gentamicin., Methods and Results: Simple, quality control methods using high performance thin layer chromatographic (HPTLC) phytochemical fingerprint, proximate analysis, and the stability of the H. indicus root powder were developed. From the toxicity study using albino Swiss mice, it was observed that the drug (H. indicus) was relatively safe up to 7 g/kg bodyweight dose. Efficacy was evaluated against gentamicin-induced nephrotoxicity in albino Wister rats. The study examined animals from the following groups: no treatment, gentamicin treated, gentamicin treated recovery, and gentamicin and plant treated. Animals from all groups were killed on day 13 of the study; those from gentamicin treated group were killed on the seventh day. Assessment of the drug efficacy drug was conducted by using haematological and histological examination., Conclusion: The treatment with H. indicus helped in the management of renal impairment, which was induced by gentamicin in rats. This is evident from the results obtained for various kidney function tests for gentamicin, along with the results from the plant treated group, and is in comparison with the results found for the gentamicin recovery group. A histological examination of kidneys also supports the findings from haematological evaluations. The plant shows promise as an adjunct therapy along side aminoglycosides as it reduces nephrotoxicity caused by aminoglycosides.

A new HPLC-method for the separation of medium polar and nonpolar compounds in preparations of Valeriana officinalis was established for stability control. Powdered valerian root and a commercial ethanolic valerian extract were investigated for apparent differences in stability behaviour. Storage conditions were chosen according to the ICH-guidelines. Changes in composition of valerenic acids and lignans were observed depending on storage conditions and packaging materials. Hydroxyvalerenic acid, pinoresinol and hydroxypinoresinol were identified as degradation products in Valerian root, especially during accelerated testing. Ethanolic extracts appeared not to be as sensitive for chemical degradation under climatic influences compared to the crude plant material, and showed no increase in the amounts of lignan-aglyka. In comparison, extracts showed high sensitivity on changes of physical properties like loss on drying and viscosity.

This paper examines how caregivers' medicinal discourse serves as an indirect critique of modernization, urbanization and development in the Brazilian Amazon. When caregivers in two peri-urban neighborhoods, Triunfo and Bairro da Luz, discuss medicinal plants they highlight the positive aspects of phytotherapy and associate it with traditional rural lifestyles. In contrast, they tend to emphasize the shortcomings of pharmaceuticals, which they link to modernity and urbanization. This discourse, which juxtaposes plants/tradition/positive with pharmaceuticals/modern/negative, contains counterhegemonic commentary about the failures of modernization, urbanization and development. While state sponsored development was supposed to bring prosperity to the Amazon, for many residents, like those in Bairro de Luz and Triunfo, it did not. In fact, some say development made their lives worse, claiming that poverty and poor health are among the prices they have paid. Due to the shortcomings of modernization and urbanization in other areas of their life, caregivers are ambivalent about biomedicine and the pharmaceuticals they associate with it. Moreover, because medicinal plant remedies embody traditional values, asserting they are stronger, more potent, better and more effective, especially in an urban context, is a moral commentary on the shortcomings of modernity. Finally, by insisting that traditional plant remedies are better at curing the health problems that result from modern, urban lifestyles, they are subtly asserting the superiority of tradition over modernity.

Many essential oils are extracted, analysed and their main components are identified, characterised and then published without any biological testing whatsoever. Their useful biological activities can remain unknown for years. Yet, the search for these activities often increases our knowledge of the potential use of oils in therapeutics. Therefore, there is a real need for a simple, reliable and reproducible methods to study the bioactivity of essential oils and their constituents which can detect a broad spectrum of action or specific pharmacological activities in aromatic plants. These methods can then be employed by natural product chemists, pharmacologists and biologists to conduct their scientific research and to valorize natural products. Standardisation of some of these methods is therefore desirable to permit more comprehensive evaluation of plant oils, and greater comparability of the results obtained by different investigators.

Botanical dietary supplements, as compared with nutritional supplements or single-component pharmaceutical drugs, are typically less-refined preparations derived from bulk plant material and, as such, require a modified approach to their development, production, and evaluation. An integrated, multidisciplinary team of scientific and clinical investigators is required in order to develop high quality phytomedicines and rigorously evaluate their safety and efficacy. Research on botanicals involves unique challenges as plant source materials frequently vary in chemical content and may contain unwanted pesticides, heavy metals, contaminant plant species, or other adulterants. Ideally, a botanical formulation should be standardized, both chemically and biologically, by a combination of analytical techniques and bioassays. This combination approach provides multiple measures by which reproducible quality and efficacy of botanical supplements may be achieved, and is particularly useful for botanical products for which the active compound(s) have not yet been identified. Safety and toxicity should be evaluated during the supplement development process in both in vitro and in vivo systems. A number of liquid chromatography-mass spectrometry methods can aid in the assessment of purity, bioavailability, toxicity, metabolism, and molecular target profiling of botanical extracts. Clinical investigators must appreciate the complexity of multi-component phytomedicines and adjust trial protocols accordingly. This review highlights practical considerations of value to basic science and clinical investigators engaged in the study of botanical supplements. Lessons and examples are drawn from the authors' experience in designing and developing a red clover (Trifolium pratense L.) standardized extract for evaluation in Phase I and Phase II clinical trials.

The medicinal value of cannabis (marijuana) is well documented in the medical literature. Cannabinoids, the active ingredients in cannabis, have many distinct pharmacological properties. These include analgesic, anti-emetic, anti-oxidative, neuroprotective and anti-inflammatory activity, as well as modulation of glial cells and tumor growth regulation. Concurrent with all these advances in the understanding of the physiological and pharmacological mechanisms of cannabis, there is a strong need for developing rational guidelines for dosing. This paper will review the known chemistry and pharmacology of cannabis and, on that basis, discuss rational guidelines for dosing.

The analysis of data collected by applying information technology in daily practice opens the possibility of validating homeopathic prescribing symptoms. The author has collected data on repertory rubrics, homeopathic medicines prescribed, and clinical outcomes, for 16 years. As an example of clinical verification the outcomes of patients prescribed Veratrum album are correlated against rubrics. Remarkable results were obtained when Verat-a was presented to 24 patients, 52 rubrics were used. The data were analysed using the classical method and the likelihood ratios method. There is good correlation in the results given by these methods. Among the most important symptoms of Verat-a are: ailments from mortification, vomiting and cough in Spring.