• herbal medicine
• complementary and alternative medicine

The editorial on herbal medicines warning about the possibility of serious side effects from some herbal medicines is welcome.¹ The message was quite clear: “always ask your patient about herbal medicines”. It was prompted by the case report in the same issue by Fong and Kinnear on a patient with retrobulbar haemorrhage associated with chronic Ginkgo biloba ingestion.² The editorial brought to the attention of readers the risks of improperly tested “herbal medicines” to the general population, and in particular, their interactions with orthodox medications. Important drugs included in the modern pharmacopoeia have originated from plants but only after adequate scientific research. They have also been marketed following ethically approved policies. Unfortunately the latter has not been the case for some “herbal medicines” sold as complementary and alternative medicine. A very good example is the marketing of mastic gum as a killer of Helicobacter pylori. A letter published in the New England Journal of Medicine showed that mastic gum kills H pylori in vitro.³ The in vitro antibacterial effects of mastic gum has also been corroborated by another study in Italy.⁴ However, the initial report led to a frenzy of marketing mastic gum as a definitive killer of H pylori. Unfortunately, the information passed to the public appeared to show that crude mastic gum has an anti-H pylori effect but it did not state that the results were not from human studies. Indeed, more recently a report from Nottingham has shown that mastic gum does not kill H pylori in mice.⁵ Any anti-H pylori effect of mastic gum in humans remains to be seen. Until then, the public should be aware of the facts.