2nd International Symposium on Natural Drugs. Meeting organised by The University of Naples, Italy.

This international meeting took place in the breathtakingly beautiful surroundings of the coast south of Naples. It attracted more than 100 researchers, mostly from European countries. Overwhelmingly, the research presented was of a pharmacological nature; only one or two contributions could be classified as clinical. In my view, this is truly surprising and raises a crucial question. When investigating (traditional) natural drugs, there are two dramatically different ways of going about it. Should we direct our research at understanding the mechanisms of how a remedy works, or should we first establish that it works at all? Let me give you an example of some research that was discussed at the meeting. Artichoke extracts are, for a number of reasons, suspected of lowering serum cholesterol concentrations. Work was presented at the symposium which showed how this might be brought about using liver cell cultures exposed to artichoke extracts. The results are pharmacologically exciting. However, they do not bring us much nearer to determining whether or not a cholesterol-lowering effect occurs in hypercholesterolaemic patients. This question can only be decided by controlled clinical trials.

In the end, both approaches might lead to the same conclusion. However, with traditional drugs, I firmly believe, one should be adventurous and leave the well-trodden path of established pharmacological dogma. It seems much more reasonable, less time-consuming, more holistic and patient-centred to first establish clinical efficacy and then ask what the mechanism(s) might be.