If you've ever nursed a cold with hot tea and honey, jump-started the day with a cappuccino, or soothed a sore throat with a mentholated cough drop, you've practiced herbal medicine. These remedies are so much a part of our daily routine that no one thinks them flaky. Nor do most doctors mind that you use them--as long as you don't overdo it. So why are so many physicians, especially in the U.S., reluctant to recommend herbal supplements? Is it just a matter of ignorance and provincialism?

No. Physicians have legitimate concerns about the safety, efficacy and potential misuse of the herbal products that their patients are snapping up. More and more M.D.s, like their patients, accept that some herbal products may help where conventional treatments fail. The difference is that doctors tend to be more demanding of proof. Or as Dr. Yank Coble of the American Medical Association puts it, "In God we trust. All others must have data."

Fortunately, those data are starting to trickle in. At the urging of its members, the A.M.A. for the first time devoted all its research publications two weeks ago, including the flagship Journal of the A.M.A., to scientific studies on alternative, or complementary, medicine. As with conventional medicine, the results showed that some treatments work while others don't.

One of the more intriguing studies, conducted in Australia, found merit in Chinese herbal treatments for irritable-bowel syndrome, a gastrointestinal disorder that strikes 10% to 20% of the population in many industrialized countries and for which conventional medicine often offers only symptomatic relief. The study also showed the lengths to which researchers must go to make sure that the benefits ascribed to herbal remedies are not due to a biased analysis of data, or to patients' expectations--the so-called placebo effect.

Doctors in Sydney recruited 116 patients who had not responded well to Western treatments. They divided them into three groups and sent each group to a Chinese herbalist, who wrote each patient an individualized prescription based on his or her complaints. Each prescription was then filled at a different location, where patients were randomly given pills that contained either a placebo of flavored compounds that tasted like herbs but had no medicinal effects, a standardized extract of 20 herbs designed to support bowel function in general, or the individually prescribed herbs. After 16 weeks of treatment, the two groups that received herbal medicines had fewer symptoms and less pain than the placebo group. But 14 weeks later, only the group that received tailor-made herbal remedies still felt better.

Most of the other studies that were reported at the same time yielded mixed results. Researchers at St. Luke's Roosevelt Hospital Center in New York City determined that Garcinia cambogia does not, by itself, help patients lose weight. A review of all the studies conducted on saw palmetto found significant improvement in urine flow in men with enlarged prostates. But the reviewers cautioned that the saw palmetto studies lasted, on average, only nine weeks, too few to determine long-term results.

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