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We thank Professor Towers1Towers GHN FAHF-1 purporting to block peanut-induced anaphylaxis.J Allergy Clin Immunol. 2003; 111: 1140Abstract Full Text Full Text PDF PubMed Scopus (6) Google Scholar for his comments on Dr Claman's letter2Claman HN Glucocorticoids in herbal formulas?.J Allergy Clin Immunol. 2002; 109: 1038Abstract Full Text Full Text PDF PubMed Scopus (3) Google Scholar and our publication.3Li XM Zhang TF Huang CK Srivastava K Teper AA Zhang L et al.Food Allergy Herbal Formula-1 (FAHF-1) blocks peanut-induced anaphylaxis in a murine model.J Allergy Clin Immunol. 2001; 108: 639-646Abstract Full Text Full Text PDF PubMed Scopus (160) Google Scholar We also thank Professor Towers for providing additional information supporting our response that the chemical structures of known compounds in ling zhi differ from those of corticosteroids.4Towers GHN FAHF-1purporting to block peanut-induced anaphylaxis.J Allergy Clin Immunol. 2002; (< to be inserted by publisher >)Google Scholar Previous publications,5Ziment I Tashkin DP Alternative medicine for allergy and asthma.J Allergy Clin Immunol. 2000; 106: 603-614Abstract Full Text Full Text PDF PubMed Scopus (123) Google Scholar including ours,6Li XM Huang CK Zhang TF Teper AA Srivastava K Schofield BH et al.The Chinese herbal medicine formula MSSM-002 suppresses allergic airway hyperreactivity and modulates TH1/TH2 responses in a murine model of allergic asthma.J Allergy Clin Immunol. 2000; 106: 660-668Abstract Full Text Full Text PDF PubMed Scopus (89) Google Scholar suggest that Chinese herbal medicines have antiallergy and anti-inflammatory properties. Although much work remains to be done before the precise mechanisms of action of herbal medicines on allergy can be understood, the effects on T cells of the ling zhi –containing formula differ from those of the corticosteroid dexamethasone. 7Li X M., Teper A, Zou ZM, Srivastava K, Schofield B, Sampson HA. The Chinese herbal formula, MSSM-002, can reverse the established TH2 phenotype, which is accompanied with down regulation of the TH2 transcription factor GATA-3 [abstract].J Allergy Clin Immunol. 2002; 109: S155Abstract Full Text PDF PubMed Google Scholar As emphasized by Professor Towers,1Towers GHN FAHF-1 purporting to block peanut-induced anaphylaxis.J Allergy Clin Immunol. 2003; 111: 1140Abstract Full Text Full Text PDF PubMed Scopus (6) Google Scholar careful attention to chemical structures is of course essential if misleading conclusions are to be avoided. We also would like to note that in addition to careless examination of chemical structures, confusion can be generated by less-than-meticulous use of Chinese herbal medicine–related terminology, even by scientists with expertise in herbal pharmacology. Professor Towers' statement that FAHF-1 contains “Aconitum , a poisonous alkaloid-containing species” is not quite accurate. Herbal medicines, including FAHF-1, contain an extract of previously processed aconite root. Unprocessed aconite, or ni(shen) fu zi (Radix Lateralis Aconiti Carmichael), is never used in herbal medicines because of its well-known toxicity. Chinese herbology terminology is quite precise in this instance. According to Chinese Herbal Medicine: Materia Medica8Bensky D Gamble A Chinese herbal medicine: materia medica.in: Eastland Press, Seattle1993: 513-530Google Scholar and Pharmacopoeia of The People's Republic of China , 9The State Pharmacopoeia Commission of The People's Republic of China Pharmacopoeia of The People's Republic of China.in: Chemical Industry Press, Beijing2000: 3-545Google Scholar it is zhifu zi (Radix Lateralis Aconiti Carmichaeli Praeparata )—ie, processed root, treated by prolonged soaking followed by boiling in water with or without the addition of other chemicals—that is used medicinally. Furthermore, additional extraction during the boiling procedure used to prepare decoctions reduces the toxic alkaloids to levels that are virtually undetectable by chromatographic analysis. 9The State Pharmacopoeia Commission of The People's Republic of China Pharmacopoeia of The People's Republic of China.in: Chemical Industry Press, Beijing2000: 3-545Google Scholar Describing FAHF-1 as containing “Aconitum , a poisonous alkaloid-containing species” is similar to describing tapioca pudding as containing the poisonous plant Manihot esculenta , which contains high levels of the toxic cyanogenic glycosides hydrocyanic and prussic acid, or describing the rural American food poke salad (properly termed poke sallet ) as containing the poisonous plant Phytolacca americana, which contains toxic amounts of oxalic acid, saponins, and alkaloids. Although these statements might be literally correct, they are nevertheless inaccurate because they are incomplete. M esculenta , known as cassava or manioc , is the staple food of hundreds of millions of people because it is not eaten until the toxic constituents are eliminated by processing. P americana (poke weed) shoots are also processed to extract toxins before consumption. Therefore, to be accurate, the foregoing descriptions should state that FAHF-1, tapioca, and poke sallet contain poisonous plant material from which the poisons have been extracted. We also point out that guizhi (Ramulus Cinnamomi Cassiae) is not the “common spice” cinnamon, which is rougui (“the thick bark”). Guizhi is a small twig. It is not surprising that Professor Towers' group found that only some ingredients in herbal remedies for sores and rashes exhibit antibiotic activity. However, antibiotic activity might not be the sole, or even a beneficial, property of these mixtures. It is possible that other ingredients exhibit anti-inflammatory properties, which might be of greater benefit than any antibiotic properties. It is also possible that many of these herbal mixtures have no benefit whatever. Furthermore, some so-called Chinese herbal medicines sold over the counter as treatments for dermatologic symptoms have been adulterated with Western prescription drugs.10Keane FM Munn SE du VA Taylor NF Higgins EM Analysis of Chinese herbal creams prescribed for dermatological conditions.BMJ. 1999; 318: 563-564Crossref PubMed Scopus (102) Google Scholar Assessment of new pharmacologically useful ingredients in traditional herbal remedies requires not only much additional research but also strict adherence to classical herbology practices. Most important, we want to emphasize that though we found that FAHF-1 exhibited anti-allergy activity in a murine model of peanut allergy, we have not claimed and do not claim that this formula or any other known “medicine” is a remedy for human peanut allergy.