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Rational Phytotherapy: A Physician's Guide to Herbal Medicine.
I was pleased to receive my first 1998 book, signed by Varro Tyler, so pleased that I'm reviewing it right off the bat. I've always jokingly called Tip (Varro Tyler's nickname) a Germanophile since I first heard him talk at an Economic Botany meeting circa 1972 in Oxford, Mississippi. So what he says in the Preface to the English Edition does not surprise. Speaking of phytotherapy, herbal treatment, or botanical medicine, he suggests that "throughout most of the world, and especially in the United States and the United Kingdom, the practice is at best an imperfect art. In Germany, the use of plant drugs is a science." Phytomedicines can be sold "provided there is absolute proof of their safety and reasonable certainty of their efficacy." Praising Germany's Commission E monographs, originally published in German in the Bundesanzeiger, the counterpart of the U.S. Federal Register, Tyler says, perhaps prematurely (I received my copy of January 21, 1998) that the summaries have been published in English translation by the American Botanical Council in Austin, Texas, although I am assured that this publication is imminent. Tyler goes on "Of the hundreds of medicinal plants used therapeutically in Europe today, a relatively small number account for a very large percentage of the total sales. Interestingly, those enjoying the greatest popularity are those which, by and large, have been most thoroughly investigated. These are the ones that are discussed in detail in this book." Targeting skeptical physicians (I believe), the book purports to tell us how many therapeutic trials have been conducted, the dosage, whether controlled, double-blinded, and placebo controlled. Perhaps that's why Tip says "In the truest sense of the world, Rational Phytotherapy may be called the world's first qualitatively complete, science based herbal in the English language." After an in-depth introduction, the book goes on to present rational therapies for maladies, by chapter, of the CNS, cardiovascular system, respiratory system, digestive system, urinary tract, skin and connective tissue. There is a chapter devoted to gynecological indications and another to agents that increase resistance to diseases (adaptogens like ginseng and Siberian ginseng, Eleutherococcus), immune stimulants like cone flower (echinacea) and mistletoe, and botanical antioxidants like grapeseed, green tea and pinebark). Finally there's an interesting appendix detailing the 100 most commonly prescribed herbal medications in Germany. Of these the 52 most commonly prescribed single herb products can be reduced to 27 herbs, and plant parts. "Based on its pharmacologic actions and clinical effects, ginkgo extract is closely related to the class of nootropic drugs, i.e. agents that act on the central nervous system and tend to improve cognitive performance." "Most of the 36 controlled clinical studies on the use of ginkgo special extracts in patients with cognitive deficits . . . were conducted in the 1980's. (F)ew of the studies . . . would meet minimum requirement from a methodologic standpoint, and none could provide statistical evidence rigorous enough to confirm efficacy. This accounts for the extremely negative attitude of clinical pharmacologists in particular toward the use of ginkgo products. Meanwhile, tens of thousands of practicing physicians have had positive experience with ginkgo therapy over the past 30 years." This book is replete with charts showing overviews of clinical studies conducted on a number of select phytomedicines, the authors and year of each study, plus number of patients in each. This data is useful in communicating to health professionals that despite the current myth that no scientific data exists to document the safe and effective use of leading herbs and phytomedicines, that there is in fact a growing body of compelling evidence being conducted by German researchers. Other charts explain various therapeutic categories (e.g. psychotropic actions) and which herbs have been approved by Commission E for use in these areas (i.e., hops, kava, lavender, lemon balm, passion flower, St. John's wort, and valerian). Curiously, the book begins with a chapter that deals with various phytotherapeutic dosage forms (e.g. teas, extracts, etc.) and then devotes considerable space to medicinal teas, an area that may tend to put off a conventional medical type. But I think the important point here is that in Europe herbal infusions and decoctions (i.e. teas) are still an important mode of administration for traditionally used herbs with documented safety and effectiveness, in addition to the more elegantly pharmaceutically prepared standardized herbal extracts, an area where the Germans have pioneered the herbal sciences. Tip, what a nice way to start the New Year! Thanks for your help in steering America from the herbal ice ages through the centennial synthetic and antibiotic century towards the phytotherapeutic millennium that surely comes. Top 10 Sellers of ABC BookStore September through November 1997 Previous standing shown in () 1. German Commission E Monographs: Blumenthal, Goldberg, Gruenwald, Hall, Riggins, and Rister, eds., Klein and Rister, trans. (1) 2. Herbs of Choice: Tyler (3) 3. Herbal Medicine: Weiss (8) tied with 3. Herbs for Your Health: Foster (new listing) 4. Botanical Safety Handbook: McGuffin, Hobbs, Upton and Goldberg (new listing) base 5. Encyclopedia of Herbal Medicine: Bertram (6) 6. Herbal Prescriptions for Better Health: Brown (5) 7. Herbal Medicine: A Guide for Health-Care Professionals: Newall, Anderson and Phillipson (4) 8. Encyclopedia of Herbs and Their Users: Bown (2) 9. The Honest Herbal: Tyler (10) 10. Cancer and Natural Medicine: Boik (back after a short absence) See the Herbal Education Catalog in the center of this issue for these and over 300 other titles! Article copyright American Botanical Council. ~~~~~~~~ By James A. Duke">by Volker Schulz, Rudolf Hänsel, and Varro E. Tyler. 3rd ed. 1st English Edition. Translated by Terry C. Telger. New York: Springer-Verlag. 1998. Harcover. 306 pp. $49.00. ISBN # 3-540-62648-4. ABC Catalog # B326.p#