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The Toxicology of Botanical Medicines
The Toxicology of Botanical Medicines

The Toxicology of Botanical Medicines Third Edition. by Francis Brinker, N.D. 2000, 298 pp., softcover. $35.00. ABC Catalog #B491. Add To Cart

With credit, the author lists in an introductory page "in all cases of poisoning the local Poison Control Center should be contacted immediately for information and instructions," and thanks the "Oregon Poison Control and Drug Information Center … for graciously allowing me to use their database on plant toxicities." As a founder and medical toxicologist for the certified regional poison center in Dallas for 12 years, I find this heartening encouragement. Knowing the massive database on a regional poison center’s software, I call the poison center myself for toxicologic details difficult to find elsewhere on a 24/7 basis.

The critical section of this basic handbook, which everyone in the herbal field should read, is the 14-page introduction, which consists of explanations regarding constituents, doses, principles of toxicity, and signs and symptoms. Next follows 174 pages devoted to 165 individual herbs arranged alphabetically by Latin binomial, with one to two pages devoted to each specific herb. Each section covers common names, which parts contain toxins and identification of those toxic constituents, dosage information (which varies by plant to include therapeutic, toxic, and/or lethal), a Notes entry with subsections on precautions, contraindications, kinetics, mechanism of toxicity, and other information. The entry continues with toxicity signs/symptoms (which also varies by plant to include acute, chronic, prodrome, lab and x-ray expression, and withdrawal), and treatment options (emergency first aid that do not require prescription medication, and medical intervention under the care of a licensed doctor).

Two appendices focus on potential toxicity of volatile oils and botanical medicines that may disrupt pregnancy. These two sections provide helpful information that can be otherwise difficult to find. A list of 217 references follows, which are cited by number in the preceding sections.

This is a basic handbook intended for practitioners and clinicians in any health field that deals with herbals. The language, heavily laden with medical terms, is clearly directed toward healthcare professionals. In my view, the most helpful sections are the introduction and the appendices. The entries for specific herbs are problematical, except for quick verification before calling a poison control center for further details and patient management guidance. That list by Latin binomial is useful to botanists but is awkward for the rest of the world (although each entry and the index do include common names), and suffers from some major omissions. For example, St. John’s wort (Hypericum perforatum) is listed in the appendix that lists herbs contraindicated for pregnancy, but it does not appear in the main list. And the varieties of ginseng are missing, despite it being contraindicated for pregnancy and causing a range of adverse effects. In addition, most of the references are general books or literature reviews; it would be more helpul if it had expanded upon case series, (i.e., reports involving a specific herb with multiple cases).

The author, a naturopathic physician, has also published several other books, including Herb Contraindications and Drug Interactions, a related topic of readership for a companion volume.

Thomas L. Kurt, M.D., M.P.H.