Clinical Botanical Medicine by Eric Yarnell, Kathy Abascal, Carol G. Hooper. Larchmont, NY: Mary Ann Liebert Publishers, 2003. 418 pp. ISBN 0-913113-95-6. $99.

This book is based on a collection of articles by Yarnell and Abascal in Alternative and Complementary Therapies, a bimonthly journal from the same publisher. All but one of the chapters reflects revisions of the previously published articles. Each chapter in the larger first part of the book are condition or disease specific (i.e., they present a variety of botanicals that may be useful in preventing or treating the condition or disease of which the article/chapter is the focus). I have found these articles to be of significant value over the years and have chosen many of them for summary and critical review in ABC’s HerbClip service; to date, ABC has issued 19 HerbClips covering these chapters (see http://www.herbalgram.org/herbclip/search.asp?s=yarnell&m=A).

Dr. Yarnell is a naturopathic physician who is an adjunct professor at Bastyr University and the Southwest College of Naturopathic Medicine, both appropriately accredited schools of natural medicine. Dr. Abascal is an herbalist, holds a doctorate in jurisprudence, and is a recovering attorney. Carol Hooper, MD, MPH, practices internal medicine and served as medical editor.

This book is a welcome addition to the literature as it offers a variety of little-known botanical options for the prevention or treatment of a variety of conditions and diseases. Unlike some of the more evidence-based botanical guides for healthcare providers (e.g., The ABC Clinical Guide to Herbs, edited by this reviewer), the authors of this book have taken several decidedly different strategies in producing this volume. First, the chapters are organized by condition or disease, not by herb. Second, the authors are not relying strictly on clinical trial data to support their inclusion of an herb as a potentially useful treatment; pharmacological investigations and empirical data from traditional use provide a basis for consideration of an herbal therapy.

The authors explain their philosophy that they want to see herbs being used in a manner that transcends their use merely as substitutes for conventional drugs. "This use certainly has a place at times, but ignores the fact that whole herbs are not drugs but offer an important and expanded way of promoting health and healing." They then support the traditional vitalist view that "The medicines used in botanical medicine are living beings – part of the incredibly complex web we call the Earth. One of the central goals is to serve as a counterpoint to the many recent botanical texts that increasingly explain the use of herbs based solely on a constituent-based approach. We will illustrate that botanical medicine is – and should be – much deeper and more complex."

Much of this book deals with combination formulas that the authors claim can "exponentially" increase the "range of possible interactions between the constituents in the various herbs themselves as well as in the human body. Only the Asian scientists have begun to investigate this vast array of interactions." As an example they cite Asian ginseng (Panax ginseng, C.A. Meyer, Araliaceae) and its ability to enhance the absorption of saikosaponins in bupleurum (Bupleurum chinense DC., Apiaceae) where these saikosaponins were previously shown to be lacking bioavailability.

The book is divided into four parts: Treatment or Prevention of Specific Disease States or Conditions, Special Formulas, Specific Herbal Medicines (prickly pear [Opuntia spp., Cactaceae] lemon balm [Melissa officinalis L., Lamiaceae], stinging nettle [Urtica dioica L., Urticaceae] and four Ayurvedic herbs), and Issues in Botanical Medicine. The latter contains an interesting and useful chapter in which the authors clarify the relative toxicity (or lack thereof) of various popular herbs, e.g., pyrrolizidine alkaloid-containing herbs, lobelia (Lobelia inflata L., Campanaulaceae), wormwood (Artemisia absinthium L., Asteraceae), and kava (Piper methysticum G. Forst., Piperaceae). The book contains guidance regarding the potentially beneficial properties of these and other herbs when employed appropriately and properly dosed (an additional Appendix provides dosing guidelines for scores of herbs discussed in the book).

The contents of Part I includes chapters on the following conditions or diseases: prevention of cancer with herbs used as food, breast cancer, prostate cancer, immunomodulators and HIV infection, hypertension, diabetes, depression, kidney stones, heroin addiction, nicotine addiction, sports injuries and musculoskeletal problems, pregnancy and lactation, cystitis, influenza and upper respiratory tract infection, chronic sinusitis, periodontal disease, and dermatologic conditions.

This book offers some interesting, highly useful, and clinically relevant insights into many botanicals that can be considered for treating or preventing various conditions particularly for the practitioner who would like to access a wider range of options than the "usual suspects" (i.e., those herbs that have been studied in the largest amount of clinical trials). Many of the herbs covered in this book may become part of the "next wave" of herbs upon which researchers, and the market, may focus their attention.

–Mark Blumenthal