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British Herbal Compendium: A Handbook of Scientific Information on Widely Used Plant Drugs

British Herbal Compendium: A Handbook of Scientific Information on Widely Used Plant Drugs, volume 2, by Peter Bradley (editor). Esher, Surrey, United Kingdom: British Herbal Medicine Association; 2006. Hardcover; ISBN 13: 978-0903032124. $145.

After receiving volume 1 of the British Herbal Compendium in 1992, one would have to be patient in waiting for volume 2, published 14 years later. The second volume of this useful reference was worth the wait. The British Herbal Compendium serves as a companion volume to the British Herbal Pharmacopoiea (BHP). The BHP was first published in parts, and then in a consolidated edition in 1983, followed by revised editions in 1990 and 1996. Like other works of its genre it provides information on identification and specifications for herbal material. It was clear to the British Herbal Medicine Association (BHMA) that a companion volume was necessary to give modern herbal practitioners a scientific basis for the therapeutic activities of the herbs used in their practice.

In response to the Medicines Bill passed by the British Parliament in the early 1960s, which threatened the existence of herbal practice in the UK, in 1965 the BHMA set up a Scientific Committee that eventually led to the publication of the BHP. The BHMA has also been a leading member of the European Scientific Cooperative on Phytotherapy (ESCOP), which, under one umbrella, brought together 15 national herbal practice and phytomedicine-related societies from all over Western Europe. The ESCOP Monographs: The Scientific Foundation for Herbal Medicinal Products was a major contribution from that organization. Peter

R. Bradley, the author of the present volume, formerly served as chairman of the ESCOP Scientific Committee. His work and commitment to that organization slowed progress on BHC2 to spare moments over the ensuing years. While the first volume was a collective effort, volume 2 is solely the work of Bradley. His expertise, intimate knowledge of ESCOP’s monographs and other compendia, and a thorough understanding of the breadth and diversity of the exploding literature on medicinal plants, certainly makes the publication of BHC2 a welcome event.

Herbal medicine has come a long way in the UK over the past 40 years, from an obscure relic of the by-gone days, to a vibrant modern primary healthcare modality. Former trade schools are now universities through the efforts of Prince Charles (e.g., Westminster University in London and Middlesex University on London’s outskirts). Now, the products of these 4-year education programs are degree-holding, licensed herbalists. Today leading British research institutes such as Reading University, Exeter University, and London University, among others, have highly visible international research programs in clinical aspects of phytotherapy. The BHMA has helped to lead the way to promote the cultural, as well as scientific, acceptance of herbal medicine in the UK.

The BHC2 includes 80 monographs on ingredients found in the BHP that are not covered in the 1992 volume 1 of BHC. Together the two volumes represent detailed information on 166 of the 232 phytomedicines included in the 1983 BHP. BHC2 reflects the scientific literature up to 2004.

Arranged alphabetically by common name, the monographs include nomenclatural details, a brief definition of the botanical ingredient, and quick reference information on constituents with components found in major chemical groups within the plant. Chemical structures of a handful of major constituents are the only graphic elements in the book. The constituent section ends with reference to “published assay methods” for relevant components.

A pharmacology section follows, with paragraphs on major activities, and cited references. General pharmacological effects are often followed by brief reviews of in vivo studies, and pharmacological studies in humans, if available. A section on “Clinical Studies” follows. In over half the monographs, one finds the phrase “None published on mono-preparations of . . .” under the clinical studies heading. However, occasional case reports, or clinical studies relative to combination products, are included here. In the cases of relatively widely used phytomedicines such as Agnus Castus (Chaste tree Vitex agnus-castus, Verbenaceae), Arnica flower, Calendula flowers, Capsicum, Echinacea, Ginkgo leaf, Kava-Kava, and others, excellent brief reviews of clinical studies are included. If a significant number of clinical studies are reviewed, results are also presented in tabular form.

A section on therapeutics follows, which for practitioners provides the practical details for use of the ingredient in the clinic. This section includes actions, indications, uses based on experience or tradition, contraindications, side effects, interactions with other drugs, and dosage information. It is instructive to follow the information to the source reference. Much of the dosage information cites the 1983 BHP, the German Commission E Monograph, or secondary works such as the second edition of Herbal Medicines by Joanne Barnes, Linda A. Anderson, and

J. David Phillipson (Pharmaceutical Press 2002), along with relevant human studies, and sometimes a popular book as well.

Each monograph includes an excellent review of safety of the ingredient with relevant references to animal studies, human toxicological reports, and in vitro studies. For those who wish quick reference information on the controversial potential hepatoxicity of Kava-Kava, for example, a balanced assessment of the basis of the concerns and regulatory response is provided, along with an assessment of safety data based on clinical studies. In light of reports of hepatotoxicity and what some consider a kneejerk regulatory response in Germany, France, the UK, and elsewhere, a harried practitioner advising a patient will find a rationale and wellreasoned assessment of safety by Bradley. Clinical studies reviewed in the book reveal that “Kava-kava extracts are well tolerated by most users and, in general, adverse events are rare, mild, and reversible.”

A regulatory status section follows with reference to the ingredient’s status as medicine or food in the UK, France, Germany, US, or the Council of Europe, among others. Next, a reference section enumerates cited literature with complete facts of publication. This includes the full title of foreign-language periodical articles (or an English title if supplied in the original publication) and language of the original publication. If neither are available, an English-translation of the title is provided. In the case of books, ISBN numbers are included. The thorough referencing is a particularly valuable aspect of the book for those readers seeking further information.

Following the reference list is the heading “Regulatory Guidelines from other EU Countries” which, in the vast majority of cases, includes the text of French and German regulatory monographs.

The subtitle “A Handbook of Scientific Information on Widely Used Plant Drugs” might have read “widely used and obscure plant drugs,” as herbs such as bayberry bark (Myrica cerifera, now Morella cerifera, Myricaceae), birch leaf (Betula pendula, Betulaceae), grindelia (Grindelia spp., Asteraceae), hydrangea (Hydrangea arborescens, Hydrangeaceae), and white deadnettle (Lamium album, Lamiaceae), among others, may not be on everyone’s list of “widely used drugs.” However, the book does provide limited information on a handful of relatively obscure herbs. Of the more obscure items, 14 herbs are not covered in official pharmacopeias, though 11 are covered in the BHP (the 1983, 1990, and 1996 editions). Most of the herbs in the book are monographed in Pharmacopoeia Europea, and 20 additional items are covered in national pharmacopeias. The book does include major phytomedicines such as ginkgo leaf, saw palmetto berry, and other important herbal drugs not included in early versions of BHP.

British Herbal Compendium, volume 2, although limited in the number of herbal medicines covered, is an excellent companion volume to complement other British Herbal Medicine Association publications such as the 1983 BHP, the 1996 BHP, and the BHC volume 1 (1992), and the 2003 edition of A Guide to Traditional Herbal Medicines. All of these useful publications, poorly distributed in the United States, are available from the BHMA. British Herbal Compendium, volume 2, is also an excellent complement to the ESCOP Monographs, German Commission E Monographs, and other standard works. This valuable compilation is an important addition to any professional herbal library. It is assumed a volume 3 will appear in due time and perhaps new editions of BHC volumes 1 and

2. In the meantime, this book reflects important scientific information on herbal medicine presented in a detailed, user-friendly presentation, valuable for practitioners, and for anyone interested in a scientific approach to herbal medicines.

—Steven Foster President of Steven Foster Group, Inc. Eureka Springs, AR