Textbook of Complementary and Alternative Medicine, 2nd ed. Chun-Su Yuan, Eric Bieber and Brent A. Bauer, eds. New York, NY: Informa Healthcare; 2006. Hardcover; 794 pages. ISBN-13: 978-9184214-297-4. $419.95.
Complementary and alternative medicine (CAM) has reached a height in popularity among various western nations. Various courses, including phytotherapy (herbal medicine) and Ayurvedic and Chinese medicine, for example, are slowly being incorporated into the curricula of some medical schools throughout the United States. Although many publications addressing various complementary or alternative therapies exist, there are only a few that cover a wide array of therapeutic modalities in depth. The second edition of Textbook of Complementary and Alternative Medicine covers a diverse number of alternative therapies and does so in a comprehensive manner.
This humongous work is a collection of 70 chapters (40 of which are new to this edition) related to diverse alternative and complementary therapies currently in use. The book is divided into 2 main sections. Section 1 includes commonly used CAM therapies and is further subdivided into 5 subsections: Dietary Supplements, Traditional Medical Systems and Therapies, Mind and Body Approaches, Energy Therapies, and Manipulative and Body-based Therapies.
The subsection on Traditional Medical Systems and Therapies includes chapters on Traditional Chinese Medicine, Chinese herbal medicine and formulations, acupuncture, Tai Chi, Qigong, diet and nutrition in Traditional Chinese Medicine, Ayurveda, yoga, homeopathy, naturopathic medicine, and music therapy. The Mind-Body subsection includes chapters on meditation, biofeedback, religion, spirituality and medicine, imagery and belief, and the space of healing. The subsection regarding Energy Therapies includes chapters on energy medicine, magnet therapy, and healing touch. The Manipulative and Body-based Therapies subsection mentions the importance of chiropractic, massage, and osteopathic medicine.
Since this review is being published in a medicinal plant-oriented publication, it will emphasize the chapters or sections dealing with herbs and herbal medicine.
The Dietary Supplements subsection includes 11 diverse chapters. Chapter 1 includes the definitions and regulatory status of herbs and other dietary supplements in the United States. Chapter 2 discusses 11 of the most commonly used herbs in the United States, including aloe (Aloe vera, Liliaceae), echinacea (Echinacea spp., Asteraceae), ephedra (Ephedra sinica, Ephedraceae), garlic (Allium sativum, Liliaceae), Ginkgo biloba (Ginkgoaceae), the true ginsengs: American (Panax quinquefolius, Araliaceae) and Korean (or Chinese or Asian) ginseng (P. ginseng), kava (Piper methysticum, Piperaceae), milk thistle (Sylibum marianum, Asteraceae), saw palmetto (Serenoa repens, Arecaceae), St. John’s wort (Hypericum perforatum, Clusiaceae), and valerian (Valeriana officinalis, Valerianaceae).
For each of these herbs, the background, uses, phytochemistry, safety, preparation and dosage are mentioned. For most of the herbs, there is a balanced coverage of their effects on human health, either positive or negative, with the possible exception of kava. The brief section on this herb seems to focus mostly on its potentially negative effects (e.g., “kava dermopathy,” which is seen only in people habituated to the plant who are taking large doses for prolonged periods, but not in persons taking prescribed doses during limited periods of time), as well as its possible association to liver toxicity documented in a limited number of individuals.
Chapter 3 presents a succinct overview of 25 selected herbs in table format, including the herbs’ actions, common uses, daily dosages, as well as any adverse effects or warnings against their use.
Medicinal herbs of Latin America is the topic of chapter 4, but unfortunately, it mentions only 4 species: maca (Lepidum meyenii, Brassicaceae), cat’s claw (Uncaria tomentosa, Rubiaceae), guaraná (Paullinia cupana, Sapindanceae), and dragons’ blood (Croton lechleri, Euphorbiaceae). For each of these herbs, the author mentions the plant’s historical use, its phytochemistry and pharmacology, safety, and preparation or dosage. Although undoubtedly the herbs covered in this brief chapter are important medicinally, it does not do justice to the plethora of medicinal plants currently in use today in various countries of Latin America, from Mexico and the Caribbean to Argentina. Perhaps the editors may decide to include a much wider coverage of Latin American medicinal plants in a future edition of this book.
Chapter 5 focuses on the identification, analysis, and evaluation techniques for medicinal plants. This important section deals both with qualitative and quantitative analyses of medicinal herbs, from microscopic visual identification techniques to the more sophisticated high-performance liquid chromatography (HPLC) and ultraviolet-visible spectrophotometry, for example. Various techniques are well-explained and enriched by various drawings and pictures for better comprehension. This chapter also mentions the need to apply Good Manufacturing Practices (GMPs) to the processing of herbal medicines in order to ensure a better quality product for the market.
Chapter 6 describes the ginsengs’ chemistry and biological effects in a comprehensive manner. The author includes the plants’ diverse active ingredients and their mechanisms of action both at the cell membrane level, as well as on specific tissues and organs of the human body. Research studies with both types of ginseng, employing animals or humans, are discussed, along with the results pertaining to benefits or possible toxicity. The author also mentions the so-called “ginseng abuse syndrome,” much popularized by the sensationalist media 25 years ago, which was based on an uncontrolled clinical trial that has been criticized for its shortcomings in both design and interpretation of results.
Green tea (Camellia sinensis, Theaceae) and its effects on health are mentioned in chapter
7. The history and the different types of tea and the fermentation techniques employed are briefly discussed, as well as green tea’s effect upon cardiovascular disease, cancer, obesity and infectious disease.
Chapter 8 discusses the evidence-based use of both fat-soluble and water-soluble vitamin supplements, while chapter 9 includes a brief explanation regarding the possible interactions between herbs, drugs, and certain foods. Emphasis is made on St. John’s wort, grapefruit juice, certain nightshade plants (potato and eggplant, for example) and their effects upon the metabolism of certain medications.
Chapter 9 mentions an herbal-derived product once used to treat prostate cancer known as “PC-Spes” (PC stands for prostate cancer, and Spes is the Latin name for hope), including its potential benefits and its ultimate disappearance from the market due to evidence pertaining to the adulteration of the herbal product with pharmaceuticals.
Chapter 10 deals with the risks of taking supplements containing ephedra. This brief chapter mentions clinical trials regarding the health effects of ephedra supplements, as well as the probable reasons that made weight loss or “ergogenic” supplements containing this plant potentially dangerous to health and ultimately taken off the market by the US Food and Drug Administration.
Section 2 is entitled CAM Therapies for Common Medical Conditions. This section is further subdivided into chapters covering the following topics: cardiovascular disease, respiratory disease, gastrointestinal disease, metabolic disease, genitourinary and reproductive diseases, central nervous system, psychiatric disorders, musculoskeletal disorders, cancer and AIDS, prevention and special populations, and, finally, ethical and social implications. As mentioned previously, this review has focused primarily on the chapters involving herbs and herbal medicine.
The second edition of the Textbook of Complementary and Alternative Medicine is an encyclopedic work that can be very helpful in the development and application of CAM courses in biomedical colleges and institutions. Its wide coverage of diverse alternative and complementary therapies makes it an important contribution to the bibliography regarding these diverse and sometimes vaguely understood healing modalities in the West.
Although this volume contains important and varied information for both CAM as well as conventional medical practitioners, the excessively high price will make it less available to other healthcare providers and students. However, it can be an important acquisition for libraries and research institutions interested in this topic.
—Armando González-Stuart, PhD University of Texas at El Paso/ UT at Austin Cooperative Pharmacy Program El Paso, TX