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Herbs of Choice: The Therapeutic Uses of Phytomedicinals.
Dr. Varro Tyler, Lilly Distinguished Professor of Pharmacognosy at Purdue University, is best known to the herb public as the author of The Honest Herbal, now in its third edition, which takes a conservative approach to the uses of herbs primarily found in the health and natural food realm. Some, after reading this book, have erroneously gained the impression that Dr. Tyler is not an advocate of the use of herbs in a proper therapeutic context. Nothing seems further from the truth after reading Herbs of Choice. Dr. Tyler, through his latest work, Herbs of Choice, clearly advocates the use of herbs which have been well researched, for which safety is reasonably established, and for which efficacy is accepted in a clinical setting, notably in Germany. He approaches the subject from the standpoint that herbs are drugs and have a place in modem health care, no matter how they are classified in the regulatory milieu. The opening chapter, "Basic Principles," explores definitions, differences between herbs and other drugs, herb quality, paraherbalism, rational herbalism, and herbal dosage forms. Chapter 2, "The Herbal Regulatory Dilemma," presents an excellent overview of the current and historical regulatory developments in the United States that have led to the current situation where herbs sit in regulatory purgatory. Tyler writes,"...the herbal regulatory situation in the United States is a very fluid one, and the outcome is still unknown." Those wishing to understand the regulatory system will find "The Herbal Regulatory Dilemma" one of the best overviews of the subject, which includes real solutions that could easily be implemented, and, if this ever happens, could catapult therapeutic use of phytomedicinals into their rightful role in U.S. health care. While the polemics of the introductory chapters set the stage for a new way of utilizing and regulating herbs in the U.S., the bulk of the book is a practical guide to "what works," intended primarily for health care practitioners with little or no training in the use of botanicals. Chapters 4 through 12 are arranged by therapeutic indications, allowing easy access to data on individual disease conditions or health needs. Tyler reviews the use of specific botanicals in particular categories of disease, body systems, or conditions. Following a general and brief description of the pathophysiology of the condition or disease are individual monographs on phytomedicinals the author feels are the most useful for those diseases or syndromes based on current world usage supported by the scientific literature. The practitioner attempting to discover why a patient is interested in using a particular treatment will find the necessary background material to help make informed choices, both for the practitioner and patient. The material presented generally represents scientific consensus and the most up-to-date information and assessment of the herb. However, in rare cases, the author has relied on unreliable secondary literature which does not provide a reasonable evaluation of the published scientific account. A case in point is the commentary on Schizandra on page 65, which cites a 1988 Lawrence Review monograph on the subject. If primary literature had been relied upon, or a review by a source that could read the language in which the original literature had been published, completely different conclusions may have been drawn. However, this is a minor exception to an otherwise exceptional book. There is not one practitioner, pharmacist, herbalist, or anyone elses interested in the phytomedicine realm who will not benefit from pulling this book from the shelves for a balanced assessment of the best use, dose, and possible side effects of the most commonly used and most thoroughly documented herbs. Herbs of Choice catapults herbal medicine from folklore into mainstream medicine. Varro Tyler's Herbs of Choice does have the potential to significantly impact the debate on health care reform in the United States. In the minds of the curious practitioner, with little training in botanical topics, Dr. Tyler has raised herbal medicine from the ashes of pseudoscience to its rightful status as an integral part of modem medicine. Article copyright American Botanical Council. ~~~~~~~~ By Steve Foster">by Varro E. Tyler, Ph.D., Sc.D. 1994. Pharmaceutical Product Press, an imprint of The Haworth Press, Inc. Hardcover. 209 pp. $24.95. ISBN