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Adverse Effects of Herbal Drugs Vol. 2.
by P.A.G.M. De Smet, K. Keller, R. Hansel, R.F. Chandler (eds.). 1993. Springer-Verlag, Berlin and New York. Softcover. 348pp. $79. ISBN 0-387-55800-4. Available from ABC Books, Item #B049.

This is the second in a series of reviews of adverse effects of various herbs and related issues. The first volume, published in 1992, sold out almost immediately and is currently out of print. This book, like the first, is not meant to focus unduly on the adverse safety issues regarding herbal use; the editors acknowledge (in the first volume) the potential and actual role of herbs in health care, saying that it is "not our intention to place botanical remedies indiscriminately in an unfavorable light," but instead to show the potential adverse consequences of improper or sometimes even normal use.

This second volume contains an extensive first chapter by primary editor De Smet, of the Drug Information Center at the Royal Dutch Association for the Advancement of Pharmacy, titled "Legislatory Outlook on the Safety of Herbal Remedies," which is worth the price of the book in itself, at least to anyone in the U.S. who is interested in the regulatory status of herbs internationally. The 90-page chapter deals with the statutory and regulatory status of several hundred herbs in Germany according to Commission E, as well as France, Belgium, and Sweden. Unfortunately, in the section explaining the status of herbs in the U.S. the author unnecessarily includes the infamous list of 27 "Unsafe Herbs" published by FDA in 1977, even though the list and a companion list of "Herbs of Undefined Safety" were rendered obsolete in 1986, as noted by the author in the text. However, the heading for the table of "unsafe herbs" (which includes St. John's Wort, Hypericum perforatum, a major error on FDA's part) does not indicate the revocation of the list, thereby causing potential confusion among some readers.

Five chapters cover anthranoid derivatives (e.g. laxative anthraquinones in aloe, cassia, cascara and buckthorn, and rhubarb). Additional chapters discuss burdock, borage, blue cohosh, Eupatorium species, juniper, chaparral, pokeroot, mayapple, scullcap, dandelion, and bilberry, among others. As is plainly evident in the selections, many of these herbs do not generally produce adverse reactions in normal use. The chapter on Siberian ginseng (Eleutherococcus senticosus) curiously omits mention of adulteration by Periploca, the so-called Chinese silk vine. However, to the credit of the editors, a final chapter, "Notes Added in Proof," attempts to update each chapter to include relatively recent published material that may not have been included. Here De Smet does mention Periploca substitution for Eleuthero, as pointed out by Dennis Awang in the letters section of the Journal of the American Medical Association.

This book is important for all those interested in herbal research, for health care practitioners using herbs in clinical settings, and for those manufacturing and marketing herbal products. Hopefully, the publishers have printed more of the second volume than the first one so this vital information is more widely available.

Article copyright American Botanical Council.


By Mark Blumenthal