Rational Phytotherapy: A Physician's Guide to Herbal Medicine. Fourth Edition. by Volker Schulz, Rudolf Hänsel, and Varro E. Tyler. Springer Verlag. 2001 383 pp. Hardcover. ISBN 3-540-67096-3. $49.95.

The first English version of this book was published in 1998 and was reviewed in HerbalGram.1 That edition was translated from the 1994 third German edition. This revision contains additional material and other revisions reflecting the recent research published since then. The first author, Dr. Schulz, a physician, is retired from having been a top scientist at Lichtwer Pharma, one of Germany's leading phytomedicine producers. He has overseen the conduct of numerous clinical trials. Lichtwer products are extensively studied in clinical trials, many of which are summarized in this book. However, lest the reader of this review get the wrong impression, the book is not about the company's research per se, but about the range of evidence available on numerous phytomedicines as documented in clinical trials conducted on a variety of commercial phytomedicinal products in Europe, many of which are not available in English translation. Prof. Hänsel is an emeritus professor at the Free University in Berlin and is the author of Pharmacognosie, a leading text in Germany. Prof. Tyler, of course, needs little introduction, as he is well known as a leading authority on pharmacognosy in the United States, having been the principal author of the formerly leading textbook on pharmacognosy and numerous other books. Thus, this book is written by three recognized authorities on phytomedicinal research, making it an obvious choice for physicians and other conventionally trained healthcare professionals.

The text covers over three dozen of the better researched herbs and phytomedicines with 90 figures and color photos and 50 tables providing extensive summaries of data on hundreds of clinical trials. The chapters are arranged by physiological systems, with details on each herb within the appropriate physiological condition affected. Herbs added to this edition include some that have become increasingly popular in the United States but are not used in Germany, including the Ayurvedic herbs ashwagandha (Withania somnifera) and boswellia (Boswellia serrata), plus the Chinese herb cordyceps (Cordyceps sinsensis), and the increasingly popular cat's claw (Uncaria tomentosa), red yeast rice (from Monascus purpureus), and soy (Glycine max), plus goldenseal (Hydrastis canadensis) and numerous others.

"Rational phytotherapy" is the use of herbal preparations, not purified chemical drugs, used in clinical practice in an evidence-based manner, i.e., those herbs that have shown safety and efficacy in clinical trials and/or have been approved as medicines by a regulatory agency using a standard of reasonable evidence for efficacy (e.g., the German Commission E process).

This volume provides some of the best clinical discussions on phytomedicines available in the English language from authors who are some of the most expert in the field of medicinal plant research.The authors' mastery of the subject matter is a result of over 100 years combined study and research in the fields of pharmacognosy and phytotherapy.

I have one complaint about this book, and it is based on format, not content: As with the previous English edition, all the titles of table headers are printed in black ink against a strong blue screen, providing very low contrast and making it difficult to read the title of the table (as well as making it virtually impossible to read them in photocopies or faxes, a definite real-world consideration for those of us in research and education). Why the publishers chose to repeat this unfortunate formatting faux pas was definitely puzzling to me. From one of the co-authors I learned that the publisher was sold during the editorial process of the new edition, and the request of the authors to make this change "got lost in the shuffle" - an unfortunate, but bearable, flaw in an otherwise excellent book.

-Mark Blumenthal

1. Duke JA. Rational Phytotherapy: A Physician's Guide to Herbal Medicine. HerbalGram 1998;42:71-2.