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Pharmacodynamic Basis of Herbal Medicine
Pharmacodynamic Basis of Herbal Medicine, 2nd edition by Manuchair Ebadi. Boca Raton, FL: CRC Taylor & Francis, 2007; Hardcover, 699 pages. ISBN 0-8493-7050-7. $169.95.

With the proliferation of texts on alternative, complementary, herbal, integrative, natural and nutritional medicine, it is important to discern whether a book is published because it really has anything new to say or whether it is just a “me too” publication that is being added to the field’s body of literature. Reaching a second edition is generally a sign that a book has found a purpose and an audience. However, in this case, there is no indication provided as to what the second edition purports to provide or accomplish that the first did not, other than to suggest that the “second edition separates fact from myth.” We can only hope that this had been accomplished in the first edition as well.

In a book of this type, it is inevitable that traditional herbal remedies will be treated as sources of active ingredients for the pharmaceutical industry within the biomedical model. However, they should also be important in their own right, with synergistic effects and cultural meanings. While the author does bring forth ethnomedical perspectives to complement the pharmacodynamic perspective, he misses the social and cultural dimensions of herbal medicine as a major consumer health movement. For example, older Americans are correctly identified as more frequent users of complementary and alternative medicine (CAM), but paradoxically, the author explains this phenomenon with home-grown philosophical reasons rather than associating aging with an increased prevalence of health conditions that benefit from CAM.

The organization of the text presents no clear taxonomy for the contents by basic or applied principles, origins, actions, uses, or any other discernable rationale. Rather, in the tradition of CRC compendia, the property of alphabetization appears to be the central organizing principle. In the Introduction, there is a confusing, intrusive list of selected plants with their characteristics, in alphabetic order. No identification or explanation for the purpose of this list is provided.

The first 5 chapters provide overviews of the basic science of pharmacokinetics and pharmacodynamics, drug interactions (herb-drug interactions would have been relevant and important here), and the drug development model. These are followed by a sketchy chapter on alternative therapies. The author touches on a random (alphabetic) list of what he considers “chief” modalities without explaining whether this “chieftancy” is based upon frequency of use by consumers, number of practitioners, antiquity and historical precedence, amount and quality of scientific research, comprehensiveness of the modality, or any combination(s) of these criteria. Remarkably, there is a section on herbal remedies in the chapter on alternative therapies (in a book focusing on herbal remedies). However, there is no articulation of the principles of herb identification and selection, nor indigenous cultures from which they originated. The purpose of this section and of this chapter, in a 700-page book, is unclear.

Chapter 7 promises information on “historical use” of herbal remedies but provides only another alphabetic list with the occasional reference to a distinguished semi-mythical Greek ancient. Chapter 8, which from its title promises to discuss “dietary constituents,” goes on to a disquisition on cancer therapy. Chapter 9, on “regulatory issues,” provides more information on historic use than does the chapter on “historic use,” as does the following Chapter 10. Chapter 10 treats us to another alphabetic list from algae to yogurt (not actually herbs), primarily organized by herb, but with the periodic physiologic function or disease condition thrown onto the list for good measure. There is no standard chapter format.

The author and the text provide a wealth of information, but it is an organizational hash.

Illustrations are crisp, but the purpose of some is marginal. References comprise only 8 pages for a text of 700 pages—a little more than one reference page per 100 pages of text. This is very sparse referencing for the amount of information provided. They are lumped together at the end of the book instead of being provided for each chapter, further compromising their utility.

This book is desperately in need of competent, disciplined, thoughtful and thorough developmental and copy editing from “A to Z.” I have often wondered why CRC Press is even in the business of printing CAM texts, and this book did nothing to answer my question. The identification of CRC as a “Press” is appropriate insofar as it indicates the ability to print lines of text even in the absence of an editorial component. A book that is primarily a compendium should pay particular attention to issues of organization and taxonomy, which are notably absent from this effort. A great deal of useful information is available in this book, but there is no coherent approach to presenting it to the audience. While the sole reliance on alphabetization calls into question the publisher’s editorial capabilities, it should settle the question that indeed the publisher had to have at least attended grade school.

—Marc S. Micozzi, MD, PhD Policy Institute for Integrative Medicine, and Private Practice in Forensic Medicine Bethesda, MD