Combining Western Herbs and Chinese Medicine, A Clinical Materia Medica: 120 Herbs in Western Use by Jeremy Ross. Bristol, England: Greenfields Press; 2010. Hardcover; 433 pages. ISBN: 9783927344921. $75.00.

There is a significant difference between the precision and depth of herbal knowledge found in the major traditional systems of medicine and what is found in Western herbal practice. In Traditional Chinese Medicine (TCM), Ayurveda, Unani-Tibb (Graeco-Arabic), and Tibetan medicine, each herb has been used for millennia, and a general consensus has been reached on its qualities (taste and energetics), therapeutic uses, dosage, safety, contraindications, and how to effectively combine it with other herbs. In comparison, Western herbal medicine is a mélange of bits and pieces of older American systems of medicine (e.g., Thomsonian medicine, Eclectic medicine, Physiomedicalism, Native American medicine), folk remedies and regional traditions, British phytotherapy, and—over the last 40 years—the additional influences of TCM, Ayurveda, European phytomedicine, and modern scientific research.

While earlier American practices such as Eclectic medicine or Physiomedicalism are supported by more than a century of case reports, both are functionally extinct (there are a handful of clinical herbalists and naturopathic physicians who are still familiar with these systems and utilize them in practice or teach about them, but neither are widely practiced) and both lasted less than 100 years. In essence, what could have become Western equivalents of TCM or Ayurveda ceased to exist before they had the time and numbers to reach a consensus of practice. This leaves Western herbal practitioners with little agreement on dosing, appropriate uses of plants, recognition of contraindications, methods of formulation, and in some cases, even terminology. On the positive side, while unorganized in approach and practice, Western herbal medicine (especially in the United States) is an amazingly vibrant, eclectic, creative, and often effective form of therapy.

To remedy this situation, several herbalists trained in TCM and Ayurveda have attempted to take Western herbs and fit them into the Chinese and Indian models. This is a daunting task, and the groundbreaking early attempts (Michael Tierra’s Planetary Herbology [Lotus Press, 1988], Peter Holmes’s The Energetics of Western Herbs [Snow Lotus Press, 1989], Vasant Lad and David Frawley’s The Yoga of Herbs [Lotus Press, 1986]), while not perfect, started a process, which has continued with each new work, improving in its scope and accuracy.

In his book, A Clinical Material Medica: 120 Herbs in Western Use, Jeremy Ross makes a notable contribution to this area of study. He has a multi-disciplinary background in Western science, Chinese medicine, and Western herbal medicine (he studied with Michael Tierra from 1973 to ’74). Ross has also been in clinical practice for 27 years and has been teaching his system of integrating Western herbs and Chinese medicine for over 20 years. His previous book, Combining Western Herbs and Chinese Medicine: Principles, Practice and Materia Medica (Greenfields Press, 2003), was an important and successful addition to the literature and his latest book continues to build upon that established foundation, bringing the rigor and deep understanding of TCM materia medica and practice to that of Western herbs.

The book has in-depth monographs on 120 herbs, most of which are not used in Chinese medicine. This includes popular herbs such as saw palmetto (Serenoa repens, Arecaceae), chamomile (Matricaria recutita, Asteraceae), calendula (Calendula officinalis, Asteraceae), and cayenne (Capsicum annuum, Solanaceae) as well as lesser-known but valuable medicinal plants such as black horehound (Ballota nigra, Lamiaceae), English ivy (Hedera helix, Araliaceae), blue flag (Iris versicolor, Iridaceae), and European wild pansy (Viola tricolor, Violaceae).

Each monograph contains information on the plant’s name(s), Latin binomial, part used, botanical description, and dosage. The author also describes the herb’s taste, energetic qualities (hot, cold, moist, dry, etc.), the TCM organs it affects, and both Chinese and Western uses. Ross then gives the reader greater insight into each herb by giving examples of effective therapeutic pairings of herbs, comparisons with similar herbs, a review of relevant constituents and their pharmacology, a listing of actions linked to a constituent, Western and TCM contraindications, information on adverse effects, safety in pregnancy and lactation, and drug interactions.

The book is well-referenced and one of the appendices gives a good synopsis of Chinese organs and disease patterns, which is essential to introduce these concepts to the Western herbal practitioner wanting to use this text. A repertory of Western indications for herb pairs (e.g., Vitex [Vitex agnus-castus, Verbenaceae] and Berberis [Berberis vulgaris, Berberidaceae] for anger with PMS headache) is also a well-considered and useful addition for any herbal clinician. It is books of this caliber that are helping to create higher standards for herbal practice and offer practitioners a clear and relatively easy to grasp paradigm for going beyond the simplistic allopathic use of “this herb for that disease.”

In the midst of all that is useful about this text, I would be remiss as a reviewer if I did not point out that there are a few minor flaws. In the section on cautions, the author seems to rely rather heavily on Mills and Bone’s book, The Essential Guide to Herbal Safety (Churchill Livingstone, 2005) as well as the ESCOP Monographs (Thieme, 2003). Both titles are excellent works of exceptional value. Unfortunately, they are not up-to-date, and information on herbal safety has, in some cases, progressed rapidly. An example of this is a caution about using black cohosh root (Actaea racemosa, Ranunculaceae) in patients with estrogen-sensitive breast cancer. While there continues to be some contradictory data in animal studies,¹ human studies and reviews of the data overwhelmingly state that the black cohosh appears to be safe when used in breast cancer patients.^2,3,4

Another minor issue comes up when the author compares Western and Chinese herbs and their uses. In some cases, as in the comparison between motherwort (Leonurus cardiaca, Lamiaceae) and Chinese motherwort (L. tataricus; Chinese: yi mu cao), the chemistry and activities of each plant are similar, and this enhances the reader’s understanding of both herbs. The comparison of skullcap (Scutellaria lateriflora, Lamiaceae) and the Chinese Baikal skullcap root (S. baicalensis) is less successful. While these plants are related and share some chemistry, with a slight overlap in usage, they are in reality 2 very different medicines. Attempting to discuss them in the same monograph may be more confusing than if each was given its own presentation or if the Chinese species was only briefly mentioned. One other example of this type of misapplied information is the author’s discussion of chickweed (Stellaria media, Caryophyllaceae) herb where he lists the constituents of the roots of the Chinese species, S. dichotoma. Since the fine, hair-like roots of chickweed are not used in Western herbal medicine, the phytochemical and pharmacological data in the text are unlikely to be of any relevance or use.

Since perfection in people or books is not possible, I believe that despite these few imperfections, this is a book that deserves to be read, studied, and admired for its clarity and ability to improve herbal knowledge and practice by any herbal practitioner, Eastern or Western.

—David Winston, RH (AHG) Herbal Therapeutics Research Library Washington, New Jersey

References

1.     Davis, VL, Jayo, MJ, Ho A, et al. Black Cohosh Increases Metastatic Mammary Cancer in Transgenic Mice Expressing c-erbB2. Cancer Res. 2008;68(20):8377-8383.

2.     Roberts, H. Safety of Herbal Medicinal Products in Women with Breast Cancer. Maturitas. 2010;66(4):363-369.

3.     Walji R, Boon H, Guns E, Oneschuk D, Younus J. Black Cohosh (Cimicifuga racemosa [L.] Nutt.): Safety and Efficacy for Cancer Patients. Support Care Cancer. 2007;15(8):913-921.

4.     Ruhlen, RL, Haubner, J, Tracy JK, et al. Black Cohosh Does Not Exert an Estrogenic Effect on the Breast. Nutr Cancer. 2007;59(2):269-277.