The Western Herbal Tradition: 2000 Years of Medicinal Plant Knowledge by Graeme Tobyn, Alison Denham, and Margaret Whitelegg. Edinburgh, UK: Churchill Livingstone; 2011. Hardcover; 392 pages. ISBN: 978-0-443-10344-5. $81.95.

This is a unique book covering an often-ignored topic. There is a rich diverse basis for modern Western herbalism whose roots can be traced back beyond the Greek physician Dioscorides (1^st century CE). From botany to pharmacy, from theory to practice, there are clear precedents that, if ignored, undermine the modern contribution of herbal medicine to modern healthcare.

In recent discussions with the Canadian National Heath Products Directorate (NHPD), this reviewer was told that there is no Western herbal tradition. After a lifetime of involvement in an apparently non-existent tradition, I realized that they actually meant there was no book that spelled it out for them. Now there is.

In today’s regulatory environment it has become too easy to ignore the rich theoretical basis of what the authors call “The Western Herbal Tradition.” However, this is the first book for clinicians (as opposed to medical historians) I am aware of that gives the tradition the quality of attention it deserves. As well-respected practitioners of medical herbalism, the authors are uniquely qualified to explore this fascinating topic. Their historical overview of theory and concepts is made meaningful to the modern mind by being grounded solidly in the reality of clinical practice. Sheila Kingsbury, chair of botanical medicine at Bastyr University, provides an insightful foreword.

The discussion of the Western tradition is informed by a scholarly presentation of material from original sources — many of which are inaccessible to the modern practitioner. The following list includes authors cited in the book, as many texts can be ascribed to each. Greco-Roman sources include Dioscorides, Pliny the Elder, Galen, and Pseudo-Apuleius. Arabic sources are referenced through Ibn Sina (Avicenna) and Serapio the Younger. Insights from Anglo-Saxon and Late Middle Ages come from the Old English Herbarium, Macer, the Salernitan Herbal, Hildegard of Bingen, and the Welsh physicians of Myddfai. Renaissance and early modern texts include those by Fuchs, Mattioli, Turner, Dodoens, D’Alechamps, Bauhin, Gerard, Parkinson, and Culpeper. Eighteenth and 19^th century American and British herbalists include Quincy, Miller, Hill, Cullen, Coffin, Fox, Cook, and Ellingwood. The 20^th century is represented by Pelikan, Wren, Hool, Grieve, Weiss, Priest and Priest, and Bartram.

The core of the book’s discussion is based on the 21^st century texts written by modern clinicians of medical herbalism including Chevallier, Hoffmann, Menzies-Trull, Mills and Bone, Williamson, and Wood.

Thirty plants are placed in this historical, conceptual context, and discussed in 28 monographs. I find the selection rather limited, but I suppose there is only so much space for such. I would have appreciated it if the unique treatment the authors applied to their herbs was given to such essentials of modern herbal practice as, for example the following: skullcap (Scutellaria lateriflora, Lamiaceae), valerian (Valeriana officinalis, Caprifoliaceae), and nettles (Urtica dioica, Urticaceae).

The monographs cover the following herbs, listed in order of appearance in the text, many of which are not highly popular in the dietary supplement market in the United States: agrimony (Agrimonia eupatoria, Rosaceae); lady’s mantle (Alchemilla vulgaris, Rosaceae); marshmallow (Althaea officinalis, Malvaceae); common mallow (Malva sylvestris, Malvaceae); hollyhock (Alcea rosea, Malvaceae); wild celery (Apium graveolens, Apiaceae); burdock (Arctium lappa, Asteraceae); wormwood (Artemisia absinthium, Asteraceae); mugwort (Artemisia vulgaris, Asteraceae); centaury (Centaurium erythraea, Gentianaceae); wild carrot (Daucus carota, Apiaceae); squill (Drimia maritima. Asparagaceae); fumitory (Fumaria officinalis, Papaveraceae); goosegrass (Galium aparine, Rubiaceae); ground ivy (Glechoma hederacea, Lamiaceae); hyssop (Hyssopus officinalis, Lamiaceae); elecampane (Inula helenium (Asteraceae); white deadnettle (Lamium album, Lamiaceae); basil (Ocimum basilicum, Lamiaceae); peony (Paeonia officinalis, Paeoniaceae); tormentil (Potentilla erecta, Rosaceae); damask rose (Rosa damascena, Rosaceae); raspberry (Rubus idaeus, Rosaceae); rue (Ruta graveolens, Rutaceae); figwort (Scrophularia nodosa, Scrophulariaceae); wood betony (Stachys officinalis, Lamiaceae); coltsfoot (Tussilago farfara, Asteraceae); vervain (Verbena officinalis, Verbenaceae); sweet violet (Viola odorata, Violaceae); and heart’s-ease (Viola tricolor, Violaceae).

[Editor’s note: The common names listed above were taken from the reviewed text and may vary slightly from the standardized common names found in Herbs of Commerce, 2^nd edition (American Herbal Products Association, 2000).]

The monographs discuss modern usage followed by an in-depth look at the developing thoughts about the herb through the written history of the Western materia medica. The modern indications benefit greatly from the insights and experiences of the authors as authoritative clinicians. The indications are not simply those given in modern pharmacopeias, but rather a wonderfully complex therapeutic palette when seen in the context of traditional herbal polypharmacy. The erudite review of historic precedents for the herb leads to useful recommendations for the herb’s use and insights about safety.

Where important theoretical considerations arise, they are explored in a refreshing degree of depth. For example, the discussion of the “alterative” action is, in my humble opinion, the most comprehensive yet written. This discussion alone justifies the reading of this book by all clinicians and students of Western herbal medicine. Similar depth is applied to the theoretical foundations for the clinical concepts of astringency, bitterness, and partus preparator (a term that describes herbs used in preparation for childbirth).

The focus is clearly on the modern form of medical herbalism that uses the insights of the Physiomedicalists and Eclectics, as opposed to the much newer phytotherapy which can be said to use medicinal plants within the modern paradigm. The profound impact of the principles and practice of physiomedicalism on the development of modern herbalism in the United Kingdom is clearly shown. This is reflected in the herbs used and the approach to protocol development. The social upheaval of 19^th century Britain (the Chartist movement, etc.) is appropriately presented as the context for the welcoming of Physiomedicalism to UK herbalism.   

It is especially refreshing to see the continuity of focus on the quality of wild medicinal plants from Dioscorides through the International Standards for Sustainable Wild Collection of Medicinal and Aromatic Plants and the Medicinal Plant Specialist Group.

The Western Herbal Tradition is an important contribution to the rational and informed use of medicinal plants in modern health care.