Rational Phytotherapy: A Physician’s Guide to Herbal Medicine. 4th edition. Volker Schultz, Rudolph Hansel, and Varro E. Tyler. Published by Springer-Verlag, Berlin, Heidelberg, New York, 2001. ISBN 3-540-67096-3. 382 p. Tables, Appendix, Index; Illustrations in color.
In Rational Phytotherapy: A Physician’s Guide to Herbal Medicine. 4th edition, herbal medicines are classified in the pharmacy much like generally available commercial drugs and medicines. The label herbal drugs indicates the categories of substances that have been identified and standardized in the manner of prescribed drugs, and are those substances which are herbal in origin. Medicinal plants are recognized and generally known as traditional medicine, but in this book, medicinal plants are compared with conventional drugs, and are acceptable as medicines only where clinical studies have indicated their appropriate use and only as standardized products. In the United States, most herbal medicines are categorized as dietary supplements. In Germany, the term phytotherapy is appropriate, especially since it became the legal term for alternative medicine in 1976, p.15. The authors explain that rational phytotherapy is herbal medicine by means of tested and approved substances, “… herbal medicines whose safety and efficacy conform to current testing standards as fully as conventional drugs”, p. 15.
Herbs are shown in this book to have value alongside conventional drugs which treat the same or similar symptoms, illnesses and disorders. For physicians wishing to acquaint themselves with the properties of herbal medicines, the text compares therapeutic range, pharmacologic effects and clinical evidence from studies in the 1980s and forward. The text is clearly written and organized to deliver information that can be easily referenced by readers looking for a deeper explanation of herbal drugs and their uses. Charts, graphs and tables are shown in each chapter. For a serious researcher wishing to access entire drug testing, the charts indicate the kinds of studies, author names, dates published, etc. In graphic form human responses are tabulated to show reaction to specific herbal drugs. Tables are used to compare herbal drug indications, amount of prescriptions given for specific disorders, the active constituents in the most popular herbal drugs, and a review of the brand names, herbal medicines and their rank as commonly prescribed in 1997 in Germany, p. 361. Color photographs of herb flower heads and/or leaves, etc., give the reader images from which to identify the crude plant under discussion. In this respect the book adds a dimension in pharmacognosy, the knowledge of medicinal plants in their original form.
The text offers introductory chapters on preparation, forms of administration, the meaning of phytotherapy, and how to dispense herbal teas for medicinal benefit. Following these general notes the book is divided into parts of the body and its disorders, each leading the discussion of a signature herb for the main disorder. The herb most often prescribed is explained by an introduction to its native habitat and traditional use, a botanical description of the herb, the crude drug and extract, its constituents, its pharmacology and clinical efficacy, and finally its dosage, contraindication, therapeutic value, and the herb product by name. In the chapter on the Central Nervous System, p. 41 to 106, Ginkgo biloba leads the discussion for Cognitive Deficiency, St. John’s Wort (Hypericum perforatum), for depression, Kava (Piper methysticum) for anxiety, Valerian (Valeriana officinalis) for sleep disturbances, and Hops, Lavender, Lemon Balm and Passion Flower also for restlessness and sleep disturbances. After each herb a section follows entitled References, listing the sources for the material in the section. The reader can successfully search for “restlessness”, names of disorders, and plant medicines in the Subject Index, p. 369 to 383, or the table of contents. The chapter Respiratory System treats colds and flu with Elder, Linden, and Meadowsweet Flowers, Willow bark, Salicylates, teas, essential oils, nasal ointments and nose drops, inhalation, lozenges, and gargles. There are also cough remedies, expectorants, and methods for treating sinusitis. In the chapter on Skin, Trauma, Rheumatism and Pain, Table 8.1 lists herbs for external use from the Commission E Monographs, including Chamomile, Witch Hazel, Evening Primrose, Bittersweet, Calendula, Purple Coneflower, St. John’s Wort, Arnica, Comfrey, and Bromelain. Among these Calendula flowers were noted for wounds and skin ulcerations, with St. John’s Wort and Arnica also useful externally for wounds. Witch Hazel (Hammamelis virginiana) is considered due to its tannin, or astringent, properties. Nettles (Urtica species) are considered useful in rheumatic disorders.
With a final chapter entitled “Agents that Increase Resistance to Diseases”, the book offers a classification of herbs called adaptogens and immune stimulants. It is difficult to quantify the effects of adaptogens and immune stimulants in clinical studies. In these very promising, but not well-understood areas of herbal medicine, Ginseng leads the discussion for adaptogens and Purple Coneflower (Echinacea purpurea) for immune stimulants. A venerable herbal medicine, ginseng is known botanically as Panax ginseng (for Asian ginseng, or Panax quinquefolius for American ginseng) or Eleutherococcus senticosus (Siberian ginseng). The text frankly reports discrepancies between herbs as medicines based on tradition and herbs as drugs and therapeutic effects. In the section on Gotu Kola (Centella asiatica), p. 337, the value of the herb as an adaptogen is challenged, while its effectiveness for healing wounds is found to be adequate. While another herb, Ashwaganda (Withania somnifera), known in the United States for its adaptogenic qualities, was tested clinically to enhance red blood cells, hair melanin and lower serum cholesterol, p. 337. References to additional herbal medicines show or deny their value, according to clinical studies and the Commission E Monographs.
The Appendix contains a table, “The 100 Most Commonly Prescribed Herbal Medications in Germany”. The table is supported by a list of the most commonly prescribed herbal medicines by category: those medicines for the central nervous system and respiratory system lead cardiovascular, urinary tract, stomach-bowel-liver and biliary tracts, in that order; adaptogenic, skin, and gynecological disorders form the least-often prescribed herbal medicines. While assessing the value of these tables, it should be remembered that the authors state the importance of prescriptions given, i.e. sales of the specific herb, as an indicator of the actual value of the herb. It cannot be stressed enough that traditional usage has been replaced, for the purposes of this text, by clinical value, product, and ensuing popularity. It is possible to interpret the tabulated results in a variety of ways: since the reasons the authors give for the recognition of herbal medicine have to do with patients’ perceived understanding of medicines and demand for more natural therapy, what does a particular ranking do for an herb’s popularity? Are herbs for the central nervous system popular due to the recent shift in demand for herbs versus conventional medicines? For their availability–there exist many plant medicines for nervous conditions? Or have they become popular simply due to their effectiveness?
Follow
