Tyler's Herbs of Choice: The Therapeutic Use of Phytomedicinals

Rating:
Summary: Wait for the paperback or use the older version
Review: I have been waiting for an update of this classic book. However, for most health care professionals or herb users, I don't feel the $40 price tag makes this book worth it. Wait for the paperback of this updated version or get the paperback 1994 version.

Rating:
Summary: A "must" for all herbal remedies reference collections.
Review: Tyler's Herbs of Choice provides an important treatise on the therapeutic use of phytomedicinals (herbal remedies) and provide important information on the most effective herbs, what they do, how they work. This is not for the casual reader: technical medical descriptions of common conditions and treatments cover details doctors will need to know and provide explanations of how the herbs interact with the body, and what constitutes acceptable levels of dosage.

Rating:
Summary: An old school viewpoint?
Review: Written by two pharmacognosists at Perdue University, this book is an update to the original volume in 1994, describing the safe use of the most widely available medicinal herbs. They address recent developments in the use of herbal medicines in a manner that is easy to read and without unnecessary jargon. They include some updated references for most plants, encompassing the clinical literature, known chemical constituents, and the history of their use. Introductory essays describe the basic principles of herbal medicine and problems that the regulatory authorities have had in attempting to deal with these products, especially since the passage of the Dietary Supplement Health and Education Act (DSHEA). The chapters are arranged by general therapeutic indication and discuss the herbs used to treat various ailments and their reported efficacy based on clinical or preclinical results.

One obvious distinction of the book is the clear message that classical pharmacognosy is the only valid scientific viewpoint. There is still in this updated edition, the strong notion that there is a magic bullet within each plant that we only need identify and standardize. But this is seldom as straightforward as it may appear. For example, in the basic principles section there is praise of standardized preparations of hypericum, yet no acknowledgment that standardization based on hypericin is probably not useful, since it is no longer believed to be essential for the antidepressant activity of St. John's Wort. Standardization and pharmacology of the currently favored constituent, hyperforin, was not mentioned. Publication in a scientific journal does not make a particular finding (e.g. hypericin inhibition of MAO) a "fact." Subsequent studies showed no MAO inhibition with pure hypericin. Conclusions and extrapolations drawn from results of in vitro studies are based on the conventional wisdom, which is often incorrect. While proposing a mechanism of action is a worthy goal, it must be remembered that true drug mechanisms (even the synthetic ones) are still beyond our medical understanding in most cases, particularly for psychotherapeutic medications. For example, while SSRI's are known to act by blocking reuptake of serotonin, the connection between serotonin uptake and antidepressant action still remote.

Also mentioned as "pseudoscience" is the notion that whole herbs are more effective than their isolated active constituents. The basic principles section states that for every example in support of this statement that there is at least one denying it. While a 50:50 ratio hardly seems in itself a reasonable criterion for pseudoscience, I think one would be hard pressed to give one example of constituents being more effective than the whole herb for every example of the inverse. While I completely agree that hyperbole and sometimes outright fabrication are seen in the marketing of herbals, we shouldn't be too quick to categorically discount what herbal practitioners have been saying for so long, but rather to weight them with the same standards as ideas that the "scientists" have generated.

Rating:
Summary: An old school viewpoint?
Review: Written by two pharmacognosists at Perdue University, this book is an update to the original volume in 1994, describing the safe use of the most widely available medicinal herbs. They address recent developments in the use of herbal medicines in a manner that is easy to read and without unnecessary jargon. They include some updated references for most plants, encompassing the clinical literature, known chemical constituents, and the history of their use. Introductory essays describe the basic principles of herbal medicine and problems that the regulatory authorities have had in attempting to deal with these products, especially since the passage of the Dietary Supplement Health and Education Act (DSHEA). The chapters are arranged by general therapeutic indication and discuss the herbs used to treat various ailments and their reported efficacy based on clinical or preclinical results.

One obvious distinction of the book is the clear message that classical pharmacognosy is the only valid scientific viewpoint. There is still in this updated edition, the strong notion that there is a magic bullet within each plant that we only need identify and standardize. But this is seldom as straightforward as it may appear. For example, in the basic principles section there is praise of standardized preparations of hypericum, yet no acknowledgment that standardization based on hypericin is probably not useful, since it is no longer believed to be essential for the antidepressant activity of St. John's Wort. Standardization and pharmacology of the currently favored constituent, hyperforin, was not mentioned. Publication in a scientific journal does not make a particular finding (e.g. hypericin inhibition of MAO) a "fact." Subsequent studies showed no MAO inhibition with pure hypericin. Conclusions and extrapolations drawn from results of in vitro studies are based on the conventional wisdom, which is often incorrect. While proposing a mechanism of action is a worthy goal, it must be remembered that true drug mechanisms (even the synthetic ones) are still beyond our medical understanding in most cases, particularly for psychotherapeutic medications. For example, while SSRI's are known to act by blocking reuptake of serotonin, the connection between serotonin uptake and antidepressant action still remote.

Also mentioned as "pseudoscience" is the notion that whole herbs are more effective than their isolated active constituents. The basic principles section states that for every example in support of this statement that there is at least one denying it. While a 50:50 ratio hardly seems in itself a reasonable criterion for pseudoscience, I think one would be hard pressed to give one example of constituents being more effective than the whole herb for every example of the inverse. While I completely agree that hyperbole and sometimes outright fabrication are seen in the marketing of herbals, we shouldn't be too quick to categorically discount what herbal practitioners have been saying for so long, but rather to weight them with the same standards as ideas that the "scientists" have generated.