Category Archives: herbal medicine

The Working of Herbs, Part 4: The Herb Monograph

By Anne Stobart
In my previous posts I have raised issues about looking at medicinal herbs in terms of contemporary and modern understandings (see the Working of Herbs, Part 1, Part 2 and Part 3). My interest stems from my background as historical researcher and also as a trained clinical practitioner of herbal medicine in the UK. I have spent over a decade teaching students on one of the few professional practitioner degree courses in the UK at Middlesex University.
So, how do we get accurate information which is based on modern knowledge for each of the herbal ingredients in a recipe? What referenced sources are readily available, and how do we recognise when information about herbs is reliable?  Here I suggest that a way forward is to look for sources that can provide a good herb monograph.

What is a herb monograph?

Essentially, a modern herb monograph is a compilation or report about a specific herb providing detailed information which is organised in a logical structure, including botanical and pharmaceutical information.[1] Monographs can vary in length, from a single page summary to a multi-page text, and may include the following details:

  • botanical and common name(s)
  • identifying characteristics of the plant
  • traditional uses
  • constituents
  • herbal actions
  • research findings
  • clinical indications
  • preparations and products
  • prescribing information with dosages
  • references

Published herb monographs have served an important role in ensuring the quality of herbal supplies by including detailed descriptions of their physical characteristics, particularly of dried herbs in trade.[2] More recently, some excellent updated herb monographs have been compiled by professional clinical practitioners and include safety information such as contraindications and potential side effects, alongside extensive listings of research papers.[3] Such monographs provide a basic foundation for herbal practitioners in training (often students are asked to compile their own). If herb monographs are comprehensive and effectively referenced, with the inclusion of key plant constituents and herbal actions, they should also be helpful to historical researchers. Finding a good range of reliable herb monographs can be a challenge …. but there are some sources online.

Where can you find herbal monographs online?

Figure 1. American Botanic Council monographs
Figure 1. American Botanic Council monographs

(a) The American Botanic Council  has published an extensive set of herbal monographs which are available online to subscribers, particularly useful for herbal clinical practitioners.

(b) European Medicines Agency. These (not very aptly named) ‘community herbal monographs’ are published online, forming the basis of herbal medicine and traditional product regulation in the European Community. A limited range of herbs is covered: for example ash, bittersweet, horehound, lime flower, liquorice, oregano, primula, thyme. Each monograph includes common names in all languages within the European Community and this may be of interest for some researchers.

Figure 2. World Health Organization Monographs
Figure 2. World Health Organization Monographs

(c) World Health Organisation. A range of monographs were published in four volumes between 1999-2005 and some give extensive detail online, including herbs such as cinnamon, lemon balm, mallow, rosemary. Volume 1 can be found online and links to the other volumes are provided. An index is provided for each volume with listings of plant constituents.

(d) Several online subscription-based sources of monographs are regularly updated with the latest clinical research findings. These can provide considerable detail on individual herbs, for example the Natural Standard database where both summaries and extensive versions of natural product monographs can be obtained. Some other collections of information appear to draw on these monographs, for example, the Plant Profiler‘ pages.

Figure 3. Natural Standard on 'Foods, Herbs and Supplements'
Figure 3. Natural Standard on ‘Foods, Herbs and Supplements’

What makes a good herb monograph?

There is no agreed standard for herb monographs and length of monograph is not a guide to quality of information! Some good sources are ‘potted’ versions [4] but others may give very limited information and lack references. Be wary of the summary such as Herbs at a Glance which provides a condensed version of details drawn from other sources, and lacks clear referencing. Or WebMD (for example on Hyssop) which rarely indicates herb constituents and provides very limited references. On the other hand, some lengthy monographs can be so repetitive and technical to the point that it is hard to understand them. Overall, a ‘good’ monograph source should ideally be comprehensible and be well-referenced, but there are several key things to look out for – these are herb constituents and actions.

Need to know herbal constituents and actions

With the rise of evidence-based medicine, many plant monographs are being revised to exclude traditional uses of plants unless some published research has been carried out. This can narrow down details considerably. For historical researchers the modern designations given to health complaints are not necessarily appropriate, indeed sometimes there is no way to identify a specific condition in the past. However, if it is possible to identify herb constituents and associated actions then we can make sense of the many ways in which a herb might be used. Herbal actions are closely connected with plant constituents – for example, an astringent action or drying effect is found in herbs which are rich in tannins. – this may be appropriate in numerous internal and external complaints, for example, from injuries with blood loss to weeping sores. Monograph sources which provide details of plant constituents and herbal actions are definitely worth seeking out and the references below [3 and 4] are useful examples.

Conclusion

The herbal monograph provides an organised set of information about an individual plant, ideally giving details of traditional uses, constituents, actions, and research findings with references.  A reliable herbal monograph saves a lot of time and effort searching for evidence. In my next post I consider further detail about plants in a particular recipe in terms of their active constituents and medicinal actions.

Notes

[1] A useful web site in the US which outlines finding and using herbal monographs is run by Bastyr University.

[2] Such information is still useful for bulk herb supplies in the pharmaceutical trade, for example William C. Evans, Trease and Evans’ Pharmacognosy, 16th ed (Elsevier, 2009). Also see British Herbal Medicine Association Scientific Committee, British Herbal Pharmacopoeia (Bournemouth: BHMA, 1983). Some highly detailed US monographs are individually published, such as Roy Upton, ed. American Herbal Pharmacopoeia and Therapeutic Compendium: Willow Bark, Salix Spp. Analytical, Quality Control and Therapeutic Monograph. (Santa Cruz: America Herbal Pharmacopoeia, December 1999).

[3] An authoritative text compiled by herbal practitioners is that of Kerry Bone and Simon Mills, The Principles and Practice of Phytotherapy: Modern Herbal Medicine  (Edinburgh: Churchill Livingstone, 2000). This text is currently being re-issued in expanded form (and would be a good Christmas present for a herbal practitioner!).

[4] For example, the useful brief herb descriptions in Potter’s New Cyclopedia (covering many native and exotic herbal remedies) which have been considerably revised, to the extent that it may be preferable to locate an older edition such as R. C. Wren, Elizabeth M. Williamson, and Fred J. Evans. Potter’s New Cyclopaedia of Botanical Drugs and Preparations, rev. ed. (Saffron Walden: C. W. Daniel, 1988).

The Working of Herbs, Part 2: Take One Herbal Recipe

By Anne Stobart

In the first post of this series, I flagged up some problems in finding out how herbs might work in a medicinal recipe. The question of medicinal herbs and their historical efficacy is a rather difficult area.[1] Through study of one recipe, I hope to provide pointers to useful sources, to indicate their relevance and to suggest caution where appropriate. Any recipe would work, but the one I have chosen is of particular interest because it has cropped up several times in my study of the late seventeenth-century recipe collections of a Devon household.

A water for After throwes

The receit of the water for affter Throwes.
The receit of the water for affter Throwes.

Take two hanfull of Isope [hyssop] two of peneroyall and two hanfull of Groundsell one handfull of wild mints two hanfulls of balme: These hearbs Cleane pickt and Sume fare water put upun all these hearbs togeather wash them Claine [‘and lay them in’ crossed out] then lay them in a pott or Earthen vessell: Shred these hearbs and put them in a quart of Spring water and let them lye in the water for a day and a night: then still the hearbes and water togather in a rose still then let the Glass bottle stand in the Sume Sinnce two Months Close Stopped from andy Ayre it Makes the water mush better. [2]

We will have to assume for this discussion that these plants are correctly identified as hyssop, pennyroyal, groundsel, wild mint and balm–although plant identification is another uncertain factor in considering recipes! Ideally we need to know:

  • the seventeenth-century indications for these plants.
  • the key constituents.
  • the likely physiological actions of these constituents.
  • the potential combinations of herbs in a preparation.
  • the dosage and its likely effects in the body.
Hyssop (Hyssopus officinalis)
Hyssop (Hyssopus officinalis)

My first step is to explore Internet sources using hyssop as an example.The Internet brings a wealth of information, but finding out about a particular medicinal herb can be frustrating. This problem is worse if you seek a ‘historical’ source. Many sites readily repeat information about ‘traditional’ uses without reference to sources. For example, numerous sites claim that hyssop has been used for millennia and dates back to the Bible. If you search for ‘herbal medicine hyssop’ in Google, you are likely to draw up Wikipedia, Mrs Grieve’s herbal, commercial websites offering herbal medicines and medical databases.

Relatively few of these sites give accurate historical background. However, a reasonable starting point is Maud Grieve’s A Modern Herbal, which still provides more detail than most sources on medicinal constituents, actions, uses and preparations.[3] First published in 1931, the book is good value as a secondhand hard copy purchase and provides succinct information on many plants. Grieve draws on a variety of classical to early modern sources for constituents, medicinal actions and uses. But… A Modern Herbal needs considerable updating.

A more recent publication from Tobyn et al. follows selected herbs in texts from Dioscorides onwards, including hyssop, and provides details of therapeutic use with constituents and clinical research evidence.[4] Although limited to 27 plants, this text has a useful overview of relevant authors from classical to modern times.

Internet searching can be confusing if you are looking for reliable sources on historical use of plants and their consituents and medicinal actions. In my next two posts, I will outline some qualities and indications of the herbs in this recipe and the benefits of locating a good quality herb monograph.

Notes

[1] For example: John K. Crellin, ‘Revisiting Eve’s Herbs: Reflections on Therapeutic Outcomes’, In Herbs and Healers from the Ancient Mediterranean through the Medieval West: Essays in Honour of John M Riddle, edited by Anne Van Arsdall and Timothy Graham (Farnham, UK: Ashgate, 2012, pp.307-27).

[2] ‘The Right Honorable The Lady Receipt Booke Anno Dom 1690’, p.82, Ugbrooke House, Chudleigh, Devon. My thanks to Lord and Lady Clifford for permission to access their private archive.

[3] Maud Grieve, A Modern Herbal: The Medicinal, Culinary, Cosmetic and Economic Properties, Cultivation and Folklore of Herbs, Grasses, Fungi, Shrubs and Trees with All Their Modern Scientific Uses. First 1931 ed. (London: Penguin, 1980).

[4] Graeme Tobyn, Alison Denham, and Margaret Whitelegg, The Western Herbal Tradition: 2000 Years of Medicinal Plant Knowledge (Edinburgh: Churchill Livingstone/ Elsevier, 2010).

The Working of Herbs, Part 1: Did Herbal Recipe Ingredients Really Work?

By Anne Stobart

As a clinical herbal practitioner with a research background in the history of medicine, I am sometimes asked the question: ‘Did the herbs work?’. In this post, the first of a series (The Working of Herbs), I consider how we might examine whether medicinal plants in recipes might have worked.

The question may seem simple, but it is a tough one to answer. It provokes even more questions, including:

  1. What are the herb constituents (phytochemistry and pharmacognosy)?
  2. What research has been done on the effects of medicinal plants (herbal pharmacology)?
  3. Should we be thinking about efficacy (historiography and medical history)?
  4. Do we know the parts of herbs, the preparation and dosage of the recipe (pharmacy)?

[Pharmacy: Illustration of pharmaceutical chest] Carl Linnaeus, Materia medica, Liber I. De plantis (Holmiae - Laurentii Salvii, 1749, title page & frontis). Courtesy of the National Library of Medicine.
[Pharmacy: Illustration of pharmaceutical chest] Carl Linnaeus, Materia medica, Liber I. De plantis (Holmiae – Laurentii Salvii, 1749, title page & frontis). Courtesy of the National Library of Medicine.
It is unsurprisng that historians often avoid raising the question in the first place. But I believe that we need to clarify the potential effects of medicinal recipes, and I have been thinking about how to establish a rational protocol for answering this question in relation to a medicinal recipe. I hope that other readers will chip in with their thoughts and useful advice!

Figure 2. [Plants of medicinal value to particular human body parts], Michael Bernhard Valentini, Medicina nov-antiqua (Francofurti ad Moenum: Joan, Maximiliani à Sande, 1713,  fol. 286). Courtesy of the National Library of Medicine.
Figure 2. [Plants of medicinal value to particular human body parts], Michael Bernhard Valentini, Medicina nov-antiqua (Francofurti ad Moenum: Joan, Maximiliani à Sande, 1713, fol. 286). Courtesy of the National Library of Medicine.

Presentism

A discussion of how herbal ingredients of recipes might have worked raises at least three problems of historiographical concern.

First, we need to be aware of ‘presentism’. Current knowledge about plant constituents and medicinal effects can easily influence our view of what people knew/did in the past. Second, implicit assumptions that the use of medicinal herbs was connected to therapeutic efficacy should be questioned since there might have been other reasons for their use. (Figure 2 shows the links between plants and body parts, some of which were probably based on shape). Third, some authors suffer from what I call ‘plantaholicism’–overly sympathetic and exclusively plant-focused view of the past. This may provide a narrow viewpoint, particularly when we consider that many other items were used in the materia medica including animal and mineral ingredients.

I fully understand that I may be guilty at times of demonstrating all of the above problems, and part of my rationale for drafting these posts is to help to clarify how to manage these issues.

Finding out more

This post flags up some problems in trying to assess efficacy. Although my examples in this series will be drawn from early modern sources, I hope that some points made will be relevant to other periods.[1] In further posts in this series I aim to provide some pointers for historians and others looking at recipes who wish to seek out reliable sources and information about herbal constituents and their actions.

Coming up in future posts…

  • how to locate reliable information about herbs
  • why the herbal monograph can be a useful tool
  • how to consider the effects of combining herbs in a recipe

 

[1] See for example, classical pharmacology in Laurence M. V. Totelin, Hippocratic Recipes: Oral and Written Transmission of Pharmacological Knowledge in Fifth- and Fourth-Century Greece (Boston: Brill, 2009).