September 5, 2018

Book Review: Herbal ABC’s The Foundation of Herbal Medicine

A systems approach to botanical prescribing
Sharol Tilgner’s latest book on herbal medicine is a well-written, concise guide to the practice of herbal medicine using a novel organ system–based approach.

Book reviewed: Tilgner S. Herbal ABC’s The Foundation of Herbal Medicine. Frances D, Berner P, Graham D, Fiore L, eds. Pleasant Hill, OR: Wise Acres LLC; 2018.

What Herbal ABC’s Is

Most botanical medicine books are arranged in a materia medica fashion: they focus on the plants as the stars, listing them in alphabetical order and describing their function. Tilgner’s previous book, Herbal Medicine From the Heart of the Earth, is a good example of this. Herbal ABC’s The Foundation of Herbal Medicine is unusual because it is structured as a course in how to prescribe botanicals based on first understanding how each system of the body works and how it needs support. In Herbal ABC’s, Tilgner guides you through the process of choosing a plant medicine to address each situation by helping you think first about how the imbalanced part of the body should function.

When I was in botanical medicine school back in the late 1990s, one lesson really stuck with me. Because each plant has multiple active phytochemicals that can influence many systems of the body, a small collection of plant medicines can help support an extremely wide range of imbalances. For this reason new herbalists often start with about 15 herbs in their formulary that will cover a wide range of actions. As their expertise expands, the formulary will also expand to address the finer nuances of a given clinical situation, but understanding the basic physiological processes that you want to support is really the key to successful prescribing. Tilgner’s book reads like a course in this principle.

How Herbal ABC’s Is Structured

Each chapter focuses on one organ system. Tilgner first explains the physiology of each organ system, then she discusses how we can use herbs to support different facets of each system. For example, in the digestive system she has a section on carminatives, laxatives, and bitters. Within each of these subsections, she provides a list of herbs that will support that function, and then highlights a few plants in detail, supporting the use of each herb with a great deal of information from the scientific literature. The text is similar to Bill Mitchell’s Plant Medicine in Practice in this way, but she spends much more time describing the thought processes behind the choices a practitioner would make in his or her prescribing. She also includes case studies, “herbal tidbits” about the plants, and lists other organ systems supported by the herbs from each section to assist with formulations.

Who Herbal ABC’s is for

While Tilgner’s explanations of physiology are clear and basic enough for a new practitioner to understand, they are also useful for those with more medical education because they set the stage for the herbal explanations that follow. She brings her experience in the classroom and clinic to her writing, with clear explanations and many clinical pearls appearing throughout the text. I garnered interesting new tidbits of information about the subtleties of the plants themselves and gained new understanding of their relevance to physiological processes.

This book is an interesting example of how the practice of Western herbal medicine has evolved over the past few decades. Tilgner incorporates Western physiology, contemporary research that elucidates mechanisms of action, and practices from a variety of traditions. She uses plant medicines that grow native to North America (eg, black cohosh and plantain), traditional European plants (eg, borage and calendula), herbs from the Chinese tradition (eg, dang shen), and Ayurvedic herbs (eg, ashwagandha). The book shows how this particular practice of herbalism has moved from lay herbalists who collected herbs from their own backyards to a more professionalized hybrid that asks practitioners to keep in touch with the earthy origins of these plants even though (for better or for worse) they may never actually see where the plants grow.

What Herbal ABC’s Is Not

Herbal ABC’s includes the use of many plant medicines, but it is not an exhaustive materia medica. While it does list quite a few conditions, this book also is less focused on pinpointing specific herbs for specific clinical manifestations. It clearly is a training manual for Western herbal practitioners who wish to incorporate the use of herbs into a holistic, science-based practice. Herbal ABC’s asks the reader to think more holistically, beyond a named diagnostic pathology to the process underlying the pathology. For example, you won’t find “Crohn’s disease” in the index, but the book helps you think through the process of how to use anti-inflammatories and vulneraries to help heal the gut.

Herbal ABC’s also lacks information for people who would like to identify or harvest wild plants. There are 6 lovely photos of medicinal plants on the front cover; I wonder how many of us could identify them?

On one hand, plant identification is obviously not the intent of the book and there are already many other volumes by many other authors covering this subject. This book is clear, concise, well-written, and adds valuable depth to our practice as herbalists and naturopathic doctors.

On the other hand, it leads me to consider herbalism in the current practice of naturopathic medicine in North America, a new brand of herbal medicine distinct from any that has come before. Western herbalism is not rooted in one place and the plants that grow there. Rather, it is rooted in a new paradigm of research and the clinical experience of people who have easy access to the world at their fingertips.

There is a power and ease in knowing we have so many plant medicines to choose from. However, I do wonder: By divorcing ourselves from the process of identifying, collecting, and preparing these medicines, are we somehow diluting our efficacy in utilizing our plant allies?

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