Traditionally, Western medical knowledge from Graeco-Roman times onward has been transmitted by means of authoritative printed texts. Today, both patient and physician may be more likely to use the Internet as a first reference source. The sheer amount of medical information available on the World Wide Web and the speed of its renewal and retrieval may outpace the Caxtonian mechanics of printed textbook production, but has done little to erode the authority of the printed word. Conversely, in fact, major medical reference texts are these days being “ported” into the memory of hand-held electronic devices or on-line databases. This development, welcomed by gadgetry enthusiasts, eliminates the hefty size and weight of the printed tome, but decreases the legibility and convenience of the printed page as well as undermining the narrative qualities of the traditional medical textbook.
However, another, and only slightly less illustrious tradition has long co-existed with that of the major medical opus. This is the “vade mecum,” literally “go with me,” intended as a portable tome to be kept on hand for immediate reference. To be successful, this format requires authors to possess a high degree of intimacy and fluency with their subject matter, to be able to communicate its essentials with precision and confidence, compacting prose and condensing content without sacrificing narrative. The size of the resultant printed volume must be compact nough to make it easily portable, which nowadays translates as “pocket guide.”
The present pocket guide is a medical vade mecum devoted specifically to the field of phytotherapy (herbal medicine), authored by the German physician and phytotherapist Karin Kraft. Prof. Kraft is a member of the Commission E (the official expert committee which originally considered the safety and efficacy of phytomedicines in Germany), and is currently a member of the supervising editorial board of ESCOP (European Scientific Cooperative on Phytotherapy). ESCOP produces the scientific monographs that provide the official core data for herbal medicines in the EU.
In Germany, phytotherapy enjoys a higher degree of integration into general medical practice than in any other European country, with physicians regularly writing millions of prescriptions for approved phytomedicines on a daily basis. In the original German edition of this pocket guide, Prof. Kraft provides the busygeneral practitioner with a compact and practical reference guide that includes a materia medica of herbs, a prescriber for many conditions, and extensive data on dosage, forms of administration, safety data and technical standards for German commercial herbal products. (Special mention should made of Prof. Kraft’s inclusion of an often neglected area, that of topical applications of herbal medications such as poultices and compresses, more popular in Europe than in the USA).
In North America, herbal medicine is a more marginal discipline, ultimately the legacy of a period of political opposition between medical factions at the turn of the 19th century which resulted in the effective outlawing of botanical medical practice following the Flexner Report of 1910. Although the majority of “official” medicines in the United States Pharmacopoeia were originally botanicals or botanically derived, there remains a sharp discontinuity between standard practice medicine today and its botanical past. The once widespread schools of physiomedical and eclectic botanical medicine were preserved partly through their migration
to the United Kingdom, where an unbroken tradition today enables qual-ified British medical herbalists to diagnose and treat conditions with phytomedicines, alongside their conventional medical colleagues. The British model is distinct again from the German experience and emphasizes the importance of understanding different cultural and national expressions of traditional herbal medicine, education, and practice.
Sensitive to such cultural variations, Thieme wisely enlisted the aid of Christopher Hobbs, a fourth-generation American herbalist, to help render the translation of Prof. Kraft’s German text into the US cultural context. Hobbs, one of the most highly regarded herbal practitioners in the US, addressed this challenging task by reviewing every line of the text. Hobbs has replaced some herbs in the material medica, suggested more appropriate local equivalents for herbal products, and annotated bi-cultural comments where relevant. He has also rewritten doses into the typically higher US forms. Meanwhile, Hobbs has deftly preserved the nuances of the German text; Prof. Kraft actively participated in, and agreed to, all the changes. The result of this bi-cultural collaboration is an almost seamless representation of the German original harmonized to the North American audience.
As more physicians in this country recognize the need to investigate the CAM (complementary and alternative medicine) modalities that are being espoused by many of their patients, a premium is inevitably placed upon reliable sources of data and clinical information about CAM. Botanical medicines in particular have sadly been the subject of excessive amounts of published secondary and tertiary “information” devoid of clinical context, and largely irrelevant to the primary care provider. By contrast, Karin Kraft and Christopher Hobbs present us with a succinct and authoritative survey of herbal medicine that is accessible to the physician and can readily be applied to everyday clinical practice. The “pocket guide” represents a unique cross-cultural and trans-disciplinary blend of reliable, accurate, and accessible information about phytotherapy; it is a mini-masterpiece of integrative medicine.
Ashland, Oregon, USA