Combining Western Herbs and Chinese Medicine: Principles, Practice and Materia Medica
Jeremy Ross Greenfields Press. Seattle, 2003. First edition Hardback, 970 pages, £95.00
(Reviewed by Steve Kippax, EJOM Vol. 4 No. 4)
Jeremy Ross gained a Bachelor’s degree in biological sciences, completed a year’s post graduate research and qualified as a science teacher. In 1973 he moved to California and took his first course in western herbal medicine with Michael Tierra. Returning to England he completed the National Institute of Medical Herbalists training and became a member in 1982. In 1988 he completed Ted Kaptchuk’s two year course and received further training in Nanjing PRC.
Parallel with his herbal training he also started studying acupuncture in 1973, graduating from the College of Traditional Chinese Acupuncture in 1977, studied again at Nanjing in 1981, and qualified as a Doctor of Acupuncture from the British College of Acupuncture in 1985. With over 25 years’ practice experience and his academic history, coupled with his writing and teaching past, he is in a perfect position to write a book such as this. He has been specialising in integrating western herbs and Chinese medicine for 15 years. This book brings together his experience gleaned from the last 38 years.
Any book which boasts 970 pages is obviously a sizeable tome. It is published in a highly readable manner with clear font and layout. In this book Ross continues and expands upon previous publications which have attempted to explain non-TCM herbs in a TCM fashion. Authors such as Michael Tierra and Peter Holmes immediately spring to mind as obvious antecedents.
This book however raises this nascent subject to a previously unobtained level of academic excellence. For instance, at the end of most chapters there are over 40 references (up to 90 for some) to support the topics discussed. The references are exhaustive, and the information contained throughout the book represents the most up-to-date sources available at the time of going to print. Ross has expanded traditional syndromes with clinical observations from his experience. Heart qi irregularity, uterus stagnant qi, and kidney stagnant qi amongst others are introduced as non-traditional categories.
After the obligatory foreword and explanation of terminology, the main body of the book is divided into two sections: Part 1 Herbal medicine in theory and practice and Part 2 Materia Medica. Finally we have a section comprising Additional herbs. The Appendices are: Glossary, Healing crises, Herb properties, Herb names and a cross reference section before the Index.
The first part has ten chapters entitled: History, Temperature, Taste, Actions, Actions glossary, Principles of herb combination, Practical herb combination, Dose, Safety, Safety and the organ system, Safety in clinical practice. The second part, Materia Medica, has 50 individual herbs, starting with Achillea and ending with Zingiber. Before the appendices there is a section on additional herbs which have been mentioned as combinations but do not have a full entry themselves.
The size, terminology, in-depth referencing and research that this book contains (and cost) places this firmly in the serious practitioner’s book shelf/college library. I would not imagine breezily advising an interested lay person to invest in this excellent scholarly work.
From the first chapter on History the book compares and contrasts the western tradition with TCM with Phytotherapy. The chapters on Temperature and Taste neatly compares the oriental and occidental traditions and offers a framework for curious practitioners to begin to arrive at their own unique, personal understandings. For instance, here Achillea is categorised as ‘warm - cool variable temperature herb’ (page 24). If herbs having specific, fixed temperatures has become a limiting factor in prescribing, this concept creates a flow of expansion, opening up a multitude of possibilities.
Actions and Action glossary provides again a useful area for contrast. Actions are listed under headings such as anti–tussive and then, in this case, seven different situations are classified and examples of herbs given e.g. expectorant - ‘.. to relieve non productive cough with sticky mucus - Marrubium’ (page 73). The following chapter on Actions glossary explains that anti-tussives generally come from TCM categories like herbs that transform phlegm and stop cough, but also tonify yin fluids and clear heat, or herbs that calm the heart spirit.
Practical herb combinations, presents a clear treatment strategy - ‘Which disorders are primary and which are secondary’ (page 89), which is then followed by a chapter on dosage. The different ways of delivering herbs is looked at, (water based extraction, ethanol tinctures, Glycerol, etc) and the question of a therapeutic (or not) dose raised.
The final three chapters in the first section are taken up with safety issues, general issues ‘Herbs are safe’/’Herbs are unsafe’, risk benefit ratio and potential herb drug interactions e.g. Digoxin and Crataegus.
Safety and the organ system gives more specific information, again from a western perspective ‘This subject (hepatotoxicity) has been reviewed by Mcleod et al and the use of herbal medicine is unlikely to cause significant and consistent elevation of serum enzymes or to cause hepatotoxicity’ (page 142) and a TCM example liver hyperactive yang ‘Ephedra or Panax ginseng should be avoided.’ (page 142). Whilst Safety in clinical practice offers good common sense: take a full case history, prescribe a balanced herb combination, monitor for adverse reactions, advice such as ‘Stop the herbs if the patient has unacceptable side effect’ may seem patently obvious. It is another example of the care and the thoroughness this book exhibits.
Part 2 Materia Medica looks at 50 herbs in detail. After describing what each individual herb is used for traditionally he then has a neat section entitled ‘What is special about it’. Chinese actions, western actions, and western use follow in most cases, then Limitations, then one of the very useful practical aspects - pairings with other herbs. Combinations, which are basically formulas which Ross recommends come next. Again very helpful. Inevitably these combinations may vary from your own favourites, but cannot be faulted for their elegance and probable effectiveness. Constituents and Pharmacological and clinical research complete the picture. Dosage, regulatory status, and comparisons neatly rounds off each chapter. Before the next herb chapter are the exhaustive references to support the information.
As the wider debate on incorporation or not of ‘Western’ herbs into TCM continues, this book will probably ruffle a few feathers of the epigones who consider TCM sacrosanct. Who needs anything else when you have the treasure trove that is TCM at your disposal? It is just as likely to raise howls of anguish from Phytotherapists who question the need for an energetic understanding at all - decrying this approach as scientifically invalid and unsustainable, whilst smacking of superstition and antiquity. This energetic understanding is irrelevant to good prescribing, they may say. For the rest of us who just wish to broaden our knowledge and deepen our relationship with plants/patients/and the planet for the good of all, this book provides guidance and encouragement, whilst setting an academic bench mark for future publications.
The aim of this book is to provide the interested, open minded herbalist the necessary information to use the listed herbs safely. Safety justifiably takes up approximately 33% of the first section. It only requires a small step for you to be able to create a template (based on temperature and taste analysis) to further your own energetic understanding of herbs you may be less familiar with. This book helps to enlarge, and places itself firmly at the epicentre of the growth in eclectic global herbal understanding and knowledge.
The author successfully juxtaposes a TCM, phytotherapeutic and western traditional understanding of theory and the individual herbs chosen for the Materia Medica section. If you have an open mind and a thirst for expanding your knowledge then buy it.
Steve Kippax Steve Kippax qualified from the School of Herbal Medicine (Phytotherapy) and became a Member of the National Institute of Medical Herbalists in 1985 when he commenced practice in Suffolk and London. From 1988-1990 he learnt Chinese herbal medicine at The School of Chinese Herbal Medicine. In 1991 he studied and worked in the herbal medicine department in TCM university hospital in Guangzhou PRC. He learnt acupuncture in 1993 at the same hospital and returned for advanced courses in 1995. He worked at The Gateway clinic, and is now Joint Head of Medical Services at The Third Space Medicine in London. He has an MSc in herbal medicine and lectures internationally.