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By Anne StobartIn 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 planttraditional usesconstituentsherbal actionsresearch findingsclinical indicationspreparations and productsprescribing information with dosagesreferencesPublished 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?[caption id="attachment_2699" align="alignleft" width="300"] Figure 1. American Botanic Council monographs[/caption](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.[caption id="attachment_2850" align="alignleft" width="300"] Figure 2. World Health Organization Monographs[/caption](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.[caption id="attachment_2700" align="alignright" width="300"] Figure 3. Natural Standard on 'Foods, Herbs and Supplements'[/caption]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 actionsWith 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.ConclusionThe 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).