Blending with Bone

A Clinical Guide
to Blending  Liquid Herbs:
Herbal Formulations for the Individual Patient

by Kerry Bone

You can’t always tell a book its cover, and this is probably fortunate in the case of this latest book by Kerry Bone, as the cover is indicative of a significant problem in an otherwise potentially valuable text. The glossy hardcover bears a cropped image of two (rather anemic looking) calendula flowers alongside a white-coated Kerry Bone staring at a glass graduated cylinder, containing what is presumably a “liquid herb”. All this is set against a background of numerous bottles bearing the MediHerb product label—and therein lies the clue to the central problem in this book. Turning the page, author Kerry Bone’s name appears without the usual acronyms of his distinguished credentials, and instead is suffixed only with the MediHerb company name. Another clue, and now the cover art becomes clearer. Before returning to this troublesome detail, we must describe the main contents of the book.

The main text has three chapters and various more --or less-- useful appendices. The first chapter covers the use of liquid herbal extracts from a practical point of view including discussions of manufacturing methods, quality control and standardization, herbal synergy, posology, prescription dispensing, and record keeping, most which are rarely dealt with in other herbal textbooks. The second chapter provides a number of cameos that explain the clinical rationale for prescribing different combinations of liquid herbal extracts, covering some seventeen health topics with illustrative formulas and case histories. These examples do not entirely live up to the promise of the title – individuals are not the same as conditions, and this is probably the weakest part of the book as a whole.

The third chapter, and by far the largest section of the book, consists of one hundred and twenty five herbal monographs. These are essentially therapeutic mini-monographs with a concentrated focus on clinical indications and associated evidential support. The template is identical throughout, but the length varies from a couple of pages to five or more where there is substantial clinical evidence available. Citations are used for supporting evidence, and considerable reference is made to the author’s collaborative text with Simon Mills, Principles and Practice of Phytotherapy. The overall tone of the monographs is clear, concise, easy to read, and without the clutter of extraneous detail included by so many “informational” texts. The herbs covered in the monographs include many from the traditional materia medica that are not usually described in scientific monographs, as well as several Eastern imports into the Western materia medica. Bone refreshingly brooks no nonsense from the US-dominated supplement industry model, such as confusing red clover standardized extracts with traditional red clover flower – in the Trifolium monograph he declines to review the isolated isoflavone data, which has no bearing on a traditional extract of the inflorescences. As usual, Kerry Bone does an admirable job of distilling the literature into meaningful, manageable, and well-organized evidence for clinical herbalism. The overall list of herbs does, however, bear a striking resemblance to the Mediherb product list, even including mention of proprietary extracts such as “hypericin enriched” St John’s Wort.

This is symptomatic of a problem that pervades the volume. It is no secret in the herbal community that Kerry Bone founded Mediherb Pty, an Australian extract company, with which he remains closely associated. However, when an executive of an herbal extract company writes a book on herbal extracts, then clarification regarding potential conflict of interest is in order. It is not hard to discern a bias towards Mediherb products which runs throughout the book. For example, Bone argues, rather overenthusiastically, in favor of using a 1:2 herb:menstruum ratio in hydroethanolic extracts. All dose information in the book is reduced to the 1:2 algorithm. Now this happens to be the default specification of Mediherb extracts, but is not at all common in either the UK or the USA, where 1:3 and 1:5 are more usual. While there is nothing wrong with 1:2, it is also not inherently superior.  Further, given the inherent but undivulged conflict of interest, some of Bone’s less obvious positions on controversial issues are harder to accept as objective. For example, he argues for the generic superiority of dried herb over fresh plant material for making extracts, and since Mediherb uses dried plant material, the reader is left in doubt here, and by extension, perhaps elsewhere where the point is not so obvious. If the text were repackaged as a Mediherb product manual, questions of bias would be sidestepped, but there should have at least been a clear disclosure of interest.

This is all a bit of a pity, because the book has some good features and discusses numerous issues that do not receive adequate attention outside the herb school classroom. For example, on the vexed issue of dosing in “drops” (gtt.) Bone conducted simple experiments with different viscosities and different dropper sizes. His results confirmed the fact that the size of a drop of a liquid is governed primarily by the surface tension of that liquid. Since this varies with the percentage of ethanol in a hydroethanolic extract, it follows that apothecaries’ drops are not really a reliable measure for accurate dosing of different herbal extracts.

It really seems that neither Kerry Bone nor Churchill Livingstone were quite sure of how to deal with Bone’s Mediherb association, and as a result avoided dealing with it altogether. Unfortunately this colors what is otherwise a useful book. With these qualifications, it is likely nonetheless that many herbalists will find the book a practical resource, and it would be especially suitable for inclusion in required reading lists in herb school curricula.

© 2004 Jonathan Treasure

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