Make Room on Your Desktop: Herbal ABC’s Needs a Spot

Review by Jacob Schor, ND, FABNO

Herbal ABC’s: The Foundation of Herbal Medicine by Sharol Tilgner, ND.

ISBN-10: 1881517047; c. 2018; 440 pp; $29.95

It’s been nearly twenty years since Dr. Sharol Tilgner published her first book in 1999. That first book, Herbal Medicine From the Heart of the Earth. has sat on my desktop ever since.

By desktop, I mean the shelf that sits above the cubby holes that separate my stapler, otoscope, thumbdrives etc., not the home screen on my computer. Tilgner’s first book is in good company; it shares space with my Merck Manual, Morrison’s desktop companion, Murphy’s homeopathic repertory, Fischbach’s manual of lab tests, and Kruzel’s homeopathic emergency guide. Tilgner is a valuable and trusted resource that has long been kept close at hand. I suppose I could practice without it but I would prefer not to try. After all these years of using Sharol’s book as a reference, I am hesitant to even pick up her new book.

She did something rather unique in that first book. She shared the herbal formulas she had created for her company Wise Woman Herbals. While one can guess the approximate proportion of different herbs in compounded formulas by reading the order of ingredients on the label, Sharol actually shared the percentages of each herb that she added. Perhaps that is why ‘from the earth’ earned its spot on the desktop. I use it all the time to create formulas. I’m what you might call a copycat herbalist. To me this was typical of Dr. Tilgner; it was just another example of her generosity of spirit.

Thus, I took up this new book with hesitation. Tilgner’s original book set the bar high and will be hard to top. I once worked for a large food corporation that set out to make a better Oreo cookie and challenge the long reign of Nabisco. For months we baked one batch of imitation Oreos after another and never came close to even matching the unique qualities of an Oreo in blinded taste tests. At first I worried that we would be in a similar pickle here, that trying to replace the original would be impossible.

Dr. Tilgner has nonetheless risen to the challenge and improved on her earlier book. Only fifty pages longer, the new book feels as if it contains far more information. The information feels easier to find. She’s shuffled the way the book is organized. In a way she has created a unified field theory of herbalism. The book is organized by body systems and the materia medica is incorporated into these system sections, sub-divided by herbal actions. That sounds complicated so let me give you an example. Under the chapter on the digestive system, she starts by reviewing the physiology of digestion, describing the organs of the digestive tract from mouth on down, talking about healthy function and diets that maintain that health before talking about herbs. She first covers nutritive herbs (burdock, chickweed, dandelion, nettle, oats, plantain, parsley and rose hips) then bitters, talking first about how they stimulate digestion spending several pages covering these actions and indications prior to speaking about specific herbs. She then highlights a few bitter herbs (gentian, horehound, and hops). She then covers carminatives the same way, describing the actions, indications and preparations before highlighting fennel, and caraway. Dr. Tilgner goes on to cover herbal laxatives, covering physiology first and then highlighting slippery elm, Oregon grape, cascara and senna. Parasites and anti-parasitic herbs, astringents, demulcents, mucilaginous herbs are covered in a similar manner starting with physiological effects, and several highlighted herbs rounding out each section.

The chapters and subsections flow so smoothly from one to the other that things seem to make sense and practicing herbal medicine seems like it is easier to do than my experience has been over the years. Actually with this book at hand, it might get easier. Ideas for formulas pop up as sidebars throughout the text. One need not reinvent the wheel.

Although each section that covers a particular herbal action under a physiologic system discusses a handful of selected herbs, one specific plant tends to be highlighted; I can easily imagine Sharol standing in front of a group of students holding the plant aloft, gracing the plant with special attention.

As mentioned, the book is divided into chapters by body system and each chapter begins with a summary of the physiology of that system. In the liver chapter, Dr. Tilgner devotes 22 pages to liver physiology and function. One might think this would not be adequate to cover everything one might need to know about the liver, but it is well written, surprisingly complete and readable, covering the majority of main points and even hitting some trivia that gave me pause. I learned things that I didn’t know. The main phases of liver detoxification are covered, and the CYP450 pathways along with their substrates, inducers and inhibitors are discussed in detail. Even specific enzymes are discussed in detail and not just the popular ones like CYP3A4, which by the way is induced by garlic, Siberian ginseng, St John’s wort, Panax ginseng, valerian, DHEA, nicotine etc., but the less popular enzymes such as CYP2D6 that is induced by alcohol and inhibited by hydrastis and black seed. Who knew?

Under inhibitors of glucuronidation, there is an interesting aside about curcumin and piperine. Recall how for a period this was the hot combination that was claimed to enhance absorption 20-fold. Dr. Tilgner discusses the theory that piperine inhibits glucuronidation and so increases curcumin action. Being the naturopathic herbalist that she is, she questions the modern tendency to add piperine to a range of herbs to increase action, what has become something of the elephant in the room, and asks politely whether, “… using piperine or eating a lot of black pepper or anything else that is meant to decrease glucuronidation could backfire on a person and lead to an increased cancer activity. Inhibitors of glucuronidation may expose a person to the ravages of toxins.” I think she’s asking the right question.

Liver herbs are then divided into the traditional categories of hepatoprotectives, cholagogues and choleretics…. It flows so smoothly and sensibly.

The book is well referenced with recently published studies where needed, giving the impression that although Dr. Tilgner is something of a traditionalist she keeps close tabs and is fluent in the recent advances in the science of botanical medicine.

In fact, I admit that this new book is a better book than her first one. She’s managed to balance a presentation of current science and biochemical knowledge of these plants into a framework of classic herbal actions and then speak about them sharing her hard-won knowledge about how to use them in clinical practice from a place of wisdom. One can learn a lot when one applies oneself to acquiring a skill for over a quarter of a century. Sharol certainly has an abundance to share. It doesn’t get much better than this.

Sharol Tilgner was an experienced herbalist when I first met her as a naturopathic student in Portland in the 1980s. No one batted an eye when she named her herbal company “Wise Woman Herbals” before she had even graduated; she had already earned that title in our eyes. Thirty years later, she’s graduated from being our wise woman to, on some level, even more sage. This book is proof of it. I count myself lucky to have lived long enough to view the fruit of her decades of practice.

Now my only problem is making room for this book on my desktop.