My #1 Method for Learning Herbs: The Clinical Monograph

The Best Way to Learn Herbal Medicine

Most people learn herbal medicine through books that offer a window into the traditions that have worked with herbs for a long time, and/or by learning from people who have done the same.  

However, in an ideal situation, you would also learn about herbs through your own direct experience — out in the fields, forests, and mountains, observing the plants in nature, touching, smelling, and tasting them, harvesting and preparing them. You would take them into your body to fully experience them. 

The best way to truly understand an herb is to balance intellectual study with experiential understanding. Otherwise, you run the risk of simply accumulating intellectual knowledge about plants. When you have a tactile, experiential understanding of the plants, you’re not just memorizing them; you’re learning them by heart. 

When it comes to the intellectual study of plants, it is vital to approach the process strategically, and the way we typically study medicinal plants, at least in Western herbalism, is through monographs. 

An herbal monograph is a focused report, and there are many types with varying focuses. In some herb books, there is a whole chapter on each herb. In most, it’s perhaps a page or two. In the less ideal herb books, a monograph might be a mere quarter or a third of a page. In that amount of space, it’s tough to learn all you need to know. 

Some monographs are botany-based or plant ID-based. You will find these types of monographs in bioregional plant ID books, for example. Some monographs include chemical and scientific analyses of the herbs, listing their constituents, biochemical mechanisms of action, and their pharmacodynamics and pharmacokinetics. Others are safety-oriented, listing the contraindications and drug interactions. Some have folklore, history, and ethnobotanical information, listing the ways various cultures have used them. Finally, we have clinical monographs.

The Clinical Monograph

As a practicing herbalist, I consider the clinical monograph the most important. Let’s go through some of the key features of the optimal clinical monograph — the main things you need for a monograph to be effective.  

Species-Specific Latin names

Latin names are essential when it comes to plants, because you can only be sure which plant you’re working with if you know the Latin name. There are many common names for each plant, and some common names overlap but refer to different plants. Sometimes, a common name refers to multiple species within a genus. So, there isn’t much clarity with common names alone. A species-specific Latin name allows you to pinpoint precisely which medicinal plant you’re learning about or using.

Fundamental Medicinal Properties – The Five Keys

From there, you really need to understand the herb’s fundamental medicinal properties. I call these the five keys for understanding plants holistically. We will not go into that here, but you need to list those five keys very clearly so you have a foundational understanding of the herb’s properties. In the free Herbal Monograph Map workshop, I go into much more detail on this topic, so be sure to check that out. 

Clinical Patterns and Uses

The next section you need to have in your monograph is clinical patterns and uses. You might call this the “good for” section, though that isn’t the best way to think about herbs, in my opinion. You need more detail than what an herb is “good for” when you’re thinking about how to use a medicinal plant.

Knowing that an herb is good for a headache is somewhat helpful. It is much more useful to know specifically that it’s a relaxant, nervine, spasmolytic, that is cooling and specific for occipital headaches. This gives you a clinical pattern to look for in a person so that you can match the remedy to them. For this reason, it is incredibly useful to have a clinical pattern section. In this section, you take the herb’s fundamental medicinal properties and weave them into an understanding of what to look for in people.

Safety Information and Contraindications

You must know your safety information. For example, is the herb contraindicated in pregnancy and lactation? Does it have major humoral contraindications? Do you need to avoid it with pitta constitutions or people with too much heat? Do you need to avoid it in people with too much damp accumulation, phlegm, or cold? Does it have any drug interactions — do you need to make sure that someone is not taking an SSRI when you administer this herb?

This is all vital information to have in your clinical monograph, especially at a time when most people are on some kind of medication. It is not uncommon for people to be on two or more medications, so you need to know how to work with these situations.

Extraction, Pharmacy, and Dosage

A clinical monograph should also include some pharmacy information. You need to know the most optimal way to extract and prepare an herb for medicinal use. Does it need to be administered as an infusion? Or as a decoction? Does it tincture well? If it does, what percentage alcohol should you tincture it in? At what strength ratio? 

You also need to include dosage information. Is this a low-dose herb? Wild Indigo, for example, should not exceed 10 drops per dose. On the other hand, you could administer 5 ml of Lemon Balm to an adult without a problem.

Having some basic pharmacy information is helpful because, as a clinician, you’ll be considering whether to use an herb for a particular person.

Here’s an example: You want to administer a formula as a tincture. You look up the pharmacy info for one of the herbs, Slippery Elm (Ulmus rubra), and realize you really can’t tincture it. So you know you need to offer a capsule or powder, or find another herb you can add to the tincture that will serve the same purpose. 

This is a very clinically relevant area of the monograph, because it’s good to have that information available at a glance. As a clinician, you’re busy, so it should be convenient to find that information. 

Formulation methods

Including formulation strategies in a monograph is very useful. What you include can be based on tradition, your formulation preferences, or on what your teachers have done. 

It is helpful to have lists of simple pairs, triplets, and even complete formulas that address the main clinical patterns you would consider for this herb, if only to trigger ideas.

For example, if you are considering using Pipsissewa (Chimaphila umbellata) to treat a urinary tract infection, you might consider which other urinary antiseptics to use alongside it. You might consider the berberine herbs. Yarrow (Achillea millefolium) might be a good option, or Juniper (Juniperus communis), Uva Ursi (Arctostaphylos uva-ursi), or Madrone (Arbutus menziesii).

Maybe the main herb you’re working with is a little harsh for the urinary tract, so you might want to combine it with a urinary demulcent. Then you consider your pairing options, such as Corn Silk (Zea mays), Couch Grass (Elymus repens), or Marshmallow (Althaea officinalis) — something to soften it a bit.

Thinking through how you might combine that herb, either to exemplify specific properties or to balance out other properties to make it more acceptable to a broader range of constitutions, and which other actions would synergize well with that herb, will save you time when you’re with a client. This can help you get the gears turning. We can’t memorize everything all the time, so it’s helpful to have some lists to get your brain working. 

Those are the key features of a good, clinically relevant monograph. As a practitioner, hopefully, you’re busy, but there is a balance. It’s nice to be busy because it means you have clients, which lets you make a living. However, it is also important not to be so busy that you’re stressed! If you do get busy, you probably won’t have time to pull out your herb books and compile them into a monograph that provides the depth you need to determine if it’s the right remedy for your client. There is a balance — you want all the information you need, but you don’t want it to be too long, complex, or time-consuming to sort through to determine whether it’s the right remedy for the situation. 

What You Don’t Need In Your Clinical Monographs

Many monographs contain information that is unnecessary or clinically irrelevant. It isn’t because the information isn’t good, interesting, or valuable. However, not all information is clinically relevant for a quick reference tool. You need to be able to check whether an herb is hot or cold quickly, its dosage range, tastes, etc., without superfluous details bogging you down.

Constituent Listings

Constituent listings are useful and interesting, but not always clinically relevant. Knowing a plant’s chemistry helps us determine the optimal way to extract an herb, so when you’re creating a monograph, it makes sense to include that information. However, simply knowing and understanding constituents is sometimes unnecessary. I often say that knowing your constituents doesn’t make you a better practitioner; it makes you a better herbal pharmacist.

Botany, Plant Identification and Morphology

Some books have very long descriptions of the herb — botanical descriptions,  identification, and morphological characteristics. That information is essential for a botany or plant ID book. If you’re out in the bush trying to identify a plant, obviously, you’ll need that information. However, in a clinical context, it isn’t relevant. 

Pharmacological Methods of Action

In plants, the chemistry provides pharmacological mechanisms of action, such as pharmacokinetics and pharmacodynamics. Not a lot of monographs contain this information because, to be perfectly honest, not a lot is known about that with herbs. This can really bog down a monograph, and isn’t necessary clinically, unless it truly pertains to contraindications and safety.

If you have herbs, for example, that affect the Cytochrome P450 detoxification pathways in the liver, that will affect the metabolism of certain drugs. So, it is helpful to know that an herb has that kind of pathway. St. John’s Wort is an example of that.

Why Writing Your Own Monographs Changes Everything

While referencing monographs is an excellent way to learn about medicinal plants, an even better way is to create your own monographs. After all, reading only goes so far!

Writing down information takes your learning to the next level. It is said that you really know something when you can teach it or when you’ve really taken the time to think it through. When you’re just reading about plants, it’s more passive. You sit there, read the monograph, then close the book, and walk away. It’s easy to forget everything you just read because most people read passively.

When it comes to studying plants and learning anything, really, I have noticed that I retain information significantly better when I write about it while actively reading. When I actively read, I hunt for patterns. I have multiple books spread out in front of me, and I say, “Okay, what are the similarities? What’s the crossover? Where are their differences? Where is this book saying something a little different from that book?” I have to figure out how to resolve the information, so to speak. This is especially true if there is conflicting information, which is pretty common.

I encourage you to write your own monographs, because it helps you retain the information. It lets you dig deep into a single herb. You can look through the lenses of Chinese medicine and Ayurveda, as well as those of traditional Western herbalism and modern science. You look at it through the eyes of this instructor, that teacher, and that author. The goal is to get a well-rounded understanding of that herb. Then, to consolidate all of that down and bring all that information together in a cohesive way, in a comprehensive monograph, that’s organized in a way that makes sense to you.

The Importance of Organizing in Your Own Way

Figuring out my own organizational structure was huge for me. I’m an organizational freak, and my mind functions in a very particular way. Oftentimes, when I look at how other people organize things, it doesn’t align with how I would organize them. Our minds all work in slightly different ways, so I encourage you to build your own herbal monographs and organize them in a way that makes sense to you. 

As you build your monographs, you can organize not only the individual monograph but also your collection of monographs in a multitude of ways to turn it into a cross-referencing database. What’s cool about, say, PDF documents is that they’re searchable. When you have your monographs as PDFs, you can create a single file, add shortcuts to it, and organize the folder structure so you can quickly and easily find what you’re looking for, saving time. This is how I personally organize my information when I need to look things up. 

I encourage people to type their monographs. Handwritten notes are great, but digital documents are especially useful because you have more flexibility with them. Here’s an example: On your computer, create a folder for each organ system. Within that organ system, you can create sub-folders organized by herbal actions associated with that system. Within a particular herbal action associated with an organ system, you can have a list of all the herbal monographs that correspond to that category. 

You can open “liver,” and within the liver category, you could have bitter tonics, choloretics, cholagogues, and hepatoprotectives. And then you could organize all of your herbs so that you know exactly where to find what you’re looking for. So that’s a very simple way you could do it.

If you use Google Drive or a similar service, you could create a Google document with all of the categories and listings, which then link to your monograph. So you could have the liver category, then hepatoprotectives, and a list of all your monographs in that category with links to each.

Under the heading of hepatoprotectives, you might have Milk Thistle, Reishi, Turmeric, and Dandelion, linked directly to the monographs. 

With either of the above options, you’ll have a reference tool that guides you to the herbs so that you can get your information quickly and easily. And I think that is key, especially when you become a busy herbalist — the more time you can save, the better.