The Commission E Monographs were imported into the United States with considerable fanfare in 1998 by The American Botanical Council. They were unequivocally endorsed in a foreword by the late Varro Tyler, a well-known professor of pharmacognosy at Purdue University. Tyler states in his foreword that "...safety data were reviewed by the Commissioners according to a "doctrine of absolute proof" and efficacy according to a "doctrine of reasonable certainty."
As a result of this heavy promotion, Commission E is frequently confused with books on alternative medicine in the USA; but in fact, it is an administrative law book for German national regulation of herbs. As such, the book has attracted criticism for having a covert government agenda to assist commerce that is incompatible with science, medicine, and traditional, as well as experiential herbalist, systems of healing.
The best known critic of Commission E is Jonathan Treasure, MNIMH, a UK licensed medical herbalist and author of numerous herbalism monographs
Treasure's lengthy review (31K) offers evidence in detail after detail that the book is not a work of science, medicine, or vitalist herbalism. Rather it is a book of German legal-medical regulations, since "In Germany, only those herbs with Commission E Approved status are (or will eventually become) legally available."