Mai Men Dong Tang-dosage variation

[Guest guest]

Dear collegues,

 

Last week I received the new Chen and Chen " Chinese Herbal Formulas and

Applications. "   It's quite a book--all 1600+ pages of it!    It is very readable

and covers formulas that heretofore I was not aware of.  As with their earlier

book,  " Chinese Medical Herbology and Pharmacology, "   the is extensive biomedical

research and application as well.   

 

Specifically, I happened to notice that on the listing of ingredients and

dosages for Mai Men Dong Tang, they list a dosages of 60-70g of Mai Men Dong and

10-18g of Ban Xia.  In the section of Author's comments they explain, " Because

Mai Dong is mild in potency, a large amount (60-70g) is needed or the effects

will not be realized. "   Has anyone heard of this before?

 

To compare: in Bensky and Barolet the doses listed are:15-18g and 4.5-9g

respectively, (though they mention in their analysis that " some sources

recommend a doseage of as much as 45 g of this herb " ).

                 In Yeung  the doses listed are:  15-20g and 6-9g

respectively,        

In Wiseman and Ellis the doses listed are:    9-18g and 5-6g       "

       and in Maciocia  the doses listed are:       60g and   9g        "

 

Obviously there are differences of opinion as to whether MMD is effective only

in larger doses in cases of vacuity.  Chen and Chen also point out that the

relatively large dose of Ban Xia ( which no one else mentions!) serves as a

check and balance with Mai Men Dong, to quote them, " These two herbs also

provide mutual checks and balances, as MMD controls the drying nature of

BX while BX checks the cloying nature of MMD. "

 

Comments?

 

 

 

 

 

 

 

 

 

[Guest guest]

, yehuda frischman

< wrote:

>

Chen and Chen also point out that the relatively large dose of Ban Xia

( which no one else mentions!) serves as a check and balance with Mai

Men Dong, to quote them, " These two herbs also provide mutual checks

and balances, as MMD controls the drying nature of BX while BX checks

the cloying nature of MMD. "

 

 

This idea about the opposing yet complementary nature of mai men dong

and ban xia in mai men dong tang is very widespread in the literature.

Basically all Chinese formula texts draw attention to this dui yao in

similar terms, and these eloquent combinations are precisely what

makes Zhang Zhong-Jing's formulas so distinctive.

 

As for your dosage question, no one has the final answer. The

original Jin Gui specified 7 sheng of mai dong and 1 sheng of ban xia,

but there is disagreement as to the volume represented by the later

Han Dynasty sheng measurement, so the corresponding dosage is

uncertain. One major curriculum text ( " 5th edition teacher's book " )

recommends 60 g mai dong and 18 g ban xia, while another major

curriculum text ( " 7th edition student's book " ) recommends 42 g mai

dong and 6 g of ban xia.

 

Eric Brand

[Guest guest]

Dear Eric,

 

Even if it isn't  clear what measure a sheng represents, isn't the ratio of 7:1

pretty clear from the   " Jin Gui Yao Lue? "   Could you also comment on Chen and

Chen's statement that  " Because Mai Dong is mild in potency, a large amount

(60-70g) is needed or the effects

will not be realized. " ?  And as a counterpoint, just how high of a dose of Ban

Xia have you seen mentioned in the literature.

 

Thanks very much,  

 

 

 

 

 

 

--- On Mon, 12/22/08, Eric Brand <smilinglotus wrote:

 

Eric Brand <smilinglotus

Re: Mai Men Dong Tang-dosage variation

 

Monday, December 22, 2008, 4:29 PM

 

 

 

 

 

 

, yehuda frischman

<@.. .> wrote:

>

Chen and Chen also point out that the relatively large dose of Ban Xia

( which no one else mentions!) serves as a check and balance with Mai

Men Dong, to quote them, " These two herbs also provide mutual checks

and balances, as MMD controls the drying nature of BX while BX checks

the cloying nature of MMD. "

 

This idea about the opposing yet complementary nature of mai men dong

and ban xia in mai men dong tang is very widespread in the literature.

Basically all Chinese formula texts draw attention to this dui yao in

similar terms, and these eloquent combinations are precisely what

makes Zhang Zhong-Jing's formulas so distinctive.

 

As for your dosage question, no one has the final answer. The

original Jin Gui specified 7 sheng of mai dong and 1 sheng of ban xia,

but there is disagreement as to the volume represented by the later

Han Dynasty sheng measurement, so the corresponding dosage is

uncertain. One major curriculum text ( " 5th edition teacher's book " )

recommends 60 g mai dong and 18 g ban xia, while another major

curriculum text ( " 7th edition student's book " ) recommends 42 g mai

dong and 6 g of ban xia.

 

Eric Brand

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

[Guest guest]

, yehuda frischman

< wrote:

>

> Dear Eric,

>

> Even if it isn't clear what measure a sheng represents, isn't the

ratio of 7:1 pretty clear from the " Jin Gui Yao Lue? "

 

Dear Yehuda,

 

Remember that a sheng is a volume measurement, not a weight

measurement. Ban xia is denser and harder than mai men dong, so it

will have a greater weight at the same volume. Some of the Chinese

textbooks do have a 7:1 ratio (42g:6g), but others do not. We can't

assume that the two should have a 7:1 ratio by weight, though.

Another variable is the fact that the processing method of ban xia at

the time of the Jin Gui was likely different than it is now, it is

clear that in JG times they took measures to reduce Ban Xia's

toxicity, but it is not clear exactly what process they used.

 

 

Could you also comment on Chen and Chen's statement that " Because Mai

Dong is mild in potency, a large amount (60-70g) is needed or the effects

> will not be realized. " ? And as a counterpoint, just how high of a

dose of Ban Xia have you seen mentioned in the literature.

 

Like I said before, the few books I checked give a range from 6-18 g

for the ban xia. As to the question of how much mai dong or ban xia

is needed clinically, I suppose that would depend on other factors

like the disease being treated, the strength of the disease, the

constitution of the patient, the modifications to the formula, etc.

Many classical formulas have wide ranges of use and are often used in

dosages that vary from the original. Xiao chai hu tang is a perfect

example, it traditionally uses a huge amount of chai hu and is often

used for a wide range of conditions. We rarely use it based on the

exact presentation stated in the Shang Han Lun, and we often modify

the dosage of its ingredients.

 

Sorry I can't be of more help. John and Tina Chen's book is based on

primary sources, so no doubt their original statement came from a

reliable source. But Chinese medicine has many many primary sources

that offer different perspectives, so we need to think dynamically

about the nature of the herbs and the nature of the diseases that we

are treating, Shang Han Lun and Jin Gui is just the foundation, not

the comprehensive final conclusion.

 

Eric Brand