COMPLIANCE

[Guest guest]

I'd like to know the other practitioners' experiences with patient's

compliance in herb-

taking. I have discovered that my patients are already taking so many

supplements

and herbs that they are reluctant to add more to their regimen. Perhaps I am

not educating them enough about the function of the chinese herbs (in pill

form) for them to maybe drop some of their current self-medicating selections

- st. johns wort, mild thistle, say palmetto, ginseng, etc. - whatever they

have discovered on their own. It seems the average user of alternative

medicine is educated in herbs from the media and advertising. How is the

compliance with raw herb prescriptions?

 

Sherril Gold, AP

sherrilgol

[Guest guest]

Compliance seems to vary depending on several factors, the main one

being the seriousness of the ailment. Those with the most to gain are

the most compliant. However, even this group needs an extra perk. I

have also found that no one will put up with the herbs in tea form if

they do not get substantial relief in a short period of time. Pills

will generally not give this short term satisfaction in symptom relief

in most cases, so education for the long haul is crucial. I also have

run into the situation quite commonly where even taking pills is hard

because they are already taking so much other stuff (supplements and

drugs).

 

first, if the supplements were prescribed by a licensed practitioner

other than yourself, you really can't give any advice at all in that

regard. However, if patients are self medicating with herbs, this is an

opportunity to explain why this is not good. I usually talk aboout

differential dx in lay terms to show why haphazard use of herbs is only

a shade better than using drugs. I also try and point out that since

they are paying to see me, they should take advantage of my expertise

and get an individulized formula. The tricky part is if they are

getting a perceived benefit from their OTC supplement. I say perceived

benefit because the majority of self medicators are taking cheap, low

quality herbs at dosages far too low to have any substantial true

benefit. But a placebo benefit is often harder to wean a patient from.

 

If you can't tactfully get them off other herbs, just be thankful that

they are probably having no pharmacological effect at all. But if the

patient will still not add chinese herbs to their regimen or you are

concerned that their self medication is actually causing ill effects,

than what to do? If I feel that patient's refusal is really bad for

their health, I will come right out with it and tell them so.

Basically, we need to remember that no medicinal substance is neutral.

It pushes the body in one direction or another, sometime multiple

directions at once. but they have action in the body; they do not just

promote harmony. Thus, if an herb is not the right medicine for you ,

it is the wrong one.

 

Even if you get symptom relief, that is meaningless. If that were the

only criteria, then opium is clearly the pain reliever of choice,

because nothing works better on the branch sx of pain. I mean why

bother to move blood or expel wind damp, because these herbs do not even

scratch the surface of pain that opium can easily banish for hours?

Ludicrous, right? Or how about coffee or guarana for chronic fatigue

syndrome? Way better than milder chinese herbs for quick sx relief, but

long term good? I think not? Sometimes painting an outlandish analogy

can be very helpful.

 

[Guest guest]

I've found that compliance with the tea pills is surprisingly high as there

are so different from anything my clients have come in contact with. Being in

SW FL. most of the people I see are retired and just will not drink the

decoctions mostly because of the taste but also because of the effort

required to cook it. Tea pills are small and easy to swallow with the elderly

this is important.

[Guest guest]

Hi Howard

I want to speak to your concern. I think it is true that most people find

taking herbs unpalatable at first, but I found that what your teachers said

is true: if they are serious about getting better - they will take their

medication. However, boiling herbs is not a form that my clients will take

under the best of scenarios for any length of time. I opt for the powdered

extracts - sometimes in capsules, usually in hot water. People do get used to

their taste after a while if they see results.

However, if you were to work with native born Chinese, Japanese, or Koreans -

they think nothing of taking the herbs home and decocting them daily - I

watch them do it in my teachers clinic every day - so cultural values have a

significant part to play. We expect to do little and get a lot of results in

this society, we don't even have to exercise or use restraint to loose weight

anymore - just take fat burners while we sleep (or so we seem to think). So

the first step is to implant the idea that your clients health is their

primary concern and is truly in their hand. When they see some definite

changes that they have created themselves, the next step of compliance is

easier although never easy.

I was a clinical therapist for 20+ years and compliance with non-medication

regimes were difficult if the person thought that they could not influence

the outcomes. Once they understand that they can truly make a difference in

their health and life by what they do - things change - for the better

usually.

 

something to consider anyway. Thanks for listening.

Jim Chaffee L Ac

Marlboro Ma

[Guest guest]

Todd:

Just thought I 'd add my two cents as this subject finally allows me to

offer an opinion! As a student in my second year of TCM study, I have found

the various herbal decoctions to be almost unpalatable. The pills are tiny

and require multiple dosing. When I bring this point up to my instructors,

they inevitably answer with " If the patient wants to get well, they will

take the herbal remedy. " Nothing could be further from the truth. I come

from a pharmaceutical background and patient compliance is even awful with

qd dosing! Compliance drops off dramatically with b.i.d.and t.i.d. regimens

not to mention multiple pills! This has been the one subject that has truly

bothered me since beginning my schooling in TCM. To think that a patient

will spend 1- 1-1/2 hours a day making a decoction is naive and sets both

practioner and patient up for failure. I would love to hear some feedback on

compliance esp. the elderly since those pills are so tiny. I can't imagine a

geriatric population being able to take 15 tiny pills t.i.d.! What about

tinctures?

 

thanks

Howard Portman

Student!

[Guest guest]

Re: herbal decoctions, I've said this before on compliance, but I've had very

little difficulty in getting patients to both cook and drink their teas.

What I have found true, is that the proper formula is quite palatable, even

being described as tasting good when the patient first starts taking it. As

it starts working and the patient becomes stronger, the flavor begins to

deteriorate to the point of being unpalatable when the formula is no longer

needed. This makes total sense to me, as the herbs are not teas, but

medicinals, and as being such, are not meant to be taken unless indicated.

If they tasted good all the time, they would be misused.

 

Two cases as illustration:

The first was a patient going into anaphylactic shock from penicillin. After

emergency acupuncture, a tea was administered with the main ingredient being

di long. We all know how this smells, let alone tastes. The patient

described the tea as tasting like sweet water - for the first 3 cups. By the

fourth, she was quite recovered and the tea began to make her gag.

 

As the second example, I had an abscessed tooth, and was prescribed a

decoction with mo yao and ru xiang and many heat-clearing herbs. It was

totally drinkable - until the abscess receded, as which time I couldn't even

handle the odor. I no longer needed the formula.

 

Although it is true that some patients cannot handle the decoctions due to

weak spleens, but in such cases, I have them water them down to where they

can manage, and this works for them.

 

I'm also battling the self-dosing from the health food stores, but when I

explain the situation to patients, ie: insufficient medicinal dose, false

health-claims, high price and unreliable information on herbal properties and

usage, they usually stop buying them. Cayenne is a major problem for me as

it is touted as a cure-all for heart problems and prevention; and St. John's

Wort is being consumed by the gallon, yet very few patients claim that it

helps them. Melatonin in another one, but so far has been sucessfully

overcome with point an-mian.

 

I do not typically prescribe pills as I do not believe that their preparation

produces the desired result. If a patient absolutely refuses to drink herbs,

then just go with acupuncture more often, explaining the need for increased

treatments and how their refusal to comply will lengthen their recovery time.

After a few treatments with results, they usually will agree to try a

decoction.

Gina

[Guest guest]

Hello all,

 

I only have a couple of comments regarding this:

 

1. Patients (any patient) might take raw formulas if they really want to get

well. I have a 84 yo patient that has been taking a raw formula for over 5

months. ( I started to periodically break it up for a week of two with the

same formula in a powdered extract form after over three months of raw

formulas).

 

2. I think Todd comment on OTC herbs is incorrect (for the most part) many

of the OTC herbs are very good quality and people can easily get an

appropriate medicinal dosage. I agree there is a lot of crap out there, but

there are a lot of good preparations out there as well. Further, regarding's post, how can a TCM trained practitioners have any opinion on

something like St. John's Wort or Saw Palmetto? Do any of you have an

understanding of how these herbs function (from the TCM view)? How can you

in good conscious advise your patient about these herbs? Also to Todd's post

why can't you discuss supplements or drugs prescribed by another health care

professional? All practitioners make mistakes, perhaps your patient would

benefit a great deal from you having this discussion with them.

 

3. I agree with Todd (and others) that how you present the medication has a

great deal to do with how your patient will react to your medication. I like

to try to get every patient to at least try raw herbs. This sometimes

backfires but even when patients don't like it they have been exposed to it

and I think that is good. Further, your assesment of the patient (ie sizing

them up), your approach to them taking any medication and how you actually

" present your case " is of critical importance. Most patients want to feel

like you know what your taking about and want to try anything that might

help (given that what they are in for is really bothersom or worse). One of

my teachers used to say that clinical work is at least 50% theatrical. He

meant that how you present yourself to your patient has a lot to do with how

they comply and heal, I couldn't agree more and I take this to heart with

each and every patient. A good dx, tx plan and px is only good if there is

complience. If you patient believes in you they will try almost anything,

that is my experience.

 

 

Chinese Herbology and Acupuncture

 

 

" Serve others and cultivate yourself simultaneously "

Lao Tzu

[Guest guest]

I have been saying for twelve years, over and over, to everyone, that

EXTRACTS (water alcohol, low temperature, closed vessel) are the best

prepared medicine delivery system for Chinese polypharmacy herbal formulas.

They are concentrated, dosage is relatively controlled (i.e. can be

regulated), and can be modified by combining with other ingredients or

prescriptions. I have little if any problem with patient compliance. . .it

is easy to take one-half to one dropper, two or three times a day (more in

acute attacks), and even children and elderly compliance is good.

 

 

 

 

 

 

 

 

 

> " hp " <hnp

>

>Todd:

>Just thought I 'd add my two cents as this subject finally allows me to

>offer an opinion! As a student in my second year of TCM study, I have found

>the various herbal decoctions to be almost unpalatable. The pills are tiny

>and require multiple dosing. When I bring this point up to my instructors,

>they inevitably answer with " If the patient wants to get well, they will

>take the herbal remedy. " Nothing could be further from the truth. I come

>from a pharmaceutical background and patient compliance is even awful with

>qd dosing! Compliance drops off dramatically with b.i.d.and t.i.d. regimens

>not to mention multiple pills! This has been the one subject that has truly

>bothered me since beginning my schooling in TCM. To think that a patient

>will spend 1- 1-1/2 hours a day making a decoction is naive and sets both

>practioner and patient up for failure. I would love to hear some feedback on

>compliance esp. the elderly since those pills are so tiny. I can't imagine a

>geriatric population being able to take 15 tiny pills t.i.d.! What about

>tinctures?

>

>thanks

>Howard Portman

>Student!

>

>>Chronic Diseases Heal - Chinese Herbs Can Help

[Guest guest]

I agree here.

I learned many years ago from Robert Zeiger, from Berkeley, that raw herb

decoctions should have relatively few ingredients, and be palatable in

order to be accepted by the spleen and stomach without damage. This is

especially important if they are to be taken for an extended period. Many

modern clinics, both here and in China, use very large prescriptions with

many ingredients at high dosage. I've seen at the PCOM school clinic that

these are not well tolerated by patients. A more Shang Han Lun style, with

five to eight ingredients would be more appropriate. Also, many new

practitioners and students 'load on' the ingredients without matching them

properly. . .this can lead to iatrogenic difficulties, beginning with

serious digestive responses.

 

We need to get over this attitude that 'real herbalists use only

decoctions'. All forms of herb preparation are valuable and valid, if the

potency, quality, and intelligent formulation is there.

 

To quote Xu Da-chun, from the Yi xue liu lun/Forgotten Traditions of

Ancient (Ch 14, " On the Inadequacy of Decoctions to

Completely Cure Illnesses " ): " Decoction (tang) stands for agitation (tang).

Decoctions move fast. Their substance is light, their strength quickly

subsides and does not stay. Their effects are especially fast when it

comes to illnesses affecting the ying or wei, the intestines or stomach.

IN ALL OTHER ILLNESSES, either pills, powders or pastes may be appropriate " .

 

Z;ev Rosenberg

 

 

 

 

 

>Fourwolves

>

>

>Re: herbal decoctions, I've said this before on compliance, but I've had very

>little difficulty in getting patients to both cook and drink their teas.

>What I have found true, is that the proper formula is quite palatable, even

>being described as tasting good when the patient first starts taking it. As

>it starts working and the patient becomes stronger, the flavor begins to

>deteriorate to the point of being unpalatable when the formula is no longer

>needed. This makes total sense to me, as the herbs are not teas, but

>medicinals, and as being such, are not meant to be taken unless indicated.

>If they tasted good all the time, they would be misused.

[Guest guest]

Who makes such a product? Website or 800# please.

 

 

" " <zrosenberg

 

I have been saying for twelve years, over and over, to everyone, that

EXTRACTS (water alcohol, low temperature, closed vessel) are the best

prepared medicine delivery system for Chinese polypharmacy herbal formulas.

They are concentrated, dosage is relatively controlled (i.e. can be

regulated), and can be modified by combining with other ingredients or

prescriptions. I have little if any problem with patient compliance. . .it

is easy to take one-half to one dropper, two or three times a day (more in

acute attacks), and even children and elderly compliance is good.

 

 

 

 

 

 

 

 

 

> " hp " <hnp

>

>Todd:

>Just thought I 'd add my two cents as this subject finally allows me to

>offer an opinion! As a student in my second year of TCM study, I have found

>the various herbal decoctions to be almost unpalatable. The pills are tiny

>and require multiple dosing. When I bring this point up to my instructors,

>they inevitably answer with " If the patient wants to get well, they will

>take the herbal remedy. " Nothing could be further from the truth. I come

>from a pharmaceutical background and patient compliance is even awful with

>qd dosing! Compliance drops off dramatically with b.i.d.and t.i.d. regimens

>not to mention multiple pills! This has been the one subject that has truly

>bothered me since beginning my schooling in TCM. To think that a patient

>will spend 1- 1-1/2 hours a day making a decoction is naive and sets both

>practioner and patient up for failure. I would love to hear some feedback on

>compliance esp. the elderly since those pills are so tiny. I can't imagine a

>geriatric population being able to take 15 tiny pills t.i.d.! What about

>tinctures?

>

>thanks

>Howard Portman

>Student!

>

>>Chronic Diseases Heal - Chinese Herbs Can Help

 

Chronic Diseases Heal - Chinese Herbs Can Help

[Guest guest]

regardless of what a patient MIGHT be doing, in my experience, the vast

majority are taking low quality herbs at inadequate dosage. I never

said there were not good herbs out there or that you couldn't increase

the dose, but that is not the typical reality in MY practice. Most

patient now get their supplements on the web or at rite-aid and low

price is their only criteria. As we all know, the herb market is

unregulated and is now dominated by large corporate interests who only

care about their bottom line. We know good suppliers, but our patients

do not and many of them do not realize no one is watching the shop, so

to speak.

 

 

As to the TCM properties of saw palmetto and the like, we don't know

them and that is the reason to advise patients not to self-medicate.

With all due respect to thomas, the state of Oregon considers it a

breach of ethics to alter another practitioner's regimen uness the

patient has discontinued treatment or the original prescriber is

consulted. So I would tread lightly in this area. To suggest to a

patient that another practitioner scewed up is very dangerous legal

territory, as well (defamation of character).

 

 

" " <>

 

Hello all,

 

I only have a couple of comments regarding this:

 

1. Patients (any patient) might take raw formulas if they really want to get

well. I have a 84 yo patient that has been taking a raw formula for over 5

months. ( I started to periodically break it up for a week of two with the

same formula in a powdered extract form after over three months of raw

formulas).

 

2. I think Todd comment on OTC herbs is incorrect (for the most part) many

of the OTC herbs are very good quality and people can easily get an

appropriate medicinal dosage. I agree there is a lot of crap out there, but

there are a lot of good preparations out there as well. Further, regarding's post, how can a TCM trained practitioners have any opinion on

something like St. John's Wort or Saw Palmetto? Do any of you have an

understanding of how these herbs function (from the TCM view)? How can you

in good conscious advise your patient about these herbs? Also to Todd's post

why can't you discuss supplements or drugs prescribed by another health care

professional? All practitioners make mistakes, perhaps your patient would

benefit a great deal from you having this discussion with them.

 

3. I agree with Todd (and others) that how you present the medication has a

great deal to do with how your patient will react to your medication. I like

to try to get every patient to at least try raw herbs. This sometimes

backfires but even when patients don't like it they have been exposed to it

and I think that is good. Further, your assesment of the patient (ie sizing

them up), your approach to them taking any medication and how you actually

" present your case " is of critical importance. Most patients want to feel

like you know what your taking about and want to try anything that might

help (given that what they are in for is really bothersom or worse). One of

my teachers used to say that clinical work is at least 50% theatrical. He

meant that how you present yourself to your patient has a lot to do with how

they comply and heal, I couldn't agree more and I take this to heart with

each and every patient. A good dx, tx plan and px is only good if there is

complience. If you patient believes in you they will try almost anything,

that is my experience.

 

 

Chinese Herbology and Acupuncture

 

 

" Serve others and cultivate yourself simultaneously "

Lao Tzu

 

Chronic Diseases Heal - Chinese Herbs Can Help

[Guest guest]

I think bulk herbs are an outmoded form of treatment for the general

population. With powders, you can bulk strength when necessary and pare

back for long term use. While I advocate high dose, we should consider

Zev's position on long term high dose rx, too. What constitutes high

dose? What is the minimum dose? I use sometimes the equivalent of

100-125 g/day of herbs in early stages of serious illnesses. However,

long term, it's more like the equivalent of 30-75 g/day. Is anyone

suggesting that doses below a 30g/day equivalent are effective? I've

asked this before. Has anyone seen great relief from lupus or hep c

with low dose prodcuts?

[Guest guest]

>Who makes such a product? Website or 800# please.

>

>K'an Herb Company. . . .1-800-543-5233

 

 

[Guest guest]

Z'ev

 

I have never been able to figure out from K'an literature how much raw

herb is used to produce the final extract. What I need to know is how

much raw herb is used to produce an ounce of liquid.

 

Also, while there is no doubt that the kanherb process extracts all the

active constituents from the herbs, is this always desirable? Water

decoctions do NOT extract everything, thus aren't dried decoctions more

faithful to an actual decoction? On the other hand, pills and pastes

contained all the active ingredients, not just water soluble. Thus,

those forms might be more similar to products like kanherbs.

 

However, this then begs the question, why bother to do an extract at

all? Ground dried herbs have all the same stuff in them? I think this

is where we get into the dosage issue? A person might need to take 25

large vitamin style tablets per day (like ITM literature recommends for

Seven forest products). Obviously, taking a few droppers is better.

But what is the real dose of these liquid products? This is something I

insist on knowing.

 

Also, contrary to xu da-chun, zhu dan xi appears to frequently use

longterm administration of decoctions (for months sometimes). Isn't

this correct?

[Guest guest]

Hi Thomas

I don't about other schools but I know that NESA taught us only about

decoctions and extracts. About making pills, extracts, etc I am totally

unfamiliar.

Jim Chaffee

 

PS

I have to say however, that I cannot forsee a time when I would want to use

other than extracts or decoctions unless they were premade patents.

[Guest guest]

Zev can confirm or rebut this but I believe Kan and others like them are

making their extracts at 5:1 which means that for every ml of extract there

is 5g of herb.

As to Todd's comment/question regarding having " all " the constituents

present in a extraction like Kan's, I have had the same concerns. This

process does NOT accurately represent the original decoction. When you add

alcohol to the mix, as it were, you get a whole different product. I'm not

saying that this is wrong or bad, only different. To my mind this means that

the product could very well act quite differently and your clinical results

may be altered. I personally have very little experience with those products

but make my own that are similar, only less concentrated due to the

expensive equiptment needed to make this type of extract. I find that for

some preparations alcohol preps are better, ie wind-damp bi pain, but for

others I don't think they work as well, ie yin vacuity (especially with

vacuity heat). Alcohol is warm and stimulating in small doses and this alone

will effect the properties of the prep. Look forward to your comments Z'ev!!

 

 

Chinese Herbology and Acupuncture

 

 

" Serve others and cultivate yourself simultaneously "

Lao Tzu

[Guest guest]

Todd said:

> As to the TCM properties of saw palmetto and the like, we don't know

> them and that is the reason to advise patients not to self-medicate.

> With all due respect to thomas, the state of Oregon considers it a

> breach of ethics to alter another practitioner's regimen uness the

> patient has discontinued treatment or the original prescriber is

> consulted. So I would tread lightly in this area. To suggest to a

> patient that another practitioner scewed up is very dangerous legal

> territory, as well (defamation of character).

 

I didn't mean to suggest that you tell the patient that you think another

practitioner screwed up! And I certianly didn't mean to suggest that you or

any practitioner change another practitioners regimen. This is obviously

poor ethics, at best. BUT if you think they did screw up, it is my ethical

duty to educate the patient, without suggesting anything, and let them

decide for themselves. Of course you need to suggest that they consult their

other practitioner before changing any meds or therapies.

[Guest guest]

I have heard this concern from others for some time now. . . . .and have

never seen it in clinical practice, over ten years of using the extracts

(and, yes, I do think they are 5:1). I use such formulas as yin qiao san,

long dan xie gan tang (quell fire) and other heat-clearing formulas without

observing heat reactions in the patients. I have not seen aggravations in

yin xu patients as well. What I HAVE seen is that anyone who is a

recovering alcoholic should not use these extracts.

 

I don't think decoctions are the perfect gold standard. . . .I think that

there are problems of dosage with boiling herbs, considering length of

time, amt of herbs, amt of water, cooking some ingredients for a longer or

shorter time, some herbs in cloth bags, etc. Some formulas are so complex

to prepare that if I need a decoction, I will often prepare it myself for

patients and have them bring a thermos to bring it home in. However,

sometimes decoctions are the right thing. We should be familiar with all

methods of administration of medicinals. . . from compresses to nasal

douche to steam to decoction to pill, wine, etc.

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

> " " <>

>

>

>

>Zev can confirm or rebut this but I believe Kan and others like them are

>making their extracts at 5:1 which means that for every ml of extract there

>is 5g of herb.

>As to Todd's comment/question regarding having " all " the constituents

>present in a extraction like Kan's, I have had the same concerns. This

>process does NOT accurately represent the original decoction. When you add

>alcohol to the mix, as it were, you get a whole different product. I'm not

>saying that this is wrong or bad, only different. To my mind this means that

>the product could very well act quite differently and your clinical results

>may be altered. I personally have very little experience with those products

>but make my own that are similar, only less concentrated due to the

>expensive equiptment needed to make this type of extract. I find that for

>some preparations alcohol preps are better, ie wind-damp bi pain, but for

>others I don't think they work as well, ie yin vacuity (especially with

>vacuity heat). Alcohol is warm and stimulating in small doses and this alone

>will effect the properties of the prep. Look forward to your comments Z'ev!!

>

>

>Chinese Herbology and Acupuncture

>

>

> " Serve others and cultivate yourself simultaneously "

> Lao Tzu

>

>>Chronic Diseases Heal - Chinese Herbs Can Help

[Guest guest]

> sometimes decoctions are the right thing. We should be familiar with all

> methods of administration of medicinals. . . from compresses to nasal

> douche to steam to decoction to pill, wine, etc.

>

>

 

 

Agreed, but the fact is that most schools, if any other than SW, teach any

prep class and almost all the TCM folks that I have talked to don't know

anything about these and I think this is a major weak spot in TCM education

in the US.

 

 

Chinese Herbology and Acupuncture

 

 

" Serve others and cultivate yourself simultaneously "

Lao Tzu

[Guest guest]

> " " <>

>

>> sometimes decoctions are the right thing. We should be familiar with all

>> methods of administration of medicinals. . . from compresses to nasal

>> douche to steam to decoction to pill, wine, etc.

>>

>>

>

>

>Agreed, but the fact is that most schools, if any other than SW, teach any

>prep class and almost all the TCM folks that I have talked to don't know

>anything about these and I think this is a major weak spot in TCM education

>in the US.

>

 

 

Agreed. We are trying to redress this weakness for the future at PCOM.

 

Z'ev

[Guest guest]

Pao Zhi is integrated in introduction to herbs at Emperor's College, however it

is insufficient and we are examining other ways of developing real experience

with preparations.

 

Will

 

wrote:

 

> " " <zrosenberg

>

> > " " <>

> >

> >> sometimes decoctions are the right thing. We should be familiar with all

> >> methods of administration of medicinals. . . from compresses to nasal

> >> douche to steam to decoction to pill, wine, etc.

> >>

> >>

> >

> >

> >Agreed, but the fact is that most schools, if any other than SW, teach any

> >prep class and almost all the TCM folks that I have talked to don't know

> >anything about these and I think this is a major weak spot in TCM education

> >in the US.

> >

>

> Agreed. We are trying to redress this weakness for the future at PCOM.

>

> Z'ev

>

> > Chronic Diseases Heal - Chinese Herbs Can Help

[Guest guest]

I have recently begun working chinese herbs as to making preparations. My

background is in western herb processing and spagyrics.

 

I had studied something similar to pao zhi in India for processing ayurvedic

therapeutic substances. I purchased the translation of Sioneau's book and other

works that describe processing and phytochemicals present in Chinese herbs..

Here is the first statement; the books are vague at best and if one is preparing

ie roasting etc herbs based only on having read descriptions than i would

venture to say that this is a risky and incomplete approach.

 

I studied pharmaceutical arts as a benedictine monk in France and the art of

medecine preparing is not something to be learnt from a book; you must see,

hear, smell and taste it done by someone who has experience.

 

Here is another piece of news; raw herb quality varies greatly from place to

place; I obtained samples of tienchi, jujube berries , eucommia (sp) , angelica

sinensis and aconitum. Wow, quite a lot of variety in quality. Having seen

this, I think people should find a good manufacturer. But I digress.

 

I examined assorted books where the formulas and uses were discribed and cross

referenced with scientific descriptions of phytochemicals present in raw herbs.

My conclusions were;

 

In some cases, classical processing will decompose some of the phytochemicals

present in raw herbs; good or bad ? that is up to the therapist to decide. But

if you are cold percolating a herb that is normally decocted, you may not be

getting the same product. Because some times the classical processing also

induces saponification, esterification and thingsrequiringclarification that are

going to keep me busy over the next 20 years so this part time degree in TCM

that I am doing is serving as backdrop rather than a primary factor in research.

 

Now for a practical example; tienchi and other ginseng like plants. Ginsensides,

like glycosides, are not fond of heat and PH changes. this tends to have them

decompose, turning into expensive sweeteners. My advice: run 300ml of 70 %

alcohol through 600 grams of root as percolation. The result, in my case, if

taken a teaspoon in the morning and evening in cold green tea took care of a

6month long knee injury that hundreds of little pills barely made notch in. It

can be a little rough on the lower digestive tract but I suspect that if I do a

high temp extraction of the marc in a soxhlet using water and alcohol and add

this to the percilating menstruum for the next batch this should alleviate the

problem. Ginsengs do contain resins, gums, essential oils , polysachs etc.

 

I am aware that ginsengs are made into teas, steamed, eaten raw, cooked in TCM.

Along with the multiple preparation methods come multiple uses. And with

research, I think we can find more uses and processing methods.

 

Gilbert

[Guest guest]

I really appreciate hearing your point of view, Gilbert, and hope you will

continue to contribute to this list.

 

I agree that the translated Chinese literature is sketchy. . . .I wonder

sometimes if the herbal preparation techniques (as well as seed stocks) are

carefully guarded by the herb industry in China to protect it from

competition. I also agree, from my own experience in taking courses in

herbal pharmacognosy (with Michael Moore), that working with plants

directly, including harvesting and preparation gives a dimension that

books cannot. I also agree, as I've discussed in previous posts, that

there are pros and cons to all preparation methods, including traditional

decoctions.

 

 

 

 

 

 

 

 

 

 

 

 

 

> " Gilbert Arnold " <ArnoldG

>

>I have recently begun working chinese herbs as to making preparations. My

>background is in western herb processing and spagyrics.

>

>I had studied something similar to pao zhi in India for processing

>ayurvedic therapeutic substances. I purchased the translation of Sioneau's

>book and other works that describe processing and phytochemicals present

>in Chinese herbs.. Here is the first statement; the books are vague at

>best and if one is preparing ie roasting etc herbs based only on having

>read descriptions than i would venture to say that this is a risky and

>incomplete approach.

>

>I studied pharmaceutical arts as a benedictine monk in France and the art

>of medecine preparing is not something to be learnt from a book; you must

>see, hear, smell and taste it done by someone who has experience.

>

>Here is another piece of news; raw herb quality varies greatly from place

>to place; I obtained samples of tienchi, jujube berries , eucommia (sp) ,

>angelica sinensis and aconitum. Wow, quite a lot of variety in quality.

>Having seen this, I think people should find a good manufacturer. But I

>digress.

>

>I examined assorted books where the formulas and uses were discribed and

>cross referenced with scientific descriptions of phytochemicals present in

>raw herbs. My conclusions were;

>

>In some cases, classical processing will decompose some of the

>phytochemicals present in raw herbs; good or bad ? that is up to the

>therapist to decide. But if you are cold percolating a herb that is

>normally decocted, you may not be getting the same product. Because some

>times the classical processing also induces saponification, esterification

>and thingsrequiringclarification that are going to keep me busy over the

>next 20 years so this part time degree in TCM that I am doing is serving

>as backdrop rather than a primary factor in research.

>

>Now for a practical example; tienchi and other ginseng like plants.

>Ginsensides, like glycosides, are not fond of heat and PH changes. this

>tends to have them decompose, turning into expensive sweeteners. My

>advice: run 300ml of 70 % alcohol through 600 grams of root as

>percolation. The result, in my case, if taken a teaspoon in the morning

>and evening in cold green tea took care of a 6month long knee injury that

>hundreds of little pills barely made notch in. It can be a little rough

>on the lower digestive tract but I suspect that if I do a high temp

>extraction of the marc in a soxhlet using water and alcohol and add this

>to the percilating menstruum for the next batch this should alleviate the

>problem. Ginsengs do contain resins, gums, essential oils , polysachs etc.

>

>I am aware that ginsengs are made into teas, steamed, eaten raw, cooked in

>TCM. Along with the multiple preparation methods come multiple uses. And

>with research, I think we can find more uses and processing methods.

>

>Gilbert

>

>

>>Chronic Diseases Heal - Chinese Herbs Can Help

[Guest guest]

Hi Z'ev,

 

Thank you for your comments. I'll be keeping the list updated with my research.

As to growing them, I'll be working on that also. I had to take a bunch of ag

courses back when I got my degree in ag engineering so I'll get to use the hort.

I'm a little worried that a great system like TCM is almost totally dependent on

imported medicines; so among cries of " it wont work " and " it wont be the same "

and it can only be grown over there " or " it did not work in California " I'm

going to plant some TCM herbs in my garden.

 

And yes, there is secrecy. Almost as intense as for Ayurveda. You should hear

what I've been told by responsible people ie " I trained inthe hospital clinic

and did not practice preparation " while I'm standing in the herb room and smell

the characteristic smell of burnt rice wine in the air. Sheesh. Another closet

" non-practionner " , 2 days after disclaiming knowledge sent a fax to my

non-profit lab (not associated with my name) with a request for chinese

liquorice concentrate to be diluted in water. I'll remember. Tables have a way

of turning. The grease is kindness.

 

Anyway, If anyone reading this has any practical (ie acquired from a reliable

source) knowledge of processing and is giving a course (weekend format) let me

know.

 

Gilbert