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Yunnan Pay Yao Restrictions

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Hi All,

 

I'm not sure if my last message went through because I pressed Post

instead of Send at the bottom of the screen, so here goes again.

 

Does anyone know why the orange package of Yunnan Pai Yao capsules

carries the caution - do not take within 24 hours of eating broad

beans, fish, cold or sour foods? I can't find any such restrictions

in Materia Medica for San Qi.

 

Thanks,

 

Diane

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Diane,

 

Here's an ethical question for everyone. Granted, Yunann Bai Yao is

extremely effective. However, as far as I know, it's ingredients are

not listed on the packaging. Yes, it's common knowledge that one of

its main ingredients is San Qi. However, I'm under the impression

that, like Liu Shen Wan, this is a " secret formula " and its full list

of ingredients is not published. If that's correct (I don't have a

recent package at hand to check this, so I could be all wrong on

this), should we prescribe a medicine whose ingredients we don't know?

 

I'm just imagining myself in court being questioned by a hostile

attorney. " So tell me, Mr. Flaws, did you or did you not prescribe a

Chinese patent medicine named Yunnan Bai Yao to Ms. So-and-so on

Sept. 10, 2001? If so, can you tell me the ingredients in that

medicine? If you cannot, can you explain to me why you thought or

currently do think it was/is okay to prescribe something to someone

whose ingredients you do not know? What would you say about an MD, DC,

or ND who prescribed something whose ingredients they didn't know?

Would you think they were acting responsibily, professionally,

credibly? "

 

I'm asking this question having prescribed this med myself many, many

times in the past. However, I've begun to question this practice.

Maybe that's because, after 22 years in practice, I have been deposed

and I have had to testify in court. So I know this can and does

happen.

 

Bob

 

 

, diane@s... wrote:

> Hi All,

>

> I'm not sure if my last message went through because I pressed Post

> instead of Send at the bottom of the screen, so here goes again.

>

> Does anyone know why the orange package of Yunnan Pai Yao capsules

> carries the caution - do not take within 24 hours of eating broad

> beans, fish, cold or sour foods? I can't find any such restrictions

> in Materia Medica for San Qi.

>

> Thanks,

>

> Diane

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The Yunnan Bai Yao that I have in my clinic has the ingredients listed. I added up the percentages of the ingredients and it came up short a percentage or two ( I am at home now and don't have it in front of me to be exact). Don't know if there are many different brands, I ordered mine through Crane Herb? For the benefit of the profession I don't think products of unknown content should be used. Does anyone know if it has been analyzed by HPLC or other means?

 

 

 

Sean

 

 

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Can you post the ingredients and percentages?

 

Jim Ramholz

 

 

 

, " Nashua Natural Medicine " <sean@n...>

wrote:

> The Yunnan Bai Yao that I have in my clinic has the ingredients

listed. I

> added up the percentages of the ingredients and it came up short a

> percentage or two ( I am at home now and don't have it in front of

me to be

> exact). Don't know if there are many different brands, I ordered

mine

> through Crane Herb? For the benefit of the profession I don't think

> products of unknown content should be used. Does anyone know if it

has been

> analyzed by HPLC or other means?

>

>

>

> Sean

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Bob,

 

> " So tell me, Mr. Flaws, did you or did you not prescribe a

> Chinese patent medicine named Yunnan Bai Yao to Ms. So-and-so on

> Sept. 10, 2001? If so, can you tell me the ingredients in that

> medicine? If you cannot, can you explain to me why you thought or

> currently do think it was/is okay to prescribe something to someone

> whose ingredients you do not know? What would you say about an MD,

DC,

> or ND who prescribed something whose ingredients they didn't know?

> Would you think they were acting responsibily, professionally,

> credibly? "

>

Excellent point, Bob.

 

What if the attorney were asking about

yin1 and yang2?

 

What if the attorney were asking about qi4?

 

Ken

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, " James Ramholz " <jramholz> wrote:

> Can you post the ingredients and percentages?

>

> Jim Ramholz

 

 

recent imports do include ingredient lists, but it is unclear if they

are correct and there are no laws that regulate labeling in china.

Bob's point is well taken. Ken's is interesting, but I think it would

easier to defend the use of yinyang theory than it would be to defend

using a product of unknown ingredients.

 

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, @i... wrote:

>recent imports do include ingredient lists, but it is unclear if

they are correct and there are no laws that regulate labeling in

china.

 

 

No doubt that many Chinese formula labels are unreliable. Yet, I

would like to compare it to other, similar formulas and test

different versions of it---but without having to buy any more.

 

 

> Bob's point is well taken. Ken's is interesting, but I think it

would easier to defend the use of yinyang theory than it would be to

defend using a product of unknown ingredients.

>

 

As we become more mainstream, this problem will affect more

practitioners. I hear that throughout the nation, trial attorneys are

pressuring legislatures to make sure acupuncturists have liability

insurance just for such an occasion. Does anyone know of any cases of

an MD already facing this problem?

 

What defense of yinyang theory is there without scientific proof of

its existence and application? Skeptic magazine labels it as

metaphysical and unscientific.

 

Jim Ramholz

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" and there are no laws that regulate labeling in china. "

 

yes , I know this only to well..........I knew of an Australain company

importing patents and when fu zi was illegal to be put in , they just

merely altered the label for Australian export , and called it dang

shen.

 

But it was OK , because the factory was GMP approved...! And the way to

get that is to pay off some Beijing official ....

 

thats why I do my own formula

 

Heiko

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>>>It is too difficult to identify an unknown herb by HPLC

alon

 

 

Alon,

I know that this is true, but thought it would be nice information to have. I suppose if there is as much lot to lot variability as people say, a spot check will not be helpful. It is too bad since it is the only patent I carry. I guess I will have to remedy this and find an alternative.

 

Sean

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On Monday, September 10, 2001, at 11:40 PM, James Ramholz wrote:

 

 

>

> What defense of yinyang theory is there without scientific proof of

> its existence and application? Skeptic magazine labels it as

> metaphysical and unscientific.

>

> Try Dr. Yan's "DNA and the I Ching".or the Chinese text, Zhong guo ba gua yi xue.

>

 

 

 

>

>

>

>

>

>

 

 

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Does anyone know of any cases of an MD already facing this problem?>>>>An MD as liability if he prescribes any non-AMA, FDA approved procedure or medicine. I know of several that have lost their licenses for just doing nutritional work

Alon

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I suppose if there is as much lot to lot variability as people say, a spot check will not be helpful.

>>>The problem is that herbs do not have a simple print. So that it is virtually impossible to identify the ingredients

Alon

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Ken,

 

I'd quote from your excellent books, both Who Can Ride the Dragon and

the one on qi soon to be released, and, to be honest, I'm sure I would

feel a certain amount of dismay at finding myself in such a no-win,

unsatisfactory situation.

 

Bob

 

, yulong@m... wrote:

> Bob,

>

> > " So tell me, Mr. Flaws, did you or did you not prescribe a

> > Chinese patent medicine named Yunnan Bai Yao to Ms. So-and-so on

> > Sept. 10, 2001? If so, can you tell me the ingredients in that

> > medicine? If you cannot, can you explain to me why you thought or

> > currently do think it was/is okay to prescribe something to

someone

> > whose ingredients you do not know? What would you say about an MD,

> DC,

> > or ND who prescribed something whose ingredients they didn't know?

> > Would you think they were acting responsibily, professionally,

> > credibly? "

> >

> Excellent point, Bob.

>

> What if the attorney were asking about

> yin1 and yang2?

>

> What if the attorney were asking about qi4?

>

> Ken

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Recently I attended a meeting in Boulder, CO with the heads of the

Chinese FDA in charge of Chinese medicinals and medicines, a group of

a dozen functionaries with translators in tow. One of the interesting

things about that meeting is that the Chinese are trying to create

standard chemical fingerprints of each herb and each composite

medicine as a way of insuring standardization and quality control.

For someone who knows next to nothing about chemistry, the overhead

projections were impressive and encouraging. Not only is the Chinese

FDA imposing GMP standards on all medicinal manufacturers, but they

will be the first country to adopt GAP (Good Agricultural Procedures).

They are creating standards for the growing of each of 300-500 herbs,

including seed sources and lineages, geographic locations, field

siting, soil chemistry, use of pesticides, fertilizers, and

irrigation, harvesting methods, storage methods, methods of

preparation, etc., etc. There was a list of about 20 standards that

each grower of a particular herb had to meet or fall within certain

parameters.

 

Will this system be corruptible? Ren shi ren, people are people.

However, at least on paper it suggests to me a high level of

consciousness about the issues surrounding the standarization and

quality control of Chinese medicinals and medicines. This is a

potentially huge source of revenue for the PRC. So they are well

motivated to try to get it right.

 

Bob

 

, <alonmarcus@w...> wrote:

> I suppose if there is as much lot to lot variability as people say,

a spot check will not be helpful.

> >>>The problem is that herbs do not have a simple print. So that it

is virtually impossible to identify the ingredients

> Alon

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trying to create standard chemical fingerprints of each herb and each composite medicine as a way of insuring standardization and quality control

>>>It would still be close to impossible and very expensive to identify all ingredients in a complex formula

Alon

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Alon:

 

What's your impression of the present standardizing around a

particular component in an herb?

 

Jim Ramholz

 

 

 

, <alonmarcus@w...> wrote:

> trying to create

> standard chemical fingerprints of each herb and each composite

> medicine as a way of insuring standardization and quality control

> >>>It would still be close to impossible and very expensive to

identify all ingredients in a complex formula

> Alon

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What's your impression of the present standardizing around a particular component in an herb

>>>>It really depends on what markers are used. If some general markers are used it is probably good has the general characteristics of the herbs are maintained. If it is standardized to a particular active ingredient than we have to view this as a new approach and would not be able to use are usual differential diagnosis. This would have benefits as well as obvious disadvantages

Alon

 

-

James Ramholz

Tuesday, September 11, 2001 10:44 PM

Re: Yunnan Pay Yao Restrictions

Alon:What's your impression of the present standardizing around a particular component in an herb?Jim Ramholz, <alonmarcus@w...> wrote:> trying to create > standard chemical fingerprints of each herb and each composite > medicine as a way of insuring standardization and quality control> >>>It would still be close to impossible and very expensive to identify all ingredients in a complex formula> AlonChinese Herbal Medicine, a voluntary organization of licensed healthcare practitioners, matriculated students and postgraduate academics specializing in Chinese Herbal Medicine, provides a variety of professional services, including board approved online continuing education.

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>...I think it would

> easier to defend the use of yinyang theory than it would be to

defend

> using a product of unknown ingredients.

>

 

 

Really? I think it would be far more

troublesome to mount a convincing

defence of yin1 yang2 theory.

 

The fundamental ingredients of yin1 yang2

theory, which is the fundamental methodology

employed to fashion virtually al of the

other ingredients of Chinese medicine,

are unknown to most courts of law. Unknown,

unrecognized...if not unrecognizable, and

certainly not accepted as givens.

 

How would you go about your defence?

 

Bob says he'd hold up our books. But

I don't think a jury of your peers

would be convinced by such a gesture.

 

I think they would want to know what

is your personal understanding and

how did you get it.

 

Now this is all a somewhat exaggerated

hypothetical situation, but it certainly

can allow us to consider the issue of

how do we develop our understanding of

the basic tools of our trade. For certainly

as the trade grows it will experience

the inevitable clashes and conflicts

that necessitate the formulation of

the kind of defence we're talking about.

 

This is one of the strategic reasons why

those of us who make such a stink about

Chinese language learning do so: to help

people strengthen their foundations...and

defences of their thinking, ideas, and

practices.

 

Ken

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yulong wrote:

>

>

>

> >...I think it would

> > easier to defend the use of yinyang theory than it would be to

> defend

> > using a product of unknown ingredients.

> >

>

>

> Really? I think it would be far more

> troublesome to mount a convincing

> defence of yin1 yang2 theory.

 

 

Yin/Yang

Anatomy/Physiology

 

Yin/Yang

metabolite/metabolism

 

Yin/Yang

Parasympathetic/sympathetic

 

Yin/Yang

myocardium/cardiac output

 

Yin/Yang

glands/endocrine secretions (or responses from target organs)

 

I don't think that yin/yang would be too difficult to explain in

biomedical terms, though I do agree with Bob's issues with the herbal medicines.

 

--

Al Stone L.Ac.

<AlStone

http://www.BeyondWellBeing.com

 

Pain is inevitable, suffering is optional.

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Al,

>

> Yin/Yang

> Anatomy/Physiology

>

> Yin/Yang

> metabolite/metabolism

>

> Yin/Yang

> Parasympathetic/sympathetic

>

> Yin/Yang

> myocardium/cardiac output

>

> Yin/Yang

> glands/endocrine secretions (or responses from target organs)

>

> I don't think that yin/yang would be too difficult to explain in

> biomedical terms,

 

Our hypothetical problem is to defend

oneself in a legal context. You'd

have to do more than just think that

it would not be too difficult.

 

You'd have to actually do it. And

since I'm not aware of anyone ever

having done it, I am not inclined

to merely accept your assertion that

it would be easy.

 

One prevalent tendency among biomedical

personnel when confronting theoretical

structures such as yin1 and yang2 is to

define and thereby confine them in the

realm of the metaphysical. There is, of

course, a whole epistemological mechanism

whereby such metaphysics transform into

the practical applications of Chinese medicine.

 

And this would therefore have to be part

of one's explanation/defence.

 

So, although you and I seem to have

differing assessments as to the difficulty

of doing so, perhaps you can prepare the

explanation you have in mind. I would love

to be able to read it and I would like to

publish any such explanation in CAOM.

 

 

Ken

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Bob,

 

The Chinese most definitely are determined

to increase their share of the world herb

market. Currently that share stands at around

3% for Mainland China.

 

We have gotten involved in a research initiative

that is aimed at the same target but from a

somewhat different angle, namely complexity

and Chinese medicine.

 

If anyone is interested in getting involved,

I've set up yet another list that can be

accessed by emailing to:

 

Complexity_and_Chinese_Medicine-

 

 

We are still compiling materials that describe

this initiative, but for anyone who has contemplated

the confluence of complexity and Chinese medicine

or who is interested in developing bi-lingual

access to the Chinese medical knowledge base

that is comprehensible to and consistent with

both the ancient Chinese and the contemporary

scientific contexts, we can certainly start

the discussion now.

 

Ken

 

, pemachophel2001 wrote:

....

> However, at least on paper it suggests to me a high level of

> consciousness about the issues surrounding the standarization and

> quality control of Chinese medicinals and medicines. This is a

> potentially huge source of revenue for the PRC. So they are well

> motivated to try to get it right.

>

> Bob

>

> , <alonmarcus@w...> wrote:

> > I suppose if there is as much lot to lot variability as people

say,

> a spot check will not be helpful.

> > >>>The problem is that herbs do not have a simple print. So that

it

> is virtually impossible to identify the ingredients

> > Alon

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The fundamental ingredients of yin1 yang2theory, which is the fundamental methodologyemployed to fashion virtually al of theother ingredients of Chinese medicine,are unknown to most courts of law.

>>>They are not musch more than servo systems and can be explained as such

Alon

 

-

yulong

Wednesday, September 12, 2001 9:23 AM

Re: Yunnan Pay Yao Restrictions

>...I think it would > easier to defend the use of yinyang theory than it would be to defend > using a product of unknown ingredients. > Really? I think it would be far more troublesome to mount a convincingdefence of yin1 yang2 theory.The fundamental ingredients of yin1 yang2theory, which is the fundamental methodologyemployed to fashion virtually al of theother ingredients of Chinese medicine,are unknown to most courts of law. Unknown,unrecognized...if not unrecognizable, andcertainly not accepted as givens.How would you go about your defence?Bob says he'd hold up our books. ButI don't think a jury of your peerswould be convinced by such a gesture.I think they would want to know whatis your personal understanding andhow did you get it.Now this is all a somewhat exaggeratedhypothetical situation, but it certainlycan allow us to consider the issue ofhow do we develop our understanding ofthe basic tools of our trade. For certainlyas the trade grows it will experiencethe inevitable clashes and conflictsthat necessitate the formulation ofthe kind of defence we're talking about.This is one of the strategic reasons whythose of us who make such a stink aboutChinese language learning do so: to helppeople strengthen their foundations...anddefences of their thinking, ideas, andpractices.KenChinese Herbal Medicine, a voluntary organization of licensed healthcare practitioners, matriculated students and postgraduate academics specializing in Chinese Herbal Medicine, provides a variety of professional services, including board approved online continuing education.

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What's

your impression of the present standardizing around a

particular component in an herb

>>>>It

really depends on what markers are used. If some general markers are used it is

probably good has the general characteristics of the herbs are maintained. If

it is standardized to a particular active ingredient than we have to view this

as a new approach and would not be able to use are usual differential

diagnosis. This would have benefits as well as obvious disadvantages

Alon

 

Alon et

al,

 

True standardization

is a broader based approach to the provision of consistent product quality than

just the use of chemical component analysis. A product can be standardized using consistent agricultural

practices, processing protocols, warehousing practices, and dose form

preparation without evaluating the consistency of chemical components in the

plant material. However, if one

can choose one or more chemical components that represent the major classes of

chemicals in a plant material and quantify those components at appropriate

stages of the supply chain management process outlined above, then one can

eventually establish normal ranges of variation, and a basis for comparison of

material quality that assist in the provision of a product of consistent quality. The impetus for standardization has

most predominately been related to ensuring that funds devoted to clinical

research on a product result in data that can be credibly associated with

batches of that same product which are produced in subsequent manufacturing

runs.

 

Stephen

 

 

 

Chinese Herbal Medicine, a voluntary organization of licensed

healthcare practitioners, matriculated students and postgraduate academics

specializing in Chinese Herbal Medicine, provides a variety of professional

services, including board approved online continuing education.

 

 

 

Your use of

is subject to the

Terms of Service.

 

 

The Chinese Herb

Academy, a voluntary organization of licensed healthcare practitioners,

matriculated students and postgraduate academics specializing in Chinese Herbal

Medicine, provides a variety of professional services, including board approved

online continuing education.

 

 

 

Your use of

is subject to the

Terms of Service.

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yulong [yulong]

Wednesday, September 12, 2001 10:24 AM

 

Re: Yunnan Pay Yao Restrictions

 

 

 

>...I think it would

> easier to defend the use of yinyang theory than it would be to

defend

> using a product of unknown ingredients.

>

 

 

Really? I think it would be far more

troublesome to mount a convincing

defence of yin1 yang2 theory.

 

Ken

 

I believe you are confusing a scientific issue for a legal issue.

Substantiation of yin1 yang2 theory would not likely concern a court of law.

However a licensed practitioner providing a medicinal substance known to

contain unlisted ingredients would very definitely raise liability and

professional judgment issues that comfortably fall within the parameters of

the legal system.

 

That said, however, I and others on this list would most likely be more

interested in hearing defenses of yin1 yang2 theory from any unique

perspective.

 

Stephen

 

 

 

Chinese Herbal Medicine, a voluntary organization of licensed healthcare

practitioners, matriculated students and postgraduate academics specializing

in Chinese Herbal Medicine, provides a variety of professional services,

including board approved online continuing education.

 

 

 

 

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