Guest guest Posted January 25, 2002 Report Share Posted January 25, 2002 My question is how >many patterns can be effectively treated herbally in addition to the >formula choosen in response to the differential diagnosis of the main >complaint.(The center, as Alon calls it) Kelly:I think ultimately this question is unanswerable in as much as you are trying to give it a number. How many arrows does one need to hit the bulls eye. However...... For no apparent reason that I could assess, my teachers always wanted us to select 12 herbs (and 6 points for acupuncture). They stressed that this number would force one to prioritize a specific pattern and add a few herbs to treat closely related patterns. It also affords one the opportunity to see how close they got to the bulls eye. With too many herbs you have no idea what is working and what is not. i have found this as a general guideline to be an excellent model to move from clinically. (this is assuming you have experience writing your own formulas)... Just my experience..Kelly _______________ Send and receive Hotmail on your mobile device: http://mobile.msn.com Quote Link to comment Share on other sites More sharing options...
Guest guest Posted January 25, 2002 Report Share Posted January 25, 2002 Yes, I noticed one of my teachers counting to twelve as well. It seems like a good amount, and I do amend or change formulas most of the time. , " Kelly Welch " <kdwelch25@h.. ..> wrote: > For no apparent reason that I could assess, my teachers always wanted us to > select 12 herbs (and 6 points for acupuncture). They stressed that this > number would force one to prioritize a specific pattern and add a few herbs > to treat closely related patterns Quote Link to comment Share on other sites More sharing options...
Guest guest Posted January 26, 2002 Report Share Posted January 26, 2002 , " gabriellemathieu " < gabriellemathieu> wrote: > > Yes, I noticed one of my teachers counting to twelve as well. > It seems like a good amount, and I do amend or change formulas most > of the time. I typically use a maximum of 12 herbs in my rx, but only becasue more gets too costly for the patient. However, under certain circumstances, I will use more. Just yesterday, I could delete the 13th herb, so I went with it. However, I do completely disagree with the idea that using more than 12 herbs misses the mark or is somehow shotgun therapy. Many classic formulas are larger thanthis ian d it has been common since the qing dynasty to see quite large formulas. I think tian wang bu xin dan and du huo ji sheng tang are both exfellent and large formulas that make perfect sense and do not at lall seem like overkill in many of the cases in which I use them. while both are overused when the tx principles do not match the formulas (kneejerk herbalism, OI call it, giving DHJST for all chronic bi, for example), there are many occasions where these rx match the tx principles perfectly. As Bob Flaws has pointed out and as a theme seen in Subhuti Dharmananda's clinical reports and case studies from china that he has been printing for over a decade, it seems more common than not to see large formulas of 18 or so herbs used in modern chinese clinics. For an example of how these large formulas do fit nicely into the TCM model, just read the rx descriptions in the BP herb catalog and the accompanying article on yin fire. I know yin fire is not a mainstream theory, but the large formulas do seem mainstream and yinfire theory is a good way of explaining their mechanisms of action. Another example of large formulas addressing complex illnesses and multiple tx principles is Heiner Fruehauf's work on gu syndrome. Having said all that, I do agree that most patients canbe treated with 12 herbs formulas and I do find it to be more legeant in my mind to use smaller formulas. But that is my bias, not some rule from the gods of TCM. Quote Link to comment Share on other sites More sharing options...
Guest guest Posted January 26, 2002 Report Share Posted January 26, 2002 1 wrote: > > Yes, I noticed one of my teachers counting to twelve as well. > > It seems like a good amount, and I do amend or change formulas most > > of the time. Because I use herb extracts in powdered form, I sometimes put together formulas not of individual herbs, but of premixed, and sometimes predecocted formulas. In this way, I think of the formula as a singular entity. For instance, today I treated someone with anxiety attackes as her chief complaint. The diagnosis was food stagnation and phlegm heat. Her tongue had a thick dry yellow coating and she complained of some typical food stagnation signs such as low appetite and the sensation of fullness that didn't diminish in time after a meal, etc.. I'm confident of the food stagnation portion of the diagnosis, though less so of the phlegm heat. So I gave her a formula that was 66% Bao He Wan and 33% Wen Dan Tang. These seems to me to about the right ratio given my sense of her condition. Ever do things like that, Todd? -- Al Stone L.Ac. <AlStone http://www.BeyondWellBeing.com Pain is inevitable, suffering is optional. Quote Link to comment Share on other sites More sharing options...
Guest guest Posted January 26, 2002 Report Share Posted January 26, 2002 , Al Stone <alstone@b...> wrote: So I gave her a formula that was 66% Bao He > Wan and 33% Wen Dan Tang. These seems to me to about the right ratio > given my sense of her condition. > > Ever do things like that, Todd? > Definitely. In fact, according to Andy Ellis, this is standard practice amongst many taiwanese herbalists. And the rationale is the same as yours. However, I do not like to combine so many that I end up with 35 herbs or something like that. Bao he wan and wen dan tang is a nice choice and some herbs actually overlap, so its about 12-14 herbs, I think Quote Link to comment Share on other sites More sharing options...
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