Shang Han Sweating/Number of Herbs

[Guest guest]

Alon, Danny, Jim,

, " Alon Marcus " <alonmarcus@w...> wrote:

> Prof Xioa's " 10 rule " is a totally arbitrary number

> >>>There are many such methods. One of the most effective TCM dr i

have ever seen only uses 9 herbs in almost all his formulas (cooking

formulas) with a strict rule of never treating more than 3

pathoconditions at one >>>>time, and often with 3 herbs for each

 

I agree with this method. I think that since the liver must eventually

metabolize all the active ingredients in each herb, formulas with

large number of ingredients will place unnecessary burden on the

liver. Also, it seems to me that with rx of 9 to 12 herbs, one can

easily make needed substitutions should the patient's condition not

improve as expected. I recall my teacher saying that the " famous

doctor, only uses one needle " . It seems that this idea is/can be

applicable to herbal rx. Carefull pattern discrimination, dietary

changes, and qi gong therapy, can offset the need for large formulas.

 

I'm familiar with Jim's Shaolin and longevity formulas. I personally

use a formula of over 35 herbs prepared with brandy. However, I only

take a very small amount of this rx. Furthermore, in contrast to my

patients, I'm very active in the martial arts, teaching several

classes a week and practicing dynamic push-hands. My point is that

Jim's example of these formulas do not give sufficient support, imo,

to the use of large formulas. Naturally, there are exceptions.

 

Fernando

[Guest guest]

In , " Fernando Bernall " <fbernall@a...> wrote:

>>> I agree with this method. I think that since the liver must

eventually metabolize all the active ingredients in each herb,

formulas with large number of ingredients will place unnecessary

burden on the liver. >>>

 

This has never been a problem. If you're taking 3 grams of a formula

with 100 herbs or 3 grams of a formula with 10 herbs, it's still

only 3 grams to metabolize. I suspect that smaller amounts of active

ingredients are easier to metabolize. But since there are numerous,

even an unknown amount of active ingredients in many herbs, this

seems a moot point.

 

 

>>> I recall my teacher saying that the " famous doctor, only uses

one needle " . >>>

 

I've never actually seen anyone regularly use only one needle in

their practice. This is like the last thought in Zen. It's still a

thought. If the doctor was really good, he wouldn't need needles; he

would only do qi gong.

 

 

>>> My point is that Jim's example of these formulas do not give

sufficient support, imo, to the use of large formulas. Naturally,

there are exceptions. >>>

 

Now I'm confused. The number of large formulas are not solely

limited to my two examples. And if there are many large formulas in

the Chinese literature, what more " sufficient support " would you

require for their use?

 

My point wasn't to replace the TCM style of herbalism but to point

out the rich variety of formulas that can be found in the classical

literature.

 

 

Jim Ramholz

[Guest guest]

James Ramholz wrote:

 

> >>> I recall my teacher saying that the " famous doctor, only uses

> one needle " . >>>

>

> I've never actually seen anyone regularly use only one needle in

> their practice. This is like the last thought in Zen. It's still a

> thought. If the doctor was really good, he wouldn't need needles; he

> would only do qi gong.

 

There's a piece of art on the wall at the ECTOM clinic that reads (in

chinese characters) " One needle cures 100 diseases " . I've never see

this as a suggestion that you use one needle, but as a reminder to

address the root.

 

--

Al Stone L.Ac.

<AlStone

http://www.BeyondWellBeing.com

 

Pain is inevitable, suffering is optional.

[Guest guest]

>>> Furthermore, in contrast to my patients, I'm very active in the

martial arts, teaching several classes a week and practicing dynamic

push-hands. My point is that Jim's example of these formulas do not

give sufficient support, imo, to the use of large formulas.

Naturally, there are exceptions. >>>

 

 

 

Fernando:

 

Not to belabor the point, but I became curious as to what the actual

number of long formulas might be in a given text. So, I looked

through Shaolin Secret Formulas for the Treatment of External

Injuries by the Patriarch De Chan (Zhang Ting-liang translated it

for Blue Poppy)---without question, it is the most important herbal

text in English for martial artists. In it, 94 of the 268 formulas

have more than 10 herbs in them---that is 35%. Of that 94, 31 are

modifications of the famous Modified 13 Flavors Formula (Jia Jian

Shi San Wei Fang).

 

That the Shaolin monks used large formulas at least a quarter or a

third of the time is an interesting and significant finding. This

book is similar to the other Shaolin herbal texts I have read in

Chinese; so, at least in this area of expertise, large formulas are

fairly common. And going through my library, formulas using more

than 10 herbs are not that unusual in other Chinese nonmartial art

herbal texts.

 

 

Jim Ramholz

[Guest guest]

One simple rule of thumb. . .

 

The more complex the pattern, the more complex the prescription. Early

taiyang stage or yang ming bowel or channel patterns are examples of

simple acute patterns that require simple, elegant prescriptions. Jue

yin mixed heat-cold complexes have more ingredients that are mixtures

of hot and cold, bitter, sweet, sour and acridity.

 

Li Dong-yuan prescriptions, which treat complex patterns of repletion

and vacuity, tend to have several ingredients as well.

 

 

On Monday, November 11, 2002, at 02:34 PM, James Ramholz wrote:

 

>>>> Furthermore, in contrast to my patients, I'm very active in the

> martial arts, teaching several classes a week and practicing dynamic

> push-hands. My point is that Jim's example of these formulas do not

> give sufficient support, imo, to the use of large formulas.

> Naturally, there are exceptions. >>>

>

>

>

> Fernando:

>

> Not to belabor the point, but I became curious as to what the actual

> number of long formulas might be in a given text. So, I looked

> through Shaolin Secret Formulas for the Treatment of External

> Injuries by the Patriarch De Chan (Zhang Ting-liang translated it

> for Blue Poppy)---without question, it is the most important herbal

> text in English for martial artists. In it, 94 of the 268 formulas

> have more than 10 herbs in them---that is 35%. Of that 94, 31 are

> modifications of the famous Modified 13 Flavors Formula (Jia Jian

> Shi San Wei Fang).

>

> That the Shaolin monks used large formulas at least a quarter or a

> third of the time is an interesting and significant finding. This

> book is similar to the other Shaolin herbal texts I have read in

> Chinese; so, at least in this area of expertise, large formulas are

> fairly common. And going through my library, formulas using more

> than 10 herbs are not that unusual in other Chinese nonmartial art

> herbal texts.

>

>

> Jim Ramholz

>

>

>

>

>

[Guest guest]

, " Fernando Bernall " <fbernall@a...> wrote:

My point is that

> Jim's example of these formulas do not give sufficient support, imo,

> to the use of large formulas. Naturally, there are exceptions.

>

> Fernando

 

It is my understanding that formulas since the early qing dynasty continuing to

the formulas of modern research typically have more than ten herbs. That

formulas with more than ten ingredients have been the rule, not the exception,

for the past 400 years. This is certainly true when one considers that a

prescribed formula as opposed to a textbook formula is usually a modified

formula. this means it is typical to add perhaps 3 or more herbs to a base

formula of 8-9 herbs. With the practice of additions in mind, a significant

number of the formulas in Bensky, Sionneau and most other internal med

books become greater than ten herbs when actually prescribed. Whether this

is a positive development remains to be seen. I tend to believe people do

things better over time. I rarely write a ten herb or less formula, but some of

my colleagues write much larger ones than me. Mine range from 11-13

typically, as did those of the teachers whose success I observed most closely.

 

An interesting historical trend in the qing was a neoclassical revival as

explained by Unschuld in forgotten traditions. It came as a backlash to many

centuries of new ideas from such as Li dong yuan and zhu dan xi and the wen

bing school and their further development during the qing. At this same time,

there was a perceived decline in the the education of many doctors (hmmm.

sound familiar?). One response was to reject most of the new ideas and

return to the older and smaller prescriptions from the han. I was also taught

this by Subhuti Dharmanada and Heiner fruehauf. Subhuti typically preferred

new and heiner old. As usual, it is hard to say which is better. Maybe others

can comment on what is typical in a more extensive survey of untranslated

chinese texts.

 

[Guest guest]

Z'ev, Jim,

 

 

I simply agreed with Alon's dr method of using 9 herbs per formula

with about 3 herbs for each for each pathocondition. I dont't think

one should be rigid or dogmatic about such or any other method. It's

the concept of using less but better targeted ingredients that I'm

interested in.

 

Since I use KPC extracts, I try to keep the number of herbs between

ten to twelve. It seems that when I use larger prescriptions with

granules (12 and above), the quantity for each herb in the rx is less

for a five day formula. I don't see how effective such low dosages per

each ingredient would be.

 

Z'ev, you pointed out that complex patterns required complex

prescriptions; and that " ...Li Dong-yuan prescriptions, which treat

complex patterns of repletion and vacuity, tend to have several

ingredients as well.. " This is true. I find that in Blue Poppy's

article on " The Formulas of Li Dong-yuan: Complex Formulas for Complex

Conditions " , Bob Flaws lists 37 formulas he feels that, and I quote:

" most Western patients with complex chronic diseases require " . Of

these 37, 21 prescriptions contain 10 or less herbs. Eleven rx,

include between 11 to 15 herbs and a handfull up to 18 herbs. Now, I

know that all rx must be tailored to the pt's pattern, but I do not

see these 30+ ingredient formulas that Jim referred to as the norm;

rather the exception.

 

The literature may not support my thinking but perhaps, at times,

patients with chronic conditions require complex analysis of their

symptoms leading to formulas of elegant design where less is more.

 

~Fernando

 

 

 

, " " <@i...> wrote:

> , " Fernando Bernall " <fbernall@a...>

wrote:

> My point is that

> > Jim's example of these formulas do not give sufficient support,

imo,

> > to the use of large formulas. Naturally, there are exceptions.

> >

> > Fernando

>

> It is my understanding that formulas since the early qing dynasty

continuing to

> the formulas of modern research typically have more than ten herbs.

That

> formulas with more than ten ingredients have been the rule, not the

exception,

> for the past 400 years. This is certainly true when one considers

that a

> prescribed formula as opposed to a textbook formula is usually a

modified

> formula. this means it is typical to add perhaps 3 or more herbs to

a base

> formula of 8-9 herbs. With the practice of additions in mind, a

significant

> number of the formulas in Bensky, Sionneau and most other internal

med

> books become greater than ten herbs when actually prescribed.

Whether this

> is a positive development remains to be seen. I tend to believe

people do

> things better over time. I rarely write a ten herb or less formula,

but some of

> my colleagues write much larger ones than me. Mine range from 11-13

> typically, as did those of the teachers whose success I observed

most closely.

>

> An interesting historical trend in the qing was a neoclassical

revival as

> explained by Unschuld in forgotten traditions. It came as a

backlash to many

> centuries of new ideas from such as Li dong yuan and zhu dan xi and

the wen

> bing school and their further development during the qing. At this

same time,

> there was a perceived decline in the the education of many doctors

(hmmm.

> sound familiar?). One response was to reject most of the new ideas

and

> return to the older and smaller prescriptions from the han. I was

also taught

> this by Subhuti Dharmanada and Heiner fruehauf. Subhuti typically

preferred

> new and heiner old. As usual, it is hard to say which is better.

Maybe others

> can comment on what is typical in a more extensive survey of

untranslated

> chinese texts.

>

 

[Guest guest]

Subhuti typically preferred new and heiner old. As usual, it is hard to say which is better.

>>>>But makes for good conversations.

I also wander if newer developments tend to reflect reality while referring to the good old times just a fantasy. I struggle with this every time I write a prescription since I too had diverse teaching

Alon

[Guest guest]

the quantity for each herb in the rx is less for a five day formula.

>>>Do you give a fixed amount per day. I use the powders as if they were row herbs so that if it is a larger formula then there is more per day

alon

[Guest guest]

I find that in Blue Poppy's article on "The Formulas of Li Dong-yuan: Complex Formulas for Complex Conditions",

>>>Is this on the his web site

Alon

[Guest guest]

, " Alon Marcus " <alonmarcus@w...> wrote:

> I find that in Blue Poppy's

> article on " The Formulas of Li Dong-yuan: Complex Formulas for

Complex

> Conditions " ,

> >>>Is this on the his web site

> Alon

 

 

Yes, here's a link

 

" http://www.bluepoppy.com/press/download/articles/dongyuan_formulas.ht

m "

 

Fernando

[Guest guest]

> Alon Marcus wrote:

>

> the quantity for each herb in the rx is less

> for a five day formula.

> >>>Do you give a fixed amount per day. I use the powders as if they

> were row herbs so that if it is a larger formula then there is more

> per day

> alon

 

Yeah, that would work, if you're using powders. The problem with using

capsules is that you're generally limited to making 100 at a time, or

50, if you have one of those smaller machines.

 

If I have a larger formula (i.e. more ingredients) I can't add 10 or 15

capsules to the batch.

 

--

Al Stone L.Ac.

<AlStone

http://www.BeyondWellBeing.com

 

Pain is inevitable, suffering is optional.

[Guest guest]

, " Alon Marcus " <alonmarcus@w...> wrote:

> the quantity for each herb in the rx is less

> for a five day formula.

> >>>Do you give a fixed amount per day. I use the powders as if they

were row herbs so that if it is a larger formula then there is more

per day

> alon

 

 

Yes, I instruct the pt to use two little spoons which add to roughly 3

grams tid total around 9 to 10 grms. Lately I've been increasing the

dosage to three little spoons which is about 41/2 grms tid. Frankly, I

don't think I've got the granule dosage thing down pat. I rather err

on the side of caution and include other therapeutic techniques to

make up for my herbal deficiencies.

 

Fernando

[Guest guest]

about 41/2 grms tid. Frankly, I don't think I've got the granule dosage thing down pat. I rather err on the side of caution and include other therapeutic techniques to make up for my herbal deficiencies.>>>I use it as if it was raw herbs in a 1=5 ratio. Thus the larger the formula usually the larger the daily dose

alon

[Guest guest]

To me, a prescription doesn't need 30 herbs to work on a complex

pattern, 9-15 should be enough in most cases. I am open to the idea of

Jim's 30 ingredient prescriptions, but I also think that prescriptions

should be as refined and elegant as possible. This means

'no waste', no unnecessary ingredients.

 

 

 

 

On Tuesday, November 12, 2002, at 05:10 AM, Fernando Bernall wrote:

 

> Z'ev, you pointed out that complex patterns required complex

> prescriptions; and that " ...Li Dong-yuan prescriptions, which treat

> complex patterns of repletion and vacuity, tend to have several

> ingredients as well.. " This is true. I find that in Blue Poppy's

> article on " The Formulas of Li Dong-yuan: Complex Formulas for Complex

> Conditions " , Bob Flaws lists 37 formulas he feels that, and I quote:

> " most Western patients with complex chronic diseases require " . Of

> these 37, 21 prescriptions contain 10 or less herbs. Eleven rx,

> include between 11 to 15 herbs and a handfull up to 18 herbs. Now, I

> know that all rx must be tailored to the pt's pattern, but I do not

> see these 30+ ingredient formulas that Jim referred to as the norm;

> rather the exception.

>

> The literature may not support my thinking but perhaps, at times,

> patients with chronic conditions require complex analysis of their

> symptoms leading to formulas of elegant design where less is more.

>

> ~Fernando

[Guest guest]

People - it is a matter of style, there are those who are effective with large formulas and those who are effective with small formulas given appropriate context. Also, there are plenty of people who are ineffective with either. Noone is going to be 'right' on this.

 

Will

 

 

To me, a prescription doesn't need 30 herbs to work on a complex pattern, 9-15 should be enough in most cases. I am open to the idea of Jim's 30 ingredient prescriptions, but I also think that prescriptions should be as refined and elegant as possible. This means

'no waste', no unnecessary ingredients.

 

 

 

William R. Morris, OMD

Secretary, AAOM

Dean of Clinical Education

Emperor's College of TOM

310-453-8383