Guest guest Posted January 31, 2006 Report Share Posted January 31, 2006 Hi everyone, I'm sorry if this topic has been done to death already (i'm sure it has, just tell me so and I'll do a search of the old threads) I am in the middle of trying to help a college here in Sydney integrate the dispensation of concentrated granules (one of the big companies from Taiwan) into their current curriculum. They have been using raw herbs in their clinic for a while now but there is not much experience amongst the staff in how to handle granules. I was just wondering if anyone could give me any tips or pointers on the differences in raw herb dosaging and granulated herb dosaging from their experience in clinic, and/or help in translating the raw herb way of thinking of the current faculty to the granule mixing way of thinking? The main issues I can see are: 1) Granules come in formula, and whilst these cannot be altered, they are likely stronger than than mixed singles. Some people have suggested to me that it is useful to consider each granulated formula as a single herb and carefully play with it. Does anyone agree with this? 2) Single granulated herbs come in all different types of extraction ratios, is there no other way to use them well than to play with each and get a feel? 3) It does not make sense to get a raw prescription and simply divide by an extraction ratio, unless we want our clients taking 20g a day of powder at times. Most practitioners have met usually keep the daily dosage stable at 6-10g/day and just play from there, do you agree with this? 4) Are there any books on granulated mixing by Taiwanese masters that have the most experience in this that anyone can point me towards (English or Chinese is fine)? Looking forwards to your responses, Lionel -- If we do not look we will not see. The gathering of more reliable evidence is always a good thing, but the choice to open to the possibility of the possibility must be made before this process can begin. Quote Link to comment Share on other sites More sharing options...
Guest guest Posted January 31, 2006 Report Share Posted January 31, 2006 , <lionel.y.chan@g...> wrote: > 1) Granules come in formula, and whilst these cannot be altered, they are > likely stronger than than mixed singles. Some people have suggested to me > that it is useful to consider each granulated formula as a single herb and > carefully play with it. Does anyone agree with this? It is common to combine multiple formulas together with a few single additions in Taiwanese clinics. The granule prescription method used in Taiwan is unique to Taiwan, it is different than approaches used in mainland China or Japan. > 2) Single granulated herbs come in all different types of extraction > ratios, is there no other way to use them well than to play with each and > get a feel? The concentration of different formulas varies. In the Taiwanese market, the ratio of raw medicinals to powder is clearly stated, but this is not done for the US labels. I don't know about Australia. In Taiwan, one can compute the dose precisely to match what we would do with raw herbs. Also of note is that gelatins and minerals are not concentrated when prepared as single agents. > 3) It does not make sense to get a raw prescription and simply divide by an > extraction ratio, unless we want our clients taking 20g a day of powder at > times. Most practitioners have met usually keep the daily dosage stable at > 6-10g/day and just play from there, do you agree with this? I disagree. Taiwanese hospitals nearly always prescribe 18 g per day (6g TID). Occasionally doctors use less, but not much less than 12 g/day. > 4) Are there any books on granulated mixing by Taiwanese masters that have > the most experience in this that anyone can point me towards (English or > Chinese is fine)? > No books exist. We are trying to get Feng Ye to write a book or do a DVD on the subject. Eric Quote Link to comment Share on other sites More sharing options...
Guest guest Posted January 31, 2006 Report Share Posted January 31, 2006 Hi Lionel Andrew Ellis (Notes from South Mountain) has written a method of dispensing granules using formulas and single herbs you can read about it here http://botanicum.com/usingherbconcentrates.html I don't know if this is strictly related to the KPC-granules of just the " Taiwanese " way. Good luck ALwin , <lionel.y.chan@g...> wrote: > > I am in the middle of trying to help a college here in Sydney integrate the > dispensation of concentrated granules (one of the big companies from Taiwan) > into their current curriculum. They have been using raw herbs in their > clinic for a while now but there is not much experience amongst the staff in > how to handle granules. Quote Link to comment Share on other sites More sharing options...
Guest guest Posted January 31, 2006 Report Share Posted January 31, 2006 I would say the Andrew Ellis's take on things is the only sane way to approach this. doug , " Alwin van Egmond " <@v...> wrote: > > Hi Lionel > > Andrew Ellis (Notes from South Mountain) has written a method of > dispensing granules using formulas and single herbs > > you can read about it here > > http://botanicum.com/usingherbconcentrates.html > > I don't know if this is strictly related to the KPC-granules of just > the " Taiwanese " way. > > Good luck > > ALwin > > , > <lionel.y.chan@g...> wrote: > > > > I am in the middle of trying to help a college here in Sydney > integrate the > > dispensation of concentrated granules (one of the big companies > from Taiwan) > > into their current curriculum. They have been using raw herbs in > their > > clinic for a while now but there is not much experience amongst > the staff in > > how to handle granules. > Quote Link to comment Share on other sites More sharing options...
Guest guest Posted February 1, 2006 Report Share Posted February 1, 2006 " I disagree. Taiwanese hospitals nearly always prescribe 18 g per day (6g TID). Occasionally doctors use less, but not much less than 12 g/day. " Eric, Thank you for sharing this with all of us. This is what I have been saying for years. Bob Quote Link to comment Share on other sites More sharing options...
Guest guest Posted February 1, 2006 Report Share Posted February 1, 2006 , " Bob Flaws " <pemachophel2001 wrote: > > " I disagree. Taiwanese hospitals nearly always prescribe 18 g per > day (6g TID). Occasionally doctors use less, but not much less than > 12 g/day. " > > Eric, > > Thank you for sharing this with all of us. This is what I have been > saying for years. Actually, many doctors would use even more, but the national insurance won't pay for more than 6g doses (which they can stretch to QID if needed- 24g total/day). The quantity of crude herbs ingested is even higher if people use raw herbs, which are self-pay rather than insurance-covered in Taiwan. Generally, if people aren't using the equivalent of 75-150 g of crude medicinals per day, they are underdosing by Chinese standards. Eric Quote Link to comment Share on other sites More sharing options...
Guest guest Posted February 2, 2006 Report Share Posted February 2, 2006 " Generally, if people aren't using the equivalent of 75-150 g of crude medicinals per day, they are underdosing by Chinese standards. " Eric I totally agree. Bob Quote Link to comment Share on other sites More sharing options...
Guest guest Posted February 7, 2006 Report Share Posted February 7, 2006 Eric- Do you have any info on the exact concentrations of the formulas that KPC and other manufacturers produce? Also, since minerals and resins cannot be concentrated, how do practitioners dose the granules? If they want 15g/day of long gu, for instance, does that mean they will dose 15 scoops into the formulas? Thanks. -Steve On Feb 1, 2006, at 1:20 AM, Eric Brand wrote: > , > <lionel.y.chan@g...> wrote: >> 1) Granules come in formula, and whilst these cannot be altered, > they are >> likely stronger than than mixed singles. Some people have > suggested to me >> that it is useful to consider each granulated formula as a single > herb and >> carefully play with it. Does anyone agree with this? > > It is common to combine multiple formulas together with a few single > additions in Taiwanese clinics. The granule prescription method > used in Taiwan is unique to Taiwan, it is different than approaches > used in mainland China or Japan. > >> 2) Single granulated herbs come in all different types of > extraction >> ratios, is there no other way to use them well than to play with > each and >> get a feel? > > The concentration of different formulas varies. In the Taiwanese > market, the ratio of raw medicinals to powder is clearly stated, but > this is not done for the US labels. I don't know about Australia. > In Taiwan, one can compute the dose precisely to match what we would > do with raw herbs. > > Also of note is that gelatins and minerals are not concentrated when > prepared as single agents. > >> 3) It does not make sense to get a raw prescription and simply > divide by an >> extraction ratio, unless we want our clients taking 20g a day of > powder at >> times. Most practitioners have met usually keep the daily dosage > stable at >> 6-10g/day and just play from there, do you agree with this? > > I disagree. Taiwanese hospitals nearly always prescribe 18 g per > day (6g TID). Occasionally doctors use less, but not much less than > 12 g/day. > >> 4) Are there any books on granulated mixing by Taiwanese masters > that have >> the most experience in this that anyone can point me towards > (English or >> Chinese is fine)? >> > > No books exist. We are trying to get Feng Ye to write a book or do > a DVD on the subject. > > Eric Chinese Herbal Medicine offers various professional services, > including board approved continuing education classes, an annual > conference and a free discussion forum in Chinese Herbal Medicine. > > > > Quote Link to comment Share on other sites More sharing options...
Guest guest Posted February 8, 2006 Report Share Posted February 8, 2006 , Stephen Bonzak <smb021169 wrote: > > Eric- > > Do you have any info on the exact concentrations of the formulas that > KPC and other manufacturers produce? The exact concentration is listed on the packaging of Taiwanese granules. It varies from formula to formula and from company to company. The fillers are different as well. Some meds use ground herbs of the same meds as a filler, while others use starch. Some companies make an effort to use non-potentially-allergenic starches (including KP), which others do not. If you give me some specific formulas, I can check the concentration, but I am only in Taiwan till this weekend (then I will be in Beijing and won't have access to the labels). Interestingly, most doctors in large hospitals don't know what brand they are prescribing at any given time. The main brands send their brokers to the big hospitals, who haggle on the market price to maintain their inventory. So the doctors in the hospital rarely know exactly which batch is present at any given time. Fortunately, the big brands all have comparable quality and techniques. > Also, since minerals and resins > cannot be concentrated, how do practitioners dose the granules? If > they want 15g/day of long gu, for instance, does that mean they will > dose 15 scoops into the formulas? Thanks. Minerals are a problem with granules that is not easily resolved with certainty. In a formula like ma xing shi gan tang, the shi gao is cooked with the other medicinals (predecocted to replicate the original preparation method). So the prescription is basically exactly as it is intended to be, and there is probably a very small quantity of non-water-soluble minerals present in the solution (though of course the qi is present and any interaction with the other decocting herbs is achieved). Most Taiwanese doctors combine whole prescriptions with additional singles, so lots of minerals are decocted with the other ingredients in the traditional way as part of the base formulas. But when extra minerals are added as a single agent, everything changes. Actually dumping one gram of a non-water-soluble mineral in your mouth gives you a greater mineral intake than decocting 90 g of the same medicinal. This becomes an issue with things like dai zhe shi, which has slight toxicity. People still use minerals as additions in granule prescriptions, but generally the dose is much lower than they would use in a decoction. Because granules are often done based on a ratio, the ratio can be thrown off by using weaker medicinals and minerals. This has a significant impact on the methods in Taiwan, because national insurance only pays for 6 g doses (TID-QID). Say you want to add yi yi ren to liu jun zi tang. If you have a 5:1 extract of yi yi ren combined with liu jun zi tang, to use the equivalent of 30 g of yi yi ren in that formula, you have 33% of the TOTAL daily medication composed of yi yi ren, so the amount of liu jun zi tang that you can ingest is diminished if you have a weight limit on what you can prescribe based on insurance. If there is no weight limit, sure, just take in a large amount of powder. But if there is a weight limit, you either have to use a lower dose of yi yi ren or you need to favor medicinals that are stronger by weight to get the most medicinal value out of the insurance coverage. This problem doesn't occur in raw decoctions because there is no limit on the size of the pack- 30 g of long gu and 30 g of shan yao won't dilute the effect of 6 g of ren shen if they are decocted together. These problems have no real solution, they are simply the problems inherent to granule methods. Gelatins, minerals, and weak medicinals can affect the ratios. So using whole formulas is preferable because the chemisty is different, the herbs can interact in the cooking process, and the ratios are more correctly managed. In practice, many doctors are limited by the insurance system. But the formulas are definitely still effective, the cost is low, and compliance is high. So despite these problems to be aware of, granules are still a very good way to go overall. Eric Brand Quote Link to comment Share on other sites More sharing options...
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