Granules: Formulas vs.Your Own Mix

[Guest guest]

Just wondering...do you feel patients benefit from a well-crafted(

hopefully!) granula formula as well as starting from a premade

formula to which you are adding ingredients? Do you feel that

indidual ingredients of your own crafted formula are assimilable

enough? Does it depend upon the patients digestion? What if you want

to give yr. patient Chai Hu Jia Long Gu Mu Li Tang but don't see the

need for Da Huang and Huang Sum? I guess I'm trying to get a sense of

what's happening out there with those of you who only use granules. I

really miss the old days of using " crude " herbs but my patient

compliance and successes have been much greater.....well so maybe I

don't miss the old days... Thanks for listening.

[Guest guest]

On 7/15/06, turiyahill <turiya wrote:

>

> Just wondering...do you feel patients benefit from a well-crafted(

> hopefully!) granula formula as well as starting from a premade

> formula to which you are adding ingredients?

>

 

I'm not sure what you're asking. You want to know if individual powders put

together into a formula is the same as a formula cooked together and put

into a powder?

 

Some believe there's a big difference, others aren't so sure.

 

Do you feel that

> indidual ingredients of your own crafted formula are assimilable

> enough?

>

 

 

 

Does it depend upon the patients digestion?

>

 

Probably. Someone who can't digest well won't benefit from their herbs as

much as someone who's digestion is working well. This isn't unique to

granules, though.

 

What if you want

> to give yr. patient Chai Hu Jia Long Gu Mu Li Tang but don't see the

> need for Da Huang and Huang Sum?

>

 

Then perhaps you don't have the presentation that would call for this

formula? Though to answer your question, I just take them out, or make the

formula from individual powders instead of the pre-mixed formula.

 

I guess I'm trying to get a sense of

> what's happening out there with those of you who only use granules.

>

 

There have been a few discussions on the strengths of working with formulas

that are cooked together vs. those that are put together from individual

ingredients. Seems like the practitioners in Taiwan prefer the formulas

cooked together and don't use the individual herbs.

 

You can perhaps catch up on that topic by searching for " taiwan " and

" granule " at the site for the CHA list.

 

-al.

 

--

 

Pain is inevitable, suffering is optional.

 

 

 

[Guest guest]

Al

 

I am talking about KPC indidual granules and complete formulas.

And I do think you can have the presentation for Chai Hu Jia Long Gu

Mu Li tang and not wish to use Da Huang....but that's not what I want

to pursue here. I am aware of the Taiwanese style of practice that

combines pre-made formulas. I'm curious how things are playing out in

our Chi and Blood American Lifestyle Domain and herbal practices. Are

there those on this list who frequently construct their own individual

granular formulas and are satisfied with the results? This is my

question. Thanks to all who respond.

[Guest guest]

Certainly this issue has been debated several times on this list with

seemingly equal numbers in support of either position. The one thing that

does seem agreed upon (based on my own interpretation) in the end is the

resulting daily dose of herbs being directly related to the eventual

efficacy - regardless of whether a custom granule mix of indiviual herbs was

used vs. a pre-manufactured formula w/ some jia wei. And even then, there is

still room for debate.

 

I think the bottom line is there is no correct answer here. There are no

absolutes in this medicine, are there?

 

I took all this into account when I had to make my own decisions about what

I wanted my herbal pharmacy to consist of. I decided to look at it from a

business perspective (gasp - the horror!) and compare that to the kind of

service I wanted to be able to offer to my patients. I had made a personal

(business) decision long ago that I wasn't going to attempt to make huge

profits by the sale of herbs, supplements, what-have-you. It was important

to me that I serve my community by passing along as much of my professional

discounts as possible. I felt that the fees for my services were accounting

for my knowledge, experience, etc., and since I feel that herbal therapy is

an important aspect of this medicine, it felt uncomfortable to me to say " I

really think you need herbs and oh by the way, you can buy them from me at

the standard retail sales markup " - which we all know is about 100% the

wholesale price. Anyway...I digress a bit.

 

When I compared the unit cost of pre-manufactured granule formulas to what

it would cost to make that same formula from individual herb granules....the

price difference was remarkable. After several days of comparing data and

tracking numbers in spreadsheets, etc., I came to the conclusion that I can

offer granule formulas made from individual herbs at a substantially less

unit cost than if I use pre-manufactured formulas and there is still room to

add a wee bit of a markup to cover the time-cost of ordering, stocking,

mixing.

 

Of course, I didn't make my decisions based on cost alone, but considering

that there seems to be equally staunch supporters of either techniques, both

advocating patient efficacy it seemed a logical place to start.

Additionally, I have two influential and respected mentor practitioners who

utilize single granules custom mixed into formulas in their practices with

good clinical results. Who am I to argue with all that? And so my decision

was made.

 

Having made that decision, I must say I'm quite satisfied with it. Using the

individual granules enables me to write herbal formulas and keep my skills

sharp (and keeps the herbs " close " if you know what I mean) and provides for

a flexibility that would not be available if I were simply mixing pre-made

formulas. For me, personally, I could not be satisified in just dispensing

pre-made formulas - I love the challenge of a well crafted formula based on

solid tenets. And it keeps me reading source texts and analyzing others

formulas.

 

As for digestability/assimilation - if I find the need to bu the spleen a

bit, then I make recommendations for congees (for which I keep on had an

assortment of basic raw herbs that can be added to the pot during cooking)

and miso soups and perhaps even the use of digestive enzymes and probiotics

(either food or supplement based...which I just happen to have on

hand...:-).

 

Not sure if that gives you any answers. Utimatley, the only one who can

answer this particular question for you is you.

 

Joy

 

________

Joy Keller, LAc, Dipl.OM

Board Certified in Acupuncture & Oriental Medicine

Ramona Acupuncture & Oriental Medicine Clinic

Phone: (760) 654-1040 Fax: (760) 654-4019

www.RamonaAcupuncture.com

 

 

 

[Guest guest]

I have been using KPC granules for five years now, and I'm very satisfied

with the results clinically. I primarily use individual herbs to build

formulas, and occasionally will use a KPC formula as the base. I tend to

dose 12-18 scoops/day for about 150 pounds. If I'm not mistaken, the

standard Taiwanese dosing is roughly 18 scoops/day ~ is this correct, Eric?

 

_____

 

 

On Behalf Of turiyahill

Saturday, July 15, 2006 2:57 PM

 

Re: Granules: Formulas vs.Your Own Mix

 

 

 

Al

 

I am talking about KPC indidual granules and complete formulas.

And I do think you can have the presentation for Chai Hu Jia Long Gu

Mu Li tang and not wish to use Da Huang....but that's not what I want

to pursue here. I am aware of the Taiwanese style of practice that

combines pre-made formulas. I'm curious how things are playing out in

our Chi and Blood American Lifestyle Domain and herbal practices. Are

there those on this list who frequently construct their own individual

granular formulas and are satisfied with the results? This is my

question. Thanks to all who respond.

 

 

 

 

 

 

 

[Guest guest]

, " Kip Roseman " <kip wrote:

>

> I have been using KPC granules for five years now, and I'm very

satisfied

> with the results clinically. I primarily use individual herbs to build

> formulas, and occasionally will use a KPC formula as the base. I tend to

> dose 12-18 scoops/day for about 150 pounds. If I'm not mistaken, the

> standard Taiwanese dosing is roughly 18 scoops/day ~ is this

correct, Eric?

 

In Taiwan: 18 grams per day (how many " scoops " would depend on the

size of the scoop). Insurance limits the doses to 6 gram doses, with

a maximum of 4 doses per day (24 grams total). Few people use more

than 30 grams of extract per day, even without insurance

considerations. Using doses lower than 18 grams is less common in

Taiwan, but lower doses are sometimes used for children or mild cases.

 

In Taiwan, generally whole formulas are combined with the addition of

single medicinals rather than building a formula from scratch. They

feel that whole formulas are stronger than combined singles in terms

of their effect, so practitioners are trying to get as much mileage as

possible without exceeding the limit that the insurance covers. It is

also more economical in terms of the time it takes to fill formulas

that if it was all done from singles.

 

Personally, I have seen very good results with granule formulas that

were built from scratch from single extracts. Clearly both approaches

work. I think that the experience of the Taiwanese is valuable

because they have the most experience with the use of granules, and

Taiwanese practitioners often say that the result is superior with

whole formulas (but of course at this stage in its development, few

people probably make the comparison, they just use whole formulas with

single additions habitually).

 

The main distinction in Taiwan is that they use whole formulas in

combination, with more than one entire formula in a given

prescription. Here, they are using a whole formula as an addition

similar to the addition of a single herb. They think that adding a

whole formula that contains the target principle is stronger than

adding a single herb for that target principle. But of course they

have more formulas on hand and have a far greater proficiency than

most of us in terms of memorizing the formulas, their principles, and

their ingredients. Lacking the rhymes used in memorization (plus a

less memorization-based educational system) gives us Westerners

comparatively fewer options in terms of combining formulas, simply

because our repetoire of formulas that we have mastered is smaller.

Nonetheless, at the end of the day, many good doctors use a small

number of formulas and medicinals, they just use them well.

 

Because I've seen good results with singles, I wouldn't take any

extreme stance on this issue. All of it works if the diagnosis is

correct and the patient is responsive. I'm just reporting on the

trends in use. If there is anything that I would personally add, it

is that people should pay attention to the dose and should attempt to

replicate the potency of raw formulas.

 

Eric

[Guest guest]

On 7/16/06, Eric Brand <smilinglotus wrote:

>

>

> If there is anything that I would personally add, it

> is that people should pay attention to the dose and should attempt to

> replicate the potency of raw formulas.

>

 

 

How do you assess the potency of an extract formula? I've been relying on

the taste mostly. When I take five capsules (around 2.5 grams total), as is

the common dosage for pre-manufactured formulas, open them up and dump them

into some hot water, it is not very strong of a taste. However if I can

double or triple that, it is more along the lines of a raw formula.

 

Its easier to have a patient take a teaspoon and a half or two teaspoons of

powder in water than it is to have them take 10 to 15 capsules four times

daily, the equivalent. This is mostly a perception issue.

 

-al.

 

--

 

Pain is inevitable, suffering is optional.

 

 

 

[Guest guest]

oops- by scoop I meant the spoons that KPC provides. One level scoop is on

the average about 0.9-1.1 grams depending on the herb. I had a KPC rep tell

me that going by the scoop is usually very close to the desired gram dosage.

 

Kip

 

 

On Behalf Of Eric Brand

Sunday, July 16, 2006 9:45 PM

 

Re: Granules: Formulas vs.Your Own Mix

 

 

 

@ <%40>

, " Kip Roseman " <kip wrote:

>

> I have been using KPC granules for five years now, and I'm very

satisfied

> with the results clinically. I primarily use individual herbs to build

> formulas, and occasionally will use a KPC formula as the base. I tend to

> dose 12-18 scoops/day for about 150 pounds. If I'm not mistaken, the

> standard Taiwanese dosing is roughly 18 scoops/day ~ is this

correct, Eric?

 

In Taiwan: 18 grams per day (how many " scoops " would depend on the

size of the scoop). Insurance limits the doses to 6 gram doses, with

a maximum of 4 doses per day (24 grams total). Few people use more

than 30 grams of extract per day, even without insurance

considerations. Using doses lower than 18 grams is less common in

Taiwan, but lower doses are sometimes used for children or mild cases.

 

In Taiwan, generally whole formulas are combined with the addition of

single medicinals rather than building a formula from scratch. They

feel that whole formulas are stronger than combined singles in terms

of their effect, so practitioners are trying to get as much mileage as

possible without exceeding the limit that the insurance covers. It is

also more economical in terms of the time it takes to fill formulas

that if it was all done from singles.

 

Personally, I have seen very good results with granule formulas that

were built from scratch from single extracts. Clearly both approaches

work. I think that the experience of the Taiwanese is valuable

because they have the most experience with the use of granules, and

Taiwanese practitioners often say that the result is superior with

whole formulas (but of course at this stage in its development, few

people probably make the comparison, they just use whole formulas with

single additions habitually).

 

The main distinction in Taiwan is that they use whole formulas in

combination, with more than one entire formula in a given

prescription. Here, they are using a whole formula as an addition

similar to the addition of a single herb. They think that adding a

whole formula that contains the target principle is stronger than

adding a single herb for that target principle. But of course they

have more formulas on hand and have a far greater proficiency than

most of us in terms of memorizing the formulas, their principles, and

their ingredients. Lacking the rhymes used in memorization (plus a

less memorization-based educational system) gives us Westerners

comparatively fewer options in terms of combining formulas, simply

because our repetoire of formulas that we have mastered is smaller.

Nonetheless, at the end of the day, many good doctors use a small

number of formulas and medicinals, they just use them well.

 

Because I've seen good results with singles, I wouldn't take any

extreme stance on this issue. All of it works if the diagnosis is

correct and the patient is responsive. I'm just reporting on the

trends in use. If there is anything that I would personally add, it

is that people should pay attention to the dose and should attempt to

replicate the potency of raw formulas.

 

Eric