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Hello,

 

There have been a few references to it, and I've been hearing about it

for some time: Are there any refernces to the use of powders as

employed (so I hear) at SIOM? Does anyone have experience working

with decoctions made from ground raw herbs? Here in Florida I know an

esteemed doctor who actually puts ground raw herbs in capsules. Any

insight would be appreciated.

 

Sincerely,

 

Brandt Stickley

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That is the traditional way to do so.., any formulas

called " xxxx san " was raw herbs ground to the powder

form..., the " GMP " standard herbs are modern

techniques to fit into this modern society

 

 

my two cents

 

Christine

--- Brandt Stickley <kbstickley wrote:

 

> Hello,

>

> There have been a few references to it, and I've

> been hearing about it

> for some time: Are there any refernces to the use

> of powders as

> employed (so I hear) at SIOM? Does anyone have

> experience working

> with decoctions made from ground raw herbs? Here in

> Florida I know an

> esteemed doctor who actually puts ground raw herbs

> in capsules. Any

> insight would be appreciated.

>

> Sincerely,

>

> Brandt Stickley

>

>

>

>

>

>

>

>

 

 

 

 

Christine Wei Chang, LAc, MTOM, DAOM

BOD & Herbal Medicine Committee

American Association of Oriental Medicine (AAOM)

310-951-8698 (cel)

panasiaintl

 

" I think, therefore I am. "

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I am familiar with these distinctions. My question regards the

specific way that SIOM dispenses formulas not traditionally designated

as San, using ground raw herbs. Bensky mentions it in the formulas book.

 

Thanks,

 

Brandt

 

, Christine Chang

<panasiaintl wrote:

>

> That is the traditional way to do so.., any formulas

> called " xxxx san " was raw herbs ground to the powder

> form..., the " GMP " standard herbs are modern

> techniques to fit into this modern society

>

>

> my two cents

>

> Christine

> --- Brandt Stickley <kbstickley wrote:

>

> > Hello,

> >

> > There have been a few references to it, and I've

> > been hearing about it

> > for some time: Are there any refernces to the use

> > of powders as

> > employed (so I hear) at SIOM? Does anyone have

> > experience working

> > with decoctions made from ground raw herbs? Here in

> > Florida I know an

> > esteemed doctor who actually puts ground raw herbs

> > in capsules. Any

> > insight would be appreciated.

> >

> > Sincerely,

> >

> > Brandt Stickley

> >

> >

> >

> >

> >

> >

> >

> >

>

>

>

>

> Christine Wei Chang, LAc, MTOM, DAOM

> BOD & Herbal Medicine Committee

> American Association of Oriental Medicine (AAOM)

> 310-951-8698 (cel)

> panasiaintl

>

> " I think, therefore I am. "

>

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Hello Brandt,

I have used raw herbal powders in decoction quite a lot. I believe bensky calls

them a

draft. Anyways I was given a good quality herb grinder from my mentor Dr Kinson

Wu. He

taught my how to make a draft by rough grinding a formula down, giving it to

the patient

in between 10 to 15 gram doses each time. What that means is a heaping

tablespoon in a

cup and a half of water, brought to a boil, and then depending on the herbs,

strained right

away or allowed to cook for twenty minutes. I found this technique to be quite

efficient

because I and the patient use less herbs, the cooking time is less, and the

overall cost is

lower. The only draw back is having to grind the formula in the first place. Dr

Wu makes all

his own indivual honey pills as well and because of all the extra work involved,

is only able

to see about five or so patients a day.

 

Best

Trevor

, " Brandt Stickley " <kbstickley

wrote:

>

> Hello,

>

> There have been a few references to it, and I've been hearing about it

> for some time: Are there any refernces to the use of powders as

> employed (so I hear) at SIOM? Does anyone have experience working

> with decoctions made from ground raw herbs? Here in Florida I know an

> esteemed doctor who actually puts ground raw herbs in capsules. Any

> insight would be appreciated.

>

> Sincerely,

>

> Brandt Stickley

>

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I've now seen a couple of references to putting herbs into capsule

form. Wouldn't that effect how they are metabolized, since you

wouldn't get the help of salivary amylases and the like? Does that

change the effectiveness?

 

Thanks,

 

--Sarah

 

Sarah E. Rivkin, MS, LAc, Dipl. OM

www.slopeacupuncture.com

 

 

, " Brandt Stickley "

<kbstickley wrote:

>

> Hello,

>

> There have been a few references to it, and I've been hearing about it

> for some time: Are there any refernces to the use of powders as

> employed (so I hear) at SIOM? Does anyone have experience working

> with decoctions made from ground raw herbs? Here in Florida I know an

> esteemed doctor who actually puts ground raw herbs in capsules. Any

> insight would be appreciated.

>

> Sincerely,

>

> Brandt Stickley

>

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Hi Sarah,

I use ground raw herbs often. I grind them up myself with one of those heavy

duty grinders. They are very handy.

I always give people the choice and find the compliance and pocketbook is more

condusive to powdered herbs.

Yes you are right. I do tell them too, that taking capsulated powders are the

least effective as they are almost all the way through the stomach before the

capsule is broken down. Results are still obvious though it may take longer.

I do not cap them. This they have to do themselves. I don't want to take the

time for that. I do cap them for my son, as it is the only way he will take

them. Often too people just spoon up the powder into a pot, and simmer briefly,

or let steep in boiling water. Then there is also the method of the honey balls.

This last one doesn't seem to atttractive to people I notice.

 

Marjorie

 

 

-

Sarah Rivkin

Thursday, September 21, 2006 7:02 AM

Re: Powder Herbs

 

 

I've now seen a couple of references to putting herbs into capsule

form. Wouldn't that effect how they are metabolized, since you

wouldn't get the help of salivary amylases and the like? Does that

change the effectiveness?

 

Thanks,

 

--Sarah

 

Sarah E. Rivkin, MS, LAc, Dipl. OM

www.slopeacupuncture.com

 

, " Brandt Stickley "

<kbstickley wrote:

>

> Hello,

>

> There have been a few references to it, and I've been hearing about it

> for some time: Are there any refernces to the use of powders as

> employed (so I hear) at SIOM? Does anyone have experience working

> with decoctions made from ground raw herbs? Here in Florida I know an

> esteemed doctor who actually puts ground raw herbs in capsules. Any

> insight would be appreciated.

>

> Sincerely,

>

> Brandt Stickley

>

 

 

 

 

 

 

 

 

 

Version: 7.0.405 / Virus Database: 268.12.5/451 - Release 9/19/2006

 

 

 

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On 9/21/06, trevor_erikson <trevor_erikson wrote:

 

He

taught my how to make a draft by rough grinding a formula down, giving

it to the patient

in between 10 to 15 gram doses each time. What that means is a heaping

tablespoon in a

cup and a half of water, brought to a boil, and then depending on the

herbs, strained right

away or allowed to cook for twenty minutes.

 

On what basis do you make that determination? More superficial the target of

the formula, the less time needed for cooking?

 

--

 

Pain is inevitable, suffering is optional.

 

 

 

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Exactly. If the target area is more superficial, ie an acute wind cold strike

or if the formula

countains larger amounts of sensitive aromatic/ pungent herbs then I would

probably

only cook the draft for up to five minutes.

 

Trevor

 

, " Al Stone " <al wrote:

>

> On 9/21/06, trevor_erikson <trevor_erikson wrote:

>

> He

> taught my how to make a draft by rough grinding a formula down, giving

> it to the patient

> in between 10 to 15 gram doses each time. What that means is a heaping

> tablespoon in a

> cup and a half of water, brought to a boil, and then depending on the

> herbs, strained right

> away or allowed to cook for twenty minutes.

>

> On what basis do you make that determination? More superficial the target of

> the formula, the less time needed for cooking?

>

> --

>

> Pain is inevitable, suffering is optional.

>

>

>

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Curious that so many grind their own when Mayway sells most herbs in

unsulphured raw powders. Those of you who grind your own care to comment on

why you spend the extra time? I used to grind mine, but buying herbs like

sheng di pre-ground is a blessing.

 

-Tim Sharpe

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The use of ground raw herbs in a tea bag (a draft) makes boiling a

formula much easier for patients who are pressured for time. We use

this method of administration frequently at the PCOM clinic here in

Chicago. I think this may be what you are referring to.

 

-Steve

 

On Sep 21, 2006, at 8:39 AM, Brandt Stickley wrote:

 

> I am familiar with these distinctions. My question regards the

> specific way that SIOM dispenses formulas not traditionally designated

> as San, using ground raw herbs. Bensky mentions it in the formulas

> book.

>

> Thanks,

>

> Brandt

>

> , Christine Chang

> <panasiaintl wrote:

>>

>> That is the traditional way to do so.., any formulas

>> called " xxxx san " was raw herbs ground to the powder

>> form..., the " GMP " standard herbs are modern

>> techniques to fit into this modern society

>>

>>

>> my two cents

>>

>> Christine

>> --- Brandt Stickley <kbstickley wrote:

>>

>>> Hello,

>>>

>>> There have been a few references to it, and I've

>>> been hearing about it

>>> for some time: Are there any refernces to the use

>>> of powders as

>>> employed (so I hear) at SIOM? Does anyone have

>>> experience working

>>> with decoctions made from ground raw herbs? Here in

>>> Florida I know an

>>> esteemed doctor who actually puts ground raw herbs

>>> in capsules. Any

>>> insight would be appreciated.

>>>

>>> Sincerely,

>>>

>>> Brandt Stickley

>>>

>>>

>>>

>>>

>>>

>>>

>>>

>>>

>>

>>

>>

>>

>> Christine Wei Chang, LAc, MTOM, DAOM

>> BOD & Herbal Medicine Committee

>> American Association of Oriental Medicine (AAOM)

>> 310-951-8698 (cel)

>> panasiaintl

>>

>> " I think, therefore I am. "

>>

>

>

>

>

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.

>

>

>

>

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I was told that the herbs do not keep very well unless you have the

equipment to extract all moisture content from the herbs, (freeze drying?)

for instance companies like Koda (whose powders are very expensive). If

you are powdering your own, then moulds will grow very quickly if they are

kept. Unless they are herbs that have antimicrobial actions, like huang

lian. I was told that herbs such as fu ling will start to go " off " very quickly.

This sounded reasonable to me, does anybody concur?

 

Lea Starck.

, " Tim Sharpe "

<listserve wrote:

>

> Curious that so many grind their own when Mayway sells most herbs in

> unsulphured raw powders. Those of you who grind your own care to

comment on

> why you spend the extra time? I used to grind mine, but buying herbs

like

> sheng di pre-ground is a blessing.

>

> -Tim Sharpe

>

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, Stephen Bonzak

<smb021169 wrote:

>

> The use of ground raw herbs in a tea bag (a draft) makes boiling a

> formula much easier for patients who are pressured for time. We use

> this method of administration frequently at the PCOM clinic here in

> Chicago. I think this may be what you are referring to.

 

On a similar note...If you make your own liniments, grind the herbs

first, then when you soak them in liquor or vinegar the formula will

need far less time to steep before it can be used. The other

advantage is that you can take the mud of the steeped ground herbs out

of the jar and use the mud as a paste for topical application. Just

wrap the mud in gauze and apply it to the affected site.

 

Eric

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All this powder talk reminds me of when we used to grind herbs in a herbal

pharmacy I

worked in. We quickly learned what didn't work- Sheng di - bad, bad idea. Di

Long - just

really creepy. And E jiao which would melt with the heat and bond (like glue!)

to the insides

of the grinder.

Still at home I grind up huang lian, chuan chan jia was an interesting

experience.

 

doug

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Why would any ground raw formula need to be cooked longer than 10 minutes?

When the material is powdered you get immediate water saturation of the

entire plant/mineral fiber. I would be surprised if you extracted " more "

from a raw powder with longer boiling. When I started doing raw powders

several years ago I had to rethink the preparation concepts we all

originally learned. Some issues become a little murky IMO, cooking times is

one for sure. The subtle art of altering cook time to alter function is

tough to know for ground raw. Da huang is a great example. How long of a

cook differentiates it's clear heat vs purgative effects? I don't know of

any literature on the subject.

 

Other unclear issues involve potency. Most people I know dose significantly

lower with raw powders. However, some herbs like huo ma ren are routinely

ground - so the dosing already considers that and it's dosage shouldn't be

lowered when adding to other ground raw herbs. Here's an example:

 

Assume a typical sample whole herb formula of 100g with 15g of huo ma ren.

Many use 1 bag for 2 days, so 50g per day including 7.5g of huo ma ren. Now

in general, practitioners utilizing ground raw herbs would give 9-12g per

day, not unlike granulars. If herbs are reduced in dosage roughly

proportionally in this scenario you would only get 1.5g of huo ma ren.

Since huo ma ren's moistening function is largely d/t it's physical

properties, this would not be an ideal dosage.

 

Other related dosing issues involve the degree to which bioavailability is

increased d/t grinding. Roots, barks, and other dense fibrous matter will

likely gain the most because their entire surface area will be made

available after grinding. Leaves, flowers, and the like will I think gain

less from the grinding process. So formula ratios will need to be adjusted

from the norm to compensate for this.

 

Other issues such as rancidity make it advantageous to order some herbs

whole to grind as needed, e.g. bai zi ren, huo ma ren. I would appreciate

any feedback on what herbs others have found to be prone to spoilage. Fu

Ling was mentioned recently.

 

Nearly all of this is based on my personal experience. I welcome the input

or objections of anyone with formal or experiential knowledge on this

matter.

 

Tim Sharpe L.Ac.

 

 

 

trevor_erikson

Friday, September 22, 2006 8:47 AM

 

Exactly. If the target area is more superficial, ie an acute wind cold

strike or if the formula contains larger amounts of sensitive aromatic/

pungent herbs then I would probably only cook the draft for up to five

minutes.

 

Trevor

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, " Tim Sharpe "

<listserve wrote:

 

> Other unclear issues involve potency. Most people I know dose

significantly

> lower with raw powders.

> Many use 1 bag for 2 days, so 50g per day including 7.5g of huo ma

ren. Now

> in general, practitioners utilizing ground raw herbs would give

9-12g per

> day, not unlike granulars.

 

You bring up some good points, Tim, especially about awareness of the

ratios of different meds when used as powders.

 

Boiling the powder solves the hygiene problem, and using a giant

teabag solves the filtering problem. The water circulation is

probably not as good at the interior of the teabag, but I would agree

that the method is still quite useful.

 

About the da huang thread, I think the breakdown of the purgative

constituents has more to do with the amount of time that they are

exposed to the boiling temperature, rather than the amount of time

that it takes them to enter the solution. Maybe a little less time is

needed to reduce its purgative effect? But probably not too much,

since da huang should be crushed before use anyway.

 

Directed at no one in particular:

 

While it is true that the increased surface area and bioavailability

of powders gives a bit more mileage per gram, why does our community

constantly underdose our patients? Is giving someone 9-12 grams of

powdered herbs per day ethical when the standard of care is at least

12-18 grams of approx. 5:1 extract per day? Can we advertise this as

Chinese medicine even though we are giving a fraction of the medicine

that is used in Chinese " medicine " ?

 

Is the main issue cost? Should we give patients the option of $3 per

pack for Chinese medicine or $1 per pack for placebo? Should we at

least inform them that the doses that we are using are far below the

standard for every hospital and small clinic in China?

 

People often split one pack into 2 days, whereas the standard dosing

in the East is one pack per day. People often rationalize this

(largely economic) decision based on the notion that " Westerners don't

have a history of using Chinese herbs, and are more sensitive to them

as a result. " Never mind that many Chinese people have never taken

the herbs that you are prescribing before. Imagine this scenario.

You go to a untouched rural area of an ethnically Samoan island. All

the locals are bigger than you in terms of body mass, but none have

encountered Western drugs before. Do you give them half doses of

aspirin? Half doses of anaesthetic? Half doses of antibiotics? Is

this ethical? Is it authentic? Should it be advertised as authentic WM?

 

We praise CM for having thousands of years of experience and

observation, then completely discard the results and recommendations

of all of that experience in favor of trail-blazing a new path on

unknowing guinea pig patients. Why? Because we fear to charge them

the cost of the raw materials (possibly even lining our own pockets

while we provide them)? Because we are worried that they won't taste

good? They taste bad to everyone. Everyone hates to pay for them.

But it is medicine, not recreation, why not just deal with it?

 

Eric Brand

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Eric,

I am in complete agreement with you on this issue. Chinese Herbology uses,

as Simon Mills put it, ³heroic dosages². I often use large dosages-

fearlessly- and I mostly get the results that I am seeking. This is

especially important in managing acute cases. But it is also important with,

say, managing side effects of chemo and radiation. And pain, and and

and.....

 

But there is a place for lower dosages.- long term tonification for

instance. And here, there is a useful place for prepared formulas.

 

That said: if we can get results with a lower dose, shouldn¹t we use less?

To use your example: if your depression was alleviated with 5 mgs Prozac,

why use the standard dose of 20 mgs? Increasing the dose risks increasing

the side effects. And with herbs and with drugs it is nearly always

axiomatic: increase the effects and thus increase the side effects. We

shouldn¹t be afraid of using large quantities of herbs if it¹s called for,

yet we have an obligation to discover the lowest effective dosage for that

patient.

 

Cara O. Frank, R.Ac, Dipl Ac & Ch.H.

President China Herb Company of the Chinese Herb Program

Tai Sophia Institute of the Healing Arts

215-438-2977

Fax 215-849-3338

 

 

Directed at no one in particular:

 

While it is true that the increased surface area and bioavailability

of powders gives a bit more mileage per gram, why does our community

constantly underdose our patients? Is giving someone 9-12 grams of

powdered herbs per day ethical when the standard of care is at least

12-18 grams of approx. 5:1 extract per day? Can we advertise this as

Chinese medicine even though we are giving a fraction of the medicine

that is used in Chinese " medicine " ?

 

Is the main issue cost? Should we give patients the option of $3 per

pack for Chinese medicine or $1 per pack for placebo? Should we at

least inform them that the doses that we are using are far below the

standard for every hospital and small clinic in China?

 

People often split one pack into 2 days, whereas the standard dosing

in the East is one pack per day. People often rationalize this

(largely economic) decision based on the notion that " Westerners don't

have a history of using Chinese herbs, and are more sensitive to them

as a result. " Never mind that many Chinese people have never taken

the herbs that you are prescribing before. Imagine this scenario.

You go to a untouched rural area of an ethnically Samoan island. All

the locals are bigger than you in terms of body mass, but none have

encountered Western drugs before. Do you give them half doses of

aspirin? Half doses of anaesthetic? Half doses of antibiotics? Is

this ethical? Is it authentic? Should it be advertised as authentic WM?

 

We praise CM for having thousands of years of experience and

observation, then completely discard the results and recommendations

of all of that experience in favor of trail-blazing a new path on

unknowing guinea pig patients. Why? Because we fear to charge them

the cost of the raw materials (possibly even lining our own pockets

while we provide them)? Because we are worried that they won't taste

good? They taste bad to everyone. Everyone hates to pay for them.

But it is medicine, not recreation, why not just deal with it?

 

Eric Brand

 

 

 

 

 

 

 

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I was told by the chair of the herbal dept at one of the larger schools that

Chinese literature suggests that powdered raw has been found to be 5-10

times more potent than whole raw. I found this hard to swallow then, and

still do. No source was provided, and I honestly don't think he cared

enough to research it on his own since he never prescribed that way. As

some support of the issue Jake Fratkin told me once that his herbal mentor

recommended 9-12g per day of raw powders. Again, not at all conclusive. I

personally base my dosing on what seems to be efficacious, and more

importantly - safe. Depending on the amount of increased efficacy though -

it's possible to exceed the recommend dosing for many herbs - especially if

10x holds true. Another related issue, about 8 months ago someone - I think

it was you Eric, mentioned the increased toxicity of powdered minerals.

 

As for cost, it is not much of an issue for ground raw. If I doubled my

dosing it would add less than $1.50 to the formula at an average of about

$.014 per gram.

 

Lastly, I want to bring up something important from the thread I started in

February on this issue. In addition to raw powder decoctions in general,

this is also in regards to consuming some or all of the crude powdered herb,

which is easy to do because it often " vaporizes " in decoction - unless you

powder it yourself. (Home-made powders seem to have much larger

particulate).

____________________

 

Tim Sharpe wrote:

> - My final cooking method concern is whether any toxic compounds

> bound in the plant fiber will be released upon grinding and cooking.

> Could a previously safe herb release a Pandora's box of whoop ass once the

 

> plant fiber is pulverized?

____________________

 

George Mandler

Wednesday, February 08, 2006 8:50 AM

 

This would be my biggest concern since with grinding we are ingesting

all compounds. There can be many inorganic solvents not hydrated by

water, so during a decoction they remain in the herb instead of

dispersing in the water. What is released during a decoction depends

on the hydrophilic/lipophilic ratio of the compounds, but in general

many of the well known chemicals are lipophilic. If they get ground

into a powder you are ingesting all the hydrophilic and lipophilic

compounds.

 

(I believe that paper released 8 months ago by Saper et al. reporting

heavy metals found in Ayurvedic herbs used the ground raw herbs.

This is the way Banyan distributes their powdered Ayurvedic herbs and

back some 5 years Banyan did not guarantee any CA on herb safety.)

 

--george

______________________

 

Eric Brand

Monday, September 25, 2006 12:29 AM

 

 

While it is true that the increased surface area and bioavailability

of powders gives a bit more mileage per gram, why does our community

constantly underdose our patients? Is giving someone 9-12 grams of

powdered herbs per day ethical when the standard of care is at least

12-18 grams of approx. 5:1 extract per day.

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, Cara Frank <herbbabe

wrote:

 

> But there is a place for lower dosages.- long term tonification for

> instance. And here, there is a useful place for prepared formulas.

 

I totally agree. And history and mainstream modern Chinese clinical

medicine also agrees. Many of the supplementing formulas were

historically made into pill forms, and tonic wines give palpable

effects even though the whole 3 liter bottle has only 5 or 8 qian of

any given ingredient in it.

 

I'm not advocating ONLY and ALWAYS using high-doses, I'm just

advocating routinely using standard doses. Honestly, there are many

people who have never tried using standard doses. It is a bit like

going straight to needling obscure points without ever trying out

St-36 and Sp-6. It's not to say that those other points don't work,

but sometimes people seem to think it is so hip to be different and

take the road less travelled that they don't ever even try the common

sense basic approach. The basics aren't meant to be rigid and

limiting, but they are basic standards for the simple reason that they

generally work consistently.

 

 

> That said: if we can get results with a lower dose, shouldn¹t we use

less?

 

Again, I agree with you that the lowest effective dose is the one that

should be used. But I do wonder how many times people have changed

their diagnosis looking for a better effect when the problem or

side-effects could have been solved simply by dosing a little higher

or a little lower.

 

Eric

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, " Tim Sharpe "

<listserve wrote:

>

> I was told by the chair of the herbal dept at one of the larger

schools that

> Chinese literature suggests that powdered raw has been found to be 5-10

> times more potent than whole raw.

 

Sounds a bit extreme to me. More potent, for sure, but 5-10 times?

By that rationale, we'd be using lu rong at a decoction dose of 10-20

grams three times per day. Maybe for some things that are clearly

better utilized in powder, this may be true- san qi, for example, is

more effective as a powder.

 

In Chinese texts, a good number of medicinals are given a lower dose

range when used in powders than they are when used in decoctions, but

it is rarely 5-10 times lower. And these are overshadowed by the vast

majority of medicinals that are just given one dose range, followed

by: " in decoctions, powders, or pills. " Granted, Chinese books are

often a bit vague and expect you to know how to vary things

accordingly (for example, they always say " use a suitable amount

externally " ), but I think that if powders were that much more potent

and effective, decoctions would have been done away with two thousand

years ago.

 

Judging from people's responses to the Salvia divinorum thread, I'd

wager that any number of people on this list could give you an

estimate on the reliability of the 5-10X potency debate of ground vs.

decocted, based on a simple assessment of a relatively common

experience that is easily and palpably quantified: ingestion of magic

mushrooms. Many people would agree that decocting mushrooms as a tea

is slightly less strong than eating them straight, which is in turn

slightly less strong than eating them straight if they have first been

finely ground to increase their surface area. But 5-10 times

stronger? You'd be hard-pressed to find people who would support that

theory.

 

 

Another related issue, about 8 months ago someone - I think

> it was you Eric, mentioned the increased toxicity of powdered

minerals.

 

If it was me, I would have only mentioned increased toxicity about

medicinals that actually possess toxicity, such as dai zhe shi.

Actually, many minerals are meant to be taken as powders. Others are

meant to be decocted- for the ones that are meant to be decocted and

are instead taken directly as powders, it should be considered virgin

territory. Doing something that hasn't been done before. Maybe

toxic, maybe benign, maybe even helpful and revolutionary. But you

don't have 2000 years of experience at your back when you do this, and

your malpractice lawyer might not endorse your pioneering.

 

Side note, then I will shut up and stop taking so much bandwidth...

 

I think storage of powders has a lot to do with climate. Most things

degrade with light, heat, moisture, and oxygen. Minimize those things

and you will maximize shelf-life. Herbs will mold much faster in Hong

Kong than they will in Montana.

 

Eric

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I think that the most important point to be made is whether a formula is

effective or

not. In the times that I like to use herbal powders, administered as a draft, I

find that cost

and patient compliance are weighing factors in having an effective outcome. The

prep time

and expense for some patients does, in my experience, deter them from taking CM.

If all

they have to do is add a heaping tablespoon of ground herbs to a cup of water

and bring it

to a boil, I have found that patients will follow through with the treatment

better. My usual

dose is 15 grams per serving. At 3 servings a day thats 45 grams a day. I don't

think that

this is a trail blazing idea. Many of the formulas listed in Benskys formula

book mention

the original use of the formula being ground into powders and administered via

drafts in

dosages, usually between 6-9g a dose, which is even lower than I or my teacher

use. Is

that to say that we don't get good results or that the formula founders didn't

either?

I think that we have to be carefull assuming so called standards for

treatment. Some

of my teachers have moved back to China so that they can actually have more

therapeutic

range with their patients. Meaning if they wanted to, they could prescribe 100g

of Fu Zi

and watch the result. This is true with the lower end dosages as well. I feel

that the real

beauty of CM is that we have room to explore. We can play with dosage and

ingredients

much more so than western medicine, all for the betterment of the patient and

our

profesion. If practitoners hadn't " trail blazed " new ideas related to standards

of care then

many more species would be extinct on our planet than are already, as in using

Shui Niu

Jiao instead of Xi Jiao. We would also still be using ren shen instead, of the

more recently

common, dang shen.

As Dr Kingson Wu told me when I passed my liscencing exams, ' Don't simply

believe

everything that you are told to be true, prove it in your clinical practice. "

 

Trevor

 

 

, " Eric Brand " <smilinglotus

wrote:

>

> , " Tim Sharpe "

> <listserve@> wrote:

>

> > Other unclear issues involve potency. Most people I know dose

> significantly

> > lower with raw powders.

> > Many use 1 bag for 2 days, so 50g per day including 7.5g of huo ma

> ren. Now

> > in general, practitioners utilizing ground raw herbs would give

> 9-12g per

> > day, not unlike granulars.

>

> You bring up some good points, Tim, especially about awareness of the

> ratios of different meds when used as powders.

>

> Boiling the powder solves the hygiene problem, and using a giant

> teabag solves the filtering problem. The water circulation is

> probably not as good at the interior of the teabag, but I would agree

> that the method is still quite useful.

>

> About the da huang thread, I think the breakdown of the purgative

> constituents has more to do with the amount of time that they are

> exposed to the boiling temperature, rather than the amount of time

> that it takes them to enter the solution. Maybe a little less time is

> needed to reduce its purgative effect? But probably not too much,

> since da huang should be crushed before use anyway.

>

> Directed at no one in particular:

>

> While it is true that the increased surface area and bioavailability

> of powders gives a bit more mileage per gram, why does our community

> constantly underdose our patients? Is giving someone 9-12 grams of

> powdered herbs per day ethical when the standard of care is at least

> 12-18 grams of approx. 5:1 extract per day? Can we advertise this as

> Chinese medicine even though we are giving a fraction of the medicine

> that is used in Chinese " medicine " ?

>

> Is the main issue cost? Should we give patients the option of $3 per

> pack for Chinese medicine or $1 per pack for placebo? Should we at

> least inform them that the doses that we are using are far below the

> standard for every hospital and small clinic in China?

>

> People often split one pack into 2 days, whereas the standard dosing

> in the East is one pack per day. People often rationalize this

> (largely economic) decision based on the notion that " Westerners don't

> have a history of using Chinese herbs, and are more sensitive to them

> as a result. " Never mind that many Chinese people have never taken

> the herbs that you are prescribing before. Imagine this scenario.

> You go to a untouched rural area of an ethnically Samoan island. All

> the locals are bigger than you in terms of body mass, but none have

> encountered Western drugs before. Do you give them half doses of

> aspirin? Half doses of anaesthetic? Half doses of antibiotics? Is

> this ethical? Is it authentic? Should it be advertised as authentic WM?

>

> We praise CM for having thousands of years of experience and

> observation, then completely discard the results and recommendations

> of all of that experience in favor of trail-blazing a new path on

> unknowing guinea pig patients. Why? Because we fear to charge them

> the cost of the raw materials (possibly even lining our own pockets

> while we provide them)? Because we are worried that they won't taste

> good? They taste bad to everyone. Everyone hates to pay for them.

> But it is medicine, not recreation, why not just deal with it?

>

> Eric Brand

>

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Cara O. Frank, R.Ac, Dipl Ac & Ch.H.

President China Herb Company of the Chinese Herb Program

Tai Sophia Institute of the Healing Arts

215-438-2977

Fax 215-849-3338

 

We are on the same page. When I am getting somewhat satisfactory results,

but not really nailing a problem, I always look at dosages first. Before I

re-write the formula

Cara

 

Again, I agree with you that the lowest effective dose is the one that

should be used. But I do wonder how many times people have changed

their diagnosis looking for a better effect when the problem or

side-effects could have been solved simply by dosing a little higher

or a little lower.

 

Eric

 

 

 

 

 

 

 

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Re: Large doses of herbs.

 

I would like to discuss two points. The first is that in China, the quality

of the herbs used is often much poorer than that which is used here in

Australia. (I cant speak for the rest of the world.) In China, many

dispensary's use, say, grade c and d dang gui, whereas in Australia it

is more usual to use a or b grade. Same for many of the herbs. (Of

course you can pay for quality herbs in China, but I am talking about

your average street dispensary / pharmacy or hospital dispensary.) It is

for this reason that I was told that even though I was seeing dosages of

often about 30g of raw herbs in China, this wasnt always necessary in

practice in Australia. (I had a look at the quality of herbs in many

dispensaries in China, and found this to be true.) When I first learnt

this, it ran sort of counter to my expectations, but is nonetheless the

case.

The second point I would like to mention is something that I learnt in a

student clinic a few years ago. I had one supervising clinician (new in

from China) and he supervised one of my prescriptions and

recommended 30g of He Shou Wu for a patient with hair loss.) The

next time I saw that patient, my supervising clinician (another Chinese

practitioner, but this time a lady) saw the 30g dosage and pointed out

to me that from her perspective you shouldnt always start with a huge

dosage, as then you have nowhere to go with it. If you start lower then

you can always increase it. I thought this was pretty good advice.

That being said, I use large doses of herbs such as ban lan gen for

acute cases such as Herpes / shingles, and also tend to recommend

that some of my western clients take larger than stated doses of

Chinese manufactured patent formulae, purely because they are

physically larger than the Asian clients the doses were formulated for.

My two cents. :)

Lea Starck.

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I believe you can buy sheng di in powdered form already. Not sure

which distributor does this.

 

-Steve

 

On Sep 24, 2006, at 12:34 AM, wrote:

 

> All this powder talk reminds me of when we used to grind herbs in a

> herbal pharmacy I

> worked in. We quickly learned what didn't work- Sheng di - bad, bad

> idea. Di Long - just

> really creepy. And E jiao which would melt with the heat and bond

> (like glue!) to the insides

> of the grinder.

> Still at home I grind up huang lian, chuan chan jia was an interesting

> experience.

>

> doug

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.

>

>

>

>

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Lea,

 

Your point about adjusting dosages based on patient size (up OR down)

is well taken. I find that this factor is often overlooked. Adjusting

dose based on age is also important, especially as the population

using Chinese medicine ages. IMO, Western CM practitioners need to pay

more attention to the issue of variability of dose. As an extension of

that, when it comes to using ready-made medicines, one needs to know

their equivalency to bulk-dispensed, water-decocted medicinals before

one can actually determine the correct dose. Interestingly, more and

more in the Chinese journal literature, authors are including such

equivalences (i.e., extract ratios) when discussing ready-made

medicines used in RCTs.

 

Bob

 

, " Lea Starck " <leabun1

wrote:

>

> Re: Large doses of herbs.

>

> I would like to discuss two points. The first is that in China, the

quality

> of the herbs used is often much poorer than that which is used here in

> Australia. (I cant speak for the rest of the world.) In China, many

> dispensary's use, say, grade c and d dang gui, whereas in Australia it

> is more usual to use a or b grade. Same for many of the herbs. (Of

> course you can pay for quality herbs in China, but I am talking about

> your average street dispensary / pharmacy or hospital dispensary.)

It is

> for this reason that I was told that even though I was seeing

dosages of

> often about 30g of raw herbs in China, this wasnt always necessary in

> practice in Australia. (I had a look at the quality of herbs in many

> dispensaries in China, and found this to be true.) When I first learnt

> this, it ran sort of counter to my expectations, but is nonetheless the

> case.

> The second point I would like to mention is something that I learnt

in a

> student clinic a few years ago. I had one supervising clinician (new in

> from China) and he supervised one of my prescriptions and

> recommended 30g of He Shou Wu for a patient with hair loss.) The

> next time I saw that patient, my supervising clinician (another Chinese

> practitioner, but this time a lady) saw the 30g dosage and pointed out

> to me that from her perspective you shouldnt always start with a huge

> dosage, as then you have nowhere to go with it. If you start lower then

> you can always increase it. I thought this was pretty good advice.

> That being said, I use large doses of herbs such as ban lan gen for

> acute cases such as Herpes / shingles, and also tend to recommend

> that some of my western clients take larger than stated doses of

> Chinese manufactured patent formulae, purely because they are

> physically larger than the Asian clients the doses were formulated for.

> My two cents. :)

> Lea Starck.

>

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