Granule dosage question

April 3, 2007

I'd be interested in hearing more experiences between the use of

granules and teas. For instance the upper dosage of Minor Bupleurum in

him Che Yeung comes to about 72 to 80 grams a day -- depending on how

many grams of jujube dates one uses. Using a 5 to 1 dry extract

granule preparation this would mean that a patient take about 16 grams

of granules each day, divided into two or three doses.

Sorry but I haven't measured out the weight amount of a teaspoon of

granules but this formula only involves 7 herbs. Compare this to a

total of 141 grams for tian wang bu xin dan which would mean that in

granules a patient would need to take 28 grams a day to equal the raw

herb dose.

(of course one would leave out the cinnabar).

This is a great difference both in the concentration of herbs taken

and the expense.

Now how does this even begin to compare with the dosage of the 8

little pills of the patent tian wang.

My general approach is to have a patient take a teaspoon of most

granules two or three times daily, swallowed down with water.

Measured by this standard, cancer formulas can aspire to the

gargantuan both in the amount of herbs and grnuales that would be

indicated.

I'm forced to consider why I may not always achieve the kind of

metabolic changes reflected in symptomology ad other signs such as

tongue using such low non-standard doses.

I then consider the fact that Kanpo uses about a third of the dosage

of TCM formulas and treats the classical formulas almost as if they

were homeopathic versions of the same with wider uses and indications

than TCM.

So I'm interested in:

1. How does one measure and prepare a TCM herbal formula using granules.

2. Comments about the efficacy of dosage variances between TCM raw

herb, Kanpo and granules.

3. How much of the granules of a specific formula does one need to

prescribe to achieve the results of the TCM formulation.

April 3, 2007

Good questions... my experience is not really a good answer, only my

experience. So, generally I don't have the patient take more of a

formula when there are more herbs in it. What sets the upper limit of

my dosage is often what the patient can handle, both in their stomach

and the economics. For difficult cases, such as cancer, I tell them

that the raw herbs are the strongest and most flexible and generally

they comply. My hope and justification is that even if there are less

ingredients the synergy of the many makes the formula that much more

potent without the raise in dosage of each herb. It's a blind spot,

but it seems to work and I would go nuts trying to figure out each

dosage per the number of ingredients (not mention the concentrations).

So it usually stays at 90 grams of the total weight for each patient.

I wonder about dosage, how much a body can absorb, if big dosages

aren't the equivilant of China style acupuncture vs. light needling.

It may just be a justification, again, but I'd still maintain that a

formula right on the mark doesn't have to require huge dosages.

doug

, " Michael Tierra "

<mtierra wrote:

>

> I'd be interested in hearing more experiences between the use of

> granules and teas. For instance the upper dosage of Minor Bupleurum in

> him Che Yeung comes to about 72 to 80 grams a day -- depending on how

> many grams of jujube dates one uses. Using a 5 to 1 dry extract

> granule preparation this would mean that a patient take about 16 grams

> of granules each day, divided into two or three doses.

>

> Sorry but I haven't measured out the weight amount of a teaspoon of

> granules but this formula only involves 7 herbs. Compare this to a

> total of 141 grams for tian wang bu xin dan which would mean that in

> granules a patient would need to take 28 grams a day to equal the raw

> herb dose.

>

> (of course one would leave out the cinnabar).

>

> This is a great difference both in the concentration of herbs taken

> and the expense.

>

> Now how does this even begin to compare with the dosage of the 8

> little pills of the patent tian wang.

>

> My general approach is to have a patient take a teaspoon of most

> granules two or three times daily, swallowed down with water.

>

> Measured by this standard, cancer formulas can aspire to the

> gargantuan both in the amount of herbs and grnuales that would be

> indicated.

>

> I'm forced to consider why I may not always achieve the kind of

> metabolic changes reflected in symptomology ad other signs such as

> tongue using such low non-standard doses.

>

> I then consider the fact that Kanpo uses about a third of the dosage

> of TCM formulas and treats the classical formulas almost as if they

> were homeopathic versions of the same with wider uses and indications

> than TCM.

>

> So I'm interested in:

>

> 1. How does one measure and prepare a TCM herbal formula using granules.

> 2. Comments about the efficacy of dosage variances between TCM raw

> herb, Kanpo and granules.

> 3. How much of the granules of a specific formula does one need to

> prescribe to achieve the results of the TCM formulation.

>

April 3, 2007

Agreed.

-Jason

_____

On Behalf Of

but I'd still maintain that a

formula right on the mark doesn't have to require huge dosages.

April 3, 2007

The search for the ever elusive 'formula right on the mark' -- I've seen it

a few times in my career but I must confess that too often I wind up pushing

a lot of elements in the body just to make a dent in one -- and hoping that

i'm not causing further imbalance.

What happened to that old saying that students tend to use many formulas but

masters tend to use fewer with appropriate adjustments. I still use a lot of

different formulas so I'm not sure that i've made the master level yet (in

fact, I don't think i have) but after 35 years I'm still trying.

Chang chung jing used some 120 formulas mostly variations of a few for most

of his cases. Li Dong Yuan used his favorite set of formulas. The way I see

it a master formula such as Bu Zhong, Liu Wei, Xiao Chai Hu San, Da cheng qi

tang, etc represents not only a patient but a strategy for treatment and it

is the strategy of how to treat liver or kidney yin deficiency that comes

before the formula. --- and this is part of the 'style' of treatment of the

practitioner.

We must each strive for the highest but at the same time recognize that

those masterful case studies of Jiao Shu De represents the creme and no, we

don't get to hear the compromises and failures. Its sort of like how power

hitters in baseball who hit the most homeruns are also most often struck

out.

So is dosage of granules important? I see that most are willing to settle

for 9 grams of a formula with any number of herbs in it. Doesn't quite make

sense to me -- but oh well.

As for me, I tend to overlap a lot in my practice. Patients with more

complicated conditions than a cold or flu, often get granules tailored to

their pattern conformation, a more general tea (I like to use Western herbs

and try to choose from those that are not so obnoxious tasting like

sassafras, sarsaparilla, burdock, dandelion, parsley root, celery seed,

althea, etc. easy on the bitter herbs like Oregon grape. Then I might give

them some pills that somewhat embody the treatment principle. Everyone gets

triphala and everyone past the age of 50 gets guggul -- you can ask me about

those if you like. As of late Iike prescribing Chyavanprash the 'all

purpose' Ayurvedic tonic.

So that's how I do it. I'm always interested to hear how others dispense

herbs.

_____

On Behalf Of

Tuesday, April 03, 2007 5:29 PM

Re: Granule dosage question