Guest guest Posted May 22, 2008 Report Share Posted May 22, 2008 Dear Group, For those of you that are interested in granulars check out the latest Cinnabar Creek. Andy Ellis does a great job in describing the problems with dosage and potency related to the commonly touted " extraction ratio. " A few months ago I did quite a bit of research, having some in depth discussion with him and other experts in the field. His paper summarizes most of the issues quite well. Here is some summary ideas and further thoughts. One major point that he nails is that ratios are pretty meaningless for determining dosage (and potency), and this is one reason I think they have been dropped from US labels. I started my pursuit, because I wanted to know every ratio of every single herb so I could calculate the best dosage for my patient. Seems logical at first... well not really. Now, I have little concern if 1 of the herbs is a 3:1 or a 6:1. IMO, this ratio thinking only confuses the issue. The fact is, even from batch to batch, ratios of the same medicinal will differ, depending on factors such as the quality of given batch of herbs (i.e. moisture content). However there are additional considerations that are employed to balance out the equation so that the potency is relatively the same, even though the extraction ratios may differ. (FYI- Extraction ratio of 3:1, is i.e. 3 KG of dang gui yielding 1 KG of powdered extract). However, while merely beefing up extraction ratios by starting with more herbs (better for sales), the final product may drastically suffer in quality. For example, the ratio of active constituents can change dramatically based on which ingredients get pulled out first. (The water can only hold so much extracted material before it gets saturated. Starting with more herbs can saturate the liquid too fast, not allowing important (deeper) ingredients to be extracted. This concept is well known in Western herbalism. Since this is a relatively new technology for Chinese medicine, it is my observation that it may be insightful to look at the processing of Western Botanicals (maybe Thomas can proved some further insight). I think they have many of the same issues. Because health foods stores are the largest market for sales this lends itself to many complications. Essentially we have an uneducated public making choices based on labels and a cursory read of " ratios " and " amounts. " Companies tweak these numbers to maximize buying appeal. For example one may see a bottle with a 20:1 ratio, and one with a 5:1 ratio. Without proper education one might assume that the 20:1 is a better buy, but in such cases many times this is a mere marketing tool more than clinical relevance. However, as the educated buyer knows some lower concentrations (or extraction ratios) outperform the higher ones. The reasons are many. One is of course the quality of the starting product, but more important and relevant to this discussion is the process and the optimal ratio for that given medicinal. Ratio used for tinctures, although slightly different technology provides some insight. For example, when making tinctures, different herbs require different ratios of alcohol to plant (i.e. 1:5 or 1:2), as well as different ratios of alcohol to water (i.e. 55% or 80%). Although there is some debate within the community about optimal numbers, nonetheless they are important measures that are used by many herbalists. Chinese herbs are no different. Optimal cooking time, ratio of starting herb to finished extract, has been determined by the granular companies (for each herb) in hope of the end product mimicking a water decoction as close as possible. Therefore one herb may require a 3:1 ratio, while another 7:1. This is precisely why the common 5:1 concept is not technically accurate, although may be helpful in thinking about dosage. Actually most singles are not 5:1. If the methods are correct, then an end product of 3:1 or 6:1 makes little difference. They still should be prescribed as equals. For example, if dang gui and sheng di (much different extraction ratios) are 8 grams in a normal decoction based formula, one might choose to use 1 gram a day of both of these in a given granular formula. In the end, a company could easily make a 10:1, 20:1 or 30:1 extract, but this does not translate into a better product and knowing the individual ratios of herbs seems of little concern. Note: Formulas that are cooked together bypass many of these issues. Most of this is explained much better and in more detail by Andy. I think this is an interesting topic, other's comments? -Jason <http://maps./py/maps.py?Pyt=Tmap & addr=2600+30th+Street%2C+Suite+20 0 & csz=Boulder%2C+Co & country=us> 2600 30th Street, Suite 200 Boulder, Co 80301 <http://www.plaxo.com/signature?src=client_sig_212_1_simple_sig<=en> Want a signature like this? Quote Link to comment Share on other sites More sharing options...
Guest guest Posted May 22, 2008 Report Share Posted May 22, 2008 And then go to www.bluepoppy.com to read my rebuttal of some of Andy's points. Also, please keep in mind that both Andy and myself have personal economic stakes in this discussion. I mention this as fair disclosure and to help promote critical reading and thinking skills. Bob , " " wrote: > > Dear Group, > > > > For those of you that are interested in granulars check out the latest > Cinnabar Creek. Andy Ellis does a great job in describing the problems with > dosage and potency related to the commonly touted " extraction ratio. " A few > months ago I did quite a bit of research, having some in depth discussion > with him and other experts in the field. His paper summarizes most of the > issues quite well. Here is some summary ideas and further thoughts. > > > > One major point that he nails is that ratios are pretty meaningless for > determining dosage (and potency), and this is one reason I think they have > been dropped from US labels. I started my pursuit, because I wanted to know > every ratio of every single herb so I could calculate the best dosage for my > patient. Seems logical at first... well not really. Now, I have little > concern if 1 of the herbs is a 3:1 or a 6:1. IMO, this ratio thinking only > confuses the issue. > > > > The fact is, even from batch to batch, ratios of the same medicinal will > differ, depending on factors such as the quality of given batch of herbs > (i.e. moisture content). However there are additional considerations that > are employed to balance out the equation so that the potency is relatively > the same, even though the extraction ratios may differ. (FYI- Extraction > ratio of 3:1, is i.e. 3 KG of dang gui yielding 1 KG of powdered extract). > > > > However, while merely beefing up extraction ratios by starting with more > herbs (better for sales), the final product may drastically suffer in > quality. For example, the ratio of active constituents can change > dramatically based on which ingredients get pulled out first. (The water can > only hold so much extracted material before it gets saturated. Starting with > more herbs can saturate the liquid too fast, not allowing important (deeper) > ingredients to be extracted. This concept is well known in Western > herbalism. > > > > Since this is a relatively new technology for Chinese medicine, it is my > observation that it may be insightful to look at the processing of Western > Botanicals (maybe Thomas can proved some further insight). I think they have > many of the same issues. Because health foods stores are the largest market > for sales this lends itself to many complications. Essentially we have an > uneducated public making choices based on labels and a cursory read of > " ratios " and " amounts. " Companies tweak these numbers to maximize buying > appeal. For example one may see a bottle with a 20:1 ratio, and one with a > 5:1 ratio. Without proper education one might assume that the 20:1 is a > better buy, but in such cases many times this is a mere marketing tool more > than clinical relevance. However, as the educated buyer knows some lower > concentrations (or extraction ratios) outperform the higher ones. The > reasons are many. One is of course the quality of the starting product, but > more important and relevant to this discussion is the process and the > optimal ratio for that given medicinal. > > > > Ratio used for tinctures, although slightly different technology provides > some insight. For example, when making tinctures, different herbs require > different ratios of alcohol to plant (i.e. 1:5 or 1:2), as well as different > ratios of alcohol to water (i.e. 55% or 80%). Although there is some debate > within the community about optimal numbers, nonetheless they are important > measures that are used by many herbalists. > > > > Chinese herbs are no different. Optimal cooking time, ratio of starting herb > to finished extract, has been determined by the granular companies (for each > herb) in hope of the end product mimicking a water decoction as close as > possible. Therefore one herb may require a 3:1 ratio, while another 7:1. > This is precisely why the common 5:1 concept is not technically accurate, > although may be helpful in thinking about dosage. Actually most singles are > not 5:1. If the methods are correct, then an end product of 3:1 or 6:1 makes > little difference. They still should be prescribed as equals. For example, > if dang gui and sheng di (much different extraction ratios) are 8 grams in a > normal decoction based formula, one might choose to use 1 gram a day of both > of these in a given granular formula. In the end, a company could easily > make a 10:1, 20:1 or 30:1 extract, but this does not translate into a better > product and knowing the individual ratios of herbs seems of little concern. > > > > Note: Formulas that are cooked together bypass many of these issues. > > > > Most of this is explained much better and in more detail by Andy. I think > this is an interesting topic, other's comments? > > > > -Jason > > > > <http://maps./py/maps.py?Pyt=Tmap & addr=2600+30th+Street%2C+Suite+20 > 0 & csz=Boulder%2C+Co & country=us> 2600 30th Street, Suite 200 > Boulder, Co > 80301 > > > > > > > > <http://www.plaxo.com/signature?src=client_sig_212_1_simple_sig<=en> Want a > signature like this? > > > > > > Quote Link to comment Share on other sites More sharing options...
Guest guest Posted May 22, 2008 Report Share Posted May 22, 2008 , " Bob Flaws " <pemachophel2001 wrote: > > And then go to www.bluepoppy.com to read my rebuttal of some of Andy's > points. Also, please keep in mind that both Andy and myself have > personal economic stakes in this discussion. I mention this as fair > disclosure and to help promote critical reading and thinking skills. Both Bob and Andy's articles are very interesting. Mandatory reading for herbalists, to say the least. I've been to multiple factories in both China and Taiwan, I've seen their research labs, their cooking facilities, and the hospitals that use their products. China and Taiwan use different extraction and packaging technology as well as a different style of dosing and formula composition. Both styles have unique advantages and disadvantages, and each has merit and efficacy when used correctly. There are many factors that need to be considered if we are going to discuss the differences between the Taiwanese and mainland Chinese methods and products. I'll be posting at length on this topic as soon as I have some free time to sit down and write. Certainly I'm glad to see the issue coming up, and I really enjoyed both Andy and Bob's articles on the topic. Eric Quote Link to comment Share on other sites More sharing options...
Guest guest Posted May 22, 2008 Report Share Posted May 22, 2008 Where can I find Andy¹s article ? Cara O. Frank, R.OM, Dipl Ac & Ch.H. Eric Brand <smilinglotus Thu, 22 May 2008 18:04:20 +0000 Re: Granulars <%40> , " Bob Flaws " <pemachophel2001 wrote: > > And then go to www.bluepoppy.com to read my rebuttal of some of Andy's > points. Also, please keep in mind that both Andy and myself have > personal economic stakes in this discussion. I mention this as fair > disclosure and to help promote critical reading and thinking skills. Both Bob and Andy's articles are very interesting. Mandatory reading for herbalists, to say the least. I've been to multiple factories in both China and Taiwan, I've seen their research labs, their cooking facilities, and the hospitals that use their products. China and Taiwan use different extraction and packaging technology as well as a different style of dosing and formula composition. Both styles have unique advantages and disadvantages, and each has merit and efficacy when used correctly. There are many factors that need to be considered if we are going to discuss the differences between the Taiwanese and mainland Chinese methods and products. I'll be posting at length on this topic as soon as I have some free time to sit down and write. Certainly I'm glad to see the issue coming up, and I really enjoyed both Andy and Bob's articles on the topic. Eric Quote Link to comment Share on other sites More sharing options...
Guest guest Posted May 22, 2008 Report Share Posted May 22, 2008 Jason I was told the same thing by Sheng Cheng (Quali herbs) pharmaceuticals when i visited taiwan. They said that depending on the formula or herb there is a limit to how high concentration can go and still keep the same analysis print as the raw herb or formula cooked by traditional methods. I do not see any reason for them to say this if its wrong as they can develop all the same technologies and make same marketing claims. The question is do the higher concentrations, even though are not the same as traditional formulas work better or worse clinically. I do not believe we know the answer. And the other issue is the liquid extracts on the market. We see many people that support all their positions on CM based on their traditional historical usage promote such extracts. Here we have is the same issue, perhaps these fluid extract work better clinically but one cannot use any of the traditional information on herb usage to justify their effectiveness. 400 29th St. Suite 419 Oakland Ca 94609 alonmarcus Quote Link to comment Share on other sites More sharing options...
Guest guest Posted May 22, 2008 Report Share Posted May 22, 2008 It seems from my reading that the conventional wisdom among experienced professional herbalists is that decoctions are the most effective way to treat our patients (given that they both cook and drink them). But both Andy's and Bob's articles mention that the extraction process used with granules is much superior to stove-top decoctions. It would stand to reason that if taken in a proper amount, granules would be at least as good as decoctions, if not better. So why do I always hear about the superiority of decoctions? Does it have to do with the fact that these are individual substances or separate formulas that are combined together, but not cooked together? Or is it a " softer " issue of the patient being more actively involved in their own healing when they cook their own decoctions? Carl Quote Link to comment Share on other sites More sharing options...
Guest guest Posted May 22, 2008 Report Share Posted May 22, 2008 Carl, I do not interpret Andy's article to indicate that water decoctions are inferior to granulars. When he says " There are several reasons why the homemade product is inferior to the facility-produced one. " He is referring to making a " crude concentrated extract " at home as compared to a company (see the previous 2 paragraphs in the article). This is much different than comparing clinical efficacy of a water decoction and granulars. I am pretty sure he believes that overall water decoctions are the gold standard. I know there are a whole range of opinions on clinical efficacy of both methods, some of which are economic or political. For what it is worth, here is my opinion. To put my commentary into perspective, my biases are two-fold. One, I like raw herbs, and the idea of raw herbs. Two, I like to write custom formulas. I have the belief that combining of single granulars presents problems leading to reduced efficacy that we have discussed before. This may or may not be true. My practice is about 80% bulk and 20% granular. Most of my granular patients are one's that have graduated from bulk and are now on maintenance and relatively symptom free. Other granular patients are temporary ones that travel and do not want to (or unable) to cook herbs. I also work with 4 other herbalists that primarily use bulk herbs and their practice and experience is similar to mine. My observations: First, granular herbs do not have the punch as compared to bulk. In acute situations or certain serious diseases there is no comparison. This is not a dosage issue. One can smell, taste and feel the difference quite easily. Just take GZT or MHT in both forms and note the differences. Second, no matter how hard the industry tries, there seems to be something fundamentally different between granulars and decoctions. I am not referring to potency, but some much more difficult to nail down. This is evidenced by the numerous times I have switched people from bulk to granulars without changing the formula. This has lent itself to a very interesting " research study. " The amount of complaints are far-ranging. There are some side-effects (i.e. digestive) but more importantly a return of symptoms or exacerbation of a certain aspect of their condition. Increasing the dosage does not seem to change things in a certain group of people. Within another group, there is a smooth transition. All that I know is there is something different. There have also been a group of people that started with granulars. I have tried formula after formula with sub-optimal results. After scratching my head, I switched to bulk and bamm, things improved. Extraction ratios and conversion from bulk dosages seem to be obvious explanations for the above issues, hence, why I originally started researching extraction ratios etc more deeply. However, either way you slice it, if extraction ratios are important or not, I see no solution clinically. Meaning if we decided that one's conversion from bulk to granular must take into consideration every extraction ratio for each herb /batch of herbs, it would be a mathematically nightmare to line things up. Fortunately leading experts and doctors do not use herbs this way. However, many people use the method of combining singles and claim results. So I cannot discount it as a valid and effective delivery system. This is especially true, if that is all one does. Hence, one then learns how to tweak dosages etc. based on what works and does not. This what I have done with bulk herbs (not granulars). Again, most of this discussion is based on mixing singles, and not giving ready made formulas. I do think that ready made formulas have more punch then mixing the singles, but I do not think they are as strong as bulk. I have quite a few cases where I compared these side by side. I would like to hear other's opinions. I understand I am probably the minority here, but I think I offer a unique perspective because we have a full bulk and full granular (single and complete formula) pharmacy. I would say most people have one or the other, not allowing for direct comparison. Some (most) schools now have both, although deciphering efficacy within school clinics presents a whole host of additional problems. Comments? -Jason _____ On Behalf Of carlstimson Thursday, May 22, 2008 6:40 PM Re: Granulars It seems from my reading that the conventional wisdom among experienced professional herbalists is that decoctions are the most effective way to treat our patients (given that they both cook and drink them). But both Andy's and Bob's articles mention that the extraction process used with granules is much superior to stove-top decoctions. It would stand to reason that if taken in a proper amount, granules would be at least as good as decoctions, if not better. So why do I always hear about the superiority of decoctions? Does it have to do with the fact that these are individual substances or separate formulas that are combined together, but not cooked together? Or is it a " softer " issue of the patient being more actively involved in their own healing when they cook their own decoctions? Carl Quote Link to comment Share on other sites More sharing options...
Guest guest Posted May 22, 2008 Report Share Posted May 22, 2008 Jason- What is " Cinnabar Creek " ? Is it a newsletter? I would love to read what Andy has written about this. Some colleagues and I are having a discussion about this currently. -Steve Stephen Bonzak, L.Ac., Dipl. C.H. http://www.health-traditions.com sbonzak 773-470-6994 On May 22, 2008, at 9:42 AM, wrote: > Dear Group, > > For those of you that are interested in granulars check out the latest > Cinnabar Creek. Andy Ellis does a great job in describing the > problems with > dosage and potency related to the commonly touted " extraction > ratio. " A few > months ago I did quite a bit of research, having some in depth > discussion > with him and other experts in the field. His paper summarizes most > of the > issues quite well. Here is some summary ideas and further thoughts. > > One major point that he nails is that ratios are pretty meaningless > for > determining dosage (and potency), and this is one reason I think > they have > been dropped from US labels. I started my pursuit, because I wanted > to know > every ratio of every single herb so I could calculate the best > dosage for my > patient. Seems logical at first... well not really. Now, I have little > concern if 1 of the herbs is a 3:1 or a 6:1. IMO, this ratio > thinking only > confuses the issue. > > The fact is, even from batch to batch, ratios of the same medicinal > will > differ, depending on factors such as the quality of given batch of > herbs > (i.e. moisture content). However there are additional > considerations that > are employed to balance out the equation so that the potency is > relatively > the same, even though the extraction ratios may differ. (FYI- > Extraction > ratio of 3:1, is i.e. 3 KG of dang gui yielding 1 KG of powdered > extract). > > However, while merely beefing up extraction ratios by starting with > more > herbs (better for sales), the final product may drastically suffer in > quality. For example, the ratio of active constituents can change > dramatically based on which ingredients get pulled out first. (The > water can > only hold so much extracted material before it gets saturated. > Starting with > more herbs can saturate the liquid too fast, not allowing important > (deeper) > ingredients to be extracted. This concept is well known in Western > herbalism. > > Since this is a relatively new technology for Chinese medicine, it > is my > observation that it may be insightful to look at the processing of > Western > Botanicals (maybe Thomas can proved some further insight). I think > they have > many of the same issues. Because health foods stores are the > largest market > for sales this lends itself to many complications. Essentially we > have an > uneducated public making choices based on labels and a cursory read of > " ratios " and " amounts. " Companies tweak these numbers to maximize > buying > appeal. For example one may see a bottle with a 20:1 ratio, and one > with a > 5:1 ratio. Without proper education one might assume that the 20:1 > is a > better buy, but in such cases many times this is a mere marketing > tool more > than clinical relevance. However, as the educated buyer knows some > lower > concentrations (or extraction ratios) outperform the higher ones. The > reasons are many. One is of course the quality of the starting > product, but > more important and relevant to this discussion is the process and the > optimal ratio for that given medicinal. > > Ratio used for tinctures, although slightly different technology > provides > some insight. For example, when making tinctures, different herbs > require > different ratios of alcohol to plant (i.e. 1:5 or 1:2), as well as > different > ratios of alcohol to water (i.e. 55% or 80%). Although there is > some debate > within the community about optimal numbers, nonetheless they are > important > measures that are used by many herbalists. > > Chinese herbs are no different. Optimal cooking time, ratio of > starting herb > to finished extract, has been determined by the granular companies > (for each > herb) in hope of the end product mimicking a water decoction as > close as > possible. Therefore one herb may require a 3:1 ratio, while another > 7:1. > This is precisely why the common 5:1 concept is not technically > accurate, > although may be helpful in thinking about dosage. Actually most > singles are > not 5:1. If the methods are correct, then an end product of 3:1 or > 6:1 makes > little difference. They still should be prescribed as equals. For > example, > if dang gui and sheng di (much different extraction ratios) are 8 > grams in a > normal decoction based formula, one might choose to use 1 gram a > day of both > of these in a given granular formula. In the end, a company could > easily > make a 10:1, 20:1 or 30:1 extract, but this does not translate into > a better > product and knowing the individual ratios of herbs seems of little > concern. > > Note: Formulas that are cooked together bypass many of these issues. > > Most of this is explained much better and in more detail by Andy. I > think > this is an interesting topic, other's comments? > > -Jason > > > > > <http://maps./py/maps.py?Pyt=Tmap & addr=2600+30th+Street%2C > +Suite+20 > 0 & csz=Boulder%2C+Co & country=us> 2600 30th Street, Suite 200 > Boulder, Co > 80301 > > <http://www.plaxo.com/signature? > src=client_sig_212_1_simple_sig<=en> Want a > signature like this? > > Quote Link to comment Share on other sites More sharing options...
Guest guest Posted May 23, 2008 Report Share Posted May 23, 2008 Carl, Somewhere I've published Chinese research showing that decoctions and powdered extracts are equally effective as long as their doses are equivalent. Lotus/Evergreen Herbs also published this same research some years ago. The research was conducted in the PRC. Bob , " " wrote: > > Carl, > > > > I do not interpret Andy's article to indicate that water decoctions are > inferior to granulars. When he says " There are several reasons why the > homemade product is inferior to the facility-produced one. " He is referring > to making a " crude concentrated extract " at home as compared to a company > (see the previous 2 paragraphs in the article). This is much different than > comparing clinical efficacy of a water decoction and granulars. I am pretty > sure he believes that overall water decoctions are the gold standard. I know > there are a whole range of opinions on clinical efficacy of both methods, > some of which are economic or political. For what it is worth, here is my > opinion. > > > > To put my commentary into perspective, my biases are two-fold. One, I like > raw herbs, and the idea of raw herbs. Two, I like to write custom formulas. > I have the belief that combining of single granulars presents problems > leading to reduced efficacy that we have discussed before. This may or may > not be true. > > > > My practice is about 80% bulk and 20% granular. Most of my granular patients > are one's that have graduated from bulk and are now on maintenance and > relatively symptom free. Other granular patients are temporary ones that > travel and do not want to (or unable) to cook herbs. I also work with 4 > other herbalists that primarily use bulk herbs and their practice and > experience is similar to mine. > > > > My observations: > > > > First, granular herbs do not have the punch as compared to bulk. In acute > situations or certain serious diseases there is no comparison. This is not a > dosage issue. One can smell, taste and feel the difference quite easily. > Just take GZT or MHT in both forms and note the differences. > > > > Second, no matter how hard the industry tries, there seems to be something > fundamentally different between granulars and decoctions. I am not referring > to potency, but some much more difficult to nail down. This is evidenced by > the numerous times I have switched people from bulk to granulars without > changing the formula. This has lent itself to a very interesting " research > study. " The amount of complaints are far-ranging. There are some > side-effects (i.e. digestive) but more importantly a return of symptoms or > exacerbation of a certain aspect of their condition. Increasing the dosage > does not seem to change things in a certain group of people. Within another > group, there is a smooth transition. All that I know is there is something > different. > > > > There have also been a group of people that started with granulars. I have > tried formula after formula with sub-optimal results. After scratching my > head, I switched to bulk and bamm, things improved. > > > > Extraction ratios and conversion from bulk dosages seem to be obvious > explanations for the above issues, hence, why I originally started > researching extraction ratios etc more deeply. However, either way you slice > it, if extraction ratios are important or not, I see no solution clinically. > Meaning if we decided that one's conversion from bulk to granular must take > into consideration every extraction ratio for each herb /batch of herbs, it > would be a mathematically nightmare to line things up. Fortunately leading > experts and doctors do not use herbs this way. > > > > However, many people use the method of combining singles and claim results. > So I cannot discount it as a valid and effective delivery system. This is > especially true, if that is all one does. Hence, one then learns how to > tweak dosages etc. based on what works and does not. This what I have done > with bulk herbs (not granulars). > > > > Again, most of this discussion is based on mixing singles, and not giving > ready made formulas. I do think that ready made formulas have more punch > then mixing the singles, but I do not think they are as strong as bulk. I > have quite a few cases where I compared these side by side. > > > > I would like to hear other's opinions. I understand I am probably the > minority here, but I think I offer a unique perspective because we have a > full bulk and full granular (single and complete formula) pharmacy. I would > say most people have one or the other, not allowing for direct comparison. > Some (most) schools now have both, although deciphering efficacy within > school clinics presents a whole host of additional problems. > > > > Comments? > > > > -Jason > > > > _____ > > > On Behalf Of carlstimson > Thursday, May 22, 2008 6:40 PM > > Re: Granulars > > > > It seems from my reading that the conventional wisdom among > experienced professional herbalists is that decoctions are the most > effective way to treat our patients (given that they both cook and > drink them). But both Andy's and Bob's articles mention that the > extraction process used with granules is much superior to stove-top > decoctions. > > It would stand to reason that if taken in a proper amount, granules > would be at least as good as decoctions, if not better. So why do I > always hear about the superiority of decoctions? Does it have to do > with the fact that these are individual substances or separate > formulas that are combined together, but not cooked together? Or is it > a " softer " issue of the patient being more actively involved in their > own healing when they cook their own decoctions? > > Carl > > > > Quote Link to comment Share on other sites More sharing options...
Guest guest Posted May 23, 2008 Report Share Posted May 23, 2008 Jason, I agree with much of what you say here. To me, decoctions are most importantly used in the acute cases, perhaps exterior mainly because of the aromatic (term used generically) qualities. On the other hand, blood builders are best served by the oils in the raw herbs. I agree with the proper diagnosis patents, even in small dosages, can do wonders. But I hear you about those cases that don't ever resolve. " > It would stand to reason that if taken in a proper amount, granules > would be at least as good as decoctions, if not better. " Doug , " " wrote: > > Carl, > > > > I do not interpret Andy's article to indicate that water decoctions are > inferior to granulars. When he says " There are several reasons why the > homemade product is inferior to the facility-produced one. " He is referring > to making a " crude concentrated extract " at home as compared to a company > (see the previous 2 paragraphs in the article). This is much different than > comparing clinical efficacy of a water decoction and granulars. I am pretty > sure he believes that overall water decoctions are the gold standard. I know > there are a whole range of opinions on clinical efficacy of both methods, > some of which are economic or political. For what it is worth, here is my > opinion. > Quote Link to comment Share on other sites More sharing options...
Guest guest Posted May 23, 2008 Report Share Posted May 23, 2008 In some cases, the alcohol-based fluid extracts actually work better than decoctions. Resins like Ru Xiang and Mo Yao are extracted very poorly in water and very efficiently in alcohol. In most other cases, decoctions are superior. I have generally found that powdered extracts work nearly as well as decoctions, but in critical cases, decoctions seem to have the best results. I tend to use the powdered or liquid extract on a day-to-day basis. If the results aren't optimal, or if there is an acute infection, I switch to decoctions. I have seen a lot of cases where only decoctions will get the desired results. - Bill Schoenbart , alon marcus <alonmarcus wrote: > > Jason > I was told the same thing by Sheng Cheng (Quali herbs) pharmaceuticals > when i visited taiwan. They said that depending on the formula or herb > there is a limit to how high concentration can go and still keep the > same analysis print as the raw herb or formula cooked by traditional > methods. I do not see any reason for them to say this if its wrong as > they can develop all the same technologies and make same marketing > claims. The question is do the higher concentrations, even though are > not the same as traditional formulas work better or worse clinically. > I do not believe we know the answer. And the other issue is the liquid > extracts on the market. We see many people that support all their > positions on CM based on their traditional historical usage promote > such extracts. Here we have is the same issue, perhaps these fluid > extract work better clinically but one cannot use any of the > traditional information on herb usage to justify their effectiveness. > > > > 400 29th St. Suite 419 > Oakland Ca 94609 > > > > alonmarcus > Quote Link to comment Share on other sites More sharing options...
Guest guest Posted May 23, 2008 Report Share Posted May 23, 2008 Bob what is the link to your article i could not find it Quote Link to comment Share on other sites More sharing options...
Guest guest Posted May 23, 2008 Report Share Posted May 23, 2008 Here you go Alon. http://tinyurl.com/6lxbc6 On Behalf Of Alon Marcus Friday, May 23, 2008 5:37 PM Re: Granulars Bob what is the link to your article i could not find it Quote Link to comment Share on other sites More sharing options...
Guest guest Posted May 23, 2008 Report Share Posted May 23, 2008 Bob and all, I am sure there is research purporting that these two methods are equal. One can find research that spins almost anything. I think we should examine it with a critical eye. There are many variables that must be considered. As we know, research methodology, especially in China, can be fairly poor, with agendas dictating outcomes more than academic rigor. In addition, companies like Lotus, of course, have a financial incentive. Bob, himself, has similar incentives for wanting people to believe that this is true. If such a statement is going to me made please post something we can evaluate. However, either way, it seems to contradict the clinical reality of a large number of serious herbalists. Just for the record, I have no attachment either way. I would love the see the same results from granulars as compared to bulk. I am sure my patients would love it also. I just have not. However, quite often I have patients calling and telling me they want to switch back to bulk. Sometimes I forget that at one point we switched, and I make the suggestion (to switch to granular) and they tell me, " no, remember we tried that. they just don't work as well. " (dosage has been explored!) Clinical reality is hard to argue with. Much of this is what has shaped my 80% (bulk) / 20% (granular) practice. However, if we are going to talk about our clinical observations here in the West, it is important to look at our level of herbal education and practice, which Bob and others have commented on quite extensively. I think it is generally true that our herbal prescribing abilities compared to China's doctors is much lower. Although things are changing, we still are essentially practicing a simplified form of Chinese medicine. We are still developing. In many schools, students will only write a hand full of formulas before graduating, and most of them are not even bulk herbs. Furthermore, we not only have a limited number of herbs to work with (in comparison), but for the most part, very little access to paozhi (processing of medicinals). Actually even with such access, we do not have the training to know how to really prescribe them. (we really need to start local pharmacies in active towns like Boulder, hint hint.. business idea for someone) Most practitioners don't even try bulk herbs and go straight to other forms and claim " results. " Are these equal to the results they would have gotten if they knew bulk herbs and used them? Good Question. Bulk herbs allow practitioners a greater potential for higher levels of practice, whereas the use of granulars / ready-made formulas seem to get capped fairly quickly. There are many reasons for this. Only one of which is because bulk herbs require a much more sophisticated diagnosis and knowledge base which allows for fine-tuning. For example, just modifying cooking times based on the desired outcome is something many do not really pay attention to. But does using paozhi, having a more precise diagnosis (and hence more specific choice of herbs), or manipulating things like cooking times, lead to better or the same results? Good question! However, we are comparing something we do at a mediocre level with a simplified method of prescribing (i.e. ready-made formulas). One reason I am writing this is to encourage the raising of our " herbal bar. " When we promote ready-made formulas vs. individual prescriptions, or granulars over decoctions we are severely limiting our herbal potential in the West. Instead of offering easier methods, why don't we start exploring the full potential of the medicine? Teaching things like paozhi (as at SIOM and Austin) can only be done when working with bulk herbs. Teaching people how to write individual prescriptions falls by the wayside when we push ready-made formulas designed to treat western diseases or multiple Chinese patterns of a given disease. Of course the latter has very high money making possibilities where-as the former does not. One should acknowledge that people are going to defend what they " do " or " sell. " Chinese bulk herbalists are going to put down granulars. Taiwanese are going to tell you granulars are completely equal, even though they may prescribe them only because of insurance compensation. A granular company will find research to support their product, as does US supplement companies. Does a Taiwanese granular doctor get the same results as a Chinese bulk doctor? Since there are so many variables to this comparison, I have no idea. Are they potentially the same? I have no idea. However, before we make up our minds, trying to practice our medicine at its fullest potential seems only intelligent. Pushing all aspects of our medicine up a few notches seems essential, especially if we are going to survive long-term in this country. In my experience, there is no question the methods are different. Therefore I can't image they are " equally effective. " I do think we can say they are both effective, as are tea pills, homeopathics, supplemetns etc. We just have to figure out what kind of conditions and what kind of people they are effective for. This is something that I have yet figure out. One of the major complaints in the West is lack of results. Bob has stated he feels it is a dosage issue. Alon thinks Chinese medicine just is unable to treat certain things. Others think it is not understanding classical literature. Others feel it is a lack of integration with Western medicine. Some think it is a terminology issue. I think all are somewhat right. I also think it is a skill level issue. Part of that skill is diagnosis. Part of it is learning how to write formulas and utilizing the tools the great doctors from the past and present use. I just have a hard time seeing how any simplification at this early stage of the game, is going to help us in the long run. Sorry for the long post. - _____ On Behalf Of Bob Flaws Friday, May 23, 2008 9:07 AM Re: Granulars Carl, Somewhere I've published Chinese research showing that decoctions and powdered extracts are equally effective as long as their doses are equivalent. Lotus/Evergreen Herbs also published this same research some years ago. The research was conducted in the PRC. Bob Quote Link to comment Share on other sites More sharing options...
Guest guest Posted May 23, 2008 Report Share Posted May 23, 2008 , " " wrote: Taiwanese > are going to tell you granulars are completely equal, even though they may > prescribe them only because of insurance compensation. In my experience, most Taiwanese doctors (and patients) believe that granules are slower and more moderate in their medicinal effect than raw herbs. Raw herbs are still used regularly, some patients prefer them and some doctors recommend them in acute or serious conditions. Generally speaking, the consensus is that granules give consistent and reliable clinical results, but they are not as fast or strong as raw. Part of this is a dosage issue; in Taiwan, granules are typically prescribed in lower total doses than raw herbs. However, there are many times when the moderate action and convenient method of administration are huge clinical advantages. Taiwanese doctors also use a different formula construction style when they use granules vs. raw herbs. I think there is an inherent limitation to discussing the clinical application of the Taiwanese products if we don't take into account the methods of formula combining and dosing that Taiwanese doctors use. If we are asserting that the results are less than satisfactory without taking these factors into account, it is not a fair comparison. Most of the granule revolution was led by Taiwan and Japan, and each has a unique approach to using the granules they produce. Mainland China also has its own style, its own method of compounding and its own approach towards extraction and dosage calculation. There are many issues to consider with things such as dosage and extraction ratios. Downplaying the importance of concentration ratios is premature at a time when most of us have only a very tenuous understanding of the variety of techniques and approaches seen in Asia, both with regard to extraction techniques and formulation styles. Eric Quote Link to comment Share on other sites More sharing options...
Guest guest Posted May 23, 2008 Report Share Posted May 23, 2008 , " " wrote: > One major point that he nails is that ratios are pretty meaningless for > determining dosage (and potency), and this is one reason I think they have > been dropped from US labels. I don't think that we can say that extraction ratios are meaningless. Consider the following two products, both made in Taiwan with the same technology and method. This information comes off the Taiwanese label of two well-known granule producers: 1) Ma zi ren wan (Brand A) Two parts of 5.5:1 concentrate and one part starch. 4.5g of the final powder contains the equivalent of 4g huo ma ren, 2g bai shao, 2g zhi shi, 2g hou po, 2.5 xing ren, and 4g da huang. 2) Ma zi ren wan (Brand B) one part 4.25:1 concentrate and one part starch. 4.0g of the final powder contains the equivalent of 2.5g huo ma ren, 1g bai shao, 1g zhi shi, 2g da huang, 1g hou po, and 1g xing ren. As you can see, these two formulas have very different concentrations. One is nearly twice as strong as the other. Oddly enough, the stronger one is cheaper at the store. Note that neither is 5:1 in its final stage. Brand B is 2.15:1. Brand A is 3.66:1. These herbs are the same herbs, so presumably they all have the same ideal extraction conditions, concentrations, etc. Both companies have the same technology and the same degree of sophistication. Yet one product delivers nearly twice as much da huang, as well as everything else. How can this not have a clinical impact? While I fully agree that there are many factors that have greater impact than the simple mathematical ratio, how could removing information on concentration ratios from the US label possibly be advantageous? Eric Brand Quote Link to comment Share on other sites More sharing options...
Guest guest Posted May 24, 2008 Report Share Posted May 24, 2008 Eric, I think my post, and the quote you reproduce is referring, to singles. Sorry I did not make that more clear. I think Andy's article is also mainly aimed at singles, formulas represent different issues. However, I think your example is illustrative. I agree that it SEEMS that formulas have a greater potential for using extraction ratios to compare them. Although the same issues that Andy brings up, can be applied. For example, is a formula that is 2x (10x) as " potent " (via extraction ratio), really so? As Alon mentioned, formulas also have a saturation ratio and at a certain point da huang will stop being extracted. Furthermore, labeling something at 2:1 or 4:1 can also be extremely misleading because we have no idea how the companies are calculating the ratios. For example, did both calculate with binders? Did they calculate " the extraction ratio as an expression of weight of the liquid extraction to the weight of the final dried powder or granule (ellis)? " It is clear that there is no standard for extraction ratios. Companies my have the same technology, but that doesn't mean they express their product the same. If they all have the same technology why would the ratios be different? I guess it is to gain a competent edge. Beefing up the numbers so the cheaper one looks like it has more, is very likely. Therefore the only way to say that 1 has almost twice as much da haung as the other is to a post-chemical analysis on the final product or have a regulated standard when it comes to labeling of extraction ratios. I just don't buy that the simple number on the bottle is truthful and can be easily compared from company to company. Honestly we have no idea how much da huang is in these. Therefore of course there is clinical impact it is just not clear what the real impact is from comparing extraction ratios. - _____ On Behalf Of Eric Brand Friday, May 23, 2008 11:49 PM Re: Granulars @ <%40> , " " wrote: > One major point that he nails is that ratios are pretty meaningless for > determining dosage (and potency), and this is one reason I think they have > been dropped from US labels. I don't think that we can say that extraction ratios are meaningless. Consider the following two products, both made in Taiwan with the same technology and method. This information comes off the Taiwanese label of two well-known granule producers: 1) Ma zi ren wan (Brand A) Two parts of 5.5:1 concentrate and one part starch. 4.5g of the final powder contains the equivalent of 4g huo ma ren, 2g bai shao, 2g zhi shi, 2g hou po, 2.5 xing ren, and 4g da huang. 2) Ma zi ren wan (Brand B) one part 4.25:1 concentrate and one part starch. 4.0g of the final powder contains the equivalent of 2.5g huo ma ren, 1g bai shao, 1g zhi shi, 2g da huang, 1g hou po, and 1g xing ren. As you can see, these two formulas have very different concentrations. One is nearly twice as strong as the other. Oddly enough, the stronger one is cheaper at the store. Note that neither is 5:1 in its final stage. Brand B is 2.15:1. Brand A is 3.66:1. These herbs are the same herbs, so presumably they all have the same ideal extraction conditions, concentrations, etc. Both companies have the same technology and the same degree of sophistication. Yet one product delivers nearly twice as much da huang, as well as everything else. How can this not have a clinical impact? While I fully agree that there are many factors that have greater impact than the simple mathematical ratio, how could removing information on concentration ratios from the US label possibly be advantageous? Eric Brand __________ Information from ESET NOD32 Antivirus, version of virus signature database 3128 (20080523) __________ The message was checked by ESET NOD32 Antivirus. http://www.eset.com Quote Link to comment Share on other sites More sharing options...
Guest guest Posted May 24, 2008 Report Share Posted May 24, 2008 Actually I think you example is very close to what happens in the supplement world (in the West). They all have very similar technology (at least the major companies). However, to increase market appeal, many ignore common sensibilities and tweak the numbers, but i.e. starting with more herbs, making a higher concentration ratio. One may have 6:1, one may have 4:1. Which is better? Which has more? For example, recently I saw a 30:1 supplement at the health food store and compared it to a 4:1. I asked a pretty educated employee their thoughts. They said don't even consider buying the higher one, everyone know that 4:1 is about the max one can make for that specific plant without changing the ratio of active constituents etc. He said the 4:1 routinely gets better results. He further said that the 30:1 was literally impossible and probably had very little of the active constituents in it. Numbers can deceive us very easily. - _____ On Behalf Of Eric Brand Friday, May 23, 2008 11:49 PM Re: Granulars @ <%40> , " " wrote: > One major point that he nails is that ratios are pretty meaningless for > determining dosage (and potency), and this is one reason I think they have > been dropped from US labels. I don't think that we can say that extraction ratios are meaningless. Consider the following two products, both made in Taiwan with the same technology and method. This information comes off the Taiwanese label of two well-known granule producers: 1) Ma zi ren wan (Brand A) Two parts of 5.5:1 concentrate and one part starch. 4.5g of the final powder contains the equivalent of 4g huo ma ren, 2g bai shao, 2g zhi shi, 2g hou po, 2.5 xing ren, and 4g da huang. 2) Ma zi ren wan (Brand B) one part 4.25:1 concentrate and one part starch. 4.0g of the final powder contains the equivalent of 2.5g huo ma ren, 1g bai shao, 1g zhi shi, 2g da huang, 1g hou po, and 1g xing ren. As you can see, these two formulas have very different concentrations. One is nearly twice as strong as the other. Oddly enough, the stronger one is cheaper at the store. Note that neither is 5:1 in its final stage. Brand B is 2.15:1. Brand A is 3.66:1. These herbs are the same herbs, so presumably they all have the same ideal extraction conditions, concentrations, etc. Both companies have the same technology and the same degree of sophistication. Yet one product delivers nearly twice as much da huang, as well as everything else. How can this not have a clinical impact? While I fully agree that there are many factors that have greater impact than the simple mathematical ratio, how could removing information on concentration ratios from the US label possibly be advantageous? Eric Brand Quote Link to comment Share on other sites More sharing options...
Guest guest Posted May 24, 2008 Report Share Posted May 24, 2008 Eric, I think your point about many of us not truly understanding how to properly use granulars is correct. It is the same point I make for bulk herbs. For both, the level of education needs to increase before a proper comparison can be made, as well as a true gauge of how well CM can treat diseases. However, I still think a granular style of practice can be learned fairly quickly, while bulk herbs and all the nuances can take exponentially longer, hence leading to a more detailed level of practice (if that is what one wishes.) I also think extraction ratios are potentially great tool for evaluation. However, I think companies need to agree on a standard before we can make use of it clinically. Until that happens they just give us misleading and confusing information, as Andy well points out. - _____ On Behalf Of Eric Brand Friday, May 23, 2008 11:06 PM Re: Granulars @ <%40> , " " wrote: Taiwanese > are going to tell you granulars are completely equal, even though they may > prescribe them only because of insurance compensation. In my experience, most Taiwanese doctors (and patients) believe that granules are slower and more moderate in their medicinal effect than raw herbs. Raw herbs are still used regularly, some patients prefer them and some doctors recommend them in acute or serious conditions. Generally speaking, the consensus is that granules give consistent and reliable clinical results, but they are not as fast or strong as raw. Part of this is a dosage issue; in Taiwan, granules are typically prescribed in lower total doses than raw herbs. However, there are many times when the moderate action and convenient method of administration are huge clinical advantages. Taiwanese doctors also use a different formula construction style when they use granules vs. raw herbs. I think there is an inherent limitation to discussing the clinical application of the Taiwanese products if we don't take into account the methods of formula combining and dosing that Taiwanese doctors use. If we are asserting that the results are less than satisfactory without taking these factors into account, it is not a fair comparison. Most of the granule revolution was led by Taiwan and Japan, and each has a unique approach to using the granules they produce. Mainland China also has its own style, its own method of compounding and its own approach towards extraction and dosage calculation. There are many issues to consider with things such as dosage and extraction ratios. Downplaying the importance of concentration ratios is premature at a time when most of us have only a very tenuous understanding of the variety of techniques and approaches seen in Asia, both with regard to extraction techniques and formulation styles. Eric __________ Information from ESET NOD32 Antivirus, version of virus signature database 3128 (20080523) __________ The message was checked by ESET NOD32 Antivirus. http://www.eset.com Quote Link to comment Share on other sites More sharing options...
Guest guest Posted May 24, 2008 Report Share Posted May 24, 2008 The American Herbal Products Association describes the standard method for calculating an extract ratio for dried extracts. It's the ratio of the weight of the starting material to the weight of the finished extract, including any excipients. In other words if it takes 5 pounds of herbs to make one pound of finished extract, the ratio is 5:1. - Bill Schoenbart , " " wrote: > > Actually I think you example is very close to what happens in the supplement > world (in the West). They all have very similar technology (at least the > major companies). However, to increase market appeal, many ignore common > sensibilities and tweak the numbers, but i.e. starting with more herbs, > making a higher concentration ratio. One may have 6:1, one may have 4:1. > Which is better? Which has more? > > Quote Link to comment Share on other sites More sharing options...
Guest guest Posted May 24, 2008 Report Share Posted May 24, 2008 Jason I totally agree that schools should focus on bulk herbs. Its the best way to learn to write Rxs 400 29th St. Suite 419 Oakland Ca 94609 alonmarcus Quote Link to comment Share on other sites More sharing options...
Guest guest Posted May 24, 2008 Report Share Posted May 24, 2008 Eric How much experience do you have with high dose granules, either using singles or formulas? Have you seen Taiwanese Dr using high dose granules? 400 29th St. Suite 419 Oakland Ca 94609 alonmarcus Quote Link to comment Share on other sites More sharing options...
Guest guest Posted May 24, 2008 Report Share Posted May 24, 2008 , " " wrote: Therefore the only > way to say that 1 has almost twice as much da haung as the other is to a > post-chemical analysis on the final product or have a regulated standard > when it comes to labeling of extraction ratios. They do have a regulated standard for expressing the extraction ratios in Taiwan. Both of these products are labeled with the same information- the quantity of filler, the quantity of extract before the filler is added (with the data on the quantity of raw herbs the extract corresponds to). In other words, there is no reason that these two products cannot be directly compared, except for the quality of the raw herbs that they started with. > I just don't buy that the simple number on the bottle is truthful and can be > easily compared from company to company. Honestly we have no idea how much > da huang is in these. We know exactly how much da huang is in there. This is a pharmaceutical science in Taiwan, with government mandated clear and open labeling. Eric Quote Link to comment Share on other sites More sharing options...
Guest guest Posted May 24, 2008 Report Share Posted May 24, 2008 Eric I would think the quality of the raw materials may play an unseen role. Is the higher concentration a more potent formula if raw material is of much lower quality? that is a big advantage of bulk herbs, you can actually see for your self. That is also why i do taste tests on all my powders on a regular bases, I do solubility and taste comparisons. Since i do not have access to sophisticated testing equipment at this point taste is all i have to go by and i have to say there is a huge difference between companies. I suggest anyone using powders should do this often and not just have company loyalty. 400 29th St. Suite 419 Oakland Ca 94609 alonmarcus Quote Link to comment Share on other sites More sharing options...
Guest guest Posted May 24, 2008 Report Share Posted May 24, 2008 Eric, I guess Andy Ellis paints a different picture. I will defer to the experts at this point. -Jason Eric Brand Saturday, May 24, 2008 12:58 PM Re: Granulars , " " wrote: Therefore the only > way to say that 1 has almost twice as much da haung as the other is to a > post-chemical analysis on the final product or have a regulated standard > when it comes to labeling of extraction ratios. They do have a regulated standard for expressing the extraction ratios in Taiwan. Both of these products are labeled with the same information- the quantity of filler, the quantity of extract before the filler is added (with the data on the quantity of raw herbs the extract corresponds to). In other words, there is no reason that these two products cannot be directly compared, except for the quality of the raw herbs that they started with. > I just don't buy that the simple number on the bottle is truthful and can be > easily compared from company to company. Honestly we have no idea how much > da huang is in these. We know exactly how much da huang is in there. This is a pharmaceutical science in Taiwan, with government mandated clear and open labeling. Eric __________ Information from ESET NOD32 Antivirus, version of virus signature database 3106 (20080516) __________ The message was checked by ESET NOD32 Antivirus. http://www.eset.com Quote Link to comment Share on other sites More sharing options...
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