Guest guest Posted May 31, 2008 Report Share Posted May 31, 2008 I would be greatful for the opinions of the group on the following: I am a PA Intensivist in a University Hospital setting as well as an OM student. We are starting to work on a proposal for a study using TCM on our post-operative thoracotomy lung cancer patients. Now Columbia has done a study using acupuncture and Sloan-Kettering will be finishing up their study on acupunture on post-thoractomy patients in August. We are planning on using ALL aspects of TCM...Acupunture, Bodywork, Qi Gong, as well as herbal therapy. It is my intention to prove the superiority of TCM when it is used as a whole and not just acupuncture. Now our biggest hurdle will be the herbal usage and my chief wants to know exactly which herbs we will be using. That alone can be a daunting task since every lung cancer patient may need different herbal therapy. So I ask your opinion of the following: Would you concentrate only on herbs that would tonify and strengthen Qi or would you also include herbs that would help to alleviate pain? Keep in mind that the patient will still be recieving traditional pain medication (most likely Fentanyl, Oxycontin and Roxicodone) Your input would be greatly appreciated, Wishing you wisdom, Randy Quote Link to comment Share on other sites More sharing options...
Guest guest Posted June 1, 2008 Report Share Posted June 1, 2008 I think the only way to accomplish this is to have a list of perhaps a 100 or so herbs that the acupuncture doctors who are writing the formulas might use. Gather the information that is requested and then let the acupuncture doctors write the prescriptions from that list. I sat in a cancer outpatient ward for a few days where the doctor specialized in lung cancer. I've uploaded a file to the files section of about 50 of these cases. These are very incomplete notes and should not in any way be guidelines for treatment but should give you an idea of how wide ranging the herbs that were given by 2 doctors. Doug , " rparrny " <rparrny wrote: > > I would be greatful for the opinions of the group on the following: > > I am a PA Intensivist in a University Hospital setting as well as an > OM student. We are starting to work on a proposal for a study using > TCM on our post-operative thoracotomy lung cancer patients. Now > Columbia has done a study using acupuncture and Sloan-Kettering will > be finishing up their study on acupunture on post-thoractomy patients > in August. We are planning on using ALL aspects of TCM...Acupunture, > Bodywork, Qi Gong, as well as herbal therapy. It is my intention to > prove the superiority of TCM when it is used as a whole and not just > acupuncture. > Now our biggest hurdle will be the herbal usage and my chief wants to > know exactly which herbs we will be using. That alone can be a > daunting task since every lung cancer patient may need different > herbal therapy. So I ask your opinion of the following: > Would you concentrate only on herbs that would tonify and strengthen > Qi or would you also include herbs that would help to alleviate pain? > Keep in mind that the patient will still be recieving traditional > pain medication (most likely Fentanyl, Oxycontin and Roxicodone) > > Your input would be greatly appreciated, > Wishing you wisdom, > Randy > Quote Link to comment Share on other sites More sharing options...
Guest guest Posted June 1, 2008 Report Share Posted June 1, 2008 Doug, Thanks you for the info, I will take a look at your notes. I'm not looking for which herbs to use, but rather which approach to concentrate on with the herbs. In a hospital setting, I'm sure no one will be surprised to know that getting approval of the use of herbs will be the bain of my existence. I need to keep it as simple as I can. The endpoints of the study will be comparing pain med usage to the non-TCM patients, as well as quality of life and length of stay (and eventually nutritional status but my chief thinks it should be done as a seperate study). So with the goal of keeping this first herbal introduction as simple as possible....which approach will give me the most bang for my buck. I'm sure any herbs used for pain will be scrutinized at the highest level...but if their inclusion would be more beneficial to the recovery of the patient I'm willing to go the distance on that fight. And I wonder if concentrating more on tonification and Qi of both the lung and the body in general, won't also have a endpoint result of reducing the need for pain meds...in which case, why fight that fight? If I try to use herbs for both, the list will be too exhaustive and I will get nowhere with approvals. Hence, I look for opinions and rationale from those practitioners that more routinely use herbal therapy in conjunction with their treatment. I should have been more specific in my request, sorry. Wishing you wisdom, Randy , " " wrote: > > I think the only way to accomplish this is to have a list of perhaps a > 100 or so herbs that the acupuncture doctors who are writing the > formulas might use. Gather the information that is requested and then > let the acupuncture doctors write the prescriptions from that list. > I sat in a cancer outpatient ward for a few days where the doctor > specialized in lung cancer. I've uploaded a file to the files section > of about 50 of these cases. These are very incomplete notes and should > not in any way be guidelines for treatment but should give you an idea > of how wide ranging the herbs that were given by 2 doctors. > Doug > > > > > , " rparrny " <rparrny@> wrote: > > > > I would be greatful for the opinions of the group on the following: > > > > I am a PA Intensivist in a University Hospital setting as well as an > > OM student. We are starting to work on a proposal for a study using > > TCM on our post-operative thoracotomy lung cancer patients. Now > > Columbia has done a study using acupuncture and Sloan-Kettering will > > be finishing up their study on acupunture on post-thoractomy patients > > in August. We are planning on using ALL aspects of TCM...Acupunture, > > Bodywork, Qi Gong, as well as herbal therapy. It is my intention to > > prove the superiority of TCM when it is used as a whole and not just > > acupuncture. > > Now our biggest hurdle will be the herbal usage and my chief wants to > > know exactly which herbs we will be using. That alone can be a > > daunting task since every lung cancer patient may need different > > herbal therapy. So I ask your opinion of the following: > > Would you concentrate only on herbs that would tonify and strengthen > > Qi or would you also include herbs that would help to alleviate pain? > > Keep in mind that the patient will still be recieving traditional > > pain medication (most likely Fentanyl, Oxycontin and Roxicodone) > > > > Your input would be greatly appreciated, > > Wishing you wisdom, > > Randy > > > Quote Link to comment Share on other sites More sharing options...
Guest guest Posted June 1, 2008 Report Share Posted June 1, 2008 Randy, thanks for the additional information. I certainly didn't put the notes up to show what herbs to use. In a way, it was to show pretty much how different what I saw is compared to what you would like to do. If you think the MDs are going to resistant to this type of study I think you may see more skepticism from the TCM sector. To me you would have to define such a narrow range of patient to fit one or more set of herbs. Any patients that fall out of those parameters you risk doing harm. If I understand your concerns you are really hoping for an ideal patient to fit the ideal herb(s). The approach to treatment (pain or tonification) is inextricably tied to the parameters of the study itself. You really have set up the ultimate dilemma for the TCM study. These are just off the top of my head comments. I don't mean to be discouraging and I would urge you to dialogue with the Pine Street Foundation in Northern California. You can look at at least one of their papers online:The Pine Street Survival Study: Evaluating Integrative Traditional Chinese Medicine with Chemotherapy. They are obviously more experienced in providing the answers you seek here. Michael Broffman, LAc, at the Foundation is well known and respected in the TCM community. Perhaps Z'ev could help with an introduction. Al Stone also has some if not a lot of training in research design. This is an important study, keep us posted as to what you find. http://www.pinestreetfoundation.org Pine Street Foundation · 124 Pine Street · San Anselmo · California · 94960-2674 P: (415) 455-5878 · F: (415) 485-1065 , " rparrny " <rparrny wrote: > > Doug, > > Thanks you for the info, I will take a look at your notes. I'm not > looking for which herbs to use, but rather which approach to > concentrate on with the herbs. In a hospital setting, I'm sure no > one will be surprised to know that getting approval of the use of > herbs will be the bain of my existence. I need to keep it as simple > as I can. The endpoints of the study will be comparing pain med > usage to the non-TCM patients, as well as quality of life and length > of stay (and eventually nutritional status but my chief thinks it > should be done as a seperate study). > So with the goal of keeping this first herbal introduction as simple > as possible....which approach will give me the most bang for my buck. > I'm sure any herbs used for pain will be scrutinized at the highest > level...but if their inclusion would be more beneficial to the > recovery of the patient I'm willing to go the distance on that > fight. > And I wonder if concentrating more on tonification and Qi of both the > lung and the body in general, won't also have a endpoint result of > reducing the need for pain meds...in which case, why fight that fight? > If I try to use herbs for both, the list will be too exhaustive and I > will get nowhere with approvals. > Hence, I look for opinions and rationale from those practitioners > that more routinely use herbal therapy in conjunction with their > treatment. > I should have been more specific in my request, sorry. > Wishing you wisdom, > Randy > > > Quote Link to comment Share on other sites More sharing options...
Guest guest Posted June 1, 2008 Report Share Posted June 1, 2008 Randy, I agree with Doug, my experience (only two of the type of patient you want to study) is that you will need to both quicken the blood and supplement and nourish, doing only one would no give you the results you are looking for, but I offer the following as some food for thought. Perhaps choosing a small group of formulas along with a group of medicinals that the practitioners could choose from to modify the formulas would limit the length of you list. This may not be ideal, but it may, at least in part, solve your problem. Good luck, and be sure to keep us up to date on how this process it moving along...and be sure to keep some liver depression medicinals on hand at all times :-) Beijing, China Author of Western Herbs According to Traditional : A Practitioners Guide www.sourcepointherbs.org Quote Link to comment Share on other sites More sharing options...
Guest guest Posted June 1, 2008 Report Share Posted June 1, 2008 Doug, The Pine Street Study will be invaluable for me to take a look at. Actually, I'm not trying to limit the patient population...I'm hoping to have a long list of possible herbs that could be used. That's why I'm trying to limit what I will be working on. Can you even begin to imagine the group of herbs I'm asking for approval on if I were to be treating both endpoints (of course you can, that was a stupid question). As it is, the list will be exhaustive. I don't want to have to limit patient groups, I want this to be a true TCM approach. I found a research protocol from an oncology organization (I apologise for not knowing it off the top of my head, but I am at work and would need to access my email to answer the question) that is to be used for integrative medicine and specifically geared toward TCM. I'm hoping if I can get approval to use that protocol, a lot of my issues with the number of herbs I need approved may be somewhat allievated. Ah yes...lots of hurdles...but I have a Chief who is motivated to prove that our service can offer true integrative medicine and a surgeon heading the project with me who heads the integrative department of our service. She is well respected and the very best candidate to get a green light from the brass. And I am determined to see herbal therapy in a hospital setting and the TCM approach is IMO the most likely to prove successful. I think I'll go look up that protocol and post it in files for any of those interested. Wishing you wisdom, Randy , " " wrote: > > Randy, thanks for the additional information. I certainly didn't put the notes up to show > what herbs to use. In a way, it was to show pretty much how different what I saw is > compared to what you would like to do. If you think the MDs are going to resistant to this > type of study I think you may see more skepticism from the TCM sector. To me you would > have to define such a narrow range of patient to fit one or more set of herbs. Any patients > that fall out of those parameters you risk doing harm. If I understand your concerns you > are really hoping for an ideal patient to fit the ideal herb(s). The approach to treatment > (pain or tonification) is inextricably tied to the parameters of the study itself. > > You really have set up the ultimate dilemma for the TCM study. These are just off the top > of my head comments. I don't mean to be discouraging and I would urge you to dialogue > with the Pine Street Foundation in Northern California. You can look at at least one of their > papers online:The Pine Street Survival Study: Evaluating Integrative Traditional Chinese > Medicine with Chemotherapy. They are obviously more experienced in providing the > answers you seek here. > > Michael Broffman, LAc, at the Foundation is well known and respected in the TCM > community. Perhaps Z'ev could help with an introduction. Al Stone also has some if not a > lot of training in research design. This is an important study, keep us posted as to what > you find. > > http://www.pinestreetfoundation.org > > > Pine Street Foundation · 124 Pine Street · San Anselmo · California · 94960-2674 > P: (415) 455-5878 · F: (415) 485-1065 > > > > , " rparrny " <rparrny@> wrote: > > > > Doug, > > > > Thanks you for the info, I will take a look at your notes. I'm not > > looking for which herbs to use, but rather which approach to > > concentrate on with the herbs. In a hospital setting, I'm sure no > > one will be surprised to know that getting approval of the use of > > herbs will be the bain of my existence. I need to keep it as simple > > as I can. The endpoints of the study will be comparing pain med > > usage to the non-TCM patients, as well as quality of life and length > > of stay (and eventually nutritional status but my chief thinks it > > should be done as a seperate study). > > So with the goal of keeping this first herbal introduction as simple > > as possible....which approach will give me the most bang for my buck. > > I'm sure any herbs used for pain will be scrutinized at the highest > > level...but if their inclusion would be more beneficial to the > > recovery of the patient I'm willing to go the distance on that > > fight. > > And I wonder if concentrating more on tonification and Qi of both the > > lung and the body in general, won't also have a endpoint result of > > reducing the need for pain meds...in which case, why fight that fight? > > If I try to use herbs for both, the list will be too exhaustive and I > > will get nowhere with approvals. > > Hence, I look for opinions and rationale from those practitioners > > that more routinely use herbal therapy in conjunction with their > > treatment. > > I should have been more specific in my request, sorry. > > Wishing you wisdom, > > Randy > > > > > > > Quote Link to comment Share on other sites More sharing options...
Guest guest Posted June 1, 2008 Report Share Posted June 1, 2008 Thomas, Thank you for your opinion. Let me clarify something you said in case I got it wrong...because it opens up another window for me and really sparked my interest. It may be possible to choose a group of herbs that are more commonly used that are often found in different formulas, therefore one herb on my list may be used as an ingredient in several formulas. Choosing more of these common herbs would give me more of the " bang for the buck " I was looking for. I'm going to be submitting names of individual herbs not formulas (if I can help it) so careful consideration of the base list could give me many more options than I realized. Outstanding! Wishing you wisdom, Randy , wrote: > > Randy, > > I agree with Doug, my experience (only two of the type of patient you want to study) > is that you will need to both quicken the blood and supplement and > nourish, doing only one would no give you the results you are looking > for, but I offer the following as some food for thought. Perhaps choosing a small group of formulas along with a group of medicinals that the practitioners could choose from to modify the formulas would limit the length of you list. This may not be ideal, but it may, at least in part, solve your problem. > > Good luck, and be sure to keep us up to date on how this process it moving along...and be sure to keep some liver depression medicinals on hand at all times :-) > > > > Beijing, China > > Author of Western Herbs According to Traditional : A Practitioners Guide > > > > www.sourcepointherbs.org > > Quote Link to comment Share on other sites More sharing options...
Guest guest Posted June 2, 2008 Report Share Posted June 2, 2008 On Sun, Jun 1, 2008 at 5:13 PM, rparrny <rparrny wrote: > I found a research protocol from an oncology organization that > is to be used for integrative medicine and specifically geared > toward TCM. > I'd be interested in looking at that. Can you provide us its citation information? Studies that I've proposed to research TCM herbal interventions cause chief investgators' eyes to roll due to the number of herbs involved. They just have trouble with really complex polypharmacy. I do agree with your idea about looking at the herbs that appear in the most formulas that address toward what you want. I do that sometimes when I can't quite find a formula that really conforms to a patient's presentation. Do you have access to any patients undergoing this procedure so you can get a sense of what they may need in the study? This might help to limit your options a bit. -al. -- , DAOM Pain is inevitable, suffering is optional. Quote Link to comment Share on other sites More sharing options...
Guest guest Posted June 2, 2008 Report Share Posted June 2, 2008 , " Al Stone " <al wrote: > > On Sun, Jun 1, 2008 at 5:13 PM, rparrny <rparrny wrote: > > > I found a research protocol from an oncology organization that > > is to be used for integrative medicine and specifically geared > > toward TCM. The normal thing to do in China is to identify the disease you are looking at, find the TCM diseases that overlap with it, and research the chapters in integrative books and TCM books based on the modern and traditional disease categories. You then know which main patterns are likely to show up, and you create a base formula for each of the patterns. The patients are then divided into cohorts based on TCM patterns, typically using the numeric rating scale that is used in China to maximize inter-rater reliability, which is particularly essential for TCM diagnosis. This has been discussed on the past here at CHA. A good English reference book for the Chinese integrative approach is Bob Flaw's Treatment of Modern Western Medical Diseases with Chinese Medicine. This general style of using pattern differentiation and base formulas is a good place to begin a research study, and then you only have to split the patients into a small number of cohorts based on pattern. Much easier research design. A bit imperfect because you can't customize as much, but far easier to work with logistically. Eric Brand Quote Link to comment Share on other sites More sharing options...
Guest guest Posted June 4, 2008 Report Share Posted June 4, 2008 I have uploaded it under files. It is more of a practice protocol, but may have some research applications. Wishing you wisdom, Randy , " Al Stone " <al wrote: > > On Sun, Jun 1, 2008 at 5:13 PM, rparrny <rparrny wrote: > > > I found a research protocol from an oncology organization that > > is to be used for integrative medicine and specifically geared > > toward TCM. > I'd be interested in looking at that. Can you provide us its citation > information? > > Studies that I've proposed to research TCM herbal interventions cause chief > investgators' eyes to roll due to the number of herbs involved. They just > have trouble with really complex polypharmacy. > > I do agree with your idea about looking at the herbs that appear in the most > formulas that address toward what you want. I do that sometimes when I can't > quite find a formula that really conforms to a patient's presentation. > > Do you have access to any patients undergoing this procedure so you can get > a sense of what they may need in the study? This might help to limit your > options a bit. > > -al. > > > > -- > , DAOM > Pain is inevitable, suffering is optional. > > > Quote Link to comment Share on other sites More sharing options...
Guest guest Posted June 4, 2008 Report Share Posted June 4, 2008 Eric, At first glance I thought this might be too complicated to attempt (not the idea, just trying to get it past the brass for approval). After thinking about it, this might actually help me simplify the herbal portion of the study. As you all know, getting these herbs approved for the study will be the biggest challenge. I'm trying to figure out a way to start small and get it approved, if I run into issues with the herbs during the study...it will nix any future endevours and the herbal portion is (for me) the most important aspect as it has been excluded in every study in the US thus far. My chief for the research is already talking about doing another study with the same population for nutrition, so what I do with this study will determine my success with getting herbs approved in future studies. There is no way I will be able to utilize all the herbs a TCM practitioner would use. I just need to have an amorment of herbs that are non-toxic (cause you know if they see the word toxic it will be rejected), that will help my endpoints...now I think staying away from herbs that treat pain specifically and concentrate on tonifying, building Qi and (someone contacted me and added this possiblity) treating phlegm could be used for my endpoints of quality of life and/or length of stay. I will find Bob Flay's book and check it out. Thanks, Wishing you wisdom, Randy > > The normal thing to do in China is to identify the disease you are > looking at, find the TCM diseases that overlap with it, and research > the chapters in integrative books and TCM books based on the modern > and traditional disease categories. You then know which main patterns > are likely to show up, and you create a base formula for each of the > patterns. The patients are then divided into cohorts based on TCM > patterns, typically using the numeric rating scale that is used in > China to maximize inter-rater reliability, which is particularly > essential for TCM diagnosis. This has been discussed on the past here > at CHA. > > A good English reference book for the Chinese integrative approach is > Bob Flaw's Treatment of Modern Western Medical Diseases with Chinese > Medicine. This general style of using pattern differentiation and > base formulas is a good place to begin a research study, and then you > only have to split the patients into a small number of cohorts based > on pattern. Much easier research design. A bit imperfect because you > can't customize as much, but far easier to work with logistically. > > Eric Brand > Quote Link to comment Share on other sites More sharing options...
Guest guest Posted June 4, 2008 Report Share Posted June 4, 2008 Can you go the other direction? Ask the docs what herbs they WONT allow. It's interesting the response you hear back from the Western side about using Chinese herbs - even that they are all poisonous. I'm sure the docs aren't going to know, as anyone else could, know of all the potential billions of permatations of interactions. But - I would think you would be well covered if they gave you a list of herbs that they don't want you to use to cover your back side, rather than having them flip out and just say 'don't use anything' when you give them a list of 75 herbs that they have never heard of. Geoff , " Al Stone " <al wrote: > > I do agree with your idea about looking at the herbs that appear in the most > formulas that address toward what you want. I do that sometimes when I can't > quite find a formula that really conforms to a patient's presentation. > > Do you have access to any patients undergoing this procedure so you can get > a sense of what they may need in the study? This might help to limit your > options a bit. > > -al. > > Quote Link to comment Share on other sites More sharing options...
Guest guest Posted June 6, 2008 Report Share Posted June 6, 2008 Geoff, We spoke of that very thing this week, and I told her of my posing this question to the group. We are both well aware that we are trailblazing and that there will be lots of opposition. We decided to keep it as simple as possibe for the first study and use the success of that study to expand the use of herbs in future studies. (Hence my query to the group) We both agreed that any herb that pharmacy will find a reference as known toxic will have to be off the list. Knowing that there will be those that will use any excuse to nix this part of the study, I suggested that we stick to only those herbs that are already FDA approved as dietary supplements. They will have a harder time opposing herbs that the patient can purchase on their own at any GNC or health food store, and question whether they feel they are above the judgement of the FDA on using these herbs. With that in mind, I think that tonification ect. types of herbs are more likely to be in this catagory. I recieved so many private emails with suggestions on readings, thank you all. I have ordered several of the books that you have all recommended and we are both looking forward to the guidance they will offer. So I guess the next step is to look through these references and see how many of the herbs noted in the books are FDA dietary supplements. Wishing you wisdom, Randy , " G Hudson " <ozark.canuck wrote: > > Can you go the other direction? Ask the docs what herbs they WONT > allow. It's interesting the response you hear back from the Western > side about using Chinese herbs - even that they are all poisonous. > I'm sure the docs aren't going to know, as anyone else could, know of > all the potential billions of permatations of interactions. But - I > would think you would be well covered if they gave you a list of herbs > that they don't want you to use to cover your back side, rather than > having them flip out and just say 'don't use anything' when you give > them a list of 75 herbs that they have never heard of. > > Geoff > > , " Al Stone " <al@> wrote: > > > > I do agree with your idea about looking at the herbs that appear in > the most > > formulas that address toward what you want. I do that sometimes when > I can't > > quite find a formula that really conforms to a patient's presentation. > > > > Do you have access to any patients undergoing this procedure so you > can get > > a sense of what they may need in the study? This might help to limit > your > > options a bit. > > > > -al. > > > > > Quote Link to comment Share on other sites More sharing options...
Guest guest Posted June 6, 2008 Report Share Posted June 6, 2008 > > Do you have access to any patients undergoing this procedure so you can get > a sense of what they may need in the study? This might help to limit your > options a bit. > > -al. > Al, Cardio-Thoracic is what I do so a good portion of my patient population is lung and most of them lung cancer. I'm not sure if I'm answering your question correctly as to " what they need in the study " What the patient's need is pain control, thoracotomies are very painful and not well controlled with WM pain meds. They all come out with epidurals and/or patient controlled analgesia. As a result of the narcotics, gut motility, nausea, vomitting and anorexia are an issue. Add to that, many are already malnourished, a few down to skin and bones...throw in the mental stigmata of being told you have cancer...and they have mental blocks to their own healing. I find that only TCM seems to address every issue to some degree and that addressing all of the issues rather than just pain as several studies have done will (in our opinion)improve all aspects of healing including the mental healing. Hence the quality of life endpoint among the study. Hope that answers your question, Wishing you wisdom, Randy Quote Link to comment Share on other sites More sharing options...
Guest guest Posted June 6, 2008 Report Share Posted June 6, 2008 I had a thought that this study might be where a trained herbalist would either prescribe Ren Shen, Dang Shen, Tai Zi Shen or Xi Yang Shen or nothing based on the individual patient. Doug , " rparrny " <rparrny wrote: > > Geoff, > > We spoke of that very thing this week, and I told her of my posing > this question to the group. We are both well aware that we are > trailblazing and that there will be lots of opposition. We decided > to keep it as simple as possibe for the first study and use the > success of that study to expand the use of herbs in future studies. > (Hence my query to the group) > We both agreed that any herb that pharmacy will find a reference as > known toxic will have to be off the list. Knowing that there will be > those that will use any excuse to nix this part of the study, I > suggested that we stick to only those herbs that are already FDA > approved as dietary supplements. They will have a harder time > opposing herbs that the patient can purchase on their own at any GNC > or health food store, and question whether they feel they are above > the judgement of the FDA on using these herbs. With that in mind, I > think that tonification ect. types of herbs are more likely to be in > this catagory. > I recieved so many private emails with suggestions on readings, thank > you all. I have ordered several of the books that you have all > recommended and we are both looking forward to the guidance they will > offer. > So I guess the next step is to look through these references and see > how many of the herbs noted in the books are FDA dietary supplements. > > Wishing you wisdom, > Randy > > > , " G Hudson " > <ozark.canuck@> wrote: > > > > Can you go the other direction? Ask the docs what herbs they WONT > > allow. It's interesting the response you hear back from the Western > > side about using Chinese herbs - even that they are all poisonous. > > I'm sure the docs aren't going to know, as anyone else could, know > of > > all the potential billions of permatations of interactions. But - I > > would think you would be well covered if they gave you a list of > herbs > > that they don't want you to use to cover your back side, rather than > > having them flip out and just say 'don't use anything' when you give > > them a list of 75 herbs that they have never heard of. > > > > Geoff > > > > , " Al Stone " <al@> wrote: > > > > > > I do agree with your idea about looking at the herbs that appear > in > > the most > > > formulas that address toward what you want. I do that sometimes > when > > I can't > > > quite find a formula that really conforms to a patient's > presentation. > > > > > > Do you have access to any patients undergoing this procedure so > you > > can get > > > a sense of what they may need in the study? This might help to > limit > > your > > > options a bit. > > > > > > -al. > > > > > > > > > Quote Link to comment Share on other sites More sharing options...
Guest guest Posted June 7, 2008 Report Share Posted June 7, 2008 Doug, Amazing idea, short sweet and to the point. At a quick glance it seems that they are all FDA dietary supplements (still new at learning the Pinyin names). They all have tonifying qualities. Now would anyone think that just by tonifying, we might get an end result of increased gut motility and less nausea? Wishing you wisdom, Randy , " " wrote: > > I had a thought that this study might be where a trained herbalist > would either prescribe Ren Shen, Dang Shen, Tai Zi Shen or Xi Yang > Shen or nothing based on the individual patient. > Doug > Quote Link to comment Share on other sites More sharing options...
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