Dose of herbs prescribed to Westerner in Beijing

[Guest guest]

A client of mine just returned from Beijing with a loose herb formula from an

herbalist with a storefront there. Each bag weighs 180 grams. Instructions were

to boil herbs twice and drink resultant tea during one day. 14 bags for 14 days.

She doesn't have an acute or severe disease. I was surprised how high the dosage

is.

 

Marian

[Guest guest]

He probably just wanted to make a little extra cash of a foreigner.

Gabe Fuentes

--- On Thu, 4/9/09, Marian Blum, L.Ac., DNBAO <chinesemed wrote:

 

Marian Blum, L.Ac., DNBAO <chinesemed

Dose of herbs prescribed to Westerner in Beijing

 

Thursday, April 9, 2009, 3:00 PM

 

 

 

 

 

 

 

 

A client of mine just returned from Beijing with a loose herb formula from an

herbalist with a storefront there. Each bag weighs 180 grams. Instructions were

to boil herbs twice and drink resultant tea during one day. 14 bags for 14 days.

She doesn't have an acute or severe disease. I was surprised how high the dosage

is.

 

Marian

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

[Guest guest]

Marian,

 

 

 

Yes dosages vary widely in China, as in the US. However, we should be

reminded that in China, most of the doctors get paid for the herbs they

prescribe (via kickbacks). So many doctors are in the habit of writing large

formulas, as well as prescribing expensive tonic herbs that are not

warranted. I would like to say that your client's experience is unique and

only for Westerners, but it is not the case. This happens all the time, even

in my US town of Boulder.

 

 

 

Consequently, I have found it most valuable to study with doctors who write

small formulas with small/smaller dosages. Not only are these doctors

usually more ethical, they usually have clearer thinking in their diagnosis,

hence better to learn from.

 

 

 

Hope this helps,

 

 

 

-Jason

 

 

 

 

On Behalf Of Marian Blum, L.Ac.,

DNBAO

Friday, April 10, 2009 4:00 AM

 

Dose of herbs prescribed to Westerner in Beijing

 

 

 

 

 

 

 

 

A client of mine just returned from Beijing with a loose herb formula from

an herbalist with a storefront there. Each bag weighs 180 grams.

Instructions were to boil herbs twice and drink resultant tea during one

day. 14 bags for 14 days. She doesn't have an acute or severe disease. I was

surprised how high the dosage is.

 

Marian

 

 

 

 

Checked by AVG - www.avg.com

Version: 8.0.238 / Virus Database: 270.11.48/2048 - Release 04/08/09

19:02:00

 

 

 

 

[Guest guest]

180 gms/ bag could be dangerous...

how would that affect the liver?

 

 

On Thu, Apr 9, 2009 at 5:33 PM, Gabriel Fuentes <fuentes120wrote:

 

>

>

>

>

> He probably just wanted to make a little extra cash of a foreigner.

> Gabe Fuentes

> --- On Thu, 4/9/09, Marian Blum, L.Ac., DNBAO

<chinesemed<chinesemed%40redshift.com>>

> wrote:

>

> Marian Blum, L.Ac., DNBAO

<chinesemed<chinesemed%40redshift.com>

> >

>

> Dose of herbs prescribed to Westerner in Beijing

> <%40>

> Thursday, April 9, 2009, 3:00 PM

>

> A client of mine just returned from Beijing with a loose herb formula from

> an herbalist with a storefront there. Each bag weighs 180 grams.

> Instructions were to boil herbs twice and drink resultant tea during one

> day. 14 bags for 14 days. She doesn't have an acute or severe disease. I was

> surprised how high the dosage is.

>

> Marian

>

>

[Guest guest]

180 gms is actually quite a moderate dose from a traditional perspective.

Dosages in Taiwan tend to average 4 to 6 liang (one bag per day). One liang is,

in taiwan, 37.5g. Small dosages on the mainland has a lot to do with the

economic situation of the average person than it does with concern for

'overdosing'. In taiwan, many clinics (not herbal shop) have a set price for

their formulas--they charge per bag not per gram. So they actually lose money

with large prescriptions. Of course, this does not necessarily speak for what

happened in Beijing, but there are quite a few well known physicians in China

who retain old style treatment methods and use large doses.

 

 

 

Daniel Altschuler

 

 

 

 

johnkokko

Thu, 9 Apr 2009 23:14:58 -0700

Re: Dose of herbs prescribed to Westerner in Beijing

 

 

 

 

 

 

 

180 gms/ bag could be dangerous...

how would that affect the liver?

 

On Thu, Apr 9, 2009 at 5:33 PM, Gabriel Fuentes <fuentes120wrote:

 

>

>

>

>

> He probably just wanted to make a little extra cash of a foreigner.

> Gabe Fuentes

> --- On Thu, 4/9/09, Marian Blum, L.Ac., DNBAO

<chinesemed<chinesemed%40redshift.com>>

> wrote:

>

> Marian Blum, L.Ac., DNBAO

<chinesemed<chinesemed%40redshift.com>

> >

>

> Dose of herbs prescribed to Westerner in Beijing

> <%40>

> Thursday, April 9, 2009, 3:00 PM

>

> A client of mine just returned from Beijing with a loose herb formula from

> an herbalist with a storefront there. Each bag weighs 180 grams.

> Instructions were to boil herbs twice and drink resultant tea during one

> day. 14 bags for 14 days. She doesn't have an acute or severe disease. I was

> surprised how high the dosage is.

>

> Marian

>

>

[Guest guest]

Daniel,

 

 

 

I actually believe the opposite, and would like to see some evidence that

larger dosage formulas are the norm for a 'traditional perspective.' I think

larger dosage formulas are a more modern approach, many times fueled by

pharmacological / Western style research. I cannot speak for Taiwan, for I

have only studied their once, but in the mainland there are plenty of famous

doctors, actually most of the one's I have studied with, that do not use

large dosages. It is also clear that one can get results with serious skin,

autoimmune, etc with small concise formulas. THIS is what I see as a

traditional approach, hence practiced usually only by the really old

doctors, with strong classical training.

 

 

 

Actually one just needs to look through case studies and see how small and

precise the formulas were by some of the best doctors in history - hence

what I call a traditional approach. Of course there are exceptions with

doctors using large dosages, but there are plenty of examples of small

dosage formulas. Check out Ye Tian-Shi, Ding Gan ren, Qin Bo-wei, Liu

Bao-yi, and the meng-he doctors to see this style in real clinical

practice.

 

 

 

However your definition of traditional might be different than mine. I think

of a traditional approach from doctors prior to 'Modern TCM " and who used a

traditional approach to diagnosis and based their formulas on classical

ideas and prescriptions. Just for the record there is too much debate for

the SHL's dosages to weigh in on this topic.

 

 

 

I also disagree that 'smaller dosages' has to do with the economic situation

of the patient. There are doctors that I study with that just use small

dosages because they find no need to blast people out of the water. The get

some of the best results around hence are the busiest doctors. These

doctors do say that overdosing is an issue and too many herbs can be

harmful.

 

 

 

I always wonder why one would opt for an approach where one has to

constantly monitor Liver enzymes. Of course safe is best if you choose such

an approach, but such a strong approach IMHO is just unnecessary.

 

 

 

-

 

 

 

 

 

 

 

 

 

 

On Behalf Of Daniel Altschuler

Saturday, April 11, 2009 11:37 AM

 

RE: Dose of herbs prescribed to Westerner in Beijing

 

 

 

 

 

 

 

 

 

180 gms is actually quite a moderate dose from a traditional perspective.

Dosages in Taiwan tend to average 4 to 6 liang (one bag per day). One liang

is, in taiwan, 37.5g. Small dosages on the mainland has a lot to do with the

economic situation of the average person than it does with concern for

'overdosing'. In taiwan, many clinics (not herbal shop) have a set price for

their formulas--they charge per bag not per gram. So they actually lose

money with large prescriptions. Of course, this does not necessarily speak

for what happened in Beijing, but there are quite a few well known

physicians in China who retain old style treatment methods and use large

doses.

 

Daniel Altschuler

 

 

 

irus Database: 270.11.48/2048 - Release 04/10/09 18:27:00

 

 

 

 

[Guest guest]

Jason,

 

You are always writing about the ability use low dosages in small well crafted

and focused formulas for conditions that can be quite severe. I am really

curious to hear or see some of your own clinical experience.

 

Do you yourself achieve excellent results with the conditions you speak of?

 

Perhaps you can share with us some of your clinical expertise in treating such

autoimmune conditions as:

 

Widespread and stubborn psoriasis

Severe rheumatoid arthritis

Graves disease

 

If you have cured psoriasis, how long did it take? Did you follow up three years

later? 10 years later?

 

If you have opinions on treating autoimmune conditions with low dosed formulas,

I am assuming that you also have the confidence as shown through your own

clinical experience to back up these claims.

 

I have talked to many doctors who claim they " cure " psoriasis within a few weeks

using these small formulas, but when I inquire further they are only ever able

to quote one or two cases- not hundreds. Which to me either represents a lack of

seeing these types of patients, or the majority of the cases they do see are not

successful. They just got lucky a couple times.

 

Testing ones liver enzymes may have nothing to do with larger dosages of

formulas. It has also to do with the type of herb used, ie its toxicity. By

testing allows a practitioner to use a herb that they normally wouldn't even

consider out of fear- lei gong teng, Huang Yao Zi, etc. A high percentage of

individuals with conditions like psoriasis already have elevated liver enzyme

counts, testing can be a way to protect a patient from further elevations. Many

reactions to herbs are idiosyncratic and will happen even with small dosed

formulas. I have a patient who has chronic severe uriticaria triggered from

taking a very small dose of elderberry tea 3 years ago.

 

Of course having the ability to dose at smaller levels is beneficial for many

reasons, but I think we have to be very careful about making blanket statements

about large dosages being completely un-necessary. Formula dosages should

represent the patient's condition and to me there is nothing wrong with using

larger dosages when warranted, if it means a patient is alleviated from the

years of suffering that they have been experiencing.

 

Saying that large dosages are never necessary to me seems very un-ethical,

unless you can truly back up these claims with solid clinical confidence and be

a good guide to the rest of the profession.

 

Trevor

 

 

, " " wrote:

>

> Daniel,

>

>

>

> I actually believe the opposite, and would like to see some evidence that

> larger dosage formulas are the norm for a 'traditional perspective.' I think

> larger dosage formulas are a more modern approach, many times fueled by

> pharmacological / Western style research. I cannot speak for Taiwan, for I

> have only studied their once, but in the mainland there are plenty of famous

> doctors, actually most of the one's I have studied with, that do not use

> large dosages. It is also clear that one can get results with serious skin,

> autoimmune, etc with small concise formulas. THIS is what I see as a

> traditional approach, hence practiced usually only by the really old

> doctors, with strong classical training.

>

>

>

> Actually one just needs to look through case studies and see how small and

> precise the formulas were by some of the best doctors in history - hence

> what I call a traditional approach. Of course there are exceptions with

> doctors using large dosages, but there are plenty of examples of small

> dosage formulas. Check out Ye Tian-Shi, Ding Gan ren, Qin Bo-wei, Liu

> Bao-yi, and the meng-he doctors to see this style in real clinical

> practice.

>

>

>

> However your definition of traditional might be different than mine. I think

> of a traditional approach from doctors prior to 'Modern TCM " and who used a

> traditional approach to diagnosis and based their formulas on classical

> ideas and prescriptions. Just for the record there is too much debate for

> the SHL's dosages to weigh in on this topic.

>

>

>

> I also disagree that 'smaller dosages' has to do with the economic situation

> of the patient. There are doctors that I study with that just use small

> dosages because they find no need to blast people out of the water. The get

> some of the best results around hence are the busiest doctors. These

> doctors do say that overdosing is an issue and too many herbs can be

> harmful.

>

>

>

> I always wonder why one would opt for an approach where one has to

> constantly monitor Liver enzymes. Of course safe is best if you choose such

> an approach, but such a strong approach IMHO is just unnecessary.

>

>

>

> -

>

>

>

 

> On Behalf Of Daniel Altschuler

> Saturday, April 11, 2009 11:37 AM

>

> RE: Dose of herbs prescribed to Westerner in Beijing

>

>

>

180 gms is actually quite a moderate dose from a traditional perspective.

> Dosages in Taiwan tend to average 4 to 6 liang (one bag per day). One liang

> is, in taiwan, 37.5g. Small dosages on the mainland has a lot to do with the

> economic situation of the average person than it does with concern for

> 'overdosing'. In taiwan, many clinics (not herbal shop) have a set price for

> their formulas--they charge per bag not per gram. So they actually lose

> money with large prescriptions. Of course, this does not necessarily speak

> for what happened in Beijing, but there are quite a few well known

> physicians in China who retain old style treatment methods and use large

> doses.

>

> Daniel Altschuler

>

>

>

> irus Database: 270.11.48/2048 - Release 04/10/09 18:27:00

>

>

>

>

[Guest guest]

Carl,

 

 

 

I am well familiar with Mazin's results. As stated if one is going to

practice this style one SHOULD monitor Liver enzymes. That is no question

the responsible thing to do. However, my point is only that I don't see the

need to use high dosages to treat such conditions. My judgment is not by any

means quick, it is well thought out, as once I practiced Mazin's style for

skin disease. I no longer use such a heavy approach. TO each their own.

 

 

 

Let us keep in mind 'results' must be quantified. Western medicine can knock

out conditions and provide results very quickly, however it many times comes

with a price to the body. Chinese herbs have the same potential.

 

 

 

-Jason

 

 

 

 

On Behalf Of Carl

Sunday, April 12, 2009 1:10 AM

 

SV: Dose of herbs prescribed to Westerner in Beijing

 

 

 

 

 

 

 

 

Hi Jason

 

Are you familiar with the results of Mazin when treating skin disorders?

They are unmatched by anyone in the west.

 

I guess his approach is just one way, but his experience for several decades

treating very difficult skin problems must count for something. Without

meaning anything personal, is sometimes find you very quick to judge:-).

Results must be respected, no matter what treatment style and testing Liv

enzymes sounds to my like a caring and safe way for a professional to handle

his patients. We should need more of this attitude in Chinese medicine if we

want to call ourselves professionals!

 

Just my two cents

 

Best regards

 

Carl Wallmark

 

 

 

Database: 270.11.52/2053 - Release 04/10/09 18:27:00

 

 

 

 

[Guest guest]

Trevor,

 

 

 

AS always this is an interesting topic, and you are right, I am always

writing about small dosages etc. because I think it makes much more sense.

It is just my style, that is it. IMHO, it is more eloquent, less toxic, less

wasteful, but requires a refined diagnostic methodology. However, I have no

problem if you want to you use larger dosages, as said, to each their own.

But, I really do not think this discussion is anything about me, although I

am happy with my results, because I, nor probably anyone in the West, has

experience like the older Chinese doctors.

 

 

 

For example, my main teacher, has well over 50+ clinical years experience

with seeing over 100 people a day. Now retired he sees about 40-60 people in

the AM. He is the one who I have learned to do this from. One could say he

is in the meng-he lineage. One of his main teachers is Qin Bo-Wei and of

course his is Ding Gan-ren. (Please consult Volker's books to understand

meng-he style medicine, and the use of smaller formulas and dosages). He

also studied dermatology with one of the most famous dermatologist, Zhao

Bing-Nan. I myself am currently working through / translating Zhao

Bing-nan's case studies. One of my good friends is now writing a case study

book (of our teacher) with such examples that you look for. He has followed

the same patients for years now, and yes there are 100's if not 1000's of

cases he is picking from. I have also seen these patients over years and the

degree of severity of conditions (skin etc) are unparalleled to what at

least I have seen in the West. The results are no joke and yes the formulas

are small.

 

 

 

My mere purpose here is not to say, " hey I get these great results look.. "

it is only to let people know, especially ones that have not been able to

search out different doctors to study with, that one can get the job done

without large prescriptions. There is such an infiltration of modern western

style formula writing in the Chinese hospitals as well in the West, that one

can walk away thinking this is the only way. Remember this discussion

started because I assume some westerner went to a Beijing with no real

problem and got prescribed 180 grams a day. 30g 30g 30g. Ok, yes this is one

way (quite common), but not the only way! But don't get me wrong, I am happy

when anyone get results.

 

 

 

BTW - My colleague, Chip Chace, is actually quite an accomplished herbalist,

who has been practicing this style for probably 25 years. He may use 20-30

grams a day. Trevor, there is no question that it is possible, it really is

if you are open to it.

 

 

 

So if someone wants to learn, watching an old doctor that can do it, is the

place to go, not from a meek laowai like myself. Furthermore I can say

anything I want about my results, but how would anyone evaluate them through

the internet? Although I am happy with my clinical results most of the time,

I do have a lot lot lot to learn. Therefore I just report to what I have

seen by others. Consequently, the only way to learn, IMHO, is to sit and

watch year after year a really good doctor and then trying these ideas out

on your patients. Learning from a book or seminar is extremely difficult.

Although just knowing that it is possible can get you thinking in a certain

way, styles of prescribing etc.

 

 

 

Since I am in China right now, I do not have access to my files, but I

happen to have some digital copies of some formulas on my laptop. Below is a

patient's last formula for a semi-serious eczema case, severe cracked hands,

blisters, red, itchy, also on legs, arms, and some on trunk. The condition

has greatly improved since the first visit starting on 2/11/09, however

there were a few formulas that preceded the one below. There is no way to

evaluate the Rx, results, etc without seeing the whole case, patient, and

all the formulas, as well as how things are in the future. But this at least

will give you an idea of the style of prescribing that I personally like to

do. This is about 42 grams of herbs a day. The previous formulas were about

the same dosage.

 

 

 

Bi xie 9 Huang bai 5

 

 

Cang zhu 6 Can sha (wrap) 6

 

Yin chen hao 9 Ze xie 6

 

Xu chang qing 9 Feng fang 6

 

Ban xia 9 Bai xian pi 9

 

 

Ku shen 6 Chan tui 4

 

 

 

Trevor, I do think large dose modern Chinese style prescribing is

unnecessary. Maybe there is that 1% of cases out there that need this, but

that is not how such practitioners prescribe. For example, the large dosage

doctors that I have seen use large dosages almost all the time, not for te

small percent that need it. AS said, do what you like, but the clinical

results from modern doctors like I mention above, as well as a whole host of

pre-modern doctors such as Ye Tian-Shi (arguably the best clinician in

History), say otherwise.

 

 

 

I would like to know what type of condition warrants mandatory use of large

dosages 200+ grams a day? I have seen some of gnarliest stuff out there

without this style get treated, so I bite, I am curious.

 

 

 

Consequent to your below comments, Trevor, do you then test all your

patient's Liver enzymes once a month?

 

 

 

IS it unethical to only prescribe small dosage formulas and think that large

formulas are unnecessary? Hhhmmm.. That is one of the strangest things I

have ever heard.. I will have to contemplate that one.J -

 

 

 

So from my end, the clinical results are there for such a style, hence I

have confidence enough to use it myself, and as far as being a guide for the

profession??? Well without trying to plug anything, there will be an

upcoming book (in the editing stage), and hopefully a few articles,

completely outlining this style. It documents exactly how to do this for the

majority of cases out there. That is all I have to offer at the moment.

 

 

 

-

 

 

 

 

On Behalf Of Trevor Erikson

Sunday, April 12, 2009 3:51 AM

 

Re: Dose of herbs prescribed to Westerner in Beijing

 

 

 

 

 

 

 

 

Jason,

 

You are always writing about the ability use low dosages in small well

crafted and focused formulas for conditions that can be quite severe. I am

really curious to hear or see some of your own clinical experience.

 

Do you yourself achieve excellent results with the conditions you speak of?

 

Perhaps you can share with us some of your clinical expertise in treating

such autoimmune conditions as:

 

Widespread and stubborn psoriasis

Severe rheumatoid arthritis

Graves disease

 

If you have cured psoriasis, how long did it take? Did you follow up three

years later? 10 years later?

 

If you have opinions on treating autoimmune conditions with low dosed

formulas, I am assuming that you also have the confidence as shown through

your own clinical experience to back up these claims.

 

I have talked to many doctors who claim they " cure " psoriasis within a few

weeks using these small formulas, but when I inquire further they are only

ever able to quote one or two cases- not hundreds. Which to me either

represents a lack of seeing these types of patients, or the majority of the

cases they do see are not successful. They just got lucky a couple times.

 

Testing ones liver enzymes may have nothing to do with larger dosages of

formulas. It has also to do with the type of herb used, ie its toxicity. By

testing allows a practitioner to use a herb that they normally wouldn't even

consider out of fear- lei gong teng, Huang Yao Zi, etc. A high percentage of

individuals with conditions like psoriasis already have elevated liver

enzyme counts, testing can be a way to protect a patient from further

elevations. Many reactions to herbs are idiosyncratic and will happen even

with small dosed formulas. I have a patient who has chronic severe

uriticaria triggered from taking a very small dose of elderberry tea 3 years

ago.

 

Of course having the ability to dose at smaller levels is beneficial for

many reasons, but I think we have to be very careful about making blanket

statements about large dosages being completely un-necessary. Formula

dosages should represent the patient's condition and to me there is nothing

wrong with using larger dosages when warranted, if it means a patient is

alleviated from the years of suffering that they have been experiencing.

 

Saying that large dosages are never necessary to me seems very un-ethical,

unless you can truly back up these claims with solid clinical confidence and

be a good guide to the rest of the profession.

 

Trevor

 

 

 

 

 

 

[Guest guest]

Well spoken Trevor!

 

 

 

Jason, do you treat Psoriasis with good results time after time with small

dosages?

 

 

 

BR

 

Carl