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HERBS

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GENERAL INFORMATION ON HERBAL PRESCRIPTION

 

Information on Traditional Chinese Medicine (TCM):

Herbal medicine is the main treatment method of TCM, dating back over 2500 years. Although acupuncture was the first Chinese method of treatment to gain wide acceptance in the West, Chinese herbal medicine is quickly establishing itself as one of the most popular and effective alternative therapies in the West. In TCM, an appropriate balance between exercise and diet, or work and play, can maintain good health and prevent illness. TCM works best when it is integrated into the patient’s lifestyle, or that is, appropriately and systematically utilizing all of its preventative modalities. TCM modalities include herbs, acupuncture and massage, exercise (qigong and tai chi), and nutrition which should be applied according to the client's condition.

Difference between Western Folk Herbalism and Chinese Herbal Medicine:

Western folk herbalism primarily treats diseases or symptoms, such as headaches, runny nose, menstrual pain, etc. Chinese herbal medicine, when practiced as a part of TCM , is based on an individualized energetic pattern diagnosis and disease. The patient’s pattern consists of signs and symptom, emotional temperament, and body composition. The TCM patient receives a custom written herbal formula prescription designed to treat the individual’s energetic pattern as well as the symptom of disease.

Origin of Herbs:

Chinese herbal medicine may include vegetable, animal and mineral ingredients, however the majority are from vegetable sources. Leaves, flowers, twigs, stems, roots, tubers, rhizomes, and bark are among the parts of the vegetable used.

The Chinese adopted and incorporated herbs from all over the world. Fifteen to twenty percent of the 500 ingredients considered standard originated from outside China. What makes them “Chinese” herbs is that they are prescribed according to TCM theory and pattern diagnosis.

Conditions (criteria) for Herbal Prescription:

Many of the TCM herbs are commonly and routinely used in Chinese cooking. Therefore, it is not necessary to separate medicinal food from pharmaceutical medications.

Herbal medicine is thought to be the bulk of TCM since diet and exercise are traditionally practiced on a daily basis. Therefore, herbal medicine is usually utilized when there is sickness. There are herbs and formulas appropriate to treat any biomedical condition. Potentially, anyone may take herbs.

Herbal medicine is preferred when the patient is not currently taking pharmaceutical medication for the following reasons:

1)      To obtain the best response

2)      To prevent adverse reactions

3)      To encourage an ideal internal climate for the patient

Selection of Herbal Formulas:

Like acupuncture, herbs and herbal formulas are selected based primarily on the patient’s diagnosis, or discovered energetic syndrome in TCM. The TCM practitioner must be aware of what herbs and formulas are cautioned and contraindicated for specific energetic conditions inherent in the patient, other herbs, or other pharmaceuticals (will not apply at HMG). Herbal formula modifications may be appropriate depending on a patient’s symptom, condition (ie. pregnancy, HBP, etc), or after an adverse effect. There may be several formulas appropriate for the patient, but ultimately the best choice depends on the practitioner’s understanding of the cause of the patient’s ailment.

Forms of Herbal Medication:

Herbal medication form may depend on the patient’s preference, condition, product availability, cost, or storage capability. Different forms include: tea, wine, pills, tablets, syrups, plasters, tinctures, etc. 

FORMS OF ADMINISTRATION

Form

Preparation

Advantages

Disadvantages

Decoctions/

Teas/

Soups

 

(Tang)

1)       placed in water or mixed w/wine and water

2)       boiled for a specified time

3)       liquid is strained from the dregs

4)       ingested from the mouth

 

  • most common

  • require no special equipment for preparation

  • easily ingested

  • easily absorbed

  • strongly affects the patient

  • changes lifestyle: allows the patient to participate in the healing process

  • can be customized to better treat the client’s needs

  • time consuming

  • aromatic

  • expensive

  • usually bad tasting

 

Boiled Powders/ Drafts

 

(San)

1)       ingredients are ground up

2)       sifted into a uniform powder

3)       draft: boil powder for a short time (10 min.) in a small amount of water  (1-1˝ cups)

4)       ingested (after strained from dregs), applied externally (skin conditions), or blown into nose or throat (localized disorders)

  • convenient preparation

  • long storage time

  • inexpensive

  • easily absorbed (medicinal action rate is between that of pills and decoctions)

 

 

 

Pills

 

(Wan)

1)       ingredients are finely ground and pulverized

2)       viscous medium is added (honey, water, wax, or paste concentrates)

3)       round pills are formed

  • specified in different sizes

  • easily stored

  • easily ingested

  • inexpensive

  • generally used for chronic deficient disorders

  • can be stored for quickly treating acute disorders

  • first choice for non-decocted administration

  • dissolves in intestines so it prevents gastric irritation

  • absorbed slowly

 

Pills made w/ honey

(bolus)

 

(Mi Wan)

1)       ground herbs mixed w/honey

2)       honey is heated to preserve adhesive characteristics and to make it easier to work with

3)       mix beeswax and sesame oil to prevent it from sticking to utensils

  • makes pills moist and lubricating

  • moderates (harmonizes) other herbs in formula

  • tonifies

  • 1-2cm dia.

Pills made w/liquids

 

(Shui Wan)

1)       ground herbs mixed w/water, wine, vinegar, or strained decoction

 

  • small (2-5mm dia.)

  • easy to swallow

  • easily digested

  • most common type of prepared medicine in China

 

Pills made w/pastes

 

(Hu Wan)

1)       ground herbs mixed w/paste made from rice or wheat flour

 

  • reduces irritation to the digestive tract

  • extremely viscous: absorbed slowly

Pills made from concentrates

 

(Nong Suo Wan)

1)       made from concentrated strained decoction w/ the addition of a starch or dried and powdered dregs from the decoction

2)       water and wine may be added at certain times during procesing

  • contains large amount of active ingredients per volume (concentrated potency)

  • very convenient

 

Special Pills

 

(Dan)

1)       are highly refined and expensive substances (ground into fine powder)

2)       viscous medium is added (honey, water, wax, or paste concentrates)

3)       round pills are formed; also called “vermilion pills,” coated with cinnabaris for protection and enhancing the calming function

  • specially processed

 

  • usually very expensive

 

Soft Extracts

 

(Gao)

1)       ingredients simmered w/water or vegetable oil until syrupy or gummy concentrate forms

2)       applied externally as plasters for skin disorders or trauma

3)       common internal soft extracts: prolonged decoction, liquid extraction, and semi-solid extraction

 

 

Plaster Medicine

[external]

 

(Gao Yao)

1)       slowly simmering ingredients in vegetable oil (sesame)

2)       discard residue

3)       add beeswax

4)       store on paper or cloth

5)       if stored, the plaster is heated prior to placement on the skin

  • good for dermatological and rheumatological disorders, fractures and sprains, and immobile masses

 

 

Medicinal Plaster

 

[external]

(Yao Gao)

1)       add powdered ingredients to heated mixture of oil and beeswax

 

 

Syrups from prolonged decoction

 

[internal]

(Gao Zi)

1)       repeatedly decoct ingredients to a specific concentration

2)       finally cook w/honey or sugar into a syrup or gel-like extract

  • easy to take

  • sweet

  • tonifying, enriching

 

Liquid extractions

 

[internal]

(Liu Jin Gao)

1)       soak ingredients in a solvent (usually alcohol) to extract the active ingredients

2)       heat result to dispose of a specified percentage of the solvent (1ml liquid extraction contains 1g active ingredients)

  • more concentrated than tinctures: less alcohol needs to be ingested in order to get the same amount of active ingredient

 

 

Semi-solid extracts

 

[internal]

(Jin Gao)

1)       sim to above, except: heat until all solvent is gone (1g of extract contains 2-5g active ingredient)

2)       either fashioned into tablets, pills, or capsules

  • effective and convenient

  • no side-effects associated w/solvent

 

Syrups

 

(Tang Jiang)

1)       strain liquid from decoction

2)       add specified quantity of cane sugar

  • sweet

  • good for TX children

  • most appropriate for chronic disorders, cough or sore throat

 

Medicinal Wine

 

(Jiu/Yao)

Sim. to internal soft extracts:

1)       soak ingredients in rice, sorghum, or other spirits (alcohol as solvent)

2)       warm wine

3)       discard dregs

4)       apply internally or externally

  • wine nourishes, invigorates blood, and unblock the channels

  • good for TX chronic deficiency

  • good for TX wind-damp or traumatic pain

 

Lozenges

 

(Ding)

1)       grind ingredients into powder

2)       form into ingot-shaped tablets (sometimes w/honey, paste, etc.)

3)       grind lozenge into thick liquid before taking

4)       apply internally or externally

 

 

Tablets/

Capsules/

Drops

 

(Pian)

1)       extract active ingredients

2)       add filler (honey, etc.)

3)       form tablet (usually under pressure)

  • high tech, highly refined

 

  • often containing western pharmaceuticals

 

Granules

 

(Chong Fu)

1)       concentrate the decoction ingredients into a thick semi-liquid

2)       add stabilizer (starch or ground dregs from decoction) and thoroughly mix

3)       make into granules or powder by sifting through a series of sieves

4)       crush granules

5)       dry granules

  • prolonged potency retention during storage

  • quickly absorbed

  • stronger-acting than most pills and tablets

  • convenient

  • require less medicine per volume than decoctions or syrups

 

Injections

 

(Zhen)

1)       extract active ingredients w/ modern methods

2)       prepare a sterile solution

3)       administer injection (subcutaneously, intramuscularly, or intravenously)

  • precise and quick delivery

  • unaffected by digestive system or foods

  • more convenient than decoctions in hospital setting

 

Herbal Medication Instructions:

It is primarily, important to let the patient understand the effectiveness of compliance with the herbal formula instructions. The TCM practitioner should then spend time to explain the herbal formula’s contents, functions, preparation method, ingestion method, dosage, frequency, course duration, and any possible adverse effects. In most cases, more than one herbal cycle will need to be required.

Adverse Reactions:

The waiver form patients are asked to sign explain the possible adverse effects, if any. The adverse effects are first recognized when the patient signs the treatment waiver form. If an adverse reaction does occur, the patient should notify the practitioner as soon as possible. Then, the TCM practitioner may opt to stop, modify, or choose a more appropriate herbal formula. It may also be necessary for the patient to consult with his/her PCP prior to taking an herbal formula in order to ensure adverse effect prevention.  

 

Places of Practice: (treatment by appointment only)

 

Chinatown: Chinese Cultural Plaza

Institute of Clinical Acupuncture and Oriental Medicine (ICAOM)

100 N. Beretania St. Ste.203B, Honolulu, HI 92813

(808) 728-2954; (808) 521-2288; Fax: (808) 521-2271

http://www.orientalmedicine.edu

 

Kaimuki:

Kaimuki Health and Wellness

1109 12th Ave. Ste.2, Honolulu, HI 96816

(808) 728-2954; (808) 924-7772

 

Outcalls also available

 

© PLUM BLOSSOM CLINIC, 2008