Chinese Herbs

Differential Diagnosis in Chinese / Asian Medicine: 

As acupuncturists / herbalists, we sometimes hear people say things like, “I’ve heard this particular herb helps [some condition]. Should I take it?” and so starts a conversation about how Chinese medicine works. 

One thing to consider is that Chinese Medicine doesn’t tend to use herbs singularly. They’re often combined with other herbs to create custom formulas based on the individual presentation of the patient. These formulas may be modifications of base formulas and there are many, many options here. It’s sort of like being a cook in the kitchen deciding whether your chicken preparation will be based predominantly by flavors in a curry, a basil-cream, lemon-tarragon, or whatever sauce. The options are endless. 

There are advantages of using multiple herbs over singular herbs. An herb in a formula may be considered a primary herb in the formula and be called its Chief. We might use herbs that reduce or increase the effects of other herbs making them stronger or weaker in the formula, depending on what we’re looking to achieve. We may have Deputy, Assistant – Envoy herbs depending on the function of a particular herb, or group of herbs, in the formula.

A formula that works wonders for one patient may not be effective for another patient with the same condition.

This is because in Chinese medicine, we look at varying patterns present in a person, ascertain Chinese medical diagnoses that represent those patterns, and recommend herbs, acupuncture, or other modalities/procedures based on those working (and changing) diagnoses. 

Let’s consider an example. A patient comes in with a request for herbs and acupuncture to help resolve previously diagnosed eczema. The practitioner will take a look at the patient’s primary concern and consider common Chinese diagnoses that those with eczema may have, ask broad questions to consider other patterns of disharmony, come up with a working Chinese medical diagnosis or diagnoses, and make treatment recommendations based on the diagnoses. Please note that diagnoses change over time as do individual practitioner approaches to treatment. 

It’s not uncommon for a patient to seek treatment for one particular health concern, but have other health issues. For example, someone’s little toe is bothering them every time they walk and so they may be looking for support in this one area. An herbalist building a custom formula will take into consideration whether that person has ample digestive strength to tolerate an herb formula, if they sleep poorly, are in a high stress environment, etc. Herbs will be added or removed from base formulas to accommodate the individual presentation of the person seeking remedy.

We choose treatments based on the constellation of multiple patterns of disharmony present and we change the formula as that constellation changes. 

So here’s the thing: this is also true for acupuncture. The practice of acupuncture includes individual or combinations of points. There are countless approaches to point selection. The practitioner may select points based on their unique studies under specific teachers who may have their own stylistic approaches.

The medicine is old, but it’s not stagnant and evolves over time. The options are also endless.

I’m always saying to people that when choosing an acupuncturist, ask them questions about how they approach treatment, what kinds of studies they undertake (we keep studying long after school), and look to see if you resonate with the conversation and approach. Be open to new ideas but understand that if one practitioner doesn’t “fit” with you, there’s many more in practice who may have a style that feels better to you. 

A short herb story…

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One time traveling, a nice thing happened in regards to Chinese herbs. I met other travelers along the way and all of us were trying to avoid local drinking water since our bodies weren’t used to it and we certainly didn’t want the experience of diarrhea, abdominal spasms, and pain. 

Over lunch one day, it came up in a conversation and most the travelers were saying they had at least a bit of diarrhea or abdominal discomfort. We had been eating together for a few days and it was asked why nearly all at the table had symptoms but I did not. They asked if I was taking something. I was. A single Chinese herb taken at a prophylactic dose of one small tablet daily. 

I’m not sure if that’s why I didn’t share their symptoms, but I thought it might be.

[ Thank you for the use of free clip art! http://www.clipartpanda.com/clipart_images/abdominal-pain-clipart-1-59922934 ]

Evolving Ancient Medicine

Often when I see writings about Chinese medicine, including my own, there’s some mention about how old it is, which is thousands of years.

Sometimes we may be highlighting this, in part, to help substantiate it, as if to lend credence. Of course, just because something’s old doesn’t make it better, nor does it make it worse. But with thousands of years of practice, it does mean that there’s been a lot of experience, many treatments, and many patients.

Even if one can’t quickly go find the perfectly matching RCT (randomized-controlled trial) that best matches the condition for which one seeks medical evidence of efficacy, that doesn’t necessarily mean that acupuncture hasn’t helped someone with it before. It also doesn’t mean it doesn’t exist (might need translation.)

So, how old is this medicine?

A longer timeline of Chinese medical history can be found at http://www.shen-nong.com/eng/history/chronology.html , but summarized parts of it (with my notes) are here:

~2000 BC, Antiquity: Yellow Emperor & Shen-nong: They are said to be the founders of traditional Chinese medicine (TCM).

1700-1100 BC, Shang: Inscriptions on bones describe the use of wine and hot water, use of needles and knives for surgical instruments, diseases and illnesses discussed.

1100-221 BC, Zhou Dynasty: Organized medical system in the emperor’s court. Specialties in surgery, diet, disease, veterinarians. The Huang Di Nei Jing: The Yellow Emperor’s Internal Classic: A&P of the human body. Foundation for TCM. Yin Yang and Five Element Theory.

221 BC-220 AD, Qin and Han Dynasties: Earliest reference to Chinese pharmacology: Shennong Bencaojing. List of 365 Chinese medicines and herb prescriptions / combos. Zhang Zhongjing: establishes diagnosis based on signs and symptoms. Shang Han Lun

220-580 AD, Chinese Middle Ages: Pulse Classic. Earliest complete reference guide to acupuncture and moxibustion. 349 acupuncture points with therapeutic properties for each. A handbook written for Emergencies.

618-907 AD, Sui and Tang Dynasties: Imperial Medical Academy. The first medical encyclopedia comprised of 30 volumes and 5,300 prescriptions, also disease prevention and health preservation. (Sun Si Miao) — NOTE: Preventive health

960-1279 AD Song Dynasty: First official prescription book with 16,834 prescriptions. (weblink lists ~40 books/treatises during this period) — NOTE: That’s a lot of prescriptions! 

More dynasties and many more books: The Jin Yuan period, Ming Dynasty, Qing Dynasty, Modern China (1950 future medical policy to include both Chinese and Western medicine options)…

There’s been a lot of time to practice, theorize, iterate, publish, proliferate, and evolve. 

One of my favorite questions people ask me about acupuncture…

Question: Do I get acupuncture and who do I see?

Answer and Explanation: Yes, I do (sometimes) and I sometimes see different practitioners based on what health concern(s) I’m working on, usually not at the same time. If it is at the same time, I tell each practitioner what kinds of other work I’m getting or doing so we’re all on the same page and so recommendations don’t overlap (for example, I’ll take herbs from only one practitioner at any given time).

Sometimes I’m using Chinese medicine to treat one thing and sometimes I’m using it to treat another, or another, etc. For example, if the condition is physical pain-related, I may opt for a practitioner who works with that specific condition or otherwise treats a lot of musculo-skeletal pain. Generally-speaking, we all work with conditions of pain, but some will have sub-specialties in certain types of pain (example: someone who focuses on the neck or joints or whatever).

Because acupuncturists (as we are called) often have specialties or sub-specialties, I try to pay attention (and ask questions!) regarding what practitioners are focusing on in their continued studies, which we all do. Some may be particularly strong in the area of herbal medicine, medicinal massage, a particular style of acupuncture (of which, there are many), etc.

If I’m looking instead for treatments for a different kind of health concern, like to improve my energy levels, sleep, digestion, stress, than I may work with another practitioner based on fit, their training and approach, etc.

I think Chinese medicine generally works better when utilized as a series of appointments so depending on whether it’s an acute or chronic condition, I consider how many appointments, and how often will I get them (weekly, 2x p/week, more often?) and for how many weeks. Sometimes I like to consider a routine 4-6 appointments just to see how I’m responding to a round of treatments.

As a general note: For acute conditions, sometimes one can need less appointments and for chronic conditions, sometimes one can need multiple rounds of treatments. Alternatively, sometimes just a random appointment on a monthly basis can be very nice as a “tune-up” (of sorts) or perhaps, as a preventive measure to help the body stay in harmony.

It’s amazing how much variety can be found within the field of acupuncture! I can’t emphasize that enough. 

 

 

 

 

 

WELCOME

Hello. My name is Sheilah. I am starting my first blog here. My intention with this site is to share tidbits about Chinese medicine, and acupuncture specifically, that pique my curiosity in the hopes that maybe others will find something helpful or interesting.

Another intention is to help potential patients of acupuncture get to know me a bit so they may have a sense of whether I may be a good choice for working with them on their health concerns.

I will probably include other types of musings just because life overlaps and there’s probably some way I believe them to be related.

Chinese medicine looks at the “big picture”, looks to patterns of harmony and disharmony in nature, to help understand how the body works and how better health may be restored. You’ll probably see various posts about change in nature since this is one way I learn about changes in the human body.

Please feel free to contact me directly if you’re interested in discussing how this medicine may help you. (415) 730-4144