Guest guest Posted May 19, 2004 Report Share Posted May 19, 2004 Dear Charles, you'writing about Bo He; according to tradition, because of the volatile components of the drug, Mentha Haplocalyx, decoction suould be avoided, because this could easily let evaporate the essential oils (mentone, menthol..). I.e. in Xiao Yao San, Bo He must be added, just at the end of decoction, keeping off the fire the pot, or strongly reducing fire, up to a few (5) minutes. A powdered herb, if dried extract as decoction could loose its active principles, being inactive, if dired herb, then powdered (herba pulverata) looses must of the active principles. When dried extract is made carefully, putting Bo He at the end of decoction and immediately filtered and extracted, it serves a good amount of active principles, and it is easy to smell it. So, it is very important how to do formulas! Do you agree with me? Thank you (I'm new in the ML, too!) Best regards, -----Messaggio originale----- Da: Charles Buck [chesterclinic] Inviato: martedì 18 maggio 2004 20.20 A: Chinese Medicine Oggetto: Re: Herbal Therapy I just want to say that i entirely agree with John Aguilar. The bulk herb prescription is the basic standard form. When it comes to compliance, I find it interesting that my recent herb student graduates (York UK) complain that less than 50% of their patients tolerate and continue with the loose herbs and yet well over 90% of my patients takes them. I think experience and confidence in the practitioner is an issue here. I don't normally tell patients I have been doing it 20 years, they can just tell. They do what I tell them!! That said, I think there are situations where much lower doses are actually preferable, and work better. I recently published an article on this in the Journal of (UK). I do think the loose herbs hve more pronounced qi. As an experiment try comparing concentrated powder bo he tea with the actual herb. My debut on this group too so I would like to say hi to everyone. best wishes charlie buck --- " John Aguilar, Jr. " <jagtao wrote: > Hi, everybody. First time posting here. > > Margie, the topic of which form of CH to use is > very near and dear to my heart. I have this > discussion all the time with fellow practitioners, > students, and Chinese medical professors. I > recently had a short paper on the topic published in > the Acupuncture Association of Colorado newsletter. > > In my practice, at least 85% of my patients are > on bulk decoctions. The others are on powders, for > the most part. I rarley use patents, pills, or > tablets, and I never use them as the sole herbal > treatment. > To me, it's a matter of standard of care. Our > knowledge of the medicine is based on past > expereince. That is, we can accurately diagnose, > treat, and prognose with Chinese medicine because of > what past practitioners have left to us. I am able > to have a high level of confidence in my treatments > because past practitioners have done this many times > before and passed on their knowledge to us. > I even go as far as saying Chinese medicine is > defined by its being founded in certain > logico-philosophical paradigms, though I'm not sure > that's a word, and collective experience. This, of > course, implies a medicine deviant from either of > these fundamental paradigms (examples being > inductive synthesis, holism, etc.) or from past > experience is necessarily not Chinese medicine. A > bit harsh, but the underlying point is important, I > think. > I use bulk decoctions, in large part, because > that is what the medicine knows. My years in > training as a Chinese medical herbalist were spent > studying knowledge accumulated using raw herbs. > This knowledge is therefore about raw herbs. If I > want to do what I read and studied about, I have to > use raw herbs. > Yes, 'pills' were used, historically, but not > modern 'teapills', and yes, powdered herbs were used > but they were ground from raw herbs, not processed > in the same way as in modern times. > Now, as far as how to get patients to take > decoctions, again, for me, it comes down to standard > of care. I am a Chinese medical professional. I > strive to practice Chinese medicine to its fullest > potential. For CH, this means using bulk > decoctions. I live by this standard. This is my > practice. In treatment, I inform the pateint that > they will be stopping by the herbal pharmacy to > pick-up a formula that they will then take home and > cook. Period. There's no listing of options to the > patient. There are no options. There is a basic > standard of care. That is my default, my basic > approach. > If it proves to be a problem, even after three > weeks of genuine effort, I may switch them to the > best compromise - powders (and hence, the roughly > 10-15% of my patients on powders.) > It should also be said that decoctions work very > well. Significant symptom alleviation is often felt > with the first week of herbs (obviously more so in > acute, excess presentations). And, often, with six > to ten weeks worth of herbal treamtent, results are > seen that all previous medical interventions failed > to achieve. You can do serious, honest-to-god > Healing with tailored raw decoctions. > I share this information with my patients. Not > only does the info, itself, assist in compliance, > but my confidence and committment to the highest > possible standards also helps. > Such are my beliefs and experiences. I enjoy > these discussions and look forward to hearing > (reading) responses. > > > > > margie parolisi <parolisi1 wrote: > Hi Pete, > > Thank you for replying. I have the Fratkin book and > I use it frequently. I also like Mayway, the Min > Shan line, and also the Plum Flower patents are > great and quite economical. My problem is that these > formulas are not strong enough to help some of my > patients. > > I noticed in a survey in the new issue of > Acupuncture Today that only a small percentage of > TCM practitioners are using patents. So I guess my > question is what are they using and how are they > getting the patients to ingest granuales, bulk teas, > decoctions,liquids,or whatever they are using. I > used to have a bulk herb pharmacy in my practice, > but they for the most part, went to waste as people > would not prepare the teas!! > > Sincerely, > > > > Margie > Parolisi > > NCCAOM > Dip. OM > > > > Pete Theisen <petet wrote: > Hi Margie! > > Get the Fratkin book, to begin with. I like Mayway, > the Min Shan line is > quite economical. > > At 03:17 PM 5/16/2004, you wrote: > > > > > > >Hello Everyone, > > > >I noticed in a survey in the new issue of > Acupuncture Today that only a > >small percentage of TCM practitioners are using > patents. Is there a > >general consensus out there of what herbal > modalities work best, i.e. > >granuales, bulk teas, decoctions,liquids, etc.? > There is also the issue of > >patient compliance. Mine all want capsules or > pills. Some patients such as > >ones with endometriosis I find do not respond very > well to patents as they > >are not strong enough. Can I hear from those of you > are happy with the > >herbal modalities, companies, etc. that you are > using? > > > > > >Sincerely, > > > > > > > > > >Margie Parolisi > > > > > >NCCAOM Dipl. OM > > > > > > > > > > > > > > > >SBC - Internet access at a great low price. > > > >[Non-text portions of this message have been > removed] > > > > > > > > > >Membership requires that you do not post any > commerical, swear, religious, > >spam messages,flame another member or swear. > > > >To translate this message, copy and paste it into > this web link > >page, http://babel.altavista.com/ > > > > > > > and adjust > >accordingly. > > > >If you , it takes a few days for the > messages to stop being > >delivered. > > > > Quote Link to comment Share on other sites More sharing options...
Guest guest Posted May 19, 2004 Report Share Posted May 19, 2004 hi gabriele, i definately agree. I normally sperately wrap the bo he and ask the patient to stir in for the last five minutes, turn off the heat and put the lid on. When i tested bo he concentrated powder when first introduced in the late 80's it tasted like mud compared to the dried herb tea. I sent all my newly bought powders back!! I repeated the experiment with herb students a few years back and the powders performed better than in the past but were still not as good as fresh in my view. Personally, I am a traditionalist - mostly! but with a scientific mind. I think we should accept pretty much the whole tradition unless parts of it are absurd or unethical, and then spend the next hundred years or so in continuous and cautious re-evaluation. best wishes charlie buck --- " " <gabrielesaudelli wrote: > Dear Charles, you'writing about Bo He; according to > tradition, because of > the volatile components of the drug, Mentha > Haplocalyx, decoction suould be > avoided, because this could easily let evaporate the > essential oils > (mentone, menthol..). I.e. in Xiao Yao San, Bo He > must be added, just at the > end of decoction, keeping off the fire the pot, or > strongly reducing fire, > up to a few (5) minutes. A powdered herb, if dried > extract as decoction > could loose its active principles, being inactive, > if dired herb, then > powdered (herba pulverata) looses must of the active > principles. When dried > extract is made carefully, putting Bo He at the end > of decoction and > immediately filtered and extracted, it serves a good > amount of active > principles, and it is easy to smell it. > So, it is very important how to do formulas! > Do you agree with me? > Thank you (I'm new in the ML, too!) > Best regards, > > -----Messaggio originale----- > Da: Charles Buck > [chesterclinic] > Inviato: martedì 18 maggio 2004 20.20 > A: Chinese Medicine > Oggetto: Re: Herbal Therapy > > > I just want to say that i entirely agree with John > Aguilar. The bulk herb prescription is the basic > standard form. When it comes to compliance, I find > it > interesting that my recent herb student graduates > (York UK) complain that less than 50% of their > patients tolerate and continue with the loose > herbs > and yet well over 90% of my patients takes them. I > think experience and confidence in the > practitioner is > an issue here. I don't normally tell patients I > have > been doing it 20 years, they can just tell. They > do > what I tell them!! > That said, I think there are situations where much > lower doses are actually preferable, and work > better. > I recently published an article on this in the > Journal > of (UK). > > I do think the loose herbs hve more pronounced qi. > As > an experiment try comparing concentrated powder bo > he > tea with the actual herb. > > My debut on this group too so I would like to say > hi > to everyone. > > best wishes > charlie buck > > > > --- " John Aguilar, Jr. " <jagtao wrote: > > > Hi, everybody. First time posting here. > > > > Margie, the topic of which form of CH to use > is > > very near and dear to my heart. I have this > > discussion all the time with fellow > practitioners, > > students, and Chinese medical professors. I > > recently had a short paper on the topic > published in > > the Acupuncture Association of Colorado > newsletter. > > > > In my practice, at least 85% of my patients > are > > on bulk decoctions. The others are on powders, > for > > the most part. I rarley use patents, pills, or > > tablets, and I never use them as the sole herbal > > treatment. > > To me, it's a matter of standard of care. > Our > > knowledge of the medicine is based on past > > expereince. That is, we can accurately > diagnose, > > treat, and prognose with Chinese medicine > because of > > what past practitioners have left to us. I am > able > > to have a high level of confidence in my > treatments > > because past practitioners have done this many > times > > before and passed on their knowledge to us. > > I even go as far as saying Chinese medicine > is > > defined by its being founded in certain > > logico-philosophical paradigms, though I'm not > sure > > that's a word, and collective experience. This, > of > > course, implies a medicine deviant from either > of > > these fundamental paradigms (examples being > > inductive synthesis, holism, etc.) or from past > > experience is necessarily not Chinese medicine. > A > > bit harsh, but the underlying point is > important, I > > think. > > I use bulk decoctions, in large part, because > > that is what the medicine knows. My years in > > training as a Chinese medical herbalist were > spent > > studying knowledge accumulated using raw herbs. > > This knowledge is therefore about raw herbs. If > I > > want to do what I read and studied about, I have > to > > use raw herbs. > > Yes, 'pills' were used, historically, but not > > modern 'teapills', and yes, powdered herbs were > used > > but they were ground from raw herbs, not > processed > > in the same way as in modern times. > > Now, as far as how to get patients to take > > decoctions, again, for me, it comes down to > standard > > of care. I am a Chinese medical professional. > I > > strive to practice Chinese medicine to its > fullest > > potential. For CH, this means using bulk > > decoctions. I live by this standard. This is > my > > practice. In treatment, I inform the pateint > that > > they will be stopping by the herbal pharmacy to > > pick-up a formula that they will then take home > and > > cook. Period. There's no listing of options to > the > > patient. There are no options. There is a > basic > > standard of care. That is my default, my basic > > approach. > > If it proves to be a problem, even after > three > > weeks of genuine effort, I may switch them to > the > > best compromise - powders (and hence, the > roughly > > 10-15% of my patients on powders.) > > It should also be said that decoctions work > very > > well. Significant symptom alleviation is often > felt > > with the first week of herbs (obviously more so > in > > acute, excess presentations). And, often, with > six > > to ten weeks worth of herbal treamtent, results > are > > seen that all previous medical interventions > failed > > to achieve. You can do serious, honest-to-god > > Healing with tailored raw decoctions. > > I share this information with my patients. > Not > > only does the info, itself, assist in > compliance, > > but my confidence and committment to the highest > > possible standards also helps. > > Such are my beliefs and experiences. I enjoy > > these discussions and look forward to hearing > > (reading) responses. > > > > > > > > > > margie parolisi <parolisi1 wrote: > > Hi Pete, > > > > Thank you for replying. I have the Fratkin book > and > > I use it frequently. I also like Mayway, the Min > === message truncated === __________ Messenger - Communicate instantly... " Ping " your friends today! Download Messenger Now http://uk.messenger./download/index.html Quote Link to comment Share on other sites More sharing options...
Guest guest Posted May 19, 2004 Report Share Posted May 19, 2004 Chinese Medicine , Charles Buck <chesterclinic> wrote: I repeated the experiment with > herb students a few years back and the powders > performed better than in the past but were still not > as good as fresh in my view. I don't know that anyone is disputing that bulk prescriptions are the standard through Chinese history and that high quality fresh herbs are best. However, the space & expense involved in storing inventory, the shelf life (especially of aerial parts), risk of pesticide or heavy-metal contamination, bugs (unwanted ones, anyway), etc, make a bulk pharmacy an expensive headache for many new practitioners. When I was in charge of the pharmacy at SEIOM in Miami, guess what -- I wrote mainly bulk prescriptions. Why not? I wasn't paying for the space, I could order what I wanted (within reason) and not take the financial hit if the unused portions got tossed, and I had a patient population (many of them students) who would likely comply with cooking instructions. When I was working in a cramped chiropractic office with one corner and a shelf in the fridge to store and dispense my herbs, granules were like a godsend -- i could customize the prescription, compliance was rarely an issue even with the most time- pressed of clients, and the method worked much better and was more economical than using patents or liquid extracts. > Personally, I am a traditionalist - mostly! but with a > scientific mind. I think we should accept pretty much > the whole tradition unless parts of it are absurd or > unethical, and then spend the next hundred years or so > in continuous and cautious re-evaluation. of course, arguments could be made that 1) we don't HAVE the whole tradition, even if we read Chinese and spent the rest of our life only reading, and non-Chinese readers have only what someone has deemed most important to represent the tradition, 2) what's absurd or unethical is kind of a value judgement that we're imposing on the tradition -- is urine or placenta absurd or unethical? how about animal products -- ejiao? xiong dan? wulingzhi (i used to joke that if patients thought their Shi Xiao San tasted like s##t, there was a good reason)? 3) where do you draw the line, at its earliest and latest? is electro-acupuncture part of the tradition? point injection? shamanism? anyway, some thoughts. someone implied that we're not doing Chinese medicine if we don't use bulk prescriptions, i guess that depends on one's definition of CM. thanks for the discussion, gotta go robert hayden Quote Link to comment Share on other sites More sharing options...
Guest guest Posted May 20, 2004 Report Share Posted May 20, 2004 I feel compelled to address the difficulties of maintaining a bulk pharmacy as reason for using other forms of CH. My love and passion for the medicine runs pretty deep (it's actually rather odd...). So I always cringe a little when I read/hear/see compromises being made. It stings a little. I bought my own bulk pharmacy right out of school. I maintained the inventory, made my own formulas, and so on for about seven months. So I can persoanlly testify to the challenges in bulk pharmacies (namely cost and time). I sold out. Literally. A new full-service prescriptive Chinese medical pharmacy recently opened in Denver (Life Gate Holistic Pharmacy), and I sold them my inventory. They make the formulas, bag 'em, give the pateint cooking instructions, etc. So I can still do bulk formulas without the hassle. I did truly enjoy having my own herbs to go play with whenever I wanted, but... My point is - inevitably we have to make compromises (cringe-cringe). That's just the way it is. BUT let's be careful when, where, and how we do it, especially when it comes to treatment efficacy, as medical professionals that has got to be our bottom line. If it's too much to have your own pharmacy, look for a professional CM pharmacy to go to. If you're in the Denver-metro area, you're in luck. If not, maybe you could get together with a couple other practitioners and maintain a pharmacy collectively. I just don't want to be to quick to take easier routes in addressing challenges in our profession. It so often seems like an uphill battle to be a (good) modern American practitioner of CM. Compromises to often feel like steps backwards, yah know. We can do this thing called healing, and we can do it really, really well. They need what we can do. Let's push forward and make it happen. Thanks, John Aguilar, Jr. kampo36 <kampo36 wrote: Chinese Medicine , Charles Buck <chesterclinic> wrote: I repeated the experiment with > herb students a few years back and the powders > performed better than in the past but were still not > as good as fresh in my view. I don't know that anyone is disputing that bulk prescriptions are the standard through Chinese history and that high quality fresh herbs are best. However, the space & expense involved in storing inventory, the shelf life (especially of aerial parts), risk of pesticide or heavy-metal contamination, bugs (unwanted ones, anyway), etc, make a bulk pharmacy an expensive headache for many new practitioners. When I was in charge of the pharmacy at SEIOM in Miami, guess what -- I wrote mainly bulk prescriptions. Why not? I wasn't paying for the space, I could order what I wanted (within reason) and not take the financial hit if the unused portions got tossed, and I had a patient population (many of them students) who would likely comply with cooking instructions. When I was working in a cramped chiropractic office with one corner and a shelf in the fridge to store and dispense my herbs, granules were like a godsend -- i could customize the prescription, compliance was rarely an issue even with the most time- pressed of clients, and the method worked much better and was more economical than using patents or liquid extracts. > Personally, I am a traditionalist - mostly! but with a > scientific mind. I think we should accept pretty much > the whole tradition unless parts of it are absurd or > unethical, and then spend the next hundred years or so > in continuous and cautious re-evaluation. of course, arguments could be made that 1) we don't HAVE the whole tradition, even if we read Chinese and spent the rest of our life only reading, and non-Chinese readers have only what someone has deemed most important to represent the tradition, 2) what's absurd or unethical is kind of a value judgement that we're imposing on the tradition -- is urine or placenta absurd or unethical? how about animal products -- ejiao? xiong dan? wulingzhi (i used to joke that if patients thought their Shi Xiao San tasted like s##t, there was a good reason)? 3) where do you draw the line, at its earliest and latest? is electro-acupuncture part of the tradition? point injection? shamanism? anyway, some thoughts. someone implied that we're not doing Chinese medicine if we don't use bulk prescriptions, i guess that depends on one's definition of CM. thanks for the discussion, gotta go robert hayden Membership requires that you do not post any commerical, swear, religious, spam messages,flame another member or swear. http://babel.altavista.com/ and adjust accordingly. If you , it takes a few days for the messages to stop being delivered. Quote Link to comment Share on other sites More sharing options...
Guest guest Posted May 20, 2004 Report Share Posted May 20, 2004 hi robert, all good points, i agree with them all. Sometimes we have to make sweeping statements to avoid running to textbook lengths!!! charlie buck --- kampo36 <kampo36 wrote: > --- In Chinese Medicine , > Charles Buck > <chesterclinic> wrote: > I repeated the experiment with > > herb students a few years back and the powders > > performed better than in the past but were still > not > > as good as fresh in my view. > > I don't know that anyone is disputing that bulk > prescriptions are the standard through > Chinese history and that high quality fresh herbs > are best. However, the space & > expense involved in storing inventory, the shelf > life (especially of aerial parts), risk of > pesticide or heavy-metal contamination, bugs > (unwanted ones, anyway), etc, make a > bulk pharmacy an expensive headache for many new > practitioners. When I was in > charge of the pharmacy at SEIOM in Miami, guess what > -- I wrote mainly bulk > prescriptions. Why not? I wasn't paying for the > space, I could order what I wanted > (within reason) and not take the financial hit if > the unused portions got tossed, and I > had a patient population (many of them students) who > would likely comply with > cooking instructions. > > When I was working in a cramped chiropractic office > with one corner and a shelf in the > fridge to store and dispense my herbs, granules were > like a godsend -- i could > customize the prescription, compliance was rarely an > issue even with the most time- > pressed of clients, and the method worked much > better and was more economical > than using patents or liquid extracts. > > > Personally, I am a traditionalist - mostly! but > with a > > scientific mind. I think we should accept pretty > much > > the whole tradition unless parts of it are absurd > or > > unethical, and then spend the next hundred years > or so > > in continuous and cautious re-evaluation. > > of course, arguments could be made that > 1) we don't HAVE the whole tradition, even if we > read Chinese and spent the rest of > our life only reading, and non-Chinese readers have > only what someone has deemed > most important to represent the tradition, > > 2) what's absurd or unethical is kind of a value > judgement that we're imposing on the > tradition -- is urine or placenta absurd or > unethical? how about animal products -- > ejiao? xiong dan? wulingzhi (i used to joke that if > patients thought their Shi Xiao San > tasted like s##t, there was a good reason)? > > 3) where do you draw the line, at its earliest and > latest? is electro-acupuncture part of > the tradition? point injection? shamanism? > > anyway, some thoughts. someone implied that we're > not doing Chinese medicine if we > don't use bulk prescriptions, i guess that depends > on one's definition of CM. > > thanks for the discussion, gotta go > robert hayden > > > > Quote Link to comment Share on other sites More sharing options...
Guest guest Posted May 20, 2004 Report Share Posted May 20, 2004 Chinese Medicine , " John Aguilar, Jr. " <jagtao> wrote: > I sold out. AHA! the TRUTH comes out ! LOL... no, seriously, John, i admire your integrity to stick up for what you believe. not an easy trait to come by these days. what you propose (a co-op or specialized CM pharmacy) of course depends on the market in whatever locality. In more CM-dense areas, it makes sense, though IIRC it was tried here in Chicago a few years back and went under. We still have Chinatown and the Vietnamese stores to send people to but in a smaller city it may be problematic. > My point is - inevitably we have to make compromises (cringe-cringe). i never really felt granules were a compromise, just a different method of administration -- then again i have a strong kampo influence and that's the common way herbs are dispensed in Japan. Funny, years ago i had a strong anti-electroacupuncture bent (though i would still put magnets w/ e-stim on people LOL) -- just wasn't traditional, bad for the qi, whatever. A couple of clients started requesting it and i, not wanting to lose the clientele, grudgingly complied. When i saw how well it worked in their cases i lost my qualms -- now it's no big deal and sometimes it's the first thing i'll try. Course in my case it's still usually pretty weak stim ..... robert hayden http://jabinet.net Quote Link to comment Share on other sites More sharing options...
Guest guest Posted May 21, 2004 Report Share Posted May 21, 2004 I don't feel that high quality granular or liquid extracts are any kind of compromise. There are several factors to consider when prescribing herbal medicine or any other treatment (acupuncture/moxabustion, diet therapy, etc.) to patients which includes compliance, dosage, length of time taking herbs, specific conditions, etc. Different things work for different people, and the important thing is to come up with the best treatment for each patient that is possible. This is why the 'weight loss' protocol thing irks me so much. It completely bypasses one of the cornerstones of Chinese medicine, which is individualized treatment based on pattern, pulse and tongue diagnosis. To give the same point or herb prescription to patients is completely forsaking the roots of our medicine. Robert, I still don't use any e-stim, haven't for years, and get the results I would expect. That doesn't mean that other practitioners shouldn't work with it, I just like to know what the needles and moxa do without the electricity. On May 20, 2004, at 2:07 PM, kampo36 wrote: > > i never really felt granules were a compromise, just a different > method of > administration -- then again i have a strong kampo influence and > that's the common > way herbs are dispensed in Japan. > > Funny, years ago i had a strong anti-electroacupuncture bent (though > i would still put > magnets w/ e-stim on people LOL) -- just wasn't traditional, bad for > the qi, whatever. > A couple of clients started requesting it and i, not wanting to lose > the clientele, > grudgingly complied. When i saw how well it worked in their cases i > lost my qualms > -- now it's no big deal and sometimes it's the first thing i'll try. > > Course in my case it's still usually pretty weak stim ..... Quote Link to comment Share on other sites More sharing options...
Recommended Posts
Join the conversation
You are posting as a guest. If you have an account, sign in now to post with your account.
Note: Your post will require moderator approval before it will be visible.