Herbs and dosages & Corrections

August 20, 2004

To All in TCM Group,

I have made an error earlier in my response to Laura's post. The mistake I made

was that I confused Wu Tou with Wu Yao which are two different herbs. Laura was

correct in using Wu Yao in her treatment of her patient, but the description I

made was in reference to the herb Wu Tou which is poisonous.

I apologize to the group, and especially to Laura, for any confusion this error

may have caused. We healers are human and will make mistakes from time to

time. I'll get over this embarassment eventually, but had I made this mistake

on a patient I would have a infinitely harder time forgiving myself. Once

again, my apologies to everyone in the TCM Group.

Sincerely,

Ming H. Lee, MPH, L.Ac.

" Ming H. Lee " <aceqihealer wrote:Laura,

Prescribing herbs is a lot trickier than prescribing acupoints, because there is

a bit more to consider here. It is here that Eight Principles Diagnosis and

Zang Fu Diagnosis becomes more important in your herbal prescription, because

they determine which herb, among those with similar indications, is more

appropriate and the dosage of the herb. Once you have nailed the patient's

symptoms according to Eight Principle Diagnosis, you can determine whether you

should use herbs with hot or cold properties. Zang Fu Diagnosis points you to

herbs that's indicated for particular channel(s) thus eliminating a few more

herbs with similar functions. Let's say for lower jiao coldness. I would go

with Fu Zi rather than Wu Yao even though Wu Yao's ability to clear coldness is

better than Fu Zi, because Fu Zi is indicated for kidney channels which is

associated with the lower jiao and Wu Yao is not indicated for any of the

channels (heart, liver, and spleen) associated with the lower jiao.

Consideration of dosage is pointless if you do not have the right herb.

As for dosage, your best clues come from your observations of your patient's

biorhythm over the course of the treatment and your experiences in treating the

particular diseases or discomforts. There is one more thing to consider though.

As you know, some of the herbs in the TCM Materia Medica is extremely poisonous

like Fu Zi, Wu Yao, and Ban Xia. Incidently, assasins in the ancient times used

to kill their victims by using arrow dipped in Wu Yao extract to make sure the

job is done correctly. That is why the dosage for these poinsonous herbs are so

low. For Wu Yao it is 3 to 9 g and should be reduced to 1 to 2 g if you are

using it as ingredient for medicinal powder or medicinal wine. When using herbs

like these for treatment, always use the lowest dosage as indicated in the

dosage range and up the dosage ever so slightly ONLY if needed. A little bit of

them goes a long way for thses poison ones. So, Wu Yao can never be in a higher

dosage than Dang Gui. Be very careful.

Ming

heylaurag <heylaurag wrote:

Hi, I am still getting my feet wet as a new practitioner prescribing

formulas outside of the school clinic, so please forgive me for this

seemingly simple question: I seem pretty comfortable with my ability

to diagnose, and relatively comfortable with my ability to choose

appropriate herbs, but lacking confidence in my ability to know what

dosages to use for each herb.

Let me give an example: Let's say that I was prescribing a formula

with Wu Yao in it. Let's say my main focus was to clear dampcold in

the lower jiao, but I wanted to add some Dang Gui to protect the

blood from the drying herbs. On the one hand I would think that I

should have a higher dose of Wu Yao than of Dang Gui because clearing

dampcold is my main focus. But on the other hand, when I look in my

herbal books I see that Dang Gui is given somewhere around 10 to 20

grams a day, whereas Wu Yao is prescribed at somewhere around 3 to 5

grams a day (this is a guess--I'm at home and my books are at my

clinic). So from that point of view I think that I should prescribe

a higher dose of Dang Gui. Which is the more accurate way to

prescribe?

Advice anyone?

Thanks a million, Laura

August 20, 2004

I used to keep the Wu Tou separate from the other herbs on the shelf for this

very reason

-- not as crucial when you use bulk herbs but I used powders and it's scary how

easily you

can make a mistake when you're in a hurry.

rh

p.s.: Ming, no need to be so hard on yourself, everybody here is human. your

input here is

always good IMO.

Chinese Medicine , " Ming H. Lee "

wrote:

> The mistake I made was that I confused Wu Tou with Wu Yao which are two

different

herbs. Laura was correct in using Wu Yao in her treatment of her patient, but

the

description I made was in reference to the herb Wu Tou which is poisonous.

<snip>

>I'll get over this embarassment eventually, but had I made this mistake on a

patient I

would have a infinitely harder time forgiving myself. Once again, my apologies

to

everyone in the TCM Group.

>

August 20, 2004

Hi Ming,

So you have a belly button, huh? As far as I know we're all

human here, so I wouldn't waste one minute of your day being

embarrassed! I very much appreciate your thoughts, and if you make a

mistake once in a while its no biggee (as long as you promise to come

and clean my house once a week for a year that is).

Laura

Chinese Medicine , " Ming H. Lee "

<aceqihealer> wrote:

> To All in TCM Group,

>

> I have made an error earlier in my response to Laura's post. The

mistake I made was that I confused Wu Tou with Wu Yao which are two

different herbs. Laura was correct in using Wu Yao in her treatment

of her patient, but the description I made was in reference to the

herb Wu Tou which is poisonous.

>

> I apologize to the group, and especially to Laura, for any

confusion this error may have caused. We healers are human and will

make mistakes from time to time. I'll get over this embarassment

eventually, but had I made this mistake on a patient I would have a

infinitely harder time forgiving myself. Once again, my apologies to

everyone in the TCM Group.

>

> Sincerely,

>

> Ming H. Lee, MPH, L.Ac.

>

> " Ming H. Lee " <aceqihealer> wrote:Laura,

>

> Prescribing herbs is a lot trickier than prescribing acupoints,

because there is a bit more to consider here. It is here that Eight

Principles Diagnosis and Zang Fu Diagnosis becomes more important in

your herbal prescription, because they determine which herb, among

those with similar indications, is more appropriate and the dosage of

the herb. Once you have nailed the patient's symptoms according to

Eight Principle Diagnosis, you can determine whether you should use

herbs with hot or cold properties. Zang Fu Diagnosis points you to

herbs that's indicated for particular channel(s) thus eliminating a

few more herbs with similar functions. Let's say for lower jiao

coldness. I would go with Fu Zi rather than Wu Yao even though Wu

Yao's ability to clear coldness is better than Fu Zi, because Fu Zi

is indicated for kidney channels which is associated with the lower

jiao and Wu Yao is not indicated for any of the channels (heart,

liver, and spleen) associated with the lower jiao.

> Consideration of dosage is pointless if you do not have the right

herb.

>

> As for dosage, your best clues come from your observations of your

patient's biorhythm over the course of the treatment and your

experiences in treating the particular diseases or discomforts.

There is one more thing to consider though. As you know, some of the

herbs in the TCM Materia Medica is extremely poisonous like Fu Zi, Wu

Yao, and Ban Xia. Incidently, assasins in the ancient times used to

kill their victims by using arrow dipped in Wu Yao extract to make

sure the job is done correctly. That is why the dosage for these

poinsonous herbs are so low. For Wu Yao it is 3 to 9 g and should be

reduced to 1 to 2 g if you are using it as ingredient for medicinal

powder or medicinal wine. When using herbs like these for treatment,

always use the lowest dosage as indicated in the dosage range and up

the dosage ever so slightly ONLY if needed. A little bit of them

goes a long way for thses poison ones. So, Wu Yao can never be in a

higher dosage than Dang Gui. Be very careful.

>

> Ming

>

> heylaurag <heylaurag@h...> wrote:

> Hi, I am still getting my feet wet as a new practitioner

prescribing

> formulas outside of the school clinic, so please forgive me for

this

> seemingly simple question: I seem pretty comfortable with my

ability

> to diagnose, and relatively comfortable with my ability to choose

> appropriate herbs, but lacking confidence in my ability to know

what

> dosages to use for each herb.

>

> Let me give an example: Let's say that I was prescribing a formula

> with Wu Yao in it. Let's say my main focus was to clear dampcold

in

> the lower jiao, but I wanted to add some Dang Gui to protect the

> blood from the drying herbs. On the one hand I would think that I

> should have a higher dose of Wu Yao than of Dang Gui because

clearing

> dampcold is my main focus. But on the other hand, when I look in

my

> herbal books I see that Dang Gui is given somewhere around 10 to 20

> grams a day, whereas Wu Yao is prescribed at somewhere around 3 to

5

> grams a day (this is a guess--I'm at home and my books are at my

> clinic). So from that point of view I think that I should

prescribe

> a higher dose of Dang Gui. Which is the more accurate way to

> prescribe?

>

> Advice anyone?

>

> Thanks a million, Laura

August 20, 2004

You guys are great!

heylaurag <heylaurag wrote:Hi Ming,