Oriental Medicine and Chinese Herbology Treatment Strategies

Often practitioners of Oriental Medicine in the west notice that most of their patients conditions do not match traditional zang-fu syndromes. It is more common to see a combination of patterns, which can make treatment principles complicated.

Trying to find herbal formulas that suit these multifaceted "mixed patterns" is bewildering. It becomes a debate whether one should attempt to find one large formula to address all the symptoms related to the chief complaint; or a formula that addresses the Root pattern but may not alleviate symptoms, or a combination of these strategies. Many classic herb formulas use 6 to 10 herbs, which add up quickly when mixing formulas. The function (or effect) of 12 to 20 herbs used in combination becomes difficult to determine. If it is difficult to readily determine a specific function, it also becomes difficult to measure results.

In an attempt to decipher and understand what the sum result is, the practitioner must be aware of several levels of interaction and chemistry taking place; in this sense chemistry should be understood in it's most broad context, not just that of strict "biochemistry". First, there is the chemistry or interaction between a specific herb and each individual's body. Herbs are classified as Hot, Cold, Downward draining, etc. by how they interact with the body; in other words, it is a relative qualitative description given their effect once ingested.

The second level of chemistry is that between the herbs themselves. Many herbs act in conjunction with each other, serving as catalysts and assistants; or are used to counteract toxic components of each other, such as the use of ginger with aconite. Many of these pairings or combinations are put together in large formulas, again creating a lot of mixed messages for the body to interpret.

The situation is further complicated if some of the herbs manage to address a certain aspect of the given condition, in turn changing the state of the patients body without changing the rest of the formula. One of the most fundamental concepts of Oriental Medicine is it's conception of the body as a network of interdependent and interrelated systems. If there is change in one system (organ, burner, etc.), it will necessarily affect the whole and it's dynamic balance. In a large herb formula with multiple functions it is unclear how such changes are accounted for when the disorder begins to be affected by some herbal agents earlier than others. It is unlikely that each facet of the syndrome will be equally addressed at the same time by a multipurpose formula. Therefore, we must ask: are all of the herbal agents still relevant once a condition begins to interact with and be affected by the formula? Is a multifaceted differentiation and diagnosis accurate for as long a period as a multifunction formula is administered for?

In light of this complicated picture, I believe it is time to employ a more focused approach, progressively addressing the patterns relative to the changes being made in the body from treatment. By employing simple formulas (two to five herbs) that have a more specific action, prescriptions can be administered for shorter periods of time and readily changed once the body has responded. With this strategy, a practitioner can focus on one or two key treatment objectives, and the patient can quickly identify and experience what has changed. When that objective is accomplished, the relative balance of the body has changed, and the herbs prescribed resonate with the body in that condition, not the state presented on first intake. With this type of approach, the patient becomes more amenable to using herbs since their experience of "nearly immediate" results provides motivation to stay committed to the treatment process.

In short, this method allows us to use the wisdom of the body to guide our selection of herbal remedies. The body responds to (or resonates with) specific herbs in our assessment process, and we as practitioners respond to the progressive changes within the dynamic system that is the human body.

That is why it is Body Responsive herbal medicine.

by Darren Tellier, D.TCM, T.AC

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