CHINESE HERBAL MEDICINE DOCTOR IN ANN ARBOR

Developed over centuries, still effective today

The herbal tradition of China is valued scientifically, as well as being a fascinating and popular tradition. Scientists working in China and Japan during the past four decades have demonstrated that the herb materials contain active components that can explain many of their claimed actions. Modern drugs have been developed from the herbs, such as treatments for asthma and hay fever from Chinese ephedra, hepatitis remedies from schizandra fruits and licorice roots, and a number of anticancer agents from trees and shrubs. Several popular formulations produced in China, called “patent medicines,” are relied upon daily by millions of Chinese (in China and abroad), such as the Bupleurum Sedative Pills and Women’s Precious Pills that invigorate the energy, nourish the blood, calm tension, and regulate menstruation, and Yin Chiao Jie Du Pian, which is a reliable treatment for the early stages of common cold, sore throat, and influenza.

In China, the two most common methods of applying herb therapies are to make a decoction (a strong tea that must be simmered for about an hour or more) and to make large honey-bound pills. Both of these forms meet with considerable resistance in Western countries. The teas are deemed too time-consuming, smelly, and awful-tasting to justify their use, and the honey pills (boluses) are sticky, difficult to chew, and bad tasting. Thus, modern forms that are more acceptable have been developed for most applications.

The two popular forms to replace the standard Chinese preparations are extract powders (or granules) and smooth, easy-to-swallow tablets or capsules. The extracts are made by producing a large batch of tea and then removing the water and producing a powder or tiny pellets; the resulting material is swallowed down with some water or mixed with hot water to make a tea. Tablets and capsules contain either powdered herbs or dried extracts or a combination of the two. Despite the convenience, one must take a substantial quantity of these prepared forms (compared to the amount of drugs one takes). For example, doses of the dried extracts range from 1-2 teaspoons each time, two to three times per day, and the tablets or capsules range from about 3-8 units each time, two to three times per day.

The herb materials used in all these preparations are gathered from wild supplies or cultivated, usually in China (some come from India, the Mid-East, or elsewhere). There are an estimated 6,000 species in use, including nearly 1,000 materials derived from animal sources and over 100 minerals, all of them categorized under the general heading “herbs.” Herbs are processed in various ways, such as cleaning, soaking, slicing, and drying, according to the methods that have been reported to be most useful. These materials are then combined in a formulation; the ingredients and amounts of each item depend on the nature of the condition to be treated.

In some cases, a practitioner of Chinese medicine will design a specific formulation for an individual patient, which might be changed frequently over a course of treatment. In other cases, one or more formulas already prepared for ingestion without modification are selected for use. The outcome is monitored, and the determination of whether to continue the current formula, change to another, or discontinue use is made on the basis of actual versus desired outcomes and the obvious or subtle effects of using the herbs.

As a general rule, acute ailments (those that arise suddenly and are to be treated right away) are treated for a period of 1-30 days. If an outbreak of influenza or eruption of herpes virus is caught early enough, a one or two day treatment will prevent further development of the disease. In the case of acute active hepatitis causing jaundice, a treatment of 15-30 days may be necessary. For chronic diseases (those that have persisted for several months or years), the treatment time is often dependent on the dosage used and the ability of the individual to undertake all necessary steps to overcome the disease (perhaps changing diet, lowering stress, and increasing exercise). When a high-dosage therapy is applied, most chronic ailments can come under control (and some are cured) by a treatment of about three months duration. If the daily dosage is lowered (because of inability to take the higher doses), the treatment time increases-perhaps to 6-12 months. Examples of chronic ailments are autoimmune disorders and degenerative diseases associated with aging. In some cases, herbs are taken daily, for an indefinite period, just as some drugs are taken daily. This is typically the situation when there are genetic disorders or permanent damage that cannot be entirely reversed, problems of aging, and ailments that have been left for too long without effective treatment.

The main reason that more Westerners are turning to Chinese herbs rather than local herbs is because of the vast scope of experience in using the Chinese materials. In every province of China, there are large schools of traditional Chinese medicine, research institutes, and teaching hospitals, where thousands of practitioners each year gain training in the use of herbs. The written heritage of Chinese medicine is quite rich. Ancient books are retained, with increasing numbers of commentaries. New books are written by practitioners who have had several decades of personal experience or by compilers who scan the vast diverse modern literature and arrange the results of clinical trials into neat categories.

American practitioners are usually trained at any one of about 45 colleges in the U.S., with a three- or four-year series of courses that include basic Oriental medical theory, acupuncture, and herb prescribing. Certification is offered at the national level and licensing or registration is offered now by most states. Many doctors from China have come to the U.S. and currently offer professional services throughout the country, but most often in the larger cities. Continuing education is provided through numerous symposia offered by the colleges and professional organizations devoted to Oriental medicine. Often, these meetings focus on the treatment of specific diseases or training in the use of a specialized acupuncture technique or valuable herb formula.

Chinese herbs are provided in the U.S. as food supplements, not as drugs. Thus, they are not strictly regulated by the FDA except for monitoring the cleanliness of manufacturing facilities (for those materials made in the U.S.; for the imported items, FDA monitors only the listing of ingredients to help ensure no toxic herbs are being used). Random testing of crude herb materials and herb products made in the U.S. indicate that they are free of harmful bacteria and chemical contaminants. Imported products must be used with some caution, as some of them are problematic, yet get past the investigators. There are a few patent remedies that are labeled with only herb ingredients, but also contain several Western drugs. Some patents from China contain only Western drugs (and say so on the box, in Chinese), but purchasers may be unaware of this because they are told only that this is an effective remedy that came from China. Thus, imported Chinese herb products should be taken solely on the basis of a prescription from a trained health professional.

Adverse responses to Chinese herbs are monitored at the Institute for Traditional Medicine through its contacts with numerous practitioners around the country and subscriptions to technical journals published in China and Japan. Negative interactions with Western drugs have not been noted for any of the common herb materials when used in the normal dosage range. A few people experience allergic reaction to individual herbs, a problem that often cannot be predicted in advance since these are idiosyncratic responses. A more common reaction is a gastro-intestinal response, which might include constipation or diarrhea, nausea or bloating. Such reactions may occur if the individual has poor digestive functions, or if the herbal formula is not quite right for the needs of the individual. Taking the herbs at a different time in relation to meals may be helpful in resolving some of the gastro-intestinal reactions. In a few cases, use of Chinese herb formulas may cause dizziness, headache, agitation, sleepiness, hungry feeling, lowered appetite, sensation of heat or cold, or other sensory reactions. If such responses persist after about three days of using the herbs, it may be necessary to change formulas.

Successful treatments based on the application of Chinese herbs are also monitored at the Institute. However, most American practitioners find themselves too busy (because of the small number of practitioners in this country) to prepare detailed reports of their successful cases; thus, it is necessary to rely primarily on the large-scale clinical trials conducted in China for the purpose of learning about the success rates. Such clinical reports, published in the Chinese language, are abstracted and published in English by the Chinese University of Hong Kong. These reports, and other translated materials, are compiled by the Institute and sent to practitioners in a variety of formats, including a technical series called Clinical Tips. Trials supported by the Institute for Traditional Medicine in the U.S. that have generated successful outcomes include treatment of HIV/AIDS, multiple sclerosis, and endometriosis.

Following are some examples of common ingredients of Chinese formulas that have become widely used because of their reliable action, the quick results usually experienced, and the diversity of therapeutic activities that can be obtained from each. These reviews serve as examples of what Chinese doctors must know. It will be noted that the dosage range is often very large, reflecting various uses and different methods of application.

Examples of Herb Combining to Make an Effective Treatment

An ancient formula prescribed for the initial stage of an infectious disease is Cinnamon Combination. It includes cinnamon, peony, licorice, and ginger. It is said that the cinnamon (twig) and peony coordinate the circulation at the surface of the body (where disease is believed to enter) and relaxes tense muscles. Ginger and licorice improve the digestive functions and improve the body’s healing energy. An ancient formula used to treat chronic illness is Ginseng and Tang-kuei Ten Combination. It includes astragalus, ginseng, atractylodes, hoelen, licorice, cinnamon, tang-kuei, peony, and rehmannia. Astragalus, ginseng, atractylodes, hoelen, and licorice promote digestive functions, increase the energy, nourish the internal organs, and enhance weakened immune responses. Cinnamon (bark) warms up the weakened metabolism. Tang-kuei, peony, and rehmannia nourish the blood. Another ancient formula, used for a variety of diseases and function disorders, is Minor Bupleurum Combination. It includes bupleurum, ginseng, ginger, hoelen, and licorice. Bupleurum harmonizes the circulation between the internal organs and the body surface, it alleviates stress in the chest and abdomen, and it reduces inflammation. As indicated above, ginseng, ginger, hoelen, and licorice benefit the digestive processes and increase energy.

All of these formulas are widely used today, often by making some slight modifications to address the particular needs of the individual or the characteristics of the disease. For example, Cinnamon Combination (with appropriate modifications) has been used in Chinese clinical trials for treatment of frostbite, pernicious vomiting of pregnancy, and appendicitis. Ginseng and Tang-kuei Ten Combination has been applied to treatment of side-effects of cancer therapy and for prevention of cancer recurrence after successful treatment. Minor Bupleurum Combination is one of the formulas frequently given in cases of chronic hepatitis B infection, and it is also used for inflammation of the stomach and pancreas.