Herbs
In Europe we often think of herbal prescribing as ‘this herb stops fevers’, or ‘that herb is good for headaches’. In Chinese herbalsim that is also true but the emphasis is on combinations of herbs…. the whole is greater than the sum of the parts. Consider the chemistry – combining chemical substances often creates new chemicals. Or two chemicals together behave differently when ingested into the body than each chemical alone.
So even quite early herbal theory (1 st century BC) outlines seven relationships between medicinals; accentuation of the effect of one by another, couteraction of one by another etc. All these relationships had been observed through development of herbal understanding, now we’re able to start seeing some of the biochemical rationale behind these interactions.
We’re so used to the purification of single active ingredients, nicely packaged and marketed, forming the cornerstone of sophisticated modern medicine; it would appear that plant based medicine might just have the edge in sophistication.
Modern prescribing versus ‘classics’
So Chinese herbal medicine is actually more about combinations of herbs – formulae – than individual plants. Over the last 2000 years we have a fairly good record of formulae as this school or that developed different styles of prescribing. But the core principles relate to the relationship of the herbs with each other; there are rules clearly delineated in the greatest theory classic the ‘huang di nei jing’ regarding this. But this is not taught in many colleges in this country (and maybe only lip service paid to those principles in many others – symptomatic treatment is very prevalent these days). So it was with enourmous relief that I started studying the formulae of Zhang Zhong Jing, a 2nd century a.d. genius who wrote possibly the greatest text on formula prescribing.
The Shang Han Zha Bing Lun
The text was written in a time of epidemic disease as a ‘workshop manual’ for practitioners; at first sight it’s for externally contracted disease but also covers what happens to the course of illness with different constitutional background states, or how to recognize when disease processes are going in contrary directions etc. And in fact it ‘s apparent that the formulae have a much further reaching application than colds and flu. But one needs to understand the principles & the physiological model to grasp the essentials. To be able to have this understanding, I’m indebted to Arnaud Versluys, with whom I’ve studied for the past three years, and his single-minded pursuit of excellence in this field which led him to a doctorate, and then his lineage teacher, in China. (See links on main page)
Basically we have diagnostic tools of wrist pulse palpation, abdominal palpation, and asking questions. The model uses levels of response to disease causing agents…if one level can’t deal with the situation it passes over to the next level and so on. So especially pulse and abdomen tell us at what level the physiology is stuck, and in what way. So this is what we have to deal with right now. When we’ve succesfully done that the pulse will change, indicating the next area where the body is having difficulty. In this way we can match the dynamic of the changing disease process with a dynamic prescribing strategy.
More importantly than all the theory, since I’ve been prescribing formulae exclusively from this approach, my clinical results have been significantly better.
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