Ever since my first herbs class, I have loved working with Chinese herbs. It is through Chinese herbs that the true art of Chinese medicine really shines. In practice, using herbs is key in helping patients progress in their healing. The building blocks of Chinese medicine are single herbs. Individual herbs are categorized based upon their taste, temperature, and channels affected. Tastes have specific functions, and therefore the way a formula tastes is indicative of what it is trying to accomplish. The tastes and their functions are as follows: bitter drains, sour astringes, sweet tonifies, spicy disperses and salty softens. Temperature of herbs also has a specific effect on the body. For example, if a patient comes in with a “hot” condition (they feel hot, have red skin, have excessive thirst, etc.), cooling herbs are required. For some herbs, it is easy to guess its temperature. Watermelon is inherently cooling, whereas ginger has a warming effect. Finally, the acupuncture channel each herb addresses is also an important consideration. Diagnosing a pattern in Chinese medicine requires determining what the problem is and where it is located. For example, heat in the heart channel is very different than heat in the liver channel. Therefore, herbal selection is important! Treatment will absolutely be unsuccessful if an herb that clears liver heat is used for heat in the heart channel.
Herbs are given to patients as formulas, which are specific combinations of herbs designed to treat a Chinese medical pattern. These formulas are over 3,000 years old and are often modified for each patient in modern practice. The skill in modern Chinese herbalism is to first choose the correct formula for the patient’s presentation and then to choose the correct additions. Modifications to formulas are often the addition of a 5-8 single herbs to the original formula. This is often a process of trial and error. The way to gauge the patient’s progress is to see how the patient is feeling and how the symptoms have changed, or even better, gone away.
Modification is my favorite and most challenging aspect in prescribing herbs. It is very easy to memorize all the individual herbs, their tastes, temperatures and channels, but it is really an art to be able to put them together effectively. I think of herbal modification like steering a car; it takes small, fine tuned adjustments to maintain the proper course. Perhaps a small increase in dosage of an herb is required or adding a different supplementing herb to an already supplementing formula that will make the difference for the patient. In the end, it is the many benefits that patients achieve after taking herbs that is truly a testament to the effectiveness and art of herbal modifications.