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In traditional Chinese medicine (TCM), Herbal therapies are generally formula based and single herbs are rarely used. TCM holds that every medicinal substance (fresh and dried herbs) has its strengths and its shortcomings, and each ingredient in the formula should be carefully balanced in quality and quantity, in order to accentuate its efficacy while reducing side effects.


Herbs in a formulae are not simply added in a cumulative fashion but combined according to specific principles. Firstly, through a unique diagnostic process, TCM physicians discern the subtle patterns according to your symptoms, which then guides them to determine therapeutic strategies and to design a formulae tailored to you.


Take influenza as an example, after meeting with your TCM herbs specialist they would look at:

  • Your symptoms: You have a chill, fever, headache, generalized aching, panting but no sweating; after looking at your tongue it shows as thin with a whitish coating, and after taking your pulses they are floating and tense.

  • Your TCM disharmony pattern: exterior syndrom due to exogenous wind-cold.

  • Best Therapeutic strategies: exterior syndrome is relieved by diaphoretic therapy (promotes perspiration) and the wind-cold invasion can be removed by pungent and warm herbs.

  • The best classical formula: Ephedra Decoction (Ma Huang Tang) that consists of ephedra, cinnamon twigs, bitter apricot kernel and liquorice root.

TCM physicians will always focus on disharmony patterns, combinations of herbs that should address your symptoms exactly. Since a TCM formula contains multiple interactive ingredients, it is customarily to rank the compositions in four groups when analyzing the role they play in the formula.

Monarch: The ingredient that exerts the major and leading effects in a formula. Generally, monarch drugs should constitute the largest proportion of a formula; a competent formula usually only contains one to two principal herbs so that the therapeutic effects can be focused.


Minister: Also known as the associate ingredient usually refers to two different functions. One is to support the monarch drug to exert major actions on the body, and the second is to improve and treat the accompanying symptoms or coexisting disharmony pattern. In comparison with the monarch drug, the minister drug usually has a weaker action.


Assistant: The ingredients can play one of the following three roles in a formula. One is to reinforce the effects of the monarch or minister drug or to treat the less important coexisting patterns. The second role is to eliminate the toxicity of the monarch and minister ingredients, or modulate their harsh properties, and the third is to provide paradoxical assistance.


Guide: These have two different functions. One is to force the actions of the formula on the target meridian or area of the body; and the second is to harmonize and integrate the effects on other drugs.


After centuries of practice, scholars perfected various formulae for some typical disharmony patterns, and today, these classic formulae have become the basis for modern day usage.


Appropriate formula prescriptions based on accurate differential diagnosis can only be made by qualified TCM physicians with Herbs Qualifications.


Eca Brady is a fully licensed physician of Chinese Medicine BSc(Ac) MBAcC PGDip(CHM), practicing Acupuncture and Herbs from Harley Street, London. Make an appointment for an acupuncture or Herbs treatment and we can discuss how we can help you, to read more about Eca click here.


Excerpts from the original article by Shen Nong.

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