The Treatment of Modern Western - Biblio.nhat-nam.ru

INTRODUCTION 33scribed].” 31 In our own times, Qin Bo-wei has said,“When I say to use Liu Wei Di Huang Wan (Six FlavorsRehmannia Pills), I don’t mean for you to use the ingredientsof Liu Wei Di Huang Wan but rather the idea of LiuWei Di Huang Wan.” 32 Rarely in professional clinical practicein China is a standard formula prescribed in its standardform. Either medicinals are added to the standardingredients (jia wei, added flavors) or some ingredients areadded while others are subtracted (jia jian, additions andsubtractions). It is the modification of standard formulaswhich allows professionally prescribed Chinese medicineto cure without side effects. Such modifications are madeon the basis of the patient’s individualized pattern discriminationplus their personal presenting signs and symptoms.Ingredients are typically added to prevent sideeffects and also to extend and strengthen a formula’s clinicaleffects.Most standard Chinese medicinal formulas are keyed to onlyone or two basic patterns. Because Western patients withchronic, difficult to treat diseases typically present with 5-8patterns simultaneously, most standard Chinese formulas fallwell short of comprehensively treating these kinds ofpatients. However, taking out unwanted medicinals is just asimportant as adding missing ingredients. Take Liu Wei DiHuang Wan for example. Three of these six ingredients aresupplementing (cooked Radix Rehmanniae, Shu Di, FructusCorni, Shan Zhu Yu, and Radix Dioscoreae (Shan Yao), whilethree are draining (Poria, Fu Ling, Rhizoma Alismatis, ZeXie, and Cortex Moutan, Dan Pi). The first two of the drainingmedicinals seep dampness, while the third clears heat andquickens the blood. If any three of these draining medicinalsare not indicated, they must be removed. Because they aredraining, they attack the righteous qi. In other words, if theyare prescribed when they are unwanted, they can actuallydamage the patient and cause problems. Therefore, we simplycannot make up a shortfall in ingredients by piling oneready-made formula on top of another. If we do this, we arebound to be prescribing unwanted medicinals, and theseeventually will take their toll. 33Because our Western patients present with such complex,multipattern diagnoses, simple, ready-made formulas rarelymatch them. In addition, these complex pattern discriminationsare themselves not static. They tend to shift constantly.Unlike disease diagnoses, patients’ patterns (or at least theirrelative proportions) tend to shift every week or so in relationshipto the weather, phases of the moon, changes in season,fluctuations in diet, rest, activity, mood, and in reactionto medical treatment. This is why most patients in Chinacheck with their Chinese medical doctors once per week.Depending on the doctor’s reassessment of their patient’spattern, the prescription will be modified further on an ongoingbasis. Because treatment based on pattern discriminationis the very definition of high quality, professionally practicedChinese medicine and patterns are so fluid and everchanging,treatment must allow for easy modification.Ready-made medicines do not allow for this.THE ISSUE OF PROCESSINGIn Chinese, the processing of Chinese medicinals prior todecoction is called pao zhi. Within Chinese medicine, thereare a number of different methods of this processing. Someof these methods are only for ease of storing or handling.Other methods are nothing more than cleaning, while yetother methods are, when all is said and done, not much morethan cosmetic. However, many of these methods actuallychange the properties (i.e., nature and/or flavor), functions,and indications of medicinals. According to PhilippeSionneau, we cannot regard uncooked and honey mix-friedRadix Astragali (Huang Qi) as the same medicinal any morethan Huang Qi and Radix Angelicae Sinensis (Dang Gui) arethe same medicinals. Once a medicinal has undergone processing,it becomes a different medicinal with different indications.Although we have tried to keep the use of processed medicinalsto a minimum in this text, processing does add a wholeother level of sophistication and efficacy to the prescription ofChinese medicinals. Some ready-made medicines are madewith properly processed medicinals, but others are not, and,when using a ready-made medicine, we cannot process a particularingredient so that it can have an even stronger, moretargeted effect with less potential side effects. The fact that wecannot further refine and tailor a prescription via processing isyet another drawback of ready-made medicines. For mostcommon processing methods, all one needs is a wok, a hotplate, some water, and a handful of common household foodstuffs,such as salt, bran, rice, honey, vinegar, and alcohol. Inaddition, many Chinese medicinal suppliers, at least in theU.S., sell already processed versions of the most commonlyprocessed Chinese medicinals. Therefore, it is not that difficultto use processed Chinese medicinals in most Western clinicalpractices. For more information on processing and the use ofprocessed Chinese medicinals, readers should see PhilippeSionneau’s Pao Zhi: An Introduction to the Use of ProcessedChinese Medicinals also available from Blue Poppy Press.THE ISSUE OF DOSEWhen we said above that the kinds of difficult to treat, knottyconditions which are the stock in trade of Western practitionerscommonly require “large” prescriptions, we meanttwo things. First, Chinese formulas for these kinds of conditionstypically have more than 12 ingredients and often 15,18, or even more than 20. If our average patient has 5-8 patternssimultaneously and most practitioners use at least twoingredients per disease mechanism, most Chinese medicinalformulas for these kinds of conditions will have at least a