Getting Started With Chinese HerbsBrush up on your Chinese herb knowledge with this in depth look at the eastern medicine. June 3, 2010 By Nancy Scanlan, DVM Some veterinarians are worried about the safety and possible toxicity of Chinese herbs,1 but this is not a concern when you buy from the companies commonly used by veterinary herbalists. Companies in China that do not have an American counterpart may add adulterants or toxic substances.2 Which companies have quality-control procedures and follow U.S. good manufacturing practices? Examples include Golden Flowers, Health Concerns, Jin Tang Herbals, K’an Herbals, May Way, Natural Path and World Herbs (Darcy Naturals).3 All these companies examine raw herbs to ensure the right species, avoid the use of toxic species and submit both the raw ingredients and the final product to laboratory tests. In addition, one company uses organic herbs. At least three of the companies import raw herbs from China and process them in the U.S. The companies belong to quality assurance groups such as the National Animal Supplement Council4 and the Chinese Herbal Medicine Coalition5, which work with the Food and Drug Administration to establish certification standards for safe and effective use of their products. All have experienced herbalists as founders or staff members. All give or sponsor continuing education, enabling practitioners to better understand their products. “Chinese Herbal Patent Medicines: The Clinical Desk Reference,” by Jake Fratkin, is an excellent reference for more detailed information on Chinese patent medicines, including tainted ones.6 Read the Label Looking for Chinese herbal formulas on a label, it appears that all are proprietary. Ingredients are listed from most to least, without specific grams for each. When the formula is a “Chinese patent formula,” it is one of more than 10,000 formulas available from more than 200 books, which specify the proportions of each herb to include in a formula.7 These formulas have been in use for periods of hundreds to thousands of years, giving substantial time for both verification of action and side effects. In addition, there are Chinese herbal materia medica8 which give specific doses of each herb. An experienced Chinese herbalist can tell by looking at the formula what the relative amounts are and what the indications are for the formula. The Chinese use combinations, not single herbs, to treat a problem. There is a primary herb, which produces the main action desired, and other herbs may decrease side effects, increase the activity of a product through synergy or address lesser symptoms associated with the main problem.9 Using a smaller quantity of each of two herbs may have a more beneficial effect—fewer side effects—than using a larger quantity of a single herb. Western medicine sometimes does the same thing—for example, when we use several drugs to treat congestive heart failure. Dosage Chart for Human Formulations When using a product designed for animals, follow the recommendations of the company. If you use human formulations you will need to adjust the recommended dose. They generally come in tablets, tea pills (small round pills) and granules. Doses for each form11,12 of a human formulation are as follows: Weight Health Concerns Tablets Golden Flowers Tablets Tea Pills Granules 0-25 lb 0.5-1 BID 0.5 BID 1-2 BID 0.5-1 gm BID 25-50 lb 1-1.5 BID 0.5-1 BID 3-4 BID 1-2 gm BID 50-75 lb 1.5-2 BID 1-1.5 BID 3-4 BID 2-3 gm BID 75-100 lb 2 BID 1.5-2 BID 5-6 BID 3 gm BID 100-125 lb 2-3 BID 2 BID 5-6 BID 3 gm BID What’s in a Name? The names of most Chinese herbal formulas sound funny to the American ear. If one does not translate them, the Chinese names are unfamiliar (such as Gui Pi Tang) and often long (such as Liu wei di huang wan). Literal translations are also problematic (“Restoring Spleen Soup” and “Six Flavor Rehmannia Pill”). Just as one Chinese term for headache literally translates as “head wind,” the term “spleen” means different things to Chinese and Americans, and Gui Pi Tang does not do what you might think it does. Most American Chinese herbal companies follow this path, but you should not judge the efficacy of a formula by the fact that the name seems strange. Odd names should not stop the practitioner from using Chinese formulas. They have a place in Western medicine, addressing areas for which we have no good Western answers. For example, some Chinese formulas are effective against MRSA and other highly resistant infections.10 Formulas for arthritis have far less effect on liver, kidneys, and the GI tract than COX-2 inhibitors. Some formulas can help reduce or eliminate the need for corticosteroids in dermatitis cases. The easiest way to get started is to use formulas that have a straightforward action, where you do not have to understand Traditional Chinese Medicine (TCM) theory in order to use them. If you read the Chinese rationale behind them, you can absorb a little TCM knowledge and eventually gain a better understanding of why you should use other formulas that are more fine-tuned for specific problems. Good Examples Here are chronic conditions and the Chinese formulas I use for them. Unless otherwise noted, the first name is the Health Concerns product; the others are the Chinese names, if ordering from other companies: • Anemia, including that caused by chemotherapy: Marrow Plus • Arthritis with inflammation: Mobility 2 (Shu Jing Huo Xue Tang) • Atopy: Skin Balance (Health Concerns original formula) • Atopy with rhinitis: Xanthium Relieve Surface (Bi Yan Pian) • Cancer: Power Mushrooms (combination of Chinese mushrooms with anti-cancer effect. Can be given with most chemotherapy except immune suppressants) • Canine cognitive dysfunction: Flavonex • Cystitis, including that with resistant bacteria: Akebia Moist Heat or Ba Zheng San • Demodectic mange: Enhance (Quan Yin formula designed by Misha Cohen OMC, L. Ac.) • Incontinence (urinary and fecal)—also helps lumbar pain: Rehmannia 8 (Shen Qi Wan) or Backbone (Bu Shen Huo Xue) • Muscle spasm (severe): SPZM (Shao Yao Gan Cao Tang) • Muscle spasm (chronic): Ease 2 (Chai Hu Gui Zhi Tang, or Bupleurum and Cinnamon) • Prostatitis, enlarged pros-tate, prostatic cysts: Essence Chamber (Combination of saw palmetto with Chinese herbs) • Pruritis: Si Wu Xiao Feng Yin No. 3 from Darcy Herbs • Pain relief: Channel Flow (Huo Luo Xiao Ling Dan) > • Rhinitis or sinusitis (chronic): Nasal Tabs 2 • Vestibular syndrome: Gastrodia Relieve Wind or Tian Ma Gou Teng Yin. This article first appeared in the June 2010 issue of Veterinary Practice News. Click here to become a subscriber. Nancy Scanlan practices at Shasta Lake Veterinary Clinic in Shasta Lake, Calif. She is immediate past president of the American Holistic Veterinary Medical Assn., president of the Veterinary Botanical Medical Assn., and president and founder of the California Veterinary Holistic Medical Assn. Her book, “Complementary Medicine for Veterinary Technicians and Nurses” (Wiley-Blackwell), is due out in January. <HOME> FOOTNOTES: 1. Robinson, Narda, Top 10 Holistic Traps, Veterinary Practice News, June 2008 2. Review of Adulteration of Chinese Patent Medicines with Synthetic Drugs, HerbalGram. 2004;61:22-23 American Botanical Council 3. note: all these companies have websites describing their practices 4. NASC, National Animal Supplement Council, PO Box 2568, Valley Center, CA 92802. Click here to see a list of their members. 5. Editorial staff, AAOM Forms Herbal Medicine Coalition, Acupuncture Today May, 2001, Vol. 02, Issue 05 accessed on 2/28/2010 here. 6. Fratkin, Jake, OMD, LAc, Chinese Herbal Patent Medicines: The Clinical Desk Reference, Shya Publications, Boulder CO, 2001 7. Personal communication from Huisheng Xie, DVM, Ph.D. 8. Bensky, Dan et al., Chinese Herbal Medicine: Materia Medica, Third Edition, Eastland Press, Seattle, WA 2004 9. Beebe, S., DM et al., Clinical Handbook of Chinese Veterinary Herbal Medicine, Herbal Medicine Press, Placitas, NM, 2005 p. 27-28. 10. Zuo GY et al., Screening of Chinese medicinal plants for inhibition against clinical isolates of methicillin-resistant Staphylococcus aureus (MRSA), J Ethnopharmacol. 2008 Nov 20;120(2):287-90. Epub 2008 Aug 28. 11. Beebe, S., op. cit. p. 37 12. Schwartz, Cheryl, Four Paws, Five Directions, Celestial Arts Publishing, Berkeley, CA 1996 p. 154.