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Featured Article
Healing Without Side Effects: Drugs vs. Herbal Formulas
Brian B. Carter, MS, LAc
"How can you say that an herbal formula will alleviate multiple symptoms, and yet have little or no side effects? How can there be a good effect without bad effects?"
- Dr. W.H., MD, Great Falls, MT
I understand your question, Dr. H., and the reason for it. Most doctors expect herbs to act just like pharmaceuticals. If there is a beneficial healing effect, they reason, there must also be side-effects. Conversely, if there are no side-effects, then there can be no healing effect. This expectation makes sense in pharmaceutical medicine where you treat with just one active ingredient (why?) at a time. But, chinese herbal formulas make use of more than one herb 99.99% of the time. Oriental medicine has been prescribing multiple-agent compounds for thousands of years. This practice is similar to the recent drug 'cocktails' developed for HIV and HCV.
Each herb in and of itself is composed of more than one ingredient, plus other 'buffers.' I suppose you could think of a pharmaceutical as a lone-gunman; he is effective in what he does, but abrasive and dangerous. An herb, on the other hand, is a more balanced and complex person. The herbs in a formula work together as a team. Each herb has strengths and weaknesses, but the whole team can do amazing things! (I could say something really tacky now like, "There's no I in TEAM, but there is an I in SIDE EFFECTS and PHARMACEUTICALS," but I won't subject you to that kind of writing. Not directly, at least.)
Problems with Drug Treatment
To see the difference between biomedical and chinese herbal prescription, let's look at an example: You go to see your MD or DO for sinus problems and they prescribe you guaifenesin. You come back a year later with anxiety, and they prescribe you Paxil (you know it's working if you're not anxious about its side effects…). Then, you develop serious heart palpitations, but they tell you it's just in your head. After demanding more tests, you get back a normal EKG or cardiac stress test. Then they really think it's in your head. I know, this is oversimplified, but bear with me - I do have a point; the end result is that you end up on several drugs, some of which try to fix the side-effects of your primary prescription.
Often Biomedicine Knows But Cannot Do
You didn't know that biomedicine is incomplete? Consider how many diseases in biomedicine have names but not treatments. In oriental medicine, we can see your constitutional tendencies ahead of time and balance the herbal formula so that it doesn't worsen any pre-existing conditions. We can see more subtle imbalances than biomedicine can or will detect with its tests (there may be appropriate lab tests or visual studies, but if the disease has not progressed very far just try to get the insurance company to approve them!). We have ways of seeing the gray areas of imbalance that precede serious disease. To be fair, in the long run, the micro-approach of biomedicine will sharpen oriental medicine, and the broad effectiveness and insights of oriental medicine will guide and inform biomedical discovery.
Oriental Medicine is Not a One-Size-Fits-All Medicine.
It's not a one-herbal-formula-fits-all medicine. It's not a one-acupuncture-point-fits-all medicine. Oriental Medicine is a get-to-know-you medicine.
In oriental medicine, we can predict and prevent side-effects because
* We understand of the causes and nature of diseases, and
* Our understanding of diseases and herbs is integrated and interwoven
In your oriental medical visit, we start with a whole-body, multi-system diagnosis. Then we design you a comprehensive herb formula. The formula is often based on one or more classical formulas, some of which are thousands of years old. Some of the herbs in your formula (there are at least 400 chinese herbs) may be added to or removed, and their dosages may be changed based on your diagnosis. Some herbs or groups of herbs have a specific healing goal, some balance other herbs, and some protect your weaknesses.
A Typical Herb Formula Treatment
For example, say you come in for sinus problems. First, we differentially diagnose you. Is it heat, cold, dryness, and/or dampness? What organs are involved? What specifically is going on? Successful treatment starts with accurate diagnosis. If we see that you have a tendency toward 'blood vacuity' (if you have symptoms like tendon problems, muscle spasms, visual floaters, poor memory, dryness, and objective signs like a pale tongue, pale lusterless face, etc.), then we tailor the herbal formula to make sure isn't going to worsen that condition.
Then we give you a formula that isn't going to make the dryness or heat worse, or increase the mucus. The guaifenesin in the first example works by drying the mucus, and so the side effect is that it can dry you too much or increase pre-existing heat in your body. Anxiety can happen when the Heart Blood is vacuous. The palpitations can be a symptom of a Heart-system problem.
Chinese Medicine Knows People Are Unique
It's not a radical concept. When you get a denture or a crown from the dentist, they first take an impression and then have a lab custom-manufacture one that will fit your unique mouth. Optometrists don't make just one prescription of contacts or glasses; they measure your sight from a number of perspectives, and then order a custom-prescription for you. They have you come back regularly and change your prescription if your vision changes. Even hats come in various sizes or are, at least, adjustable! Oriental medicine is the same way. It is an internal medicine which assesses your specific physical, mental, and emotional landscape, and then elegantly, personally balances your extremes
"If all you have is a hammer, everything looks like a nail."
If all you have is a hammer, a screwdriver, and a wrench, then everything looks like a nail, a screw, or a bolt. Practicing medicine that way is like giving a speech (monologue) when you're in a one-on-one conversation (dialogue). Some doctor's visits are that way. But what if you could look at your patient first, and then custom-design your treatment for them? This is what oriental medicine does. That's how we end up with a custom herbal formula or selection of acupuncture points that might change every week. If you are changing as a result of the treatment, then the treatment needs to change, too.
If you have asthma, your MD will probably want give you a bronchiodilator and/or corticosteroid, and isn't likely to think about how the disease or the treatment affects your emotions (although, vice versa, it's become harder and harder to deny that emotions have an effect on or cause illnesses). One of the main differences between oriental medicine and biomedicine is that the disease categories in biomedicine are sometimes too large. Contrast that to the oriental medical disease 'shan kong' which means 'dread,' or 'waiting for the other shoe to drop.' To be sure, there are disease and treatment subsets in biomedicine, but not as many, and they are not as well integrated with every other aspect of your life as they are in oriental medicine.
Why, in pharmaceutical medicine, do they use just one active ingredient at a time?
A single synthetic chemical can be patented, and so it is a safer investment for the pharmaceutical company than an herb which anyone can grow in their backyard. It's also easier to study a single chemical, and already costs around $350 million just to get one passed by FDA.
ABOUT THE AUTHOR
Acupuncturist, herbalist, and medical professor Brian B. Carter founded the alternative health megasite The Pulse of Oriental Medicine (http://www.PulseMed.org/). He is the author of the book "Powerful Body, Peaceful Mind: How to Heal Yourself with Foods, Herbs, and Acupressure" (November, 2004). Brian speaks on radio across the country, and has been quoted and interviewed by Real Simple, Glamour, and ESPN magazines.
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