Principles of Herbal Efficacy: Q&A with Jimmy Chang!

1.  Is becoming dependent on Da Huang a concern in the treatment of constipation? 

You must combine Da Huang with other herbs (Mang Xiao, Hou Po, Zhi Shi) such as in Da Cheng Qi Tang, Xiao Cheng Qi Tang, Tiao Wei Cheng Qi Tang. People will become dependent on the single herb if it’s not combined with other herbs. Please make sure not to use Da Huang by itself!

Also, if the left right guan is strong, constricted, use Tao Ren Cheng Qi Tang for MJ.

If the pulse on right cun is floating, it indicates dryness in LI so use Run Chang Wan (moistens the Lung to help with evacuation).


2.  Can you elaborate the pulse "tightness in Left Guan" for the use of Gan Mai Da Zao Tang? What if it is felt in all pulse positions? Would you try to open the pulse using openers?

Right pulse = severe constriction (like guitar string). Tight, thin, strong (may or may not be powerful)

To open the tightness and reduce pain, use something with a sweet property. For example, If tight, guitar-string pulse on L. Chi à Bone spur/Sciatica/Back Pain. Can add Gan Cao 15%. You can also use Gan Mai Da Zao Tang (good for tight pulse in all positions. Up to 50% to release tightness and pain. But it is not inflammatory).

3.  Can you give the herbs for the 6 seed combination and illustrate how it is used in formulas?
 
Liu Zi Tang
She Chuang Zi (Fructus Cnidii)
Bu Gu Zhi (Fructus Psoraleae)
Jiu Cai Zi (Semen Allii Tuberosi)
Tu Si Zi (Semen Cuscutae)
Che Qian Zi (Semen Plantaginis)

Liu Zi Tang is used for Kidney Yang Deficiency. Always combine it with Er Xian Tang (Yin Yang Huo + Xian Mao). Use 25% Liu Zi Tang & 25% Er Xian Tang. You can also add 25% Shan Yao for ladies with low libido.

How to distinguish between Kid Yin/Yang deficiency? Yang deficiency pulse is sluggish especially in the left Chi. Feel the temperature of patient’s hand. If it’s cold, it’s KD Yang Deficiency. And remember, Liu Zi Tang should only be used for patients with cold freezing palms.

 
4.  If a person has palpitations but Liver excess would you still use Yi Gan San over Jia Wei Xiao Yao San even if heart rate is not above 90?

Always use Yi Gan San for fast heart palpitations or heart rate. You can also combine it with Jia Wei Xiao Yao San. In addition, you can also add 10-15% Shui Zhi for severe emotional conditions (but no more than 1 month, and make sure patient is not pregnant, or prone to any kind of bleeding).

Chai Hu Qing Gan Tang is used for allergy, skin problems due to Liver Fire, and blood issues. When the right cun is floating and strong, it’s a Yangming pulse, which indicates Liver damage (from either physical or emotional issues). Use Chai Hu Shu Gan San for Qi issues.

 
5.  Can you please tell us the individual herbs used for skin issues?
 
The right cun can mean skin problems. Use Ban Zhi Lian, Bai Hua She She Cao, and Da Cheng Qi Tang. For acne or eczema combination, use Bo He + Chuan Tui 15% each. Bo He + Chai Hu Gui Zhi Tang are even better than Xin Yi Qing Fei Yin for nasal allergies.

Additional skin herbs are Bai Xian Pi, Bai Wei, Xhui Zhi, Bai Zhi, Ku Shen. Ku Shen 15% + Jing Fang Bai Du San 40% for oozing skin conditions. Fang Feng Tong Shen San (contains Ma Huang…discontinued). Use Yi Yi Ren if pulse is deep (water retention, darkness on the face) 25%.

 
6.  How does Liver Yin xu show up on the pulse compared to Kidney Yin xu? (He was talking about a strong muscle bound man or martial artist who complains that he is tired all the time and that he looks strong but has Liver Yin xu.)

Kidney and Liver Yin deficiency presents with the same pulse. If the pulse is floating and empty upon pressure, it means yin deficiency. If the pulse is thin floating and empty, that means there is more severe deficiency. When the HR fast and BP low, it indicates long term exhaustion (Yin Deficiency). Use Jia Wei Xiao Yao San + Gui Pi Tang to tonify Yin (general Yin deficiency). 50% each.


7.  What if the person is hot and sweaty but has weak and scattered chi pulses? How do you understand the sweating? How would you treat the empty and scattered Kidney chi pulses?

Sweating can be due to, heart problems, menopause, but it really depends on the pulse. If the palm is hot, use Zhi Bai Di Huang Wan. If palm is cold, use Liu Zi Tang + Er Xian Tang. Use Chai Hu Gui Zhi Tang 25% for balancing, plus either Zhi Bai Di Huang Wan or Liu Zi Tang + Er Xian Tang. Wu Mei Wan can also be used.

 

8.  Can you clarify the use of the Right chi to diagnose cough and cold problems? versus the Right cun position?

The right cun is directly for Upper Respiratory. If it is very jumpy, it indicates lots of heat in upper resp. Yangwei is for lower respiratory. The right chi is to the neck/Taiyang. If the pulse is long, wiry, strong, it indicates cold-wind in neck or HA. You must get rid of the wind first. Use Ge Gen Tang (cold) or Chai Hu Gui Zhi Tang (allergy) 25%/

Also, check the temperature at Ren 22 and Da Zhui. The temperature should be the same. If the temperature is lower than 34C (36.5 C is normal), that means there is a problem with the immune system so use Huang Qi Jian Zhong Tang. 20% to boost energy to fight infection.


9.  M3 (Huang Lian Jie Du Tang, Xie Huang San, Gan Lu Yin) has herbs for a deep, wiry, and forceful pulse in the R guan.  Yet Gan Lu Yin is sweet which would be contraindicated in this case.  Do the other bitter formulae in M3 override the sweetness of Gan Lu Yin?

No it does not. They balance each other out perfectly, it is especially great for diabetic patients. If the palms are hot (Type II), use Zhi Bai Di Huang 30%, Zhi Mu + Huang Bai 20%, M3 50%. If the palms are cold, use Er Xian Tang/ Liu Zi Tang (Usually Type I) Gui Fu Di Huang Wan up to 50% to tonify the Kidneys.
 

10.  What does the slippery pulse indicate?  
 
The textbook definition of “slippery” is different from my definition. I define it as “Brain Damage.” People always have slippery pulse right after stroke. A Slippery pulse means phlegm heat in the Brain/emotional/ blood issue. Use Zhu Ru Wen Dan Tang/ Zhu Ye Shi Gao Tang (anything with Bamboo is great!). Use Tian Zhu Huang to calm down the craziness by resolving phlegm. Use Tian Ma Gou Teng Yin, Ban Xia Tian Ma Bai Zhu Tang, or single herb Tian Ma for emotional phlegm/Meniere’s syndrome. You can also use Shui Zhi for Cuckoo condition. Sometimes the Slippery pulse is only on the right cun.
 

11.  What herbs or formulas can strengthen Kidney Yang for a strong back and lower body without creating heat?   

Here are the mild formulas for strengthening low back and the Kidneys:

You Gui Wan
Gui Fu Di Huang Wan
Huan Shao Dan
Qi Bao Mei Ran Wan
For women use 50% Shan Yao instead


12.  If a woman does not exercise after giving birth, how should she safely take Sheng Hua Tang to prevent blood clotting after delivery?   

The purpose of taking Sheng Hua Tang is to prevent blood from clotting post-partum. The reason is the same behind exercising to prevent blood clots.

 
13.  What part of the body does Ba Zheng San eliminate water? And, can you use Ba Zheng San by itself to eliminate water?

Ba Zheng San eliminates water from the lower Jiao and also to provides an outlet for heat to be purged. I use it not only for UTI and infections of the lower jiao, but often add it in patients with heat or with hypertension so water can be directed out through urination. The overall effect is faster and better than using heat clearing herbs alone.

 
14.  At what point does Shi Liu Wei Liu Qi Yin become ineffective for treating fibroids? Is it when the fibroids become too large or when they have been there for a long time?    

It's never ineffective. It's more of a cost issue when the fibroids become too large that patients can't afford the herbs and opt for surgery, which is covered by insurance.
 

15.  Can men use Tao Ren Si Wu Tang for Liver spots on the face like women or is there another formula?

Sure, not a problem.

16.  Can Herbal ABX be taken long term for someone with an Expanding pulse (with big fire/heat)?

Yes, as long as the pulse is still there. But you also need to find out what's causing the expanding pulse for so long. Usually heat clearing herbs will work within a few weeks and if it's not cleared in that time, ask what the patient is doing to cause this fire to persist in his lifestyle or diet and cut it out (can be stress, spicy food, alcohol, etc).
 

17.  Is the pulse different for the various types of arthritis? Is it necessary to differentiate the different types for herbal treatment?
 
Yes of course, differentiate heat, cold, deficiency, etc...