Chinese Herbal Pharmacy Terms of the Day: Chong Fu 冲服 and Rong Hua 溶化

Chong Fu (chōngfú 冲服) is an instruction typically added to written formulas to indicate that the herb in question should not be decocted, but ingested whole along with a swallow of the herbal decoction. Usually the herb is powdered to make this process easier, so the whole instruction might say yán mò chōngfú 研末冲服, which means "grind to powder and take drenched."

"Take drenched" is the translation from the World Health Organization term set, and it works for me even though it doesn't automatically conjure up an image. I like that we're using two words for two characters.

Herbs that are typically taken Chong Fu-style are expensive herbs like Lu Rong 鹿茸, Ge Jie 蛤蚧, Hai Ma 海马 and Dong Chong Xia Cao 冬虫夏草. (When dealing with an unfamiliar pharmacy or one in which you don't have complete confidence, a savvy herb customer should ask to see the herb in question before it is powdered. Of course, that assumes that you are somewhat familiar with how to differentiate authentic herbs and different quality levels - for more on these topics, keep an eye on Eric Brand's blog at the Blue Poppy website.)

A similar but very different instruction is Rong Hua (rónghuà 溶化), which simply translates as "melt" or "dissolve." An herb that is marked "Rong Hua" is added to the hot decoction after the cooking process has finished, but should dissolve completely when stirred in. Examples are the gelatins: Lu Jiao Jiao 鹿角胶, E Jiao 阿胶, Gui Ban Jiao 龟板胶. By contrast a powdered Lu Rong will never dissolve, and therefore must be ingested and chased with decoction for the best medicinal effect.

This is part of our ongoing series on Chinese pharmacy terms. Previously we've covered Hou Xia 后下, and we'll be covering more in the future. I would love to see more Chinese medicine doctors start appending these terms to their prescriptions. It makes your prescription more precise, it helps your herbal pharmacy, and it helps your patients!

One of the coolest things we saw at Mayway's facility in Hebei, China -

- the complete process of how a whole herb gets from the field to us here at Fat Turtle. Keep in mind this is leaving out the whole process of quality control in the field, which we'll cover in another blog post. There is a whole host of site visits, macroscopic examination (which essentially means having a master herbalist/agronomist examine the herbs and see if they have the correct morphology), microscopic examination, testing and et cetera to make sure the herbs are the correct species and fall well under the limits for heavy metals, pesticide residue, et cetera.

(We weren't allowed to take pictures inside the facility, which is too bad, because they had some very cool-looking equipment in there - I'll be supplementing with pictures from the internet.)

Once a batch of herbs has been accepted, it goes something like this:

• Herbs are washed with water from Mayway's on-site well, which is quite deep, although I don't remember if they ever told us exactly how deep.
  
• When we were there, they had uncut Ze Xie 泽泻 (alisma) banging around in a stainless steel washer that looked something like a concrete mixer that was open at both ends - roughly cylindrical, with jets of water shooting in.
  
• The next step is soaking - most herbs have to be thoroughly soaked to make slicing possible.
  
• From there it's on to the slicing. Each herb has a particular way it has to be cut. When we were in there blue-suited workers were feeding long uncut pieces of Sang Bai Pi into a machine that looked quite similar to this one. A blade at the end comes down at regular intervals and turns it into the familiar-looking orange and white piece we use at the pharmacy.
  
• From there it's on to drying. Just as there are several different slicing machines for different herbs, there are a few different drying machines. Some can be dried relatively quickly at high heat without any damage - this machine looks something like a huge industrial bread toaster, similar to this thing. Others, like Ju Hua 菊花 (chrysanthemum) and other flowers, have to be dried gently at relatively low temperatures. These herbs are dried on racks in temperature- and humidity-controlled cabinets that look like this.
  
• After that it's off to sorting. We walked in on a roomful of blue-suited workers hand-sorting Bai Zi Ren 柏子仁 (biotae)... huge piles of tiny seeds on stainless steel tables. If they saw one that was off-color, they threw it out. http://www.blogger.com/img/blank.gif
  
• Next, weighing and packaging. There are at minimum three people involved in packaging any one half-kilo package of raw herb. One person scoops an approximate amount into a bag. The next one weighs it and adjusts it to half a kilo. The third http://www.blogger.com/img/blank.gifperson takes the correct-weight bag and seals it, usually in a vacuum process that sucks all the air out. Mayway then takes another step and double-bags, injecting nitrogen into the space between the two bags. This is to cushion the herbs during transport.
  
  Then the herbs get taken downstairs, where they wait until they've accumulated a shipping container full. The herbs are then trucked to Tianjin, the nearest port city, and it's off to Oakland...

What does all this mean? For one, now we understand why Chinese herbs are relatively expensive. It's only because of the low cost of labor that herbs don't cost more than they already do.

It also has important ramifications for the domestic herb industry. High Falls Garden in upstate New York and the Chinese Medicinal Herb Farm in Northern California are producing small amounts of Chinese herbs every year, and at some point we'll need a facility that can process the herbs. Just as the growth of clinical Chinese medicine pushes the growth of the Chinese pharmacy industry, people who farm or gather Chinese herbs will spur an herb-processing industry.

Just as ranchers need slaughterhouses if they raise cattle on any kind of large scale, the U.S. herb industry will need processing facilities if they hope to grow to a sustainable size. What will these facilities look like? Will herb farming ever become a large enough industry to support such a venture? Maybe the answer is vertical integration - a farm with a processing facility on site, owned by the same people. These are important things to think about for the future. If you have any ideas, please share!

Pharmacy Term of the Day: 后下 Hou Xia

When you write a Chinese herbal formula and send it to Fat Turtle, it's a little bit like telling the cook exactly how you want your eggs. Over easy? Over hard? Scrambled? Sunny side up? Maybe you want something fancy like benedict?

This is the first in an occasional series highlighting the special instructions you as a Chinese medicine doctor can give to us, the herbal pharmacy, to make sure your patient cooks the formula correctly.

Today we'll be looking at the term "Hou Xia" (hòu xià 后下). "Hou" means behind or at the end. "Xia" means down, lower, underneath. A crude translation would be "throw down at the end", giving you the picture of herbs saved off to the side and then "thrown down" into the pot when the cooking is nearly done.

Some typical herbs that are packaged separately and labeled Hou Xia are:

• Mu Xiang 木香 Aucklandia Radix
  
• Sha Ren 砂仁 Amomi Fructus
  
• Cao Dou Kou 草豆蔻 Alpiniae Katsumadai Semen
  
• Da Huang 大黄 Rhei Rhizoma et Radix (when used as a purgative - when used as a blood mover Da Huang should be cooked together with all other herbs)

The rationale for preparing herbs in this way is that there are volatile oils in these herbs that cook off very quickly. Cooking for 5-7 minutes can release these active ingredients into the formula, while cooking longer than that boils them off into vapor.

The vacuum packing service that Fat Turtle offers necessarily cooks all the herbs together at once, even Mu Xiang and Sha Ren. Does this reduce the efficacy of these herbs? Surprisingly, the answer is no. In fact, the effectiveness may even be increased.

An article published in the Zhejiang Journal of Traditional Chinese Medicine (浙江中医杂志 Zhe Jiang Zhong Yi Za Zhi, Vol‐9. 2005; Weiqing Liang, Junxian Zheng, Jinbao Pu, Kemin Wei) found that extraction of flavonoids and alkaloids from herbs decocted in vacuum cookers is higher than traditional stove top cooking. The extraction of alkaloids from Mu Xiang from traditional cooking was 0.045%, while with vacuum cooking the extraction rate was 0.094% - more than double.

越南肉桂 Vietnamese Rou Gui

Watch this video in full screen HD on youtube

Beijing University of Traditional Chinese Medicine Clinic

This is a video I took in March 2010 at the Beijing University of Traditional Chinese Medicine clinic. Watch in awe as the pharmacist bangs out a prescription quickly and accurately using a traditional brass hand scale.

Professional Diversity in the TCM Field

Pharmacy counter at the Beijing University of Traditional Chinese Medicine

Eric Brand makes a very important point in a recent blog about professional diversity in the U.S. TCM field. The recently-released NCCAOM survey says that over 93% of people in the field describe themselves as "practitioner" rather than educator, administrator, or funded researcher - "pharmacist" wasn't even an option, that's how few of us there are! Eric comments:

This stat is also very interesting because it appears that nearly 94% of the people in our profession essentially have the same job. In the Asian world, the profession is much more diverse. Many professionals in Asia are funded researchers, pharmacists, merchants, scholars, advisors, etc. In the NCAAOM survey, 91% of respondents said that they were self-employed, while 30% were both self-employed and employed by others.

Overall, these numbers suggest to me that we tend to focus too much on a single model of a professional identity and lifestyle. Over 35% of respondents said that they felt “poorly prepared” in terms of marketing and PR, and we constantly hear complaints that students find difficulty finding work after graduation. Perhaps we are too focused on the idea that private practice is the ultimate goal of all graduates. Many graduates like to work for other companies rather than fending for themselves, and there are many potential industry jobs available in areas such as herbal quality control. Unfortunately, our teaching programs rarely introduce students to career tracks and lifestyle models beyond private practice. We often have little training in areas such as research or advanced herbal pharmacy, and there is hardly any competition for the jobs in these sectors. Unfortunately for the academic community and industry, there are relatively few graduates that have the skills to fill these jobs.

Hear hear! This is exactly why Nini and I started Fat Turtle Herbs. As the TCM field grows in America, there will be a corresponding need for the specialized field of TCM pharmacy to grow as well. Successful Chinese medicine practitioners simply don't have the time to be their own pharmacist - on top of being your own secretary, business manager, insurance biller, janitor, and assistant, imagine assembling raw herbal formulas or granule formulas for every single patient. It's just not do-able. This time crunch leads many people to rely on pills or simply give up on herbs altogether, which besides being very sad is doing your patients a disservice.

That's where we come in. You might not have the capital or the space for a front office person or insurance biller, but you can always send your herbal formulas to us. In the L.A. area we have a convenient pickup location close to the 405 freeway, and we ship all over the United States (regular shipping arrives the next day in Southern California, two days to the Bay Area).

I was fortunate to have Tom Leung as my Herbs 3 teacher at my TCM school in New York - later I was able to work at his herbal pharmacy Kamwo, which is a traditional Chinatown herb store that's been modernized, upgraded and made friendly to non-Chinese speaking practitioners. That's when I looked around and realized I was surrounded by people who had deep knowledge of herbs, herbal formulas, over-the-counter herbal remedies, herbal preparation and TCM theory. They knew much much more than a new graduate of a typical acupuncture college, were involved in Chinese medicine every day of their working lives, and yet none of them ever touched a needle or treated a patient.

When I moved to Los Angeles to finish my TCM schooling, I looked around for a Kamwo equivalent. Surely there must be one, I thought, this kind of herbal pharmacy is so vital to the TCM community. Herb King in Santa Monica used to perform that role, but the owner unexpectedly died in a car crash and it was bought by the owners of a medical marijuana dispensary, who quickly started selling pot there. The owner of the building then booted them rather than risk having his property seized by the DEA, and that was the end of Herb King. Although they still sell Chinese herbs, it's truly a side line - the vast majority of their business comes from marijuana.

(I worked for a little more than a year at the successor to the Herb King, and I can tell you from personal experience that Chinese pharmacy service is little more than window dressing for them. There are certainly good, earnest L.Acs working there who will assemble an herbal formula for you, but without the support of upper management the Chinese herbs displayed are, as I say, window dressing. Fat Turtle is truly focused on professional Chinese herbal pharmacy services - we don't sell pot. I support medical marijuana and I'm glad it's available to those that need it, but it falls into a special category that L.Acs legally have absolutely no jurisdiction over, and associating ourselves with medical marijuana does nothing to advance the profession or help our patients.)

Whenever I tell L.Acs and TCM students what I do, and that I don't treat patients, I get one of two reactions. 1) The students and newer practitioners get a look on their face like they heard someone died, and say "Oh, wow. That's... I mean..." 2) The more experienced practitioners say "Wow, that's great! How do I order?"

The students and new practitioners are thinking of themselves - everyone is afraid of being "one of those" who doesn't end up practicing, who puts in four years of study and borrowed money and "doesn't use it." I'm here to tell you, don't worry about it! Yes, we need lots of wonderful doctors. But we also need teachers, administrators, researchers, and yes, pharmacists, all working in the TCM field. So if you're halfway through TCM school and are realizing that you don't want to be a doctor, come talk to me. I may have a job for you.

Huang Qi

Huang Qi (黄芪 astragalus) and Mi Zhi Huang Qi (蜜炙黄芪 honey-fried astragalus)

At Fat Turtle Herb Company, Huang Qi is one the most popular herbs. Because it's generally safe in dosages up to 30 grams, practitioners freely prescribe Huang Qi in many different formulas. Yu Ping Feng San (玉屏风散 Jade Windscreen Powder) and Bu Zhong Yi Qi Tang (补中益气汤 Tonify the Middle and Benefit the Qi Decoction) are two of the most popular base formulas that use Huang Qi.

According to an article in Hei Long Jiang Zhong Yi Yao (黑龙江中医药 Heilongjiang Chinese Medicine & Pharmacology), translated and abstracted by Bob Flaws and available for free at Blue Poppy's TCM Infoline, regular Huang Qi is used in Yu Ping Feng San to help secure the exterior, disinhibit water and disperse swelling. Mi Zhi Huang Qi is used in Bu Zhong Yi Qi Tang to "upbear yang & lift the fallen, secure the qi & restrain desertion."

Benksy, Clavey and Stoger's 3rd Edition Materia Medica says that honey-fried Huang Qi

induces the astragalus to travel internally, and to specifically tonify and raise the clear qi of the middle burner. It is also somewhat moistening and is therefore more appropriate when the pattern involves blood deficiency, or dryness of the Spleen.

Chen and Chen's Chinese Medical Herbology and Pharmacology says

unprocessed Huang Qi (fresh or dried) has qualities better suited to treat exterior disorders, as it tonifies wei (defensive) qi, stops perspiration, regulates circulation of water, reduces edema, and promotes generation of flesh. The honey-processed herb has an enhanced ability to treat imbalances of the interior, such as Spleen and Lung qi deficiencies and yang deficiency. It is also commonly used to treat chronic cases of fatigue, diarrhea, organ prolapse, and all cases of deficiency.

When writing prescriptions, make sure you're using the right type of Huang Qi for the condition. Fat Turtle Herb Company carries regular Huang Qi and Mi Zhi Huang Qi in both raw and granule powder format.

More Discussion of Herbal Dosing

Carl Stimson, an American acupuncturist living and working in Tokyo, has some interesting observations on medicinal dosing - you can read part one and part two here.

Running a Chinese pharmacy, I see all different levels of dosing. Some of our practitioners use 12-15 different herbs for each prescription, with 9-15 grams for each herb. Others use as little as 4 herbs and doses of 3-9 grams maximum. Some want their patients to take one bag of raw herbs per day, others one bag every other day. If you're not getting results, dosage might be one aspect of your treatment to consider (obviously a correct diagnosis is number one).

In previous posts, I've recommended using one bag of raw herbs per day, or its equivalent in granule form. While I still feel this is the best option, I have seen many practitioners get results with varied dosage forms, and results are what matter most. Heiner Fruehauf, a member of the Fire Spirit school of Chinese medicine, uses Fu Zi in almost every formula, and in this article cites his teachers in the Fire Spirit school as saying that if a patient feels palpitations and dizziness after taking Fu Zi it's most likely because the dose was too small rather than too high (he's also very specific on the type of Fu Zi used - it must be from Jiangyou County in Sichuan province).

Here's Carl:

When I was a student I remember reading a debate on dosages between several practitioners on a TCM internet discussion group. The argument that American patients did not need as much herbs as Chinese patients because they had not developed any tolerance to herbs was being discussed. One practitioner countered that if a doctor traveled to an isolated island where the inhabitants had never been treated with aspirin or antibiotics, the doctor wouldn't reduce his dosage because of this, he would continue to dose based on weight and severity of the illness. At the time I thought this was a wonderful argument. It illustrated the fact that we are all humans with the same biology and chemistry. I still think the point is an important one, but now I wonder about a related question. I think there is no doubt that a foreign doctor arriving in a new country / culture would continue to dose using the standards he was trained in. However, if the local doctors were given this new medicine, would they continue to follow the same dosage standards after many years of practical experience? It seems, based on what we have seen with acupuncture and pain medication, that there is no guarantee the local doctors would not develop different dosage standards.

So why does this happen? After all, the human body is the human body, no matter if it is American, Chinese, or any culture. It is subject to the laws of science no matter what national borders the body is living in. I believe that differences in dosage standards across cultural lines has very little to do with science, and mostly involves differences in each culture's relationship to health and medicine. In China, many patients will not be satisfied with an acupuncture treatment that is not painful, while in the US and Japan, a practitioner is unlikely to be in practice very long if his/her treatments cause much pain. Perhaps the Chinese have more faith in the "No pain, no gain" principle. The difference in pain medication dosages between the US and Japan probably reveals the fact that being able to withstand suffering without complaint is highly valued (and expected) in Japanese society. I have also heard that US doctors start to give medication for blood pressure and cholesterol at lower levels than Japan. This could reflect a tendency of Americans to be more proactive in using outside means to control nature. It could also reflect the pervasive paranoia about liability in America.

While it is true that we are all human beings and subject to the laws of science, let's remember that the laws of science are essentially a crude way of describing the laws of nature. The Daoist tradition has a much more elegant, somewhat less exact but much more complete way of describing nature, based on the the concepts of Wu Ji, Tai Ji (yin and yang), the five phases, ba gua and so on. When you look at humans from this perspective, it helps you remember that people get sick in different ways all over the world. So when the hypothetical doctors arrive on the island, why are they giving out aspirin and antibiotics in the first place? What criteria are they using to evaluate local people and their illnesses, and are those criteria valid?

There is a trope in Chinese medicine that Northerners (northern Chinese) come from a cold climate and therefore need higher doses, take to warming tonics better, and when they catch wind (cold) need stronger exterior-releasing herbs. Southerners (southern Chinese) come from a warmer climate and therefore usually need lower doses, and when they catch wind need a different treatment strategy. So of course people in places as different as China, Japan and the U.S. need different dosages.

In a heterogeneous society like the U.S., you'll treat all different body types and all different ethnicities. Some of your patients were born in faraway places, some were born around the corner from your office. Don't get caught up in dogma, whether it relates to dosing, diagnosing, or anything else. Evaluate each patient individually and decide what's appropriate for their situation.

See also: How much is in a qian? by Eric Brand

Pao Zhi Herbs

Bai Shao and Chao Bai Shao. For more pictures of pao zhi herbs, follow the #paozhi tag on twitter

Pao Zhi 炮制 refers to the preparation of Chinese medicinal herbs. All herbs are prepared in one way or another by the time they appear in your local Chinese herb pharmacy. Some are simply washed, cut in a particular way and dried. Others undergo a more intensive preparation process to reduce toxicity and enhance medicinal effect.

Ban Xia 半夏, for instance, is prepared with either lime (calcium oxide) or ginger juice for several days before it takes on the appearance we're used to seeing. Turning Sheng Di Huang 生地黄 into Shu Di Huang 熟地黄 involves steaming the cut pieces over wine for several hours until they become much darker and deeper black (if you have an I.D. test, don't fret over Sheng Di vs. Shu Di - Sheng Di usually always has a little bit of brown somewhere on it. Shu Di will be deep black all over).

Other herbs can be processed with liquid adjuvants. The most obvious example is Gan Cao 甘草 and 炙甘草 Zhi Gan Cao. Zhi Gan Cao, of course, is prepared with honey, making it much sweeter and a stronger qi tonic than regular Gan Cao (or Sheng Gan Cao 生甘草, as it's sometimes called, to distinguish it from its honeyfied cousin). Cu Chao Chai Hu 醋炒柴胡, or vinegar-fried bupleurum, is used to direct the action of the herb to the Liver channel (because vinegar is sour and sour is the flavor associated with the Wood phase) and according to Bensky enhances the ability of Chai Hu "to soothe the Liver, harmonize the blood, and stop pain." I would guess that it also warms the herb considerably (regular Chai Hu is cool to cold).

Fat Turtle Herb Company makes many of these herbs available for your use as practitioners. Below is a short summary of the major differences between the processed and unprocessed versions of some of these herbs. For more information in English take a look at Philippe Sionneau's pao zhi book, translated by the ubiquitous Bob Flaws. The end section of each herb monograph of the third edition of the Materia Medica by Bensky et al also has good information on different herb preparations. I haven't had a chance to look at it yet, but I would be surprised if Eric Brand and Nigel Wiseman's Concise Materia Medica didn't have some excellent info on pao zhi as well.

• Bai Shao: Bitter and sour, slightly cold. Settles the Liver, downbears yang, nourishes the Liver, restrains yin.
  
• Chao Bai Shao: Bitter, sour, astringent, neutral temperature. Soothes the Liver, harmonizes the Spleen, stops diarrhea.

• Bai Zhu: Sweet, bitter, warm. Fortifies the Spleen, dries dampness, disinhibits urination, disperses swelling. Better at drying dampness.
  
• Chao Bai Zhu: Sweet, bitter, warm. Fortifies the Spleen, supplements the qi. This is a better Spleen qi tonic.

• Huang Qi: Sweet, slightly warm. Secures the exterior, stops perspiration, disinhibits urination, disperses swelling, outthrusts pus and toxins.
  
• Mi Zhi Huang Qi: Sweet, slightly warm, slightly moistening. Supplements Lung qi, tends to moisten dampness, supplements vacuity.

There are many more pao zhi preparation available. Licensed acupuncturists and students at TCM colleges call 310-691-5226 or email orders@fatturtleherbs.com to check if the herb you want is available.

Note: granule practitioners don't feel left out! We have many pao zhi preparations available in granule format as well.

Fat Turtle Herb Company: We're Just Like Google

Fat Turtle Herb Company is under cyberattack from China! Or is it?

Last night I got this email:

from: Robert Meng
date: Thu, Jan 14, 2010 at 9:24 PM
subject: Urgently-fatturtleherbs Domain names Announcement

(If you are not the person who is in charge of this, please forward to the right person/ department, this is urgent, thank you.)

Dear CEO,

We are the department of registration service in China. we have something need to confirm with you. We formally received an application on Jan.14, 2010, One company which is called " Tatief Trading Co.,LTD. " is applying to register "fatturtleherbs" as brand name and domain names as below :

fatturtleherbs.asia
fatturtleherbs.cn
fatturtleherbs.com.cn
fatturtleherbs.com.hk
fatturtleherbs.com.tw
fatturtleherbs.hk
fatturtleherbs.in
fatturtleherbs.net.cn
fatturtleherbs.org.cn
fatturtleherbs.tw

After our initial checking, we found the brand name and these domain names being applied are as same as your company's, so we need to confirm with your company. If the aforesaid company is your business partner or your subsidiary company, please DO NOT reply us, we will approve the application automatically. If you have no any relationship with this company, please contact us within 7 workdays. If out of the deadline, we will approve the application submitted by " Tatief Trading Co.,LTD ." unconditionally.

Best Regards,

Robert Meng
Senior consultant

A range of thoughts and emotions went through me, in roughly this order:
1. Okay, is this spam?
2. Wait, it looks pretty real. Shit!
3. What's the difference between a copyright and a trademark?
4. Damn the Chinese!
5. Man, we're so big that someone wants to cybersquat on some associated domain names. Oh yeah....

I looked up Tatief Trading Co. Nothing. I looked up FoWa, the company where the email originated from - it seems to be a domain-registration company based in Shanghai. I noticed that the email from Robert Meng came from a .com address, whereas FoWa has a .org address. So I sent an email to the general inquiries desk at FoWa, rather than replying to Robert (what if, by replying, I install some sort of weird virus or tracking software on my computer?). Of course I told them that we are NOT affiliated in any way with the aforementioned company.

After about a half hour, I calmed down. Who cares if someone takes those domain names in Taiwan and China? We're not planning on opening up operations overseas. Pharmacy is a very local business - patients need herbs, now. And I'm not about to pay to reserve "fatturtleherbs.whatever" for every single country, because there are a zillion of them.

So, in closing, remember that www.fatturtleherbs.com is the only legitimate web address for Fat Turtle Herb Company. Thanks!

Fat Turtle Herb Company at Hội Chợ Tết in Little Saigon

Fat Turtle Herb Company will be at the Vietnamese New Year's Festival - Hội Chợ Tết - in Little Saigon this weekend, January 24th and 25th. Come on by and get a free health screening. We will have selections from our vast inventory for sale, as well as some special items made just for the occasion.

Our booth will be at the Westminster Mall, conveniently located off the 405 Freeway's Goldenwest Exit, on the corner of Goldenwest Street and Bolsa Avenue in Westminster, California.

I've never been to a Tet celebration, so I'm pretty excited. Nini tells me it's "kind of a big deal", as the T-shirt says. To learn more about Tet, click here.

 

How To Cook Chinese Herbs

In the modern age, there are many ways to take your Chinese herbal formulas. But preparing your herbs the traditional way does have some advantages.

1. Strength. Modern technologies are all aimed at reproducing the strength of stove top cooking. While they have come close, they still can't equal what you can do in your kitchen.

2. Control. With the herbs right in front of you, you know exactly what goes into your herbal tea. Your acupuncturist may give you special instructions on whether to cook your herbs for a long time or a short time, your even whether to cook some ingredients separately.

3. Time. The cooking process forces us to slow down from the busy pace of our lives and concentrate on doing something good for ourselves. Instead of popping a pill and forgetting about it, we become more engaged in our recovery to good health.

4. Aroma. Now, this might not be a positive for some people. But we absorb just as much information from our sense of smell as we do from our other senses, and the aroma of your herbs cooking on the stove signals your body that something profound is about to happen.

5. Steam, Dregs. There are many uses for Chinese herbs other than drinking the tea. For acne or skin-related formulas, your acupuncturist may tell you to steam your face over the herbs (be very careful not to burn yourself if you do this - wait until the tea has cooled significantly, enough so that you can safely put your face or other affected body part over the steam). Or they may suggest using the cooked herbs themselves, rather than the tea, as a poultice on a particular acupuncture point or region of the body. Be sure to follow your acupuncturist's directions in this regard.

How to Cook Chinese Herbs

Keeping in mind that your Chinese medicine doctor may have special instructions for you, here are some general guidelines on cooking herbal teas.

1. Put the herbs into a pot. The best type of pot to use is a traditional ceramic herb pot. Enamel ware such as Le Creuset is also a good choice, and stainless steel will work fine as well. Just be sure to avoid aluminum pots as the herbs may react with some of the constituents of the pot.

2. Cover with cold, clean water. How much water should you use? A general guideline is two fingers above the level of the herbs, but you may have some herbs that float or very bulky, grassy herbs, in which case you can use about 5 cups.

3. Let soak for at least 30 minutes.

3a. Some people advise to then pour off this soaking water and cover the herbs again with more cold water. If you do this, be careful that you don't lose any herb material down the drain. Remember to not soak any powders as these will mix with the water and be poured off.

4. Turn the heat to high and bring to a boil.

5. Once boiling, turn down the heat to medium and simmer for about 25 minutes, or until you have about one cup of liquid left, and then pour off the decoction (use a strainer to catch any herb matter). If you are new to cooking Chinese herbs, check the water level occasionally to make sure you don't boil the herbs dry. If you do happen to burn the herbs, throw them out and start again with a fresh packet - burning the herbs completely changes their character.

6. Let the decoction cool a bit, and drink while still warm.

6a. Some herb doctors will tell you to cook the herbs again, using the same herbs but more water, BEFORE you drink your herbs. Then you combine the results with the first batch and divide them. You will then have two doses, one for the morning and one for the evening. The idea is that the second cooking extracts more active ingredients than could be achieved by simply cooking it once for a longer period of time. However some people think this is unnecessary. Ask your Chinese medicine professional which procedure to follow.

7. Do not mix any sugar or honey with your herbs, unless your Chinese medicine doctor has instructed you to. If the taste puts you off, you drink something sweet or have a small spoonful of honey directly afterwards.

8. Congratulations! You have just participated a very old tradition that still brings great benefit to our modern lives.

Case Study: Me!

Pre-cooked liquid decoction in individual dosage packs from Fat Turtle Herb Company







From the taste-of-your-own-medicine department, I bring you the success story of my current herbal formula. (Note: This post is a bit more technical than most and skips over explaining any TCM basics - if you have questions please leave a comment.) Starting a few weeks ago, I developed a rash on my stomach and legs - essentially the Liver and Gallbladder channels. In general I tend to express rashes when I have emotional stagnation. Emotional stagnation, in my case, leads to overconsumption of sugar, coffee, alcohol, and greasy, fatty foods.

The aforementioned goodies in small amounts will soften the Liver, but in large amounts will increase the amount of heat and dampness in the body. Then I went home for Christmas, where there was plenty of sugar and alcohol and fatty food and emotional stagnation.

I used the opportunity of a family outing for dim sum to get an exam and an herbal prescription from one of the herb stores in Oakland Chinatown (Hong Kong Trading, 449 9th St. at Broadway if you're interested). I poked my head in and asked "医生在吗？" (is the doctor here?) The guy at the counter pointed to the back, and I went and sat down at a desk. A few minutes later the same guy (the doctor, as it turns out) came back, sat down on the other side of the desk, and with a friendly smile started asking me questions in Chinese.

How I should have responded: "医生对不起，我只会说一点中文。可以我给你看？" (Doctor, my apologies, I only speak a little Chinese. Can I just show you?) - which is actually something I know how to say.

What I actually did: laughed nervously, said "uhh, I don't really speak Chinese," and lifted up my shirt to show him my rash. Sigh. He looked a little bit shocked, possibly because my accent when asking for the doctor was quite good, but also possibly because he didn't expect me to start acting like an undergrad on spring break in his herb store.

As a result of the language difficulties, we had a four-way translation - the doctor would ask questions in Cantonese to one of the other women who worked in the store, who would then ask Nini the same question in Vietnamese. Nini would then ask me the question in English, I would answer in English, and the whole thing goes in reverse. Fortunately experienced doctors are efficient when it comes to questioning and gather more from the tongue and pulse. The tongue he glanced at for a few seconds, but the pulse he took for a few minutes.

He told me to avoid beef, shellfish, spicy food, and deep fried food.

"What about alcohol?" Nini asked the lady. The woman translated for the doctor, who then shook his head and made a tsk-tsk noise. No no no, came the answer. "See?" said Nini.

"咖啡行不行" (how about coffee?) I asked the doctor directly, trying to preserve some tastiness in my life. Coffee's okay, just don't overdo it, he told me.

Then he proceeded to write an herbal formula in long, looping Chinese characters which I had no hope of deciphering even if I had the chance to examine them closely. Having been to a few herb-store doctors, I feel like that's part of the trade secrecy: even if someone were to steal your notebooks, they can't read your handwriting.

After writing the formula, he then went back to the counter and assembled it, with help from some other employees. Fortunately I was able to ID all the herbs and reverse-engineered it to pinyin, but then lost the page I wrote it all down on. However, I do remember some key herbs:

玄参 Xuan Shen
生地 Sheng Di
牡丹皮 Mu Dan Pi
土茯苓 Tu Fu Ling
金银花 Jin Yin Hua
丹参 Dan Shen
红藤 Hong Teng
郁金 Yu Jin
枳实 Zhi Shi
地肤子 Di Fu Zi
白鲜皮 Bai Xian Pi
泽泻 Ze Xie
柴胡 Chai Hu
甘草 Gan Cao

That's 14 herbs I can remember - there were actually 21 altogether. But you can see his idea: Blood Heat, Blood Stasis, Qi Stagnation.

I've been taking the formula for a few days now, and the rash has already subsided quite a bit. The redness is gone and it no longer itches. The formula actually doesn't taste that bad - it's more sweet than bitter, definitely cold energetically.

I've also noticed that it's harder than it seems to stick to a restricted diet. I know there are things I should avoid, but until a doctor told me I essentially have been eating whatever I want. I didn't want to take all these herbs and have it be for nothing! I don't think I'll be on this diet permanently, but it's still a bit of a hassle. Something to remember when asking patients to change their diets.

As you can see from the picture, I cooked the herbs all at once and packaged them using the Fat Turtle herb cooker. This is so convenient when taking a large formula or a long-term formula. Whenever it's time to take herbs, I just cut one open and drink it. Total time spent on herbs per day: 10 seconds. No refrigeration is required. Fat Turtle Herb Company can cook herbal formulas for you and your patients - click here to learn more or send an email to orders@fatturtleherbs.com.

Chinese Pharmacy Pictures

As long as we're looking at pictures, here are some beautiful pictures of traditional Chinese pharmacies.











Credits: Eric Lafforgue, solemnyeti, cblee, *Alexander*, Holly Gilbert. All these and more found on flickr.

Introduction to a Chinese Herbal Pharmacy Part Two

We continue today with a short explanation of Chinese herbal formulas, from the same people who brought you yesterday's video.

Introduction to a Chinese Herbal Pharmacy

This video is a good introduction to a typical Chinese herbal pharmacy that you might find in any major American city's Chinatown.

I feel obligated to point out that the doctor made one glaring error. 党参 Dang Shen (the long wrinkled-looking root) is not a type of ginseng. Ginseng is part of the Panax family. Dang Shen is a type of codonopsis. They do have similar functions, but don't let anyone try and sell you Dang Shen as a type of ginseng.

Chinese Medicine Pharmacy

Take a look at this gorgeous Chinese medicine pharmacy. I don't know where this picture came from, but it's a nice example of a beautiful herbal pharmacy. A friend of mine went to China earlier this year and saw many pharmacies just like this.

If you're unfamiliar with Chinese herbal pharmacies, it's worth a trip to your local Chinatown to see one in action. You probably won't see one as nice as the one in this picture, but the idea is the same. You walk in with your prescription from your herbalist and hand it to someone behind the counter. They'll price it for you and, once you give the okay, will start assembling the formula.

A typical Chinese herbal prescription contains anywhere from 4-18 different ingredients. Each one has to be weighed and measured out - this all takes place on the counter in front of you, so you can see what's going on. If you want to get all Chinese about it, you can criticize the herbal pharmacists as they go about their job, telling them to give you the high-grade herbs or asking if they're sure they weighed everything correctly. Of course, this has to be done in Chinese, preferably in the dialect that the herbalists are familiar with.