Dose is the Secret That is Never Taught

In this TCM Talk we examine the case that modern standard Chinese herbal medicine practice often uses a narrower dose range than is appropriate. Appropriateness, yi (宜) appears in the historical literature as a key virtue of a good physician and is an issue that applies to all aspects of practice including acupuncture. Referencing the historical fangji literature as well as his clinical experience of prescribing Chinese herbs for westerners over the past 35 years Charles concludes that some patients respond to doses that might be considered ineffectual in modern China, whilst others require doses in excess of the standard bencao recommendations.

The wide range of doses seen in the historical literature is explained as being a consequence of differences in conceptualisation of causality between the ancient and modern worlds. In modern times we tend to think in terms of pharmaceutical dose-response curves, in ancient China the relationship between medicinal interventions and patient physiology was understood in terms of resonance between substances possessing related qualities. The more similar things are the more strongly they
influence each other, an idea that might seem at first to be esoteric but has some credence in rationality.

To illustrate the narrative we will look at a few case histories, reference some historical literature, examine some pharmacology that hints of standard dose-response curve anomalies. To conclude Charles offer some ideas on how we might begin to address the challenges of this “secret that is never taught” question in our secret that is never taught question in our clinical work.

Provider: TCM Academy