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The theories behind Chinese herbal formulas were laid out more than 2,000 years ago in the Classical Chinese text, the Huang Di Nei Jing (the Yellow Emperor’s Classic). Interestingly from an anthropological standpoint, some Chinese Medicine constructs are similar philosophically to the ideas ascribed to Hippocrates (the Greek physician known as the “Father of Medicine” who also lived about 2000 years ago). Numerous other Classics of Chinese Medicine followed over time, written by different physicians, each adding to the knowledge base of the Yellow Emperor’s Classic.

Chinese Medicine places great emphasis on being in harmony with nature, and in the unity between body and mind. The physical body and the mind (represented by thoughts, emotions and feelings) are not separated in Chinese Medicine, and the role of emotions in the development of disease and in association with disease is clearly recognized and treated. Chinese Medicine emphasizes the prevention of disease, and the use of foods and gentle exercise to prevent and cure diseases.

Over time it was discovered that combining herbs was more effective than using them individually, and this tradition of combining herbs led to the potential of fewer side effects and greater efficacy. Over the years, formulas have been tried and tested; toxic herbs are no longer used, adverse effects have been discovered and recorded, and only the most effective and safe formulas remain in use. Unfortunately, several herbs have been more recently banned not because they caused adverse effects when used for their intended purpose, but because they were misused. 

Ma Huang (Ephedra) was banned in the United States in 2004. This is an example of the misuse of an herb that has been safely used as an antiasthmatic for 2,000 years, because it was combined with caffeine for weight loss. This causes the sympathetic nervous system to kick into overdrive. This is especially dangerous in obese patients whose sympathetic nervous systems are already in overdrive. The result of this misuse of Ephedra combined with caffeine is cardiovascular toxicity and hepatotoxicity. In Chinese Medicine, Ephedra is never combined with caffeine. Ephedra is used as an extremely effective bronchodilator for asthma, coughs and colds.  (Reference, Ma Huang: Setting the Record Straight).  In other cases, herbs have been banned because of newly discovered toxicities.

Why do we combine herbs and not use them singly? Because the combination of herbs produces a better and safer effect than any of the herbs used alone. A commonly prescribed herbal formula is called Yu Ping Feng San, or Jade Windscreen. It was described around 1300 AD and consists of Astragali Radix (Huang Qi), Atractylodis Macrocephalae Rhizoma (Bai Zhu), and  Saposhnikoviae Radix  (Fang Feng). It is used to prevent colds and flus, to boost immunity, and also to treat viral & bacterial upper respiratory tract infections. It’s anti-viral and anti-bacterial properties are found be enhanced by the combination of the herbs. None of the herbs studied alone exhibit as much effect as in combination. The formula is found to increase macrophage phagocytic activity and have anti-inflammatory effects. Interestingly it simultaneously stimulates pro-inflammatory cytokines, creating a unique modulating effect on the immune system. This formula was used very effectively in conjunction with Western pharmaceuticals in Hong Kong during the 2003 SARS outbreak. Several other formula studies have similarly found that the pharmaceutical effects and solubility of the active ingredients in the formulas is enhanced as compared to that of the single ingredients alone.

Consider this: Aspirin was the first (non-harmful) prescription drug synthesized and used beginning around 1899—about 100 years ago. Chinese herbs and formulas were described and tested by numerous physicians and used on plentiful numbers of patients who were separated by vast periods of time, and they continue to be in use today, 2,000 or more years later. The mechanisms by which the formulas work are beyond the effect of a single active ingredient or set of ingredients, and more because of the way in which the individual herbs act in combination. This is where the science and art of combining herbs into formulas comes into play. There is much interest in the active ingredients of Chinese herbs, active ingredients are known, and indeed some have been isolated and synthesized as prescription drugs.