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September 2, 2021

What’s an Herbal Medicine “formula” All About?

A plate of of a variety of different dried herbs, spices, and fruit used in Eastern medicine

Herbal medicines & herbal supplements have grown in popularity in recent years; they’re on grocery shelves and promoted in the pages of beauty magazines. You may reach for Elderberry and Echinacea at the first sign of a cold or flu or put “Functional Mushrooms” in your smoothies for their promises of extra brain-power or smooth skin. So what’s the difference between picking up recommended herbs off the co-op shelf and visiting an East Asian Medicine-trained Herbalist?

What Are Herbal Properties?

In East Asian Medicine, we study herbs for their many properties: they all have a taste, a temperature, a set of channels they enter, a main category of function, and secondary functions. Many have regions of the body that they have an affinity for or can guide to. Let’s take one of East Asian Medicine’s most famous & sought after herbs to see how this works:

Two ginseng roots photographed laying on top of a bed of moss

Ren Shen, Ginseng

  • Temperature: Slightly Warm
  • Taste: Sweet, Slightly Bitter
  • Channels Entered: Lung, Spleen
  • Category: Tonify Qi
  • Functions:
    • Tonify the Original Qi.
    • Tonify Spleen & Stomach (Digestive) Qi.
    • Generate body fluids & stop thirst.
    • Tonify Heart Qi & calm spirit.
    • Treat impotence related to Kidney yang.

Looking at all these functions, it would seem that Ren Shen could be considered a panacea for any fatigue, exhaustion, anxiety, or digestive sluggishness. So why is an East Asian Medicine herbalist much more likely to prescribe a formula that includes Ren Shen, like Si Jun Zi Tang, than Ren Shen alone for our patients?

Balance & Harmony

Because we know that everything in life and everything in the body is connected, an herbalist knows that using a strong, tonifying herb like Ren Shen to prop up the Qi without looking at the whole system could invite some unintended consequences. If Qi is the thing responsible for warming and lifting the muscles and organs, what will happen to someone who is exhausted and menopausal with hot flashes? If this person doesn’t have the Yin to support such a big boost in Qi, we could be setting them up for a sweaty disaster.

What about someone with sluggish digestion who also has hypertension headaches where their face flushes and their head hurts? Patients with these “Liver Yang Rising” symptoms could get worse from taking Ren Shen even though it’s energy boosts may appeal to their high-achieving work ethic.

These patients can still have a formula that includes Ren Shen– or its more mild cousin Dang Shen– when we apply the basic principles of formula building in East Asian Medicine.

Building Formulas

To build a well-balanced formula, the Classical texts teach us that each formula should ideally have:

  • Chief: The main herb to address the primary issue at hand.
  • Deputy: One or more herbs that also address the primary concern or secondary symptoms related to the chief complaint.
  • Assistants: Herbs that mitigate any unwanted effects of the Chief & Assistant herbs and help bring the formula together as one working unit. Often include “harmonizing” herbs that aid in the digestion of the formula itself.
  • Envoy: An herb or herbs that guide the formula to the specific channels, areas of the body, or organs the formula is designed for.

Classical Chinese Medicine often borrows metaphors from everyday life in the era and culture that birthed it; the metaphor of Chief or King, Deputies, Assistants, and an Envoy helps bring life and understanding to the dynamic, strategic role each herb plays in a given formula. As we build a formula or customize a Classical formula from one of the great herbalists of history, we look at the temperatures, tastes, regions of the body, and functions of each herb to ensure that the formula won’t be too harsh, too hot or too cold, too hard to digest, too uplifting or downbearing, or any one of a hundred other factors at play in formulation.

It is both an art and a science that our student interns spend over 3 years learning to perfect in our classrooms and clinic.

Formulating with Ren Shen

We name dropped Si Jun Zi Tang earlier– it’s one of East Asian Medicine’s most famous & beloved formulas. The simple four-herb Qi Building formula is a building block for many others. Let’s take a look at how the effects of Ren Shen can be enhanced and balanced in a thoughtful formula.

  • Chief: Ren Shen, Ginseng– Powerfully tonifies Qi.
  • Deputy: Bai Zhu, Atractylodes–Tonifies Qi.
  • Assistant: Fu Ling, Poria– Drains Dampness. Moderates Ren Shen & Bai Zhu’s uplifting, warming features with some gentle downward, elimination-oriented effects for balance & harmony.
  • Envoy: Gan Cao, Licorice– Guides the Qi of the formula to the Middle Burner, or the digestive system, & harmonizes the formula.

There are many formulas that further build on the harmony of Su Jun Zi Tang and add more layers of complexity to the clinical picture: Liu Jun Zi Tang, Shen Ling Bai Zhu San, and Gui Pi Tang to name just a few.

Whole Picture Medicine

We can bring in an example from Pharmaceutical History to demonstrate the advantages of looking at the whole picture & using whole plant medicines rather than extractions, synthetic versions, or even single herbs rather than whole formulas.

Willow Bark and Aspirin

Close up photo of richly colored green willow leaves
Aspirin was developed from Willow bark, which was a traditional medicine in Indigenous communities across Europe, parts of Northern Africa, & North America. Chemists of the late 1800’s isolated Salicylic Acid as the “active ingredient” at work in this plant medicine, and set about finding a synthetic version. They successfully created acetylsalicylic acid and gave birth to Aspirin.

The trouble with this story is that salicylic acid is much less abundant in Willow bark than in a dose of aspirin, and yet Willow Bark has a powerful analgesic and anti-inflammatory effect just like high dose Aspirin. What’s more, Willow Bark does not damage the gastric mucosal lining as we know Aspirin does. With more investigation over 100 years after the discovery of the wonder-drug Aspirin, we now know that the flavanoids and polyphenols of Willow bark are an important part of it’s therapeutic effect and are even more beneficial than salycylic acid alone.

Zooming out, this lesson even extends to combining plants– the compounds in each plant can build on another’s potency, balance effects, and help our bodies integrate their medicines.

Try an Herbal Formula

Want to see the difference that a custom herbal blend can make for you? Check in with one of our Clinic Interns or Professional Acupuncturists at the AIMC Berkeley Clinic to get your custom blend. Book your appointment, where we can offer you individualized treatment advice and create an herbal medicine prescription that is tailored to you.

Learn Herbal Medicine

Come study at AIMC! AIMC Masters & Doctorate students start learning Herbal Medicine in their very first trimester and continue building on that foundation throughout their several years of training. Learn the difference combining Eastern and Western medicine can make, for you and your patients. Contact us with any questions you may have.

About the Author

White woman with wide brim straw hat on holds a white and brown dog and smiles in front of snowy mount and frozen lake scene on a sunny dayAlly Magill is a recent AIMC graduate with a background in birthwork as a labor and postpartum doula, outdoor education, and the management of thriving community acupuncture clinics. Her mission in her practice and life is to co-create a world where individuals and families are living into their own epic radiance and embodied wellness. She studied Five Element Acupuncture at the Maryland University of Integrative Health before joining AIMC for the herbal & integrative medicine portion of her Master’s degree. She has had the opportunity to study the teachings of Daoist master Jeffrey Yuen through his students & incorporates Classical Chinese Medicine into her practice.

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