Eighteen controversial herb pairs
You may learn
from your textbook TCM that there are some herbs that should not
be used at all at the same time with other herbs in one formula.
It is called the Eighteen controversial herb pairs.
It tells us that
the herb Gancao should not be used together with other herbs
such as Gansui, Daji, Haizao, and Yuanhua. Wutou should not be
used at the same time with Banxia, Gualu, Beimu, Baiji, and
Baijian. Lilu should not be used at the same time with Xixing,
Shaoyao and the herbs with the name of Shen.
There are another herbs that should be
careful when used at the same time: Luhuang with Puxiao; Shuiyin
with Pishuang; Langdu with Mituozen; Badou with Qianniu;
Dingxiang with Yujing; Wutou with Xijiao; Yaxiao with Sanlen;
Guangui with Shizhi; and Renshen with Wulinzhi.
It is well known that a current famous TCM
doctor, Dr. Zhu Liangchun, has been using both Gancao and Haizao
to treat lymphatic tuberculosis,
hyperthyroidism
and goiter, to use Rensheng and Wulinzhi to treat chronic
gastritis, duodenal ulcer; to use Gansui and Gancao to treat
pleural tuberculosis and more.
In practice in history, this comment is in a large debate
though it is taught in the textbook.
It has been summarized that there are more than 565 formula
contain such controversial formula in a formula that have been
proven effective in clinic. Even from the modern TCM books
published in << Quan Guo Zhong Chen Yao Chu Fan Ji>>, a summery
book of currently used herb formula, we can find 34 oral herbal
formula and 68 non-oral herb formula that contain such
controversial herb pairs.
There have been a extensive researches to test if the herb pairs
are really more toxic when used together. The results are
controversial too. Some study say yes, they are more toxic when
used together, but it is dose-depended phenomenon and the toxic
also depends on how to give the herbs to the experimental
animals, orally or not.
It is still hard to know how the saying of the theory of the
eighteen controversial herb pair is proposed. It is suggested
that when the herb are used in different dose, their toxic
effect is different (dose-dependent phenomenon as all most all
chemical drugs), but it might be not so toxic when there is more
other herbs in the same formula. As we know well that the toxic
effect of a herb with the name of Wutou, can be largely reduced
by using honey, Gancao, of green bean in the formula.
There has been several very famous TCM
doctors in China
suggesting to remove this concept from the textbook. The caution
that we have to pay when we use these herbs together is pretty
much the same as we use other herbs. We wish that the Chinese
TCM authority can spend more effort to help to clarify this very
important question. For us, we suggest that we should still use
the herbs if it is well recognized formula before. So many
times, we have to depend on such herbs to treat tough cases.
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