“It is quite important to know what kind of a patient the disease has got as to know what kind of disease the patient has got.”

– Walter Moxon, attributed to William Osler, the father of modern medicine and many others who may have held the same opinion, including Hippocrates

With over 40 years of clinical experience as a TCM doctor, and bookshelves full of Chinese, Western and Ayurvedic herbal formularies which I eagerly snatched up as soon as they were published,  I didn’t think I needed another TCM formulary book. However, my interest was piqued when I received an email describing the Handbook of Formulas in Chinese Medicine (2016, Eastland Press) by Volker Scheid and Andrew Ellis.

I respect both of these TCM doctor-scholars, who are authors of numerous articles and definitive TCM books texts which I admire. They had already participated in translating and writing the exhaustive formulary tome, CHINESE HERBAL MEDICINE: FORMULAS AND STRATEGIES (second edition 2015, Eastland Press) that was chock full of pages of information on the most-used formulas in the practice of TCM. As great as that book is, I, like many of my colleagues and students, found it to be too bulky and heavy to use when I need to quickly decide the best formula to give to a patient who may be waiting in an adjoining treatment room or online.

Perhaps in light of such feedback, the authors realized that there was still a need for a quick clinical reference manual, one that could be used in the clinic and also as an aid to learn the most salient information on a large number of TCM formulas.

This is what the Handbook of Formulas in Chinese Medicine is.  As described by the publisher, the handbook “is intended as a visual reference to over 180 of the most important formulas used in Chinese medicine,” providing a snapshot of each formula to assist the reader in finding key information quickly and easily. As such, it could be considered a supplement to Formulas and Strategies.  The fact is that while definitive reference texts are extremely important, of greater practical importance is the need for concise clinical manuals and formularies.

Help Remembering Herbs and Formulas

Materia medica and herbal formularies are the heart and soul of herbal medicine. I have read and heard of dedicated traditional herb doctors who begin each day reviewing and writing about herbs, formulas and treatments for various diseases. There is always so much to know, and without having a photographic memory, doctors and researchers must rely on various mnemonic tricks to retain the information and keep it accessible when a patient appears to need just that one formula.

One such memory aid used by Chinese herb doctors was to sing the ingredients and dosage of herbal formulas. Because of this, they came to be known by patients as ‘singing doctors.’

There are no songs attached to the formulas in Handbook of Formulas in Chinese Medicine, but colors, graphics and a conscientious attempt to limit the information of each formula to just two facing pages help make it easy to remember the formula and its uses. On the left page there is a drawing of a person depicting the general type of patient for whom a particular formula might be indicated. Listed along either side of the drawing are a few of the key symptoms. Beneath that is a list of the secondary symptoms, tongue, pulse and abdominal  diagnostic patterns. This last, probably adopted from Japanese Kanpo medicine, is an innovation for a Chinese formulary. It suggests that with globalization, many traditions are adopted between different cultures, something I refer to as “planetary herbalism.”

On the right facing page is a display of the formula, with each of the ingredients effectively color-coded to show taste, temperature, and the overall nature of the formula – warming, cooling, neutral etc. – all can be seen at a glance. Also included is the pharmacological role for each formula ingredient (chief, deputy, assistant, envoy).

If one needed more information than is available in this format, CHINESE HERBAL MEDICINE: FORMULAS AND STRATEGIES, compiled and written by Scheid and Ellis with Dan Bensky and Randall Barolet, would be a natural partner resource.

Still another excellent, but equally bulky text is Chinese Herbal Formulas and Applications by John and Tina Chen.

Comparison with Handbook of Chinese Formulas by Him-che Yeung

Scheid and Ellis’ Handbook of Formulas in Chinese Medicine reminds me of Handbook of Chinese Formulas by Him-che Yeung self-published in 1995. I relied on this text in my early years as a TCM practitioner, and I’m happy to say it is still available. It is a great book that I still use and recommend to all of my students.

Besides having a far superior binding and a size appropriate as a clinical manual, Scheid and Ellis’ Handbook of Formulas in Chinese Medicine has many features as mentioned above for each of 160 plus formulas displayed on two pages in a colorfully attractive and most memorable way.

Him-che Yeung’s book, on the other hand, contains 316 formulas, one formula to a page, but does not include all included in Scheid and Ellis’ book, such as “Worry-Free Formula to Protect Birth” (Bao chan wu you fang) for threatened miscarriage. They both win points for brevity and ease of accessing the most essential information. Both books are definitely worth owning.

Perhaps I’m old-fashioned, but I prefer the older Him-che Yeung book because of its far superior index according to Western diseases (after all it is intended for Western Chinese herbalists) with sections differentiating SHANG HAN LUN (Six Stages) formulas, WEN BING LUN (epidemic febrile diseases),  ZANG-FU Internal diseases classified as XU (deficiency) and SHI (excessive) syndromes and internal organ or ZANG-FU pattern diseases.

These are the main ways a TCM diagnosis may be arrived at. However, before 1995 Chinese diagnosis was mainly thought to be based on pattern discrimination. Bob Flaws and Honora Lee Wolfe elucidated on these in The Successful Chinese Herbalist (2005, Blue Poppy Press).

The seventh of ten pattern discrimination subsystems listed in Flaws’ book is disease pattern discrimination (Bing yin bian zheng), which is the one that directly resonates with many western TCM practitioners. This was not the case in the early introduction of teaching TCM to westerners. In fact, the teaching of named diseases was deemphasized with the view that TCM treats the whole person rather than the disease. The fact however, is that while TCM is holistic and treats the whole person who has a disease, it also treats the disease the person has. TCM has prosaic names for hundreds of diseases for each of which there are prescribed different pattern manifestations necessitating different formula treatments. Further, many of these ancient Chinese names correspond many of the common diseases known in the West.

Taking this practical point into account, instead of a student or practitioner needing to differentiate between 28 or 29 different pulse types or dozens of ambiguous tongue presentations, all they need to do for a named disease is discern the difference between 2 to 6 different patterns associated with a particular disease. This is all possible with Him-che Yeung’s Handbook of Chinese Formulas.

Him-che Yeung’s Handbook of Formulas in Chinese Medicine book also includes:

• a section classifying Chinese herbal formulas both in terms of Western and Chinese herbal properties
• different forms of herbal administration
• how to make a standard Chinese decoction
• timing of taking Herbal medications and
• a unit conversion section for measurement of weight of Chinese herbs

Most of these features are non-existent in Scheid and Ellis’ Handbook of Formulas in Chinese Medicine.

Having uniquely apprenticed working in an herbal pharmacy in China, Andrew Ellis is currently one of the foremost authorities in the English-speaking world on the processing methodology and use of Chinese processed herbs. Pao zhi is a method of processing herbs to modify, change or bring out certain properties not normally available in the raw herb. This includes the ability to neutralize some of toxic properties in such herbs as toxic alkaloids in aconite and pinellia and emodin in Polygonum multiflorum (he shou wu) for instance. This is an invaluable section on the method and uses of treated Chinese herbs included in the Scheid and Ellis book which is challenging to find in other clinical manuals.

Other options for your bookshelf

Other valuable books discussing TCM disease diagnosis and its close counterparts to most of the more common western medical diseases include:

• The Treatment of Disease in TCM seven-volume series by Philippe Sionneau and Lu Gang (1997, Blue Poppy Press)
• Nigel Wiseman and Feng Ye’s Practical Dictionary of Chinese Medicine (2014, Eastland Press)
• The Treatment of Modern Western Medical Diseases with Chinese Medicine by Bob Flaws and Philippe Sionneau (2005, Blue Poppy Press)

In conclusion, at least until a future edition of The Handbook of Formulas in Chinese Medicine by Scheid and Ellis features a more user-friendly index or chapter including common ‘named’ Western diseases to its truly beautiful format, I must submit only a reserved recommendation, especially since there are other excellent, though not quite so fancy, Chinese formularies available.