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— updated 1999-11-08

How to choose a Chinese (TCM) Herbalist — How to recognize quality TCM herbal health care

Frequently asked questions about TCM herbal health care: finding a competent herbalist, typical monthly costs, most effective ways to take Chinese herbs.

Subtopics on this page…

Copyright ©1991-1999 by RMH-Publications Trust; all rights reserved.

Chinese herbal formulas have been used for several thousand years to facilitate greater health. Today China still relies on herbs for maintaining the health of its population because of their effectiveness and low cost. The World Health Organization has recommended introduction of Chinese health practices to other Third World areas, and an increasing number of states in the U.S. are recognizing it as an important health care option.

Clients generally find that even if their insurance does not cover herbal supplements, their effectiveness in restoring health often results in significant long-term cost savings.

Why are medical diagnoses or single symptom complaints not enough information to correctly choose herbs?

Perhaps the most common type of question we are asked is "What herb or herb formula should I take for disease X [arthritis, psoriasis, candida, kidney stones, etc.]?" Many people looking for herbal alternatives have learned to define their problems in terms of such medical labels. However, to be genuinely "holistic", we must recognize that such labels often only touch the surface of our problems, and that to choose herbs and herbal formulas solely on the basis of such medical terminology will give haphazard results at best. This approach may result in mere suppression of symptoms without resolving deeper factors. At worst, it may result in side effects because contraindications were overlooked.

A medical diagnosis or complaint of a single symptom (headache, fatigue) is not enough information to determine a correct herbal formula. To understand why this is almost always the case, see "Chinese herbology, correct and incorrect ways of choosing herbs". (Reading this short article may help you save thousands of dollars by avoiding herbs and supplements that are unnecessary or even contraindicated for your condition.) If a person claiming to be a TCM herbalist offers to sell you an herbal formula based only on a single complaint or medical diagnosis, and without inspecting tongue or pulse and without taking a health history, you should consider going elsewhere.

How do I recognize a competent TCM herbalist?

(1) A properly trained TCM herbalist will almost always insist upon inspecting one's tongue, feeling the pulse at both wrists, and asking about chief symptoms or complaints. Pulse palpation and tongue inspection are two methods for determining the nature of an individual's health imbalances that have evolved over a period of several thousand years. Many important aspects of one's metabolism, circulatory system health, and systemic patterns such as edema or dehydration show up first as abnormalities of the tongue coating, fissures in the tongue tissue, variations in tissue color, appearance of the sublingual veins, and as abnormalities in radial pulse strength, pulse pressure profile, rate, rhythm, and other characteristics. The standard TCM pulse method is to feel the pulse at each of 3 positions along the radial artery of each wrist, and this procedure usually takes a few minutes to do thoroughly, especially for new clients.

(2) Diet, environmental quality, and a person's work and social situation are important factors in health. Like herbs, foods, air and water quality may also have strong effects on one's health, for better or worse. A thorough TCM herbalist will ask about these factors during the first few visits. Environmental toxicity and inappropriate diet are the most common reasons why herbal formulas might not work well, in spite of being correctly chosen otherwise. Environmental factors and diet may account for 70-80% of all chronic illnesses in America, and by inquiring about these, the herbalist may determine simple and often inexpensive solutions to many of these health problems.

Does certification or licensing assure quality of care?

Professional certification and licensing, while often helping to eliminate grossly incompetent practitioners, does not solve the problem of institutional and governmental abuse of power. When our own government, corporations, and professional groups find it increasingly profitable to lie and to deceive the public, the only solution is for each of us to carefully scrutinize everything before acting, taking nothing for granted. Finding a knowledgeable practitioner in any field requires a good deal of personal judgment, intuition, self-education, and advice from friends. We must take our health into our own hands again. No one, especially a bureaucratic agency, should ever be allowed to override our own knowledge and instincts for survival.

See the following collection of articles to learn from history how professional licensing and regulation have frequently become two-edged swords:

How is acupuncture related to the practice of TCM herbology?

Acupuncture and Chinese herbology are two distinct clinical methods which are often practiced independently of each other in China. There are practitioners there who practice only acupuncture, others practice only herbology, and some practice both. It is generally more difficult to become competent in many specialities than to focus on one. In the U.S. it is important not to assume that all acupuncturists are trained equally well in Chinese herbology, since the latter is usually taught in separate courses that may or may not have been included in curricula at TCM colleges. There has been a trend among some colleges of acupuncture and TCM to increase the curriculum requirements in conventional allopathic medical training, while sacrificing curriculum hours formerly considered essential to education in TCM herbal methods.

Even thousands of years ago in ancient China, it was recognized that chronic internal disorders were best handled with herbs and herbal formulas rather than acupuncture. According to the Yellow Emperor's Classic of Internal Medicine, "In order to terminate physical illnesses and to bring health, external diseases were treated with acupuncture and internal diseases with hot water or soups, and liquid medicines."

How affordable are the services of a typical TCM herbalist?

"When I began my studies in Traditional Chinese herbal sciences, I had no idea that it would save my family so much money by giving me the power to handle many of my family's health problems. The expense of my training since l993 has been fully recouped in the savings we've made over the last six years. We now use herbs instead of rushing to the doctor every time one of us has a cold, case of poison oak, bladder infection, menopausal hotflash, headache, and many other minor health problems. We have now increased the deductible on our health insurance and cut our premiums by half! Many of my clients do not have health insurance and thank me for having studied this wonderful method that affords them competent care at a very reasonable cost. Thank you Rocky Mountain Herbal Institute!" --Leonor A. Horden, LMT and TCM herbalist (RMHI graduate, 1994); Roseburg, Oregon

Consultation fees may vary, and TCM herbalists who also have medical training (physicians, nurses) will probably charge higher consultation fees that herbalists without such training. However, monthly costs including both herbal supplies and consultation fees should rarely total more than $200 per month, and in many cases can be as little as $100 per month. For chronic illnesses that slowly improve, the herbalist may see the client each month or so, giving herbal formula supplies for several weeks at a time. In acute conditions, or in complicated chronic conditions which change in character weekly or daily, more frequent visits are generally required.

When compared with most other forms of health care from professional providers, herbal health care is one of the most inexpensive. TCM herbalists can obtain dried bulk herbs at wholesale prices that are very reasonable. In contrast, multi-level marketing salesmen are usually unqualified to dispense any useful advice, and in some cases have bilked people of thousands of dollars for over-hyped herbal products. Why not spend a few extra dollars to obtain advice from properly trained herbalists that will spare you this nuisance?

What are the most effective ways to take herbs?

Dried bulk herbs cooked in water are the method recommended and used at the Rocky Mountain Herbal Institute. By cooking the herbs in water and filtering off the tea for drinking, all of the insoluble matter (cellulose and indigestible fiber) is eliminated, allowing greater amounts of soluble active ingredients to be absorbed in the digestive tract.

Although we prefer drinking teas made from dried whole herb products as the most effective and inexpensive mode of administering herbs, there may be valid reasons for using other forms. In very hot, humid climates where product shelf life is less, the herbalist may prefer herbal products dispensed in the form of gelatin capsules or otherwise hermetically sealed. In such cases, it is important to use spray-dried extracts (from which the non-soluble components have been removed) from reputable suppliers. This form of taking herbs is also more convenient for the client. However, once such powdered-dried extracts are opened or exposed to the air, their quality degrades quickly.

By using dried whole herbs, the herbalist has greater control over herb quality by being able to inspect products for species identity, freshness, and quality. Processed products such as pills, powders, tinctures, and extracts require trusting the manufacturing processes of the supplier, and herb quality may vary widely among suppliers. Moreover, patent herbal products from China (usually pills) often have had serious problems in the past because of their containing unlisted pharmaceutical drugs, heavy metals, and endangered animals and plants; we recommend these be avoided until these problems are convincingly rectified by Chinese manufacturers.

Dried whole herbs products from China are generally of comparable quality to whole herb products from other countries. Whereas herbalists who do not have extensive education in designing their own formulas will prefer using patent products (pills) because they are easier to dispense, Chinese herb distributors know that whole herb products tend to be used by the more competent and discriminating practitioners. Moreover, the highest quality Chinese herbs are often reserved for export to the U.S. and other foreign countries.

How long should one expect to take herbs before experiencing changes?

While herbs, in general, are not as fast acting as some pharmaceutical drugs, one should experience at least some improvement in health within a few weeks. If you are taking herbs without experiencing any results after a week or two, perhaps your formula needs to be changed, unhealthy foods eliminated from your diet, or other changes made. If you are being told to take herbs for long periods of time without seeing any benefits, or are experiencing side effects, perhaps you need to see another practitioner. Sometimes determining the correct herbal formula takes a bit of trial and error, although TCM herbal methods in the hands of a skilled herbalist should eliminate much of the guess work.

What about using "western" vs. "Chinese" herbs?

The methods of TCM herbology are equally applicable to using western herbs and foods. Your TCM herbalist may be able to give you advice on the more effective use of not only Chinese herbs but western herbs and even foods that have beneficial effects in improving health. There is nothing inherently superior about a "Chinese" herb. Many of the herbs listed in the official TCM materia medica include such common herbs as dandelion, rhubarb root, fennel, licorice root, and many others. Clinical Chinese herbalists have long incorporated herbs from all over the world into their system of health care.

While many people point out that it is preferable to use food and herb products that are grown locally for economic and social reasons, the reality is that even herbs that are commonly considered to be "western" herbs are in fact grown and collected for commercial sale from all over the world. The argument that "Chinese" herbs are not suitable for westerners is an absurd conclusion that would lead to the elimination of cinnamon, ginger, and nutmeg from our kitchens as well as many other useful medicinal herbs.

Where can I find additional information about using herbs to improve health and finding an herbalist in my area?