As a TCM practitioner, we need to know that patient’s unexpected “worse” feeling could be side effects of herbs, the same as the fact that conventional drugs can cause side effects, but it can also be healing effects. It is difficult sometimes for a beginner to tell which is which, but it is very important in determining to continue or to stop the herbs.

There are following major conditions we need to clarify:

(1). Side effect.

Patients feel nausea, vomiting, diarrhea, bloating in stomach, or other discomfort feeling after taking herbs. Stop the herbs, the side effects usually subside within hours and rare need several days. However such side feelings are hard to identify with healing crisis or normal reactions with herb therapy. This is aim of this article to discuss.

(2). Healing crisis.

After treatment (with either acupuncture or together with herbs), patient may feel more pain, or more tired. After several hours, or one to two days, such feeling subside and patients feel much better for less pain and more energy (and more other nice feelings too). We call it healing crisis since it is not like side effects in which patient feel the same pain after side effect per se subside.

(3). Mark of proper dose of herb to work.

When we apply herb therapy following the Shang Han Lun style, the herbs should be taken until patient feels little drowsy, little near-headache, near-nausea feeling. Such feelings are regarded the mark for “proper” dose for the individual. Since each person is different for their body size, weight, and body reaction, the amount of herbs needed to reach such “proper mark” is variable. Old TCM doctor find that the healing effect will be the best if patient starts to feel such near-headache feeling, no matter how much dose he/she has actually taken. In clinic, we find it true and it is a very useful mark to decide the amount of herbs each patient needs to take. Such near-headache feeling should not be regarded as side effects. If you did not learn it in your textbook TCM, you should know it now. 

(4). Healing process.

To remove disease-causing factors out of body, TCM has several ways to do it: to let people have sweat, so the disease-causing factors leave body through the sweat. We call is sweating therapy. Similarly, we also have vomiting therapy, diarrhea therapy… beside what you may already know the Cooling therapy, or Warming therapy, or what you are familiar: the nourish therapy (nourish Qi or blood) in the body. In this case, the sweat, the vomiting, the diarrhea… is not a side effect at all. They are what the TCM doctor wanted. It is by this way to re-balance body function, rather than to “kill” something in the body. As TCM doctor, we need to know what may happen with each herbal formula and also tell patient what may happen, to get cooperation with the patient. Without this caution, patient may run away worrying the “side effects”.

So many times in clinic, it is very hard to set up a diagnosis. This is true for any kind of medical system, conventional medicine or traditional Chinese medicine. The nature goes by its own, not by our human standard. It means that the patient’s condition is so complex to make diagnosis. He/she may have conditions that seem belong to Fire, but not typical, or seem to be Cold, neither typical. Many times it is the mixture of the Fire and Cold. Also, for senior patient who have long history of diseases and have taken largely various medicine from conventional medicine, their body condition is the mass of accumulation of phlegm, stagnation of blood and Qi, deficiency in Qi and blood. Diagnosis and treatment for them is very difficult. In this case, we also take a trying-to-know process. It means to try some herbal therapy first and see how it works. If it releases the clinic problem, we continue the main direction of treatment. If the clinic condition becomes worse, we may use different ways.

(5). Cure process

There are different TCM styles which ordinary TCM doctor may or may not realize it. It means that most of TCM doctor wish to use herbs to solve the current clinic condition. Once the aim is reached, the treatment stops. Such doctors usually do not use “Hot” herbs. On the other side, there are a group of doctors in TCM history who belong to Huoshen Pai”, meaning that they use “hot” herb commonly in clinic. The use of such “hot” herb is to nourish Yang Qi in the body. The Yang Qi is kind of body defense ability to endure illness attack. It is a broader concept than the immune system in conventional medicine. It is due to the deficiency of Yang Qi in the body that makes the illness staying in a chronic condition.

There are so many clinic examples to explain what I mean here. One common example is the treatment of chronic sinus problem. Person with the chronic sinus problem have puffy feeling in the sinus area, running nose, frequent sneeze, light headache in front head, poor attention ability, poor sleep, etc. People tend to call it a kind of “allergic reaction” too. Ordinary TCM doctor will consider it as Fire, since the tongue of the patient might be pink and patient may feel dry in mouth. The doctor may give “Cold” herb with the use of Jinyinhua, lianqiao, Banlangen… to reduce the “inflammation” there. The symptoms may be reduced somehow but patients know it: the problem is still there since they feel the same feeling once they get in a cold morning or get tired someday. This makes such “allergic condition” so difficult to treat by ordinary TCM doctors.  Then for the doctors belonging to the Huoshen Pai, they will use hot herbs to warm up the Yang Qi in the body to treat the allergic reaction. In my experience, this is a very effective way to solve the allergic reaction.

However, a “bad” thing that I believe a good thing, is that, after solution of the allergic reaction, patients feel problem again and again. Such problem, pain or others, could be the previous problem in life, if the patient can remember. They didn’t bother the patients for a long time. Now, they come out again. Why?

Our understanding is that the body of the patients get more ability, after continuous taking of Hot herbs, to clear the previous illness that hidden in the body for a long time. For example, a trauma in wrist or in lower back, or diarrhea, or a headache subside for a while since the body has no enough energy to solve it so they stay in the body and body cannot feel it. Now with the use of hot herbs, there is more Yang Qi in the body to clear the old illness, so that patients feel them again. This is not at all a side effect. Such situation can commonly seen in senior people who have more chance to damage their body in their early life. I mean it is good, because it means that the body has more ability to work against hidden illness now. Continuing the Hot herb therapy to solve the old problems, one by one, people have high chance to get a real “Cure”, no matter if it is diabetes or cancer.