As Chinese herbal practitioners one of the most commonly asked question is: Does this herb [e. g ginseng] work well for my blood pressure or headache or fatigue or sleeping problem? We then need to explain that in Chinese herbal medicine it’s not about the single herb fixing a disease but it’s about identifying the pattern of disharmony and applying a carefully selected herbal formula (with various ingredients) to address the pattern.
We are used to the philosophy of one tablet for the one condition. Question: Why combining individual herbs? Answer: To take advantage of the synergistic effect of the combination of herbs and with this, make it more effective.
Let’s look at a case study of a common complain like fatigue:
Feeling tired, not having enough energy to get through the day, lacking motivation due to feeling tired, simply not being able to get out of bed in the morning, falling asleep (in the afternoon, or early evening) have all different reasons and roots. If we just treat the tiredness with a tonic, you might feel exactly the same when you stop taking the herbs. But if we are strengthening and at the same supplementing for instance the blood, or the kidneys, and course the energies then we are aiming at fixing the underlying problem as well.
As once the blood or the kidneys are supplemented, there is no more tiredness even though you might stop taking the herbs. In this example, Ginseng might help to address the fatigue but it doesn’t boost the kidney or enrich the blood.
This is one of the reasons, why we often prescribe an herbal formula instead of just a single herb. Of course, we would also like to advantage of the synergistic actions of the herbs in a given formula. Most formulas are ancient and have been in use and still are for many hundreds of year. The single herbs are combined due to their action (up, down, in, out) and due to their flavours: pungent, sour, sweet, bitter and salty. Each of these flavours have a quality such as dispersing (pungent), astringing (sour), moderating (sweet), tightening or firming (bitter), or softening (salty).
So in a formula, the flavours are combined to manifest a therapeutic principle. The main flavour, e.g. sweet (to moderate) is represented with the main herb usually in a higher dosage. The supporting herbs will be used to give more focus to the main herb, to restrain or channel the action of the main herb and/or to direct the herb to a certain area or tissue in the body. They will also be used to make sure that the formula is harmonised.
Formula architecture is a fascinating, highly methodical topic! It’s without a doubt that some of the early scholars of Chinese medicine have given it a lot of consideration, as most of the ancient formulas are still applied today and work as effectively as 2’000 years ago.