Patients often ask me if there is a difference between taking raw herbs vs. taking patent formulas. Questions like:
- Is one better than the other?
- Are they going to get more potency by cooking the herbs and drink the tincture themselves?
- Is taking patent formula violating the essence of “holistic” medicine?
The answer to that question really depends on who you ask. A more traditional practitioner would insist raw or else. For a pragmatist like myself, I always prescribe ready-made patent formula, because they are far more suited for modern life style. Now, it is important to remind the readers that the patent formula are made from raw herbs, so just because they look like pills does not mean you are taking pills. The difference is someone has done the preparation and packaging for you as opposed to preparing it yourself. Certainly there are pros and cons to both approaches, and I am certainly not saying you should never cook raw herbs yourself, so let me at least give you my detailed rationales, and I will let you be the judge.
All the patent formula capsules or powders are made from raw herbs just as if you were to cook them yourself at home. The manufacture process generally entails cooking the herbs into tincture in batches and then evaporating the tinctures to extract their active ingredients. The resultant granules or powders from reputable manufacturers carry high concentration of active ingredients per gram or per capsule. And this makes it easy to increase (or decrease) the amount needed for each patient by simply scaling up (or down) the numbers and frequencies of capsules intakes.
#2 Quality of Herb Source
The origin and quality of the herbs a another issue to consider.
Most people who embrace and utilize herbal medicine are usually the same group who are attentive to the origin and quality of their food, namely, they are more likely to buy organic produces for obvious reasons. However, there is no telling where the raw herbs came from, how they were harvested and processed. The unfortunate fact is that the raw herb trade is a super low margin agriculture business that simply does not have the means to offer that level of quality assurance that we are trained to expect from high-end retailers like your local organic grocers or the big one based in Austin.
However, on the other hand, major patent formula producers do have the means to monitor and control their supplies and through their purchasing power, influence and dictate the level of quality from their growers and suppliers. And the nature of a competitive market forces these patent formula manufacturers to look after their own interests by assuming the responsibilities of assuring the quality of their herb source. As consumers, we ultimately end up paying more for these products, however, it gives us a layer of built-in protection and certainty that is unavailable through raw herbs. It is also important for practitioners to identify and work only with the manufacturers who adhere to a strict quality standard.
Having said that, I believe it is the practitioner’s professional responsibilities to identify the best available manufacturers on behalf of the patients and to make their offerings available at the most economical prices, and help patients understand why they are taking the formulas, how much they should take and for how long. This is a standard practice amongst the pharmacists, and I think the herbalist community should recognize that as best practice and incorporate that accordingly.
#3 You Got Time to Cook?
How many people cook regularly? Or perhaps a better question might be: would you cook if you had time or the energy? If you are like most people, your time and energy is a precious commodity. You probably barely have a chance to prepare a home made meal for yourself or your love ones. Your standard breakfast is coffee on the go; lunch a burrito or a salad from an eatery near work, and your typical dinner is more likely to be take-out, pre-made, or left-over. If that is the case for you, honestly, how much time can you allocate to cook yourself a herbal tincture, especially when you are not doing well (often a part of the reasons why you are taking herbal medicines).
In an advanced developed society like that in the US, where patients seeking treatments from infectious disease due to poor sanitation or infection is low. So aside from season cold or flu, a large portion of patients taking herbal medicine are dealing with dysfunction brought on by a hectic and stressful life style, and a practitioner needs to be mindful of practicality of his prescription. When I was in the school clinic, the clinic supervisors always prescribed raw herbs to the patients, mostly out of dogma and reverence to tradition. The patients generally did not reject their raw herb prescription, however, in their ensuing visits, they almost always confessed that they never even opened the package, let alone cooked them as prescribed. The number one excuse was always: “I was too busy” or “I didn’t have the time”. If a patient does not take the medication as prescribed, then we as practitioners have essentially failed to make a difference for the patient. Had we recognize the practical limitation imposed by modern life style, we should have prescribed patent formulas whenever applicable. It makes it easy for the patient to not to forget and thus achieve the ultimate therapeutic goal.
#4. Taster’s Test
Last but not least, let’s be honest, most of the herbal tincture... Wait, I’ll correct that by saying almost ALL of the herbal tinctures taste awful. I hate it. It is hard for me to tolerate the sight and scent of many of them, let alone drinking them. Furthermore, because of the horrid taste, it is possible your digestive system to rebel against the tincture in the form of nausea, diarrhea, or upset stomach.
The thought of taking something so horrendous also stresses me out, and I definitely don’t need additional stress, especially when I am sick. I want to be able to relax and to give myself a chance to convalesce. I want to feel like I am being cared for, not abused. So making me drink nasty herbal tincture does not make me feel good, especially when I know I can almost always find a patent formula that is at least equally effect or better.
And don’t tell me that "the more bitter the medicine, the better it is for me”, I know better. You are not fooling me. And why do you think there is licorice (Gan Cao) in almost every Chinese herbal formula? Sure, the text says they are included to “harmonize” different ingredients. But honest, WTF does “harmonize” mean? Well, I tell you what it means... Licorice is one of very few things that is sweet in places that did not have access to sugar canes, like northern China from centuries past! So licorice was included to helps make the nasty tincture go down just a little bitty tiny easier.
I like my patients, and I want them to feel better after seeing me. I don’t want them to endure the hardship of drinking raw herbs - there is no reason for that. I prescribe patent formulas from my trusted vendors for myself and my patients. I’ll take them happily with a cup of warm water without protestation. I’ll go to bed and feel better soon....