Final Reflection

   I have so many emotions and thoughts about my time at AOMA. I could talk about all different aspects of it but I'll stick to the idea of professionalism. I feel I started off in the clinic with a bit of an advantage, I used to be in the service industry. This afforded me a level of comfort and ease in dealing with patients, supervisors and other interns. Though I had this great foundation to start off with, being a waitress and being a health care provider involve very different relationships with your patrons. Watching other student interns interact with patients was probably the most educational in learning about patient-practitioner relations.
   The other way in which I grew my professionalism was during my time with the ASA. Learning from someone like Tara was such a special gift. She showed me how to work in a community with so many complex and ever changing relationships and somehow stay on every one's good side. I don't know if I've reached her level of success in doing this yet, but I always think of her as a guide.
   My other great lesson came from being the president of the ASA. Having a cabinet full of good people who struggled to get along, failed, succeeded and struggled some more was a great challenge. Having to supervise, delegate, mediate, support and discipline was hard at times, but overall felt satisfying and strengthening.
   I could go on even more, but I also greatly respect and admire you, Lesley, and know how hard you work, so I'll leave it at that!

Self-reflection and Learning Goals 5: Level 3

     From the first tuina clinic with Dr. Fan he kept the feeling of the clinic very calm and relaxed, but as the weeks went on he started requesting more and more physical assessments. I never felt like I was fully committed or confident in my physical assessments during acupuncture rotations simply because it seemed like my findings often wouldn't change the treatment plan anyway. While in tuina, it felt more acutely important to the treatment. On reflection, it would have been a good idea if I had treated those musculo-skeletal acupuncture treatments more like a tuina treatment. I think perhaps part of why they seemed different in my mind was the lack or addition of physical contact with the patient. In a tuina treatment you start touching the patient right away, feeling for ropey, sore or knotted muscles and you don't have to ask very many questions. While in an acupuncture treatment you start with talk only, and it can be easy to forget to use palpation or alternatively difficult to transition from one to the other.
   I think the most important lesson I've learned in reflecting on this, and also my goal for the future, is to always remember touch. Get that patient permission from the beginning so you can easily move from questioning to palpation and incorporate physical assessments that way as well.

Self-reflection and Learning Goals 4: Level 3

   I had to make up one Herbal shift today after having finished the rest of my clinic hours about a month ago. Since that time I have taken the herbal board (and passed it!). When I had my last day of my herbal shift from last term I felt moderately comfortable with herbs. I still felt like I couldn't recall formulas or single herbs on the spot  most of the time. I wished I had taken one more herbal rotation and almost thought about signing up for an extra one this summer.
   Reflecting on how I feel at this moment about herbs, I feel more than moderately comfortable. This has made me fully realize the importance of simple repetition which I did so much of while studying for the herbal board. It's also inspired me going forward to always keep practicing and reading about formulas and herbs. I remember once Dr. Shen saying it took him 10 years to feel completely confident with herbs. That's not the kind of timeline a person can rush.
   Even though I feel my progress is moving slowly, I feel confident that it IS moving and that it is going at the right type of pace. My goal for the future is to simply keep the pace and continue to learn and love herbs no matter what.

Intern Reflection 5: K.G. 6/22/16

 

This was the first time I had treated a friend in clinic and I was curious to see how I would feel about it. I had heard from many differing opinions on how it felt treating family and friends. Some people were specifically getting into TCM in order to care for sick family members while others swore they would never treat a friend or family member.
  The actual treatment went well. I think K.G. was a good first candidate to do this with because she isn't shy or uncomfortable about sharing information about her personal health in general. We have an easy report but didn't take up too much time with personal conversation.
   The most difficult part came later when we were at a dinner party a couple weeks later. In front of the whole group she brought up the treatment and how well it went and how well the herbs were working. It started a conversation about TCM, which I was excited about. Someone asked me about what types of conditions TCM is "good for" and as I started listing things I had to bite my tongue because I almost stated what K.G. had come in for. Later in the conversation K.G. brought it up herself but I realized at that moment just how dangerous to HIPPA treating family and friends can be. It was a good lesson to have early on, though it didn't scare me away from wanting to treat family and friends. It just served as a reminder of how careful one must be in social situations (especially if you've had a glass of wine!).

China Trip Reflection

    Spending every day in Chengdu University Hospital changed so much of how I think about Chinese Medicine. The most obvious thing you notice about CUH was how many people were there. Thousands, every day. Not different people either, often the same people came back every single day to be treated. The herbal counter was like a bus terminal, constantly swarmed with patients waiting to get their raw herbs.    Before I went to China other China trip alums told me the medicine seems to work better in China, like magic. I saw that right away, but I also saw it wasn't like magic at all. Patients not only came to be treated every day or every other day, but they all truly followed their doctors orders. It was fascinating to see what a world where TCM is trusted and respected, as much as western medicine is back in America, is like.
    The other thing that really stuck with me was the repetition. One doctor, in a specific department would use the same basic herbs that he or she likes best and then modify that formula based on the patients other symptoms. When they did acupuncture or tuina it was the same routine every time, the same "formula" every time. Lumbar disc herniation? Lumbar Jaiji with BL40. With Sciatica? Add GB30, BL53 or 54. Finish off with tuina on the lower back for 15 minutes, some spine twisting and a hot wax compress (used in place of moxa, since there was a separate building for moxa only).
    This repetition was surprising and yet made perfect sense to me. TCM is so complex and yet when you boil it down to basics, it's so simple. Humans are the same. We're all unique and yet so simple. It was incredibly encouraging to experience this well oiled machine that was Chengdu University Hospital. It made me feel so much more assured in my abilities, ideas and plans. In the future I'm sure I'll encounter moments in my practic where I feel overwhelmed by the possibilities or the symptoms. Having had this experience I can now reflect on this time and remember treatments don't always have to be original, complex or confusing. Trust the medicine and results will follow.

Intern Reflection 4: J.B. 8/9/16

J.B. was a 34 year old woman. She came in on one of my lasts days treating at AOMA. Her chief complaints were stress and insomnia. She reported owning a small soap making business, which she loved and had good success in, but the better the business went the more stress she felt. She also had two small children, 4 and 6. She felt her insomnia, as well as her other symptoms, such as irritability, low libido, alternating loose and constipated stools, stemmed from the stress.
     This was an interesting patient for me because it felt as if I was looking at myself in the future. My hope is to own my own small successful business and maybe have a kid or two. I also suffer from insomnia triggered especially by stress as well as all the other symptoms she reported. When I looked at her tongue it was like looking into the mirror.
    What I took away from this patient was a reminder of how vitally important self-care is. It's so easy for me to have sleepless night after sleepless night before I'll ever do anything about it. These things age you, they wear you down, they lead to an imbalance of systems and can take a great fulfilling life and career and turn them into a hardship. So right after she left the treatment room I went over to the White Crane and made myself some powder. 

Set of 3 Intern Reflection 3: L.E.H. 3/16/15, 4/30/15, 6/4/15

     I started treating L.E.H, a woman in her mid-70s in late 2014. She had a long history of injuries and surgeries on her left knee. She had been a runner as a young women and had previously had reconstructive surgery on her knee. She was given the initial diagnosis of of chondromalacia patella and had undergone an arthroscopy and most recently a realignment surgery.
   Immediately before and for three months post-surgery I treated her systemically. Her wounds were still healing and it would have been far too painful and dangerous to start needling her scar area before that time.
    Once the three months had passed, acupuncture and e.stem were provided weekly to the local area and continued for 6 months. Points were chosen surrounding each scar on a 45 degree angle going toward the center of the scar. If possible the needles were inserted into the interior of the scar as well. E.stem was set between 30Hz-60Hz depending on the pain tolerance of the patient on each specific treatment day. Additional non-e.stem Ashi points were inserted as well. Distal points were chosen based on the differential and from week to week on specific systemic symptoms. Points which were commonly used include: KD3, SP6, LV8, GB34, ST36. Points and e.stem were left in for 20-25 mins and on occasion e.stem Hz were increased after patient reported electrical sensation had dissipated.
     Directly following her surgery L.E.H. reported waking up at night due to pain between 4 and 6 times. By the end of six months she reported only waking 2 times. During this time she was also practicing physical therapy 2 times a week and low impact water aerobics 3 times a week.
    Patient’s scars both reduced in size by close to half and thickness was reduced by more than half. Pain on palpation around scars was reduced and scar tissue was softer. L.E.H. reported that her orthopedic surgeon commented on multiple visits how “amazed” she was by the accelerated healing of the scar tissue.
     This case serves as a perfect example of how staying the course and keeping consistent can be the best course of action. It also shows how a combination of acupuncture, PT and water aerobics can greatly accelerate healing from major joint surgery. Treating L.E.H. showed me that finding a specific symptom to track over time (number of times woken by pain) can assist in showing a practitioner, a patient and the patient's other doctors how things are progressing. 

Herbal Intern Reflection 4: N.D. 6/20/16

N.D. was a female in her mid-60s. She was previously a practicing acupuncturist and herbalist. She came in with a recent history of fresh bright blood in her stool after having eaten whipped cream over the weekend. She also had a history of lactose intolerance. She had prescribed herself Huai Hau San and had been taking them for the past two days. She had stopped eating solid foods and was still experiencing abdominal cramps, gas and lightheadedness. Her pulse was weak, thin and slightly wiry, while her tongue was pale and dusky with a thin white coat.
      At first she was against allowing me and the other herbalist to recommend or change her self-prescribed herbs. She said she knew what she was doing and that those were the best herbs for her at this time. We left the room feeling like there really wasn't anything we could do. She had made her mind up and it wasn't as if she didn't have experience with Chinese medicine.
      As we sat in the conference room and discussed her case, the more we talked the more we realized the herbs she was taking were not only the wrong choice for her but were probably hurting her or at least delaying her recovery. We thought, why not give convincing her another shot. We went back into the room and laid out our tonifying formula. Huai Hua San, had failed to stop her bleeding and were very cold in nature. Her pulse wasn't rapid and wiry and her tongue wasn't red. After we told her all this she seemed quite convinced and agreed to change her formula.
reasoning behind wanting to shift over to a more
     This was an important lesson in staying your ground, not allowing a patient (even a former practitioner) railroad you and that sometimes the most obvious treatment isn't always the best.

Self-reflection and Learning Goals 3: Level 2

        On the first day of my last term as a level 2 intern, I arrived to find a first term level 1 intern, Jordan, had accidentally been put in a treatment room alone and without a resident. She was clearly nervous and upset to be alone in the room, so I asked my partner, who was also a last term level 2 intern, if it would be alright if I treated with her. Once I moved into the room we quickly fell into an easy rapport and I ended up acting as a sort of resident to her. When the next week came around our supervisor said she had talked with Lesley and she was planning to set up a resident for Jordan. To my surprise and delight, Jordan asked if it was alright if she simply stayed partnered with me and if I wouldn't mind continuing to help her as I had the first week. That first week I had truly enjoyed helping Jordan, so I quickly agreed.
      We spent the rest of the term as partners and, aside from enjoying the work we did together, we quickly became friends. I loved assisting her, asking her questions and giving her advice. So much of my TCM clinical knowledge was solidified during those twelve weeks. I've always been the type of person that needs to talk through ideas. I gain so much from just saying thoughts out loud and hearing other's opinions. Sometimes even saying something out loud to myself provides enough inspiration to make an important decision or accomplish a task. The experience also gave me a great deal of confidence. Having to articulate one's thought process and defend one's ideas can be challenging. Doing that with Jordan every week showed me I understood TCM much better than I gave myself credit for.
      I remember when I first came to AOMA, before there were residents, talking to interns and they would say the best thing to do was find a more advanced intern who was willing to mentor you. The idea of that sounded great but also stressed me out. It was not something the school helped put together for you and it made me nervous to think I wouldn't find an advanced intern to be my mentor. When I found out they were doing the resident program I was so relieved and thankful. Having a resident when I was a new intern made that experience vastly more secure. As a new intern the main benefit of having a resident really ends up being to calm your nerves so your brain will work through a treatment. While the main benefit of being in a resident position is you learn a great deal about yourself as a leader and teacher as well as solidifying your TCM knowledge and proving to yourself just how much you know.

Herbal Intern Reflection 3: J.F. 6/15/16

J.F. is a female in her mid-30s. She reports a "tearing" pain in her LLQ that began 3 weeks prior during intercourse. She visited an ER 10 days prior and they found she had a ruptured cyst. Pain has remained around a 4/10 but can get to 8/10 when she moves in specific ways. No pain during or after BMs, nor any change in BMs. Patient has a history of uterine fibroid surgery.
     After prolonged questioning Dr. Shen, myself and the other herbalist came to the conclusion that her pain is most likely caused by old scar tissue adhesion that was torn or pulled. We informed the patient of our thoughts on the case, but encouraged her to visit a gynecologist as soon as was convenient.
     The patient was open to using powdered herbs but stated she only wanted herbs to support her underlying deficiencies and not to treat the pain or the "tear." We discussed this with Dr. Shen and came to the conclusion that treating the pain was of primary concern. Despite this Dr. Shen reminded us that J.F. was our client and we could not simply disregard her wishes. Our resolution was a base formula for dispelling blood stasis in the abdomen, especially when related to the female anatomy and modifying it with herbs that tonify KD, LV while also working with blood and yin.
    Before we filled the script we realized we had to convince the patient that what we were doing was the best course of action, without discounting her own desires. Luckily, she was amenable and we were able to explain to her the benefits of our formula choice. The final addition to our prescription that we would call her in one weeks time to see how things were going.

Herbal Intern Reflection 2: P.W. 5/31/16

P.W. is a mid-40s female coming in for neck and shoulder pain. This is her first time receiving treatment at the AOMA clinic. Her treating intern did an excellent and through intake but because of how many physical and mental issues the patient had became a bit lost. P.W. is a single mom, has anxiety, and has unspecified alcohol dependency. She is also on a long list of western prescriptions ranging from muscle relaxants to blood pressure diuretics to Cymbalta and proton-pump inhibitors. The treating intern wanted me to prescribe something for her underlying symptoms. After reviewing her long medication list I had to inform him that I didn't feel comfortable doing that at this time. I felt this to be the best course of action for three reasons, one: Cymbalta, specifically, has many drug interactions and precautions including a higher risk of bleeding especially in the stomach. The second reason being that in order to treat her blood stasis, ST Qi rebellion and high blood pressure the herbs we would want to use could harmfully enhance the effects or side effects of the drugs she's already taking. The third reason was due to her alcohol dependency. Without knowing the full effect alcohol has had on her body it would be dangerous to put her on herbs. Once I explained these reasons to the treating intern he agreed with my assessment and went ahead with his acupuncture treatment. Treating someone who is or was an alcoholic or has abused alcohol is not something I'm opposed to or wouldn't want to do in my future treatments but I think it's vital to know the full history before prescribing anything. Finding out this information can take time and require trust before the patient may want to tell you all the information.

Intern Reflection 1: J.G. 3/11/14

Self-reflection and Learning Goals 1: Level 1 Term 2

Set of 3 Intern Reflection 1: K.C. 3/27/14, 5/1/14, 5/15/14

Pre-Internship Reflection 5: M.F. 5/1/13

Pre-Internship Reflection 4: E.C. 2/14/13

Pre-Internship Reflection 3: S.S. 1/22/13

Pre-Internship Reflection 2: N.L. 11/15/12

Pre-Internship Reflection 1: M.D. 8/28/12

Coursework: A Personal Reflection on the Five Elements and their Emotions

A Personal Reflection on the Five Elements and their Emotions

 Clinic Communications II

AOMA Summer 2015

Water

Nature of the Qi/A place before structure and conception.

Something that has been of interest to me for a long time is the connection and relationship between our “heart and mind.” How do they communicate? How do they trust each other? I find it interesting that perhaps what I have been referring to as the “heart” is more akin to water, to the kidney Qi. It is the deepest mind, or what I also call “the lizard brain,” that instinctual part of ourselves that only feels, it cannot see or hear, it cannot rationalize. It lays deep inside our bodies and connects us to our deepest desires, the inmost request. (more on this later)

Wood

Ability to say"No"

I find great power and protection in saying "no". In fact, I often have said "no" to things before they were even asked of me. I remember being in elementary school and when all the other girls would be sitting together at lunch I would choose to sit apart from them. I would reject them before they could reject me. I found power and control in that choice.

Spontaneity

Now I find myself surrounded by spontaneous “yes” people. Sometimes they can say it to a fault which can anger and frustrate me. I find it hard to watch them be unable to say no when they really need to or want to. But I think as much as I love being able to say no, to defy others, I surround myself with those “yes” people in order not to isolate myself too much. I know I’m good at planning and decision making, so surrounding myself with more flexible people has taught me how to be more bendable myself.

Fire

Spirit

As I mentioned before, I’ve always had an interest in the relationship between the “heart and mind.” What I’ve realized thru this class is that what I’ve been calling the heart is more akin to the kidney Qi and what I was calling the mind was really the heart Qi: the higher mind, or the rational mind, how we perceive each other and ourselves. As we have heart/kidney imbalance so too we can have heart/mind imbalance. How often we have all experienced knowing something in our higher mind/heart Qi to be true but feeling with our deeper emotion the very opposite. I had an experience many years ago where I followed that deeper instinct/kidney Qi and I shut out my higher mind/heart Qi. It was the wrong choice and caused me many years of pain and sorrow. After it was over my heart Qi took over and I built a great wall around my kidney qi. My heart Qi was angry at my kidney Qi for leading me so far astray and it took many years before I was able to help rebuild the trust between the two. Now I always try and sit in peace and listen to the voices of each in the hopes of keeping that balance safe.

Earth

Part of a group/Connection

Growing up in LA I never felt like I belonged. I always felt like an outsider and wondered if I would ever truly feel comfortable in my own skin. When I went to Bennington college in Vermont it was like this huge weight had been lifted. I felt like myself, among my own spiritual tribe. I felt beautiful, accepted and understood. Living in Austin has definitely made me feel the same, perhaps even more so. While I still am very connected to the northeast, there is some part of it that I find old and stuck in certain traditions, especially when it comes to creativity. In Austin, I love the unabashed love of the weird and different. It’s so inspiring and makes me feel like anything is possible in my future.

Metal

Nature of Qi/Rhythmic order.

In the tarot the death card is one of my favorites. Death, a skeleton strolling peacefully through the world is smiling because he knows what follows him: new growth. Without death, life would lose it’s preciousness. Without pain there would be no pleasure and maybe more importantly, there would be no understanding of the worth of that pleasure. I hate how in movies and shows when they show the death tarot card it always represents a bad omen. Just another example of how American's view death, with fear and misunderstanding. Death is not evil or cruel, it just is.

Coursework: Research Study on Radix Bupleuri (Chai Hu)

Research Study on Radix Bupleuri (Chai Hu)

 Herbology I 

                                                                   AOMA Fall 2013        

           

            The Chinese herb known as Chai Hu is the root of Bupleurum Root Radix Bupleuri. It is part of the Umbelliferae family and is collected in the spring and autumn. Its preparation is to dry it in the sun, slice and use raw. It can also be bake-fried with wine or vinegar to produce different effects. It has aromatic qualities which disperse and lift, it is bitter for purgation and pungent for dispersion. These qualities release half-interior half-exterior pathogenetic heat, regulate the circulation of Qi, sooth the liver and elevate Yang to treat Qi sinking in the middle Jiao (Zhixian & Xingdong, 2004).

            Chai Hu is considered the key herb for treatment of a Shaoyang syndrome. When the pathogenic factor is halfway between interior and exterior the condition is rather complex since the patient can exhibit both interior related and exterior related symptoms (Zhixian & Xingdong, 2004). Of all the symptoms exhibited the most essential one for diagnosis of Shaoyang Syndrome is “alternating chills and fever.” In TCM diagnosis, Malaria is sometimes considered a shaoyang disorder due to patients often exhibiting alternating chills and fever. Chai Hu guides the trapped pathogenic factor outwards and harmonizes the interior and exterior (Chen & Chen, 2004).

            Chai Hu’s ascending and dispersing characteristics are also commonly used to spread Liver Qi and unblock Liver Qi stagnation. It can be combined with many different herbs to treat specific manifestations of Liver Qi stagnation such as emotional distress, hypochondriac fullness and pain, cold extremities, migraine, eye pain and swelling, irregular menstruation with cramps and jaundice (Chen & Chen, 2004).

            It’s ascending nature is also excellent for lifting Yang Qi. If there is a Qi or Yang deficiency causing prolapse of internal organs Chai Hu can be used to raise and tonify Qi, especially if paired with Sheng Ma and Huang Qi. Chai Hu treats prolapse of the rectum and uterus, hypermenorrhea, lingering diarrhea and polyuria caused by deficiency and sinking Qi in the middle Jiao (Chen & Chen, 2004).

            Chai Hu is part of a formula called Long Dan Xie Gan Tang which clears and drains damp-heat from the lower Jiao and drains excess fire from the liver and gallbladder. Due to Chai Hu’s dispersing quality it is added to the formula to dissipate the excess heat being retained. Having this function qualifies it to be the second deputy of the formula. Together Huang Qin and Zhi zi make up the first deputy because they not only clear heat but also drain damp, a quality Chai Hu doesn’t possess. Chai Hu is especially vital to the formula because it plays a second role as an envoy. One of the jobs of an envoy is to guide the effects of the other herbs to specific channels. Chai Hu enters the liver and gallbladder channels, so as an envoy in this formula it leads the other herbs to those channels (Kim, 2008).

            Chai Hu has been used in Chinese medicine to treat Liver Qi stagnation for thousands of years but in 2005 it’s chemical effects relating to Liver Qi stagnation were tested by doctors at the Beijing University of TCM (Chen, Ji, Lu, Hu, 2005). The study examined the effects of Xiao Yao San containing Chai Hu on patients with Liver Stagnation and Spleen Deficiency Syndrome (LSSDS). The study looked at 58 patients suffering from depression, hypochondriac pain, listlessness, flatulence and loose stools. They assessed changes in the plasma indices of norepinephrine(NE), epinephrine(E), dopamine(DA), beta-endorphin(beta-EP), adrenocorticotropin hormone(ACTH), estradiol(E2), testosterone(T), immunoglobulin A (Ig A) and G (Ig G) (Chen, Ji, Lu, Hu, 2005). After subjects in the experimental group had been taking Xiao Tao San containing Chai Hu for one month there was a significant decrease in their self-rated anxiety scale (Chen, Ji, Lu, Hu, 2005).  Blood samples of the experimental group showed their plasma beta-EP was enhanced and their E and DA were decreased. These finding suggests that Xiao Yao San containing Chai Hu treats patients with LSSDS by it’s regulation of beta-EP, E and DA (Chen, Ji, Lu, Hu, 2005). Beta-EP has a close relationship with emotional disorders and imbalance. One of Chai Hu’s actions in the Long Dan Xie Gan Tang formula has to do with it’s relationship to the liver and gallbladder. This study supports Chai Hu in this formula because all the studied plasma hormones have important biological connections to the liver and specifically deal with emotions which could be linked to Liver Stagnation.

            In 2012, two studies were published in which the effects of Chai Hu was investigated. The first one looked at how Vinegar-Baked Chai Hu (VBCH) treats obesity and hyperlipidemia. In previous studies it was shown that VBCH had a much stronger effect on migrating pain and bile secretion than with raw Chai Hu, but little was known about it’s effect on lipid regulation (Tzeng, Lu, Liou, Chang & Liu, 2012).  The 2012 study found that VBCH suppressed the growth of adipose tissue mass as well as bodyweight gain. These finding suggest that it may inhibit lipid accumulation in adipose tissues, most notably in the liver (Tzeng, Lu, Liou, Chang & Liu, 2012). This is an important finding because ectopic accumulation of lipids in the liver is associated with many diseases including metabolic syndrome and type 2 diabetes (Tzeng, Lu, Liou, Chang & Liu, 2012). Though Long Dan Xie Gan Tang wouldn’t specifically be used to treat obesity, type 2 diabetes and hyperlipidemia, many symptoms it treats could be secondary indications for those disorders; such as, glaucoma, uveitis, pyelonephritis, eczema, headaches, etc. (Kim, 2008).

            The second 2012 research paper is directly related to Long Dan Xie Gan Tang as it has to do with the treatment of hyperthyroidism. Hyperactivity of the thyroid promotes an accumulation of oxidatively damaging molecules and since the liver is a major target organ for thyroid hormone, this directly leads to liver damage (Kim, Kim, Chung, Cheon, Ku, 2012). Researchers induced hyperthyroidism in rats and administered Chai Hu to the experimental group. Chai Hu significantly inhibited histopathological changes in the thyroid by reducing the thickness of the follicular lining of the epithelium (Kim, Kim, Chung, Cheon, Ku, 2012). This shows that Chai Hu has direct control on hyperthyroid states. By decreasing epididymal fat, liver damage was inhibited and liver antioxidant defense were enhanced (Kim, Kim, Chung, Cheon, Ku, 2012). Long Dan Xie Gan Tang can be prescribed for hyperthyroidism already, so these findings further enforce its effectiveness in this pursuit. Chai Hu’s actions of dispersing heat and focusing the other herbs towards the liver and gallbladder are now even more significant.

            There are currently no herb-drug interactions for single Chai Hu, though their are a few for the formula which Chai Hu is a part,  Xiao Chai Hu Tang (Minor Bupleurum Decoction). It was shown that after administering Xiao Chai Hu Tang the bioavailability of Tolbutamide, a type 2 diabetes treatment, was reduced. It was also reported that Xiao Chai Hu Tang may cause an increased risk of acute pneumonitis. The formula did not directly produce any lung tissue damage but may be over stimulating the neutrophils which cause damage which is then repaired by fibroblasts leading to an increase in pulmonary fibrosis (Chen & Chen, 2004).

            Chai Hu’s functions are useful for overall health as well as treating more specific syndromes. The liver is an important organ for detoxing the body, so Chai Hu’s actions of both expelling pathogens and treating imbalance in the liver and spleen makes it an extremely functional herb.

Chen, J. K., & Chen, T. T. (2004). Chinese medical herbology and pharmacology. City of Industry, CA: Art of Medicine Press, Inc.

Chen, J., Ji, B., Lu, Z., Hu, L. (2005). Effects of Chai Hu (Radix Burpleuri) Containing Formulation on Plasma β-endorphin, Epinephrine and Dopamine in Patients. American Journal Of Chinese Medicine, 33(5), 737-745.

Kim, H. (2008). Handbook of Oriental Medicine. (4th ed). Anaheim, CA: QPuncture.

Kim, S., Kim, S., Chung, I., Cheon, W., Ku, S. (2012). Antioxidant and Protective Effects of Bupleurum falcatum on the l-Thyroxine-Induced Hyperthyroidism in Rats. Evidence-Based Complementary & Alternative Medicine (Ecam), 1-12.     

Tzeng, T., Lu, H., Liou, S., Chang, C., Liu, I. (2012). Vinegar-Baked Radix Bupleuri Regulates Lipid Disorders via a Pathway Dependent on Peroxisome-Proliferator-Activated Receptor-α in High-Fat-Diet-Induced Obese Rats. Evidence-Based Complementary & Alternative Medicine (Ecam), 1-12.         

  

Zhixian, L., & Xingdong, H. (2004). The chinese materia medica. (2nd ed.). Beijing: Academy Press (Xue Yuan).