Naman,

You should ask your TCM doctor about the contents of the pill. Of course, most health care professionals are busy, and those for whom English is a second language may not communicate as clearly as they'd like to. The patent formula you mention isn't familiar, not even as a misspelling of another; that doesn't mean it isn't right for you - ask your TCM doctor for more details. But first...

Are Chinese Medicine Practitioners Doctors?

Your practitioner may not be legally allowed to be called a big-D "Doctor." There are some practitioners from about 15 years ago who did work for and earn a Ph.D. in it, but that was phased out... Chinese Medicine Practitioners have been able to get Ph.D.'s in other things, like Psychology for example, and some of them are M.D.'s too. Two colleges just received approval for their Ph.D. programs in Chinese Medicine (Bastyr and OCOM), and Columbia is integrating CM into their medical programs, so eventually this discussion will be unnecessary.

The average Chinese Medicine practitioner is educated (at least 3 years, usually 4 years) and legally licensed to practice (some states, like Ohio, are proving to be the behind-the-times backwaters of modern medicine... they don't allow acupuncturists to practice herbal medicine). In any case, Chinese Medicine is medicine, and what we do is 'doctoring' in a general sense. Some patients call their practitioner 'doctor' out of respect for what they've done for them.

Chinese Medicine Practitioners and the Herbs they Recommend

Variation in Herbal Education
All Chinese Medicine practitioners are not educated equally in Chinese Herbal Medicine. Regulations vary by state. Some states license acupuncturists but do not allow them to practice herbal medicine. Many states utilize the NCCAOM's (The National Certification Commission for Acupuncture and Oriental Medicine) testing standards for both acupuncture and herbal medicine. Other states like California have their own board and test (which is much more difficult). Even those who are licensed in California do not all practice herbal medicine to the utmost (personalized modifications of classical formulas/ideas, different for every patient, changed every visit, taken in raw boiled tea or granulated powder forms).

Chinese Patent Medicines
Patent medicines like the one you described are a convenient, simplified version of Chinese Herbal Medicine. Sometimes they are more appropriate than the teas/powders; for example, if the taste of the medicine is a greater priority.

Knowing What You're Taking
'Knowing what you're taking' is not as simple as it sounds. Many people take OTC (over the counter) remedies and pharmaceuticals all the time without really knowing what they are or what they do. We are taught to ask if there are studies, or science behind what is being prescribed. We hear words (chemicals, etc.) that we don't really understand, tune out and then assume that the healthcare professional (or marketing department) knows what it is and that it's safe.

But when we hear Chinese medical terms for diagnosis and its pathomechanisms of disease and treatment, we doubt it... partly because it sounds weird! When a pharmaceutical is only 40% or 50% effective (and it's also relatively safe), the FDA may pass it. When an herbal remedy is 40% or 50% effective, it's not good enough. Can you say 'double standard'?

The point is: to explain what the herbs do, we use Chinese Medical terms... not pharmaceutical terms. The language of Chinese Medical pathology is just as specialized and obscure as biomedical pathology.

For example, a person might have long-term anger has led to a stagnation of qi that transformed into heat. This heat combined with dampness engendered by Spleen deficiency (which in turn came from irregular eating and excessive worry) to form damp-heat, which poured downwards into their lower jiao. This damp-heat in the lower jiao may obstruct the Kidney system, leading to a Kidney deficiency, which can lead to the floating of yang to the upper jiao. This is an example of Chinese Medical pathomechanisms. Different, isn't it? That's why Chinese Medicine doctors often don't go into it. If you want to understand it, you'll have to go to school, just as you'd have to go to school to understand biomedical pathology.

Do I have Liver Disease or Liver Damage?

Probably not! A lot of misunderstanding can result from a Chinese Medicine practitioner telling their patient just a little bit of the Chinese Medicine diagnosis without explaining more.

When a western medical doctor says "liver," he is referring to a very specific organ, a collection of tissues tucked behind your ribs on the right side of your upper abdomen. When a Chinese medical practitioner says "liver," she is referring to the organ as well, but also to all of the manifestations of its functions throughout the body, including particular emotions and senses influenced by the liver's energetic system. In Chinese medicine, the Liver (capitalized) system includes the eyes, the proper flow of qi throughout the body, the fingernails, and the tendons and sinews. It partners with the Gall Bladder, and is associated with emotions of irritability, frustration, anger and rage.

The actual liver organ may or may not be involved. Usually it is not except in extreme situations like chronic alcoholism, hepatitis, acute gallstones, cholecystitis, etc. where there is liver damage.

Many of us in modern civilization have what we call 'qi stagnation' which always involves the Liver system. When we get emotionally 'stressed out,' the liver qi stagnates. This can also happen with certain foods (greasy and fried). As an example: Xiao Yao San is a common patent formula used to move the Liver qi (but that's not all it does, and there are hundreds of possible Liver formulas).

Why Hasn't Anyone Heard of These Herbs?

Unless there are licensed Chinese Medicine practitioners in your discussion group, no one will have heard of them! These are not vitamins, or the latest-greatest-health-product... these are classic medical formulas (most 200+ years old, some formulations are thousands of years old). They are too specific in their application to be sold in drug stores (at least until the public learns more about Chinese Herbal Medicine). They are meant to be recommended by trained professionals like your Chinese Medicine practitioner.

Hope that clears up some of the confusion,
B