USING THIS BOOK

Chinese Herbal Formulas for Veterinarians is intended to be a reference and educational text for the use of classical Chinese herbal formulas in animals. This book is adapted from Chinese Herbal Formulas and Applications by John Chen and Tina Chen, which offers a comprehensive look at the use of these formulas in humans. While this text focuses on veterinary applications of classical formulas, we retain the resource of many formulas of historical significance that may not be commonly used in veterinary medicine at this time. Other formulas that are specific to human medical conditions, and those that would never be used in veterinary medicine because of superior Western therapies, have been omitted entirely. Each chapter is prefaced with an introduction to the category of formulas that follow. These introductions have been written specifically to explain how the formulas in each chapter’s category apply to common pattern imbalances found in animals. In each formula monograph, we have included the following sections: Chinese therapeutic actions, clinical manifestations, veterinary clinical applications, cautions and/or contraindications, and acupuncture treatments specific to veterinary medicine. These sections are meant to expand the practitioners’ clinical skills and help assure good outcomes for patients.

Traditional Chinese veterinary medicine (TCVM) has many terms that can, on occasion, create confusion because of their similarity to Western medical terminology. This volume, like Chinese Herbal Formulas and Applications, tries to bridge this gap by providing consistent standards, such as:

• Terms that have become an accepted part of the English lexicon and are well understood by the general public, such as qi, yin, and yang, are not italicized or capitalized.


• Terms unique to the profession, understood primarily by TCVM practitioners, are given in pinyin, italicized and translated, but not capitalized; such as bi zheng (painful obstruction syndrome), xiao ke (wasting and thirsting syndrome), and lin zheng (dysuria syndrome).


• Organ names are capitalized when used in the context of traditional Chinese veterinary medicine, but not when referring exclusively to anatomical function. For example, Qing Wei San (Clear the Stomach Powder), can be used effectively to clear Stomach heat, a disorder of the stomach that commonly manifests as ulcers or gastritis in horses.


• Names and words distinct to herbal medicine are italicized, capitalized, and translated, such as Ren Shen (Radix et Rhizoma Ginseng) and Bu Zhong Yi Qi Tang (Tonify the Middle and Augment the Qi Decoction).


• Translations are omitted after the first full use of the term in one monograph or segment of a monograph, unless repetition is necessary to ensure clarity and safety in discriminating between substances or concepts.


• To avoid confusion, formulas other than the principal formula under consideration in a given monograph will be listed with their full pinyin and common names at each use, unless mentioned multiple times within a given paragraph.


• In the early development of TCVM, animal species were not mapped according to channel pathways, but rather were treated using collections of individual points, now referred to as “classical points.” More recently, efforts have been made to use “transpositional points,” that is taking human points and meridians and transferring them to animal species based on comparative anatomical locations. In monographs in which acupuncture points are suggested, transpositional points will be given, using common point nomenclature (e.g., Jiquan [HT 1] and Kunlun [BL 60]), while classical points will be listed by their pinyin designation (e.g., Qian Ti Men). In those instances where a classical point occupies the same anatomical location as a transpositional point, the transpositional point nomenclature will be used. When a classical point has the same pinyin name as a transpositional point, no corresponding numerical listing will be given. For example, the equine classical point Shenshu has the same pinyin name as Shenshu (BL 23), but is located 1 cun medial to Guanyuanshu (BL 26). In the listing of suggested treatment points, this point would be found under the classical points heading and be given simply as Shenshu. Practitioners unfamiliar with classical veterinary points are referred to Xie’s Veterinary Acupuncture (Xie and Preast, Blackwell Publishing, 2007).

One of our objectives in writing this text is to help veterinarians interested in TCVM better integrate both Western and Chinese modalities into their clinical practice. This text includes the extensive information on pharmacologic effects, toxicology, herb-drug interactions, and research gathered by John Chen and Tina Chen in Chinese Medical Herbology and Pharmacology. Moreover, this text has chapter introductions, clinical manifestations, veterinary clinical applications, formula modifications, cautions/contraindications, and practical suggestions drawn from the clinical experience of the authors and peer reviewers in small animal and equine medicine. It is hoped that texts such as this one will create greater acceptance of TCVM as a valid modality in the community and spur direct research into the actions of classic formulas in domesticated and non-domesticated animals, as well as avian species.

CHAPTER INTRODUCTIONS

The introductory section of each chapter describes traditional Chinese medical theory, therapeutic indications, and cautions specific to veterinary herbal medicine. Here, practitioners will find information on the mechanisms of pattern pathophysiology, how they manifest and are described in the context of Western veterinary medicine, and how the herbs in the chapter work to correct the imbalance, or in Western parlance, treat and/or cure the disease. The introduction should be seen as a valuable overview of theory: how pathogenic factors invade domestic animals and what environmental situations or husbandry practices lead to imbalances. Attention to this section prior to looking at specific formula monographs will be very helpful in determining which formula may be best for a specific animal.

IDENTIFICATION

Each formula is identified by four traits at the beginning of each monograph. Chinese Characters in both traditional and simplified forms are listed first. In cases where the traditional and simplified characters are identical, only one will be listed. Pinyin Names with Mandarin tone markings are provided to identify and provide pronunciation as accurately as possible. The Literal Name is the name translated directly from the pinyin name. Original Source refers to the traditional text or reference in which the formula was first documented. This is an important aspect for identification because it specifies when, where, and by whom this formula was first conceived. However, as many clinicians are using prepared formulas in tablets or granules, etc., it should be noted that these ‘patent’ formulas may vary slightly in ingredients, depending on which source text was used by the manufacturer. In most instances, these are minor substitutions that will not alter the intention of the formula, but clinicians should be familiar with the properties of the individual herbs in order to know how the substitutions may affect the formula’s action.

COMPOSITION

The authors strive to assure the accuracy of the ingredients by giving both standardized pinyin and pharmaceutical names of the herbs. This nomenclature has been carried forward from Chinese Herbal Formulas and Applications to this edition, as has the conversion of herb dosages into metric units.

It should also be noted that some formulas, as originally constructed, contained species now regulated under the Convention on International Trade in Endangered Species (CITES). Obviously, there are moral and legal issues that limit or prevent the use of such species, and their inclusion in this text should not be interpreted as the authors’ endorsement of their use; rather, their inclusion serves to provide a historically accurate portrayal of the original formula. In these situations, modern, non-CITES substitutions are provided in the formula monographs where appropriate.

DOSAGE / PREPARATION / ADMINISTRATION

This section describes the historical (and modern day) preparation of the formulas as decoctions. The decoction dosage form is not commonly used in veterinary medicine. The information provided in this section can be used by those veterinarians who may wish to extrapolate from the human dosage and prepare an individual formula as a decoction for their animal patients.

CHINESE THERAPEUTIC ACTIONS

These are the treatment strategies that link the therapeutic effects of the formula with the disease diagnosis.

CLINICAL MANIFESTATIONS

This section focuses on the diagnosis of the disorder and associated clinical signs. Veterinary medicine encompasses so many species and disease conditions that it would be impossible to produce a text for all. The authors decided to focus primarily on the predominant species seen in common practice: dogs, cats, and horses. However, Chinese patterns of disease and their manifestations can be extrapolated to any species, and although manifestations of poor hair coat or hoof quality may not apply to avian patients, other aspects of the clinical exam, as discussed in the Overview, should allow accurate assessment and treatment of any patient.

VETERINARY CLINICAL APPLICATIONS

It is extremely important that veterinarians employing this text have a complete and thorough understanding of both TCVM theory and the formulas in this text, and prescribe formulas to treat appropriate Chinese medicine patterns, with Western medical disease classification being a secondary concern. Having said this, this section summarizes the primary clinical applications of the formula in terms of biomedically-defined diseases. Please note that this is not a comprehensive list, but an account of the most commonly encountered conditions. Inclusion does not mean a formula is necessarily appropriate for use; in fact, readers will find that a specific Western disease may be listed under multiple formulas. Listing of biomedically defined diseases is designed to serve as a guide to assist practitioners in selecting the best possible herbal formula.

EXPLANATION

This section is comprised of two parts: an explanation of the etiology of the disease, and the strategy of the herbal treatment.

VETERINARY MODIFICATIONS

This section explains how the classical formulas can be modified, based on the clinical experience of the authors, to target the treatment of complications and variations of the same veterinary medical condition.

CAUTIONS / CONTRAINDICATIONS

The herbal formulas chosen for this text are very safe for use in clinical veterinary practice and have been carefully crafted with appropriate checks and balances to ensure safety and efficacy. When appropriate, cautions and/or contradictions for a specific formula are listed for individual species or as a general precaution, such as not using in pregnant animals. With appropriate diagnosis, dosage, and patient monitoring, safe and effective use of these formulas with minimal unwanted side effects should be easy to accomplish.

WESTERN SCIENCES (PHARMACOLOGICAL EFFECTS / HUMAN CLINICAL STUDIES AND RESEARCH)

An exhaustive list of the many clinical studies and research on pharmacologically active substances of herbs and formulas can be found in Chinese Medical Herbology and Pharmacology and Chinese Herbal Formulas and Applications. For this text, the authors have chosen to retain those studies most pertinent to veterinary practice. While some may find the incorporation of human studies in a veterinary text disconcerting, the authors feel their inclusion is warranted for a number of reasons. Extrapolation from humans to animals frequently occurs in conventional veterinary medicine; off-label pharmaceutical use is prevalent and choosing to do the same for plant-based medicine is not so different as to ignore such valuable research. The use of Chinese herbs in animals relies heavily on information obtained from their use in humans at this point in time. There is little to no funding for research on the use of Chinese herbs for veterinary use. On a more philosophical level, TCVM practitioners should understand that the Taoist theory that guides Chinese medical practice is a universal concept that applies to horses and dogs, as well as to humans. Damp-heat in the Bladder in a cat is not that much different than damp-heat in the Bladder in a human patient, and just as Western doctors and veterinarians will prescribe similar, if not identical, antibiotics for this condition, likewise TCM and TCVM practitioners will prescribe similar, if not identical, herbal formulas.

HERB-DRUG INTERACTION

Though critically important, there is little definitive information on the subject of herb-drug interaction in human medicine, let alone veterinary practice. Documented interactions between formulas and drugs are discussed in each formula monograph. Potential interactions are not included because they involve too much assumption and speculation. As TCVM becomes more integrated into daily veterinary practice, more information regarding both the safety and cautions for using formulas alongside Western medicine will become available and will be incorporated in later editions of this text.

TOXICOLOGY

In most cases, the toxicology of the herbal formulas is based on in vitro studies. Readers are advised to examine and understand these reports with the same attention to context, proportion, and clinical application as they would in reviewing toxicology and/or in vitro studies for any medicine or supplement.

SUGGESTED ACUPUNCTURE TREATMENT

The inclusion of suggested acupuncture points is unique to this book. The points listed in this section are for the same pattern of disease or clinical signs that the formula addresses, but it is by no means a comprehensive list. For the most part, transpositional point descriptions are those used as in human medicine for the pattern addressed by the formulas, as well as those recommended by the authors and reviewers of the text, based on clinical experience. Classical veterinary points are also included where appropriate. Practitioners will likely add or subtract points, based on their own experience and on the patients’ specific needs and the complexity of the conditions.

RELATED FORMULAS

These formulas have composition and/or functions similar to the primary formulas. This section highlights the contrasting differences between the primary and related formula(s) without restating overlapping similarities. In select cases, the related formulas are more commonly used in veterinary medicine than the primary formula. That said, infrequently-used related formulas have been included in this text as well, as they may yet find more frequent applications as practitioners gain more experience with their use.

AUTHORS’ COMMENTS

Here the authors seek to provide veterinary-specific practical insights into the use of classical herbal formulas in animals. Years of experience have been put into this section, resulting in the discussion of formula use and modification particular to conditions frequently encountered by veterinarians in the clinic or on the farm. Dietary recommendations and strategies for use alongside Western pharmaceuticals are often included to help ensure the best outcome for patients. The authors hope that as Chinese medicine is being used more widely and additional animal studies are done, future editions of this text will include even more information on how these formulas may be effectively utilized.

REFERENCES

Reference material is embedded in the text for ease of access via endnotes in each monograph. The key information from all of these notes has been carefully consolidated into two thorough bibliographic resources.

• The complete names of historical books (given in Chinese characters, pinyin names, and English names) are listed in the Bibliography of Historical Texts.
• The complete names of recent journals, articles and books are listed in the Bibliography of Contemporary References.

DISCLAIMER

Great care has been taken by the authors, editors, and other contributors to maintain the accuracy of the information contained in Chinese Herbal Formulas for Veterinarians. All information has been evaluated, double-checked and cross-verified. However, in view of the potential for human, electronic, or mechanical error, neither the authors, the publisher, nor any contributors involved in the preparation or publication of this text warrant that the information contained herein is in every aspect accurate, and they are not responsible for any errors or omissions, or for the results obtained from the use of said information.

Chinese Herbal Formulas for Veterinarians is intended to be an educational guide for healthcare practitioners, as professional training and expertise are essential to the safe practice of herbal medicine, in both the selection and recommendation of formulas, and in providing effective guidance for the use and administration of herbs. We cannot anticipate all conditions under which this information may be used, nor explicit adaptations for less-commonly treated creatures or species. In view of ongoing research, changes in governmental regulation, and the constant flow of information relating to Chinese and Western medicine, the reader is urged to check with appropriate sources for all up-to-date information. In recognition of the fact that practitioners accessing information in this text will have varying levels of training and expertise, we accept no responsibility for the results obtained by the application of the information within this text. Neither the publisher, authors, editors, nor contributors can be held responsible for errors of fact or omission, or for any consequences arising from the use or misuse of the information herein.

It is our intention to continually update and improve this text to maintain and enhance its usefulness. We welcome and encourage your comments and suggestions.