Herbal Pairing

There are a number of different possible approaches to putting Western and Chinese herbalism into conversation with one another. As has been argued already on this site, however, looking for one-to-one substitutes from one pharmacopeia to the other is probably not the way to success. Rather, we must acknowledge that every herb is different, even, typically, different members of the same genus. I'm an advocate of learning from the beauty and efficiency of the classical Chinese (mainly Shang Han Za Bing Lun) formulas and then applying some of the strategies in broad strokes to Western herbs. In other words, we may not even end up trying to replicate a specific formula, but rather use principles demonstrated in the SHZBL to create our own formulas that, like Zhang Zhong Jing's, are more than the sum of their parts. 

By way of example, take the well-known Shang Han Lun formula Si Ni San. In my understanding, it treats a pattern of slightly cold extremities due to qi constraint in the center. Unlike the Si Ni Tang or Dang Gui Si Ni Tang patient, this person isn't suffering from true cold, and may in fact have significant heat signs and be full of vitality. However, they exhibit an internal tension that prevents the qi from circulating freely, and therefore the blood circulation is also compromised. The formula consists of Chaihu, Baishao, Zhishi, and Gancao. Chaihu is of course the great disperser of constrained qi--but in order to circulate something you need to clear the way first. So I understand the strategy of this formula to be one of "relax, then circulate." The Baishao and Gancao together serve to relax the Liver, easing the tension in the center. It's a way of controlling addressing the Wood-Earth relationship: Baishao restrains Wood in its attack on Earth while Gancao bolsters Earth directly. Then the Chaihu can do its work of freeing up the qi and spreading it out to the limbs. The addition of Zhishi aids in keeping the qi dynamic moving and countering any over-cloying or over-relaxing aspect of Baishao and Gancao. 

So, how to to apply this strategy to Western herbs? In fact, the 19th Century herbalist Sameul Thomson was one step ahead of us.  He was well-known for his use of Lobelia inflata, an idiosyncratic relaxant, as well as Cayenne, an obvious stimulant. While Lobelia is no Baishao and Cayenne certainly no Chaihu, the idea behind combining the two is parallel to the operative one in Si Ni San. As in that formula, there is a principle of relaxing and one of stimulating (moving the qi or blood). In practice, the indications for the two formulas may indeed by similar, as Cayenne is specifically indicated, according to Matthew Wood, by "unequal circulation,"as expressed by out-of-sync pulse qualities, or red-purple complexion, or even varicose veins--and, presumably, by warmth in the center with cold at the periphery. Of course, the proof is in the pudding; it would be interesting to try a Cayenne and Lobelia for a Si Ni San pattern, or vice versa.

Coming finally to the topic of the title, it seems to me that building up a Western formulary should proceed from knowing individual herbs to combining them into pairs. After all, it's combinations like Guizhi-Baishao and Fuzi-Ganjiang that lie at the heart of classical formulation.

By the way, Colorado herbalist Paul Bergner has an excellent lecture available on CD on Herbal Pairing in Western herbalism.