Eric Brand:

So because they have about two to 300 formulas available off the shelf and another 300 singles or so to modify them a lot of the doctors in Taiwan start with a whole formula, and sometimes they combine multiple formulas together and then add single herb ingredients. Whereas in mainland China, uh, it's mostly done the same way as they deal with the Ragab. Decoction

Michael Max:

hi, you're back for other qiological epic. Great. I'm glad you're here. I'm Michael max. And today we're taking a deep dive into herbs, not so much their prescriptive use, but more in terms of how could I say this? I guess you could say infrastructure. It's easy for us to think that because we have a darn good English version of the material. Matika, that's a centuries of herbal knowledge is at our fingertips, but there's a whole lot of backstory to these medicinal substances where herbs come from. How they're cultivated, how different plants have been used over the centuries. There's a lot we take for granted, or we simply trust our suppliers to have worked out all the details on identification and quality in a moment. We're going to get into this conversation, but first I want to say a quick, thank you to those who have sent pictures of where you're listening to the podcast. You know, I sit here in the qiological podcast studio, AKA the waiting room of young con Chinese medicine clinic and have these conversations with you, but rarely do we get a chance to meet. So I appreciate the photos and postcards from the different places where qiological finds its way into your ears. And lately I've been hearing from a lot of students, which was a real surprise, as I thought, y'all's would be busy with your basic studies, but it sounds like some of you enjoy these conversations, that cover material that won't help you pass the licensure exams. It gladdens my heart to know that there are new people coming into this field who are thirsty for the diversity of the methods that are within Chinese and east Asian man. Well, okay. Enough of this job owning, you probably want to get into today's show. I know I do, man. I got a great job. I get to tell you, I get to have conversations with smart people who are so lit up by what. I've got Eric brand with me today. Eric is a self-described herb nerd and he has a PhD in Chinese herbal medicine to prove it too. I first met Eric in the early part of the century. When we're both in Taiwan, he's still there. At least we're not traveling to some conference or to teach. We're really lucky to have guys like Eric who are fluent in Chinese and can go deep into the culture and the modern educational and business relations in such a way that he can bring new information to us here in the west. Most especially about herbs, which is the topic of what we're getting into here today. Eric, welcome to qiological.

Eric Brand:

Thanks, Michael. It's really an honor to be here. You've got such a great group of people. I can't believe that I'm on your list here.

Michael Max:

You are, so there you go. Yeah. We met in Taiwan all those years ago. You're still there. What have you been up to these days? I know back when we were hanging out, you were really into herbs and then you headed off to Hong Kong for a PhD. What are you up to these days?

Eric Brand:

It's been quite a few years since we were hanging out drinking oolong tea together in Taiwan. So I was doing a lot of work with translation. If there's one thing that's sort of a consistent theme here in my life, I guess it's running into good teachers. So around the time that we were visiting together in Taiwan, Really fortunate to be spending a lot of time setting with a phone. Yeah. Nigel Wiseman learning foggy brought me into the hospital to do more clinical medicine. Nigel was teaching me about the translation over time. I started getting into really, really interested in the granules, started meeting a lot of the people at the owners of the granule factories started going around to mainland China throughout Taiwan, visiting all the granule factories, generally trying to learn more about the prepared products and then over time. Generally it tended to move more and more deeply into the herbs. So in Hong Kong, I was really fortunate to encounter my PhD supervisor, professor Jong Jenn. He's really, uh, one of China's very top experts for herbal identification, and I felt really fortunate to have the chance to study with professor chow in the Chinese world. He's mostly known for. Chinese medicine authentication. He did a lot of early work with microscopy the powder analysis of being able to identify Chinese herbs in powder form using just a microscope in the Chinese world, mostly known for a lot of his scientific contributions, but really his passion is that broad, traditional discipline of materia Medica. So it started in front of literature throughout the identification of herbs, traditional macroscopic differentiation. Traditional identification of quality through to poucher natural resources, basically all of the background story of the herbs before they reach you in a dried sliced form and your pharmacy. And so over the last many years, really, I've been focusing more on. You know, the plants and the, and the sliced crew drugs rather than the patients. Exactly. But I've been just having a great chance to jump into that topic. And my teacher has been bringing me throughout China to see farms, factories, or bull markets, and it's been really rare opportunity. So I've been just pursuing that as much as I can.

Michael Max:

Fantastic. I've got a few questions about that. So you were mentioning. Those of us here in the west. You know, we get these packages, we got our crude sliced herbs and you know, we've done our study and Chinese medicine school. So we've got an idea of what Europe is. And I hear you say, you've got this teacher in his main thing is herb identification and it makes me go what you mean? They don't know how to identify it. After 2000 years, what are some of the issues around herb identification that he's looking at in his pertinent? In particular to us as users of these

Eric Brand:

products. In a sense, you could say that herbal identification is relatively mature and that the vast majority of the medicinal products that we use, somebody has gone very, very deep in through the historical events, out literature, through the botanical illustrations in ancient texts. Basically verifying that, you know, what we know as today is Ren Shen was that really the product that was used as wrench in 2000 years ago, which plants in Chinese medicine have had historical changes. For example, something like you have a lot of adulterants on the market. A lot of confused species, the ancient texts often described by Taiwan with relatively vague terminology. And so clarifying exactly what was the precise botanical identity of by too long, at different points in history. Is it self custody and then figuring out, okay, what, what material is used as by Taiwan in different parts of China throughout different parts of the world. Like for example, in the U S when we encounter zits, how we often encounter, uh, adult Trent as this house, which is called potentilla, chinensis often sold in like Chinatown pharmacies under the name at top, it's an aerial part of a plant versus a purple. This material, if you go to like a typical Chinatown pharmacy in the us, or in, in Holland or in Australia or in Canada, most of the pharmacies that if you just ask for the item that they'll dispense is not actually, so it's hot, but it's a customary regional substitute. That's been used as it's how in Southern China for hundreds of years. But if you go to Taiwan, you find that same plant is sold as. That plant in Taiwan is used as by TOA in Cantonese regions tends to be as desserts. And it's neither by too long, nor is the top. So when we think about what are issues in Chinese herbal identification, it's not that nobody knows what that plant is. We know what that plant is, but it's still widely confused and trade because you have over hundreds of years. Pharmacies being in the habit of scenes. That's how looking like the earth. As you know, I, when I first started studying Chinese medicine, I did an apprenticeship in a Chinese pharmacy, a Chinatown style shop in San Diego where I was filling formulas in the shop for about three years. And the boss in that pharmacy, this is how that he has is, is the Cantonese. But if I was to go with a sample of genuine, authentic, or Navia with Chinese pharmacopeia officials, that's our product. He wouldn't recognize it. He wouldn't believe that that is genuine sets out. He would think that the genuine sits, how is the one that he's been using for the last 45 years?

Michael Max:

So there are some regional differences. There are some differences through time. How some of these substances have been used. And that can create some confusion.

Eric Brand:

Right? And so when, when I did my PhD research, for example, one of the items that we focused on was I basically had two large components. One that I was looking at during the British colonial era, the British, during the time of the Singapore and Malaysia was a British colony. They collected basically all the Chinese medicines sold and Chinese pharmacies and peninsula Malaysia, and brought them back to the UK and store them for about a hundred years. And the last hundred years, nobody has systematically gone through. That whole range of samples to look at how those historical specimens are similar or different to the decoction pieces that we use today. You can see some of the plants that we see as common substitutes in a Chinatown pharmacy in LA today. We're also. Already appearing and substitutes in Chinese pharmacies and in Malaysia a hundred years ago. And then we looked a little bit more closely on some of the ones that are related to issues of risk of low kick acid, because those have a really clear safety component to them. And the very clear example of like confusion of botanical identity and the importance. Correct botanical identity in terms of Chinese medicine safety. And so if we think about the case with Mouton, historically, the descriptions and the botanical illustrations and the ancient benzo texts suggest that Akia spaces were used as Mouton in ancient times. So as you probably know, from all your work with Hong Kong and studying with Shanghai, Lewin, the names Those two names were switched. So in early, early times they use the name to describe what we today called Mouton. But that Mouton at that early times was derived from Makiah and all the way through to the present day in Japan, they only use the Kabya sources of Mouton, but as TCM practitioners, you know, the primary. Uh, Mouton the Chinese medicine practitioners use is try Mouton and try Mouton is a safe form of Mouton that doesn't contain a risk to look acid, but try Matone has been used to at least since around 1848 it's well-documented at the benzo techs, but try Mouton is actually somewhat of a later form of. And Acadia's forms of Mouton were very rarely used in Chinese medicine today. Akiba is mostly cultivated for the fruit in China, by UHR. And so they keep the plant alive and keep harvesting the fruit rather than cutting it down and using the stamps. And so there's overall much more limited. Natural resources and medicinal material of Akiba derived Mouton in China. And basically what happened in the Ching dynasty is you started to have a substitute from Northeastern China derives from Aristolochia Manchuria, ANSYS squad, Mouton, and Guan. Wu-Tang had abundant natural resources, relatively thick, high yield in stem. And so it became used as a Mouton substance. And it was never recorded in the traditional benzol literature, but by the time they started doing a systematic market surveys in the 1960s in China, and trying to figure out what are the Latin names that correlate to all the Chinese names of the products and trade at that time, Guan Mouton was already very prevalent. And so pretty much from like the latter half of the 20th century until after the 1990s, when the dangerous of acid and Mouton were discovered and Guan Matan was eliminated from trade, it was banned from trade. But before that time, it was quite, quite prominent. And so now Butone, it's almost impossible to find it in a normal market today. It's been very effectively eliminated from trade and all that we see as trends. So for my PhD research, I was, I was looking at different historical specimens of Mouton. So taking like Mouton from Japan in the late 18 hundreds, Mouton from the mid, late 18 hundreds in China and different specimens from around a hundred to 150 years ago and figuring out can those historical specimens help clarify the timeline of when. The substitution of Mouton with theorists to look at Gasa containing species emerged. It was great. We even got to go to the British natural history museum found a 300 year old specimen of Akia confirmed that what we knew from the Bentel literature was correct. Basically. Well,

Michael Max:

this in-depth look into herbs like you've been doing, like you just described. Is this something that's commonly done in.

Eric Brand:

You know, in China, you basically have the, the field of Chinese medicine in a way it's sort of split into two branches at the school that I was at in Hong Kong. All of the major universities in Hong Kong have Chinese medicine programs, but the only one that has Chinese herbal pharmacy and Chinese medicine as two separate disciplines within the school was our school Hong Kong Baptist university. And in China, it's very common for them to have. Herbal medicine and clinical medicine as two separate tracks, basically pharmacy and medicine in the west. Basically the only part of the field that we're currently able to really access and study is the medicine side. And so we know when to prescribe versus Shandy, but we don't necessarily know much about. The origin of DUI. We may have the idea that du Hong has, uh, a Dowdy region in Hunan where the best is produced or that we have this concept that shooting Hong is, is processed with wine or it's steamed. And you have this basic idea of, of powder, but exactly how is the poucher executed? What part of China does Dijuan come from? In fact, YWAM has, has been grown from clone from cut-ins for over a thousand years. So de Hong actually, which people will plant de Hong seeds, they'll get reminded of those seeds, plant them in their garden and think, oh, I've got Dijuan growing. But actually the, the medicinal de Hong that we use is not derived from the genetic diversity of seed ground material. It's a selected cultivar. That's been grown by clone in a certain region for. Over a thousand years. And so certain herbs, like there's a whole tradition of cultivation, selection of cultivars and stuff that goes into the background of these arts. Generally in the west, we pretty much are only dealing with. How to prescribe the medicine. And in China, they have a pharmacist that they can rely on to figure out where to get the decathlon, where the good Dijuan comes from. You know, all of that stuff. They have pharmacists who can sort out the raw material supply, but in the west, we kind of need to be a Jack of all trades. We're expected to be the pharmacist and the doctor. And so there's this whole area of verbal pharmacy that thus far hasn't really reached the west because it mostly is still only available in.

Michael Max:

Yeah. We're basically relying on our suppliers and importers and hoping that they've got the background to make sure we're getting the right stuff and in a good.

Eric Brand:

And we are lucky that we are in a field where we have some very good suppliers and very good importer. So you do have some choices of people that are really passionate about sourcing and getting the right material in the field. But of course, depending on a supply chain, anytime you have people that are business people involved, where you have business and academia, sometimes these two things makes perfectly and sometimes not as perfect.

Michael Max:

Yeah, you were talking about visiting granule factories in Taiwan. You got a chance to go see all of those. Those have been around a while now, and then chance to see it in the mainland as well. How would you describe the manufacturer of granules in each of those two regions and how they're different or how they might be.

Eric Brand:

It's fundamentally similar because the process of making granules is basically replicated in a water decoction so it's not exactly. Rocket science in terms of the core principle. However, it, it does have a tremendous amount of, of modernization and that the level of technique that's applied is actually really inspiring. It's sophisticated in both mainland China and Taiwan. You have some very, very advanced, very sophisticated granule factories and to a westerner who's never seen a granule factory it's really mind blowing to see. That level of technology and scale implemented around an herbal medicine

Michael Max:

product, not to mention a bunch of laboratory

Eric Brand:

equipment, you have whole rooms full of basic equipment, like HPLC or TLC microscopy, but then you also even have things like, uh, you know, UPFC and then people even do. Testing equipment like Q TOF mass, where they're able to take these complex fingerprints, because one of the most complicated things is for whole formulas that have been cooked together, to be able to have the quality control, to measure such complex multi-component mixtures. You have some new generation technologies now that are emerging, that are doing these complex fingerprinting that are still really at the research stage. But for. Understand the complex fingerprints of whole formulas cook together, uh, as well as even identifying down to like the production region of a certain earth, like taking an Arab from different production regions in China and looking at its overall complex chemical fingerprint to try to figure out can the fingerprints even help to clarify where the earth was grown. In some cases, it seems to be able to, so you have a huge amount of technology and sophistication going on in the lab, but if you ask about the basic differences between. Taiwan and mainland China. I would say that one of the key differences is that the industry in Taiwan started very early. Originally granule technology originally was pioneered in Japan and started to become integrated for Japanese compo and became integrated into the Japanese national insurance. And after it became accepted by Japanese insurance. It really opened up the market tremendously. And the first granule factory in Taiwan suntan, the owner of suntan had studied in Japan, brought the granule technology back to Taiwan and Taiwan originally started making a lot of whole formulas for export to Japan. The industry in Taiwan gradually developed around. Whole formulas that have been cooked together and then add in single herb ingredients. And so the prescribing style in Taiwan is very heavily influenced by which products are available. So because they have about two to 300 formulas available off the shelf and another 300 singles or so to modify them a lot of the doctors in Taiwan start with a whole formula, and sometimes they combine multiple formulas together and then add single herb ingredients. Whereas in mainland China, it's mostly done. The same way as they deal with the robber of decoction. So they write out the ingredients and the raw decoction doses, and then they just replicate that in granule form. And in the past, they used to use these small little single dose packets, but now it's increasingly happening in mainland. China is they have these large automated, like sort of a refillable 300 gram tube style. It has a special lid that fits into an automated machine. And so they'll have like an automated system. Each herb has a variable concentration ratio and software that adjusts it in the computer so that the doctor writes down the raw herb dose weight, and then a computer adjusts. It weighs out each individual herb to get the same concentrated equivalent of that raw herb dose weight, mixes it all together and then dispenses it in single doses for the patients. And so basically you have two different styles of prescribing going on.

Michael Max:

I was talking with Andy Ellis here at the beginning of this year, they were talking about the so-called five to one concentration getting a true five to one. Really depends on the substance that you're working with. What I hear you saying is over on the mainland, they're aware that some things may be they're concentrated two to one or others. It might be concentrated 10 to one, depending on how they do it. And so they're writing a prescription based on. Uh, traditional prescription or whatever the doctor thinks. And then they're able to put in a certain amount of granules based, not just on weight, but also on its concentration to create what the doctor would have otherwise done with raw herbs. Is that correct?

Eric Brand:

The doctor is just writing 10 grams of by Shaw. And he wants that 10 grams of bio as though it were raw herbs in a decoction and then the software is figuring out how much of this concentrated extract to dispense, to equate to 10 grams of by shell. Whereas in Taiwan, they're not really thinking about the granule dose based on his driver equivalent. The insurance in Taiwan covers a six gram dose of ground. And they usually give that dose three times per day. And so usually in Taiwan, most doctors are dosing around like 12 to 18 grams per day of granules. But they're thinking about that total daily target those. And they're thinking proportionally within that target dose, how much of it is going to be formula a, how much will be formula B, how much of it is going to be the single or modification ABC. And so in Taiwan, In the doctor's head. It's mostly thinking about what's the total amount of granules I'm giving to this person and adjusting it proportionally rather than thinking about what's the raw or equivalent. Of that granule dose. And so oftentimes in Taiwan, you'll see the same doctor when they prescribed raw herbs, versus when they prescribed granules. If you actually do the mathematical calculation, they give a different dose weight when giving raw versus giving granules. But granules is covered by insurance. RA has to pay out of pocket. Granule has a limitation on the total dosage, that's imposed by the government. And so they generally work within. That dose range. And I think that, you know, cost is often a factor for people using granules throughout the world. So if you see practitioners in Australia who are granules are far more expensive than, than there are in America, you know, in America, the granules are maybe half the price or less than an Australia. And so in Australia, The price is very high. And so practitioners tend to use relatively low doses in America. The price is intermediate and people tend to use, uh, you know, doses lower than in Taiwan, but, but higher than Australia. And so, and then in Japan, the granule price is very, it's very high, but the dosage tends to also be very low. So in, in Japan, Typically using only about six grams of granules per person per day, and Taiwan, they're using 12 to 18. There's so much variation, even between regions of what is the total amount of granules that people are using. It's a little bit tricky to make a precise claim that when those ranges correct, you know, I

Michael Max:

think it's incredibly tricky as you pointed out, it has to do. With insurance reimbursements. It has to do with local economics ESU with local habits. I mean, I remember when I first got to Taiwan, I was there like a month and a half and I got really, really sick and a friend of mine who was also there studying language, said, Hey, I heard about this old Joni. Right? Let's go see him. Let's have him prescribed some herbs for you. So we go down and she translates. Cause I can't speak at that point. And this guy, a fossil he's like in his early nineties, You know, so we talk, he takes my Paul's blah, blah, blah, the earth girls dish up some powder. And I say to my friend, go find out what they gave me. I'm here to learn, go find out where they gave me. It turns out he gave me five different formulas, modified with like four herbs. I, you know, I looked at this and I just went, man, if I would have attempted something like this with my teachers in the United States, they would have been. Haven't you been paying attention? I thought this guy was like beyond just pull data. It's like, what am I doing? Well, it turns out I take the herbs and I'm sure that I'm going to be in the hospital the next day. Cause I was really sick and I get up the next day and I'm 80% better. I usually have a dry cough after a cold. I cough. I have a mouth full of flam and I'm thinking what happened here. Right? Here's a way of working with herbs completely foreign to me. It clearly is effective. Right. But it's a whole different way of thinking about prescribing herbs. And it seems to be a very Taiwanese style. So to speak, like you were saying on the mainland, they're really looking to replicate a raw prescription. So I'm wondering if you can go a little more into how the Chinese doctors in Taiwan are thinking when they're thinking about putting together for formula. And then modifying it with five

Eric Brand:

different herbs. Well, you know, that's actually kind of, the way I got into granules in the first place is, you know, my interest in granules really came out from being in the hospital in Taiwan, watching how they would prescribe these, this, and basically like what you said and a whole new way of using granules, something that. You had some of the teachers from mainland China would come to do lectures at the hospital and in Taiwan. And they would think that the Taiwanese style of prescribing had completely lost all direction. They thought, oh, you've got, you know, you've got three formulas with 10 ingredients, you have 30 herbs and 12 of them where you are irrelevant for this patient or whatever they say you can't subtract. You can only add, you've got basically. Too many ingredients, losing the clarity and direction of the formula and the Taiwanese doctors would think, no, it's just the opposite. Each formula has a very clear principle. And so they're seeing these three formulas. They're not seeing it as 30 herbs. They're seeing it as three. Principals almost using those three formulas as though they were three single herbs, you know, almost using a shaoyang sun as though it were one herb that courses deliver in supplements the spleen. Right. So when you're often modifying a prescription and you think, okay, the patient has problem, eh, But they've got a little bit of water it's disharmony. That's not their major concern, but if would an earth aren't in balance, it's going to be harder to address main problem. And so it, as a raw prescription, you could just add a little bit of Thai who and Viju, and, but you have to add several ingredients to make it happen, you know, whereas they would just add a little bit of shadow side to just tinker that literacy dynamic. Oftentimes like when I would look at my teacher, I phone, yeah. He would take something like. Mozzarella and one and shy. Let's say he's got somebody who has a chief complaint of constipation, but they don't need to take long-term. Purgatives really, they mostly just have Woodworth and balance that once that's corrected, then the constipation will be back in sort. He would use the Matsa ran one and the shaoyang started together and alter the ratio of the two of them. So when the person still has more constipation, the monster in one proportion is higher and the shaoyang son is lower and he is generally. Change it so that the shaoyang assigned generally gets increased in the monster and one tapers off until he can drop off the Mazzara and one altogether, keep the shaoyang sun. And then the constipation doesn't bounce back. I got really interested in looking at how people use granules just from. That difference between mainland China and Taiwan. And that made me start to talk to a lot of different doctors using granules in both places. And I realized that in Taiwan, a lot of the doctors didn't know what was going on with granules and mainland China, and a lot of doctors in mainland China didn't know really what was going on with granules in Taiwan. And so I discovered it was kind of a fascinating topic to get into. And you realize that there's so much that even with the. The Chinese world, nobody has written a handbook or a book, even in Chinese that really clearly describes some, there's still a lot of misunderstanding in mainland China about things like what does the Taiwanese companies market? Their granules overseas is five to one. What does that mean? And likewise in China. So you have all these different issues of confusion where. These two types of granule products. They're only really encountering each other for the first time overseas because the Taiwanese granules aren't legally able to be sold in China and vice versa. And so these two types of granules never actually encountered each other until they go to Germany or Singapore or Amsterdam, right. As Western consumers, we have the chance to, to choose the, you know, sort of take the best of. Of all worlds in mainland China, the way that the granular prescribing has evolved. Has influenced by the regulations so far, you don't have a place in Chinese regulations for the whole formulas cook together to be dispensed in hospitals. So the single herbs are basically regulated under the same category as decoction pieces. So they're not finished medicines and tell a doctor, prescribes them and compounds them together. Um, whereas in Taiwan, the regulations basically allow. Any formula up through the end of the Ching dynasty, basically any formula over a hundred years old, that's ducted, according to the classical text that can be made into a prescription granular and then also the single arm. So you have some differences, mainland China, a lot more single herbs with different powder choices in Taiwan, a lot more whole formulas that have been cooked. What are your thoughts

Michael Max:

on the signature of a formula that's been cooked together versus a bunch of granules that are all made up separately and then mixed together? Of

Eric Brand:

course, it's one of the most important and most popular questions. Uh it's. Most challenging questions to answer right now, when we're trying to understand, basically, historically people ducted the Arabs together. A lot of practitioners feel like the most conservative choice is to preserve that interaction in the decoction process. And there are a number of arguments that can be made that suggested it's desirable or important to preserve that, uh, whatever synergy may exist in that decoction process. So for example, let's say. I formula like my long tongue versus matching shirt on top, the two formulas fundamentally the same, except in one case you have wager accentuate in the warm, accurate, free nature of Maha. And the other case you have sugar gal being cold and causing the form that instead of being a warm, accurate formula, now it's a form able to treat lung lung heat just simply by the change of using instead of using Glazer using Shugar. But if you look at the chemistry of that, Yeah, my Hong is a lot of its activity is related to its alkaloids and the solubility of alkaloids in a decoction. And why did he, caution is going to be affected by the pH. And so if you have some herbs that are naturally sour, like a way it's a woman. ShaoYin jaw things that have a lot of organic acids. These will tend to lower the pH of the solution. Whereas if you have a lot of mineral products, like Mouli Longo, a lot of these relatively alkaline minerals still tend to raise the pH of the solution. So you would tend to have more solubility of alkaloids in a more acidic solution and less solubility in a more basic solution. So it may be that in some cases like something like You know, if you analyze it chemically, this fundamentally, most of the calcium right now is the major value of. Ingestion of the calcium per se, or is it potentially its presence in the formula, in the decoction altering the solubility of some of the other constituents and how to analyze that and how to interpret it. It's a very complex question. So you take a formula that's ducted together and you take a formula mix from singles, put them through HPLC and compare the, the chemical peaks of them. You'll see, there are some differences. In the peaks, but what is the significance of those differences is a very difficult question to answer because the peaks that you're looking at and measuring those are things where you have a pure, analytical reference standard for like, let's say you want to look at how much longly is in Hong and J Tom cook together versus wildly engaged Atomics from singles. And you can look at like the, the Burberry and con. You could even say, okay, you've got hung by in Hong Kong and they both contain bird brain. Right? So you could even look at a few different markers. If you let's say you're looking at that berberine, you have a pure sample of berberine that you can put into the machine and then, you know, okay, that peak is Burberry, but what's that peak next to it. You don't have a pure analytical reference sample. So to identify what is the chemical structure of that peak, even if it's a known chemical it's challenging. And if it's an unknown chemical to then be able to. Isolated characterize that. Even to identify what it is, right. It's potentially a $10,000 research question, you know, in terms of the cost operating costs. And then even you've identified what it is to isolate enough of it. And then to somehow test its pharmacology, to give it to how many rats under how many different models to figure out. No, maybe it treats diarrhea, but does that clear heart fire? Right? What model, what animal model can you use to, to assess that? Right. And so what is the activity. You know,

Michael Max:

you were just saying something about my and my long tongue and how adding minerals can change the pH of EduCom action. It might even change what is being pulled out. So maybe my long acts a little bit differently with the pH that sure gal is causing versus the pH that something like. Is causing. So is my thinking correct here. Let me ask you this, that there are certain things that would show up on that various equipment that shows active ingredients and such, but to, could there be some difference in the character of the moth long when it's come out in a more alkaline solution, then when it comes out in say a more acidic.

Eric Brand:

You know, when something like my hung a little bit tricky to fully answer the question, but like, if you look at Jeremiah Hong, the honey process, my home versus the unprocessed, my Hawk. So I unprocessed my home. When you cocked it more, alkaloidal enter the decoction the process model Wong. The honey actually inhibits the ephedra alkaloids from entering decoction. So you would typically expect you wouldn't be surprised to have a different intensity of alkaloid concentration. When but Jamal hung that moderated effect. Is desirable in the case where it's in my home is used or traditionally, you know, from like the Shanghai Honda. And they recommended removing the notes of my hall. And when we went to like the British natural history museum, we found a 300 year old specimen, Amal Hong from China. At that time, all the nodes had been removed, but then we looked at other specimens of from a hundred years ago, like from, for example, that, uh, And the gold, a gold dress collection of Chinese herbs. That's been preserved since, uh, for about a hundred years in Oregon, the ma there, the nodes had not been removed. And in the modern herbal shop today, you typically will find Mohan without the nodes removed the nodes of Mahwah. If you analyze them chemically, like if you take my Hong and you break open the fractured surface, it's got a little bit of a pink color on the middle of the pit. And the intensity of that pinkness is related to the alkaloid content. If you analyze the joints of my home versus the space in between the joints, the joints have much lower alkaloid content. And so the removal of the nodes in the traditional practice would have increased the potency of the mouth. By wait, but is the action of my home purely related to its effigy and alkalize difficult to say clearly it's definitely related the sinus, you know, effects are related. The sweat promoting effects are related to urination, depends related, but my Hong also has volatile oils and other things in it. And that that's never been fully. Systematically analyze. So a lot of the things that we know, like with chemistry and traditional medicine, it's hard to fully correlate. You could definitely say that the Burberry and in Hong land's related to its anti-diarrhea effect, but there's no scientific model for. Assessing what in Hong, the end clears heart fire, right? There's not a pure correlation between chemistry and traditional actions. And so we look at the HPLC fingerprint of a formula cook together versus one mix from singles. And we say, okay, there are differences. And because of the differences, some people would say it's better to follow the traditional method and keep whatever. Synergy and the decoction process was there. And if you're a chef and you're making a dish, you would know the add in the garlic and stewing the meat with it. It's going to be different than if you were to add the meat and the garlic together at the end and mix it together. And so you have a lot of ways that you think that this interaction of ingredients, it has traditional justification has scientific justification, but at the same time, the scientific justification is a little bit unclear because. When you're dealing with like a whole formula that's been cooked together, you genuinely rely on having a supply chain where the herbs are already dried and available at the same time. When you're dealing with the herbs from singles, you can get it straight from one farm, right after harvest extract the entire amount in an optimum. Decoction conditioned for each year. And so in one case, so let's say like, you want to have your child sign and you wanted to add Hong Shanti and child side. You have a little bit more like lung heat. For example, Hong sheen is going to extract best with a slightly longer decoction time. But in cello, sun is going to need a relatively short decoction time because it needs that short decoction time for that. Herbs to reach the surface of the body, according to the wind being Taliban. Like when he, when they talk about some JueYin, you know, they talk about the prolonged caution will cause the flavor to thicken, uh, into the interior. It needs a short decoction time to rise to the surface. So it'll disperse, right? And so you want a short decoction time for you and shall, but a longer decoction time for hung sheet. So any way you boil the Hong scene with the end child, it's going to be not optimized for the longterm, but will not be optimized for the other, historically people didn't ever. Test this out scientifically, they didn't have nine different pots on nine different fires and boil each verb under optimized conditions and then mix it together and compare that to everything put together. They had a limitation of firewood, a limitation of resources. They just had one pot on one fire.

Michael Max:

We're busy treating people. They weren't being researchers. They were just treating people.

Eric Brand:

Yeah. So they, I mean, they cooked it together because. They only had one fire in one pot going, it wasn't necessarily because that was systematically tested to be the best way, but that's still the most conservative thing is to preserve that traditional decoction.

Michael Max:

Yeah. So, you know, back to traditional decoctions, you know, we're talking about. The way that they prescribed this stuff in Taiwan, which is a whole different mental framework. And if you know that framework and you can work with it, you, you can actually get some pretty good results. And then you've got the thing in the mainland where they've got these incredible machines that are going to look at the actual extraction ratio, do some fancy footwork with mathematics and computers, and be able to create a granulated formula that matches what occurred. Formula would have been. What about us that are here in the west? You know, we don't have these fancy machines and the extraction ratios, generally speaking are not five to one. How do we know that? What we're thinking in terms of dosage actually matches reality when the patient drinks it out of the.

Eric Brand:

Going back to what you're saying about the, the five to one, five to one is slightly, it's often a slightly imprecise rule of thumb. The way that the five to one thing really actually started around the world was mostly from Taiwanese granule companies. When people would ask them, what's the concentration of the herbs, you know, trying to attract down, you know, where did this myth of the five to one? Where was the, you know, what. Where did it come from? Right. Andy was telling me originally that, uh, back in the day, the Taiwanese companies would take a decoction. They would make the decoction and then reduce the decoction in volume by tenfold, and then add starch to. To fivefold and they call that five to one. And actually in reality, if you haven't been to Taiwan, you've probably seen the granule bottles in Taiwan. All of the granule bottles in Taiwan have the label that clearly describes the concentration ratio. One gram of this product is D cocktail from 3.4 grams of this driver with, you know, ducted into this concentration mixed with this amount of starch. But when the products are exports to the U S they remove the. Information from the label. And, uh, for a long period of time, customers would ask, well, what's the, what's the concentration. And they would say five to one. That's not five to one in the modern way. We think about one gram of this powder equals five grams of the ROV. And decoction, if you, each of the herbs in Taiwan, every herb has a slightly different concentration ratio because every herb, when you decoction and water. Each of them has different amount of water-soluble components. So something that's got a lot of insoluble fiber, like geesh, Tom, that's a vine heavy vine that has a lot of material. That's going to be discarded after you in the drags, but it's only, only yields a relatively small amount of extract. Relative to the way naturally, it's going to have a much higher concentration ratio than something like pizza, where it has a lot of soluble component and you get a lot of extract relative to relatively small amount of the, of the driver. And so it was, uh, in mainland China, they started making granules much later. And so they only really started doing granules and mainland China in the middle. So Taiwan had already been well established and granules, but it started in the seventies. And so you had two different era in which the technology matured, and then you have two different styles of making the ground. Between Japan, Taiwan and mainland China, you have slight difference where in Japan and the granules used in Japan and mainland China, they first make a decoction and then dry the decoction without any excipients. And then they have a. Pure extract that has no excipient and variable concentration ratio. And then in Taiwan, they add the excipient at the time of the drying in all places you're taking like a large stainless steel pressurized decoction machine. Decoction a large batch of verbs. You're draining the water and evaporate in it in a low pressure, low temperature. So they put it under a vacuum so that the water boils at a low boiling temperature so that they can eliminate the water without exposing it to too much heat. And so then you're eliminating the water and making it into like a very concentrated decoction and that concentrated decoction is going to go through, uh, a spray dryer. That's going to spray that thick viscous decoction into forced warm air. And by the time it falls through that warm air, it's going to be a powder in Taiwan. They add the excipient at the stage of the dry. So when you say

Michael Max:

excipient, you're talking about like, uh, some sort of starch that they blow it on to

Eric Brand:

in Taiwan, they use starch as the excipient and they add the excipient to the dry stage. And so that makes. Uh, more or less a single step finished product in mainland China and Japan. They dry the extract first into a pure extract. That's sort of a half finished product stage. And then if you want to make that into like a five to one style granual, you would add excipient and compress it. And they basically like have a. Compresses it into a brick and cuts it into little particles and then saves it so that you have basically a large Colonel granule. The mainland Chinese companies originally never made five to one extracts, except that they wanted to compete with the time when these companies overseas. And they heard that Taiwanese companies made five to one extracts. In fact, I, when these companies, they don't make exactly five to one extracts. Every, every Arab is different, but because of a misunderstanding. Uh, misunderstanding related to the marketing of the time when he's extracts around the world, the mainland Chinese companies. The rest of the world, one's five to one concentration ratios. And so they took the herbs that can be concentrated above five to one and adjust them to an even five to one. And so in that case, if you're adjusting to precise five to one, it's possible to have up to nine, maybe 90% of the herbs at five to one, but you have some herbs that are not able to be concentrated as high as five to one because they don't naturally have like their natural extraction ratio is lower than five. And so you have some herbs that are going to be exceptions and some herbs that are going to be powders.

Michael Max:

What would those exceptions be? What are the ones that you cannot concentrate to? 500.

Eric Brand:

Well, there's several that are going to be used as, as powders that aren't going to be concentrated at all. Like Sanchi actually assigned, she could be made into a concentrated extract because Sanchi often use to stop bleeding when Sanchi is subjected to heat. And decoction the blood stop inability of Sanchia is weakened. And so Sanchi, she is usually used as a crude powder in granular form because. Maintains its ability to stop bleeding. And traditionally son, she usually use like three to nine grams in decoction or one to three grams as powder. But traditionally. Practitioners prefer to use Sanchi directly as a powder. The same is true with like, uh, Tron Bemo Tron bay move because it's valuable. People tend not to use it in decoction. They'll tend to take it as a powder with the decoction you have the gelatin products, like a urge owl. all those things. They can't be the cocktail, or they can be made into a, uh, Extract. Oh, the gel itself is already a very concentrated product. It's already made into a very concentrated gelatin. You can crush it and take it as a powder, but if you were to try to boil a jail in a decoction machine, it's just going to bounce up the machine. And it's not going to be concentrated any more than it already is. So you have some items like that where they can't be concentrated. So you typically see the ones that aren't concentrated. You'll see, like by G the blood stopping or both of those typically not concentrated in Tron bay, Mo Sri, J and Trisha. True. Those two are not very water-soluble those two just use this powders. So there's a, quite a, there's a number of herbs like that, where they're just, uh, done as powder and then the

Michael Max:

minerals. How are those

Eric Brand:

done well with minerals? You basically, there are some places that just grind the minerals and there are some places that, uh, replicated decoction process of the minerals. But the, the challenge with minerals is that it's harder to quantify. It's a concentration. So let's say you had like Maha going back to my home. Oh, or Homeland or whatever, you have like a certain amount of effigy and alkaloid naturally in the milewalk. And then if you were to decoction it, you're going to discard all this insoluble fiber and stuff that adds weight to the mile haul. Right. So then naturally, like if you were to take a look at like the, the ephedra alkaloids in the, in the concentrated extract versus in the crude mile or the amount of berberine and hung the NexTraq versus in the crude Hong land, it's going to be more concentrated than, than the raw or. Boiled it down, extracted it and gotten rid of all this drugs. But let's say you have a mineral, you have gypsum and a, in both Taiwan and mainland China. They often replicate the water decoction process with, with Chicago, but you're basically you're crushing. And then boiling it in water and because you've crushed it, right? Some of it is suspended in the water and the amount that gets suspended in the water is going to depend on whether you just throw in one whole lump or whether you crush it. Right. Cause you're going to have a, some of it more of it'll get suspended if it's somewhat crushed up, but let's say you, you boil it in the water and you strain it and you dry the water, the gypsum that you started with. Is chemically about the same as the gypsum that you ended with. And so you replicated the water decoction but did you really make it more concentrated than it was originally hard to say, right? It was the point of the gypsum in your mashing. Should've gone Taiyang to actually ingest crudes mineral gypsum, or was it to somehow influence the decoction environment of some of those other.

Michael Max:

I think a lot of Western herbalists are looking at. Putting together a formula based on that five to one and trying to think about dosages. Well, I mean, how do we think about dosages, right? You were saying in Japan, people take smaller dosages. It's partly traditional in Australia that take smaller dosages, that's economic from Taiwan. They take a certain dosage. Well, that's kind of because of the insurance system there, which by the way, is an amazing. Insurance system here in the states. We're often trying to think about replicating something that looks like cruder verbs. There's a lot of variables and a lot of moving parts here. Have you got any thoughts for our listeners on how to sort all this stuff out? Some things to think about are some areas to look and give consideration to, as we think about prescribing the right herbs for our patient.

Eric Brand:

First and foremost, just because it's not fully mathematically precise, I wouldn't discard the five to one rule of thumb altogether. It's generally a good rule of thumb because it's going to be about most of your herbs are going to be sort of in the average is going to be too far off of five to one, almost regardless of you know, which company you're using. Many of them. Many of the herbs are going to be not that far off there. So even though it's not mathematically precise, it's still a generally good rule of thumb to roughly estimate the amount of verbs that you, that you would be prescribing in rough form, the individual variation of herbs, batch to batch, and the difference between. Quality grades of herbs in a way it's more, it's more dramatic. Let's say like, if you look at ginseng, that's been grown in the forest just by spreading seeds in the forest. It takes 20 years to reach a tiny little, two gram root size. And if you take Jensen grown in the field, You know, with a six year root can be, you know, 30, 40 grams. And so a 10 gram dose of ginseng would be like a hundred years of plant growth of wild ginseng in the ancient forest. The 10 gram dosage in single fields growing ginseng is just one piece of one six year root. The difference in general. As it's evolved over the centuries. So the difference in one really awesome bachelor gen St versus one really average bachelor, Jen saying that difference is more significant than the difference of whether you're giving 1.2 grams of granules in decoction or 0.9 grams or granules, you know, as long as the, the general dose range is correct. And the general formula construct. As matched to the patient, people tend to get good results. And I would say that nobody has a perfect guide to this in Taiwan. People are just doing what they saw their teacher do. They're just trying to replicate the experience of their teacher until they have enough experience to have confidence. With it, of their own. And the west people tend to the same, many of our teachers came to America before granules were ever used in China. And so they have no experience with granules. So we learn their experience using raw herbs, or we watched the experience of our teachers using granules. But I traveled to different schools and I've seen some TCM schools where they give every patient who walks in the door, eight grams of granules per day. I've seen other schools where they give every patient that walks in the door, 12 grads, and I've seen other schools where every patient gets a different weight of granules depending on the supervisor. And so there's all these other factors, right. That are going into people's decisions. But overall, I would say for me personally, I used granules about, you know, 10 to 15 grams, a day, 12 to 18 grams a day, somewhere within that range, you know, for the average or a good rule of thumb, no less than one gram per or per day. Right. So if I've got, you know, a formula with 12 ingredients, I'm probably going to give not really less than 12 grams of that formula, but my something like roadway, that's going to be relatively strong and potent, like what roadway would use. Gunjan those I'm going to be giving less, maybe only a half gram to a gram. Something like maybe I'll be giving to three grams of those, your average, middle of the road, herbs, like dunk way bite. You, you know, maybe I'll give Graham Graham and a half or so, but I think about the Arabs proportionally in like low, medium high doses, just like when you're dealing with RA, you think of. Low dose range, medium dose range, high dose range. I think about it like that with granules too. And the low dose ones I give a more moderate proportion. The middle is sort of my middle ground and then high I go high, but you know, I just think about it proportionally and I tend to think about a total amount. Per day. We're gonna have

Michael Max:

to wind this down here in just a moment. I can't believe this hour has gone by so quickly.

Eric Brand:

That's been a lot of fun to chat with you. I know

Michael Max:

it's always good. I want to do this in Taiwan next time I was there recently, but I think you were, you were gone at that moment.

Eric Brand:

Yeah. We just missed each other and functional. Yeah.

Michael Max:

Anything on the horizon that you're looking at or focusing on something that, uh, you know, like your latest research project or inquiry that you'd like to share with us. You

Eric Brand:

know, the next big thing is that we're working on doing like a herbal pharmacy education project. So we've recently been able to do some work with, uh, Beijing tolerant to help, to do some, bring some herbal pharmacy education to America. And so that's kind of one of the biggest things that's going to be on the horizon in the coming future is that we're going to start to do some classes in herbal pharmacy to do some. Bring my teacher out to do some teaching. I'll do some teaching and we have some other people doing some clinical classes. Um, but we'll be mostly focusing on from my part. It will be mostly focusing on the, but in some material, medical literature, historical changes in Chinese medicine, powder processing or blood identification, quality discernment, and all of that fun stuff. So we kind of doing a whole little series of herbal pharmacy, CU things, hopefully in the future.

Michael Max:

That sounds great. Well, I'll be sure that all your contact, information and website and whatever other materials that you'd like to share with the listeners, I'll make sure all that's on the show notes page so people can get in touch with you. I, I suspect you've got some sort of mailing list somewhere that people could sign up for. If they want to be kept in touch,

Eric Brand:

I should be better at that. I say, I think the main, maybe the main repository of all of my articles and stuff. Isn't my company, legendary herbs. So I've got the little page called the professional corner there that I've got some articles and I've got a blog that I'm going to be reviving and doing more, uh, more, getting more photos and more, more fun, little articles up there. So the legendary ubs.com places kind of my main little home for articles and staff. And we'll start putting more of the. I need to get involved. Do there's more of these lectures, more of these talks. All right. Well,

Michael Max:

we'll just put a bookmark in it for now and, uh, shades of Jen.

Eric Brand:

Thanks, Michael. It's so wonderful to see you now. See, I said, yeah. Hi, nice to talk to you. Okay.