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Chinese
Herbal
Medicine 

Welcome to my Chinese Herbal Medicine Clinic!

       I offer personalized Chinese herbal medicine treatment via a convenient online platform. To get started, fill out my new patient herbal intake HERE. I will analyze your information and get back to you within 2-3 business days with a basic treatment plan including estimated duration and cost of treatment. This will not cost you anything. You can decide if you want to proceed, pay for your herbs, and start treatment with me. 

       If you would like to learn more about my treatment process, why I offer herbal medicine treatment online, or about Chinese herbal medicine in general, all your questions are answered below. I strongly encourage you to read these pages before starting treatment. 

       I look forward to working with you,   Sean Dugan L.Ac. 

The Treatment Process

The way I practice Chinese herbal medicine is different from how medical doctors and naturopaths work, and it’s probably also different from what you have experienced with other acupuncturists and herbalists. I’d like to take a few minutes to explain the how and why behind my process, so we can be on the same page if you decide to begin herbal medicine treatment with me

The How

 

I have been treating patients with intensive Chinese herbal medicine treatment for more than 10 years. We address problems with Chinese herbal medicine by:

  1. gathering information

  2. analyzing that information to understand the nature of the problem (ie, its pathomechanism) 

  3. writing an herbal prescription to treat the pathomechanism of the problem

 

The information that we need might be different from what you might think. We typically do not need the Western medical disease diagnosis, lab tests, or imaging. While these modern data gathering methods can be very useful in modern medicine, they are not not relevant for Chinese Medicine diagnosis and treatment.* Chinese Medicine is a stand-alone medical system, meaning that it’s unrelated to Western medicine, and the diagnostic methods we use are unique.

 

We examine the clinical history (when the problem started, etc), the metrics of your body’s global function (like your appetite, digestion, bowel movement) the nature of your problem (what makes it better or worse etc), and objective measures like examining your tongue (which tells us a great deal about your body’s inner workings). These examinations tell us everything we need to know about your health, and what we need to do to unwind the presenting pathology and direct your body towards greater wellbeing. 

 

After 10 years of clinical practice gathering information via in-person appointments, I found that there are a number of drawbacks to this practice style. So I designed an online intake to gather all the information I need, where you can answer my questions on your own time, and upload a photo of your tongue for me to analyze. 

 

The process goes like this: 

 

  1. You start by filling out the New Patient Herbal Intake. Describe your concerns, symptoms, and history of the problems in as much detail as possible. Upload a photo of your tongue by following the instructions, and submit the intake. 

  2. I will review your intake, generally within 2 business days. I will analyze the information, and determine a course of treatment. I will email you with a prognosis, an estimated timeline of treatment, and suggest an initial dosage to start with. If your concern is something I do not think I can help you with, or a condition I have had limited success with - I will let you know before you have paid for herbs. If you are wondering if I can help you, a great way to find out is simply fill out the New Patient Herbal Intake.

  3. You pay for your initial formula online, and your herbs will be delivered or available for local pickup in a few days.  

  4. Your initial formula will last 1 to 2 weeks. After 1 to 2 weeks, you’ll fill out the Return Patient Herbal Intake and provide updates on your symptoms, changes in metrics, and  any issues you may have had with the formula. 

  5. I will review your intake, analyze the information, and make any necessary changes to your herbal formula. This is a natural part of the treatment process as your body and condition will change in response to the herbs. 

 

Follow up formulas will last anywhere from 1 to 4 weeks depending on the course of treatment. Intensive Chinese herbal medicine practice can be very effective for a wide range of conditions, and one of the reasons for this is that I use traditional methods with high-dose herbal formulas. The dosage of my formulas are typically 10-50 times higher than what you get from herbal medicine that’s self-prescribed, recommended by a naturopath, functional medicine doctor, or many acupuncturists. This also means that you can’t take the same formula for 6 months. It must be re-evaluated and adjusted regularly, in most cases every 2 weeks. With more complex or severe cases, the formula may need to be adjusted weekly, and in less severe cases, or in maintenance phase the formula may be adjusted just once per month. 


There are several good reasons why the formula must change over time.

First, our herbal medicine treatment is intended to change the condition of your body and your health. Once that change happens, the formula we started with will no longer be the appropriate medicine since that job has been done. The process is a call and response with your body, as the herbs improve your health, the most important issues that need to be addressed will shift. 

 

Second, herbal medicines are very safe, but they are also very strong when used in intensive Chinese herbal medicine treatment. For example, the herbs needed to help break down a uterine fibroid may not play well with a person’s IBS, and the more complex a person’s health picture the more challenging it is to address multiple different conditions without making anything worse. Sometimes treatment has to happen in stages, for example first correcting underlying digestive problems, so that the body can absorb and metabolize the herbs needed to address the chief complaint. 

 

There are additional reasons for adjusting herbal formulas over time, such as chronic infection treatment when we need to regularly alter the herbs so that pathogenic organisms cannot build resistance to our treatment. 

 

The cost of treatment varies based on the dosage of herbs, and the complexity of the condition which will dictate how often the formula needs to be adjusted. Cost ranges from $200-720/month, with the average cost being $400/month. 

 

The Why

 

After 10 years of providing herbal medicine treatment via in-person appointments, I wanted to improve clinical efficacy, patient experience, and address some practical obstacles and inconveniences. I have found that my current treatment model provides better clinical results, is more convenient, and is less expensive than the in-person treatment model was. 

 

Why would an online model provide better results than in-person appointments?

Chinese herbal medicine is highly complex and systematic. I treat a wide range of conditions, many of which are severe, complicated, and which multiple doctors and specialists have already failed to remedy. The amount of time I need to write the proper herbal prescription varies widely. In some cases I might need 20 minutes (for example, painful periods which I’ve treated hundreds of times). In other cases, I might want to review prior cases, read case studies, reference modern TCM research, and think about the formula for several days before moving forward. This all means that intensive herbal medicine treatment does not schedule in a smooth manner, and does not blend well with my acupuncture practice appointment schedule. By gathering all the information I need through my intake and allowing a flexible timeline, I’m able to be more accurate and individualized with your herbal treatment. 

 

Now that you have read through the process, you might be thinking something like, “I have a lot of questions, and this system doesn’t seem to include time to answer them all!” You’re absolutely right, it does not. I will provide you with all the information you need for receiving effective treatment, and none that you don’t. 

 

Chinese Medicine is foreign to us here in the US, and we naturally have lots of questions about things that are unfamiliar to us. As much as I would love to educate people about Chinese Medicine, this is much harder than it sounds, especially while also performing my role as a clinician. My job is to solve the health problems that you are looking for help with.

 

In 10 years of practice, I have found that my answers to questions about Chinese Medicine don’t make patients feel any better, but my herbal formulas do. So if you’re looking for answers (to questions) I am not your guy. If you’re looking for your problem to improve or go away, then I am. 

 

Of course there is nuance to this, like all things. If your question is: “What can I do with my diet, lifestyle, exercise to help recover faster or prevent this problem from getting worse or recurring in the future?” - I am happy to provide advice via email along with your herbal formula. And in some cases, I may make recommendations even if you don’t ask. For example, when treating diabetic neuropathy, in addition to providing an herbal formula I can guarantee I will include a recommendation to reduce carbohydrate intake and increase physical exercise. 

It’s been my experience that a lot of valuable time (literally time you are paying for) can be wasted discussing lifestyle changes that a patient asks about, but is perhaps not prepared to undergo, and may be much less relevant than simply identifying the problem and utilizing an effective herbal formula to treat it.

Thank you for taking the time to understand this process, and I look forward to working with you!

 

- Sean Dugan L.Ac. 

________________________________________

*A note regarding modern diagnostic methods: I am not suggesting that these tools are not useful or should not be employed. For example, getting an ultrasound of your gallbladder to find out if you have gallstones can be a good idea. But the result of that imaging won’t change the Chinese Medicine diagnosis or treatment. The imaging may lead to a confirmation of gallstones, and a referral to surgery for gallbladder removal. Since I’m not a surgeon, this is not useful to me. In most cases, modern diagnostic methods are only relevant if you’re looking for western medical treatment (which in some cases may be a good choice). If you’re looking for Chinese Medicine treatment, then we can get all the information we need through Chinese Medicine diagnostic methods. 

Footnote

About Chinese Medicine

Chinese Medicine is a system of medicine that was developed through thousands of years of scientific observation, recording, and clinical practice. Chinese Medicine has a unique system of medical theory, diagnosis, and treatment methods. Chinese Medicine encompasses a variety of interventions, including diet and lifestyle, mind-body practices, acupuncture, massage, moxibustion, cupping, and herbal medicine, with acupuncture and herbal medicine as the two primary medical interventions we are familiar with today.
 
Some of the medical theory in Chinese Medicine overlaps with modern Western biomedicine, and some of it does not. In our current era, there are some areas of medicine where Western medicine is far more advanced - primarily in emergency life-saving medicine and late-stage disease. However, there are still many areas of medicine where Chinese Medicine remains more advanced in the understanding and treatment of disease. This includes many chronic health problems, early-stage disease and many conditions that do not have treatments available in Western medicine. 
 
Chinese Herbal Medicine is truly the most effective holistic internal medicine available to you. 
Chinese Medicine is Holistic
What does holistic really mean? People frequently misunderstand the term holistic as a synonym for “natural,”  but holistic means that in Chinese Medicine we look at the whole picture of a person’s health. When utilizing Chinese Medicine that is exactly what we do, which distinguishes it from Western medicine and naturopathic/functional medicine. 
 
Today, many health problems go unaddressed because people may go to many different specialists but none of their doctors are genuinely looking at the entire picture. Modern medicine has become so focused on the microscopic, that many conditions are not treated successfully - as a result of forgetting that the human body is an incredibly complex system of interwoven functions. 
Chinese Herbal Medicine may help you with a variety of complaints, including but not limited to:
  • Gynecological / women's health complaints including - painful menstruation/dysmenorrhea, irregular periods, PMS symptoms, PCOS, endometriosis, fibroids, infertility / fertility support, chronic yeast infections, hormone imbalance
  • Digestive complaints including - bloating, constipation, diarrhea, IBS-D, IBS-C, acid reflux, GERD, bile reflux, SIBO, incontinence, chronic dysbiosis and parasites
  • Respiratory complaints including - acute and chronic sinusitis / sinus infection, asthma, bronchitis, shortness of breath, excessive phlegm and congestion
  • Cardiovascular complaints including - high cholesterol, high blood pressure, palpitations, irregular heart rhythms 
  • Metabolic complaints including - fatty liver, high blood glucose / A1c
  • Male reproductive / urogenital system complaints including - erectile dysfunction, low libido, premature ejaculation, prostatitis, BPH / prostate swelling, symptoms of low testosterone, fertility support
  • Allergies
  • Migraines
  • Fatigue, adrenal fatigue
  • Insomnia
  • Feelings of anxiety
  • Feelings of depression
  • Chronic "fight or flight" stress response
  • Stress
  • Post-herpetic neuralgia
  • Peripheral neuropathy
  • Bone spurs
  • Recovery from surgery, injury, or fractures/broken bones
  • and more...
Chinese Herbal Medicine is Systematic 
One of the reasons that Chinese Herbal Medicine is so effective is that it is systematic and specific. In modern times, it can be hard to imagine how anyone can perform diagnosis without lab tests, imaging, and latin medical jargon. So how do we use Chinese Medicine to determine how to treat an individual? We do it the same way that people have been practicing Chinese Medicine and effectively treating disease for thousands of years. 
 
We gather information about the patient’s condition through interview, observation, and palpation and then we analyze this data, compare it to the database of thousands of years of records - and match the data to the appropriate diagnosis and herbal treatment. The data that we use is based on an understanding of the subtle metrics of your body’s health. These finer details might be metrics that you, or your doctor might not think are important or relevant (but they are important). So our diagnostic process can seem mysterious or obscure. It’s not actually - it’s just unfamiliar. 
 
We analyze the data of your presenting symptoms and entire health picture, not just your diagnosis. For example, 10 people with a migraine diagnosis may experience their migraines differently and have different underlying causes that are driving the migraines. So in order to effectively treat each person, we have to take the whole picture into account. We examine the tongue, feel the pulse, observe the appearance of the person, and ask about metrics in the body’s function like appetite, digestion, sleep, temperature, menstrual cycle. These metrics can seem like nonsense to the modern person, but in fact they are all important indicators of the state of health and disease in the body. 
Chinese Herbal Medicine is Dynamic
Are you looking for something different than your standard doctor visit? Did naturopathic or functional medicine not work for you? If you’re looking for something different, good - because you found it! Chinese Medicine is quite different from both Western biomedicine and naturopathic and functional medicine - which are both extensions of modern Western medicine. And it’s important to understand the ways in which Chinese Medicine is different. 
 
I find that a lot of people are unsatisfied with Western medicine and naturopathic / functional medicine - mostly because it didn’t work for them. But people tend to be looking for something that works, that is natural, but still comes in the same format - one or two office visits and a convenient, tiny pill. Unfortunately, that is not something that exists in most cases. 
 
Chinese Medicine is natural, it's holistic, and it works. But it is not necessarily convenient. 
 
Chinese Medicine is dynamic. We do not do one evaluation, give you a supplement or drug protocol, and tell you to come back in 6 months. This is very common in Western medicine and naturopathic/functional medicine. We are not looking to give you a protocol (drug or herb) to take for the rest of your life to suppress symptoms. We are working to unwind the pathology that is driving your condition, so that our ultimate goal is that you don’t need to take herbs anymore. 
 
When you begin herbal medicine treatment and complete your initial intake, I will write an herbal prescription that will last 1-2 weeks. After you finish this formula, you will fill out a return patient intake where I will assess how your body is responding to the herbs, and I will make adjustments to the prescription and re-evaluate again in 2 weeks. Throughout herbal treatment, your formula will be adjusted every 1-4 weeks to assess your progress and adjust the course of treatment. This is the dynamic process, and it’s necessary because your body is dynamic. We alter the herbal formula over time for a number of reasons. As the herbs do their work, they change your body's condition. So what you needed a month ago may not be needed anymore. It is sometimes likened to peeling away layers of an onion. The Chinese word for formula is Fang (pronounced "phung"), which also means direction. In the process of unwinding the pathology driving your condition - we use herbs that move your body in the direction towards health, balance, and what we refer to as center. Through this dynamic process the specific direction can change over time, as the many dynamic factors in your life and health also change.
When you begin herbal medicine treatment, you may not understand or be aware of what I am doing. Because I'm not reading lab results, drawing blood, speaking in latin medical terminology, or injecting you with anything - it may not seem like I am doing anything. This is simply because what we are doing is different, and it won't be familiar like other medicine you've experienced. After all, what you're after is something different - and something that will work for you.
 
You may notice positive changes within a few weeks, or it may take several months to notice a positive change, depending on your condition. When you complete your initial intake, I will give you an estimate of how long I think you might need to continue herbal medicine treatment. It will be longer than you want it to be. Though I will do everything in my power to help you as soon as possible, this medicine is not a quick fix. If you're looking for quick and convenient, your best bet is Western medicine. But quick and convenient has its downsides, and that's what you're here to avoid. 

Treatment Methods - Why Chinese Herbal Medicine?

 

As I mentioned above, the treatment methods in Chinese Medicine include therapeutic exercise (taiji, qigong), dietary therapy, bodywork techniques like Tuina and Shiatsu massage, acupuncture & moxibustion, and Chinese herbal medicine. All of these treatment methods have their place.

 

Lifestyle practices like therapeutic exercise and diet are like the turtle that wins (or loses) the long race. They have the biggest long-term effect, but take the longest to have an impact (positive or negative). 

 

Acupuncture is a wonderful modality, and one that I offer at my clinic. Acupuncture can be used to treat a variety of conditions, but is probably most famous for its treatment of pain and stress reduction. For more about acupuncture, click here

Chinese Herbal Medicine is the strongest and most effective treatment method for addressing internal medicine conditions - that is to say anything that is not musculoskeletal in nature

 

So why is Chinese Herbal Medicine “stronger” for treating internal medicine conditions than acupuncture?  When we use acupuncture for internal medicine conditions, acupuncture is working with what your body already has, and helping to make your body’s healing response more efficient. There are some cases, however, where what you have is not enough to get you where you need and want to be. Let’s use a money metaphor⸺ say you need a dollar for parking. You find a quarter in your purse, another couple in the glove box and one in your pocket. Now you have a dollar. You’re good to go; you just had to do a little reorganizing. If you just don’t have that final quarter, you will never have an entire dollar to work with unless some good samaritan comes along with 25 cents.
Acupuncture gathers your lost quarters.
Herbal medicine give you another coin.

 

Herbs are potent, biochemical medicine that can add, subtract, multiply, and divide. Herbs provide botanical compounds that your body isn’t capable of producing. This is one reason that Chinese Herbal Medicine is fundamentally stronger. 

 

Example: Your immune system is capable of fighting most infections, but sometimes it can’t keep up and you end up with a persistent, chronic infection. Herbs can add anti-bacterial, anti-fungal, antiviral compounds which your body can’t produce, to help fight the infection directly. Additionally, herbs can add compounds that stimulate your body to produce more T-cells to help it fight infection more effectively. 

Logistics of taking Chinese Herbal Medicine

 

There are a variety methods of taking herbal medicine - including teas, tinctures, and capsules. In Chinese Medicine we primarily use hot water extracted herbs in the form of decoctions. A decoction is cooked, simmered for 20-60 minutes where a tea is infused in boiling water. Both decoctions and teas are drunk, typically warm or hot.

 

Granules. The most common method of administering herbal medicine that I use is called a granule extract. This is a modern method where a decoction is prepared into a concentrated powder. You add water, and drink it "like a tea." Both decoctions and granule extracts both taste bad, but granule extracts save you from cooking an hour every day. Your family will also thank you for not filling the kitchen with intense herbal aromas. Granules are often referred to as "powder" but are very different than grinding raw herbs into a powder. 

Draft / San preparation. The second most common method I use, where the raw herbs are ground to a fine powder, and added an insulated thermos with boiling water and steeped overnight. This is effectively a tea or infusion, but the steeping method yields a better extraction than a standard infusion. This method is chosen when we need to use herbs with higher volatile oil content than granule extraction can provide. 

Capsules. The capsules which I use are granule extracts that have been encapsulated. Capsules are the least customizable option, because the formula composition is already fixed and there are only so many capsule formulas available. We are after a high degree of specificity in our formula prescription, in order to get the best results. With granules and draft / San preparations, we make custom formulas from a library of ~ 400 different herbs.

 

The capsule method can also be more challenging to achieve a high therapeutic dose. Capsule dosage can range from taking 6 capsules/day to 40 capsules/day to get a high therapeutic dose. 

 

That said, some conditions are well suited to the available capsule formulas. It's very hard to beat the convenience of capsules, and for those who struggle with the taste of herbs, taking an appropriate capsule formula is more effective than taking no herbal medicine at all. For best results, I recommend being open to a capsule formula and a granule or draft / San if there is not an appropriate capsule available for you. Some people who dislike the taste of herbs use a home capsule maker to put their custom granule formula into capsules - which is another good option. 

Where do you get your herbs? Your herbs will either be prepared at our clinic, or ordered from the closest large Chinese herbal pharmacy, which is located in Oregon. Herbs ordered typically arrive in 2-3 days. 

Are Chinese Herbs Safe?

The herbs that we use go through rigorous scientific testing to ensure correct botanical identity and active ingredients. They are screened for heavy metals, microbial contamination, and pesticide contamination. Granule extracts produced in China and Taiwan are held to the same high standards as pharmaceutical drug manufacturing, standards that are more highly regulated than anything seen in the US supplement market, which is largely unregulated. The suppliers that provide our granule extracts also provide herbs for modern hospitals in China and Taiwan. Our Chinese Herbs must pass the following tests to make it to us: 

  • Organoleptic Visual Check

  • TLC Active Ingredient Check

  • Total Heavy Metal Test

  • Total Yeast and Mold Test

  • Salmonella Test

  • Loss on Drying Test

  • Acid-Insoluble Ash Test

  • Individual Heavy Metal Tests (Lead, Cadmium, Mercury, Arsenic)

  • Aflatoxin Test

  • Microscopic Cellular Identity Check

  • HPLC Potency Level Test

  • Total Aerobic Microbial Count Test

  • E.coli Test

  • Enterobacteria & Other Gram Negative Bacteria Test

  • Total Ash Content Test

  • Dilute EtOH Extract Test

  • Pesticide Test (over 100 pesticides tested)

Not only are the specific herbs we use safe, Chinese herbs are safe in general. Historically there have been some problems with herb safety and they fall into two main categories: abuse or improper use and adulteration. These issues are not unique to Chinese herbs, but Chinese herbs have more PR problems due to political perception and stigmas. 

 

Improper use includes cases where athletes and diet pill companies have abused certain herbs that have stimulant qualities. Overuse of stimulants of any kind can easily lead to a variety of problems, and this is not unique to Chinese Medicine or a common problem that we see. Safety issues resulting from improper use of Chinese herbal medicines are easily avoided by seeing a qualified practitioner who will recommend the appropriate herbs and appropriate dosages for you.

Adulteration has been a historical problem because the Chinese herb trade, like any trade, is a business. So there have been bad actors just like in any sector. A classic example would be people selling Cordceyps sinensis fruiting bodies - one of the most expensive herbs on the planet - and slipping small lead bars inside the fungus to get paid more (herbs are typically sold by weight). Things like this are very easily avoided by using reputable suppliers who do rigorous quality testing.  So probably best not to use Amazon sellers or random herb websites.  

Concerns about heavy metal and pesticide contamination are real, and that's why we use companies that test for these. A lot of people have the misconception that anything from China must be contaminated, because they just think about China as massive cities. China is a big place, and if you compare rural China to the midwestern US, the latter is not necessarily more pristine. Heck, your neighborhood probably sprays a lot more insecticide and herbicide on lawns and gardens than the regions we source herbs from. 

After addressing the issues around contamination and abuse/misuse, there is another reason why Chinese herbal medicine is fundamentally safer than modern medicines. Each individual herb that we use contains hundreds of unique phytochemicals. Some of these compounds have similar actions, some of them have opposite physiologic actions that balance each other.

 

Pharmaceutical drugs are made by identifying an active ingredient in a plant, isolating it and concentrating it thousands of times over. This makes modern drugs very strong, and that's why they are valuable. But it also makes them more forceful, and fundamentally less safe. They don't work with your body to make something happen, they make it happen whether your body likes it or not. That's basically how we get side effects - the forceful and unilateral nature of drugs.

 

Herbs are fundamentally milder in action. Each herb has small amounts of many compounds, and our body is more able to take up what is helpful and excrete what is not needed. To make it even more safe, in Chinese Medicine we don't just use single herbs. Instead of using 100 grams of one herb that has a particular physiologic effect, we will use 10 grams of 10 different herbs that all support the same goal but with different phytochemicals that do it in slightly different ways. This multiplies the safety profile even more. At its core, Chinese herbal medicine uses less force than modern drug medicine, but through a deep understanding of human physiology, is able to elegantly apply a small amount of force in a way that causes a profound effect.

 

One way to think about the difference between Chinese herbal medicine and modern pharmaceutical medicine is like this: imagine that a large boulder blocks your path and needs to be moved. Using Chinese herbal medicine is like wedging a 2x4 between a smaller rock and the boulder and using a small amount of force, with leverage in the right place, to roll the boulder out of the way. Using a modern drug medication is like blowing the boulder up with a stick of dynamite - it's fast and effective, but the large amount of force applied via explosion can cause collateral damage. Some boulders require dynamite, many of them do not.

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