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Unless you feel very confident about your skills writing cus-tomized prescriptions, I personally recommend that new prac-titioners start with a line of ready-made medicines. This is how I started out practicing Chinese herbal medicine. These ready-made medicines can be either Asian-ready-made or American-ready-made.

Ty p i c a l l y, the Asian-made ready-made pills are very low poten-c y, as we have dispoten-cussed in other poten-chapters. They are poten-cheap and easy to store, but they also are not very effective for remedial treatment unless dosages are greatly increased from what is written on the bottle. Asian-made extract powders are higher p o t e n c y. These come in either loose powder form or encapsu-lated. It is also possible to encapsulate the loose powder your-self on an as-needed basis. Already encapsulated extract pow-ders range in potency from 5:1 to 15:1. Most American-made Chinese herbal pills are also made out of extracts. However, exactly what potency must be determined from your supplier.

In any case, I recommend that you start with the following classical formulas which we all studied in school:

1. Bon Xia Hou Po Tang (Pinellia and Magnolia bark decoc-tion) Spleen vacuity with dampness and phlegm

2. Bi Yan Pian (Rhinitis tablets) Wind heat with phlegm 3. Bu Zhong Yi Qi Wan (Supplement the Center & Boost the Qi Pills): Liver-spleen disharmony

4. Dan Zhi Xiao Yao San (Moutan & Gardenia Rambling Pills): Liver-spleen disharmony w/blood vacuity & depres-sive heat

5. Du Huo Ji Sheng Wan (Angelica Pubescens & Loranthus Pills): Wind, cold, damp impediment

6. Er Xian Wan (Two Immortals Pills): Yin & yang dual vacuity w/ vacuity heat

7. Er Chen Wan (Two Aged [Ingredients] Pills): Phlegm dampness

8. Gui Pi Wan (Restore the Spleen Pills): Heart-spleen dual vacuity

9. Huang Lian Jie Du Wan (Coptis Resolve Toxins Pills):

Damp heat, replete heat, heat toxins

10. Jin Gui Shen Qi Wan (Golden Cabinet Kidney Qi Pills):

Kidney yin & yang vacuity

11. Liu Jun Zi Wan (Six Gentlemen Pills): Spleen qi vacuity w/ dampness

12. Liu Wei Di Huang Wan (Six Flavors Rehmannia Pills):

Kidney yin vacuity

13. Si Jun Zi Wan (Four Gentlemen Pills): Spleen qi vacuity 14. Suan Zao Ren Wan (Zizyphus Spinosa Pills): Liver blood vacuity, vacuity, disquieted spirit

15. Tian Wang Bu Xin Dan (Heavenly Emperor Supplement the Heart Elixir): Heart qi & yin vacuity

16. Wu Ling Wan (Five [Ingredients] Poria Pills): Water dampness

17. Xiao Chai Hu Wan (Minor Bupleurum Pills): Liver-spleen vacuity w/ lung and/or stomach depressive heat 18. Xiao Yao Wan (Rambling Pills): Liverspleen disharmo -ny w/ blood vacuity

19. Xue Fu Zhu Yu Wan (Blood Mansion Dispel Stasis Pills):

Blood stasis in the chest

20. Yin Qiao Jie Du Wan (Lonicera & Forsythia Resolve Toxins Pills): Wind heat external contraction

21. Zhi Bai Di Huang Wan (Anemarrhena & Phellodendron Rehmannia Pills): Yin vacuity w/ vacuity heat

In the previous chapter on using only a few basic formulas which you can modify in many ways, I discussed how you can treat many, many patients with combinations of these basic formulas. When you need something for a patient that you don’t currently have on your shelf, order it. However, I don’t recommend that you order every ready-made medicine

in the book just to have on hand “in case.” This will tie up too much of your working capital. With FedEx and UPS, you usual-ly can order things as you actualusual-ly need them, meaning as your patients actually need them, and have them in hand by the next day if necessary. If you buy these formulas in bulk pow-dered extract form or in encapsulated extract form, they typi-cally come in 100 gram bottles and you could start with as lit-tle as one botlit-tle each. If you buy these as ready-made pills, there are usually 12 bottles to a case, and I recommend that you buy a case for two reasons. First, to get the best price, and s e c o n d l y, because you will probably have to prescribe a higher dose than what’s written on the label. Therefore, your patients will go through this type of pill much faster. If you only pre-scribe and dispense ready-made powder, capsules, and pills by the whole jar or bottle, you can run your dispensary [at least for a while] without hiring a pharmacy worker, even though I do not personally recommend this. (As Marilyn Allen states in Points for Pro f i t, it is very difficult to be the caregiver and the person who charges and receives the patient’s money. This can be emotionally confusing and embarrassing on both sides.) Yo u will probably be able to store these ready-made medicines with-out any problem in your current space with your current front desk set-up and clinic storage cabinets.

As your practice gets larger and you understand more about Chinese herbal medicine, you can add more ready-made med-icines to your inventory. However, again I recommend that you not buy every ready-made medicine on the market on the off-hand chance that some day you will need it. If you are going to be doing herbs and acupuncture in any case, you can always order a remedy for a patient and have it for the next visit. You may also find that you need higher potency, more complicated ready-made medicines for your patients. Blue Poppy Herbs sells a line of high-potency formulas designed for the most commonly seen multi-pattern disease presenta-tions in Western patients. However, I would not suggest you start with these until you feel that your pattern discrimina-tion has become relatively reliable.

When selling ready-made pills, capsules, and tablets, it is important that they be kept in their original container from the manufacturer. This should have a non-tamper seal and an expiration date plus all the FDA-mandated label information.

Do not take pills or tablets out of their original container and count them out into unlabeled baggies. This is unprofessional and potentially illegal.