THE IMPORTANCE OF TAILOR-MADE PRESCRIPTIONS
I go into the cases I'd like to make a brief comment
about products on the market aimed at addressing menopausal
complaints. If you are lucky, you can get favourable
results for a time with a ready-made pill. The problem
is that you can have many different kinds of menopausal
syndromes. If you don't make a tailor-made herbal combination
for the client, you aren't going to be able to address
their unique and changing presentation.
You may have somebody whose main problem
is heat, with hot flashes, or you may have somebody
whose main problem is cold. You also might have, and
we're going to discuss this possibility in one of the
cases today, patients who can easily swing between
hot and cold.
So, if you just have a mass-market
formula to address heat you can get problems. The patient
might start off hot and then go into too much cold
because your formula was too cold, or vice versa; if
you then try and warm them, you might make them too
hot. So they're swinging like a pendulum backwards
and forwards as you give them the herbs that are too
extreme. So you really do have to be careful and evaluate
each case separately and also be prepared to be flexible
and adapt your strategy to meet the changing needs
of the patient.
a good point to make here at the outset: every woman
experiences menopause differently.
A CHECKLIST FOR MENOPAUSAL PROBLEMS
almost like you need a mental checklist in menopause,
and this is equally true with other conditions, before
we could mix a formula. You need to mentally go through
your checklist. Do we have a hot situation here that
we need to cool? Do we have a cold situation that we
need to warm? Have we got one that easily oscillates
from hot to cold, so that we need to stabilize the
middle, if you like, to create fewer oscillations?
Then you're going to ask yourself if
you're dealing with somebody who's anxious, depressed,
or has very weak energy so that they're frequently
getting colds. Do they have poor circulation? Do they
have edema? Do they have rheumatic or other aches and
pains, which can be common with menopause? Are they
exhausted so that they need tonifying?
this mental checklist idea is your way of deciding
which herbs will go into the formula. It tells you
what you have to address with the herbs.
with this sort of approach, you're less likely to make
mistakes and make a patient worse. So, the first thing
is this concept of a checklist for a particular disease,
which you can then adapt to a particular person. You're
looking for herbs that treat a specific syndrome or
specific symptom. You've got to treat both the effect
and the causes of the effect. For example, it might
be the case that a hormonal imbalance is the cause,
and the end results of that are the hot flashes and
BQ: Let's start
with the first case.
our first patient, was perhaps the most classic menopausal
situation. She was having severe hot flashes and night
sweats, and this is what most people think menopause
is all about. This was complicated by the fact that
she had considerable muscle pain. Also, it bears mentioning
that the hot flashes were linked to some degree with
stress, and she had anxiety as well. So you see, even
in this supposed classic case there are complicating
Black cohosh (root)
Chinese angelica (root)
The herbs were prescribed as 5 ml of
1:5 tincture 3 times per day in a little water.
In Western herbal medicine, herbs that
regulate the female reproductive system are called
emmenagogues, or in Chinese medicine you might call
them herbs that regulate the Uterus. In this combination
for Sallie, the herbs work in different pairs and trios.
Leonurus (motherwort), Cimicifuga (black cohosh), and
Salvia officinalis (sage) can act as emmenagogues;
Anemone (pulsatilla) combined with Salvia can treat
hot flashes and regulate the sweating; and Leonurus
paired with Anemone is a specific pair to stabilize
mood changes and to calm anxiety in menopause.
The Cimicifuga will also combine with
the Salvia to treat Sallie's rheumatic pains.
DL: What were you
thinking of with the Schisandra and Angelica sinensis?
Schisandra is in there in combination with the Crataegus
and Leonurus to calm the Heart. The Angelica sinensis
is partly in there because it regulates the Uterus
and menstruation and is generally helpful in menopause,
but also because this patient is Deficient, easily
tired, and in Chinese medicine terms, has Deficient
Blood. Angelica sinensis is a good herb for tonifying
the Blood. So, as a general principle you can say that
you're picking herbs not just because of one function,
but they need to have two or even three functions that
fit the patient.
DL: Could I back
us up a bit and ask you to briefly run through those
herbs that you consider generally useful for menopause?
JR: Yes, the herbs
generally used for menopause in this formula are Leonurus,
Cimicifuga, Anemone and Salvia. Leonurus not only regulates
menstruation, but it also is calming to the Heart and
a good heart tonic, and it's specific for the anxiety
and palpitations which many women have in menopause.
It's interesting that quite a few menopausal women,
and I think all three women we will be discussing,
have Deficient Heart energy in Chinese terms. Either
they have palpitations or they have poor circulation
or something of this nature.
BQ: Talk about
the Anemone a bit if you would. It's not that commonly
prescribed by herbalists in this country.
JR: Sure. Anemone
is used specifically for hot flashes due to tension.
You wouldn't use it for a menopausal person with depression.
There would be a good chance of making them worse.
It specifically is for feelings of fearfulness, jumpiness
or pressurized stress, even to the point of desperation.
In Chinese terms, I would call it Kidney fear invading
or affecting the Heart.
DL: Salvia is often
prescribed to stop sweating, and you mentioned it helps
with the rheumatic pains. Does it have other functions
you're interested in here?
JR: Salvia is a generally
useful herb for menopause because it regulates menstruation,
and it can tonify the blood. It is, as you said, especially
important for regulating sweating. In hot infusion
it can make you sweat, but if taken cold it can regulate
excessive sweating. Now if that sweating is due to
stress, then the combination with Salvia would be Anemone,
which would cut the stress down. If in that situation
the sweating is also due to Deficiency, then Salvia
is going to combine with Schisandra, which is an herb
that will help to stop sweating, but especially in
cases when there is Deficiency of Kidney and Heart.
The Schisandra does more to stabilize the Heart Qi
than to tonify it.
BQ: Of course you
have Crataegus there as well.
JR: Yes, Crataegus
is there to stabilize the Heart. I've found that Crataegus,
which is normally used for heart pain or high blood
pressure, is an extremely useful herb in menopause
when the patient swings from hot to cold, or has fluctuations
of energy. When that is the case the patient is basically
Deficient, and Crataegus seems to stabilize the Heart
Qi and by doing so, helps to buffer some of these swings
of mood or swings of temperature. Qi is the thing that
helps you adapt, and helps keep you stable, so that
you can resist external changes of temperature more
easily. When your Qi drops, you can more easily feel
upset by cold or heat, and interestingly Crataegus,
by helping the Heart, seems to help this.
DL: Do you use
Crataegus in other diseases where there are significant
JR: Yes, I do. I use
it often in chronic fatigue and fibromyalgia cases
where, again, there's considerable weakness, but the
people are emotionally labile. It can be very helpful
in these situations.
BQ: Shall we move
on to the second case?
JR: Sure. Tammy is
an interesting case because she had at the time of
the intake very severe bleeding with the menopausal
situation. She had reported definite hormone imbalances,
and in addition, she was very Deficient, especially
of Heart energy, in that she could have mood swings,
and she could feel cold. Sometimes she did have hot
flashes, but the main thing was the Deficiency. She
had palpitations, her general energy was down, and
the Heart pulse was quite weak.
The principle of treatment is first
to reduce the bleeding, then to regulate the hormone
balance, and treat the Deficiency. Tammy was given
3 separate prescriptions, one for each of the principles
Stop bleeding combination
Greater periwinkle (herb)
Shepherd's purse (herb)
The herbs were prescribed as 5 ml of
1:5 tincture 3 times per day in a little water.
Hormonal regulation prescription
Tammy was advised to take 2.5 ml (half
a teaspoon) of 1:5 tincture of Vitex agnus-castus (Chaste
tree berries) every morning in a little water, at least
for the next two months. Vitex was given as a separate
herb, since it specifically regulates hormone balance
in menopause, as it does in menstruation.
This combination was only to be taken
once the bleeding was reduced, and was to treat the
Lily of the valley (leaves)
The herbs were prescribed as 5 ml of
1:5 tincture 3 times per day in a little water.
DL: This case is
really quite different from Sallie then.
JR: Right, very different.
Which just illustrates the initial point I was making:
There is no one picture for menopause; each woman has
her own experience and unique symptom picture. With
the constitutional combination for Tammy we had to
do something to stabilize the Heart and to give energy.
There was also a bit of a tendency to experience some
depression and digestive problems.
The main formula contained Crataegus
(hawthorn), Convallaria (lily of the valley), and Sarothamnus
(broom tops): a combination that can strengthen and
stabilize the heart. Convallaria can stabilize heart
arrhythmias and irregular heartbeats, amd Sarothamnus
can tonify Heart Qi, but is contra-indicated in high
blood pressure. Schisandra was also given to stabilize
the Heart, and Schisandra and Panax ginseng combine
to firm and tonify Kidney Qi. Schisandra and Salvia
combine to regulate any perspiration.
So this formula is quite different
from the one for Sallie. Since heat is not a major
problem, we can use the rosemary, which is a warm herb.
BQ: I have a question
about the formula to stop the bleeding if you don't
mind going back. The Quercus and Capsella are herbs
commonly used to stop bleeding, but the periwinkle
is something that it would be helpful if you talk a
JR: Sure. The other
herb very similar in its effects to Vinca is Trillium
(beth root). The only problem is that Trillium is an
endangered species, and therefore I don't recommend
it anymore and we use Vinca instead. Both these herbs
have the specific function of not only stopping or
reducing bleeding in menopause or in menstruation,
but regulating, in Chinese terms, the Uterus as well.
You can use Vinca for dysmenorrhea or irregular menstruation
as well; it's not just a "stop bleeding" herb,
like Quercus and Capsella. Vinca is also specific for
menorrhagia, and it combines well with Vitex; they
are both regulatory.
DL: So the Quercus
and Capsella you use just to stop the bleeding, and
you're not looking for any other function from them.
Is that right?
JR: Right. Quercus
and Capsella are herbs for any kind of bleeding or
diarrhea; they are general astringents.
BQ: What do you
see in Chinese terms as the reason she is bleeding
JR: The Qi's not strong
enough to hold in the blood. You might use Astragalus
to address that if she weren't so dry.
DL: In my TCM education
we were taught that menopause was most typically a
problem of Yin Deficiency, particularly Kidney Yin
Deficiency. With these two cases we're seeing a lot
more things like Heart Deficiency. Can you just speak
a bit about menopause in terms of general Chinese principles?
JR: Basically in menopause,
from the Chinese medicine point of view, you've got
either an Excess condition or a Deficiency condition.
A pure Excess condition is relatively rare, but you
can get it. It's almost like the caricature of a menopausal
person: they're rushing around with a bright red face,
completely hot, dripping with sweat, can't sleep at
night, maybe anxious, but definately hyperactive, and
maybe with mood swings. That's the picture people think
of first. And that could be based on deficiency of
Some of the Japanese schools say that
wherever you think you've got an Excess, there's always
an underlying Deficiency, which I think is very wise.
People don't tend to think about this, but in fact
the majority of people with menopausal problems either
have overt or under-the-surface Deficiency that can
be quite strong. They can have Deficient Blood so severe
that their tongues are really pale, their lips are
pale, they feel emotionally fragile, they've got floaters,
they've got scanty menstruation, blurred vision, poor
memory, and can't concentrate.
Or on the other hand they can actually
have Deficient Yang. They can be so Deficient that
most of the time they're exhausted, depressed, cold,
they've got arthritis worse with cold and damp, they've
got watery edema, their skin's quite pale, and so on.
Now that's the other extreme from the hot and fiery
one, and it isn't so common.
Another classic one is the alternation
between what you call Deficient Yin and Deficient Yang.
Under some circumstances, like a cold climate, a damp
climate, not enough food or, just simple exhaustion,
they might show more Deficient Yang symptoms, like
the depression and the feeling cold, no energy, that
sort of thing. If, however, they go to a hotter climate,
it may swing the other way, and they then become more
Yin Deficient. They get more night sweats and hot flashes.
They still feel tired, but now they're more restless
with insomnia, whereas before they were apathetic,
dull, depressed and so on. And that's a big category,
the people who swing from one to the other.
BQ: Now I think
you said your general strategy with those women who
swing from one extreme to the other was to treat the
middle, to solidify there. Can you talk a bit in Chinese
terms about what is typically going on there?
JR: What's very often
the problem is that the Kidney is Deficient and the
Heart is Deficient, which leads these two rather labile
organ systems to wide swings of hot to cold and excitement
to depression. That's why it's important if you are
treating menopause, to not necessarily cool heat or
warm the cold, but treat the middle, strengthen the
middle of the road, emphasize the Ômiddle way'
and avoid extremes. I already mentioned herbs that
strengthen the heart's ability to adapt, like Crataegus,
and herbs like Angelica sinensis, which tonifies the
Blood and therefore gives a kind of buffering.
The Chinese herb Pseudostellaria is
also very good because it tonifies the Qi of the Spleen
and Stomach, providing the grounding, stabilizing energy
of the Earth element, which helps to stabilize the
Heart. This helps to keep energy and behavior in the
middle of the range, and reduces extremes.
BQ: I'm glad we
touched on all that because as Doug said the first
thing we were taught to look for in menopause was Kidney
Yin Deficiency. It was really emphasized. Now, I don't
hear you saying that doesn't play a role, but this
notion of creating stability by treating the "middle" is
really a great idea.
JR: Yes, it's a fascinating
topic. The one thing I would say is that with menopausal
situations, look at tonifying the Spleen and by strengthening
the Spleen, create the stability and solidity of the
Earth element. These people are going through a major
life change, and a major change in self-image; it may
be a loss of self-respect, they may have feelings of
low self-esteem; they're bodies are changing, they're
aging. So if you tonify the Spleen, this is going to
help. That's why nutrition is so important because
you have to help them nourish themselves. I know it
seems a simple thing, but if they learn to nourish
themselves, it's like caring for themselves, and it
helps their self-esteem. It can be a vicious circle:
The more your self esteem goes down, the less likely
you are to look after yourself and eat well.
BQ: Well, Fire
is the mother of Earth, which brings us back to the
Heart, and I have a question there. You've already
mentioned a few things about Leonurus, Convallaria,
Schisandra and Crataegus. Could you discuss rosemary
in connection with the Heart?
JR: The use of rosemary
is very important in treating depression. It's a warm
and expansive herb. Culpepper said, "It eases
the melancholy vapors of the heart." The camphor,
the borneol, and some of the other volatile oils are
slightly excitatory to the central nervous system and
to the circulatory system. These aromatic oils can
make the patient less depressed initially, but then
they may become more anxious and then they may have
more hot sweats.
So rosemary very often has to be used
in small amounts. If it is not enough, then increase
it; if it is too much, reduce it. You may come to a
point in the treatment where the rosemary has done
its job. The person is less depressed, but now their
hot flashes come back. So you would have to take the
rosemary out. You do have to be careful with some of
BQ: Should we look
at the third case?
JR: Right. The third
patient's name is Christine. Although Christine occasionally
at that time had some sweats, she was predominately
Deficient and Cold: she was having repeated influenzas
and colds, very poor circulation and felt cold much
of the time. It was a major problem. She did also have,
in Chinese terms, Deficient Blood, with floaters, dizziness,
scanty and delayed menstruation and poor concentration.
Finally, she also had some side pain near the gallbladder
area, and she did have poor digestion whereby, for
whatever reason, probably sort of a mixture of deficiency
and stagnation, she would feel sort of heavy in the
middle of her stomach after eating. So, as usual we've
got a complex case.
I think it is very useful to look at
Christine as a prime example of somebody who, because
they are so Deficient, can, in different situations,
swing from cold to hot. We have to follow these extremes
by modifying the combination. So first of all, the
initial combination was given when she was feeling
Christine's initial combination
Prickly ash (bark)
The herbs were prescribed as 5 ml of
1:5 tincture 3 times per day in a little water, and
5-20 drops of Capsicum (Cayenne pepper) 1:5 tincture
were to be added to each dose of the main herb combination.
BQ: I think Christine
couldn't even take a shower without considerable discomfort
because of the chill she experienced drying off.
JR: That shows the
severity of her cold. Although we have an occasional
hot flash situation here, it's not a major one like
Sallie, and cold predominates. This is a case where
the vital fire and the energy in general is low. We
have to raise energy, but specifically we need to warm.
BQ: I think she
took it for a month with very good results. She was
much warmer, and she also got her menses. At the time
of this first formula she had not had a period in quite
some time. Taking this formula regulated her cycle
again. Could you just sort of think out loud for us
to help us see what you were thinking here, because
this formula is much more warming than I would have
had the nerve to give someone with sweats?
JR: Okay, so I think
the first thing is that what we have here is a cold
person in need of warming herbs. We try not to go over
the top, but in this case, the warm herbs, especially
the threesome of Zanthoxylum (prickly ash bark), Cinnamomum
(cinnamon bark) and Capsicum, are very important. These
are herbs to warm, not only the Interior of the body,
which is more the cinnamon and the Capsicum, but especially
to take it out to the periphery, which is the prickly
ash bark. Not only that but we need to take the warmth
into the flesh and muscles; that is the job of the
Angelica archangelica. Angelica is an warm, anti-rheumatic
and a circulatory stimulant. Rosmarinus (rosemary)
was put in to raise the energy and to warm Heart and
Spleen. In combination with the Angelica, the rosemary
will help to warm the digestion as well as warming
The other thing that the rosemary does
in this formula, because it is not only aromatic, it's
also quite bitter, is to move stagnant energy in the
Liver, Gallbladder, Spleen and Stomach, and to stimulate
and tonify the digestion. Artemisia (mugwort) is another
bitter and aromatic herb for the Liver and Spleen,
which can regulate menstruation and also stimulate
digestion. This was another part of the success of
the formula that her digestion definitely improved,
and she didn't have so much of a stuffed sensation
in the middle of her abdomen after eating. Also, she
didn't have any more colds.
DL: Is there something
in the formula that specifically treats the surface
of the body, and bolsters the Wei Qi to account for
the fewer colds?
JR: That's probably
due to the mixture of the warming herbs, also the Angelica
and Zanthoxylum specifically bringing energy out to
the periphery to protect the surface of the body. This
is also partly why she feels warmer.
DL: I have a general
question about all three of these cases. We are talking
about the fact that situations change quite a bit.
All three patients tend to be Deficient and so therefore,
they tend to go off in many different directions. That
kind of made me wonder about sweet tonics and the Spleen
connection. I was wondering when it would be appropriate
to give these women sweet tonics because most of these
herbs here are pretty bitter. Are you trying to treat
the immediate symptoms first, and then you would add
the sweet tonics later?
JR: Absolutely. I
think this is an excellent question because in the
case of Sallie, the Angelica sinensis was the sweet
herb in there as that sort of nourishment for the Spleen,
Heart, Blood and Qi and so on, to stabilize the center.
But, I think that once you could get her symptoms under
control, then would be the time to put in, in her case,
probably Ophiopogon. This would then help the Schisandra
and Salvia deal with the sweats. Ophiopogon would be
a sweet, stabilizing tonic for the Heart, and it would
add to the Angelica sinensis to give you probably as
much sweet as youÔd want in that particular combination.
The reason I didn't put it in in the
beginning was because she does have muscle pain. I
was worried about too much Damp going into the situation
in the early stages. If we can get the muscle pain
down, then I would be very happy to add another sweet
herb. Tammy is another person who actually does have
a problem with digestion. She tends to have a very
easy tendency to heaviness in the body after eating,
and her Spleen pulse is usually always in Excess even
though the rest of her pulses are normally Deficient.
It's flooding, it's slippery, and she does tend, like
many in Northwest America, to too much Damp. That's
why we've got less sweet herbs in her constitutional
combination. But you could add Angelica sinensis later,
to help to tonify the Blood.
BQ: Although the
formula you wrote for her did have some Blood tonifying
JR: Yes. We had Rosmarinus
and Salvia officinalis, a pair of aromatic, bitter
herbs that can tonify and move the Blood. Rosmarinus
and Salvia can be used to tonify Blood for example,
in cases of graying hair and hair loss. They do it
partly by calming the Spleen and all the worry that
makes you lose hair, and partly because of their bitter
effects to stimulate the digestion. Culpepper would
say that these two herbs stimulate the spleen and the
liver to breed blood.
CHANGING A COMBINATION TO MEET CHANGING NEEDS
JR: Now Christine
went on a trip to a different climate, and stopped
the herbs, and some of her problems reestablished themselves.
Is that correct?
BQ: In fairness
to you, the formula worked wonderfully for a month.
What else can you expect? People, especially in menopause,
are changing, and the formula needed to be adjusted
and she was out of your treatment at that point.
JR: Yes, she was far
away. I think the other thing to mention, which is
very interesting, is why it's so important not just
to give an unvarying formula, even if you make a combination
especially for a patient, you must be prepared to vary
it with the changing environmental requirements. She
went away, I think it was to Arizona, where the weather
outside was extremely hot and dry. She had gone from
Seattle, where the weather is not known for it's blazing
heat. She was traveling, I understand, for about one
week in a car where the other person in the car had
the air conditioning on. So she was alternating, backwards
and forwards, from a very hot and dry, to a very cold
and dry environment. Since she's very Deficient, this
unfortunately had the result to start the destabilization
mechanism going again. She started alternating between
feeling very cold and having up to twenty sweaty, hot
flashes a day. If I understand correctly, what she
did then after the trip was she stopped the original
formula and moved to another formula.
BQ: Right. On the
trip she didn't take herbs at all I believe. When she
returned to Seattle, then she tried something else
that you discussed in class.
JR: Right. She tried
something we had been talking about in class, which
wasn't made specifically for her, it was a general
combination for menopausal sweating.
Christine's new combination
The herbs were prescribed as 2.5-5
ml of 1:5 tincture 3 times per day in a little water,
and to stop other herbs during this time.
This is like a mini-formula which isn't
really meant to be used by itself, it should be tailored
to individual needs. The Ophiopogon and Salvia combination
tonifies Yin and Wei Qi and stabilizes the sweating.
Ophiopogon tonifies the Heart Yin, it tonifies the
Yin in general and helps Deficient Yin sweating with
Deficiency Heat. Salvia is a slightly calming herb
that helps menopause, as does the Ophiopogon, but the
Salvia is specifically an astringent herb that regulates
sweating. Anemone, as I mentioned earlier, is specific
for menopausal hot flashes and is particularly calming.
The problem with giving Anemone for someone like Christine
long term is that it is too Cold. But in this situation
something was needed temporarily to reduce the sweating,
and the combination worked extremely well.
The sweats were reduced from twenty
per day to three. The Glycyrrhiza (liquorice root)
is exactly what you were talking about, Doug. It is
a sweet herb in there to make a sort of center balancing
point in a formula, to give stability. With the two
sweet herbs, Glycyrrhiza and Ophiopogon, we're trying,
by tonifying the Spleen, to make a sort of anchor to
hold the person stable. If you imagine a boat on the
sea left without an anchor, it would be blown about
all over the place. If you let the anchor drop, it
holds the boat more or less in place.
Anemone, to continue the analogy, would
be rather like trying to drop your sails, so you don't
get blown about so much by the gale. But the problem
with dropping your sails is that when the gale has
gone and you want the wind to move the ship- you won't
move. So you can't use Anemone by itself for a long
period of time. The Ophiopogon and the Glycyrrhiza
are more like heavy anchors that hold the boat down.
The Salvia, if you like, is like closing the hatches
to stop the gale from getting in or you being effected
by those wind changes. That was the second formula
for Christine and it was for a time successful.
DL: It seems like
Christine is a good example where you have to treat
the branches first and then after that you have a clearer
picture of what you need to work with.
JR: That's an excellent
point. This second combination was taken without a
consultation, but sometimes even if you do a full consultation
you can't always see all the ramifications and different
facets of the person. Once you clear some of the branches
out of the way like Tammy's severe bleeding or Sallie's
muscle aches or Christine's cold, you get a more accurate
BQ: It did show
me though how quickly a formula can work because in
less than a week Christine said she was enjoying her
showers. She said she hadn't really connected in her
mind why she had such a difficult time. It seems so
obvious in retrospect to see: "I'm cold is why
I'm not enjoying my shower." But with hot flashes
going on at the same time, it was not really so obvious.
In any event the formula worked very quickly to bring
more vitality, better digestion and a more regulated
body temperature and menstruation.
JR: I think this emphasizes
what Doug was saying. Now we've seen we can control
some of the main symptoms. That's great, but what's
happened in the meantime is that she's gone through
these environmental extremes and stresses, extreme
oscillations between heat and cold. It's interesting
to know that that affects her so much.
Now we know that the next job we have
with her is to strengthen the center. She can easily
go to the hot and sweaty side, and can easily go to
the cold side. So the strategy would be to strengthen
the middle and to be prepared for whatever other oscillations
she might have due to whatever life stresses she gets.
The other thing to mention here is
that Christine was given the Capsicum separately. I
always do that and tell people to determine how many
drops they need. She only needed two to three drops
per dose. Partly because that's all she needed to warm
her up but partly also because people who are deficient
can experience too much of a shock from Capsicum, and
it will send them oscillating back and forth.
BQ: Jeremy, we
are unfortunately out of time. I think you've done
a great job of thinking out loud for us, so to speak,
so that we can see how it is you are constructing your
formulas. It was a great educational experience. Thanks
for your time.
DL: Thanks, Jeremy.
JR: You're both welcome.
Bob Quinn is the manager of People's
Herbs, Inc. in Clackamas, OR and has an acupuncture
and bodywork practice in Sandy, OR. Doug Ly is an acupuncturist
in Seattle and also a sales representative for NF Formulas.