Interviews with Practitioners Who Use Honso Products: What They Think

An Interview with Nigel Dawes, M.A., L.Ac.

This is one of a series of interviews with alternative medicine practitioners in the US who frequently use Honso Kampo products in their practices. Honso is a pharmaceutical company based in Japan and branched in Phoenix, Arizona which produces and distributes pharmaceutical-grade Chinese herbal formulas or Kampo in Japan and the US.

Nigel Dawes is on faculty at Pacific College of Oriental Medicine and Tristate College of Traditional Acupuncture in New York and frequently offers continuing education seminars for the Acupuncture Society of New York, Edokai Traditional Acupuncture Society in Long Island and workshops in Europe and Israel. He recently presented Kampo theory at the 2003 Pacific Symposium in San Diego. He maintains a busy private practice in New York City. From 1993-2001, he was Dean of the Graduate School of Oriental Medicine at New York College of Wholistic Health, an ACAOM-accredited college offering masters degrees in acupuncture and Oriental medicine. He founded and directed London College of Shiatsu from 1988-1993, which offered accredited 3-year training in shiatsu and Oriental medicine. His training included six years in Japan where he graduated from acupuncture school in 1985, pursued a formal apprenticeship in Zen shiatsu and studied Kampo followed by post-graduate clinical studies in Beijing. He returned to the UK in 1987 to pursue further post-graduate work in clinical medicine and Kampo. He is the author of two books on shiatsu and numerous articles on Oriental medicine.

Joseph Garner, L.Ac, Dipl.Ac, Dipl.CH, conducting this interview, trained at Colorado School of TCM in Denver, is a licensed acupuncturist working in Phoenix, Arizona and is on faculty at Phoenix Institute of Herbal Medicine Acupuncture.

JG: Good evening, Nigel. Can you talk about your experience with Honso granular herbal products?

ND: I have practiced Kampo (Sino-Japanese Herbal Medicine) for 20 years, mostly with granulated herbal products from Sun Ten, but I have only begun using some of the Honso formulas during the last six months. When I trained in Japan, I was mostly taught about using granular herbal formulas, though I learned raw herbs as well. The consensus of opinion there was that granulated formulas have advantages, and I have seen this in my practice.

JG: What do you see as advantages of granular formulas?

ND: Firstly, patient compliance. Most patients don't want to do raw formulas, in my experience. Unless I am vigorous and insistent with someone, or unless they have a background in such things, they tend to resist taking raw herbs. It's not in the culture. In London and New York City, patients just won't bother. And if they do agree to take raw herbs, they may not tell me till later that they've not been taking them as I prescribed them. Powders are convenient, especially Honso's little sachets-little packets. Patients don't have to measure dosages, so there's no confusion. They'll never call me up and say they've forgotten how much to take. And no boiling.

JG: I know all about compliance problems, too, unfortunately.

ND: I'm sure. Secondly, I feel that the synergy of formulas is critical-herbs boiled together. That synergy is just not there when practitioners mix individually marketed granular herbs together, as some companies are offering these days. This is the antithesis of my Japanese training. They taught me, and I believe it is so, that there is something that happens when herbs are boiled together that is lost otherwise. I have no scientific evidence for this, but it seems sensible to me. All I have is anecdotal evidence. Patients who have taken formulas made up of individual granular herbs mixed together, and who have then taken the same formulas cooked together, report there is a definite difference in the taste and feel of the herbs.

JG: It makes sense to me. I know today's science is unable to adequately measure the complex interactions of herbal formulas, but what you say only stands to reason. Anything else?

ND: I like Honso's faithful use of classical formulas. I know I'm biased by my training, but I see formulas from the Shang Han Lun and Jin Gui Yao Lue as the basis and building blocks of most formulas that have come since. Clinically this is a very useful course for a Chinese herbal company to focus on. Where I teach, students ask why I use granules. I tell them raw herbs are expensive and difficult to use, and they don't guarantee quality. Japanese granular herbal formulas are always high quality, and granules are actually cheaper than raw herbs for the same effect. Dosage is very different in Kampo than TCM. In China dosing of raw herbs is so high, I feel medical doctors would question this and be concerned about side effects. I have seen side effects with high-dose raw herb formulas, and not just nausea and such, but liver enzyme changes. I feel granules are safer.

JG: I see. Can you speak of any case histories?

ND: All right. I've had a patient for eight or nine months, a man in his 50s with a mild anxiety disorder. He has sleep problems, is nervous and has mild gastrointestinal symptoms such as occasional reflux, epigastric discomfort, and so on. Not too bad from a Western diagnostic standpoint, but he suffers. With him I tried a few formulas such as Ban Xia Hou Pu Tang (Pinellia and Magnolia Combination) with limited improvement. But then, based especially on his abdominal conformation which showed hypochondriac tightness and resistance (Kyo Ka Hi Ko), I switched to Chai Hu Jia Long Gu Mu Li Tang (Bupleurum and Dragon Bone Combination) and to my surprise this really helped him. I had thought this might be too strong for his constitution, which Kampo would have classed as moderate to weak, since it contains amongst other herbs a small amount of Da Huang (Rhubarb), but it worked wonders. He started out on the Sun Ten version of the formula, then I switched him to the Honso version (H12), and the patient remarked that the Honso formula tasted different, and that he felt better on it, and frankly this surprised me, too. This classical formula is mentioned in the Taiyang section of the Shang Han Lun as useful for treating nervousness, fright and such things when they occur as a result of interior heat generated in the Shaoyang stage.

JG: OK. Any other case histories?

ND: I had a man in his 20s who came in with hyperhydrosis: spontaneous sweating. He would have to change his shirt two or three times a day at work. He really had no other symptoms to speak of--sleep OK, not too anxious, just lots of sweating. It affected his quality of life. From a Kampo diagnostic perspective he fit the Gui Zhi Jia Huang Qi Tang (Cinnamon and Astragalus Combination) conformation (Sho). This formula is mentioned in the Jin Gui Yao Lue as being a common modification of Gui Zhi Tang (Cinnamon Combination) used for strengthening the body's resistance (Wei Qi) in a patient with a cold and deficient constitution. After three months on that formula his symptoms resolved. This made a huge difference in his life. Also, the treatment period was during the winter-time. He remarked that he usually got colds all winter, and during the treatment phase he only got one all winter, which to him was a dramatic improvement.

JG: Excellent. Well, Nigel, I'm afraid that's all we have time for. I enjoyed talking to you, and thank you for your time and expertise.

ND: You're very welcome. I enjoy promoting Kampo.

The above contents are only for the purpose of professional exchange of information. They do not necessarily represent Honso USA's opinions. All above mentioned products are not for sale on this website or without a licensed practitioner's consultatoin.