Chinese Herb Combining: Why We Mix It Up


In Chinese herbal medicine, herbs are typically combined into formulas. Rather than the Western herbal or homeopathic concept of focusing on one herb to treat a symptom, Chinese herbalists believe that herbal combining leads to greater efficacy. At Clear Skies Acupuncture, we believe that Chinese herb combining is an art and science. As such, it is based on many factors, including herb function, flavor, temperature, what channels are entered, the patient’s constitution, the season, and much more.

Acupuncturists combine herbs for many reasons, some of which are listed below:*

  • Two similar herbs can be combined to strengthen an effect. For instance, both Da Huang (Radix et Rhizoma Rhei) and Mang Xiao (Mirabilitum) may be used to treat constipation, because both herbs drain heat/fire. However, Mang Xiao softens accumulation of stool, and Da Huang helps move stool out of the bowel, so together, they can enhance the same function of relieving constipation.
  • Herbs with opposing functions may be combined to create a stronger therapeutic action. For instance, a patient may arrive suffering from Heart fire symptoms due to a deficiency of Heart yin (think of yin as the nurturing water that keeps yang’s energetic fire in check). The herbalist may prescribe Huang Lian (Coptis), which is cold and bitter and drains Heart fire, along with E Jiao (Gelatinum Corni Asini), a sweet and neutral medicinal that supports and nourishes yin and blood. In this way, the patient is relieved of symptoms of Heart fire, but the formula also nourishes the original deficiency causing the imbalance.
  • One herb can counters another herb’s harsh effect. As an example, some herbs are very cold, and thus may cause damage to the digestive fire when a patient ingests them. Combining a cold herb like Shi Gao (Gypsum Fibrosum) with a sweet nourishing plant like Geng Mi (a form of rice) can help alleviate heat without damaging digestion.
  • Herbs can harmonize other herbs. Gan Cao (Licorice) is an herb that is commonly used to help harmonize and bring into balance the actions of other medicines. It can cause herbs with opposing actions to work well together.
  • Herbs can guide other herbs to different areas of the body. Certain herbs are so intimately related to a part of the body, a channel, or an organ, that they pull other herbs toward that area. For example, Chai Hu, (Bupleurum), guides other herbs to the liver and gallbladder channels, and also to the upper body. If a patient had a Liver channel related headache, Chai Hu might be used in a formula to treat.
  • Herbs are combined because of how they move qi, their flavor, and their temperature. For example, the Spleen, the body’s primary yin digestive organ, likes warmth, sweetness, and also dryness, because the Spleen can be encumbered by the stagnation of fluids. To support the Spleen, the hot, acrid herb Gan Jiang (dried Ginger) may be combined with the sweet, bland herb Fu Ling (Poria), whose bland nature helps to drain dampness, or pathogenic fluid.

Certain herbs in Chinese medicine are such good partners that they are well known as common paired building blocks for formulas. In herbalism, we call these “Dui Yao,” or “two herbs” pairs. In a future post, we’ll explore some of the dui yao pairs and how they can be used to help with different acupuncture and herbal treatments.


This blog has been written with reference to:

Sionneau, P. (1997). Dui Yao: The Art of Combining Chinese Medicinals. Boulder, CO: Blue Poppy Press.


Understanding the Rotator Cuff


Acupuncturists often treat shoulder injuries that involve the rotator cuff. The rotator cuff is a group of muscles and tendons that help to raise and rotate the humerus, or upper arm bone, and stabilize the shoulder joint. Rotator cuff muscles and tendons keep the head of the humerus in the shoulder socket.  These muscles and tendons can become damaged by an acute injury or tear, repetitive overuse, aging, or even tendonitis. Acupuncture is a great way to alleviate pain and accelerate tissue repair in a rotator cuff injury.

The four muscles in the rotator cuff are the supraspinatus, infraspinatus, teres minor, and subscapularis. Understanding the actions of these muscles can help you understand what might be a cause of pain, and when to come in for an evaluation. The actions of the muscles in the rotator cuff are as follows:

  • Supraspinatus muscle. The supraspinatus lifts the arm bone above the head. It also helps to stabilize the shoulder, pulling the head of the humerus into the shoulder socket.
  • Infraspinatus muscle. The infraspinatus is the primary muscle that performs external rotation of the shoulder. It also stabilizes the shoulder joint and has a more minor function of pulling the arm backward.
  • Teres Minor muscle. The teres minor also helps to externally rotate the shoulder and stabilize the shoulder joint.
  • Subscapularis muscle. The subscapularis is the largest of the four muscles of the rotator cuff. It internally rotates the shoulder and helps to stabilize the shoulder joint. It also helps with arm adduction (movement of the arm toward the body’s midline).

If you’re experiencing pain when you lift, lower, or internally and externally rotate your arm, you may want to come in for a physical assessment, to determine if you may have a rotator cuff injury. Simple physical examination, palpation, and muscle testing can help your acupuncturist or other provider determine what’s injured and outline a treatment plan specific to your needs.

The Common Cold According to Chinese Medicine


Common folk wisdom will tell you to, “Bundle up when you go outside so you don’t get a chill.” Is the concept of cold weather causing a common cold just a societal misperception or myth? According to Chinese medicine, it’s pretty accurate. Chinese medical theory says that cold is a pathogen that can invade the exterior of the body, causing symptoms of a common cold, such as chills, body aches, cough, and aversion to cold.

In order to penetrate the body’s defenses, cold may combine with wind. Like wind in nature, wind as a pathogen can cause movement and change, it can be strong and aggressive, overpowering the body’s natural defense mechanisms and invading the skin and pores. Just like a turbulent wind on the prarie can become a tornado and knock over a fence or a house, a cold winter wind can knock down the body’s defenses and wreak havoc on your health. Wind-cold often invades the body at the back of the neck, which is why an acupuncturist may advise you to wear a scarf in cold and windy weather. Why the back of the neck? Acupuncture channels related to the body’s immune defense system run through this body area.

In Chinese medical channel theory, the body’s defensive system is connected to its’ more exterior aspect, often referred to as Tai Yang, which includes the Urinary Bladder and Small Intestine channels. The Tai Yang warms the skin and hair and discharges defensive qi across the surface of the body, while keeping the pores and exterior closed to external invasion. When pathogens like cold disrupt this natural dynamic, warmth and defensive qi cannot discharge outward to the body’s exterior, and a person may feel chills. Or alternately, this trapped warm qi may instead rise up the head, causing fever or headache.

To treat a cold, acupuncturists use may techniques that can release the trapped cold pathogen from the exterior layer of the body, and restore the natural dynamic of the Tai Yang. One technique we often use is cupping, wherein suction cups are placed on the skin, helping to open the pores and exterior layer to pull the pathogen out to the surface.

Acupuncture points can also help release the body’s exterior and restore balance to the Tai Yang and exterior. For instance, Lung 7, located on the wrist, is the command point for the head and neck, and can help release the exterior of the body and expel pathogens, while strengthening the body’s defensive qi. San Jiao 5, on the forearm, is another point that releases the exterior, and can help treat fever or disperse pain. Other points may be used locally or distally to unclog sinus congestion, treat head and neck pain, or alleviate other symptoms of the common cold.

So the next time you’re out in cold or windy weather, keep your neck covered and your body warm, and don’t give the cold and wind a chance to penetrate your defenses. Or if you’re feeling under the weather, stop in for a treatment, and see how acupuncture can help you.