Wandering and Wondering: Jia Wei Xiao Yao San and the Evolution of Chinese Medicine

Dr. Fritz Hudnut, author of Surfing the Timeless Wave Vol 1 and Vol 2 and The Promise of Emptiness, has been practicing acupuncture and herbalism for over 23 years and cultivating a deep spiritual practice through meditation and self-investigation since the early 90's. His work, particularly in the mental health space, has helped numerous patients and has resulted in three books and many published articles, particularly on the topic of electroacupuncture.

Shortly after receiving his Master's degree of Traditional Oriental Medicine from Emperor's College, Dr. Hudnut graduated from the first doctoral cohort at Emperor's College. He has continued to be involved in the Traditional Chinese Medicine academic space as a clinical supervisor at Emperor's College, Yo San University, and Samra University.

The following has been edited for length and clarity.

Q: Jia Wei Xiao Yao San is a very commonly prescribed patent formula in the Chinese medicine space. Do you see this as a chicken or egg scenario, i.e. its efficacy in a myriad of problems has made it popular, or the problems that most patients today present with have made it the most appropriate patent to turn to?

A: Jia Wei Xiao Yao is likely the number one prescribed patent formula on the planet. Conditions treated by it in Bensky’s Formulas and Strategies are the most of any other formula because of the “stress factor” that is at the root of many afflictions the modern human is experiencing. For the most part, it doesn’t take too much digging into patient history to find that “stress” is current or recently current in their story. Whether it is the prime factor or a contributing factor might need to be considered, but usually it is “in the room” with them. So, I would say, “Chicken AND egg”. Its efficacy has made it popular and, often, very appropriate for the clinical presentations that we see especially in fast moving towns where folks are often trying to cut to the front of the line in their life story. The natural resistance to their motivations creates stagnant heat. The near universal appearance of “Liver attack Spleen” in most people during their working years makes Jia Wei Xiao Yao a very valuable tool to have available in the clinic.

Q: You have some really creative and unique applications for Jia Wei Xiao Yao San that are not standard “textbook indications”. One application that particularly comes to mind is your addiction protocol. Can you share some of those approaches and the reasoning behind the treatment approach?

A: Well, using JWXYS in the treatment of addiction or chemical dependency is not new or necessarily “innovation”. The idea of using it to treat folks trying to go cold turkey off heroin to deal with the acute withdrawal symptoms like nausea, vomiting, etc., due to what we term “Liver attack Spleen/Stomach’’, was introduced to us by Dr. Steve Given’s Chemical Dependency class back in the mid 90’s. He also suggested that “the whole bottle” could be consumed in one day to counter the withdrawal problems experienced by folks trying to wean themselves off their chemical of choice.

In any chemical dependency condition, usually driven by the need for self-medication to inure one against some past trauma or emotional tweak they have suffered, something, some “balm”, is consumed to be able to endure the vicissitudes of our daily lives. If we ask them to stop one such form of assistance, then usually there needs to be another to substitute for the first. JWXYS can be offered as an option, in lieu of their chemical of choice. All we are trying to do is kick the can as far down the road between using episodes as possible. So, I suggest to patients, if there is an urge to use, try taking JWXYS instead in whatever dose is needed to pass through the urge. Once we can break the consistent use cycle, then there is room to wedge new directional options into their mind. Fresh newness is then possible in their lives. JWXYS is very good at reducing the stress associated with attempts to not self-medicate with the usual suspects.

Q: When do you determine that a custom formula is a better route to take than a patent formula?

A: In the general clinical setting today, patents provide good value for most of the common conditions that we see in the clinic. If the condition is a little more complicated than the range of a single formula, then it is possible to use the method espoused by Dr. Eric Brand in use in Taiwan. Mix two or three powder formulas by percentage e.g. 70% Jia Wei with 30% Gui Pi Tang to deal with possible menstrual issues due to Blood deficiency, or what-have-you. That way, it is possible to quickly provide a more complex herbal response without spending time thinking about individual herbs and building up a formula via their single functions. We can try using the synergy of the herbs that have been cooked together and then powdered which is similar to using decocted raw herbs.

The problem today is that there has not been any formal research from the powder companies on the efficacy of using their powdered single herbs to make a custom formula as there has been using decocted raw herbs. The Catch-22 is that most people in LA either don’t have time to cook herbs or don’t have the money to buy them.

If someone has used patent formulas with some consistency for a period of time, and it doesn’t seem like there has been progress, then possibly the suggestion to go “raw” would be offered. Using raw herbs generally increases the degree of difficulty for patient compliance in the course of treatment.

Q: What kind of patient conditions or symptoms have you found particularly responsive to your approach with Jia Wei Xiao Yao San?

A: Same answer as before. Any time “stress” is a factor in the condition then it could be in play. I used that formula to treat a man who had been a tank commander for Iraq in the Iran-Iraq conflict during which he was hit by shrapnel which entered next to his eye and remained there due to the surgical complications required to remove it. The sound of the blood coursing past the shrapnel was “driving him crazy.” I asked him, “Does the sound increase if stress is higher?” “Yes,” he said. I prescribed JWXYS and the results were “most excellent.” The sound was made bearable for him.

Q: Are there any patient conditions or symptoms that would be a red flag to you to stay away from Jia Wei Xiao Yao San beyond the standard cautions/contraindications we know from the textbooks?

A: First I was going to say, “Nope, generally it is appropriate,” given the near universal occurrence of Liver Qi Stagnation. But, I have learned by experience that “CEO” types generally can’t handle the calmness that is associated with JWXYS. Several of them have said after I prescribed it, “I felt like I was high, and I could see that my minions were no longer exuding fear in my presence, so I had to stop taking it.” For that lifestyle, JWXYS is not conducive and likely not worth wasting. No value and no power when dealing with that personality type.

Q: It can feel tough for a lot of practitioners in this field to think of change or “progress” in a medicine that has been successful for centuries, as is. Do you envision any kind of evolution of Jia Wei Xiao Yao San in the field of Chinese medicine?

A: This is an interesting question, not in terms of a single formula and how it will “evolve”, but in looking at the profession as a whole and its capacity for “evolution” or “innovation” while continuing the “tradition” of it.

Back in ‘13, I wrote a letter to the editor of Acupuncture Today responding to a column written by Dr. Will Morris entitled Turf Wars. It was possibly written in ‘13 and discussed the problems the profession was having around the “dry needling” phenomenon. It took a full year to find the space for my letter, during which I went down the path the profession and its education system seem to be taking i.e. following the allopathic model, focusing on the technical paradigm of studying all the things we can technically do with a needle. All while other aggressive professions are also claiming that they can use the needle, but in their style. I suggested that Our Medicine is better suited to building our own model and developing the capacity to use the transformational paradigm to provide health leadership to our patients i.e. working beyond the needle. The other problem area is the reluctance of the profession to accept or use newer technologies such as electroacupuncture or particularly LASER, choosing instead to “look backward” to what was done thousands of years ago as the model for moving forward.

The profession is facing comorbidities that are exacerbated by internecine struggles over styles of acupuncture, or geopolitical interactions, or using energy to study the cultural anthropology associated with the history of the “ancient” medicine. All of this rather than facing forward and looking into the future to determine the course of our profession, using the living Medicine that is with us now. The profession has to adapt to current conditions in order to be able to continue to prescribe valuable herbal strategies, like JWXYS. In order to move the profession forward there is a need for real innovation within the tradition. Innovation requires what the Myers-Briggs test defines as “artisan” types, but it seems like the preponderance of the population in the Medicine are “guardian” types, or protectors of what was done before as “the Way.” Sure, both are needed, but, similar to the Maginot Line, if the defenses are static, the faster moving more aggressive armies, like allopathic, etc. can just blitz around them, leaving them to read the Classics in their technical bunker of ancient style.

The other guys have already taken our tool of choice…what do we do now?