Interviews with Practitioners Who Use Honso Products: What They Think

An Interview with Ted Annenberg, 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.

Ted Annenberg, L.Ac., located in Columbia MD, has been an acupuncturist since 1982, specializing in Japanese styles. He has studied in Japan and in the U.S. with Masahilo Nakazono, Yoshio Manaka, and other masters. For the past 20 years he has continued to pursue studies in Japanese five phase meridian therapy. Meridian therapy is largely based on the practitioner's palpatory skills, ability to feel Qi and specialized needle techniques, many of which are non-insertive. Many practitioners of this style in Japan are blind and have developed extraordinary sensitivity to Qi through this practice.

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

JG: Good morning, sir. Would you please tell our readers a little about your experience with HonsoHs Kampo formulas?

TA: Of course. I often base my herbal prescriptions on acupuncture diagnosis. Kampo herbal formulas are a mainstay for my mild to moderate pediatric cases: colds, rhinitis and such. The granules are quick and easy to mix and take. Children find them reasonably palatable in a little juice. And they are cost effective.

Generally, I diagnose using Japanese abdominal diagnosis mixed with a German diagnostic system reading the omentum. I look at the psychological, autonomic nervous system, liver, adrenals, blood sugar, immune system, endocrine system, and OB/GYN systems to find the fundamental pathology, similar to homeopathy. I focus less on symptoms and signs than on classical diagnosis. The most common thing I see is liver excess with subcostal distress. For this concern I use H09/Minor or H08/Major Bupleurum. In this area of the country-Maryland-a significant number of patients present with chronic sinusitis, and for that I most commonly use H02/Ge Gen Tang Jia Chuan Xiong Xin Yi. I may also combine this with nasal rinsing and acupuncture. The next most common type of presentation I see is in OB/GYN, often with mixed patterns. I usually use H24/Jia Wei Xiao Yao San for these cases. For example, a woman may have a yeast infection with a nervous system disorder such as PMS. For this I would prescribe H06/Shi Wei Ba Du Tang plus H24/Jia Wei Xiao Yao San.

JG: Thank you. Can you give us an example of a particular woman presenting with a mixed pattern?

TA: Yes. Linda, a 65-year-old white female, came in with severe itching and rash starting in November 2003. This began when she added the drug Altase to her regimen. Altase is an ACE inhibitor for warding off stroke and cardiovascular disease. She also has hypertension. She had been treated for the itch with limited success using steroids and such. She was scratching on the LI channels and on her abdomen. I asked her about a history of liver pathology, which she denied knowing of. I find liver pathology common in itching cases. Her abdominal diagnosis revealed blood stasis and right subcostal liver excess. She was extremely tender at bilateral Liv-13 and right Liv-14, and her Pericardium and Lung fire points were tender, showing upper warmer pathology. To me this meant a mixed liver excess/deficiency pattern. Medical blood tests revealed acute liver enzyme elevation. She had been off Altase for two months. After intake I diagnosed her itching as due to chemical exposure and used acupuncture to treat the liver excess/deficiency (often the situation with acute liver problems as an acute liver excess overlays a chronic liver deficiency), mainly using rice moxa on Liv-1. Her itching was gone by the end of the treatment. I prescribed H06/Shi Wei Bai Du Tang successfully.

When I see liver excess it reveals itself as tenderness at right Liv-14 and under the right costal area. Liver deficiency is usually a sharp or ticklish pressure reaction at Liv-13. If I am still not sure, I palpate the liver channel on the inner thigh for tenderness. If treating for liver excess, usually Liv-4 and Liv-8 on the right will work. If Liv-14 is now OK but not Liv-13, then I add in Liv-3, which treats liver deficiency. I often have to treat both. In Linda's case she had this condition plus so much fire in her upper burner, which is common in cases of upregulated nervous systems-slightly rapid heartbeat, talkative, hyperthyroid people. You know the type.

JG: We've met, yes.

TA: I find some differences between acupuncture and abdominal diagnoses. This allows me some leeway. I use herbal formulas supportively. I don't always mix acupuncture and herbal diagnoses. I like to have four to five consistent signs for an herbal diagnosis.

I often see situations with chongmai syndromes-dysfunctional bleeding, pelvic inflammation and such. For this I see Kd-1, Sp-4, Sp-6, and St-30 bilaterally having pressure pain. I usually prescribe H25/Gui Zhi Fu Ling Wan, perhaps with H61/Tao He Cheng Qi Tang. Overall I find Honso's formulas convenient, economical, and high-quality. I would call their inventory very good (not excellent since they occasionally run out of something), and the company representatives are good to deal with. Patient compliance is high.

Chongmai disease can be asthma. Lots of young women on the east coast come in with dysmenorrhea, low back pain, breast tenderness and such along with respiratory and sinus problems. They are often on inhalers for asthma, and these stimulate their autonomic nervous systems, which to me are already overstimulated. I will treat the chongmai with H25/Gui Zhi Fu Ling Wan and perhaps H24/Jia Wei Xiao Yao San, often at two parts H25 and one part H24. This will usually get the asthma better due to treating the root.

JG: Can you give us a specific case history?

TA: Yes. Ann lives a very stressful life-three young kids, a husband just getting over lymphoma, her mom with multiple myelomas, hands full. She is a 36-year-old female who first came in for asthma and migraines. Her problems started after her first pregnancy-joint pain in knees, hips and lower back, migraines leading to nausea, episodic dizziness, breast tenderness, PMS, etc. She has a long scar across her thorax due to lung surgery for carcinoma in her left lower lobe. There was no chemotherapy and apparent full remission. Initial examination revealed yinqiao and renmai imbalance overlaying a chronic chongmai imbalance. I used acupuncture to help control for all that. After treating the yinqiao and renmai, her abdomen was OK, but Kd-1, Sp-6, and St-30 were still tender. I treated Sp-4 right and P-6 left, and all tenderness disappeared immediately. I made the mistake of first giving her Ding Chuan Tang herbally, which was not much help. Her primary asthma mechanism was stress, and formulas with Ma Huang will only add stress in such cases. I then gave her H25/Gui Zhi Fu Ling Wan with H16/Pinellia and Magnolia Formula for her upper and lower warmer imbalances with an empty middle warmer. This calmed her nervous system. For her, asthma was more like a panic attack. Over three months, this has resolved almost all symptoms. She still sees me monthly and continues with H16/Pinellia and Magnolia Formula.

JG: So overall which formulas do you use most consistently in your practice?

TA: Overall I use H02/ Ge Gen Tang Jia Chuan Xiong Xin Yi a lot for chronic sinusitis. I use lots of H11/Bupleurum, Cinnamon and Ginger Formula especially with autonomic nervous system, neurotic, cold hands and feet, anxious presentations. Seasonally I use H09/Xiao Chai Hu Tang for rhinitis without sinusitis. I use H24 and H25. And also H41/Bu Zhong Yi Qi Tang to supplement the middle.

JG: Thank you, Ted Annenberg. It has been fun to talk with you. Thank you for your time.

TA: My pleasure.

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.

*These statements have not been evaluated by the Food and Drug Administration. These products are not intended to diagnose, treat, cure or prevent any disease.