The Basic HIV+ Herbal Therapy Program:
Prescription for Enhanced Balance and Strength

By Misha Cohen, O.M.D., L.A.C.

I was diagnosed almost nine years ago and have had only a couple of bouts of illness. In all that time I have never used any Western antiviral medicine. Instead I use herbs to support my immune system and help keep my marrow strong. I think this has been the key to my long-term healthiness-that and the attention I pay to my diet and overall frame of mind. Some day they'll figure out exactly what these herbs do-but until then, all I need to know is that they work for me.
-Karen G., AIDS counselor and former schoolteacher, diagnosed in 1991

Have you ever walked into a Chinese herbalistspi shop with its hundreds of drawers and glass jars filled with potent plants, animal extracts, and minerals? It certainly looks mysterious, but in reality it is a well-ordered laboratory where the healing wisdom of the past 2,000 years waits to be distilled into a prescription tailored to remedy your individual disharmonies. In fact, the herbs and herb formulas that your practitioner or herbalist prescribes are potent medicine and should not be taken on a whim or without supervision. Few herbs from the vast pharmacopoeia of Chinese medicine are recommended to be used as over-the-counter remedies. Thatpis why itpis so important to put yourself in the hands of a well-trained and experienced professional who is capable of diagnosing you accurately and treating you effectively. And I strongly recommend that you see your Chinese medicine practitioner regularly while you are taking the herbs so she can monitor your responses to the treatment.

In exploring the use of herbal therapy, keep in mind that there are three important distinctions between Western drugs and Chinese herbal medicine. First, in Chinese herbal therapy the concept of how herbs interact so that they effectively counter illness and restore harmony is based on the philosophy of the Tao-that a well-balanced whole is formed by the unity of opposites. Second, Chinese herbal medicine uses only naturally occurring ingredients. For example, there is no such thing as prescribing a synthetic hormone such as progestin to replace the bodypis own progesterone. Last but perhaps most important, when prescribed by a knowledgeable. practitioner, herbs rarely have negative side effects of any consequence. So letpis take a look inside those mysterious -looking jars of strangely named herbs and find out exactly how they work to restore harmony to the Organ Systems and Essential Substances.

HOW HERBS ARE DESCRIBED

Herbs are characterized by temperature, taste, and direction. The impact of each aspect must be weighed when determining the proper herbal remedy for a specific disharmony. Temperature. An herb may be hot, cold, warm, cool, or neutral. If a disease is considered hot, then a cool or cold herb is needed. If the disharmony is cold, then a warming herb is required. Taste. An herb may be characterized as acrid, sweet, bitter, sour, or salty. Substances with none of these qualities are labeled bland (they sure are!). Each of these qualities has its own unique therapeutic impact on Essential Substances. Acrid herbs disperse and move; sweet ones tonify and harmonize. Bitter herbs drain and dry. Sour herbs are astringent and prevent or reverse the normal leakage of fluids and energy. Salty herbs purge. And bland herbs take out dampness and promote urination.

Direction. The therapeutic impact of an herb can also be measured in terms of the direction that it moves Essential Substances. Some herbs cause the Qi to rise and float (move upward and outward), some cause it to fall and sink (move downward and inward).

HERBAL THERAPY IN THE HIV+ PROGRAM

The herbal formulas I use in our program were developed by blending the wisdom of ancient Chinese herbalists with modern scientific insights into the pharmacological effects of herbs. We began systematically studying the impact of various herbs on HIV in 1986-87, when the Brion Herb Corporation, a Chinese herbal company, donated approximately $30,000 worth of herbal formulas in the form of granulated herbal powders to the San Francisco AIDS Alternative Healing Project (which I cofounded) and Qingcai Zhang, M.D., of the Oriental Healing Arts Institute (OHAI) in Long Beach, California. Together we developed the protocol (a detailed treatment plan) for a study of the effects of herbs on people with HIV/AIDS.

In that first six-month study we followed 23 people who had been diagnosed as HIV-positive (most of those who had progressed to AIDS were taking AZT) and six who had chronic fatigue immune dysfunction syndrome. During the study we measured the effects of 28 herbal formulas, monitoring their effect by using Chinese medicine diagnosis and blood tests to check platelet and white and red blood cell counts; liver, kidney, and heart function; and the presence of the p24 antigen. The University of California-San Francisco processed the blood samples in their laboratories.

At first we were simply feeling our way through this process-carefully looking for clinical indications of what was working and adjusting our treatments depending on the results we observed. Pretty soon, though, we had honed in on six formulas that seemed most effective. And we began using other substances that the clients found helpful. For example, one young man whopid been diagnosed a year earlier was suffering from severe anemia and required two to three blood transfusions a week. He was very cold and unresponsive. Dr. Zhang prescribed sliced deer antler for him and he became more energetic and needed fewer transfusions. So we decided to give deer antler to others in the study who were also anemic and cold. Thatpis how we learned that marrow -strengthening agents are an important part of herbal therapy for HIV infection.

In another instance, a visiting scientist, Dr. Chen of Shanghai, supplied us with an enema made from a traditional herbal formula for diarrhea, which we used with some Success with those suffering from cryptosporidium-related

We added a concentrated form of Ganoderma lucidum mushroom, donated by BioHerb, Inc., and found it boosted peoplepis energy levels dramatically. During this program it became more and more evident that Toxic Heat was a trigger for HIV-related symptoms and associated disharmonies. There is a category of Chinese herbs known traditionally as Clear Heat Clean Toxin-no surprise that it would make sense to use these against the epidemic factor Toxic Heat. We started using a formula of antiviral, heat-clearing herbs from this category in all the base formulas. We were able to use Western scientific discoveries to make the formulas even more effective. Western research had shown that only a few Clear Heat Clean Toxin herbs have any anti-HIV effect in vitro, and even fewer have a strong virus-killing effect.pi Therefore, in developing immune -strengthening HIV herbal formulas, we used only those herbs that had the strongest virucidal effects, not only for HIV but also for herpes, hepatitis viruses, and 2 other viruses. We also included components such as the fungus Cordyceps sineusis, which is antibacterial and is used in China for its anticancer properties.

As we proceeded, always refining our formulas, we were faced with the problem of how to measure and evaluate the participantspi responses. This was the beginning of the ongoing debate about how to assess the most common response of people taking Chinese medicine treatments for HIV infection: "I have more energy.- We decided the clearest empirical measure available was to evaluate the degree of change in the study subjectspi daily activities: Ten of the original 29 participants were unable to work at the outset of the study. Six months later, at the close of the study, all but one participant was employed or doing consistent volunteer work.

At the end of that first casual, observational study by the San Francisco AIDS Alternative Healing Project, the Quan Yin Healing Arts Center, and the Oriental Healing Arts Institute in 1988, 1 approached Dr. Subhuti Dharmananda of the Institute for Traditional Medicine (ITM) in Portland, Oregon, and we agreed to conduct the Quan Yin Herbal Program for People with AIDS. ITM, which manufactures herb formulas, agreed to supply the test formulas to Quan Yin at reduced cost in exchange for Quart Yinpis collaboration. In one month, Quan Yin Healing Arts Center recruited 90 clients from the Quan Yin Acupuncture and Herb Center. As part of the protocol we developed monitoring questionnaires, as well as a way to draw blood that would yield consistent lab results. When the two-year cooperation ended in 1990, the Quan Yin Herbal Program had formally enrolled and followed more than 600 people. Over time we went through several different herbal formulations designed by ITM and a company producing herbal formulas called Health Concerns, ultimately using one called Composition A tailored to treat HIV-positive people. In addition, Quan Yin had treated many more HIV-positive people with a combination of acupuncture and herbs. I presented the results in Beijing at ihe First International Conference on Viral Hepatitis and AIDS in 1991.

In early 1991, 1 began work on another new formula based on insights gathered through observational and clinical experience with more than 2,000 dients at Quan Yin since the beginning of the HIV/AIDS epidemic. Health (,()ncerns agreed to support its development. After a 16-week trial period, Health Concerns began distributing two formulas I developed, Enhance and Clear Heat. The next spring, in conjunction with Health Concerns founder Andrew Gaeddert, I designed Marrow Plus, based on my work with people with cancer and HIV infection. This formu la-de signed specifically for people who were receiving chemotherapy or AZT and had low blood cell countscan also benefit those who have HIV- and drug-related anemia.

In 1992-93 1 was the coinvestigator on a double-blind placebo -controlled study at San Francisco General Hospital. Using IGM-1-a formula designed from Enhance and Clear Heat-we observed that gastrointestinal and neurological symptoms improved and fatigue lessened. We also saw a trend toward improved sleep patterns and lessening of pain.

Since that early study there have been many more refinements in the herbal formulas and I have designed Source Qi for treatment of chronic diarrhea. This process of inquiry and study led to the herbal protocol outlined below that is used in my clinic and by many practitioners in the United States and around the world today.

HIV+ HERBAL PROTOCOL

The formulas I developed for regulating immunity and suppressing Toxic Heat, Enhance and Tremella American Ginseng, and specifically for suppressing Toxic Heat, Clear Heat, are based on Chinese medicine herbal therapies known as Fu Zheng and Jiedu/Qiuxie. Fu Zheng means "restoring normality," and it is used in China to tonify Qi and Xue and to increase disease resistance, normalize various bodily functions, and regulate the immune system of people with cancer. Wepive adopted it to treat chronic immune dysfunction associated with chronic viral disease and to decrease or eliminate the side effects of Western anti-HIV medications and of chemotherapy and radiation. Jiedu/Qiuxie therapy is used to clear toxins and heat from the body. These herbs are very powerful and are used only in combination with Fu Zheng therapy, which ameliorates the potential side effects of antitoxins. Traditionally, these herbs have been used in China to destroy cancers and to treat Heat Toxin diseases, which we now know include viral and bacterial infections. N From the book "The HIV Wellness Source Book" by Misha Ruth Cohen, O.M.D., L.Ac. with Kalia Doner. Copyright 1998 by Misha Cohen reprinted with permission by Henry Holt and company, LLC. If you are åinterested in obtaining a copy of "The HIV Wellness Source Book" please go to www.henryholt.com on the world wide web.