CARB-TCMPA TCM Herbalist flashcards

32 cards. Read the term and the definition here. The deck at the top of this page is optional.

Eight Principles

Exterior and interior, cold and heat, deficiency and excess, and yin and yang form four paired diagnostic categories used to summarize location, nature, strength, and overall polarity of a pattern.

Yin and Yang

Two complementary aspects of one phenomenon: yin is cool, dark, restful, and substantial; yang is warm, bright, active, and functional. They oppose, depend on, consume, and transform into each other.

Zang-Fu

Five zang (heart, liver, spleen, lung, kidney) store essence and spirit; six fu (gallbladder, stomach, small intestine, large intestine, bladder, san jiao) receive and transform; extraordinary fu include brain, marrow, bone, vessels, gallbladder, uterus.

Tongue and Pulse Diagnosis

Inspection of tongue body color, shape, moisture, and coating plus palpation of pulse position, rate, width, length, force, and rhythm provide objective signs that confirm pattern differentiation.

Four Qi

Herb nature described as cold, cool, warm, or hot; neutral herbs are also recognized. Qi describes the thermal effect on the body and guides pattern-based selection.

Five Flavors

Sour astringes, bitter drains and dries, sweet tonifies and harmonizes, pungent disperses and moves, salty softens and descends; bland leaches damp and astringent consolidates.

Meridian Entry

The channel or organ system a herb preferentially affects, determined by traditional observation and used to direct formula action; it guides but does not exclusively limit clinical use.

Herb Processing

Pao zhi methods such as honey-frying, vinegar-frying, salt-frying, wine-frying, or charring alter properties, reduce toxicity, enhance targeted action, and improve storage; processing changes cannot be ignored.

Chief Herb

The principal ingredient whose main action addresses the primary pattern; its dose and emphasis determine the formula's central therapeutic direction, though it need not have the largest quantity.

Deputy Herb

Assists the chief herb's principal action or treats a significant secondary pattern; it strengthens the main effect or broadens coverage without displacing the chief's role.

Assistant Herb

Moderates harsh or toxic effects of chief and deputy, treats an accompanying symptom, or provides a contrasting action needed to balance the formula.

Envoy Herb

Harmonizes the formula, guides ingredients toward a channel or region, or mediates among components; it helps integrate the formula and direct its action.

Root and Branch

Root is the underlying cause or pattern; branch is the presenting symptom or acute manifestation. Chronic or recurrent cases prioritize root, acute severe cases prioritize branch, and mixed cases treat both.

Pattern Differentiation

Synthesis of history, four examinations, tongue, pulse, and contextual factors into a named TCM pattern that identifies location, nature, and severity and justifies a treatment principle.

Treatment Principle

A concise method derived from the pattern, such as clear heat, drain damp, tonify qi, or move blood; it links diagnosis to formula selection and expected response.

Case Reassessment

Scheduled review of symptoms, adherence, adverse effects, and objective signs after a defined interval; findings determine whether to continue, modify, or stop the formula and whether referral is needed.

Pregnancy Herb Contraindications

Toxic, drastic purgative, strongly blood-breaking, or uterine-stimulating herbs are avoided or restricted in pregnancy; risk depends on dose, duration, trimester, and maternal condition, so herb-specific review is required.

Aconitum Toxicity

Fu zi, chuan wu, and cao wu contain cardiotoxic alkaloids; unprocessed or overdosed use can cause numbness, vomiting, palpitations, arrhythmia, and death. Use processed forms, prolonged decoction, and strict dosing.

Aristolochic Acid Risk

Aristolochic acid is nephrotoxic and carcinogenic; Aristolochia species and contaminated substitutes are prohibited or restricted. Verify botanical identity and avoid unregulated products claiming Fang Ji or Mu Tong.

Glycyrrhiza Interactions

Licorice can cause pseudohyperaldosteronism with hypertension, edema, and hypokalemia; it may potentiate digoxin toxicity and interact with diuretics, corticosteroids, and antihypertensives. Monitor electrolytes and blood pressure.

CYP450 Herb Interactions

Herbs can inhibit or induce cytochrome P450 enzymes, altering levels of drugs such as warfarin, cyclosporine, and statins; St John's Wort is a classic inducer, grapefruit a classic inhibitor.

INR Monitoring

International normalized ratio reflects warfarin anticoagulation; herbs affecting platelets, vitamin K, or CYP metabolism can change INR. Check before and after adding or stopping such herbs.

Renal Function Labs

Serum creatinine and eGFR estimate kidney filtration; reduced function raises risk from nephrotoxic herbs, heavy metals, and dose-dependent accumulation. Baseline and follow-up testing guide herb selection and dose.

Liver Function Labs

ALT, AST, alkaline phosphatase, and bilirubin detect hepatocellular or cholestatic injury; baseline testing is prudent with hepatotoxic herbs, preexisting liver disease, alcohol use, or new symptoms.

Informed Consent

Obtain and document discussion of diagnosis, proposed herbs, expected benefits, material risks, alternatives, costs, confidentiality limits, and the right to refuse or withdraw before treatment.

SOAP Note

Subjective, objective, assessment, and plan format documents chief complaint, history, examination findings, TCM pattern, formula, dose, instructions, consent, and follow-up in a retrievable record.

Adverse Event Reporting

When a suspected herb reaction occurs, stop the herb, assess severity, provide or refer for care, document details, notify required authorities, and follow up; report serious events promptly.

Record Privacy

Protected health information must be kept secure and disclosed only with patient authorization or as legally required; use minimum necessary information and follow applicable privacy law.

Scope of Practice

The legally authorized range of assessment, diagnosis, treatment, dispensing, and referral defined by state statute and board rules; practitioners must not exceed it even when trained elsewhere.

License Renewal

Maintain active licensure by meeting renewal deadlines, continuing education, fees, and any reporting requirements; practicing on an expired license is unlawful and may void insurance coverage.

Supervised Practice

Unlicensed assistants may perform only delegated tasks allowed by regulation under required supervision; they must not independently diagnose, prescribe herbs, or represent themselves as licensed practitioners.

Advertising Compliance

Public statements must be truthful, not misleading, and within scope; avoid guarantees, unsupported cure claims, and omitted material risks. Include required license information and retain advertising records as rules demand.