How an Herbal Prescription Works:
Why There’s No Single Herb for Pain or Headaches
Why I Can’t Answer “What Herb is Good for…?”
Some of the most common questions I hear are something like this:
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“What herb do you use for abdominal pain?”
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“What herb is good for headaches?” In Chinese medicine, there is no single herb for one symptom. Instead, we use formulas—carefully balanced combinations of herbs that are chosen to match a person’s pattern of disharmony within the context of their overall health.
That means the main problem—like abdominal pain—must be both looked at closely and considered in the context of digestion, sleep, energy, emotional health, and more.
Here’s a simplified look at how the diagnostic process works when prescribing herbs.
Step 1: Chief Complaint
Say the main complaint is abdominal pain. The first step is identifying where the pain occurs:
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Epigastric area (stomach)
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Under the ribs (left or right)
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Center above the belly button
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Around the belly button
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Sides of the abdomen
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Center or lower abdomen
For this example, let’s say the pain is in the lower abdomen.
Step 2: The Four Examinations
To refine the diagnosis, I use the classical Four Examinations:
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Looking: complexion, tongue, hair, eyes, skin, nails
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Listening & Smelling: voice strength, breathing, odors
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Touching: pulse, abdomen, skin temperature, edema, muscle/tendon texture
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Asking: the 10 Questions—covering temperature, sweating, digestion, urination, stools, pain, sleep, gynecology, thirst, history
Step 4: Putting It All Together
Most people don’t fit neatly into one category. Often, multiple patterns overlap.
Common Patterns of Lower Abdominal Pain
Chinese medicine looks for underlying patterns that explain the pain. The most common include:
Blood Amassment in the Lower Burner
Symptoms
• Hardness and pain in the lower abdomen
• Refuses pressure
• Inhibited urination
• Amenorrhea or scant bleeding
Severe cases: delirium or mania
Pulse: deep, replete, or choppy
Tongue: purple. Can see bruised looking area on the right side along the edge towards the back.
Base Formula:
Tao He Cheng Qi Tang
Damp-Heat in the Bladder
Symptoms
• Abdominal distention, fullness, and pain
• Short, dark urination; possible blood in urine
• Burning or painful urination, dribbling urinary block
Pulse: slippery and rapidBase Formula:
Tongue: red with a yellow coat at the root
Base formula:
Ba Zheng Tang
Liver Depression Qi Stagnation
Symptoms
• Distention and fullness with more bloating than pain
• Erratic or moving pain, better after burping or passing gas
• Possible nausea, constipation, or poor appetite
Pulse: wiry
Tongue: tightness along the edges
Base Formula: Ban Xia Xin Tang
Lower Burner Vacuity Cold
Symptoms
• Dull, cold abdominal pain better with warmth
• Cold body and limbs, long clear urination
• Lassitude, loose stools, impotence
Pulse: deep and fine
Tongue: pale and swollen
Base Formula: You Gui Wan
Example Case
Complaint: lower abdominal pain
Tongue: normal
Pulse: thin and weak
Complexion: pale
Other: inhibited urination, mild menstrual cramps, runs cold (lower belly cold to touch), water retention at the waist, tight upper back and neck
Diagnosis: Abdominal pain due to blood deficiency not nourishing the muscles, combined with cold and water accumulation.
Treatment: Dang Gui Shao Yao San, modified with Gui Zhi for cold.
Base Formula: Dang Gui – 9 g, Bai Shao – 48 g, Fu Ling – 12 g, Bai Zhu – 12 g, Ze Xie – 12 g, Chuan Xiong – 12 g
This classical formula was originally for pregnant women with abdominal pain, but its applications have expanded widely over the centuries.
The Takeaway
Chinese herbal prescriptions are never one-size-fits-all. They are individualized to match your body’s unique pattern and constitution.
So when someone asks me, “What herb do you use for headaches?” the answer is:
➡️ It depends on your body, your symptoms, and your overall health picture.
That’s the detective work of Chinese medicine—matching the right formula to the right person, for the right reasons.
