These days it's popular to use big formulas with long ingredient lists. The general principle of many of these formulas is simple, but they include many herbs with the same function just to achieve one action. This actually kind of "dilutes" the strength of the formula because so many different herbs tend to cancel each other out in terms of taste, temperature, and action. Energetically the big combinations easily lose their direction. This is the same case when too many acupuncture points are chosen for use in one treatment. The Qi becomes scattered and confused, rather than focusing unanimously on a single task.

There is a general concept in science that the simplest answer is most likely the best one. This is also true in the context of Oriental Medicine. The simplest formula is the strongest, and the simplest point prescription is the most direct. For example, Shang Han Lun formulas are very simple, yet very strong. When used correctly, they work like a snap; but when used incorrectly they may cause side effects. I believe that's the reason why the bigger formulas have become more popular.

When the skill or the confidence to choose the one single most appropriate herb is lacking, a broad spectrum approach of using a numerous herbs that have the desired action can have some effect to accomplish the desired goal while reducing the risks associated with committing to the wrong choice of a single herb. The price paid for that method, however, is not only the health of our patients but also the reputation of our profession. Simple is usually better. Why should we practice compromise when we have the knowledge to make the best choice? The key is to understand the basic principles of creating a formula, and develop the skill to custom design simple, powerful and accurate formulas based on the individual cases.

There are situations when using a milder formula or acupuncture treatment is more appropriate. For example, when treating children or the elderly, or when the diagnosis is unclear. In these situations, "diluting" the energetic direction is appropriate because it reduces side effects. The way to make a formula milder is to use multiple herbs with the same functions, but reduce the dosage of each herb so the formula doesn't become too big. The way to make an acupuncture treatment milder is to increase the number of needles but use a gentle technique. Using a gentle approach is wise when it is chosen for the right reasons. The strong simple approach may cause side effects, but when used correctly it yields a faster result and is more effective. Therefore, simple is usually better.