By Dr. Simon J. Feeney, Founder & Director, Empirical Health
Herbal formulation is both an art and a science. Over years of clinical experience, I’ve seen how precision in dosage and ratio forms the backbone of effective prescriptions, helping each formula deliver its intended therapeutic synergy.
Today, I share insights from our clinical and manufacturing experience at Empirical Health, informed not only by traditional practice but also through the evolution of modern delivery methods such as concentrated granules.
The Foundations of Dosage and Ratio
Every formula in traditional Chinese herbal medicine is built on a carefully calibrated balance of herbs. The ratios established in classical texts are not arbitrary, they reflect centuries of clinical refinement and deep understanding of how the energetic properties of individual herbs interact.
Energetic Balance
Each herb contributes a distinct energetic signature. Accurate ratios ensure that these energies harmonise to restore balance in the patient. This interplay is particularly important when managing complex, multi-layered patterns.
Therapeutic Synergy
Traditional prescriptions are the result of generations of careful observation and experimentation. The synergy created through balanced ratios enhances therapeutic effectiveness, allowing formulas to act in concert rather than in competition.
Adaptation to Patient Needs
While historical ratios provide a time-tested foundation, every patient is unique. Adjustments must be made with insight, care, and respect for the formula’s intent, a principle we prioritise in both our clinic and dispensary.
Modernising Dosing Without Compromising Precision
One of the most relevant challenges for today’s practitioner is translating traditional raw formulas into concentrated granule form. Concentrated extracts cannot always be directly substituted using raw herb ratios or assumed extract strengths. Each herb and its extraction yield can vary significantly, and granules should be treated as a distinct medium requiring thoughtful application.
Treating granules as a one-to-one substitute for raw herbs can sometimes be appropriate, but it is not a reliable default. With significant variation in quality, potency, and extraction methods across suppliers, this approach depends entirely on the integrity of the source material. In particular, the concentration of source product to final extract plays a critical role in determining whether one-to-one dosing is suitable. Practitioners should work with suppliers who understand the complexities of herbal extraction and who can provide transparency beyond the oversimplified industry shorthand of “10:1 extract ratio” claims (more on this in upcoming blog posts). When granules are properly concentrated and well understood, one-to-one dosing may be appropriate. In all cases, clinical nuance and herb-specific properties should guide any formula adjustments.
Practical Frameworks for Dosing
Here at Empirical Health, we’ve been committed to traditional formulation logic from the beginning. Our use of modern tools is guided by that foundation and shaped by the practical needs of today’s patients. The following models aim to support practitioners working with granules in a clinically useful way:
- Single Base Formula + Support Herbs:
- Base formula: ~7g/day
- Single herbs: 2–3g/day
- Total: ~9–10g/day
- Two Smaller Formulas Combined:
- Formula A: 4.5g
- Formula B: 4.5g
- Total: ~9g/day, optionally with 1g of adjustment herb
- Custom Formula of Single Herbs:
- Total 5–8 herbs in balanced ratios
- Capped at 10g/day unless clinically justified
This scaffold supports clinical flexibility without compromising clarity or accuracy in dosing.
Need a clear visual reference? Click HERE to download our Practitioner Dosage Tool (PDF) – a simple guide to help you and your clinic team quickly assess common granule dosing models at a glance.
Quality Assurance in Measurement
All our formulas are handcrafted using rigorous measurement protocols. Every herb is weighed precisely, and each formula is reviewed against both traditional ratio logic and modern clinical standards. We strongly encourage practitioners to develop what we call “prescription literacy”; the habit of reviewing dose totals, refining ratios, and questioning assumptions around extract strengths.
Clinical Example: Blood-Tonifying Formula
Consider the following classic formula:
- Dang Gui (Angelica sinensis)
- Bai Shao (Paeonia lactiflora)
- Chuan Xiong (Ligusticum chuanxiong)
- Shu Di Huang (Rehmannia glutinosa)
A commonly effective ratio is 3:3:2:4. Here, Chuan Xiong provides gentle movement and warming, balanced against the deep tonification of Shu Di Huang and the nourishing, harmonising effects of Bai Shao and Dang Gui.
If Chuan Xiong is increased disproportionately, the formula may become too activating, disrupting the intended balance. This illustrates how even minor shifts in ratio can significantly affect clinical outcomes, especially when translating the formula into a more concentrated medium like granules.
This is why formulas must be thoughtfully rebalanced for modern delivery, taking into account not only traditional intent but also daily dosing thresholds and the unique properties of granulated herbs.
Why Precision Matters
Enhanced Clinical Outcomes
Correct ratios and appropriate dosing maximise clinical efficacy, delivering more targeted and reliable results.
Patient Trust and Safety
Consistent outcomes foster trust and support patient compliance. When patients experience steady improvement, they develop greater confidence in both the practitioner and the medicine.
Elevating the Profession
A disciplined approach to formulation reflects a deeper commitment to the roots of Chinese medicine and its continued relevance in modern clinical practice. Precision is a professional virtue, it demonstrates competence, care, clinical integrity and fosters the credibility our practice deserves.
Final Thoughts
Precision in dosage and ratio is not a theoretical ideal, but a clinical necessity. By committing to formulation accuracy, whether working with raw herbs or concentrated extracts, we help uphold the tradition of Chinese herbal medicine in a way that is both clinically effective and relevant to modern practice.