In the European medical tradition, an herbal preparation often consists of one or two herbal drugs or preparations made out of them (i.e. mostly extracts). Nevertheless, fixed combinations are known which can contain preparations of up to five to nine herbal drugs and have shown their clinical efficacy [66, 67]. In other medical traditions like Tibetan Medicine or TCM, combination preparations with up to 15 or 20 herbal drugs are used. Padma 28 (synonym: Padmed Circosan) is such a fixed combination of Tibetan origin and contains 20 herbal drugs, a mineral and an essential oil (Table 8.2). On the one hand it would exceed the space limitations of this chapter to give an overview of all the herbal drugs of this preparation. On the other hand the daily dosages of the single herbal drugs combined in Padma 28 are far below the recommended effective daily dosage if each herbal drug would be used alone (Table 8.2). Thus one comes to realize that combination preparations like Padma 28 are somewhat like an own pharmacological entity, that is to say as a formula acting as a single agent.
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