The Term "Healing Crisis" — Is It a Process of Getting Better, or a Side Effect?

"I feel a bit rough after taking the herbal medicine, but they said it's a healing crisis."

When I hear this, I check once more. If it is waved through with this single word, what should have been verified passes by unverified.

How I do it

I do not end it with "It's a healing crisis, so keep taking it." If it is waved through with that one line, the checking drops out.

I will not claim that a temporary reaction never appears at all while the body is moving in the direction of getting better. There are cases where the body stirs when something long blocked begins to move. But no one can determine that in advance. Myself included.

Whether the reaction appearing now is a recovery process or a signal that the medicine does not suit you is not something to settle with words but something to verify and distinguish.

Where this term becomes dangerous

The term "healing crisis" is not itself the problem. It becomes a problem when it is used as an answer that stands in place of checking.

If getting better means the medicine worked, and getting worse means it is the process of getting better, then this medicine becomes a medicine that cannot be wrong. An explanation that cannot be wrong explains nothing. And in the meantime, a side effect that should have been checked passes straight through.

I prescribe on the premise that the medicine can be wrong. Only then can I stop when it is wrong.

So how do I distinguish?

When a reaction appears, I look at several things separately.

First, direction. A symptom that was already troubling you briefly flaring and then settling is different from a symptom that newly appears where there was none. Hives, itching, shortness of breath, swelling of the face or throat — these are not a recovery process. They may be an allergic reaction, and you must stop immediately.

Second, time. Does it subside within a few days, or does it keep going or grow steadily worse? If it does not improve for more than a week, I do not regard it as a recovery process.

Third, kind. Brief digestive discomfort is different from a stomach that keeps burning and vomiting. Feeling weary is different from being exhausted enough to break down daily life. If the degree collapses your daily life, then it is simply a side effect.

Fourth, whether there is another reason. Did you start another medicine in the meantime? Did a cold or gastroenteritis come on? Did what you eat change? Before pinning it on the medicine, I check these first.

In reality, there is usually a reason

When you look into things that were called a "healing crisis," a good many have an explainable cause.

• When the dose was too high. When it pushes harder than the body can handle, the body wavers. Reducing it usually sorts it out.
• When the gut was not ready. Herbal medicine enters the body by way of the gut. If the gut is sensitive or broken down, the same medicine reacts differently. (The Same Medicine Works Differently When the Gut Is Different)
• When the benefit and the side effect come from the same place. This is the nature of medicine. The desired action and the undesired action branch from a single root. (A Medicine's Benefit and Harm Come from the Same Place)
• When the direction was wrong. It was simply a medicine that did not suit this person. What is needed then is not patience but correcting the prescription.

So here is what I do

When I give the medicine, I tell you in advance what reactions may appear. Discomfort experienced without warning is twice as hard.

And I make this request: "If you feel uncomfortable, don't endure it — stop and contact me." Enduring is not a virtue. To me, that information is material for correcting the next prescription.

I retrace, and reduce the dose, or change the herbs, or reset the direction entirely. Correcting the medicine is not a failure — it is the practice of medicine.

When you should go to a hospital first

The following are absolutely not things to wave off with the term "healing crisis." If you are short of breath or your throat tightens or your face, lips, or tongue swell, if hives spread over your whole body with severe itching, or if a fever comes with a rash, that is an allergic reaction. The same holds if you feel a yellowish tinge coming on and your urine turns dark brown, if you vomit severely or pass black or blood-mixed stool, or if your chest hurts and you are palpitating so severely that you feel you might collapse. Stop the medicine at once and get medical care right away.

Checking comes before naming

If the medicine shook the body, that is something to be explained, not something to be endured.

It may be a process of getting better. But to make that judgment, there must be verification. A name attached without verification is not an explanation. That is why I put verification before the name.

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References

• Hives, swelling of the lips or tongue and breathlessness are the classic shape of an allergic reaction, and stopping what caused it is the surest response — Seoul National University Hospital
• Whether a medicine is behind it is worked out by looking at the timing and by reducing or stopping the dose — StatPearls

Written by Dr. Heo Ji-young (PhD in Korean Medicine Pathology, Kyung Hee University · former Research Professor of Herbology, Kyung Hee University)