Because Tibetans lived very spread out in a vast and sparsely populated territory, Tibetan medicine makes heavy use of ready-made pills. This is because Tibetans may only see their doctor once or twice a year. Therefore, Tibetan formulas tend to contain relatively low doses of each ingredient but many ingredients. By administering small doses of many different medicinals which all accomplish a similar group of functions, A) there is less likelihood for side effects from any one ingredient, and B) should the patient's symptoms change over time, one or more ingredients should cover any new symptoms. Further, because of the low doses involved, Tibetan doctors can use some very powerful but otherwise toxic ingredients, such as Ma Qian Zi (Semen Strychnotis). Therefore, such a large formula achieves very comprehensive, rounded effects.1
As humans, we tend to develop extreme positions and reactions very easily. The eighth branch reminds us that even appropriate and effective treatments can create significant changes. Tibetan herbal formulas typically include several different ingredients to balance out the potentially adverse effects of single substances and amchi tend to use 'herbal simples' or single-ingredient medications sparingly and with caution. When it comes to external therapies, doctors will try to balance out the potentially loong-increasing effects of rougher therapies with more gentle, warming therapies as well.2