This article discusses the management of Lyme disease using modern herbal formulas that effectively target the pathogen (Borrelia burgdorferi) while restoring constitutional balance. Because historical TCM classics lack direct instruction on Lyme, practitioners must utilize "borrowed knowledge" by applying insights from similar spirochete-caused disorders, such as syphilis and leptospirosis. Herbs effective against those ailments—including jinyinhua, banlangen, huangqin, and tufuling—have proven useful for Lyme disease. Additionally, the author integrated the Native American botanical desert parsley (Lomatium dissectum), which acts to "outthrust" deeply embedded pathogens, mirroring the TCM concept of "releasing the exterior". Clinical use of Lomatium often provoked a detox reaction, followed by measurable symptomatic improvement. The core strategy emphasizes multi-targeted, synergistic herbal combinations to modulate inflammation, support detoxification, and aid immune response. Recent research further validates this approach by highlighting the effectiveness of both Eastern and Western herbs, such as black walnut husks, qinghao, and Cryptolepis, which also possess documented antiparasitic properties useful for addressing common tick-borne co-infections like Babesia and Bartonella. Managing Lyme disease remains a significant clinical challenge, demanding a nuanced, integrative approach that bridges conventional and traditional healing systems.