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Chinese Herbal Medicine

Traditional Chinese medicine is a system of healing as ancient as Ayurveda with an unbroken tradition that can be traced back to around 2500 BC and includes oriental traditions from Southeast Asia that originally came from China. The first, maybe mythical herbalist was Shennong, who imparted his knowledge of hundreds of medicinal and poisonous plants to farmers.

A Chinese herbal medicine cabinet.

Illustration from Bencao Gangmu. This 15th century pharmaceutical encyclopedia features 1,892 medicinal substances.

The first major text, the Shen Nong Bencao Jing (The Yellow Emperor's Classic of Materia Medica), dated around 1000 BC in the Han dynasty, describes 365 medicines, over 250 of which are herbs, their physical actions and applications. Later additions to herbal knowledge followed the style and format of the Classic, placing emphasis on taste, the herb's heating or cooling nature, which organs and meridians it primarily affects, dosage ranges, degree of toxicity, and overall effects of the herb on specific patterns of symptoms.

The Shen Nong divided medicines into 3 categories:

1. Superior herbs which are the main remedies for returning the body and mind to health;

2. Middle level tonic herbs which boost energy and immunity;

3. Low level, more powerful herbs that should only be taken in small doses for specific symptoms.

The Compendium of Materia Medica (Bencao Gangmu) was compiled in the 16th century during the Ming dynasty, by Li Shizhen, and lists all the plants, animals, and minerals used in Chinese medicine at the time. It includes herbs that are still used including opium, ephedrine, rhubarb, and iron and is still a major reference book today.

Qi flows through meridians, or energy channels, in the body; stimulating acupoints along them rebalances energy flow.

Traditional Chinese Medicine Today

As in Ayurvedic medicine, these early texts are still studied and their precepts adhered to by modern practitioners of Chinese medicine. At the same time, Chinese medicine has continually been developed and refined in response to cultural and clinical advances and ongoing research. It survived through the rise and fall of several dynasties, and still exists happily in China alongside Western allopathic medicine, providing healthcare for the majority of the Chinese population. It continues to grow in popularity in the West despite occasional bad press concerning the adverse effects of certain Chinese herbs.

The Life Force

The Chinese, like the Indians, regard the human body and all its functions as a microcosm of the macrocosm. All forms of life are seen to be animated by the same essential life force called qi. By breathing we take in qi from the air and pass it into the lungs, and by digesting we extract qi from food and drink and pass it into the body. When these qis meet in the bloodstream they become known as human qi, which circulates around the body as vital energy. The quality, quantity and balance of qi in each person influences their state of health and lifespan, and this in turn is affected by factors such as the season, climate, lifestyle, diet and air. Wind, dampness, dryness, heat, and cold can derange the internal balance of the body, obstructing the movement of qi in the organs. Disturbance of internal wind causes vertigo, unsteady movement, and trembling; dampness causes increases phlegm and oedema, dryness causes drying of mucus membranes, cold decreases circulation and slows metabolism, while excess heat leads to inflammation.

Qi flows through a network of channels, or meridians, throughout the body, and can be stimulated and balanced using acupuncture, acupressure, diet and herbal medicine. The body is also composed of moisture, which is the fluid in the body that protects, nurtures and lubricates the tissues and blood, which is the basic material from which bone, muscle, nerves, organs and skin are made. For the body to be adequately healthy qi, moisture and blood need to circulate within a network of channels that connect all parts of the body. All illness is seen as a result of either depletion or congestion of qi, moisture and blood caused by unhealthy diets and lifestyle, stress, tension, overwork, lack of exercise or any other thing that impairs the ability of the organ networks to function properly.

A Chinese herbalist's vase.

Yin and Yang

The principles of Chinese medicine originate in traditional Taoist philosophy, China's most ancient school of thought. Central to this philosophy is the idea of fluctuation and mutability, explaining natural phenomena in terms of the constant ebb and flow of cosmic forces. Yin and yang, the two primordial cosmic forces, are concepts that are familiar to many. Yin symbolises passive, yielding force that is cold, dark, negative, contractive and female, represented by water. Yang is active, positive, hot, light, expansive and male, symbolised by fire. The constant interplay between these opposite and mutually dependent forces, produces all the change and movement in the universe. Different parts of the body are described as predominantly yin or yang. Yin is found in the internal, lower and front part of the body, in the body fluids and blood, and it governs innate instincts, while yang governs qi, vital energy and learned skills, and presides in the upper, external and back parts of the body. To maintain health, yin and yang need to be in balance.

Chinese herbs are often used combined in formulae; synergy increases their therapeutic benefits.

The Five Elements

As in Ayurveda, the theory of five elements is vital to the Chinese understanding of life in all its variety. Wood, fire, earth, metal and water are the elements that compose and relate to all aspects of life, including parts of the body, vital organs, emotions, seasons, colours and tastes. To illustrate, wood relates to spring, the colour green, the liver and gall bladder, anger and the sour taste. Fire corresponds to summer, the heart and small intestine, joy and bitter taste.

The constant interplay of the five elements along with that of yin and yang spark off all change and activity in nature. The fundamental relationships among the five elements are the key to understanding how our bodies and the environment interact and influence each other. To maintain good health, the elements need to be in harmony and if one element becomes over-dominant, imbalance and illness can result. Although the emphasis is on the internal causation of a disease, traditional Chinese medicine recognises that outside factors play a role. A 2nd century CE physician called Zhang Zhongjing wrote the Treatise of Cold-Damage Disorders, which described the diagnosis and treatment of diseases caused by external cold factors; in effect, this referred to infectious diseases.

The Organ Networks

The body is also divided into five functional systems called organ networks. These govern certain tissues, as well as mental and physical activities by regulating and preserving qi, moisture, blood, spirit (shen), and essence (jing). The kidney network is responsible for fluid balance in the body and also stores the essence or jing, which is responsible for fertility, growth, and regeneration. Its province is the teeth, bones, marrow, brain, inner ear, pupil of the eye, and the lower back, as well as the emotion of fear, the will, and the ability to think and see things clearly. The heart network circulates blood and is the home of the spirit (shen) and governs the mind. The spleen network governs digestion and assimilation of food and fluids, as well as digestion of information and ideas, while the liver network controls the storage of blood, flow of qi, and stability of mood and temperament. The lung network governs breathing, circulation and the distribution of moisture.

Diagnosis and Treatment

This involves taking a case history which includes the patient's present and past complaints, lifestyle, physical environment, family health history, work, home and emotional life. It also includes reading of the basic indicators of health and disease such as the complexion, lustre of the eyes and hair, colour and texture of the tongue and its coating. Pulse and tongue diagnosis are the principal diagnostic tools of the practitioner of Chinese medicine and enable the practitioner to detect imbalances and ill health before they show up on other modern diagnostic apparatus such as blood tests and x-rays.

Chinese treatment works to balance the four natures that relates to the degree of yin and yang within each individual.

HERBS COMMONLY USED IN TRADITIONAL CHINESE MEDICINE

Angelica polymorph (see page 110)

Artemisia annua (see page 120)

Astragalus membranaceous (see page 123)

Codonopsis pilosula (see page 144)

Lonicera japonica (see page 197)

Paeonia lactiflora (see page 213)

Polygonum multiflorum (see page 220)

Prunella vulgaris (see page 221)

Rehmania glutinosa (see page 222)

Schizandra chinensis (see page 235)

Scutellaria baicalensis (see page 236)

Treatment is aimed at harmonizing yin and yang, wet and dry, cold and heat, inner and outer, body and mind by regulating the qi, moisture and blood in the organ networks. Treatment may combine herbs, diet, exercise, and massage. Chinese herbs have been classified according to the four natures, the five tastes and the meridians. The four natures relates to the degrees of yin and yang which are: cold (extreme yin), cool, warm and hot (extreme yang).

As in Tibetan and Unani medicine, herbs and foods are all composed of five tastes: pungent, sweet, sour, bitter and salty, each of which has different qualities and actions in the body.

1. Pungent herbs increase production of sweat and direct and increase qi and blood.

2. Sweet herbs are nourishing and toning, and some act as diuretics to drain dampness.

3. Sour herbs are astringent, bitter herbs clear heat and dampness.

4. Salty herbs are used to stimulate the bowels and reduce hard masses.

5. Herbs that nourish the qi have an energising effect, herbs to enrich the blood help sleep, vision and mood, while herbs to replenish moisture soften the skin and relieve thirst. The meridians relate to the organ networks that can be helped by herbs to do their work.

Herbs are usually combined in formulae to enhance their action either in the form of dried herbs for decoctions, ground and produced as pills and powders or used in liquid extracts. Some practitioners use patent formulae in the form of pills which are certainly more easy and convenient for the patient than boiling up herbs in decoctions, but do not allow for the individualised prescriptions that practitioners can formulate themselves in response to the specific needs of each patient.

Angelica polymorph, variation sinensis, also known as Chinese angelica/dong guai, is a herb commonly used in traditional Chinese medicine.

Prunella vulgaris, or self-heal, is used to treat fever and liver imbalance and is also valued for accelerating wound-repair.

Herbs used in the Chinese tradition include codonopsis (Codonopsis pilusera), astragalus (Astragalus membranaceous), liquorice, ginger, Chinese angelica (Angelica sinensis), sweet Annie (Artemisia annua), coriander, honeysuckle, peony, fleece flower (Polygonum multiflorum), rehmania (Rehmania glutinosa), schizandra (Schizandra chinensis), baikal skullcap (Scutellaria baikalensis) and self heal (Prunella vulgaris).

Research into the medicinal properties of Chinese herbal remedies has led to some being adopted by Western medicine. For example, the drug artemisinin, used to treat drug-resistant malaria, has been derived from Chinese wormwood, (qing hao/Artemisia annua). In China, traditional herbs have also been fused successfully with Western drugs; for example aspirin has been combined with Gypsum fibrosum to treat a form of arthritis.

Rehmania Glutinosa, also known as Chinese foxglove, is used in Chinese medicine to increase energy.