It is unknown when humans first started to eat or boil various parts of plants specifically for medicinal benefit, but we do know that every culture across the globe has through its history had a similar focus on using the natural world for health benefits. From the ancient Egyptians to the Native Americans and even all of Europe up until the 20th Century regarded herbalism as essential to the life and intellectual value of each of these societies.
In China, much as I have discussed before, the lineage of a written language that has continued since the early dynasties has allowed for a continuous record on the medicinal value of various plants, animals, and minerals, the recommended harvesting period, and preparation methods to extract medicinal benefit. The profession of herbalism would become one of the most prestigious positions throughout Chinese history and has continued into the modern era as a critical part of East Asian healthcare systems.
The theory of herbalism was conceived in a similar way as internal medicine theory was, by looking at the outside world, finding patterns, and applying the macrocosm to the microcosm. There must have been a long period of trial and error, much like today’s clinical trials, experimenting to find beneficial substances that grew in the world around us. These findings would be shared, repeated, and if found to be true by many experimenters its value would be passed down to the next generation until the written word was formed.
Famously, the first emperor of China employed hundreds of herbalists and alchemists to find the secret elixir to immortality and subsequent emperors afterwards used considerable capitol to continue this trend. The result was a system based not only around immediate benefits (like ginger root calming your stomach), but more importantly categorizing herbs by their flavor and function, effect on the body temperature, the organ systems they have the most effect on, environment grown in, time of year harvested, and part of the plant or animal extracted. The result was a medicinal pharmacopeia remarkably like the ones pharmacists use today.
We know now it is the chemistry of substances that give them a pharmaceutical effect, but before microscopes and essential oil extraction a system of categorization had to be formulated so the ancient Chinese came up with 3 major requirements: taste, effect on body temperature, and targeted organ effect. All herbs are categorized as sweet, bitter, bland, acrid/spicy, sour, and salty. This categorization alone gives a determination on how a medicinal will react in the body. For example, bland herbs will have a leeching effect causing someone to urinate. If there is edema or water retention in the body eating bland foods and herbs will cause a diuretic or urinary promoting function to alleviate the problem like how a doctor will prescribe a water pill. The second organization, temperature effect, is easily understood because we have all eaten a hot pepper and immediately felt hot and sweaty after eating. There are also herbs that are cooling that help with hot flashes, swelling, and fever.
Finally, organ system is noted by function of herbs. For example, we know ginger root enters the stomach because of its effect on digestive conditions, similarly herbs that make you urinate enter the kidney and bladder systems. It is my belief that many physicians who were pulse diagnosis masters were able to determine where herbs had an effect inside the body by noting changes in the pulse and then determined more complex relationships like how Salvia Root (Dan Shen) influences the circulatory function because it affects the heart and liver.
Due to the 3 properties of herbs Chinese Medicine becomes, in my opinion, far more precise and patient specific than Western Herbalism. To continue with the ginger root example, we all know it is a useful herb for digestive complaints. In Michigan we have all heard the jokes about when you were sick you would drink a Vernors because of its ginger content (although modern Vernors is more sugar than ginger). So, would Chinese Medicine say to take ginger for any digestive complaint? The answer by looking at the 3 properties is no! Due to its spicy and warm nature if a patient has an inflammatory, highly acidic, or dry constipated digestive tract ginger could exacerbate or make their symptoms worse.
Chinese Medicine would also understand that if you wanted to capitalize on the antibacterial and antiulcer effect of ginger root in an inflamed digestive tract it must be combined with a bitter and cooling medicinal like Skullcap (Huang Qin) or/also Trichosanthes (Tian Hua Fen); or in the case of dry-type constipation with Glehnia root (sha shen) or/also Cannabis Seed (Huo Ma Ren).
I see it frequently in my clinic people taking herbal supplements because there’s reports they’re “good for this problem” or were told by an integrative physician “these herbs are good for this bacterium.” While this may be true in a laboratory, it is cherry picking one function of a plant when herbs are very dynamic in their function. Most commonly: turmeric for joint pain, black cohash for hot flashes, and ginseng for fatigue.
While they all do have the ability to help those symptoms Chinese Medicine says it has to be right for the patient’s syndrome that is leading to that symptom. Turmeric is very spicy and warming like ginger and is not appropriate for rheumatoid arthritis joint pains or hyper inflammatory joint pains unless it’s paired with a cooling medicinal.
Black Cohash is not even used in Chinese Medicine for menopause related hot flashes, its indication is for opening the pores of the skin and venting mild fevers, so some cooling of body temperature may occur, but it does not affect the hormonal or cardiovascular reasons that may be causing menopausal related hot flashes.
Finally, ginseng is an incredible herb for fatigue and is a primary use in Chinese Medicine, however, in the current American society it is most likely unsafe to use by itself. Most American lifestyles have led to endemic congestive heart and artery diseases, by using ginseng alone it could increase heart rate, blood pressure, and fluid production leading to more edema. In my clinic ginseng is reserved for patients after hypertension is treated with other herbs. It is more suitable for weaker low-blood pressure patients to strengthen their cardiac output.
The practice of herbal medicine and the 3 factors of herbs was first mentioned in the Yellow Emperor’s Cannon we have discussed before, but the first compendium was written down at the start of the Han Dynasty (about 50CE) under the name of The Divine Farmer’s Classic of Herbs (ShenNongBenCaoJing) where 150 herbs were detailed. The first clinical manual on herbal techniques is attributed to one of the most famous physicians in Chinese history: Zhang Zhong Jing (gee-yang joe-ng jing). Born during the fall of the Han Dynasty his techniques as a physician were earned through treating possibly hundreds of thousands of people whose health was facing societal and economic collapse.
Zhang Zhong Jing recorded all his clinical techniques in manual now known as the Classic on Cold Damages (Shang Han Lun). He paired the signs, symptoms, and syndrome diagnoses that are required in medicine with herbal treatment, and not just one or two herbs, but was the first to record a systematic theory in combining herbs together in a decoction to address the complexity of disease.
His most famous GuiZhiTang (goo-way jih tah’ng) Cinnamon Decoction is a combination of Cinnamon Twig, Peony Root, Ginger Root, Chinese Dates, and wine-fried Licorice Root, is the subject of two-thousand years of discussion. It is the go-to formula for an early stage common cold or rigid/cold upper back and limbs from being exposed to cold weather for too long. Zhang argued it strengthen the warming yang function of the body while also improving the nutritive function of the body by using digestion strengthening medicinal to improve immunity and constitutional health. We know from modern pharmacological effects that cinnamon twig indeed is a peripheral dilator that helps cardiac and peripheral vascular function that would alleviate rigid blood vessels contracted from prolonged cold exposure.
It also has analgesic (pain reducing), antibacterial, and antiviral functions that would be beneficial to early onset of the common cold and the aches that accompany it. Pairing it with peony root creates a synergistic effect in alleviating tight muscles and having an anti-inflammatory/anti-fever action to help with aches. The addition of licorice root, dates, and ginger root allowed an improvement of the digestive function which Chinese Medicine understands that if appetite ceases in a patient their recovery is prolonged as they can no longer receive new nutrients to nourish the immune system.
Now this is a simple explanation of just one herbal formula! There are literally thousands and thousands of them with all different kinds of pairings that were conceived throughout history for all different kinds of ailments. You can see why some of the cleverest minds in history were herbalists as it is a tremendous amount of information to memorize and apply clinically.
Clinicians also had to change and adapt to new or different problems they faced in clinic from epidemic diseases to diseases that arose in times of wealth and gluttony, to a diverse field of gynecology and women’s health all using different herbal strategies.
In the 1500s a rather ambitious man named Li Shi Zhen (lee shh jen) spent his entire life compiling every herb book and encyclopedia he could find and compounded their knowledge into the largest and most comprehensive materia medica in the world at the time.
The Compendium of Materia Medica (Ben Cao Gang Mu) had almost 2,000 entries and discussed every aspect of the most used herbs and materials used in medicine. Herbs were categorized beyond their 3 properties into sections for clinical usage that is strikingly like modern pharmacology. Examples are herbs with antitussive or cough suppressant functions being categorized in the Phlegm and Cough Reducing section or blood thinning function were categorized in the Blood Stasis Removing and Pain-Relieving section.
Modern pharmacopeias in China and Japan still use Li Shi Zhen’s compendium as their organizational basis, but include a great more detail on modern chemical constituents, studies, and clinical relevance. This is especially true of Dr’s of pharmacology and Chinese Medicine John & Tina Chen’s Chinese Medical Herbology and Pharmacology that I use almost every day as it is the most comprehensive in English.
Historically, herbs were mostly prepared by boiling into a decoction and drank. Some called for grinding into pills or powders and being ingested. Today the options are limitless with modern machinery. Raw herbs can be decocted at home, extract powders taken with water, or patent pills made from ground herbs or extract liquid.
In China herbs are used in injections in hospitals and large sections of pharmacies have herbal salves, plasters, and ointments for all kind of ailments. At Garuda Health we’ve chosen the herbal extract powders as they are the easiest form for combing to meet the diverse needs of patients and for ease of accessibility over having to boil raw herbs at home or being stuck to patent formulas in pills that can get pricey. It truly is the heart of my practice as so many conditions can be treated or improved with herbs and there is such a tremendous history of clinical application that there is no disease that has not been seen and treated before in history.
Thank you for sticking with me on these long entries for the 4 Part Series explaining the basics of Chinese Medicine. Although it was a lot of information, I would like these articles to be used as a reference for future blogs or those new to Chinese Medicine. Future blog posts should be a lot more concise and focusing on particular topics. If you have any topics you are curious about that you’d like me to discuss, let me know! I hope you’ve enjoyed!
Until next time!