HERBAL MEDICINE
Introduction
Herbal Medicine History
Herbal Medicine Regulation
Chinese Herbal Medicine Pharmacology System
Single Herbs
Multi-Herb Formulas
Introduction
Plant based medicine includes flowers, bark, grasses, and roots while herbal medicine encompasses plants based medicine, bugs, and animal parts. There are over 400 commonly used herbs in standard professional herbal practice, but it is prefer to use only those material considered of the highest class per the Divine Farmer’s Materia Medica. This ancient text was authored by Chinese Emperor Shen Nong; the most respected authority on Chinese medicine. He discovered healing properties of over 365 herbs. The information he handed down from third century BC is supported by modern pharmaceutical research.
Basis for Chinese Medical Development
Chinese herbal medicine provides the basis for corresponding systems of diagnosis and treatment. It is believed that acupuncture was developed as a way to mimic herbal actions in the body. Like acupuncture point combinations, Chinese herbal formulas work synergistically to address both simple and complex illnesses. In 600 AD, Sun Si Miao, a scientist and humanitarian, scribed the first comprehensive encyclopedia of Chinese medicine which included over 4500 formulas. Many of those formulas are still used today.
Ancient Wisdom with Modern Technology
Traditionally, Chinese herbs were only available in fresh or dried form. The herbs had to be boiled for many hours to release or reduce active ingredients. While this is still an option and the method used in traditional Chinese medical schools (California), modern advances offers alternate methods of extraction so that herbs can be prescribed as pills, tinctures, and granules. I prefer Kan Herb Company in Santa Cruz California. The company provides scientific proof that their preparation methods are in accordance with strict Good Manufacturing Practices (GMP).
Training and Skills
A skilled practitioner of Chinese medicine will provide thorough differential diagnosis, appropriate acupuncture, and strategically selected herbs designed to address both symptoms and etiology. The goal of traditional Chinese medical treatment, including Chinese herbal formulas and acupuncture, is resolution and prevention of illness through physical balance and emotional well-being.
Herbal Medicine History
Chinese herbal medicine has a profound history that forms the backbone of an outcome-driven healthcare system. Spanning from the early Han Dynasty to the late Han Dynasty, this ancient practice witnessed significant advancements, refinement, and expansion. During this period, clinical experience led to the refinement of medical theories, pulse diagnosis, acupuncture techniques, and herbal prescriptions. Classical texts emerged, providing a systematic framework for Chinese medicine and guiding practitioners for generations to come.
One of the most influential texts, the Huangdi Neijing (Yellow Emperor’s Inner Canon), compiled around the 2nd century BCE, synthesized medical knowledge and theories of the time. Divided into the Suwen (Plain Questions) and the Lingshu (Spiritual Pivot), this treatise covered human physiology, diagnosis, treatment principles, and acupuncture techniques comprehensively.
Daoist philosophy played a significant role in shaping Chinese medicine during the Daoist Hundred Schools of Thought era. The harmony of Yin and Yang, the flow of vital energy, and the interconnectedness of humans with nature became foundational principles in Chinese medical theory. Scholars and alchemists explored various substances, including herbs, minerals, and other natural materials, seeking longevity and immortality. This exploration led to the discovery and utilization of numerous herbs that are now essential components of Chinese herbal medicine.
Classical texts such as the Shang Han Lun (Treatise on Cold Damage Disorders) and Shennong Bencao Jing (Divine Farmer’s Materia Medica) further contributed to the advancement and codification of Chinese medicine. The Shang Han Lun focused on the diagnosis and treatment of complex diseases, prescribing formulas and considering acupuncture points for specific conditions. The Shennong Bencao Jing cataloged a wide range of herbs and their therapeutic properties, serving as a fundamental reference for herbal medicine.
Modern Chinese herbal medicine draws upon this rich tradition. With over 500 medical materials and thousands of formulas dating back thousands of years, practitioners combine single herbs to create multi-herb formulas for mass production or custom prescriptions. This pharmacological system requires in-depth knowledge of single herbs and the ability to create formulas that direct the chief agents to specific areas of the body. While mainstream pharmacology tends to isolate and synthesize specific chemical constituents for patenting, traditional Chinese herbs continue to provide inspiration for pharmaceutical development.
It’s worth noting that traditional medicine, including herbal medicines, acupuncture, and other local therapies, is widely used worldwide. According to the World Health Organization Global Centre for Traditional Medicine, approximately 88% of countries incorporate traditional medicine into their healthcare systems. While the US healthcare system primarily relies on synthetic medications, the medical properties of herbs have still contributed to the development of various drugs through the isolation and synthesis of specific chemical constituents.
Blending modern pharmacological underpinnings with medicinal herbs, Chinese Medical Herbology & Pharmacology provides single herb information while Chinese Herbal Formulas and Applications provides information to a range of healthcare practitioners. These texts include herb monographs; photographs, chemical structure diagrams, toxicology, cautions and contraindications, herb-drug interactions, formulas, and evidence-based research.
Herbal Medicine Regulation
Dietary Supplement Health and Education Act of 1994 – US Food and Drug Administration . Dietary Supplement Health and Education Act of 1994. US Food and Drug Administration; Silver Spring, MD, USA: 1994. Public Law 103–417.
Current Good Manufacturing Practice in Manufacturing, Packaging, Labeling, or Holding Operations for Dietary Supplements: Final Rule. http://www.gpo.gov/fdsys/pkg/FR-2007-06-25/html/07-3039.htm
FDA Industry Guidance on Complementary and Alternative Medicine Products and their Regulation by the Food and Drug Administration. Link to https://www.fda.gov/regulatory-information/search-fda-guidance-documents/complementary-and-alternative-medicine-products-and-their-regulation-food-and-drug-administration
Dietary Supplement and Non-Prescription Drug Act. United States Government Printing Office; Washington, DC, USA: 2006. Public Law 109–462.
Herbal Medicine Resources
Common Herb Allergies
Allergen Labeling and Consumer Protection Act 2004
Wheat – fu xiao mai, shen qu
Gluten – e jiao, fu xiao mai, lu jiao jiao, mai ya, shen qu, yi tang
Soy – dan dou chi, e jiao, he shou wu, lu jiao jiao
Tree Nuts – bai guo, hu tao ren, shen qu, xing ren, yu li ren
Others – sesame (zhi ma) and cuttlefish (hai piao xiao)
Herb-Drug Interactions
Chen X.W., Sneed K.B., Pan S.Y., Cao C., Kanwar J.R., Chew H., Zhou F. Herb-drug interactions and mechanistic and clinical considerations. Curr. Drug Metab. 2012;13:640–651. doi: 10.2174/1389200211209050640.
FDA on Botanical Drugs and Supplements
Chinese Herbal Medicine Pharmacology System
Chinese herbal medicine pharmacology is an intricate system that categorizes herbs based on their properties and actions within the body. Each herb possesses distinct characteristics, including temperature, taste, direction, and specific effects on the body. Before we evaluate those properties, let’s look at an example by comparing the practice of Western herbology to that of Chinese herbal medicine.
The system of Chinese herbal medicine differs from Western herbology in several ways. Western herbology matches a symptom to an herb, such as turmeric for inflammation. Chinese medicine does not treat symptoms. It treats patterns of imbalance. To treat those patterns, it must take direct aim based on properties of herbs.
In Chinese herbal medicine, two parts of the turmeric plant are used as medicine: the root and the tuber. These are separate medicines because the root and the tuber have different properties and are used in different ways. While both flavors are considered pungent and bitter, the root (Ezhu) is considered warm, works in the liver and spleen systems, and often used as an anti-tumor. The tuber (Yu Yin) is considered cold, works in the liver, heart, and lungs systems, and often used as an anti-depressant. These differences can be evaluated through their phytochemical and pharmacological differences, which are codified into properties of temperature, taste, direction, and action.
Temperature
Herbs are classified as hot, warm, cool, and cold. This classification refers to the thermal nature of the herb and its effect on the body. For example, hot or warm herbs are used to dispel coldness and promote circulation, while cool or cold herbs are employed to clear heat and cool down the body.
Taste
Herbs are categorized as bitter, sweet, sour, spicy, and salty. Each taste corresponds to specific actions in the body. For instance, bitter herbs often have a draining effect, promoting elimination and drying dampness, while sweet herbs are nourishing and tonifying, helping to strengthen and harmonize bodily functions.
Direction
This property indicates the herb’s affinity for certain body regions or organs. For example, some herbs have an upward or ascending direction, which means they promote the circulation of energy (qi) and fluids towards the upper body, benefiting the head and the respiratory system. Conversely, downward, or descending herbs assist in moving energy and fluids downward, benefiting the digestive system or relieving symptoms like coughing or nausea.
Actions
Herbs can have various actions in the body, such as dispersing, harmonizing, tonifying, or purging. These actions describe the specific therapeutic effects an herb has on the body. For instance, dispersing herbs help to move energy and alleviate stagnation, while tonifying herbs nourish and strengthen deficient conditions.
By understanding these properties, Chinese medicine practitioners select and combine herbs to create customized formulas that address a person’s specific pattern of disharmony. This holistic approach considers the individual’s overall constitution, symptoms, and the dynamic interplay of various herbs to restore balance and promote health.
Videos
For more on herb classification based on properties, see https://www.youtube.com/watch?v=9rLreD3UWNU
For a Beginner’s Guide to Chinese Medicine, see https://www.youtube.com/watch?v=dpOv9gr8MP8&t=178s
Single Herbs
Herbal medicines are not limited to the Chinese herbal medicine system. There are an eclectic variety of herbs that can be adopted into the system by understanding key properties.
The refinement and expansion of Chinese medicine involved continuous observation, experimentation, and integration of diverse perspectives due to the interaction between Chinese medicine and local medicine traditions in other countries. This cultural fusion and exchange of medicinal knowledge not only enriched both Chinese and local medicine but also laid the foundation for cross-cultural cooperation that continue to influence medical practices today.
One of Li Dong-Yuan’s most famous Chinese herbal formula is Bu Zhong Yi Qi Tang (Tonify the Center and Regulate the Qi Decoction) that includes ginseng, astragalus, and white atractylodes.
To learn more about single herbs to include attributes and uses, feel free to download the Front and Back herb cards file. These can be modified or simply print at home or a Fed Ex location. Have them printed on card stock and cut for a learning reference.
Multi-Herb Formulas
Herbal formulas are an integral part of Chinese medicine and have been used for centuries to promote health and treat various ailments, known as patterns. The formulas consist of a combination of substances carefully selected and combined to achieve specific therapeutic effects. Formulas are a crafted blend of substances designed to function synergistically. This synergy applies to combinations consisting of multiple substances. The blends often serve many purposes. Herbal pairs can serve to balance or enhance to strengthen the effects, counterbalance an undesirable property, or harmonize herbs in the formula.
Additionally, specific therapeutic strategies and methods underlie the formulation and application of herbal combinations. One of the fundamental principles in formulating herbs is the concept of herb pairs. Another fundamental principle in formulating herbs is to enhance a targeted area and or affect.
Herb Pairs
Herb pairs in formulas refer to the strategic combination of two herbs that work synergistically to enhance their therapeutic effects. These pairs are designed to balance each other’s properties, increase potency, and minimize potential side effects. For example, one herb may target a specific symptom or organ, while the other herb can harmonize or enhance its action.
Herb Formula Assembly
When assembling a formula, several factors are taken into consideration. One consideration is to enhance a targeted area or effect through assembly under 4 categories. The categories are chief, deputy, assistant, and envoy.
Chief. The chief herb(s) is the main ingredient in the formula that is directed toward the principal pattern of pathology. The chief herb(s) is indispensable as it has the greatest effect for treating the pattern.
Deputy. The deputy herb(s) aids the chief herb in treating the principal pattern or pathology and serves as the main ingredient to treat any coexisting patterns or comorbidities.
Assistant. The assistant herb(s) reinforces the effect of both the chief and deputy herbs, and directly influences a less important aspect of the target pattern or comorbidities. The assistant herbs also moderate or eliminate potential harsh nature of other ingredients to reduce toxicity or side effects of other herbs in the formula.
Envoy. The envoy herb(s) guide the actions of the chief ingredients to specific target areas within the body and focuses the action of the formula on a certain channel or area of the body. The envoy also harmonizes and integrates the actions of the other ingredients in the formula.
Additionally, the directions in which the herbs are combined in a formula are crucial. The order and proportion of each herb are carefully determined to maximize their synergy and minimize potential interactions or side effects. The precise assembly of these herbs aims to create a harmonious and effective blend that addresses the underlying imbalances causing the symptoms.
By combining herbs strategically, Chinese herbal formulas offer a holistic approach to healing, aiming to restore balance and promote well-being in the body. These formulas are tailored to individual needs and have been widely used to treat a broad range of health conditions in TCM.