Chinese Herbal Theory

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Traditional Chinese Medicine

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hinese herbal theory, the theoretical base of Chinese Material Medica, has been established through long-term empirical clinical practice. It defines the character and functions of each herb, which include property, flavor, functional tendency, meridian channel tropism, and toxicity. Chinese herbal theory is based on the theory of Yin-Yang and the Five Phases (Wu Xing), which are the foundation of Traditional Chinese Medicine. Thus, each herb is closely related to Zang-Fu organs and meridian channel systems. This unique structure of theory forms the core of Traditional Chinese Medicine.

There are terms used in TCM theory that differ in meaning from the English definitions of those terms. These include terms such as Qi, the names of the Zang-Fu Organ systems, the names of the Eight Principal patterns of disharmony in the body, the names of the Six Pernicious Influences involved in disease, other TCM terms, and certain descriptive words. These terms are capitalized in the text.

The Zang-Fu Organ systems are the Heart, Lung, Kidney, Spleen, Liver, Small Intestine, Large Intestine, Bladder, Stomach, Gall Bladder, Triple Heater, and Pericardium. These Organs have a functional significance in TCM that differs somewhat from their meanings in Western medical terminology. For example, in TCM, the Kidney has functions that include not only the filtration of consumed liquids and the absorption of nutrients from those liquids, but also the regulation of mental and emotional states.

In TCM, the term "channel" is used to describe a route of Qi flow through the body. Specific channels can be associated with specific Zang-Fu Organs. The name of the Organ is also capitalized when used to describe a channel. For example, an herb may be described as acting on the Lung channel.

The Eight Principal patterns are pairs of opposites that form the basis of medical diagnosis in TCM theory. They are Yin, Yang, Deficiency, Excess, Interior, Exterior, Hot, and Cold. These terms are often combined. For example, Yin Deficiency (or Deficient Yin) may indicate general weakness and lethargy, or if localized to a particular Organ system, it may indicate a more specific syndrome. Exterior Heat may indicate a rash. There are no exact equivalents for these combinations in Western terminology—exterior heat suggests an August afternoon in Yuma, Arizona.

The Six Pernicious Influences are Wind, Cold, Summer Heat, Dampness, Dryness, and Fire. In TCM theory, the term Wind describes changes in conditions that occur rapidly. The changes could be due to weather, an environmental irritant such as an allergen, or an infectious virus or bacteria. The Pernicious Influences can also be combined with the Principal patterns and the Organ systems as a diagnostic aid. For example, Excess Spleen Dampness often indicates diarrhea.

Additional terms and descriptive words used in TCM theory are Essence, Mind, Blood, Phlegm, Vital, Pathogenic, Stagnant, Stasis, and Rebellious. Thus, there can be Deficient Vital Essence, Blood Stasis, Stagnant Qi, and even worse, Rebellious Qi. Rebellious Qi indicates a localized counterflow of Qi against the balanced, harmonious flow of Qi.

A number of specific herbal formulas have been in use in China for hundreds and in some cases thousands of years. Many of these have been so widely used that they have achieved a titled status. These titled formulas are enclosed in quotation marks, and are also capitalized.

When a term has a meaning that is essentially identical in TCM and English, the word is not capitalized. For example, in TCM, the term Phlegm indicates an accumulation of fluid that may be localized in the Lung, Kidney, and/or Spleen, and is considered a cause of disease. In English, the occurrence of phlegm is generally confined to the lung and respiratory passages, and is considered a by-product of disease. If the term phlegm refers to the English meaning, it is not capitalized.

Descriptions of some of these capitalized terms can be found in the glossary.

i. Properties

Properties of each herb refer to its temperature characteristics. They are cold, hot, warm, cool, and neutral. These properties are derived from observing the therapeutic effects of a medical substance. For example, a hot disease must be cooled by substances of a cold or cool property. Cold diseases must be warmed with substances with a hot or warm property. A substance with a cold property is different from one with a cool property only in degree, and so is the substance with a warm property and with a hot property. The cold and cool substances may have the function of clearing Heat, purging Fire, removing toxicity or nourishing Yin. They are used for Heat syndromes. The hot and warm substances may have the function of dispersing Cold syndromes, warming the interior or supporting Yang. Substances with a neutral property, neither hot nor cold in property, are used for either hot or cold syndromes.

2. Five Flavors

Five flavors refers to sour, bitter, sweet, pungent, and salty flavors of the herbs. Some substances may have a sixth, bland, flavor as well. Different flavors represent different functions. Substances with the same flavor may have similar functions. Functions of the substances represented by the five flavors are briefly summarized as follows.

sour Substances of sour flavor have the function of astringing and arresting discharge. Most of them are used to treat deficiency syndromes or diarrhea. For example, Fructus Schisandrae (Wu Wei Zi) has the function of stopping seminal emission and sweating. Galla Chinensis (Wu Bei Zi) acts as an astringent in the intestine to stop diarrhea. Most sour substances may taste astringent as well. The function of the astringent flavor is somewhat similar to that of sour flavor. Thus, the astringent flavor is usually not considered as a separate entity in substance flavors.

bitter Substances of bitter flavor have draining and drying functions. They are used for clearing Heat, purging Fire, treating constipation, resolving dampness, or lowering the rebelling Qi. Some bitter substances have the function of preserving Yin. For example, Rhizoma Anemarrhenae (Zhi Mu) and Cortex Phellodendri (Huang Bai) are used to treat atrophy syndromes due to Kidney Yin Deficiency.

sweet Most of the substances of sweet flavor are tonics or herbs with the function of regulating middle Jiao (Heater) or relieving spasms. They are commonly used to treat deficiency symptoms [such as treating Qi deficiency with Radix Codonopsis (Dang Shen) and Yin deficiency with Radix Rehmanniae

Preparata (Shu Di Huang)]; or to coordinate the function of other substances, such as Radix Glycyrrhizae (Gan Cao). Most substances with sweet flavor are good at removing moisture.

pungent Substances of pungent flavor have the function of dispersing, and promoting Qi and Blood circulation. These substances, such as Herba Ephedrae (Ma Huang) and Herba Menthae (Bo He), are commonly used to treat exterior symptoms. Others such as Flos Carthami (Hong Hua) and Radix Aucklandiae (Mu Xiang) are used to treat symptoms due to Qi and Blood Stagnation.

salty Substances of salty flavor have functions of softening hardness and soothing sore throats and relieving constipation by purging. Most of them are used to treat scrofula, hard masses, and constipation, such as Concha Arcae (Wu Leng Zi) and Natrii Sulfas (Mang Xiao).

bland Substances with bland flavor function as diuretics and help to eliminate dampness. These herbs, such as Polyporus (Zhu Ling) and Poria (Fu Ling), are used to treat edema and difficult urination.

In Chinese herbal theory, the property and flavor are integrative concepts. They work together to define the function of each herb. Clinically, however, flavor alone is not sufficient to represent the function of the herb. For example, both Rhizoma Coptidis (Huang Lian) and Radix Rehmanniae (Sheng Di Huang) are cold in property, but Rhizoma Coptidis (Huang Lian) is bitter and used for Damp-Heat syndromes while Radix Rehmanniae (Sheng Di Huang) is sweet and used for Yin Deficiency. Both Herba Ephedrae (Ma Huang) and Herba Menthae (Bo He) have the pungent flavor, but Herba Ephedrae (Ma Huang) is warm in property and used for dispersing Wind-Cold while Herba Menthae (Bo He) is cold in property and used for dispersing Wind-Heat.

3. Functional Tendency

Functional tendency refers to the rising, falling, floating, and sinking functions of each substance. The functional tendency of each substance is closely related to clinical situations and to the site of disease in the body. Rising means going up or sending up, while falling means the opposite. Floating means going outward or sending to the surface, while sinking means going inside or purging away. Substances with rising and floating function move upward and outward, and may have the function of raising Yang, relieving exterior syndromes, or causing resuscitation. Substances with falling and sinking function move downward and inside, and may have the function of clearing Heat or purgation. They redirect rebellious Qi to stop vomiting, relieve cough and asthma, calm wheezing, and anchor ascending Yang.

Disease appears at different locations of the body. Some diseases are in the upper part of the body while others are in the lower part; some are interior and others are exterior. The tendency of the disease may be different as well. Some diseases move upward (such as in vomiting) while others move downward (such as in diarrhea); some move outward (such as in sweating); while others move inward (such as internal transmission of Exterior syndromes). The functional tendency of each herb corresponds to the location of the disease but is opposite to its tendency. Descending substances move Qi downward, while sinking substances keep the empty Yang from floating upward. Ascending substances move the Qi upward, while floating substances keep the organs from collapsing.

The functional tendency of substances is closely related to their properties and flavors. Most substances with ascending and floating tendencies are pungent or sweet in flavor and hot or warm in property, while most substances with descending and sinking tendencies are sour, bitter, salty, or astringent in flavor and cold or cool in property.

In addition, the functional tendency of substances may be manipulated by processing techniques or combining them with other substances. For example, substances stir-baked with wine have an ascending tendency; substances stir-baked with ginger liquid have a dispersing tendency; substances stir-baked with vinegar have a stringent tendency; substances stir-baked with salt have a descending tendency. On the other hand, in an herbal formula the substances with descending and sinking tendency will affect the ascending and floating tendency of the herb if they are used together.

4. Meridian Channel Tropism

Meridian channel tropism refers to a specific effect of substances on a certain part of the body. Different substances may have different effects on a certain meridian channel or several meridian channel systems. For example, substances with a cold property have the function of clearing Heat, but some of them tend to clear Lung Heat, while others tend to clear Liver Heat. Various substances have a tonifying effect, strengthening or supplementing a weak, or deficient, body part, or function. Some examples of substances entering meridian channels are listed in table 1.

table i. Examples of the Herbs Entering Meridian Channels

Meridian Channel

The Lung Meridian of Hand—Taiyin

The Large Intestine Meridian of Hand—Yangming

The Stomach Meridian of Foot—Yangming

The Spleen Meridian of Foot—Taiyin

The Heart Meridian of Hand—Shaoyin

The Small Intestine Meridian of Hand—Taiyang

The Bladder Meridian of Foot—Taiyang

The Kidney Meridian of Foot—Shaoyin

The Pericardium Meridian of Hand—Jueyin

The Three Heater Meridian of Hand—Shaoyang

The Gallbladder Meridian of Foot—Shaoyang

The Liver Meridian of Foot—Jueyin

Herb

Radix Scutellariae (Huang Qin) Radix Platycodi ( Jie Geng) Cortex Mori (Sang Bai Pi) Semen Armeniacae Amarum (Xing Ren)

Radix et Rhizoma Rhei (Da Huang) Radix Puerariae (Ge Gen) Gypsum Fibrosum (Shi Gao) Fructus Forsythiae (Lian Qiao)

Rhizoma Pinelliae (Ban Xia) Rhizoma Atractylodis (Cang Zhu) Rhizoma Atractylodis Macrocephalae (Bai Zhu) Massa Fermentata Medicinalis (Shen Qu)

Radix Glycyrrhizae (Gan Cao) Radix Astragali (Huang Qi) Rhizoma Atractylodis (Cang Zhu) Radix Angelicae Sinensis (Dang Gui)

Herba Ephedrae (Ma Huang) Radix Rehmanniae (Sheng Di Huang) Fructus Schisandrae (Wu Wei Zi) Rhizoma Coptidis (Huang Lian)

Rhizoma Atractylodis Macrocephalae (Bai Zhu) Radix Rehmanniae (Sheng Di Huang) Rhizoma Seu Radix Notoperygii (Qiang Huo) Cortex Phellodendri (Huang Bai)

Rhizoma Alismatis (Ze Xie) Ramulus Cinnamomi (Gui Zhi) Rhizoma Seu Radix Notoperygii (Qiang Huo) Fructus Viticis (Man Jing Zi)

Rhizoma Anemarrhenae (Zhi Mu) Cortex Phellodendri (Huang Bai) Cortex Lycii (Di Gu Pi) Fructus Corni (Shan Zhu Yu)

Rhizoma Atractylodis Macrocephalae (Bai Zhu) Radix Bupleuri (Chai Hu) Cortex Moutan (Mu Dan Pi) Radix Rehmanniae Preparata (Shu Di Huang)

Rhizoma Chuanxiong (Chuan Xiong)

Radix Bupleuri (Chai Hu)

Cortex Fraxini (Qing Pi)

Radix Aconiti Lateralis Preparata (Fu Zi)

Radix Bupleuri (Chai Hu) Rhizoma Pinelliae (Ban Xia) Radix Gentianae (Long Dan Cao) Pericardium Ciri Reticulatae Viride (Qing Pi) Rhizoma Seu Radix Notoperygii (Qiang Huo) Radix Angelicae Sinensis (Dang Gui) Radix Gentianae (Long Dan Cao)

Substances entering the same meridian channel may have different functions. For example, Radix Scutellariae (Huang Qin), Rhizoma Zingiberis (Gan Jiang), Bulbus Lilii (Bai He), and Semen Lepidii (Ting Li Zi) all enter the Lung channel, but they have different applications. Radix Scutellariae (Huang Qin) is mainly used for clearing Lung Heat; Rhizoma Zingiberis (Gan Jiang) is used for warming the Lung; Bulbus Lilii (Bai He) is used for tonifying the Lung; and Semen Lepidii (Ting Li Zi) is used for purging the Lung. Therefore, meridian tropism is only part of the therapeutic theory and must be considered along with the tendency, flavor, and the property of the herb.

5. Toxicity

Some herbal substances can be toxic or slightly toxic. They may lead to a toxic reaction if an overdose occurs. Some of them may give rise to severe side effects even within a therapeutic dosage. However, some toxic substances have obvious therapeutic effects. In order to use these substances properly and safely, the age and constitution of the patients should to be considered carefully as well as the severity and location of the disease. The dosage of extremely toxic substances should be strictly controlled.

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