& Chinese 'erbal Medicine
Chinese herbs are one of the main forms of treatment in Chinese medicine, like acupuncture.
Probably they started off as a form of 'kitchen' medicine, given by people to their families and based on local knowledge, belief and experience.
However, about 2000 years ago, someone called Zhang Zhong-jing got his act together.
Zhang Zhong-jing described the use of a wide range of herbs in formulae dealing with disease.
He was really the father of modern Chinese medical herbalism. We still use around a quarter of his prescriptions.
He also showed how to shape a prescription that did what you wanted it to do, combining herbs so that they worked together harmoniously and any less desirable effects from one herb were compensated for by the positive attributes of other herbs.
What distinguishes Chinese Herbal medicine from Western Herbal medicine?
- Most herbs used are Chinese or Chinese varieties of Western herbs, and are stored in their dried form
- To get the effect of the Chinese herbal prescription, you nearly always have to boil the ingredients together for quite a while then drink the liquid
- This is quite different from Western herbalism where the herbs are often soaked for a period of time in water to extract their 'active principle' and each herbal extract is stored independently as a liquid concentrate. Drops from this are combined with drops from other concentrates to form the prescription, a few drops of which, taken with water, constitute the dose.
- Although Chinese herbs are often given in ground form, in capsules, the traditional way was to chop and cook the whole herb with other whole or chopped herbs.
- Many formulae are now available in powdered form where the powder has been made by boiling up the prescription and then boiling off the liquid to leave a powder which is then usually taken with warm water to replace that which was boiled off. (Picture is of Bai Zhu and Huang Qi.)
- Chinese herbal formulae are prescribed on the basis of the Chinese medical syndromes diagnosed in the patient.
- The chemical actions of the plants used in Chinese herbal formulae were of no great interest until Western herbal experts categorised the Chinese herbs' actions in terms of their pharmaceutical actions.
Chinese herbs - sources
Chinese herbs come, traditionally, from animal, vegetable and mineral sources. Nowadays, at least in countries where there is awareness of endangered species, sources used are mainly vegetable and mineral.
The few 'animal' sources used at all in the West are such as the carapaces of insects - such insects being numerous and not thought to be endangered.
Illegal and banned 'herbs'
Unfortunately, some animals are still killed for the properties thought to be associated with parts of their bodies, whether their horns or gallbladders or penises.
This is illegal in nearly all countries and it is doubtful whether the properties attributed to them were really ever much more than wishful thinking. Such is the power of wishful thinking and money, however, that some animals will soon face extinction unless their needless, cruel and terrible slaughter is controlled.
Anyway, there are nearly always alternatives.
However, some useful herbs are banned unless prescribed eg by a doctor or dentist because
- they are considered poisonous or
- because they are easily confused with poisonous herbs or
- their misuse by ill-informed or unqualified personnel lead to poisoning.
One such herb is Aconitum Napellus (monk's-hood, aconite, wolfsbane) which, in combination with other herbs and in appropriate quantities is effective and safe in Chinese medicine for expelling Cold and warming the interior.
Not being able to use it often hampers the speed with which a herbal prescription would otherwise take effect.
How to pronounce Chinese 'Herbs'
For reasons not entirely clear to me, but probably deriving from American usage, Chinese 'herbs' are almost universally pronounced 'erbs'. (Like me, you may fight this, but it's no use.)
How do Chinese Herbal prescriptions work?
First, to understand this you have to learn the properties of individual Chinese herbs.
Herbs are divided into one or more of 18 different categories, according to their actions in Chinese medicine. Such categories include:
- Downward draining herbs
- Herbs that regulate the Qi
- Herbs that drain Dampness
- Herbs that Transform Phlegm and Stop Coughing
- Herbs that regulate the Blood
- Tonifying herbs
Second, the above categories won't make proper sense unless you have a good knowledge of Chinese medicine' theory - same as used for acupuncture treatment.
Thirdly, that knowledge will help you understand the finer points, for instance:
Herbs are also categorised according to other properties such as:
And herbs are also classified into which acupuncture Channels they influence or 'enter', so you need to know the channels, for example:
Every herb has a part of itself (root, leaf, bark, fruit) that is used, sometimes several parts, and each part works differently form the others.
Also, herbs from different geographical locations can work differently.
There are many thousands of herbs. Most are now grown for profit, which may mean they lose some of their qualities, or be grown where herbicides, pesticides and fungicides, not to mention non-organic fertilisers are used. This is becoming big business.
Of course, 2000 years ago they lacked anything but natural earth and natural fertilisers. Possibly, the wilder the herb, the closer its potency will nowadays be to that described in the literature.
Becoming an 'expert'
.... takes quite a few years! In the UK this is what happens.
- Most people do a three year course in acupuncture, which moulds their minds to think in terms of, and gives them a good grounding in, Chinese medicine and its theory.
- Once they've got some experience under their belts, (which may take many years for some very able practitioners) they do another three year course, this time concentrating on Chinese herbal medicine.
- By this stage they are excited, but then they need many more years of learning from experience to understand how it all actually works.
Your 'erbalist' is giving you a prescription - what might you expect?
- If he thinks you're up for it, he'll give you a specially put-together bag of herbs. In fact you'll probably be given 5 or 10 bags, enclosed in a bigger bag.
- Each bag will contain pieces of anything from 2 to 20 herbs. You'll be given copious instructions! How to boil them, how to boil them again, how the 'fragrances' from boiling them will get rid of any friendly neighbours you happen to have, how to strain the liquid, when to take it and how much to take. The contents of each bag can usually be re-used at least once. (I usually eat the herbs too, not always a good idea, I should point out.)
- Holding your nose and thinking of your favourite football team you'll drink some of the liquid. Chinese herbs are not sold on taste. If you're a Royalist, you'll think of the Queen (UK only.)
- Or, looking down his nose at you, he'll prescribe either powders or capsules or tubs of tablets.
- If he suggests powders, he'll mix them together in the right formula. You then take a few teaspoons of the powder mix and dissolve it in hot water. Guess what you do next? Correct! ... Think of the Queen.
- If he chooses capsules, he'll put ground-up herbs in the right proportions into capsules. Believe me, it's a fiddly job and it helps if he's got the patience of a Saint, or is still new and enthusiastic about this. You then swallow the capsules with warm water.
- Or he might have the formula compressed into tablets. In this case, he's almost certainly using a well-known formula, already prepared by someone else. If it's near enough what you need, this is the most convenient way of taking the herbs, but of course it won't have been put together exactly right for your particular individual needs, but that may not matter. These tablets can still do a good job. You may just need more of them. High Street Chinese herbal shops have realised this is the best way to make money, and you won't get out of such a shop without spending at least part of a gold bar. You'll often get a better and fairer deal from a professional. You take the tablets with warm water. Just a reminder: Chinese herbs are not sold on taste.
Why is it better to boil the whole herbs together in a formula?
This is the kind of tiresome question that crops up when the examiners want you to demonstrate you can string sentences together in your language.
- Who knows?
- Opinions differ.
- OK, boiling them up makes the herbs combine into something greater than their individual parts whereas ...
- if taking them in a ground-up powder form with warm water the formula might not work the same way, as they're being mixed up inside you, and you're ill so who knows what's going on in there?
- Ah Hah! Herbal formula are now being properly cooked for the requisite time in the prescribed manner and simmered until there's just the powder left, which is then compressed into tablets and taken by you, with warm water. Clever! Does this work as well as boiling them up yourself, inhaling (with your neighbours) the vital fragrances as they cook? Who knows? Nobody is ever told what would have happened if they hadn't done what they did. Except, years later, by researchers after years of expensive wrangling and statistical fun... by which time you'll have either lost interest because you're well again or long since died. Sorry, passed out or away.
Can you use 'erbs' at the same time as acupuncture?
They both use the same theory so yes. But often one or the other does the job perfectly well on its own, and adding the other is superfluous.
However, sometimes one or other is better.
- Acupuncture is better when the problem is channel based (ie can be explained in terms of problems in or with an acupuncture channel) or points on the channels work powerfully together to do a particular job
- For Phlegm, although acupuncture works quite well, there are Chinese herbal formulae that work faster and better
- During pregnancy, there are acupuncture points 'forbidden' to use. Sometimes 'erbs can substitute. But you've got to drink them and if you're very nauseous or sensitive to 'erbs', well... Anyway, there are plenty of other acupuncture points that usually do the job pretty well.
Why are Chinese herbs so expensive?
I don't think they are (unless you go to a high street shop when God help you if they pile you high with every bottle they have):
- The correct herb has to be grown in carefully prepared beds
- Time passes, during which gardeners must be paid, buildings planned, vehicles oiled and manufacturing processes prepared
- The herbs must be harvested at the correct level of maturity
- They must be carefully cleaned and extraneous stuff filtered out eg weeds
- Some of them have to be further treated by boiling or roasting to remove toxic qualities or make them more effective
- The whole herbs have to quality tested and approved for export
- They have to be identified with labels saying where grown, batch number, sell-by date, da-di-dah ...
- They have to be bulk packed for export, then despatched
- By boat or air: can be expensive
- Time passes, particularly at Customs of the importing country where they have to be examined in case they aren't what they claim or contain unwelcome fellow-travellers
- More time passes as samples may have to go to a central purity testing station (in the UK this is at Kew Gardens)
- Then someone has to collect and transport them to the depot of the middleman who
- eventually sells them to the herbal supplier who
- stores them until they are needed, and has to destroy some because of bugs or mould found growing on them, or because they are past their sell by date, but eventually sells them to your herbalist who
- ... has to make a profit or he'll get bitter and twisted and need treatment and won't be around for long
And anyhow, have you considered the cost of the medicines you get from your doctor? If you enjoy a National Health Service, they're paid for by someone - Who? Your country's taxpayers! Ask the pharmacist what they cost. You may be surprised.
- ... stores them in his garage or cellar or top of his wardrobe or in big glass jars to impress you, until he has to destroy them because of bugs or mould or sell-by dates ...
- ... gathers them into bags and writes copious instructions for you to disregard and complain about so he has to provide more for free which also makes him bitter and twisted and needing treatment ...
- ... not least because you complained about the price!
What's the secret behind 'erbs'? How does the formula work?
The secret is 2000-plus years of experience.
Oh! And Chinese medical theory.
- You have one or two principal 'erbs. These are the work-horses that do the main job needed. They apply the main strategy of the formula.
- There will often be some 'deputy' herbs. These assist the main herbs but may refine their actions or help to do something else needed in the strategy but not covered by the main herbs.
- There may be 'assistant' or messenger herbs which move the action into some particular area of the body, say the upper part of the thorax or which compensate for the actions of the principal herbs. For instance, the principal herbs might be too cooling, so an assistant herb might be added to warm the Stomach. This helps the Stomach do its job without getting so cold that it can't.
- There will be some harmonising herbs to make them work together and help you digest them without always getting diarrhoea or nausea. (Chinese herbs take a little getting used to, so don't give up too soon. We've all been spoiled in the West by having all our medicines sugar-coated. Herbs come from the earth and can taste earthy.)
How Different from Western medicine?
What makes this different from modern Western drug therapy, is that the Chinese formulae have mostly been in use and regular testing for hundreds if not thousands of years.
During that time, herbs that perhaps were too powerful or had major side-effects have been calmed by the addition of other herbs to steady and direct them.
Chinese herbal formulae are nearly always a mix of between two and 20 herbs, commonly 6 to 10. If you read my page on Primary and Secondary Actions you'll perhaps appreciate that one of the problems with modern medicine is that, in an attempt to isolate the pure active principle of a medicine, you lose all the other compensating qualities that are present in the original herb or formula.
Consequently, although Chinese 'erbal formulae are prescribed on the basis of their primary actions, their secondary actions are looked after by the combination of deputy, assistant and messenger herbs added to the formula to make it do what is needed. The whole combination therefore has few if any secondary actions.
Not so, pure drugs in Western medicine which are notorious for their secondary actions, some of which are not discovered until some time later after damage has been done.
Doctors giving Western medicines are often foxed by what happens when they give a range of medicines on the same day or together. The medicines don't always behave as expected, and doctors now realise that in some patients, combinations are either ineffective or cause additional problems.
What works with what is only slowly being discovered, it seems by trial and error.
Also, 'erbal formulae are very seldom as strong as modern medicine though because they address a recognised syndrome, may work just as fast as the western drug, which is given for a specific symptom or disease, but ignoring the energetic state of the patient, which is always what the Chinese herbs address.
Creams and Liniments
Chinese herbs can also be ground up and turned into creams and liniments, dressings and what-have-you.
Often used in this form, but better if combined with the correct formula taken internally.
Confuse Herbs with Homoeopathy?
Please don't confuse these!
They are quite different, not least because homoeopathy, unlike any other form of therapy I'm aware of, purports to treat people based on the secondary actions of the remedies (= homoeopathic medicines) chosen.
However, it is my belief that homoeopathy in effect uses the same 'energetic' theory behind Chinese medicine.
By that I mean that it relies on the signs and symptoms it sees and which are experienced by the patient, related in words that have colour, depth, emotion and intensity.
For examples, symptoms
- are cold or hot, cramping or burning
- press in or out, up or down
- get worse in the morning or when walking or after meals
- go from there to here, or left to right or vice versa
- make you angry or sad, or grind your teeth, or dream of waterfalls
- only happen when something else happens such as when there's a thunderstorm, or during your menses, or at full moon or after eating raw onions
- come with a desire for some foods and dislike of others
- have been like this since something happened, possibly many years before
Both require patience and experience, so in that at least they aren't different, nor, if we're honest, much different from the best of modern Western medicine either.
In general, because I think they pursue the same path but by different means, I do not give my patients treatment with Chinese medicine at the same time as giving them homoeopathic remedies - and certainly not the latter in what are called 'high potencies'.
Why can't Western Herbs be used in Chinese formulae?
Well, they can, but we don't have much experience of how they work this way yet, so practitioners of Chinese herbalism are cautious. After all you want to use something that does work and which you understand, rather than something which may work and which you aren't sure about.
However, a book was written in two volumes in 1989 by Peter Holmes called 'The Energetics of Western Herbs'. Very useful and worth every penny or cent.
I have used Peter Holmes' book many times over the years and referred to it when writing my book on clearing Phlegm.
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Jonathan Clogstoun-Willmott Books
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Qi Stagnation - Signs of Stress
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Western Astrology and Chinese Medicine
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