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Chinese Herbal Medicine

Traditional Chinese medicine is rapidly advancing onto the world stage as a medicine that has endured through time and history to assuage the ills of humankind and assist in the prevention of further diseases and imbalances of health.


Chinese herbal medicine is notable for its sophistication in addressing clinical concerns while remedying an individual’s particular needs. Thousands of years old, the herbal medicine tradition remains a vibrant player in today’s health field.

 

(32) Chinese Herbal Medicine

Chinese herbal medicine's new life

CHM31

What are the characteristics of Shi Gao (Gypsum)? Why is it often used with Zhi Mu (Anemarrhenae rhizoma)? What are the differences between their actions?

Shi Gao is the most important substance to clear internal Heat, especially Heat in the Qi level. As it is a mineral substance and is heavy in weight, it is considered to have a descending tendency. It is pungent, sweet, and very cold, and enters the Lung and Stomach meridians.

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(33) Chinese Herbal Medicine

Chinese Herbs

Chinese Herbal Medicine

Chinese-Herbs

What are the differences between Sheng Shi Gao (raw Gypsum) and Duan Shi Gao (calcined Gypsum)?

 Shi Gao is a kind of mineral substance which contains calcium sulfate. After being mined, cleaned and smashed, the product is called Sheng Shi Gao. Sheng Shi Gao is sweet, very cold and pungent, and enters the Lung and Stomach meridians. It can strongly clear Excessive-Heat in the Lung and can be used for febrile diseases which manifest with high fever, intense thirst, irritability, profuse sweating, shortness of breath and cough. At the same time, it can clear Stomach-Fire and can therefore treat headache, toothache, mouth ulcers, a foul smell in the mouth and burning in the Stomach.

After Shi Gao is calcined by strong fire, it is called Duan Shi Gao. Its cold and pungent properties are reduced by this process, while it obtains an astringent property and is effective in drying Dampness.

This fine powder can be applied topically to treat skin diseases or wounds that are weeping, and are also used if the healing process is slow, such as in eczema, burns and ulcerated sores.

Why is Shi Gao (Gypsum) the first-line choice when Excessive-Heat spreads through the entire body?

The syndrome of Excessive-Heat spreading throughout the entire body is often seen in acute febrile diseases which manifest as high fever without chills, profuse sweating, anxiety, thirst, irritability, even unconsciousness and delirium. The patient has a very red tongue with dry yellow coating and a rapid, forceful pulse. This syndrome can be seen in some infectious diseases and inflammations in Western medicine. At this stage, the Heat is so strong that it is hard to tell which organ is not disturbed by the Heat. The treatment must be given in time to reduce Heat quickly and protect the Yin and Body Fluids in order to stop the process of the disease.

The Stomach meridian of foot Bright Yang has an abundance of Qi and Blood from the digestion and transportation of food. It also easily produces Heat from all these activities; that is why the Bright Yang meridian and organ are regarded as the ‘Sea of Food’ and the ‘Sea of the Yang and Heat’.

One of the strategies for clearing Heat from the entire body is to clear Heat from the Bright Yang meridian and organ. After that it will be much easier to reduce the Heat from the other organs and meridians.

As Shi Gao enters the Stomach meridian and is very cold in nature, it can rapidly and strongly clear Heat from the Bright Yang organ and meridian in order to reduce Heat elsewhere. Since it is sweet and cold, it can also generate the Yin and Body Fluids to supplement the consumed fluids and to prevent their further consumption. Moreover, it is also pungent, so can disperse Heat and direct it downwards; therefore it can clear Heat without the possibility of forming hidden Fire. For these reasons, Shi Gao is an excellent substance for treating internal Excessive-Heat.

What are the differences in clearing Liver-Heat between the herbs Zhi Zi (Gardeniae fructus), Xia Ku Cao (Prunellae spica), Long Dan Cao (Gentianae radix) and Chuan Lian Zi (Toosendan fructus)?

All four of these herbs are bitter and cold, are very effective for draining Liver-Fire and are often used for Excessive Liver-Heat syndrome. However, there are differences between their actions. Zhi Zi is bitter and cold, and does not enter the Liver meridian, but enters the Heart, San Jiao and Lung meridians. Its bitter and cold nature gives it a descending action, and it is able to clear Heat and to reduce Fire from the Upper Jiao, especially from the Heart. As the Liver and Heart have a mother– son relationship according to the Five Elements theory, Liver-Fire can very easily and quickly transport the Heat into the Heart. Treatment aimed at reducing Heart-Fire in order to reduce Liver-Fire is very effective and has become a commonly used strategy. For this reason, Zhi Zi can not only reduce Heart-Fire and treat restlessness, insomnia, a bitter taste in the mouth and a warm sensation in the chest, but also reduces Liver-Fire indirectly and treats irritability and dream-disturbed sleep. Besides clearing Heart-Fire and Liver-Fire, this herb has the function of promoting urination, reducing Fire and regulating the San Jiao water passage. It is also used for painful urinary dysfunction due to Damp-Heat in the Lower Jiao, as well as jaundice due to Damp-Heat in the Liver and Gall Bladder when bile is obstructed by Damp-Heat, such as in acute hepatitis and acute cholelithiasis.

Xia Ku Cao is bitter, cold and pungent, and enters the Liver meridian. Cold and bitterness can reduce Liver-Fire; pungency may disperse stagnant Qi and constrained Heat. Compared with the other herbs, which are cold and bitter with a drying property, it has a gentle action of nourishing the Liver-Blood. As the Liver opens into the eyes, Liver-Fire may in turn lead to disorders of the eyes. Xia Ku Cao is particularly effective for treating painful and dry eyes, a distending sensation of the eyes that worsen at night or in stressful situations due to weakness of blood, and stagnation of Liver-Qi with Liver-Fire, such as in hypertension or glaucoma. As Xia Ku Cao is pungent and has a dispersing tendency, it is quite different from the other bitter-cold herbs, which have only a descending action. It is effective for dissipating lumps and nodules which are caused by stagnation of Liver-Qi and accumulation of Phlegm and Heat, such as galactocele, scrofula, lipoma and goiter. A cream made from this herb can be applied topically in these diseases.

Long Dan Cao is very bitter and cold and enters the Liver, Gall Bladder and Bladder meridians. Its functions are twofold: it clears Liver-Fire from the upper body and eliminates Damp-Heat from the lower body. As Fire always flares up, the symptoms are headache, dizziness, red, painful and swollen eyes, insomnia and irritability. In clinical practice, the herb is very useful for treating hypertension, eczema, acute conjunctivitis, nerve deafness and nerve tinnitus which worsen under stressful conditions.

Long Dan Cao can eliminate Damp-Heat from the Liver meridian and the Lower Jiao. As Dampness often accumulates in the lower body, the symptoms are itching in the genital area, a swollen scrotum, and turbid, foul-smelling urine or leukorrhea. Long Dan Cao can be used for herpes zoster, urinary tract infections, vaginitis, scrotal hydrocele and scrotitis. It is a strong herb that can clear Heat and Damp-Heat in the Liver rapidly, but it should not be used for a long period of time as it is too cold and bitter. Overdose may cause diarrhea and an uncomfortable sensation in the stomach and intestines. Patients with Spleen deficiency should use this herb with caution.

Chuan Lian Zi is bitter and cold and enters the Liver, Small Intestine and Bladder meridians. Like Long Dan Cao, it is very bitter and cold. It not only clears Heat in the Liver, but also drains stagnant Liver-Qi and constrained Fire; therefore it can relieve pain, especially distending pain in the hypochondriac region and sides of the lower abdomen. As the draining action is very strong, this herb is used only for pain caused by intensive Liver-Fire with Qi stagnation.

In addition, this bitter-cold herb should not be used for a long period of time because it may irritate the Stomach and injure the Stomach-Yin and Stomach-Yang. Chuan Lian Zi contains toxic substances and overdose may lead to liver damage, even death; therefore the dosage should be controlled carefully.

What are the characteristics of the herbs that clear Liver-Heat and benefit the eyes?

As the Liver opens into the eyes, disorders of the Liver may cause disorders of the eyes. For instance, emotional disturbance and stress cause Liver-Qi stagnation, which can change into Liver-Heat or Fire; exogenous pathogenic Wind-Heat may disturb the Qi movement in the Liver and Gall Bladder meridians of the head and cause disorders of the eyes; if the Liver-Yin and Liver-Blood are insufficient, they may fail to nourish the eyes, and cause dryness of the eyes and blurred vision. Deficiency of the Liver-Yin and Kidney-Yin may cause Liver-Yang rising, which leads to pain and distension of the eyes, blurred vision and headache. Most of the herbs that are able to cool the Liver and benefit the eyes are cold in nature and enter the Liver meridian. They can reduce Liver-Fire or constrained Heat of the Liver, expel Wind-Heat in the head (especially from the eyes) and direct the Liver-Yang to descend; therefore they treat different kinds of disorders of the eyes. In clinical practice, Qing Xiang Zi (Celosiae semen), Mi Meng Hua (Buddlejae flos), Jue Ming Zi (Cassiae semen), Xia Ku Cao (Prunellae spica), Man Jing Zi (Viticis fructus) and Shi Jue Ming (Haliotidis concha) are often used. Although they are often used together to enhance the effects, there are some differences between their functions.

Qing Xiang Zi and Mi Meng Hua are sweet and cool in nature. They both enter the Liver meridian. They are able to clear Excessive Liver-Heat or Wind-Heat to treat red, painful, swollen eyes, excessive tearing and photophobia. These complaints can be seen in hay fever, acute infectious conjunctivitis or influenza. If you compare the functions of these two herbs, Mi Meng Hua can gently nourish the Yin and Blood and is able to treat blurred vision; Qing Xiang Zi is able to reduce Fire directly, so its function is stronger than Mi Meng Hua in treating Excessive-Fire. Jue Ming Zi is bitter, sweet, salty and cool. It enters the Liver and Kidney meridians. Compared with Qing Xiang Zi and Mi Meng Hua, it has a stronger action in clearing Liver-Heat and reducing Liver-Fire. As it is also able to nourish the Kidney-Yin and Liver-Yin, it is also used for the syndrome of Liver-Yin deficiency with Liver-Yang rising, which manifests as asthenopia, dry, painful eyes and blurred vision. These disorders can be found in hypertension and glaucoma.

Xia Ku Cao is pungent, bitter and cold. It enters the Liver meridian. Compared with the three herbs mentioned above, it is the strongest one for reducing Fire and clearing Heat. Meanwhile it can also nourish the Yin of the Liver. It is especially useful for pain in the eyes which worsens at night. It is also often used to treat hypertension if combined with other herbs that spread the Liver-Qi and descend the Liver-Yang.

Man Jing Zi is bitter, pungent and cold. It enters the Liver, Stomach and Bladder meridians. It has a similar function to Qing Xiang Zi and Mi Meng Hua in clearing Wind-Heat, but it is stronger in expelling Wind because it has a pungent nature. It is used only for treating syndromes that are caused by Excess and exogenous pathogenic factors. Because it also has the function of drying Dampness, it can also be used for pain, itching of the eyes and increased secretion in meibomitis, hordeolum and blepharitis.

Shi Jue Ming is salty, slightly cold and enters the Liver and Kidney meridians. It has no function in expelling Wind-Heat in the head, but can strongly clear Heat from the Liver and direct the Liver-Yang to descend because it is a cold, mineral substance. It can treat headache, dizziness, red eyes, photophobia and pterygium in hypertension, glaucoma and cataract.

 What are the differences in the function of cooling the Blood between Mu Dan Pi (Moutan cortex) and Chi Shao Yao (Paeoniae radix rubra)?

Mu Dan Pi and Chi Shao Yao are both cold in nature. They are very often used for cooling the Blood and treating Heat in the Blood. Moreover, both of them are also able to promote Blood circulation and they are often chosen because they have fewer side-effects than other cold herbs of making congealed Blood in the process of cooling the Blood. However, there are some differences between these two herbs.

Mu Dan Pi is bitter, pungent and slightly cold, enters the Liver meridian and the Blood level primarily and the Heart and Kidney meridians secondarily. Bitterness and Cold can clear Heat; pungency can disperse stagnation. The characteristic of this herb is that it can treat both Excessive-Heat and Empty-Heat in the Blood. Excessive-Heat in the Blood is often manifested in febrile diseases as symptoms of fever, irritability, bleeding, irregular menstruation, menorrhagia and polymenorrhea. Empty-Heat in the Blood is caused by deficiency of Kidney-Yin and Liver-Yin, and manifests as menorrhagia, polymenorrhea, hot flushes during the menopause, ‘bone steams’ and a warm feeling in the chest and on the palms and soles of the feet.

Chi Shao Yao is bitter and cold, and enters the Liver meridian and the Blood. Compared with Mu Dan Pi, it is especially effective in clearing Excessive-Heat in the Blood, but it does not reduce Empty-Heat, so it is only used for Excessive syndromes. At the same time, compared with Mu Dan Pi, it is stronger in promoting the Blood circulation and removing congealed Blood, so is very effective in alleviating pain and reducing swelling. This herb is thus used more for bleeding conditions in febrile diseases or dysmenorrhea which is caused by Excessive- Heat in the Blood. It is also used for treating pain and swelling in cases of trauma, strain and fracture. Chi Shao Yao is one of the commonly used herbs for applying topically to relieve pain and reduce swelling. In addition, as it enters the Liver meridian, it can also be used for red and swollen eyes and pain in the hypochondriac region due to Heat accumulation in the Blood.

 

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(34) Chinese Herbal Medicine

 Introduction to Chinese Herbal Medicine

Chinese Herbs

Traditional Chinese Medicine: In Depth

chinese herbal medicine

What are the differences between Chi Shao Yao (Paeoniae radix rubra) and Bai Shao Yao (Paeoniae radix lactiflora)?

Chi Shao Yao and Bai Shao Yao come from similar plants. Both are cold in nature and enter the Blood and the Liver meridian. Because Chi Shao Yao is cold and bitter, it is able to reduce Liver-Heat as well as Heat in the Blood. It has a dispersing property, can invigorate the Blood and remove congealed Blood, and is therefore often used for treating pain due to Blood stagnation.

Compared with Chi Shao Yao, Bai Shao Yao is less cold but bitter, so it can clear Liver-Heat or Heat in the Blood, but its function is weaker than that of Chi Shao Yao. One difference is its sour taste, which results in an astringent property. Cold and sourness may generate and stabilize the Yin. As it enters the Liver meridian, it particularly nourishes the Liver-Yin and Blood. It is an appropriate herb when there is Yin deficiency with slight Empty-Heat in the Blood. In this situation, the main symptoms are dizziness, dry and burning eyes, irritability, hypochondriac pain and distension. Like Chi Shao Yao, Bai Shao Yao can also alleviate pain, but it alleviates pain caused by Liver-Yin and Blood deficiency, in which the muscles and tendons lose their nourishment. This pain is cramping in nature, such as in abdominal pain and cramp after diarrhea, menstruation, labor or cramp of the muscles of the limbs. Moreover, as Bai Shao Yao has a sour taste, it may stabilize the Yin and Body Fluids and inhibit sweating, so is used for spontaneous sweating and night sweating.

What are the differences between and characteristics of Sheng Di Huang (Rehmanniae radix) and Xuan Shen (Scrophulariae radix) in the function of clearing Heat?

Sheng Di Huang and Xuan Shen are both cold in nature. They have similar functions in clearing Heat, especially when the Heat has consumed the Yin of the body. Both of them are often used for treating internal Heat syndromes with Yin deficiency.

However, there are differences between their functions. Sheng Di Huang is sweet, bitter and cold and moist in nature. It enters the Heart, Liver and Kidney meridians. Bitterness and Cold can clear Heat, and sweetness and Cold may generate the Yin of the body. It can directly clear Excessive-Heat in the Heart and Liver and therefore calm the Mind, and relieve irritability, restlessness, thirst and sensations of warmth in the chest. It is often used in febrile diseases. Sheng Di Huang can also be used for Empty-Heat due to deficiency of Heart-Yin, Liver-Yin or Kidney-Yin. The manifestations are insomnia, restlessness, irritability, a dry throat and ‘bone-steaming’ disorder.

As this herb enters the Heart and Liver meridians, it can also enter the Blood. It is particularly effective in clearing Heat from the Blood, cooling the Blood and stopping bleeding. This is why Sheng Di Huang is an important herb for clearing Heat not only in the Qi level, but also in the Nutritive and Blood levels. It can generate the Yin to prevent the consumption of Yin from Heat. Xuan Shen is bitter, cold and salty, and enters the Kidney meridian. It can clear Heat and reduce Fire. Unlike Sheng Di Huang, it is not sweet and has no function in generating the Yin. As it does not enter the Liver and Heart meridians, it does not enter the Blood and has no function in cooling it. In clinical practice, Xuan Shen is often used instead of Sheng Di Huang to treat Excessive-Heat and Empty-Heat in the Heart, and to relieve thirst, a dry throat, sensation of warmth in the chest and irritability. This is because it has a characteristic of lifting the Kidney Water (Yin) upwards to reduce the Fire of the Heart. It is often used for Excessive-Heat and Empty-Heat in the Upper Jiao. However, its function is not to nourish the Yin but to transport it so it is quite different from Sheng Di Huang.

When a patient has Yin deficiency, especially Kidney-Yin deficiency, this herb should not be used over a long period of time, or it should only be used with herbs that tonify the Yin. Xuan Shen also has some other characteristics. It is salty and able to soften hardness and is especially effective in relieving toxin. It is used for painful and swollen throat or eyes, chronic dry eczema, sores, scrofula and tumors.

However, Xuan Shen can have a toxic effect if it is used in overdose; 10-15 grams of crude herbs or 1–1.5 grams of concentrated herbal powder per day is a safe dosage.

What are the differences between the products of Di Huang (Rehmanniae radix)?

There are three kinds of product from the same plant. The part of the plant that is used is called Di Huang. As it is processed in different ways, the functions are different and the names are also different.

The first is Gan Di Huang, which is also called Sheng Di Huang. (‘Gan’ means ‘dry’ and ‘Sheng’ means ‘raw’.) It is the most commonly used form of Di Huang. The herb is processed by baking, and is then dried by wind or the sun until it turns black. Gan Di Huang is sweet, bitter and cold, and enters the Heart, Liver and Kidney meridians. Sweetness and Cold may generate the Yin and Body Fluids; as this herb is also moist in nature, it can nourish the Yin of the body. Bitterness and Cold can clear Heat, cool the Blood and stop bleeding. This herb is especially effective when internal Heat has injured the Yin and disturbed the Blood. For instance, this may occur in febrile disease with symptoms of fever, thirst, irritability, constipation, scanty urine, night sweating, flushes, menorrhagia, nose bleeding and hemoptysis.

Xian Di Huang is fresh Di Huang. It is collected in spring or autumn and is used directly after washing. It is juicy and fresh, sweet, bitter and very cold. The function is similar to the dried form but weaker in its effect of nourishing the Yin and stronger in clearing Heat. It is very effective in relieving irritability and thirst. This herb is used in clinical practice for diabetes. When Sheng Di Huang is steamed, or alternatively, soaked in rice wine and dried in the sun until both its outside and inside have turned black and glossy, the product is called Shu Di Huang (Rehmanniae radix praeparata). Shu Di Huang is quite different from Sheng Di Huang. The main difference is that it is not cold but warm in nature and sweeter in taste. Sweetness and warmth can generate the Qi; sweetness and glossiness can tonify the Essence and Blood. As it enters the Kidney and Liver meridians, its main function is to tonify the Kidney-Essence and the Liver-Blood. It is a strong herb for treating dizziness, tinnitus, forgetfulness, weakness in the back and knees, and tiredness due to deficiency of the Kidney-Yin and Essence, Liver-Yin and Blood. Shu Di Huang is able to reduce Empty-Heat but its action is quite different from that of Gan Di Huang and Xian Di Huang. It is used in conditions where the Blood and the Kidney-Essence have been severely consumed and they are not able to control the Fire so the Empty-Fire blazes up. The symptoms are ‘bone steaming’, warmth in the palms and soles, fever in the afternoon or in the evening, hot flushes and night sweating. In addition, as it is not cold, it does not have the function of clearing Heat and cooling the Blood as with Sheng Di Huang and Xian Di Huang.

What are the characteristics of pathological change when Heat enters the Blood and what precautions should be observed when using herbs that cool the Blood and stop bleeding?

Herbs that cool the Blood are used for conditions where Heat enters the Blood. Heat in the Blood causes several specific pathological changes. First of all, Heat disturbs the Blood circulation so that the Blood moves recklessly and leaves its normal pathways; specific symptoms of this include bleeding, such as nose bleeding, hemoptysis, uterine bleeding, and blood in the urine and stools. Meanwhile, Heat may consume the Blood, making the Blood thicker and forming congealed Blood. When the Blood is disturbed by Heat it may also directly cause stagnation. In this situation, deep-red maculopapular or other types of rashes appear in infectious diseases such as scarlet fever, epidemic meningitis and encephalitis, as well as in skin diseases such as eczema. If Heat enters the Blood, then the patient does not feel thirsty or rinses the mouth with water but has no desire to swallow it, although the tongue proper is red and the pulse is rapid. This indicates that the Heat is consuming the Blood instead of the Body Fluids.

In treating the syndrome of Heat in the Blood, an important principle is to cool the Blood and avoid Blood stasis. The Blood in a normal condition should circulate smoothly and quietly. Heat may force it to move faster, become unstable and, at the same time, the Heat may consume the Blood and cause Blood stagnation and bleeding. If cold herbs are used they may slow the Blood circulation but may also cause the Blood to stagnate. Therefore, to treat Heat in the Blood, herbs that enter the Blood and are coldpungent-sweet or sour-cold in property are often used-for example, Sheng Di Huang (Rehmanniae radix), Chi Shao Yao (Paeoniae radix rubra), Um Dan Pi (Moutan cortex) and Zi Cao (Arnebiae/ Lithospermi radix). They have the function not only of cooling the Blood but also of promoting its circulation and preventing its stagnation. Some are pungent, which may disperse stasis; some are sweet, which may generate the Yin. They mainly enter the Heart and Liver meridians so that they can easily regulate the Blood circulation. These herbs are suitable for the pathogenic changes of Heat in the Blood.

To treat Heat in the Blood, cold and bitter herbs should not be used as they may dry the Blood. Herbs that enter the Qi level should not be used either because the pathological change is not in the Qi level. Very cold herbs should not be used for a long period of time or in a very large dosage, otherwise they may cause Blood stasis.

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