Chinese herb substitution and using local species
I thank you all for your patience as I adjust to my workload. The reality of the situation is that I’m going to have to post what I can, when I can. But, with the onset of clinic I find myself coming up with many new thoughts to share - I’ll do my best to get them up in a timely fashion. Look also for the return of the podcast this week. I know you’ve missed me. :)
Anyway, in a fantastic lecture by Dr. Arnaud Versluys this weekend, I was reinspired to consider a very real problem in Chinese herbal medicine. We use herbs that travel long distances, are sometimes beset with chemical and heavy metal toxicity, are sometimes banned by ill-informed government agencies and some of which are becoming rare and, thus, expensive. Given that I am very serious about a rigorously authentic Shang Han Lun
The particular herb that came up in discussion about this issue was Xi Xin - Asarum - Wild Ginger. I love this herb. It’s used in a couple of indispensible formulas, perhaps most importantly in Dang Gui Si Ni Tang. Most herbalists agree that there’s simply no substitute for Xi Xin, but I’ve seen or heard of people try to replace it with Wu Tou, Yu Jin, Sheng Jiang + Mai Men Dong (?!) and other interesting combinations. Most of these same herbalists agree that it’s simply not the same without Xi Xin.
The ban on Xi Xin for practitioners is ridiculous to the extreme and I’m not going to discuss that here. What I would like to hear people discuss is how they make substitutions in these cases. When an herb you need isn’t around, what do you do? What herbs have you had to learn to live without? I understand that UK herbalists are quite restricted in what they can prescribe - how have my UK readers dealt with this problem? Even when a governmental agency isn’t busy interfering, we sometimes lose herbs. Consider Xi Jiao, rhino horn. Consider the precarious state of Ren Shen, ginseng.
There are a couple of associated questions that come up when one considers this issue. One is - should we simply learn to work with fewer, simpler herbs? Dr. Versluys is known to say that he thinks he could do a fair job of treating patients with only 10 herbs - a set of cooling herbs in each of five flavors and a corresponding set of warming herbs. If you know formula science and architecture, such artistry is certainly possible. Is this the standard towards which we should strive? It seems far superior to the never ending quest for the “perfect herb for cancer” or memorizing five hundred herbs, over half of which are specialized for particular symptoms.
Taking this a little bit farther, we should consider the wisdom of relying on herb sources that can only be accessed by air shipments from another continent. Given peak oil, given the unstable political nature of our planet, given the environmental crisis we find ourselves in… should we at least consider the possibility that we may need to rely on local sources for our herbs at some point in the future?
My friend said an interesting thing to me today. In the course of discussing this various issue he said, “To be true Classical Chinese herbalists, we should use the herbs we find around us.” I didn’t question him any farther on this issue, but I think he’s right from some perspectives. Learning the Chinese herbs and formula science so deeply that it is second nature allows us to look at all plants, animals and minerals with the eyes of a Classical Chinese herbalist. Then it seems at least possible that we could, if necessary, find other materials that meet the needs of our patients.
I’d be interested to hear your thoughts on this rambling post. Doubtless there are many opinions out there - share them here on Deepest Health by responding in the comments. No registration is necessary and you can even post anonymously if you are respectful.
Thanks for reading,
Eric
If you like what you read here, you may want to keep updated by using my RSS feed. Want to know more about RSS/feeds? - read more here. Thanks for visiting!
Tags: chinese-herb, chinese-herbs, environment, flavors, formulas, herbs, nature, versluysRelated posts
Salt-sensitive hypertension and Classical Chinese Medicine, Part 1
Editor intro
This is a Guest Post by 3rd year Classical Chinese Medicine student (and Chinese medicine blogger) Brandon Brown. Brandon is a friend of mine and an excellent student. He approached me with this paper and I immediately knew it would be a fantastic contribution to the site as many folks have asked me for rigorous examinations of the cross-pollination between Western and Chinese science as expressed in medicine. This will be a 3 part series released over the next 3 days, please feel free to leave comments - Brandon is a regular reader of the site. I should note that he has posted references for the entire series on his blog, you can access those references by clicking on this link. -Eric
—
Author intro
The following three posts are from a paper I wrote in the Winter of 2008 for Dr. Edward Neal’s Clinical Physical Diagnosis course at NCNM. It is my attempt to apply classical Chinese medical knowledge to a modern disease processes that is pervasive, salt-sensitive hypertension. In looking at all modern diseases, I believe it is extremely beneficial as CCM practitioners to understand the patho-mechanism as presented to us by current research in Western materialism. Because yang (energy) leads and yin (substance) follows, by knowing the yin we can garner important clues that can allow our yang treatments to strike with more clarity, force, and efficacy. I welcome your thoughts and comments. - Brandon
—
Salt-sensitive hypertension : Western science and the macrocosmic view
“The highest good is like water, it settles in the lowest place where people do not like to be.”
Dao De Jing
It is estimated that salt-sensitive hypertension (SSH) accounts for over two-thirds of people over 60 who have primary hypertension . Though there are genetic variants to the tolerance of the amount of salt that effects hypertension, dietary sodium is considered the most important environmental influence. This begs the question: why are some people who are hypertensive experience a salt sensitivity and others do not? The answer to this question may lie in the theories of Chinese Medicine and in the fundamental nature of salt, and its relationship to water and the Kidney. I will first give a summary of hypertension in western terms and discuss current research theories. Following this, I will discuss salt: cultural symbology, the natural formation, and specific references in the medical classics. By so doing, I hope to show how an ancient medicine sheds important light on this modern disease, through the connection of the Kidney and the Heart.
Hypertension - a more Western perspective
Primary hypertension is defined as chronically elevated blood pressure where systolic arterial blood pressure consistently exceeds 140 mmHg or greater. To be considered primary, the hypertension must be idiopathic, and not due to secondary factors such as kidney disease or adrenal tumors, for example. Primary hypertension is considered to be a major risk factor for strokes and cardiovascular disease, and is a leading cause of chronic renal failure . Heart disease is the number one killer in the United States, leading to well over half a million deaths per year.
It was observed in a strict rice and low-sodium diet study performed in 1944 that patients with kidney disease and hypertension were able to lower their blood pressure by as many as 100 mmHg in some cases . Current theories of the pathological mechanism of SSH posit abnormalities in renal sodium transport in the nephron structure of the kidneys . The cause for these kidney abnormalities are thought to be caused by both genetic and environmental factors. Because salt generally attracts water through osmosis, increased blood sodium not excreted by the filtering mechanisms in the kidney causes an increase in the water content of the blood, thereby causing the vessels to swell. This increased swelling, is an increase of “total peripheral resistance of the vasculature”, and is thought to create a long-term load on cardiac output ultimately leading to heart failure. Therefore, we can say that the presence of salt in the blood pushes out from the inside. This is contrary to the renin-angiotensin mechanism of the Kidney, which vasoconstrics and thus pushes in from the outside.
Salt in the Macrocosm
“Ye are the salt of the earth; the best of the human race.”
Jesus Christ in Matthew 5:13
The creation story of salt begins with fresh water falling from the sky as rain, and landing on the elevated earth. The nature of water is to always seek the lowest point of any terrain. The rain water falls on the hills at first as drops, which coalesce to form a trickle, which then join to form streams and these eventually join to form massive rivers, which empty into the sea. On this journey, constant erosion takes place as minerals are stripped from the earth and mountains and carried to the ocean. Because of its polar nature, water acts as a solvent to all matter. Place any material in water, and given enough time, transformation will occur. Metal will rust, vegetation will decay, and other liquids will eventually diffuse and become one with the water. The mineral rich streams, which still taste like fresh water to us, empty into the vast oceans that today are heavily salted and totally unpalatable, even though they are only 3.5% salt . The oceans continue to accumulate more and more salts because over millions of years evaporation extracts the water from the ocean, but not the minerals. The minerals are too heavy and earthbound to be steamed up to the heavens. This process is depicted in Figure 1.
Figure 1: The generation of saltwater
Of special interest in Figure 1 is how it reflects the generating cycle of the 5 Phases (五行). That is, Water falls from Heaven onto Earth and Metal, flowing down to Water, where through the energy of Fire, the fresh water is evaporated upwards toward heaven by the process of Wood. What is left behind is a storehouse of salt. Because of this, we would expect to find that places of warmer climate would have oceans with higher salt content. This is in fact the case, as places such as the Mediterranean Sea have a much higher salinity than that of cold water oceans (the Arctic and Northern Pacific, for example).
Salt is very much a dissolved solid from the Metal sphere. It is highly organized and crystalline, and looks almost identical to ice (Figure 2). Salt was the first currency of the civilized world, due to its value as a preserver of meat. As Richard Manning writes in Against the Grain, it was the ability to preserve and store meat which essentially lead to the creation of wealth and signaled the shift from nomadic hunter-gatherer societies to those of sedentary agrarian caste systems. Earlier than 800 A.D., the Yellow Emperor himself is said to have fought the very first war over the precious commodity . In 450 B.C., iron was put to use to boil sea water in huge pots to extract salt, a method that was used for the next 2000 years. By expediting the evaporative process, larger amounts of salt could be garnered more quickly and thus a greater amount of wealth could be amassed. Even in these ancient times salt stored, or preserved, wealth. To this day, the word “salary” comes from the Latin “salarium”, or “to be payed with salt.”
Not surprisingly, then, salt as a symbol of wealth came to symbolize all that is good. It is common practice to throw salt over the shoulder to ward off the devil, sumo wrestlers throw salt in the wrestling ring to purify it before a match, and placing piles of salt in tombs purifies the soul’s journey from earth to heaven, for example. Throughout history and across the world, in almost every culture, salt has been used in religious, medical, and cultural contexts to purify and clean the soul and the body from evil and disease . Ultimately, however, it is argued that salt is a often a cultural metaphor for semen, and the essence of man.
—
In the next article in this three part series, Brandon will dive into the microcosm - discussing the mechanisms above as they reflect into the human body. Look for it coming soon.
Tags: disease, environment, heart, kidney, macrocosm, metal, nature, salt, Science, water, western research, western-scienceRelated posts
How would a sage care for the planet?
April has already begun and I’ve spent quite a bit of time thinking about the habit I would like to develop in pursuit of a more sagely existence. First, let’s recap what was said in the inaugural Year of Sagely Living post:
April - Large Intestine, Mao 卯 (Rabbit) - Care of the planet/consumption: This category will contain practices that develop us into compassionate and sane consumers, while helping to develop our deep relationship with the natural world. Why this pairing? April is a time when we can see the beauty of nature all around us, so is a great time to contemplate our dependence on it and responsibility towards it. Also, the negative side of LI/Rabbit is a tendency to run rough-shod over the needs and wants of others, these practices will seek to counterbalance this.
My lifestyle is already very much concerned with what I would call “compassionate consumerism,” which is to say that I consider the human and non-human ramifications of my actions every time I buy, consume or discard something. I recycle about 20 times more than I throw away, my version of whole-foods veganism lives lightly on the planet, I use my own two feet and public transportation most of the time, so on and so forth. Looking for a way to leave the planet in better shape than I found it has been a sort of part-time job of mine. So, figuring out an excellent practice for April’s Year of Sagely Living both had more weight and seemed more challenging.
At the end of March, I really took some time to review the whole Year of Sagely Living project. I have a passion for personal development, and my thoughts and actions naturally tend in this direction. However, “regular” personal development is not what my schooling, future career, and this blog are really about! The point is to look at categories of practice that seem to be aligned with the essence of Chinese medical philosophy, live by them, and analyze the results. The hypothesis is that these practices, particularly when they are very deeply rooted in Chinese medical philosophy, will be productive of excellent human beings. What I’m getting to here is that I want to be sure that I stay connected to the aim of reaching back to the ancient wisdom.
So, when considering my April YSL goal, I really tried to consider what kind of practice I could do that would bring me in line with the overall aim of the project. I’ve decided, with my family, to try to grow as much of our produce as possible in our backyard. I have been trying for a long time to develop the habit of growing food. We have beautiful houseplants and have managed to grow some excellent flowers, shrubs and trees in our yard. We have several fruit trees, raspberry bushes, and now a strawberry patch. We have had a container garden on our back stoop for two years running that was mildly successful. Now we have the space and the desire to really make a push and create a beautiful, bountiful space to provide our fruit and vegetable needs and we should use it.
This goal is ideal in a number of respects. First, it really brings us into line with our desire to buy the majority of our food locally. We shop at our local coop which has this goal as one of its goals, so we generally eat food that comes from pretty close to home. However, growing it in our yard would take that to another level. Eating locally is one of the greatest things you can do to reduce your environmental impact, as it reduces theamounto of petroleum used to get you the things you eat. It has a number of residual benefits as well, such as strengthening the local economy. We are making an attempt to make this even more petroleum-neutral by using public transportation when we can to get things for our garden, sharing some supplies (and their transportation) with a garden-savvy friend, etc…
Another reason why this goal is ideal for the YSL is that it connects the two vital practices of interacting with nature and ensuring the viability of our ecosphere. Chinese medicine has nature observation and contemplation at its root. Watching the cycle of growth, death, and rebirth will certainly deepen my understanding of this root. Third, there are a number of health benefits involved in growing a significant portion of our food. Micro-agriculture seems to yield more Qi-laden veggies, having lots of veggies around will promote us to eat them more often and the work itself (when done mindfully) can be tremendously good exercise. Finally, I really believe that interacting with nature on this level will confer some spiritual benefits - improving my general level of personal cultivation.
Some details:
- We will be growing the following: two kinds of kale, two kinds of chard, two kinds of lettuce, lots of tomatoes, potatoes, broccoli, summer squash, delicata squash, cucumbers, spicy peppers, chicory, carrots, fennel, basil, oregano and maybe a couple of other herbs. I will be seeking out Chinese herbs to grow as well. I know our local Classical Chinese Garden sometimes has plant sales.
- We will be using all organic soil amendments and pest control.
- We will not be using any machines in creation of the garden.
- We will be using heirloom varieties whenever possible, open pollinated.
- We will be using raised beds created from recycled wood (left in our yard by the landlord) or FCS certified wood
I will discuss the particulars of my experience and probably even find a way to post pictures of the garden as it grows. This will obviously be more than a month, but I will use my Year of Sagely Living intensity to really engage in the process of setting up the garden and getting it in the ground and then do periodic reports as time goes on. I can’t wait to hear about other people’s April Year of Sagely Living goals!
Eric
Tags: chinese-herb, chinese-herbs, environment, environmentalism, garden, habits, nature, organic, Personal Development, Year of Sagely LivingRelated posts
Blog Action Day 2007 : Is Chinese medicine environmentally friendly?
Today is Blog Action Day - one day where many writers come together to blog about a single topic to increase our total impact. This year, the topic is the environment - something near and dear to my heart. In this article, I’d like to suggest that Chinese medicine can easily be a strong part of the solution to our growing environmental problems while also mentioning one area in which Chinese medicine practitioners need to advocate for more ecologically friendly practices.
Balance is as balance does (or vice versa)
One of the most powerful features of Chinese medicine is its ability to bring us into closer harmony with the natural world. In fact, all of the Classics talk about the importance of people’s closeness to and concordance with the processes of Earth. QiBo and Huangdi, some of Chinese medicine’s founding fathers, repeatedly lament the lack of people’s ability to live within nature’s boundaries and point to it as a major cause of disease as well as treatment resistance. Now it could easily become (and in some ways has become) a watered down forceless statement to say that Chinese medicine can bring you into harmony with nature - what does that really mean and why does it matter from an ecological perspective?
Being in balance means simply this - your body is in a physiological state whereby there are no extreme states. No intense cravings, no wildly oscillating emotions, nothing like that. You can sleep. You can smile. When you eat normal food, your guts don’t hurt. You don’t go into sneezing fits at the merest whiff of cat dander. There may be pain, sure, there may be problems of varying kinds - but the body is generally in balance around these points and things are moving in a more or less effortless fashion. When some adverse condition arises, your body is able to respond appropriately.
It is my assertion here that this state of balance, whatever it looks like for a particular individual, produces generally balanced behavior. Balanced behavior is less likely to be destructive in a number of ways. So much of what goes on from an environmental damage perspective comes from people’s unordered responses to life. Think about vices, for instance. So many of these (tobacco, alcohol, coffee) are intensively farmed with the accompanying herbicides and pesticides. Also, a body in balance may be more likely to ask for things that are generally good for it - such as fresh air, long walks and clean water. I know that when I’m the least in balance, I’m least likely to care whether I am drinking filtered water or eating organic food. It just doesn’t matter to me. Maybe I’m the only one.
Ecological medicine
Chinese medicine is generally ecologically friendly. Our equipment needs are minor, we don’t require huge research facilities that use a variety of toxic chemicals to operate. Because many Chinese medicine practitioners are likely to be following the principles set out in the classics, they may be more likely to pay attention to the way their products are produced and the way the electricity for their offices is generated. This is, of course, not always the case and probably less so outside of the Western world. Chinese medicine also doesn’t ask people to consume synthetic drugs, the production of which puts a heavy environmental load on the planet.
But what about herbs? If you’ve thought about it even for a little while, you’ve likely been concerned about the ecological impact of Chinese herbs. I know I have and I’d like to address a couple of the most obvious problems here.
Herbs frequently travel long distances, increasing our dependence on fossil fuels : what to do?
The vast majority of Chinese herbs are produced in Asian countries. If you do not live in an Asian country, it follows that these substance are going to have to be transported to your place of practice. The travel may be considerable and of course this means reliance on significant amounts of fossil fuels. There are a number of things Chinese herbalists can do to reduce their impact. Probably the easiest and most effective behavior is to research the herbs you are procuring from grower to distributor. Where do they come from? How are they transported? Can you find a distributor close by so you can use alternative transportation to get them? Can you find a supply line with a minimal number of links? Can you find a supply line that includes companies that have an ecological frame of mind? This will, of course, require some research - but it will be well spent.
Another possibility is to grow some of your own herbs or form growers coops in your local area. This is energy intensive and there is some question as to the energetic quality of the resulting materials, but I think it is at least something to consider. Going a step further, some people have suggested that instead of using the Chinese species of herbs we should do the research required to find local correlates to all of the herbs. These folks argue that the herbs will be more likely to resonate with our own physiology and the disease patterns we present if they are local. I am not convinced that this is the case and I am by no means sure that we are energetically sensitive enough to discover the Wei and Qi of herbs in an accurate manner today.
Chinese herbs are commonly produced using lots of chemicals in China : what to do?
Simply demand organic, or at least pesticide and herbicide free herbs. This is a very similar tactic as has worked with the organic foods movement. Simply know where your consumables are coming from and how they are grown and when the practices are ecologically damaging, demand better. Only buy from companies/distributors that support best practices - and when that is not possible, communicate your desires to the people you are working with. Finding chemical free herbs is not only good for the environment, but it’s great for your patients and will do a lot to alleviate their fears about taking products produced in China.
There may be other positive and negative environmental impacts of Chinese medicine, but these are the ones I think of most frequently. I’d like to hear what others think on these and related topics - please add your voice in the comments.
Eric
Related posts
Should Chinese medicine be modernized?
You probably already know my answer to this question. Reading through my Chinese Medicine news feed, I came across this article - China to further modernize Traditional Chinese Medicine. Here’s their description of what modernizing means for the medicine.
“In modernizing TCM, efforts will be made to improve standards, study new applications and standardize planting, production and processing of medicinal herbs, according to the report of the center, which is under the Ministry of Science and Technology.”
This doesn’t sound too bad, actually. I can understand the wisdom in standardizing planting, production and processing of herbs. Unfortunately, standardization too often means bringing everything down to the standard of the least excellent instead of bringing everything up to the standard of the most excellent! If they are going to standardize the herb industry they need to take care to:
- Make sure the integrity of biological systems is maintained, or where already damaged, improved. The energetic quality of the herb is certainly impacted by its environment. In ancient times, these herbs grew wild - in harmony with their surroundings. The best quality of many herbs is still found in their wild counterparts! In standardized cultivation, one should do the best they can to replicate that environment - even if it harms yields.
- Follow traditional guidelines in harvest and processing of herbs. If in the Materia Medica an herbs is meant to be mix-fried until yellow, don’t char it. If it is meant to be processed in salt water, process it in salt water. Perhaps contemporary research methods don’t pick up the difference between one processing method and another - but don’t kid yourself into thinking that the sages that developed this medicine were stupid. Their guidelines were precise and developed over centuries of testing. Respect that.
- Use the implementation of standards to ensure the elimination of heavy metals, pesticides and non-edible products from the herbs.
Unfortunately, this isn’t all “modernization” has in store for Chinese medicine in China. If prior activity is any measure, it will almost certainly entail the purging of important information from the official canon and redoubled efforts to justify Chinese medicine from a Western scientific standpoint. Further, practitioners with diverse (yet vital and functional) theoretical standpoints, diagnostic methods and treatment principles may be forced to embrace the standard despite the fact that it is not clinically more effective. This, so the line goes, is the only way that Chinese medicine will be accepted into the mainstream.
If that’s what it takes to be accepted into the mainstream - I’ll take the tributaries.
Eric
Tags: activity, china, clinic, Cultivation, environment, herbs, news, Science, standardization, study, tea, Technology, traditional-chinese-medicine
Related posts
-
-
What am I up to?
-
Subscribe to Deepest Health
