Understanding Chinese herbs using Classical Chinese Medical thinking
Sometimes I learn small things that turn out to be very useful. I would like to start sharing these as bite sized treats interspersed in between the thicker cuts that many of you are accustomed to here on Deepest Health. Today, I would like to offer one of those which is a way of thinking about herbs (and, thus, formulas) that I initially learned from my mentor, Dr. Arnaud Versluys. It’s a simple thing, maybe, but hopefully helpful to you.
In our Classical Chinese Medicine education here in Portland, OR, we are given a variety of types of information. I’ve talked about this several times before. We are sometimes told that truly Classical Chinese Medicine includes the information in the standard TCM system and includes information in the Western/allopathic system, but then goes outside of those reaching back to the Classical texts and cultivated ways of knowing. All of this information must be explored and, ultimately, integrated. We are encouraged to find that which really drives us and dive deep into that, but always asked to keep our minds open to the whole symbol field of information that human striving has uncovered.
In that spirit, consider the study of Chinese herbs. There’s a huge amount of information one could associate with any given single herb. The information has many different aspects - let us consider the relative materiality and the relative size (in time and/or space) of the information. We can create two axes. One from grossly material to highly immaterial, and one from microscopic to quite macroscopic. We can find useful information anywhere in the field created by these two axes. Let me provide a partial list of information along these two axes that I use to understand single Chinese herbs. The information will be listed from more material and more microscopic to less material and more macroscopic (obviously not a perfect gradation).
- Specific biochemical constituents, chemical bonding (for example, discussion of specific alkaloids)
- Classes of biochemical constituents, herb-herb interaction (for example, what are alkaloids?)
- Western medical physiological understanding (for example, discussion of the endocrine system)
- This might include information from Western medical studies/clinical trials
- Habitat and other botanical information (what kind of plant is this?)
- Chinese herbal category information (qi, flavor, channel affinity) and dosage information
- Contradictions (both Chinese and Western)
- Use of the herb through history in China (what formulas? what doctors? what contexts?)
- Understanding via various systems of differentiation (Ba Gan/8 Pillars, 6 Conformations, 5 Element)
- Information in various Classical texts concerning this herb other than what’s already been covered in another category
- Symbolism behind any of the previous categories of information (for instance, given the relevant habitat in which the herb grows - how can we understand it symbolically)
- Use of categories of information associated with the organ clock (If this is a Spleen herb, how can the symbolism of the snake help us think about it?
Let’s just look at a quick example on a very basic level using just some of the partial list above. Bai Shao, anyone?
白芍 Bái Sháo (Yào)
Biochemical constituents/other minute level Western information
- Paeoniflorin, albiflorin, oxypaeonifloring, benzoylpaeoniflorin, paeonin, hydorxypaeoniflorin (glycosides), gallotannin, d-catechin, eugeniin (tannins), benzoic acid, proteins and other constituents
- To extend this into the next category, we might be interested to look more deeply at the general function of glycosides and tannins, their function in the body and the families of things on the planet that either create or use them in high amounts. Of course this must all be evaluated symbolically.
- Herb-herb interaction? We might consider that Bai Shao is often paired with Gui Zhi, look into the chemical constituents of Gui Zhi and investigate, from a Western standpoint, what those interactions tend to produce.
- Herb-drug interaction? What drugs does Bai Shao resemble? What drugs does Bai Shao work poorly with? For instance, one is asked to have care when using Bai Shao for patients on anti-coagulants. What does this mean?
We could definitely find many clinical studies about Bai Shao and isolate what pharmacological effects allopathic medical researchers have found. A quick look tells me that some researchers have found that Bai Shao has:
- CNS suppressant, gastrointestinal, antibiotic, antipyretic, anti-inflammatory, anti-platelet and cardiovascula effects
Habitat and other botanical information
Bensky tells us that Bai Shao is Paeonia lactiflora with the bark removed and that Chi Shao is a wildcrafted version of the same species - with bark intact. It would be interesting to know more about this distinction and to understand whether this distinction held during the Han dynasty. Anyone with information to that effect?
It is native to a large part of the area from Tibet through China up to Russia. It enjoys a wide range of habitats and the entire plant can be used medicinally or as food. This may help us to understand its rather broad range of effects and its extensive use in the classics.
Chinese herbal category information, inclusion in formulas
- Wei/Flavor: Bitter and sour
- Qi/Temperature: Slightly cold/cool
- Channel affinity: Liver and Spleen
- Dosage: Typically 6-15 grams
A quick search at Rootdown.us shows us that Bai Shao is included in 48 formulas. As the formula database is not complete on that site (it’s growing every day!) I’m certain the number is much higher. We could look at the usage of Bai Shao in each of those formulas and come to some conclusions about what kinds of effects it has and use those findings to further dive into the symbolism associated with the herb.
Use of the herb through the history of Chinese medicine, inclusion in various Classical texts
How did Zhang Zhong Jing use Bai Shao? How is this different from the way later physicians used it? What is said about Bai Shao in the Shennong Ben Cao Jing? This entry is getting a bit too long already, so I won’t delve into these questions — but you can see how the information would be very useful in coming to a full understanding of Bai Shao.
Understanding some of the above information more symbolically
Just as a quick example take the broad habitat adaptation of Bai Shao. It’s a relatively easy plant to grow - and it grows quickly. The Earth seems to want to give it to us in abundance. An herb that adaptable has to be important for the basic physiology of the body - one might think. Perhaps it lends itself to a certain adaptability in us as well.
Various systems of differentiation
Again, to save time I will be very brief. One way to understand Bai Shao is that it backs Wood off of Earth. This doesn’t mean that Wood has to be very excessive. Earth merely needs to be a bit under the weather (so to speak) and the normal amount of Wood will be too much for it. This is part of the way we can come to understand Bai Shao’s use in Xiao Jian Zhong Tang. One symptom one might find in a XJZT syndrome is mild muscle cramping or mild abdominal cramping due to a weak Earth being unable to resist the basically “normal” Wood energy. Bai Shao mildly backs Wood off of Earth so it can recover.
Organ clock and other high level theoretical constructs
Bai Shao is basically a Wood herb. How can we use the symbolism behind the Wood organs - Liver and Gallbladder, to come to a fuller understanding of Bai Shao? We can consider, perhaps, the symbol of the Ox or the Wood constellations in Chinese astronomy. We could look at the clock pair of the Liver and try to uncover any mysteries there.
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Ok, so this turned out a little longer than I expected. My gut level instinct is simply this. While I am not personally interested in going down every little rabbit hole that the current information culture serves up for me, I am certainly open to embracing a wide variety of information sources. I find that when I am able to see an herb (and by extension a formula) from many angles, my relationship with it deepens. I can only assume that this is molding me into a better clinician. I’d be very interested to hear anyone else’s thoughts on this topic in the comments. Go on - take a chance!
Eric
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Tags: chinese-herb, chinese-herbs, formula-science, formulas, herbs, integrative-medicine, scholar, study-methods, studying, western researchRelated posts
On entering into a philosophical morass: Chinese medicine and Western science
Let’s get something straight. I’m very confused about the role of Western scientific research as it is currently practiced in verifying the claims of practitioners of Chinese medicine. Various studies, including the famous “sham acupuncture” study seem to challenge the premise that the theoretical bases of Chinese medicine are an accurate description of reality and our interactions with it. For instance, concerning the study referenced above, if any old needle through the skin will cure migraines - what of channel theory? What of our highly developed ideas about acupuncture techniques? Similar doubt is cast on Chinese herbalism by placebo controlled double blind studies showing no significant improvement in patient outcomes with the administration of various herbal extracts or even, in some cases, whole herbal formulas. What gives? Why spend all this money to learn a highly nuanced medical system if that system can’t stand on its own two feet? (Yes, I know, there are plenty of studies that verify CM’s efficacy, but that’s beside my specific point here).
I’ve talked in various articles on this site about my basic opinion about the relationship between Western science and Chinese medicine. At my school, NCNM, we talk about these things quite a bit in classes, in the hallways, in subversive meetings around Portland, Oregon. But, to be totally frank, the conversations don’t often delve deeply. This isn’t because we don’t want to go beyond the surface. Sometimes it feels like these concepts are coated with Teflon - the mind so readily slips off. It’s such work just to get through the program, I think most of us just don’t have the mental energy to work through this kind of analysis. Further, most of us weren’t attracted to the medicine because of analytical research indicating that it is effective. To some extent, it’s a gut level reaction. Or you could say that it’s a spiritual attraction - whatever you like.
I find, though, with my dual background in Western philosophy and Western science, I simply can’t let the matter lie. Believe me, I’d rather it be any other way. So, I’m going to attempt to unpack this issue - it’s going to take some time. It’s going to take a lot of reading and a lot of thinking and I’m not even sure what kind of result I can expect. I want to make it abundantly clear that I fully believe that Classical Chinese Medicine *does* stand on its own two feet, that it is deeply rooted in a science that needs no independent verification. I simply want to understand, for myself, what that means. In a sense, for me, this (long) journey will be an intellectual exercise. Perhaps an important one. We’ll see.
In a preliminary way, I can imagine that my exploration is going to have to go over some of the following terrain:
1. What is the nature of Western science as it is currently practiced? Essentially, what assumptions does Western science take for granted and how are they being challenged? My sense is that I’ll have to look pretty deep into the gaping maw of materialism in this part of my journey.
2. How do modern research standards grow out of the above assumptions? How are they independent from them? How have modern research standards evolved and how are they currently evolving?
3. How can the ideas of a non-material essence to the human being come back into acceptance by science? Is that desirable or necessary? What would that mean and what are the philosophical and practical implications?
4. Is there merit to the assertion that the scientific system that grows out of one world view cannot be adequately assessed or criticized by the scientific system that grows out of another? If so - what does this mean for an increasingly globalized world where many different worldviews are forced to interact?
5. What produces the most favorable patient outcomes and how would we measure those outcomes?
I’m going to have to look into a lot of disciplines in which I don’t have much expertise. That’s okay with me. I’ve come to accept that in any endeavor, there’s probably someone who knows more than me. That’s the benefit of this kind of public dialogue - lots of folks can contribute.
I’m interested to hear your thoughts in the comments.
Eric
Tags: Acupuncture, chinese-herb, classical-chinese-medicine, integrative-medicine, philosophy, philosophy of science, Theory, western research, western-scienceRelated posts
Integrative medicine: What is the purpose of two kinds of medicine interpenetrating?
At NCNM, we learn Western medicine as part of our Classical Chinese Medicine education. Part of that is simply because a working knowledge of biomedicine is necessary for licensure. Part of it is because it’s good to be able to talk to Western physicians and Western educated patients about things that they can easily understand. Part of it, for some people, is more than that. Our Western classes are, for the most part, taught by Naturopaths. These are folks who are already in deep dialogue with contemporary Western medicine since they represent both its past and its future. So it is natural for them to try to help us see how Chinese medicine and Western medicine theory can come into conversation.
This has been the effort of integrators in Chinese medicine for a long time. A slapdash and ill-informed effort to accelerate the conversation resulted in TCM, narrowly defined. The idea is interesting, truly. In theory, we are all talking about the same thing just emphasizing different portions and using different language. In the West, I think we are particularly interested in explaining Chinese medicine concepts through our own language because we seem to have such a hard time understanding other people’s languages. Materialism and dualism are powerful mind altering substances, to be sure - they make the mind cloudy.
But what, really, is the potential benefit of describing Chinese medicine concepts in Western medicine terms - and vice versa? What could be gained by melding these two medicines together? I already know the dangers. The most persistent danger and the one that has been most roundly realized is the possibility that Western medicine will come to dominate the relationship. In this way, Chinese medical professionals will be mandated to learn well everything in Western medicine - Chinese medical research will be required to meet Western standards. The parts of Chinese medical theory and practice that don’t fit easily into a Western context will be discarded. The reverse will not be true. Or, at least, it hasn’t been.
So what is to be gained by this relationship and how can we avoid, or counteract, the negative forces inherent in it? I’d love to hear your thoughts. I am well aware that there are examples of good interactions between the two medicines and I’d like to hear your stories concerning them.
Eric
Tags: chinese-medicine, integrative-medicine, Theory, traditional-chinese-medicine, western-scienceRelated posts
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