History of Chinese Herbal Medicine
Why should I use Chinese herbal medicine?
How does the Chinese herbalist construct a formula?
Can Chinese herbal formulas replace western drugs?
Are Chinese herbs safe?
What about drug/herb interactions?
Raw Herbs, Powders, Tinctures and Pills
A Brief History of Chinese Herbal Medicine
As one of the main branches of Traditional Chinese Medicine (TCM), Chinese herbal medicine's origins are found many millenniums ago in shamanic or folk traditional medicine. It became formalized during the Han dynasty in China (200 BCE to 200 CE) when several important herbal texts were written. In the first century of the common era the Divine Farmer's Materia Medica, the first herbal text was compiled that classified individual herbs and listed their medicinal function. This text is the archetype for the Chinese tradition of herbology. During the forth century of the common era, the most celebrated classic of herbal prescriptions was written, the Treatise on Cold Damage and Prescriptions from the Golden Cabinet. About twenty percent of Chinese herbal prescriptions used today come from these two texts, which stress combining acupuncture with medicinal herbs. By 225 CE herbal anesthesia was being used for surgical operations. [History of Chinese Medicine]
Chinese herbal medicine has continued developing since then. Modern physicians rely on Chinese herbs for treating an array of clinical conditions ranging from headaches, allergies, colds and flu, digestive disorders, gyn conditions, dermatological conditions, traumatology, and chronic disease such as Parkinson's disease, hepatitis, cancer, HIV and AIDS . Whereas convention medicine uses drug therapy to treat pain and disease, Chinese medicine utilizes classical herbal formulas to address both internal and external health conditions. <BACK>
Chinese Herbal Formulas:
Why Should I Use Them?
Chinese herbs work synergistically with acupuncture. Used safely and medically for over 2,000 years, Chinese herbs have minimal side effects when prescribed correctly by a trained herbalist. What makes Chinese herbs particularly safe and effective is the art of combining herbs to form a carefully balanced prescription, or herbal formula. (Chinese herbs are rarely taken individually.) These individualized formulas not only treat the patient's main, presenting problem but also address associated, secondary problems.
Chinese herbal formulas are based on standard, classical prescriptions that have been tried and tested through millenniums of clinical use, and are modified to fit the individual needs of the patient. The herbalist modifies the prescription by taking out unnecessary herbs or those with redundant functions and adding herbs to address any additional symptoms the patient has.
Nourishing and harmonizing herbal formulas serve as excellent tonics, strengthening those weakened by overwork, serious illness, childbirth or poor diet and irregular eating. Herbs with a cooling action can counteract fevers, night sweating and hot flashes. Similarly, herbs with a warming action can help those who feel cold. They work on the mind (shen, in Chinese) as well as the body, treating stress, anxiety, depression and insomnia. Herbs can be used for acute and chronic conditions, e.g. colds, allergies, digestive disorders, menstrual conditions, rashes and pain . <BACK>
How does the herbalist construct a Chinese herbal formula?
The medicinal use of each Chinese herb is determined by the herb's properties, therapeutic functions and by the herb's ability to influence certain channels (where Qi flows) or organs. TCM herbalists combine herbs to form synergistic pairs that enhance their common herbal function. They also include herbs with different therapeutic functions when designing formulas to treat a particular complexity, or subtlety in a patient's condition.
One to three of the herbs in the formula are considered the ‘chief' herbs that direct the formula to treating the main symptom or problem. Additional herbs are called ‘assistant' herbs. Assistants support the chief herbs in treating the main problem and perform other necessary functions or treat additional symptoms, that are not addressed by the chiefs. Assistant herbs help the body to absorb and assimilate the herbs ingested, and counteract any potential adverse side effects that could be caused by the more powerful herbs used.
Often a third type of herbal function is used in the formula, called the ‘envoy' or ‘messenger herb'. Envoys direct the formula to the particular area of the body requiring treatment, such as the back, knee or chest. Envoys are particularly useful in pain formulas. For example, certain herbs hone to the forehead, top or back of the head, a useful function for treating headaches. <BACK>
Can Chinese Herbs Replace Western Drugs?
Yes. Many conditions treated by western drugs can also be successfully treated with Chinese medicine. Examples include: hypertension, headaches and pain conditions, fibromyalgia, allergies and sinus infections, acid reflux disease, bowel problems (IBS and Crohn's disease), bladder infections , herpes, skin conditions, menstrual cramping, Perimenopausal syndrome , Parkinson's disease, insomnia, anxiety and depression. Patients and their physicians are often discouraged by the undesirable side effects of western medications, or the prospect of having to remain on these drugs for long term periods. Especially for chronic conditions, Chinese medicine often offers superior clinical results and longer lasting treatment than does conventional medicine. When beginning TCM treatments, patients on western drugs may continue taking their medications. As the condition improves, they begin titrating (weaning) off the drug under their prescribing doctor's supervision. Once they are completely off the drug and symptom free, the patient is released from regular TCM visits. <BACK>
Are Chinese Herbs Safe?
The minimization of side effects while maintaining clinical efficacy is the chief benefit of Chinese herbal formulas. While strong medicine, Chinese herbs are slower acting than drug therapy. Their comparatively gentler action reduces the potential for side effects drugs cause. Using single herbs require higher dosages to achieve therapeutic effect, thus increasing potential of side effects. By combining herbs with similar functions that moderate each other's actions into an herbal formula, Chinese herbalists are able to the lower the dosages of individual herbs so to minimize the likelihood of side effects. Although rare, when side effects do occur they are generally limited to gas, indigestion or changes in bowel habits and will stop when the herb's use is discontinued. To prevent future recurrence, the TCM herbalist can modify the formula by adding herbs that improve digestive function in order to counteract the harsh property of the herbs. <BACK>
What about interactions between drugs and herbs?
Because drugs are strong, powerful medicine, they have a tendency to negatively interact with each other and with other substances, such as food or herbs. What causes interactions is a biochemical process described as competition for binding sites on cells. Cells have something called binding sites that enable them to absorb substances and nutrients through the cell wall into the interior cell body. Each cell has a limited number of binding sites that substances can lock onto in order to pass through the cell wall. When many different substances try to gain entrance to the cells simultaneously, they flood the available binding sites and are unable to get in. This causes problems of interactions. Taking herbs and drugs two hours apart from each other will usually eliminate the cause of this scenario. The interval allows one substance to use the available binding site to gain entry to the cells. After the substance passes through the cell wall the binding site is available for a second substance to be ingested by the cell; therefore, interactions do not occur.
Though in the majority of cases it is safe to combine western drugs with Chinese herbs, there are exceptions to this rule particularly in the case of drugs with narrow therapeutic margins, such as Cumadin. These drugs have a small dosing range that can easily be affected by changes in body chemistry. In this case, the introduction of Chinese herbs will affect the dosing of the drug. Actually, there are herbs that can be combined successfully with Cumadin; however, in these instances the prescribing physicians (conventional doctors and TCM practitioners: acupuncturists or Chinese herbalists) should work together to insure patient safety. <BACK>
Raw Herbs, Powdered Herbs, Pills and Tinctures
Herbs come in many forms, and patients should work with their herbalist to determine their optimal delivery method. Traditionally in China , herbs were made as teas, or herbal decoctions (a.k.a. raw herbs). The individual parts of plants, minerals or shells are simply cut and dried in preparation for decoction and storage. The herbalist weighs out each ingredient individually, and prepares a packet of ‘sticks and twigs' for the patient to brew at home into a tea. The patient drinks one cup of tea twice a day, and a packet lasts for two days.
In modern times other forms of processing herbs have become available. The dried, bulk herbs can be processed into a concentrated powder (a.k.a. granulated herbs, or granules). The herbalist still doses and weighs out each herb individually, giving the patient a container containing the powdered herbal formula. The patient mixes the powder with warm water, taking the herbs two or three times daily. Herbs can be extracted in alcohol to make an herbal tincture. The patient places a few dropperfuls of the tincture in warm water and drinks the solution. Another common form of herbal delivery is pills. In this case, herbal manufacturers process commonly used herbal formulas into tea pills or tablets. The formula is decocted, concentrated and mixed with a binder to form the pills. Traditionally, the raw herbs were powdered and mixed with honey to form pills.
Raw herbs (teas) are the most common and traditional way for herbs to be delivered in China . They are also considered to be the most effective form. However; though many satisfied western patients cook and drink these teas, some don't like the herbs' earthy or malty flavor, others do not want, or lack facilities to cook the herbs twice a week. Granulated (powdered) herbs generally satisfy these concerns. They are not quite as strong or powerful as the raw herbal teas, but they are a common delivery method and offer satisfactory results. Tinctures, though convenient, are less easily individualized or modified by the herbalist, so are not as precisely targeted as the raw and granulated herbal formulas. Many Chinese herbalists object to the alcohol extraction method. Finally pills, while tasteless and easily swallowed, cannot be individualized and therefore are more broad-spectrum and less specifically targeted than the individualized raw or powdered formulas. In addition, because the pills are small, the patient must swallow a large number of them several times a day to achieve a therapeutic dose near to that of raw herbs. So pills are weaker and less effective than the other forms of herbal preparation.
In addition to taking herbs internally, herbs can also be delivered externally in the forms of soaks, liniments and plasters, or even herbal suppositories. External herbs are used to treat skin conditions, traumatic injuries and muscle or joint pain.
Asheville Center for Chinese Medicine has a large herbal pharmacy of over 250 herbs in both raw and granulated forms. If needed, herbal tinctures and pills may be special ordered. Kath Bartlett, MS, LAc will work with you to determine the herbal delivery method that best suits you and your lifestyle. <BACK>