Chinese Herbs


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	Chinese Herbs History and Background of Chinese Herbology Traditional Chinese Medicine (TCM) was introduced into America by James Reston's account of his acupuncture analgesia during an emergency appendectomy in Beijing, while he was covering the Sino-American ping pong tournament in 1971. His account, on the front page of the New York Times was the first popular account of Chinese Medicine to reach the mass media in America. There were Chinatowns and practicing acupuncturists and herbalists in many major American cities, especially on the West Coast, but there was little public awareness of Chinese Medicine until that report. President Nixon's visit to China with his personal physician in 1972, and the visit of three American physicians in 1971, added credence to Chinese Medicine with a positive report in JAMA on several observed surgeries using acupuncture analgesia. The history of TCM in China goes much farther back. The roots are probably from the natural and folk medicine practiced during the Warring States period (475-221 B.C.) of the Zhou dynasty (1027-221 B.C.). The first classical book on Traditional Chinese Medicine was the Huang Di Nei Jing (The Yellow Emperor's Classic of Internal Medicine) and is ascribed to the Yellow Emperor - Huang Di, with its nucleus being written in the first century B.C. during the Han dynasty. It is presented as an 81 part dialogue between the Yellow Emperor and his private physician, Chi Po. The book is in two sections: the Su Wen (simple questions), which deals with preventative medicine and Chinese medical principles; and the Ling Shu, which deals with therapeutics. There are over 10,000 ancient Chinese medical treatises surviving from previous centuries and each have had their share of influence as Chinese medicine has evolved and matured over time. The introduction of Chinese medicine into Japan, Korea and South East Asia, starting in the sixth century A.D., led to a regional and secular approach to Chinese medicine that was specific for each country that embraced the medical system. This development of Chinese medicine continues to this day in France and the United States. The Language of Chinese Medicine Chinese Medicine is somewhat simplistic in the language it uses for diagnosis. The diagnosis is not the name of a disease, but the description of a pattern that seems to be pre-eminent in the whole person. The Chinese Physical Exam is able to show a predominant pattern of imbalance in the patient, which in the Chinese physician's eyes, is the disease to be treated. Many dissimilar Western diagnoses will have similar Chinese patterns of disharmony, and many similar Western diagnoses will have different Chinese patterns of disharmony. The language and concepts of Chinese medicine describe the ways we get out of balance. The most important issue in the Chinese way of thinking about disease is not, is X causing Y, but what is the relationship of X to Y? In order to differentiate these patterns we have to learn the language of these patterns under the headings: The Eight Diagnostic Principles, The Six Evils and The Five Fundamental Substances. The Six Evils act as stressors on the body, and produce a reactive change in the Chinese Zang-Fu Organs and the Five Fundamental Substances, to produce a bodily response called "The Pattern of Disharmony" - the illness or imbalance, represented as a mixture of the Eight Diagnostic Principals. Identification of Patterns The identification of patterns underlying the basic imbalance or disharmony in the patient is the most important "diagnostic" activity in Chinese medicine. This activity is very consistent with Chinese philosophy where relationships rather than causes are of paramount importance. The Eight Diagnostic Principles *The Eight Diagnostic Principles are:* 1. Yin and Yang 2. Cold and Heat (Wet/Dry) 3. Interior or Exterior 4. Deficiency and Excess When we look at a patient in TCM we need to define the patient in reference to each of the paired four diagnostic principals. We will address the clinical presentations of these paired concepts and then go on to understand the concepts of the external factors that cause disharmony - the six evils and lastly the constituents of the body - the five fundamental substances. 1. Yin and Yang Yin/Yang is a symbolic representation of the universe that embodies the concept of change, relationships, patterns, process or flow from one concept into the other, at all levels of existence. Yin and Yang can only be defined in relationship to each other. This relationship is seen graphically in the Yin/Yang symbol, where Yin gradually turns into Yang, but even when Yang is full, it still has a small dot of Yin contained within it. The same is true of a full Yin. Another way of looking at it is that a part can only be understood in relationship to the whole. Yin and Yang are two convenient polar opposites that are used to explain how things function in relation to one another and to the universe. No entity can be seen in isolation; no thing exists apart in of itself - there are no absolutes. Everything in the universe has two aspects to its nature – a Yin and a Yang aspect. The qualities of Yin and Yang are polar opposites. Clinically, Yin and Yang are related mostly to the two elements, which in combination, permit life to exist on this planet - that is sunlight or heat, and water. Yin is cold, wet and dark; Yang is hot, dry and light. Practically speaking, Yin and Yang are not all that important when trying to establish a pattern of disharmony in a particular patient, but relate more to the deficiency or excess of Yin or Yang in relationship to each other, that will place the patient's biology into a particular pathological state (Table 2). It is therapeutically more important to address the patterns of Heat versus Cold, Wetness versus Dryness and Excess versus Deficiency. The importance of exterior versus interior is mostly related to the depth of invasion of the pathogenic principle in the patient - exterior disease is less harmful than interior disease. 2. Heat and Cold The concepts of heat and cold define two important states of bodily imbalance. Most diseases or symptoms may be hot or cold. For example, acute rheumatoid arthritis is hot because the joints feel hot and look red, while osteoarthritis is cold, because it has none of the heat symptoms. One can have a headache that is either a cold or a hot pattern, usually differentiated by the general pattern of the patient as well as the observation that the pain is better by application of ice, in the case of a heat pattern headache, and a hot water bottle in the case of a cold pattern headache. A female patient with a leucorrhea that is abundant, watery and pale or white has a cold pattern, while a thick, yellow, smelly leucorrhea is a heat pattern. Some patients will have mixed patterns that are difficult to treat - the patient who has an overall cold pattern - feeling chilled and wants warm drinks - but has pneumonia and is coughing up thick yellow sputum - a heat pattern. In general, dryness is usually associated with, and is a major symptom of heat, but may be caused by other factors such, as Blood deficiency. Heat patterns tend to be easier to treat because they represent a vigorous reaction on the part of the patient's immune system. These patterns are seen classically in children who are able to spike a fever and look heated in the face, with rosy cheeks, in no time at all. This represents a good response to the invading principle and should not be suppressed with antipyretics. In the last five years I have noticed that this pattern of response has become less and less apparent especially in adults, and the relationship to most viruses, for example, has been a cold response. This indicates either a fundamental virulent change in the viruses we see, or a decrease in the general immunity of the populace, or both. 3. Wetness and Dryness Wetness or dampness is a condition where the body fluids congest and accumulate in the body. Dryness is the opposite condition, where body fluids are lessened. Dryness is often a symptom of heat, as heat will dry up the body fluids. Dryness is readily apparent if we look at the skin and mucous membranes, which have little moisture. Wetness however, also relates to not so obvious wet conditions such as sinus congestion and peripheral edema. 4. Excess and Deficiency One can consider excess and deficient conditions either as a general state of the patient or as an excess or deficiency of a particular bodily fluid, energy or appearance. In deficiency conditions the bodily functions are weak or under-active. In excess conditions, the bodily functions are overactive, or there may be obstructions, stagnations or accumulations of substances in the body that are in excess. Let's look at the more general concept with a clinical example. Two men telephone the clinic on a Friday afternoon during the flu season with a report of low grade fever, muscle pain and sore throats. Neither can come in at that time so both elect to be seen on Monday. On Monday morning both have become more invaded by the pathogen and present with bronchopneumonia with cough and copious sticky yellow sputum - a heat condition with dryness. Neither wants to be treated with Chinese herbs and both are given an appropriate antibiotic - a cooling substance. They are asked to come in for a check on the following Monday. The first patient has cleared the cough, has no sputum, fever or lung sounds, while the second patient has developed a chronic dry cough, with fatigue and shortness of breath. The first patient had an excess condition that was easier to treat and cleared up on the antibiotic; the second patient had a deficient condition for which the antibiotic was not sufficient, as it did nothing to tonify his weak lung Qi (cough and shortness of breath) and his overall low Qi as seen by his fatigue. The issue in these two patients is the strength of the invading pathogen versus the susceptibility and response of the patient. When they are mismatched and the invading pathogen too strong, or the response too weak and the patient super susceptible, then the disease will not be cleared and become chronic as evidence of the patient's underlying deficient condition. The most important indicator of a deficient condition or deficient pattern is that they are chronic and the symptoms do not clear within 7-10 days. These patients need Chinese Herbs to correct the underlying imbalance or deficiency. Your Chinese Pattern When selecting a Chinese Herb to treat your imbalance or pattern, it is important to know whether your picture is hot or cold, wet or dry, acute or chronic, because your picture will tell you which product to use. If you are hot and dry, you need a cold and moisturizing herbal mix and vice versa. The clinical descriptions describing the imbalance under each product will tell you which product is right for you.