The Herb in Traditional Chinese Medicine

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The Herb: Traditional Chinese Medicine’s Catalyst of Harmony


Traditional Chinese Medicine (TCM) utilizes medicinal herbs as the predominant catalyst in the effort to hone and nurture wellness. The primary focus of TCM is directed upon obtaining and sustaining balance between Yin and Yang as manifested within the human organism. Illness is caused when there is an imbalance, called disharmony, between these forces. When this occurs, the methods of TCM are aimed at identifying the source of the disharmony and then restoring the organism to proper balance. This is done through a concise step by step procedure in which the entire lifestyle, diet, and appearance of an individual are taken into account when searching for the possible causes of the Yin/Yang imbalance. Once a disharmony is distinguished, medicinal herbs are used to assist the body in regaining its ideal equilibrium.

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By Wade Shepard of http://www.VagabondJourney.com

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This study was conducted with the idea of conciseness and brevity as an ever-present frame. It is simply not possible to project the entire ebb and flow of Traditional Chinese Medical philosophy, as manifested through Herbology, in a report of this length. I simply intend to give a brief overview of the basics TCM philosophy, its approach towards medicinal herbs, how a TCM diagnoses is reached and, subsequently, how an herbal prescription is created. If any thing that is mentioned is unclear nor completely through please resort to the footnotes for direction on obtaining a fuller analysis. According to TCM, and subsequently Yin/Yang, theory, everything in the universe is mutually dependent upon everything else; to point at a single tree is to include an entire forest. I can only hint at this range of depth in this study.

Yin/Yang theory asserts that all things in the universe (including the universe itself) have intrinsic qualities that can be attributed to either Yin or to Yang. The archetypical modal of Yin/Yang phenomena is the division of two sides of a mountain; in which one side is hidden in shade (Yin) whilst the other is in basked in sunlight (Yang). Yin and Yang properties work to balance each other through oppositional support- very much like a scale that has weight distributed equally on both sides. Yin is designated to entities, phenomena, and states that have qualities that are generally dark, solid, cold, slow, smooth, and passive. The moon, heart, winter and women are examples of manifestations that have dominant Yin properties. The Yang designation is placed upon phenomena that show attributes that are bright, warm, hollow, dynamic, and active. Examples include the sun, summer, kidneys, and men. Even though certain entities are designated as either Yin or Yang they also have inherent qualities that are of the opposing designation. Meaning that a Yin entity has certain Yang properties within it and a Yang entity will invariably have some Yin qualities. In this way, balance is achieved microcosmically, within an organism and, macrocosmically, within the interplay of all entities; in which Yin and Yang forever roll onwards into an equalized infinitude.

Yin/Yang theory can be shown in the example of a dog chasing its own tail. The dog’s head and tail are at opposite extremes but they act together to make up the whole dog. The entire universe is arranged in the same manner: all entities are thoroughly dependent upon all others; everything is one contiguous everything- nothing is autonomous. The dog chases the tail only to find that it is the tail. Yin and Yang, therefore, cannot be separated from each other and, in essence, are each other. The whole is nothing other than the elemental balance of oppositional forces and oppositional forces are nothing other than the balanced whole. In the Tao Te Ching Lao Tzu proclaims:

The whole world knows the beautiful as beautiful
Only because of the existence of the ugly;
The whole world knows the good as good
Only because of the existence of the bad.
Hence Being and Nothingness exist in opposition;
The difficult and the easy complement each other;
The long and the short
manifest themselves by comparison;
The high and the low are inclined
as well as opposed to each other;
The consonants and vowels
harmonize with each other;
The front and the back follow each other.

Traditional Chinese Medicine theory views illness as the outward manifestation of imbalances within an organism’s Yin/ Yang interplay. These imbalances, which are referred to in TCM as disharmonies, arise when the conditions in which an organism lives cause its Yin or Yang to either become excessive or deficient. The causes of these disharmonies are manifold, and include environmental, emotional, dietary, psychological, and interpersonal factors of such magnitude that I cannot fully explain them within the bounds of this study; nor is it necessary for me to do so. The particular Yin/Yang imbalance which brings upon illness is usually present within an organism long before there are obvious signs of sickness. Therefore, it is in accordance with the ideas of TCM for one to continuously nurture their Yin/Yang harmony with the use of medicinal herbs. The Hangzhou stationed TCM practitioner, Dr. Greg Livingston, elaborated this
fact in an interview that I conducted with him in March of 2006:

Yin Yang theory is integral to all aspects of TCM. As for herbology, this is an extremely complex question because it encompasses the herbs themselves, diagnostics, and treatment. Herbs themselves have properties and functions which can be classified as either yin or yang. In the simplest terms, when treating patients, conditions which are more related to yin are treated with herbs more belonging to yang, and vice versa. This is however, an extremely simplified explanation, but is the fundamental idea.

A medicinal herb is commonly defined as any plant (or portion of) that can potentially be used to promote health in the human organism by preventing, soothing, and alleviating ailments and disease. But the delineation of herb does not end with just plants, as there are many other substances which are not derived from floral materials that are also considered to be herbs. Dr. Greg Livingston, puts it as such:
An herb is any naturally occurring substance that can be used medicinally.

The word herb implies a plant derived substances, but in fact includes plant, animal, and mineral substances. There are around six or seven hundred herbs that are commonly used in TCM. One of the main efforts of herbal discovery was conducted in the fourth century B.C. by a sage named Shen Nung; who walked through the hills of China tasting, cultivating, and, most importantly, recording the impacts and properties of thousands of herbs. The line between an herb and a food is very fine and, in the context of TCM thought, almost impertinent. According to my understanding, the delineation of “herb” is more of a practical label derived from way a substance is utilized and its medicinal strength rather than the actual physical makeup of the substance. Therefore, an herb can be used as a food and a food can be utilized as an herb. The particular ways in which herbs are combined and utilized will be breeched latter on.

Herbs have the same Yin/ Yang properties as all other phenomenon and, if ingested by another organism, they have the unique ability of being able to share their particular qualities. The herbal material is absorbed by the body’s “digestive, respiratory, and cutaneous tissues. They [then] reorganize the body constituents (Qi, moisture, and blood) within the Organ Networks and oust the Adverse Climates [disharmonies].” This, in turn, affects the organism’s Yin/Yang balance in relation, and in proportion, to the properties of the herbal combination that is ingested.

Therefore, herbs which have a lot of heat (Yang) are typically used to treat excessive Yin or deficient Yang conditions. In simplistic form, the herb’s Yang properties, upon ingestion, are transferred to the individual and, consequently, rises its Yang to a level where it would again be equal to its Yin. The same is true for conditions in which cold (Yin) herbs are needed for re-harmonizing excessive Yang and deficient Yin. I stress that this is a highly simplified modal of how herbs effect an individual’s Yin/Yang levels. The actual practice of herbology is highly complex and involves combinations of multiple herbs of varying properties to treat even the simplest of disharmonies.

According to the great Traditional Chinese Herbologist, Geng Junying, there are four main property classes by which herbs are organized. The first of these classes is called the four energies and five tastes which indicates an herb’s outward temperature and taste qualities. The second is labeled ascending, descending, floating, and sinking which indicates the direction that the herb influences the ingester’s Qi to flow. The third category is called herbs entering the meridians which delineates a particular meridian or organ that an herb is intended to act upon. The last is toxicity or non-toxicity which divides herbs based upon wether they are, ultimately, toxic to humans. These categories are reductionistic in style and serve the function of funneling down the multitude of herbs into an accessible context. For example, a particular herb may be filtered through each of these four categories and end up with a specified designation of being cold, sweet, sinking, non toxic, and liver impacting.

The “four energies and five tastes” classification is, as aforementioned, aimed towards categorizing herbs based upon their immediate sensory qualities. The four energies are hot, cold, warm, and cool. According to Junying, “These terms describe the therapeutically significant, energetic characteristics of herbs and their actions.” The five tastes separate herbs base upon their taste properties. The designations are sour, bitter, sweet, pungent-spicy, and salty. This labeling system refers directly to the herb’s obvious and perceivable properties; this is in no way an abstract synopsis. If a particular herb is classified as being cold it is because it is cold, if an herb is classed as being bitter it is because it is bitter. These herbs act upon an organism in accordance with their nomenclature- a cold herb has the effect of cooling, adding Yin to, a body. The meanings of such labels hold the same standing throughout the entire stream of Chinese medical thought and philosophy. The heat of summer is the same as the heat of cooking. This system of categorizing takes all phenomenon as being on the same scale and interrelated. As to this point, Dr. Greg Livingston stated that, “a substance’s form is its function, its properties are its nature.”

In the second category, the impact which an herb has upon an individual’s Qi flow is segmented into the following four classes: ascending, descending, floating, and sinking. An herb that influences a body’s Qi flow to move upward (ascending) will, “promote sweating, raise Yang, cause vomiting, and open the orifices.” Whilst descending herbs move the Qi downward and, “promote urination and defecation, subdue Yang, and calm the mind.” Herbs that influence floating or sinking tendencies are often times porous and lightweight and, again, show how a substances physical make up affects its internal function.

Herbs that enter specific meridians are those that are chosen to act directly upon a particular part of the body that needs to be harmonized. For example, if someone had a disharmony that could be traced back to the kidneys, an Herbologist would prescribe a combination of herbs which would impact the Yin/Yang balance of that specific organ system (in TCM all organs are connected to other organs and the reharmonizing of one, invariably, means that others also need to be impacted). This category serves the function of delineating herbs based upon what specific body function they affect. In my interview with Dr. Greg Livingston he explained the “herbs entering specific meridians” classification as follows:

This [herbal classification] can be viewed in two ways. One is that the
herbs effect a particular part of the body, which in turn is related to the
distribution of a particular meridian/vessel. In other words, an herb that
treats flank pain may be said to enter the Liver vessel because that vessel
is related/distributes to that area of the body. The other way to understand
this is that the herb affects that particular organ. So an herb that enters the
Liver vessel affects the Liver and its associated functions.

The final class by which herbs are organized is based upon whether an herb is toxic or non-toxic. While most herbs fall into the former category, many herbs that are commonly use in TCM are, ultimately, toxic to the human body. TCM theory regularly places entities on relative scales in which a certain substance is placed at the center as a base and other comparable entities are place upon the scale at proportionate intervals according to their deviation from the center substance. For example, lets say that the toxicity scale has rice at the center; all other herbs that are placed upon this scale will be relationally based off rice in proportion to their toxicity or non-toxicity (this is very much like the western Ph scale). So cinnabar, which is has a high mercury content and is, consequently, very toxic, will be placed towards the toxic end of the scale whilst oregano, a cooking herb that is very non-toxic, will be placed towards the benign side.

The reasons for using toxic herbs are multiplex and their actual impact upon the body is far too deep to go into here, but they are usually used when a patient needs a particularly strong herbal combination. An example of this are patients who undergo TCM therapy to treat diseases such as viral hepatitis. Toxic herbs may also be used in cases in which the body needs to starve out particularly strong ailments. When I asked Dr. Greg Livingston about the, seemingly paradoxical, reasons as to why substances that are toxic to the human body are used as medicine he answered as follows:

They [toxic herbs] are used because of their therapeutic effects. Some herbs that have good effects also happen to be toxic. It can also be that the toxicity is in some ways related to its therapeutic effect, but not necessarily. Many pharmaceutical drugs are also, to varying degrees, toxic. But they are used because they have effects that can only be achieved by using them. Most
Chinese herbs are not toxic. When toxic herbs are used they are generally prepared in ways to reduce their toxicity and are almost without exception combined with other herbs that will minimize any deleterious effects from the
toxic herbs.

I then asked him if, owing to the nature of toxic herbs, they are utilized differently than non-toxic ones. He answered this question as such:

. . . yes and no. Different because they are used sparingly and only when
necessary. No, because when they are indicated for use, they are used, just
like any other herb. In fact, even a non toxic herb can be toxic if it is
not suitable for a person, just the way a relatively benign pharmaceutical
drug could be toxic to someone who it was not appropriate for. Finally, one
of the things that separates the great TCM doctors from the not-so-great is their
use of toxic herbs. Because their effects tend to be strong, they are often very
effective, but they have to be dosed in a very appropriate way- too much will
lead to side effects, but not enough will lead to inferior results. They are very
tricky to use well.

For conditions of disharmony that require herbal treatment, the practitioner of TCM will usually prescribe a mixture of herbs rather than just a single variety. Kendall explains the general process of herbal combination in his book the Dao of Chinese Medicine; an excerpt of which follows:

Herbal remedies can consist of a single ingredient, although most formulas contain several herbs. Formulas are derived from the main therapeutic effect of the key herb. Other herbs are added to harmonize the ingredients, enhance the effect of the remedy, or improve its palatability. Typical formulas may contain four to eight different herbs. Normally, a particular remedy is boiled down with a certain amount of water to produce a decoction. The solid remains are removed and the concentrated remaining liquid is taken orally.

The mechanics of combining herbs is a science in itself and requires the TCM doctor to know, not only the individual properties of each herb but, how they complement and effect each other once combined. It is my understanding that the TCM doctor must approach the Yin/Yang balance of these herbal decoctions very much like he would treat that of the patient- as the two will become one upon ingestion. He should attempt to compliment a patient’s Yin/Yang disharmony with an herbal combination that is the conversely related to it- so that Yin deficiencies are boosted with Yang or so Yang deficiencies are leveled with Yin. Therefore, the patient’s disharmonies are returned to proper balance; which is the integral motive behind TCM’s ideal of wellness. Dr. Greg Livingston explains the typical strategy behind TCM herbal combinations:

Herb formulas are very strategically constructed. There are four types of herbs in a formula: sovereign, minister, assistant, and courier. The sovereign performs the principle action of the formula, addressing the main pattern. The minister provides direct assistance to the sovereign. The assistant addresses secondary patterns or reduces the toxicity or harsh qualities of the sovereign. The courier makes the other herbs act on the desired part of the body or harmonizes the other herbs. There can be one or more of each type in a formula.

The use of herbs in Traditional Chinese Medicine is an extremely subtle practice which requires the doctor to take a patient’s entire lifestyle, body, and environment into consideration when constructing a remedy. The TCM doctor, in effect, acts as a grand manipulator as he constructs herbal combinations to compliment and alter the Yin/Yang disharmonies of actual human beings. The herb is the medium by which this holistic interplay is carried out and, in this way, acts as a catalyst for wellness.