Herbology is the oldest and arguably the most comprehensive branch of Chinese medicine. When Westerners consider taking herbs, most will go to their local nutritional supplement or natural foods store and ask for help from the staff. They might be given echinacea for a cold, St. John’s wort for depression, ginger for an upset stomach, black cohosh for a menstrual difficulty, or valerian for insomnia. This isn’t a bad thing, as those herbs are often a better choice than a drug alternative. Many Western herbalists and naturopathic doctors (NDs) use this approach, even when creating herb formulas. However, results can vary considerably, and the desired improvement might not occur, possibly leading one to believe that herbs are ineffective. This is not due to a problem with the herb itself but with the rationale behind how it was selected and administered.
That approach follows the Western pharmaceutical/allopathic model, where one drug is used to treat one symptom or disease. That is, it’s the disease that is being addressed, not the individual who has the disease. Even though a natural substance is being substituted for a drug, this is not really a holistic approach. As you’ve seen, there are many possible root causes for any symptom. If the root imbalance, the pattern of disharmony, isn’t addressed, the person is not brought back into balance. Some symptoms may improve, some may not, and others could get worse (See Appendix 2, Note 14.1), while the pattern remains unchanged, setting the stage for future occurrences of the same problem.
The following introduction provides insight into the main criteria and methods used in Chinese herbology, from analyzing and categorizing individual herbs to constructing herbal formulas. This is a completely holistic application of herbs as medicine.
Main Attributes of Chinese Herbs: Temperature and Taste
There are two primary characteristics that define Chinese herbal properties. They are temperature, also referred to as Qi, and taste.
All herbs, and in fact all ingestible substances, can be analyzed according to temperature. In common experience, everyone understands that pepper is hot and mint is cool. Chinese pharmacology recognizes five temperatures along the hot-cold spectrum: hot, warm, neutral, cool, and cold. Sometime qualifiers are noted to hone degree, such as slightly cold or slightly hot. The most obvious use of this understanding is that hot herbs are used to treat cold diseases, and cold herbs are used to treat hot ones. (See Appendix 2, Note 14.2.)
The second characteristic all herbs and consumables have is taste. Herbal medicine recognizes five primary tastes that correspond to the Five Element tastes—spicy (acrid), sweet, bitter, sour, and salty—along with a neutral taste, bland. An herb may have more than one taste.
The tastes may indicate the organ or organs that the herb most readily influences, and each has additional therapeutic effects. Spicy has an affinity for the Lungs and Large Intestine and makes Qi scatter and move. That Qi movement can direct various accumulations to scatter or can direct fluids like blood and sweat to move. Sweet has an affinity for the Spleen and Stomach, tonifies Qi, and harmonizes and sometimes tonifies Yin to promote moistening. Sweet also slows and moderates the effects of harsh herbs. (See Appendix 2, Note 14.3.) Bitter has an affinity for the Heart and Small Intestine and produces drying and draining effects. Sour has an affinity for the Liver and Gall Bladder, is astringent, and restrains or prevents leakage of fluids or Qi. Salty has an affinity for the Kidneys and Urinary Bladder, softens hardness (such as cysts), and purges. Bland does not have a definitive organ affinity, although based on its function, which is to leech out Damp and promote urination, some sources say it has an affinity for the Spleen, the organ most sensitive to Damp.
Some herbs have specific directional qualities and are able to address targeted locations in the body through differing means.
Some physically heavier substances are not herbs at all but bones, shells, and rock-like minerals that are part of the Chinese pharmacopoeia. Their heaviness imparts a weighty, descending quality that is used to subdue inappropriately rising Qi, Yang, or Heat, which can disturb the Heart and cause anxiety, palpitations, and insomnia. Accordingly, many of these heavier substances are found in the category “Settles and Calms the Spirit.”
Light and aromatic herbs can produce an upward and outward dispersing effect. Both physically light and aromatic, Bo He (peppermint) has an upward movement that helps clear the Lungs, throat, head, and eyes, and it directs Qi outward to the body’s surface to fight off external invading Wind Heat pathogens.
Still other herbs have the ability to direct Qi through no discernible means. Huang Qi (Astragulus) directs Qi upward (notably Stomach and Spleen Yang Qi), which can be overstimulating if taken in large doses. Jie Geng(Platycodon grandiflorus) directs the effects of other herbs upward, primarily to the chest, useful in formulas treating any type of constriction or accumulation in the chest or lungs. Niu Xi(Achyranthes bidentata) directs the effects of other herbs downward, useful in formulas treating any type of pain below the waist.
Every Chinese herb is said to enter an acupuncture channel or channels. This means that the effects of an herb most strongly influence the organ or organs of the related channel, so if an herb enters the Lung channel, it will most strongly affect the Lungs or the Lung channel itself, in cases of a channel pathology.
There is often a correspondence with taste, so a spicy herb is likely to enter the Lung channel, for example. There are many exceptions, especially in herbs with complex tastes, so this is not always the case. The channels entered have largely been determined empirically, through careful observation of an herb’s therapeutic effects over time.
Chinese herbs are classified into categories with herbs that share similar functions and attributes. While primarily addressing its category designation, each herb has its own individual qualities that allow it to function slightly differently from others within the same category. This provides a great deal of versatility in selecting the herbs that best match the patient’s presentation, helping address various symptoms related to the primary concern. Secondary symptoms or concerns may be addressed by herbs from other categories, creating a highly individualized formula for each patient’s needs.
What follows is a list of the most commonly recognized herb categories, along with a short description of its purpose. Below each description you’ll find the following:
• Representative Herbs: These may not always be the most commonly used herbs in the category, but they are ones that most Westerners will recognize. Their common name is followed by their Chinese name. (Many Chinese herbs only have Chinese names and botanical name counterparts.) You will note that not every substance is an herb; some are animal and mineral substances. They are all loosely called “herbs” as a matter of convenience among many herbalists, so there is no distinction made to point those out when they occur.
The herbs presented in this chapter are intended to provide some common representative examples only. Only an experienced herbalist should attempt to include these individual herbs in their self-care. Each herb can produce a variety of effects or target only one set of symptoms from its category. When used improperly, the results may be unpredictable and in some rare cases harmful.
• Common Symptoms Treated: These are some of the symptoms most commonly treated by the category of herbs. Not every symptom needs to be present in order to beneficially use these herbs. Not every herb in its category will treat all of the common symptoms. Determining which herbs within a category may best treat the patient is part of the art of constructing an effective Chinese formula.
• Related Western Diseases:. These are the disease or condition names commonly used in Western medicine where some, most, or all of the symptoms imply a Chinese diagnosis may be present. Remember there are no one-to-one correspondences between Chinese and Western diagnoses. The Western disease name implies one set of symptoms a Chinese physician may take into consideration when making a diagnosis.
• Similar Western Drug Actions: The herbs within a category will have actions similar to, or in some cases identical to, these Western-defined drug actions. Not every herb in its category will provide all of these actions. Some of the actions are only a secondary effect of an herb and may not directly relate to its category. In some cases, herbs produce effects that have no clear Western pharmacological counterpart, as when tonifying Qi, Yang, or Yin.
1. Spicy (Acrid) Warm
These herbs treat superficial conditions that are cool or cold in nature. Those conditions are usually caused by Wind alone or a Wind Cold combination, sometimes additionally combined with Damp. Most of these herbs are diaphoretic, causing sweat to assist in releasing the external pathogens.
• Representative Herbs: Cinnamon twig (Gui Zhi), ginger root (Sheng Jiang).
• Common Symptoms Treated: Chills more than fever, headache, body ache, sinus congestion.
• Related Western Diseases: Common cold, flu.
• Similar Western Drug Actions: Antimicrobial, analgesic, antipyretic, decongestant, diaphoretic.
2. Spicy (Acrid) Cool
These herbs treat superficial conditions that are warm or hot in nature. Those conditions are usually caused by Wind alone or a Wind Heat combination and include common colds and flus. They are also used to treat early stages of Wind Damp and Summer Heat.
• Representative Herbs: Peppermint (Bo He), white mulberry leaf (Sang Ye), chrysanthemum flower (Ju Hua).
• Common Symptoms Treated: Fever more than chills, sore throat, itchy red eyes, headache, sinus congestion.
• Related Western Diseases: Common cold, flu.
• Similar Western Drug Actions: Antimicrobial/antibiotic, analgesic, antipyretic, decongestant, diaphoretic.
3. Clears Heat, Purges Fire
These are among the coldest herbs in the Chinese materia medica. They are used to treat all conditions that present internal Heat signs and high fevers.
• Representative Herbs: Gypsum (Shi Gao), gardenia fruit (Zhi Zi), bamboo stem and leaves (Dan Zhu Ye).
• Common Symptoms Treated: High fevers, irritability, thirst, fever-induced delirium.
• Related Western Diseases: Most diseases involving high fever.
• Similar Western Drug Actions: Anti-inflammatory, antipyretic, antimicrobial.
4. Clears Heat, Cools Blood
These cold herbs are used to treat conditions that exhibit signs of Heat in the Blood. This presents as Heat signs combined with bleeding disorders that are attributable to internal Heat.
• Representative Herbs: Rhinoceros horn (Xi Jiao), wolfberry root (Di Gu Pi), Chinese foxglove root (Sheng Di Huang). Note that rhinoceros horn is from an endangered species and is no longer used. It is mentioned here for historical reference and as a substance that is more familiar to most readers than others in this category.
• Common Symptoms Treated: Fever (often worse at night), dry throat, nosebleeds, coughing or spitting up blood, blood in the urine or stool, fever-induced delirium, rashes.
• Related Western Diseases: Diseases involving high fever with bleeding symptoms/hemorrhage.
• Similar Western Drug Actions: Anti-inflammatory, antipyretic, antimicrobial, hemostatic.
5. Clears Heat, Dries Damp
These cold herbs are also drying, used primarily in Damp Heat patterns. This includes things such as dysentery, painful, burning urination, and weeping, hot skin conditions.
• Representative Herbs: Skullcap root (Huang Qin), cork tree bark (Huang Bai).
• Common Symptoms Treated: Severe diarrhea, painful, burning urination, inflamed sores, swelling.
• Related Western Diseases: Jaundice, eczema, boils, encephalitis, diphtheria.
• Similar Western Drug Actions: Anti-inflammatory, antipyretic, antimicrobial, antifungal, possibly anticholinergic.
6. Clears Heat Toxin
These cold herbs are used to treat Heat patterns causing fever along with other signs of infectious or internal disease, indicative of toxins or purulent infection that must be cleared from the body.
• Representative Herbs: Honeysuckle flower (Jin Yin Hua), forsythia fruit (Lian Qiao), dandelion (Pu Gong Ying).
• Common Symptoms Treated: Fever, hot, painful swellings usually containing pus, lethargy, generalized malaise.
• Related Western Diseases: Shingles, abscesses, appendicitis, mastitis, dysentery.
• Similar Western Drug Actions: Anti-inflammatory, antibiotic, antiviral, diuretic.
7. Clears Summer Heat
These herbs can be cold, cool, or neutral and treat Summer Heat patterns of Damp combined with high Heat. Heat pathogens can be drying and create thirst, so these herbs both drain pathogenic Damp and generate healthy fluids while clearing Heat.
• Representative Herbs: Mung bean (Lu Dou), watermelon (Xi Gua), hyacinth bean (Bai Bian Dou).
• Common Symptoms Treated: Fever, profuse sweat, thirst, diarrhea, scant and dark urination.
• Related Western Diseases: Most febrile conditions that occur during summertime.
• Similar Western Drug Actions: Antibiotic, antipyretic, diuretic.
Downward Draining (for 8, 9, and 10)
All of the downward draining herbs either stimulate intestinal movement (peristalsis), moisten the intestines, or cause a strong diarrhea, in order to evacuate intestinal accumulations. They are used in different circumstances and produce their effects in different ways, described in the categories list.
8. Downward Draining, Purgative
These bitter, cold herbs clear Heat and are used either in cases of constipation caused by internal Heat, which dries intestinal fluids and usually present with high fever, or cases of constipation from internal Cold, which weakens peristalsis. In the latter case, other herbs are added to warm the interior in order to relieve internal Cold symptoms at the same time.
• Representative Herbs: Rhubarb rhizome (Da Huang), senna leaf (Fan Xie Ye), aloe juice, dried (Lu Hui).
• Common Symptoms Treated: Constipation, fever, dizziness, irritability, red and painful eyes.
• Related Western Diseases: Chronic constipation, jaundice, amenorrhea.
• Similar Western Drug Actions: Cathartic, laxative.
9. Downward Draining, Moist Laxative
These relatively mild herbs are nuts and seeds, primarily used to moisten and lubricate the intestines of the very weak or elderly suffering from a Blood or Yin Deficiency.
• Representative Herbs: Marijuana seeds (Huo Ma Ren).
• Common Symptom Treated: Constipation.
• Related Western Diseases: Constipation, edema.
• Similar Western Drug Actions: Laxative, diuretic.
10. Downward Draining, Harsh Expellant
These cold, bitter herbs induce strong diarrhea and possibly excess urination. They are used to treat constipation due to various disruptions of fluid metabolism, presenting with an inflammation of and fluid accumulation in the membranes around the lungs or with a fluid accumulation in the abdomen caused by cirrhosis of the liver. As these conditions are very serious, the herbs are accordingly very harsh, in order to produce their desired effects rapidly. They must be used with extreme care, as they can deplete and harm both Yin and Qi.
• Representative Herbs: Morning glory seeds (Qian Niu Xi), poke root (Shang Lu).
• Common Symptoms Treated: Constipation with thoracic or abdominal edema, difficult urination.
• Related Western Diseases: Pleurisy, ascites and cirrhosis.
• Similar Western Drug Actions: Cathartic, diuretic.
11. Drains Damp
These cool or cold herbs help drain accumulated fluids anywhere in the body, including the respiratory and digestive systems, and below the waist. They may also be combined with herbs that clear Heat in Damp Heat conditions.
• Representative Herbs: Talcum (Hua Shi), Job’s tears/pearled barley (Yi Yi Ren), winter melon seed (Dong Gua Ren).
• Common Symptoms Treated: Fluid accumulation in the chest, abdomen, or below the waist, painful urination, rashes.
• Related Western Disease: Edema.
• Similar Western Drug Action: Diuretic.
12. Expels Wind Damp
These herbs treat various painful obstruction syndromes of the joints, muscles, or channels, characteristic of Wind Damp patterns. They are also useful in Cold and Hot painful obstruction syndromes, typically found in various types of arthritis.
• Representative Herbs: Chinese clematis root (Wei Ling Xian), Chinese quince fruit (Mu Gua).
• Common Symptoms Treated: Joint pain, back pain, painful, cramped muscles.
• Related Western Disease: Arthritis.
• Similar Western Drug Actions: Analgesic, anti-inflammatory, antipyretic.
Transforms Phlegm (for 13, 14, and 15)
In Chinese medicine, the term “Phlegm” can have many meanings. One is the same as is used in Western medicine: phlegm is the thick, sticky fluid that often accumulates in the lungs due to a cold, the flu, or allergies. This causes the familiar cough and wheeze associated with those conditions.
The Spleen both dislikes Damp and generates Damp when it is not functioning well. Some generated Damp can congeal into Phlegm and be sent to the Lungs, but some is readily sent to the Stomach, where it can cause nausea, poor appetite, distension, and other digestive disorders. Another aspect of Phlegm accumulates in the channels and muscles, forming Phlegm nodules. These can be simple lipomas or cysts, goiters, inflamed lymph glands, or the glandular swelling found in tuberculosis when Phlegm is combined with Fire. Insubstantial Phlegm, which is not an obvious physical fluid, can obstruct the Heart orifice, leading to various perceptual disorders, some types of seizures, stroke, and coma.
The three herb categories that address these manifestations of Phlegm are Dissolves (or Transforms) Hot Phlegm, Dissolves (or Transforms) Cold Phlegm, and Relieves Cough and Wheeze. Depending upon the presentation, herbs from each category may be used to treat any of the above Phlegm disorders.
13. Dissolves (or Transforms) Hot Phlegm
These cold herbs are used to treat Hot and Dry Phlegm disorders.
• Representative Herbs: Dried bamboo sap (Zhu Li), bamboo shavings (Zhu Ru), pumice (Fu Hai Shi), seaweed (Hai Zao).
• Common Symptoms Treated: Cough and wheeze with thick sputum, lung and breast abscess, chest pain, distension or constriction.
• Related Western Diseases: Lymphadenopathy, goiter.
• Similar Western Drug Actions: Expectorant, antitussive, anti-inflammatory, sedative.
14. Dissolves (or Transforms) Cold Phlegm
These warm herbs are used to treat Cold Phlegm conditions.
• Representative Herbs: White mustard seed (Bai Jie Zi), jack-in-the-pulpit rhizome (Tian Nan Xing).
• Common Symptoms Treated: Nausea, vomiting, chest pain, distension or constriction, nodules, facial paralysis, seizure, stroke.
• Related Western Diseases: Bell’s palsy, lymphoma, opisthotonos, lockjaw, tuberculosis.
• Similar Western Drug Actions: Expectorant, antitussive, antiemetic.
15. Relieves Cough and Wheeze
These herbs are used to reduce coughing and wheezing and are the mildest of the herbs that transform Phlegm. They can be combined with other categories of herbs to facilitate a wider range of effects, clearing Heat, Cold, or Phlegm.
• Representative Herbs: Almond kernel (Xing Ren), bark of mulberry root (Sang Bai Pi).
• Common Symptoms Treated: Cough, wheeze, chest constriction, nausea, sore throat, hoarseness.
• Related Western Disease: Chronic bronchitis.
• Similar Western Drug Actions: Expectorant, antitussive, bronchodilator, antibiotic, diuretic, laxative.
16. Aromatic, Transforms Damp
Most of these herbs are spicy, warm, and aromatic, awakening the Spleen to transform Damp in the Middle Jiao. Primarily they are used for acute digestive disorders. Their warm, aromatic nature makes many of these herbs drying, potentially damaging Yin. They should be used carefully, and short-term use is recommended.
• Representative Herbs: Patchouli (Huo Xiang), magnolia bark (Hou Po).
• Common Symptoms Treated: Nausea, vomiting, abdominal distension, diarrhea, poor appetite.
• Related Western Diseases: Food poisoning, gastroenteritis, amoebic dysentery.
• Similar Western Drug Actions: Antibiotic, antiviral, antiemetic.
17. Relieves Food Stagnation
Most of these herbs are warm or neutral with a slightly sweet taste that guides their effects to the Spleen and Stomach. They work to dissolve food stagnation and guide that accumulation out of the body through the intestines. They can be combined with Heat-clearing herbs in cases of Hot Stagnation, with Warms the Interior herbs in cases of Cold Stagnation, or with purgative herbs if stronger evacuation is required.
• Representative Herbs: Hawthorn fruit (Shan Zha), barley sprout (Mai Ya), radish seed (Lai Fu Zi).
• Common Symptoms Treated: Poor digestion, abdominal distension, belching, acid regurgitation, diarrhea.
• Related Western Diseases: All digestive problems from poor digestive functions or overeating.
• Similar Western Drug Actions: Enzymatic, antimicrobial.
18. Regulates Qi
These herbs are primarily spicy and warm, and each herb possesses additional qualities. Regulating Qi means moving Qi, required in cases of Qi stagnation. This commonly manifests as discomfort or pain and sometimes as emotional distress, along with symptoms that vary according to the organ most involved.
• Representative Herbs: Tangerine peel (Chen Pi), sandalwood (Tan Xiang), Chinese rose (Mei Gui Hua).
• Common Symptoms Treated: Abdomen and chest pain, breathing difficulties, bloating, poor appetite, nausea, indigestion, food stagnation, constipation or diarrhea, depression, irritability.
• Related Western Diseases: Various discomforts and pain syndromes in the chest or abdomen. Many of these are not definitively diagnosable by Western methods, since the root cause is often a Qi obstruction, which is outside the province of Western medicine.
• Similar Western Drug Actions: Cholinergic agonists, prokinetic agents, laxatives or antidiarrheals (depending on presentation), analgesic, antimicrobial.
19. Stops Bleeding
These herbs are used to stop bleeding from any cause. Trauma is one clear cause of bleeding, but other bleeding disorders can be caused by Heat, Deficiencies of Qi or Yin, or other causes. The underlying cause must be addressed by other types of herbs added to these. Blood loss itself usually creates Blood Deficiency, which must be addressed once the acute bleeding has stopped.
• Representative Herbs: Cattail pollen (Pu Huang), pseudoginseng root (San Qi), charred human hair (Xue Yu Tan).
• Common Symptoms Treated: Blood in the stool, urine, or vomit, nosebleeds, excessive menstrual bleeding, coughing blood, trauma.
• Related Western Diseases: Any diseases involving excessive or abnormal bleeding, hemorrhagic disorders.
• Similar Western Drug Actions: Hemostatic, anti-inflammatory, antibiotic, antiemetic.
20. Invigorates Blood
These herbs are used to move the Blood in cases of Blood Stasis. Presentations can include acute onset of localized sharp pain from a known injury, ulcerations and abscesses in skin, muscles, or internal organs, enlarged liver or spleen, or abdominal or pelvic tumors. Herbs of varying strength are used in differing types of presentations.
• Representative Herbs: Turmeric (Yu Jin), peony root (Chi Shao), peach kernel (Tao Ren), safflower (Hong Hua).
• Common Symptoms Treated: Sharp focal pain, inflammation, masses, painful or absent menstruation.
• Related Western Diseases: Appendicitis, hepatomegaly, splenomegaly, thrombosis, abdominal tumors and cysts, ulcers, abscesses, ischemia, some gynecological disorders.
• Similar Western Drug Actions: Anticoagulant, analgesic, antibiotic, anti-inflammatory.
21. Warms Interior, Expels Cold
These warm herbs treat Interior Cold patterns, whether caused by external or internal pathogenic factors.
• Representative Herbs: Dried ginger (Gan Jiang), cinnamon bark (Rou Gui), fennel (Xiao Hui Xiang), black pepper (Hu Jiao).
• Common Symptoms Treated: Generalized cold, absent thirst, loose stool, excessive urination, weakness and fatigue. More serious symptoms: profuse sweating, watery diarrhea, frigid extremities.
• Related Western Diseases: Shock, some cardiovascular events, impotence, gastroenteritis.
• Similar Western Drug Actions: Cardiotonic, anti-inflammatory, antiparasitic, antibiotic.
22. Tonifies Qi
These herbs are generally warm or neutral and are sweet. They are used in Deficient Qi patterns, where the functional energy of an organ or organs is low.
• Representative Herbs: Ginseng (Ren Shen), astragalus (Huang Qi), licorice root (Gan Cao)
• Common Symptoms Treated: Shortness of breath, spontaneous sweating, weak voice, weak limbs, poor appetite, diarrhea, fatigue.
• Related Western Diseases: Any diseases involving generalized weakness or low energy, especially when involving the lungs or digestive system. Many of these are not definitively diagnosable by Western methods, since the root cause is often Qi Deficiency, which is outside the province of Western medicine.
• Similar Western Drug Actions: Some of the herbs in this category have antibiotic, antineoplastic, blood pressure regulatory, endocrine, cardiovascular, and other effects as secondary attributes. Primarily, they are highest-quality nutrition targeted toward specific organs, improving the efficiency and functional energy of those organs.
23. Tonifies Blood
These sweet herbs treat all types of Deficient Blood patterns and are used to nourish and build the Blood both in quality and quantity. They are not limited to treating the Western diagnosis of anemia, a common misperception.
• Representative Herbs: Goji berries (Gou Qi Zi), peony root (Bai Shao).
• Common Symptoms Treated: Dizziness, insomnia, poor vision, heart palpitations, menstrual disorders, dry hair and skin, sore back and legs.
• Related Western Diseases: Cardiovascular disorders, amenorrhea, dysmenorrhea.
• Similar Western Drug Actions: Some of the herbs in this category are antibiotic, sedative, or analgesic, lower blood pressure and cholesterol, improve glucose metabolism, and have cardiovascular and other effects as secondary attributes. Primarily they are highest-quality nutrition targeted toward building the quality of Blood, and they contain many vitamins, amino acids, sterols, lecithin, small amounts of healthy sugars, and other nutrients.
24. Tonifies Yang
These herbs are used to treat Deficient Yang patterns, primarily of the Heart, Spleen, and Kidneys. Common symptoms include very low energy and a strong aversion to cold.
• Representative Herbs: Horny goat weed (Yin Yang Huo), fenugreek seed (Hu Lu Ba), walnut (Hu Tao Ren).
• Common Symptoms Treated: Sexual (impotence, spermatorrhea) and urogenital (incontinence, profuse urination) disorders, low back pain, pallor, shortness of breath, diarrhea.
• Related Western Diseases: Possibly endocrine disorders. Many of these diseases are not definitively diagnosable by Western methods, since the root cause is often Yang Deficiency, which is outside the province of Western medicine.
• Similar Western Drug Action: Androgenergic.
25. Tonifies Yin
These primarily sweet and cool herbs are used to treat Deficient Yin patterns. They are nourishing and moistening, generate fluids, and mainly address Lung, Liver, Kidney, and Stomach Yin. The presentations vary some based on the organs or organs most involved.
• Representative Herbs: American ginseng (Xi Yang Shen), black sesame seed (Hei Zhi Ma), tortoise shell (Gui Ban). Note that endangered species are not used in contemporary Chinese medicine.
• Common Symptoms Treated: Thirst, dry throat, dry cough, dry skin, insomnia, vertigo, tinnitus, constipation, poor appetite, weak low back and knees, low sexual energy.
• Related Western Diseases: Various respiratory, digestive, gynecological, and pain disorders. Many of these diseases are not definitively diagnosable by Western methods, since the root cause is often Yin Deficiency, which is outside the province of Western medicine.
• Similar Western Drug Actions: Laxative, diuretic, anti-inflammatory, antibiotic, analgesic. Some lower blood pressure and serum cholesterol.
These primarily sour herbs restrain the leakage of fluids and help hold organs in their proper positions.
• Representative Herbs: Nutmeg seed (Rou Dou Kou), pomegranate husk (Shi Liu Pi), lotus seed (Lian Zi).
• Common Symptoms Treated: Profuse sweating, excessive urination or incontinence, diarrhea, some types of bleeding disorders, nocturnal emission, premature ejaculation, prolapse of the uterus and rectum.
• Related Western Diseases: Some autonomic nervous system disorders.
• Similar Western Drug Actions: Astringent, hemostatic, antidiarrheal.
27. Settles Heart, Calms Spirit
These minerals and shells settle the Heart to calm the spirit, in large part by their heaviness. Their weight causes settling of Qi that rises inappropriately to disturb the Heart. When other organ patterns cause Qi to rise (as in Liver Yang Rising, for example), their influence is also subdued.
• Representative Herbs: Oyster shell (Mu Li), pearl (Zhen Zhu), amber (Hu Po).
• Common Symptoms Treated: Anxiety, insomnia, restlessness, palpitations, headaches, tinnitus, dizziness, coughing, vomiting, belching.
• Related Western Diseases: Insomnia, some psychological and emotional disorders.
• Similar Western Drug Actions: Sedative, tranquilizing.
28. Nurtures Heart, Calms Spirit
Similar but milder in effect than the minerals and shells in the previous category, these primarily sweet herbs nourish the Heart. They treat similar problems caused by Heart Blood Deficiency and Liver Yin Deficiency patterns.
• Representative Herbs: Sour jujube seed (Suan Zao Ren), mimosa tree bark (He Huan Pi).
• Common Symptoms Treated: Insomnia, anxiety, irritability, confusion, and palpitations.
• Related Western Diseases: Insomnia, some psychological and emotional disorders.
• Similar Western Drug Actions: Sedative, hypnotic, tranquilizing.
29. Aromatic, Opens Orifices
These herbs are used for changes in or loss of consciousness, usually associated with Hot or Cold Closed syndromes. The orifices that require opening are internal, always associated with the Heart in its role of housing the mind, and roughly correlate with the Western idea of sensory and motor neural pathways. The Spleen and Liver are two other frequently involved organs.
• Representative Herbs: Gall stone from cattle (Niu Huang), musk deer navel gland secretion (She Xiang). Note that musk is from an endangered species and no longer used. It is mentioned here for historical reference and as a substance that is more familiar to most readers than others in this category.
• Common Symptoms Treated: Coma, tetany or other seizure disorders, convulsions, delirium, fainting.
• Related Western Diseases: Meningitis, encephalitis, heat stroke, coronary artery disease, cerebrovascular events.
• Similar Western Drug Actions: Central nervous system stimulant, tranquilizing.
30. Extinguish Wind, Stop Tremors
These herbs and animal substances treat internal Wind, usually arising from Liver or Kidney Yin Deficiency, Blood Deficiency, or strong internal Heat.
• Representative Herbs: Antelope horn (Ling Yang Jiao), abalone shell (Shi Jue Ming), earthworm (Di Long). Note that antelope horn and abalone shell are from endangered species and are no longer used. They are mentioned here for historical reference and as substances that are more familiar to most readers than others in this category.
• Common Symptoms Treated: Headache, dizziness, blurred vision, palpitations, insomnia, anxiety, muscle twitch or spasm, facial paralysis, hemiplegia, high fever, convulsions, loss of consciousness.
• Related Western Diseases: Hypertension, atherosclerosis, anemia, opisthotonos, epilepsy, some psychological disorders, some nervous system disorders.
• Similar Western Drug Actions: Antihypertensive, sedative, anticonvulsant.
31. Expels Parasites
Herbs in this category are used to kill and expel many types of parasites, including tapeworm, roundworm, hookworm, pinworm, ringworm, trichomonas, and others.
• Representative Herbs: Garlic (Da Suan), pumpkin seed (Nan Gua Zi), betel nut (Bing Lang).
• Common Symptoms Treated: Abdominal distension, pain, poor appetite, lethargy, weakness, and diarrhea, all when caused by parasites.
• Related Western Disease: Parasitic infestation.
• Similar Western Drug Action: Antiparasitic.
32. External Application/Miscellaneous
These substances are used topically to treat bleeding and various types of infection or inflammation and to accelerate the healing of skin lesions. Some of these substances may be used internally, but most are too toxic for anything other than topical application as plasters, ointments, and soaks.
• Representative Herbs: Alum (Ming Fan), calamine (Lu Gan Shi), sulfur (Liu Huang).
• Common Symptoms Treated: Itch, open sores and ulcerations, superficial parasites (scabies), bleeding, swelling.
• Related Western Diseases: Eczema, parasites, syphilis (chancres), leukoderma, tinea/ringworm, dermatomycoses, neurodermatitis.
• Similar Western Drug Actions: Antiparasitic, antifungal, anti-inflammatory, antimicrobial.
A Chinese herbalist will rarely prescribe a single herb to treat a patient. It’s much more common to formulate a detailed prescription to treat multiple facets of a pattern of disharmony, addressing the root cause as well as the expression of symptoms and often addressing related side concerns and the patient’s constitutional needs. Typical formulas contain between four and twelve herbs, although formulas with fewer or more herbs are not uncommon. Over many weeks or months of treatment, a prescribed formula may be modified slightly or significantly to accommodate changes in the patient as their health improves.
According to You-Ping Zhu’s Chinese Materia Medica, there are approximately 8,000 herbs in the Chinese pharmacopoeia.20 However, most herb shops and clinics in the United States stock between two and three hundred loose herbs, which are more than adequate to handle most patient needs. These are augmented by Chinese patent medicines, commonly used herbal formulas primarily in pill form. Since there is no set number of herbs in a formula and new ones are continually created, there is nearly an infinite number of formulas possible.
A competent herbalist may know a hundred or so classic formulas, understanding how and why they are constructed, along with two or three hundred single herbs, most of which may be contained within those formulas. The effects of a classic prescription can change considerably simply by subtracting or adding a couple of herbs, modifying it to best meet the patient’s individual health challenges. Many herbal texts include a number of such modifications to base formulas, so they can address a wide range of variations patients may present.
Formulas follow a basic template (principles used for combining herbs), with each herb filling one of four roles within the formula. Traditionally, these roles are the following:
1. Chief/Lord: The primary herbs or herbs in a formula, addressing the main complaint and providing the main therapeutic focus.
2. Deputy/Minister/Associate: These herbs have similar effects to the chief herb, strengthening or enhancing the main therapeutic focus.
3. Assistant/Adjutant: These herbs may address a secondary health issue, serve to attenuate harsh or unwanted effects of other herbs, or provide symptomatic relief without necessarily addressing the root disharmony.
4. Envoy/Messenger: These herbs may provide directionality to the other herbs, guiding them to specific parts of the body, or they may harmonize the effects of the other herbs, which is especially important in larger formulas or those containing herbs of diverse and possibly conflicting attributes.
This template is followed most often, but liberties are taken as needed. There can be more than one herb fulfilling each role or one herb fulfilling more than one role. Not every formula will necessarily include all four roles. Small formulas may have just two or three herbs, and even some larger formulas may only have herbs functioning as chief and deputy. It always comes down to what will make the best formula for the needs of each individual patient.
There are many other factors that an herbal physician must take into account when constructing formulas, such as knowing which herbs are incompatible and may become toxic when combined, which enhance each other’s functions in specific settings, and which counteract or suppress each other. Contemporary herbal physicians also know what herbs may interact with specific Western medications, for good or ill. These are professional-level concerns and won’t be covered here.
20. You-Ping Zhu, Chinese Materia Medica: Chemistry, Pharmacology and Applications (Boca Raton, FL: CRC Press, 1998), 33.