Chinese herbology (p=zhōngyào xué) is the theory of traditional Chinese herbal therapy, which accounts for the majority of treatments in traditional Chinese medicine (TCM). A Nature editorial described TCM as "fraught with pseudoscience", and said that the most obvious reason why it has not delivered many cures is that the majority of its treatments have no logical mechanism of action.
The term herbology is misleading in the sense that, while plant elements are by far the most commonly used substances, animal, human, and mineral products are also used, some of which are poisonous. In the they are referred to as 毒藥 (links=no) which means "poison-medicine". Paul U. Unschuld points out that this is similar etymology to the Greek and so he uses the term pharmaceutic.
Research into the effectiveness of traditional Chinese herbal therapy is of poor quality and often tainted by bias,
History
The practice of Chinese herbal medicine stretches back for millennia. The earliest written record of prescriptions is the manuscript
Recipes for 52 Ailments (五十二病方,
Wǔshí'èr Bìngfāng), discovered in the
Mawangdui tombs, which were sealed in 168 BCE.
Later tradition credits the legendary figure Shennong (神農, lit. "Divine Farmer") as the founder of Chinese herbology. He is said to have lived around 2800 BCE and to have tasted hundreds of herbs to ascertain their medicinal value.
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"Superior" (上品, shàng pǐn): herbs considered safe for long-term consumption to maintain health, with few to no side effects.
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"Medium" (中品, zhōng pǐn): substances with some therapeutic action that may have mild toxicity depending on the dosage.
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"Inferior" (下品, xià pǐn): substances taken for specific illnesses, often for shorter periods, as they are considered to have a higher potential for toxicity.
The next pivotal work was the Shanghan lun (傷寒雜病論, Shānghán Zábìng Lùn), compiled by Zhang Zhongjing near the end of the Han dynasty (c. 196–220 CE). It is the first medical text that organized therapeutic principles around the diagnosis of symptom patterns (, 證), and it combined Yinyang and Five Phases theory with specific herbal prescriptions.
Succeeding generations augmented these works, as in the (l=Treatise on the Nature of Medicinal Herbs), a 7th-century Tang dynasty Chinese treatise on herbal medicine.
There was a shift in emphasis in treatment over several centuries. A section of the Huangdi Neijing Suwen including Chapter 74 was added by Wang Bing in his 765 edition. In which it says: 主病之謂君，佐君之謂臣，應臣之謂使，非上下三品之謂也。 "Ruler of disease it called Sovereign, aid to Sovereign it called Minister, comply with Minister it called Envoy (Assistant), not upper lower three classes (qualities) it called." The last part is interpreted as stating that these three rulers are not the three classes of Shénnóng mentioned previously. This chapter in particular outlines a more forceful approach. Later on Zhang Zihe ( Zhang Cong-zhen, 1156–1228) is credited with founding the 'Attacking School' which criticized the overuse of tonics.
Arguably the most important of these later works is the Compendium of Materia Medica (, 本草綱目) compiled during the Ming dynasty by Li Shizhen, which is still used today for consultation and reference.
The use of Chinese herbs was popular during the medieval age in western Asian and Islamic countries. They were traded through the Silk Road from the East to the West. Cinnamon, ginger, rhubarb, nutmeg and cubeb are mentioned as Chinese herbs by medieval Islamic medical scholars Such as Rhazes (854–925 CE), Haly Abbas (930–994 CE) and Avicenna (980–1037 CE). There were also multiple similarities between the clinical uses of these herbs in Chinese and Islamic medicine.
Raw materials
There are roughly 13,000 medicinals used in China and over 100,000 medicinal recipes recorded in the ancient literature.
Plant elements and extracts are by far the most common elements used.
In the classic
Handbook of Traditional Drugs from 1941, 517 drugs were listed – out of these, only 45 were animal parts, and 30 were minerals.
For many plants used as medicinals, detailed instructions have been handed down not only regarding the locations and areas where they grow best, but also regarding the best timing of planting and harvesting them.
Some animal parts used as medicinals can be considered rather strange such as cows' gallstones.
Furthermore, the classic materia medica describes the use of 35 traditional Chinese medicines derived from the human body, including bones, fingernail, hairs, dandruff, earwax, impurities on the teeth, feces, urine, sweat, and organs, but most are no longer in use.
Preparation
Decoction
[[File:Chinese herbal decoction (一貫煎) on snow.jpg | thumb | 220x124px | right | alt= An image of decocted Chinese medicine 一貫煎 on snow, taken in the United States. The snow is on the border of a forest near a residential area, with a small lake in the background near trees. |
A traditional Chinese herbal decoction (湯劑/汤剂)]]
Typically, one batch of medicinals is prepared as a
decoction of about 9 to 18 substances.
["According to the experience of the author, 99% of prescriptions in the PR of China range from 6 to 20 herbs; in the majority, however, it is 9 to 12,..." From .] Some of these are considered as main herbs, some as ancillary herbs; within the ancillary herbs, up to three categories can be distinguished.
["Regarding the content of the prescription, one can differentiate between main herbs and ancillary herbs. For classical prescriptions, detailed analyses exist for each single ingredient which discriminate between up to three categories ( Chen, Zun, and Chi) of ancillary herbs." From .] Some ingredients are added to cancel out toxicity or side-effects of the main ingredients; on top of that, some medicinals require the use of other substances as
catalysts.
Chinese patent medicine
Chinese patent medicine (labels=no) is a kind of traditional Chinese medicine. They are standardized
Herbalism formulas. From ancient times, pills were formed by combining several herbs and other ingredients, which were dried and ground into a powder. They were then mixed with a binder and formed into pills by hand. The binder was traditionally honey. Modern teapills, however, are extracted in stainless steel extractors to create either a water decoction or water-alcohol decoction, depending on the herbs used. They are extracted at a low temperature (below ) to preserve essential ingredients. The extracted liquid is then further condensed, and some raw herb powder from one of the herbal ingredients is mixed in to form a herbal dough. This dough is then machine cut into tiny pieces, a small amount of excipients are added for a smooth and consistent exterior, and they are spun into pills.
These medicines are not patented in the traditional sense of the word. No one has to the formula. Instead, "patent" refers to the standardization of the formula. In China, all Chinese patent medicines of the same name will have the same proportions of ingredients, and manufactured in accordance with the PRC Pharmacopoeia, which is mandated by law. However, in western countries there may be variations in the proportions of ingredients in patent medicines of the same name, and even different ingredients altogether.
Several producers of Chinese herbal medicines are pursuing FDA clinical trials to market their products as drugs in U.S. and European markets.[ "Chinese Herbal Medicine Passes FDA Phase II Clinical Trials" ]
Chinese herbal extracts
Chinese herbal extracts are herbal decoctions that have been condensed into a granular or powdered form. Herbal extracts, similar to patent medicines, are easier and more convenient for patients to take. The industry extraction standard is 5:1, meaning for every five pounds of raw materials, one pound of herbal extract is derived.
[ Chinese Herbal Extract FAQs ]
Categorization
There are several different methods to classify traditional Chinese medicinals:
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The Four Natures (p=sìqì)
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The Five Flavors (p=wǔwèi)
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The meridians (p=jīngluò)
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The specific function.
Four Natures
The Four Natures are: hot (first=t), warm (first=t), cool (涼), cold (寒) or neutral (平).
Hot and warm herbs are used to treat cold diseases, while cool and cold herbs are used to treat hot diseases.
Five Flavors
The Five Flavors, sometimes also translated as
Five Tastes, are: acrid/pungent (辛), sweet (甘), bitter (苦), sour (酸), and salty (first=t).
Substances may also have more than one flavor, or none (i.e., a bland (淡) flavor).
Each of the Five Flavors corresponds to one of the zàng organs, which in turn corresponds to one of the Five Phases:
A flavor implies certain properties and presumed therapeutic "actions" of a substance: saltiness "drains downward and softens hard masses";
sweetness is "supplementing, harmonizing, and moistening";
pungent substances are thought to induce sweat and act on qi and blood; sourness tends to be astringent (first=t) in nature; bitterness "drains heat, purges the bowels, and eliminates dampness".
Specific function
These categories mainly include:
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exterior-releasing
[Xu & Wang 2002, Summary of Contents] or exterior-resolving
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heat-clearing
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downward-draining
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wind-damp-dispelling
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dampness-transforming
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promoting the movement of water and percolating dampness
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interior-warming
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qi-regulating
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dispersing food accumulation
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worm-expelling
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stopping bleeding
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quickening the Blood and dispelling stasis
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transforming phlegm, stopping coughing and calming wheezing
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Spirit-quieting
[
]
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calming the Liver and expelling wind
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orifice-opening
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supplementing
[ this includes qi-supplementing, blood-nourishing, yin-enriching, and yang-fortifying]
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astriction-promoting
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vomiting-inducing
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substances for external application
Nomenclature
Many herbs earn their names from their unique physical appearance. Examples of such names include (
Radix cyathulae seu achyranthis), 'cow's knees,' which has big joints that might look like cow knees; (
Fructificatio tremellae fuciformis), 'white wood ear', which is white and resembles an ear; (
Rhizoma cibotii), 'dog spine,' which resembles the spine of a dog.
Color
Color is not only a valuable means of identifying herbs, but in many cases also provides information about the therapeutic attributes of the herb. For example, yellow herbs are referred to as (yellow) or (gold). (
Cortex Phellodendri) means 'yellow fir", and (
Flos Lonicerae) has the label 'golden silver flower."
Smell and taste
Unique flavors define specific names for some substances. means 'sweet,' so (
Radix glycyrrhizae) is 'sweet herb,' an adequate description for the licorice root. means 'bitter', thus (
Sophorae flavescentis) translates as 'bitter herb.'
Geographic location
The locations or provinces in which herbs are grown often figure into herb names. For example, (
Radix glehniae) is grown and harvested in northern China, whereas (
Radix adenophorae) originated in southern China. And the Chinese words for north and south are respectively and .
(''Bulbus fritillariae cirrhosae'') and (''Radix cyathulae'') are both found in Sichuan province, as the character indicates in their names.
Function
Some herbs, like (
Radix Saposhnikoviae), literally 'prevent wind,' preventing or treating wind-related illnesses. (
Radix Dipsaci), literally 'restore the broken,' treating torn soft tissues and broken bones.
Country of origin
Many herbs indigenous to other countries have been incorporated into the Chinese materia medica. (
Radix panacis quinquefolii), imported from North American crops, translates as 'western ginseng,' while (
Radix ginseng Japonica), grown in and imported from North Asian countries, is 'eastern ginseng.'
Toxicity
From the earliest records regarding the use of medicinals to today, the toxicity of certain substances has been described in all Chinese materia medica.
Since TCM has become more popular in the Western world, there are increasing concerns about the potential toxicity of many traditional Chinese medicinals including plants, animal parts and minerals.
For most medicinals, efficacy and toxicity testing are based on traditional knowledge rather than laboratory analysis.
The toxicity in some cases could be confirmed by modern research (i.e., in
scorpion); in some cases it could not (i.e., in
Curculigo).
Further, ingredients may have different names in different locales or in historical texts, and different preparations may have similar names for the same reason, which can create inconsistencies and confusion in the creation of medicinals,
with the possible danger of poisoning.
"concluded that adverse effects of herbal medicines are an important albeit neglected subject in dermatology, which deserves further systematic investigation."
Research suggests that the toxic heavy metals and undeclared drugs found in Chinese herbal medicines might be a serious health issue.
Substances known to be potentially dangerous include aconitine,
Also, adulteration of some herbal medicine preparations with conventional drugs which may cause serious adverse effects, such as , phenylbutazone, phenytoin, and glibenclamide, has been reported.
However, many adverse reactions are due to misuse or abuse of Chinese medicine.
Most Chinese herbs are safe but some have shown not to be. Reports have shown products being contaminated with drugs, toxins, or false reporting of ingredients. Some herbs used in TCM may also react with drugs, have side effects, or be dangerous to people with certain medical conditions.
Efficacy
Only a few trials exist that are considered to have adequate methodology by scientific standards. Proof of effectiveness is poorly documented or absent.
A 2016
Cochrane review found "insufficient evidence that Chinese Herbal Medicines were any more or less effective than placebo or hormonal therapy" for the relief of menopause related symptoms.
A 2012 Cochrane review found no difference in decreased
mortality rate for
SARS patients when Chinese herbs were used alongside Western medicine versus Western medicine exclusively.
A 2010 Cochrane review found there is not enough robust evidence to support the effectiveness of traditional Chinese medicine herbs to stop the bleeding from
haemorrhoids.
A 2008 Cochrane review found promising evidence for the use of Chinese herbal medicine in relieving
dysmenorrhea, compared to conventional medicine such as
and the oral contraceptive pill, but the findings are of low methodological quality.
A 2012 Cochrane review found weak evidence suggesting that some Chinese medicinal herbs have a similar effect at preventing and treating
influenza as
Antiviral drug medication.
Due to the poor quality of these medical studies, there is insufficient evidence to support or dismiss the use of Chinese medicinal herbs for the treatment of influenza.
There is a need for larger and higher quality randomized clinical trials to determine how effective Chinese herbal medicine is for treating people with influenza.
A 2005 Cochrane review found that although the evidence was weak for the use of any single herb, there was low quality evidence that some Chinese medicinal herbs may be effective for the treatment of acute
pancreatitis.
Ecological impacts
The traditional practice of using now-endangered species is controversial within TCM. Modern Materia Medicas such as Bensky, Clavey and Stoger's comprehensive Chinese herbal text discuss substances derived from endangered species in an appendix, emphasizing alternatives.
Parts of endangered species used as TCM drugs include tiger bones[ Facts about traditional Chinese medicine (TCM): rhinoceros horn, Encyclopædia Britannica, Facts about traditional Chinese medicine (TCM): rhinoceros horn, as discussed in rhinoceros (mammal): – Britannica Online Encyclopedia ] Poachers supply the black market with such substances,[ "Rhino horn: All myth, no medicine", National Geographic, Rhishja Larson] Concerns have also arisen over the use of turtle plastron
TCM recognizes bear bile as a medicinal. In 1988, the Chinese Ministry of Health started controlling bile production, which previously used bears killed before winter. Now bears are fitted with a sort of permanent catheter, which is more profitable than killing the bears.["治人病还是救熊命——对养熊"引流熊胆"的思考"南风窗. November 12, 2002]
Collecting American ginseng to assist the Asian traditional medicine trade has made ginseng the most harvested wild plant in North America for the last two centuries, which eventually led to a listing on CITES Appendix II.
Chinese medicinal plant materials (CMPMs) release chemicals that attracts the Drugstore beetle, leading to the accumulation of this pest and further infestation and damage to these plants.
Herbs in use
Chinese herbology is a pseudoscientific practice with potentially unreliable product quality, safety hazards or misleading health advice.
There are regulatory bodies, such as China GMP (Good Manufacturing Process) of herbal products.
There is a lack of high-quality scientific research on herbology practices and product effectiveness for anti-disease activity.
[ In the herbal sources listed below, there is little or no evidence for efficacy or proof of safety across consumer age groups and disease conditions for which they are intended.][
]
There are over 300 herbs in common use. Some of the most commonly used herbs are Ginseng (p=rénshēn), wolfberry (p=gǒuqǐzǐ), dong quai ( Angelica sinensis, p=dāngguī), astragalus (p=huángqí), atractylodes (p=báizhú), bupleurum (p=cháihú), cinnamon (cinnamon twigs (p=guìzhī) and cinnamon bark (p=ròuguì)), coptis (p=huánglián), ginger (p=jiāng), hoelen (p=fúlíng), licorice (p=gāncǎo), ephedra sinica (p=máhuáng), peony (white: p=báisháo and reddish: p=chìsháo), rehmannia (p=dìhuáng), rhubarb (p=dàhuáng), and salvia (p=dānshēn).
50 fundamental herbs
In Chinese herbology, there are 50 "fundamental" herbs, as given in the reference text,[Wong, Ming (1976). La Médecine chinoise par les plantes. Le Corps a Vivre series. Éditions Tchou.] although these herbs are not universally recognized as such in other texts. The herbs are:
|
|
| Korean mint, Patchouli |
| Chinese Alangium root |
| (translated) Mountain henbane |
| Marlberry |
| Tatar aster, Tartar aster |
| Mongolian milkvetch |
| Tea plant |
| Cannabis |
| Safflower |
| Cassia (bark), Chinese cinnamon |
| Velvet leaf |
| Sichuan lovage, Szechuan lovage (Szechwuan lovage), belongs to the genus Conioselinum |
| Chinese goldthread |
| Chinese poppy, Yan Hu Suo, close relative to Corydalis ambigua and fumewort |
| Purging croton |
| Lilac daphne |
| Devil's trumpet |
| Jimson weed |
| Noble dendrobium |
| Costus root |
| Chinese ephedra |
| Hardy rubber tree |
| Peking spurge |
(, ) | a type of shrub-like bushweed of the family Phyllanthaceae |
| Weeping forsythia |
| () | Loureiro's gentian |
| Chinese honeylocust |
| Licorice |
| Chaulmoogra tree |
| Blue evergreen hydrangea, Chinese quinine |
| Purple holly |
| Chinese motherwort |
| Creeping lobelia |
| Amur cork tree |
| Chinese arborvitae |
| Golden larch |
| Naked rue |
| Kudzu |
| Chinese anemone |
| Sarpagandha, Indian snakeroot |
| Chinese foxglove |
| Chinese or Eastern rhubarb |
| (, ) | Qinghai rhododendron (Qinghai alprose) |
| Chinese magnolia vine |
| Baikal skullcap |
| () | tuberous stemonia of the family Stemonaceae |
| Stephania root |
| Pagoda tree |
| Chinese cucumber |
| Indian stringbush |
Other Chinese herbs
In addition to the above, many other Chinese herbs and other substances are in common use, and these include:
Herbal Formulas
Types of Formulas
Traditional Chinese herbs are used either standalone, or in a grouping, jointly with other herbs. When several herbs are used together, this amalgamation is called a 'herbal formula'.
There are, generally speaking, three types of herbal formulas used in TCM:
1. Classic Formulas – these are formulas which TCM practitioners believe have withstood the test of time over the centuries, and are mentioned in classical texts, such as the Shanghan Lun.
2. Patent Formulas – these are either classic formulas, or newer commonly used formulas created in recent decades. The patent formulas stand out in that their usage is common enough, that they are frequently mass-produced by large companies, in China, the United States, and elsewhere.
3. Custom-Made Formulas – these formulas are composed by a TCM Practitioner, to match the specific diagnosis and medical condition of a patient. These formulas are often partially based on the older, classic formulas.
Formula Hierarchy
The prescription of TCM formulas, is based on 4-tier system of hierarchy.
This feudal-like hierarchy denotes the power and role of each herb in a given formula.
Most herbs can serve as either Jun (Monarch), Chen (Minister) or Zuo (Assistant) – the first three tiers in the herbal hierarchy. But only certain herbs, are considered fit to serve as Shi. This is because only some herbs are believed to have the ability, to guide other herbs into a given bodily area or organ system.
Matching and contrasting herbs
Within TCM formulas, there are also strict rules about which herbs pair well together (Dui Yao), and which are either contradictory, incompatible, or may cause a reaction amongst themselves, or with Western Medicine Drugs.
Notable people
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Ji Desheng (1898–1981), Chinese herbalist from Nantong.
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Li Ching-Yuen (died 1933), Chinese herbalist, martial artist and tactical advisor.
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Aw Chu Kin (died 1908), Burmese Chinese herbalist, inventor of Tiger Balm.
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Ing Hay (1862–1952), migrated to the United States in 1887 and practiced traditional Chinese medicine in Oregon.
See also
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Chinese classic herbal formula
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Chinese food therapy
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Chinese ophthalmology
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Compendium of Materia Medica
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Hallucinogenic plants in Chinese herbals
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Herbal medicine, for the use of medicinal herbs in other traditions.
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Japanese star anise
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Jiuhuang bencao
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Kampo (traditional Japanese medicine)
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Li Shizhen
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Pharmacognosy
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Star anise
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Traditional Chinese medicine
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Traditional Korean medicine
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Traditional Vietnamese medicine
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Yaoxing lun
External links
