Why Is Chinese Herbal Medicine Unique?
I've already mentioned two standout features of Chinese herbal medicine: that single herbs are almost always combined into formulas, and that these formulas work to treat the patient's underlying pattern of imbalance (the "root" of the problem) which causes the patient's symptoms (the "branch" or manifestation of the root). Chinese herbs are also classified according to categories such as temperature, taste, and which body organs they "enter" and have an effect upon. Also, an "herb" in Chinese medicine doesn't have to come from the plant kingdom: animal parts, bones, shells, and minerals are used as well, and over time, toxic and endangered materials have been filtered out of the materia medica. And while herbs and formulas are primarily ingested, they can also be used topically in poultices and washes, or used in TCM manual therapies like tui na massage or cupping.
An Example of an Herbal Diagnosis and Treatment
Herbs
How Did Chinese Herbal Medicine Begin?
The documented use of herbs and herbal formulas in Chinese medicine coincides with that of acupuncture. Even though TCM's first recognized herbalist, Shennong (The Divine Farmer) is thought to have lived around 2800 BCE, the true date of the materia medica attributed to him is the first century BCE, around the same time as the Huang Di Nei Jing was written, in which herbs are also mentioned. Shennong's book classifies 365 different substances into three categories. A few hundred years later, another seminal book, Zhang Zhongjing's Shang Han Lun (The Treatise on Cold Damage Disorders) took the imortant steps of relating herbs to both Yin-Yang theory and Five Elements theory, which are the main influences of diagnosis and treatent in Chinese internal medicine to this day. Zhang was also the first to focus on combining herbs into formulas, as well as the first to group symptoms into standardized patterns of imbalance that are still the primary diagnostic method used by practitioners.
How Does Getting and Using TCM Herbs Work?
Just like with acupuncture, your herbal treatment starts with a series of diagnostic questions to determine your pattern of imbalance. Usually, an acupuncture treatment or other manual therapies are done at the same time that an herbal prescription is given. There are also differnt options as to how you'll receive your herbs: raw, a tincture, or granules. I use granules, the most popular and easiest to use method. Granules are an herb or formula brewed at a high concentration and then dehydrated. You simply use a spoon to measure out your dosage of granules into a glass of warm water, stir, and drink. Herbs are usually taken 2-3 ttimes per day for one or two weeks. If you're new to Chinese herbs and have heard anything about them, it was probably about their famous "earthy-medicinal" taste. I personally find TCM herbal formulas to be as palatable as many supermarket shelf "medicinal" herbal teas, and almost all TCM formulas have ingredients like fresh ginger, red dates, and licorice root which, among other things, make the formulas sweeter tasting.
Let's say you wanted an herbal formula to help you with fatigue. During our interview, you tell me it's especially hard for you to wake up, shake off the "fog" in the morning and get going. When I ask about your emotional state, you tell me that you have the tendency to worry and "overthink" things more than you should. When I ask about your diet, you tell me you lack an appetite at times, and at other times you feel bloated right after eating and sometimes hear gurgling noises. You eat a lot of dairy, sometimes your abdomen feels heavy, and your stools tend to be on the looser, more frequent side. When I feel the three pulses on your right wrist, the middle one feels weaker, and when I check your tongue, it looks puffy and the sides look a little wavy.
Your diagnosis is Spleen Qi Deficiency, and the formula I choose for you is the classic, four-ingredient, Si Jun Zi Tang (Four Gentlemen Decoction). Let's break down how the herbs work together:
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Ren Shen (ginseng root): tonifies Spleen Qi to help with the fatigue, abdominal distention, loose stools, and to calm the mind.
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Bai Zhu (atractylodis rhizome): helps Ren Shen tonify Spleen Qi, also helps with the lack of appetite, dries Dampness: the heavy body feeling, which is caused by the accumulation of fluids when the Spleen system is deficient and not functioning properly.
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Fu Ling (poria): helps Ren Shen strengthen the Spleen and addresses the bloating, helps Bai Zhu dry dampness, in this case via urination, but moderates the overly-drying nature of the next herb on the list:
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Zhi Gan Cao (prepared licorice root): moderates the draining properties of Fu Ling, warms and strengthens the Spleen, harmonizes the other herbs in the formula to work better together and, as Gan Cao literally means "sweet herb" in Mandarin, helps improve the flavour of the formula.
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All these herbs have the following in common: they're all considered "sweet" (the flavour that correspoinds to the Spleen), they're all warm-natured, and they all enter the Spleen. I hope this helps you get a better picture of why herbs are used to work together in TCM.