Western Herbs according to Traditional Chinese Medicine

A Practitioner's Guide

Thomas Avery Garran

• Publisher: Healing Arts Press
• Year: 2008
• Print ISBN: 9781594771910
• eBook ISBN: 9781594777417
• Topic: Medicine
• Subtopic: Alternative & Complementary Medicine

The first book to exclusively use Chinese medical theories and terminology to guide practitioners of Chinese medicine in the use of Western herbs • Written entirely according to the theory, diagnosis, and treatment paradigm of traditional Chinese medicine (TCM) • Explains how to combine and modify the standard TCM formulas to non-Chinese herbs suitable for Western practitioners • Includes 58 monographs of common Western healing herbs, detailing how each plant is used clinically The ever-growing number of Chinese medicine practitioners in the West has brought about an amalgamation of many styles of Chinese medicine and various other forms of medicine from around the world. This book addresses the increasing demand for knowledge of how to integrate plants from outside the standard Chinese materia medica into the fold of Chinese medical practices in the West. It is the first in-depth guide to using Western herbs exclusively according to the theories, diagnoses, and treatments of traditional Chinese medicine that harmonizes the unique terminology and theories of TCM with other botanical medicines.The book contains 58 monographs, illustrated with full-color photographs, of herbs commonly used by Western herbalists. Each herb is grouped by the basic categorization for medicinals in Chinese medicine, such as Herbs that Resolve the Exterior and Herbs that Regulate Blood. The monographs detail the energetics, function and indication, channels entered, dosage and preparation, and contraindications of each plant. The author also explains how to use the herbs to modify standard formulas used in everyday Chinese herbal medicine, based on his own clinical experience. An appendix of Western Analogs for Chinese Herbs further highlights 40 Chinese medicinals that have related species growing in the West.

UNDERSTANDING WESTERN HERBS FROM THE CHINESE MEDICAL PERSPECTIVE

One of the advantages of the Chinese medicine materia medica over the Western materia medica is that it represents the culmination of thousands of years of clinical data. In the West, much of our herbal knowledge includes large gaps of time during which information was not passed on, or when entire lines of understanding were broken. Consider the Native American tradition and how little is known about how these people used plants, or think of the four-humors system of Western–Arabic medicine. Over time, with a continued and unbroken chain of doctors who used many of the same herbs, the Chinese were able to build and record an extensive and specific materia medica based on an ever-evolving system of medicine. Although Chinese medicine has changed through the years, the basic theories have remained more or less the same through the millennia. That being said, it is important to remember that there is also a large body of literature concerning the use of herbs in the West, and with the current resurgence in herb popularity, there will undoubtedly be much more.

Many materia medicas written in the West, especially the popular ones, are largely regurgitations of work done in the past. Moreover, the theories of Western biomedicine are in a constant state of flux; what is true today may well be false tomorrow. I am sure that replication of materia medicas also occurred in Chinese medicine, but instead of getting more general, as some of the (popular) Western materia medicas have, the Chinese materia medicas have become more specific. In the West, works such as Scudder’s Specific Medication show just how specific Western herbal medicine can be. However, many of the popular Western materia medicas are written according to generalities. For example, if you look up “cough” in most Western materia medicas, you will find listed many herbs that are good for cough, but little differentiation among the different herbs or the different types of coughs for which they may be appropriate. There are some good, professionally oriented materia medicas (and a few popular ones) that avoid this pattern. However, looking in a Chinese materia medica, one will find more or less the same number of herbs listed for cough as in the Western herbal, but find that they are differentiated into categories according to the type of cough to be treated, an obvious asset for the practitioner.

Another difference between Chinese and Western materia medicas is that there is much more emphasis in Chinese medicine on the use of formulas and combinations (polypharmacy); the old formulas from Western herbalism are rarely used. This may have to do with the fragmented history of herbal medicine in the West.^a In Chinese medicine, where some of the same formulas written two thousand years ago are still used and discussed today, the idea of formulation and herb combinations is critical to practice.

The term “Western herb” as used in this book has broad meaning. The majority of these herbs are native to Europe, the Middle East, and North America. Others that are commonly used hail from Africa, South America, and the South Pacific. Many plants from Asia also have been incorporated into various systems of Western herbology. There has been trade of herbs and spices between Asia and Europe since the beginning of the Common Era. Herbs such as ginger, cardamom, and cinnamon were among the earliest traded into some parts of Europe. As early as 65 CE, there was enough cinnamon in Rome for a year-long funeral rite for Poppaea, Nero’s wife.

Likewise, various herbs used in Chinese medicine come from other parts of the world. As early as the seventh century, herbs such as frankincense, myrrh, dragon’s blood, and aucklandia came from the Middle East.¹ In 667 CE, Christian missionaries from Daqin brought opium from Europe.² Between the fifth and thirteenth centuries there was much trade between China and other Asian countries, the first of which were India and Vietnam. From Vietnam came coix, aquilaria, clove, amomum fruit, fennel fruit, black pepper, long pepper, alpinia, alpinia fruit, zedoraria, erythrina bark, cinnamon bark, turmeric, momordica seed, evodia fruit, sappan wood, and areca fruit. Finally, from the Americas came American ginseng, corn silk, echinacea, and now perhaps a few more. Some herbs used in Chinese medicine grow here in the West as native plants, nonnative weeds, or cultivars. These include glehnia, eclipta, cyperus, honeysuckle flowers, and round-leaf vitex.

In a lecture I attended once, the teacher stated that Chinese herbs must be stronger because we generally use the top three hundred to four hundred herbs from a materia medica of around five thousand substances, and that the Western materia medica represented “the best fifty herbs from a choice of one hundred to two hundred.” I am quite sure this person merely misspoke. Those familiar with the Chinese materia medica know that the list of five thousand substances to which the speaker referred consists of 15 to 20 percent animal and mineral products. Further, the first book I reached for on Western herbs, Potter’s New Cyclopaedia of Botanical Drugs and Preparations, by R.C. Wren, F.L.S., discusses nearly five hundred and fifty botanical medicines. Thousands of botanical medicines not mentioned in this book are used by practitioners throughout the Americas, Europe, and Australia. In fact, tens of thousands of plants are used throughout the world as medicine. Certainly, some of those are stronger, or even better or more applicable to specific conditions than others in use. However, there is no correlation between potency and the country or region in which the herbs grow. Ultimately, the herbs we choose to treat a specific pattern or condition should not be based on their country of origin as much as on their ability to treat the patient and relieve suffering.

The importance of clear terminology to describe medicinal plants and their actions has been an issue in Western herbal medicine through the years. This is evidenced in the monograph on echinacea from King’s American Dispensatory, originally published in 1899. Professor King states,

The day is rapidly approaching when these qualifying terms [Author’s note: e.g., antiseptic and alterative] will have no place in medicine, for they but inadequately convey to our minds the therapeutic possibilities of our drugs. Especially is this so with regard to such terms as alterative, stimulant, tonic, etc. If any single statement were to be made concerning the virtues of echinacea, it would read something like this: “A corrector of the depravation of the body fluids,” and even this does not sufficiently cover the ground.

There is a striking resemblance here to the way ideas about medicinals are expressed in Chinese medicine. This is particularly interesting because King’s American Dispensatory is without question the most comprehensive materia medica written in American history.^b This monumental piece of literature stands as the epitaph of Eclectic medicine (an important plant-based system of medicine that flourished in the United States from the mid-nineteenth into the early twentieth century), even though it was revised for the last time in 1898—forty years before the last Eclectic medical school closed its doors. Perhaps the Eclectics were moving toward a more energetic understanding of botanical medicine. Unfortunately, because of various factors that contributed to the decline of botanical medicine in North America, we’ll never know for sure.^c

THE CONSTRUCTION AND USE OF A MATERIA MEDICA

Creating a materia medica of Western herbs using the language of Chinese medicine is no small undertaking, and I certainly do not consider this work absolute. However, I feel strongly that the material herein is an important step toward uniting the roots of Western herbalism with Chinese medicine. The old English proverb says it simply: “Both together do best of all.”

I have studied many materia medicas. The information gleaned from this study, combined with the experience of my teachers, my own experience, and the experience of fellow practitioners is the basis for my viewpoint on individual herbs in the Western materia medica. Because I am a trained Chinese herbalist, the idea of combinations (duì yào) is important to me; thus I try to incorporate this concept with Western herbs in as much detail as possible. Many of these combinations come from historical references. Because some of the combinations are new, I admit that I have less data on them than I would have liked to have. However, I have tried everything described in this book and found that it worked to my satisfaction, or I would not have included it.

When I initiated this work, I first outlined what I had learned from teachers and from my clinical experience. I looked through patient files to see how I had used specific herbs for specific Chinese diagnoses, and determined whether or not the patient had responded in the way I expected. This was a difficult process, as I use polypharmacy and it was not always easy to see how a single herb or combination of herbs affected a person. However, with careful study, patterns began to arise, and what at first was obscure began to come clear.

The next step was to research how these plants have been used in their native systems of medicine. I have drawn heavily on the work of the American physicians of the nineteenth and early twentieth centuries in the Physio-medical and Eclectic schools of medicine. Much of my understanding of the Western herbal tradition is based on the body of clinically based information they amassed. I find many of the much older European texts to be a bit obscure and cumbersome. This does not mean that I have not referenced some of the great classical herbalists, such as Culpeper, Gerard, Parkinson, Dioscorides, Galen, and even Hippocrates, but only that their contributions do not make up the bulk of the material presented herein. This stands in marked contrast to the tradition of Chinese medicine, in which the classics are heavily weighted.

When considering the five flavors and qì of herbs, I considered not only the actual taste as it occurs in the mouth, but also the physiological response each herb produces in the body. I am trained in the culinary arts, and the idea that the flavor of an herb can suggest something about how it acts physiologically has always intrigued me. In my early days as an herb student I spent hours on end tasting herbs, trying to understand how the Chinese came up with the flavors they ascribed to each herb. At first, I was often befuddled, because my mouth could not taste the flavors listed in the texts. I then learned that taste means more than mere flavor in the mouth, and that it has more to do with effects on physiological function than anything else. In other words, in order for a plant to be ascribed a particular taste, it had to perform the action representative of that flavor. With this understanding, I was able to train my palate and my body to taste the five flavors (plus bland) of Chinese medicine. These actions are clearly laid out in the theories of Chinese medicine: Acrid flavors disperse and move; sweet flavors supplement, harmonize, and sometimes moisten; bitter flavors drain and dry; sour flavors astringe and stop or prevent leakage; salty flavors purge and soften; and bland flavors leach dampness and promote urination.

Michael Tierra, Peter Holmes, and Dan Kenner had already done much work in ascribing the five flavors to Western herbs, and I have translated some Chinese sources describing the flavors, qì, actions, and indications of some of the herbs found in this text. However, I took it upon myself to decide how I would ascribe flavors and qì to the herbs, based on my own clinical experience and many hours of meditation, before referencing any other work. This allowed me to consider each herb clearly without outside influence; I could then sit down and compare my ideas with the other available material to decide how to present each medicinal in this book. It is important to note that flavors and qì within the Chinese materia medica often differ, at least somewhat, from book to book.

Next, by looking at symptom groups (i.e., how symptoms can be grouped to show a pattern, as defined by Chinese medicine) I was able to get ideas about how the actions of the medicinals relate to the Chinese concepts of how the body works. Coupled with the five flavors and qì, these ideas gave me the basis for the majority of the work I’ve presented in this book. This involved a tedious process of reviewing many texts and looking for similarities as well as discrepancies, and then comparing and contrasting these with my own experiences and the experiences of my teachers and colleagues. However, it was also an extremely interesting process of learning and discovery. For example, I found that some Chinese books described applications for Western herbs that were nearly the same as Western applications, though they used different words to explain the clinical picture and diagnosis.

Some herbs were easier to figure out than others. Lobelia, for instance, was a struggle, because it has such a wide range of uses—some seemingly contradictory. In contrast, herbs like usnea were relatively easy. Throughout the process, I applied my ideas in clinical practice and occasionally made changes and modifications to the text according to what I observed. I also asked certain colleagues—those with training and experience with both Chinese medicine and Western herbs—to read through drafts and critique my work, and consequently made some additions and changes based on their input.

In conclusion, although it was challenging, I believe my process was far easier than the one Chinese herbalists underwent to classify Chinese herbs. I say this because I had a base of literature from which to work and teachers to guide me. In the early days of Chinese medicine, practitioners had much less to work with and probably even needed to experiment with their patients in order to get a clear understanding of how specific medicinals worked.

EASTERN VS. WESTERN WAYS OF WORKING WITH HERBS

There are a number of differences in the primary methods by which herbs are employed in Chinese and Western systems of herbal medicine. Most of these relate to either preparation or formulation styles. Gaining a better understanding of how these methods differ gives us insight into the healing systems the plants have been used in for millennia. I believe this insight helps us create the paradigm shift necessary to understand the use of medicinal plants that currently fall outside the traditional Chinese materia medica through the eyes of Chinese medicine.

Formulation is the main mode in which Chinese herbalists use botanicals, a concept that is often overlooked in Western herbology, at least as evidenced by many of the popular products available in health food stores and markets. When Chinese herbalists see a patient, they generally think of formulas that might be helpful for that particular patient, whereas the Western herbalist is more likely to think in terms of individual herbs that may prove beneficial to the case. Both ways of seeing have inherent benefits, but being able to see with an eye from each perspective is perhaps most useful of all. On the one hand, there are formulas that may address the pattern(s) at hand, while on the other, there may be specific herbs that can be used to modify the representative formula to best suit the individual case. The Chinese herbalist formulates in this way as a matter of course, but many Western herbalists strive for simple, to-the-point prescriptions. This keeps formulas small and makes it easier to pinpoint potential problems and thus determine how to make changes to a particular formula. Further, the bulk of Western formulas are acutely focused on the treatment principle to treat a specific disease rather than a constellation of symptoms that make up the patterns of Chinese medicine. For example, the formula may address only an acute manifestation of a disease, with little consideration for other symptoms that make up underlying patterns and may be contributing to the acute illness.

Western herbal preparation methods are also somewhat different from those employed in Chinese medicine. The most significant difference is the large amount of tinctures dispensed in the West, compared with a relatively insignificant number of tinctures dispensed in China. In Chinese medicine the vast majority of preparations are water extracts and, recently, an ever-increasing number of powdered extracts (especially in Taiwan). The bulk of the water extracts are simple decoctions. This means the herbs are simmered in a pot of water for the appointed amount of time, strained, and drunk. (Some notable exceptions are uncaria [gōu téng], mint [bò hé], agastache [huò xiāng], and a few other aromatics, which are added for the last five minutes of decoction or sometimes incorporated as powders into a finished decoction.) In spite of this fact, there is a very long tradition of medicated wines in Chinese medicine, dating back to at least the Shang Dynasty (1766–1122 BCE).³ Furthermore, Chinese herbalists widely prescribe powdered or solid extracts, which are basically nonexistent in Western herbal practice (with the exception of modern phytomedi...

Table of contents

• Cover
• Title Page
• Acknowledgements
• Contents
• Foreword By Michael Tierra, L.Ac., OMD
• Foreword By Z’EV Rosenberg, L.Ac.
• Preface
• Introduction
• Part One: Methods and Measures
• Part Two: The Materia Medica
• Appendices
• Footnotes
• Notes
• Bibliography
• About the Author
• About Inner Traditions
• Books of Related Interest
• Copyright