Benefits of Herbal Medicine
There are many benefits of herbal medicine. What is the best herb for insomnia, hair loss, menopause, arthritis or weight loss? These are the questions that are very hard for a traditional Chinese medicine (TCM) practitioner to answer because “insomnia” and “menopause” are not the way TCM doctor view and analyze “diseases”, and herbs function in teams, not as an individual. We can explore these questions from two aspects: (1) How TCM doctors diagnose and treat diseases and (2) How herbal medicine work.
East meets West in Diagnosis of Causative Agents and Disharmony Patterns
Chinese Medicine was developed 4000 years ago
Let’s take the example of stomach ulcer. A western gastroenterologist would diagnose the condition with upper GI and endoscopy and his standard treatment would be antibiotics and proton pump inhibitor. To the western doctor, the cause of patient’s stomach pain is the ulcer. Any other symptom the patient may experience elsewhere in his body has little bearing on the diagnosis or treatment of the ulcer. To a TCM doctor, however, he doesn’t see one disease entity (ulcer) but several patterns of disharmonies.
Our first example patient is a middle age businessman. He is under a lot of stress and his manner is aggressive. In addition to stomach pain he is constipated and passes scanty amount of dark yellow urine. He complained of alternating sour belching and bitter taste in his mouth as well as periodic headache around the temples and ringing in the ear.
Upon examination is face and tongue are red and the coating of the tongue is yellow. His pulse is wiry, pounding and fast and the stomach pain is aggravated by abdominal palpation. This patient has “Liver and Gallbladder Fire Invading the Stomach” and the treatment would be calming the fire.
Our second patient also complains of sour belching and headaches. She is a pre-menopausal lady who is very moody and acknowledges that emotional stress and menses would worsen her stomach pain. In addition to stomach pain she complains of migratory distension and soreness in her chest and flanks and “lumps” in her breasts that come and go. She has dark red tongue with thin white coat and her pulse is wiry and thin. This lady has Stagnation of Liver Qi but lack the heat signs of the businessman. We treat her by soothing the liver congestion.
Curiously, herbal medicine that is mainly used to regulate the menses could be used here to treat her stomach pain for in TCM principles, liver is the organ that stores blood, regulates menses and modulate emotions. In the mind of a TCM practitioner, this is not a woman with two different diseases, PMS and ulcer. Rather, this is a woman with Liver Qi Congestion.
This is not mere semantics but a perceptual difference of great importance. When you look at the lady face on then from the back, you get two drastically different images. However, her face and the back of her head, different though they are, don’t constitute two women. They are the images of the same woman from different perspectives, just as mood swing and stomach ache are the different manifestations of Liver Qi Congestion.
Our third patient is an elderly lady who is thin with ashen complexion and ruddy cheeks. In addition to stomach pain she complains of vague pain and weakness in her back and knees as well as thirst, sweaty palms, night sweats, insomnia, poor memory and nervousness. This patient has “Deficient Yin in both Kidney and Stomach” and the treatment would be nourishing Yin.
Our fourth patient is a timid retired teacher who complains of cold limbs (including hands and feet,) fatigue and poor appetite. His “mild but nagging” stomach pain is relieved by warm compress, massage and eating. He tends to have loose bowels which are worsened by salad and cold drinks while his urine is clear and his urination frequent. This patient is treated by stoking the fire in his middle heater.
. Physicians of that time didn’t have the technology we have now to measure the intricate physiologic processes inside the body. They were forced to gather “outside” clues ranging from luster of the hair to quality of the voice, from sweaty palms to cold feet, from color of the urine to changes of bowel habits to infer what was going on “inside” the body.
Out of this comes the concept of “holism” where to a western trained physician, seemingly unrelated complaints and “signs and symptoms of incidental finding and questionable diagnostic significance” are weaved as components of distinct patterns of disharmony.
Thus one disease entity, i.e. peptic ulcer, can be discerned into several patterns of disharmony, each requiring different treatment. The science of western medicine strives for standardized care while the art of TCM yields individualized treatment plans.
One or Many, of the Central Importance of Qi
Upon to this point you may think TCM is just a method of classifying diseases into endless categories of disharmonies. But nothing can be further from the truth. TCM deals with Qi, the vital energy and general guiding principle that drives and controls every process in the body.
The definition of Qi usually encompasses 5 functions:
- Warming and Moistening Aspect that nourishes the viscera, muscles and sinew, skin and hair and keeps the body’s constant temperature
- Holding Aspect that keeps everything in its place---blood in vessels, urine in the bladder, tear in the eyes, saliva in the mouth, organ in its proper location
- Protecting Aspect that fends off external evils (roughly the western equivalent of the immune system)
- Transforming Aspect that assimilates nutrients (roughly the western equivalent of the digestive system)
- Moving Aspect that regulates and controls movement of all types in the body—i.e. heart Qi for circulation, lung Qi for breathing, bladder Qi for urination, and most importantly, kidney Qi for the life cycle (birth, growth, maturation, reproduction, aging and dying.)
To illustrate the utility of Qi in both diagnosis and treatment, let’s examine a pattern of disharmony in TCM called Collapsed Qi, where the energy of the patient gets so weak such that it loses its holding action and patient’s blood seeps out of the blood vessels.
At the same time the patient may also suffer from any of these symptoms: fatigue, weight gain, shortness of breath, low soft voice and little desire to speak, spontaneous sweating, coldness in body and limbs, stiffness and pain in muscles and joints, dry skin and brittle hair, excessive tearing or dryness of the eyes, dry mouth or excessive drooling, chronic diarrhea, incontinence, hemorrhoids/prolapsed rectum, or prolapsed uterus.
If we take the subspecialty mentality of western medicine to the extreme, this patient would need to see a hematologist for his bleeding disorder, internist or endocrinologist for sweating, fatigue and weight gain, psychiatrist for the lack of desire to speak or move about, fatigue and weight gain, rheumatologist or orthopedist for joint pain, physiatrist for muscle pain, dermatologist for skin and hair, opthomologist for eye complaints, otolaryngologist for dry mouth or drooling, pulmonologist for SOB, gastroenterologist for diarrhea, urologist for incontinence, proctologist for hemorrhoids and OBGYN for prolapsed uterus.
But to the TCM doctor, all these symptoms are just different manifestation of a single entity---Collapsed Qi---which can be treated effectively with a single formula.
Silver Bullet vs Teamwork, of Cars and Herbal Medicine Formulae
Now let’s talk about how herbal medicine works. Chinese medicine does not talk about bacteria, yet it has combinations of herbs called formulae that can be used effectively to treat ailments from bacterial endocarditis to skin infection.
The oldest formulae are more than 3000 years old and the newest ones are several hundred years old. This is a remarkable feat when we consider the fact that in western medicine, a new generation of antibiotics would encounter resistance in 10 to 20 years.
The secret for herbal medicine’s longevity lies in the combination---Each herb may have hundreds of active compounds. When that herb is mixed with ten or so other herbs (each with its hundreds of active compounds) in a hot water solution, they can combine and generate thousands upon thousands of new compounds that no bacteria would have the enzymatic machinery to inactivate them all.
Each herbal medicine could have several actions, but to treat a particular ailment, we need to use only one or two but not all of its actions. That’s where the formulae come in.
Just like the Chinese culture is a culture that emphasize hierarchy and order and TCM stresses the pattern of discord, the TCM formulae are the model of balance and harmony.
A typical formula consists of one or two emperor herbs that have main action, several assistants herbs that augment the action of the emperor herbs, several minister herbs that curb the unwanted actions of the emperor herbs and finally one or two ambassador herbs that bring the entire formulae to the proper meridian and general location of the body.
Thus herbs function in teams, each one playing its part to achieve the purpose of restoring balance. To take the metaphor of a car, engine (the emperor herb) is arguably the most important part of the whole system, but it needs fuel pump and gas tank (the assistant herb) to provide it with fuel, radiator (minister herb) to cool the engine block to prevent overheating, steering wheel and tires (ambassador herb) to take the car to its destination. To talk about a single herb for a particular condition makes as much sense to a TCM practitioner as a person taking out the engines of several cars and expecting them alone to take him to his destination faster than an intact car.
Instead of asking what herb would alleviate my insomnia, a more fruitful way of inquiry may be what disharmony in my body that is causing the insomnia as my major presenting symptom.
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