Chinese herbal medicine

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Although acupuncture is still by far the most popular TCM modality in the West, Chinese herbal medicine is gaining in popularity around the world. In China herbology is unquestionably the most popular form of TCM healing. So popular, in fact, that amazingly some doctors of herbology see 50 or 60 or sometimes even more patients a day! However, no matter the skill of the doctor, the kind of high-volume medicine necessitated by China's huge population has many drawbacks and thankfully has not become the norm elsewhere.

The category of so-called “herbs” includes medicinal substances obtained mostly from plant, animal, and mineral sources. The vast majority of herbs do indeed come from plants, including a few that are commonly eaten (ginger and licorice are two very important TCM “herbs”).

Very seldom is a single herb prescribed alone. Instead, herbs are prescribed in combinations, ranging from as few as three or four, to as many as two dozen or more. Most prescriptions contain somewhere between 5 and 20 herbs. Since TCM doctors in the West are generally far less busy than their Chinese counterparts, many of them have the time to use both acupuncture and herbs, which can greatly speed up the healing process.

Herbal prescriptions can be delivered in a number of ways, which we will discuss below. Your doctor will tell you in what form you should take your medicine and give you specific instructions. Herbs are usually taken sometime before or after a meal, but not with food. However, there are exceptions—again, if there is doubt, ask your physician, because timing can be important!

“Soup Medicine”—Herbal Decoctions

Decoction is the most common and, it is generally held, the most efficacious way of preparing herbal prescriptions.

Many TCM doctors have herbal pharmacies housed within their clinics, while others (especially in cities that have dedicated herbal apothecaries) do not sell the herbs. If your doctor’s clinic does not sell herbs, you will need to deliver the prescription to a herbal pharmacy in your area. Any big city with a sizeable Chinese population will have lots of them, and today even many small cities have a few such establishments—your doctor will know where to point you.

If you are too busy to boil your herbs yourself, some pharmacies can do so for your for an additional price, and will give you your herbs in sealed plastic pouches which you can then heat up on the stove or in the microwave at home or at work. However, in order to ensure freshness as well as—if you are open to such ideas—to allow your qi to mingle with that of the herbs as you prepare them and inhale the aromatic (some might say pungent) steam given off during cooking, it is generally agreed that it is best to boil the herbs yourself. This is easier than you would think and although the herbs do smell strong and unusual, they will not leave a permanent odor in your kitchen. Your doctor or herbal pharmacist will probably give you specific cooking instructions, but in case you need extra help, we have a tutorial on boiling herbal decoctions here.

Note: the flavor of herbal decoctions can range from slightly sweet to downright ghastly. Sometimes there is no way to doctor the flavor, and the Chinese know well that in order to get the powerful healing effects of TCM herbs, sometimes you have no choice but to “eat a little bitter,” as the saying goes. Even if the flavor is not pleasant, do not wash your prescription down with a large “chaser” of juice or water—you might diminish the effectiveness of the prescription and over-fill your stomach with liquid. Ask your doctor for more specific instructions.

Pills and Gel caps

Gel caps are a new invention, but Chinese herbal medicine has been prepared in pill form since ancient times.

Pills come in two forms: those which you chew, and those which are washed down with a bit of water (or soup or other liquid, if so directed). In both cases, herbs are first ground into fine powders, which are then mixed with honey and allowed to dry. They usually appear black or dark brown. The chewy ones are mildly sweet with a distinct, woodsy flavor. Pills you swallow are very small and leave very little flavor in your mouth. Gel caps, of course, are always swallowed with no chewing; they may contain either powdered or liquid herbal medicine and sometimes also have a woodsy flavor.

If your doctor or herbal pharmacist is very well-equipped, then you may be able to purchase made-to-order pills. In other words, your doctor will write an individualized prescription which will then be filled and ground into powder and placed in pills or gel caps at the clinic or the pharmacy. Because making pills (which requires kneading the herbal powder into honey, squeezing out balls in a mold, and drying time) is very labor intensive, unless you encounter a true connoisseur, you’re unlikely to get made-to-order TCM herb pills. Quite common, however, are made-to-order gel caps, because they can be quickly produced by small grinding and packing machines that fit into a clinic or pharmacy.

Although personalized, made-to-order pill prescriptions are rare today in China and the West, you may very well encounter pills as I have described them in the form of TCM “patent medicines.” These pre-packaged, widely-sold remedies are based upon classic herbal formulas which have been passed down for a very long time, usually centuries if not millennia (this is not an exaggeration—many of the most effective prescriptions still being used all over the world today came were formulated around the time Jesus was preaching the Gospel!). Because they have been in use for such a long time, TCM patent medicines are both safe and effective for a spectrum of conditions, but only if prescribed by a qualified physicians—do not take matters into your own hands and start buying over the counter pills because they sound like they might work for you! TCM Patent medicines are often sold right at the clinic, and can be found at all TCM herbal pharmacies.

Note: washing down pills or gel caps with a huge amount of water or other drink will probably diminish their effectiveness. Ask your practitioner how much fluid to take with your medicine.

Powders (for oral consumption)

Powders are just what they sound like—TCM herbs that have been ground into a powder, which you then take by the spoonful and wash down with water, or else stir into warm water like a pack of Swiss Miss (I concede, of course, that this experience is not likely to be nearly as sweet). Although this is a time-honored method of preparing herbs, it is nevertheless used fairly rarely.

Powders can be made on-demand at some clinics and pharmacies, while others are sold as pre-packaged TCM patent medicines.

Note: washing down powders with a huge amount of water or other drink will probably diminish their effectiveness. Ask your practitioner how much fluid to take with your medicine.

Externally Applied Herbs

Externally applied herbal preparations have also been used since time immemorial in China, with balms, ointments, powders, steaming, baths, plasters, poultices, and so forth all appearing during this huge country's long history. Although it might once have been common for an emperor with a toothache to insufflate his mouth with the steam rising from herbs boiling in a specially-designed pot, this method along with many others has seen its time come and go. We’ll just look at the most common methods still in use today.

Topically-applied Chinese herbal medicines can be used for a variety of conditions. Perhaps the most famous topical Chinese medicine outside of China is the legendary Tiger Balm, which, with its signature eucalyptus smell, is a well-known option for stiff muscles. It is kind of like the Eastern equivalent to Bengay, and is just one of many preparations with similar functions. Very different from Tiger Balm is Yunnan White Medicine, which might well be the most famous topical Chinese medicine in China. Yunnan White Medicine is usually used in powdered form (which is actually pink—go figure) and is so effective at stopping bleeding and promoting wound healing that it is said to have been one of the keys to helping North Vietnamese soldiers fight so effectively during the Vietnam War.

In addition to preparations such as the two famous ones above, it is also very common to come across what might best be called TCM herbal “plasters,” which today are a lot like giant Dr. Scholl’s stick-on patches for sore muscles. In this case, of course, their medical ingredients come from herbs in the Chinese pharmacopeia. Your physician may suggest you use one of these products, which can be especially useful for sprains and all types of aches and pains. Note: although these products’ packaging and names may all seem very similar, make sure you’re buying the right type. In TCM, soreness and pain can be caused by a variety of conditions, so there is no one-size-fits-all pain patch. Today, there are still a very small number of doctors who make their own stick-on plasters, which are often sticky black-brown goop on wax paper which you adhere to your skin for a period of hours or days.

Finally, although somewhat seldom seen outside of martial arts circles, Chinese medicine also boasts many recipes for spirits in which were steeped large amounts of herbs (more on this below). These spirits can be rubbed into the body after strenuous or excessive exercise or in the case of minor injury of overstrain. Kung-fu enthusiasts will know these products as “dit da jow,” which is Cantonese for “traumatic injury liquor.” The dramatic-sounding name is deserved—in the past, having the right secret dit da jow recipe on hand was a key to preventing long-term injury when practicing martial arts conditioning techniques like “iron palm,” “iron fist,” or even “iron forehead.” Even if your athletic program is not quite so intense, you may find these spirits useful in the event of minor over strain. They can often be bought in Chinatown drugstores or even steeped at home in a big jar—ask your TCM physician or pharmacist for advice, and always seek medical attention in the case of serious injury.

Herbal Liquors

TCM has an ancient tradition of using alcohol as a medicine, with written documentation of this practice going back at least 2,500 years. In fact, the steeping of herbs in alcohol was once so prevalent that the bottom part of one of the traditional Chinese characters referring to the field of medicine—醫—is a depiction of a lidded jar used for holding spirits.

In addition to the dit da jow liquors described above, which only are rubbed onto the body externally, alcohol is also used in medicines which are taken internally. Occasionally, herbal decoctions call for a splash of Chinese baijiu (a fierce 80-100 proof drink which is usually distilled from rice or sorghum), but much more common is to find recipes in which herbs are steeped for weeks or months in baijiu before being ready to drink. Such infusions are drunk daily in very small quantities, most frequently to obtain a tonifying effect.

Because they are generally used to tonify, traditionally, herbal liquors are usually drank after middle age has really started to make itself felt, to do things like stave off cold hands and feet in the winter by giving a bit of yang heat to a body no longer in the full glory of youth. Some recipes are known to improve sexual performance for people in this age group, as well. Some Chinatown supermarkets and drugstores may sell such liquors in branded bottles, or the herbal ingredients can be bought individually and then steeped in baijiu at home.

Warning: Before you get carried away with the idea of a drink that will cure your cold hands, turn you into a sexual powerhouse, and get you nice and tipsy remember: these liquors must be drunk in very small quantities and you should definitely check with your TCM doctor before drinking any medical liquors, whether bought off the shelf or home-made. Over-tonifying and blindly-tonifying are two very well-known ways of making oneself very sick by misusing TCM herbs. Herbal liquors used to excess or drank by a person who doesn’t need them will quickly cause major disharmony in the body. If you’re just looking for a nice glow, a glass of red wine or a good pint of Guiness is a much safer route.