Welcome to Traditional Chinese Materia Medica!

Transcription

1 Traditional Chinese Materia Medica Terry Willard PhD Cl.H and Tiffany Freeman R.Ac TCMD Cl.H 2010

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3 Welcome to Traditional Chinese Materia Medica! The following course is a series of 12 lessons focusing on a specific category of traditional Chinese herbology and the individual herbs within each category. Each lesson looks in depth at these Chinese herbs through herbal monograph studying: the names, origins, meridians entered, energetics or temperature, traditional Chinese usages, famous combinations, other usages, and scientific research, etc. The objective is to gain an understanding of each herb and their clinical usages. Please complete lesson worksheets (labeled WRC COPY) and complete final exam,they are to be handed in to the Wild Rose College. Ensure to write your name, student number and date in the spaces provided. Extra copies of the lesson worksheets are yours to keep for your reference. Each question is multiple choice/choose the best answer and therefore has 1 right answer; marking more than one answer will be marked incorrect. The assignments are worth 60% of your total mark and the final is worth 40% of your total mark. Course Outline Lesson Topic Assignment 1 Introduction to Traditional Chinese Lesson 1 worksheet Materia Medica 2 Herbs that release the exterior Lesson 2 worksheet 3 Herbs that clear heat Lesson 3 worksheet 4 Downward draining herbs Lesson 4 worksheet 5 Herbs that drain dampness Lesson 5 worksheet Herbs that expel wind-dampness 6 Herbs that transform phlegm & stop coughing Lesson 6 worksheet 7 Aromatic herbs that transform dampness Lesson 7 worksheet Herbs that relieve food stagnation 8 Herbs that regulate qi Lesson 8 Worksheet 9 Herbs that regulate blood Lesson 9 Worksheet 10 Tonifying herbs Lesson 10 worksheet 11 Herbs that warm the interior and expel Lesson 11 worksheet cold Herbs that tonify yang 12 Herbs that stabilize & bind Lesson 12 NO worksheet Herbs that calm the spirit Herbs that extinguish wind and stop tremors FINAL EXAM FINAL EXAM Enjoy! Terry Willard PhD Cl.H, Melonie Jensen R.Ac TCMD & Tiffany Freeman R.Ac TCMD Cl.H 2010

4 Lesson 1: Introduction LESSON 1: Introduction to Traditional Chinese Materia Medica History The use of natural substances as medicine in China, such as herbs, minerals and medicines of zoological origins, can be traced back to 1.7 million years ago to the time of first human activity. Lay doctors or Shamans, who were mostly women at that time, would use these substances that were found in their surroundings to treat the ills in their communities. These shamans or!wu!, meaning women who can bring down the spirits, had a close relationship, understanding and communication with nature. Among the peoples of that time it was believed that illness and health were subject to the principles of a natural order and much of that belief was steeped in superstitions. 1.!Wu! Shaman The shamanistic tradition was partly absorbed by Taoism; with medicine playing an important role in the development of Taoist religious activities. Later, in the sixth century BCE, this was still the case with Confucius noting that, "A man without persistence will never make a good shaman or a good physician". Bear in mind that apart from the recorded documents, much of what is said about the origins of Chinese medicine is more legend than history. It was quite common to write material anonymously and attribute it to historical figures and heroes. According to the legend, the origins of traditional Chinese medicine are traced back to three legendary emperors/mythical rulers: Fu Xi, Shen Nong and Huang Di. Historians believe that Shen Nong and Fu Xi were early tribal leaders. Fu Xi was a cultural hero who developed the trigrams of Yi Jing (I Ching) or

5 Lesson 1: Introduction the Book of Changes. Ancient texts record that Fu Xi drew the eight trigrams, and created the nine needles. Shen Nong, the legendary emperor who lived 5000 years ago, is hailed as the "Divine Cultivator"/ "Divine Farmer" by the Chinese people, as he is attributed with being the founder of herbal medicine, and taught people how to farm. In order to determine the nature of different herbal medicines, Shen Nong sampled various kinds of plants, ingesting them himself to test and analyzed their individual effects. According to the ancient texts, Shen Nong tasted a hundred herbs in a single day, including 70 toxic substances, in an effort to understand how to relieve people's pain from illness. As there are no written records, it is said that the discoveries of Shen Nong was passed down verbally from generation to generation. It was first put to paper in approximately 101 BCE in the Sheng Nong Ben Cao Chien (The Divine Husbandman"s Classic of Materia Medica), commonly referred to as Ben Cao meaning material medica. 2. Fu Xi, Shen nong, Huang di The first emperor, Huang Di (Yellow Emperor) came to the throne 100 years later in 2696 BCE. The classic, the Yellow Emperor's Inner Classic (Huang di nei jing), was also verbal until compiled onto paper between 200 BCE and 100 CE (current or Christian era). It is divided into two sections, Basic Question (Su wen) and Spiritual Pivot (Ling shu), each containing eighty one chapters. This book is the theoretical foundation of Chinese medicine. Even though Traditional Chinese Medicine (TCM) has a long written tradition, going back 2-5,000 years, much of it is still somewhat oral. Many of the ancient texts and even some of the modern works are considered notes to aid a 'master' to teach students from. They have almost been considered 'code' books that can only be fully utilized under the guidance of a master. Many converging traditions make up what is now called TCM. The Chinese government has attempted to solidify many of these #"

6 Lesson 1: Introduction Compiling the Classics traditions into a modernized, written tradition. This effort has fallen under a great amount of communist influence over the years and is consider only partial material by some. Traditions coming out of non-communist China, as well as many secret 'mystery schools' have very strong oral traditions attached to them, teaching different versions of the same material. By the Later Han Dynasty ( CE) the complete Yellow Emperor's Inner Classic (Huang Di Nei Jing) was compiled and published. This classic shows that observation of the natural world reflected the principle of human health. The Huang Di Nei Jing was a philosophic expression of medicine, showing the basis of yin and yang and the five phases and that the human microcosm is a miniature of universal reality. The herbal content is rather slim with only 12 prescriptions and a total of 28 medicinal substances. 3. Huang di, the yellow Emperor The Divine Husbandman's Classic of Materia Medica on the other hand, contained 364 (5) medicinal substances, one for each day of the year. There are 252 botanicals, 45 (6) minerals and 67 zoological entries. It was the first book of it kind to focus on individual herbs and is the origin of the term medicinal property (in TCM literature). It further divided substance into upper, middle and lower grades. The upper grade nourishes life, the middle grade nourishes constitutional types (xing) and the lower grade expels disease. Each substance is evaluated for taste (wei) and temperature characteristics (qi), as well as toxicity. It also outlines 170 kinds of diseases that can be treated with the above medicinal substances. Although this classic is attribute to the famous and mythical Divine Husbandman (Shen nong), it was compiled in the first century by various authors and then complied in the sixth century by famous Taoist, Tao Hong- Jing. By the first century the term 'ben cao' was employed, which $"

7 Lesson 1: Introduction literally translates to mean 'materia medica', but also implies the knowledge from the information. Zhang Zhong-Jin (ca. 2nd - 3rd century CE), one of the most famous physicians in Chinese history, lived in the late Han Dynasty. He wrote several works, including the famous!shang Han Lun! (Treatise on Cold Disease). This 16 volume collection has details on diagnosis and treatment for 397 ailments with corresponding herbal prescriptions and is the origin of several famous formulas still used today. By this time there was much work done (mostly in secret) by the Taoists, who concentrated on alchemy and the elixirs of longevity and immortality. Much of this material is either lost or held by secret societies. Other works Guo Hong ( CE) wrote!bou Po Shi!, an alchemical introduction to medical chemistry. His 3-volume!Yue Han Fan! was a collection of many classic and folk remedies Tou Yu-Gin ( CE) was a famous herbalist that created the!ben Cao Chein! (seven volumes, 730 herbs) and!yung-san Chian! (a book on longevity). The Newly Revised Materia Medica,!Tang Ben Cao" (659 CE), was commissioned by the Emperor Li Chi for Su Ching and 20 scholars to create the new materia medica. It had 54 chapters, with 850 drug descriptions, including illustrations and 20 of the drug descriptions imported from other countries. It reportedly corrected many mistakes found in earlier works. Tang Shen-Wei's Materia Medica Arranges According to Pattern (Zheng lei ben cao, 1108) was the major materia medica of the Song dynasty ( ). It contained 1,558 medicinal substances. 4. Li Shi Zhen %"

8 Lesson 1: Introduction By 1596 famous physician Li Shi-Zhen's Grand Materia Medica (Ben cao gang mu) is published, having 52 volumes containing: 1,892 substances: 1,173 botanical, 444 animal and 275 mineral entries. It also has an appendix with 11,096 prescriptions. It has been translated into over 60 languages, part of which is still used today. Much work and research has been done in the development of Traditional Chinese Materia Medica"s during the past two thousand years. Official transcripts and texts now include folk remedies from the countryside and many other herbs from outside of China. Post-revolution Period ( present) The Chinese republic was born after the 1911 revolution, with Western-educated physician Dr. Sun Yat-sen becoming the new leader. He basically outlawed all forms of ancient outdated 'folk medical practice' in favour of new western medicine. Herbal use fell into a dark age with most knowledge in the cities going underground, but still active in the countryside. During the long march ( ), then revolutionary Mao Zedong had no modern medicine available to him and relied on acupuncture and natural remedies for himself and troops. He was so impressed that he pronounced in 1949 that "Chinese medicine is a great national treasure; we must strive to improve and elevate its status." Since that time considerable resources have gone into studying and researching TCM. The current Encyclopedia of Traditional Chinese Medicinal Substance (Zhong yao da ci dian) contains 5,767 entries and is considered the definitive Chinese compilation to date. Today, China embraces traditional Chinese medicine and it is practiced throughout the country. Most Chinese hospitals are fully integrated and provide traditional and modem medicine together. Major medical universities provide two tracks of study. Students may choose to study traditional or conventional medicine. Regardless of the course of study, doctors in China receive training in both forms of medicine. The only difference is that one form is stressed over the other. Medical research facilities continue to study traditional Chinese medicine and are creating strong evidence to support its use for both old and new medical problems. &"

9 Lesson 1: Introduction Comparing Chinese and Western Medicine Even though these two cultures were virtually isolated until the famed Marco Polo visit in the 13th century, there were many concordant advances in their respective landmarks of medical history. The Yellow Emperor Classic appeared around the same time as Egyptian papyrus (approx BCE) revealed ancient medical practice in the west. Both based their philosophies on a macro/micro-cosmos reality of the universe, nature and man. The knowledge of blood circulation, with similar diagrams, makes one wonder what was behind this era of history/civilization. Two historic figures, Confucius ( BCE) in China and Hippocrates ( BCE) in Greece, lived almost at the same historic time, since Hippocrates was born within two decades of the death of Confucius. More amazing was the contemporary appearance of two great physicians, Hua Tuo ( CE) and Galen ( CE). Hua Tuo, a legendary Chinese surgeon who reportedly used anesthesia (Ma Fei San) for surgery centuries before such achievement in the West, could have met Galen in Rome for a medical conference, if they could have traveled by air. Galen of course was a titan in Western medicine, whose ideas influenced European medicine for more than a millennium. Imagine while Hua Tuo was draining an abscess for an army general, Galen was amputating the mauled leg of a gladiator in a Roman theatre. According to Professor Joseph Needham of Oxford, by the time William Harvey explained our modern concept of blood circulation in "De Motu Cordis" (1628 CE), Chinese physicians were already able to make differential diagnosis between typhoid fever and typhus fever, and had extracted steroids from urines. Herbal Energetics Herbs are a natural form of qi, with specific actions and properties. Their qi is used to influence the qi of the body and therapeutically restore balance. These energetic qualities are described through the '4 Qi': nature, taste, tendency and quality. '"

10 Lesson 1: Introduction Nature A herb's nature implies the temperature qualities of: hot, warm, neutral, cool and cold. Therapeutically, hot and warm are considered yang and are used to treat yin conditions, while cold and cool are yin and used to treat yang conditions. "Hot diseases must be cooled, and cold diseases must be warmed." -Nei Jing, chapter 74 Taste A herb's taste is categorized as acrid, sweet, bitter, sour, and salty. Energetically, acrid flavours cause qi to scatter and disperse, as do sweet flavours. Acrid and sweet are both yang in nature due to their ability to move qi. Bitter, sour and salty flavours all cause qi to move downward and consolidate, this makes them yin. 5 Tendency Acrid flavours enter the lungs and travels in the qi, when there is a disease of the qi, acrid flavours are to be avoided. Sweet flavours enter the spleen and moves in the flesh, when the disease is of the flesh sweet flavours are to be minimized. Bitter flavours enter the heart and moves in the bones, when the disease is of the bones bitter flavours are to be avoided. Sour flavours enter the liver and move in the sinews, when the disease is of the sinews sour flavours are to be avoided. Salty flavours enter the kidneys and travel in the blood, when the disease is of the blood salty flavours should be avoided. Generally speaking, each taste has a function; sweet is tonifying, harmonizing and moderating, sour is astringent, acrid/pungent is dispersing and invigorates qi and blood, bitter reduces and dries, and salty softens and purges. The tendency of an herb is ascending or descending; therefore tendency represents its direction of travel in the body. Herbs may be chosen for a formula to guide the action of other herbs up or down, du huo (Angelica root) has a tendency to descend to the ("

11 Lesson 1: Introduction lower part of the body and is used to guide damp clearing herbs to the lower back and legs. Quality The herb's density (in taste and texture) is either thick or thin this describes the quality. In a person with a very yin constitution (damp or cold) it is advised to use thick (yin) herbs with caution because they will create further stagnation. A thin herb on the other hand will not ground energies that are rising excessively, such as the case with an excess type headache. 8 therapeutic methods The 4 qi contribute to the action a herb performs, and the action of a herb is categorized in the "ba fa! - 8 therapeutic methods: 1. Diaphoresis (han fa): promoting sweating, regulates nutritive qi (ying) and defensive qi (wei), disseminates and stimulates lung qi 2. Vomiting (tu fa): Expelling matter from the throat, chest and stomach. Pathogens are typically phlegm, stagnated food or toxins. 3. Purging (xia fa): also known as draining downward, cleanse the bowels by promoting defecation. 4. Harmonizing (he fa): Harmonizes the functions of organs or harmonizes different levels. 5. Warming (wen fa): Warmimg the interior and yang, dispelling cold. 6. Clearing (qing fa): Clears heat and toxin, and drains fire. 7. Tonifying (bu fa): Nourishes, augments and replenishes areas that are week. 8. Reducing (xiao fa): Eliminating accumulations or clumping due to stagnation (e.g. food accumulation) The 8 therapeutic methods are the basis of categorization of TCM herbology. )"

12 Lesson 1: Introduction Processing & Preparation Depending on suppliers and personal preference, herbs can be ordered dried, powdered, and in tablet and tincture form. The dried form (known as raw, sheng yao) is very effective and many find that results may be seen quicker, although to some the process of preparing raw herbs can be inconvenient and requires the most preparation for the herbalist and the client. Others may find it not as palatable, for those not accustomed to the new flavours. Powdered, tincture and tablet forms tend to be more convenient and therefore have a higher compliance. Raw herbs take much more knowledge of the plant morphology and preparation of each herb in order to ensure quality control and proper combining. Much of the raw or dried herbal product and herbs to manufacture tablets, powders etc. is grown in Asia, Southeast Asia and India, although there is a growing market for herbs grown here in Canada and from our neighbours down south (USA). Other forms of Chinese herbal preparations include: hand rolled honey pills, syrups, medicinal wines, special pills (vermillion) made of expensive ingredients, and patented remedies. 6 When decocting herbs recommend to your patients to use glass, porcelain or clay pots and wooden utensils, metallic substances are generally not advised and affect the properties of the herbs used. Ceramic electric herbal cookers may also be used. Generally speaking, herbs (raw form) should be put into a pot and covered with water (up to 2 finger widths above the level of the herbs) and brought to a boil, then simmered on lower heat for minutes. Drain off the water and repeat this procedure with the same herbs, combine the liquids and divide into 2 dosages for the day. The advantage of decoctions is that it is possible to vary the cooking times of individual herbs in a formula. *"

13 Lesson 1: Introduction The preparation of herbs will alter their actions. Longer cooking times make a herb more warming and tonifying, it also minimizes the toxicity of some herbs, such as fu zi (Aconitum). Quicker frying and cooking methods will help to preserve. Other methods such as: dry frying, frying with wine, vinegar, ginger juice or honey will give the herb a more warming quality. Charring the herb will allow it to aid in stopping bleeding; soaking in vinegar or wine will create an invigorating effect. Dosages are given in grams and range from 1-3g for more toxic substances to 120g for plasters and poultices. Most common dosages are 9-12 grams. Traditionally, the Chinese herbalists had their own sets of measurements that are still used today in shops in Chinatown. 1 liang = 30 grams 1 qian = 3 grams 1 fen =.3 grams 1 Ii =.03 grams 7. Traditional scale Formulas & Combinations When administering herbs we must educate our patients about refraining from caffeine, greasy and spicy foods because they will interfere with the actions of the herbs. Often patients will ask if they can add juice or sugar/honey to their decoctions, again this is not advised because it changes the properties of the formula you have created. Illnesses present in many different forms, as simple one root (cause), one branch (symptom) or they may be more complex involving multiple roots and branches. When creating a formula we take this into consideration.!+

14 Lesson 1: Introduction We can categorize formula combinations in 7 ways. 1. Simple!dan xing! - the use of a single herb to treat a simple illness. 2. Mutual Accentuation!xiang xu! - using similarly acting herbs to achieve a similar function. 3. Mutual Enhancement!xiang shi! using 2 or more herbs with different functions to enhance the affect of one of the herbs. 4. Mutual Counteraction!xiang wei! - when the main herb has undesirable side effects other herbs may be added to counterbalance those side effects. 5. Mutual Suppression!xiang sha! - the main herb is used to counter balance supporting herbs negative side effects. 6. Mutual Antagonism!xiang wu! - (this is more to be aware of when combing rather than intentional) the actions of two herbs will nullify or neutralize each other's desired effects. 7. Mutual Incompatibility!xiang fan! - (again, this is for awareness rather than intention) the combination of certain herbs will cause negative side effects that on their own would not normally occur. Traditionally there "18 incompatibilities" that are not be combined to due to their ill effect. The main herb in a formula is designated as the chief (or king) the action of the formula is based on this herb. The main supporting herbs are called deputies, and the assistants are more minor herbs that address side effects or accompanying symptoms. The envoys are the herbs that direct the main actions of the formula to specific organs or meridians. Traditional Chinese formulas typically include 6-12 herbs per formula; it is rare that single herbs are used on their own. Cautions & Contraindications Cautions and contraindications are based on the condition of the patient, herbal combinations/incompatibilities, herbs/drug/nutrient interactions, herb toxicity, and dietary incompatibilities. For children and seniors dosages should be lowered; with pregnant!!

15 Lesson 1: Introduction women dosages should be lowered and certain herbs are to be avoided. In some cases herbs that move the blood and have a downward moving property are to be prohibited during pregnancy due to potential miscarriage. Contraindications for individual herbs will be discussed in their respective sections. REFERENCES Images url deldrago.it/info/mtc.html&usg= 8MajldEjiefFUZK9ncEbAjl1iuI=&h=245&w=248&sz=16&hl=en&start=0&zoom=1&tbnid=s _QLbxJA4XpKoM:&tbnh=161&tbnw=164&prev=/images%3Fq%3Dfu%2Bxi%2Bshen%2Bnong%2Band%2Bhuang%2Bdi %26um%3D1%26hl%3Den%26safe%3Doff%26client%3Dsafari%26sa%3DN%26rls%3Den%26biw%3D1081%26bih%3D 802%26tbs%3Disch:10%2C443&um=1&itbs=1&iact=rc&dur=370&ei=CJErTfmcC4e4sAP83cX6Bg&oei=koorTdaiOMOdn Af2lKjODQ&esq=6&page=1&ndsp=20&ved=1t:429,r:19,s:0&tx=21&ty=103&biw=1081&bih= echinaexpat.com/articlesarchive/tabid/63/articletype/articleview/articleid/9/tcm--famous-ancient-chinese- Physicians.aspx&usg= xrfbw7xgevvotmdjdlrn_kz7csa=&h=302&w=300&sz=19&hl=en&start=0&zoom=1&tbnid=u cunczspd7xtkm:&tbnh=169&tbnw=168&prev=/images%3fq%3dyellow%2bemperor%26um%3d1%26hl%3den%26saf e%3doff%26client%3dsafari%26sa%3dn%26rls%3den%26biw%3d1081%26bih%3d802%26tbs%3disch:1&um=1&itbs =1&iact=rc&dur=834&ei=T5ErTZSELIbGsAPNspjxBQ&oei=T5ErTZSELIbGsAPNspjxBQ&esq=1&page=1&ndsp=22&ved= 1t:429,r:1,s:0&tx=124&ty= &source=og&sa=N&hl=en&tab=wi&biw=1081&bih= shutterstock.com!#

16 Lesson 2: Herbs that release the exterior LESSON 2: Herbs That Release The Exterior Herbs that release the exterior release disorders lodged in the very superficial levels of skin, muscle and channels; also known as the exterior. We can classify these herbs as sudorifics or diaphoretics. They disperse and dispel "surface evil" (exterior pathogenic factors including wind-heat, wind cold, wind dampness and summer heat). They are sometimes also called 'Lung-defensive Qi portion', as the Lung controls both the skin and Defensive Qi (wei qi), which circulates in the skin and muscles. Symptoms associated with exterior are: chills, fever, headaches, stiff neck, aversion to wind and cold, and general muscle aches; usually with a floating pulse. These, usually pungent (acrid) flavoured herbs, enter the lung and bladder meridians (Tai yang meridians) producing five basic action: 1. Induce perspiration 2. Disperse wind 3. Expand lungs and calm asthma; while benefiting water 4. Facilitate eruption of measles 5. Some release pain If sweating resolves one of the evil exterior pathogens, then usually no treatment is needed. If there is no sweating or it does not change the condition, these herbs are employed. A traditional Chinese saying is: "When [the disease] is in the skin sweating will bring it out." Usually if these herbs are employed soon enough, the problem is speedily resolved, e.g.: drinking ginger root tea when a person gets the chills from being outside. If disease gets deeper than the skin, it gets lodged in the muscles. In this case symptoms include fevers, general body aches and profuse sweating. If no positive changes happen, then herbs that release the muscles are used. If the condition is one from Cold (such as Wind-Cold) the symptoms are: slight or absent fever, aversion to cold, aches in body, stiff neck, chilliness, aversion to wind and cold, no sweating, no thirst and floating-tight pulse and a thin-white coating of the tongue. 1

17 Lesson 2: Herbs that release the exterior If the condition is one of Heat (such as Wind-Heat) the symptoms are fever, aversion to cold, slight sweating, thirst, a floating rapid pulse and a thin-yellow tongue coating. Usually the body aches are not as pronounced. Main differentials are: Thirst (Hot) or its absence (Cold) White (Cold) or yellow (Hot) tongue coating Tight (Cold) or rapid (Hot) pulse Fever (Hot) or its absence (Cold) Even though these patterns affect the skin and muscles, it would be wrong to presume that all problems in these areas represent releasing exterior patterns. In fact most chronic skin problems have to do with interior problems, such as in the Liver. Many of the herbs that release the exterior also have the functions of: Stopping coughs and wheezing Control pain and spasms Venting measles and rashes In Chinese medicine, the idea to resolve rashes such as measles consists of bringing the heat to the surface and dispersing it. These herbs can also work on heat or rashes that are trapped in the body. Warm, Acrid Herbs that Release the Exterior We can further subdivide these herbs that release the exterior by character and function of warm, acrid and cool, acrid. The warm, acrid herbs dispel wind-cold, being used for exterior disorders with mild fever, aversion to cold, headaches, body aches, absence of thirst, and/or neck pain. This sub-class can also be used in the summer to disperse summer heat by inducing perspiration, but must be supplemented by herbs that can warm up and transform dampness. The botanicals in this subclass are: Ma huang - Ephedra sinica Gui zhi - Cinnamomum cassia Gao ben - Ligusticum sinensis Sheng jiang - Zingiber officinale Cong bai - Allium pstulosum 2

18 Lesson 2: Herbs that release the exterior Cool, Acrid Herbs that Release the Exterior These cool, acrid herbs are used to treat wind-heat patterns with symptoms of: high fevers, mild aversion to cold, sore throats, headaches, and thirst. These herbs induce perspiration and clear heat. If the symptoms are primarily caused by wind-heat, they should be treated in combination with herbs that clear up heat and counteract toxic effects. The diseases treated are "wind-hot-superficial". They can be used effectively for venting rashes or treating eye problems due to wind heat. The botanicals in this sub class are: Bo he - Mentha haplocalyx Ju hua - Chrysantheum morifolium Mu zei - Equisetum hiemale Chai hu - Bupleurum chinense 3

19 Lesson 2: Herbs that release the exterior Ma Huang Ephedra sinica Family: Ephedraceae Other names: Mao, Mahwang, 'hemp yellow', ephedra stems, Ephedra sinica, Ephedraceae Plant description: This fragrant perennial shrub has glabrous stems, smooth and purplish, with light linear striations, growing about m high. The inferior leaves are tripinnate, superior leaves are often simply pinnate; leaflets are oval, dentate-incised, the teeth obtuse; petiole is 3-11 cm long, sheathed bracts are rudimentary, not prominent. The florets are in umbels (10-14), with irregular rays. The flowers are white, five petals, blooming June-July. The fruit appears July-August. Ma Huang is grown in China, Korea and Japan. Part used: green herbaceous stems. Habitat, ecology and distribution: Primarily in Jilin, Liaoning, Inner Mongolia, Hebei, Shanxi and Henan History: Divine Husbandman's Classic of Materia Medica (1596 CE). While Ephedra sinica did not appear in Native Amerindian ethnobotany's, a number of Ephedra species (generally called Mormon tea or Indian tea) were used extensively by the tribes of the Southwest. 1 Constituents: Ma Huang contains between % alkaloid content varying between species and time of the year of picking; the highest alkaloid content being in September. The alkaloid content is mostly I-ephedrine (ca.50-85%) with the next most important one being d- pseudoephedrine. There are also small amounts of other related alkaloids present. The chemical pathway seems to be a biosynthesis of phenylalanine and methionine into ephedrine. Also present are glycans (ephedrans A-E), volatile oils (includes limonene, caryophyllene, phellandrene and others), and small amounts of saponins, catechin, and tannins 2,3,4,5,6,7,8 Energetics Properties and Channels Entered: The herb is acrid, slightly bitter and warm, entering the Lung and Urinary bladder meridians. Ma Huang releases the exterior and disperses cold, facilitates Lung Qi circulation, and controls wheezing. 9,10 The root (Ma Huang Gen) is sweet with a neutral character and enters the Lung meridian, It stops qi deficiency caused by Blood deficiency. 11,12 Tierra lists ephedra (herb) as pungent, bitter and warm entering both Lung and Bladder meridians. 13 4

20 Lesson 2: Herbs that release the exterior Actions and Indications: Ephedra releases the exterior and disperses cold; it is useful for patterns of wind-cold exterior excess (greater yang stage of the six stages) with chills, fevers, headaches, absence of sweating, and a floating, tight pulse. It will open pores and release exterior disorders. Excellent for facilitating the movement of Lung qi, controlling wheezing and coughs due to obstructions of Lung qi by wind and cold. This herb promotes the Lung qi to flow more easily; while causing it to descend. Used for either externally contracted or internally generated wheezing. Ma Huang also promotes urination and reduces edema; specific if edema is accompanied by an external pathogen. 14 Medical Research: Ephedrine is classed as an adrenergic bronchodilator. It excites the sympathetic nervous system, depressing smooth muscle and cardiac muscle action, producing similar effects to those of epinephrine. Its major difference from epinephrine is that it is not changed in the GI tract or upon absorption. It also has a more prolonged effect. Ephedrine is known to raise blood pressure, diminish hyperemia and dilate the pupils. There is a definite, though mild sudorific effect upon taking this herb. It will reduce the temperature. Pseudoephedrine exerts a dilating effect upon the renal blood vessels. The essential oil has been shown to be antiviral. 15 Other uses include malarial fevers, rhinitis, asthma, hay fever, emphysema, epilepsy, nocturnal enuresis, and myasthenia gravis. D-pseudoephedrine increases urine output, reduces spasms in bronchial smooth muscles and stimulates striated muscle. 16,17,18,19,20,21,22,23,24,25,26,27,28,29,30,31,32 The alkaloids have been shown to have anti-inflammatory activity on experimental edema. The glycans produce significant hypoglycemic effect. Ma Huang is often used as an anti-air-bound allergy treatment. 33 There has been much controversy over the use of Ma Huang, as it has also been employed in weight loss, sexual stimulant and euphoria type products. Abuse of Ma Huang can cause insomnia, motor disturbance, high blood pressure, glaucoma, impaired cerebral circulation, and urinary disturbances. There have been several reported cases of cardiac infarction and even deaths related to its overuse. While highly controversial, the results of these cases are not conclusive. For this reason the US FDA want to limit Ma Huang use to no more that 8 mg of ephedrine per dosage and no more than 24 mg daily. 34 Toxicity, Contraindications and cautions: Ma Huang is contraindicated in cases of heart problems and high blood pressure. The toxic dose is grains per day of powder and 90 mg of the extract. The antidote to ephedrine toxicity is 15g of Gan cao (licorice) or 6 g of Ma Huang root or nodes (Ma huang gen). Pharmacy and dosage: Dosage Powder Extract: 1/2-10 grams, mg 5

21 Lesson 2: Herbs that release the exterior Major Combinations: With gui zhi (cinnamomum cassia) for patterns of wind-cold exterior excess, presenting chills and no sweating. Also used for wind-cold damp causing painful obstruction. With xing ren ( Prunus armeniaca) for wind-cough and wheezing. With shi gao (Gypsum) for cough associated with heat obstruction of Lung with wheezing and nasal flaring. Often combine with huang qin (Scutellaria baicalensis root) and sang bai pi (Morus alba, root bark). With gan Jiang (Zingiberis officinalis, ginger root) for congested fluids. If too much heat is generated shi gao (Gypsum) and/or huang qin (Scutellaria baicalensis root)is added for a cooling effect. REFERENCES 1. Moerman, D.E., Medicinal Plants of Native America, University of Michigan Museum of Anthropology, Technical Reports, Number 19, Ann Arbor, Michigan, 1986, YoU, p The British Pharmaceutical Codex 1934, Pharmaceutical Press, London, 1934, p The Merck Index, 5th ed.,merck & Co. Inc., Rahway, N.J., 1940, p Trease, G.E., and Evans, W.e., Pharmacognosy (11th ed.), Bailliere Tindall, London, 1978, p Remington's Pharmaceutical Sciences, Philadelphia College of Pharmacy and Science, Mack Publishing Co., Easton, Penn., 1980, p Chen, K.K., and Schmidt, C.F., Ephedrine and Related Substances, Williams and Wilkins Co., Baltimore, Md., 1930, p Duke, J.A., Handbook of Medicinal Herbs, CRC Press Inc., Boca Raton, FL, 1985, p Leung, A.Y. and S. Foster, Encyclopedia of Common Natural Ingredients: Used in Food, Drugs, and Cosmetics, John Wiley & Sons, Inc., New York, 1996, p Hsu, H.Y., Chen, Y.P., et at., Ib.id. p Bensky, D. and Gamble, A., Ibid., p Bensky, D. and Gamble, A., Ibid., p Hsu, H.Y., Chen, Y.P., et at., Ibid., p Tierra, M., Planetary Herbology, Lotus Press, Santa Fe, NM, 1988, p Bensky, D. and Gamble, A., Ibid., p Hsu, H.Y., Chen, Y.P., et at., Oriental Materia Medica: a concise guide, Oriental Healing Arts Institute, Long Beach, CA, 1986, p Yeung, H.C., Handbook of Chinese herbs and Fonnulas, Vol. 1, Institute of Chinese Medicine, Los Angeles, p British Pharmaceutical Codex 1934, Ibid. 18. Tyler, V.E., Phannacognosy, 6th ed., Lea & Febiger, Phila., PA, 1976, p Morton, J.F., Major Medicinal Plants: Botany, Culture and Uses, Charles C. Thomas, Springfield, Ill., p. 20. The Merck Index (5th ed.), Ibid. 21. Wood, H.C., and Osol, A., Dispensatory of the United States of America, 23rd ed., J.B. Lippincott, Montreal, PQ, 1943, p Trease, G.E., and Evans, W.C., Ibid. 23. Ross, M.S.F., and Brain, K.R., An Introduction to Phytophannacy, Pitman Medical, Tunbridge Wells, U.K., 1977, p Youngken, H.W., Textbook of Pharmacognosy, Blakiston, Toronto, Can., 1950, p Herbal Phannacology in the People's Republic of chins, Trip Report of the American Herbal Phannacology Delegation, National Academy of Sciences, Washington, D.C., 1975, p Wallis, T.E., Textbook of'phannacognosy, J. & H. Churchill, London, 1967, p Allport, N.L., Chemistry and Pharmacy of Vegetable Drugs, George Newnes Ltd., London, 1943, p.76. 6

22 Lesson 2: Herbs that release the exterior 28. Chen, K.K., and Schmidt, C.F., Ibid. p Pang, T.Y., Chinese Herbal, Tai Chi School, Honolulu, 1982, p Wren, R.C., Potter's New Cyclopedia of Botanical Drugs and Preparations, Health Science Press, Rustington, Sussex, U.K., 1975, p Remingtons's Phannaceutical Sciences, Ibid. 32. Bensky, D. and Gamble, A., Chinese Herbal Medicine: Materia Medica, Eastland Press, Seattle, WA, 1986, p Leung Foster abid 34. Reunter report; FDA Seeks Limits on Ephedrine Products; Westport Newsroom, June Image 7

23 Lesson 2: Herbs that release the exterior Gui Zhi Cinnamomum cassia Family: Lauraceae Other names: cinnamon twigs, cassia twig, Kuei-chih, keishi (Japanesa), kyechi (Korean) Plant description: An evergreen, aromatic tree. The bark is gray, smooth and thick up to 1.5 cm. The leaves are oblong-elliptic, dark shiny green and with a three prominent nerves from the base. The flowers are small in lax, spreading, terminal, with axillary panicles. The fruits are black, pulpy, aromatic, elliptic drupes with a single seed borne in the cup of the calyx lobe. The shoots from truncated stocks are cut down when nearly two years old and from 1 to 2 meters long, the bark is stripped off, and, after exposure to the air for about twentyfour hours, freed from epidermis and cortex by scraping. The strips are then packed inside one another in long quills, and dried. The bark occurs in long slender sticks, containing numerous small quills or channeled pieces. The quills are dull pale brown in colour, extremely thin and brittle, and often marked with little scars or holes. The inner surface is darker and marked with faint longitudinal striations. No cork is present and not more than traces of the cortex. The drug has a fragrant odour and warm sweet aromatic taste. Inferior qualities are generally thicker, less carefully scraped, more mucilaginous, and less aromatic. Powdered cinnamon may be identified by the presence of numerous isolated bast fibres with thick walls and of sclerenchymatous cells with horseshoe thickening. Small, simple starch grains and minute prisms of calcium oxalate also occur, together with the debris of oil cells. It may be distinguished from powdered cassia bark by the more slender bast fibres, smaller starch grains and absence of cork. The drug yields about 4 per cent ash. Cinnamomum Saigonicum, U.S.P., is the bark of an undetermined species; the dose of Saigon cinnamon is the same as that of Ceylon cinnamon. Part used: twigs Habitat, ecology and distribution: It is reported to grow wild in isolated places in Mizoram and also cultivated to a limited extent in Tamil Nadu. It is extensively cultivated in China. The major source of Cinnamon in world trade is China, especially Ceylon, but grows plentifully in Malabar, Cochin-China, Sumatra and Eastern Islands. Has also been cultivated in Brazils, Mauritius, India, and Jamaica, etc. 1 Collection: The fine branches are collected between March and July. Branch pieces of cm in length are cut and sun-dried. 8

24 Lesson 2: Herbs that release the exterior History: First appeared in Tang Materia Medica. Theophrastus described it as a precious odoriferous substance. It has been mentioned in Greek literature as well, referring to the old cinnamon. Ceylon cinnamon was not known to the ancients. Under the name 'Kwei', it has its place in Chinese literature. In India, several species of cinnamon were used. The Arabs got it from the Persians. Dioscorides mentions the use of different varieties of cinnamon. The Mohammedan writers differentiate the Chinese, Ceylon and Indian cinnamon. European Pharmacographica also gives interesting information on cinnamon. Constituents: Melilotic acid is one of the major active constituents of the bark.2 Cinnamaldehyde, cinnamic acid, cinnamyl acetate, phenyl propyl acetate, and other essential oils. 3 Energetics Properties and Channels entered: acrid, sweet, warm entering Heart, Lung, Bladder meridians. Actions and Indications: Stimulant, tonic, stomachic, carminative, antiseptic and astringent; also reputed emmenagogue, and capable of diminishing the secretion of milk Specific indications and Uses: Post-partum and other uterine hemorrhage: with profuse flow, cold extremities, and pallid surface, haematuria, and haemoptysis. Used at drop dosage level or homeopathically. 4 Medical Research: Decoction of gui zhi has a strong antibiotic effect against Staph. Aurens, and Salmonella typhi; with an inhibiting effect against Asian flu A and EC 0 virus.5 The alcohol extract also inhibits Staph as well as Bacillus typhi. Antifungal effect has been shown for white ringworm and other fungal infections of the skin. In vitro tests have shown antiviral effects on influenza. 6,7 Due to mild antipyretic effect (primarily by vasodilation), gui zhi can regulate temperature. This appears to be due to cinnamaldehyde. This same chemical has a tranquilizing effect on mice central nervous system. 8 Gui zhi produces an analgesic effect by raising the pain threshold of the brain. Its headache release mechanism appears to be due to antispasmodic action in the blood vessels in the head. This antispasmodic action also relieves abdominal pain. Cinnamon stimulates gastric and saliva secretions and thus improves digestion. 9 Used as a diuretic in the classical formula wu ling san (five-ingredient powder with Fu ling Poria). It has shown choleretic and analgesic effects. It also has diuretic activity. Melilotic acid has anti-ulcerogenic activity. The essential oil has shown analgesic and germicidal properties.10 9

25 Lesson 2: Herbs that release the exterior Toxicity, Contraindications and cautions: contraindicated for warm-febrile disease, yin deficiency with heat signs; heat in the blood with vomiting. Use with caution during pregnancy and excessive menstruation. Medicinal uses: Adjusts nutritive levels (ying) and protective of qi (wei) levels. Useful where sweating has occurred (without patient improvement) causing exterior cold. Warms channels while dispersing cold: wind-cold-damp causing painful obstruction in joints, and limbs (especially shoulders). In gynecological problems, such as dysmenorrhea, caused by cold obstructing the blood. Unblocks yang while transforming qi: edema due to cold phlegm accumulation or weak movement of yang qi. Warms and facilitates the flow of yang qi in chest: palpitations due to obstruction of yang qi flow in chest; due to either stagnation or deficiency. Warms and facilitates flow in blood vessels: for dysmennorhea with or without abdominal masses.11 Carminative, astringent, stimulant, antiseptic; more powerful as a local than as a general stimulant; is prescribed in powder and infusion but usually combined with other medicines. It stops vomiting, relieves flatulence, and given with chalk and astringents is useful for diarrhea and hemorrhage of the womb.12 Pharmacy and dosage: The branches are soaked in water until they are moist throughout. Then they are cut in pieces and air dried. Sifting removes the scraps. Gui Zhi Mu (cinnamon wood): The bark is removed from the branches, which are then soaked in water until moist throughout, cut in pieces, and air-dried. Gui Zhi tips: The thin and slender parts of the branches are soaked in water until moist throughout, cut in pieces, and air-dried. Stir-fried Gui Zhi: Gui Zhi pieces are put in a pot, stir-fried over low heat until they become a deep yellow color and have slight burn-marks on their outside. I. Cinnamon Water. Twenty ounces of bruised cinnamon are mixed with two gallons of water, and one gallon distilled over. Or half a fluid drachm of the oil may be rubbed with sixty grains of carbonate of magnesia, and afterward triturated with a quart of water, in the usual manner for Medicated Waters. It is used as an adjuvant. II. Tincture. Three ounces of cinnamon are treated carefully in the percolator with diluted alcohol till two pints have passed. Dose, half a fluid drachm to two fluid drachms. Used as an adjuvant. 10

26 Lesson 2: Herbs that release the exterior III. Aromatic Powder. Cinnamon, four ounces; pimento, three ounces; ginger, asarum, and cardamon, (freed from their capsules,) each, one ounce. Procure the powders separately, and then mix with a pound and a half of fine sugar. This is a preparation similar to one of the same name in the American and other Pharmacopoeias, each having a formula of its own. It is an excellent aromatic and stimulating compound for faintness and sudden prostration, and a good adjunct to more positive articles. 13 Dosage: Decoction: 3-10g. Major Combinations: With ma huang; for patterns of cold excess in exterior With bai shao (Paeoniae lactiflorae) for externally contracted wind-cold which causes disharmony of the nutritive and protective qi, with exterior deficiency and spontaneous sweating. Also used for warming and toning the middle burner. With fu zi (Aconitum carmicharli) for chills and painful extremities from yang deficiency and obstructions. With honey fried licorice ( zhi gan cao) for palpitations and shortness of breath due to injured yang of the chest. With fu ling (Poriae Cocos mushroom) to unblock the yang, while facilitating the removal of congested fluid associated with yang-deficiency edema. Also beneficial for palpitations and dyspepsia due to yang in chest. REFERENCES 1 Grieves M; Modem Herbal 2 The Review of Natural Products, 2001, Becker, Simon A; A More Complete Analysis of Ramulus Cinnamomi Cassiae (Gui Zhi) Bensky D, Gamble A; Chinese Herbal Medicine Materia Medica;Eastland Press Seattle Wa; p Hsu, H.Y., Chen, Y.P., et ai., Oriental Materia Medica: a concise guide, Oriental Healing Arts Institute, Long Beach, CA, 1986, 7 TangW, Eisenbrand; Chinese Drugs of Plant Origin; Springer-Verlag; New York; 1992, p Hsu, H.Y., Chen, Y.P., et ai., Oriental Materia Medica: a concise guide, Oriental Healing Arts Institute, Long Beach, CA, 1986, 9 Hsu, H.Y., Chen, Y.P., et ai.. Oriental,~ateria Medica: a concise guide, Oriental Healing Arts Institute, Long Beach, CA, 1986 '-" 10 The Review of Natural Products, 2001, Bensky D, Gamble A; Chinese Herbal Medicine Materia Medica;Eastland Press Seattle Wa; p Grieve, M; Ibid 13 Image: 11

27 Lesson 2: Herbs that release the exterior Gao ben Ligusticum sinense Family: Umbelliferae Other names: chuan gao ben, xiang gao ben, Chines lovage, ligusticum root, kao-pen, kolon (Japenese), Kobon (Korean) Part used: Rhizome and root Habitat, ecology and distribution: Shaanxi, Gansu, Henan Sichuan, Human. Harvested in autumn after aerial parts have become desiccated. It can also be harvested in the spring at time of first sprouting. History: Divine Hubandman's Classic of Materia Medica Constituents: butylidene phthalide, cnidilide, nothosmymol, ligustrzine.1, 2, 3 Energetics Properties and Channels entered: acrid, warm entering the Bladder meridian. Actions and Indications: antispasmodic, stimulant, anti-microbial, emmenagogue. Medical Research: Antiviral has been shown in vitro on several influenza viruses and many common dermatophytes (antifungal). Both butylidene phthalide and cnidilide have emmenagogic antispasmodic action. Ligustrzine has been shown to inhibit platelet aggregation, preventing arterial thrombus formation. In dog ligustrzine has shown to have a blood pressure lower ability, reducing myocardial contractile force. The extract of the plant has had favorable clinic trail for treatment of coronary patients.4, 5, 6 Toxicity, Contraindications and cautions: when associated with blood or yin deficiency as it is very drying. Medicinal uses: Expels wind and alleviates pain from externally contracted wind-cold, especially used for headaches. Useful for pain in the lower back due to wind-cold. Known to treat both ends of the governing vessel. Pharmacy and dosage: Dosage 2-9g 12

28 Lesson 2: Herbs that release the exterior Major Combinations: With xi xin (Asarum sieboldii) for headaches due to wind-cold-dampness, especially if in the vertex, with stiff neck or toothache. With chuan xiong (Ligusticum chuanxiong) and bai zhi (Angelica dahurica) to increase its pain-relieving effect. These tree herbs are classically used together. With cang zhu (Atractylodes lancea) for back and joint pain, associated with initial stages of painful obstruction. REFERENCES 1 Hsu, H.Y., Chen, Y.P., et al., Oriental Materia Medica: a concise guide, Oriental Healing Arts Institute, Long Beach, CA, 1986, p Huang CK, The Phannacology of Chinese Herbs 2nd Ed. ; CRC Press; 1999, p Tang W, Eisenbrand; Chinese Drugs of Plant Origin; Spinger-Verlag; New York; 1992 p Tang W, Eisenbrand; Chinese Drugs of Plant Origin; Spinger-Verlag; New York; 1992 p Bensky D, Gamble A; Chinese Herbal Medicine Materia Medica;Eastland Press Seattle Wa; Hsu, H.Y., Chen, Y.P., et al., Oriental Materia Medica: a concise guide, Oriental Healing Arts Institute, Long Beach, CA, 1986, p. 54 Image: Image: 13

29 Lesson 2: Herbs that release the exterior Sheng jiang Zingiber officiale Family: Zingeraceae Other names: Fresh ginger root, sheng jiang pian, shokyo (Japanese), saeng gang (Korean) The English botanist William Roscoe ( ) gave the plant the name Zingiber officinale in an 1807 publication. Chinese medicine considers fresh ginger and dried ginger to be two different commodities. In fact, one author of an early ben cao (Chinese materia medica) felt that they were so different; they must come from two different plants. The dried root is known as gan-jiang. Plant description: Native to Asia but cultivated in Jamaica and sold commercially. The ginger plant has a perennial tuberous root or rhizome, erect annual stems with smooth sheathed leaves, m high. The leaves are sub-sessile, on long sheaths, alternate, lanceolate, linear entire, cm long, 2.5 cm wide. The solitary yellow flower is small, calyx tubular, opening on one side, three toothed, corolla with a double limb, outer three - inner three-lobed lip of dark purple. The ginger family is a tropical group especially abundant in Indo-Malaysia, consisting of more 1200 plant species in 53 genera. The genus Zingiber includes about 85 species of aromatic herbs from East Asia and tropical Australia. The name of the genus, Zingiber, derives from a Sanskrit word denoting "horn-shaped," in reference to the protrusions on the rhizome. Part used: Rhizome, fresh Habitat, ecology and distribution: Cultivated throughout China, especially Sichuan, Guizhou, Guangdong. Usually harvest just before the winter solstice History: Ginger has been considered the great remedy of the abdominal area. It eases both menstrual and intestinal cramps and cleanses the liver. Ginger is also used to bring circulation to peripheral areas such as the hands and feet. The Chinese often use ginger at the first stages of a cold.1,2 Cultivated for millennia in both China and India, it reached the West at least two thousand years ago. It was recorded as the subject of a Roman tax in the second century after being imported via the Red Sea to Alexandria. Tariff duties appear in the records of Marseilles in 1228 and in Paris by Ginger is found in the herbals of Gerard (1597), Pomet (1712), King (1882) and throughout Eclectic literature.3 It is first noted in Chinese literature in the Collection of Commentaries of the Classic of the 14

30 Lesson 2: Herbs that release the exterior Materia Medica (500 CE) and has been used in Ayurvedic medicine for over 2000 years. Constituents: Ginger contains from % of a volatile oil responsible for the aroma. The volatile oil consists mostly of terpenes, dcamphene and beta-phellandrene, a sesquiterpene, zingiberene, bisabolene, cineol, citral and borneol. The pungent (hot) factor is due to gingerol, shogaols and related phenolic ketones.5,6,7 The pungency of gingerol is destroyed by boiling the ginger in a 2% solution of some alkaline substance like potassium hydroxide. This method is often used to determine the presence of Capsicum, which remains pungent after the test.8,9,10,11 Ginger also contains a ketone known as zingerone (closely related to vanillin and capsaicin), 6-8% lipids consisting of triglycerides, phosphatidic acid, lecithin, and free fatty acids (lauric, palmitic, stearic, oleic, linoleic), up to 50% starch, Vitamin A and niacin. Ginger's oleoresin contains mainly gingerols and shogaols, as well as some zingerone. Shogaols and zingerone are dehydration products of gingerol.12 Also present are small amounts (2% of fresh juice) of a proteolytic enzyme called zingibain.13 Energetics Properties and Channels entered: Ginger is pungent (acrid), having a mild warm to hot property. It enters the Lung, Spleen and Stomach meridians, releasing the exterior and dispersing cold.14,15 The dried rhizome (gan Jiang) is extremely pungent and extremely hot. It enters the Heart, Lung, Spleen, Stomach and Kidney meridians. It warms the middle heater, reinvigorates yang, warms lungs and resolves phlegm. 16 Holmes lists ginger as very pungent, a bit sweet, hot and dry. Ginger has secondary qualities of stimulating, relaxing, restoring while dispersing movement. The herb enters the Lung, Spleen and Stomach meridians, influencing the lungs, digestive system, uterus, and immune system. Its organism is warmth and air. 17 Tierra describes dry ginger as spicy and hot; influencing the Heart, Lung, Spleen, Stomach and Kidney meridians.18 Ayurvedic Rasa - katu (pungent); Guna - lagu, singdha, guru (heavy), rooksha (oily), teekshna; Veerya - ushna (hot); Vipak - madhura (sweet). Action: Kaf-bata samaka, sotha har, badanasamak, dipan pachan, batanuloman,arsoghna, kafaghana, sawas har.19 Actions and Indications: Stimulant, carminative, tonic, diaphoretic, and diuretic. Specific Indications and Uses: Loss of appetite; flatulence; borborygmus; spasmodic gastric and intestinal contractions; painful menstruation; acute colds; cool extremities; and cold surface in children's diseases. 20 Medical Research: The extract of ginger stimulates vasomotor and respiratory centers in anesthetized cats, and acts as a direct heart stimulant.21 Ginger has also been shown to lower both serum and hepatic cholesterol in rats fed cholesterol and to inhibit platelet aggregation. 22,23 15

31 Lesson 2: Herbs that release the exterior,24,25 Ginger's ability to lower platelet aggregation seems to be due to gingerol' s ability to inhibit thromboxane synthesis and prostacyclin synthesis, which inhibit platelet cyclooxygenase products. This gives ginger very acceptable antithrombotic properties. 26,27 The anti-inflammatory activity of ginger is as functional as ASA, without the analgesic activity. This is accomplished by the inhibition of arachidonic acid metabolism and thus some prostaglandins, giving more evidence for the Chinese uses in rheumatism and arthritis.28 The action Ginger has on reducing migraines seem to follow the same path.29,30 Its mechanism here seems to be slightly different than Feverfew, as Ginger does not inhibit serotonin release the same way Feverfew does. The antipyretic and thermogenic activity of ginger is quite interesting. Ginger has been shown to lower fever, most likely due to the inhibition of prostaglandin synthesis. It does not lower temperature in individuals that have no fever. On the other hand, we can find Ginger to be quite warming if given when a person is cold. Studies have suggested it is the pungent agent that stimulates the thermoregulatory receptors. This is probably due to zingerones ability to evoke catecholamine secretion from the adrenal medulla (in vivo) thus inducing a warming action. This should only account for short term action though. Long term effect appears to be related to inhibiting serotonin-induced hypothermia. Ginger is also known to stimulate cytokine secretion by human peripheral blood mononuclear cells.31 Ginger is known to kill vaginal trichomonads in vitro.32 It also significantly inhibits the growth of bacteria (both Gram -positive and -negative), has antifungal action and antirhinoviral activity. The antioxidant effect of Ginger is comparable to synthetic antioxidants, usually contributed to gingerol and zingerone. They have been shown to scavange superoxides and hydroxyl radicals in vitro, as well as inhibit lipid peroxidation.33 Several studies published in the last two decades have confirmed the traditional claims for use as an anti-vomiting or anti-motion sickness agent. In one study published in The Lancet, researchers D.B. Mourey and D.E. Clayson found that capsules containing 940 mg. of dried ginger powder when given to persons who suffer from motion sickness, actually produced better results than dimenhydrinate, an antihistamine used in an overthe-counter motion sickness product. The 36 volunteers involved in the study were blindfolded and placed in a rotating chair for six minutes. Those who received the ginger capsules lasted an average of 5.5 minutes. Those who had the antihistamine held out for 3.5 minutes. A more recent double-blind randomized placebo trial tested ginger capsules on seasickness. Eighty naval cadets, not used to heavy high seas were involved in the trial. Those who took the placebo experienced symptoms of seasickness. Those who received dried ginger root capsules had reduced tendencies to both cold sweats and nausea.34 A NASA-sponsored study by researchers at Louisiana State University, published in 1988, concluded that dried powdered ginger given in capsules two hours before testing, 16

32 Lesson 2: Herbs that release the exterior or minced fresh ginger given one half hour before testing, was ineffective when used as an anti-motion sickness medication. Forty two men and women were subjected to testing periods in a special rotating chair. The study was conducted in response to that fact that 50% of Space Shuttle crew members experience motion sickness. The study did not involve testing the ginger itself to determine if it contained appreciable quantities of what is believed to be the primary active chemical component, gingerol, found in the essential oil, and responsible for the "hot" taste produced by ginger.35 Ginger has been shown to reduce the destruction of, glutathione and lipid peroxidation problems in mice that had been exposed to whole body gama-radiation.36 In China, fresh ginger is a clinically effective treatment for rheumatism, acute bacterial dysentery, malaria, and orchitis (inflammation of the testicles).37 Ginger's beneficial effect on colic and flatulence has been well known for centuries. Ginger oil has been shown to increase capillary permeability and to induce phagocytic activity of capillary endothelium, similar to histamine.38,39 Toxicity, Contraindications and cautions: Ginger, fresh, powdered or in an oil form has no toxic effect. It is non-irritating, nonsensitizing even in the vaginal cavity and has low phototoxicity.40 ESCOP says there is no contraindications and no restriction on duration of use. It is suggested that Ginger might enhance the absorption of sulfaguanidine.41 German Commission E says not to use for morning sickness during pregnancy, but other studies have negated this.42 Contraindicated in cases of Lung heat or Stomach heat with vomiting. Medicinal uses: Ginger is mostly used as a carminative, often along with other herbs, because of its great ability to stop griping and cramping, especially in the abdomen, intestines, and uterus. In this nature, it is more beneficial than dimenhydrinate, as a prophylaxis for nausea and vomiting of motion sickness, dyspepsia and hyperemesis gravidarum (extended nausea and vomiting during pregnancy).43,44 It has also shown anti-ulcer qualities and significant hepatoprotective activity.45,46 Topically, the fresh juice of ginger is used for treating thermal burns. The essential oil of ginger is used topically as an analgesic.47 Releases the exterior and disperses cold; for exterior cold patterns Warms middle burner and prevents vomiting caused by cold in Stomach. Disperses cold and stops coughing due to both acute wind-cold cough patterns and chronic Lung disorders with phlegm. 17

33 Lesson 2: Herbs that release the exterior Reduces toxicity of other herbs, often given when overdoses of fu zi or ban xia. Adjusts nutritive and protective qi for patients suffering from exterior deficiency, who sweat without an improvement in their condition. Pharmacy and dosage: Dosage: Fresh Root 1/2 oz. of powder in one pint of water.48 Dry powder grains 49 Tincture BP USP 1/2-1 dram ( ml) Syrup 1/2-1 dram ( ml) Capsules/powder 0.5 to 2 g 50 Chemotherapy-induced nausea and vomiting: All dosage forms 1.5 g (Myer et ai, 1995). Dyspepsia: Capsules/powder -- 2 to 4 g/day Hyperemesis gravidarum: Capsules/powder -- 1 g/day given for 4 days (Fischer- Rasmussen et ai, 1990). Motion sickness: Capsules/powder -- 1 g to be taken 30 minutes before travel; for continuing symptoms, 0.5 to 1 g every 4 hours (Muller & Clauson, 1997). Postoperative nausea and vomiting: Capsules/powder to 2 g daily Rheumatoid arthritis, osteoarthritis: Powder -- 1 to 2 g/day (Srivastava & MustafaI 1992). Storage: Powdered ginger root should be stored in a cool, dry place protected from light. Powdered ginger should not be stored in plastic containers. Quick fried ginger (pao jain) is made by frying it until the surface is slight black. This makes it bitter, astringent and warm entering the Liver and Spleen meridians. Pao jain is less potent for warming the interior, but is better in stopping bleeding associated with cold deficiency and treating lower abdominal disorders. I. Tincture. Crush two and a half ounces of ginger, and tincture for fourteen days with a pint of seventy-five percent alcohol. Express, filter, and add enough alcohol to make a pint. Or the root may be macerated in alcohol for two days, and then treated by percolation, using a pint of the menstruum, expressing the dregs, filtering, and adding enough alcohol to make a pint. If diluted alcohol is used, the tincture is liable to become muddy after a few weeks. Dose from ten drops to a fluid drachm. Used as a carminative, and as a valuable adjunct to bitter and cathartic mixtures. The officinal 18

34 Lesson 2: Herbs that release the exterior United States method employs four ounces of the crushed root to obtain one pint of tincture by percolation, and is usually called Essence of Ginger.51 II. Syrup: Evaporate two fluid ounces of ginger tincture to one fluid ounce; rub it with two drachms of carbonate magnesia and one ounce of sugar, gradually add one pint of water by trituration, filter, melt into this one and a half pounds of sugar at a gentle heat, and strain while hot. This is the elegant method of the U. S. P. The common practice mixes one fluid ounce of the above tincture with seven fluid ounces of simple syrup, but the preparation is neither so clear nor so palatable. It is used as a flavoring vehicle, especially for fluid extracts. Dose: one to four fluid drachms. III. Fluid Extract. "Take ginger in fine powder, sixteen troy ounces; alcohol, a sufficient quantity. Moisten the ginger with four fluid ounces of alcohol, introduce it into a cylindrical percolator, press it firmly, and gradually pour alcohol upon it until twelve fluid ounces of tincture have passed. Set this aside, and continue the percolation until twenty fluid ounces more of tincture have been obtained, evaporate this to four fluid ounces, mix it with the reserved tincture, and filter through paper. (U. S. P.) Dose, ten to thirty drops in water. An oleo-resin is obtained by treating the root with ether and then with alcohol, and evaporating. It is a thick, dark fluid, very intense in action, of which a single drop may be triturated with a drachm of sugar and given as a dose. IV Cholera Tincture. Zingiber, myrica, caulophyllum, liriodendron, each, four ounces; myrrh, four drachms; capsicum, one drachm. Treat by percolation with diluted alcohol till two quarts pass; and add, by trituration, twenty drops each of oils of peppermint and anise. "I used this with good advantage in the cholera epidemic of 1867; and also value it in colic from sudden exposure." Dose, one to three fluid drachms, in any suitable infusion. GINGER BEER. A good ginger beer may be prepared as follows: Take of white sugar, 2 pounds; lemon juice or cream of tartar, 14 drachms; honey, 12 1/2 drachms; bruised ginger, 13 drachms; water, 2 gallons. Boil the ginger in 2 pints of the water for 3 hour; add the sugar, lemon juice, and honey, with the remainder of the water, and strain; when cold, add the white of an egg, and 24 minims of essence of lemon; let it stand for 4 days, and then bottle. Major Combinations: With da zao (Zizyphi jujubae) for externally contracted wind-cold; alleviating epigastric pain, nausea, and vomiting by strengthening Spleen qi. This formula is known to protect the Stomach qi, while reducing irritation of the gastrointestinal tract from other herbs. With ban xia ( Pinelliae temate )for vomiting due to many causes and for productive coughs due to phlegm-dampness. With zhu Ii (Bambusae succus )for headaches and coughs due to heat-induced phlegm, or aphasia and numbness from wind-stroke due to phlegm obstruction. 19

35 Lesson 2: Herbs that release the exterior With zhu ru (Bambusae in taeniis, caulis )for vomiting due to heat and Stomach qi deficiency. Related Herbs Gan Jiang - dried ginger root Compared with sheng jiang (fresh ginger), gan jiang is more effective in warming the middle burner and expelling interior cold; while sheng jiang is more effective to promote sweating and disperse exterior cold. Energetics Properties and Channels entered: acrid, hot; entering Heart, Lung, Spleen, Stomach Toxicity, Contraindications and cautions: contraindicated in cases of yin deficiency with heat signs or reckless movement of hot blood. Use in caution during pregnancy. Medicinal uses: Warms the middle while expelling cold by warming the spleen and stomach, when caused by externally-contracted cold, as well as cold from deficiency due to insufficiency of yang qi. Rescues devastated yang and expels interior cold; with signs of very weak pulse and cold limbs. Warms the lung and transforms phlegm when the Lung is cold with expectoration of thin, watery, or white sputum. Warms the channels and stops bleeding when cold from deficiency, especially uterine bleeding. Only used if bleeding is chronic and pale in color and accompanied by cold limbs, ashen white face and a soggy, thin pulse. Pharmacy and dosage: Dosage 3-12 g. Major Combinations: With gan cao (licorice) for epigastric pain and vomiting due to cold from deficient Stomach and Spleen. With gao liang jiang (Alpiniai officinalis) for abdominal pain and vomiting due to Stomach cold. With ban xia (Pinelliae ternate) for vomiting due to cold-induced congested fluids; add ren shen (Ginseng) for vomiting due to deficiency. 20

36 Lesson 2: Herbs that release the exterior With huang lian (Coptis) for epigastric pain and distension, dysenteric disorders, and indeterminate gnawing hunger that may be Candida related. With wu wei zi (Schisandra) and xi xin (Asari herb) for coughing and wheezing due to cold congested fluids preventing the normal descent of Lung qi. REFERENCES 1. Grieve, M., A Modem Herbal, Jonathan Cape, London, 1931, p Willard, T.W., Textbook of Modem Herbology, c.w. Progressive Publishing Inc., Calgary, AB, Can., 1988, p Crellin, J.K. and Philpott, J., Herbal Medicine: Past and Present (Vol. II), Duke University Press, London, 1990, p Bensky, D. and Gamble, A., Ibid. 5. The British Phannaceutical Codex The Phannaceutical Press, London, p Leung, A.Y. and S. Foster, Encyclopedia of Common Natural Ingredients: Used in Food, Drugs, and Cosmetics, John Wiley & Sons, Inc., New York, 1996, p Spoerke, D.G., Herbal Medications, Woodbridge Press Publ. Co., Santa Barbara CA, p The British Phannaceutical Codex Ibid. 9. Leung, A.Y., Ibid. 10. Spoerke, D.G., Herbal Medications, Ibid. 11. Textbook of Phannacognosy, Ibid. 12. Leung, A.Y., Ibid Reading Gina; Zingiber offinciale; ATOMS,Voll(1) 1995, pp Hsu, H.Y., Chen, Y.P., et az., Oriental Materia Medica: a concise guide, Oriental Healing Arts Institute, Long Beach, CA, 1986, p Bensky, D. and Gamble, A., Chinese Herbal Medicine: Materia Medica, Eastland Press, Seattle, WA, 1986, p Hsu, H.Y., Chen, Y.P., et az., Ibid., p Holmes, P., The Energetics of Western Herbs (2 vols.), Artemis Press, Boulder CO, 1989, p.110-lil. 18. Tierra, M., Planetary Herbology, Lotus Press, Santa Fe, NM, 1988, p Kapoor, L.D., CRC Handbook of Ayurvedic Medicinal Plants, CRC Press, Boca Raton, FL, 1990, p Felter; King's dispensatory 21. Leung, A.Y., Ibid. 22. Srivastava K.C., Effects of aqueous of onion, garlic and ginger on platelet aggregation and metabolism of arachidonic acid in the blood vascular system: In vitro study, Prostaglandins Med 13:227-35, Leung, A.Y., Ibid. 24. Gujarak, S., Bhumra, et al., Effect of ginger (Zingiber officinale roscoe) oleoresin on serum and hepatic cholesterol levels in cholesterol-fed rats, Nutr. Rep. Int. 17: , Bhandari U, Sharma IN et al; The protective action of ethanolic ginger extract in cholesterol fed rabbits; J Ethnopharmacol; 61(2) 1998 P Bone ibid 27. Srivastava, K.C., Ibid. 28. Srivastava KC Mustafa et al; Ginger in Rheumatism and Musculoskeletal Disorders; Med Hypothese 39, 1992; P Mustafa T, Srivastava KC; Ginger in Migraine Headaches; J of Ethnophar, 29; 1990 P Brown D, Gaby et al; Clinical Application of Natural Medicine: Migraine; American J of Nat Med; Vol 4(9), Nov 97 p 14-16, Bone ibid 32. Leung, A.Y., Ibid. 33. Bone ibid 34 Leung, A. and S. Foster. Encyclopedia of Common Natural Ingredients Used in Foods, Drugs and Cosmetics. 2nd. ed. New York: John Wiley & Sons,

37 Lesson 2: Herbs that release the exterior 35 Wood, C. D., et al. Comparison of Efficacy of Ginger with Various Antimotion Sickness Drugs. Clinical Research Practices and I;:>rug Regulatory Affairs, 6(2): , Ganesh C J, Manjeshwar B, Ponemone V, et al; Influence of Ginger Rhizome (Zingiber officinale Rose) on Survival, Glutathione and Lipid Peroxidation in Mice after Whole-Body Exposure to Gamma Radiation; Radiation Research: Vol. 160,No. 5,pp (2003) 37. Leung, A.Y., Ibid. 38. Gozsy, B., et al., Effect of phagocytic stimulation on experimental tuberculosis of guinea pigs, Amer. Rev. of Tuberculosis, 73(3) Suzi, Y. et al., Pharmacological studies on Zingiber mioga. General Pharmocologial effect of water extracts, Folia Pharm. J. 75: , Leung, A.Y., Encyclopedia of common natural ingredients used in food, drugs, and cosmetics, Ibid. 41. ESCOP Monographs on the Medincinal Uses of Plant Medicine; Zingiberis, March Blumenthal, M. (ed.) et ai., The Complete Gennan Commission E Monographs: Therapeutic Guide to Herbal Medicines, American Botanical Council, Austin, TX, 1998, p Mowrey DB, Clayton DE; Motion Sickness, Ginger and psychophysics; Lancet 1 (8273); 1985; p Fischer-Ramussen W, et al; European J of Obstetrics and Gyn and Repro BioI; 38, Reading ibid 46. Bone K; Ginger; British J of Phytotherapy; Vol 4(3), Summer 1997, P Grieve, M., Ibid. 49. Grieve, M., Ibid. 50 Bisset NG (ed). Herbal Drugs and Phytopharmaceuticals; a Handbook for Practice on a Scientific Basis. Medpharm Scientific. Publishers, Stuttgart and CRC Press, Boca Raton, Cook, William; The Physiomedical Dispensatory; Image: 22

38 Lesson 2: Herbs that release the exterior Cong bai Allium pstulosum Family: Liliaceae Other names: Scallion, spring onions, sohaku (Japanese), Chongbaek (Korean) also use Allium fistulosum Plant description: The white bulb and green parts of scallions, or spring onions, are prescribed to improve digestion and help regulate the metabolic rate. They affect the body in a manner similar to garlic but are often preferred because of their less powerful odor. Traditional Chinese medicine characterizes the herb as acrid and warm. Part used: Bulbs Habitat, ecology and distribution: cultivated throughout China and the rest of the world; harvested year round. History: Found in miscellaneous records. Listed in Shen nong ben cao ching as medium-grade herb. Constituents: malic acid, allidn, allyl sulfide, vitamins A BI, B2, C, fatty acids (palmitic, stearic, arachadonic, oleic and linoleic acids), iron- salts, s-(prop-i-enyl)- cysteinsulfoxide, cydoalliin.1,2 Energetics Properties and Channels entered: acrid, warm entering Lung and Stomach meridians. Mild properties. Actions and Indications: diaphoretic, antimicrobial, expectorant Medical Research: Antimicrobial effect of the essential oils against some: Staphs, Streptococcus, Shigella and Corynebacterium diptheriae, Trichomonas vaginalis. Has antifungal action against ringworm. Used as an enema mixed with Pinelliae ternatae (ban xia) and ginger juice for acute mastitis with 96.9% success rate.3 Stimulates bronchial secretions. Cycloallin is known to stimulate tears. Toxicity, Contraindications and cautions: Not to be used in cases of exterior deficiency with profuse sweating. Some traditional Chinese authorities warn against ingesting mixtures of honey and scallions, but others recommend the use of such preparations. 23

39 Lesson 2: Herbs that release the exterior Medicinal uses: Releases the exterior and induces sweating, used at early stages of externally contracted wind-cold. Used for chills and fevers, nasal congestion, abdominal pain and distention. Disperses cold and unblocks the yang used for either abdominal pain and distention or nasal congestion. Relieves toxicity and disperse clumps: for sore abscesses, applying as a poultice. Febrile disease, sore throat, ocular disorder, cramping rheumatic pain, habitual miscarriages.4 In a clinical trial, a combination of scallions, pinellia root and ginger juice, given as an enema, seemed useful in treating acute mastitis (breast inflammation). Pharmacy and dosage: Tea: Two to five scallions chopped and steeped in a cup of boiling water. The brew topped with honey should be drunk at the first signs of chills and fever. When prepared as a decoction, add near the end Poultice: Scallions mixed with honey, wrapped in a cloth and applied to sores and abscesses. Combinations: Prepared with soybeans for chills, fever and nasal congestion. Major Combinations: With honey used as an external poultice for sores and abscesses. REFERENCES 1 Bensky D, Gamble A; Chinese Herbal Medicine Materia Medica;Eastiand Press Seattle Wa; p Hsu, H.Y., Chen, Y.P., et al., Oriental Materia Medica: a concise guide, Oriental Healing Arts Institute, Long Beach, CA, 1986, p Bensky D, Gamble A; Chinese Herbal Medicine Materia Medica;Eastiand Press Seattle Wa; p. 4 Hsu, H.Y., Chen, Y.P., et ai., Oriental Materia Medica: a concise guide, Oriental Healing Arts Institute, Long Beach, CA, 1986, p.44. Image: 24

40 Lesson 2: Herbs that release the exterior Bo he Mentha haplocalyx Family: Labiatae Other names: field mint, M. arvensis, menthe, hakka (Japanese), pakha (Korean) Plant description: Square stems are a distinctive characteristic common to all members of the Mint family. Bo he is very similar to Peppermint. Part used: herb Habitat, ecology and distribution: cultivated throughout China, especially Jiangsu, Zhejiang, Jiangxi. Harvested several times a year. History: First found in Grandfather Lei's Discussion of Herb preparations. Mints have an extensive history of both culinary and medicinal uses. One of the most common uses is as a digestive aid. By exciting the gastric membrane, mints reduce bloat after a large meal. Peppermint has also been used to induce relaxation, for influenza, light fevers, suppressing menstruation, sore throats, diarrhea, headaches, toothaches, cramps and many other uses.1,2 Peppermint has been noted in Chinese medical literature since the Tang pen tsao (659 CE).3 Four Northeastern Amerindian tribes used Mentha piperita, and many tribes used other members of the genus Mentha. Mints can be used for flatulence, bowel problems, tonification, colds and fevers. 4 Constituents: volatile oils (menthol, menthone, menthyl acetate, camphene, limonene, isomenthone, pinene, menthenone, rosmarinicacid, d-neomenthol, and other). Bo he also includes flavonoids, phytol, tocopherols (Vitamin E), carotenoid, betaine, choline, tannins and others.5,6,7 Energetics Properties and Channels entered: acrid, aromatic, cooling; entering the Lung and Liver meridians. Ayurvedic: Rasa - katu (pungent); Guna - laghu (light), rooksha(dry), teekshna; Veerya - ushna (hot); Vipak - katu (pungent). Action: Badana sthapan, dipan, rochan, vata anuloman, krimighan, hiridoutejek, jawarghana. 8 Holmes lists mints as pungent, a bit sweet, being warm with a secondary cooling effect and a dry nature. The secondary quality is stimulating, restoring, astringing, and relaxing with a dispersing movement. Peppermint enters the Lung, Liver and Spleen meridians, while influencing the head, heart, lungs, stomach, intestine, gall bladder, liver, uterus and nerves. Its organism is air and warmth. The Tri Dosas increase Vayu and Pitta.9 25

41 Lesson 2: Herbs that release the exterior Tierra describes mints as spicy, bitter and slightly cooling, and influences the Lung and Liver meridians. 10 Actions and Indications: Aromatic, carminative, diaphoretic, antispasmodic, stomachic Medical Research: Bo he oil has antimicrobial, as well as antiviral properties and is active against Newcastle disease, herpes simplex, Vaccinia, Semliki culture, and fungus. 11,12,13,14,15 The flavonoids have been demonstrated to have choleretic activity in dogs. They have increased bile secretions about nine times above normal, while also improving component ratios in the bile. The underlying mechanism is not agreed upon, but it is felt that the essential oils stimulate the vagus nerves leading to bile secretion.16,17,18 The azulene, isolated from the oil, has been shown to be antiinflammatory and anti-ulcer in animals.19 As a stomachic and mucous membrane irritant, bo he has been very successful for dyspepsia, colic and flatulence. It is also useful for sudden cramps in the abdominal area.20 The oil relaxes the lower sphincter muscle of the esophagus, easing gas burping. The oils have also been shown to be spasmolytic against a large range of drugs in many different mammals. 21,22 The oil produces local vasodilatation, stimulates the skin, and regulates the nerve centers controlling body temperature, thus producing a diaphoretic action and a cooling effect.23 This oil will slowly penetrate the dermal layers of the skin, improving local circulation. Menthol can desensitize sensory irritation; exert a counterirritant effect while reducing histamine-induced itching. Menthol has been shown to increase topical absorption of other drugs by decreasing skin polarity and opening pores, increase corticosterone 10-fold and indomethacin 100-fold. Menthol can produce an antitussive effect by stimulating CI secretion across the airway epithelial tissue 24 Toxicity, Contraindications and cautions: contraindicated in cases of exterior deficiency, or yin deficiency with heat signs. Not recommended for lactating mothers as it might reduce lactation. Large amount of menthol have been shown to suppress the central nervous system and can cause paralysis of the spinal cord in animal models.25 Medicinal uses: Disperses wind-heat of fever, headaches and coughs. Also, clearing the headaches, red eyes, and sore throat associated with wind-heat. In can speed some rashes (like measles) to come to the surface faster, thus speeding up recovery. By aiding in the free flow of constrained Liver qi, mint can aid in the reduction of symptoms such as pressure in the chest or flanks, emotional instability and some gynecological problems. Pharmacy and dosage: g. steeped, not decocted or over cooked. 26

42 Lesson 2: Herbs that release the exterior Major Combinations: With ju hua (Chrysanthemum flowers) for headaches due to externally contracted wind heat or Liver fire. Beneficial for pain, redness, and swelling of the eyes. With jing jie (Schizonepeta tenuifolia), lian qiao (Forsythia suspense), and jin yin hua (Lonicera japonica) for exterior wind-heat. With xia ku cao (Prunella vulgaris) for inflammation of the eyes or scrofula. With jie gen (Platycodon grandifolium) and jiang can (Bombyx mori infected with Beauveria bassiana - sick silk worm) for painful, swollen throat. With bai shao (Paeonia lactiflora), and chai hu (Bupleurum chinense) for constrained Liver with symptoms such as stifling sensation in chest or pain and distention in flanks REFERENCES 1. Willard, T.L., Textbook of Modern Herbology, C. W. ProgressivePubl. Inc, Calgary Alta Canada, 1988, p Leung, A.Y., Encyclopedia of common natural ingredients used in food, drugs, and cosmetics, John Wiley & Sons Inc., New York, p Bensky, D. and Gamble, A., Ibid. 4. Moerman, D.E., Medicinal Plants of Native America, University of Michigan Museum of Anthropology, Technical Reports, Number 19, Ann Arbor, Michigan, 1986, VoU, p Spoerke, D.G., Herbal Medications, Woodbridge Press Publ. Co., Santa Barbara CA, p Leung, A.Y., Encyclopedia of common natural ingredients used in food, drugs, and cosmetics, John Wiley & Sons Inc., New York, p Huang CK, The Pharmacology of Chinese Herbs 2nd Ed. ; CRC Press; 1999, p Kapoor, L.D., CRC Handbook of Ayurvedic Medicinal Plants, CRC Press, Boca Raton, FL, 1990, p Holmes, P., The Energetics of Western Herbs (2 vols.), Artemis Press, Boulder CO, 1989, P Tierra, M., Planetary Herboiogy, Lotus Press, Santa Fe, NM, 1988, p Hermann, E.C., et al., Antiviral substance in plants of the mint family (Labiatae). III Peppermint (Mentha piperita) and other mint plants, Proceeding of the Soc. for Exper. BioI. and Med. 124, , Abdullin, K.K., Bactericidal effect of essential oils, Uch. Zap. Kazansk Vet. Inst. 84, 75-79, Farnworth, N.R., et al., A review of some biologially active compounds isolated from plants as reported in the literature, Lloydia 39(6),422-55, Maruzzella, J.C., et al., The in vitro antifungal activity of essential oils, J. of the Arner. Pharm. Assoc. 47, 250, Leung, A.Y., Ibid. 16. Chabrol, E., et al., Les agent therapeutic de la secretion biliare, Ann. de Med. 37(1) List, P.H., et al., Hagers handbuck der Pharo praxis, Six volumes, n.p Pasechnik, I., Study of choleretic properties specific to flavinoids from Mentha piperita leaves, Farm. I. Toksikologia 29(6), , Leung, A.Y., Ibid. 20. Grieve, M., A Modern Herbal, Jonathan Cape, London, 1931, p Forster, H., Spasmolytische wirkung pflanzlicher carminativa, Zeit der All. Med. 59, , Image: 27

43 Lesson 2: Herbs that release the exterior Ju hua Chrysanthemum morifolium Family: Compositae Other names: chrysanthemum flowers, ganju hua, huangju hua, hangju hua kikuka (Japanese), kukhwa (Korean) Plant description: Bai ju hua. (white chrysanthemum) is considered the best to nourish the Liver and clear the eyes. Used for Liver and Kidney yin deficiency. Also sometime called gan ju hua (sweet chrysanthemum). Huang ju hua (yellow chrysanthemum) has best wind-heat dispensing quality. It is most often used for red eyes and headache due to external-contracted wind-heat. The best quality of yellow chrysanthemum comes from Hangzhou. It is sometimes called hang ju hua. Part used: Flowers Habitat, ecology and distribution: Cultivated widely. Can grow locally. Harvested in late summer through to early winter (depending on climate) when flowers are at their height. Constituents: Two novel sesquiterpenes chlorochrymorin and chrysandiol; 2,2,4- trimethyl-cyclohexene-(3 )-l-carboxylic acid, borneol, bornyl acetate, acacretin-7 - rhamnoglucside, camphr, chrysanthemone, apigenin-glucoside, stachydrine (alkaloid) choline other B-vitamin and some carotinoids.1,2, 3 History: first found in Divine Husbandman's Classic of Materia Medica Energetics Properties and Channels entered: sweet, bitter, slightly cold; entering the Liver and Lung meridians. Actions and Indications: antibiotic, diaphoretic, vasodilator, hypotensive Medical Research: Ju hua has antibiotic effects, in vitro, against staph. aurens, E. coli hemolytic Strep and Shigella. Has anti-fungal action when used topically. This herb increases coronary vasodilation and coronary blood flow, but appears to have very little effect on cardiac contractility or oxygen consumption. Ju hua has been shown to reduce capillary permeability induced by histamine. Combined with jin yin hua (Lonicera japonica) for treatment of hypertension and arteriosclerosis; relieving symptoms of headaches, dizziness and insomnia in over 75% of subject within one week.4, 5 28

44 Lesson 2: Herbs that release the exterior Toxicity, Contraindications and cautions: use with caution in patients with qi deficiencies who have poor appetites and/or diarrhea Medicinal uses: This herb is very popular in southern China during the summer, as it gives a cooling effect. It disperses wind and clears heat for patterns of fever and headaches. Clears the Liver and problems manifested as red, painful, dry eyes or excessive tearing, or yin deficiency of Kidney and Liver with such symptoms as spots in front of eyes, blurry vision, or dizziness That may be Candida related. Calms the Liver, extinguishes wind for symptoms such as dizziness, headaches and deafness due to ascendant Liver yang.6 Pharmacy and dosage: Dosage 9-18 g used as infusion Major Combinations: With chuan xiong (Ligustica chuanxiong root) for headaches due to externallycontracted wind-heat or ascendant Liver yang With gou qi zi (Lycii fruit) for dizziness and blurred vision due to Liver and Kidney deficiency. With bai shao (Paeoniae lacifora root), shijue ming (Haliotidis, Conca), ming tian ma ( Gastrodiae elatea root) and gou teng (Uncaria) for headaches, dizziness and vertigo due to ascendant Liver Yang. Also used for seizure and convulsion in children due to internal movement of Liver wind. With jin yin hua (Lonicerae japonicae) for colorless, painless, flat, slow-healing suppurative inflammation of the soft tissue and other toxic swellings. REFERENCES 1 Hsu, H.Y., Chen, Y.P., et at., Oriental Materia Medica: a concise guide, Oriental Healing Arts Institute, Long Beach, CA, 1986, p.70 2 Huang CK, The Pharmacology of Chinese Herbs 2nd Ed. ; CRC Press; 1999, P Tang W, Eisenbrand; Chinese Drugs of Plant Origin; Spinger-Verlag; New York; 1992 p311 4 Bensky D, Gamble A; Chinese Herbal Medicine Materia Medica;Eastland Press Seattle Wa; p.44 5 Hsu, H.Y., Chen, Y.P., et at., Oriental Materia Medica: a concise guide, Oriental Healing Arts Institute, Long Beach, CA, 1986, p.70 6 Bensky D, Gamble A; Chinese Herbal Medicine Materia Medica;Eastland Press Seattle Wa; p.44 Image: 29

45 Lesson 2: Herbs that release the exterior Mu zei Equisetum hiemale! Other names: Herba Equiseti Hiemalis, scouring rush, shave grass, horsetail, mokuzoku (Japanese), mokchok (Korean), mu zei cao, mu tsei Family: Equisetaceae Plant description: Horsetails botanical name is derived from two Latin terms, equis meaning horse, and seta for bristle. The name resulted from its peculiar bristled appearance at the stem joints. The stems are erect, brittle and grooved; hollow except at the joints. Air cells are found under the grooves. The joints terminate in toothed sheaths. There are two stem types, fertile and barren. The fertile stem is unbranched, withering in the spring. It bears terminal cones like catkins. The roots are numerous and jointed. Part used: Herb Habitat, ecology and distribution: Grows through north and northeastern China, especially in the Yangtze River. Other varieties grow throughout North America. It is usually harvested in late summer or early autumn. History: This herb has been used for dropsy, gravel and kidney afflictions, gout, rheumatism, acid stomach, dyspepsia, female complaints, internal hemorrhages, cystic ulcerations in the urinary tract, and as a wash for swelling eyelids. 1 Decoctions, poultices and infusions were used for polyps, abdominal, and oral cancer. In Guatemala, it is used for cancer.2 We can find horsetail in the herbals of Gerard (1597), Lewis (1769), Linnaeus, Culpepper, and Galen.3,4 It has been found in Chinese literature since the Materia Medica of the Jia You Era (1061 A.D.). Equisetum species were broadly used by Native Americans. Equisetum hyemale saw especially wide use (roughly 20 tribes) primarily as a urinary and venereal treatment.5 Constituents: Horsetail contains large amounts of silica (5-8%), varying between species and even from location to location. It also contains aconitic acid (equisetic acid); equisitine; 5% equisetonin (a saponin), flavonoids, starch, several fatty acids and a trace of nicotine." Energetics Properties and Channels entered: Horsetail is sweet, bitter and neutral while entering the Lung, Liver and Gallbladder meridians. Horsetail disperses wind-heat and removes film on the eyes.9,10 Holmes lists horsetail as a bit bitter, astringent and bland, with a cold dry property. The secondary quality is astringing, dissolving, restoring, nourishing, while stabilizing movement. Horsetail enters the Liver, Bladder and Lung meridians and influences the 30

46 Lesson 2: Herbs that release the exterior bladder, kidneys, lungs, intestines, bones and skin. The organism is warmth and fluid. Tri Dosa decreases Pitta and Kapha.11 Tierra describes horsetail as sweet, bitter and cool and influencing the Lung, Liver and Gallbladder meridians. 12 Actions and Indications: Astringent, diuretic and mild emmenagogue. Medical Research: Horsetail is strongly astringent and is therefore used for both internal and external wounds. It has been used for centuries as a diuretic appropriate for kidney infection, dropsy, and gravel.13,14 Horsetail has been shown to have antibiotic properties, inhibiting Staphylococcus aureus and Streptococcus pyogenes and certain mycobacteria. It is also felt to have anti-tubercular properties.15,16,17 Used to treat silicosis, reducing coughing, wheezing and chest pain.18 Horsetail apparently has mild to moderate anti-inflammatory activity. 19 Screen test have indicated mu zei is useful against stomach, tongue and liver cancers.20 Toxicity, Contraindications and cautions: This herb is contraindicated in cases of hypertension and/or cardiovascular problems.21 Used with caution in cases of urinary frequency, depleted fluids, or qi deficiency. Also use with caution during pregnancy. Livestock experience a toxic reaction if over 20% of their diet is horsetail. Medicinal uses: Disperses wind-heat and eliminates superficial visual obstruction affecting eyes such as redness, pain, swelling, cloudiness, blurred vision, pterygium and excessive tearing. Clears heat and stops bleeding or hemorrhoids or blood in stool. Pharmacy and dosage: Dosage Fluid extract: drops 22 Tincture: 5-20 drops Infusion/decoction: 1 tsp per cup of water. Powder: 3-9 grams Major Combinations: With ju hua (Chrysanthemum) for swelling, pain and redness of the eyes and pterygium. With bai ji Ii (Tribuli terrestrus fruit) for hives and itching, pterygium and excessive tearing. With cang zhu (Atractylodis root) for blurred vision and excessive tearing. With di yu (Sanguisorbae officinalis root)and huang qin (Scutellaria baicalensis root)for bleeding hemorrhoids due to heat in the blood. 31

47 Lesson 2: Herbs that release the exterior REFERENCES 1. Grieve, M., A Modem Herbal, Jonathan Cape, London, 1931, p Duke, J.A., Handbook of Medicinal Herbs, CRC Press Inc., Boca Raton FL, p Grieve, M., Ibid. 4. Crellin, J.K. and Philpott, J., Herbal Medicine: Past and Present (Vol. II), Duke University Press, London, 1990, p Moerman, D.E., Medicinal Plants of Native America, University of Michigan Museum of Anthropology, Technical Reports, Number 19, Ann Arbor, Michigan, 1986, Vol.1, p.i Spoerke, D.G., Herbal Medications, Woodbridge Press Publ. Co., Santa Barbara CA, p Grieve, M., A Modem Herbal, Jonathan Cape, London, 1931, p Duke, J.A., Handbook of Medicinal Herbs, CRC Press Inc., Boca Raton FL, p Bensky, D. and Gamble, A., Chinese Herbal Medicine: Materia Medica, Eastland Press, Seattle, WA, 1986, p Hsu, H.Y., Chen, Y.P., et ai., Oriental Materia Medica: a concise guide, Oriental Healing Arts Institute, Long Beach, CA, 1986, p Holmes, P., The Energetics of Western Herbs (2 vols.), Artemis Press, Boulder CO, 1989, p Tierra, M., Planetary Herbology, Lotus Press, Santa Fe, NM, 1988, p Spoerke, D.G., Herbal Medications, Ibid. 14. Grieve, M., Ibid. 15. Sommer, L., et al., Antimicrobial activity of volatile oil extracted from Equisetum arvense, Farmacia 10, , Nishika, H., Screening test for antibiotic action of plants extracts, Jap. J. of Exp. Med Fitzpatrick, F.K., Plant substances active against mycobacterium tuberculosis, Antibiot. and Chemotherapy 4(5), , Bensky D, Gamble A; Chinese Herbal Medicine Materia Medica;Eastland Press Seattle Wa; p 19. Benoit, P.S., et ai., Equisetum, Lloydia 39:160, Hsu, H.Y., Chen, Y.P., et al., Oriental Materia Medica: a concise guide, Oriental Healing Arts Institute, Long Beach, CA, 1986, p Spoerke, D.G., Herbal Medications, Ibid. 22. Grieve, M., Ibid. p.420. Image: 32

48 Lesson 2: Herbs that release the exterior Chai hu Bupleurum chinense Family: Umbelliferae Other names: Radix Bupeuri, hare's ear root, thorowax root, bupleurum, ying chai hu, ruan chai hu, xi chai hu, saiko (Japanese), siho (Korean) Plant description: B. chinesis is known as "northern bupleurum" (bei chai hu) it is considered more effective in resolving lesser yang disorder and reducing heat. Bei chai hu Cylindrical to elongated conical, 6-15 cm long, cm in diameter, root stock expanded. Apex remained with 3-15 stem-bases or short fibrous leaf-bases, branched at the lower part. Externally blackish-brown or light brown, with longitudinal wrinkles, rootlet scars and lenticels. Texture is hard and tenacious, uneasily broken, fracture laminated-fibrous, bark light brown, wood yellowish-white. Odour is slightly aromatic; taste, slightly bitter. B. scorzoneraefolium (nan chai hu) is known as southern bupleurum. Nan chai hu is relatively thin and conical. Apex with numerous hairy fibers from withered leaves usually not branched or slightly branched at the lower part. Externally reddish-brown or blackish-brown, with dense and transverse annulations near the root stock. Texture slightly soft, easily broken, fracture slightly even, and nonfibrous. Rancid odour. Xil chai hu or ruan chai hu is consider "fine bupleurum" and is associated with being the most effective in spreading Liver qi and relieving constraint. Part used: root Habitat, ecology and distribution: many parts of China. Harvested in spring and fall. History: First found in the Divine Husbandsman's Classic of Materia Medica Constituents: bupleurumol, adonitol, spinasterol, adonitol, oleic acid, linolenic acid, palmitic acid, stearic lignoceric acids, saikosaponin, dikogenin, longispinogenin, rutin. 1, 2,3 Energetics Properties and Channels entered: bitter, acrid, cool; entering Gallbladder, Liver, Pericardium, and Triple Burner meridians. Actions and Indications: diaphoretic, antibiotic, hepatic, antiphlogistic, antitussive, mild analgesics 33

49 Lesson 2: Herbs that release the exterior Medical Research: temperature regulation is debated, but some studies show it has an antipyretic action lowering fevers. It is most specific if fever is secondary to upper respiratory infection. Chai hu has been show to reduce capillary permeability cause by histamine and 5-HT, but not enough effect to reduce anaphylactic shock. Bupleurum has a bacteriostatic effect against Mycobacterium tuberculosis (TB), as well as several flu and poliomyelitis viruses. Chai hu has been shown to have mild blood pressure lowering effect; with a negative inotropic effect on the heart in animals models. The saponins have shown tranquilizing effects in mice models.4,5 In vitro test have shown that saikosaponins can inhibit growth of liver cancer cells,6 and are anti-inflammatory.7, 8 The constituent, given orally produces a tranquilizing effect, prolonging sleep time, with a moderate analgesics and strong antitussive effect. Antibacterial and antiviral effects have been shown against Bacillus tuberculosis and on the proliferation of influenza virus; while most likely antimalarial. A group of crude saponin, given orally produced an anti-inflammatory effect reducing edema.9 Toxicity, Contraindications and cautions: Contraindicated in cases of yin deficiency cough or Liver fire ascending to the head. May in some cases cause nausea and vomiting, thus might have to lower dosage. 10 Medicinal uses: Bupleurum has been used in TCM for thousands of years to help relieve numerous conditions such as: fevers, flu, the common cold, cough, fatigue, headache, tinnitus, liver disorders, premenstrual syndrome (PMS), dysmenorrhea, depression, anorexia, cancer, inflammation, lung congestion, malaria, angina, epilepsy, pain, muscle cramps, rheumatism, asthma, bronchitis, indigestion, ulcers, hemorrhoids, diarrhea, constipation, as a sedative, antioxidant, antiseptic, antifungal, antiviral, as an immune stimulant, and for reducing cholesterol and triglyceride levels. It is also used orally for increasing sweating, as a protectant against kidney problems, a liver tonic, and a spleen and stomach toner. Most particularly it is used for: infections with fever, liver problems, indigestion, hemorrhoids, and uterine prolapse. Resolves lesser yang disorders (of externallycontracted disorders), while reducing fevers; with symptoms of alternating chills and fevers accompanied by a bitter taste in the mouth, flank pain, irritability, vomiting and a stifling sensation in the chest. Spreads and relieves constraint of Liver qi, with symptoms such as: dizziness, vertigo, chest and flank pain, emotional instability or menstrual problems. Also known to reduce disharmony between the Liver and the Spleen with symptoms such as: epigastric and gastric pain, a stifling sensation in the chest, abdominal bloating, nausea and indigestion

50 Lesson 2: Herbs that release the exterior Raises the yang qi in patterns of Stomach and Spleen deficiency in cases of hemorrhoids, anal or uterine prolapses and diarrhea due to collapsed Spleen qi. Pharmacy and dosage: Dosage 3-12 grams Major Combinations: In traditional Chinese medicine bupleurum is not usually used alone, but rather as part of various herbal remedies. In combination, chai hu / Bupleurum is used in many herbal formulas. It is included in a Chinese herbal formula used for treating thrombocytopenic purpura and in a Japanese herbal formula (Sho-saiko-to, TJ-9, Xiao-chai-hu-tang) used for various chronic liver diseases. With huang qin for heat in lesser yang stage of disease when the pathogen is half exterior and half interior. This usually has alternating chills and fever. This combination is also famous for restoring normal function of Liver and Gallbladder to clear and drain damp-heat smoldering in the interior. Symptom related to this would be; biter taste in mouth, dry throat, dizziness a strong feeling of fullness and pain in chest and flank. With bai shao for vertigo and dizziness, thoracic and costal pain and menstrual irregularities due to obstruction of Liver qi. o Plus dang gui and chuan xiong to harmonize the blood. o Plus dang shen and bai zhu to fortify qi With zhi ke for strong sensation in chest and abdominal pain, poor appetite, and irregular bowel movements. With qiang huo and fang feng for Spleen deficiency and dampness, when the body is feeling weighed down associated with soreness and pain in the extremities. With bo he for emotional depression, a strong sensation in the chest associated with irregular menstruation due to Liver blood deficiency and obstruction. With gan cao for hepatitis and pain in the upper right quadrant. In vitro test studies have shown that the sho-saiko-to combination can increase production of various chemicals (known as cytokines) that immune cells use to signal one another.12 Sho-saiko-to (xiao-chai-hu-tang or minor bupleurum formula) contains the following: Bupleurum falcatum (thorowax) root, 16% - Chai hu Paeonia lactiflora (peony) root, 16% - Bai shao Pinellia ternata (ban xia) rhizome, 14% - Ban xia Cinnamomum cassia (cassia) bark, 11 % - Gui zhi Zingiber officinale (ginger) rhizome, 11 % - Sheng jiang Zizyphus jujuba (jujube) fruit, 11 % - Da zao 35

51 Lesson 2: Herbs that release the exterior Panax ginseng (Asian ginseng) root, 8% - Ren shen Scutellaria baicalensis (Chinese scullcap) root, 8% - Huang qin Glycyrrhiza uralensis (licorice, gan cao) rhizome, 5% - Zhi gan cao Human trials, only one double blind, have shown that sho-saiko-to can reduce symptoms and blood liver enzyme levels in children and adults with chronic active viral hepatitis. 13,14,15,16 These studies concentrated on people with hepatitis B infection, though one trial did show benefit in people with hepatitis C.17 Sho-saiko-to was also found, in a large, preliminary (but not double-blind), study to reducing chronic viral hepatitis developing into liver cancer.18 Sho-saiko-to can decrease the severity of liver cirrhosis, though clinical studies on this condition are generally lacking. One randomized trial did show that sho-saiko-to could reduce the rate of liver cancer in people with liver cirrhosis. 19 Several uncontrolled trials in Japan have shown that sho-saiko-to or very similar traditional Japanese and Chinese herbal formulas (all containing bupleurum) can reduce seizure frequency and/or severity in people with epilepsy that does not respond to antiseizure medications.20, 21, 22, 23 Sho-saiko-to has been found to inhibit HN in vitro.24 This formula has been shown to increase the efficacy of the standard anti-hiv drug lamivudine in vitro.25 REFERENCES 1 Hsu, H.Y., Chen, Y.P., et al., Oriental Materia Medica: a concise guide, Oriental Healing Arts Institute, Long Beach, CA, 1986, p. 2 Bensky D, Gamble A; Chinese Herbal Medicine Materia Medica;Eastland Press Seattle Wa; p 3 Tang W, Eisenbrand; Chinese Drugs of Plant Origin; Spinger-Verlag; New York; 1992 p229 4 Bensky D, Gamble A; Chinese Herbal Medicine Materia Medica;Eastiand Press Seattle Wa; p 5 Hsu, H.Y., Chen, Y.P., et ai., Oriental Materia Medica: a concise guide, Oriental Healing Arts Institute, Long Beach, CA, 1986, p Motoo Y, Sawabu N. Antitumor effects of saikosaponins, baicalin and baicalein on human hepatoma cell lines. Cancer Lett 1994;86: Yamamoto M, Kumagai A, Yamamura Y. Structure and actions of saikosaponins isolated from Bupleurum fa1catum L. I. Anti-inflammatory action of saikosaponins. Arzneim Forsch 1975;25: Utrilla MP, Zarzuelo A, Risco S, et al. Isolation of a saikosaponin responsible for the antiinflammatory activity of Bupleurum gibralticum Lam root extract. Phytother Res 1991 ;5: Hsu, H.Y., Chen, Y.P., et al., Oriental Materia Medica: a concise guide, Oriental Healing Arts Institute, Long Beach, CA, 1986, p Bensky D, Gamble A; Chinese Herbal Medicine Materia Medica;Eastland Press Seattle Wa; p 11 Bensky D, Gamble A; Chinese Herbal Medicine Materia Medica;Eastland Press Seattle Wa; p 12 Yamashiki M, Nishimura A, Nomoto M, et al. Herbal medicine sho-saiko-to induces tumor necrosis factor-alpha and granulocyte colony-stimulating factor in vitro in peripheral blood mononuclear cells of patients with hepatocellular carcinoma. J Gastro Hepatol 1996; 11: Hirayama C, Okumura M, Tanikawa K, et al. A multicenter randomized controlled clinical trial of shosaiko-to in chronic active hepatitis. Gastroent Jap 1989;24:

52 Lesson 2: Herbs that release the exterior 14 Fujiwara K, Ohta Y, Ogata I, et al. Treatment trial oftraditional Oriental medicine in chronic viral hepatitis. In: Ohta Y (ed). New Trends in Peptic Ulcer and Chronic Hepatitis: Part II. Chronic Hepatitis. Tokyo: Excerpta Medica, 1987, Tajiri H, Kozaiwa K, Osaki Y, et al. The study of the effect of sho-saiko-to on HBeAg clearance in children with chronic HBV infection and with abnonnalliver function tests. Acta Paediatr Jpn 1991;94: Gibo Y, Nakamura Y, Takahashi N, et al. Clinical study ofsho-saiko-to therapy for Japanese patients with chronic hepatitis C (CH-C). ProgMed 1994;14:217~9. 17 Gibo Y, Nakamura Y, Takahashi N, et al. Clinical study ofsho-saiko-to therapy for Japanese patients with chronic hepatitis C (CH-C). Prog Med 1994;14: Oka H, Yamamoto S, Kuroki T, et al. Prospective study of chemoprevention of hepatocellular carcinoma with shosaiko-to (TJ-9). Cancer 1995;76: Yamamoto S, Oka H, Kanno T, et al. Controlled prospective trial to evaluate Shosaiko-to in preventing hepatocellular carcinoma in patients with cirrhosis of the liver. Gan To Kagaku Ryoho (Jpn J Cancer Chemother) 1989;16: [in Japanese]. 20 Narita Y, Satowa H, Kokubu T, et al. Treatment of epileptic patients with the Chinese herbal medicine 'saiko-keishi-to' (SK). IRCS Med Sci 1982;10: Nagakubo S, Niwa Sol, Kumagai N, et al. Effects oftj-960 on Sternberg's paradigm results in epileptic patients. Jpn J Psych Neur 1993;47: Packer M, Kligler B. Bupleururn for the treatment of epilepsy. Int J Chin Med 1984;1: Hiramatsu M, Edamatsu R, Kohno M, et al. The possible involvement of free radicals in seizure mechanism. Jpn J Psych 1986;40: Buimovici-Klein E, Mohan V, Lange M, et al. Inhibition of HI V replication in lymphocyte cultures of virus-positive subjects in the presence of sho-saiko-to, an oriental plant extract. Antiviral Res 1990; 14: Piras G, Makino M, Baba M. Sho-saiko-to, a traditional kampo medicine, enhances the anti-hiv-l activity of lamivudine (3TC) in vitro. Microbiol IrnrnunoI1997;41: Image: 37

53 Lesson 2: Herbs that release the exterior Sheng ma Cimicifuga foetida Other names: bugbane roots, Chinese black cohosh roots, Rhizoma Cimicifugae, shoma (Japanese), sungma (Korean) Actaea foetida. C. heracleifolia, C. dahurica, and C. simplex. Sheng means to raise, and refers to the herb's property of raising the yang qi; ma is the term for hemp-like plants, referring to the stem's tough consistency. This genus has now been considered to be Acteaa. Family: Ranunculaceae Plant description: Cimicufuga has dark brown roots, given off by underground rhizomes that are bluntly quadrangular and furrowed. The stem is slender and unbranched, m tall. The palmate compound leaves have incised leaflets. It flowers from June to July with regular, numerous, small white racemes cm long, having a peculiar scent. Recently (1998) there has been a move to place the entire genus of Cimicifuga into the genus of Actaea (baneberry). This is due to morphological and DNA sequence studies. Part used: roots Habitat, ecology and distribution: Grown in Northern China, closely associated with C. racemosa. Found in North America. Harvested in the fall History: First found in the Divine Husbandman's Classic of Materia Medica listed as a high grade herb. Constituents: Sheng ma contains steroids (ferulic acid, isoferulic acid, cimigenol and others); triterpenoids (xyloside, cimiside A and B) several phenolic glycosides.1 Black Cohosh contains a resinous material called cimicifugin (macrotin) 15-20% which is the active principal. 2,3,4,5 Black Cohosh also contains tannin, isoferulic acid, volatile oil, triterpine glycosides (actein, cimigoside and others) racemosin, and acetic, palmitic, salicylic, gallic, butyric and oleic acids.6 There also is said to be an alkaloid, N- methylcytisine, as well as some un-named alkaloids.7 Energetics Properties and Channels entered: The flavor is sweet, pungent; with a mild, cold property. These herbs enter the Lung, Large intestine, Spleen, and Stomach meridians. The action resolves surface, promotes eruptions, removes toxic heat, and raises yang Qi.8,9 Holmes finds Black Cohosh bitter, a bit pungent, cool and dry; with secondary action of relaxing, calming, stimulating and restoring. It enters the Lung, Heart, Kidney, Chong and Ren meridians; has a warm organism and is air quality. Its action is on the 38

54 Lesson 2: Herbs that release the exterior lung, heart, circulation, stomach, kidney and reproductive organs. 10 Tierra lists the herb as sweet, pungent, slightly bitter and cool; influencing the Liver, Spleen, Stomach, and Colon. 11 Actions and Indications: Nervine, tonic, antispasmodic, an alterative, sedative and emmenagogue.12,13,14,15,16,17,18,19 It is also used as an antitussive, a bitter stomachic, a diuretic and diaphoretic.20 Medical Research: As an antibiotic, sheng ma has been shown to inhibit TB and many pathogenic fungi (in vitro). The tincture of sheng ma has an antipyretic effect lowering body temperature.21 Sheng ma has shown to lower cholesterol, while having a hepatic protective effect.22 Related species Black Cohosh (c. racemosa) has been used as an analgesic. 23,24 Actein has been shown to be hypotensive in cats and rabbits but not dogs.25 It has anti-inflammatory activity in animals and acts as a peripheral vasodilator in man. Extract of Black Cohosh creates selective reduction in luteinizing hormone (LH) levels by 20% with no effect on follicle-stimulating hormone (FSH) or prolactin levels by acting on the hypothalamus and vasomotor centers to reduce menopausal symptoms. This suggests we don't need progesterone "opposing" therapy as found with HRT (Hormone Replacement Therapy) when using Black Cohosh. Black cohosh as a root extract works, but none of the single ingredients on their own are effective, thus showing it is the sum total of many factors that makes it work. One of the most significant factors of using Black Cohosh over HRT is that it does not have to be consumed on a long term basis. It helps a person through the symptom stages of menopause. In Germany, it was introduced under the brand name Remifemin in the mid-1950s, and is still one of the prominent products used to reduce menopause symptoms in that country. Black Cohosh is currently used by 1.5 million German women annually or nearly 10 million monthly doses.26,27 The use of this product has been shown to be more effective for common menopausal symptoms (hot flashes, vaginal atrophy, depression and anxiety) than conjugated estrogen (HRT). Many people know that one of the risks of HRT is the stimulation of estrogen receptor cancer growth in the breast and uterus. Black Cohosh has been shown to not stimulate established breast tumors, and in fact has an inhibitory effect. Black Cohosh has been shown to exert no effect on endometrium, so there is no need to "oppose" therapy with progesterone, as is done with conventional HRT.28 Toxicity, Contraindications and cautions: Overdose in humans can cause headaches, dizziness, vomiting, tremors, gastroenteritis and pathogenic erections. Contraindicated in case of heat due to yin deficiency, and for patterns where the upper burner is excessive and the lower burner is deficient. Should not be used in cases of fully erupted measles or with patients having a hard time breathing.29 Medicinal uses: Releases the exterior and vent measles, reducing headaches due to exterior wind heat or early stages of measles. Clears heat and relieves a variety of fire 39

55 Lesson 2: Herbs that release the exterior toxicity in the upper or superficial aspect of the body. Often used for sore teeth, swollen or painful gums, ulcerated lips, cankers, sore or swollen throat. Raises the yang and "lifts the sunken" for middle qi deficiencies leading to shortness of breath, fatigue and prolapsed internal organs (such as the anus and uterus). It is said that this herb "lifts the sunken"; therefore, it is used to direct other herbs upward and is also indicated for prolapsed organs. Often used to guide other herbs.30 Pharmacy and dosage: Dosage 2-10 g Major Combinations: With niu bang zi and da qing ye for incomplete expression of fire toxins rashes. With Gypsum (shi gao) to clear excess heat and fire toxins from the yang brightness channels. Often adding da qing ye for blotches from warm-febrile disease. With huang lian (Coptidis) to clear and drain Heart and Spleen fire with swelling of gums, and toothaches or cancer of mouth and tongue. With bai zhi for yang brightness channel headaches. With chai hu for chronic dysentery, rectal or uterine prolapse caused by yang qi deficiency. REFERENCES 1 Huang CK, The Pharmacology of Chinese Herbs 2nd Ed. ; CRC Press; 1999, p Gathercoal, E.N. and Wirth, E.H., Phannacognosy, Lea & Febiger, Phila. PA, p Spoerke, D.G., Herbal Medications, Woodbridge Press Pub!. Co., Santa Barbara CA, p Allport, N.L., Chemistry and Phannacy of Vegetable Drugs, George Newnes Ltd., London, p The Merck Index 5th ed., Merck & Co. Inc., Rahway NJ, p Leung, AY., Encyclopedia of common natural ingredients used in food, drugs, and cosmetics, John Wiley & Sons Inc., New York, p Duke, J.A, Handbook of Medicinal Herbs, CRC Press Inc., Boca Raton FL, p.12!. 8. Bensky, D. and Gamble, A, Chinese Herbal Medicine: Materia Medica, Eastland Press, Seattle, WA, 1986, p.7!. 9. Hsu, H.Y., Chen, Y.P., et ai., Oriental Materia Medica: a concise guide, Oriental Healing Arts Institute, Long Beach, CA, 1986, p '. 10. Holmes, P., The Energetics of Western Herbs (2 vols.), Artemis Press, Boulder CO, 1989, p Tierra M.; Planetary Herbology; Lotus Press; Santa Fe; 1988 p Gathercoal, E.N. and E.H. Wirth, Ibid. 13. The Merck Index 5th ed., Ibid. 14. Wren, R.C., Potter=s New Cyclopaedia of Botanical Drugs and Preparations, Health Science Press, Rustington, Sussex, UK, 1975, p Lloyd, J.U. and C.G, Drugs and Medicines of North America, VoL2, Cincinnati, OH, , p Squire, P.W., Ibid. 17. Herbal Phannacology in the People=s Republic of China, Trip Report of the American Herbal Pharmacology Delegation, National Academy of Sciences, Washington DC, 1975, p Veninga, L. and Zaricor, B.R., GoldenseallEtc.: A Pharmacognosy of Wild Herbs, Ruka Publications, Santa Cruz CA, pp.l Leung, A.Y., Encyclopedia of common natural ingredients used in food, drugs, and cosmetics, Ibid. 20. The Merck Index 5th ed., Ibid. 40

56 Lesson 2: Herbs that release the exterior 21 Hsu, H.Y., Chen, Y.P., et al., Oriental Materia Medica: a concise guide, Oriental Healing Arts Institute, Long Beach, CA, 1986, p Tang W, Eisenbrand; Chinese Drugs of Plant Origin; Spinger-Verlag; New York; 1992 p Squire, P.W., Squire's Companion to the Latest Edition of the British Phannacopeia, J & A Churchill, London, p Leung, A.Y., Ibid. 25. Tyler V.E., The Honest Herbal, George F. Stickley, Phil 1983, p Hobbs,C; Black Cohosh - A woman=s herb comes of age; Herbs for Health; March Murray, M; Remifemin: Answers to Common Questions; Am 1. of Nat. Med; Vol 4, # April 97, p The Lawrence Review; Black Cohosh; May Bensky D, Gamble A; Chinese Herbal Medicine Materia Medica;Eastland Press Seattle Wa; p50 30 Bensky D, Gamble A; Chinese Herbal Medicine Materia Medica;Eastland Press Seattle Wa; p50 Image: 41

57 Lesson 2: Herbs that release the exterior 42

58 Lesson 3: Herbs that clear heat LESSON 3: Herbs that Clear Heat Herbs that clear heat are cold or cool in nature and often have a bitter flavour. When we discuss herbs that clear heat we are referring to their actions at the interior of the body, versus lesson 2 herbs that release exterior heat - they are acting on the exterior of the body. Heat may be internally generated (from organ dysfunction, improper diet, emotional disturbance, external heat and cold moving internally, etc.) or due to an external attack. Herbs that clear heat are divided into 5 categories, they are: 1. Clear heat and drain fire 2. Clear heat and cool blood 3. Clear heat and dry damp 4. Clear heat and relieve toxicity 5. Clear summer heat Herbs that clear heat and drain fire Herbs that cool blood These herbs are cold in nature, and have a strong tendency to move downward, hence their draining action. Fire is an extreme of heat and moves upward and outward. This movement settles in the yang part of the body superficially and upper body. Fire gives rise to symptoms of high fever, irritability, mania and delirium, dry mouth, dry throat and eyes, severe headaches, burning pain, burning urination, deeply red complexion and excessive sweating. These herbs are considered antibiotic, antiinflammatory, antimicrobial and antipyretic. Herbs discussed in this section are: - Shi Gao, Gypsum/Calcium Sulphate - Zhi Zi, Gardenia jasminoidis In the 4 levels (wei, qi, ying and blood) of disease diagnosis, these herbs act on the heat that has penetrated to the blood level. This is the deepest level and includes heat that affects the organs. The result of this deeply rooted heat is erratic movement of blood that tends to escape the vessels and cause bleeding form the orifices, excessive menstruation, blood in the

59 Lesson 3: Herbs that clear heat urine and stools. Other signs of blood heat include a reddish purple tongue, night sweats, afternoon fever and delirium, as well rashes and other hot and red skin ulcers and disorders. Infectious diseases that are not resolved at the exterior move internally and enter the blood level. In these cases blood cooling herbs reduce the heat and consolidate the vessels to contain the blood, they also promote coagulation. The herbs we will discuss in this section are: - Mu Dan Pi, Paeonia suffruticosa - Xuan Shen, Scrophularia ningpoensis Herbs that Clear Heat and Dry Dampness Damp-heat is obviously, dampness in combination with heat. Signs and symptoms include the presentation of heat (redness, fever, etc.) with the concurrent signs of dampness: presence of phlegm that is yellow, a thick greasy tongue coating, and includes disorders such as jaundice, eczema that is suppurative and red, sores, ulcers and carbuncles containing yellow purulent pus. The herbs discussed here are more specifically antimicrobial, anti-inflammatory and antipyretic. These herbs will include: - Huang Lian, Rhizoma Coptidis - Huang Qin, Radix Scutellariae Baicalensis - Long Dan Cao, Radix Gentianae *Caution must be used with these herbs - due to the presence of damp we can infer there is likelihood of a spleen deficiency and the cold nature of the herbs will further injure the spleen, creating more dampness. Herbs that Clear Heat and Relieve Toxicity This section is an extension of damp-heat; toxicity refers to bacterial and viral presence. The herbs used in this section have been found to have antiviral and antimicrobial effects. They address signs and symptoms with severe heat and swelling, fever, etc. This group of herbs is indicated for abscesses, infections that become systemic, and a large gamut of disorders involving infection, such as mastitis, appendicitis, encephalitis, etc. Herbs to be examined here are: - Jin Yin Hua, Lonicera japonica - Lian Qiao, Forsythia suspense

60 Lesson 3: Herbs that clear heat Herbs that Relieve Summerheat This final category of herbs refers to the seasonal affliction of summerheat, characterized by intense fever, sweating, irritability, diarrhea and thirst. This group of herbs is diuretic and antipyretic as well as generates fluids and relieves thirst. In this section we will limit our discussion to: - Lu Dou, Phaseolus radiatus/mungo

61 Lesson 3: Herbs that clear heat Shi gao Gypsum fibrosum Family: Mineral Other names: Calcium Sulfate, stone paste, crystalline gypsum, sekko (japanese), seokgo (korean) Description: White and fibrous crystals Part used: crystals Habitat, ecology and distribution: through out China History: Divine Husbandman's Classic of Materia Medica Constituents: Calcium Sulfate Energetics Properties and Channels Entered: sweet, pungent and extremely cold, entering the lung, kidney and stomach meridians Actions and Indications: antipyretic, sedative, antiphlogistic, astringent1 Medical Research: Toxicity, Contraindications and cautions: Contraindicated when there is deficiency of the stomach, spleen or yang deficiency, as well as cold. Long time use blocks calcium absorption and decreases functions of the glands. Medicinal uses: Clears heat, especially of the stomach, and drains fire. Shi gao clears heat by moving the heat and fire to the surface to be resolved, Clears heat at qi level Indicated for lung heat presenting as cough and wheezing with thick yellow sputum Stomach heat with symptoms of: headache, red painful swollen gums, thirst and restlessness Used topically for burns, eczema and ulcerated sores. 23 Pharmacy and dosage: 9-30 g for internal dosage, up to 90g for severe fever or external application

62 Lesson 3: Herbs that clear heat Major Combinations: With zhi mu (Rhizome Anemarrhenae asphodeloidis) for high fever associated with yang ming stage and qi level heat, irritability and strong thirst With ma huang (Ephedra sinica) for cough and nasal flaring due to obstruction of externaliy contracted heat With xi xin (Herba cum Radice Asari) for toothache and swollen gums With dan zhu ye (Herba Lophatheri Gracilis) for lingering fever from sequelae of febrile disease With shu di huang (Radix Rehmanniae Glutinosae Conquitae) for yin deficiency thirst With xi jiao (Cornu Rhinoceri) for dampheat presenting with high fever, loss of consciousness, nosebleed and rash * for reference only, not used (endangered) With huang bai (Cortex Phellodendri) topically for burns and eczema4 REFERENCES 1http://academic.brooklyn.cuny.eduicore9/phalsalllstudpages/friedberg/shigaocap.htm 2 Macciocia, Giovanni; The Practice of Chinese Medicine; Churchill Livingstone, 1997, p804 3 Bensky, D. and Gamble, A.; Chinese Herbal Medicine Materia Medica; Eastland Press Seattle, 1993, p56 4 Bensky, D. and Gamble, A.; Chinese Herbal Medicine Materia Medica; Eastland Press Seattle, 1993, p56 Image:

63 Lesson 3: Herbs that clear heat Zhi zi Fructus Gardeniae jasminoidis Family: Rubiaceae Other names: Shan zhi zi, shan zhi, cape jasmine fruit, gardenia Plant description: Prolate-ovoid or ellipsoid, cm long, cm in diameter. The outer surface reddishyellow or brownish-red, with 6 longitudinal winged ribs and a conspicuous longitudinal and branched vein between two ribs. Summit bearing remains of sepals, base somewhat tapering and having a remain of fruit stalk. Pericarp thin and brittle, somewhat lustrous; the inner surface relatively pale in colour, lustrous, with 2-3 raised false septa. Seeds numerous, flattened dovoid, aggregated into a mass, deep red or reddish-yellow, with fine and dense warts on the surface.1 Part used: Fruit and seedpod Habitat, ecology and distribution: found in the provinces of Hunan, Jiangxi, Hubei, Zhejiang, Fujian, this herbs is harvested in September thru to November when the fruit and skin turn reddish yellow History: Divine Husbandman's Classic of Materia Medica Constituents: gardenin, crocin, crocetin, D-mannitol, sitosterol, gardenoside, geniposide, genipin-1-glucoside, genepin-1-b-d-gentiobioside, shanzhiside Energetics Properties and Channels Entered: bitter and cold, entering the heart, liver, lung, stomach and triple burner meridians Actions and Indications: Antibiotic and anti-inflammatory, increases bile production, mild sedative, anti-hypertensive, antimicrobial and increases circulation Medical Research: Intravenous administration to rabbits showed increase in bile production for up to 1 hour, however the same solution orally had no effect on bile production Oral administration to humans showed gallbladder contraction for minutes after ingestion Oral administration to rabbits with biliary ligation showed reduced bilirubin levels In combination with Chinese wormwood, this herb increases liver cell regeneration. This herb has also been shown to increase bile secretion.2

64 Lesson 3: Herbs that clear heat Toxicity, Contraindications and cautions: contraindicated in cases of spleen deficiency diarrhea and loss of appetite Medicinal uses: Clears heat and reduces irritability, effective for heat and fire that rises to the head causing headache, insomnia, mania and restlessness Drains damp-heat, cools blood and stops bleeding Reduces swelling and hematomas, apply as a poultice mixed with egg white and vinegar. 3 Pharmacy and dosage: 3-12g, partially charring will help to stop bleeding, crushing and dry frying will decease this herb's tendency to cause diarrhea Major Combinations: With dan dou chi (Semen Sojae Praeparatum) for deficiency yin heat causing insomnia and irritability With hua shi (Talcum) for painful urination due to damp-heat in the lower burner With yin chen hao (Herba Artemisia Yinchenhao) and da huang (Radix et Rhizoma Rhei) for damp-heat jaundice With mu dan pi (Cortex Moutan Radicis) to treat dysmenorrhea, headache, dry scratchy eyes and intercostal pain With ce bai ye (Cacumen Siotae Orientalis) and sheng di huang (Radix Rehmanniae Glutinosa) for bleeding (vomiting blood, nosebleed, blood in urine and stools) due to heat REFERENCES I Bensky, D. and Gamble, A.; Chinese Herbal Medicine Materia Medica; Eastland Press Seattle, 1993, ps8 Image:

65 Lesson 3: Herbs that clear heat Mu dan pi Peonia suffruticosa Family: Ranunculaceae Other names: dan pi, fen dan pi, cortex of tree peony root, moutan Plant description: Quilled or semi-quilled, longitudinally fissured, somewhat involute or opened, 5-20 cm long, 5-12 mm in diameter, 1-4 mm thick. Outer surface greyish-brown or yellowishbrown, showing numerous transverse lenticels and rootlet scars, the exposed surface where cork fallen off appearing pink; inner surface pale greyish-yellow or pale brown, with obvious fine longitudinal striations, usually showing bright crystals. Texture hard and fragile, easily broken, fractures relatively even, mealy, pale pink. Part used: stem and branch Habitat, ecology and distribution: through out China, especially An Hui, also found in Henan, Shaanxi, Shandong, Gansu and Guizhou History: Pouch of Pearls, 1186 CE Constituents: paeonol, paeonoside, paeonolide, paeoniflorin, oxypaeoniflorin, campesterol Energetics Properties and Channels Entered: pungent, bitter, and cool; mu dan pi enters the heart, liver and kidney meridians Actions and Indications: anti-inflammatory, antimicrobial, diuretic, antihypertensive, analgesic, sedative Medical Research: In vitro inhibitory effect against various bacteria (Staphylococcus aureus, Bacillus subtilis and Salmonella typhi) Intravenous injection lowered blood pressure in anesthetized dogs, cats and rats (orally had similar effects, though more gradual) Paeonol decreased edema in the feet of rats as well as deceasing permeability of capillaries In an experiment with 20 hypertensive patients given mu dan pi, with in 33 days all diastolic readings had dropped mm Hg. and accompanying symptoms had decreased Decreased temperature of normal mice and those with artificially induced fevers

66 Lesson 3: Herbs that clear heat Had a tranquilizing, hypnotic and analgesic effect when given intraperitoneally or orally. Toxicity, Contraindications and cautions: when there is a yin deficiency with night sweats, in cold disorders and during pregnancy. Mu dan pi counteracts Tu si zi (Semen Cuscutal Chinesis), Bei mu (Bulbus Fritillariae), and Da huang (Radix et Rhizoma Rhei), and avoid when using garlic. Medicinal uses: Clears heat and cools blood (heat at blood level causing bleeding and excessive menstruation) Clears deficiency heat Invigorates blood and dispels stasis (especially in amenorrhea due to liver blood stasis Clears liver fire (especially for headaches and eye pain) Drains pus and decreases swelling - topically or internally Pharmacy and dosage: 6-12g, raw to cool blood, dry fry to invigorate blood, charred to stop bleeding 0 Major Combinations: With Chi shao (Radix Paeoniae Rubrae) for heat at blood level or deficiency heat causing dysmenorrhea Bai mao gen (Rhizoma Imperatae Cylindricae) due to heat caused bleeding Qing hao (Herba Artemisiae Annuae) for yin deficiency - bone steaming fever With Tao ren (Semen Persicae) for blood stasis due to traumatic injury With Gui zhi (Ramulus Cinnamomi Cassiae) for chest and abdominal pain due to blood stasis obstruction of the meridians With Da huang (Radix et Rhizoma Rhei) for unsupperated intestinal abscesses causing abdominal pain, constipation and low grade fever Ju hua (Flos Chrysanthemi Morifolii) for liver fire rising and causing dizziness and red burning eyes REFERENCES Bensky, D and Gamble. A, Chinese Herbal Materia Medica, Eastland press, Seattle,1993; p Image:

67 Lesson 3: Herbs that clear heat Xuan shen Scrophularia ningpoensis Family: Scrophulariaceae Other names: yuan shen, hei shen, hei xuan shen, ningpo, figwort root, scrophularia Plant description: Scrophularia is a coarse erect perennial with thick, sharply square, fleshy stems. Growing up to 150cm tall, it arises from a knotted horizontal rootstock. The leaves are opposite, shortstemmed ovate at base, lanceolate near the top, with toothed margins. The flowers are in loose cymes in pyramidal or oblong panicles; each flower is globular, five green sepals encircling a green or purple flower, giving way to an egg-shaped seed capsule. It grows in moist and cultivated waste ground, in woodlands and copses throughout the northern hemisphere except western North America. Good quality is thick and hard with thin skin and black colour. Part used: root Habitat, ecology and distribution: Mainly in zhe jiang province, but also in Hu Bei, Jiang Su, Jiang Xi and Sichuan. The root is harvested in winter. History: Divine Husbandman's Classic of Materia Medica Constituents: 1-asparagine, oleic acid, linoleic acid, stearic acid and carotene Energetics Properties and Channels Entered: Salty, sweet and bitter are this herb's tastes, its nature is cold and it enters the kidney, lung and stomach meridians. Actions and Indications: antimicrobial, vasodilator, antibacterial, anti- inflammatory, sedative, antipyretic, diuretic and anodyne. Medical Research: Xuan shen is shown to have a strong in vitro inhibitory effect against Pseudomonas aeruginosa, also effective for renal hypertension. Several studies of formulas containing xuan shen have shown positive results for the oral glucose tolerance test (implies improvement for diabetes mellitus) and decreased blood glucose levels. Toxicity, Contraindications and cautions: Use cautiously for spleen and stomach dampness, or diarrhea due to spleen deficiency. This herb may be antagonistic to huang qi (Radix Astragali Membranacei), Gan Jiang (Rhizoma lingiberis Officinalis), Da Zao (Fructus lizyphi Jujubae), Shan Zhu Yu (Fructus Corni Officinalis) and is considered

68 Lesson 3: Herbs that clear heat incompatible with Li Lu (Rhizoma et Radix Veratri). Li Lu, Ku Shen and Xuan Shen may trigger irregular heart rate. Medicinal uses: Clears heat and cools blood (heat signs at blood level) Nourishes yin (due to depletion of fluids from febrile disease) Drains fire and relieves toxicity (causing sore, swollen throat, red irritated eyes) Softens masses and dissipates nodules (toxic fire build up that causes masses and nodules in the neck) Pharmacy and dosage: 9-30g. Dry frying in salt increases this herbs ability to nourish yin. Major Combinations: With Mu Dan Pi (Cortex Moutan Radicis) for red purulent rashes With Niu Bang Zi (Fructus Arctii Lappae) and Lie geng (Platycodi Grandiflori) for painful and swollen throat and for purpuric rashes With Mu Li (Concha Ostreae) and Zhi Bei Mu (Bulbus Fritillariae Thunbergii) for scrofula, goiter and other phlegm nodules With Jin Yin Hua (Flos Lonicerae ]aponicae) and Dang Gui (Radix Angelicae Sinesis) for recalcitrant ulcerated sores due to toxicity and blood stagnation REFERENCES 1. Benski D. and Gamble A.; Chinese Herbal Medicine Materia Medica; Eastland Press Seattle W A; 1993, P httr://alternativehcali11l.!.org/xuall shen.htm 3. syndrome x.cfrn Image

69 Lesson 3: Herbs that clear heat Huang lian Coptis chinensis Family: Ranunculaceae Other names: chuan lian, wei lian, ya lian, yun lian, goldenthread, cankerroot Plant description: Dainty, half-inch white blossoms adorn this delicate little wildflower of cool, moist woodlands. The glossy, evergreen leaves form a low mat, with long, thread-like, yellow rootlets, attached to a slender, terete rhizome, mixed with trifoliate leaves. The underground stem resembles a golden yellow thread and reportedly has been chewed as a remedy for mouth sores. Good quality is thick, strong and solid with many interconnections. The cross section should be reddish yellow (C. chinensis) or yellow (C.deltoidea). Part used: rhizome Habitat, ecology and distribution: Sichuan (C. chinensis, C. deltoidea, C. omeiensis), hubei, shaanxi, Ganxu, Yunnan (C. teetoides). Harvested from October to November. History: Divine Husbandman's Classic of Materia Medica Constituents: berberine C20H17N03, coptisine C19H15NO5, worenine C21H15N04, palmatine C21H25N05, columbamine, obacunone, obaculactone, palmatine, jatrorrhizine, magnoflorine, ferulic acid. Energetics Properties and Channels Entered: bitter and cold, entering the heart, large intestine, liver and stomach meridians. Actions and Indications: antimicrobial, antiviral, antifungal, anti-inflammatory, vasodilator, anticancer Medical Research: Antimicrobial effects were observed in vitro against Streptococcus pheumoniae, Neisseria meningitides, and Staphylococcus aureas, and inhibit the bacteria that cause dysentery, especially Shigella dysenteriae and S. flexneri. Berberine is the constituent considered to be antimicrobial, proving effective against streptomycin and chloramphenicol resistant bacteria. It is considered more effective than sulfa drugs, but less effective than streptomycin and chloramphenicol. Berberine has shown an in vitro inhibitory effect against pathogenic fungi, such as Leptosplra.

70 Lesson 3: Herbs that clear heat Huang lian is effective against various influenza viruses and the Newcastle virus. In vitro studies showed Huang lian to be more effective than streptomycin and chloramphenicol against Hemophilus pertussis; however a test done on guinea pigs given oral Huang lian showed no morbidity of Hemophilus p. Huang lian and berberine have proven effective for bacillary dysentery and typhoid fever. Huang lian given to patients with pulmonary tuberculosis showed 30 of the 30 patients had improvement of symptoms after a 3 month course of treatment and 83.3% had no sputum. For scarlet fever a 10% solution of huang lian was given to 44 patients, all were recovered and the solution was as effective as penicillin or a combination of penicillin and a sulfa drug. It successfully treated diphtheria; subduing the fever in 1-3 days. It reduces the incidence of infection when applied as anointment to first and second degree burns. It lowered the blood pressure of cats, dogs and rats when given orally and injected, decrease in blood pressure was attributed to the vasodilator effect of berberine. It had an anti-adrenaline effect that was short lived and it counteracts the arrhythmic of adrenaline and other compounds. Berberine stimulated smooth muscle contraction in the organ specimens and intact organs of the uterus, bladder and bronchioles. Berberine stimulates bile production and reduces its viscosity, making it effective for chronic cholecystitis. When given to rats orally and intramuscularly berberine lowers serum cholesterol, in rabbits on a high cholesterol diet or given a thyroidectomy it normalizes cholesterol/phosphate ratio and lowers serum triglycerides; rats In small doses berberine stimulates the cerebral cortex and in large doses is inhibitory. An ethanol extraction of huang lian showed anti-inflammatory effects, when given locally it reduces granulomas induced by cotton oil in rats. 15/18 cases of ulcerative colitis were cured (improvement of symptomology and repeat endoscopy) with a course of treatment involving local administration of preparations of huang lian. In one study a 10% solution of huang lian and huang bai (Cortex Phellondendri) applied repeated with increasing pressure over anal fissures showed very good success. The studied involved 20 cases, bleeding stopped and itching decreased in 1-2 treatments and in 2-5 treatments the fissures had completely healed. In 49 cases of Trichomonas infections of the vagina, a 20% solution of huang lian applied locally was 95% curative. 5-10% solution of huang lian was effective for conjunctivitis and superficial keratitis Local and oral administration of huang lian was effective in the treatment of exudative erythema multiforme, and as ear drops for supperative otitis media. Toxicity, Contraindications and cautions: up to 2g berberine and 100g huang lian, separately, have been taken orally with no side effects. Huang lian is contraindicated when there is a yin deficiency, stomach cold from deficiency and diarrhea due to spleen

71 Lesson 3: Herbs that clear heat or kidney deficiency. Long term use will injure the spleen and stomach. This herb is antagonistic with ju hua (Flos Chrysanthemi Moriflorii), bai xian pi (Cortex dictamni dasycarpi Radicis), xuan shen (Radix Scrophulariae Ningpoensis) and jiang can (Bonbyx Batryticatus - silk worm). It counteracts the effects of kuan dong jua (Flos Tussilagi Farfarae) and niu xi (Radix Achyranthis Bidentatae). Some say it should not be taken with pork. Medicinal uses: Drains fire and relieves toxicity for excess heat causing delirium, high fever, irritability, red tongue and a rapid and full pulse, as well as sore throat, boils, carbuncles and abscesses. Clears heat and drains dampness of the stomach and intestines, as with diarrhea, dysentery and vomiting or acid regurgitation. Clears heart fire causing insomnia and irritability Clears heat and stops bleeding Clears heat topically for red irritated eyes and mouth sores. Pharmacy and dosage: 1.5-9g, dry fried to increase the herbs cold properties, with ginger juice to ease vomiting and diarrhea, and frying with evodia will help to treat damp heat diarrhea, vomiting and belching at the qi level. Major Combinations: With huang qin (Radix Scutellariae Baicalensis) and zhi zi (Fructus Gardeniae ]asminiodis) for toxic fire in the triple burners With sheng di huang (Radix Rehmanniae Glutinosae) for heat at the nutritive level With mu xiang (Radix Aucklandiae Lappae) for hot dysenteric disorders With wu zhu yu (Fructus Evodia Rutaecarpae) for fire of the liver assaulting the stomache. With rou gui (Cortex Cinnamomi Cassiae) to re-establish communication between the heart and kidneys. With xi xin (Herb cum Radice Asari) and shi gao (gypsum) for stomach fire causing toothache, mouth ulcers and painful, bleeding gums. REFERENCES 1. Bensky, D. and Gamble, A.; Chinese Herbal Medicine Materia Medica; Eastland Press Seattle, 1993; p term details/huang Lian io.org/herbmed/ec lectic/sayrc/coptis. lltm I 6. Image:

72 Lesson 3: Herbs that clear heat Huang qin Scutellaria baicalensis Family: Labiatae Other names: tiao qin, ku qin, pian qin, nen qin, dan qin, baical skullcap root, scutellaria, scute root Plant description: Good quality is long, thick, solid, yellow and with out a cortex. Part used: root Habitat, ecology and distribution: Huang qin is found in the provinces of Hubei, Shanxi, Shandong, Inner Mongolia, Liaoning, Jilin. Baical skullcap thrives on sunny grassy slopes and in open areas between 350 ft. (100 m) and 8,000 ft. (2,000 m) above sea level. Baical skullcap is propagated from seed sown in autumn and the root of 3- to 4-year-old plants is harvested in autumn or spring.1 History: First appeared in the Divine Husbandman's Classic of Materia Medica. Constituents: baicalein, baicalin, wogonin, wogonoside, neobaicalein, oroxylin aglucuronide, camphesterol, betasitosterol and benzoic acid Energetics Properties and Channels Entered: bitter and cold, entering the gallbladder, large intestine, lung and stomach meridians Actions and Indications: anti-allergic, bronchodilator, antibiotic, antimicrobial, antipyretic, antihypertensive, diuretic, increases bile production and reduces cholesterol Medical Research: Baicalein showed and inhibitory affect on the skin reaction of guinea pigs to passive allergic and histamine tests. Baicalein and baicalin also showed bronchiole dilation in guinea pigs with allergic asthma. Both substances also showed inhibition of angioedema and reduced capillary permeability in mice. Baicalin prevented pulmonary edema in mice subjected to extremely low pressure. In vitro inhibitory effect against: Staphylococcus aureaus, Corynebacterium diphtheriae, Pseudomonas aeruginosa, Streptococcus pneumoniae, Neisseria meningitides and many dermatomycoses, and showed the ability to kill Leptospira. Tests involving Mycobacterium tuberculosis have shown mixed results. When Huang qin was given to 100 patients with Bacillary dysentery the mean recovery times were 2.5 days until resolution of symptoms, 3.3 days until normal examination of stool and 4.3 days until negative stool cultures. Dating back to 1935, there is evidence huang qin had an antipyretic effect, though studies since have been inconclusive, perhaps due to varying botanical specimens.

73 Lesson 3: Herbs that clear heat Decoctions, tinctures, infusions and both alcohol and water extractions lowered blood pressure of dogs, cats and rabbits. It showed a diuretic effect in dogs and humans. A 1:1:1 ratio of huang lian, huang qin and da huang (Radix et Rhizoma Rhei) lowered cholesterol of rabbits given a 7 week high cholesterol diet, as well as those with a thyroidectomy. There was in increase in bile flow of rabbits and dogs when given decoction or alcohol extraction of huang qin. Tinctures and decoctions of huang qin inhibited intestinal movement, and the effect of pilocarpine. Baicalin reduced movement and reflexes of mice in a dosage related manner.2 Toxicity, Contraindications and cautions: contraindicated for yin deficiency heat, any type of cold in the middle burner and restless fetus due to cold in the blood. Huang qin is thought to counteract mu dan pi (Cortex Moutan Radicis) and Ii lu (Rhizoma et Radix Veratri) Medicinal uses: Clears heat and drains fire, especially excess heat in the upper burner, it may be applied topically or orally for sores of the mouth and nose Clears heat and dries dampness, mainly of the stomach and intestines. It may be used as an assistant herb when treating jaundice Clears heat and stops bleeding, in particular of the upper and lower burners (blood in vomit, cough, stools and urine) Clears heat and calms the fetus, when the fetus is restless due to heat Sedates excessive liver yang that is rising Pharmacy and dosage: 6-15g, dry frying will reduce its cooling properties and helps it enter the blood level (use this when it is meant to move to the lower burner or to calm restless fetus), wine frying makes it more ascending for the upper burner, and charring helps its ability to stop bleeding. Major Combinations: With huang lian (Rhizoma Coptidis) for excess heat With fang feng (Radix Ledebouriellae) for intestinal wind with blood in stools For damp-heat dysentery use with bai shao (Radix Paeoniae Lactiflorae), add zhi zi (Fructus Gardeniae Jasminoidis), yin chen hao (Herba Artemisiae Yinchenhao) and Huang bai (Cortex Phellodendri) for damp-heat jaundice, when there is nosebleed and vomiting blood add mu dan pi (Cortex Moutan Radicis) and da huang (Radix et Rhizoma Rhei)

74 Lesson 3: Herbs that clear heat With zhi mu (Rhizoma Anemarrhenae Asphodeloidis) for lung heat cough With bai mao gen (Rhizoma Imperatae Cylindricae) and sheng di huang (Radix Rhemanniae Glutinosae) for blood heat causing bleeding With bai zhu (Rhizoma Atractylodis Macrocephalae) and dang gui (Radix Angelicae Sinensis) for restless fetus - due to heat With xia ku cao (Sica Prunellae Vulgaris) for liver fire causing dizziness and headache, add mu Ii (Concha Ostreae) for scrophula (accumulations due to heat)3 REFERENCES 1 skullcap research 2 Bensky, D. and Gamble, A.; Chinese Herbal Medicine Materia Medica; Eastland Press Seattle, 1993; p Bensky, D. and Gamble, A.; Chinese Herbal Medicine Materia Medica; Eastland Press Seattle, 1993; p Image

75 Lesson 3: Herbs that clear heat Long dan cao Gentiana scabra # Family: Gentianaceae Other names: long dan, cao long dan, dan cao, ku dan, ling you, guan yin, Chinese gentian root, gentiana Plant description: Rhizome vertically grown, irregular masses, 1-3 cm long, cm in diameter; stem base and scar remained at the upper end, numerous slender roots growing around the lower parts; annular wrinkles appearing on the upper part and longitudinal wrinkles on the lower part. Good quality is long, thick, Intact and yellow or brownish yellow. Part used: root Habitat, ecology and distribution: G. scabra found mainly in NE China; G. triflom found mainly in NE China and Inner Mongolia; G. manshurica found in NE and E China; G. regescens found in Yunnan. History: first appeared in Divine Husbandman's Classic of Materia Medica Constituents: gentianine, gentiopicrin, gentianose Energetics Properties and Channels Entered: bitter and cold entering the liver, gallbladder and stomach meridians Actions and Indications: antibiotic, cholagogue, antibacterial, anti-inflammatory, antispasmodic, hepatobiliary sedative, anti-inflammatory, laxative 2,3 Medical Research: Small doses 1/2 hour before meals increases gastric juices, while taken after meals reduced gastric juices, effects were noticed only when taken orally and not sublingually or intravenously In vitro inhibitory effect against many bacteria 23 cases of encephalitis B (11 severe, 6 moderate, 6 mild) were treated with a preparation of long dan cao in addition to normal western protocol, 15 had normal temperatures in 3 days, and only 1 had sequelae 4 Toxicity, Contraindications and cautions: contraindicated in cases of spleen and stomach deficiency

76 Lesson 3: Herbs that clear heat Medicinal uses: Drains damp heat from liver and gallbladder meridians, especially at the sinuses and lower burner Drains and pacifies excessive liver fire, and extinguishes excess liver wind Pharmacy and dosage: 3-9g Major Combinations: With chai hu (Radix Bupleuri) and huang qin (Radix Scutellariae Baicalensis) for liver fire and liver fire due to liver qi stagnation With yin chen hao (Herba Artemisiae Yinchenhao) and zhi zi (Fructus Gardeniae Jasminoidis) for jaundice With ku shen (Radix Sophorae Flvescentis), huang bai (Cortex Phellodendri) and che qian zi (Semen Plantaginis) for wind damp heat of the liver and gallbladder meridians, symptoms of eczema or vaginal itching and discharge REFERENCES _chinese _ root.html 4 Bensky, D. and Gamble, A.; Chinese Herbal Medicine Materia Medica; Eastland Press Seattle, 1993; p 82 Image

77 Lesson 3: Herbs that clear heat Jin Yin Hua Lonicera japonica! Family: Caprifoliaceae Other names: yin hua, ren dong hua, shuang hua, er hua, er bao hua, honey suckle flower, lonicera Plant description: Good quality has many big, soft, pale yellow buds, and is aromatic. Part used: flower Habitat, ecology and distribution: grown through out China, especially in the provinces of Shandong and Henan. It is harvested before the flowers bloom in may. History: Tang Materia Medica (tang ben cao), also known as Newly Revised Materia Medica (xin xiu ben cao), 659 (Tang Dynasty) 1 Constituents: luteolin, inositol, tannin Energetics Properties and Channels Entered: sweet and cold, entering the large intestine, lung and stomach meridians Actions and Indications: Anti-inflammatory, antipyretic, anti-microbial2 Medical Research: Jin yin hua shows a strong in vitro inhibitory effect against Salmonella Typhi, Pseudomonas Aeruginosa, Staphylococcus Aureus and Streptococcus Pneumoniae In vitro inhibitory effect against Mycobacterium tuberculosis Reduced serum cholesterol levels when administered simultaneous large doses of cholesterol and a preparation of jin yin hua Effective in the treatment of appendicitis with perforation, mastitis and erysipelas, as well as chronic conjunctivitis, keratitis and corneal ulcers 3 Toxicity, Contraindications and cautions: contraindicated in cases of spleen deficiency diarrhea, qi deficiency ulcers (clear exudate) and yin ulcers (cold type) Medicinal uses: Clears heat and relieves toxic fire, for abscesses and yang sores Expels external wind heat, i.e.: heat at the yang ming stage or at the defensive and qi levels Clears damp heat from the lower burner

78 Lesson 3: Herbs that clear heat Pharmacy and dosage: 9-15g Major Combinations: With lian qiao (Fructus Porsythiae Suspensae) and many other herbs for varied heat disorders With Huang qin (Radix Scutellariae Baicalensis) for supperative boils that have not ulcerated or are not discharging pus With di yu (Radix Sanguisorbae Officinalis) and huang qin (Radix Scutellariae Baicalensis) for intestinal abscesses dysentery involving bleeding and damp heat4 REFERENCES Bensky, D. and Gamble, A.; Chinese Herbal Medicine Materia Medica; Eastland Press Seattle, 1993, p Bensky, D. and Gamble, A.; Chinese Herbal Medicine Materia Medica; Eastland Press Seattle, 1993, p85 Image

79 Lesson 3: Herbs that clear heat Lian Qiao Forsythia suspensa Family: Oleaceae Other names: bei lian qiao, forsythia fruit, golden bells, weeping golden bell Plant description: Leaf: Opposite, simple, ovate to oblong, coarsely serrated, 2 1/2 to 4 inches long, green above, lighter below. Flower: Light to dark yellow, 1 to 1 1/2 inch long, bell shaped flowers, appearing in early spring. Fruit: Dry, brown capsules, 2 cells, 1/3 inch long. Twig: Moderate, light brown to yellow brown, sometimes square, numerous lighter lenticels, pith hollow or chambered, buds small, brown cone shaped. Bark: Light brown, raised lenticels, developing shallow splits. Form: A shrub that is often shaped as a hedge. Naturally develops arching stems with numerous straight suckering.1 Part used: fruit Habitat, ecology and distribution: through out north eastern China, mainly Shanxi, Shaanxi and Henan, harvested in the autumn History: Divine Husbandman's Classic of Materia Medica Constituents: phillyrin, matairesinoside, betulinic acid, phyillygenin, pinoresinol Energetics Properties and Channels Entered: bitter, slightly pungent and cool, enters the heart, liver and gallbladder meridians Actions and Indications: antiparasitic, antiemetic, diuretic, antimicrobial Medical Research: Similar antimicrobial traits are observed between jin yin hua (Flos Lonicerae Japonicae) and lian qiao, though lian qiao has a stronger effect against Shigella spp. and Staphylococcus aureus. There has not been any proof on synergistic effects in vitro. Weak in vitro inhibitory effect against Leptospirosis Proven to prevent vomiting in pigeons with digitalis toxicity, as well as other causes of vomiting In cases of acute nephritis, lian qiao caused disappearance of edema and proteinuria!!

80 Lesson 3: Herbs that clear heat In 2 cases of retinal hemorrhage at the macular region were treated with decoctions of lian qiao, and with in 4 weeks there was marked reabsorption and an increase in visual acuity Toxicity, Contraindications and cautions: contraindicated when there is spleen deficiency diarrhea, ulcerated boils and yin ulcers Medicinal uses: Clears heat and toxins, and reduces hot nodules, sores and carbuncles Expels external wind heat Pharmacy and dosage: 6-15g Major Combinations: With ban Ian gen (Radix Isatidis seu Saphicacanthi) for toxic heat disorders With ju hua (Flos Chrysanthemi Indici) for initial stages of an external heat disease With ma huang (Herba Ephedrae), chi shao (Radix Paeoniae Rubrae) and gan cao (Radix Glycyrrhizae Uralensis) for allergic rashes REFERENCES Bensky, D. and Gamble, A.; Chinese Herbal Medicine Materia Medica; Eastland Press Seattle, 1993, p86-87 Image:

81 Lesson 3: Herbs that clear heat Lu Dou Phaseolus mungo Family - Leguminosae Other names: mung bean, phaseolus Part used: legume Habitat, ecology and distribution: through out China, harvested after the autumnal equinox - when ripe History: Materia Medica of the Kai Bao Era, Mai Zhi 973 A.D.1 Constituents: phosphatidyl choline, phospatidylethanolamine, phosphatidylserine, phosphatidic acid, protein, calcium, iron, phosphorus, carotene, thiamine (molecular structure shown), nicotinic acid, riboflavin Energetics Properties and Channels Entered: sweet and cool entering the heart and stomach Actions and Indications: Antipyretic, antihypertensive, antidote to toxic poisonings, nutritive tonic 2 Medical Research: Shown good results for the treatment of poisoning due to pesticides Used in the treatment of 1st and mild 2nd degree burns. Lu dou was made into a paste, powder and alcohol Toxicity, Contraindications and cautions: contraindicated in the case of spleen deficiency diarrhea Medicinal uses: Clear summerheat, made as a decoction Antidote for fu zi (Radix Lateralis Aconiti Carmichaeli Praeparata) Pharmacy and dosage: 15-30g Major Combinations: with Huang lian (Rhizoma Coptidis) and gan cao (Radix Glycyrrhizae Uralensis) for thirst and irritability associated with summerheat 3

82 Lesson 3: Herbs that clear heat REFERENCES Bensky, D. and Gamble, A.; Chinese Herbal Medicine Materia Medica; Eastland Press Seattle, 1993; plg8 Image:

83 Lesson 3: Herbs that clear heat

84 Lesson 4: Downward draining herbs LESSON 4: Downward Draining Herbs There is a Chinese proverb that states: "Sickness come from the top, while rescue comes from the bottom." This shows that a common herbal strategy in Chinese medicine is similar to Western Herbal medicine; and that is cleanse the bowels. Some authorities suggest that 20% of Chinese prescriptions contain some purgative element. The most popular of these, Da huang (Rheum palmatum) or rhubarb root, very common in Western herbal traditions. Purgatives This general classification of botanicals is used to induce bowel movements, sedate excess-heat, sedate water, treat constipation, accumulations, and excess heat and water in the body. This is done by: 1. Unblocking feces to expel overnight-undigested food, accumulations and dry feces from the intestines. 2. Cleansing fever and purging fire to eliminate fever and stagnation. 3. Discharging water and resolving swelling to eliminate water stagnancy and resolve edema by expelling water evil through urine and stool. These downward draining herbs are ones that either stimulate or lubricate the gastrointestinal tract to produce bowel movements. We will be dividing them into three categories: purgative, moist laxatives and hash expellants. Purgative are used when the pattern is one of excess - either internal heat or internal cold. When heat reaches or gets trapped in the Stomach and Intestine it will, of course, deplete fluids and thus cause constipation. In these cases we need to drain the heat downward to induce a bowel movement. If constipation is due to the accumulation of cold, we need to add herbs to a formula that warms interior (Lesson 11).

85 Lesson 4: Downward draining herbs Moist Laxatives Purgative herbs are generally bitter and cold in nature, with a strongly descending tendency. We will be looking at the following purgatives: Da huang - Rheum palmatum Fan xie ye - Cassia angustifolia Lu hui - Aloe vera There are several seeds and nuts that are known to moisten the Intestine, thus increasing bowel movements. Often these herbs contain a fatty or mucilaginous material that increases moisture content. They are usually very mild in action and are often used in the elderly and around parturition. They are employed in cases of constipation due to deficiency of yin, blood, or qi. The following are the herbs we are reviewing in this section. Huo ma ren - Cannabis sativa Yu Ii ren - Prunus japonica Harsh Expellants (Drastics) When there is stagnation of fluids in the thoracic or abdominal cavities, we can get constipation and/or poor water metabolism. These herbs are used to drive out excess water. In Western medicine terms these could be things like pleurisy or ascites. In these cases drastic action is needed. It should be noted that these herbs can injure yin and qi and thus should be used with caution. We will review two botanicals in this subsection. Gan sui - Euphorbia kansui Ba dou - Croton tiglium

86 Lesson 4: Downward draining herbs Da Huang Rheum palmatum Family: Polygonaceae Other names: R. tanguticum, R.officinale, rhubarb, turkey rhubarb, East Indian Rhubarb, chuanjun, shengjun,jiangjun,jin wen, daio (Japanese), taehwang (Korean). Plant description: These species of rhubarb resemble the common garden variety. The genus is cultivated outside of its native habitat, Tibet and China, primarily for decorative purposes. The rootstock is conical, fleshy, and has a yellow interior. The large leaves are cordate (heart shaped) to orbicular, have seven lobes, thick petioles, and are 3-45 cm long. The hollow flower stem stands m and is topped by a leafy panicle of green or white flowers. Part used: root, rhizomes Habitat, ecology and distribution: Grown throughout the world and harvested September - October, after leaves wither and turn yellow. The best root come from at least three year old plants. History: This herb has been employed extensively as a cathartic. In smaller doses it has been used as a stomach tonic, increasing both salivary and gastric flow, for improving appetite and cleansing the liver by supporting bile flow, thermal burns and jaundice. 1,2,3,4 In China, this herb was mentioned in the Divine Husbandman's Classic of the Materia Medica (220 BCE) and was also used in Ayurvedic medicine. Constituents: The chemistry of the rhubarb is complex, but very well studied. There are two major, groups of active ingredients: glycosides (anthraquinones and derivatives) and tannins. There is usually a 5% anthraquinone derivative. Of this, 75% is in true glycoside form. The rest are found in some intermediate anthrone, anthrol or other derivatives. The major groupings are emodin, chrysophanic acid, aloe-emodin and rhein. The major tannins are of both catechin and gallic acid types. Some rhubarbs have a volatile oil with up to 100 constituents in it. Other constituents include 6% calcium oxalate, fatty acids,1.3% rutin, 16% starch, resin and others.5,6 Anthraquinone

87 Lesson 4: Downward draining herbs Energetics Properties and Channels entered: Turkey Rhubarb has a bitter and cold property and enters the Stomach, Colon, Liver, Spleen and Heart meridians. Its action is to drain heat, remove stool, drain dampness, cool blood, regulate menstruation, disperse stagnant blood and invigorate blood.7,8 Ayurvedic(related species R. emodi) Rasa - arnala; Guna - laghu (light), rooksha (oily), tikshna (sharp); Veerya - ushna (hot); Vipak - amla (sour). Action: Kapha vat samak, pittawardhak, dipan, pachan, anuloman, bedhan, hridotajek swas har, hicaahar.9 Actions and Indications: Cathartic, astringent, stomachic and alterative Medical Research: The cathartic action of rhubarb root is caused by the glycosides. The specific ratio of the anthraquinone is of special interest because some of the derivatives have a dilating effect on the colon muscle, whereas others have a constricting effect upon the muscles. This whole process is further assisted by the tannins, which have an astringent action upon diarrhea. This makes rhubarb a very useful agent as a regulating cathartic for diarrhea as well as a laxative. Chrysophanol can be passed onto a child via the milk through breast-feeding. 10 Da huang has a stimulating effect on digestive and gallbladder flow. It also has an antibacterial effect on a large spectrum of bacteria, including staph and streptococcus.11 It has also shown to have an antifungal effect on Candida albicans. This herb displays antispasmodic action four times stronger than papaverine (alkaloid in opium) inhibiting choleretic and hemostatic action. As a diuretic it does increase urination excreting Na+ and K+, producing alkaline urine with a ph as high as 8.4. Used in China for renal failure, with both animal and clinical backup. The extract has been shown to suppress production of TNF and IL-l by macrophages as well as IL-6 by human mesangial cells.12 The extract of rhubarb root has been shown to be anti-tumor (in Walker and lymphocytic leukemia models), antimicrobial, hypotensive and anti-inflammatory. 13,14 Toxicity, Contraindications and cautions: In very large doses rhubarb can be griping and cathartic. The leaf of any rhubarb is very poisonous - causing vomiting and severe kidney and liver damage. Past students felt the oxalates caused the toxic effect, but it has now been shown to be caused by monoanthrones.15 Da huang is contraindicated in case of exterior disorders, qi or blood deficiency, and cold from deficiency of the Spleen and Stomach. Used with extreme caution during pregnancy, menstruation, and post partum period. Active ingredient will enter through breast milk and is therefore contraindicated for nursing. 16 Medicinal uses: Drains heat, purging accumulation when associated with high fever, profuse sweating, thirst, constipation, abdominal distention with pain, delirium, yellow tongue coating and a full pulse. This is considered Intestinal heat excess.

88 Lesson 4: Downward draining herbs Drains damp-heat via stools, especially related to jaundice or acute dysentery. This can also be used for painful urinary problems. Drains heat from the blood, especially when found in stool from hemorrhoids or heat accumulation in the Intestine. Might also be indicated for vomiting of blood or nosebleeds associated with constipation. Invigorates the blood while dispelling stasis in cases such as amenorrhea, immobile abdominal masses or pain with stasis. Can be used when blood stasis is due to traumatic injury or Intestinal abscess. Important in Chinese medicine to treat recent and long-term blood stasis. Clears heat obstructing the blood level used for fevers, hot, swollen and painful eyes, or fire toxins sores due to heat excess obstructing the blood level. Clear heat and reduces fire toxicity when used either topically or internally for burns or hot skin lesions. Pharmacy and dosage: Dosage Powder 5-60 grains Decoction 3 oz Fluid extract 1/4 tsp Tincture 1/2-1 tsp Syrup 1 tsp Raw herb (add to end of decoction) 3-12 g Major Combinations: With mang xiao (Mirabilitum), hou po (Magnolia officinalis) and zhi shi (Citri Aurantii) for unremitting high fever, delirious speech and constipation. With huang lian (Coptis) for a full distention due to heat accumulation. Add huang qin (Scutellaria baicalensis) for vomiting blood or nosebleed due to hot blood. With fu zi (Aconiti carmichaeli) for constipation due to cold accumulation With yin chen hao (Artemisia yinchehao) and zhi zi (Citri Aurantii) for jaundice and associated flank pain. With rou gui (Cassia) for severe constipation. With dang gui (Angelica sinensis) for blood stasis With shi gao (Gypsum) as a topical plaster for bums. Official Recognition and Medical References Fluid extractum, Rhei, U.S.P. 17 Rhubarb extract N.F Extractum Rhei B.P.C ,19 Aromatic Rhubarb Tincture 20 Infusum Rhei B.P. 1914, Fr. Codex 21

89 Lesson 4: Downward draining herbs Extractum Rhei B.P. 1914, U.S.P Tinctura Rhei et Gentianae N.F Tinctura Rhei Vinosa N.F GRAS REFERENCES 1. Willard, T.W., Textbook of Modem Herbology, c.w. Progressive Publishing Inc., Calgary, AB, Can., 1988, p Duke, J.A., Handbook of Medicinal Herbs, CRC Press Inc., Boca Raton FL, p Grieve, M., A Modem Herbal, Jonathan Cape, London, 1931, p Leung, A.Y., Encyclopedia of common natural ingredients used in food, drugs, and cosmetics, John Wiley & Sons Inc., New York, p Leung, A.Y., Encyclopedia of common natural ingredients used in food, drugs, and cosmetics, John Wiley & Sons Inc., New York, p Duke, J.A., Handbook of Medicinal Herbs, CRC Press Inc., Boca Raton FL, p Bensky, D. and Gamble, A., Chinese Herbal Medicine: Materia Medica, Eastland Press, Seattle, WA, 1986, p Hsu, H.Y., Chen, Y.P., et az., Oriental Materia Medica: a concise guide, Oriental Healing Arts Institute, Long Beach, CA, 1986, p Kapoor, L.D., CRC Handbook of Ayurvedic Medicinal Plants, CRC Press, Boca Raton, FL, 1990, p Duke, J.A., Ibid. 11 Hsu, H.Y., Chen, Y.P., et al., Oriental Materia Medica: a concise guide, Oriental Healing Arts Institute, Long Beach, CA, 1986, p Huang CK, The Pharmacology of Chinese Herbs 2nd Ed. ; CRC Press; 1999, p Leung, A.Y., Ibid. 14. Duke, J.A., Ibid. 15. Leung, A.Y., Ibid. 16 Bensky D, Gamble A; Chinese Herbal Medicine Materia Medica;Eastland Press Seattle Wa; p The National Fonnulary 6th ed., American Pharmaceutical Association, Washington DC, p Martindale: The Extra Phannacopeia, The Phannaceutical Press, London, p The British Pharmaceutical Codex The Phannaceutical Press, London, p Youngken, H.W., Textbook of Phannacognosy, Blakiston, Toronto, p Lucus, E.W. and Stevens, H.B., The Book ofphannacopeias, J & H Churchill, London, p Lucus, E.W. and Stevens, H.B., Ibid., p Lucus, E.W. and Stevens, H.B., Ibid.,p Lucus, E.W. and Stevens, H.B., Ibid. 25. Leung, A.Y., Ibid. Images commons.wikimedia.org

90 Lesson 4: Downward draining herbs Fan Xie Ye Cassia angustifolia Family: Leguminoseae Other names: Senna, xie ye, fan-hsieh-yeh, banshayo (Japanese), ponsayop (Korean) Part used: dried leaflets and pods Plant description: There are several species of Cassia that are sold as senna. This information will focus on Cassia senna. Senna is a small shrub, m tall, that grows in the Nile region of Egypt. It has been cultivated extensively in China and India. The stems are erect, woody, whitish and branching. The leaves are alternate, 4-5 pair of pinnates, 2 small stipules at the base. The flowers are fairly large, yellow in axillary racemes. The fruit are few, legumes 5 cm long, 18 mm wide, thin, broadly elliptical, reniform, membranous, dark green, 6-7 celled with ash coloured seed. History: Cassia has been used primarily for its cathartic action. It can be fairly griping, therefore an aromatic such as ginger (sheng jiang) is often taken with it. 1,2 It was also used externally by the Arabians for skin afflictions.3 It has been used in Egypt since 1500 BCE and was noted in Gerard (1597).4 The Amerindians used at least five species of Cassia, including C. marilandica and C. hebecarpa, known as American senna and wild senna respectively. Usage was not restricted to purgative or laxative applications.5 Senna, as we know it, is not native to North America. Constituents: The active constituents of Cassia leaves are % dianthrone glycosides, mostly consisting of sennosides A and B (a pair of optic isomers of rheindianthrone glucosides) and smaller amounts of sennoside C and D (one molecule of rhein and one of aloe-emodin or rhein-aloeemodin-hetero-dianthrone glucoside). Also present are aloe-emodin. The dianthone appears to be absent in the fresh plant, but forms in the drying process through enzymatic oxidation of monoanthrone glycosides.6,7 There seems to be a small amount of primary glycoside of sennoids also present along with a small amount of free anthraquinones (rhein, aloe-emodin, chrysophanol).8,9 Alexandrian senna leaves generally contain higher amounts of sennosides than Indian senna. Senna also contains free sugars, mucilage, flavonoids, traces of volatile oil, and resin. 10,11 Senna pods contain 2-5% sennoside. Again, Alexandrian senna has higher quantities than the Indian senna. The pods have also been shown to contain another glycoside called sennoside A1.12 The content of sennoside in the leaves drops dramatically during fruit development. The green pods have higher activity than ripe ones. 13

91 Lesson 4: Downward draining herbs Energetics Properties and Channels entered: Senna is sweet, bitter and extremely cold, and enters the Large intestine meridians. Its action is to cleanse heat and remove stagnancy. 14 Holmes lists senna as bitter and hot with a secondary cooling effect, and dry. The secondary quality is stimulating with a sinking movement. It enters the Small Intestine while influencing intestines and uterus. 15 Tierra describes senna as bitter, sweet and cold, and influences the Colon.16 Ayurvedic Rasa - tikta (bitter), katu (pungent); Guna - laghu (light), rooksha (oily), teekshna; Veerya - ushna (hot); Vipak - katu (pungent). Action: Kapha vat samak. lakhan, vamak, anuloman, sansarn, krimighan, rakt sodhak.17 Actions and Indications: Laxative, vermifuge, diuretic Medical Research: The major action of Cassia seems to come from the dianthrones or sennosides. These anthrones work as local irritants in the colon to cause catharsis. The catharsis is most often associated with griping. Herbalists usually combine senna with an aromatic such as ginger. Preparations made from the fruit (without bruising the seeds) are found to be less griping. Cassia's action relies mostly on the anthrone working as a local irritant. In contrast, anthroquinones working on the nerve plexus are responsible for the cathartic effect in cascara sagrada and turkey rhubarb. As a result, Cassia is considered more habit forming than cascara or turkey rhubarb. With extended use, more Cassia is necessary for the same cathartic action, whereas dosage levels of cascara and rhubarb can be reduced after a few months yet still remain effective. 18,19,20,21 Toxicity, Contraindications and cautions: Cassia can be griping and habit forming, but is considered fairly safe. Extended use can cause damage to the colon. It is contraindicated during pregnancy, menstruation, and nursing. Not recommended for weak patients or people with chronic 22,23 Medicinal uses: Drains downward and guides stagnation of constipation due to heat accumulation in the Intestine. Used in the summer in southern China to prevent summer-heat disorders. Pharmacy and dosage: Dosage Powder grains Infusion 2 oz Fluid extract 1/2 tsp Tincture drops Raw (decoction) g (mild purgation) and 5-10g (potent)

92 Lesson 4: Downward draining herbs Major Combinations: With zhi shi (Citri Aurantii) and hou po (Magnolia officinalis) to strengthen the action of draining downward and guiding out stagnation. With huo xiang (Agastaches herb) and mu xiang (Aucklandiae lappae root) for heat accumulation in the Large Intestine channel REFERENCES 1.Leung, A.Y., Encyclopedia of common natural ingredients used in food, drugs, and cosmetics, John Wiley & Sons Inc., New York, p Grieve, M., A Modem Herbal, Jonathan Cape, London, 1931, p Duke, J.A., Handbook of Medicinal Herbs, CRC Press Inc., Boca Raton FL, p Crellin, J.K. and Philpott, J., Herbal Medicine: Past and Present (Vo!. II), Duke University Press, London, 1990, p Moerman, D.E., Medicinal Plants of Native America, University of Michigan Museum of Anthropology, Technical Reports, Number 19, Ann Arbor, Michigan, 1986, VoU, p Leung, A.Y., Encyclopedia of common natural ingredients used in food, drugs, and cosmetics, John Wiley & Sons Inc., New York, p Duke, J.A., Handbook of Medicinal Herbs, CRC Press Inc., Boca Raton FL, p Leung, A.Y., Ibid. 9. Duke, J.A., Ibid. 10. Leung, A.Y., Ibid. 11. Duke, J.A., Ibid. 12. Leung, A.Y., Ibid. 13. Morton, J.F., Major Medicinal Plants: Botany, Culture and Uses, Charles C. Thomas Inc, Springfield IL, 1977, p Hsu, H.Y., Chen, Y.P., et al., Oriental Materia Medica: a concise guide, Oriental Healing Arts Institute, Long Beach, CA, 1986, p Holmes, P., The Energetics of Western Herbs (2 vols.), Artemis Press, Boulder CO, 1989, P Tierra, M., Planetary Herbology, Lotus Press, Santa Fe, NM, 1988, p Kapoor, L.D., CRC Handbook of Ayurvedic Medicinal Plants, CRCPress, Boca Raton, FL, 1990, p The British Pharmaceutical Codex The Pharmaceutical Press, London, p Leung, A.Y., Ibid. 20. Wood, H.C. and Osol, A., Dispensatory of the United States of America 23rd ed.,j.b. Lippincott, Montreal, P.Q., p Grieve, M., A Modem Herbal, Jonathan Cape, London, 1931, p Bensky D, Gamble A; Chinese Herbal Medicine Materia Medica;Eastland Press Seattle Wa; pl Leung, A. Y., Ibid. Image

93 Lesson 4: Downward draining herbs Lu Hui Aloe vera Family: Liliaceae Other names: rokai (Japenese), nohwa (Korean) Plant description: Native to the East Indies and Barbary, aloe is cultivated in the West Indies, North America, and some southern areas of Europe. It has a simple, woody stem, cylindrical and short. The fleshy leaves first spread, and then ascend into lanceolate, glaucous green leaves. The leaves are flat above, convex below and possess hard reddish spines perpendicular to the margin, somewhat mottled and darker in colour. Flowers start in an erect fashion then spread to a pendulous yellow shape, and are not longer than the stamens. Part used: dried concentrate juice of the leaf History: Aloe has been considered one of the sovereign healing agents among herbal medicines. Muslims used aloe medicinally and religiously. The Jews later adopted the herb in Cairo. It was also used in ancient Greece on Socotra in the fourth century B.C. Its used can be traced through Disocorides, Celsus, and Pliny, as well as later Greek and Arabian physicians. It was imported into England in the 17th century. 1 It first appears in Chinese medicine in the Materia Medica of the Jia You Era (1061 CE). 2 Constituents: The major constituents are known communally as aloin (0.5-25%) with the major anthraquinone being barbaloin.3 Emodin and chrysophanic combinations has been noticed. The content of aloin varies greatly from variety to variety. A. vera has the lowest aloin content, sometimes absent altogether. Aloe vera gel contains glucomannan, a polysaccharide or guar gum, which is believed to be responsible for many of its activities. Aloe also contains steroids, organic acids, enzymes, antibiotic principal, amino acids, saponins and minerals. 4,5,6,7,8,9,10,11,12,13,14,15,16,17,18,19,20. Energetics Properties and Channels entered: Aloe has a bitter flavour, cold property, entering the liver, stomach and large intestine meridians.21 Bensky says it enters Liver, Heart and Spleen meridians.22 Holmes feels aloe is initially hot with a secondary cooling effect (not from this author's experience), with a moist quality, entering the Liver and Small Intestine meridians while influencing the liver, stomach, intestine, and uterus. He calls it a warming organism.23 Tierra says it is cold, bitter entering the Liver, Heart and Spleen meridians.24 Actions and Indications: Bitter tonic, laxative (or purgative), emmenagogue, stomachic, hepatic, vermifuge, demulcent, emollient and vulnerary.

94 Lesson 4: Downward draining herbs Medical Research: Barbaloin and other anthraquinones are known to have cathartic activity (see Cascara sagrada). The mechanism of this varies depending on the form or derivative. Reduced forms are considered more stable than the free anthraquinone. The mechanism for the reduced form seems to be that the glycoside is transported unchanged to the site of absorption or action. The sugar group is removed by enzymatic cleavage and then the compound is slowly oxidized, releasing anthraquinones which act as a peristaltic stimulator. Aloe-emodin has been reported to have anticancer properties.25 Aloe has been shown to be effective in controlling many microorganisms such as Pseudomonas aeruginosa and some Staphylococci.26 The responsible chemical is not identified and appears not to be present in all plants. The oral administration of aloe extract has been effective in treating chronic bronchial asthma, taking affect after a six month period. The extract had to be kept in the dark at 4 C for seven days before administration. This produced a change in the glycoprotein and polysaccharides, 27,28 Aloe has been studied for its role in prophylaxis and possible treatment of leukopenia caused by exposure to cobalt 60, and its anti-tumor activity against sarcoma 180 and Ehrich ascites. 29,30,31 Toxicity, Contraindications and cautions: Toxicity varies with variety. Barbaloin can be very griping (especially in a dried form), causing severe intestinal irritation. Aloe vera, which has very little, if any barbaloin, seems to be nontoxic. It should not be used internally during pregnancy, menstruation or rectal bleeding. Contraindicated when cold due to Spleen or Stomach deficiency. Strength of dried powder varies considerably. 32 Medicinal uses: It cleanses morbid matter from the stomach, liver, spleen, kidney, and bladder, usually soothing all tissue, even blood and lymph. For those few that experience griping, ginger should be added to the aloe. Aloe in powdered form is a much more potent cathartic and can cause severe griping. One should begin aloe therapy with one-quarter of a tablespoon and work up to a suitable dosage. Aloe vera is often used for suppressed menstruation, having soothing and cleansing qualities.33 Aloe is often used for external application. It is a remarkable agent for soothing sunburn and preventing peeling. Aloe juice or salve will take the heat and sting out of sunburns, stop blistering and help convert the sunburn into a tan. Aloe is also an excellent remedy for burns and scalds. The juice from the leaves is beneficial for small burns, while the commercially available gel or juice is suggested for larger burns. Aloe juice should be kept cool and the affected area should be immersed entirely in the juice. The patient will soon realize and appreciate the very remarkable healing power of Aloe vera. People report this juice was so soothing to their painful bum that they found it difficult to remove their hand from the bath. Aloe can also be applied very effectively to!!

95 Lesson 4: Downward draining herbs cuts, as it cleanses them and assists in healing. For acne it has been used both internally (118-2 cup daily) and externally with great results. Nursing mothers can apply aloe to their nipples to dry up milk supply and indirectly trigger weaning. In case of exposure to x-ray radiation, aloe is held to be very beneficial (used topically and internally). Aloe has been used extensively to sooth burned areas after radiation treatment for tumors. It is believed that it will also help decrease a tumor. Aloe is useful as a cosmetic aid. There are many soaps, ointments, skin refreshers, and bum ointments presently on the market, and for the most part, the ones containing large amounts of aloe are the best. TCM usages: Drains fire and guides out accumulation for constipation, dizziness, red eyes and irritability due to heat accumulation. Its mild action can be used for chronic constipation. Kills parasites and strengthens the stomach, often used for round worms and pinworms in children. Clears heat and cools the Liver, used for epigastric discomfort, dizziness, headaches, tinnitus, irritability, constipation and fever due to Liver channel. Pharmacy and dosage: Dosage Gel 1 oz - 2 pints Powder 1-10 grains Tincture drops Fluid extract 1/2-1 tsp Powder extract 1-5 grains B.P oz. U.S.P. 30 drops Raw herbs in pills or powder 1-2g Major Combinations: With zhu sha (Cinnabaris) for chronic constipation due to heat accumulation. With long dan cao (Gentiana longdancao) and huang qin (Scutellaia baicalensis) for liver heat with epigastric pain, dizziness headaches and irritability.

96 Lesson 4: Downward draining herbs REFERENCES 1. Grieve, M., A Modern Herbal, Jonathan Cape, London, 1931, p Bensky D, Gamble A; Chinese Herbal Medicine Materia Medica;Eastland Press Seattle Wa; p Leung, A.Y., Encyclopedia of common natural ingredients used in food, drugs, and cosmetics, John Wiley & Sons Inc., New York, p Spoerke, D.G., Herbal Medications, Woodbridge Press Pub\. Co., Santa Barbara CA, p.2l. 5. Tyler, V.E. et al., Pharmacognosy (7th ed.), Lea & Febiger, Phila. PA, p.8l. 6. Leung, A.Y., Encyclopedia of common natural ingredients used in food, drugs, and cosmetics, John Wiley & Sons Inc., New York, p.24. J 7. Morton, J.F., Major Medicinal Plants: Botany, Culture and Uses, Charles C. Thomas Inc, Springfield IL, p Spoerke, D.G., Herbal Medications, Woodbridge Press Pub\. Co., Santa Barbara CA, p.2l. 9. The Merck Index 5th ed., Merck & Co. Inc., Rahway NJ, p.18, Wood, H.C. and Osol, A., Dispensatory of the United States of America, 23rd ed.,j.b. Lippincott, Montreal, P.Q., p Gathercoal, E.N. and Wirth, E.H., Pharmacognosy, Lea & Febiger, Phila. PA, p.lo. 12. Trease, G.E. and Evans, W.C., Pharmacognosy 11 ed., Bailliere Tindall, London, 1978, p Ross, M.S.F. and Brain, K.R., An Introduction to Phytopharmacy, Pitman Medical, Tunbridge We\1s U.K., p Youngken, H.W., Textbook of Pharmacognosy, Blakiston, Toronto, p Wallis, T.E., Textbook of Pharmacognosy, J & H Churchill, London, p Herbert, B.E. and Ellery, K.W., Textbook of Practical Pharmacognosy, Bailliere, Tindall, and Cox, London, 1948, p Allport, N.L., Chemistry and Pharmacy of Vegetable Drugs, George Newnes Ltd., London, p Osol, A. and Pratt, R. (eds.), The United States Dispensory (271l1 ed.), LB. Lippincott, Phila. Pa, 1983, p Steinmetz, E.F., Codex Vegetabilis, Amersterdam, p Tyler, V.E. et al., Pharmacognosy (71l1 ed.), Lea & Febiger, Phila. PA, p Hsu, H.Y., Chen, Y.P., et al., Oriental Materia Medica: a concise guide, Oriental Healing Arts Institute, Long Beach, CA, 1986, p Bensky, D. and Gamble, A., Chinese Herbal Medicine: Materia Medica, Eastland Press, Seattle, W A, 1986, p.17l. 23. Holmes, P., The Energetics of Western Herbs (2 vols.), Artemis Press, Boulder CO, 1989, p.18l. 24. Tierra, M., Planetary Herbology, Lotus Press, Santa Fe, NM, 1988, p.17l. 25. Leung, A. Y., Encyclopedia of common natural ingredients used in food, drugs, and cosmetics, Ibid. 26. Spoerke, D.G., Herbal Medications, Woodbridge Press Publ. Co., Santa Barbara CA, 1980, p Shida, T., et al., Proceeding ofwakananyaku Symposium 13,1980, pp Shih, T., et al., Effect of aloe extract on peripheral phagocytosis in adult bronchial asthma, Plant Medica, , Soeda, M., et al., Studies on the antitumor activity of Cape Aloe, Nippon Act. Radiol., 23, , Yagi, A., et al.; Aleo manna, polysaccharide from aloe, Planta Med. 31(1), 17-20, Arendarevslii, L.F., Factors effecting the efficiency of chemotherapy and recurrence of tumors, Onkologiya (Kiev), No.2, (Russ) Spoerke, D.G., Ibid., p.2l. 33. Duke, J.A., Handbook of Medicinal Herbs, CRC Press Inc., Boca Raton, FL, 1985, p.31. Image

97 Lesson 4: Downward draining herbs Huo Ma Ren Cannabis sativa Family: Moraceae Other names: hemp seeds, pot seeds, marihuana seeds, ma ren, ma zi ren, da ma ren, mashinin (Japanese), hwamain (Korean) Plant description: Annual herb, usually erect; stems variable, up to 5 m tall, with resinous pubescence, angular, sometimes hollow, especially above the first pairs of true leaves; basal leaves opposite, the upper leaves alternate, stipulate, long petiolate, palmate, with 3-11, rarely single, lanceolate, serrate, acuminate leaflets up to 10 cm long, 1.5 cm broad; flowers monoecious or dioecious, the male in axillary and terminal panicles, apetalous, with 5 yellowish petals and 5 poricidal stamens; the female flowers germinate in the axils and terminally, with one I-ovulate ovary; fruit a brown, shining achene, variously marked or plain, tightly embracing the seed with its fleshy endosperm and curved embryo. Fl. summer; from late summer to early fall; year round in tropics. Seeds weigh g/100 seeds. Part used: seeds Habitat, ecology and distribution: Locally grown hydroponically, usually in expensive houses, and distributed through an illegal network. Largest crop grown in British Columbia. Native to Central Asia, and long cultivated in Asia, Europe, and China. Now a widespread tropical, temperate and subarctic cultivar and waif. The oldest use of hemp seems to be for fiber. Later the seeds began to be used for culinary purposes. Plants yielding the drug were discovered in India, and cultivated for medicinal purposes as early as 900 BCE. In medieval times it was brought to North Africa, where today it is cultivated exclusively for hashish or kif. History: First found in the Household Materia Medica. Marijuana has been cultivated for at least 10,000 years, and is one of the world's oldest cultivated crops. Sativa means "with a long history of cultivation." Native to northern India and Iran, it is considered sacred to Shiva, "Lord of Bhang" and to Indra. A cloth made from cannabis sativa was found in a European cave with 6,000 year old cultural artifacts. Constituents: Seeds contain protein, lipids, choline, and inositol. Per 100 g, the seed is reported to contain 8.8 g H20, 21.5 g protein, 30.4 g fat, 34.7 g total carbohydrate, 18.8 g fiber, and 4.6 g ash. In Asia, per 100 g, the seed is reported to contain 421 calories, 13.6 g H20, 27.1 g protein, 25.6 g fat, 27.6 g total carbohydrate, 20.3 g fiber, 6.1 gash, 120 mg Ca, 970 mg P, 12.0 mg Fe, 5 mg beta-carotene equivalent, 0.32 mg thiamine, 0.17 mg riboflavin, and 2.1 mg niacin. A crystalline globulin has been isolated from defatted meal. Also contains lipids, cannabinol, phytin.1

98 Lesson 4: Downward draining herbs Medical Research: Hemp seeds have been shown to lower blood pressure, accompanied with lowered breathing and cardiac rate.3 Energetics Properties and Channels entered: The seeds are sweet and neutral; entering the Large Intestine, Spleen and Stomach meridians.2 Actions and Indications: mild laxative, emollient and moistening. Toxicity, Contraindications and cautions: Over dosage or long-term us may result in vaginal discharge or spermatorrhea. Medicinal uses: Nourishes and moistens the Intestines, often used for constipation in the elderly and after febrile disease, post-partum or in cases of blood deficiency. Nourishes Yin and is considered one of the primary herbs used to tonify Yin when constipation is present. Clears heat, while promoting healing of sores, as an auxiliary herb used orally or topically. Pharmacy and dosage: Dosage: 9-15 g up to 45 g; best if ground before using. Major Combinations: With dang gui (Angelica sinensis) and shu di huang (Rehmannium) for constipation due to lack of fluids and blood deficiency, especially in elderly and post partum. With xing ren (Prunus armeniaceas) and bai shao (Paeonia lactiflora), zhi shi for constipation due to heat-induced dryness in the Stomach and Intestines With jin yin hua (Lonicerae japonicae, flowers) and gan cao (Glycyrrhiza) for redness, pain, ulceration of the oral cavity due to Stomach heat. REFERENCES 1. Duke James A;. Handbook of Energy Crops; 1983: _energy/cannabis _sativa.html 2 Bensky D, Gamble A; Chinese Herbal Medicine Materia Medica;Eastland Press Seattle Wa; Bensky D, Gamble A; Chinese Herbal Medicine Materia Medica;Eastland Press Seattle Wa; Image

99 Lesson 4: Downward draining herbs Yu Li Ren Prunus japonica Family: Rosaceae Other names: bush cherry pits, P. humulis, yu Ii ren rou, yuh Ii jen, ikurini (Japanese), ungniin (Korean) Plant description: seeds ovoid, 5-8 mm long, 3-5 mm in diameter. Externally yellowish-white or pale brown, one end acute, and the other end obtuse, with a linear hilum on the edge of the acute end and a dark-coloured chalaza at the centre of the obtuse end from which many vascular bundles extend upwards. Test thin, cotyledons 2, milky white, oily. Odour is slight; taste is slightly bitter. 1 Part used: cherry pits Habitat, ecology and distribution: Grows throughout much of China. Harvested in Aug - Oct when the fruit has fully ripened. History: Found in the Divine Husbandman's Classic of Materia Medica. Constituents: contains lipid (60-75%), amygdalin, vitamin B1 and Vitamin C.2,3 Energetics Properties and Channels entered: acrid, bitter, sweet, neutral; entering the Large Intestine, Small Intestine and Spleen meridians. Actions and Indications: To relax the bowels, to subdue the upward qi, diuretic. Toxicity, Contraindications and cautions: use caution during pregnancy or in cases of yin deficiency with depleted fluids. Medicinal uses: Used as a folk remedy in china for stubborn insomnia after a frightening event. It is decocted in yellow wine for ten minutes and added to other herbs that might be needed. It is considered stronger than Cannabis seeds. (huo ma ren). Moistens the intestine and unblocks the bowels. Used when constipation is due to qi stagnation in the Intestines. Promotes urination while reducing edema (especially in the legs), especially if it is associated with constipation.

100 Lesson 4: Downward draining herbs Pharmacy and dosage: Dosage is 3-9g. Must be ground with mortar and pestle Major Combinations: Used with huo ma ren (Cannabis seeds) and xing ren (Prunus armeniacae) for chronic constipation caused by dry Intestine or qi deficiency. With yi yi ren (Coicis lachryma-jobi, seed) and fu ling (Poriae cocos) and hua shi (Talcum) for edema accompanied with abdominal distention, constipation and urination. REFERENCES Hsu, H.Y., Chen, Y.P., et al., Oriental Materia Medica: a concise guide, Oriental Healing Arts Institute, Long Beach, CA, 1986, p Bensky D, Gamble A; Chinese Herbal Medicine Materia Medica;Eastland Press Seattle Wa; p121 Image

101 Lesson 4: Downward draining herbs Gan Sui Euphorbia kansui Family: Euphorbiaceae Other names: kansui, kan-sui, kamsu (Korean) Plant description: Root tuber elliptical, catenulate or oblong, l-5 cm long and cm in diameter. The surface without cork appearing yellow white, that with cork yellow-brown. Brittle in texture, easily broken; fracture white and powdery, with vascular bundles of wood, showing fine radial grains. Bitter in taste, cold in nature, toxic, and attributive to lung, kidney and large intestine channels. Part used: root Habitat, ecology and distribution: Shaanxi, Henan, Shanxi provinces of China. Harvested in spring, before flower blooms, or in fall after the aerial parts wither. History: Found in the Divine Husbandman's Classic of Materia Medica. Constituents: euphorbon, euphadienol, euphol, tirucallol, kansuinine A, 20- deoxyingerol, ingenol, oxalic acid, sucrose, glucose and vitamin B 1.1,2,3 Energetics Properties and Channels entered: bitter, sweet, cold and toxic; entering the Kidney, Large Intestine and Lung meridians. Actions and Indications: drastic cathartic, diuretic, anti-viral, anti-tumor. Medical Research: The active constituents stimulate the intestinal mucosa causing inflammation, strong peristalsis and intense liquid diarrhea. Kansuinine A has been shown to have an analgesic effect.4 The water based extract has been shown to enhance macrophage action in the immune system, as well as having a diuretic action.5 There has been a lot of interest in studying the constituents of this plant for its anticancer and antiviral effects. In laboratory tests, a compound derived from dried roots of Euphorbia Kansui, inhibited HIV in extremely low concentrations, 0.1 nanomolar, which is thousands of times lower than the amount of AZT required. The concentration toxic to cells was 100,000 times the antiviral concentration. This series of compounds was also effective against viruses resistant to AZT, viruses resistant to non-nucleoside reverse transcriptase inhibitors, and HN-2. It is believed that these compounds work by preventing the entry of viruses into cells. This work was done by researchers at a number of Japanese universities and companies.6

102 Lesson 4: Downward draining herbs Toxicity, Contraindications and cautions: This herb should only be used in robust patients with patterns of severe excess. It should never be used during pregnancy. Even though this herb can be used externally with Gan cao (licorice), it should not be used internally. Side effects of the toxicity include nausea, vomiting, palpitations, abdominal pain, backache and hematuria.7 Medicinal uses: Drains water downward and drives congested fluid out of chest and abdomen. Used for severe accumulation of fluid. Can be used for general edema, facial edema and abdominal distention. This is a drastic cathartic that causes one to pass water anally. Clears Heat and reduces swelling used topically for swollen, painful, nodular skin lesions due to damp heat. Usually combined with oral doses of milder heat clearing herbs. Pharmacy and dosage: Dosage: Powder g Decoction 0.5g-1g (Although effective component is not water soluble, use powdered form) Major Combinations: With da huang (Rheum palmatum), hou po (Magnolia officinalis) and tao ren (Persicae seeds) for intestinal obstruction. With da huang (Rheum palmatum) as a topical application for ulceration, swelling and mumps. A decoction of this combination is used for fluid accumulation in the chest. With gan coa (Glycyrrhiza) as a topical plaster to the naval for abdominal distention and ascites. REFERENCES 1 Bensky D, Gamble A; Chinese Herbal Medicine Materia Medica;Eastland Press Seattle Wa; p Hsu, H.Y., Chen, Y.P., et al., Oriental Materia Medica: a concise guide, Oriental Healing Arts Institute, Long Beach, CA, 1986, p Huang CK, The Pharmacology of Chinese Herbs 2nd Ed. ; CRC Press; 1999, p Hsu, H.Y., Chen, Y.P., et ai., Oriental Materia Medica: a concise guide, Oriental Healing Arts Institute, Long Beach, CA, 1986, p Huang CK, The Pharmacology of Chinese Herbs 2nd Ed. ; CRC Press; 1999, p Bensky D, Gamble A; Chinese Herbal Medicine Materia Medica;Eastland Press Seattle Wa; p Image:

103 Lesson 4: Downward draining herbs Ba Dou Croton tiglium Family: Euphorbiaceae Other names: croton seeds, pa-tou, jiang zi, gang zi, ba dou rou, hazu (Japanese), padu (Korean) Plant description: Small shrub or tree up to 12 m tall, evergreen; leaves alternate, membranous, ovate with broadly rounded, sometimes slightly decurrent base, acuminate, acute or blunt, very shallowly serrate, glabrous above, with few stellate hairs beneath, cm long, cm broad, metallic green to bronze or orange; petiole slender, about 4 cm long; stipules caducous, subulate, mm long; axis of inflorescence glabrous; flowers small, inconspicuous; male flowers stellately hairy with narrowly oblong petals and stamens; female flowers apetalous; capsule scabrid with stellate hairs, triangular, rnm long, mm broad, oblong or ellipsoid, 3-lobed; seeds 3 per fruit, oblong-ovoid, orange, about 12 mm long, smooth, about 41601kg. Part used: seeds and seed oil Habitat, ecology and distribution: Sichuan, Guangxi, Yunnan, Guizhou provinces. Harvested in the fall. History: Divine Husbandman's Classic of Materia Medica, considered it a low grade herb due to its drastic action. Felter lists croton oil in King's as "a powerful irritant and cathartic. In large doses it is a dangerous poison, occasioning emesis, painful gripings, hypercatharsis, and other serious symptoms. Its action is prompt, frequently causing catharsis within an hour; and, from the smallness of its dose, it is especially adapted to cases where medicines requiring large doses can not be given, as in trismus, coma, insanity, congestive apoplexy, etc. In most cases, placing a drop or two on the back part of the tongue may produce catharsis. It is principally used as a purgative when the bowels are very torpid; in comatose conditions as a revellant; and in dropsy as a hydragogue. It is admissible in obstinate constipation when no inflammation exists, and is the most efficient purgative in lead colic. It is likewise asserted that, irrespective of its cathartic property, it possesses efficacious influences in spasmodic and painful nervous affections. It may be used in all cases where prompt and active purgation is indicated. It is distinguished from other powerful cathartics by occasioning much borborygmus or rumbling of wind, by its action commencing speedily and ending soon, and by the purgative effect, however exhausting at the time, being followed by little debility. In certain forms of diarrhoea and other enteritic affections, I have derived great benefit by dissolving croton oil, 1/2 fluid drachm, in alcohol, 2 fluid ounces, and administering it in doses of from 5 to 15 drops,

104 Lesson 4: Downward draining herbs according to circumstances. Externally, it produces erythematic redness, intense burning, and an eruption of minute vesicles." "A croton-oil liniment is made by mixing 1 part of croton oil with 4 or 5 parts of olive oil, or 6 parts of turpentine; it is rubbed on the skin several times a day, to cause redness and a pustular eruption; it is very beneficial in follicular disease of the throat, affections of the larynx, bronchial vessels, and lungs, indolent tumors, and all painful attacks. The dose of croton oil is from 1 to 6 drops, which is best given on sugar, or made into a pill with crumb of bread, in order to avoid the disagreeable, acrid sensation it occasions in the throat, with a constant tendency to hawk, as well as to prevent nausea or vomiting. Four drops of the oil, thoroughly rubbed around the navel, will, it is said, produce catharsis. Croton oil is now seldom used externally; it was once very popular as a counter-irritant. Soubeiran recommends the following lozenges: Take of vanilla chocolate, 112 ounce; sugar, 2 drachms; starch, 40 grains; croton oil, 10 drops; mix thoroughly together, and form into 60 lozenges. 1 Constituents: Croton oil contains fatty acids (oleic, linolic, arachic, stearic, palmitic, lauric, tiglic and crotonic acids); resin (croton resin; phorbol esters); crotin 2,3,4 Energetics Properties and Channels entered: acrid, hot, toxic; entering the Stomach, Large Intestine and Lung meridians. Actions and Indications: Drastic cathartic, causes skin blistering when used externally Medical Research: Very strong drastic cathartic action. Has been shown to reduce encephalitis, reducing death rate. Appears to have mild carcinogenic activity. 5 Toxicity, Contraindications and cautions: This herb is said to "chop through the gate and force open the door" and therefore should be used with caution. Should not be used with weak and debilitated patients. Never used during pregnancy. Ingestion of as little as 20 drops of croton oil can be lethal. The oil used topically can cause blistering. Should not be used with qian niu zi (Semen Pharbitidis). It is suggest not to be taken with hot liquids as this can severely increase cathartic effect. If laxative is too strong take cool rice water or congee. Herbs that can help are huang lian (coptis) and huang bai (Phellodendri).6 Medicinal uses: Warmly unblocks and vigorously purges; used for severe cold accumulation in the interior leading to constipation and abdominal distention, fullness and pain. Drives out water reducing edema and ascites. Bursts clogged phlegm clogging the throat, which causes wheezing, breathing difficulties and severe distention and fullness in the chest and diaphragm. Also used when phlegm reduces senses.

105 Lesson 4: Downward draining herbs Used topically to promote healing of abscesses and ulcers. Used to accelerate ulceration process. Pharmacy and dosage: Dosage: g in a pill Major Combinations: With da huang (Rheum palmatum) and gan jiang (Ginger) for accumulation of cold in the interior. With shen qu (Massa fermentata) and nan xing (Arisaematis root) for accumulation and stagnation of milk in infants causing phlegm. With jie geng (Platycodi grandiflori root) and bei mu (Fritularia) for Lung abscess with coughing, chest pain and copious, fishy-smelling sputum. REFERENCES 1 2BenskyD.GambleA;ChineseHerbalMedicineMateriaMediCa;EaStlandPressSeattleWa;1993.P Hsu, H.Y., Chen, Y.P., et al., Oriental Materia Medica: a concise guide, Oriental Healing Arts Institute, Long Beach, CA, 1986, p Huang CK, The Phannacology of Chinese Herbs 2nd Ed. ; CRC Press; 1999, p Hsu, H.Y., Chen, Y.P., et al., Oriental Materia Medica: a concise guide, Oriental Healing Arts Institute, Long Beach, CA, 1986, p Bensky D, Gamble A; Chinese Herbal Medicine Materia Medica;Eastland Press Seattle Wa; p126 Image

106 Lesson 5: Drain dampness & Expel Wind damp LESSON 5: Herbs that Drain Dampness & Herbs that Expel Wind Damp Herbs that Drain Dampness Dampness is the accumulation of fluid in the body; as a pathogen it has the characteristics of sticky, heavy, slow moving, and is difficult to resolve. Internally, dampness is a yin pathogen that arises from spleen or kidney deficiency, because it is a yin pathogen it may easily injure yang. Generally dampness sinks to the lower aspects of the body causing edema, arthritis, elimination difficulties, and swellings. When dampness affects the upper part of the body it primarily affects the lung and the lung meridian. Symptoms associated with dampness vary depending on location and whether it is associated with heat. General symptoms are: heavy feeling, muzzy feeling of the head, fullness in the epigastrium and chest, poor appetite, urinary difficulties, the pulse will be slippery, and the tongue coating will be sticky or wet. When dampness combines with heat there will be symptoms of red supperative sores, jaundice, painful urination, foul smelling diarrhea and genital infections. These symptoms are treated with the combination of heat clearing damp drying and draining herbs. Therapeutically, dampness may be dried, drained or transformed; this group of herbs drains dampness by moving the pathogenic fluids out through the urinary bladder. Biomedically, these herbs are considered diuretics. As with any therapeutic principle that involves the removal of fluids from the body care must be taken to ensure yin is not depleted in the process. Herbs to be discussed in this section are: Fu Ling - Poria cocos Yi Yi Ren - Ciox lachryma jobi Ze Xie - Alisma plantago-aquatica Che Qian Zi - Plantago asiatica

107 Lesson 5: Drain dampness & Expel Wind damp Herbs that Dispel Wind Damp Wind damp is the combination of dampness and wind. Since we have already discussed the qualities of dampness in the previous section, we will limit this discussion to the qualities of wind. Wind, internally and externally, moves quickly, it is constantly changing, often accompanied by cold or heat and damp. In this section we will be focusing on internal wind and it's presence with dampness. Together they tend to take residence in the joints or the skin. They cause migratory pain, which in the joints presents as swelling and on the skin as itching. At the joints wind damp is considered to contribute to painful obstruction: biomedically called arthritis; symptoms include: pain that is heavy and moves from joint to joint. When wind damp is associated with cold the symptoms are severe pain, better with heat, this pain has a tendency to be in a fixed location and has a decrease in mobility. Wind damp associated with heat will have more severe swelling and a burning pain that presents with redness. Wind damp may be wind dominant or damp dominant. Wind dominant painful obstruction has the main characteristic of wandering pain. Damp dominant painful obstruction has the main characteristic of swelling and heaviness, and accompanying symptom of numbness. Generally these herbs are anti-inflammatory, analgesic, antipyretic and have circulation promoting properties. Because arthritis (painful obstruction/ Bi Syndrome) is mainly located at the joints (sinews, tendons and bones) a lot of these herbs act on the liver and kidney meridians. In this section we will discuss the following herbs: Du Huo - Radix Angelicae pubescentis Qin Jiao - Radix Gentianae Qinjiao Mu Gua - Fructus Chaenomelis Wu Jia Pi - Cortex Acanthopanacis Cang Er Zi - Fructus Xanthii sibirici

108 Lesson 5: Drain dampness & Expel Wind damp Fu Ling Poria cocos Family: Polyporaceae Other names: yun ling, bai fu ling, fang ling kuai, Poria, Tuckahoe, Indian bread, or Hoelen Plant description: a solid white fungus that grows on the roots of old, dead pine trees 1, the outer skin should be reddish. Part used: scleroderma of fungus Habitat, ecology and distribution: Hubei, Anhui, Henan, Yunnan (superior quality, know as yun fu ling), Guizhou, Sichuan, harvested July thru to March History: first documented in The Divine Husbandman's Classic of Materia Medica Constituents: beta-pachyman, a polysaccharide beta-pachymarose, several organic acids such as tumulosic acid, eubricoic acid, pinicolic acid, and pachymic acid, 3-betahydroxylanosta-7, 9(11). 24-trien-21-oic acid, chitin, protein, fat, glucose, sterols, lecithin, gum, choline 2, adenine Energetics Properties and Channels Entered: sweet, bland and neutral, entering the heart, spleen and lung meridians Actions and Indications: tranquilizing, diuretic, cardiotonic effects, anticancer 3 Medical Research: Life Sci 2002 Jan 18;70(9): Antioxidant activity of anti- inflammatory plant extracts Phytochemistry 1998 Aug;48(8): beta-p-hydroxybenzoyldehydrotumulosic acid from Poria cocos, and its anti-inflammatory effect Chem Pharm Bull (Tokyo) 1997 Mar;45(3): Effect of the basidiomycete Poria cocos on experimental dermatitis and other inflammatory conditions Oncology 1996 Sep-Oct;53(5): Inhibitory effects of lanostane-type triterpene acids, the components of Poria cocos, on tumor promotion by 12- O- tetradecanoylphorbol-13-acetate in two-stage carcinogenesis in mouse skin Chem Pharm Bull (Tokyo) 1996 Apr;44(4): Isolation of inhibitors of TPA-induced mouse ear edema from Hoelen, Poria cocos Planta Med 1995 Dec;61(6): Anti-emetic principles of Poria cocos Jpn J Pharmacol 1992 May;59{1 ): Studies on anti-nephritic effects of plant components (3): Effect of pachyman, a main component of Poria cocos Wolf on originaltype anti-gbm nephritis in rats and its mechanisms

109 Lesson 5: Drain dampness & Expel Wind damp Zhonghua Min Guo Wei Sheng Wu Ji Mian Yi Xue Za Zhi Suppression of tumor necrosis factor-alpha, interleukin-1 beta, interleukin-6 and granulocyte-monocyte colony stimulating factor secretion from human monocytes by an extract of Poria cocos 4 Intraperitoneal injections to healthy rabbits and rats that had adrenalectomies showed increased secretion of sodium, some researchers believe this is due to the herbs high potassium concentration5 Tranquilizing effect on mice 6 Relaxing effect on rabbit intestine specimens 7 Toxicity, Contraindications and cautions: caution in cases of excessive urination from cold deficiency. It is recommended not to take large doses of fu ling or for a long period of time. Fu ling is thought to counteract qin jiao (Radix Gentianae Qinjiao), di yu (Radix Sanguisorbae Officinalis), and Bie Jia (Carapax Amydae Sinensis). Medicinal uses: Promotes urination and drains dampness: urinary difficulty, diarrhea or edema due to stagnation of fluids, and for scanty urination due to damp-heat Strengthens spleen and harmonizes the middle burner: deficiency diarrhea, loss of appetite and epigastric distention Strengthens spleen and transforms phlegm: congestion of fluids causing palpitations, headache, dizziness (accompanying signs of thick pale greasy tongue coating) Quiets heart and calms the shen: palpitations, insomnia or forgetfulness There are 4 layers to the fungus of Fu ling. Each with varying uses: Fu ling pi: pi meaning peel, it is the outer layer of the fungal node. It is black/brown on the outside and grayish brown on the inside. Therapeutically it is used to promote urination and reduce edema. It is less tonifying than fu ling (bai fu ling) Bai fu ling: meaning white fu ling. Most commonly used, and referred to as fu ling (This is the fu ling discussed in this monograph). Chi fu ling: meaning red fu ling. The red part grows closest to the peel, in between the white part and the brown peel. Therapeutically it is used facilitating urination, useful in cases of: scanty urine, dark urine and urinary difficulty. Fu shen: this is the innermost part of the fungus including the root of the pine tree. It is used primarily for calming the spirit.

110 Lesson 5: Drain dampness & Expel Wind damp Pharmacy and dosage: 9-15g, up to 60g may be used for facial edema Major Combinations: With ze xie (Rhizoma Alismatis Orientalis) for painful urination, add gui zhi (Ramulus Cinnamomi Cassiae) and bai zhi (Rhizoma Atractylodis Macrocephalae) for edema and a feeling of heaviness throughout body With che qian zi (Semen Plantaginis) for cloudy painful urination With ban xia (Rhizoma Pinelliae Ternatae) to expel phlegm and damp causing vomiting. Add chen pi (Citri Reticulatae) for congested feeling in the chest with accompanying symptoms of nausea and loss of appetite With mu xiang (Radix Aucklandiae Lappae) for damp diarrhea and accompanying borborygmy With gan cao (Radix Glycyrrhizae Uralensis) for palpitations, shortness of breath and facial edema due to spleen and heart deficiency With suan zao ren (Semen Zizyphi Spinosae), yuan zhi (Radix Polygalae Tenuifoiae) and wu wei zi (Fructus Schisandrae Chinensis) for palpitations and insomnia REFERENCES asp 5 Bensky, D. and Gamble, A.; Chinese Herbal Medicine Materia Medica; Eastland Press, Seattle; 1993; p132 6 Bensky, D. and Gamble, A.; Chinese Herbal Medicine Materia Medica; Eastland Press, Seattle; 1993; P Bensky, D. and Gamble, A,; Chinese Herbal Medicine Materia Medica; Eastland Press, Seattle; 1993; p132 8 Bensky, D. and Gamble, A.; Chinese Herbal Medicine Materia Medica; Eastland Press, Seattle; 1993; p132 Images mdidea.com

111 Lesson 5: Drain dampness & Expel Wind damp Yi Yi Ren Coix lacryma jobi Family - Gramineae Other names: St. Job's tears, yi ren, yi mi, yi ren mi, coix, adlay, adlay millet Plant description: This annual grass is native to southeast Asia and grows to a height of around 3 ft. (1 m), with knobbly, bamboo-like stems from the bases of which new 'tillers' arise, these sometimes self- layering. The glossy deep green leaves are up to 2 in (5 cm) wide with slightly wavy edges. The flowering and fruiting spikelets are insignificant, but the shiny, pea-sized receptacles that enclose their bases harden in fall (autumn) to a pale bluish gray and have often been used for beads and other decorative purposes. Some selected strains are cultivated for their edible grains.1 Part used: seed Habitat, ecology and distribution: through out China, especially in the provinces of Hebei, Fujian, Liaoning History: The Divine Husbandman's Classic of Materia Medica Constituents: coixol, coixenolide, Vitamin B1, leucine, lysine, arginine Energetics Properties and Channels Entered: sweet, bland and slightly cold, entering the spleen, lung, and kidney meridians Actions and Indications: bronchiodilator, anticancer, diuretic Medical Research: Preparations made from the oil of yi yi ren injected into the striated muscles of frogs showed decreased muscle spasm (mechanism involved muscles and not nerves) Low dosages of the oil of yi yi ren stimulates respiration and high doses inhibits respiration Inhibitory affect on neoplastic cells 2 Toxicity, Contraindications and cautions: use with caution during pregnancy, lethal dosage in mice g/kg subcutaneously, and in rabbits g/kg intravenously Medicinal uses: According to Hartwell ( ), the fruits are used in folk remedies for abdominal tumors, esophageal, gastrointestinal, and lung cancers, various tumors, as well as

112 Lesson 5: Drain dampness & Expel Wind damp excrescences, warts, and whitlows. This folk reputation is all the more interesting when reading that coixenolide has antitumor activity (List and Horhammer, ). Job's tear is also a folk remedy for abscess, anodyne, anthrax, appendicitis, arthritis, beriberi, bronchitis, catarrh, diabetes, dysentery, dysuria, edema, fever, goiter, halitosis, headache, hydrothora, phthisis, pleurisy, pneumonia, puerperium, rheumatism, smallpox, splenitis, strangury, tenesmus, and worms (Duke and Wain, 1981). Walker (1971) cites other medicinal uses.3 Promotes urination and drains dampness: edema, urinary difficulty, damp leg ql Strengthens spleen and stops diarrhea Clears heat and expels pus: for carbuncles, as well as lung and large intestine abscesses Expels wind damp in the joints, relating to arthritis Clears damp heat involving digestion with the presentation of greasy tongue coating and slippery pulse Also used to treat plantar warts Pharmacy and dosage: 9-30g, dry fry for spleen tonification, may be taken long term Major Combinations: With dong gua pi (Epicarpium Benincasae Hispidae) for scanty urination due to damp obstruction Add fu ling (Sclerotium Poriae Cocos) and bai zhu (Rhizoma Atractylodis Macrocephalae) for spleen deficiency diarrhea With lu gen (Rhizoma Phragmitis Communis), dong gua ren (Semen Benincasae Hispidae) and tao ren (Semen Persicae) for lung abscesses With bai jiang cao (Herba cum Radice Patriniae) and mu dan pi (Cortex Moutan Radicis) for intestinal abscesses REFERENCES Bensky, D. and Gamble, A.; Chinese Herbal Medicine Materia Medica; Eastland Press, Seattle; 1993; p energy/coix _lacryma-joblhtml#uses Image chinese.herbs.webs-sg.com

113 Lesson 5: Drain dampness & Expel Wind damp Ze Xie Alisma plantago-aquatica Family: Alismataceae Other names: alisma, water plantain, fu ze xie Plant description: perennial erect 4"-40" semiaquatic, 3 petals much longer than sepals parted 1/4 inch whiteflower; head whorls of 4 or more, blooms Jun.-Sep., fruit: achene 1 dorsal groove, leaf: elliptical, long stalk, smooth, firm; emersed or terrestrial1 Part used: herb, tuberous stem Habitat, ecology and distribution: Fujian, Jiangxi, Sichuan History: The Divine Husbandman's Classic of Materia Medica Constituents: alisol A, alisol B, alisol A monacetate, alisol B monacetate, epialisol A, asparagines, beta-sitosterol Energetics Properties and Channels Entered: sweet, bland and cold, entering the bladder and kidney meridians Actions and Indications: diuretic, anesthetic, antihypertensive, lowers blood lipids: total cholesterol, inhibits hardening of main artery, prevents fatty liver, anti-pyretic (lowering fever), anti-bacterial (inhibits mycobacterium tuberculosis), hypoglycemic, hypotensive, galactagogue (promote milk secretion), anti tumor, induces interferon, antiallergic 2 Medical Research: Diuretic effect varies depending on season of harvesting: winter harvesting has the most potent effect and springs the least potent. Preparations increased the excretion of sodium and urea; this may be due to a high potassium concentration Intravenous injections into anesthetized dogs lowered their blood pressure Preparations lower blood glucose 3 Toxicity, Contraindications and cautions: contraindicated when there is kidney deficiency yang, spermatorrhea or vaginal discharge, as well as damp cold. Although this is a very safe herb, oral preparations of 4g/kg can irritate the intestinal tract of rats and long-term ingestion caused gastroenteritis.4

114 Lesson 5: Drain dampness & Expel Wind damp Medicinal uses: Promotes urination and drains dampness: stagnation of damp causing edema, diarrhea and difficult urination Drains kidney fire: for kidney yin deficiency (i.e.: dizziness, tinnitus), although this herb promotes urination it is less likely to injure yin compared with the other damp draining herbs Used for urinary tract infections, hematuria and cystitis 5 Used for acute diarrhea, enteritis 6 Used for allergic rhinitis, urticaria and asthma 7 Used for edema and nephritis 8 Pharmacy and dosage: 6-15g Major Combinations: With mu tong (Caulis Mutong) for painful urination and edema With sha ren (Fructus Amomi) for painful scanty urination with abdominal distention With ban xia (Rhizoma Pinelliae ternatae) for epigastric and abdominal distention, scanty urination, due to turbid dampness stagnating in the middle burner With mu dan pi (Cortex Moutan Radicis) for dizziness, vertigo, deep hot pain in bones REFERENCES Bensky, D. and Gamble, A.; Chinese Herbal Medicine Materia Medica; Eastland Press, Seattle; 1993; p, Bensky, D. and Gamble, A.; Chinese Herbal Medicine Materia Medica; Eastland Press, Seattle; 1993; p http:// 8 Image plumdragonherbs.com

115 Lesson 5: Drain dampness & Expel Wind damp Che Qian Zi Plantago asiatica # Family: Plantaginaceae Other names: che qian ren, plantain Plant description: Ellipsoid, irregularly oblong or triangular oblong, slightly flattened, about 2 mm long, 1 mm wide. Externally yellowish-brown to dark brown, with fine wrinkles, and a grayish-white concave pointed hilm on one side. Texture hard.1 Part used: seeds Habitat, ecology and distribution: grown through out northern China, harvested in summer and autumn once seeds have ripened History: The Divine Husbandman's Classic of Materia Medica Constituents: plantasan, plantagomucilage A, platenolic acid, palmitic acid, arachidic acid, succinic acid, adenine, cholic acid, stearic acid, oleic acid, linoleic acid, linolenic acid Energetics Properties and Channels Entered: sweet and cold, entering the bladder, kidney, liver and lung meridians Actions and Indications: Anti-inflammatory, antitussive, antidiarrheal, diuretic, expectorant, lowers blood pressure 2 Medical Research: Injections of che qian zi into the joint capsule has the effect of tightening the lax joint; this has been used clinically in cases of recurrent dislocation of the temporomandibular joint (TMJ) Roasted and ground into powder and used to treat uncomplicated indigestion in children; of 63 cases, 53 had no more diarrhea within 2.1 days and 6 had marked reduction of bowel movements - effective within 2.5 days Powdered che qian zi was used to treat 68 cases of mal positioned fetus at the 8th month, 90% of the cases had normal presentation at birth Toxicity, Contraindications and cautions: Contraindicated during pregnancy, except for mal positioned fetus, use with caution when there is yang deficiency or spermatorrhea due to kidney deficiency or overwork.

116 Lesson 5: Drain dampness & Expel Wind damp Medicinal uses: Promote urination and clear heat: for damp heat edema or urinary obstruction (damp heat in the lower burner) Damp heat diarrhea: promotes urination to solidify the stools Clears the eyes: for liver/kidney deficiency, liver heat. Here it is best to use the whole plant, which is more effective at relieving toxicity and clearing heat. Use topically or orally (9-30g); useful for abscesses and swellings as well. Expels phlegm and stops cough: lung heat with copious sputum More effective than many Chinese or Western herbs for back and neck pain. "In sufficient quantities it is mildly paralyzing and creates a euphoric but clear minded state in which the drinker cannot be annoyed." - - Dr. W. Arthur Whistler Pharmacy and dosage: 4.5-9g, wrap in cheesecloth during decoction, dry fry to promote urination; fry in wine to tonify kidneys. Major Combinations: With zi xie (Rhizoma Alismatis orientalis) for edema, distention, and painful urination With niu xi (Radix Achyranthis bidentatae) for kidney deficiency edema With hai jin sha (Spora Lygodii japonici) and zhi zi (Fructus Gardeniae jasminoidis) for dribbling painful urination due to heat in the lower burner With bai zhu (Rhizoma Atractylodis Macrocephalae) and yi yi ren (Semen Coicis Lachryma jobi) for diarrhea presenting with reduced urination due to either spleen deficiency or dampness bearing summerheat With cang zhu (Rhizoma Atractylodis) for vaginal discharge due to damp heat and spleen deficiency With shu di huang (Radix Rehmanniae gluntinosae conquitae), gou qi zi (Fructus Lycil) and tu si zi (Semen Cuscutae chinensis) for cataracts due to liver and kidney deficiency REFERENCES Bensky, D, and Gamble, A.; Chinese Herbal Medicine Materia Medica; Eastland Press, Seattle; 1993; p. 142 Image tcm.health-info.org!!

117 Lesson 5: Drain dampness & Expel Wind damp Du Huo Angelica pubescens Family:Umbelliferae Other names: tu huo, angelica root Plant description: The leaves have enlarged convex sheaths at the base of the leaf stalks and have 2 to 3 pinnate parts. They become smaller toward the top of the plant and are less clefted. The upper part of this herb is branchy. At the branch!s end grow the inflorescences; radiate double umbels with bristly small leaves. The tiny greenish-white flowers smell of honey. Some angelica plants flower white blossoms or more rarely, pale-purple flowers. Oval fruits are ridged with thin lateral wings. Angelica can grow 5 to 8 feet tall.1 Part used: root Habitat, ecology and distribution: Hubei, Sichuan, Anhui, Zhejiang, Jangxi, Guangxi, harvested in spring or late autumn. The roots are dried in the sun and then sliced. History: Divine Husbandman's Classic of Materia Medica Constituents: angelol, angelicone, bergapten, osthol, umbelliferone, scopoletin, angelic acid, tiglic acid, palmitic acid, sterols, stearic acid, linolenic acid, oleic acid, glucose, essential oils (The essential oils obtained from the seeds and roots by steam distillation are known to contain d--phellandrene, -pinene, osthenole, osthole, angelicin, -thujene, camphene, and numerous other compounds ( , ). The fruits of angelica contain a higher percentage of oil and are rich in coumarins ( , ). Root oil is considered superior to the oils obtained from other parts of the plant) 2, Hydroxynaphthaquinone 3 Energetics, Properties and Channels Entered: bitter, pungent and warm, entering the kidney and bladder meridians Actions and Indications: Tranquilizing, sleep-inducing, anti-arthritic, hypotensive, antibiotic activity against tuberculosis bacilli, analgesic, diaphoretic, anti-inflammatory, diuretic, uterine stimulant, emmenagogue, expectorant, interferon inducent.5 Medical Research: Decoctions given orally and intra peritoneally to rats and mice showed both a tranquilizing and hypnotic effect Alcohol extractions of du huo showed an increased antihypertensive effect in comparison with water extractions

118 Lesson 5: Drain dampness & Expel Wind damp Inhibitory effect in vitro against tuberculosis bacilli Toxicity, Contraindications and cautions: All members of this genus contain furocoumarins, which increase skin sensitivity to sunlight and may cause dermatitis.6 Medicinal uses: Dispels wind damp and stops pain: wind-cold-damp of the lower body Specific for disorders below the waist Disperses wind-cold-damp and releases the exterior: external attack of wind cold damp Used for shao yin stage headache and toothache Pharmacy and dosage: 3-9 g Major Combinations: With xi xin (Herba cum Radice asari) and qin jiao (Radix Gentianae qinjiao) for wind damp pain of neck, back and lower extremities With qiang huo (Rhizoma et Radix notopterygii), gao ben (Rhizoma et Radix Ligustici) and man jing zi (Fructus Viticis) for headache due to external wind cold damp With ma huang (Herba Ephedrae) for external wind cold with out sweating (symptoms of body aches and pains) With fang feng (Radix Ledebouriellae divaricatae) for numbness of the legs due to wind damp 7 REFERENCES Bensky, D. and Gamble, A; Chinese Herbal Medicine Materia Medica; Eastland Press, Seattle; 1993, p ANGELI CP.html 6http://gardenbed,comlAl3 77.cfm 7 Bensky, D. and Gamble, A.; Chinese Herbal Medicine Materia Medica; Eastland Press, Seattle; 1993, p. 156 Image tcm.health-info.org

119 Lesson 5: Drain dampness & Expel Wind damp Qin Jiao Radix Gentianae Qinjiao Family: Gentianaceae Other names: Gentiana macrophylla root, chin-chiu Plant description: This plant has a thick, branching, yellowish brown root that produces a hollow, erect stem reaching four feet in height. The stem bears opposite obovate leaves that are bright green, sessile, and have five prominent veins. Lower leaves are also present and emerge from the root. Large, orange-yellow flowers bloom from July to August, appearing in the upper leaf axils, growing in whorls of 3 to 10 blossoms. The fruit is an obovate capsule.1 Part used: root Habitat, ecology and distribution: Gansu, Shanxi, Shaanxi, Inner Mongolia, throughout northeastern China; harvested in spring or autumn History: The herb reputedly takes its name from a 2nd century BCE king of Illyria named Gentius, who discovered its ability to reduce fevers. Powerfully bitter, the herb is an essential ingredient of traditional aperitifs and such bitters as Angostura bitters. The customary aperitif is taken about one-half hour before meals, but it has become more of a social expectation rather than a medicinal one. In medieval times, it was an ingredient of the alchemical brew called "theriac", a supposed cure-all made according to a highly secret recipe. It was officially listed in the US Pharmacopoeia from 1820 to Qin Jiao is one of the 252 herbs listed in the Divine Husbandman's Classic (Shen nong Ben cao jing), a Chinese herbal written in the 1st century CE. 2 Constituents: gentianine, gentianidine Energetics Properties and Channels Entered: bitter, pungent, slightly cold, entering the gallbladder, liver and stomach meridians Actions and Indications: anti-inflammatory, analgesic, sedative, antibiotic, antifungal, antihypertensive Medical Research: In rats with arthritis artificially induced by formaldehyde, gentianine given intraperitoneally (90 mg/kg) was as effective as aspirin (200mg/kg),

120 Lesson 5: Drain dampness & Expel Wind damp this was attributed to its effect on the adrenals, since it had no anti-inflammatory effect in adrenalectomized animals. Gentianine acts as a prophylactic against histamine shock in guinea pigs and anaphylactic shock in rats. It also markedly lowers the permeability of the capillaries. A small dose of gentianine acts as a central nervous system sedative in mice and rats, but is stimulatory in large dosage. Gentianine is an effective analgesic in both rats and mice. There is a synergistic effect with Rhizoma Corydalis Yanhusuo (yan hu suo). Qin jiao has an inhibitory effect in vitro against many bacteria including Staphylococcus aureaus, Streptococcus pneumoniae, Shigella and Vibrio cholerae. It showed the same in vitro effects against many pathogenic fungi. Preparations of qin jiao infected intramuscularly were used in treating 21 cases of meningitis (type not reported). All 21 cases recovered with in 3-7 days, and no sequellae developed. Qin jiao (both water and alcohol extractions) was shown to lower the blood pressure in a variety of animal studies. Duration of effect was short.3 Gentianine's anti-inflammatory property has been studied in rat hind leg inflammation caused by subcutaneous injection of egg white at the ankle joint. Administered intraperitoneally at dosage of 90 mg/kg, 30 minutes before the egg white, it was effective in reducing swelling and causing its disappearance sooner than controls. Further study revealed that the substance does not work on the adrenal glands per se; its action is mediated by the nervous and hypophyseal system. In formalin-induced arthritis, gentianine was more effective than sodium salicylate, and just as effective as chloroquine and cortisone.4 If gentian is being used on a daily basis, the following drugs may be imperfectly absorbed: tetracycline derivatives, oral anticholinergics, phenothiazines, digoxin, isoniazid, phenytoin, and warfarin.5 Certain antipsychotic drugs, such as phenothiazines, as well as other psychoactive agents which are poorly absorbed in the gastrointestinal tract, may be even more poorly absorbed if gentian is also being used.6 Toxicity, Contraindications and cautions: humans taking relatively high dosage of this herb have developed nausea and vomiting, Medicinal uses: Dispels wind-dampness and relaxes the sinews: Painful obstruction of the extremities, acute or chronic, cold or hot Clears heat from deficiency: yin deficiency with fever and night sweats Resolves dampness and reduces jaundice: especially for acute cases and infants Moistens intestines and unblocks the bowels: for dry constipation. Also used to counteract drying qualities of other herbs that dispel wind damp

121 Lesson 5: Drain dampness & Expel Wind damp Pharmacy and dosage: g Major Combinations: With zhi mu (Rhizoma Anemarrhenae aspholdeloidis) and ren dong teng (Caulis Lonicerae) for hot painful obstruction With fang feng (Radix Ledebouriellae divaricatae), du huo (Radix angelicae pubescenti) and qiang huo (Rhizoma Notopterygii) for wind cold damp painful obstruction With bie jia (Carapax Amydae sinensis), qing hao (Herba Artemisiae annuae), and di gu pi (Cortex Lycii Radicis) for yin deficiency heat associated with a long term illness With dang gui (Radix Angelicae sinensis) and bai shao (Radix Paeoniae lactiflorae) for hemipalegia presenting with blood deficiency With huang qin (Radix Scutellariae) and cang zhu (Rhizoma Atractylodis) for damp heat jaundice in children With huo ma ren (Semen Cannabis sativae) and yu Ii ren (Semen Pruni) for constipation due to dry intestines 7 REFERENCES Bensky, D. and Gamble, A.; Chinese Herbal Medicine Materia Medica; Eastland Press, Seattle; 1993; p _gentian.html 5 _gentian.html Bensky, D. and Gamble, A.; Chinese Herbal Medicine Materia Medica; Eastland Press, Seattle; 1993; p 157 Image tcm.health-info.org

122 Lesson 5: Drain dampness & Expel Wind damp Mu Gua Fructus Chaenomelis Family - Rosaceae Other names: Chinese quince fruit, chen mu gua, xuan mu gua Plant description: purplish-red colour with a wrinkled peel Part used: fruit Habitat, ecology and distribution: Anhui (best), Hubei, Sichuan, Zhejiang; harvested in autumn when fruit is ripe History: Grandfather Lei's Discussion of Herb Preparation (470 CE) Constituents: saponins, fructose, citric acid, flavones, tartaric acid, tannin Energetics Properties and Channels Entered: sour, slightly warm, enters the liver and spleen meridians Actions and Indications: Anti-rheumatic, anti-inflammatory, antispasmodic, digestive, antiemetic 1 Medical Research: Decoctions reduced swelling from arthritis in mice due to albumen injection 2 Decoction inhibits the development of egg-white induced arthritis in mice 3 Toxicity, Contraindications and cautions: excessive use can harm teeth and bones, contraindicated for exterior disorders Medicinal uses: Relaxes the sinews and unblocks the channels: damp painful obstruction of the extremities Harmonizes the stomach and transforms dampness: for abdominal pain, spasms, and cramping of the calves, and edema due to leg qi Reduces food stagnation: for indigestion 4 Pharmacy and dosage: g

123 Lesson 5: Drain dampness & Expel Wind damp Major Combinations: With huo xiang (Herba Agastaches seu pogostemi) and sha ren (Frucus Amomi) for sudden turmoil disorder - often characterized by spasms of the calf muscles due to summerheat With dang gui (Radix Angelicae sinensis) and Dai shao (Radix Paeoniae lactiflorae) for muscle spasms due to blood deficiency With hu gu (Os tigris*) and du huo (Radix Angelicae pubescentis) for weakness, atrophy and joint pain in the lower extremities * Reference only, illegal! With wu zhu yu (Fructus Evodiae rutaecarpae), xiao hui xiang (Fructus Foeniculi vulgaris) and sheng jiang (Rhizoma Zingiberis officinalis) for damp cold abdominal pain and diarrhea.5 REFERENCES Bensky, D. and Gamble, A.; Chinese Herbal Medicine Materia Medica; Eastland Press, Seattle; 1993; p Bensky, D, and Gamble, A.; Chinese Herbal Medicine Materia Medica; Eastland Press, Seattle; 1993; p160 5 Bensky, D. and Gamble, A.; Chinese Herbal Medicine Materia Medica; Eastland Press, Seattle; 1993; p160 Image plumdragonherbs.com

124 Lesson 5: Drain dampness & Expel Wind damp Wu Jia Pi Cortex Acanthopanacis graciiistyli radicis Family - Araliaceae Other names: acanthopanax root bark, nan wu jia pi, bark of 5 additions Plant description: Irregular quills, 5-15 cm long, cm in diameter, about 2 mm thick. Outer surface greyish-brown, with slightly twisted, longitudinal wrinkles, and transverse lenticels. Inner surface pale yellow or greyish-yellow, with fine longitudinal striations. Texture light, fragile, easily broken, fracture irregular, greyish-white.1 Part used: skin of root (root bark) Habitat, ecology and distribution: Hubei, Henan, Sichuan, Hunan, Anhui; harvested in summer or autumn History: The Divine Husbandman's Classic of Materia Medica Constituents: essential oils including: 4-methyl salicyladehyde, tannin, palmitic acid, linoleic acid, and vitamins A and B1 Energetics Properties and Channels Entered: pungent, bitter and warm, entering the liver and kidney meridians Actions and Indications: Anti-rheumatic, diuretic, circulatory stimulant, antipyretic and analgesic Medical Research: none noted Toxicity, Contraindications and cautions: use with caution for yin deficiency with heat symptoms Medicinal uses: Dispels wind dampness: for chronic wind damp painful obstruction Strengthens the sinews and bones: when liver and kidney deficiency generates weak or soft sinews and bones. Especially useful for obstruction to smooth flow of qi, for the elderly and developmental delays in the motor functions of children Transforms dampness and reduces swelling: for urinary difficulty, edema and damp leg qi

125 Lesson 5: Drain dampness & Expel Wind damp Pharmacy and dosage: g Major Combinations: With wei ling xian (Radix Clematidis), qiang huo (Rhizoma et Radix Notopterygii) and qin jiao (Radix Gentianae Qinjiao) for pain and muscular spasms due to wind damp painful obstruction With sang ji sheng (Ramulus Sang ji sheng), niu xi (Radix Achyranthis bidentatae) and xu duan (Radix Dipsaci asperi) for painful obstruction due to long term illness and subsequent liver and kidney deficiency. This combination is especially useful for developmental delays of children in with the addition of mu gua (Fructus Chaenomelis Lagenariae) With da fu pi (Pericarpium Arecae catechu) and fu ling pi (Cortex Poriae cocos) for mild edema 3 REFERENCES Bensky, D, and Gamble, A.; Chinese Herbal Medicine Materia Medica; Eastland Press, Seattle; 1993; p 162 Image plumdragonherbs.com

126 Lesson 5: Drain dampness & Expel Wind damp Cang Er Zi Fructus Xanthii Sibiric # Family - Compositae Other names: cocklebur fruit, xanthium, Plant description: Fusiform or ovoid, cm long, 4-7 mm in diameter. Externally yellowish-brown or yellowishgreen, with hooked spines throughout. Summit with 2 relatively thick spines, separated or linked up, base with a fruit stalk scar. Texture hard and flexible, the centre of transverse section showing a septum and 2 loculi, each having an achene. Achene slightly fusiform, relatively even at one side, apex with a protruding remains of style, pericarp thin, grayish- black, with longitudinal wrinkle.1 Part used: fruit Habitat, ecology and distribution: Throughout China, especially Shandong, Jiangxi, Hubei, jiangxi; harvested August to September once the fruit is ripe History: The Divine Husbandman's Classic of Materia Medica Constituents: xanthostrumarim, resin, alkaloids, ceryl alcohol, sitosterol, vitamin C Energetics, Properties and Channels Entered: sweet, slightly bitter, warm and toxic, entering the lung meridian Actions and Indications: antimicrobial, Anti-rheumatic, analgesic, antifungal, decongestant 2 Medical Research: In vitro inhibitory effect against Staphylococcus auraus Local application of cang er zi and sesame oil was used to treat 207 cases of chronic rhinitis, symptoms disappeared in all but 15 cases for as long as 3 years Intramuscular injections into points of pain of a 30% solution of cang er zi were 89% effective in treating lower back pain of various etiologies. Improvement was noticed after 1 treatment, but usually it took 3-4 treatments before being judged effective.3 Lowering blood sugar, with similar mechanism as phenethyl biguanide 4 Toxicity, Contraindications and cautions: Toxic ingredients are changed after decocting this herb or subjecting it to high heat. The lethal dosage for intraperitoneal injection in mice is 0.93 g/kg; symptoms included reduced movement and lowered reaction to outside stimuli, and irregular breathing, followed by difficulty in breathing and coma. Pathological examinations revealed

127 Lesson 5: Drain dampness & Expel Wind damp damage to all major organs, especially the liver and kidneys.5 Its chief poisonous component is rhamnose. The toxic effects in rats, guinea pigs and rabbits by different routes of administration are similar. LD50 is 0.93g/kg in mice.)6 Overdose can result in vomiting, abdominal pain, and diarrhea.7 Medicinal uses: Disperses wind and dispels dampness: for wind damp painful obstruction or skin disorders with itching Opens the nasal passages: for any nasal or sinus problem with a thick, viscous discharge and related headache Dispels exterior wind: as an auxiliary herb for exterior disorders with a splitting headache that radiates to the back of the neck.8 Most commonly used for dampness in the exterior Pharmacy and dosage: 3-9g Major Combinations: With xin yi hua (Flos Magnoliae) for headache and nasal obstruction; for acute wind heat patterns add shi gao (gypsum) and huang qin (Radix Scutellariea Saicalensis); for chronic wind heat add qian cao gen (Radix Rubiae Cordifoliae) and jin yin hua (Flos Lonicerae Japonicae); for allergic rhinitis add wu wei zi (Fructus Rosae Laevegatae) With wei ling xian (Radix Clematidis), chuang xiong (Radix Ligustici Chuanxiong) and cang zhu (Rhizoma Atractylodis) for pain and numbness due to wind damp painful obstruction With bai ji Ii (Fructus Tribuli Terrestris) internally and externally for wind rash or dampness induced sores 9 REFERENCES Bensky, D. and Gamble, A.; Chinese Herbal Medicine Materia Medica; Eastland Press, Seattle; 1993; p htm 5 Bensky, D. and Gamble, A.; Chinese Herbal Medicine Materia Medica; Eastland Press, Seattle; 1993; p htm Bensky, D. and Gamble, A.; Chinese Herbal Medicine Materia Medica; Eastland Press, Seattle; 1993; p163 9 Bensky, D, and Gamble, A.; Chinese Herbal Medicine Materia Medica; Eastland Press, Seattle; 1993; p163 Image plumdragonherbs.com!!

128 Lesson 6: Herbs that transform phlegm & stop cough LESSON 6: Herbs that Transform Phlegm The term 'phlegm' in TCM is much more than the pathological accumulation of thick fluid in the respiratory and digestive tract. Phlegm can also be found in the muscle, integument or other body tissue. The Lung and its meridian are considered the receptacle of phlegm and thus most herbs that transform phlegm act on this organ system. The Spleen is considered the organ that produces phlegm, thus some useful herbs can leech dampness out of and strengthen the Spleen. The Kidney and liver also play a role in the production of phlegm. When the kidneys are deficient it is unable to control the fluids, these fluids overflow and then cause phlegm. When the liver, which governs the smooth flow of qi in the body, is stagnant or constrained so is its ability to circulate the fluids around the body, giving rise to phlegm. Phlegm is the mother of 100 diseases physician Wang Gui (of the Yuan dynasty). Phlegm in TCM is also considered the culprit in other diverse disorders such as: scrofula, goiter, seizure and convulsions, back pain, and skin problems. In the classics a disease to which there can be no explanation for is attributed to phlegm. Phlegm may cause the following symptoms: 1. Pulmonary phlegmatic symptoms: with primary symptoms of shortness of breath, wheezing, intercostal pain in the chest (costalgia), frequent acute or chronic bronchitis, emphysema, pneumonia, hiccoughs, and pulmonary TB. The goal here is to unblock the lungs by reducing phlegm. These herbs should expel abnormal secretions, reduce inflammatory stimuli and have antitussive properties. Some famous herbs that do this are Bei mu, Xing ren, and Zi wan. 2. Gastrointestinal Phlegm: with primary symptoms of nausea, vomiting, loss of appetite, epigastric discomfort, sometimes with an accompanying cough. This can be: influenza's that have both digestive and respiratory symptoms, gastrointestinal neurosis, acute dyspepsia and chronic gastritis. Here we need to harmonize the Stomach and resolve phlegm using stomachics and anti-emetics. Common herbs used here are Ban xia and Xuan fu hua. 3. Intradermomuscular phlegm, often referred to as 'phlegmatic fire', is a combination of fire and phlegm. Examples are: goiter, cervical lymphatic edema, or inflammation. Softening the tissue and resolving phlegm resolve these issues. Here often iodine containing herbs are used such as

129 Lesson 6: Herbs that transform phlegm & stop cough laminara and seaweed (both not in this lesson). Bei mu (Fritillaria) is also useful. 4. Phlegmatic turbidity covering the heart cavity: including symptoms of impaired consciousness, profuse drooling, tight locked teeth and firm gripping hands. These could be diseases such as epilepsy, other seizures, and apoplexy (stroke, or copious effusion of blood into an organ). This is caused by 'wind phlegm'. Here we use sedative, expectorant, antispasmodics like arisaema (jack-in-the-pulpit) and Korean aconite (both not in this lesson). Some botanicals that transform phlegm are expectorants that intensely stimulate the lungs. These herbs would be contraindicated with patients that have hemoptysis (blood in sputum). For coughs that accompany the first stage of measles, herbs that spread the Lung qi are of primary importance. If you try to stop a cough, especially those that are warming with binding properties, you can make the problem worse. Herbs that Cool and Transform Phlegm-heat These cold herbs are used to treat phlegm-heat and dry-phlegm. They will work on coughs; treat scrofula (TB in cervical lymph nodes), goiters, and convulsions due to phlegm-heat. We can consider these herbs expectorant, antitussive, anti-inflammatory and sedative in properties. We will be looking at the following botanical in this category: Bei mu - Fritillaria cirrhosa Gua lou - Trichosanthus spp. Zhu li/ Zhu ru - Bambusa spp. Warm Herbs that Transform Phlegm-Cold These botanicals are mostly warming in nature and are used to treat phlegm-cold or phlegm-dampness. Their action can be very drastic and can be toxic, thus close attention needs to be paid to patients during this process. Care is needed to properly prepare the formula and should not be given for fever phlegm or dry phlegm. Ban xia - Pinellia ternata Xuan fu hua - Inula japonica

130 Lesson 6: Herbs that transform phlegm & stop cough Herbs that Relieve Coughing and Wheezing These botanicals relieve coughing and wheezing. They usually only deal with surface symptoms and are therefore always combined with other herbs that deal with the root of the problem. If the condition is an exterior cough, then they are combined with herbs that release exterior. If the cough is of an interior nature, then they are combined with botanicals that are toning. If a hot cough is present, than herbs that clear heat are used. For cold coughs, they are combined with warming herbs. We can consider these herbs as antitussive, expectorant, antibiotic, diuretic and laxative in properties. The herbs we will be looking at in this category are: Xing ren - Prunus armeniaca Zi wan - Aster tataricus Herbs that Expel Phlegm by vomiting In TCM, as with the Eclectics, vomiting was an important method of treatment. It is not as popular these days as it was in more ancient times. These herbs are employed when there is problematic phlegm or food clogging the upper body (throat, thorax, or epigastrium). These herbs are quite strong and thus are only used on robust patients. They are contraindicated for children, pregnancy, the weak or people that have recently lost blood. The herb we are using as an example here is: Gua di - Cucumis melo

131 Lesson 6: Herbs that transform phlegm & stop cough Bei Mu Fritillaria cirrhosa Family: Liliaceae Other names: Bulbus Fritillatiae Cirrhosae, F. unibracteata, F. delavayi, tendrilled fritillaria bulbs, pei-mu, chuan bei, jian bei ma, senbaimo (Japana), ch 'onp 'aemo (Korean) Plant description: Fritillaria refers to the bulb (corm) of Fritillaria cirrhosa or Fritillaria thunbergii. The name, bei mu, refers to the appearance of the bulb being similar to that of the cowry shell (bei) of which the plant is the source (mu = mother). Fritillaria cirrhosa, known as chuan bei mu (chuan = from Sichuan Province) has a very small corm, which is considered medicinally superior to the corm from Fritillaria thunbergii (zhe bei mu; mainly from Zhejiang Province), which is larger. Due to the difficulty and high cost of collecting a large number of plants to get an adequate quantity of small bulbs from Fritillaria cirrhosa, Fritillaria thunbergii has become extensively utilized as a substitute, though it is said to have slightly different applications. Part used: bulb processes Habitat, ecology and distribution: Today, virtually all supplies of fritillaria are cultivated, although some limited collection of wild chuan bei mu still takes place in Tibet and Yunnan province. Fritillaria is the processed bulb of Fritillaria cirrhosa, a flowering plant in the Liliaceae family. A perennial temperate herb, it grows on mountain slopes and sub-alpine meadows, usually on open, stony, and moist hillsides. It is traditionally valued as an herbal remedy in Nepal and China, where it grows in the Gansu, Qinghai, Sichuan, Xizang, and Yunnan provinces. History: Found in the Divine Husbandman's Classic of the Materia Medica, and classed as a medium grade herb. Constituents: fritilline, fritillarine, verticine (peinine), verticilline, apoverticine and fritimine.1,2,3 Energetics Properties and Channels entered: bitter, sweet, and slight cold; entering the Heart and Lung meridians.4 Actions and Indications: antitussive, analgesic, expectorant, bronchodilator. Medical Research: The alkaloid groups have atropine like activity, producing antitussive and expectorant action. Bei mu has a bronchodilation ability, while decreasing secretions. The alkaloids will also dilate the pupils.5

132 Lesson 6: Herbs that transform phlegm & stop cough Toxicity, Contraindications and cautions: This herb is not effective in treating coughs from phlegm secondary to damp-cold. It is also incompatible with wu tou and qin jiao. Bei mu should always be process, as the unprocessed herb is quite toxic. This herb can cause uterine contractions and stimulate intestinal contractions. Medicinal uses: This herb is one of the most widely used botanicals, traditional used for relieving cough and wheezing in cases of chronic bronchitis or upper respiratory infections. It has been used for TB, and whooping cough. It has also been employed to treat gastric and duodenal ulcers due to its antacid and analgesic effects. 6 Clears heat and transforms phlegm. Used for coughs, especially chronic coughs, with signs of yin deficiency, coughs with slight sputum that is difficult to expectorate or cough with blood in the sputum. It is specific for treating coughs accompanied by constrained qi, manifested by reduced appetite and stifling sensation in chest and upper abdomen. Clears heat and dissipates nodules in conditions of phlegm-fire such as sores, swelling, scrofula and Lung or breast abscesses. Pharmacy and dosage: Dosage: 3-15 grams of processed herbs Major Combinations: With zhi mu for cough with minimal or difficult-to-expectorate sputum due to fire from yin deficiency burning the Lungs. With xing ren (Prunus armeniaca) for cough and wheezing with copious sputum. With yuan zhi, fu ling (Poria cocus) and gua lou for painful obstruction of chest with palpitations and insomnia. REFERENCES 1 Hsu, H.Y., Chen, Y.P., et al., Oriental Materia Medica: a concise guide, Oriental Healing Arts Institute, Long Beach, CA, 1986, p Huang CK, The Pharmacology of Chinese Herbs 2nd Ed. ; CRC Press; 1999, p Tang W, Eisenbrand; Chinese Drugs of Plant Origin; Spinger-Verlag; New York; 1992 p Bensky D, Gamble A; Chinese Herbal Medicine Materia Medica;Eastland Press Seattle Wa; p Hsu, H.Y., Chen, Y.P., et ai., Oriental Materia Medica: a concise guide, Oriental Healing Arts Institute, Long Beach, CA, 1986, p Huang CK, The Pharmacology of Chinese Herbs 2nd Ed. ; CRC Press; 1999, p Image

133 Lesson 6: Herbs that transform phlegm & stop cough Gua Lou Trichosanthes spp. Family: Cucurbitaceae Other names: Fructus Trichosanthis, Semen Trichosanthis, Radix Trichosanthis Kirilowii, tian hua fen (root), hua fen, gua lou gen, kua-lou-ken, tenkafun (Japanese), ch'onhwabun (Korean) gua lou (fruit), kua-lou, quan gua lou, karo (Japanese), kwalwi (Korean) gua lou ren (seed), gua lou pi (skin), lou ren, gua lou zi, kua-lou-jen, karonin (Japanese), kwalwiin (Korean) Plant description: Gourd spherical or oblong, 6-9 cm long. Surface yellowish brown, irregularly shrunken; apex with remnant style base, and its base with fruit stalk scars remaining. Peel thin and brittle, containing the pulp and many ovate seeds inside. Burnt sugar in odour. Exocarp appearing the same as the outer surface of gourd; endocarp yellowish white, with vascular bundles. Part used: fruits, seeds, root Habitat, ecology and distribution: grows throughout China especially Shandong, Hebei, Shanxi and Shaaxi provinces. Usually harvested in the fall when the fruit has ripened. The root can also be harvested in the winter. History: Found in the Divine Husbandman's Classic of Materia Medica. Usually considered a medium herb Constituents: Fruit: trichosanthine Seed: saponins organic acids, resins, trichosanthes acid and saturated fatty acid (30%) Root: stigmasterol, beta-sitosterol, saponins, trichosanthin Energetics Properties and Channels entered: Fruit: sweet and cold entering the Large intestine, Lung and Stomach meridians. Seed: sweet and cold entering the Large intestine, Lung and Stomach meridians. Root: bitter, slightly sweet, cold entering the Lung and Stomach meridians. Actions and Indications: expectorant, laxative, diuretic, analgesic Medical Research: There has been a fair amount of research done on this plant lately with on its activity on cancer, HIV and diabetes all being part of the trend. 1, 2, 3,4

134 Lesson 6: Herbs that transform phlegm & stop cough Fruit: has antibiotic effect against E. coli, Shigella sonnei and Pseudomonas, as well as others. A twenty percent decoction has been used to treat cancer, especially hepatic cancer with ascites. The husk of the fruit is considered stronger. Has shown significant results in treating coronary artery disease. Gua lou can dilate the coronary vessels, while increasing myocardial tolerance to oxygen deprivation. It has a 78.9% effective rate for treating angina pectoris. Seed: Similar to fruit. The seed can absorb large amount of fluid, while stimulating peristalsis action in the intestines, producing a medium stimulus laxative effect. The decoction of the seed can lower blood pressure, acting as a diuretic with an analgesic effect. Root: The root, especially trichosanthin, among others has been used as injection (2-10 ml of raw herb) to induce abortions. This is one of the most common methods used in China. The root is known to have blood sugar lowering effect, used as a decoction. The extract has been found to inhibit cancer growths. Toxicity, Contraindications and cautions: Fruit: contraindicated in cases of cold from deficiency of Spleen and Stomach, phlegmcold or phlegm dampness. Not to be combined with wu tou, gan jiang (Zingiber) or niu xi Seed: similar to fruit and not to be used in cases of diarrhea Root: contraindicated during pregnancy and as others. Medicinal uses: Fruit: Clears heat and transforms phlegm heat. Used for heat induced colds with thick sputum that is hard to expectorate. Expands the chest and dissipates nodules. Used for condition in which qi accumulates in the chest creating a stifling or distended sensation, constriction, pain or diaphragmatic pressure. Seed: Clears heat and transforms phlegm similar to fruit; while also expanding chest. Moistens the intestines. Used for dry constipation, especially when there is Lung heat present with dry mouth, thirst and irritability. Promotes healing sores as an adjunctive therapy for breast abscesses and swelling of sores that have not yet formed pus (suppurated) Root: Clears and drains Lung heat while transforming phlegm and moistening dry lungs.

135 Lesson 6: Herbs that transform phlegm & stop cough Drains heat and creates fluids. Used when heat injures fluid. Makes a person thirsty and irritable; deficient yin thirst and wasting thirst disorders. Can be used for thick sputum and blood streaked sputum Relieves toxicity and expels pus, used for hot carbuncles and sores. Especially used for breast abscess, both internally and topically. Pharmacy and dosage: Dosage: 9-15 grams Major Combinations: Fruit: With zhe bei mu (Fritillaria) and jie geng (Platycodi grandiflora) and chen pi (Citri reticulatae) for wind-heat induced dry cough with thick hard to expectorate sputum. With xie bai and ban xia for painful obstruction in the chest. With pu gong yin and ru xiang for early stage breast abscess. Seed: With ban xia and huang lain (Coptis) for cough with chest pain and difficult to expectorate sputum. Add chai hu (Buplerium) and huang qin (Scutellaria baicalensis) if there is extreme heat. With ban xia and xie bai for painful obstruction of the chest or Heart. With huo ma ren, tao ren and bai zi ren for constipation especially if due to internal phlegm-heat obstruction, with symptoms of dry mouth and thirst. Root: With bei mu (Fritillaria), sang bai pi and jie geng for cough due to phlegm-heat in the lungs with thick, viscous sputum or blood-streaked sputum With zhi mu, ge gen and wu wei zi for wasting thirst disorder, usually after high fever. With chuan shan jia, zao jiao and jin yin hua for yang-type breast or intestinal abscess. REFERENCES 1 Bensky D, Gamble A; Chinese Herbal Medicine Materia Medica;Eastland Press Seattle Wa; pl Huang CK, The Pharmacology of Chinese Herbs 2nd Ed. ; CRC Press; 1999, p Hsu, H.Y., Chen, Y.P., et al., Oriental Materia Medica: a concise guide, Oriental Healing Arts Institute, Long Beach, CA, 1986, p Tang W, Eisenbrand; Chinese Drugs of Plant Origin; Spinger-Verlag; New York; 1992 p Image itmonline.org

136 Lesson 6: Herbs that transform phlegm & stop cough Zhu Li, ru Bambusa spp. Family: Gramineae Other names: Zhu Ii: dried bamboo sap, Succus Bambusae, zhu you, Chu Ii, chikureki (Japanese), chikujo (Korean) Zhu ru: bamboo shavings, Caulis Bambusae in Taeniis, chu ru, zhu er qing, dan zhu ru, chikujo (Japanese), chukchu (Korean) Tian zhu huang: siliceous secretion of bamboo, Concercreti silicea Bambusae, tien chu huang, zhi huang, zhi huangjing, tenyikuo (Japanese), ch'onhwabun (Korean). Part used: siliceous secretions, sap, shavings Habitat, ecology and distribution: Grows throughout Yangtze river valley and southern China. History: Bamboo was first found in the Grand Materia Medica and Collection of Commentaries on the Classic of the Materia Medica. Constituents: Zhu ru: pentosan, lignin, cellulose, triterpenes.1 Tian zhu huang: silicone, potassium hydroxide, ferric oxide and calcium. Energetics Properties and Channels entered: Zhu Ii: sweet, very cold; entering Heart, Lung and Stomach meridians Zhu ru: sweet and slightly cold; entering Gallbladder, Lung and Stomach meridians. Tian zhu huang: sweet and cold; entering Gallbladder, Heart and Liver meridians. Actions and Indications: antipyretic, expectorant, antitussive, clears heat, hemostatic Medical Research: Zhu ru has been shown to have antimicrobial action (in vitro) on Staph aureus, E. coli and Salmonella typhii. Although this ingredient effectively treats a number of somatic complaints, such as nausea and vomiting, it also has a pronounced psychotropic effect. When correctly prescribed on the basis of the patient's pattern of discrimination, formulas containing this medicinal are especially effective for the treatment of psychiatric disorders. This ingredient is effectiveness for mental-emotional complaints associated with fear and fright, phlegm and heat. 2

137 Lesson 6: Herbs that transform phlegm & stop cough Toxicity, Contraindications and cautions: Zhu Ii is contraindicated in cases of cough due to cold, and loose stools due to Spleen deficiency. Zhu ru is contraindicated in case of nausea and vomiting due to Stomach cold or cold food stagnation. 3 Medicinal uses: Zhu Ii: Clears heat, transforms phlegm while penetrating the channels, specific for phlegm obstruction of the Heart (sensory) orifices. The paralysis of hand or feet, or hemiplegia (paralysis of one side of the body, often due to a stroke). Zhu li is often used in conjunction with other herbs to transform phlegm-heat and stop coughing. Zhu ru: clears and transforms phlegm-heat, when there is thick hot sputum in the Lungs, often accompanied with stifling sensation in the chest or coughs up blood. Zhu ru stops vomiting while clearing heat. The signs are bitter or sour material due to heat in the Stomach with bad breath, aversion to heat and a yellow, greasy tongue. Zhu ru is very good for stopping vomiting. It has also been used to cool blood in cases of nosebleeds and vomiting blood. Tian zhu huang: clears and transforms phlegm-heat especially when it is difficult to expectorate sputum from the Lung. Tain zhu huang will also clear the Heart and arrest convulsion due to phlegm-heat, wind-stroke with phlegm obstructions, with a gurgling in the throat. It works on spasm and convulsions especially in children. Pharmacy and dosage: Zhu Ii: grams or 9-15 grams for coughing, taken directly or often mixed with ginger juice Zhu ru: grams. Often fried in ginger juice for colds Tian zhu huang: 3-9 grams if mixed with the bamboo; or gram ifpure REFERENCES 1 Hsu, H.Y., Chen, Y.P., et ai" Oriental Materia Medica: a concise guide, Oriental Healing Arts Institute, Long Beach, CA, 1986, p Bob Flaws, Wan Mi-zhai's Zhu Ru Tang (Caulis Bambusae Decoction) & Fear and Fright; 3 Bensky D, Gamble A; Chinese Herbal Medicine Materia Medica;Eastland Press Seattle Wa; p Image tcm.health-info.org

138 Lesson 6: Herbs that transform phlegm & stop cough Ban Xia Pinellia ternata Family: Araceae Other names: Rhizoma Pinelliae Ternatae, Green dragon, pan hsia, fa ban xia, jiang ban xia, hange (Japanese), panha (Korean) Plant description: The plant grows to about 0.2 m by 0.15 m. It is in flower from July to August. The flowers are hermaphrodite (have both male and female organs). The plant can grow in semi-shade (light woodland) or no shade. It requires moist soil. The leaves are tripartite (3 parted) and resembles a Jack-in-the-pulpit. Beginning in late spring and continuing all summer, the clumps are topped with arisaema like (spathe and spadix) flowers of medium green. It has up to a 10 inch tongue coming out of the flower. Part used: rhizomes (processed) Habitat, ecology and distribution: Sichuan, Hubei, Henan, Guizho provinces of China. It is considered an invasive weed in California, several eastern states and part of Ontario. Native to eastern Asia, it is grown in cultivated fields, roadsides, shady and damp grass thickets on mountain sides and stream edges in China, Japan and Korea. Ban xia is collected in late summer and early autumn, with outer bark and fibrous roots removed; it is then processed with ginger or alum or a combination of the two by soaking together then draining; the resulting dried material is translucent. History: Found first in the Divine Husbandman's Classic of the Materia Medica.1 Constituents: phenol (homogentisic acid, homogentisic acid glucoside, 3,4- dihydroxybenzaldehydw); alkaloids (ephedrine); amino acids (argine, aspartic acide, glutamic acid, serine, glycine, ornithine); sugar; sitasterol, choline, calcium oxalate.2 Energetics Properties and Channels entered: acrid, warm, toxic; entering the Lung, Spleen and Stomach meridians. Medical Research: Has a distinct antiemetic action, usually mixed or decocted with ginger to enhance this action. It is always mixed with alum to reduce its toxic effect. The unprocessed herb is quite emetic. Heating the herb will reduce the emetic effect, while preserving antiemetic effect. The boiled herb has a sedative action on the lungs. The decoction has been shown to be effective in slightly reducing pressure in the eyes.3 The decoction has a significant antitussive effect in several animal models. Ban xia is known to be an antidote for strychnine and acetylcholine toxicity. It has been shown to have a 95% success rate in reducing pain from toothaches.4!!

139 Lesson 6: Herbs that transform phlegm & stop cough Toxicity, Contraindications and cautions: Due to toxic effect this herb is almost always mixed with alum and ginger. Medicinal uses: Dries dampness, transforms phlegm and causes rebellious qi to descend, thus reducing coughs with copious sputum. Specific for conditions of phlegm-cold in the Lungs. Especially useful in transforming phlegm due to dampness of the Spleen. Harmonizes the Stomach and stops vomiting when accompanied with nausea due to lingering phlegm-cold in the Stomach that rebels upwards. Dissipates nodules and reduces distention for nodules, pressure, distention or pain due to phlegm lingering in chest or neck (such as goiters and scrofula). It will work on obstruction caused by phlegm anywhere in the body. Especially good for distention in chest and epigastrium. Pharmacy and dosage: Dosage grams. Raw ban xia is toxic and only used externally to reduce sores and ulcers. The prepared herb is deep fried with ginger, vinegar and/or alum (usually in a 5: 1 pinellia to alum ratio) and is the one found in Chinese dispensaries Major Combinations: With chen pi for epigastric and abdominal distention, nausea and vomiting due to disharmony of the Stomach qi. Can also be used for productive coughs, with a stifling sensation in the chest due to obstruction of phlegm-dampness or Spleen qi deficiency. With huang lian (Coptis) for epigastric distention and indigestion due invasion pathogens in the Stomach With huang qin (Scutellaria root) for phlegm-heat induced by rebellious qi with cough, nausea and vomiting. With gua lou (Trichosanthis fruit) for distention in chest, coughs and vomiting due to phlegm-heat obstructing the interior. With hou po (Magnolia cortex) for phlegm-induced cough, vomiting and epigastric and abdominal distention. "This is a peculiar neurological symptom which I have witnessed in a number of patients of something being lodged at the base of the throat. Its cause is reported to be rooted in anxiety, fear or shock. The herbs in the formula (Ban xia hou pu tang), 6 to 9 grams each of pinellia ternata (ban xia), magnolia bark (ho pou), perilla seeds (zi su ye), 9-12 grams poria mushroom (fu ling) and grams fresh ginger (sheng jiang) are primarily individually indicated for respiratory and digestive disorders with an accumulation of dampness or phlegm. Pinellia resolves respiratory and gastrological dampness by promoting the energetic downward flow of qi and food, which makes it useful for nausea and vomiting. Other indications for this formula further imply

140 Lesson 6: Herbs that transform phlegm & stop cough underlying neurological and psychospiritual imbalances. They are "hysteria, gastrointestinal neurosis, esophagiospasm, chronic laryngitis and trachitis". The sense is that this formula is particularly useful for individuals who are blocked in their expression."5 REFERENCES 1 Bensky D, Gamble A; Chinese Herbal Medicine Materia Medica;Eastland Press Seattle Wa; p Hsu, H.Y., Chen, Y.P., et ai., Oriental Materia Medica: a concise guide, Oriental Healing Arts Institute, Long Beach, CA, 1986, p Hsu, H.Y., Chen, Y.P., et al., Oriental Materia Medica: a concise guide, Oriental Healing Arts Institute, Long Beach, CA, 1986, p Bensky D, Gamble A; Chinese Herbal Medicine Materia Medica;Eastland Press Seattle Wa; p Tierra M, Psychospiritual aspects of Herbal Medicine; Image plumdragonherbs.com

141 Lesson 6: Herbs that transform phlegm & stop cough Xuan Fu Hua Inula japonica Family: Compositae Other names: Inula flowers, Flos Inulae, Elecampane, fu hua, hsuan fu hua, chin fei tsao, senpukuka (Japnaese), sonbokhwa (Korean) Plant description: Inula is a large herbaceous perennial, indigenous to southeastern Europe and western Asia but naturalized in Britain, Ireland and the north mid-west US. It has a thick, cylindrical, branched rhizome and an erect, sparsely branched, tough, furrowed stem, hairy in the lower part and downy above. The oval basal leaves narrow into a winged petiole, pointed at the tip and blunt-toothed at the edges. The alternate stem leaves are irregularly toothed at the margin, large, tapering-oval in shape with a heart-shaped base, sessile and shorttapered. The single flower heads grow at the ends of the branches from the axils of the leaves or bracts, and are sometimes arranged in sparse umbels. The outer, inwardly turned bracts are oval and felty on the outside with a large heart-shaped green appendix, which bends backwards. The inner bracts are lineate, dry membranous, and widened towards the ends. The bright yellow strap-shaped ray florets are numerous and about twice the length of the bracts. Both these and the inner disc florets are tubular. The plant flowers between June and October and grows wild in hedgerows and damp meadows. It is also cultivated. Part used: Flowers Habitat, ecology and distribution: This plant grows around the world. It is in flower from August to October, and the seeds ripen from August to October. The flowers are hermaphrodite (have both male and female organs) and are pollinated by bees and flies. The plant is self-fertile, but cannot grow in the shade. It requires moist or wet soil. In China, inula flower is mainly produced in the provinces Guangdong, Henan, Hebei, Jiangsu, Anhui, and Inner Mongolia. Reaped when the plant comes into bloom in summer and autumn, the impurities are removed from the flowers, and then the flowers are dried in the air or sun for use when raw or after being fried with honey. History: First found in the Divine Husbandman's Classic of the Materia Medica. Constituents: Inusterol A (taraxasterol), inusterol Band C, britannin, alantolactone inulicin, inulin quercetin, isoquercetin, caffeic acid, cholorogenic acid.1,2,3 Energetics Properties and Channels entered: acrid, slightly warm; entering the Liver, Lung, Stomach and Spleen meridians.

142 Lesson 6: Herbs that transform phlegm & stop cough Actions and Indications: expectorant, antiemetic, anti-nausea, stomachic Medical Research: Chologenic acid stimulates the central nervous system to increase secretion of acids by the stomach in a manner similar to caffeine. It will also increase rate and force of peristalsis and increase tone of smooth muscles. It has a negative chronotrophic (decrease rate) of the heart muscle. Alantolactone has antifungal properties. 4,5 The flavonoid glycoside can remit bronchial spasms caused by histamine and it has a weak diuretic effect. The flowers have an antibacterial action, but this can be destroyed by proteins in the body, as reported in 'Handbook of Chinese Herbs and Formulas', (Institute of Chinese Medicine, Los Angeles 1985). The plant has been mentioned in 'Medicinal Plants of China,' (Reference Publications, Inc. 1985) as a possible treatment for cancer of the esophagus.6 Toxicity, Contraindications and cautions: Xuan fu hua should be used sparingly in cases of deficiency. The flowers should be avoided by those with tuberculosis or cough due to wind heat. Medicinal uses: Redirects the qi downward and expels phlegm, used when qi repels upwards, with accumulation of phlegm. This can be seen with copious sputum, congested fluid disorders with wheezing. Stops vomiting and calms rebellion due to cold from Stomach and Spleen deficiency or dampness, also good for stopping hiccups. Pharmacy and dosage: Dosage 3-12 grams usually decocted in cheesecloth bag. It is fried in honey for use in cases of Lung deficiencies, to warm and prevent it from harming qi or yin. Major Combinations: With ban xia (pinellia root) and xi xin (Asarum sieboldi) for coughing and wheezing due to cold and phlegm attacking the Lung. With jie geng (Platycodon grandiflorum) and sang bai pi and da huang (Rheum officinale) for cough and wheezing due to phlegm-heat With ren shen (Ginseng) and dai zhe shi (hematite) for vomiting and hiccoughs due to cold from Spleen and Stomach deficiency. With ban xia (pinellia root) for vomiting, cough, wheezing and epigastric distention due to congested fluids.

143 Lesson 6: Herbs that transform phlegm & stop cough REFERENCES 1 Hsu, H.Y, Chen, Y.P., et ai., Oriental Materia Medica: a concise guide, Oriental Healing Arts Institute, Long Beach, CA, 1986, p Bensky D, Gamble A; Chinese Herbal Medicine Materia Medica;Eastland Press Seattle Wa; p Tang W, Eisenbrand; Chinese Drugs of Plant Origin; Spinger-Verlag; New York; 1992 p Bensky D, Gamble A; Chinese Herbal Medicine Materia Medica;Eastland Press Seattle Wa; p Tang W, Eisenbrand; Chinese Drugs of Plant Origin; Spinger-Verlag; New York; 1992 p _ db/viewherb.php3?viewid=432&setlang= Image deepesthealth.com

144 Lesson 6: Herbs that transform phlegm & stop cough Xing Ren Prunus armeniaca Family: Rosaceae Other names: Apricot seed, Semen Pruni Armeniacae, hsingjen, ku xing ren, bei xing, kyonin (Japanese), sian (Korean) Plant description: A deciduous, large and spreading tree with dark-brown to black bark; height, around 10 metres, may grow up to 15 metres; girth, 82 cm; wood, hard and durable. Leaves, broad, cordate, dark green, petiolate (petiole, 24 cm long), alternate, having reticulate pinnate venation; length, 6.2 cm; breadth, 6.1 cm; margin, serrate. Flowers, simple, sessile, pentamerous, perigynous, actinomorphic, complete, hermaphrodite, light pink; 2 to 5 flowers per cluster; calyx, gamosepalous, companulate, with five sepals, light red, having 3 to 5 mm long lobes of sepals; corolla, polypetalous with 5 petals, rosaceous, valvate, actinomorphic, angular, imbricate, 1.5 to 2.0 cm long, white to light pink; androecium, polyandrous, with 35 stamens, dorsi fixed; anther-lobes, yellow, episepalous, bithecus; gynoecium, monocarpellary, perigynous; ovary, unilocular, having basal placentation. Fruit, a drupe, velvety when young, but nearly smooth at maturity, round to oblong; diameter, 2.5 to 2.6 cm; weight, 12.6 g; volume, ml; fruit, externally yellow; pulp, deep yellow, less juicy than that of the cultivated apricots; endocarp, flat, smooth, stony and hard. Stone, 1.7 to 2 cm long, 1.6 to 1.7 cm broad, 2.5 g in weight, 1.3 ml in volume; 2 kernels, per seed; kernels, 1.5 cm long, 1.2 cm broad; weight, 879 mg; volume, 757 microlitres. The bitter kernels (ku xing ren or bei xing ren) are grown in Northern China and are often consider the best. The southern ones are sweeter and are called tian xing ren or nan xing ren. They are more often used for dry or deficient coughs. Part used: seed, kernel, pit Habitat, ecology and distribution: Lianoning, Hebei, Inner Mongoloa, Shandong and throughout Northern China. It can be found around the world. History: Found first in the Collection of Commentaries on the Classic of the Materia Medica. Constituents: amygdalin (laetrile), amygdalase, prunase; oils (mostly oleic), estron, estradiol, desmosterol.1,2

145 Lesson 6: Herbs that transform phlegm & stop cough Energetics Properties and Channels entered: bitter, slightly warm, slightly toxic; entering the Large Intestine, Lung meridians Actions and Indications: antitussive, anti-asthmatic, mild cathartic, mild analgesic Medical Research: Amydalin and amygdalase combine in the digestive tract to produce prunasin and madelonitrile. These are responsible for the antitussive action. These chemicals can further break down into benzaldehyde and hydrocyanic acid (which is quite toxic). In bronchitis it has about a 50% improvement or cure rate. Used externally as a paste for vaginitis or Trichimonas it has about a 90% effective rate. The drug laetrile is derived from extracts of apricot seeds. As a controversial therapy for cancer, there are a few reports of tumor regression and pain reduction. The National Cancer Institute in the USA claimed laetrile was an ineffective cancer treatment in It is still legal in Mexico, and some will cross the border to seek laetrile therapy when other cancer treatments fail. The theory behind laetrile is this: the apricot pit extract breaks down to release CN-, but only when in contact with B-glucuronidase, an enzyme common to tumor cells. The CN- is released preferentially at tumor sites, killing the cells. Toxicity, Contraindications and cautions: Use with caution for treating infants with diarrhea. It is consider to antagonize huang qi (Astragulus), huang qin (Scutellaria baicalensis) and ge gen (Pueraria root). Over dosing causes dizziness, nausea, vomiting and headaches. It can also progress to dyspnea, spasm, dilated pupils arrhythmias and even coma. Lethal dose for adults is about kernels and in children as little as 10. Cooking and removing the outer coating reduces the toxicity Medicinal uses: Stops coughing and calms wheezing and can be used quite broadly for either hot or cold patterns depending on the combination. Due to it moist nature it is best for dry coughs. Moistens the Intestines and unblocks the bowels. This secondary effect is due to the oils. Pharmacy and dosage: Dosage 3-9 grams. This is chopped and decocted, often added in near the end. Major Combinations: With zi su ye (Perihla frutescens) for dry coughs due to externally contracted wind-cold With mai men dong (Ophiopogon uaponicus) for dry coughs due to dry and heat injured Lungs With sang ye for nonproductive, dry cough due to externally-contracted wind-heat

146 Lesson 6: Herbs that transform phlegm & stop cough With ma huang (Ephedra) for cough and wheezing due to excess. Add shi gao (Gypsum) for symptom of the Lung with significant heat With huo ma ren (Cannabis sativa) and dang gui (Angelica sinsensis) for constipation due to deficient qi and dry Intestine. REFERENCES 1 Hsu, H.Y., Chen, Y.P., et ai., Oriental Materia Medica: a concise guide, Oriental Healing Arts Institute, Long Beach, CA, 1986, p Bensky D, Gamble A; Chinese Herbal Medicine Materia Medica;Eastland Press Seattle Wa; p Images tcm.health-info.org, bikudo.com

147 Lesson 6: Herbs that transform phlegm & stop cough Zi Wan Aster tataricus Family: Compositea Other names: purple aster root, Radix Asteris Tatatici, tzu wan, ci wan, sion (Japanese), chawan (Korean). "Zi" means purple, referring to the colour of the flowers, "wan" is a garden. This plant makes a beautiful garden of colourful, daisy-like flowers. Plant description: Large leaves (to 2') emerge in the spring and provide a bold backdrop for earlier blooming perennials. In the fall, numerous flower stalks rise to 4 or 5 feet and each is covered with 1" pink daisy-like flowers. Flowering is later than many other asters and this species often provides brilliant color until frost. Tatarian aster (sometimes misspelled as tartarian aster) is a large, rangy aster that gets 6-8 ft ( m) tall and forms colonies from stout underground rhizomes. This big, rather weedy looking aster spends much of the year as a basal rosette of large paddle shaped, sandpapery leaves that grow up to 24 in (61 cm) long and 6 in (15 cm) wide with long petioles and toothed margins. In this stage, tatarian aster looks like a mound of tobacco or Swiss chard leaves, 2-3 ft ( m) across. In early autumn it sends up flowering stalks with leaves that get progressively smaller and lose the marginal teeth and petioles. By mid to late autumn the flower stalks branch near the top and bear large and abundant flat-topped clusters of flower heads which are lavender with yellow centers and about 1 in (2.5 cm) across. 'Jin-Dai' is a smaller, more compact selection, only 3-4 ft ( m) tall, with light blue ray flowers. Rhizomes in irregular masses, varying in size, apex with remains of stems and leaves. Texture slightly hard. Rhizomes bearing numerous, fascicular rootlets, 3-15 cm long, cm in diameter, frequently braided. Externally purplish-red or greyish-red, with longitudinal wrinkles. Texture flexible. Odour, slightly aromatic; taste, sweet and slightly bitter. Part used: root Habitat, ecology and distribution: Hebei, Anhui, Henan, Heilongjiang, Shanxi in China. It is native to southern Siberia, northern China, Mongolia, Korea and Japan, where it grows in meadows and wetlands. It has escaped cultivation and established self-sustaining populations in parts of eastern North America. History: First found in the Divine Husbandman's Classic of the Materia Medica.

148 Lesson 6: Herbs that transform phlegm & stop cough Constituents: astersaponin, eprifriedelinol, succinic acid, friedelin, shionone, quercetrin, lachnophyllol, lachnophyllol acetate, anethole, and oleic acid. 1,2 Energetics Properties and Channels entered: bitter slightly warm; entering the Lung meridian. Actions and Indications: expectorant, mildly antitussive Medical Research: Zi wan has been shown to have significant expectorant effect on animal models. Astersaponin has shown to increase secretions in the respiratory tract, thus diluting the phlegm and aiding in expectoration of the sputum. This herb has shown a strong antibiotic effect against Shigella sonnei, E.co!i, Vibrio proeus, Pseudomonas aeruginosa, TB, Bacillus dysenteriae and others. It has a proven antiviral effect on several influenza strains. Astersaponin on its own has a marked diuretic effect, but when taken with quercetin there is a milder effect. 3,4 Toxicity, Contraindications and cautions: Use with coughs due to yin deficiency with heat signs, or those associated with excess heat patterns. Large doses over a long time are not recommended. Not the be used with yin chen hao (Artemisia yinchenhao herb). Medicinal uses: This herb is used to moisten the lung, bring down adverse rising of Qi, resolve phlegm and relieve cough. Since this herb is moist rather than dry in nature, it is a main herb for resolving phlegm and relieving cough, whether the cough is due to lung-heat or lungcold. In treating pulmonary tuberculosis with consumptive fever due to deficiency of yin and cough with blood, the herb can be used in combination with Zhi mu (Rhizoma anemarrhenae), Bei mu (Bulbus fritillaria), E jiao (Colla Corii Asini), etc. In treating long lasting cough, the herb can be used in combination with Kuan dong hua/ coltsfoot (Flos Far Farae), Bai bu (Radix Stemonae), etc. In treating cough and asthma without fever due to deficiency of lung-qi, the herb can be used in combination with Dang shen (Radix Codonopsis pilosulae), Huang qi (Radix Astragali seu Hedysari), Sheng jiang (Rhizoma Zingiberis), etc. In treating cough with profuse sputum due to exogenous wind-cold, the herb can be used in combination with Jing jie (Herba Schizonepetae), Bai qian (Rhizoma Cynanchi Stauntonii), Chen pi (Pericarpium Cirti Reticulatae), etc.

149 Lesson 6: Herbs that transform phlegm & stop cough Relieves cough and expels phlegm, used for stopping chronic cough especially cold induced, with copious sputum that is difficult to expectorate, or with blood streaked sputum. Pharmacy and dosage: Dosage 3-9 grams Frying the herb with honey will increase the action of moistening the Lung and relieve coughing Major Combinations: With kuan dong hua for cough and wheezing with copious sputum and rebellious qi. This is a common formula. With bai bu for acute or chronic cough with blood in sputum. With wu wei zi for productive cough, wheezing and spontaneous sweat. REFERENCES 1 Hsu, H.Y., Chen, Y.P., et al., Oriental Materia Medica: a concise guide, Oriental Healing Arts Institute, Long Beach, CA, 1986, p Bensky D, Gamble A; Chinese Herbal Medicine Materia Medica;Eastland Press Seattle Wa; p Hsu, H.Y., Chen, Y.P., et ai., Oriental Materia Medica: a concise guide, Oriental Healing Arts Institute, Long Beach, CA, 1986, p Bensky D, Gamble A; Chinese Herbal Medicine Materia Medica;Eastland Press Seattle Wa; 1993, p Images tcmtreatment.com, greenhealthlive.com!!

150 Lesson 6: Herbs that transform phlegm & stop cough Gua Di Melo pedicellus Family: Curcubitaceae Other names: melon stalks or prickles, Pedicellus Cucumeris, kua ti, tian gua di, xiang gua di, ku ding xiang, katei (Japanese), kuach'e (Korean) Melon, Muskmelon, Cantaloupe, Honeydew, Sugar melon Plant description: Fruit stalk slender, twisted, yellowgreen, enlarged at one end, with longitudinal ridges and outward curved margin. Part used: unripe (young) stalks Habitat, ecology and distribution: Grows throughout China, but mainly in the coastal regions. Harvested in the summer, from not completely ripe stalks. Grows in much of North America, especially warmer areas. History: First found in the Divine Husbandman's Classic of the Materia Medica. Constituents: cucurbitacin B, E and D; isocucurbitiacine B, cucurbitacin beta-2-0-beta- Dpyranoglucoside; melotoxin (elaterin). 1, 2, 3 Energetics Properties and Channels entered: bitter, cold, slightly toxic; entering the stomach meridian Actions and Indications: emetic Medical Research: In both animal and human studies, oral use of gua di has produced a very strong emetic effect. Intravenous injection does not have the same effect, therefore it is felt that it works by stimulating (irritating) the gastric mucosa, thus stimulating vomiting centers in the brain. The cucurbitacins have shown to produce a liver protective effect against chemical toxins. Cucurbinacin B markedly increases liver glycogen levels, stopping fatty changes of liver cells, thus reducing cirrhosis. Often given by injection for hepatitis. Both oral and nasal administration of gua di increased white blood cells and reducing hepatitis.4 Toxicity, Contraindications and cautions: Not to be used with debilitated patients, patients that have recently lost blood, or in the absence of excess. If the vomiting is too persistent, use she xiang (Secretio Moschus; grams) as an antidote. The nasal powder is quite severe and should not be used in weak patients. Over dose can cause severe vomiting and in a few cases, has led to respiratory paralysis and death.

151 Lesson 6: Herbs that transform phlegm & stop cough Medicinal uses: Induce vomiting to relieve phlegm-heat or retained food. This considered the preferred treatment for accumulations above the diaphragm. This type of phlegm in the chest is known to manifest as seizure, mania, painful obstruction of the throat, wheezing, irritability and/or insomnia. This herb can also be used for retained food in the stomach, both distention and pain of the chest and epigastrium. Dispel damp-heat and relieve jaundice when dampness predominates. Often given by nasal ingestion to effect jaundice of face and eyes, when accompanied by headaches and nasal congestion. Pharmacy and dosage: Dosage: g in decoction g in pills and powder Major Combinations: With huang lian (Coptis) and bing pian (Borneol); used as a powder for chronic rhinitis. Following administer by a piece of rock brown sugar, will usually strengthen the vomiting effect. REFERENCES 1 Benskey D, Gamble A; Chinese Herbal Medicine Materia Medica;Eastland Press Seattle Wa; p Hsu, H.Y., Chen, Y.P., et al., Oriental Materia Medica: a concise guide, Oriental Healing Arts Institute, Long Beach, CA, 1986, p Huang CK, The Pharmacology of Chinese Herbs 2nd Ed. ; CRC Press; 1999, p Bensky D, Gamble A; Chinese Herbal Medicine Materia Medica;Eastland Press Seattle Wa; p Image agroatlus.org

152 Lesson 7: Herbs that transform damp & Relieve food stagnation LESSON 7: Aromatic Herbs to Transform Dampness & Herbs that Relieve Food Stagnation Aromatic Herbs that Transform Dampness Dampness, as mentioned in lesson 5, is an accumulation of fluid in the body; it is caused from either a dysfunction of the Spleen and its transformation and transportation mechanism, or from the Kidney not governing the water. In this lesson we will be discussing dampness that arises from Spleen deficiency. When the Spleen!s transformation and transportation functions are obstructed by dampness aromatic herbs come to the rescue. Aromatic herbs are light and have a tendency to the lift the qi; they assist the spleen with their warming, pungent and aromatic qualities, and are ascribed to the qualities of transforming sludge to mist. This group of herbs acts on the spleen and stomach, relieving symptoms of distention in the epigastrium, abdomen and chest, nausea, and lack of appetite or thirst. Due to the yang nature of these herbs they may injure yin, so care must be taken to ensure yin is preserved. Herbs in this section are: Huo Xiang - Agastache rugosa Hou po - Magnolia officinalis Cang zhu - Atractylodes lancea Bai dou kou - Amomum kravanh Sha ren - Amomum villosum Of these herbs, Huo xiang is most effective for relieving the exterior and stopping vomiting; Cang zhu is most effective for drying dampness and expelling wind damp; Hou po is most effective for relieving fullness and distention; Sha ren is best for middle burner obstructed by dampness and Bai dou kou is best for upper and middle burner obstruction by dampness. Herbs that Relieve Food Stagnation Food stagnation is the accumulation of food in the middle burner. It is may be caused by a number of factors such as: the liver over acting on the spleen (may be associated with emotional irritation), a spleen or stomach

153 Lesson 7: Herbs that transform damp & Relieve food stagnation deficiency, eating too fast, eating too much, eating excessively hot or cold natured foods, or too much greasy foods. Herbs that relieve food stagnation do so by reducing or dissolving the accumulation or they guide the stagnation out through the digestive tract. Herbs in this section are: Shan zha - Crataegus pinnatifida Mai ya - Hordeum vulgare Shen qu - Massa Fermentata Lai fu zi - Raphanus sativis Ji Nei jin - Gigeriae galli Endothelium corneum Of these Mai ya is most effective for food stagnation from carbohydrates and tonifys the spleen as well; Shan zha is for excessive consumption of meat; Shen qu is most effective for over consumption of alcohol and starches.

154 Lesson 7: Herbs that transform damp & Relieve food stagnation Huo Xiang Agastache rugosa Family: Labiatae Other names: tu huo xiang, agastache, guang huo xiang (pogostemon), patchouli Plant description: Good quality has many leaves, bluegreen stems and branches, and is aromatic (agastache); or has a coarse stem, soft and thick leaves, and is green and aromatic (pogostemon). In general Herba Pogostemi is considered better quality. Part used: stem and leaves Habitat, ecology and distribution: Throughout China (agastache); Guangdong, Guangxi, Taiwan, Yunnan (pogostemon); harvested June to July when plant grows vigorously History: Miscellaneous Records Constituents: methylchavicol, anethole, anisaldehyde, d- limonene, p-methoxycinnamaldehyde, alpha- pinene, 3-octanone, 3-octanol, p-cymene, locten- 3-01, linalool, beta-humulene, alpha-ylangene, beta-farnesene (agastache), patchouli alcohol, benzaldehyde, eugenol, cinnamic aldehyde, pogostol, patchoulipyridine, epiguaipyridine, caryophyllene, beta-elemene, alloaromadendrene, y-patchouleme, beta-gurjunene, alpha-guaiene, balencene, alpha-gurjunene, y-cadinene, o-guaiene, alpha-patchoulene, calamenene (pogostemon) Energetics Properties and Channels Entered: pungent and slightly warm, entering the Lung, Spleen and Stomach meridians Actions and Indications: antibiotic, stomachic, anti-emetic, anti-diarrhea, antipyretic, diaphoretic, anti-fungal, antibacterial (active against leptospira), mild sedative, antispasmodic 1 Medical Research: Preparations of huo xiang have a significant inhibitory effect in vitro on many pathogenic fungi and leptospirosis. In the latter case, high concentrations on the order of 31 mg/ml are required to have any killing effect.2 Toxicity, Contraindications and cautions: yin deficiency with heat signs and stomach fire

155 Lesson 7: Herbs that transform damp & Relieve food stagnation Medicinal uses: Aromatically transforms dampness: for turbid dampness creating internal obstruction. For dampness obstructing the middle burner and interfering with the spleen's transformative functions, presenting with symptoms of abdominal or epigastric distention and fullness, nausea, vomiting, reduced appetite and a white, moist tongue coating.3 Harmonizes the middle burner and stops vomiting: commonly used for cases of nausea or vomiting due to dampness obstructing the middle burner; also useful for morning sickness.4 Releases the exterior and transforms turbidity: for exterior disorders with dampness including the early stages of damp warm-febrile diseases or summerheat, as well as externally contracted wind-cold with internal injury from dampness, with the accompaniment of dampness interfering with spleen.5 Pharmacy and dosage: 4.5-9g, not to be cooked for more than 15 minutes. Major Combinations: With ban xia (Rhizoma Pinelliae Ternatae) and cang zhu (Rhizoma Atractylodis) for nausea and vomiting; fullness and distention of the chest, epigastrium and abdomen; reduced appetite and diarrhea due to turbid dampness obstructing the middle burner. With huang lian (rhizome Coptidis) and zhu ru (Caulis Bambusae) for vomiting due to damp heat With sha ren (Fructus Amomi) for morning sickness With bai zhu (Rhizoma Atractylodis Macrocephalae) and dang shen (Radix Codonopsitis Pilosulae) for vomiting and diarrhea due to spleen and stomach deficiency With pei Ian (Herba Eupatorii Forunei) for symptoms such as fatigue, stifling sensation in the chest, abdominal distention, nausea, and a thin, greasy coating on the tongue associated with damp summerheat With zi su ye (Folium Perillae Frutescentis) and hou po (Cortex Magnoliae Officinalis) for fever and chills, stifling sensation in the chest and epigastruim, wind-cold dampness obstructing the middle burner With huang qin (Radix Scutellariea Baicalensis), lian qiao (Fructus Forsythiae Suspensae), and hua shi (talcum) for early stages of damp warm febrile disease with fever, achy limbs, lethargy, abdominal distention and dark scanty urine REFERENCES 1 AGAST ACH.html 2 Bensky, D. and Gamble, A.; Chinese Herbal Medicine Materia Medica; Eastland Press, Seattle; 1993; p214 3 Bensky, D. and Gamble, A.; Chinese Herbal Medicine Materia Medica; Eastland Press, Seattle; 1993; p214 4 Bensky, D. and Gamble, A.; Chinese Herbal Medicine Materia Medica; Eastland Press, Seattle; 1993; p214 5 Bensky, D. and Gamble, A.; Chinese Herbal Medicine Materia Medica; Eastland Press, Seattle; 1993; p214 Image

156 Lesson 7: Herbs that transform damp & Relieve food stagnation Hou po Magnolia officinalis Family: Magnoliacea Other names: chuan po, magnolia bark Plant description: Good quality bark is thick, finely textured, oily, and aromatic, with a deep purple inner surface. Part used: bark; the flower (hou po hua) is pungent, warm, and aromatic, with similar but weaker actions than the bark, but focuses more on the upper and middle burners and also regulates the liver qi. It is often used in treating a stifling sensation in the chest or stomachache due to disharmony between liver and stomach, dosage 3-6g 1 Habitat, ecology and distribution: Sichuan, Hubei, Zhe jiang, Jiang xi, harvested April to June (the bark of plants years old is used). History: Divine Husbandman's Classic of Materia Medica Constituents: magolol, iso-magnolol, honokiol, machilol, eudesmol, magnocurine Energetics Properties and Channels Entered: Bitter, pungent, warm aromatic, entering the large intestine, lung, spleen and stomach meridians Actions and Indications: antimicrobial, antiviral Medical Research: Hou po has an inhibitory effect in vitro against a variety of pathogenic bacteria including Streptococcus pneumoniae, b-hemolytic Streptococcus, Shigella sonnei, and Staphylococcus Aureus. When used for artificially induced viral hepatitis in guinea pigs, huo po showed and ability to improve pathological changes. In treating amebic dysentery, on clinical study of 46 patients with amebic dysentery treated with huo po, 43 recovered and 2 improved with the vast majority of symptoms resolved by the third day and negative stool cultures by the fifth day. Decoctions of hou po stimulated mouse and guinea pig intestinal specimens Toxicity, Contraindications and cautions: Hou po is safe orally, however, when administered intravenously it does exhibit some curare (poison arrow) like effects. The LD50 for an intraperitoneal injection of a decoction is 6g/kg, and the lowest lethal dose in cats is 4.25g/kg. Use with caution during pregnancy, some traditional sources believe this herb to antagonize Ze xie (Rhizoma Alismatis) and Han shui shi (Calcitum)

157 Lesson 7: Herbs that transform damp & Relieve food stagnation Medicinal uses: Promotes the movement of qi, transforms dampness, and resolves stagnation: used when dampness distresses the spleen and stomach or in the cases of food stagnation with such symptoms as chest and/or abdominal distention and fullness, loss of appetite, vomiting, and diarrhea. This herb is an important herb for reducing and eliminating distention and fullness, especially when due to excess Warms and transforms phlegm and directs rebellious qi downward: for wheezing, primarily due to obstruction by phlegm with coughing and a stifling sensation in the chest Pharmacy and dosage: 3-9g Major Combinations: With cang zhu (Rhizoma Atractylodis) and chen pi (Pericarpium Citri Reticulatae) for stomach excess manifesting as epigastric fullness and distention, acid regurgitation, distasteful belching, and nausea or vomiting With zhi ke (Fructus Citri Aurantii) for epigastric and abdominal distention due to qi and food stagnation With da huang (Radix et Rhizoma Rhei) and zhi shi (Fructus Immaturus Citri Aurnatii) for constipation due to accumulation and stagnation With ren shen (Radix Ginseng) and gan cao (Radix Glycyrrhizae Uralensis) for distention and fullness due to cold from deficiency With xing ren (Semen Pruni Armeniacae) and ma huang (Herba Ephedrae) for cough and wheezing with copious sputum due to congested fluids REFERENCES 1 Bensky, D. and Gamble, A.; Chinese Herbal Medicine Materia Medica; Eastland Press, Seattle; 1993; p216 Image

158 Lesson 7: Herbs that transform damp & Relieve food stagnation Cang Zhu Atractylodis rhizoma Family: Asteraceae Other Names: sojutsu (Japanese), changchul(korean), Southern Atractylodes root, Shan cang zhu Parts used: Root Habitat, ecology and distribution: Superior quality from Mao shan (Mt. Mao), Mao shan cang zhu, in Jiangsu province and near by city Nan jing (jing cang zhu), more commercial varieties harvested in other areas of China History: Materia Medica Arranged According to Pattern Constituents: Volatile oils (atractylol, elemol, hinesol, patchoulene etc.), alcohol, trytophane, sesquiterpine glycosides Energetics Properties and Channels entered: Acrid, warm and bitter, enters the Spleen and Stomach meridians Actions & Indications: dries dampness, induces sweating, strengthen the spleen and stomach, helps vision Medical research: none noted, some research has been done on cang zhu's ability to treat pain associated with Diabetic neuropathy (reference needed) Toxicity, Contraindications and cautions: Internal heat from yin deficiency and deficiency sweating from exterior deficiency. "Acrid, warm and extremely drying, it is contraindicated in those with dry clumped stools or excessive sweating" Harm and Benefit in the Materia Medica Medicinal uses: Dries dampness and strengthen the spleen: dampness blocking the middle jiao therefore blocking transformation and transportation, symptoms: reduced appetite, diarrhea, distention of the epigastrium, nausea, vomiting, thick greasy tongue coating. Promotes sweating and dispels wind-damp: due to exterior attack of wind, cold and damp causing chills, headache, fever, body ache and nasal congestion Eliminate damp from lower Jiao/ burner: vaginal discharge, swollen and sore joints.

159 Lesson 7: Herbs that transform damp & Relieve food stagnation Improves Vision: night blindness Pharmacy & dosage: 3-9g, dry fry to enhance harmonizing the middle jiao Major combinations: with Chuan xiong (chuanxiong rhizoma), Bai zhi (Angelicae dahuricae radix), Qiang huo (Notopterygium rhizoma) for exterior wind cold damp with Shi gao (gyspsum fibrosum) and Zhi mu (Anemarrhenae rhizoma) for early stages of damp heat with yi yi ren (Coicis semen) for damp painful obstruction where damp is predominant symptom with hei zhi ma (sesami semen nigrum) for night blindness, cataracts and glaucoma REFERENCES 1 Bensky, D. and Gamble, A.; Chinese Herbal Medicine Materia Medica; Eastland Press, Seattle; 1993; Image

160 Lesson 7: Herbs that transform damp & Relieve food stagnation Bai Dou Kou Amomum kravanh Family: Zingiberaceae Other names: Amomum cardamomum, bai kou ren, kou ren, white cardamom fruit Plant description: Good quality is large full and thick skinned Part used: seed Habitat, ecology and distribution: Southeast Asia, harvested in October to December when fruit is yellow green and not completely ripe History: Omissions from the Materia Medica Constituents: borneol, camhor, humulene, eucalyptole, pinene, caryophyllene, laurelene, terpinene, myrtenal, carvone, sabinene Energetics Properties and Channels Entered: pungent, warm aromatic, entering the lung, spleen and stomach meridians Actions and Indications: anti-tubercular, anti-flatulence, laxative Medical Research: In experiments on guinea pigs, preparations of bai dou kou were helpful in increasing the potency of small doses of streptomycin against tuberculosis a-pinene and B-pinene expells phlegm and inhibits cough 1 8-Cineole can have calming, pain relieving and asthma inhibiting effects 2 B-pinenean has strong antibiotic and anti-inflammation effects; geraniol has strong antibiotic and antifungal effects 3 Small amounts of bai dou kou can stimulate intestine but large amount inhibits it.4 When taken orally geraniol inhibited the activities of the digestive tract of rats. Small amount mildly promotes urination Rids guinea pigs of round worms 5 Toxicity, Contraindications and cautions: Contraindicated in cases of blood and yin deficiency. Use with caution in cases with out damp cold

161 Lesson 7: Herbs that transform damp & Relieve food stagnation Medicinal uses: Aromatically transforms dampness: used in damp warm febrile diseases with such symptoms as a stifling sensation in the chest, lack of appetite and a very greasy tongue coating Warms the middle burner and causes rebellious qi to descend: for vomiting due to cold from deficiency of the spleen and stomach or stomach cold Promotes the movement of qi and transforms stagnation: for stagnant qi of the spleen and stomach with such symptoms as fullness in the chest or epigastrium with distention and lack of appetite Pharmacy and dosage: 3-6g, add at the end of decocting or (preferably) as a powder in doses of g. Major Combinations: With xing ren (Semen Preuni Armeniacae) and yi yi ren (Semen coicis Lachryma jobi) for headache, stifling sensation in the chest, fatigue, dark urine with reduced output, diarrhea and usually accompanied by a white, greasy tongue coating as in the early stages of damp warm febrile diseases. With huang qin (Radix Scutellariae Baicalensis), hua shi (talcum) and zhu ling (Sclerotium Polypori Umbellati) for damp warm febrile disease in the middle burner with recurrent fevers and body aches With sha ren (Fructus Amomi) for fullness and a stifling sensation in the chest, vomiting and diarrhea due to spleen and stomach deficiency with a subsequent accumulation of turbid dampness With huo xiang (Herba Agastaches seu Pogostemi) and ban xia (Rhizoma Pinelliae Ternatae) for nausea and vomiting, epigastric discomfort and reduced appetite due to either damp cold or food stagnation With chen pi (Pericarpium Citri Reticulatae) for fullness and discomfort in the chest and abdomen, belching, nausea, vomiting and diarrhea due to spleen and stomach deficiency with a subsequent accumulation of turbid dampness With hou po (Cortex Magnoliae Officinalis) for distention due to qi obstruction or damp cold in the spleen and stomach REFERENCES Image

162 Lesson 7: Herbs that transform damp & Relieve food stagnation Sha Ren Amomum villosum Family: Zingiberaceae Other names: chun sha ren, grains of paradise fruit, cardamon Part used: seeds Plant description: Habitat, ecology and distribution: Guangdong, Guangxi, Southeast Asia, harvested in August to September when fruit has ripened History: Origins of the Materia Medica Constituents: camphor, borneol, bornyl acetate, linalool, nerolidol, limonene Energetics Properties and Channels Entered: pungent, warm, aromatic, entering the spleen and stomach meridians Actions and Indications: Stomachic, carminative, expectorant, tonic, anti-emetic, antispasmodic interferon inducent 1 Medical Research: none noted Toxicity, Contraindications and cautions: in cases of yin deficiency with heat signs and blood deficiency due to drying nature Medicinal uses: Transforms dampness and stops vomiting: used when dampness distresses the spleen or stomach with symptoms of discomfort in the epigastrium, nausea, abdominal pain, and diarrhea Promotes the movement of qi and strengthens the stomach: for spleen or stomach stagnant qi patterns that manifest in loss of appetite or epigastric or abdominal distention, pain and diarrhea Calms the fetus: for morning sickness or restless fetus Also used to prevent tonifying herbs from causing stagnation Pharmacy and dosage: 1.5-6g, added near the end of decoction, should be crushed prior to use!!

163 Lesson 7: Herbs that transform damp & Relieve food stagnation Major Combinations: With hou po (Cortex Magnoliae Officinalis) and bai dou kou (Fructus Amomi Dravanh) for epigastric and abdominal pain, distention, nausea and vomiting due to qi obstructing the spleen and stomach With bai zhu (Rhizoma Atyractylodis Macrocephalae) and dang shen (Radix Codonopsitis Pilosulae) for abdominal pain and diarrhea due to dampness obstructing the spleen and stomach. This combination is also used for morning sickness With mu xiang (Radix Aucklandiae Lappae) and zhi shi (Fructus Immaturus Citri Aurantii) for qi stagnation due to food stagnation With sang ji shen (Ramulus Sangjisheng) for restless fetus REFERENCES 1 Images

164 Lesson 7: Herbs that transform damp & Relieve food stagnation Shan Zha Crataegus pinnatifida Family: Rosaceae Other names: shan zha rou, bei shan zha, nan shan zha, hawthorn fruit, crataegus, C. cuneata Plant description: Rounded slices shrunken and uneven, cm in diameter, 2-4 mm thick. Externally red, wrinkled, with small grayish-white spots. Pulp dark yellow to pale brown. Transverses slices of the middle part showing 5 pale yellow kerns, mostly fallen off, and loculi hollowed. Some slices exhibiting a slender fruit stalk or remains of calyx. Part used: fruit Habitat, ecology and distribution: Shandong, Hebei, Henan, Liaoning, Jiangsu, Zhejiang, Guangdong, Guangxi, Yunnan; harvested in autumn when fruit has ripened History: Supplement to the Extension of the Materia Medica Constituents: crategolic acid, citric acid, tartaric acid, flavone, sugars, glycosides, vitamin C Energetics Properties and Channels Entered: sour, sweet, slightly warm, entering the liver, spleen and stomach meridians Actions and Indications: antibiotic, vasodilator, uterine restorative, cardiovascular restorative, circulatory, nervous sedative, vermifuge Medical Research: In experiments involving rabbits, intravenous administration of a preparation of Shan zha lowered blood pressure for up to three hours. In other experiments this herb caused systemic vasodilation. Experiments in China and other countries have shown that Shan zha from plants grown in various parts of the world may be useful in the prevention and treatment of atherosclerosis. In animal experiments, changes have been observed in both serum cholesterol levels and the degree of potency of the coronary arteries and aorta. In one clinical trial of 20 cases, the mean serum cholesterol decreased from 253 mg% to 207 mg%. Statistically this was considered to be highly significant. Preparations of Shan zha have a significant inhibitory effect in vitro against Shigella app. and Pseudomonas aeruginosa. Hawthorn fruit is hypolipidemic in rabbits fed a high cholesterol diet.

165 Lesson 7: Herbs that transform damp & Relieve food stagnation A 20% solution of Shan zha and sugar was used in two series of patients with acute bacillary dysentery. Of the combined total of 54 patients, only 3 did not show significant improvement with in one week. Toxicity, Contraindications and cautions: use cautiously for cases of spleen and stomach deficiency with out food stagnation, and in cases with acid reflux. Medicinal uses: Topically, hawthorn leaf is used as a poultice for boils, sores, and ulcers. Hawthorn fruit preparations are used as a wash for sores, itching, and frost bite Orally, hawthorn is used for cardiovascular conditions such as congestive heart failure (CHF), coronary circulation problems, and arrhythmia's. It is also used to increase cardiac output reduced by hypertension or pulmonary disease, to treat hypotension and hypertension, atherosclerosis, hyperlipidemia, and Buerger's disease. Hawthorn is also used as a sedative, antispasmodic, astringent, and diuretic. It is also used for gastrointestinal conditions such as indigestion, enteritis, epigastric distention, diarrhea, and abdominal pain. Hawthorn fruit is also used orally to treat tapeworm infections, acute bacillary dysentery, and amenorrhea. Pharmacy and dosage: 9-15g, use raw for blood stasis, and dry-fried for food stagnation. When used alone the dosage may be as high as 30g. Major Combinations: With mai ya (Fructus Hordei Vulgaris Germinantus) and shen qu (Massa Fermentata) for abdominal distention, belching and reduced appetite associated with food stagnation. Also effective for childhood malnutrition due to improper breast-feeding. With zhi ke (Fructus Citri Aurantii) for epigastric and abdominal distention. With mu xiang (Radix Aucklandiae Lappae), rou dou kou (Semen Myristicae Fragrantis) and bian dou (Semen Dolichoris Lablab) for abdominal distention and pain, diarrhea and dysenteric disorders; dry fry ingredient before concocting With chuan xiong (Radix Ligustici Chuanxiong) and dang gui (Radix Angelicae Sinensis) for menstrual pain and post partum lower abdominal pain due to blood stasis With dan shen (Radix Salviae Miltiorrhizae) for painful obstruction of the chest due to blood stasis in the heart meridian With xiao hui xiang (Fructus Foeniculi Vulgaris) for hernial conditions with testicular pain and swelling associated with prolapse REFERENCES goy I entrezl query.fcgi? cmd=retrieve&db= PubMed&list_ uids= OO&d opt= Abstract Image

166 Lesson 7: Herbs that transform damp & Relieve food stagnation Shen Qu Massa fermentata Family: various Other names: medicated leaven, shen chu, shinkyoku (Japanese), singok (Korean), spirits leaven Plant description: A fermented product containing wheat flour, bran and various herbs. It may contain Xing ren (Armeniacae semen), Chi xiao dou (Phaseoli semen), Qing hao (Artemisiae annua herba), and Cang er cao (Xanthii herba). Good Quality consists of dry, aged pieces without insect holes or an unpleasant moldy smell. Part used: whole mixture History: Materia Medica of Medicinal Properties Habitat, ecology and distribution: Varies, see each individual herb Constituents: yeast, glycosides, vitamin B Energetics Properties and Channels Entered: sweet, pungent and warm, entering the spleen and stomach meridians Actions and Indications: stomachic Medical Research: None of significance noted Toxicity, Contraindications and cautions: use with caution during pregnancy and in cases of stomach fire Medicinal uses: Reduces food stagnation and harmonizes the stomach: for stomach cold with food stagnation or accumulation with such symptoms as epigastric and abdominal fullness or distention, lack of appetite, borborygmus and diarrhea Used to aid digestion and absorption of minerals Promotes qi flow, regulates middle jiao, and unbinds the stomach. Best for digestion of carbohydrates and grains Pharmacy and dosage: 6-15g, dry-frying enhances the relieving food stagnation actions

167 Lesson 7: Herbs that transform damp & Relieve food stagnation Major Combinations: With bai zhu (Rhizoma Atractylodis Macrocephalae) for food stagnation and diarrhea due to spleen deficiency With zhi ke (Fructus Citri Aurantii) for reduced appetite and fullness and distention of the epigastrium and abdomen due to cold stagnation With bing lang (Semen Arecae Catechu) for childhood malnutrition or focal distention of the abdomen due to food stagnation With mu xiang (Radix Aucklandiae Lappae) and sha ren (Fructus Amomi) for abdominal pain associated with food stagnation With exterior releasing herbs for diarrhea accompanying externally contracted disorders REFERENCES Image

168 Lesson 7: Herbs that transform damp & Relieve food stagnation Mai Ya Hordeum vulgare Family: Gramineae Other names: da mai ya, barley sprout, malt History: Grand Materia Medica Plant description: Part used: grain seed Habitat, ecology and distribution: through out China, harvested year round Constituents: amylase, invertase, dextrin, phospholipid, maltose, glucose, vitamin B Energetics Properties and Channels Entered: sweet and neutral, entering the liver, spleen and stomach meridians Actions and Indications: Stomachic, enzymatic digestant, carminative, aids digestion process in candidiasis, nutritive, anti-galactagogue 1 Medical Research: The combination of enzymes and vitamin B in mai ya are useful in aiding digestion Preparations of powdered mai ya and sugar were used, together with enzyme preparations and vitamins, in treating 161 cases of hepatitis. As measured by a reduction in symptoms, hepatomegaly, and transaminase levels, the treatment was successful in 108 cases. It was much more effective in acute than chronic cases. Toxicity, Contraindications and cautions: according to Materia Medica of Diet Therapy long-term use of mai ya may injure the kidneys. Medicinal uses: Reduces food stagnation and strengthens the stomach: for poor digestion due to stagnation and accumulation of undigested starchy food, as well as poorly digested milk in infants. Also for weak digestion and loss of appetite in cases of spleen deficiency Inhibits lactation: for women who are discontinuing nursing, or for distended and painful breasts Facilitates the smooth flow of liver qi: for constrained liver qi manifesting as a stifling sensation and distention in the epigastrium or ribs, belching and loss of appetite

169 Lesson 7: Herbs that transform damp & Relieve food stagnation Pharmacy and dosage: 6-15g directly as a powder, or 12-30g as a decoction; large doses of 60g for cessation of lactation. Raw form it is neutral and used mainly to guide out and reduce, dry-fried tends to be warmer and more potent in strengthening the spleen, improving appetite, and inhibiting lactation; powdered is stronger for aiding in digestion of grains/starches. Major Combinations: With shen qu (Massa Fermentata) for indigestion due to food stagnation; Also for breast tenderness and swelling associated with discontinuation of nursing. Use larger doses and dry-fried With gan jiang (Rhizoma Zingiberis Officinalis) for indigestion due to spleen and stomach deficiency With tonifying herbs to prevent undesirable side effects such as gas and distention REFERENCES 1 Image Similar herb Gu ya Setariae (Oryzae) fructus germinatus Other names: grain sprouts typically rice, Gu refers to grain sprouts but can be sprouted rice, unhusked rice or millet. Millet is often called Su ya. Part used: seed Energetics Properties and Channels Entered: Sweet and neutral, enters the spleen and stomach meridians Medicinal uses: Dissolves Food Stagnation, Harmonizes the Middle Jiao, Promotes Digestion Mildly improves food digestion. Treats indigestion and poor appetite. Strengthens the Spleen, Improves Appetite, Treats poor digestion, diarrhea, and poor appetite

170 Lesson 7: Herbs that transform damp & Relieve food stagnation Lai Fu Zi Raphanus sativus Family: Cruciferae Other names: luo bo zi, diakon seed, radish seed, turnip seed, raphanus, raifukushi (Japanese), naebokja (Korean) Part used: seed Plant description: basal leaves, scattered hairs on the leaves and stems, and a taproot. Flowers are white, lavender, or yellowish with pink or purple veining. It favors disturbed areas such as roadsides,1 Habitat, ecology and distribution: throughout China, harvested in summer until autumn when seeds have ripened History: Materia Medica of Ri Hua Zi Constituents: erucic acid, oleic acid, linolenic acid, linoleic acid, glycerol sinapate, raphanin Energetics Properties and Channels Entered: acrid, sweet and neutral, entering the lung, spleen and stomach meridians Actions and Indications: antimicrobial, antiseptic Medical Research: Raphanin has a significant inhibitory effect against such bacteria as Staphylococcus Aureus, Streptococcus pneumoniae, and E. coli Preparations of lai fu zi have a significant inhibitory effect in vitro against many pathogenic fungi Toxicity, Contraindications and cautions: preparations of lai fu zi were slightly cardiotoxic in experiments with frog heart specimens. Contraindicated in weak qi or deficiency. Not to be used with Ren shen (Ginseng radix), Shu di huang (Rehmanniae radix preparata), and Zhi he shou wu (Polygoni multiflori radix preparta). Medicinal uses: Reduces food stagnation and transforms accumulation: for food stagnation accumulating in the middle burner with fullness and distention, belching with a rotten smell, acid regurgitation or abdominal pain with difficult diarrhea Descends qi and reduces phlegm: for chronic productive cough or wheezing.

171 Lesson 7: Herbs that transform damp & Relieve food stagnation Most effective in cases due to excess Pharmacy and dosage: 6-12g, raw for food stagnation and raising qi, dry fried for productive cough and directing qi downward Major Combinations: With shan zha (Fructus Crataegi), shen qu (Massa Fermentata) and chen pi (Pericarpium Citri Reticulatae) for abdominal distention, borborygmus, belching, acid regurgitation and diarrhea due to stagnation in the stomach and intestines With zhi ke (Fructus Citri Aurantii) for focal distention, belching and loss of appetite due to food stagnation With ban xia (Rhizoma Pinelliae Ternatae) for damp phlegm induced cough and wheezing. This combination is also used for distention and vomiting due to food stagnation With xing ren (Semen Pruni Armeniacae) for chronic productive cough With su zi (Frucus Perillae Frutescentis) and bai jie zi (Semen Sinapis Albae) for chronic cough and wheezing, especially that due to excessive phlegm disorders REFERENCES 1 Image chineinformations.com

172 Lesson 7: Herbs that transform damp & Relieve food stagnation Ji Nei Jin Gigeriae galli Endothelium corneum # Family: Phasianidae Other names: Chicken gizzard, literal English translation: chicken inner gold, keinaikin (Japenese), kyenaegeum (Korean) Part used: lining of chicken gizzard History: Divine Husbandman!s Classic of Materia Medica Constituents: Proteins: ventriculin, amylase, pepsin, diastase, keratin; Amino acids: lysine, histidine, arginine, glutamic acid, aspartic acid, leucine, threonine, serine, glycine, alanine, casteine, valine, methionine, isoleucine, tyrosine, phenylalanine, proline, tryptophane; vitamin B1, B2, C, nicotinic acid Energetics Properties and Channels Entered: Sweet and neutral, enters the urinary Bladder, small intestine, spleen and stomach meridians Actions and Indications: stomachic, antiemetic, anti-enuresis Medicinal uses: Strongly reduces food stagnation of various types. Improves the spleen transformation and transportation function; treats nausea, vomiting, diarrhea Childhood nutritional impairment from accumulated undigested food Transforms urinary and biliary stones Secures the kidney essence and halts enuresis: spermatorrhea, urinary incontinence and childhood bedwetting Toxicity, Contraindications and cautions: Caution with Spleen deficiency where food stagnation is absent. If there is accumulation, it reduces it. If there is no accumulation, it reduces one!s primal qi. Harm and Benefit in the Materia Medica. Not suitable for vegetarians and vegans. There has been one reported case of epistaxis following ingestion.1 Pharmacy and dosage: 3-9 g Major Combinations: With Mai ya (Hordei fructus germinatus), and Shan zha (Crataegi fructus) for indigestion, fullness and distention of epigastrium and abdomen.

173 Lesson 7: Herbs that transform damp & Relieve food stagnation With Sang piao xiao (Mantidis ootheca), Long gu (Fossilia ossis mastodi) and Mu li (Ostreae concha) for bedwetting in children and frequent urination in adults. With Tu si zi (Cuscutae semen) and Wu wei zi (Schisandrea fructus) for spontaneous emmissions REFERENCES 1 Bensky, D. and Gamble, A.; Chinese Herbal Medicine Materia Medica; Eastland Press, Seattle; 1993 Image futurosity.com!!

174 Lesson 8: Herbs that Regulate Qi LESSON 8: Herbs that Regulate Qi When Qi and blood are flush and harmonious, the myriad diseases cannot arise. Once they become restrained and constrained (fu yu), various diseases arise from that. Thus, among the various human diseases, most arise from constraint. Teachings of (Zhu) Dan-Xi, 14th century Herbs that regulate qi work to create smooth and free flow in the body, they achieve this by facilitating the proper workings of the qi dynamic called Qi ji or the Qi mechanism. The organs involved in workings of the qi dynamic are the: Lungs which govern the qi, the Liver which governs smooth flow of qi and governs dredging and draining, the Spleen which governs transformation and transportation and is the root of post heaven qi/essence, the Stomach which governs receiving, and the Kidneys which govern the root of pre heaven qi/essence. Disruption of the qi dynamic arises from either stagnation or rebellion. The characteristic symptoms of qi stagnation include: abdominal distention, discomfort and migratory pain. Sometimes distention pain eases after eructation or flatulence. Symptoms can also include depression, irritability, gloomy feelings, frequent mood swings, and frequent sighing. The patient often has a wiry or tight pulse and slightly purple tongue. Other symptoms depend on which organ or meridian is affected, the Liver being the most common. Rebellion of qi is due to a disruption in the normal coursing of qi; characteristic symptoms are: belching, vomiting, nausea, wheezing and dyspnea. The selection of qi regulating herbs depends on the mode of qi stagnancy, symptom nature (chill or fever), pain location and complications. The mode or organ is usually one of three Organs: 1. Stagnant Spleen and Stomach qi: symptoms include epigastric pain, abdominal distention, belching, gas, vomiting, acid fluid, nausea, diarrhea or constipation. These could result in biomedicine diagnosis of: dyspepsia, neurotic gastroenteritis, chronic gastritis, or peptic ulcer. They can also be the result of Candida albicans. 2. Stagnant Liver qi: symptoms include a stifling sensation in the chest, pain in the flank, loss of appetite, vomiting bitter sour water, menstrual irregularities, tender breast, depression, irritability and in severe cases hernial pain. These could result in biomedicine diagnosis of: chronic hepatitis, neurotic gastroenteritis, neurasthenia and autonomic neurosis. Often a fever can arise in these cases: "liver stagnation turning into fire".

175 Lesson 8: Herbs that Regulate Qi This might result in violent headaches, a ruddy face, eye congestion, dry mouth, bitter mouth, acute hearing difficulties and acute tinnitus. If stagnant liver qi affects the stomach we get a hepatic gastric disharmony causing nausea and epigastric pain. If it affects the spleen it will produce abdominal aches and diarrhea. 3. Stagnant Lung qi: symptoms include coughing, wheezing and laboured breathing, with a stifling sensation in the chest. These could result in biomedicine diagnosis of: bronchitis, bronchial asthma or emphysema. Herbs that regulate the qi are rarely used alone; they are combined with other botanicals specific for the nature of the disorder. Because most of these herbs are aromatic and dry in nature, long-term use should be avoided as they might exhaust yin and cause qi deficiency. If the patient has weak yin, usually nourishing and moistening herbs like Bai shao (white peony) is used to protect yin fluids. These herbs should not be decocted more than fifteen minutes as they usually contain volatile oils. The herbs in this lesson are: Chen pi - Citrus reticum Qing pi - Citrus reticulata Zhi shi - Citrus aurantium Da fu pi - Areca catechu Mu xiang - Aucklandia lapa Chen xiang - Aquilaria agallocha Xie bai - Allium macrostemon Li zhi he - Litchi chinensis Xiang fu - Cyperi rhizoma

176 Lesson 8: Herbs that Regulate Qi Chen Pi Citri reticulatae pericarpium Family: Rutaceae Other names: Chen pi : Tangerine peels, aged peel, Pericarpium Citri Reticulatae, chu pi, zhu pi, ju pi, guang chen pi, guang gan pi, chinpi (Japanese), chinp'i (Korean) Qing pi : unripe /green tangerine peel, Pericapium Citri Reticulatae Virde, blue citrus peel, ching pi, jyohi (Japanese), ch'ongp'i (Korean) Zhi shi #$: immature fruit of bitter orange, Fructus Immaturua Citri Aurantii, chisel (Korean). Plant description: Pericarp usually separated into several pieces, or pieces jointed at the base, varying in size, about 1 mm in thickness. Exocarp orange-red, with numerous rounded oil spots; mesocarp white, loose, with numerous reticular vascular bundles. Aromatic in odour. Part used: aged peel, green peel, immature fruit. Habitat, ecology and distribution: Guangdong, Fujian, Sichuan, Jiangsu, Zhejiang, Hunan, Yunnan, Guizhou History: Found first in the Divine Husbandman's Classic of Materia Medica, and Pouch of Peals. Constituents: 1,2 Chen pi: limolene, isopropenyltroluene, elemen, copanene, humulene, betasesquiphellandrene, alpha-humulenol acetate, hesperidin, rutin, carotene, cryptoxanthin, B 1 and Vit C. (often consider better as limonene, one of the principal constituents, is higher in the mature peel) Qing pi: similar to chen pi, with flavonoid, and synephrine Zhi shi: neohesperidin, naringin, rhoifolin, lonicerin, Vit. C Energetics Properties and Channels entered: Chen pi: acrid, bitter, warm, aromatic; entering Lung, Spleen, and Stomach meridians. Qing pi: bitter, acrid, warm; entering the Gallbladder, Liver and Stomach meridians. Zhi shi: bitter, acrid, slightly cold; entering the Large intestine, Spleen, Stomach meridians.

177 Lesson 8: Herbs that Regulate Qi Actions and Indications: stomachic, stimulant, moves stagnant qi Medical Research:3,4 Chen pi: The volatile oil acts as a slight irritant to the gastrointestinal tract, promoting the secretion of digestive fluid and expelling the flatus. It also has a stomachic action with an inhibitory effect on the smooth muscles. Small amounts can increase cardiac output (positive inotropic effect), without increasing heart rate. Large amounts can have an inhibitory effect. Both hesperidin and rutin have a strengthening effect on capillaries, with anti-inflammatory action. Antibacterial action has been found, inhibiting staphylococci. Qing pi: has a stomachic property similar to chen pi, with a stronger qi-moving and stagnancy removing action. Qing pi also produces a diaphoretic and cold-removing effect. Synephrine will significantly increase systolic and mean arterial blood pressure, while not effecting diastolic pressure or heart rate. This increases cardiac index and reduces peripheral vascular resistance.5 Zhi shi: has been shown to inhibit uterine muscle contractions in mice, but stimulate them in rabbits. Zhi shi reduces muscle action in intestine. The cardiac effect is similar to chen pi. Synephrine 6 is chemically very similar to the ephedrine and pseudo-ephedrine found in many OTC cold/allergy medications and a number of weight loss and energy supplements that contain Ma Huang. But synephrine differs from ephedrine, in that synephrine is considered a semi -selective sympathomimetic (because it targets some tissues such as fat, more than it targets others such as the heart), versus a nonselective sympathomimetic (like ephedra which targets many tissues equally and thus often causes side effects). For example, although some high-dose ephedra-containing supplements have been associated with certain cardiovascular side effects such as elevated blood pressure and heart palpitations, researchers at Mercer University in Atlanta have shown that Citrus aurantium extract (because it targets fat tissue rather than heart tissue) has no effect on hemodynamics such as heart rate and blood pressure. Claims Increases metabolic rate Increases caloric expenditure Fat burner Promotes weight loss Increases energy levels

178 Lesson 8: Herbs that Regulate Qi Theory Because synephrine is a mild stimulant similar in some ways to caffeine and ephedrine, it is thought to have similar effects in terms of providing an energy boost, suppressing appetite, and increasing metabolic rate and caloric expenditure. In traditional Chinese medicine, zhi shi is used to help stimulate qi - but in order to maximize the metabolic benefits of these extracts, total synephrine intake should probably be kept to a range of 2-10 mg/day. Although synephrine and several other compounds found in zhi shi are structurally similar to ephedrine and are known to act as stimulants (via adrenergic activity), zhi shi does not appear to have the same negative central nervous effects of ma huang (ephedra). Through its stimulation of specific adrenergic receptors (beta-3, but not beta-1, beta-2 or alpha-1), zhi shi is theorized to stimulate fat metabolism without the negative cardiovascular side effects experienced by some people with Ma Huang (which stimulates all beta-adrenergic receptors). Scientific Support The effects of synephrine alone or in combination with other ingredients such as kola nut and guarana (both are caffeine sources) or with salicylates such as white willow (a natural form of aspirin), generally fall into the category of acting as a mild stimulant. The extract of citrus aurantium, in addition to synephrine, also contains tyramine and octopamine. Octopamine may be related in some way to appetite control, as it is thought to influence insect behavior by stopping bugs from eating the citrus fruit (so if you're an insect, this may be the perfect weight loss supplement for you). A recent study conducted in dogs suggests that synephrine and octopamine can increase metabolic rate in a specific type of fat tissue known as brown adipose tissue (BAT). This effect would be expected to increase fat loss in humans. Up until very recently, synephrine-containing supplements existed with only some interesting theories on how they might work to increase metabolic rate and promote significant weight loss. At this writing, there are now at least two clinical studies showing that synephrine-containing supplements help promote weight loss, and at least three clinical studies showing an enhanced thermogenesis (calorie expenditure) from these supplements. There is a great deal of research currently underway into the weight loss benefits of synephrine and supplements with related thermogenic effects, leading researchers in the Department of Physiology at Georgetown University to conclude that "Citrus aurantium may be the best thermogenic substitute for ephedra." Safety Early animal studies using high doses of isolated (purified) synephrine have been shown to raise blood pressure - but more recent human studies of citrus aurantoum extracts (standardized for synephrine) have not demonstrated any cardiovascular side effects. When used as directed, synephrine-containing supplements appear to be quite safe and should be treated as a mild stimulant (similar to a cup of coffee) with appetite controlling and mild thermogenic properties.

179 Lesson 8: Herbs that Regulate Qi Value The most likely explanation for weight loss effects attributed to citrus aurantium supplements is the mild appetite reduction and thermogenesis. Although these effect is likely to be somewhat less dramatic that effects induced by Ma Huang (ephedra alkaloids), users can expect variable effects including reduced appetite and heightened feelings of energy (similar to caffeine) - both of which are likely to result in weight loss - but with less chance of cardiovascular involvement (palpitations, blood pressure, heart rate, etc). Toxicity, Contraindications and cautions: Some chen pi samples have been tested with pesticide residue. Get organic chen pi if you can; otherwise soak chen pi in water for several hours and wash it thoroughly before use. Chen pi: contraindicated in cases of dry cough due to yin or qi deficiency. Use with caution if the tongue is red and in cases of hot phlegm or dry heat cough or spitting blood. Qing pi: Use with caution in qi deficiency Zhi shi: Use with caution during pregnancy, weak qi or where to Stomach is cold from deficiency. Medicinal uses: Chen pi: Regulates the qi, improving transportation function of the Spleen, adjusts the middle and relieves the diaphragm. It is specific for stagnant qi in the Stomach or Spleen, with symptom patterns of epigastric or abdominal distention, fullness, bloating, belching and nausea or vomiting. Chen pi promotes downward movement of qi. Transforms phlegm, while drying dampness; used for phlegm-damp coughs with stifling sensation in chest and/or diaphragm with copious viscous sputum. Great for damp phlegm in the digestive tract, associated with abdominal distention, loss of appetite, fatigue, loose stool and a thick greasy tongue coating. Prominent herb for qi flow in both Lung and Spleen, often used when both meridians are involved. Used as a prevention of stagnation, tonifying Lung and Spleen. Qing pi: Spreads Liver qi and breaks up stagnant qi, with symptoms of distention and pain in chest, breast or hypochondriac region, or hernial pain. Dissipates clumps and reduces stagnation of food with distention or pain in epigastric region. Used for severe food stagnation. Sometimes used to raise blood pressure.

180 Lesson 8: Herbs that Regulate Qi Zhi shi: Breaks up qi stagnation and reduces accumulation, with epigastric or abdominal pain and distention from indigestion and gas. Directs qi downward and unblocks bowels; used for constipation and abdominal pain caused by accumulation and stagnant qi Transforms phlegm and expels distention; for fullness in chest and epigastrium due to phlegm obstruction and qi mechanism (Candida). Used to tone qi in the GI for gastriectasis, gastroptosis, rectal prolapsed or uterine prolaspe. Used to raise blood pressure Pharmacy and dosage: Chen pi: 3-9 grams. Qing pi: 3-9 grams Zhi shi: 3-9 grams Major Combinations: Chen pi: With hou po (Magnolia cortex) and cang zhu (Atractylodis roots) for epigastric and abdominal fullness and distention, acid regurgitation, fatigue, loose stool and damp-cool stagnation of Spleen and Stomach. With ban xia (Pinelliae root) for a stifling sensation in the chest with cough and excess sputum due to obstruction of damp-phlegm. Add fu ling (Poriae cocos) and hou po (Magnolia cortex) to enhance the phlegm transformation. Used to strengthen the Spleen. With sheng jiang (Ginger root) for vomiting and hiccups due to disharmony of Stomach qi. With zhu ru (Caulis Bambusae) and huang lian (Coptis) for vomiting due to phlegm heat. With dang shen (Codonopsistis root) and huang qi (Astragulus root) to prevent the side effect of bloating from other herbs in a formula. Qing pi: With chai hu (Bupleuri root) and yu jin (Curumae tuber) for pain and distention in the chest and flank associated with disharmony between the Liver and Stomach. Add bie jia (Carapax AmydaeSinensis) and dan shen (Salvia miltiorrhizae root) for enlargement of the spleen and or liver. Zhi shi: With hou po (Magnolia cortex) for focal distention, swelling and pain associated with food stagnation and qi obstruction.

181 Lesson 8: Herbs that Regulate Qi With da huang (Rhubarb root) for constipation and abdominal swelling due to food stagnation or qi obstruction. It can also be used for diarrhea, dysenteric disorders and abdominal pain due to obstruction from a damp-heat. With bai zhu (Atractylodis macrocephalae root) for focal distention in the epigastrium and abdominal region due to Spleen and Stomach deficiency or food stagnation. With bai shao (Paeniae root) for abdominal pain due to qi and blood obstruction With da huang (Rhubarb root), huang qin (Scutellaria baicalensis) for dysentery with tenesmus due to accumulation and stagnation of damp-heat, especially when associated with food accumulation. REFERENCES 1 Bensky D, Gamble A; Chinese Herbal Medicine Materia Medica;Eastland Press Seattle Wa; p Hsu, H. Y., Chen, Y.P., et at., Oriental Materia Medica: a concise guide, Oriental Healing Arts Institute, Long Beach, CA, 1986, p Bensky D, Gamble A; Chinese Herbal Medicine Materia Medica;Eastland Press Seattle Wa; p Hsu, B.Y., Chen, Y.P., et at., Oriental Materia Medica: a concise guide, Oriental Healing Arts Institute, Long Beach, CA, 1986, p Tang W, Eisenbrand; Chinese Drugs of Plant Origin; Spinger-Verlag;New York; 1992 p Images foodsnherbs.com, tcm.health-info.org

182 Lesson 8: Herbs that Regulate Qi Da Fu Pi Areca catechu Family: Palmae Other names: betel husks, areca peels, Pericarpium Arecae Catechu, ta fu pi, daifukuhi (Japanese), taebokp'i (Korean) Plant description: A very attractive palm to about 10 m high, with dark green leaves, and an attractive dark green, ringed trunk. It has fragrant, scented, white flowers, which form into orange/scarlet fruit about 50 mm (2 inches) long. Da fu pi: Somewhat elliptical or long-ovate gourd-shaped, 4-7 cm long, cm wide, thick. Epicarp deep brown to blackish, with irregular longitudinal wrinkles and raised transverse lines on the surface; style scars at apex and a fruit stalk and remains of calyx at the base. Endocarp dented, brown or deep brown, smooth and hard shell shaped. Texture light and hard, mesocarp fibers visible torn longitudinally. Odour, slight; taste, slightly astringent. Da fu mao: Somewhat elliptical or gourd-shaped. Epicarp mostly lost or remained. Mesocarp fibres yellowish-white or pale brown. Texture lax and soft. Endocarp hard shell-shaped, yellowish-brown or brown, inner surface smooth, sometimes broken in longitudinal. Odourless; taste, weak. Part used: husk, dried fruit skin Habitat, ecology and distribution: Found in tropical rainforests; it has been widely cultivated for centuries, so its original home is uncertain, though it is probably Malaysia. In China it can be found in Guangdong, Hainan, Yunnan, Fujian, Guangxi, Taiwan History: Medical Recipes by Hou Nig-ji Constituents: tannins, arecoline, pararecoline.1, 2 Energetics Properties and Channels entered: acrid, slightly warm, entering Large Intestine, Small Intestine, Spleen and Stomach meridians. Actions and Indications: qi stagnation, diuretic, stomachic. Medical Research: a decoction of Da fu pi strengthens the contraction and tension of the intestines; being eliminated by atropine.

183 Lesson 8: Herbs that Regulate Qi Toxicity, Contraindications and cautions: Used with caution in cases of qi deficiency. Some allergic responses have been witnessed with symptoms of: urticaria, diarrhea or severe abdominal pain. Medicinal uses: Used in Chronic hepatitis, indigestion, edema, oliguria, and diarrhea. Da fu pi / Areca is used as a recreational drug (India) because of its central nervous system (CNS) stimulating properties. It is also used orally for treatment of schizophrenia, but is otherwise rarely used therapeutically. Areca has been used for glaucoma and as a mild stimulant or digestive aid. In veterinary medicine, an extract of areca is used for expelling tapeworms in cattle, dogs, and horses; as a cathartic; and for treating intestinal colic in horses. Promotes downward movement of qi, reducing stagnation of food and qi obstructions. Signs include epigastric and abdominal distention, regurgitation of food, belching acids. It is especially useful if symptoms are accompanied with constipation. Expels damp stagnation in Stomach and Intestine Promotes urination, reducing edema (when accompanied with abdominal distention), and treats food stagnation. It is also used for damp leg qi. Pharmacy and dosage: 6-9 grams Major Combinations: With hou po (Magnolia cortex) and chen pi (Citrus reticum) for epigastric and abdominal distention accompanied with constipation and stagnant qi and dampness. With fu ling pi (Pariae cocos cortex) and sheng jiang pi (Ginger cortex) for mild edema or superficial edema REFERENCES 1 Bensky D, Gamble A; Chinese Herbal Medicine Materia Medica;Eastland Press Seattle Wa; p Hsu, H.Y., Chen, Y.P., et ai., Oriental Materia Medica: a concise guide, Oriental Healing Arts Institute, Long Beach, CA, 1986, p. 404 Image chine-informations.com

184 Lesson 8: Herbs that Regulate Qi Mu Xiang Aucklandia lapa Family: Compositae Other names: costus root, saussurea, aucklandia, Radix Aucklandiae Lappe, guang mu xiang, mokko (Japanese), mokhyang (Korean) Also known as Saussurea costus (Falc.), or Saussurea lappa (Decne.) Plant description: This perennial grows to about 3 m by 1 m. It is in flower from July to August, and the seeds ripen from August to September. The scented flowers are hermaphrodite (have both male and female organs) and are pollinated by insects. The plant can grow in semi-shade (light woodland) or no shade. It requires moist soil. Part used: root Habitat, ecology and distribution: Native to East Asia, it is grown in the Himalayas, the Middle Eastern countries, Burma, China, India and Spain. In China it is primarily found in Yunnan, but also found in Sichuan and Tibet. History: Divine Husbandman's Classic of the Materia Medica Constituents: aplotaxene, alph-ionone, beta-seline, saussurealactone, costunolide, costic acid, costene, costuslatone, camphene, phellandrene, dehydrocostuslactone,' dihydrodehydrocostuslactone, stigmasterol, betulin, saussurine.1 Energetics Properties and Channels entered: acrid, bitter, warm; entering the Gallbladder, Large Intestine, Spleen and Stomach meridians. Actions and Indications: antispasmodic, bronchodilator, hypotensive, mild astringent. Medical Research: The alkaloids have shown to inhibit histamine-induced bronchospasm and intestinal spasm in guinea pigs. This herb can inhibit typhoid bacillus, Bacillus dysenteriae, Bacillus coli and a variety of fungi. A 1991 study published in the Journal of the Pakistani Medical Association found that oral doses of an extract of the root of Saussurea lappa significantly reduced nematode infestation in children. Nematodes are parasitic roundworms. Another 1998 study done in Korea found that an extract of Saussurea lappa killed tiny brine shrimp. One compound isolated in the brine shrimp investigation is known to be moderately effective in killing some types of human tumor cell types in a laboratory setting. 2,3,4!!

185 Lesson 8: Herbs that Regulate Qi Toxicity, Contraindications and cautions: contraindicated in cases of yin deficiency and depleted fluid. Medicinal uses: Promotes the movement of qi, alleviating pain for Stomach and Spleen qi stagnation. With symptoms such as lack of appetite, epigastric or abdominal pain, distention, nausea and also be used for stagnant Liver and Gallbladder qi with symptoms of flank pain, distention or soreness. Adjusts and regulates stagnant qi in the Intestines for diarrhea and dysenteric disorders. Can also be used for abdominal pain and tenesmus (a distressing but ineffectual urge to evacuate the rectum or bladder), due to its mild astringent quality. Strengthen Spleen, while preventing stagnation. Often used with toning herbs to ameliorate their side effect. Aucklandia is used in Ayurvedic medicine, where it is valued mainly for its tonic, stimulant and antiseptic (preventing or arresting the growth of microorganisms) properties. It is said to be aphrodisiac (arouses sexual desire) and to be able to prevent the hair turning gray. In India, aucklandia is used primarily as an antiseptic, an insecticide, and a fungicide. It is also said to be effective against yeast infections. Some research suggests that aucklandia may be effective against infections such as cholera and typhoid. The root is used in Tibetan medicine, where it is considered to have an acrid, sweet and bitter taste with a neutral potency. It is used in the treatment of swelling and fullness of the stomach, blockage and irregular menses, pulmonary disorders, difficulty in swallowing and rotting/wasting of muscle tissues. Pharmacy and dosage: Dosage grams usually added during the last five minute of boiling. It can be toasted to increase absorbability (especially in cases of diarrhea). Major Combinations: With bing lang (Arecae seeds) and da huang for epigastric and abdominal fullness, distention and pain accompanied by constipation and stagnation of Stomach and Intestine transforming damp-heat. With sha ren (Amomi fruit) for local distention, epigastric and abdominal pain, loss of appetite and nausea. With huang lian (Coptis) for dysentery, diarrhea. Curing Pills contains: Yi yi ren (Coix lachryma jobi seed), Cang zhu (Atractylodes lancea rhizome), Huo xiang (Agastache rugosa herb), Hou po (Magnolia officinalis bark), Mu xiang (Aucklandia lappa root), Ge gen (Pueraria lobata root), Bai zhi (Angelica dahurica root), Shen qu (Massa fermneta), Gu ya (Orzya sativa sprout), Fu ling (Poria

186 Lesson 8: Herbs that Regulate Qi cocos fungus), Tian hua fen (Trichosanthes kirilowii root), Ju hua (Chrysanthemum morifolium flower), Ju hong (Citrus erythrocarpae peel), Tian ma (Gastrodia elata rhizome), and Bo he (Mentha haplocalyx herb). - (Yi yi ren, Cang zhu, Huo xiang, Hou po, Mu xiang, Ge gen, Bai zhi, Shen qu, Gu ya, Fu ling, Tian hua fen, ju hua, ju hong, Tian ma, Bo he) for nausea, vomiting, acid regurgitation, indigestion, and motion sickness. REFERENCES 1 Bensky D, Gamble A; Chinese Herbal Medicine Materia Medica;Eastland Press Seattle Wa; p237 2 Bensky D, Gamble A; Chinese Herbal Medicine Materia Medica;Eastland Press Seattle Wa; p db/viewherb.php3?viewid=289&setlang= 4 liartic1e.jhtml Image futurosity.com

187 Lesson 8: Herbs that Regulate Qi Chen Xiang Aquilaria agallocha Family: Thymelaeceae Other names: aloeswood, aquilaria, Lignum Aquilariae, Agarwood, eaglewood, gaharu, luoa shui chen, chen hsiang, jinko (Japanese), ch'irnhyang (Korean) It gets its name from heartwood that sinks in water, hence its name "sinking fragrance". Part used: Secretions of the plant. Habitat, ecology and distribution: Indonesia, Malaysia, Cambodia, Vietnam. Taiwan, Guangdong, Guangxi, Fujian. The tree (at least 3 m in diameter) is cut m above the ground, after several years, the secretion of the tree is collected. History: Miscellaneous Records. Constituents: Essential oils (13%; benzylacetone and methoxybenzylacetone) hydrocinnamic acid and others. After the wood is infected with microbe; agarospirol, agarospiral, agarol, agarofuran, dihydroagarofuran, 3,4-dihydroxy-dihydroagarofuran, 4- hydroxydihydroagarofuran and others. 1, 2 Energetics Properties and Channels entered: acrid, bitter, warm, aromatic; entering the Kidney, Spleen and Stomach meridians. Actions and Indications: anti-emetic, moves qi, stomachic, nervine, analgesic, antiasthmatic, antimicrobial, digestive, stimulant. Medical Research: The tea has shown antibacterial effects against typhoid and dysentery. The volatile oil has a tranquilizing and analgesic action. Agarospirol decreases methamphetamine and apomophine-induced spontaneous mobility and exerts antiemetic action.3,4 Toxicity, Contraindications and cautions: Use with caution in cases of prolapse due to qi deficiency and heat sign due to yin deficiency.5 Heavily over harvested like Sandlewood, best to obtain from sustainable resources. Medicinal uses: Aquilaria has been used to enhance cerebral function, balance the mind/body connection and the nervous system. Cheng xiang is being currently employed for epileptic therapy. This herb has been used in India and Europe for cancerous tumor..6, 7 It is used to make calming incense, said to enlighten one.

188 Lesson 8: Herbs that Regulate Qi Promotes movement of stagnant qi while alleviating pain. Symptoms include distention, pain, epigastric or abdominal pressure. Especially useful when problem is due to cold from deficiency or blood stasis. Directs rebellious qi downwards, while regulating the middle. Stops wheezing either from deficiency or excess, or vomiting, belching or hiccups due to cold from deficiency of the Stomach or Spleen. Aids the Kidneys in taking on qi. Used for asthma and wheezing due to Kidney deficiency. Pharmacy and dosage: grams as a powder. Should never be decocted. The wood, when infected by certain fungi, develops large and irregular patches of dark streaks charged with the oleoresin and becomes odiferous. The intensity of the dark patches of agar is a measure of the quantity of oleoresin present. Agar is found frequently in trees that are c. 20 years old; but commercially exploitable amounts of agar are found in 50-year-old trees. Trees c. 80 years old are known to be riches in their content of agarwood, varying from 6.9 kg to 9.0 kg per tree. Agar is the pathological product of a fungal disease contracted by the tree chiefly through wounds on the trunk. Since agar is located deep within the trunk, its detection is not easy. Generally such trees are distinguished by poor crown development, the presence of swellings or depressions or cankers on the bole. Depending upon the extent of the resin accumulation the heart - wood is graded into four categories:(1) Grade I or Black or True Agar; (2) Grade II or Batang; (3) Grade III or Bhuta or Phuta; and (4) Grade IV or Dhum. In true black agar, the impregnation of the resin is intense and the wood resembles black stone. It is heavy to the extent that it sinks in water, and bears the highest content, but it is difficult to distill. True agar is mainly exported to the Middle Eastern countries where it is used as incense. Bantang is brown in colour without any black tone. Bhuta is also brown in color but interspersed with 50 per cent or more of yellow-colored wood. These two grades are also usually used in incense. Dhum is the lowest grade. It is mostly yellow with scattered streaks of brown or black resin. It is chiefly distilled for the oil. Sometimes oil is also extracted from Bhuta and this oil is reported to be superior to that from Dhum. Wealth of India Volume Other Uses: When dusted on clothes and skin as a preventative against fleas and lice. Used in fumigators such as pastilles and agarbatis. (The ancient Indian name for incense "agarbati" means lights of agar.) Bark is a source of the writing material sachpat, which is immune to insect attack and used for writing religious scriptures.8 Major Combinations: With wu yao (Linderae Strychnifoliae root) for abdominal pain, in cases when lower abdomen is cold or has tension. Used for stifling sensation in the chest and diaphragm with wheezing, with focal pain and loss of appetite.

189 Lesson 8: Herbs that Regulate Qi REFERENCES 1 Hsu, H.Y., Chen, Y.P., et ai., Oriental Materia Medica: a concise guide, Oriental Healing Arts Institute, Long Beach, CA, 1986, p Huang CK, The Phannacology of Chinese Herbs 2nd Ed. ; CRC Press; 1999, p Hsu, H.Y., Chen, Y.P., et al., Oriental Materia Medica: a concise guide, Oriental Healing Arts Institute, Long Beach, CA, 1986, p Huang CK, The Phannacology of Chinese Herbs 2nd Ed. ; CRC Press; 1999, p Bensky D, Gamble A; Chinese Herbal Medicine Materia Medica;Eastland Press Seattle Wa; p Image plumdragonherbs.com

190 Lesson 8: Herbs that Regulate Qi Xie Bai Allium macrostemon Family: Liliaceae Other names: Chinese chive bulbs, Bulbus Alii, hsieh pi, ye bai tou, gaihaku (Japanese), haebaek (Korean) xie is the term for this particular plant; bai means white and refers to the bulb, the part used, which is white Plant description: Bulb irregularly ovate, cm high, cm in diameter. Surface yellow-white to yellow-brown, semi opaque, with membranous scaly remained; base round-obtuse; top acute-obtuse. Odour of garlic. Part used: bulb of chives Habitat, ecology and distribution: Throughout China, harvested in the spring in Northern China and summer through autumn in the rest. History: The Divine Husbandman's Classic Materia Medica Constituents: scorodose, and other sugars; essential oils Energetics Properties and Channels entered: acrid, bitter, warm; entering the Large intestine, Lung and Stomach meridians. Actions and Indications: cardiac, antimicrobial, expectorant, stimulate, and cathartic. Medical Research: This herb first stimulates the smooth muscles for a short period and then inhibits them. The extract has been employed successfully to treat angina pectoris. Inhibits the growth of Staphylococcus aureus and pneumococcus in vitro. 1,2 Toxicity, Contraindications and cautions: Use with caution in cases of qi deficiency. Not to be used long term allium can produce peptic ulcers.3 Medicinal uses: Unblocks yang qi and disperses cold phlegm; used for damp-cold painful obstruction of the chest due to cold turbid phlegm, congealing and stagnation in the chest. It helps to make the flow of yang qi. Promotes the movement of qi and blood, while alleviating pain. Used for cold stagnant qi with symptom of epigastric fullness, distention and abdominal pain. Used for blood obstruction in the Heart channel.

191 Lesson 8: Herbs that Regulate Qi Directs qi flow downward, reducing stagnation. Used for damp stagnation in the Large Intestine associated with dysenteric disorders. Pharmacy and dosage: gram of dried or grams of fresh. Major Combinations: With chai hu (Buperuri root) and bai shao (Paeoniae root) for dysenteric diarrhea due to qi stagnation. With gua lou (Trichonsanthis fruit) and ban xia (Pinelliae ternatae root) for damp-cold painful obstruction of the chest. Add dan shen (Salvia miltiorrhizae root) and hong hua (Carthami tinctorii flowers) if there is blood stasis. REFERENCES 1 Hsu, H.Y., Chen, Y.P., et al., Oriental Materia Medica: a concise guide, Oriental Healing Arts Institute, Long Beach, CA, 1986, p htm 3 Bensky D, Gamble A; Chinese Herbal Medicine Materia Medica;Easdand Press Seattle Wa; 1993 Image futurosity.com

192 Lesson 8: Herbs that Regulate Qi Li Zhi He Litchi chinensis Family: Sapindaceae Other names: litchi, leechee nuts, Semen Litchi Chinensis, Ii chih ho, reishikaku (Japanese), yojihaek (Korean) Plant description: A graceful, slim-trunked tree, the lychee reaches a height of 30 ft (9 m) and a spread of ft (3-4.5 m). Bright green compound leaves, gold or pink when young, form a low spreading crown. Clusters of small, petal-less, greenish yellow flowers are borne in abundance in spring, followed by the bright red, edible fruit, which enclose a brown seed. The fruit contain a sweet whitish pulp reminiscent in texture and flavor to that of grapes. Part used: dried seed Habitat, ecology and distribution: Guangdong, Guangxi, Fujian, Sichuan; harvested in June or July when the fruit has ripened History: Extension of the Materia Medica. Constituents: saponins, tannins, alpha-methylenecyclo-propyl glycine. 1,2 Energetics Properties and Channels entered: sweet, astringent, warm; entering the Liver and Stomach meridians. Actions and Indications: hypoglycemic, PMS, stomachic, hepatic. Medical Research: Can reduce blood sugar and glycogen stores in liver. Toxicity, Contraindications and cautions: Use only in cases of stagnant qi associated with damp-cold. Medicinal uses: Regulates qi and stops pain in abdominal and epigastric region that is due to Liver qi constraint. Can also be used for abdominal premenstrual and post parturition pain due to stagnant qi or blood stasis. Disperses cold and stagnation, while stopping pain. Used for hernial or testicular pain due to cold congealing in Liver channel. Pharmacy and dosage: 6-15 grams, crush before dispensing

193 Lesson 8: Herbs that Regulate Qi Major Combinations: With mu xiang (Auckladiae lappa root) for chronic epigastric pain due to Liver qi stagnation. With xiang fu (Cyperi rotundi root) for PMS or postpartum pain The fresh flesh of the fruit is also medicinal being sweet, warm and essence neutral. It is used to move qi. REFERENCES 1 Bensky D, Gamble A; Chinese Herbal Medicine Materia Medica;Eastland Press Seattle Wa; Hsu, H.Y., Chen, Y.P., et al., Oriental Materia Medica: a concise guide, Oriental Healing Arts Institute, Long Beach, CA,1986 Image futurosity.com

194 Lesson 8: Herbs that Regulate Qi Xiang Fu Cyperi rotundus Family: Cyperaceae Other names: Cyperus, sha cao gen, nut grass rhizome, nut sedge, Kobu (Japanese), hyangbu (Korean), literal English translation aromatic appendage Parts used: rhizome Plant description: Perennial plant, up to 40 cm tall, leaves sprout in ranks of three from the base of the plant. Flower stems have triangular cross-section, bisexual, has three stamina and three stigma carpel, Fruit is a three angled achene. 1 One of the most invasive weeds known. Known as the worlds worst weed, it is found in over 90 countries, mostly temperate and tropical regions. Habitat, ecology and distribution: Wild spread from hill grass land, cultivated fields, roadside, water side, available from east to middle, west south China, volumes output from Shan Dong, Zhe Jiang Fu, Hu Nan, He nan areas. 2 History: First appeared in Miscellaneous Records of Famous Physicians Constituents: volatile oil: B-pinene, camphene, 1,8-cineole, limonene, p-cymene, cyperene, selinatriene, b-selinine, patchoulenone etc. Flavonoids: rhamnetin-3-0- rhamnosyl-(1-4)-rhamnopyranoside. Other: proteins and sugars. Energetics Properties and Channels entered: Acrid, slightly bitter, slightly sweet, neutral. Enters the San jiao, Gallbladder and Liver meridians, Actions and Indications: Hepatic, emmenagogue Medical Research: none noted Toxicity, Contraindications and cautions: Not be used without stagnation, or with yin deficiency heat or blood heat Medicinal uses: Moves and regulates liver qi: symptoms of hypocondrium pain, epigastric distention and hernial pain. Harmonize the liver and spleen, directs rebellious qi downward. Regulates menstruation and alleviates pain: Regulates the liver meridian to stop pain in cases of dysmenorrhea, breast distention, ammenorrhea and treats irregular menstruation.

195 Lesson 8: Herbs that Regulate Qi Pharmacy and dosage: 6-12 grams Major Combinations: With Chai hu (Bupleuri radix) and Bai shao (Paeoniae radix alba) for distention and pain in the hypochondriac region and epigastrium. With Mu xiang (Aucklandia radix) and Fo shou (Citri sacrodactylis fructus) for distenstion and pain in the abdomen and epigastric region, indigestion, vomiting, and diarrhea. With Dang gui (Angelica sinensis) and Chuan xiong (Chuanxiong rhizoma) for irregular menstruation and dysmenorrhea due to blood and qi stagnation. REFERENCES Image futurosity.com!!

196 Lesson 9: Herbs that Regulate Blood LESSON 9: Herbs that Regulate Blood In general there are three pathologies that may affect the blood according to TCM theory: blood deficiency, blood stagnation and bleeding. In this lesson we will be looking at herbs that regulate the blood to stop bleeding and treat blood stagnation. Herbs to treat blood deficiency are addressed in Lesson 10 Tonifying herbs. Regulating the blood implies restoring balance to the state of blood. Blood is without balance when there is excess or deficiency, heat or cold, yin deficiency or yang excess, and when blood moves externally from its internal state. Herbs that stop Bleeding The definition of bleeding is simply blood that has left its normal passages. Bleeding is considered pathogenic when it is present with symptoms such as: vomiting blood, coughing blood, nosebleeds, blood in the stool or urine, menstruation that is excessive or outside of a regular cycle, and bleeding that is associated with trauma. These types of bleeding may be caused by blood moving recklessly due to heat, excess yang, deficient yin, blood stagnation, qi stagnation, or qi deficiency. When treating bleeding, it is important to use the herbs to 'stop bleeding' in conjunction with herbs that treat the root cause of the problem (i.e. herbs that cool the blood, tonify yin or qi, or invigorate the blood). Herbs that stop bleeding are: Pu huang - Typha angustifolia Xian he cao - Agrimonia pilosa San qi - Panax notoginseng Ai ye - Artemisia argyi Of these herbs Pu huang and San qi may be used when blood stasis is present, Pu huang is better for blood in the urine and San qi generally speaking is the stronger of the two. Xian he cao is astringent and helps to stop bleeding in this way. Ai ye is warming and used when the cause of bleeding is due to cold and deficient yang. Herbs that Invigorate the Blood When the circulation of blood is prevented it becomes stagnant, a pathological state. This disruption of flow is caused by several factors such as: a deficiency of qi which is unable to circulate the blood, qi stagnation preventing circulation, cold coagulating the blood, and blood heat

197 Lesson 9: Herbs that Regulate Blood preventing free flow. Whenever the blood is stagnant it is necessary to invigorate it and harmonize its movement. Blood stagnation is associated with pain that is stabbing, often worse at night and there may be visual bruising or dark distended vessels. Abscesses and ulcers are also associated with stagnation of qi and blood. Additionally, it is important to recall pain that is associated with qi stagnant has subjective sensation but no objective palpability, when qi stagnation affects the blood to the point of stagnation there will be an actual palpable mass. Masses may be mobile or not, both may be treated by these herbs but special consideration must be given to the possibility of cancerous tumours. Blood stagnation will give rise to bleeding and therefore care in selecting herbs that invigorate blood and stop bleeding should be chosen. Herbs that invigorate the blood are: Chuan xiong - Ligusticum chuanxiong Dan shen - Salvia miltiorrhiza Yi mu cao - Leonurus heterophyllus Chi shao - Paeonia veitchii Tao ren - Prunus persica Hong hua - Carthamus tinctorius Niu xi - Achyranthes bidentata Chuan xiong is effective for blood stasis associated with the liver meridian and stagnation of qi; Chi shao is also effective in this regard though not as strong. Dan shen, yi mu cao, Tao ren, Hong hua and Niu xi are all indicated for stagnation of blood that affects menstruation. Niu xi is tonifying to the kidneys and also acts as an envoy to move herbs downward, making it useful for stagnation associated with deficiency and trauma at the low back and legs. Hong hua and tao ren are most commonly used for all types of blood stagnation, they are synergistic herbs and are seen together in many formulas. Though not discussed in this section, other useful herbs for blood stagnation are: curcuma (turmeric), frankincense, myrrh and wingless cockroaches.

198 Lesson 9: Herbs that Regulate Blood Pu Huang Typha angustifolia Family: Typhaceae Other names: cattail pollen, bulrush, typha pollen, hoo (Japanese), pohwang (Korean), Typha orientalis Plant description: Good quality is yellow and shiny. Part used: Pollen Habitat, ecology and distribution: Jiangsu, Zhejiang, Shangdong, Anhui, Hubei, harvested in summer from blooming flowers History: Divine Husbandman's Classic of Materia Medica Constituents: Pollen typhae augustatae - isorhamnetin, pentacosane, al phasitosterol, palmitic acid, alpha-typhasterol Energetics Properties and Channels Entered: sweet, pungent and neutral entering the liver, heart and spleen meridians Actions and Indications: anti-hypertensive, smooth muscle stimulant, hemostatic Medical Research: Water or alcohol preparations of pu huang (Pollen Typhae) given orally to rabbits reduced bleeding time and thrombin time, and increased platelet count Preparations of pu huang stimulated the uterus in animal experiments. The effect was more pronounced on non-pregnant uteri, and was especially strong post partum. Large doses of decoctions or alcohol extractions of pu huang (Pollen Typhae) lowered blood pressure in cats and dogs. This effect was countered by atropine. Large doses had a negative inotropic effect, while small doses stimulated the hearts of frogs. No significant effect was noted in dogs given large doses of the herb. Preparations of pu huang increased peristalsis in rabbit intestine specimens. This action was inhibited by atropine.1 This herb has recently been used in treating angina pectoris.2 Toxicity, Contraindications and cautions: use with caution during pregnancy, especially the unprepared form (raw) as it may cause uterine contractions. Medicinal uses: Stops bleeding: for external bleeding associated with traumatic injury, and various forms of internal bleeding such as: uterine bleeding, vomiting blood, nosebleed, coughing of blood, blood in the urine, blood in the stool, or subcutaneous bleeding.

199 Lesson 9: Herbs that Regulate Blood This herb has an astringent nature and is quite effective in stopping bleeding. Can be used for bleeding due to heat or cold due to its neutral nature. Invigorates the blood and dispels blood stasis: for chest pain, post partum abdominal pain, and menstrual pain due to blood stasis Pharmacy and dosage: g, use raw to dispel blood stasis, toasted to stop bleeding. Usually decocted alone, or if added to a decoction wrap in cheesecloth. Major Combinations: With xiao ji (Herba Cephalanoplos) for bloody urine associated with painful urinary dysfunction due to damp heat in the bladder. With pao jiang (quick fried Rhizoma Zingiberis Officinalis) for abdominal pain and distention associated with lochioschesis. This combination is also used for chronic bloody stools due to cold from deficiency of spleen and kidneys. With wu ling zhi (Excrementum Trogopteri seu Pteromi) for chest and abdominal pain due to blood stasis, especially when associated with menstrual irregularity and lochioschesis. With hai piao xiao (Os Sepiae seu Sepiellae) as a topically applied powder for external bleeding resulting from traumatic injury. With honey as a topically applied powder for pain and swelling associated with sores. REFERENCES 1 Bensky, D. and Gamble, A.; Chinese Herbal Medicine Materia Medica; Eastland Press, Seattle; 1993; p250 2 Bensky, D. and Gamble, A.; Chinese Herbal Medicine Materia Medica; Eastland Press, Seattle; 1993; p250 Image scarfamilyditdajow.com

200 Lesson 9: Herbs that Regulate Blood Xian He Cao Agrimonia pilosa Family: Rosaceae Other names: tuo Ii cao, agrimony, long ya cao Plant description: Good quality has purple red stems and well shaped leaves. Part used: stems and leaves Habitat, ecology and distribution: through out China, harvested in summer and autumn when the stems and leaves are at their height, but before the flowers have bloomed History: Catalogued Differentiation of Erroneous Medicines Constituents: agrimonine, agrimonolide, cosmosiin, agrimol A, B, C, D, E, saponins, luteolin-7 -B-glucoside, apigenin-7 -B-glucoside, tannin Energetics Properties and Channels Entered: bitter, pungent, neutral, entering the lung, liver and spleen meridians Actions and Indications: hemostatic, vasoconstrictor, vasodilator, sedative (smooth muscle), antibiotic, analgesic Medical Research: Shown to reduce bleeding time in animal studies, as well as peripheral vasoconstriction. In 11 cases using agrimonine to treat bleeding disorders, 3 showed increase of thrombin. Powdered Xian he cao is commonly used in surgery or treatment of trauma as a hemostatic. In one clinical study of 20 surgical cases hemorrhage or seepage stopped in 1-2 minutes. Agrimonolide was shown to reduce the frequency and strength of rabbit intestinal contractions and can prolong the relaxation phase. Decoctions of Xian he cao had an in vitro inhibitory effect against Staphylococcus aureus and Bacillus subtilis, as well as a weak effect against Mycobacteruim tuberculosis. Alcohol extractions of Xian he cao inhibited the growth of the Columbia SK virus in mice. Decoctions of Xian he cao reduced conjunctivitis from either mustard oil or Staphylococcus aureus in rabbits. A large dosage ( mg/kg) of water extractions of Xian he cao given intravenously to rabbits produced a significant analgesic effect (dental pulp stimulation test).

201 Lesson 9: Herbs that Regulate Blood Toxicity, Contraindications and cautions: may cause nausea or vomiting, may cause skin allergy in powdered form Medicinal uses: Restrains leakage of blood and stops bleeding: widely used for various types of bleeding such as vomiting blood, coughing blood, nosebleed, bleeding gums, blood in the urine or uterine bleeding. Depending on its particular combination with other herbs, this herb can be used for bleeding due to heat, cold, excess or deficiency. Alleviates diarrhea and dysenteric disorders: for chronic problems, as this herb has a restraining nature. Kills parasites: for trichomonas vaginits and tapeworm. Pharmacy and dosage: 9-15g, 15-30g when used fresh. Used as a suppository for diarrhea and as a topical wash for trichomonas vaginits. Major Combinations: With hai piao xiao (Os Sepiae seu Sepiellae) for excessive uterine bleeding or dark bloody stool associated with pain in the middle burner (equivalent to peptic ulcer in modern biomedicine). With huai hua mi (Flos Sophorae Japonicae Immaturus) for bloody stool. With bai mao gen (Rhizoma Imperatae Cylindricae) for bloody urine. Add ou jie (Nodus Nelumbinis Nuciferae Rhizomatis) for nosebleeds. With ce bai ye (Cacumen Biotae Orientalis) for vomiting blood REFERENCES Bensky, D. and Gamble, A.; Chinese Herbal Medicine Materia Medica; Eastland Press, Seattle; 1993 Image tcm.health-info.org

202 Lesson 9: Herbs that Regulate Blood San Qi Panax notoginseng Family: Araliaceae Other names: tian qi, shen san qi, notoginseng root, pseudoginseng root, literal English translation: three seven Plant description: Good quality is large, solid and heavy, with a thin cortex and dark colour. Part used: root Habitat, ecology and distribution: Yunnan, Guangxi, Sichuan, Guizhou, Jiangxi, harvested in autumn or winter of the third or seventh year, either before the flowers bloom (better) or after the fruit is ripe. History: Grand Materia Medica Constituents: arasaponin A, arasaponin B, dencichine Energetics Properties and Channels Entered: sweet, slightly bitter and warm entering the liver, stomach and large intestine meridians Actions and Indications: hemostatic, antihypertensive, antibiotic Medical Research: San qi decreases bleeding time in animals, this effect is not achieved if the portal vein is ligated first. It is therefore believed that the liver plays an important role in this herb's effectiveness. San qi also shortens thrombin time. Intravenous injections of san qi increase coronary blood flow and reduce blood pressure. Subcutaneous injections reduce capillary permeability in mice. Powdered san qi was used in one clinical trial of 16 patients with coronary artery disease whose main complaint was angina pectoris. All but one had satisfactory relief of pain. Those who had been on chronic nitroglycerin therapy tapered off that therapy, those with hypertension showed significant reduction in blood pressure, and in four cases there was mild improvement in the ECG. In a small study, daily use of powdered san qi was associated with a reduction in serum lipids and cholesterol. San qi preparations have been shown to have an in vitro inhibitory effect on the Norwalk virus and some dermatomycoses. In one series of 8 patients with acute attacks of Crohn's disease, powdered san qi was helpful in seven cases. On the average, within 2 days the pain lessened, within four days peristalsis had been restored, and with in 10 days the acute condition had passed.

203 Lesson 9: Herbs that Regulate Blood Toxicity, Contraindications and cautions: contraindicated during pregnancy. Use with caution in patients with blood or yin deficiency. Medicinal uses: Stops bleeding and transforms blood stasis: for internal and external bleeding including vomiting blood, nosebleed, and blood in the urine or stool. Because this herb can stop bleeding with out causing blood stasis it is widely used. Reduces swelling and alleviates pain: the herb of choice for traumatic injuries, used for swelling and pain due to falls, fractures, contusions and sprains. Effective in invigorating the blood, it is used for chest and abdominal pain, as well as joint pain that is caused by blood stasis. Pharmacy and dosage: 1-3g when taken directly as a powder, 3-9g when used in decoctions. Also used topically. Major Combinations: With bai ji (Rhizoma Bletillae Striatae) for vomiting and coughing blood as well as nosebleed and bloody urine. With hua rui shi (Ophicalcium) and xue yu tan (Crinis Carbonisatus Hominis Hominis) for vomiting and coughing of blood, nosebleed, excessive uterine bleeding, bloody stool, or bloody urine. With long gu (roasted Os Draconis) and wu bei zi (Rhois Chinensis) as a topically applied poultice, for trauma induced bleeding. Ingredient in famous formula Yunnan baiyao, a hemostatic patented formula REFERENCES Bensky, D. and Gamble, A.; Chinese Herbal Medicine Materia Medica; Eastland Press, Seattle; 1993 Image scarfamilyditdajow.com

204 Lesson 9: Herbs that Regulate Blood Ai Ye Artemisiae argyi Family: Compositae Other names: mugwort leaf, artemesia, wu yue ai, qi ai, bai ai, moxa leaf Plant description: Good quality is grey white in colour, aromatic and has a thick, hairy texture Part used: leaf Habitat, ecology and distribution: throughout China, especially Shandong, Anhui, Hubei and Hebei; harvested at the end of spring and early summer when the leaves are growing vigorously, but before the flowers bloom. History: Collection of Commentaries on the Classic of Materia Medica Constituents: cineole, terpinen-4-01, B-caryophellene, Artemisia alcohol, camphor, borneol, linalool Energetics Properties and Channels Entered: bitter, pungent and warm, entering the spleen, liver and kidney meridians. Actions and Indications: antibiotic, antimalarial Medical Research: Decoctions of ai ye have an in vitro inhibitory effect against such pathogens as Staphylococcus aureus, B-hemolytic Streptococcus, Streptococcus pneumoniae, Shigella sonnei, Salmonella typhi and Salmonella paratyphi. Both infusions and decoctions of ai ye caused strong contractions in rabbit or guinea pig uterus specimens. Large doses of ai ye given for 2 days to malaria patients 2 hours before the onset of symptoms showed control of symptoms in 89% of the cases, together with negative blood examinations for the parasite in over half of those cases. Crushed fresh ai ye placed over warts of 12 patients many times per day led to a falling off of the warts within 3-10 days. Toxicity, Contraindications and cautions: use with caution in cases of blood heat or yin deficiency. Medicinal uses: Warms the womb and stops bleeding: for prolonged menstrual bleeding and uterine bleeding due to cold from deficiency

205 Lesson 9: Herbs that Regulate Blood Warms the womb and pacifies the fetus: for restless fetus, lower abdominal pain and vaginal bleeding as in threatened miscarriage. Also used for Infertility due to cold womb. Disperses cold and alleviates pain: for cold abdominal pain, especially menstrual pain. Pharmacy and dosage: 3-9g. Char to enhance both its warming and hemostatic properties. In its raw form it is relatively neutral and may be combined with other herbs that cool the blood (for blood heat). Major Combinations: With e jiao (Gelatinum Corii Asini) for restless fetus and threatened miscarriage. With xiang fu (Rhizoma Cyperi Rotundi) for abdominal pain due to cold from deficiency and stagnant qi. With gan jiang (Rhizoma Zingiberis Officinalis) for abdominal pain due to cold, especially menstrual pain. With di fu zi (Fructus Kochiae Scopariae) for a variety of itching skin lesions due to damp-cold. REFERENCES Bensky, D. and Gamble, A.; Chinese Herbal Medicine Materia Medica; Eastland Press, Seattle; 1993 Image tcm.health-info.org

206 Lesson 9: Herbs that Regulate Blood Chuan Xiong Ligusticum chuanxiong Family: Umbelliferea Other names: cnidium, szechuan lovage root, senkyu (Japanese), cheongung (Korean), Ligusticum wallichii Plant description: aromatic, thinly sliced root that is orange in colour. Part used: root Habitat, ecology and distribution: Sichuan, Guizhou, Yunnan, Shaanxi, Hubei; harvested in summer when stems have a purple hue. History: Materia Medica for Decoctions Constituents: tetramethylpyrazine, perlolyrine, ferulic acid, chrysophanol, sedanoic acid,4-hydroxy-3-butyphthalide Energetics Properties and Channels Entered: pungent and warm, entering the liver, gallbladder and pericardium meridians Actions and Indications: sedative, anti-hypertensive, smooth muscle stimulant, antibiotic Medical Research: Decoctions of chuan xiong orally administered in a dosage of 25-50g/kg had a definite sedative effect in rats and mice. It prolonged the hypnotic effect of barbiturates, but did not counteract the effect of caffeine. Oral administration of decoctions of chuan xiong had a weak anti-hypertensive effect in animal experiments, but intravenous and intramuscular injections caused a significant reduction in blood pressure in anesthetized animals. Water extractions had the most pronounced effect on blood pressure. In long term experiments on dogs and rats, decoctions of this herb in doses of 4g/kg per day lowered blood pressure in renal hypertensives by 20mm Hg, but had no effect on experimental essential hypertensives. Very small amounts of a 10% solution of chuan xiong stimulated pregnant rabbit uterus specimens, while large amounts stopped contractile effects completely. Continued injection of a solution of this herb in pregnant rabbits and rats resulted in death of the fetus with out expulsion. Small amounts of a decoction of this herb inhibited the contraction of rabbit or guinea pig small intestine specimens, while large amounts brought all contraction to a halt.!!

207 Lesson 9: Herbs that Regulate Blood Chuan xiong has an in vitro inhibitory effect against many pathogenic bacteria such as Shigella sonnei, Pseudomonas aeruginosa, Salmonella typhi, and Vibrio cholerae. It also has an in vitro inhibitory effect against many dermatomycoses. Toxicity, Contraindications and cautions: contraindicated in cases of yin deficiency with heat signs, headaches due to ascendant liver yang, qi deficiency, or excessive menstrual bleeding. Vomiting and dizziness may occur from over dosage. Medicinal uses: Invigorates the blood and promotes the movement of qi: for any blood stasis pattern. This is an important herb in gynecology and is used for such problems as dysmenorrhea, amenorrhea, difficult labour, or lochioschesis. It is also indicated for patterns of stagnant qi and blood stasis with pain in the chest, flanks or hypochondria. Expels wind and alleviates pain: a leading herb for any externally contracted wind disorder characterized by headache, dizziness or painful obstruction. Also used for a variety of skin problems caused by wind. Headaches: moves the qi upward and alleviates pain. Depending with which other herbs it is combined; it can be used for headaches due to wind, heat, cold or blood deficiency. Pharmacy and dosage: 3-6g; for irregular menstruation, up to 9g may be used. Major Combinations: With fang feng (Radix Ledebourielle Divaricatae) and jing jie (Herba seu Flos Schizonepetae Tenuifoliae) for headache from externally contracted wind cold. With qiang huo (Rhizoma et Radix Notopterygii) and jiang can (Bombyx Batryticatus) for wind dampness lateral headache. With chai hu (Radix Bupleuri) and chi shao (Radix Paeoniae Rubrae) for headache and/or chest pain due to stagnant liver qi and blood. With dang gui (Radix Angelicae Sinensis) for irregular menstruation, dysmenorrhea, amenorrhea or late and scanty menstruation due to blood deficiency. This combination is also used for pain, numbness and paralysis from wind dampness and stagnant qi blocking the blood connecting channels, which greatly limits or prevents nourishment from reaching the sinews. With yi mu cao (Herba Leonuri Heterophylli) and tao ren (Semen Persicae) for problems due to post partum blood stasis. REFERENCES Bensky, D. and Gamble, A.; Chinese Herbal Medicine Materia Medica; Eastland Press, Seattle; 1993 Image tcm.health-info.org

208 Lesson 9: Herbs that Regulate Blood Dan Shen Salvia miltiorrhizae Family: Labiatae Other Names: Cinnabar root, Salvia root, zi dan shen, chi dan shen, tanjin (japanese), Dan sam (korean) Parts used: Root Habitat, ecology and distribution: Native to Mongolia and Manchuria. Hardy and tough perennial mint that can reach up to 32 inches tall with tooth edged oval leaves and purple flowers. Grows on sunny slopes of hills and light woodland clearings. Harvested in the late autumn through to spring of the next year. History: Divine Husbandman's Classic of the Materia Medica Constituents: quinones, diterpene keones, diterpene lactones, phenoles, baicalin, sitosterol, daucosterol Energetics Properties and Channels entered: Bitter and slightly cold, enters the heart, pericardium and liver Actions & Indications: Invigorates the blood, tonify's the blood, calms irritability due to blood heat Medical research: Inhibits platelet aggregation Animal trails have shown Dan shen to have cardiovascular benefits, particularly in patients with ischemic stroke or coronary artery disease/angina. More recent studies have focused on possible roles in liver disease (hepatitis and cirrhosis) and as an antioxidant.1 Water soluble extracts of the herbal plant, Salvia miltiorrhiza (Dan shen) exhibited potent effect against HIV-1 integrase activity in vitro and viral replication in vivo.2 A small number of studies suggest that dan shen may provide benefits for treating disorders of the heart and blood vessels, including chest pain, heart attacks, and ischemic stroke. 3 Toxicity, Contraindications and cautions: Contraindicated during pregnancy, do not use with Li lu. Side effects may appear in some patients and gradually decrease without stopping the treatment such as: dry mouth, dizziness, general weakness, numb and swollen hands, shortness of breathe, anxiety, tachycardia, nausea, vomiting and GI symptoms. May also cause headaches. Caution in cases without stagnation.

209 Lesson 9: Herbs that Regulate Blood Injection preparations of Dan shen have been reported to cause one known case of liver damage and two cases of shock. Medicinal uses: Enters the blood level of the Heart, pericardium and liver channels. Invigorates blood, transforms stasis and tonify's the blood. Primarily used for gynecological disorders involving blood heat and blood stasis, and for joint pain. Invigorates blood and dispels stasis: for blood stasis in any part of the body Cools the blood and reduces abscesses: early stage of breast abscess and as an adjunctive treatment for sores Nourishes the blood and calms the spirit: for heat entering the ying and blood level or insufficient heart blood Clears heat and soothes irritability: for restlessness, irritability, palpitations and insomnia due to heat entering the ying level. Clears Deficiency heat from Heart and Kidney yin deficiency. Pharmacy & dosage: Major Combinations: With Tao Ren (Persicae semen) and Yi mu Cao (Leonuri Herba) for postpartum adbominal pain With Ru xiang (Olibanum) for pain and swelling due to blood stasis With Mu dan pi (Moutan Cortex) and Sheng di huang (Rehmanniae Radix) for high fever, irritability, spitting of blood, subcutaneous bleeding and nose bleed due to heat in ying level With Jin yin hua (Lonicerae Flos) and Lian Qiao (Forsythae Fructus) for early stages of breast abscess REFERENCES 1. Healthline.com - Connect to Better Health Bensky, D. and Gamble, A.; Chinese Herbal Medicine Materia Medica; Eastland Press, Seattle; 1993 Image futurosity.com

210 Lesson 9: Herbs that Regulate Blood Yi Mu Cao Leonurus heterophyllus Family: Labiatae Other names: kun cao, chong wei, Chinese motherwort, leonurus Plant description: Good quality has thin stems and is green in colour. The entire plant (except root) of an annual herb with red and white flowers and a disagreeable odor.1 Part used: stems and leaves Habitat, ecology and distribution: throughout China, harvested in summer and autumn when the stems and leaves are flourishing and the flowers have just opened. History: Illustrated Classic of the Materia Medica Constituents: leonurine, stachydrine, leonuridien, leonurinine, lauric acid, linolenic acid, sterol, stachose, 4-guanidino-1-butanol, 4-guanidino-butyric acid, vitamin A Energetics Properties and Channels Entered: pungent, bitter, slightly cold, entering the heart, liver and bladder meridians. Actions and Indications: antihypertensive Medical Research: In many animal experiments, yi my cao directly stimulated uterine specimens in a manner similar to, though weaker than, oxytocin. In one experiment an alkaloid from the herb had this effect in anesthetized animals. Treatment of the post partum uterus: decoctions of yi mu cao were as effective as ergotamine in causing the uterus to contract after deliver. While the onset of action was slower, it was safer. Intravenous injection of water extractions of yi mu cao has consistently lowered blood pressure in many animal experiments. This effect was of short duration. Leonurine stimulated the respiratory center in the brain, and an alkaloid from the herb inhibited the central nervous system in frogs. Decoctions of yi mu cao were given to 80 patients of varying ages with acute glomerulonephritis, together with normal care. If there was also infection, antibiotics were given as well. All patients were cured, the shortest with in five days, the longest within 36 days. Cases were followed for as long as 5 years without recurrence or sequellae.

211 Lesson 9: Herbs that Regulate Blood Toxicity, Contraindications and cautions: contraindicated during pregnancy, use with caution in cases of yin or blood deficiency. Oral administration of yi mu cao in pregnant rabbits resulted in miscarriages. Otherwise no side effects were noted. Daily subcutaneous injection of this herb in rabbits in doses-of 30mg/kg for 2 weeks resulted in no side effects. The LD50 for intravenous injection of this herb in mice was 572mg/kg. Medicinal uses: Invigorates the blood and regulates the menses: commonly used for gynecological disorders such as irregular menstruation, premenstrual abdominal pain, immobile abdominal masses, infertility, and post partum abdominal pain with lochioschesis. Invigorates the blood and reduces masses: for abdominal masses or infertility caused by stasis from blood deficiency. Promotes urination and reduces swelling: for acute systemic edema. Especially useful for that which is accompanied by blood in the urine. Pharmacy and dosage: 9-60g; up to 120g may be used for treating edema from glomerulonephritis. Major Combinations: With chi shao (Radix Paeoniae Rubrae), dang gui (Radix Angelicae Sinensis) and mu xiang (Radix Aucklandiae Lappae) for irregular menstruation, scanty menstruation, lower abdominal distention and pain and infertility due to blood stasis. With pu huang (Pollen Typhae) for lochioschesis. With bai mao gen (Rhizoma Imperatae Cylindricae) for edema accompanied by blood stasis. Recently this combination has been used to treat edema associated with nephritis. With huang jing (Rhizoma Polygonati), shi wei (Folium Pyrrosiae) and dong kui zi (Semen Abutili seu Malvae) for kidney stone and bloody urine. REFERENCES 1 Image futurosity.com

212 Lesson 9: Herbs that Regulate Blood Chi Shao Peonia veitchii Family: Ranunculaceae Other names: chi shao yao, red peony root, sekishaku (Japanese), jeokjak (Korean) Plant description: good quality has an outer cortex that is easily peeled and deep, coarse wrinkles. Part used: root Habitat, ecology and distribution: P. veitchii: Sichuan, Yunnan, Gansu, Shaanxi, Qinghai; P. lactiflora: Inner Mongolia and throughout northeastern China; harvested in spring and autumn. History: Collection of Commentaries on the Classic of Materia Medica Constituents: paeoniflorin, tannin Energetics Properties and Channels Entered: sour, bitter and slightly cold, entering the liver and spleen meridians. Actions and Indications: antispasmodic, antihypertensive, vasodilator, antiinflammatory, antibiotic, antipyretic. Medical Research: The effect of chi shao on intestinal specimens has varied in different experiments, probably owing to different plant sources. Generally, in rabbits a large dosage was necessary before significant antispasmodic effects ere observed. However, paeoniflorin had relatively strong antispasmodic effects on guinea pig and rat intestines as well as intestinal specimens. Paeoniflorin has also been shown to counteract the effect of oxytocin on the uterus of rats. Paeoniflorin reduced the blood pressure of guinea pigs in a dose related manner. It also increased the coronary blood flow in dogs, although this effect was much less pronounced than that of nitroglycerin. Chi shao had a weak inhibitory effect on rabbit heart specimens, and a mild vasodilatory effect on visceral blood vessels in frogs. Preparations of chi shao effectively counteracted convulsions from strychnine. Paeoniflorin showed a mild anti-inflammatory effect and a protective function against stress ulcers in white rats. Paradoxically, it slightly raised the acidity of stomach secretions and improved appetite. Decoctions of chi shao have been shown to have a very strong in vitro inhibitory effect against Shigella sonnei, and to inhibit the growth of Staphylococcus aureus, herpes zoster virus and various pathogenic dermatomycoses.

213 Lesson 9: Herbs that Regulate Blood Paeoniflorin lowered the temperature of both white mice with normal temperatures and those with artificially induced fevers. Toxicity, Contraindications and cautions: use with caution in cases of blood deficiency, LD50 for intravenous infection of paeoniflorin into white mice is 3530 mg/kg. Medicinal uses: Invigorates the blood and dispels blood stasis: for dysmenorrhea, amenorrhea, abdominal pain and immobile abdominal masses. Also for the swelling and pain associated with traumatic injury, and the early stages of abscesses and boils. Clears heat and cools the blood: for heat entering the blood level with fever, purple tongue, skin blotches, red painful sores and bleeding due to the reckless movement associated with hot blood. Clears liver fire: for red swollen and painful eyes. Pharmacy and dosage: 4.5-9g. Major Combinations: With chuan xiong (Radix Ligustici Chuanxiong) for blood stasis induced gynecological disorders such as immobile abdominal masses and amenorrhea with abdominal pain. This combination is also used for abscesses, boils and trauma induced pain. With tao ren (Semen Persicae) for blood stasis induced menstrual disorders, especially those characterized by premature onset of period, excessive bleeding and the presence of purple thick clots. With xiang fu (Rhizoma Cyperi Rotundi) for flank pain, abdominal pain and dysmenorrhea due to obstruction of qi and blood. With ru xiang (Gummi Olibanum) and mo yao (Myrrha) for bruising, swelling and pain form traumatic injury. Add detoxifying herbs, such as jin yin hua (Flos Lonicerae Japonicae) and lian qiao (Fructus Forsythiae Suspensae) for pain and swelling associated with boils and abscesses. With ju hua (Flos Chrysanthemi Morifolii) and huang qin (Radix Scutellariae Baicalensis) for redness, swelling and pain in the eyes. REFERENCES Image tcmtreatment.com

214 Lesson 9: Herbs that Regulate Blood Tao Ren Prunus persica Family: Rosaceae Other names: tao he ren, guang tao ren, dan tao ren, peach kernel, persica Plant description: Good quality is whole, white yellow and oval shaped. Part used: kernel (seed) Habitat, ecology and distribution: through out China, harvested in July through August when fruit is ripe. History: Collection of Commentaries on the Classic of Materia Medica Constituents: amygdalin, emulsion, oleic acid, glyceric acid, linoleic acid Energetics Properties and Channels Entered: bitter, sweet and neutral, entering the heart, large intestine, liver and lung meridians. Actions and Indications: anticoagulant, anti-tubercular Medical Research: Alcohol extractions of tao ren have a weak anticoagulant effect. Used in treating tuberculosis in white mice. Toxicity, Contraindications and cautions: contraindicated during pregnancy. The equivalent of 4g of tao ren was given orally to rats on a daily basis for one week with out any observed effect on serum glucose, serum albumin, liver function studies or the histology of the major organs. Medicinal uses: Breaks up blood stasis: an important herb used in resolving many kinds of problems associated with blood stasis, including menstrual disorders, abdominal pain, traumatic injury, flank pain, lung abscesses and intestinal abscesses with immobile abdominal mass Moistens the intestines and unblocks the bowels: for constipation due to dry intestines. Pharmacy and dosage: 4.5-9g.

215 Lesson 9: Herbs that Regulate Blood Major Combinations: With hong hua (Flos Carthami Tinctorii) for blood stasis induced dysmenorrhea and amenorrhea presenting clinically with abdominal pain, clotting, and a scanty flow. Add dang gui (Radix Angelicae Sinensis) and chi shao (Radix Paeoniae Rubrae) for pain due to trauma. With da huang (Radix et Rhizoma Rhei) and mang xiao (Mirabilitum) for pain and swelling associated with intestinal abscess. This combination is also used for trauma accompanied by constipation. With yi yi ren (Semen coicis Lachryma jobi) and dang gua ren (Semen Benincasae Hispidae) for lung abscess. With xing ren (Semen Purni Armeniacae) and huo ma ren (Semen Cannabis Sativae) for constipation due to deficiency and or stagnation. REFERENCES Image tcm.health-info.org

216 Lesson 9: Herbs that Regulate Blood Hong Hua Carthamus tinctorius Family: Compositae Other names: chuan hong hua, du hong hua, hong Ian hua, safflower flower, zang/xi hong hua- Tibet, carthamus, fake saffron Plant description: Good quality has long petals, a fresh red colour, and is soft. Part used: flower Habitat, ecology and distribution: Henan, Gebei, Zhejiang, Sichuan, Yunnan; harvested June through July when the colour of the flower is changing from yellow to red. Best picked in the morning of a cloudy day, before the dew has dried. History: Illustrated Classic of Materia Medica Constituents: carhamin, carhamone, neocarthamin, palmitic acid, stearic acid, arachic acid, oleic acid, linoleic acid, linolenic acid Energetics Properties and Channels Entered: pungent and warm, entering the heart and liver meridians. Actions and Indications: anti-hypertensive, circulatory, hemostatic, anti- inflammatory Medical Research: Decoctions of hong hua showed a weak inhibitory effect on the heart of anesthetized animals and caused a reduction in blood pressure. They also caused vasoconstriction of peripheral blood vessels in the ear. In experiments on anesthetized dogs, decoction of this herb caused an increase in coronary blood flow and no significant effect on blood pressure. Decoctions of hong hua, together with other herbs that invigorate the blood and promote the movement of qi, were given in 44 cases of coronary artery disease for up to 4 months. Symptoms were significantly reduced in 49%, and there was marked improvement in ECG in 41 % of the cases. Most improvement was seen as early as one month after the onset of treatment, and a total of 90% of the patients in the series were able to stop taking nitroglycerin on a regular basis. Decoctions of hong hua stimulated the uterus in many different kinds of animals. Oral administration of safflower oil lowered the serum cholesterol of rabbits with elevated levels. In one clinical series, 1 % tinctures of hong hua were used in 775 cases of swelling and subcutaneous hemorrhage due to acute sprains. Complete cures were achieved in

217 Lesson 9: Herbs that Regulate Blood 347 cases, and another 399 were improved. Even in relatively severe cases the condition usually had cleared with in 3-5 days. Toxicity, Contraindications and cautions: contraindicated during pregnancy. Xi hong hua (Stigma Crocus Sativae) or saffron form Tibet is much stronger and much more expensive than Flos Carthami Tinctorii. It is used in relatively severe cases, most often for painful obstruction of the chest. Animals given a meal containing 6% hong hua experienced no change; however when the dose was increased to 8-10% weight loss was experienced. A meal containing 2% xi hong hua caused weight loss in animals. Medicinal uses: Invigorates the blood and unblocks menstruation: for blood stasis patterns with amenorrhea, abdominal pain, post partum dizziness, lochioschesis and abdominal masses. Dispels blood stasis and alleviates pain: for blood stasis wounds and pain, nonsupperative sores, carbuncles and dark purplish erythema. Also for incomplete expression of the rash of measles or painful obstruction of the chest due to blood stasis. Pharmacy and dosage: 3-9g, g when used to harmonize the blood. Added near the end in decoctions because it should not be cooked for a long time. Major Combinations: With chuan xiong (Radix Ligustici chuanxiong) for pain in the chest and abdomen due to blood stasis and stagnant qi. With dang gui (Radix Angelicae Sinensis) and sum u (Lignum Sappan) for pain and swelling associated with trauma. With yi mu cao (Herba Leonuri Heterophylli) for abdominal pain or post partum lochioschesis due to blood stasis. With sheng di huang (Radix Rehmanniae Glutinosae), chi shao (Radix Paeoniae Rubrae) and lian qiao (Fructus Forsythiae Suspensae) for pain, redness and swelling of the eyes. With zi cao (Radix Arnebiae seu Lithospermi) for measles presenting with purpuric rash. This combination is also used for carbuncles, boils and other toxic swellings. REFERENCES Image tcm.health-info.org!!

218 Lesson 9: Herbs that Regulate Blood Niu Xi Achyranthes bidentata Family: Amaranthaceae Other names: achyrantes root, huai niu xi, chuan niu xi, huai niu, literal English translation cow knee joint Plant description: Good quality is long, thin and hard with a light yellow colour. Part used: root Habitat, ecology and distribution: Hebei, Shanxi, Shandong, Jiangsu, Liaoning; harvested in winter, once the stems and leaves have withered. History: Divine Husbandman's Classic of Materia Medica Constituents: triterpenoid saponins, ecdysterone, inokosterone Energetics Properties and Channels Entered: bitter, sour and neutral, entering the liver and kidney meridians Actions and Indications: stimulation and inhibition of smooth muscle, antihypertensive, analgesic Medical Research: Varying from animal to animal, and sometimes depending on whether the animal is pregnant, preparations of the herb always caused contractions in rabbits and mice, while it caused relaxation in the nonpregnant uteri of cats, and contractions in pregnant cat uteri. Applied locally, it caused dilation of the cervical os in women.1 Decoctions of niu xi inhibited the motility of mice intestinal specimens, but increased contractions in guinea pig intestine. Intravenous injection of preparations of the herb into dogs and rabbits caused a temporary increase in gastric motility, followed by inhibition of the same.2 Injection of either decoctions or alcohol extractions of niu xi into dogs, cats and rabbits resulted in a reduction in blood pressure due to both an inhibition of the heart and peripheral vasodilation.3 Peritoneal injection of decoctions of niu xi into mice with artificial sprains had an analgesic effect that was much less than that of morphine.4 Toxicity, Contraindications and cautions: not be used in cases of diarrhea due to spleen deficiency, or in cases of excessive menstruation or spermatorrhea due to zheng qi deficiency. Contraindicated during pregnancy

219 Lesson 9: Herbs that Regulate Blood Medicinal uses: Invigorates the blood and expels blood stasis: for blood stasis patterns with such symptoms as dysmenorrhea, amenorrhea and lochioschesis. Strengthens sinews and bones and benefits the joints: for pain and soreness affecting the lower back and knees due to deficiency, as it tonifies and nourishes the liver and kidneys. Clears damp-heat in the lower burner: for cases of damp heat pouring downward manifesting as knee pain or lower back damp painful obstruction. It is also an auxiliary herb for painful urinary dysfunction or vaginal discharge. Especially useful for painful urinary dysfunction with stones and accompanied by lower back pain and bloody urine. Induces the downward movement of blood: for reckless movement of hot blood in the upper burner or yin deficiency with ascending fire. Manifestations include nosebleed, vomiting blood, toothaches and bleeding gums. Also for dizziness, headache and blurred vision due to ascendant liver yang. Used as an envoy to direct herbs to the lower part of the body Pharmacy and dosage: 9-15g. Raw invigorates the blood and cooked is more tonifying. Major Combinations: With hong hua (Flos Carlhami Tinctorii), dang gui (Radix Angelicae Sinensis) and rou gui (Cortex Cinnamomi Cassiae) for amenorrhea, dysmenorrhea and delayed menstruation due to blood stasis. With du zhong (Cortex Eucommiae Ulmoidis) for pain and weakness of the lower back and extremities due to kidney deficiency and for painful obstruction. With shi gao (gypsum) for pain, swelling and ulceration of the teeth, gums and tongue. With jin qian cao (Herba Lysirmachiae) for painful urinary dysfunction, especially in cases due to kidney stones accompanied by bloody urine and lower back pain. With dang gui (Radix Angelicase Sinensis) and huang qin (Radix Scutellariae Baicalensis) for hot painful urinary dysfunction. With gou teng (Ramulus cum Uncis Uncariae) and sang ji sheng (Ramulus Sangjisheng) for headache, dizziness and blurred vision associated with ascendant liver yang With sheng di huang (Radix Rehmanniae Glutinosae) and dai zhe shi (Haematitum) for pain and swelling of the gums due to yin deficiency with heat signs. REFERENCES 1 Bensky, D. and Gamble, A.; Chinese Herbal Medicine Materia Medica; Eastland Press, Seattle, 1993; p Bensky, D. and Gamble, A.; Chinese Herbal Medicine Materia Medica; Eastland Press, Seattle, 1993; p Bensky, D. and Gamble, A.; Chinese Herbal Medicine Materia Medica; Eastland Press, Seattle, 1993; p Bensky, D. and Gamble, A.; Chinese Herbal Medicine Materia Medica; Eastland Press, Seattle, 1993; p.285 Image tcm.health-info.org

220 Lesson 10: Tonifying Herbs LESSON 10: Tonifying Herbs Broadly speaking there are two kinds of diseases: deficiency disease and excess disease. Deficiency diseases are caused by an internal deficiency or weakness. Excess diseases are caused by abundance or stagnation. Tonifying herbs treat deficiency for as long as there are signs of deficiency. This is often considered the most important classification of a herb, but equally miss-used and miss-understood. These herbs will strengthen and nourish areas or processes of the body that are weakened or insufficient. Tonifying herbs can strengthen the body's defenses against disease; therefore they can be used in combination with herbs that expel external pathogens, when the normal qi is weak. Clinically, this strategy is called 'supporting the normal and expelling the pathogenic' (fu zheng qu xie). Tonifying herbs are most often used in convalescence stages to assist in recovery of a patient who has a chronic or degenerative disorder. We can split tonics into four major patterns: those used to treat deficiency of qi, blood, yang, and yin. The energy and flavour of the tonics usually follows these classifications: qi and yang tonic mostly being warm, acrid (pungent) and hot; blood and yin tonics are mostly sweet, neutral, salty and cold. For the purpose of discussion, we are organizing them according to these four aspects, but clinically they are often combined depending on the patient's patterns. It is common for a person with a yang deficiency to also present a qi deficiency and even a yin deficiency. We have to therefore be flexible on how we use these herbs. There are a few cautionary points that should be observed when using tonifying herbs: 1. Tonifying herbs are only part of the healing process. It is tempting for debilitated people to rely completely on the tonic herbs for recovery. Clean air, physical exercise, good food and water, along with a proper attitude have just as important of a role. 2. Tonics should not be used excessively or prematurely, as they can strengthen the pathogen equally as well as they can strengthen the body. Use releasing the exterior (evil qi-expelling) herbs to rid the body of fever or inflammation, along with small amounts of tonic herbs to increase resistance. Many tonic herbs have astringent, antidiuretic, antidiarrheal effects that can retain toxins in the body.

221 Lesson 10: Tonifying Herbs 3. You should be aware of a condition called 'deficient and unable to take tonification!. This can cause dyspepsia, abdominal distention, loss of appetite and/or a flare up of 'weakness fire', which can produce dry mouth and lips, irritability, and insomnia. Many of the tonics are quite rich and therefore harder to digest and absorb, especially if a person's digestion is weak (Stomach and/or Spleen qi deficiency). We have to strengthen and harmonize the Spleen and Stomach first or as well. Many people who need tonics, especially yin tonics, are low in fluids and have an imbalance in the autonomic nervous system. Some tonics, especially qi and yang tonics will excite the sympathetic nervous system and thus promote physiological functions that produce deficiency state fire. There can also be patterns of deficiency in each organ e.g. Spleen qi deficiency or Liver yin deficiency or Kidney yang deficiency. Each of these are dealt with tonics and formulas that are specific for that organ meridian area. Herbs That Tonify The Qi Qi tonifying herbs are used to treat qi deficiency patterns within the general body, but often are used on specific organs. The most common qi pattern deficiencies are around the two yin Organs, Spleen and Lungs. These two are responsible for extracting qi from food and air, as well as transporting it within the body. The major signs of Spleen qi deficiency are lethargy, weakened limbs, loss of appetite, abdominal distention, abdominal aches, loose stools, or diarrhea. These symptoms are often called "collapse of central qi" and can include symptoms of vertigo while standing, drooping sensation in lower abdomen, prolapse of anus or uterus, and often laxness of other muscle tissue. This is exhibited by a swollen tongue, with teeth marks on the outer edge, and is an extremely common sign to see in the clinic. The major symptoms of Lung qi deficiency are shortness of breath, shallow breathing, pallor, dyspnea (labored breathing) upon mild exertion, weakened voice, and spontaneous sweating. Qi tonics are often used for Blood deficiencies, as qi is partially responsible for the generation of blood and its movement. Qi tonics are often sweet and rich; therefore excess or chronic use can easily lead to a sense of fullness in the chest and diaphragm or a sensation of heat. Usually herbs that regulate and move qi are used along with qi tonics.

222 Lesson 10: Tonifying Herbs Herbs that we are going to study under qi tonics are: Ren shen - Panax ginseng Dang shen - Codonopsis pilosula Huang qi - AstraguIus membranaceus Da zao - Ziziphus jujuba Gan cao - Glycyrrhiza uralensis Herb that Tonify the Blood These herbs are used in treating the pattern of Blood deficiency; they treat the blood by nourishing it. The primary symptoms associated with Blood deficiency are: pale lips and face, vertigo, diminished vision, tinnitus, low energy, cardiac palpitations, dry skin, menstrual irregularities, pale tongue and a fine or thready pulse. The two meridians that are mostly affected by this pattern are Heart and Liver, which governs and stores the blood respectively. Blood deficiency is not only associated with anemia, but are often associated with liver and heart disorders. Many of the herbs that are classified under this subgroup do not build the blood directly, but work on the overall body to produce better blood. Blood deficiencies often arise from psychosomatic disorders, hearth failure or chronic hepatitis. Blood qi tonics are very seldom used alone and are often combined with yin tonics or qi tonics. Blood and qi tonics are often very moistening in nature and thus over use can sometimes cause indigestion (water putting out digestive fire). To reduce this factor, formulas will combine these herbs with others that strengthen the Stomach and/or Spleen. Botanicals that we will look at that are good Blood qi tonics are: Shu di huang - Rehmanniae glutinosa He shou wu - Polygonum multiflorum Dang gui - Angelica sinensis Bai shao - Paenia lactiflora Herbs that Tonify the Yang This section will be dealt with in Lesson 11. Herbs that Tonify the Yin These herbs are used mostly to tonify, nourish and/or moisten the yin of Lungs, Stomach, Liver and Kidneys. They are often combined with other botanicals to: moisten dryness, transform phlegm, moisten the Intestine,

223 Lesson 10: Tonifying Herbs promote the passage of stool and urine, alleviate thirst, calm the spirit, tonify the Blood, stop bleeding, or increase strength. Mild Lung yin deficiency has symptoms of: light dry cough, loss of voice, hoariness, thirst, dry throat or skin, and thick sputum. More severe cases have afternoon or tidal fevers, night sweats, chronic cough (often with blood), and a thick rapid pulse. For these more severe cases qi tonics such as ren shen (Ginseng) and huang qi (Astragulus) are also added. Stomach yin deficiency is caused by a lack of fluid in the stomach. The symptoms are: reduced appetite, irritability, thirst, dry mouth, constipation, and vomiting. This condition often occurs after a high fever. We use the same herbs here as we do for Lung yin deficiency. Liver yin deficiency can be split into two types: Liver Blood deficiency and Liver yin deficiency with ascendant Liver yang. Liver Blood deficiency is caused by depletion of blood and has the symptoms of: decrease in visual acuity, dry, dull eyes, night blindness, vertigo, tinnitus, and dry nails, with a low grade heat sensation. You will see a pale tongue, especially on the sides, and a quick pulse. For these conditions we need to nourish both blood and yin. Liver yin deficiency, with ascendant Liver yang, has the symptoms of vertigo, tinnitus, dry mouth, disturbed sleep, a red tongue and a thin, quick pulse. Hypertension is often associated with this pattern, as well as Kidney yin deficiency. Kidney Yin deficiency involves many processes and chronic disease. The symptoms include: vertigo, tinnitus, weak lower back and knees, warm palms and soles, low-grade afternoon fevers, scanty and dark urine, red, dry tongue, with thin and strong pulse. This usually means the kidneys fail to nourish the Liver, usually leading to Liver yin deficiency. This is therefore often called "Liver-Kidney deficiency". Yin tonics are usually sweet, cold, enriching and moistening and therefore need to be balanced with other herbs so not to aggravate or worsen conditions of Spleen or Stomach deficiency, internal obstruction of dampness or phlegm, abdominal distention or diarrhea. The herbs we will look at under this subheading are: Xi yang shen - Panax quinguefolium Tian men dong - Asparggus cochinchinensis Bai he - Lilium brownii

224 Lesson 10: Tonifying Herbs Ren Shen Panax ginseng Family: Araliaceae Other names: ginseng root, radix ginseng, jen shen, ninjin (Japanese), insam (Korean). There are many names for ginseng depending on where and how it is grown or prepared: Wild mountain root - ye shan shen Mountain root - shan shen From Jilin province - ji lin shen Cultivated root - yuan shen White root - bai shen Sugar root - tang shen Rootlet whiskers - shen xu Red by steaming - hong sheng Korean ginseng - gao Ii shen or chao xian shen Plant description: This small shrub grows up to.3 m; with smooth, serrated leaflets in 5's; flower are yellowish, fruit scarlet. The root is 5-14 cm long, with a central taproot with many secondary branched brownish-yellow rootlets. Part used: mostly the root, sometimes the leaves Habitat, ecology and distribution: It grows in many parts of China and Korea, but mostly Jilin, Liaoning and Heilongjiang. Usually 6-7 year old roots are harvested in Sept - Oct. Wild roots in late Aug - Sept. History: Ginseng has an extensive written and traditional history, primarily because of its fame in the Orient for extending lifespan. Considered a superior herb since the Divine Husbandman's Classic of Materia Medica. Constituents: The root contains a group of saponin complexes; these are often split into two groups: 1) Rb1 group (protopanaxadiol: Rb1, Rb2, Rc and Rd) 2) Rg1 group (propanaxatriol: Rgl, Re, Rf, and Rg2) It also contains, acetylene panaxynol (C17H260), a 1,9-cis-hepta-decadiene- 4,6-diyn-3-01, beta-element, beta-sitosterol, 0.05% essential oils, panacene (C15H24), a pyrrolidone, 5-peptides sugars, 3.3% disaccharides (saccharose and maltose). It contains small amounts of pantothenic acid (B5), biotin, vitamins B1, B2, B12, nicotinic acid (B3), choline, citric, fumaric, malic, maleic, panaxic and tartaric acids and traces of Mn, V, Cu, Co, S, and As.1,2,3,4

225 Lesson 10: Tonifying Herbs Energetics Properties and Channels Entered: Chinese ginseng has a sweet, slightly bitter and warm property; entering the Lung and Spleen meridians. A powerful tonic of original Qi; expels "evil" Qi, supplements lung yin (vital essence) while it benefits yin and generates fluids. 5,6 Tierra lists Chinese ginseng as sweet, slightly bitter, slightly warm; entering the Spleen, Lung and Heart. Actions and Indications: adaptogen, nervine, tonic, aphrodisiac Medical Research: Since the various Ginsengs have different properties, there are inconsistencies in the interpretation of the various Ginseng studies. A good overview of this is documented by Lewis.7 We can find even further problems associated with studies not identifying species or type of plant; nomenclature of constituents, extraction technique, purification, dosage, or even the animal species used in studies. The Ginsengs do work different for different animals. Ginseng is considered a panacea due to its broad-spectrum use and its long history. There are differences between the Ginsengs, as well as many contraindications. Even though it is a great Qi tonic, it is not considered a perfect herb. While undoubtedly many of the physiological properties of the Ginsengs have to with other factors, the main components are the saponin groups Rg1 and Rb1, which are diametrically opposed to each other - a fact that means a lot when it comes to their function. Most ginsengs contain both factors, but the Asian Ginseng contains much higher amounts of Rg1 than American Ginseng does. American Ginseng contains more Rb 1. This ratio is the significant factor between how the two work. Rg1 group (highest in Asian Ginseng, water soluble extract) has the following influence: slight central nervous system stimulant (activates brain activity), hypertensive, antifatigue, enhances mental acuity and intellectual performance, anabolic (stimulates DNA, protein and lipid synthesis).8 Rb1 group (highest in American Ginseng, alcohol soluble extract) has the following properties: central nervous system depressant (anticonvulsant, analgesic, tranquilizing), hypotensive, anti-stress (protecting gastrointestinal tract from ulcers), antipsychotic (inhibition of conditioned avoidance response), weak anti-inflammatory, antipyretic (fever-reducing), facilitates small intestine motility, increases liver cholesterol synthesis, increases RNA activity in rat's liver, (Rg has opposite effect).9 Asian ginseng has more of a tonic or adaptogenic effect than the American ginseng. It would also appear, since many of these factors are opposite, that the two Ginsengs might cancel each other out. This is not true, these opposing properties tend to balance each other, rather than combat each other.

226 Lesson 10: Tonifying Herbs Asian Ginseng (Panax ginseng): Most of the study on these Ginsengs has focused on radioprotective, antitumor, antiviral and metabolic effects. We also see lots of studies on antioxidant activity, effects on the nervous system, sexual performance, cholesterol and lipid metabolism and endocrinological activity. Ginseng has a tonic effect, acting on the pituitary (stimulating ACTH release) thus activating the adrenals, giving it its adaptogen effect. By hastening the nervous reflexes, this herb increases analytical and overall mental performance, while diminishing fatigue. It is useful for insomnia. An extract, especially an alcohol one, causes the heart to contract more strongly, with a hypertensive action. By being a tonic to the lung it can be used for wheezing, shortness of breath and labored breathing. The saponin hormonallike structure has a stimulatory action on sexual function in both males and females. By working synergistically with insulin, Ginseng has a blood sugar reducing property. By increasing aldosterone Ginseng has an antidiuretic action, decreasing urine excretion. Protein synthesis is increased as well as appetite, while lowering cholesterol. Ginseng has been known to decrease the shock of allergies.10,11 We find that Asian Ginseng has a very good protective quality associated with radiation. If not contra-indicated for other reasons, Ginseng can be used to protect a patient from x-rays, or radiation therapy for cancer. It should be noted the wild mountain roots (Ye Shan Shen) are considered the best, but are very expensive. Most Ginseng is cultivated. Cured in rock candy, the "white roots" (Bai Shen) is used for Deficient Qi and Yin patterns. Small rootlets are usually used to make a beverage called "Root whiskers" (Shen Xu). Cultivated roots not cured are (Sheng Shai Shen) or "Dried Roots" and are used to nourish yin similar to American Ginseng. Steamed roots turn red and become warmer in nature, called "Red Roots" (Hong Shen) and are used for deficient Qi and yang patterns. 12 An excellent review of material available on ginseng can be found in Stephen Fulder's book The Tao of Medicine and Medicinal Values of Ginseng. 13,14 Toxicity, Contraindications and cautions: Chinese ginseng should be avoided in the following conditions: deficient yin patterns with heat signs, damp heat or excess heat patterns, ascending Liver Yang patient with high blood pressure (systolic over 180 mmhg).15 This herb has a very low toxicity with an LD50 of 1167mg/Kg. When 100 ml of 3 % tincture is ingested by humans, a mild degree of unrest is seen; 200 ml causes symptoms of systemic rash, pruritus, vertigo, headaches, fever, and in severe cases, hemorrhage. One case of consumption of 500mI was fatal.16 Medicinal uses: Strongly tonifying to basal qi for extreme collapse of the qi or abandoned conditions; symptoms of shallow respiration, shortness of breath, cold limbs, profuse sweating and a minute or weak pulse. Often used alone after severe blood loss.

227 Lesson 10: Tonifying Herbs Tonifies the Lungs, while augmenting the qi when a person is wheezing, shortness of breath and labored breathing. Used for Lung qi deficiency. Often associated with failure of the Kidneys to grasp the qi. Strengthens the Spleen, and tonifies the Stomach. Symptoms include lethargy, lack of appetite, chest and abdominal distention, chronic diarrhea. Sometime including prolapsed stomach, uterus or rectum. Generates fluids and stops thirst in wasting and thirsting disorders; especially when high fever and profuse sweating have injured the qi and fluids. Benefits the Heart qi and calms the spirit in cases of palpitations with anxiety, insomnia, forgetfulness and restlessness due to qi and blood deficiency. Pharmacy and dosage: Dosage: 2-8g Cooked separately from other herbs while decocting to preserve the quality and to get the most from the herb. Major Combinations: With bai zhu (Atractylodes niacrocephala) and fu ling (Poria cocos) for anorexia, diarrhea, vomiting, focal distention of abdomen and fatigue due to Spleen and Stomach qi deficiency. With wu wei zi (Schizandra chinensis) and mai men dong (Ophiopogon uaponicus, tubers) for shortness of breath and spontaneous sweating associated with qi and yin deficiency. With shu di huang (Rehmannia glutinosa) and tian men dong (Asparagi cochinchinensis, tubers) for fever, thirst, irritability, shortness of breath, and dry, red tongue due to qi and yin deficiency With dang gui (Angelica sinensis root), long yan rou (Euphoria longan) and yuan zhi (Polygala tenuifohia) for palpitations, shortness of breath, reduced appetite and insomnia due to Heart and Spleen deficiency. Official Regulations and Medical References British Pharmaceutical Code 1934 U.S.P. Matindale UK - General Sales List, Schedule 2, Table A France - Accepted for specific indications No 90/22 Gennan - Commission E; 1984 p138 PDR for Herbal Medicine - p1009

228 Lesson 10: Tonifying Herbs REFERENCES 1. Duke, J.A., CRC Handbook of Medicinal Herbs, CRC Press, Boca Raton, FL, 1985, p Mowrey DB; Guaranteed Potency Herbs; Next Generation Herbal Medicine; Keats Pub; New Canaan Con; p Bensky D., Gamble A.; Chinese Herbal Medicine:Materia Medica; Eastland Press Seattle; p Hsu Hong-yen, Chen Yuh-Pan, et al; Oriental Materia Medica: a concise guide; Oriental Healing Arts Institute; Long Beach CA.; P Bensky, D. and Gamble, A., Chinese Herbal Medicine: Materia Medica, Eastland Press, Seattle, WA, 1986, p Hsu, H.Y., Chen, Y.P., et al., Oriental Materia Medica: a concise guide, Oriental Healing Arts Institute, Long Beach, CA, 1986, p Lewis, WH; Ed. Etkin NL; Ginseng: A Medical Enigma; in Plants in Indigenous Medicine % Diet: Biobehaviora! Approaches; Bedford Hills; Redgrave Pub! Co; 1986; Mowrey ibid 9. Mowrey, D.B., Ibid. 10. Bensley, D. and Gamble, A., Ibid. 11. Hsu, H.Y., Chen, Y.P., et al., Ibid. 12. Bensley, D. and Gamble, A., Ibid. 13. Fulder, S., The Tao of Medicine, Destiny Books, New York, Li, TSC, Harries D; Medicinal Values of Ginseng. The Herb, Spice and Medinal Plant Digest; Vol 17(3); 1996; ppl Bensley, D. and Gamble, A., Chinese Herbal Medicine: Materia Medica, Eastland Press, Seattle, WA, 1986, p Bensley, D. and Gamble, A., Ibid. Image chinese.herbs.webs-sg.com

229 Lesson 10: Tonifying Herbs Dang Shen Codonopsis pilosula Family: Campanulaceae Other names: Radix Codonopsitis Pilosulae, tang shen, lu dang shen, fang dang, tojin (Japanese), tangs am (Korean) Plant description: Axial root stout, few of branch roots, cm long, cm in diameter. Cork greyish yellow, lenticellate; root base with numerous tuberculate stem bases or buds; dense annular marks appearing at the upper part and spotted fibrous root scars covered with brown sticky material at the lower. Cross section even or showing radial marks. Soft and tenacious in texture, with an aromatic odor. Part used: root Habitat, ecology and distribution: Grown in Shanxi, Shaanxi, Gansu, Sichuan and most of northeastern China. It grows well in Canada. Harvested in the fall. History: Found its way into literature in the Thoroughly Revised Materia Medica. Constituents: Alkaloids, saponins, proteins, starches; taraxerylacetate, friedelin;, delta7 -stigmastenol, stigmasterol, beta- D-glucose-saponin, delta 7 -stigmastenol-beta- D- gulcoside, alpha-spinasterol-beta~d-glucoside, delta7-stigmastemone-3, stigmasta-7, 22-dien-3-one, stigmasta- 5,22-dine-3-one; inulin, fructose, Cp-l, Cp-2, Cp-3, Cp-4, n- hexyl-beta-d-gulucopy-ranoside, ethyl- alpha-d-fructofuranoside; Choline, n-butylallophanate, codopiloic acid, 3-carboxy-3,4,5,6- tertrahydoxazine, 6-hydroxy-2- pyridinemethanol, pyridine, nicotine 1 Energetics Properties and Channels Entered: This plant is sweet and neutral entering the Lung and Spleen meridians Actions and Indications: tonic, stomachic, stimulant. Medical Research: Codonopsis has been shown to increase red blood cells as well as hemoglobin, decrease leucocytes with increased neutrophils. Hypotensive action is thought to be from dilating capillaries as well as inhibiting adrenal cortex activity. Prolonged swimming time was observed after mice took Codonopsis in a dose-related manner. Dang shen is stimulating to the nervous system, increases body resistance, promotes digestion, absorption and metabolism 2,3 Toxicity, Contraindications and cautions: Not to use in cases of infection of the digestive system. Incompatible with Ii lu (Veratrum nigrum)

230 Lesson 10: Tonifying Herbs Medicinal uses: Often considered poor man's ginseng as it has many of the properties of ginseng, but to a lesser degree and at a more economical cost. Tonifies the middle burner and augments the qi in cases of lack of appetite, fatigue, tired limb, diarrhea, vomiting or any chronic illness with Spleen qi deficiency. It can be used for case of prolapsed uterus, stomach, or rectum due to collapsed Spleen qi. Tonifies the Lungs in deficiency with chronic cough and shortness of breath or copious sputum due to Spleen qi deficiency. Harmonizes Spleen and Stomach; increases secretions of fluids. Strengthens the qi and nourishes fluids in wasting and thirsting disorders, especially after injury to fluids. Used with herbs to release the exterior or drain downward if there are also symptoms of qi deficiency. Pharmacy and dosage: Dosage 9-30 g per day in decoction Major Combinations: With bai zhu (Atractylodes niacrocephala, root) for reduced appetite, loose stool and vomiting in cases of Spleen qi deficiency. With huang qi (Astragalus membranaceus, root) for fatigue, shortness of breath, diarrhea due to Lung and Spleen qi deficiency. With wu wei zi (Schizandra chinensis, fruit) and mai men dang (Ophiopogon uaponicus, tuber) with shortness of breath and thirst due to injury of fluid and qi. With dang gui (Angelica sinensis, root) and shu di huang (Rehmannia glutinosa, root) for dizziness, weakness and lassitude associated with insufficient qi or blood. REFERENCES 1 Huang CK, The Pharmacology of Chinese Herbs 2nd Ed. ; CRC Press; Bensky D, Gamble A; Chinese Herbal Medicine Materia Medica;Eastland Press Seattle Wa; p Hsu, H.Y., Chen, Y.P., et ai., Oriental Materia Medica: a concise guide, Oriental Healing Arts Institute, Long Beach, CA, 1986, p Image theabundentlifeonline.com!!

231 Lesson 10: Tonifying Herbs Huang Qi Astragalus membranaceus Family: Leguminosea Other names: Milk vetch, huang chi, radix astragali membranaceus, bei qi, ogi (Japanese), hwanggi (Korean). Can also use Hedysarum species (sweet root, sweet vetch) Plant description: The root is cylindrical, with some branches, cm long and cm in diameter. Externally pale brownish-yellow or pale brown, with irregular, longitudinal wrinkles or furrows. Not easily fractured, it is hard and tenacious, with a strongly fibrous fracture. The odour is weak while the taste is slightly sweet and slightly bean-like on chewing.1 Some researchers believe that the North American species A. americanus is really the same species as A. membranaceus because it has the same chemical markers when assessed by thin-layer chromatography. Part used: root Habitat, ecology and distribution: Grows in Shanxi, Heilongjiang, Inner Mongolia, Gansu, and northern China. A. americanus appear to be the same species, or very similar, growing in Canada and northern U.S.A. It is harvested in the spring or autumn of fourth or older years. History: First discussed in the Divine Husbandman's Classic of the Materia Medica and in Pen tsao kang mu. It was consider a superior herb with qi meaning leader and huang meaning yellow. It has been considered one of the most important tonic herbs, thus the name. Constituents: Astragalus contains a large group of glycosides, astragalosides 1- vn, isoastragaloside I-II, soyasaponin I,linoleic acid, linolenic acid, beta-sitosterol, betain, choline as well as pigment and sugars; eight flavonoids (including calycosin-7 -O-beta- D-glucoside, calycosin-7 -O-beta- D-glucoside-6'-O-malonate (2), ononin, (6aR, llar)-3- hydroxy-9,1odimethoxypterocarpan-3-0-beta-d-glucoside, calycosin, (3R)-7,2'- dihydroxy-3',4'-dimethoxy-isoflavan-7 -O-beta-D-glucoside, fonnononetin-70-beta- Dglucoside-6'-O-malonate, and fonnononetin). 2,3,4 Energetics Properties and Channels Entered: Astragalus is sweet, slightly warm and enters Heart, Lung, and Spleen. From an energetic point of view it tonifies spleen and augments qi, and is appropriate for cases where there is lack of appetite, fatigue, diarrhea, prolapsed rectum, and abdominal bleeding. It is used to tonify the lung and therefore used for frequent colds or shortness of breath. It is also recommended to tonify qi and blood for postpartum fever and blood deficiency. 5,6,7,8

232 Lesson 10: Tonifying Herbs Actions and Indications: Tonic, adaptogen, diuretic, cardiotonic and antibiotic. Medical Research: Described by the Chinese as a qi tonic; it increases body weight and endurance. Astragalus is considered an adaptogen, providing deeper immune system support than echinacea. The polysaccharides have been shown to increase immune response in both animal and human models. It increases the number of stem cells in bone marrow and lymph tissue and encourages their development into active immune cells. It appears to help trigger immune cells from a "resting" state into heightened activity. One study showed that Astragalus root helps promote and maintain respiratory health. It also enhances the body's production of immunoglobulin and stimulates macrophages. Astragalus can help activate T -cells and natural killer (NK) cells. This herb has shown to increase RNA in the spleen and other reticuloendothelial tissue. The number of macrophages has been shown to increase after administering the decoction. The natural killer cytotoxicity of lymphocytes effector cells was also markedly enhanced (5-6-fold). The saponin fraction has been shown to increase camp after 30 min; keeping increase up to 4 hr after injection. These saponinals seem to enhance DNA biosynthesis, especially in the liver. 9,10 On the other hand Patients with SLE have significantly decreased NK-cell activity when compared to normal controls. This shows a true modulating effect useful for autoimmune individuals.11 The polysaccharides have demonstrated anti-inflammatory action, decreasing histamine or serotonin vascular permeability. Hypotensive action has also been demonstrated. Effective for treating symptoms related to chronic hepatitis, it reduces serum GPT within 1-2 months. Mice models have demonstrated protective, preventive and curative functions on the hepatic area. Both phagocytosis and reticuloendothelial cells were stimulated in hepatitis patients. 12 It has been shown to have a diuretic and tonifying effect on the kidneys and is thus specific for nephritis. As a cardiotonic, it increases the contraction of normal hearts. Several studies also show Astragalus offers heart-protecting effects, including protection against oxidative damage. Additionally, the flavonoids, saponins, and polysaccharides found in Astragalus root help minimize free radical damage to membranes. 13, 14 In 92 patients with ischemic heart disease treated with Astragalus, significant relief from angina was achieved, and the effective rate of electrocardiogram improvement was 82.6 percent. 15 In another study of 20 patients with angina pectoris given Astragalus for two weeks, cardiac output was significantly increased and, unlike digitalis, adenosine triphosphatase activity was not inhibited. 16 Astragalus membranaceus demonstrated a significant stimulatory effect on the sperm of healthy donors. Using a solution of 10 mg/ml, sperm motility was increased to [+ or -] 22.6 percent of control. 17

233 Lesson 10: Tonifying Herbs The flavonoids and saponins in Astragalus can significantly inhibit membrane lipid peroxidation generated by superoxide ([O.sub.2]), hydrogen peroxide ([H.sub.2][O.sub.2]), and ultraviolet rays, while the polysaccharides of Astragalus possess weaker protective activity.18 Astragalus has been shown to have inhibitory effects lipid peroxidation and protein oxidative modification by copper. The results of a study showed the free radical scavenging effects were similar to, and stronger than, those of mannitol and superoxide dismutase, respectively, demonstrating inhibitory effects on oxidative stress induced by copper. 19 Its tonic effect is even more noticeable in individuals exhausted by fatigue or poison. It can stimulate vasodilation and, improve circulation to the skin. Its antibacterial effect has been shown effective against Shigella dysenteriae, Streptococcus haemolyticus, Diplococcus pneumonia and Staphylococcus aureus. It is hypotensive and lowers blood pressure, again probably through vasodilation. Astragalus protects the liver from toxic exposure (carbon tetrachloride). It has a positive effect on regulating blood glucose levels. Toxicity, Contraindications and cautions: In extensive tests, no toxicity has been found in this herb even when taken in large quantities. Because this herb raises the yang, tonifies the qi and stabilizes the exterior it should not be used in case of excessive exterior, qi stagnation, damp obstruction, food stagnation or yin deficiency with heat signs. Many members of this genus contain toxic glycosides. All species with edible seedpods can be distinguished by their fleshy round or oval seedpod that looks somewhat like a greengage. A number of species can also accumulate toxic levels of selenium when grown in soils that are relatively rich in that element. Medicinal uses: This herb has been used to strengthen digestion, raise metabolism, invigorates the immune system, and build up kidney Qi. It has been used as a specific for chronic weakness in the lung with shortness of breath and for cases of nephritis.20 Current Western applications of Astragalus are primarily for restoring and strengthening the immune response, enhancing cardiovascular function, and increasing vitality. Indications supported by clinical trials include impaired immunity, adjunctive cancer treatment, and viral infections, including the common cold and cervical erosion associated with Herpes simplex. Western preparations include dried root for decoction, liquid extract, tablets, and powdered root. In Chinese terms we can say it: Tonifies the Spleen and augments the qi in cases of deficiency, shown by lack of appetite, fatigue and diarrhea.

234 Lesson 10: Tonifying Herbs Raise the yang qi of Spleen and Stomach, especially beneficial for prolapse of the uterus, stomach, rectum, and uterine bleeding. Augment the protective qi (wei qi) and stabilizes the exterior. Used as a tonic for deficiency with spontaneous sweating. Strengthens the Lungs, presenting as frequent colds or shortness of breath. This herb can be used for excessive sweating with certain herbs, while producing sweating along with diaphoretic herbs. Tonifies the qi and blood in convalesces, especially postpartum fever due to qi and blood deficiency; and in recovery stage after blood loss. Promotes urination and reduces edema. Promotes the discharge of pus and generates flesh after ulceration that have a hard time healing. Used as tonic in wasting and thirsting disorders, with numbness of limbs, paralysis and painful obstructions. Pharmacy and dosage: Dosage 9-30 g, daily. Drug interaction: Recombinant interleukin-2 can be potentiated 10-fold by Astragalus extract. Recombinant interferon-l can be therapeutically enhanced by Astragalus, thus improving the outcome in chronic viral cervicitis. 21,22 There is speculation Astragalus could theoretically offset or minimize the immunosuppressive effects of corticosteroids and cyclosporine, based on its T-cell stimulating activity. 23 Major Combinations: With ren shen (Panax spp) for general debility, reduce appetite, fatigue and spontaneous sweating due to qi deficiency. With fu zi (Aconite cannichaeli), for spontaneous sweating due to yang deficiency. With bai zhu (Atractylodes niacrocephala, roots) for weakness, lassitude and loose stools associated with Spleen qi deficiency With dang gui (Angelica sinensis, roots) for blood deficiency due to blood loss, with symptoms of fatigue, low grade fever, irritability, and thirst. Can also be used for nonhealing sores, painful obstruction, and numbness due to qi and blood deficiency. With sheng ma (Cimicifuga root) and chai hu (Bupleurum chinense,root) for weak and sunken Spleen qi, especially associated with prolapsed uterus or rectum and excessive uterine bleeding. With gui zhi (Cinnamomum cassia) for numbness and painful obstruction of musculature due to qi and blood deficiency, as well as the protective qi.

235 Lesson 10: Tonifying Herbs With sheng di huang (Rehmannia glutinosa, root) and huang bai (Phellodendri cortex) for night sweats due to yin deficiency. With shan yao (Dioscorea opposite, root) and sheng di huang (Rehmannia glutinosa, root) for wasting and thirsting disorders REFERENCES 1. Tu, G. (ed.), Pharmacopeia of the People's Republic of China (English Edition 1988), People's Medical Publishing House, Beijing,China, 1988, p Hsu, H.Y., Oriental Materia Medica: a concise guide, Oriental Healing Arts Instimte, Long Beach, CA, 1986, p Bensky, D. and A. Gamble, Chinese Herbal Medicine: Materia Medica (Revised Edition), Eastland Press, Seattle, WA, 1993, p Lin LZ, He XG, Lindemnaier M, et at. Liquid chromatography-electrospray ionization mass spectrometry study of the flavonoids of the roots of Astragalus mongholicus and A. membranaceus. J Chromatogr A 2000;876: Bensky, D. and A. Gamble, Ibid. 6. Hsu, H.Y., Ibid. 7. Tierra, M., Planetary Herbology, Lotus Press, Sante Fe, NM, 1988, p He Z, Findlay J. Constituents of Astragalus membranaceus. J Nat Prod 1991;54:810 9 Tang W, Eisenbrand; Chinese Drugs of Plant Origin; Spinger-Veriag; New York; 1992 p Jiao Y, Wen J, Yu X. Influence of flavonoid of Astragalus membranaceus's stem and leaves on the function of cell mediated immunity in mice. Zhongguo Zhong Xi Yi Jie He Za Zhi 1999;19: Zhao XZ. Effects of Astragalus membranaceus and Tripterygium hypoglancum on natural killer cell activity of peripheral blood mononuclear in systemic lupus erythematosus. Zhongguo Zhong Xi Yi Jie He Za Zhi 1992;12: , Tang W, Eisenbrand; Chinese Drugs of Plant Origin; Spinger-Veriag; New York; 1992 p Wang D, Shen W, Tian Y, et at. Protective effect of active components extracted from Radix astragali on human erythrocyte membrane danlages caused by reactive oxygen species. Zhongguo Zhong Yao Za Zhi 1996;21: , Toda S, Shirataki Y. Inhibitory effects of Astragali radix, a crude drug in Oriental medicines, on lipid peroxidation and protein oxidative modification by copper. J EthnophannacoI1999;68: Li SQ, Yuan RX, Gao H. Clinical observation on the treatment of ischemic heart disease with Astragalus membranaceus. Zhongguo Zhong Xi Yi Jie He Za Zhi 1995:15: Lei ZY, Qin H, Liao JZ. Action of Astragalus membranaceus on left ventricular function of angina pectoris. Zhongguo Zhong Xi Yi Jie He Za Zhi 1994; 14: , Hong CY, Ku J, Wu E Astragalus membranaceus stimulates human sperm motility in vitro. Am J Chin Med 1992;20: Wang D, Shen W, ibid 19 Toda S, Shiratake ibid 20. Tierra, M., Ibid. 21 Qian ZW, Mao SJ, Cai XC, et at. Viral etiology of chronic cervicitis and its therapeutic response to a recombinant interferon. Chin Med J (Engl) 1990;103: Yoshida Y, Wang MQ, Liu IN, et at. Immunomodulating activity of Chinese medicinal herbs and Oldenlandia diffusa in particular. Int J ImmunopharmacoI1997;19: Miller LG. Herbal medicinals: selected clinical considerations focusing on known or potential drug-herb interactions. Arch Intern Med 1998; 158: Image aznhealth.com

236 Lesson 10: Tonifying Herbs Da Zao Jujubae fructus! Family: Rhamnaceae Other Names: Direct English translation: Big date, Chinese date, red date, jujube, Taiso (Japanese), Daechu (Korean), red jujube (hong zao), black jujube (hei zao), southern jujube (nan zao) Plant Description: Red jujubes are thick, light red in colour, uniform, have a sweet taste, and small seeds. Black jujube are large, have wrinkled and glossy skin, and are sweet. Both are the same herb, the black variety is processed by smoking. Parts used: Fruit Habitat, ecology and distribution: Good quality is large, full, thick and light red or black depending on variety used. Grown throughout Asia. History: Divine Husbandman's Classic of the Materia Medica Constituents: triterpene glycosides, sugars (30-40%), flavonoids, alkaloids, organic acids, carotene, vitamin C, riboflavin, catechol Energetics Properties and Channels entered: Sweet and warm, enters the Spleen and stomach meridians. Actions & Indications: Tonify's the qi and blood, generates body fluids, harmonizes the spleen, reduces toxic effects of other herbals in a formula Medical research: Da zao has been found to increase the oxygen content of the body, nourish cells. Water based extracts have a significant suppressive effect on the proliferation and colony formation of human leukemia K562 cells Counteract release of leukotrien D4 by basophilic white blood cells in human peripheral blood Toxicity, Contraindications and cautions: Some allergic reactions have been reported with in 2 hours of ingestion causing urticaria of the skin, edema of the eyelid and difficult breathing. Over ingestion of large quantities may cause flatulence and indigestion. Avoid in cases of dampness accumulation, food stasis, parasites, phlegm, heat, coughing and in all warm diseases.

237 Lesson 10: Tonifying Herbs Medicinal uses: Tonify's the Spleen and augments the qi: manifesting as reduced appetite, weakness, shortness of breathe, loose stools Nourishes the blood and calms the spirit: for irritability and restlessness Moderates and harmonizes harsh properties of other herbs in a formula: harmonizes the stomach Large black dates are more used for tonifying Kidney and Liver yin and blood, they excel at moistening the stool and urine Transforming the Significance of Medical Substances Pharmacy & dosage: 3-10 dates or g Major Combinations: With Dang shen (Codonopsis Radix) and Bai Zhu (Atractylodis macrocephalae rhizoma) for weakness and lassitude due to spleen and stomach deficiency. With Sheng Jiang (Zingiberis Rhizoma) to harmonzie the ying and wei qi, facilitate digestion and assist other herbs effects on tonifying the qi and blood With E jiao (Asini corii colla) and Dang gui (Angelica sinensis) for ying qi and blood deficiency REFERENCES Wei Hu Lai, et al. Journal of Gansu College of TCM. 1996;13(3): Wu Wei Kang, et al. Foreign Medicine (vol. of TCM). 1984;6(4):54. Image tcm.health-info.org

238 Lesson 10: Tonifying Herbs Gan Cao Glycyrrhiza uralensis Family: Leguminosae Other names: licorice, kan tsao, guo lao, kanzo (Japanese), kamch'o (Korean), literal English translation!sweet herb" Plant description: This perennial herb has a stem m tall rising from a thick rhizome. The leaves are pinnate with 4-7 pairs leaflets, ovate, entire, smooth, glutinous beneath dark green. The flower is yellowish-white or purplish born in pulseshaped racemes. The fruit is a legume, 2.5 cm long, brown, ovate, and flat. The root (rhizome) is basically cylindrical, usually prepared in pieces cm long and 5-20 mm thick. The pieces are yellowish-brown to dark brown, longitudinally wrinkled; yellow inner, radiate; fracture coarsely fibrous. Part used: Root (rhizome). Habitat, ecology and distribution: Inner Mongolia, Gansu, Xinjiang, northeastern China, harvested in spring and autumn (best). It grows well in many parts of Canada. History: This herb is one of the most popular in China. First found in the Divine Husbandman's Classic of the Materia Medica. One might claim that it is the number one "drug" in the world because of the scale of its use. For centuries Licorice has been used as medicine in both Western and Eastern cultures. Traditionally, we find it used for almost everything. Some of the most common uses were for: ulcers, sore throats, insomnia, abdominal pain, bronchitis, blood cleanser, in cough medicines, sores, herpes, abscesses, food poisoning, for treatment of cancer in many cultures and to support the adrenal glands when under stress. 2,3 There is plenty of documentary evidence for Licorice usage throughout the last 2,000 years in Europe. Examples include German herbals (1264), Gerard (1597), Hill (1751) and throughout the Eclectic era.4 Licorice is also extensively used in Ayurvedic medicine. Roughly half a dozen Western Aboriginal cultures are known to have made use of Glycyrrhiza lepidota for earaches, toothaches and as a pediatric febrifuge. 5 Constituents: The major constituent is 1-24% of a triterpene known as glycyrrhizin (also known as glycyrrhizic or glycyrrhizin acid). The variation of this constituent is due to different varieties and growing conditions, but might vary up to 10 fold due solely to analytical techniques. Glycyrrhizin, on hydrolysis, yields glycyrrhentinic (or glycyrrhetic) acid and

239 Lesson 10: Tonifying Herbs two glucuronic acid molecules. Other significant triterpenes include glabrolide acetate, 11- deoxoglabrolide acetate, soyasaponin, liquiritic acid, glabrolide, isoglabrolide, deoxoglabrolide and deoxoglycyrrhetic acid. Other constituents are; flavonoids, isoflavonoids (licoflavonol, kumatakenin, licoricone,glabrol, glabrone and others); coumarins (glycycoumarin, liqcoumarin, umbelliferon and others); starch (2-20%), 3-14% sugar (glucose and sucrose), lignin, 2-4% asparagine, a complex volatile oil, and a trace of tannin. 6,7,8,9,10,11,12,13,14,15,16 Energetics Properties and Channels Entered: Raw/ unprepared (Sheng gan cao): sweet and neutral. Toasted/ dry fried (Chao gan cao): sweet and warm. Enhances its warming property and harmonizes the stomach. Honey fried (Zhi gan cao): Extra sweet and neutral. Increases its function of tonifying the middle jiao, harmonize other herbs in a formula, and increase in its function to augment the spleen and heart. Licorice enters all twelve primary meridians, especially the Spleen and Lung. It tonifies the Spleen, replenishes Qi, clears heat, removes toxins, moistens lungs, controls coughs, harmonizes the stomach and spleen, harmonizes all drugs, soothes spasms and acts as the great antidote. 17,18,19 Ayurvedic Rasa - mahura; Guna - guru (heavy), snigdha (pacifies vata); Veerya - sheeta; Vipakmadur. Action: Vat pitta samak, daha, samak, shura bardhak, kapha nisarak, vatanuloman, kantaya, raket sthambk, jawar nasak, jiviniya, sandhaniya, rasayan, balya.2o Other: Holmes describes licorice as very sweet, slightly bitter, cool and moist; with secondary qualities of restoring, calming, relaxing with a stabilizing movement. Licorices enters all twelve meridians; influencing the lungs, stomach, intestines, bladder, adrenal cortex, and pituitary. Its organism is warmth and air. 21 Actions and Indications: Demulcent, expectorant, emollient, stomachic, antiinflammatory, mildly laxative, and as a flavouring. Medical Research: Many preparations of Licorice to produce relief in ulcer patients are well documented. Traditionally, the best one is a methanol extract. A modem preparation with glycyrrhizin removed (DGL) is now preferred, as it avoids possible problems with high blood pressure (a recorded effect). The anti-inflammatory properties have been attributed to glycyrrhizin, but most studies and clinical experience shows DGL is quite effective on ulcers, even though there have been conflicting reports. Other constituents also inhibit gastric secretions. It appears that the methanol extract inhibits the liberation of gastrin from pyloric mucosa. Because research has proven that licorice preparation does not

240 Lesson 10: Tonifying Herbs inhibit acetylcholine action and does not inhibit spontaneous motility of the stomach, licorice is more useful than chemicals such as atropine. Licorice is often used for upper respiratory catarrhal conditions, and traditionally used for the treatment of sore throats, coughs and "dry lung" condition. 22 Glycyrrhizin is 50 times sweeter than sugar and can be used as a sweetener substitute. 23 Licorice has been shown to be estrogenic in laboratory animals (with possible other steroidal activities), to have mineralocorticoid properties (causing sodium retention and potassium loss), and to inhibit tumors (due to glycyrrhizinic acid salts). It is antiinflammatory, anti-trichomonas, antitussive (comparable to codeine, due to 18-betaglycyrhinic acid), anti-convulsive and antibacterial. It is useful in Addison's disease because licorice contributes to mineral balancing of the mineralocorticoids. Glycyrrhizin is responsible for the anti-inflammatory effect, and it has some impact on the corticoid mechanism. It is presumed not to produce direct hormonal activity. However, it may enhance the activity of both mineral and glucocorticoids indirectly by inhibiting the metabolic activity in the liver. Licorice enhances pharmacological effect of corticosteroids and anti-inflammatory drugs such as prednisone. Glycyrrhetrinic acid has been shown to suppress dexamethasone stimulated histamine synthesis and arachidonic acid release in rat mast cells. Other hormones are known to interact with this mechanism, such as deoxycorticosterone, progesterone and aldosterone. In China, it is often used as a first aid remedy for cuts, burns, as an antidote to many types of poisoning and to build muscle and bones Licorice's pseudoalderosterone activity is due to the glycerrhizin and glycyrrhetinic acid content. This can produce hypertension, hypokalemia, sodium and water retention, low plasma rennin activity, and suppressed urine and serum aldosterone levels A person would have to consume over 12 g of raw herb to induce these effects. As a detoxifier (used for thousands of years by the Chinese), it has been shown to counteract toxins related to diphtheria, tetanus and tetrodotoxin. 38 Glycyrrhizin and its derivatives have been shown to successfully inhibit several viruses including; Herpes simplex 1, Newcastle disease and vesicular stomatitis. For Herpes, it both reduces pain and prevents reoccurrence. 39,40 In clinical practice the glycyrrhetinic acid has been found fairly effective in treating these viruses, but extremely effective in treating hives, both internally and externally. Glycyrrhizin demonstrated interferon induction ability. This ability has been directly associated with Licorice's capacity to treat hepatitis B. It has also had success in inhibiting HIV. 41 Licorice has been successful in preventing cytotoxicity from E. coli. Both tumor promotion and initiation has been inhibited by glycyrrhetic acid. Several of the constituents have demonstrated anti-hepatotoxic activity, giving more fuel to the Chinese concept that Licorice is the great detoxifier and balancer. 42

241 Lesson 10: Tonifying Herbs Externally, glycyrrhizin suppresses scalp sebum secretion by a rate of 1 day per week.43 It has been an effect ointment or Herpes Zoster. Liquiritigenin and isoliquiritigenin have MOA-inhibitory activity, thus effecting mood. 44 Toxicity, Contraindications and cautions: Licorice is a very safe herb in moderate doses. In large doses it can cause sodium retention and potassium depletion and as a result lead to hypertension and edema. It is not recommended for patients with heart or blood pressure problems.45 Contraindicated in cases of excess dampness, nausea or vomiting. This herb should not be combined with jing da ji (Euphorbia seu knox root), yuan hua (Daphnes genkwa flowers), gan sui (Euphorbia kansui root), hai zao (Sargassum fusiform, herb), or yuan zhi (Polygalae tenuifoliae root). Medicinal uses: Tonifies the Spleen and augments the qi in cases of Spleen deficiency. Some of the symptoms are shortness of breath, lassitude and loose stools. It is also useful for qi or blood deficiency patterns with irregular or intermittent pulse and/or palpitations. Moistens the Lungs and stops coughing and wheezing. It can be used for either heat or cold in the Lungs due to its neutral properties. Clears heat and relieves fire toxicity (raw) for carbuncles, sores, or sore throat due to fire toxins. Used internally and/or externally. Moderates spasms and alleviates painful spasms of abdomen or legs. Moderates and harmonizes the character of other herbs. In a natural state it will aid other herbs getting into the meridian, as it can enter in to all 12 meridians. Antidote for various toxic substances; used both internally and externally. Pharmacy and dosage: Dosage Powdered root 1-5 g 46 Fluid extract 2-5 ml 47 Solid extract 1/2-1 dram 48 Decoction g Major Combinations: With dang shen (Codonopsis pilosula) for reduced appetite, fatigue and loose stools due to Spleen deficiency. This combination can be also used for heart palpitation due to Heart qi deficiency, sometimes combined with gui zhi (Cinnamomum cassia root) and other to nourish the Heart yin and blood.!!

242 Lesson 10: Tonifying Herbs With ma huang (Ephedra sinica) and xing ren (Prunus anneniaca, seeds) for coughing and wheezing due to wind-cold attacking the Lung With jie geng (Platycodon grandiflorum, roots) for acute, mild pain and swelling of the throat. With bai shao (Paeonia lacttfiora) for abdominal pain, intestinal spasms, or spasms of calf or other muscles. With xing ren (Prunus anneniaca, seeds) and chuan bei mu (Fritillaria cirrhosa) for heat induced dry cough. Official Recognition and Medical References UK In BHP and General Sale list Belgium Accepted for specific indication France In Ph. Fr. X accepted for specific indications Germany In Commission E p.161 PDR for Herbal Medicine p 875 REFERENCES 1. Bensley, D., and Gamble, A., Ibid. 2. Leung, A.Y. and S. Foster, Encyclopedia of Common Natural Ingredients: Used in Food, Drugs, and Cosmetics, John Wiley & Sons, Inc., New York, 1996, p Grieve, M., A Modern Herbal, Jonathan Cape, London, 1931, p Crellin, 1.K. and Philpott, J., Herbal Medicine: Past and Present (Vol. II), Duke University Press, London, 1990, p Moerman, D.E., Medicinal Plants of Native America, University of Michigan Museum of Anthropology, Technical Reports, Number 19, Ann Arbor, Michigan, 1986, YoU, p Leung, A.Y. and S. Foster, Encyclopedia of Common Natural Ingredients: Used in Food, Drugs, and Cosmetics, John Wiley & Sons, Inc., New York, 1996, P Morton, J.F., Major Medicinal Plants: Botany, Culture and Uses, Charles C. Thomas Inc, Springfield IL, p Spoerke, D.G., Herbal Medications, Woodbridge Press Publ. Co., Santa Barbara CA, p Snow JM; Glycyrrhiza L (monograph); The Protocol J of Botanical Med.; Winter 1996; pp Textbook of Pharmacognosy, J. & A. Churchill Ltd., Rahway, N.J., (citation not confirmed) p Wood, H.C. and Osol, A., Dispensatory of the United States of America 23rd ed.,j.b. Lippincott, Montreal, P.Q., p Gathercoal, E.N. and Wirth, E.H., Pharmacognosy, Lea & Febiger, Phila. PA, p Herbal Pharmacology in the People's Republic of China, Trip Report of the American Herbal Pharmacology Delegation, National Academy of Sciences, Washington DC, p Wallis, T.E., Textbook of Pharmacognosy, J & H Churchill, London, p Remington's Pharmaceutical Sciences (16th ed.), Mack Publ. Co., Easton PA, p.l Osol, A. and Pratt, R. (eds.), The United States Dispensory (27th ed.), J.B. Lippincott, Phila. PA, p Hsu, H.Y., Chen, Y.P., et al., Oriental Materia Medica: a concise guide, Oriental Healing Arts Institute, Long Beach, CA, 1986, p Bensley, D. and Gamble, A., Chinese Herbal Medicine: Materia Medica, Eastland Press, Seattle, WA, 1986, p Tierra, M., Planetary Herbology, Lotus Press, Santa Fe, NM, 1988, p Kapoor, L.D., CRC Handbook of Ayurvedic Medicinal Plants, CRC Press, Boca Raton, FL, 1990, p

243 Lesson 10: Tonifying Herbs 21. Holmes, P., The Energetics of Western Herbs (2 vols.), Artemis Press, Boulder CO, 1989, p Blumenthal et ai, Licorice Root monograph; American Botanical Council; 1997 p Cantelli-Forti GF, et al' Interaction of Licorice on Glycyrrhizin Pharmacokinetics; Enviromental Health Perspectives; Vol 102; Nov pp The British Pharmaceutical Codex Ibid. 25. Leung, A. Y., Encyclopedia of common natural ingredients used in food, drugs, and cosmetics, Ibid. 26. Spoerke, D.G., Herbal Medications, Ibid. 27. Textbook of Pharmacognosy, Ibid. 28. The Merck Index 5th ed., Merck & Co. Inc., Rahway NJ, p Trease, G.E. and Evans, W.C., Pharmacognosy 11 ed.ibid. 30. Chen, K.K. and Mukerji, B., Pharmacology of Oriental Plants, McMillan Co., New York, p.l. 31. Squire, P.W., Squire's Companion to the Latest Edition of the British Pharmacopeia, J & A Churchill, London, p Thompson, W.A.R., Herbs that Heal, J. of Royal College of General Practitioners, Vol. 26, pp , p Larkworthy, W. et al., Deglycyrrihizinised Licorice in Duodenal Ulcer, B.M.J. 2 (6095), pp. 1123, Oct p.1l Grieve, M., A Modern Herbal, Jonathan Cape, London, 1931, p Deglycerrhized Licorice in Gastric Ulcers - A Double Blind Controlled Study, Gut, Vol. 17, No.5, pp. 397, p Takeda, R., et al., Prolonged pseudoaldosterones induce glycyrrhizin, Endoc. Japan 26:541-7, Eptien, M., Espiner, E., et al., Effect of eating licorice on renin-angiotensin aldosterone receptors, Br. Med. 1. 1: Suzuki, H., et al., Effect of glycyrrhizin on biochemical tests in patients with chronic hepatitis - Double blind trial, Asian Med. J. 26:423-38, Partridge, M., et al., Topical carbonoxolone sodium in management of herpes simplex infection, Br. 1. Oral. Max. Surg. 22: , Csonka, G., et at., Treatment of herpes genitalis with carbonoxolone and cicolone creams: A double blind placebo controlled study, Br. J. Ven. Dis. 60:178-81, Leung, ibid 42. Snow ibid 43. The Review of Natural Products; Licorice; Feb Leung, Foster; ibid 45. Spoerke, D.G., Herbal Medications, Ibid. 46. Bradley, P.R. (Ed.), British Herbal Compendium, Vol. 1, British Herbal Medicine Association, Bournemouth, UK, 1992, p Bradley ibid 48. Grieve, M., Ibid Image artemesiahealingarts.com

244 Lesson 10: Tonifying Herbs Shu Di Huang Rehmannia glutinosa Family: Scrophurlariaceae Other names: Chinese foxglove root cooked in wine, shou ti huang, prepared rehmannia, steamed dried root, Radix Rehmanniae Glutinosae Conquitae, shu di, sheng di huang, jukujio (Japanese), sukchihwang (Korean The name of this plant is really di huang.!di" means earth and!huang" means yellow, which is the color associated with the earth element in the five elements system; this herb material is the essence of the earth (soil), being very moist. Shu means cooked or prepared, while sheng mean raw. Plant description: Chinese Foxglove has large bright pink & red bellflowers with yellow-spotted throats, which last well in bouquets. The bells are arranged very much like common foxglove (Digitalis purpurea) but even more gorgeous, though the flower spikes are usually shorter. The spikes are sometimes only three feet tall. It blooms as early as late spring & in climates that don't stress it with too much warmth. It is at its height June & July, continuing to blooming until first frosts of autumn, or later. Part used: steam or cooked root, to reduce toxicity Habitat, ecology and distribution: Henan (primarily), Liaoning, Hebei, Shandong and Zhejiang provinces. Harvested in the autumn History: First found in the Illustrated Classic of the Materia Medica. Constituents: iridoid g1cosides (rehmannioside A-D, catapol, aucubin), Stachyose, sitosterol, mannitol, stigmasterol, campesterol, rehmannin,, arginine, glucose, and beta carotene. 1,2,3 Energetics Properties and Channels Entered: shu di huang is sweet, mild and slightly warm; entering the Heart, Kidney and Liver meridians. Actions and Indications: cardiotonic, tonic, diuretic, stimulant, hypotensive, hypoglycemic, immune modulator. Medical Research: Has a hypotensive action, as well as improving cerebral blood supply. Cardiotonic, strengthening a weak heart, having a diuretic effect by dilating the renal blood vessels. Shu di huang shows a hypoglycemic and nutritive action in both animal and human studies. Rehmannia significantly increases the activity of hepatic glucokinase and glucose-6- phosphatase dehydrogenase and reduces glycogen content in mice livers.

245 Lesson 10: Tonifying Herbs This herb has a positive modulating effect on the immune system, stimulating T lymphocytes proliferation and IL2 production; inhibiting NK cell activity. Often used in tumor systems. Shu di huang!s polysaccharides stimulate bone marrow hemopoietic cells, useful for treating hemorrhagic anemia. It also promotes blood coagulation when needed. 4,5,6 Toxicity, Contraindications and cautions: Used with caution in cases of Spleen and/or Stomach deficiency, or in case of stagnant qi or phlegm. Over use has been known to cause abdominal distention and loose stools. Side effect can cause abdominal pain, dizziness, lack of energy and palpitations. These symptoms often disappear after continuous use of the herb. Medicinal uses: It is the major herb in China used for thirsting disease, especially if associated with diabetes. Tonifies the blood in case of deficiency, with symptoms of pallid complexion, dizziness, palpitations and insomnia. Often used after excessive menstruation, uterine bleeding and postpartum bleeding. Nourish Kidney yin with symptoms as night sweat, nocturnal emissions, steaming bone and wasting or thirsting disorders. Used to nourish the sperm, increasing the count Nourishes the blood and tonifies the essence for: back pain, weakness in lower extremities, light headiness and dizziness, tinnitus, diminished aural acuity and premature graying due to exhausted blood and essence. Unprepared Rehmannia, Sheng di huang, is sweet, bitter and cold. It also enters the heart, kidney and liver meridians. It is used to clear heat in the blood and to nourish yin and generate fluids. Sheng di should be cooked prior to consumption. Dosage 9-15g Pharmacy and dosage: Dosage 9-30 g This herb is prepared by stirring and steaming the dried herb in wine until both the inside and outside is black and moist. It is often toasted with sha ren (Amomum villosum, fruit) and chen pi (Citrus reticulate, skin) to counteract its heavy, cloying properties. It is charred to stop bleeding. Major Combinations: With dang gui (Angelica sinensis, root) and bai shao (Paeonia lacttfiora, root) for symptoms of dizziness, palpitations, insomnia, menstrual blood disorders. Adding e jiao (Equus asinus) and ai ye (Artemesia vulgans, herb) for excessive uterine bleeding.

246 Lesson 10: Tonifying Herbs With shan zhu yu (Comus officinalis, fruit) and shan yao (Dioscorea opposite root) for dizziness, tinnitus, weakness and soreness in lower back, impotence, night sweats, spermatorrhea or other Liver, Kidney deficiencies. With sha ren (Amomum villosum, fruit) for both blood and Spleen deficiency. With lean pork or other lean meat for chronic constipation from deficiency. REFERENCES 1 Bensky D, Gamble A; Chinese Herbal Medicine Materia Medica;Eastland Press Seattle Wa; p Hsu, H.Y., Chen, Y.P., et al., Oriental Materia Medica: a concise guide, Oriental Healing Arts Institute, Long Beach, CA, 1986, p Tang W, Eisenbrand; Chinese Drugs of Plant Origin; Spinger-Verlag; New York; 1992 p Bensky D, Gamble A; Chinese Herbal Medicine Materia Medica;Eastland Press Seattle Wa; p Hsu, H.Y., Chen, Y.P., et al., Oriental Materia Medica: a concise guide, Oriental Healing Arts Institute, Long Beach, Cft., 1986, p Huang CK, The Phannacology of Chinese Herbs 2nd Ed. ; CRC Press; 1999, p Image tcmedicine.org

247 Lesson 10: Tonifying Herbs He Shou Wu Polygonum multiflorum! Family: Polyganaceae Other names: fleece flower, Fo ti, Radix Polygoni Multiflori, ho shou wu, shou wu, kashuu (Japanese), hasuo (Korean), Sheng he shou wu, literal English translation!black haired (Mr.) He" Plant description: Perennial-rooted plants; rhizome horizontal, thick; stem erect or curving; flowers axillary, pendant, greenish white. Perianth tubular; limb short, six-lobed, erect; stamens six, included; ovary free, three-celled; style slender, included; berry globular, three to six seeded. P. multiflorum: Stem recurved, smooth; leaves arranged in two rows, two-anda-half to six inches long, one third as broad, more or less clasping at the base, smooth and glossy above, paler and generally pubescent beneath; peduncles round, branching, scarcely a fifth as long as the leaves, axillary, one to four flowered; berries dark blue or blackish when ripe. In some varieties of this species, the stem is from five to seven feet high, and much recurved at the top. Part used: root Habitat, ecology and distribution: Henan, Hubei, Guangxi, Guangdong, Guizhou, Sichuan province; harvested in spring or autumn History: first appeared in Materia Medica of Ri Hua-Zi. This herbs name (he shou wu), literally translates the black-haired Mr. He. It was said that at the age of 58 Mr. He hadn't yet sired a child. A monk told him to take this plant and not only did he sire a child, he had several. Well taking this plant, his hair turned from gray to black and remain full and black until his death at 160 years old. Constituents: chrysophanic acid, emodin, rhein, polygoacetophenoside, chrysohanic acid anthrone, lecithin.1,2,3,4 Energetics Properties and Channels Entered: bitter, sweet, astringent, slightly warm; entering the Liver and Kidney meridians. Actions and Indications: lowers cholesterol, arteriolosclerosis, cathartic, anti-aging, tonic, anti-malarial Medical Research: He shou wu has been shown to reduce the amount of blood cholesterol (62-82% success), in both human and animals. It appear to reduce absorption of cholesterol in the intestine, but has also been shown to work on liver enzymes to lower LDL:HDL ratio.

248 Lesson 10: Tonifying Herbs Triglyceride deposits in the liver have also been lowered in rat studies. He shou wu can lower levels of arteriolosclerosis, reduce heart rate and slightly increase coronary circulation. It purgative action is attributed to the antraquinone constituents. Antibiotic action has been shown against Mycobacterium tuberculosis and Shigella flexneri. Combined with licorice root, he shou wu has been successful in treat malaria. It can increase SOD activity in mice, having a selective inhibitory action on thromboxane (TXA2) production.5,6,7,8 Toxicity, Contraindications and cautions: contraindicated in cases of Spleen deficiency, phlegm or in case of diarrhea. Some authorities suggest it should not be combines with onions, chives or garlic. Medicinal uses: Tonifies the Liver and Kidneys, nourishing the blood, while augmenting the essence. It is specific for yin or blood deficiency such as dizziness, blurred vision, premature graying with lower back, knee pain and insomnia. Secures the essence and stop leakage in cases of nocturnal emissions, spermatorrhea, or vaginal discharge. Relieves fire toxins when used raw, in cases of carbuncles, sores, scrofula, goiter and neck lumps. Moistens the Intestines and unblocks the bowels, especially if associated with blood deficiency. Expels wind from skin nourishing it in case of rashes due to blood deficiency. Pharmacy and dosage: Dosage: 9-30 g It should not be decocted in a steel container. Use raw for moistening the Intestines and for anti-inflammatory action, or to tonify the Liver and Kidney. Major Combinations: With sang ji sheng (Loranthus parasiticus), nu zhen zi (Ligustrum lucidum, fruit), and niu xi (Achyramthes bidentata, root) for dizziness, blurred vision and numbness of the extremities due to Liver blood deficiency. With re shen (Ginseng), dang gui (Angelica sinensis, root) and chen pi (Citrus reticulate, skin) for chronic malarial disorders and physical debility. REFERENCES 1 Huang CK, The Phannacology of Chinese Herbs 2nd Ed. ; CRC Press; 1999, p121-22

249 Lesson 10: Tonifying Herbs 2 Bensky D, Gamble A; Chinese Herbal Medicine Materia Medica;Eastland Press Seattle Wa; p Tang W, Eisenbrand; Chinese Drugs of Plant Origin; Spinger-Verlag; New York; 1992 p Hsu, H.Y., Chen, Y.P., et ai., Oriental Materia Medica: a concise guide, Oriental Healing Arts Institute, Long Beach, CA, 1986, p Huang CK, The Pharmacology of Chinese Herbs 2nd Ed. ; CRC Press; 1999, p Bensky D, Gamble A; Chinese Herbal Medicine Materia Medica;Eastland Press Seattle Wa; p Tang W, Eisenbrand; Chinese Drugs of Plant Origin; Spinger-Verlag; New York; 1992 p Hsu, H.Y., Chen, Y.P., et ai., Oriental Materia Medica: a concise guide, Oriental Healing Arts Institute, Long Beach, CA, 1986, p Image riceplex.com

250 Lesson 10: Tonifying Herbs Dang gui Angelica sinensis! Family: Apiacea Other names: Dong quai, Radix Angelicae Sinensis, Twang Kwei, Chinese Angelica, quan dang gui, toki (Japanese), tanggwi (Korean), A. polymorpha Plant description: This fragrant perennial herb has a glabrous, smooth, purplish stem, with light linear striations. It grows m high. The lower leaves are tripinnate, with upper leaves being pinnate; leaflets are oval, dentate-incised; 3-11 cm long, sheathed; bracts are rudimentary. The inflorescence is formed in umbels, with flowers per umbel. The flowers are white with five petals, blooming June - July. Fruit appears July - Aug. Part used: Root Habitat, ecology and distribution: Grows in China, Korea and Japan History: This herb has been used extensively in China, especially after delivery of a child as a post-parturition tonic. Dang gui was also traditionally used to regulate menses, as a blood tonic, as a mild sedative, and for abdominal pains. It has been used for angina, chills, diabetes, hypertension, headaches, nephritis and lumbago. It is first found in Chinese literature in Collection of Commentaries on the Materia Medica (500 BCE).1.2 Other sources say it first appeared in the Divine Husbandman!s Classic of the Materia Medica. Constituents: Dang gui root has % volatile oils, butylidene phthalide, nvaleropheneone-o-carboxylic acid, dihydrophthalic anhydride, carvacrol, safrole, isosafrol, sesquiterpenes, cadinene, dodecanol, tetradecanol, n-butylphalid, ferulic acid, succinic acid, nicotinic acid, a number of coumarins and furocoumarins, uracil, adenine, ligustilide, folinic acid, betasitosterol, vitamin E, vitamin B12 ( mcg/100g), betacarotene, palmitic acid, angelic acid, angelol, myristic acid, angelicone and sucrose.3,4,5 Energetics Properties and Channels Entered: Sweet, acrid, bitter and warm properties; entering the Heart, Liver and Spleen meridians. Dang gui tones, invigorates and harmonizes the blood, while regulating menses.6,7,8 Actions and Indications: Emmenagogue, sedative, analgesic, blood tonic and diuretic Medical Research: Dang gui has been shown to both contract and relax uterine muscles in anesthetized dogs, cats and rabbits. The contractive and excitatory ingredient is felt to be a water and

251 Lesson 10: Tonifying Herbs alcohol-soluble, non-volatile oil component; whereas the relaxing, inhibitory component is considered to be a volatile oil with high boiling point. This is thought to be the mechanism underlying its effectiveness in dysmenorrhea, not an estrogenic effect. It is also thought to increase sexual activity in female animals, but doesn't have reliable clinical support. 9,10,11 Dang gui!s effect on body metabolism and endocrine function has been demonstrated by mixing 5% raw root to the diet of mice for four weeks. Body metabolism was enhanced, oxygen utilization increased in the liver, as well as glutamic acid and cysteine oxidation enhancement. It also protected the liver of laboratory mice against carbon tetrachloride toxicity. This herb has shown to act against Vitamin E deficiency, which may relate to its fetusstabilizing effect, and prevention of testicular disease. Dang gui root, especially alcohol extract of the root, has a quinidine-type effect on animal hearts, an inhibitory effect on frog hearts, and depresses tachycardia. Dang gui can prevent experimental coronary atherosclerosis, and prevents lipid deposits in arteries. The blood pressure lowering activity in anesthetized animals is thought to be due to the release of neurotransmitters, which excite acetylcholine and histamine receptors, causing dilatation of peripheral blood vessels. Aqueous extracts have been shown to inhibit both writhing and capillary permeability, along with a strong inhibition of platelet aggregation (by inhibiting 5HT) and inhibition of thromboxane formation, suggests an anti-inflammatory action. 15,16,17,18 Anti-tumor action of Dang gui has been observed in several studies. It has been shown to increase lymphocyte activity to form mature antibodies, while increasing IL-2 formation. It has been observed to increase B cells' capability to respond to T helper cells and stimulate T lymphocyte production. 19 A decoction of Dang gui root has been shown to inhibit many bacteria: Gram negative bacteria such as Bacillus dysenteriae, B. typhi, B. comma, B. paratyphi and Escherichia coli as well as Gram positive bacteria, such as Streptococcus, Corynebacterium diphtheriae and Shigella.20,21,22 Polysaccharides in Dang gui have shown to be both stimulating and modulating. A mild sedative effect by the volatile oil inhibits brain activity, and smooth muscles in intestine and bladder. One of the constituents, ligustilide, has shown strong antiasthmatic activity in vivo as well as anti-spasmodic action in the GI tract. Dang gui is heavily used in China, injected into acupuncture points to inhibit pain. It has been shown to have a diuretic effect. 23,24,25,26 Toxicity, Contraindications and cautions: Side effects of this herb are rare, but use caution in "Cold deficiency" diarrhea (as determined by traditional Chinese medical diagnosis). There has been a very small number of people exhibit hypersensitivity to the herb, which may lead to excessive bleeding and occasionally fevers. Some cases of photosensitivity and a mild laxative effect in others have been noted. 27 Some authorities are concerned about toxicity because of the safrol content of Dang gui, but with such a substantial amount of usage across centuries of Chinese history, there would appear to be little need for concern when the herb is consumed within the therapeutic range.

252 Lesson 10: Tonifying Herbs Medicinal uses: Classified as a tonic herb in China and as such would be rarely used in acute stages of a disease. Even for an acute condition as simple as the common cold, normally it would be suggested to correct the acute state first, before initiating use of Dang gui. As a tonic, it is usually combined with other botanicals and is rarely used alone. Often the center of gravity of the other ingredients will direct the action of Dang gui. Its tonic action is mostly seen in its ability to 'tone the blood'. This TCM concept is different than what Western medicine practitioners might initially assume, referring to much more than anemia; it can mean psychological issues as well as nutrient or physiological issues. "Deficient blood", in the TCM sense, is suggested by a pallid face and lips, dizziness, vertigo, diminished vision, lethargy, palpitations, dry skin, menstrual irregularities, pale tongue and a fine pulse. This is the most commonly used herb in the Orient to regulate menstrual function and to tone the female organs. It can also be used by males to tone their blood and is very efficient in teenage acne. Tonifies the blood and regulates menses in patterns of blood deficiency with symptom as pallid, ashen complexion, tinnitus, blurred vision, and palpitations. Commonly used for blood deficiency associated with menstrual disorders including amenorrhea, and dysmenorrhea. Invigorates and harmonizes blood, while dispersing cold, thus stopping pain due to blood stasis. Often used for abdominal pain after traumatic injury, carbuncles where cold or chronic wind dampness is present. Moisten the intestines and unblocks the bowels, especially if associated with blood deficiency. Reduces swelling, expels pus, generates flesh and alleviates pain. Used for treating abscesses when both toning and invigorating the blood is indicated. In some text they talk about the different parts of the root having different qualities. The head or upper most part (dang gui tou) is said to be most toning, but less effective for moving blood. The tail or extremities (dang gui wei) is not as toning, but better for moving blood. The body of the herb (dang gui shen) is considered more toning that invigorating. Most people use the whole root and don't distinguish between the parts. Pharmacy and dosage: Dried herb 3-30g 28 Bensky lists the dosage at g Major Combinations: With huang qi (Astragalus membranaceus, root) for pallor, debility, fatigue and/or low grade fever associated with excessive blood loss. Beneficial when a person has abscesses with insufficient drainage.!!

253 Lesson 10: Tonifying Herbs With bai shao (Paeonia lacttfiora, root) and shu di huang (Rehmannia glutinosa, root) and chuan xiong (Ligusticum wahhichii root) for menstrual irregularities (Formula: Si wu tang) With huang qi (Astragalus membranaceus,root), and ginger and lamb for postpartum abdominal pain, hernia pain associated with cold from deficiency and symptoms of exhaustion. REFERENCES 1. Duke, J.A., CRC Handbook of Medicinal Herbs, CRC Press, Boca Raton, FL, 1985, p Hsu, H.Y., Chen, Y.P., et ai., Ibid. 3. Chu, D., A contribution to my Knowledge of Dong Qai, typescript, Calgary Alberta. personal correspondence 4. Bensky, D. and Gamble, A., Chinese Herbal Medicine: Materia Medica, Eastland Press, Seattle, WA, 1986, p Hsu, H.Y., Chen, Y.P., et ai., Oriental Materia Medica: a concise guide, Oriental Healing Arts Institute, Long Beach, CA, 1986, p Hsu, H. Y., Chen, Y.P., et ai., Oriental Materia Medica: a concise guide, Oriental Healing Arts Institute, Long Beach, CA, 1986, p Bensky, D. and Gamble, A., Chinese Herbal Medicine: Materia Medica, Eastland Press, Seattle, WA, 1986, p Tierra, M., Planetary Herbology, Lotus Press, Santa Fe, 'N'M, 1988, p Chu, D., Ibid. 10. Hsu, H.Y., Chen, Y.P., et ai., Ibid. 11. Bensky, D. and Gamble, A., Ibid. 12. Bensky, D. and Gamble, A., Ibid. 13. Hsu, H.Y., Chen, Y.P., et ai., Oriental Materia Medica: a concise guide, Oriental Healing Arts Institute, Long Beach, CA, 1986, Ibid. 14. Bensky, D. and Gamble, A., Ibid. 15. Bensky, D. and Gamble, A., Ibid. 16. Moe J.E; Angelica sinensis: A Monograph; Journal of Naturopathic Medicine; winter 1997, pp Hsu, H.Y., Chen, Y.P., et ai., Oriental Materia Medica: a concise guide, Oriental Healing Arts Institute, Long Beach, CA, 1986, Ibid. 18. Bensky, D. and Gamble, A., Ibid. 19. MoeJE; Ibid. 20. Bensky, D. and Gamble, A., Ibid. 21. Hsu, H.Y., Chen, Y.P., et ai., Oriental Materia Medica: a concise guide, Oriental Healing Arts Institute, Long Beach, CA, 1986, Ibid. 22. Bensky, D. and Gamble, A., Ibid. 23. Bensky, D. and Gamble, A., Ibid. 24. Hsu, H.Y., Chen, Y.P., et ai., Oriental Materia Medica: a concise guide, Oriental Healing Arts Institute, Long Beach, CA, 1986, Ibid. 25. Bensky, D. and Gamble, A., Ibid. 26. Tang, W. and G. Eisenbrand, Chinese Drugs of Plant Origin: Chemistry, Pharmacology, and Use in Traditional and Modem Medicine, Springer-Verlag, Berlin, 1992, p McGuffin, M., eta.l., American Herbal Products Association's Botanical Safety Handbook, CRC Press, Boca Raton, FL, Hsu, H.Y., Chen, Y.P., et ai., Ibid. Image herbalvitalhealth.com

254 Lesson 10: Tonifying Herbs Bai Shao Paeonia lactiflora Family: Ranunculaceae Other names: white peony root, Radix Paeoniae Lactiflorae, pai shao, bai shao yao, byakushku (Japanese), paekcak (Korean) Plant description: These popular, gorgeous hardy perennials are commonly called Peony. They are valued for their beautiful flowers, usually colorful foliage, and decorative seedpods. The blossoms are ordinarily very fragrant and may be single, double or anemone form (with broad, outer petals and a pincushion-like mound of central petals or flowers - modified stamens). The foliage is often tinted bronze when new and takes on reddish tones in the fall. The leaves are large, alternately arranged on the stems, and divided into oval to lance-shaped linear leaflets. There are other types of Peonies, less we known, called Tree Peonies. These are cultivars of P. suffruticosa and are natives to Japan and China. They are open shrubs usually growing over 6 feet. P. lactiflora 'Cornelia Shaylor' grows up to 34 inches high and has double flowers with ruffled petals thickly and neatly arranged, from early to midsummer. In TCM there are 3 possible medicines that are produced from peony plants: 1. Mu Dan pi: The bark of the root from P. suffruticosa (tree peony). In lesson 3 2. Chi Shao: Known as red peony, the part used is the root that has the bark attached from P. lactifiora, P. veitchii and P. obovata. Chi shao cools the blood, breaks up blood stasis and clear heat from the Liver. 3. Bai shao: The root without the bark of these same three plants (P. lactifiora, P. veitchii and P. obovata) provides bai shao (white peony), although most often this medicine is derived from P. lactiflora. The color designation does not refer to the flowers of these plants (which are most commonly pink, red, purple, or white) but to the color of the root after processing. Part used: white peeled root Habitat, ecology and distribution: Zhejiang (best), Anhui, Sichuan, Guizhou, Shandong provinces; harvested in summer or autumn (usually 3-4 year old plants). History: First found in the Collection of Commentaries on the Materia Medica. Constituents: paeoniflorin, paeonol, paeonin, albiflorin, triterpenoids, sistosterol, oxypaeoniflorin, alliflorin, benzoylpaeoniflorin, benzoic acid, P sitosterol, gallotannin, pedunculagin, 1-0-Galloylpedunculagin, eugeniin, tannin acid, fat, essential oil, resin, sugar, starch, and protein. 1,2,3

255 Lesson 10: Tonifying Herbs Energetics Properties and Channels Entered: bitter, sour and cool, entering the Liver and Spleen meridians Actions and Indications: nervine, antispasmodic, anti-bacterial, hypotensive, antidiaphoretic and antidiuretic Medical Research: Bai shao has shown significant antispasmodic and analgesic activity in smooth muscle of the intestinal tract and uterus of both human and animal models. This is attributed mostly to paeoniflorin, which also shows anti-inflammatory action. This constituent also exhibits a hypotensive activity on peripheral vasodilatation, as well as in coronary vessels. It is most likely responsible for inhibiting platelet coagulation. We can find antibacterial action against Staphylococcus aurus, E.coli, Bacillus subtilis and Shigella dysenteriae, attributed to paeonol content. Paeonol has a sedative action on the central nervous system. One of the primary actions of bai shao is its ability to inhibit gastric secretions to inhibit and prevents ulcer. Bai shao increases leukocyte count including lymphocytes. Clinical observation has shown it inhibits diaphoresis and diuresis.4,5,6 Toxicity, Contraindications and cautions: Use with caution in cases of diarrhea due to cold from deficiency or weak yang. Some authors suggest this herb not be used with shi hu (Dendrobium nobile) and mang xiao (Mirabilitum). It is said to counteract bie jia (Amydae sinensis) and xiao ji (Cephalanoplos segeti) and is incompatible with Ii lu (Veratri). Medicinal uses: Often used for muscle spasm of limbs, back and neck, face. Jerky legs. As pain killer. Bone spurs of the heels. Viral hepatitis. Chronic constipation. Asthma. Whooping coughs. Diabetes. Ulcers of duodenum or stomach. Nourishes the blood and regulates menses in blood deficiency cases. Often used for uterine bleeding and vaginal discharge. One of the most commonly used herb for female complaints. Calms and curbs Liver yang and alleviates pain; for symptoms in the flank, chest and abdominal area. Specific for pain due to liver constraint or disharmony between Liver and Spleen. The herb is said to soften the Liver, stop pain and spasm in hand and feet as well as abdomen. Preserves the yin and adjusts nutritive and protective levels. Useful for vaginal discharge and spermatorrhea, as well as wind-cold. Pharmacy and dosage: Dosage: 6-15 g but sometimes up to 30 g Used dry to pacify the Liver

256 Lesson 10: Tonifying Herbs Dry fried to nourish blood and harmonize the nutritive and protection level. Major Combinations: With dang gui (Angelica sinensis) and shu di huang (Rehmannia glutinosa, root) for burred vision and dysmenorrhea. Associated with blood stasis or deficiency. Add mai men dong (Ophiopogon uaponicus, tuber) for tinnitus, dizziness, blurred vision and numbness in extremities. With xiang fu (Cyperus rotundus, root) and yan hu suo (Corydahis yanhusuo, root) for abdominal pain with menstruation. With gan cao (Licorice) for abdominal pain due to dishannony of the Liver and Stomach. Also useful for muscle spasm, especially in the calf. With huang qin (Scutellaria baicalensis) and huang lian (Coptis) for damp-heat dysenteric disorders. REFERENCES 1 Tang W, Eisenbrand; Chinese Drugs of Plant Origin; Spinger-Verlag; New York; 1992 p267 2 Bensky D, Gamble A; Chinese Herbal Medicine Materia Medica;Eastland Press Seattle Wa; p Hsu, H.Y., Chen, Y.P., et al., Oriental Materia Medica: a concise guide, Oriental Healing Arts Institute, Long Beach, CA, 1986, p Huang CK, The Pharmacology of Chinese Herbs 2nd Ed. ; CRC Press; 1999, p Tang W, Eisenbrand; Chinese Drugs of Plant Origin; Spinger-Verlag; New York; 1992 p267 Image tcm.health-info.org

257 Lesson 10: Tonifying Herbs Xi Yang Shen Panax quinquefolium Family: Araliaceae Other names: America ginseng, Radix Panacis Quinquefolii, hsi yang shen, hua qi shen, xi shen, seiyojin (Japanese) soyangsam (Korean) Plant description: This small shrub grows up to.3 m, with smooth, serrated leaflets in 5!s; flower is yellowish, fruit scarlet. The root is 5-14 cm long, with a central taproot with many secondary branched brownish-yellow rootlets. Part used: root and rootlets Habitat, ecology and distribution: mostly northern USA and Canada. Cultivated in Northern China History: First found in the Omissions from the Grand Materia Medica. Panax quinquefolium and Panax trifolium make an appearance in the ethnobotanical records of roughly a dozen Northeastern Amerindian tribes. No particular pattern of usage is evident. 1 Constituents: The root contains a group of saponin complexes. These are often split into two groups: 1) Rb1 group (protopanaxadiol: Rb1, Rb2, Rc and Rd) 2) Rg1 group (propanaxatriol: Rg1, Re, Rf, Rg2) Ginseng also contains, acetylene panaxynol (C17H260), a 1,9-cis-heptadecadiene-4,6- diyn-3-01, beta-element, beta-sitosterol, 0.05% essential oils, panacene (C15H24), a pyrrolidone, 5-peptides sugars, 3.3% disaccharides (saccharose and maltose). It contains small amounts of pantothenic acid, biotin, vitamins B1, B2, B12, nicotinic acid, choline, citric, fumaric, malic, maleic, panaxic and tartaric acids and traces of Mn, V, Cu, Co, S and As. 2,3,4,5 Energetics Properties and Channels Entered: sweet, slightly bitter and cold; entering the Heart, Kidney and Lung meridians. Actions and Indications: adaptogen, nervine, tonic, aphrodisiac. Medical Research: Since the Ginsengs have different properties, there are inconsistencies in the interpretation of the various Ginseng studies. Lewis documents a good overview of this.6 Further problems associated with studies are: not identifying species or type of plant; extraction technique, purification, dosage, or even the animal species used in studies.

258 Lesson 10: Tonifying Herbs The Ginsengs do work differently with various animals. These plants are considered panaceas due to their broad spectrum use and their long history. Even though many of the uses of the Ginsengs are similar, there are differences between them, as well as many contraindications. Ginsengs are thought of as the great Qi tonics, but they are not considered perfect herbs. While undoubtedly many of the physiological properties of the Ginsengs have to do with other factors, the main components are the saponin groups Rg1 and Rb1. These two factors are diametrically opposed to each other. The ratio of these factors means a lot when it comes to their function. Both American and Asian Ginsengs contain both factors, but the Asian Ginseng contains much higher amounts of Rg1, while there is more Rb1 in the American Ginseng. This ratio is the significant factor between how the two work. Rb1 group (highest in American ginseng, alcohol soluble extract) have the following properties: central nervous system depressant (anticonvulsant, analgesic, tranquilizing), hypotensive, anti-stress (protecting gastrointestinal tract from ulcers), antipsychotic (inhibition of conditioned avoidance response), weak anti-inflammatory, antipyretic (fever-reducing), facilitates small intestine motility, increases liver cholesterol synthesis, increases RNA activity in rats liver, (Rg has opposite effect).7 American ginseng (P. quinquefolium): acts to tranquilize the brain, while moderately stimulating the vital organs. It also helps to relieve fatigue. 8,9 An excellent review of material available on ginseng can be found in Stephen Fulder's book The Tao of Medicine and Medicinal values of Ginseng. 10,11 Toxicity, Contraindications and cautions: Contraindicated in cases of damp-cold of the Stomach. Not recommended to combine with Ii lu (Veratri root). This herb has a very low toxicity with an LD50 of 1167mg/Kg. When 100ml of 3% tincture is ingested by humans, a mild degree of unrest is seen; 200 ml causes symptoms of systemic rash, pruritus, vertigo, headaches, fever, and in severe cases, hemorrhage. One case of consumption of 500 ml was fatal. 12 Medicinal uses: Not as strong of a tonic as Asian ginseng (ren shen), but best used for nourishing the yin. Benefits qi by generating fluids and nourishing yin. Used for yin deficiency with heat signs and chronic fevers. Useful in the convalescent stage after health issues that include fevers, with symptoms of weakness, irritability and thirst. Nurtures the Lung yin and clears fire from the lungs. The symptoms are wheezing and coughing blood-streaked sputum or loss of voice due to Lung yin deficiency.

259 Lesson 10: Tonifying Herbs Pharmacy and dosage: Dosage Powder 1-6 g Decoction 3-6 g usually cooked separately Major Combinations: With shi gao (Gypsum) and zhi mu (Anemarrhena asphodeloides, roots) for high fever, thirst, diarrhea and dehydration due to warm-febrile diseases, especially if qi and fluids are injured. With mai men dong (Ophiopogon uaponicus, tuber) and e jiao (Equus asinus, gelatin) for wheezing and coughing up blood streaked sputum. Steamed with long yan rou (Euphoria longan) for blood in stools due to Intestinal heat. Official Regulations and Medical References British Pharmaceutical Code 1934 U.S.P. Matindale UK - General Sales List, Schedule 2, Table A France - Accepted for specific indications No 90/22 Gennan - Commission E ;1984 p138 PDR for Herbal Medicine - p1009 REFERENCES 1. Moerman, D.E., Medicinal Plants of Native America, University of Michigan Museum of Anthropology, Technical Reports, Number 19, Ann Arbor, Michigan, 1986, VoU, p Duke, J.A., CRC Handbook of Medicinal Herbs, CRC Press, Boca Raton, FL, 1985, p Mowrey DB; Guaranteed Potency Herbs; Next Generation Herbal Medicine; Keats Pub; New Canaan Con; p Bensky D., Gamble A.; Chinese Herbal Medicine:Materia Medica; Eastland Press Seattle; p Hsu Hong-yen, Chen Yuh-Pan, et al; Oriental Materia Medica: a concise guide; Oriental Healing Arts Institute; Long Beach CA.; p Lewis, WH; Ed. Etkin NL; Ginseng: A Medical Enigma; in Plants in Indigenous Medicine % Diet: Biobehavioral Approaches; Bedford Hills; Redgrave Publ Co; 1986; Mowrey, D.B., Ibid. 8. Bensky, D. and Gamble, A., Chinese Herbal Medicine: Materia Medica, Eastland Press, Seattle, WA, 1986, p Hsu, H.Y., Chen, Y.P., et al., Oriental Materia Medica: a concise guide, Oriental Healing Arts Institute, Long Beach, CA, 1986, p Fulder, S., The Tao of Medicine, Destiny Books, New York, Li, TSC, Harries D; Medicinal Values of Ginseng. The Herb, Spice and Medinal Plant Digest; Vol 17(3); 1996; ppl Bensky, D. and Gamble, A., Ibid. Image plumdragonherbs.com

260 Lesson 10: Tonifying Herbs Tian Men Dong Asparagus cochinchinensis! Family: Liliaceae Other names: asparagus tuber, Asparagi radix, tenmendo (Japanese), cheonmundong (Korean), tein men tung, tian dong Part used: tuber Habitat, ecology and distribution: Grown in Guizhou, Sichuan, Guangxi, Hubei, Zhejiang, Jiangxi provinces. Harvested in autumn or early winter (preferred). Plant description: Asparagus is a perennial plant with short, horizontal rootstock having long, thick roots and sending up the young shoots that we eat as vegetables. The parts of this plant used medicinally are the root, shoots, and seeds. The word Asparagus is from the Persian "asparag", referring to tender shoots that can be consumed. Due to its phallic shape, it has long been regarded as an aphrodisiac. The Ayurvedic name, Shatavari, means "she who has one hundred husbands". History: Found in the Divine Husbandman's Classic of Materia Medica. Constituents: Saponins (Asp-IV, V, VI, Vll), the aglycone being protosarsasapongenin; asparagines, citrulline, serine, threonline, praline, clyccine, smilagen, rhamnose, glucose, fructose, 5-methoxyl-methyl furural, beta sitosterol.1,2 Energetics Properties and Channels Entered: sweet, bitter and very cold; entering the Kidney and Lung meridians Actions and Indications: antibacterial, anti-neoplastic, antitussive, diuretic and laxative Medical Research: Tian men dong has an antibiotic effect against bacteria, including Streptococcus, Staphylococcus, pneumonia, hemolytic, and Bacillus subtilus. The tuber has antineoplastic effect in vitro against leukemia. It is antitussive, diuretic and laxative. Toxicity, Contraindications and cautions: Contraindicated in cases of cold deficiency of the Spleen and Stomach with loss of appetite and diarrhea. Wind-cold coughs also have contraindication. Medicinal uses: Nourishes Kidney Yin and clears Lung heat. Used for yin deficiency with heat signs in upper burner, typically showing a dry mouth. Can be useful for dry Lungs patterns.

261 Lesson 10: Tonifying Herbs Moistens the Lung, nourishes the Kidney and general fluids. Used especially for wasting thirsting disorder and consumption with low-grade fever. Can be useful if constipation is present, associated with these issues. Pharmacy and dosage: Dosage: 5-16 g Major Combinations: With mai men dong (Ophiopogon uaponicus, tuber) for dry cough, thirst and symptoms associated with yin deficiency and injured fluids. With sheng di huang (Rehmannia glutinosa, root), chuan bei mu (Fritillaria cirrhosa, bulb), and bai he (Lilium brownie) for chronic dry cough due to heat with difficulty to expectorate sputum. With ren shen (Asian Ginseng) and sheng di huang (Rehmannia glutinosa, root) for low grade fever due to yin deficiency, as an aftermath of a significant illness. REFERENCES 1 Hsu, H.Y., Chen, Y.P., et ai., Oriental Materia Medica: a concise guide, Oriental Healing Arts Institute, Long Beach, CA, 1986, p Bensky D, Gamble A; Chinese Herbal Medicine Materia Medica;Eastland Press Seattle Wa; p Image tcm.health-info.org

262 Lesson 10: Tonifying Herbs Bai He Lilium brownii Family: Liliaceae Other names: lilly bulbs, Bulbus lilii, pai ho, byakgo (Japanese), paekhap (Korean) Plant description: Elongated elliptical, 2-5 cm long, 1-2 cm wide, 3-4 mm thick at middle. Externally whitish, pale brownish-yellow or purplish, with several longitudinal and parallel white vascular bundles. Apex somewhat acute, base relatively broad, margins thin, undulate, slightly curved inwards. Texture hard and fragile, fracture relatively even, horny. Part used: bulb Habitat, ecology and distribution: throughout China, can grow in North America. Harvested in autumn or winter. History: Found in the Divine Husbandman's Classic of the Materia Medica. Constituents: cochiceine. 1 Energetics Properties and Channels Entered: sweet, slightly bitter, slightly cold; enter Heart and Lung meridians. Actions and Indications: antitussive, nervine, cardiotonic Medical Research: decoction of Bai he has an antitussive effect, alleviating histamine induced asthma.2 Medicinal uses: Moistens Lungs and clears heat, while stopping coughs from dry Lungs or Lung-heat coughs or sore throats. Clears the Heart and calms the spirit. Used for insomnia, intractable low-grade fevers, and restlessness. Can reduce heart palpitations, brought on by insufficiency of qi and yin. Commonly used in food preparations such as soups and stews, especially useful in the fall to treat dry cough due to lack of moisture and lung yin deficiency.

263 Lesson 10: Tonifying Herbs Pharmacy and dosage: Dosage 9-30 g Major Combinations: With kuan dong hua (Tussihago farfara) for chronic coughs due to lung heat; often associated with blood streaked sputum. With mai men dong (Ophiopogon uaponicus), xuan shen (Scophulariae ningpoensis) and chuan bei mu (Fritillaria cirrhosa) for chronic, dry cough and sore throat due to Lung yin deficiency or consumption. REFERENCES 1 Bensky D, Gamble A; Chinese Herbal Medicine Materia Medica;Eastland Press Seattle Wa; Hsu, H.Y., Chen, Y.P., et ai., Oriental Materia Medica: a concise guide, Oriental Healing Arts Institute, Long Beach, CA,1986 Image ironpalm.com!!

264 Lesson 11: Herbs to warm the interior & expel cold, Tonify yang LESSON 11: Herbs that Warm the Interior, Expel cold and Herbs that Tonify Yang Herbs That Warm the Interior and Expel Cold Herbs That Tonify Yang Herbs that warm the interior are a group of warming herbs that are very similar to yang tonifying herbs, both are warming but this group has stronger actions for expelling the cold. In practice yang tonics and herbs that expel cold and warm the interior are used together. In general, cold and yang deficiency present simultaneously. The etiology may be a development of external cold moving interiorly and depleting yang, or a deficiency of yang allowing cold to develop in the interior. Accompanying symptoms of interior cold are: cold extremities, aversion to cold, no thirst or desire for warm fluids, loose stools, white tongue coating, tight pulse and a pale or bluish complexion. The differentiating factor of interior cold from yang deficiency is a lack of sweating, when there is a predominant yang deficiency there will be sweating. Biomedically, these herbs are cardiotonics and stimulate blood flow. They aid digestion, increase intestinal nutrient absorption, release nausea and vomiting. Traditionally, they are considered warming to the kidney and spleen, and are generally pungent warm and drying. As with all warm herbs it is important to use caution when there is yin deficiency and heat. Herbs that warm the interior and expel cold are: Fu zi - Aconitum carmichaeli Gan jiang - Zingiber officinale Rou gui - Cinnamomun cassia Yang and qi are the functional aspects of the body. When deficient, both are characterized by weakness and fatigue; yang is an extension of qi deficiency and also shows signs of cold. Organs that typically show signs of yang deficiency are spleen, kidney and heart. Symptoms of spleen yang deficiency include: weakness of the 4 limbs and digestive dysfunction; symptoms of heart yang deficiency include: cold limbs, chest pain, heaviness and congestion of the thoracic region; kidney yang deficiency will show symptoms of sexual dysfunction, endocrine deficiency, delayed development, low back pain and immune weakness. Yang tonics are used to warm and stimulate the body's functions, regulating hormones, digestion and improving immune function.

265 Lesson 11: Herbs to warm the interior & expel cold, Tonify yang Some of these herbs tonify yang as well as yin, and are useful for rehabilitation, developmental delays or athletic performance improvement. Yang tonics reviewed in this section are: Lu rong - Cervus Nippon Dong chong xia cao - Cordycops sinensis Ba ji tian - Morinda officinalis Hu tao ren, - Juglans regia Bu gu zhi - Psoralea corylifolia Du Zhong - Eucommia ulmoides

266 Lesson 11: Herbs to warm the interior & expel cold, Tonify yang Fu Zi Aconitum carmichaeli Family: Ranunculaceae Part used: root (radix) Other names: shu fu zi, fu pian, fu kuai, chuan fu zi, wu tou, chuan wu, cao wu, root of Sichuan aconite, prepared aconite, Monkshood. Blue Rocket. Friar's Cap. Auld Wife's Huid Plant description: Good quality is large and solid with a salty-white surface Habitat, ecology and distribution: Sichuan, Shaanxi; harvested in summer, when the daughter root is separated from the parent, or winter when the parent root has withered. History: Divine Husbandman's Classic of Materia Medica Constituents: hypaconitine, aconitine, mesaconitine, talatisamine, chuan-wu-base A, chuan-wu-base B. Energetics Properties and Channels Entered: pungent, hot and toxic, entering the heart, kidney and spleen meridians. Actions and Indications: antihypertensive, vasodilator, anti-inflammatory, pituitary/adrenal stimulant, adrenergic, antipyretic, cardiotonic, sedative Medical Research: Preparations of fu zi given to anesthetized dogs or cats demonstrated a sharp and transient drop in blood pressure that was reversed by a large dose of atropine. In another experiment it was discovered that fu zi caused vasodilation in the lower extremities, as well as the coronary vessels. In normal dosage for humans, fu zi causes bradycardia and slightly lowers the blood pressure, while a large overdose can cause tachycardia or even ventricular fibrillation. Although some of this effect is mediated through the vagus nerve, most of it is believed to be a direct effect. Very high concentrations of calcium block the fibrillation caused by aconitine, which is one of the primary ingredients of this herb. Aconitine is not itself a cardiotonic, but a product of its decoction, aconine, it has a toxicity 1/2000-1/4000 that of aconitine. This herb does appear to have some cardiotonic function, as well as a regulatory effect on the rhythm of the heart. In one experiment on frog hearts, water in which this herb had been cooked for over 10 hours still had a very weak cardiotonic effect. Many investigators, especially in Japan, believe that the alkaloids are not the source of the cardiotonic action of this herb. Reports from research in China, however, state that preparations of this herb without alkaloids are not cardiotonic, while those with alkaloids are cardiotonic. Fu zi in

267 Lesson 11: Herbs to warm the interior & expel cold, Tonify yang combination with other herbs such as rou gui (Cortex Cinnamoni Cassiae), ren shen (Radix Ginseng), gan jiang (Rhizoma Zingiberis Officinalis) and gan cao (Radix Glycyrrhizae Uralensis) raised blood pressure in animals with acute hemorrhage. But a combination of the first two herbs lowered renal hypertension in rats.1 In one study, 13 patients with congestive heart failure of various etiologies were treated by intramuscular injections of a preparation of fu zi. In all cases, including one of cardiogenic shock, there was improvement in cardiac output, dyspnea, hepatomegaiy, and edema. In a few cases, side effects of flushing and slight tremor; appeared, but these were transient and self-limited. 2 Decoctions of fu zi given either orally or intraperitoneally had significant antiinflammatory effects against artificially-induced arthritis in animals.3 Fu zi can reduce the content of vitamin C in the adrenal cortex in rats. Other experiments have shown that it increases the urine content of 17- hydroxysteroid while decreasing the peripheral numbers of neutrophils, and therefore stimulates the pituitaryadrenal axis. Mice given decoctions of this herb showed an increase in secretions by the adrenal cortex and the metabolism of sugar, fats, and proteins. In one clinical study, when fu zi was given to patients with adrenal insufficiency, there was improvement in their condition. However, in another experiment when rough extractions of this herb were given to rats and mice, they showed no sign of any adrenergic effect. 4 Aconitine in doses of mg/kg has the effect of diminishing both conditioned and non conditioned reflexes, as well as lowering the concentration of ammonia throughout the brain. Aconitine injected into the fourth ventricle of rabbits in a dosage of 0.002mcg/kg produced an anesthetic effect. It was determined from the tail-flick test that aconitine inhibits the respiratory centers in animals, leading to slower breathing.5 When applied to peripheral sensory receptors, aconitine first stimulates and gives a burning, itching sensation that progresses to numbness.6 In one experiment aconitine lowered the temperature of both febrile and normal animals. 7 Experiments in Nanjing on the roots of both Aconitum carmichaeli and Aconitum chinense showed that lengthy decoction increased the cardiotonic effect of both while decreasing toxicity; that between the two, Aconitum carmichaeli had a stronger effect. In these experiments it was felt that the concentration of calcium influenced the degree of cardiotonicity.8 Toxicity, Contraindications and cautions: Fu zi is a very toxic drug. Toxicity varies widely depending on the source of the herb, when it was harvested, how it was prepared and how long it was decocted.

268 Lesson 11: Herbs to warm the interior & expel cold, Tonify yang For example, the toxicity of fu zi from different locales was found in one study to vary 8- fold. Preparation usually removes much of the toxicity; in one study the toxic properties of the drug had been reduced 81 %. Another study found that there was no linear relation ship between the amount of alkaloid in the herb and its toxicity. Animals in a hypersympathetic state are more susceptible to the toxic effects than tired or hungry ones. A toxic dose is usually far above normal levels, on the order of 15-60g. When a massive dose of fu zi is administered to animal, atropine reduces the changes on ECG, and in some studies, also reduces mortality. Lidocaine has been shown to be very useful in reducing the morality rate of animals in experimental over dosage of fu zi. Clinically, atropine has been very effective in treating over dosage of this herb. When gan cao (Rhizoma Glycyrrhizae Uralensis) and gan jiang (Rhizoma Zingiberis Officinalis) are combined with this herb in decoctions, its toxicity is substantially diminished. Xi jiao (Cornu Rhinoceri), jin yin hua (Flos Lonicerae Japonicae) and lu dou (Semen Phaseoli Radiatt) also reduce its toxicity. Signs of toxic overdose include drooling, nausea, vomiting, diarrhea, lightheadedness, blurred vision and numbness in the mouth and extremities. In advanced cases there may be premature atrial contractions, dyspnea, tremors, incontinence, stupor and reduced temperature and blood pressure.9 Contraindicated in cases of yin deficiency with false cold and true heat, and during pregnancy. Traditionally not to be used together with bei mu (Bulbus Fritillariae), gua lou (Fructus Trichosanthis), bai ji (Rhizoma Bletillae Striatae), ban xia (Rhizoma Pinelliae Ternatae) or bai wei (Radix Cynanchi Bai wei). According to some traditional sources, this herb antagonizes wu gong (Scolopendra Subspinipes) and counteracts xi jiao (Cornu Rhinoceri) and lu dou (Semen Phaseoli Radiatt). Note that the latter 2 herbs are used to reduce the toxicity of this herb. Medicinal uses: Restores devastated yang: for devastated yang disorders where the yang qi is extremely weak and the cold yin is abundant. Symptoms include: diarrhea containing undigested food particles, chills, cold extremities and a faint or imperceptible pulse. This condition often occurs after severe vomiting, diarrhea or sweating. This herb is critical in these situations since it both assists the heart yang to unblock the vessels and improve circulation, and tonifies the kidney yang to augment the fire and avoid loss of the basal yang. Warms the fire and assists the yang: for any problem associated with weakness or deficiency of the heart, spleen or kidney yang. It is a widely used herb, especially when the pattern involves interior cold due to yang deficiency.

269 Lesson 11: Herbs to warm the interior & expel cold, Tonify yang Disperses cold, warm the meridians and alleviates pain: for wind-damp=cold painful obstruction, especially when cold is predominant. Also for cold blocking the organs, meridians sinews, bones or blood vessels. Orally, Fu Zi / Aconite is used for pain, facial paralysis, joint pain, arthritis, gout, rheumatic complaints, inflammation, pleurisy, pericarditis sicca, fever, skin and mucosal diseases, disinfection, and wound treatment. Topically, Fu Zi / Aconite is used as a counterirritant in a liniment. Historically, Fu Zi / Aconite has been used orally as a cardiac depressant and an agent to induce mild sweating. Aconite has been used topically for facial neuralgia, rheumatism, and sciatica. 10 Pharmacy and dosage: g. Boil minutes before adding other ingredients in a decoction and then cook the decoction as prescribed (typically another minutes), this reduces its toxic properties. Always use Zhi Fu Zi (prepared) as this also greatly reduces its toxicity. Major Combinations: With gan jiang (Rhizoma Zingiberis Officinalis) to warm the spleen and kidneys, benefit the yang and disperse cold. Add a large dose of gan cao (Radix Glycyrrhizae Uralensis) to strengthen the combination's action in fortifying the qi and benefiting the yang. Used for chills, cold extremities and diarrhea containing undigested food due to collapse of the spleen and kidney yang. With ren shen (Radix Ginseng) for severe deficiency of the source qi and collapse of the yang qi. Symptoms include cold extremities, sweating, weak breathing, dizziness and an extremely pale complexion. With rou gui (Cortex Cinnamomi Cassiae) and shu di huang (Radix Rehmanniae Glutinosae Conquitae) for kidney yang insufficiency with waning of the gate of vitality. Symptoms include aversion to cold, weak and sore lower back and legs, impotence and urinary frequency. With bai zhu (Rhizoma Atractylodis Macrocephalae) for wind damp painful obstruction. o Add fu ling (Sclerotium Poriae Cocos) for kidney and spleen yang deficiency with retention of pathogenic water. Symptoms include abdominal pain aggravated by cold, urinary difficulty and deep aching and heaviness in the extremities. o Add gan jiang (Rhizoma Aingiberis Officinalis) for internal ascendance of yin cold leading to lack of arousal of spleen yang. Symptoms include pain and cold in the abdomen with watery diarrhea. With ren shen (Radix Ginseng) and gui zhi (Ramulus Cinnamomi Cassiae) for weak heart yang with palpitations, shortness of breath and chest pain. With huang qi (Radix Astragali Membranaceus) for spontaneous sweating and chills due to yang deficiency.

270 Lesson 11: Herbs to warm the interior & expel cold, Tonify yang With gui zhi (Ramulus Cinnamomi Cassiae) for damp cold painful obstruction in the meridians with generalized aches and pains and difficulty in rotating the torso. With ma huang (Herba Ephedrae) and xi xin (Herba cum Radice Asari) for externally contracted wind cold in cases with preexisting yang deficiency. ADDENDUM Wu tou (Radix Aconiti) is an alternative form of this herb. In ancient times there was no consistent differentiation of subtypes; two are now recognized. The first is Sichuan aconite - chuan wu (Aconiti Carmichaeli); it is pungent bitter, warm and very toxic, and enters the heart, liver and spleen meridians. It is used to expel wind dampness, disperse cold, and alleviate pain in the treatment of such disorders as damp cold painful obstruction, cold and pain in the chest and abdomen, intense headaches, and pain from trauma. It is more effective than zhi fu zi (Radix Lateralis Aconiti Garmichaeli Praeparata) in dispelling cold and alleviating pain, but is more toxic and has less tonifying properties. The dosage is 1.5-9g, and the contraindications are identical to those of the principal herb. It should also be cooked for minutes before adding other ingredients to the decoction. The second subtype is wild aconite, or cao wu (Radix Aconiti Kusnezoffii). It is usually wild rather than cultivated, and has properties and action that are similar to the first subtype, but is both stronger and more toxic. Its use is rare.11 REFERENCES 1 Bensky, D. and Gamble, A.; Chinese Herbal Medicine Materia Medica; Eastland Press, Seattle; 1993; p299 2 Bensky, D. and Gamble, A.; Chinese Herbal Medicine Materia Medica; Eastland Press, Seattle; 1993; p299 3 Bensky, D. and Gamble, A.; Chinese Herbal Medicine Materia Medica; Eastland Press, Seattle; 1993; p299 4 Bensky, D. and Gamble, A.; Chinese Herbal Medicine Materia Medica; Eastland Press, Seattle; 1993; p299 5 Bensky, D. and Gamble, A.; Chinese Herbal Medicine Materia Medica; Eastland Press, Seattle; 1993; p299 6 Bensky, D. and Gamble, A.; Chinese Herbal Medicine Materia Medica; Eastland Press, Seattle; 1993; p299 7 Bensky, D. and Gamble, A.; Chinese Herbal Medicine Materia Medica; Eastland Press, Seattle; 1993; p299 8 Bensky, D. and Gamble, A.; Chinese Herbal Medicine Materia Medica; Eastland Press, Seattle; 1993; p299 9 Bensky, D. and Gamble, A.; Chinese Herbal Medicine Materia Medica; Eastland Press, Seattle; 1993; p Bensky, D. and Gamble, A.; Chinese Herbal Medicine Materia Medica; Eastland Press, Seattle; 1993; p300 Image tcm.health-info.org

271 Lesson 11: Herbs to warm the interior & expel cold, Tonify yang Gan Jiang Zingiber officinalis Family: Zingiberaceae Other names: dan gan jiang, dried ginger rhizome, dried ginger Plant description: Good quality is solid with a grayish yellow exterior and a powdery, grayish white cross section. Part used: root Habitat, ecology and distribution: Sichuan, Guizhou, and elsewhere in China; harvested in winter after aerial parts have withered. History: Divine Husbandman's Classic of the Materia Medica Constituents: zingiberene, phellandrene, camphene, shogaol, gingerol, zingiberone, borneol, zingiberol, citral Energetics Properties and Channels Entered: pungent and hot, entering the heart, lung, spleen and stomach meridians Actions and Indications: hypertensive Medical Research: By acting on the central sympathetic centers, gan jiang raises blood pressure.1 Ginger extracts have been extensively studied for a broad range of biological activities including antibacterial, anticonvulsant, analgesic, antiulcer, gastric anti-secretory, antitumor, antifungal, antispasmodic, antiallergenic, and other activities. Gingerols have been shown to be inhibitors of prostaglandin biosynthesis. Danish researchers at Odense University have studied the anticoagulant properties of ginger and found that it was a more potent blood-clotting agent than garlic or onion. The same research group studied the potential use of ginger in the treatment of migraine, based on the long history of ginger use for neurological disorders by practitioners of India's traditional medicine system known as Ayurveda. The researchers proposed that ginger might exert migraine-headache-relieving and preventative activity without side effects. 2 Other scientific studies show that gingerol, one of the primary pungent principles of ginger, helps counter liver toxicity by increasing bile secretion. Ginger has potent antimicrobial and anti-oxidant (food preservative) qualities as well. A recent study, furthering ginger's reputation as a stomachic, shows that acetone and methanol extracts of ginger strongly inhibits gastric ulceration. 3

272 Lesson 11: Herbs to warm the interior & expel cold, Tonify yang Toxicity, Contraindications and cautions: contraindicated in cases of yin deficiency with heat signs, or the reckless movement of hot blood. Use with caution during pregnancy. Medicinal uses: Warms the middle and expels cold: for warming the spleen and stomach both in condition of excess due to externally contracted cold, as well as cold from deficiency due to insufficiency of yang qi. Rescues devastated yang and expels interior cold: for devastated yang with such signs as a very weak pulse and cold limbs. Warms the lungs and transforms phlegm: for lung cold with expectoration of thin, watery or white sputum. Warms the meridians and stops bleeding: for cold from deficiency that may present with hemorrhage of various types, especially uterine bleeding. It is used in treating hemorrhage only if the bleeding is chronic and pale in colour, and is accompanied by cold limbs, ashen white face and a soggy, thin pulse. In foods and beverages, ginger is used as a flavoring agent. 4 In manufacturing ginger is used as a fragrance component in soaps and cosmetics. The oleoresin of ginger is also used as an ingredient in digestive, laxative, antitussive, anti-flatulent, and antacid preparations. 5 Pharmacy and dosage: 3-12g. Major Combinations: With gan cao (Radix Glycyrrhizae Uralensis) for epigastric pain and vomiting due to cold from deficiency of the stomach and spleen. With gao liang jiang (Rhizoma Alpiniae Officinari) for abdominal pain and vomiting due to stomach cold. With ban xia (Rhizoma Pinelliae Ternatae) for vomiting due to cold induced congested fluids. Add ren shen (Radix Ginseng) for vomiting due to cold from deficiency. With huang lian (Rhizoma Coptidis) for epigastric pain and distention, dysenteric disorders and indeterminate gnawing hunger. The latter is a disorder characterized by a feeling of hunger, vague abdominal pain or discomfort sometimes accompanied by belching, distention and nausea, which gradually culminate in pain. With hou po (Cortex Magnoliae Offininalis) for epigastric distention and pain due to cold induced congealed fluids. With bai zhu (Rhizoma Atractylodis Macrocephalae) for diarrhea associated with spleen deficiency. Char both herbs for treating bloody stool and excessive uterine bleeding.

273 Lesson 11: Herbs to warm the interior & expel cold, Tonify yang With wu wei zi (Fructus Schisandrae Chinensis) and xi xin (Herba cum Radice Asari) for coughing and wheezing due to cold congested fluids preventing the normal descent of the lung qi. ADDENDUM Compared with sheng jiang (Rhizoma Zingiberis Officinalis Recens), gan jiang is more effective in warming the middle burner and expelling interior cold, while sheng jiang promotes sweating and disperses exterior cold. Pao jiang (quick fried Rhizoma Zingiberis Officinalis) is made by frying the herb until the surface is slightly blackened. It is bitter, astringent, and warm, entering the liver and spleen meridians. It is less potent for warming the interior, but is effective in stopping the bleeding associated with cold from deficiency. Some sources suggest that it is more effective than gan jiang in treating lower abdominal disorders.6 REFERENCES 1 Bensky, D. and Gamble, A.; Chinese Herbal Medicine Materia Medica; Eastland Press, Seattle; 1993; p ginger.html Bensley, D. and Gamble, A.; Chinese Herbal Medicine Materia Medica; Eastland Press, Seattle; 1993; p301 Image tcm.health-info.org

274 Lesson 11: Herbs to warm the interior & expel cold, Tonify yang Rou Gui Cinnamomum cassia Family: Lauracea Other names: cinnamon bark, inner bark of Saigon cinnamon, gui sin, guan gui Plant description: Good quality has a thick cortex, a purplish red cross-section and oily and aromatic. Part used: bark (cortex) Habitat, ecology and distribution: Guangdong, Guangxi, Yunnan, Fujian, Vietnam; harvested September to October from trees that are at least 7 years old (also harvested April to May, but this is poorer quality) History: Tang Materia Medica Constituents: cinnamaldehyde, cinnamyl acetate, phenyl propyl acetate. Its volatile oil contains cinnamic aldehyde, cinnamic acid and cinnamyl acetate, can promote saliva secretion and digestion, and exert an antispasmodic effect on smooth muscles of internal organs.1 Energetics Properties and Channels Entered: pungent, sweet and hot, entering the heart, kidney, liver and spleen meridians. Actions and Indications: tranquilizing, antipyretic, antibiotic Medical Research: In experiments on mice, cinnamaldehyde had a tranquilizing effect as measured by a decrease n activity. It counterbalanced the stimulatory effect of methamphetamine, and enhanced the effect of Phenobarbital. It also showed an analgesic effect. Cinnamaldehyde delayed the onset of convulsions and death in animals infected with an overdose of strychnine. 2 Cinnamaldehyde had an antipyretic effect in mice given typhoid vaccine at the same time they were inoculated with Salmonella typhi. It also lowered the temperature of normal mice. 3 A combination of rou gui and fu zi was useful in treating rats with artificially induced adrenal hypertension, but not renal hypertension.4 Rou gui has shown a very strong inhibitory effect in vitro against many gram positive bacteria and pathogenic fungi. 5 An alcohol based preparation of rou gui injected into the acupuncture point BL 13 (lung shu point) bilaterally was very effective in controlling bronchial asthma in 19 of 21!!

275 Lesson 11: Herbs to warm the interior & expel cold, Tonify yang cases. Of the remaining 2 cases, one showed some improvement and the other had no change. A limited follow up one month later showed no recurrences. 6 Toxicity, Contraindications and cautions: contraindicated in cases of yin deficiency with heat signs, interior excess heat and the reckless movement of blood. Use with caution during pregnancy. Rou gui is a very safe herb, but a large dose can cause respiratory changes, dilation of the auricular blood vessel and convulsions. Toxicity is related to the oil of the herb and varies between different species of animals. Medicinal uses: Warms the kidneys and fortifies yang: for a wide variety of problems due to insufficiency of kidney yang and waning of the gate of vitality. Common manifestations include: aversion to cold, cold limbs, weak back, impotence and frequent urination. Also for waning of the spleen and kidney yang with abdominal pain and cold, reduced appetite, and diarrhea. Also important for wheezing due to the failure of the kidneys to grasp qi. Leads the fire back to its source: the principal herb for treating the upward floating of deficient yang. Manifestations include: flushed face, wheezing, severe sweating (sweat pouring out like oil), weak and cold lower extremities, and a deficient and rootless pulse. This pattern is called false heat and true cold, or heat above/cold below. Also used for other conditions where the upper part of the body is hot and the lower part is cold. Disperses deep cold, warms and unblocks the meridians and vessels, and alleviates pain: for deep cold causing qi stagnation or blood stasis. Associated problems include: cold in the blood causing amenorrhea or dysmenorrhea, damp cold painful obstruction, yin type boils (chronic sores that are usually concave and ooze clear fluid) and abscesses or sores that do not heal. Pharmacy and dosage: g. Crush into small pieces before using. Usually it is taken as a powder, pill or tincture. It is rarely decocted because this causes the loss of the volatile oils, which carry much of its effect. When used with decoctions, the powdered herb is generally taken with the strained decoction; less often the herb is added near the end of the decoction process. Major Combinations: With fu zi (Radix Lateralis Aconiti Carmichaeli Praeparata) for kidney yang insufficiency and waning fire at the gate of vitality. Add gan jiang (Rhizoma Zingiberis Officinalis) for cold and painful abdomen, reduced appetite and diarrhea due to yang deficiency of the spleen and kidneys. With ren shen (Radix Ginseng) and shu di huang (Radix Rehmanniae Glutinosae Conquitae) for palpitations and shortness of breath due to deficiency of heart and kidneys.

276 Lesson 11: Herbs to warm the interior & expel cold, Tonify yang With huang bai (Cortex Phellodendri) and zhi mu (Rhizoma Anemarrhenae Asphodeloidis) for urinary discomfort and urinary retention due to kidney deficiency. With dang gui (Radix Angelicae Sinensis) and chuan xiong (Radix Ligustici Chuanxiong) for dysmenorrhea or amenorrhea due to cold form deficiency of the penetrating and conception vessels. With shu di huang (Radix Rehmanniae Glutinosae Conquitae) and ma huang (Herba Ephedrae) for yin type localized, painful swellings that blend into the surrounding tissue. REFERENCES Bensky, D. and Gamble, A.; Chinese Herbal Medicine Materia Medica; Eastland Press, Seattle; 1993; p302 3 Bensley, D. and Gamble, A.; Chinese Herbal Medicine Materia Medica; Eastland Press, Seattle; 1993; p302 4 Bensley, D. and Gamble, A.; Chinese Herbal Medicine Materia Medica; Eastland Press, Seattle; 1993; p302 5 Bensley, D. and Gamble, A.; Chinese Herbal Medicine Materia Medica; Eastland Press, Seattle; 1993; p302 6 Bensley, D. and Gamble, A.; Chinese Herbal Medicine Materia Medica; Eastland Press, Seattle; 1993; p302 Image chinese.herbs.webs-sg.com

277 Lesson 11: Herbs to warm the interior & expel cold, Tonify yang Lu Rong Cervus nippon Family: Cervidae Other names: nen lu rong, velvet of young deer antler, deer antler, cervi Herb description: Good quality is thick, firm, lightweight, fine cross section, fine hairs and oily, shiny appearance. Part used: velvet of deer antler Habitat, ecology and distribution: Jilin, Liaoning, Heilongjiang, Hebei, Beijing (Cervus Nippon); Heilongjiang, Jilin, Inner Mongolia, Tibet, Qinghai, Gansu (G. elaphus); harvested in late summer or autumn when a male over 3 years old starts to have new velvet. Generally harvested with the use of anesthesia; majority domesticated male deer antlers are removed for reasons of safety even if not used for medicinal purposes. History: Divine Husbandman's Classic of Materia Medica Constituents: calcium, magnesium, phosphorus, small amounts of estrone, pantocrinum Energetics Properties and Channels Entered: sweet, salty and warm, entering the kidney and liver meridians. Actions and Indications: diuretic, immune stimulant, vasodilator, circulatory, anti fungal, anti tumor, anti inflammatory, anti narcotic, anti ulcer1 Medical Research: Moderate doses of pantocrinum have a significant positive inotropic and chronotropic effect, leading to increased cardiac output in heart specimens. This effect is especially marked on weak hearts; it can also regulate hearts with arrhythmias. Given orally to subjects with chronic poor circulation and low blood pressure, it increased the blood pressure and the strength of the pulse. Very large doses of this substance have a negative inotropic and chronotropic effect and cause peripheral vasodilation, leading to a drop in blood pressure. 2 Pantocrinum is a general tonic that increases work capacity, improves sleep and appetite, and decreases the rate of muscle fatigue. Lu rong increases the oxygen uptake of the brain, liver, and kidneys of white rats. When fed to rats, it increased their weight with in two weeks. 3 When powdered lu rong was given orally to rabbits, or when they were injected with preparations of the substance, there was an increase in both red and white blood cells.

278 Lesson 11: Herbs to warm the interior & expel cold, Tonify yang When large amounts were given, there was a marked increase in the production of red blood cells. 4 Preparations of lu rong promote granulation of long standing ulcers and wounds, as well as the healing of fractures. The local metabolism of nitrogen and carbohydrates is also affected. 5 Preparations of lu rong had no significant sexual hormonal effect on rats and mice that had their gonads removed.6 Pantocrinum given to animals that have been sensitized to a particular substance inhibits a reaction when they are re-exposed to the substance.7 Preparation of lu rong have a diuretic effect. 8 Toxicity, Contraindications and cautions: Start with a mild dosage and gradually increase; this prevents yang from rising and the movement of inner wind from developing (symptoms: dizziness and red eyes). It can also injure yin, which can lead to fire from deficiency and may even cause hemorrhage. Contraindicated in patients with heat from yin deficiency, heat in the blood level, phlegm-heat in the lungs, blazing stomach fire, or warm febrile diseases. Medicinal uses: Tonifies kidneys and fortifies yang: for deficient kidney yang patterns with such symptoms as: fatigue, impotence, cold extremities, lightheadedness, tinnitus, soreness and lack of strength in the lower back and knees, and frequent, copious, clear urination. Tonifies the governing vessel, augments essence and blood, and strengthens sinews and bones: used especially in cases of deficient essence and blood in children with such physical and/or mental developmental disorders as failure to thrive, mental retardation, learning disabilities, insufficient growth or skeletal deformities (including rickets) Regulates the penetrating and conception vessels and stabilizes the girdle vessel: for cold deficient vaginal discharge or uterine bleeding. Also for infertility with a cold womb. Tonifies and nourishes the qi and blood: used especially for chronic ulcerations or yin type boils. Lu Rong/Deer velvet is also used to improve fertility, for menstrual and menopause problems, to reduce hormone replacement therapy dose, to reduce cholesterol and high blood pressure, for liver and kidney disorders, to protect the liver from toxins, for migraines, asthma, indigestion, osteoporosis, and acne. 9 Lu Rong/Deer velvet is also used for its anticancer and anti-inflammatory properties, as a source of growth factors IGR-1 & IGF-2, to stimulate production and circulation of blood, to increase blood count, and lower the level of free radicals. 10

279 Lesson 11: Herbs to warm the interior & expel cold, Tonify yang In Korean Medicine, Lu Rong/Deer velvet is used at the onset of winter to ward off infections.11 Pharmacy and dosage: 1-3g (as Powder) divided into two or three doses daily; 3-4.5g (double boiled by itself); it can also be soaked in wine. Major Combinations: With shu di huang (Radix Rehmanniae Glutinoae Conquitae) for impotence and spermatorrhea (in men) and infertility and thin vaginal discharge (in women) form cold deficient kidneys. This combination is also used for retarded physical development in children. With e jiao (Gelatinum Corii Asini), dang gui (Radix Angelicae Sinensis) and hai piao xiao (Os Sepiae seu Sepiellae) for deficient kidney induced excessive uterine bleeding. With gou ji (Rhizoma Cibotii Barometz) for copious vaginal discharge. With ren shen (Radix Ginseng) for such symptoms as palpitations, lower back pain, and decreased and difficult urination associated with severely deficient heart and kidneys. With dang gui (Radix Angelicae Sinensis) and sheng di huang (Radix Rehmanniae Glutinosae) for such problems as aplastic anemia associated with severely deficient blood and essence. REFERENCES Bensky, D. and Gamble, A.; Chinese Herbal Medicine Materia Medica; Eastland Press, Seattle; 1993; p337 3 Bensky, D. and Gamble, A.; Chinese Herbal Medicine Materia Medica; Eastland Press, Seattle; 1993; p337 4 Bensky, D. and Gamble, A.; Chinese Herbal Medicine Materia Medica; Eastland Press, Seattle; 1993; p337 5 Bensky, D. and Gamble, A.; Chinese Herbal Medicine Materia Medica; Eastland Press, Seattle; 1993; p337 6 Bensky, D: and Gamble, A.; Chinese Herbal Medicine Materia Medica; Eastland Press, Seattle; 1993; p337 7 Bensky, D. and Gamble, A.; Chinese Herbal Medicine Materia Medica; Eastland Press, Seattle; 1993; p337 8 Bensky, D. and Gamble, A.; Chinese Herbal Medicine Materia Medica; Eastland Press, Seattle; 1993; p Image foodsnherbs.com

280 Lesson 11: Herbs to warm the interior & expel cold, Tonify yang Dong Chong Xia Cao Cordyceps sinensis Family: Hypocreaceae Other names: chong cao, dong chong cao, cordyceps, Chinese caterpillar fungus, yartsa gungu (Tibetian), keera jhar (India), aweto (Maori), tochukaso (Japanese), dongchunghacho (Korean), literal English translation!winter bug summer herb" Part used: fungus. Plant description: Good quality is intact with a short stick like fungus and a bright yellow, fat, full and round insect part with a yellowish white cross-section. There are 680 known species of the Cordyceps genus, Cordyceps sinensis being the best known. The fungus is a result of a parasitic relationship. The caterpillar (Lepidoptera) is invaded by the fungus, typically while the caterpillar is eating on roots underground where the fungus has been busy propagating; the fungus fills the body cavity of the caterpillar with mycelium and eventually the caterpillar dies and becomes mummified. A black-brown fruiting body emerges from the caterpillar"s head and typically emerges from below the ground in the spring or early summer. This fruiting body, which is columnar in shape, reaches 5-15 cm and once emerged releases spores to propagate. Habitat, ecology and distribution: Sichuan, Qinghai, Guizhou, Yunnan, Tibet, India History: Thoroughly Revised Materia Medica. It is believed that the use of caterpillar fungus originated in Tibet in the late 1400"s and is first found in Doctor Zurkar Namnyi Dorje"s book!man ngag bye ba ring bsrel! (Instructions on a Myriad of Medicines), although other sources say that it was discovered much before that and used by other doctors and lay herbalists. Constituents: cordycepic acid, cordycepin, glutamic acid, phenylalanine, praline, histidien, valine, oxyvaline, arginine, alanine, d-mannitol, vitamin B12 Energetics Properties and Channels Entered: sweet and warm entering the lung and kidney meridians Actions and Indications: antibiotic, bronchodilator, anti-stress, anti-aging, aphrodisiac 1. Increases erythroid progenitor cells in bone marrow 2. Immunostimulating and immunoregulating 3. Stimulate phagocytic action 4. Lower cholesterol

281 Lesson 11: Herbs to warm the interior & expel cold, Tonify yang 5. Improve renal function 1 Medical Research: Very dilute solutions of dong chong xia cao have an in vitro inhibitory effect against some of the tuberculosis bacilli. Preliminary studies also show an inhibitory effect in vitro on Streptococcus pneumoniae.2 Water extractions of dong chong xia cao inhibit the contraction of smooth and cardiac muscle in many animal experiments. This herb causes bronchodilation of intestinal and uterine specimens form rabbits, and inhibits heart specimens and in situ heart tissue from frogs. 3 Cordyceps has been proven by ample medical research to be a powerful energybuilder. Cordyceps also benefits the glandular, circulatory and immune systems producing enormous amounts of endurance and stamina. It is superior to the most potent forms of Ginseng, the better-known energy herb. All this is supported by many Chinese clinical tests -- including the ones at Hunan Medical University and the double blind, placebo-controlled trials at Beijing Medical University. 4 A study was performed on 155 cases of sexual hypofunction. While 31.57% showed improvement with a placebo, more than twice that many (64.15%) had improvement from using 1/3 gm. of cultivated Cordyceps sinensis each time, three times a day for 40 days. More than one quarter of the participants in the study (46) was able to continue with a normal sex life after the study. When tested, an increase in the hormones 17- ketosteroid and 17 -hydroxycorticosteroid was found in these patients. Treatment of sexual hypofunction with Cordyceps sinensis. Yang et a I. Jiangxi Zhongyiyao, 1985, A study was conducted at a medical institute in Sichuan China, which found that in addition to several immunological responses, Cordyceps sinensis also gave protection against radiation damage and was antitumor against Sarcoma 180. Pharmacological action of the polysaccharide from cordyceps (Cordyceps sinensis). Zang et ai., Zhongcaoyao, 1985, 16(7), Toxicity, Contraindications and cautions: use cautiously in exterior conditions; a relatively small dose of dong chong xia cao can be tranquilizing and even hypnotic in animals. Intraperitoneal injection of 5g/kg into mice caused no fatalities, but doses of g/kg were universally fatal. Medicinal uses: Increases the strength of the kidneys, especially the yang aspect: good for impotence, soreness and weakness in the lower back and lower extremities. Tonifies the kidney yang, builds up the lung yin, transforms phlegm, and stops bleeding: for chronic coughs with blood streaked sputum. Tonifies both the yin and yang and can therefore be taken over a long period of time. It is a very safe substance.

282 Lesson 11: Herbs to warm the interior & expel cold, Tonify yang Pharmacy and dosage: g Major Combinations: With du zhong (Cortex Eucommiae Ulmoidis), yin yang huo (herba Epimedii) and rou cong rong (Herba Cistanches Deserticolae) for such symptoms as impotence, sore and weak lower black and lower extremities, and spermatorrhea associated with deficient kidney yang. With sha shen (Radix Adenophorae seu Glehniae), chuan bei mu (Bulbus Fritillariae Cirrhosae) and e jiao (Gelatinum Corjj Asini) for such symptoms as: cough, wheezing, coughing up blood, and chest pain form deficient lung yin. With duck, chicken, pork or fish as a stew for weakness, dizziness, spontaneous sweating and other symptoms of debility and lowered resistance from a weakened protective qi. REFERENCES Bensky, D. and Gamble, A.; Chinese Herbal Medicine Materia Medica; Eastland Press; Seattle; 1993; p Bensky, D. and Gamble, A.; Chinese Herbal Medicine Materia Medica; Eastland Press; Seattle; 1993; p Image drpinna.com

283 Lesson 11: Herbs to warm the interior & expel cold, Tonify yang Ba Ji Tian Morinda officinalis Family: Rubiaceae Other names: ba ji, morinda root Plant description: Good quality is large, thick, interconnected and purple. Part used: root Habitat, ecology and distribution: Guangdong, Guangxi, Fujian; the roots are dug in spring or winter. After the fibrous roots have been removed and the roots are dried in the sun, the dried roots are steamed or soaked. The core of the root is discarded, and the remaining root is cut into slices.1 History: Divine Husbandman's Classic of Materia Medica Constituents: morindin, vitamin C Energetics Properties and Channels Entered: pungent, sweet and warm, entering the kidney and liver meridians Actions and Indications: Impotence, seminal emission, infertility, menstrual disorders, pain and cold feeling in the lower abdomen; rheumatic arthralgia; limpness of the legs.2 Medical Research: Crude preparations of ba ji tian showed no androgen-like effect when given orally to rats or mice.3 Ba ji tian extract can be used to counter act the adverse effect of hydrocortisone on the atrophy of thymus gland, and adrenal cortex, and the increase level of SGPT. 4 Toxicity, Contraindications and cautions: contraindicated for patients with either damp-heat or heat form yin deficiency, also in patients who have difficulty urinating. According to some traditional sources this herb antagonizes dan shen (Radix Salviae Miltiorrhizae).5 Medicinal uses: Tonifies the kidneys and yang: for deficient kidney yang patterns with the symptoms of: impotence, male or female infertility, premature ejaculation, irregular menstruation, frequent urination, urinary incontinence, painful and cold lower abdomen, and weakness and soreness of the back.

284 Lesson 11: Herbs to warm the interior & expel cold, Tonify yang Strengthens the sinews and bones: for deficient kidney patterns with such symptoms as back pain and muscular atrophy. Disperses wind and expels damp-cold: for damp cold painful obstruction and leg qi pain in the back and legs. Pharmacy and dosage: 6-15g. Major Combinations: With tu si zi (Semen Cuscutae Chinensis) and rou cong rang (Herba Cistanches Deserticolae) for impotence, spermatorrhea, and premature ejaculation from deficient kidney yang. With ren shen (Radix Ginseng) and shan yao (Radix Dioscoreae Oppositae) for impotence or infertility. With bu gu zhi (Fructus Psoraleae Corylifoliae), fu pen zi (Fructus Rubi Ghingii) and yi zhi ren (Frucus Alpiniae Oxyphyllae) for urinary incontinence and frequency form deficient kidney yang. With du zhong (Cortex Eucommiae Ulmoidis), Niu Xi (Radix Achyranthis Bidentatae) and xu duan (Radix Dipsaci Asperi) for pain, swelling and muscular weakness and atrophy associated with chronic painful obstruction with deficient kidneys. REFERENCES Bensky, D. and Gamble, A.; Chinese Herbal Medicine Materia Medica; Eastland Press; Seattle; 1993; p Bensky, D. and Gamble, A.; Chinese Herbal Medicine Materia Medica; Eastland Press; Seattle; 1993; p.343 Image mdidea.com

285 Lesson 11: Herbs to warm the interior & expel cold, Tonify yang Hu Tao Ren Juglans regia Family: Juglandaceae Other names: walnut, he tao rou, Juglans semen, koto (Japanese), Hodoin or haekdoin (Korean) Plant description: Good quality is large, full, oily and yellowish brown. A large deciduous tree that reaches m, with the trunk up to 2 m in diameter. The bark is smooth, olive brown when young and silvery grey on older branches, and features scattered fissures with a rougher texture...the pith of the twigs contain airspaces; this chambered pith is brownish in color. The leaves are alternately arranged, cm long, odd pinnate with 5-9 leaflets, paired alternately with one terminal leaflet. The largest leaflets the three at the apex, cm long and 6 8 cm broad; the basal pair of leaflets much smaller, 5 8 cm long, the margins of the leaflets entire. The male flowers are in drooping catkins 5 10 cm long, and the female flowers terminal, in clusters of two to five, ripening in the autumn into a fruit with a green, semifleshy husk and a brown corrugated nut. The whole fruit, including the husk, falls in autumn; the seed is large, with a relatively thin shell, and edible, with a rich flavor. 5 Part used: seed Habitat, ecology and distribution: throughout northern China (Shaanxi is considered best), harvested September to October when ripe. Native to a wide area, from the Balkans, east to the Himalayans and southwest China. History: Materia Medica of the Kai Bao Era Constituents: linoleic acid, linolenic acid, oleic acid, carotene, vitamin B2 Energetics Properties and Channels Entered: sweet and warm entering the kidney, large intestine and lung meridians. Actions and Indications: astringent, anthelmintic, antiseptic Medical Research: When oil from hu tao ren was mixed with dog feed, the dogs gained weight very quickly, with an increase in serum albumen and a slower rise in serum cholesterol as compared to a control group.1 A paste made of hu tao ren, when given to patients with urinary calculi, usually led to expulsion of stones with in a few days, together with milky urine. It is therefore thought that the herb may have some effect in dissolving calculi. 2!!

286 Lesson 11: Herbs to warm the interior & expel cold, Tonify yang A paste made of hu tao ren was used for 172 patients with a variety of dermatological diseases (including contact dermatitis, seborrheic dermatitis, and atopic dermatitis) with a 76% cure rate. 3 Toxicity, Contraindications and cautions: contraindicated in phlegm fire patterns or hot cough, in deficient yin patterns with heat signs, in patients with watery stool; some traditional sources believe this herb should not be taken with strong tea. Medicinal uses: Tonifies the kidneys and strengthens the back and knees: for deficient kidney patterns with such symptoms as cold and painful back and knees and frequent urination. Warms the lungs and helps the kidneys to grasp qi: for deficient lungs and kidneys. Moistens the intestines and unblocks the bowels: for constipation in the elderly or that from injured fluids following febrile illnesses. Topically, Hu Tao Ren/English: walnut hull is used for skin diseases, abscesses, and eyelid inflammation. The leaf is used topically for superficial inflammation of the skin; excessive hand and/or foot perspiration; and for skin conditions such as acne, eczema, scrophula, pyoderma, and ulcers.4 Pharmacy and dosage: 9-30g. Traditionally when used for constipation the skin is peeled off; when used for coughing and wheezing it is left on. Major Combinations: With du zhong (Cortex Eucommiae Ulmoidis) and bu gu zhi (Fructus Psoraleae Corylifoliae) for pain in the lower back and weakness in the legs form kidney deficiency. Add jin qian cao (Herba Lysimachiaee) and hai jin sha (Spora Lygodii Japonici) for back pain associated with kidney stones. With ren shen (Radix Ginseng) and ge jie (Gecko) for wheezing form deficient lung and kidneys. Cooked with honey and taken with warm water for chronic cough from cold deficiency. With huo ma ren (Semen Cannabis Sativae) and rou cong rong (Herba Cistanches Desericolae) for constipation due to insufficient fluids in the intestines. REFERENCES 1 Bensky, D. and Gamble, A.; Chinese Herbal Medicine Materia Medica; Eastland Press; Seattle; 1993; p Bensky, D. and Gamble, A.; Chinese Herbal Medicine Materia Medica; Eastland Press; Seattle; 1993; p Bensky, D. and Gamble, A.; Chinese Herbal Medicine Materia Medica; Eastland Press; Seattle; 1993; p Image tcm.health-info.org

287 Lesson 11: Herbs to warm the interior & expel cold, Tonify yang Bu Gu Zhi Psorlea corylifolia # Family: Leguminosae Other names: po gu zhi, psoralea fruit Plant description: Good quality is large, full, solid and black. Part used: fruit Habitat, ecology and distribution: throughout China especially the northeast, northwest and southwest; harvested in autumn when fruit is ripe. History: Grandfather Lei's Discussion of Herb Preparations Constituents: psoralen, isopsoralin, bavachin, bavachinin, isobavachalcone, isobavachalcone, bakuchiol, raffinose. Energetics Properties and Channels Entered: pungent, bitter and very warm, entering the kidney and spleen meridians. Actions and Indications: antipruritic, antibiotic, antitumor, anti-aging, hemostatic, antiarthritic Medical Research: Preparations of bu gu zhi selectively dilate the coronary blood vessels in many animals. Psoralen has a positive inotropic effect on guinea pig and white rat hearts.1 Preparations of bu gu zhi have an in vitro inhibitory effect against Staphylococcus aureus, including penicillin resistant strains.2 Preparations of bu gu zhi stimulated both intact animal intestines as well as intestinal specimens. The herb had a relaxing effect on the uterus of rats.3 Intramuscular injections of bu gu zhi and local antipruritic treatments were given to 120 patients with severe cases of psoriasis with a cure rate of 24%, AND significant improvement in another 40%. In another clinical study of 49 patients with vitiligo, intramuscular injection of a preparation of his herb, in concert with its local application and exposure to ultraviolet light, had some effect. Within 3-6 months 14% were cured and another 19% had at least a 66%return of pigmentation.4 Injection of preparations of bu gu zhi, together with exposure to ultraviolet light, were used for 45 cases of alopecia. With in six months the hair returned completely in 36%, and there was significant return in another 30%. 5 A combination of bu gu zhi and chi shi zhi (Halloysitum Rubrum) showed over 90% success rate in stopping menorri1agia in one clinical series of more than 300 subjects. In severe cases, other unspecified measures were taken. 6

288 Lesson 11: Herbs to warm the interior & expel cold, Tonify yang Toxicity, Contraindications and cautions: contraindicated in deficient yin patterns with heat signs or constipation; use cautiously for deficient cold of the stomach (this herb may be hard on the stomach); traditional sources believe this herb to antagonize gan cao (Radix Glycyrrhizae Uralnesis). Medicinal uses: Tonifies the kidneys and fortifies the yang: for kidney yang deficiency patterns with such symptoms as impotence, premature ejaculation, cold and painful lower back or weak lower back and extremities. Stabilizes the essence and reserves urine: for enuresis, incontinence of urine, frequent urination and spermatorrhea. Aids the kidneys to grasp qi: for wheezing when the kidneys do not grasp the lung qi. Recently used topically for alopecia, psoriasis and vitiligo. Present Applications: 7 Enuresis: bu gu zhi and yi zhi ren 60 g of each. Stir fry with salt. Grind into fine powder and make into 6 packages. Add one bag to rice porridge. Take 1 in the morning. (double the dosage for adults). Six days is therapy cycle. Result: 60 patients, age 2 to 60 years old. All healed. Monitored for 5 years. No relapse [1] Leukoderma of the vagina: apply bu gu zhi extract (paste) every other day on affected areas. Result: 53 patients. Healed: 50. Improved: 3. Seven patients developed dermatitis due to allergenic reaction of the herb.[2] Bronchial asthma Bleeding of the uterus Low white cell count Psoriasis Flat warts Normal warts Leukoderma and bald spot Eczema Impotence, irregular menses, fungus infection of nails Pharmacy and dosage: 3-9g should be crushed before using. Major Combinations: With hu tao ren (Semen Juglandis Regiae) and chen xiang (Legnum Aquilariae) for impotence. With rou dou kou (Semen Myristicae Fragrantis), wu wei zi (Fructus Schisandrae Chinensis) and wu zhu yu (Fructus Evodiae Rutaecarpae) for daybreak diarrhea characterized by abdominal pain and borborygmus in the early morning hours that is

289 Lesson 11: Herbs to warm the interior & expel cold, Tonify yang alleviated upon evacuation, and is accompanied by a deep, thin pulse and a white coating on the tongue. With tu si zi (Semen Cuscutae Chinensis) and yi zhi ren (Fructus Alpiniae Oxyphyllae) for urinary frequency, both daytime and nighttime, from deficient kidney yang. With hu tao ren (Semen Juglandis Regiae) for lower back pain, premature ejaculation, coughing and wheezing form deficient kidney yang. REFERENCES 1 Bensky, D. and Gamble, A.; Chinese Herbal Medicine Materia Medica; Eastland Press; Seattle; 1993; p Bensky, D. and Gamble, A.; Chinese Herbal Medicine Materia Medica; Eastland Press; Seattle; 1993; p Bensky, D. and Gamble, A.; Chinese Herbal Medicine Materia Medica; Eastland Press; Seattle; 1993; p Bensky, D. and Gamble, A.; Chinese Herbal Medicine Materia Medica; Eastland Press; Seattle; 1993; p Bensky, D. and Gamble, A.; Chinese Herbal Medicine Materia Medica; Eastland Press; Seattle; 1993; p Bensky, D. and Gamble, A.; Chinese Herbal Medicine Materia Medica; Eastland Press; Seattle; 1993; p _gu _ zhi.htm Image futurosity.com

290 Lesson 11: Herbs to warm the interior & expel cold, Tonify yang Du Zhong Eucommia ulmoides Family: Eucommiaceae Other names: eucommia bark, tochu (Japanese), duchung (Korean) Plant description: Good quality is large and thick with a yellowish brown outside and dark purple inside. When broken, the bark should produce many thin white threads. Part used: bark Habitat, ecology and distribution: Hubei, Sichuan, Guizhou, Yunnan, Shaanxi; 15+ year old trees are harvested in spring or summer. History: Divine Husbandman's Classic of Materia Medica Constituents: gutta-percha, aucubin, alkaloids, glycosides, potassium, vitamin C Energetics Properties and Channels Entered: sweet, slightly pungent and warm, entering the kidney and liver meridians. Actions and Indications: antihypertensive, diuretic, anti-aging, sedative, musculoskeletal restorative, connective tissue restorative Medical Research: Decoctions of du zhong lower blood pressure profoundly in many animal experiments. However, its effect upon renal hypertension in 3 dogs was not ideal, lowering systolic pressure 8-22 mmhg in four weeks. It had more effect in rabbits with atherosclerosis than upon normal ones. The mechanism of its effect is unknown, but because its direct effect on the heart and peripheral blood vessels is rather mild, it is thought to be central in nature. Decoctions are more effective than alcohol extractions, and the fried herb has a stronger effect than the dried herb.1 10% tinctures of du zhong were used for 119 cases of hypertension; satisfactory results were recorded in 46%, without side effects. It was not particularly useful for severe cases. In another experiment while preparations of the herb were found to be much less successful in lowering blood pressure than reserpine, they were much more successful in improving the symptomatology. Clinical studies have demonstrated that fried du zhong has a stronger antihypertensive effect than the dried herb and that water extractions are more potent than alcohol extractions.2 Large doses (20-25g/kg per day) of du zhong have an inhibitory effect on the central nervous system of dogs and mice.3 Various preparations of du zhong have a diuretic effect in dogs, rats and mice.4

291 Lesson 11: Herbs to warm the interior & expel cold, Tonify yang Cortex Eucommiae Ulmoidis (Du Zhong) contains latex and, therefore, may be allergenic in a certain percentage of patients. 5 Toxicity, Contraindications and cautions: contraindicated in heat from yin deficiency; according to some traditional sources this herb antagonizes xuan shen (Radix Scrophulariae); no symptoms of overdose have been recorded in literature. Not be used with persons with latex allergy. Medicinal uses: Tonifies the liver and kidneys, strengthens the sinews and bones: for liver and kidney deficiency with such symptoms as weak, sore, or painful lower back and knees, fatigue and frequent urination. Aids in smooth flow of qi and blood: used to promote circulation, especially in those with weakness of the sinews and bones. Recently used for dizziness and lightheadedness (hypertension) form rising liver yang. Pharmacy and dosage: 6-15g. Salt water fried to increase the kidney tonification properties. Major Combinations: With bu gu zhi (Fructus Psoraleae Corylifoliae) and hu tao ren (Semen Juglandis Regiae) for lower back pain and wheezing from deficient kidney yang. With shan zhu yu (Fructus corni Officinalis) and tu si zi (Semen Guscutae Chinensis) for impotence and frequent urination form cold deficient kidneys. With xu duan (Radix Dipsaci Asperi), tu si zi (Semen Cuscutae chinensis) and sang ji sheng (Ramulus Sangjisheng) for deficient kidney induced lower back pain or threatened miscarriage. With xu duan (Radix Dipsaci Asperi) and shan yao (Radix Sioscoreae Oppositae) for habitual miscarriage. With gui zhi (Ramulus Cinnamomi Cassiae), du huo (Radix Angelicae Pubescentis) and qin jiao (Radix Gentianae Qinjiao) for damp-cold back pain characterized by sore, swollen feeling and localized coldness that is exacerbated by exposure to cold, and accompanied by such signs as deep, slow pulse and white, greasy tongue coating. With bai shao (Radix Paeoniae Lactiflorae) and xia ku cao (Spica Prumellae Vulgaris) for dizziness and lightheadedness form rising liver yang. REFERENCES 1 Bensky, D. and Gamble, A.; Chinese Herbal Medicine Materia Medica; Eastland Press; Seattle; 1993; p Bensky, D. and Gamble, A.; Chinese Herbal Medicine Materia Medica; Eastland Press; Seattle; 1993; p Bensky, D. and Gamble, A.; Chinese Herbal Medicine Materia Medica; Eastland Press; Seattle; 1993; p Bensky, D. and Gamble, A.; Chinese Herbal Medicine Materia Medica; Eastland Press; Seattle; 1993; p download/ articles/cortex Jatex _ ai I. cfm Image scarfamilyditdajow.com

292 Lesson 12:Herbs that Stabilize & bind, Calm the spirit, and Extinguish wind & Tremors LESSON 12: Herbs that Stabilize & Bind, Substances that Calm the Spirit, and Substances that Extinguish Wind & Stop Tremors Herbs that Stabilize and Bind Herbs that stabilize and bind are used when there is abnormal discharge of the bodily substances or when the proper positioning of the structures in the body is displaced or slip. They are used whenever there is excessive leakage from the body such as in cases of: diarrhea, sweating, vaginal discharge and incontinence and in conditions such as coughing, miscarriage, and prolapse. These disorders are often due to weakness after a chronic illness, old age, or improper usage of downward draining or dispersing herbs. Generally, these are astringent herbs with a sour flavour. They are used to treat the branch and not the root cause of a condition and therefore should be combined with other herbs to treat the root cause. Due to their nature of binding and stabilizing, they are not to be used in cases of an exterior disorder. If these herbs are used in conjunction with an unresolved exterior disorder the condition and its symptoms will be aggravated and slow to resolve. Herbs discussed in this section are: Wu wei zi - Schisandra chinensis Shan zhu yu - Cornus officinalis Rou dou kou - Myristica fragrans Bai Guo - Gingko biloba Substances that Calm the Spirit The spirit is the!shen", the heart mind, or the manifestation of a persons nature or vitality, also known as our consciousness. It is housed in the heart, manifests on the complexion and is affected by the state of the organs, blood and yin. An unsettled spirit may manifest as irritability, insomnia, anxiety, palpitations, and even mania. This may be caused by fear, fright, shock, anxiety, jitteriness and even overwork. The substances that calm the spirit can be divided into two categories, substances that anchor, settle and calm the spirit and Herbs that nourish the heart and calm the spirit. The first category uses heavy anchoring mineral and shells and the second/ later herbs that are sweet, sour, moistening and therefore nourishing to the heart, liver, yin, blood and calm the spirit. 1

293 Lesson 12:Herbs that Stabilize & bind, Calm the spirit, and Extinguish wind & Tremors Substances that anchor, settle and calm the spirit are heavy and sedating, bringing the shen down when it is floating, as the case with liver yang hyperactivity. They are used to treat symptoms of emotional outbursts, flushed face, dizziness, insomnia and headaches. They can also be used to descend rebellious qi when there is belching, vomiting and hiccoughs. These substances are heavy and can injure the spleen and stomach; care must be taken to preserve the qi of the middle burner. The herb to be examined here is: Mu Li - Ostrea gigas Herbs that nourish the heart and calm the spirit focus on nourishment of the blood and yin of the heart and liver. Rather than using minerals, herbs are used and the effects are gentler with fewer side effects. These herbs treat palpitations with anxiety, insomnia and emotional upset. Herbs to be discussed here are: Suan Zao Ren - Semen Zizyphi Spinosae Yuan Zhi - Radix Polygalae Tenuifoliae The treatment principle is aimed at calming the shen, nourishing the heart and/or sedating the yang hyperactivity. Substances that Extinguish Wind and Stop Tremors Substances used in this lesson are aimed at internal wind. Internal wind differs from external wind (as described in lessons 1, 2) in that it is generated from the organs, from a lack of blood or in cases extreme internal heat. Wind is produced when there is: a) Insufficient yin of the kidneys or liver b) Deficiency of blood, usually of the liver c) Excessive heat from fever d) Excess of liver yang or fire. Symptoms of internal wind may include: headache, dizziness, blurred vision, tinnitus, twitches, facial ticks, tremors, hypertonicity, sudden loss of consciousness, aphasia, and paralysis. In general these symptoms are associated with deficient yin of the liver and kidney or hyperactivity of liver yang/fire. 2

294 Lesson 12:Herbs that Stabilize & bind, Calm the spirit, and Extinguish wind & Tremors Childhood convulsions associated with high fever are another example of internal wind. When there is a blood deficiency, wind arises due to the lack of substance to root the qi. The result is also dizziness, blurred vision, tinnitus, numbness and itchiness; all of which present as deficiency type. When wind is present the treatment principle is to extinguish wind. Depending on the cause the practitioner must: tonify yin, nourish the blood, stop tremors, sedate or anchor the yang and clear heat, cool the fire. Herbs to be discussed in this section are: Gou Teng - Uncaria rhynchophylla Di Long - Pheretima aspergillum 3

295 Lesson 12:Herbs that Stabilize & bind, Calm the spirit, and Extinguish wind & Tremors Wu Wei Zi Schisandra chinensis Family: Magnoliaceae Other names: bei wu wei zi, schisandra fruit, five flavoured seed Plant description: Good quality is large, thick, fleshy, oily shiny and purplish red Part used: fruit Habitat, ecology and distribution: Jilin, Liaoning, Heilongjiang, Hebei; harvested in autumn when fruit is completely ripe. History: Divine Husbandman's Classic of Materia Medica Constituents: sesquicarene, b-bisabolene, b-charmigrene, a-ylangene, schizandrin, pseudo-y-schizandrin, deoxyschizandrin, schizandrol, citral, stigmasterol, vitamin C, vitamin E Energetics Properties and Channels Entered: sour and warm, entering the heart, kidney and lung meridians Actions and Indications: stimulatory, cholinergic stimulant, vasodilator, adaptogenic, astringent, anti-tussive, expectorant, anti-bacterial, hepatoprotective, adaptogenic, CNS stimulant/restorative, sedative, uterine stimulant, emmenagogue, cardiotonic, cholagogue, analgesic, regulates stomach acid secretion, urogenital restorative, aphrodisiac, regulates blood pressure, prevents excessive sweating, interferon inducent.1 Medical Research: Central nervous system effect: preparations of wu wei zi have shown a stimulatory effect on the various parts of the central nervous system in frogs. It strengthened and quickened reflexes in normal human volunteers, and also increased work efficiency when tested in such circumstances as receiving telegraph messages. Its excitatory effects on conditioned reflexes and EEGs were weaker than those of caffeine. 2 Respiratory Effect: preparations of wu wei zi stimulate respiration through direct effect on the central nervous system centers. It has been used to help resist respiratory depression from morphine use. 3 Peripheral nervous system effect: oral or intraperitoneal administration of schizandrin to mice resulted in a clear stimulation of the cholinergic system, and small doses stimulated the nicotinic receptors.4 Cardiovascular effect: in commonly used doses wu wei zi has no effect on blood pressure. When given intravenously in large doses, there is a decrease in blood 4

296 Lesson 12:Herbs that Stabilize & bind, Calm the spirit, and Extinguish wind & Tremors pressure. This does not occur from formulations in which the acidic nature of the herb has been removed. Alcohol extractions of the herb have shown a vasodilatory effect.5 Uterine effect: preparations of wu wei zi had a uniformly stimulatory effect on rabbit uterus specimens, whether pregnant, not pregnant, or post partum. The principal effect was to strengthen rhythmic contractions. It has been useful in inducing and especially in promoting labour.6 Metabolic effect: most reports state that preparations of wu wei zi increase the usage of both liver glycogen stores and serum glucose, as well as lactic acid levels. Other reports state that there is no effect on serum glucose. Reports also differ as to whether preparations of this herb have any effect on oxygen utilization in kidney, liver or brain specimens. Use of this herb increases absorption of P32 from the gastrointestinal tract, increases its concentration in the viscera, and strengthens the activity of phosphatase.7 Sensory effect: preparations of wu wei zi increased visual acuity and visual fields in normal volunteers and eye patients. It also raised the acuity of tactile discrimination.8 Wu wei zi, like ren shen (Radix Ginseng), contains adaptogens which regulate various body functions and increase the organism's ability to deal effectively with stress. This is demonstrated in many ways, including increasing the duration of swimming endurance or regulating gastric acidity (increasing ph when the stomach is too acidic, or decreasing the ph if it is insufficiently acidic). Although its adaptogen effects are relatively weak, it is also a very safe herb.9 Powdered wu wei zi was used in treating 102 patients with hepatitis, with an overall success rate of 76%. In those patients with SGPT levels over 3001U, the success rate was 72%, and the average time in which the liver enzyme levels returned to normal was 25 days. No side effects were noted.10 Neurasthenia: alcohol extractions of wu wei zi were used in treating 73 cases of neurasthenia with such symptoms as headache, insomnia, dizziness, and palpitations. Of the total, 43 were cured and 13 significantly improved. No side effects were noted.11 Studies suggest that Schizandra may improve physical performance, increase strength, and reduce fatigue through its adaptogen activity. 12 Toxicity, Contraindications and cautions: toxic dosage in mice was 10-15g/kg. Symptoms of overdose include restlessness, insomnia, or dyspnea. May occasionally cause heartburn. 15 Medicinal uses: Astringes lung qi and stops coughing: for chronic cough and wheezing due to lung deficiency or patterns of lung and kidney deficiency. This herb inhibits the leakage of lung qi above, enriching the kidney yin below, and also stops coughing. As such it is an important and effective herb for chronic coughs. Tonifies the kidneys, binds up essence, and stops diarrhea: for nocturnal emission, spermatorrhea, vaginal discharge and urinary frequency due to kidney deficiency. Also used for daybreak diarrhea due to spleen and kidney deficiency. 5

297 Lesson 12:Herbs that Stabilize & bind, Calm the spirit, and Extinguish wind & Tremors Inhibits sweating and generates fluids: for excessive sweating, especially when accompanied by thirst or dry throat. Depending on the other ingredients in the formula, it can be used for spontaneous sweating, night sweats or even wasting and thirsting disorders. Quiets the spirit and calms the heart: for irritability, palpitations, dream disturbed sleep, and insomnia due to injury to the blood and yin of the heart and kidneys. Recently used for allergic skin disorders and to improve liver function in patients with hepatitis. Pharmacy and dosage: 1.5-9g. Use 1.5-3g for chronic cough, and 6-9g as a tonic. Crush before using in decoctions. Use dried for heat from deficiency, and prepared in wine for use as a tonic.13 Major Combinations: With Shu di huang (Radix Rehmanniae Glutinosae conquitae), shan yao (Radix Dioscoreae Oppositae), and shan zhu yu (Fructus Corni Officinalis) for cough and wheezing due to lung and kidney deficiency. With gan jiang (Rhizoma Zingiberis Officinalis) and xi xin (Herba cum Radice Asari) for unremitting cough and wheezing due to cold in the lung channel. With bu gu zhi (Fructus Psoraleae Corylifoliae) and rou dou kou (Semen Myristicae Fragrantis) for chronic dysenteric disorders and daybreak diarrhea due to kidney deficiency. With long gu (Os Draconis) and sang piao xiao (Ootheca Mantidis) for spontaneous emissions With ren shen (Radix Ginseng) and mai men dong (Tuber Ophiopogonis Japonici) for shortness of breath, cough, thirst, and other symptoms associated with exhaustion of the qi and yin (e.g.: after profuse fluid loss in febrile diseases). With mu Ii (Concha Ostreae) and ma huang gen (Radix Ephedrae) for night sweats due to yin deficiency. With huang qi (Radix Astragali Membranacei) for spontaneous sweating due to yang deficiency. With huang qi (Radix Astragali Membranacei), mai men dong (Tuber Ophiopogonis Japonici) and tian hua fen (Radix Trichonsantis Kirilowii) for wasting and thirsting disorders with intense thirst. With suan zao ren (Semen Zizsyphi Spinosae) and shen di huang (Radix Rehmanniae Glutinosae) for insomnia, irritability, and forgetfulness associated with patterns of heart deficiency. With 80%-proof alcohol, as a medicinal wine, for itchiness and irritation of the skin associated with wind rash. In Ancient China Schizandra was used in combination with yin yang huo and ren shen (ginseng) to enhance the sex drive. 14 6

298 Lesson 12:Herbs that Stabilize & bind, Calm the spirit, and Extinguish wind & Tremors REFERENCES Bensky, D. and Gamble, A.; Chinese Herbal Medicine Materia Medica; Eastland Press; Seattle; 1993; p Ibid. 4 Ibid. 5 Ibid. 6 Ibid. 7 Ibid. 8 Ibid. 9 Ibid. 10 Ibid. 11 Ibid Bensky, D. and Gamble, A.; Chinese Herbal Medicine Materia Medica; Eastland Press; Seattle; 1993; p Bensky, D, Clavey, S, Stoger, E.; Chinese Herbal Medicine Materia Medica; Eastland Press; Seattle; 2004; p860 Image vegetalistabotanicals.com 7

299 Lesson 12:Herbs that Stabilize & bind, Calm the spirit, and Extinguish wind & Tremors Shan Zhu Yu Cornus officinalis Family: Cornaceae Other names: cornus, asiatica cornelian cherry fruit, dogwood, japanese cornel dogwood Plant description: A deciduous tree with a height of feet, feet wide. The leaves are 4 inch opposite, simple leaves with a purple fall colour. The Flowers are yellow clusters with short stalks and drooping bracts. Shiny red fruit in clusters in the fall. Quality Shan zhu yu is large, pliable, reddish purple with majority of the seeds removed. The steamed variety is black in colour. Part used: fruit Habitat, ecology and distribution: spread in provinces of China, such as Shanxi, Shaanxi, Gan Su, ShanDong, An Hui, Jiang Xi, He Nan, Hu Nan, and SiChuan. 1 History: Divine Husbandman's Classic of Materia Medica Constituents: volatile constituents: isobutanole, limonene, trans-linalool etc; glycosides and aglycons: cornin, morroniside, sweroside etc; tannins, organic acids, Vitamin A, flavones, polysaccarids and B-sitosterol. Energetics Properties and Channels Entered: sour and slightly warm, entering the kidney and liver meridians Actions and Indications: genitourinary urinary tonic, emmenagogue Medical Research: none noted Toxicity, Contraindications and cautions: Contraindicated in damp heat, urinary pain and difficult urination. Traditionally antagonizes: Jie geng (Platycodi radix), Fang feng (Saposhnikoviae radix), and Fang ji (Stephaniae/cocculi/etc. radix) Medicinal uses: Secures the essence and stabilizes the kidneys: secures leakage of fluids as seen in: incontinence, spermatorrhea, frequent urination and spontaneous sweating. Tonifys the Liver & Kidneys essence and yang: symptoms of dizziness, lightheadedness, weak and sore back and/or knees, or impotence. 8

300 Lesson 12:Herbs that Stabilize & bind, Calm the spirit, and Extinguish wind & Tremors Stops sweating and rescues devastated yang and collapsed qi: for excessive sweating, or to correct a wrong treatment that induced sweating. Pharmacy and dosage: 6-12g Major Combinations: With Bu gu zhi (Psoralea fructus) and Dang gui (Angelica sinensis) for kidney yang deficiency: premature ejaculation, spermatorrhea and low back pain. With Yi zhi ren (Alphiniae oxyphyllae fructus) and Bai zhu (Atractylodis macrocephalae) for urinary incontinence in the elderly due to kidney qi deficiency. With Huang qi (Astragulus radix) and Dang shen (Codonopsis radix) for spontaneous sweating due to qi and yang deficiency. In famous formula Liu Wei Di Huang Wan (six ingredient pills with rehmannia) to tonify the kidney yin. With Shan yao, Shu di huang, Mu dan pi, Fu ling and Ze xie With Bai shao (Peoniae radix alba) and E jiao (Asini cornii colla) for thick dark menstrual bleeding due to yin deficiency heat, with symptoms of alternating trickling and gushing of blood REFERENCES 1 Bensky, D, Clavey, S, Stoger, E.; Chinese Herbal Medicine Materia Medica; Eastland Press; Seattle; 2004; p Image plumdragonherbs.com 9

301 Lesson 12:Herbs that Stabilize & bind, Calm the spirit, and Extinguish wind & Tremors Rou Dou Kou Myristica fragrans! Family: Myristicaceae Other names: rou kou, rou guo, yu guo, nutmeg seeds, myristica Plant description: good quality is large, heavy, solid, glossy and aromatic. Part used: seed Habitat, ecology and distribution: Malaysia, Indonesia, Sri Lanka; harvested in April to June and November to December (7 year old trees). History: Materia Medica of Medicinal Properties Constituents: d-camphene, a-pinene, myristicin Energetics Properties and Channels Entered: pungent and warm, entering the large intestine, spleen and stomach meridians. Actions and Indications: GI stimulant, anesthetic, gastrointestinal restorative, digestive stimulant, liver restorative, astringent. Medical Research: Rou dou kou and one of its constituents (myristicin) strengthens the effect of tryptamine and moderately inhibits monoamine oxidase, both in vitro and in vivo. The oil from this herb, in addition to being aromatic, has a definite anesthetic effect. In cats the anesthetic dose is often toxic and can lead to hepatic failure.1 Very small doses ( ml) of rou dou kou oil directly stimulates the gastrointestinal tract. 2 Toxicity, Contraindications and cautions: contraindicated for hot diarrhea or hot dysenteric disorders. Doses of 1.9g/kg of rou dou kou are often fatal in cats, with liver damage found on autopsy. In humans ingestion of 7.5g of the powdered herb can lead to dizziness or stupor. Death from large overdoses has been reported. The primary toxic ingredient is myristicin, which is also a hallucinogen.3 Medicinal uses: Binds up the intestines and stops diarrhea: for chronic intractable diarrhea or daybreak diarrhea due to cold from deficiency of the spleen and kidneys. 10

302 Lesson 12:Herbs that Stabilize & bind, Calm the spirit, and Extinguish wind & Tremors Warms the middle burner, moves the qi and alleviates pain: for pain and distention in the epigastrium and abdomen, poor appetite, and vomiting due to cold from deficiency of the spleen and stomach. Nutmeg has been widely used since AD 540 when it was brought from India to Constantinople. It was used as a cosmetic to remove freckles. Medicinally it was first mentioned by Avicenna (a Persian physician and astronomer) in the 11th century, who called it "the nut Banda" (referring to the Banda Islands in Indonesia). It was given for stomach upsets, headaches, and to ease gas. It has also been taken as a hallucinogenic. The essential oil is good for rheumatic pain. Pharmacy and dosage: 1.5-9g. Roasted to increase the effect of the warming the middle burner and stopping diarrhea. Major Combinations: With mu xiang (Radix Aucklandiae Lappae) for poor appetite, diarrhea, and cold abdominal pain due to cold from deficiency of the spleen and stomach. With ren shen (Radix Ginseng), bai zhu (Rhizoma Atractylodis Macrocephalae) and rou gui (Cortex cinnamomi cassiae) for chronic diarrhea due to deficiency cold of the spleen and stomach. With bu gu zhi (Fructus Psoraleae Corylifoliae) for chronic diarrhea and dysenteric disorders. With ban xia (Rhizoma Pinelliae Ternatae) and gan jiang (Rhizoma Zingiberis Officinalis) for vomiting, diarrhea, abdominal distention, and reduced appetite due to deficiency cold of spleen and stomach. With the addition of shen qu (Massa Fermentata) and sha ren (Fructus Amomi): this combination is especially effective in treating children with this presentation. REFERENCES 1 Bensky, D. and Gamble, A.; Chinese Herbal Medicine Materia Medica; Eastland Press; Seattle; 1993; p382 2 Ibid. 3 Bensky, D. and Gamble, A.; Chinese Herbal Medicine Materia Medica; Eastland Press; Seattle; 1993; p uses Image tcm.health-info.org 11

303 Bai Guo Gingko biloba Lesson 12:Herbs that Stabilize & bind, Calm the spirit, and Extinguish wind & Tremors Family: Gingkoaceae Other names: yin xing, ginkgo nut, living fossel, Semen gingko biloba Plant description: Good quality is white, full and round. Somewhat ellipsoidal, one end relatively acute and the other end obtuse, cm long, 1-2 cm wide, about 1 cm thick. Externally yellowish-white or pale brownish yellow, smooth, with 2-3 ribs. Mesotesta (shell) bony and hard. Endotesta membranous. Kernel broadly ovoid or ellipsoidal, one end pale brown and the other end golden-yellow; transverse section yellow, gelatinized in the outer part, and pale yellow or pale green in the inner part, starchy, with a fissure in the centre.1 Part used: seed Habitat, ecology and distribution: throughout China, especially Henan province; harvested in October to November when ripe. History: Household Materia Medica Constituents: gibberellin, cytokinin-like substances, ginkgolic acid, hydroginkgolinic acid, bilobol, ginnol, aspartine, calcium, phosphorus, iron. Energetics Properties and Channels Entered: sweet, bitter, astringent, neutral, and slightly toxic; entering the kidney and lung meridians. Actions and Indications: astringent, anti-tubercular, antibiotic Medical Research: Ginkgolic acid has shown a very strong in vitro inhibitory effect against Mycobacterium tuberculosis, but has not been useful in in vivo tests. 2 Preparations of bai guo have shown an in vitro inhibitory effect against many pathogenic bacteria, including Staphylococcus aureus, Corynebacterium diphtheriae and Samonella typhi. 3 Preparations of bai guo caused the body of the uterus to contract while paralyzing rabbit intestinal specimens. 4 Clinical studies demonstrate that daily doses of mg of standardized ginkgo biloba extract can lead to an improvement in the following medical conditions: circulatory problems in the elderly, especially cerebral insufficiency and the consequent cognitive effects, peripheral circulatory impairment, intermittent claudication (poor circulation to the lower legs), vertigo and tinnitus, altitude sickness, and erectile 12

304 Lesson 12:Herbs that Stabilize & bind, Calm the spirit, and Extinguish wind & Tremors dysfunction in males. Improvement in the memory loss, depression, and tinnitus could be achieved within 8-12 weeks. 5 Two very recent experiments were done using mice with induced cerebral ischemia. The mice showed a great improvement when given the ginkgo extract, with increased demonstrated memory in a maze (Gajewski et al 1999) and reduced effects in induced amnesia (Tadano et a/1998, p127). With enough ginkgo extract the unfortunate mice will be smart enough to escape any more scientific tests. 6 Ginkgolides and bilobalides also have strong antioxidant properties (Lugasi et a/1999). Antioxidants are vital in our body in the scavenging of free radicals, which break down existing human tissue and cells. The brain is very vulnerable to free radicals; however, antioxidants such as those contained in ginkgo extracts can minimize cumulative free radical damage. Dementia is a severe form of memory loss, especially in the aged. Itil et al (1999) conducted a study comparing the effects of conventional drugs used to treat dementia in America with use of a common ginkgo extract. This study concluded that ginkgo was in fact more effective on more patients than the synthetic conventional drugs.7 Toxicity, Contraindications and cautions: contraindicated for cases of excess. Use with caution whenever there is viscous sputum that is difficult to expectorate. This herb is slightly toxic and should not be taken in large quantities or long term. Symptoms of overdose include headache, fever, tremors, irritability, and dyspnea. The antidote is 60g boiled raw gan cao or 30g of boiled ginkgo shells. To avoid this reaction, one may also include the hard shells and thin linings of the seed when using this herb.8 Medicinal uses: Expels phlegm and stops wheezing: for wheezing with coughing and copious sputum. Eliminates dampness and stops discharge: for vaginal discharge and turbid urine. This herb is used both in cases of deficiency and damp heat. Stabilizes the lower burner: for urinary frequency or incontinence or spermatorrhea. Ginkgo biloba is best known for its ability to enhance mental alertness by promoting blood circulation to the brain and bodily extremities.9 The nuts also played an important part in traditional medicine in Japan and China. After feasts they were often ground up into porridge and eaten to aid digestion. Children who repeatedly wet the bed were given roasted ginkgo nuts as a cure. Despite the medicinal properties of the nuts, in large doses they are quite poisonous, and care must to be taken in administering them (Hori et al 1997).10 Pharmacy and dosage: 4.5-9g. Use raw for treating phlegm and clearing heat, prepared for stopping wheezing and restraining urine. Because of its greater toxicity, 13

305 Lesson 12:Herbs that Stabilize & bind, Calm the spirit, and Extinguish wind & Tremors when the raw herb is used the dosage is reduced. Usually the husk is removed and the seed is crushed before use. Major Combinations: With ma huang (Herba Ephedrae), xing ren (Semen Pruni Armeniacae) and sang bai pi (Cortex Mori Albae Radicis) for cough and wheezing with an excessive production of yellow sputum due to lung deficiency with hot phlegm. With huang bai (Phellodendri) and qian shi (Semen Euryales Ferocis) for damp heat induced vaginal discharge. With lian zi (Semen Nelumbinis Nuciferae), hu jiao (Fructus Piperis Nigri) and chicken for thin watery vaginal discharge due to deficiency of the lower burner. With sang piao xiao (Ootheca Mantidis) and yi zhi ren (Fructus Alpiniae Oxyphyllae) for urinary frequency and incontinence. REFERENCES Bensky, D. and Gamble, A.; Chinese Herbal Medicine Materia Medica; Eastland Press; Seattle; 1993; p390 3 Ibid. 4 Ibid Ibid. 7 Ibid. 8 Bensky, D. and Gamble, A.; Chinese Herbal Medicine Materia Medica; Eastland Press; Seattle; 1993; p Image chinese.herbs.webs-sg.com 14

306 Mu Li Ostrea gigas Lesson 12:Herbs that Stabilize & bind, Calm the spirit, and Extinguish wind & Tremors Family: Ostreidae Other names: oyster shell, mu Ii ke, borei (Japanese), moryeo (Korean), Ostrea concha Plant description: Good quality is large, white and has a clean and shiny inner side. Shell of Ostrea gigas. Elongated pieces, dorsal and ventral edges almost parallel, cm long, 4-15 cm high. The right shell relatively small, scales strong and thick, arranged in laminated or laminating striated order. The outer surface smooth or with several depressions. Pale purple, grayish-white or yellowish-brown; the inner surface porcelain white, without denticles at both sides of the umbo. The left shell with deep depression, scales bigger and rougher than those of the right shell, attachment surface of the umbo small. Texture hard, fracture laminated, white.1 Part used: shell Habitat, ecology and distribution: coastal waters, harvested year round. History: Divine Husbandman's Classic of Materia Medica Constituents: calcium carbonate, calcium phosphate, calcium sulfate, magnesium, aluminum, ferric oxide. Energetics Properties and Channels Entered: salty, astringent, and cool, entering the liver and kidney meridians. Actions and Indications: astringent, anti-tubercular Medical Research: Decoctions of mu Ii were used in ten cases of night sweats from tuberculosis. After the sweating stopped, the preparation was continued for 2 days. In this clinical study, 7 patients responded after a few days, and two of the remaining three were successfully treated with the addition of long gu (as Draconis) and suan zao ren (Semen Ziziphi Spinosae).2 Toxicity, Contraindications and cautions: contraindicated in cases of high fever due to excess with an absence of sweating. According to some traditional texts, mu Ii is synergistic with bei mu (Bulbus Fritillariae), gan cao (Radix Glycyrrhizae Uralensis), niu xi (Radix Achyranthis Bidentatae), yuan zhi (Radix Polygalae Tenuifoliae) and has adverse effects when combined with ma huang 15

307 Lesson 12:Herbs that Stabilize & bind, Calm the spirit, and Extinguish wind & Tremors (Herba Ephedrae), wu zhu yu (Fructus Evodiae Rutaecarpae) and xi xin (Herb cum Radice Asari). Overdose may lead to indigestion or constipation. Medicinal uses: Settles and calms the spirit: for palpitations with anxiety, restlessness, and insomnia. Benefits the yin and anchors the floating yang: for irritability, insomnia, dizziness, headache, tinnitus, blurred vision, bad temper or a red, flushed face due to yin deficiency with ascendant yang. Prevents leakage of fluids: for continuous sweating in patients with steaming bone disorder or in the aftermath of a warm febrile disease. Also used as an astringent for spontaneous sweating, night sweats, nocturnal emissions, spermatorrhea or vaginal discharge and uterine bleeding due to deficiency. Softens hardness and dissipates nodules: for various kinds of lumps in the neck such as scrofula and goiter. Absorbs acidity and alleviates pain: used in calcined form for excessive stomach pain with a sour taste in the mouth. To induce sedation, to nourish yin and subdue the overflowing of yang, and to soften hard masses and eliminate nodulation.3 Pharmacy and dosage: 15-30g. Calcined to absorb acidity and prevent leakage of fluids, otherwise use the raw form. Cook for minutes before adding other ingredients to a decoction. Overuse may cause: lethargy, constipation and/or abdominal distention. Major Combinations: With long gu (as Draconis) and bai shao (Radix Paeoniae Lactiflorae) for anxiety, palpitations, insomnia, and dream disturbed sleep. Also for symptoms associated with yin deficiency and ascendant yang such as headache, dizziness and tinnitus. For internal movement of liver wind in the aftermath of a febrile disease manifesting as tremors or twitching, add gui ban *(plasterum testudinis) and bie jia (carapax amydae sinensis) *Reference only, banned substance With huang qi (Radix Astragali Membranacei) and fu xiao mai (Semen Tritici Aestivi Levis) for spontaneous sweating and night sweats. With xuan shen (Radix Scrophulariae Ningpoensis), xia ku cao (Spica Prunellae Vulgaris), and zhe bei mu (Bulbus Fritillariae Thunbergii) for scrofula. With chai hu (Radix Bupleri), dan shen (Radix Salviae Miltiorrhizae) and chi shao (Radix Paeoniae Rubrae) for subcostal pain and swelling. 16

308 Lesson 12:Herbs that Stabilize & bind, Calm the spirit, and Extinguish wind & Tremors REFERENCES Bensky, D. and Gamble, A.; Chinese Herbal Medicine Materia Medica; Eastland Press; Seattle; 1993; p Image jadeinstitute.com 17

309 Lesson 12:Herbs that Stabilize & bind, Calm the spirit, and Extinguish wind & Tremors Suan Zao Ren Zizyphus spinosa Family: Rhamnaceae Other names: jujube seed, zizyphus, literal translation!sour date seed" Plant description: Good quality is large, full and purplish red. Oblate or flattened ellipsoidal, 5-9 mm long, 5-7 mm wide, about 3 mm thick. Externally purplish-red or purplishbrown, smooth, lustrous, some fissured. One surface even, with 1 raised longitudinal line in the centre; the other surface slightly raised. One end dented, showing a linear hilum; the other end having a finely raised chalaza. Testa fragile; endosperm white; cotyledons 2, pale yellow, oily. 1 Part used: Seed Habitat, ecology and distribution: Hebei, Shaanxi, Liaoning, Henan, harvested in autumn when ripened. History: Divine Husbandman's Classic of Materia Medica Constituents: betulic acid, betulin, jujuboside A, 8, 81, [1-3], jujubogenin, ebelin lactone, daucosterol, ceanothic acid, Alphitolic acid swertisin, Zivulgarin, Spinosin, (2"-O-B-D glucopyranosylswertisin)[6], 6"-Sinapoylspinosin, 6"Feruloylspinosin, 6"-p- Coumaroylspinosin. 2 Energetics Properties and Channels Entered: sweet, sour and neutral, entering the gallbladder, heart, liver and spleen meridians. Actions and Indications: sedative, analgesic, antipyretic, antihypertensive Medical Research: In one experiment decoctions of suan zao ren given orally to dogs had a sedative and hypnotic effect, regardless of the time of day or whether or not the dogs had first been given caffeine. Experiments on mice had similar results. This herb also caused a reduction in deep tendon reflexes and conditioned reflexes. Tolerance does develop to the herb, but after a week's interruption it is again effective. While experiments have not demonstrated any difference in effect between the raw and dry fried forms, there is difference of opinion as to whether the active ingredient is an oil or is water soluble.3 Intraperitoneal injection of decoctions of suan zao ren showed a definite analgesic effect in mice as measured by sensitivity to heat. 4 Oral administration and injection of decoctions of suan zao ren lowered the body temperature in white mice. 5 18

310 Lesson 12:Herbs that Stabilize & bind, Calm the spirit, and Extinguish wind & Tremors Suan zao ren lowers blood pressure and has an inhibitory effect on the heart. 6 The use of suan zao ren reduced mortality rates in white mice and white rats with extensive burns, and reduced local edema from burns in white mice.7 Toxicity, Contraindications and cautions: the LD50 for intraperitoneal injection was 14g/kg. Use with caution in cases of severe diarrhea or heat excess. Medicinal uses: Nourishes heart yin, augments the liver blood, and quiets the spirit: for irritability, insomnia, and palpitations with anxiety due to either blood deficiency (inability to nourish the heart) or yin deficiency (with upward rising fire). Prevents abnormal sweating: for both spontaneous sweating and night sweats. To replenish the liver, to cause tranquilizations, to arrest excessive perspiration, and to promote the production of body fluid. Pharmacy and dosage: 9-18g. Crush before decocting, also taken as a powder before bed with a dosage of 1.5-3g. Traditionally used raw for a stronger calming effect or restlessness due to fire from deficiency and dry fried for stomach and spleen deficiency or excessive sweating. Major Combinations: With bai shao (Radix Paeoniae Lactiflorae), dang gui (Radix Angelicae Sinensis) and he shou wu (Radix Polygoni Multiflori) for irritability, insomnia and palpitations with anxiety due to heart blood and yin deficiency. With zhi mu (Rhizoma Anemarrhenae Asphodeloidis) and fu ling (Sclerotium Poriae Cocos) for insomnia and irritability due to liver yin deficiency and its accompanying heat. With dang shen (Radix codonopsis pilosulae), fu ling (Sclerotium Poriae Cocos) and long yan rou (Arillus Euphoriae Longanae) for insomnia, palpitations, and irritability due to deficiency of the spleen qi and heart blood. With wu wei zi (Fructus Schisandrae Chinensis), huang qi (Radix Astragali Membranacei) and mu Ii (Concha Ostreae) for spontaneous sweating and night sweats. REFERENCES Bensky, D. and Gamble, A.; Chinese Herbal Medicine Materia Medica; 4 Ibid. 5 Ibid. 6 Ibid. 7 Ibid. 8 Eastland Press; Seattle; 1993; p404 Image tcm.health-info.org 19

311 Yuan Zhi Polygala tenuifolia Lesson 12:Herbs that Stabilize & bind, Calm the spirit, and Extinguish wind & Tremors Family: Polygalaceae Other names: Chinese senega root, polygala, milkwort, snakeroot Plant description: Good quality is thick with a thick cortex. Cylindrical, somewhat curved, 3-15 cm long, 3-8 mm in diameter. Externally grayish-yellow to grayishbrown, with dense and dented transverse wrinkles, longitudinal wrinkles and fissures, old roots with denser and deeply dented transverse wrinkles, somewhat nodular. Texture hard and fragile, easily broken, fracture brownish-yellow in bark, yellowish-white in wood, bark easily separating from wood.1 Part used: root Habitat, ecology and distribution: Shanxi, Shaanxi, Hebei, Henan, Jilin, harvested in the spring, before sprouting, or autumn after aerial parts have withered. History: Divine Husbandman's Classic of Materia Medica Constituents: tenuigenin A, tenuigerin 8, polygalitol, tenuidine, and xanthones. Energetics Properties and Channels Entered: bitter, pungent, slightly warm, entering the heart and lung meridians. Actions and Indications: expectorant, uterine stimulant Medical Research: The saponins in yuan zhi reflexively increase secretions in the bronchioles and act as expectorants. They also stimulate the lining of the stomach and cause mild nausea. In anesthetized dogs given intravenous injections of decoctions of this herb, no expectorant effects were noted.2 Decoctions of yuan zhi given orally or intravenously to guinea pigs, dogs and rabbits (both pregnant and nonpregnant) caused significant stimulation of the uterus.3 Toxicity, Contraindications and cautions: contraindicated for yin deficiency with heat signs. Use with caution in cases with ulcers or gastritis. According to some traditional sources, this herb counteracts zhen zhu (Margarita) and Ii lu (Rhizoma et Radix Veratri)4 20

312 Lesson 12:Herbs that Stabilize & bind, Calm the spirit, and Extinguish wind & Tremors Medicinal uses: Calms the spirit and quiets the heart: for insomnia, palpitations with anxiety, restlessness, and disorientation. Most effective in cases related to excessive brooding or constrained, pent up emotions. Expels phlegm and clears the orifices: used when phlegm envelops the orifices of the heart with such manifestation such as emotional and mental disorientation or seizures. Expels phlegm from the lungs: for coughs with copious sputum, especially when difficult to expectorate. Reduces abscesses and dissipates swellings: for boils, abscesses, sores, and swollen and painful breasts. Used in powdered form and applied topically or taken with wine. Topically, senega is used as a gargle for pharyngitis. Historically, senega was a cure for rattlesnake bite.5 The drug irritates the mucous membranes in the throat, causing hyper secretion and expectoration; combined with Chinese licorice (gan cao), it is a good expectorant for heavy smokers.6 Pharmacy and dosage: 3-9g. Major Combinations: With fu shen (Sclerotium Poriae Cocos Pararadicis) and suan zao ren (Semen Zizyphi Spinosa) for irritability, disorientation, palpitations with anxiety and insomnia due to heart blood deficiency or constrained qi. With chuan bei mu (Bulbus Fritillariae Cirrhosae) and ban xia (Rhizoma Pinelliae Ternatae) for wheezing and coughing due to cold phlegm With yu jin (Tuber curcumae) and shi chang pu (Rhizoma Acori Graminei) for disorientation associated with phlegm enveloping the orifices of the heart. With quan xie (Buthus Martensi) and tian Ma (Rhizoma Gastrodiae Elatae) for seizures associated with phlegm enveloping the orifices of the heart. A decoction of this herb may be mixed with a little rice wine and applied topically for the early stages of sores. REFERENCES Bensky, D. and Gamble, A.; Chinese Herbal Medicine Materia Medica; Eastland Press; Seattle; 1993; p406 3 Ibid. 4 Bensky, D. and Gamble, A.; Chinese Herbal Medicine Materia Medica; Eastland Press; Seattle; 1993; p Image tcmtreatment.com 21

313 Lesson 12:Herbs that Stabilize & bind, Calm the spirit, and Extinguish wind & Tremors Gou Teng Uncaria rhynchophylla Family: Rubiaceae Other names: shuang gou teng, gambir - stems and thorns, cat's claw Plant description: Good quality has double thorns, thin stems and lacks desiccated stems. It should be glossy and purplish red. It was traditionally believed that the more hoods and less stems, the stronger the effect. Cylindrical or sub square, 2-3 cm long, 2-5 mm in diameter. Externally reddish- brown to purplish-red, with fine longitudinal striations and glabrous; or yellowish green to greyish-brown, sometimes with white dotted lenticels, covered with yellowish-brown pubescences. Most nodes bearing with two opposite downward curved hooks (sterile peduncles), some ones with a hook at one side and a raised scar at another side; hooks slightly flattened or rounded, apex acute, base relatively broad; dotted scars of falling petiole and ring-shaped scars of stipule visible on the branch connected with the hook base. Texture hard and tenacious, fracture yellowish-brown, bark fibrous, pith yellowish-white or hollowed.1 Part used: stems and thorns Habitat, ecology and distribution: Guangxi, Guangdong, Hubei, Hunan, Zhejiang, Jiangxi, Sichuan, Yunnan, Guizhou; harvested in autumn and winter. History: Miscellaneous Records Constituents: rhynchophylline, isorhynchophylline, corynoxeine, isocorynoxeine, corynantheine, nicotinic acid, hirsutine, hirsuteine. Energetics Properties and Channels Entered: sweet and cool, entering the heart and liver meridians. Actions and Indications: sedative, antihypertensive Medical Research: Decoctions of gou teng injected intraperitoneally into mice in doses of 0.1 g/kg had a significant sedative effect. In doses of 1 g/kg it inhibited conditioned reflexes. The herb has also been used for experimental epilepsy in guinea pigs with good success. However, at the effective doses there were also signs of sedation.2 Decoctions of gou teng lowered blood pressure in anesthetized dogs and rabbits and in rats with artificially induced hypertension (denervation of the carotid bodies). Atropine did not affect the antihypertensive function of the herb, but vagotomy greatly diminished them. The herb did not cause peripheral vasodilation. If cooked form more than 15 22

314 Lesson 12:Herbs that Stabilize & bind, Calm the spirit, and Extinguish wind & Tremors minutes there was a decrease in the anti-hypertensive effect. Old stems (those without thorns) did not show any antihypertensive effect.3 Given a dose of 50 mg/kg or 100 mg/kg for two consecutive months, the group with low dosage suffered from mild dystrophy in kidney, and the group with high dose suffered from significant pathogenic in heart, liver, and kidney. Toxicity, Contraindications and cautions: LD50 in mice for decoction of gou teng is 29g/kg, for rhynchophylline it is 162mg/kg. Medicinal uses: Extinguishes wind and alleviates spasms: for liver heat patterns with internal movement of liver wind, with such symptoms as tremors, seizures and eclampsia. Drains liver heat and pacifies liver yang: for liver fire and ascendant liver yang patterns with such symptoms as headache, irritability, red eyes, and dizziness. Recently used for hypertension, especially of this type. Releases the exterior: for exterior wind-heat patterns with such symptoms as fever, headache and red eyes. Pharmacy and dosage: 6-15g. Do not cook for more than 10 minutes. Major Combinations: With ling yang jiao (Cornu Antelopis) and quan xie (Buthus Martensi) for seizures associated with high fever. With tian ma (Rhizoma Gastrodiae Elatae), quan xie (Buthus Martensi) and shi jue ming (Concha Haliotidis) for convulsions (including eclampsia) due to liver wind. With ju hua (Flos Chrysanthemi Morifolii), shi jue ming (Concha Haliotidis) and sang ye (Folium Mori Albae) for dizziness and vertigo due to liver wind. In more extreme cases of ascendant liver yang with accompanying symptoms of facial flush, short temper, and a wiry pulse, add shi gao (gypsum) and fu shen (Sclerotium Poriae Cocos Paradadicis) With xia ku cao (Spica Prunellae Vulgaris) and huang qin (Radix Scutellariae Baicalensis) for liver heat. REFERENCES Bensky, D. and Gamble, A.; Chinese Herbal Medicine Materia Medica; Eastland Press; Seattle; 1993; p422 3 Ibid &ctype=tcrnh Image vertigopower.com 23

315 Lesson 12:Herbs that Stabilize & bind, Calm the spirit, and Extinguish wind & Tremors Di Long Pheretima aspergillum Family: Megascolecidae Other names: earthworm, lumbricus, qiu yin, guang di long, gan di long, literal translation!earth dragon" Description: Good quality is thick, long, and intact. Part used: entire worm Habitat, ecology and distribution: Guang dong (best), Guangxi, Fujian and throughout China, harvested in summer and autumn. History: Divine Husbandman's Classic of Materia Medica Constituents: lumbrofebrine, lumbritin, terrestro-iumbrolysin, hypoxanthine, xanthine, adenine, guanine, choline, guanidine. Energetics Properties and Channels Entered: salty and cold, entering the bladder, liver, lung and spleen meridians. Actions and Indications: anti-hypertensive, bronchodilation, sedative Medical Research: Preparations of di long lowered blood pressure in anesthetized animals and in dogs with chronic renal hypertension. When injected intravenously, tolerance develops rapidly, but this does not occur with oral administration. 1 Preparations of di long given to patients with essential hypertension had an effectiveness rate of over 90%. Only 72% of the control group (given diuretic) had a significant reduction in blood pressure. No side effects were noted. 2 An unidentified ingredient of di long given orally to rabbits and white rats caused marked bronchodilation and inhibited the effects of histamine and pilocarpine on the bronchioles. When injected intravenously into guinea pigs, it raised by 50% the lethal dosage of histamine. It also inhibited the effects of histamine on guinea pig intestinal specimens. Experiments in Japan on smooth muscle indicate that di long causes vasoconstriction directly, but vasodilation via the central nervous system. 3 In several clinical studies, intramuscular injection of either di long or a combination of this plus huang qin (Radix Scutellariae Baicalensis) were shown to be approximately 40% effective in the treatment of uncomplicated bronchial asthma. 4 Preparations of di long caused sedation in white mice and rabbits. It also inhibited the effects of caffeine, but not those of strychnine. 5 Toxicity, Contraindications and cautions: The LD50 for intraperitoneal injection in mice is 95g/kg. 24