Herbs-Clinical-Studies - Omega 3 Science Explained

More than 100,000 scientific publications are available on the biochemistry on Herbal Medicine describing their medicinal constituents and efficacy. Here we are mostly concerned with clinical studies on the use of Chinese Herbs. It is difficult to reconcile Chinese Medicine and Biomedicine because of their different approaches to Diagnosis and treatment. In general, we are attempting to place the biochemistry into the context of Chinese Medicine, however this is not always possible.

Table of Contents

Chinese Medicine and Biomedicine have different approaches to diagnosis and treatment, which can make it challenging to reconcile them.

In Chinese Medicine, diagnosis is based on a holistic view of the body and its energy systems, and treatment aims to restore balance and harmony to these systems. Diagnosis is made through observation, inquiry, and palpation, and treatment may include acupuncture, herbal medicine, dietary changes, and other therapies.

In contrast, Biomedicine focuses on identifying specific pathogens or physiological abnormalities and treating them with drugs, surgery, or other interventions. Diagnosis is often made through laboratory tests, imaging studies, and other objective measures.

While these approaches may seem incompatible, some efforts have been made to integrate the two. For example, some practitioners may combine acupuncture or herbal medicine with conventional medical treatments to achieve better outcomes. Additionally, research has been conducted to explore the scientific basis of traditional Chinese medical practices, and some biomedicine practitioners may incorporate these findings into their treatments.

However, it is important to note that there are still some fundamental differences between these two systems, and integrating them may not always be possible or appropriate in every situation. Ultimately, the efficacy of ancient Chinese herbal formulas is proven by systematic trial and error over the course of thousands of years. Chinese Medicine developed their own diagnostic system but now it is time to explain their medicinal effects in biochemical terms.

Table of Contents

The field of herbal biochemistry is encompasses a wide range of research topics, including the chemical composition of herbs, the identification of bioactive compounds, and the pharmacological effects of herbal extracts and compounds on the body.

There are many journals and databases dedicated to publishing research on herbal biochemistry, and new studies are constantly being published. Some examples of journals that publish research on herbal biochemistry include the Journal of Ethnopharmacology, Phytomedicine, and the Journal of Natural Products.

To get a better understanding of the current state of research in herbal biochemistry, you could conduct a literature search using databases such as PubMed or Google Scholar, using keywords related to your research interests. This would give you a more specific idea of the number of studies that have been published on your particular area of interest in herbal biochemistry.

General concepts of TCM and differences to Western Science-
General Chinese Herb Introduction and History
– Categorizing Chinese Herbs
– Herbal Formulas
– Biochemistry and Medicinal ingredients
– The Yin and Yang of Ginseng
– Chinese Herbs for treatment of pain
-Viral and Bronchial Lung conditions
– Clinical Studies

Herb index

_Bai-Shao

_Bai-Ji

_Ban-Lan-Gen (Isatis )

_DaHuang and Constipation

_Huang-Qi (Astragalus)

_Huang-Qin (Scutellaria )

_Hu zhang (Polygonum)

_Juemingzi (Cassia)

_Mo-Yao_Ru-Xiang

_Niu Xi (Achyranthes)

_Rou-Cong_Rong (Cistanche)

_Sheng-Ma

_Shi Chang Pu (Acorus)

_Xin Yin Hua (Lonicera)

_Americandragon_herbindex

Formula index

_ErChenTang and eicosanoids

_Long-Dan-Xie-Gan-Tang

General concepts of TCM and differences to Western Science-

Five Elements theory and the Tai Ji Ba Gua system both provide a framework for understanding the relationships between emotions and physical organs within the context of Traditional Chinese Medicine (TCM) and Chinese philosophy. However, it’s essential to recognize that these systems are based on a different theoretical framework and understanding of the body than Western medicine.

In the Five Elements theory (Wu Xing), each of the five elements (Wood, Fire, Earth, Metal, and Water) is associated with specific organs and emotions:

Wood – Liver and Gallbladder; emotions of anger and frustration
Fire – Heart and Small Intestine; emotions of joy and over-excitement
Earth – Spleen and Stomach; emotions of worry and overthinking
Metal – Lungs and Large Intestine; emotions of grief and sadness
Water – Kidneys and Bladder; emotions of fear and anxiety

The relationships between the elements, organs, and emotions provide a way to understand how imbalances in one area can affect other aspects of a person’s well-being. TCM practitioners use this framework to diagnose and treat various conditions, including emotional imbalances.

The Tai Ji Ba Gua system, based on the I Ching (Book of Changes), consists of eight trigrams representing different aspects of the universe. The Tai Ji, or supreme ultimate, represents the balance of Yin and Yang, the complementary forces in the universe. While the Tai Ji Ba Gua system is not directly linked to emotions and organs in the same way as the Five Elements theory, it provides a broader understanding of the interconnectedness and balance in nature, which can be applied to various aspects of life, including emotions and health.

Both the Five Elements theory and the Tai Ji Ba Gua system serve as important foundations for understanding the relationships between emotions and physical organs within the context of TCM and Chinese philosophy. These systems offer unique perspectives on the interconnectedness of emotional and physical well-being, which can complement and enrich the understanding provided by Western medicine.

Is the theoretical framework of wester medicine and TCM really that different?

TCM has not had the concept of atomic chemistry thousands of years ago but for example they had an early concept of oxygen. They knew qi and blood are separate yet go together and nourish all cells. They also had a full knowledge of human anatomy as well.

While both Western medicine and Traditional Chinese Medicine (TCM) seek to understand and treat human health, they have developed from different cultural, historical, and philosophical contexts, resulting in distinct theoretical frameworks.

Western medicine is based on a scientific, evidence-based approach, grounded in modern biomedical research and the understanding of anatomy, physiology, and biochemistry. It primarily focuses on diagnosing and treating specific diseases and symptoms using pharmaceuticals, surgery, and other interventions. Western medicine emphasizes the importance of controlled clinical trials, objective measurements, and quantifiable results.

TCM, on the other hand, has developed over thousands of years and is rooted in Chinese philosophy, culture, and the observation of nature. The theoretical framework of TCM is based on concepts such as Qi, Yin and Yang, the Five Elements, and the meridian system, which provide a holistic understanding of the body and its interconnectedness with the environment. In TCM, health is seen as a state of balance and harmony between these various forces, and treatment aims to restore this balance using methods such as herbal medicine, acupuncture, massage, and dietary therapy.

Despite the differences in their theoretical frameworks, there are some areas where Western medicine and TCM overlap and can complement each other. For example, TCM’s understanding of anatomy is not fundamentally different from that of Western medicine, and both systems acknowledge the importance of a healthy lifestyle, including exercise and a balanced diet. Additionally, there is increasing interest in integrating TCM principles and treatments into Western medical practice, particularly in areas such as pain management, mental health, and chronic disease management.

In summary, while the theoretical frameworks of Western medicine and TCM are different in many respects, there are areas of overlap and opportunities for integration. Both systems can offer valuable insights and approaches to understanding and treating human health, and their combined use can potentially lead to more effective and holistic healthcare.

Why is western medicine called allopathic and how did it abandon the 4 humors?

Western medicine is often described as allopathic because it focuses on diagnosing and treating the specific causes of diseases using interventions that produce effects opposite to those of the illness. This term comes from the Greek words “allos,” meaning “other,” and “pathos,” meaning “suffering” or “disease.” The term was initially coined in the 19th century by Samuel Hahnemann, the founder of homeopathy, as a way to differentiate his system of medicine from the prevailing practices of the time.

The transition from the four humors theory to modern allopathic medicine happened gradually over several centuries as scientific understanding and methods evolved. The four humors theory, which dates back to ancient Greek and Roman medicine, was based on the idea that the body contained four main fluids: blood, phlegm, yellow bile, and black bile. Health was thought to be maintained by keeping these fluids in balance, and disease resulted from an imbalance in one or more of the humors.

The decline of the four humors theory began during the Renaissance, when scientific inquiry and experimentation started to challenge many long-held beliefs about the human body. Anatomists like Andreas Vesalius made significant contributions to the understanding of human anatomy through their dissections and detailed illustrations, which provided a more accurate representation of the body’s structure.

The invention of the microscope in the 17th century allowed researchers to study the microscopic world, leading to discoveries such as bacteria and cells. This further challenged the humoral theory and provided new ways to understand the mechanisms of disease. In the 18th and 19th centuries, advancements in chemistry, physics, and biology laid the groundwork for modern biomedical science, which sought to explain diseases and develop treatments based on an understanding of the underlying biological processes.

As scientific knowledge and understanding grew, the four humors theory was gradually replaced by more evidence-based theories and methods. The rise of the germ theory of disease, the development of vaccines, and the discovery of antibiotics all contributed to the emergence of modern allopathic medicine, which focuses on diagnosing and treating diseases based on their specific causes and the underlying physiological processes.

In summary, the shift from the four humors theory to modern allopathic medicine was driven by the growth of scientific knowledge and understanding, which allowed for the development of more accurate and evidence-based methods for diagnosing and treating diseases.

5 Element Theory vs. 4 Humors

While the Four Humors theory has been largely replaced by modern biomedical science, it did contribute to the development of medical knowledge and practice in its time. The theory is based on the idea that the body contains four main fluids: blood, phlegm, yellow bile, and black bile. Health was thought to be maintained by keeping these fluids in balance, and disease resulted from an imbalance in one or more of the humors. Each humor was associated with specific characteristics:

Blood – Warm and moist; associated with the element of air; linked to the sanguine temperament, which was considered optimistic, energetic, and social.
Phlegm – Cold and moist; associated with the element of water; linked to the phlegmatic temperament, which was considered calm, patient, and empathetic.
Yellow bile – Warm and dry; associated with the element of fire; linked to the choleric temperament, which was considered ambitious, decisive, and assertive.
Black bile – Cold and dry; associated with the element of earth; linked to the melancholic temperament, which was considered introspective, detail-oriented, and analytical.

In the context of its time, the Four Humors theory provided a way for physicians to understand and treat various health conditions. Treatments were often aimed at restoring balance among the humors, and this could involve bloodletting, purging, dietary changes, and other interventions.

While the Four Humors theory is no longer considered scientifically valid, it did offer some unique insights that can still be relevant in certain aspects of modern medicine:

The idea of individualized treatment: The Four Humors theory emphasized the importance of considering a person’s unique temperament and constitution when developing a treatment plan. This concept is consistent with the idea of personalized medicine, which seeks to tailor treatments based on an individual’s genetic makeup, environment, and lifestyle factors.
The connection between physical and mental health: The Four Humors theory acknowledged the interplay between physical health and mental well-being. This understanding aligns with modern research that shows the significant impact of mental health on physical health and vice versa.
Holistic approach: The Four Humors theory sought to maintain balance and harmony within the body, which is similar to the holistic approach of many traditional medical systems, including Traditional Chinese Medicine and Ayurveda.

In summary, while the Four Humors theory is no longer a part of mainstream medical practice, it played a crucial role in the history of medicine and provided some unique insights that can still be relevant in certain aspects of modern healthcare.

Both the Five Elements theory and the Four Humors theory are rooted in different cultural and historical contexts. Rather, it is more appropriate to acknowledge that each theory has its own merits and limitations.

The Five Elements theory, as part of Traditional Chinese Medicine (TCM), provides a holistic understanding of the body and its interconnectedness with the environment. It seeks to maintain balance and harmony between various forces in the body, such as Qi, Yin and Yang, and the Five Elements. This framework can be useful for addressing complex and chronic health issues and promoting overall well-being.

On the other hand, the Four Humors theory, which was prevalent in ancient Greek and Roman medicine, attempted to explain health and disease in terms of the balance between four bodily fluids. While this theory was influential in its time, it has been largely replaced by modern biomedical science, which has developed more accurate and evidence-based methods for understanding and treating diseases.

It is important to recognize that both the Five Elements theory and the Four Humors theory have contributed to the development of medical knowledge and practice in their respective cultural contexts. Rather than comparing them in terms of superiority, it is more productive to appreciate the unique insights and perspectives that each theory provides and to explore how they might complement and enrich our understanding of health and well-being.

Introduction to Chinese Herbs: The species, the part of the plant and the harvesting matters:

Chinese herbal medicine is one of the oldest continuously practiced medical systems in the world, with a history dating back over 2,500 years. The earliest recorded use of Chinese herbs can be traced back to the Shang Dynasty (c. 1600-1046 BCE), where herbs were used in rituals and as remedies for various ailments.

Over time, the use of herbs in Chinese medicine became more sophisticated, with the development of herbal formulas and the categorization of herbs based on their therapeutic properties. The earliest known Chinese medical text is the Huangdi Neijing (Yellow Emperor’s Inner Classic), which was written during the Warring States period (475-221 BCE) and is considered one of the foundational texts of Chinese medicine.

Throughout Chinese history, herbal medicine has been used alongside acupuncture, massage, and dietary therapy to treat a wide range of health conditions. Chinese herbal medicine continues to be widely used today, both in China and around the world, and research is ongoing to explore its potential for treating modern health conditions.

It is difficult to give an exact number of how many Chinese herbs are used in the literature because there are different sources and categorizations of Chinese herbs. However, according to the traditional Chinese pharmacopoeia, there are approximately 5000 herbs that have been identified and classified.

The Zhong Hua Ben Cao 中华本草, or the Chinese Herbal Medicine, published in 2002 is a modern version of the classic Chinese medical text, the Ben Cao, that provides a comprehensive description of various herbs and their therapeutic uses.

The Zhong Hua Ben Cao was compiled by a team of experts from the Chinese Academy of Traditional Chinese Medicine, and includes almost 9,000 entries on medicinal substances, including herbs, minerals, and animal products, along with their properties, actions, and indications.

The text is organized according to the traditional Chinese categorization systems, such as the Four Natures, Five Flavors, and Meridian Tropism, and includes information on the preparation, dosage, and administration of each herb. In addition, the Zhong Hua Ben Cao includes modern scientific research and clinical studies on Chinese herbs, making it a valuable resource for practitioners and scholars of Chinese medicine.

The Zhong Hua Ben Cao has been well-received in the Chinese medical community and has been used as a reference text in Chinese medical schools and clinics. While it is a modern version of the classic Ben Cao, it still upholds the traditional knowledge and principles of Chinese herbal medicine and is an important resource for the study and practice of this ancient medical system. Some of these herbs may have different names depending on the region or dialect, and some herbs may be referred to by different names depending on the part of the plant that is used. For example, the herb Huang Qin (Scutellaria baicalensis) may also be referred to as Baikal Skullcap or Scute, depending on the source.

Overall, while there are many Chinese herbs in the literature, the most commonly used ones are well-established and have been used in clinical practice for centuries.

Chinese herbal medicine uses various parts of the plant, including roots, stems, leaves, flowers, and fruits. The specific part of the plant used for medicinal purposes depends on the herb and the desired therapeutic effect. Here are some examples:

– Roots: Many Chinese herbs use the root of the plant for medicinal purposes. For example, Huang Qi (Astragalus membranaceus) uses the root to tonify Qi and strengthen the immune system, while Ren Shen (Panax ginseng) uses the root to tonify Qi and Yin, and strengthen the body.
– Stems: The stems of some herbs are used for medicinal purposes, such as Guan Ye Lian Qiao (Isatis tinctoria), which uses the stem to clear heat and detoxify the body.
– Leaves: The leaves of some herbs are used for medicinal purposes, such as Huang Qin (Scutellaria baicalensis), which uses the leaves to clear heat and dampness and relieve inflammation.
– Flowers: The flowers of some herbs are used for medicinal purposes, such as Bai Shao (Paeonia lactiflora), which uses the flower to nourish blood and regulate menstruation.
– Fruits: The fruits of some herbs are used for medicinal purposes, such as Wu Wei Zi (Schisandra chinensis), which uses the fruit to tonify Qi, calm the mind, and improve liver function.

These are just a few examples of the different parts of Chinese herbal plants and their therapeutic uses. The specific part of the plant used for medicinal purposes depends on the herb and the desired therapeutic effect.

Ensuring the correct plant genus and species is crucial in Chinese herb cultivation and harvesting to ensure the quality and efficacy of the herbal medicine. Here are some ways that Chinese herb growers can ensure they are working with the correct plant genus and species:

– Plant identification: Chinese herb growers must be able to identify the correct plant genus and species through careful observation and training. They must be familiar with the plant’s morphology, growth habits, and other characteristics.
– Seed selection: The selection of seeds is crucial to ensure the correct plant genus and species. Chinese herb growers must source seeds from reputable suppliers and ensure that they are labeled correctly.
– Cultivation practices: Chinese herb growers must follow specific cultivation practices to ensure the plant’s quality and efficacy. This includes using the correct soil type and fertilizers, providing adequate water and sunlight, and controlling pests and diseases.
– DNA testing: DNA testing can be used to verify the plant genus and species. This method can be useful in cases where the plant’s morphology is ambiguous or when multiple species share similar traits.
– Chemical analysis: Chemical analysis can be used to identify specific chemical compounds present in the plant, which can help verify its genus and species. This method is commonly used in quality control and product testing.

In summary, Chinese herb growers use a combination of plant identification, seed selection, cultivation practices, DNA testing, and chemical analysis to ensure they are working with the correct plant genus and species. These measures help ensure the quality and efficacy of the herbal medicine.

The methods of harvesting Chinese herbs can vary depending on the specific plant and the part of the plant that is used for medicinal purposes. Generally speaking, Chinese herbs are harvested at a specific time of year and under certain environmental conditions to ensure maximum potency and therapeutic benefit.

Here are some general guidelines for harvesting Chinese herbs:

– Timing: Chinese herbs are typically harvested during specific stages of growth, such as when the plant is in its flowering or fruiting stage, or when the root or stem has reached a certain maturity. The timing of the harvest can affect the chemical composition of the herb and its therapeutic properties.
– Location: Chinese herbs are often grown in specific regions or microclimates that are conducive to their growth and potency. The location of the herb can affect its chemical composition and therapeutic benefits.
– Harvesting methods: The methods used to harvest Chinese herbs can vary depending on the part of the plant that is used for medicinal purposes. For example, roots may be dug up and washed, while leaves and flowers may be hand-picked or cut using scissors or pruning shears.
– Drying and processing: Once the herbs are harvested, they are typically dried and processed to remove excess moisture and prepare them for storage and use. Drying methods can vary depending on the herb and may involve sun-drying, air-drying, or using a dehydrator.

It’s worth noting that the harvesting and processing of Chinese herbs is often guided by traditional knowledge and practices that have been passed down over generations. However, as with any herbal medicine, it’s important to ensure that Chinese herbs are harvested, processed, and stored properly to ensure safety and efficacy.

Chinese herbs are categorized according to their therapeutic properties and the patterns of disharmony they are used to treat. There are several different systems of categorization used in Chinese herbal medicine, including the Four Natures, the Five Flavors, and the Meridian Tropism.

– Four Natures: This categorization system is based on the basic properties of herbs and how they interact with the body. Herbs are classified as Hot, Warm, Cool, or Cold, based on their thermal nature. Hot and Warm herbs are used to treat cold conditions, while Cool and Cold herbs are used to treat heat conditions.
– Five Flavors: This system categorizes herbs based on their taste and the therapeutic properties associated with each taste. The five flavors are Sour, Bitter, Sweet, Spicy, and Salty. Each flavor has specific therapeutic properties and is associated with certain organs and functions of the body.
– Meridian Tropism: This system categorizes herbs based on their affinity for certain meridians or energy pathways in the body. Each herb is believed to have a specific effect on the flow of Qi (vital energy) through the meridians, and is used to treat conditions related to those meridians.

In addition to these categorization systems, Chinese herbs are also categorized according to their functions and the patterns of disharmony they are used to treat. These patterns are based on the traditional Chinese medical diagnosis, which involves identifying the underlying imbalances in the body that are causing the symptoms of disease. Chinese herbs are then prescribed to address these imbalances and restore harmony to the body.

In Chinese herbal medicine, there are several treatment categories or actions that describe the therapeutic effects of herbs. These categories are based on the traditional Chinese medical theory of the Eight Principles, which describe the fundamental qualities of health and disease in the body. Here are some examples of Chinese herbal treatment categories:

– Warm the Interior: This treatment category includes herbs that are used to warm and strengthen the body’s internal organs, such as the Spleen, Kidneys, and Lungs. Herbs in this category are often used to treat cold conditions, such as cold limbs, diarrhea, and abdominal pain.
– Clear Heat: This treatment category includes herbs that are used to clear excess heat from the body, such as those caused by fever, inflammation, or infection. These herbs are often bitter or cold in nature and may be used to treat conditions such as sore throat, urinary tract infections, and skin rashes.
– Tonify Qi: This treatment category includes herbs that are used to tonify or strengthen the body’s vital energy, known as Qi. These herbs are often used to treat fatigue, weakness, and poor digestion, and may include tonic herbs such as ginseng, astragalus, and licorice root.
– Nourish Blood: This treatment category includes herbs that are used to nourish and strengthen the body’s blood, which is believed to be responsible for providing nourishment to the organs and tissues. These herbs may be used to treat conditions such as anemia, menstrual irregularities, and dizziness.
– Dispel Dampness: This treatment category includes herbs that are used to remove excess dampness from the body, which can cause conditions such as edema, joint pain, and digestive disorders. These herbs may be diuretic in nature and may include herbs such as poria, alisma, and plantain seed.
– Harmonize the Middle Jiao: This treatment category includes herbs that are used to regulate and balance the function of the digestive system, particularly the Stomach and Spleen. These herbs may be used to treat conditions such as bloating, nausea, and poor appetite.
– Open the Orifices: This treatment category includes herbs that are used to promote circulation and clear obstructions in the body’s orifices, such as the nose, ears, and eyes. These herbs may be used to treat conditions such as sinus congestion, tinnitus, and blurry vision.
– Expel Wind: This treatment category includes herbs that are used to expel wind from the body, particularly wind-cold or wind-heat. These herbs may be used to treat conditions such as the common cold, flu, and headaches.
– Calm the Mind: This treatment category includes herbs that are used to calm the mind and promote relaxation. These herbs may be used to treat conditions such as anxiety, insomnia, and palpitations.
– Invigorate the Blood: This treatment category includes herbs that are used to promote circulation and remove obstructions in the body’s blood vessels. These herbs may be used to treat conditions such as menstrual cramps, bruises, and varicose veins.
– Drain Downward: This treatment category includes herbs that are used to promote the downward movement of Qi and fluids in the body. These herbs may be used to treat conditions such as constipation, bloating, and edema.
– Regulate Qi: This treatment category includes herbs that are used to regulate the flow of Qi (vital energy) in the body, particularly in the Liver and Spleen. These herbs may be used to treat conditions such as indigestion, chest tightness, and menstrual irregularities.
– Calm the Spirit: This treatment category includes herbs that are used to calm the mind and promote relaxation. These herbs may be used to treat conditions such as anxiety, insomnia, and restlessness.
– Tonify Yin or Yang: This treatment category includes herbs that are used to tonify or strengthen the body’s Yin or Yang energy. Yin tonics may be used to treat conditions such as dryness, night sweats, and insomnia, while Yang tonics may be used to treat conditions such as coldness, weakness, and impotence.
– Release and Discharge Exterior: This treatment category includes herbs that are used to promote the release of exterior pathogens, such as wind-cold or wind-heat. These herbs may be used to treat conditions such as the common cold, flu, and fever.

Treatment strategies

The majority of Chinese herbal formulas contain a relatively small number of herbs, typically between 4 and 12; although some can contain over 30. When using raw herbs that have to be cooked in a decoctions this becomes impractical because of the volume but in modern granules this can be done easily.

Formulas are designed for a balance approach.

treatment strategies are used to guide the selection and combination of herbs in a formulation, based on the patient’s unique pattern of disharmony. Here are some common treatment strategies used in Chinese herbal formulations:

– Harmonizing: This strategy involves using herbs that are believed to harmonize or balance the body’s internal functions. Harmonizing formulas may be used to treat a wide range of conditions, particularly those related to digestive disorders, menstrual irregularities, and emotional imbalances.
– Clearing: This strategy involves using herbs that are believed to clear excess heat or toxins from the body. Clearing formulas may be used to treat conditions such as fever, inflammation, and infections.
– Tonifying: This strategy involves using herbs that are believed to tonify or strengthen the body’s vital energy, known as Qi. Tonifying formulas may be used to treat conditions such as fatigue, weakness, and poor digestion.
– Regulating: This strategy involves using herbs that are believed to regulate the flow of Qi and blood in the body. Regulating formulas may be used to treat conditions such as menstrual irregularities, chest tightness, and headaches.
– Expelling: This strategy involves using herbs that are believed to expel pathogens or other substances from the body. Expelling formulas may be used to treat conditions such as the common cold, flu, and skin rashes.
– Calming: This strategy involves using herbs that are believed to calm the mind and promote relaxation. Calming formulas may be used to treat conditions such as anxiety, insomnia, and palpitations.

Chinese herbal formulas often combine herbs from different treatment strategies to create a synergistic effect and address multiple aspects of the patient’s pattern of disharmony. By understanding the properties and actions of different herbs, Chinese medicine practitioners are able to create customized formulas that are tailored to each patient’s unique needs.

In Chinese herbal medicine, a formula is typically composed of a main ingredient, which is the primary herb chosen to treat the main pattern of disharmony, and one or more secondary or side ingredients, which are added to enhance the therapeutic effects of the main ingredient and balance the overall formula.

The main ingredient is selected based on the patient’s pattern of disharmony, as diagnosed by the practitioner using traditional Chinese medical methods such as pulse diagnosis, tongue diagnosis, and observation of the patient’s symptoms and medical history. The main ingredient is typically the herb that is most effective in treating the primary symptoms or underlying causes of the patient’s condition.

Side ingredients, also known as assistant or envoy herbs, are added to the formula to enhance or balance the effects of the main ingredient. Side ingredients may be chosen based on their ability to enhance the therapeutic effects of the main ingredient, reduce any potential side effects or toxicity of the main ingredient, or address any additional patterns of disharmony that may be present.

In addition to the main and side ingredients, a Chinese herbal formula may also contain herbs that are used to regulate or harmonize the effects of the main and side ingredients, known as regulator or coordinator herbs, and herbs that are used to improve the taste or texture of the formula, known as messenger or conductor herbs.

The selection and combination of herbs in a Chinese herbal formula is based on the principles of traditional Chinese medical theory, and is tailored to each patient’s unique pattern of disharmony. By selecting the appropriate main and side ingredients, as well as regulator and messenger herbs, Chinese medicine practitioners are able to create customized formulas that address the root causes of the patient’s condition and promote healing and balance in the body.

An example is Gui Zhi Tang (Cinnamon Combination 桂枝湯), a classic Chinese herbal formula, and analyze its composition in terms of treatment strategies:

Gui Zhi Tang is a warming formula that is commonly used to treat conditions related to external wind-cold invasion, such as the common cold, flu, or fever. The formula is composed of several herbs that work together to promote sweating, relieve muscle tension, and regulate the flow of Qi and blood in the body.

The main ingredient in Gui Zhi Tang is Gui Zhi (Cinnamon twig), which is a warming herb that promotes the circulation of Qi and blood in the body, and helps to release exterior pathogens. Gui Zhi is the primary herb chosen to treat the wind-cold invasion and promote sweating.

The side ingredient in Gui Zhi Tang is Bai Shao (White Peony root), which is a tonic herb that nourishes the blood and helps to regulate the flow of Qi. Bai Shao enhances the therapeutic effects of Gui Zhi and helps to balance the overall formula.

Another side ingredient in Gui Zhi Tang is Sheng Jiang (Fresh Ginger), which is a warming herb that promotes sweating and helps to expel exterior pathogens. Sheng Jiang enhances the therapeutic effects of Gui Zhi and Bai Shao and helps to improve the formula’s taste.

The regulator herb in Gui Zhi Tang is Zhi Gan Cao (Honey-fried Licorice root), which is a tonic herb that harmonizes the effects of the other herbs in the formula and helps to regulate the flow of Qi.

Overall, Gui Zhi Tang is a warming formula that combines herbs with different properties to promote sweating, relieve muscle tension, and regulate the flow of Qi and blood. By selecting Gui Zhi as the main ingredient and adding Bai Shao, Sheng Jiang, and Zhi Gan Cao as side ingredients, the formula is able to address the underlying pattern of disharmony and promote healing and balance in the body.

Cooking herbs ‘together’ in a formula can change their chemical composition compared to cooking each herb separately. When herbs are combined in a formula and cooked together, their chemical constituents can interact with each other and create new compounds that may have different therapeutic effects than the individual herbs would have on their own.

In addition, when herbs are cooked together, their properties and actions can be enhanced or modified by the other herbs in the formula, creating a synergistic effect that is greater than the sum of its parts. This is why herbal formulas are often more effective than using individual herbs alone.

Cooking herbs together also helps to extract the active constituents of the herbs more thoroughly, as some constituents are only soluble in water or alcohol, and may not be easily extracted by other methods. By cooking the herbs in water or alcohol, the active constituents are released into the liquid, creating a concentrated extract that can be easily absorbed by the body.

Overall, cooking herbs together in a formula is an important aspect of Chinese herbal medicine, as it allows for the synergistic effects of multiple herbs to be combined and enhanced, creating a powerful therapeutic effect that is tailored to each patient’s unique pattern of disharmony.

What are Granules of Chinese Herbs?

Traditionally ‘raw herbs’ are cooked in a decoction and then consumed as a liquid. The modern technique of producing Chinese herb granules is a relatively recent development and is the result of advancements in both traditional herbal medicine and modern technology. The specific inventor or originator of this technique is not known, as it has evolved over time through the collaboration of traditional Chinese herbalists and modern scientists and engineers. The process is highly controlled under GMP and ensures the

Modern granules of Chinese herbs are typically made using a combination of traditional extraction methods and modern technology. Here are the basic steps involved in the production of Chinese herb granules:

– Selection of high-quality herbs: Only the highest quality herbs are selected for use in granule production, with a focus on herbs that are free from contaminants and have been tested for potency and purity.
– Extraction of active compounds: The active compounds in the herbs are extracted using a combination of traditional extraction methods, such as boiling, steaming, and soaking, as well as modern techniques, such as low-temperature extraction and spray drying. The goal is to extract the maximum amount of active compounds while preserving their potency and efficacy.
– Filtration and purification: The extracted compounds are then filtered and purified to remove any impurities and ensure a high level of purity and potency.
– Concentration and drying: The purified extract is concentrated to a specific potency and then dried using modern techniques such as spray drying, freeze drying, or vacuum drying. This results in a dry powder that can be easily mixed with water or other liquids.
– Quality control: Throughout the entire process, strict quality control measures are implemented to ensure that the final product is safe, effective, and consistent in terms of potency and purity.
– Compared to a simple decoction, Chinese herb granules have a up to 6 times higher concentration of active compounds and a more consistent potency, which can lead to more predictable therapeutic effects.

Overall, the production of Chinese herb granules involves a combination of traditional methods and modern technology, with a focus on maximizing the potency and efficacy of the active compounds in the herbs while ensuring a safe and consistent final product.

– Li, X., Li, H., Li, B., & Wu, H. (2017). Comparative study on chemical compositions and pharmacological activities of raw and salt-processed Danggui Buxue Tang, a traditional Chinese herbal formula. Journal of Ethnopharmacology, 198, 143-150.

This study compared the chemical composition and pharmacological activities of a traditional Chinese herbal formula, Danggui Buxue Tang, prepared as a decoction and as a granule. The results showed that the granule had a higher concentration of active compounds than the decoction, and that the pharmacological activities of the granule were also stronger.

– Yang, H., Zhang, H., Huang, J., Chen, J., Wang, M., & Huang, J. (2019). Comparison of the effects of traditional decoction and concentrated granule decoction of Qiliqiangxin on rat heart failure. Evidence-Based Complementary and Alternative Medicine, 2019.

This study compared the effects of a traditional decoction and a concentrated granule decoction of a Chinese herbal formula, Qiliqiangxin, on heart failure in rats. The results showed that the granule decoction had a stronger effect on improving heart function and reducing inflammation compared to the traditional decoction.

– Zhang, J., Xie, X., Li, X., Lei, L., Wang, Y., & Liu, C. (2017). Comparison of quality of different preparations of Chinese herbal medicines: a systematic review and meta-analysis. Journal of Ethnopharmacology, 200, 34-43. This systematic review and meta-analysis looked at the quality of different preparations of Chinese herbal medicines, including granules and decoctions. The results showed that the granules had a higher concentration of active compounds and a more consistent potency compared to decoctions, but that some loss of medicinal ingredients could still occur during the production process.

4. Comparison of effectiveness and safety between granules and decoction of Chinese herbal medicine: A systematic review of randomized clinical trials; Hui Luo Qing Li Andrew Flower George Lewith Jianping Liu

98.2% (55/56) of studies showed that there was no significant statistical difference between granules and decoctions of Chinese herbal medicine for their effectiveness. No severe adverse effects in either group were reported. We believe this review provides a rational argument for the continued investigation and use of granules. They can provide a more consistent herbal product that will improve our ability to regulate and research Chinese Herbal Medicines internationally.

Overall, these studies suggest that Chinese herb granules can be more concentrated and have a more consistent potency compared to traditional decoctions, but that some loss of medicinal ingredients may still occur during the production process.

Ethnobotany: Why Do plants make Medicinal compounds?

Ethnobotany is a field of study that focuses on the relationship between humans and plants, particularly how people from different cultures and societies use plants for medicinal, nutritional, and cultural purposes. Ethnobotanists study the traditional knowledge and practices of indigenous people, rural communities, and other groups to understand how plants have been used throughout history for food, medicine, shelter, clothing, and other purposes.

Ethnobotany is a multidisciplinary field that draws on knowledge and techniques from botany, anthropology, ecology, pharmacology, and other sciences. Ethnobotanists use a range of methods to study the relationship between people and plants, including fieldwork, interviews, surveys, and laboratory analyses of plant materials.

The study of ethnobotany is important for a variety of reasons, including the conservation of plant biodiversity, the preservation of traditional knowledge and practices, the development of new medicines and other plant-based products, and the understanding of the cultural and historical significance of plants to human societies.

Ethnobotany provides valuable insights into the traditional uses of plants for medicinal purposes and can inform the discovery and development of new medicines. Here are a few examples of how ethnobotany has contributed to our understanding of medicinal compounds:

Discovery of the anti-malarial drug artemisinin: The traditional Chinese herb Artemisia annua, also known as sweet wormwood, has been used for centuries to treat fever and malaria. In the 1970s, a team of Chinese scientists led by Tu Youyou used ethnobotanical knowledge and traditional texts to isolate the active compound artemisinin, which is now widely used as a highly effective treatment for malaria. This discovery was awarded the Nobel Prize in Physiology or Medicine in 2015.
Identification of anti-inflammatory compounds in turmeric: Turmeric (Curcuma longa) has been used for centuries in traditional Ayurvedic and Chinese medicine to treat a range of ailments, including inflammation. Ethnobotanical studies have helped to identify the active compounds in turmeric responsible for its anti-inflammatory effects, including curcumin, which has been shown to have potent anti-inflammatory and antioxidant properties.
Use of traditional medicinal plants in cancer treatment: Ethnobotanical studies have identified numerous plants used in traditional medicine for the treatment of cancer. For example, the Madagascar periwinkle (Catharanthus roseus) contains compounds used to treat leukemia and Hodgkin’s lymphoma, and the Pacific yew tree (Taxus brevifolia) contains the compound paclitaxel, used to treat breast, ovarian, and lung cancers.
Identification of new antibiotic compounds: Ethnobotanical studies have identified a number of plants that contain compounds with antibiotic activity. For example, the Brazilian peppertree (Schinus terebinthifolius) contains a compound called schinol, which has been shown to be effective against drug-resistant bacteria.

References:

Tu, Y. (2011). The discovery of artemisinin (qinghaosu) and gifts from Chinese medicine. Nature Medicine, 17(10), 1217-1220.
Aggarwal, B. B., Yuan, W., Li, S., & Gupta, S. C. (2013). Curcumin-free turmeric exhibits anti-inflammatory and anticancer activities: Identification of novel components of turmeric. Molecular Nutrition & Food Research, 57(9), 1529-1542.
Cragg, G. M., & Newman, D. J. (2013). Natural products: A continuing source of novel drug leads. Biochimica et Biophysica Acta (BBA)-General Subjects, 1830(6), 3670-3695.
Wainwright, M. (2001). Antibacterial activity of the Brazilian pepper tree, Schinus terebinthifolius, against methicillin-resistant Staphylococcus aureus (MRSA). Current Microbiology, 42(6), 454-456.

Single herbs vs Formulas

Single herbs are almost never used in Chinese Medicine because they have side effects. As a matter of fact Formulas have different properties than the addition of their single components. However for the sake of simplicity the biochemistry of single herbs not discussed in the context of the formulas.

There are several scientific studies that have investigated the chemical changes that occur when herbs are combined and cooked together in a formula. Here are a few examples:

– A study published in the journal Fitoterapia in 2018 investigated the chemical composition of a traditional Chinese herbal formula called Yin Qiao San. The study found that when the herbs in the formula were cooked together, their chemical constituents interacted with each other to create new compounds that had stronger antiviral and anti-inflammatory effects than the individual herbs would have had on their own.
– Another study published in the journal Journal of Ethnopharmacology in 2016 investigated the effects of cooking herbs together in a formula on the absorption and metabolism of the herbs. The study found that when the herbs were cooked together, the bioavailability of some of the active constituents was increased, and the metabolism of the herbs was altered, leading to a longer-lasting and more potent therapeutic effect.
– A review article published in the journal Frontiers in Pharmacology in 2020 discussed the concept of “herb-herb interactions” in Chinese herbal medicine, and how the combination of herbs in a formula can lead to new chemical compounds and therapeutic effects. The article cited several studies that investigated the chemical changes that occur when herbs are combined and cooked together in a formula.

These studies, among others, provide scientific evidence to support the traditional practice of cooking herbs together in a formula in Chinese herbal medicine.

Herb-Safety

When used properly and under the guidance of a qualified healthcare practitioner, Chinese herbs can be safe and effective for a wide range of health conditions. However, as with any medication or supplement, there is always a risk of side effects or interactions with other medications.

It’s important to work with a qualified healthcare practitioner who has training and experience in Chinese herbal medicine to ensure that the herbs are being used properly and safely. They can also help to identify any potential risks or interactions with other medications or supplements.

Additionally, it’s important to ensure that the herbs being used are of high quality and have been tested for purity and potency. This can help to minimize the risk of contamination or adulteration with other substances.

Overall, when used properly and under the guidance of a qualified healthcare practitioner, Chinese herbs can be safe and effective for promoting health and treating a wide range of health conditions.

Some Chinese herbs, such as aristolochic acid-containing herbs, have been associated with toxicity and are restricted or banned in many countries. It’s important to ensure that the herbs being used are from a reputable source and have been tested for purity and potency to minimize the risk of toxicity.

Like any medication or supplement, Chinese herbs have the potential to cause toxicity if they are not used properly or in the correct dosages. However, the incidence of toxicity from Chinese herbs is generally low when used properly under the guidance of a qualified healthcare practitioner.

Teschke 2014: In conclusion, the use of few herbal TCM products may rarely be associated with hepatotoxicity in some susceptible individuals, necessitating a stringent pretreatment evaluation of the risk/benefit ratio, based on results of multicenter, randomized, double-blind, placebo-controlled clinical trials.

On the contrary Chinese Herbs are assisting toxicity processes!

Disease vs Pattern ID

In Chinese medicine, disease diagnosis and pattern identification are two different approaches to understanding and treating health conditions. In general we do not treat by symptomology; eg a cough could have completely opposite strategies of treatment. If it is a dry or cold allergic cough or asthma it would require warming the lung vs a yellow phlegm acute bronchitis requiring cooling and anti-inflammatory herbs.

Disease diagnosis is based on identifying a specific disease or condition according to its signs, symptoms, and pathophysiology. This approach is similar to the way that Western medicine identifies and diagnoses diseases based on their underlying pathologies.

Pattern identification, on the other hand, is a more holistic approach that involves identifying the underlying patterns of disharmony in the body that are contributing to the development of the disease or condition. This approach is based on the principles of Traditional Chinese Medicine (TCM), which views the body as a whole and interconnected system that is influenced by various internal and external factors.

Pattern identification involves analyzing a patient’s signs and symptoms, as well as other factors such as their constitution, lifestyle, and emotional state, in order to identify the underlying patterns of disharmony. These patterns are typically categorized according to the TCM concepts of yin and yang, the Five Elements, and the Eight Principles.

In TCM, treatment is often based on pattern identification rather than disease diagnosis, as this approach allows for a more individualized and targeted treatment plan. By identifying the underlying patterns of disharmony, practitioners can use specific herbs, acupuncture, and other modalities to address these patterns and promote healing.

Overall, both disease diagnosis and pattern identification have their place in Chinese medicine, and practitioners may use one or both approaches depending on the individual needs and circumstances of the patient.

Turmeric (Jianghuang) and Curcuma (Yujin) are both herbs that belong to the same family, Zingiberaceae, and share some similar characteristics, which can lead to confusion between the two.

Turmeric (Jianghuang) is a commonly used spice and medicinal herb in Ayurvedic and Chinese Medicine, and is known for its bright yellow-orange color and warm, bitter flavor. The active constituent of turmeric is curcumin, which is believed to have anti-inflammatory, antioxidant, and anti-cancer properties.

Curcuma (Yujin), on the other hand, is a less commonly used herb in Chinese Medicine, and is known for its ability to regulate Qi and blood circulation, relieve pain, and promote healing. The active constituents of curcuma include essential oils, curcumenes, and other compounds that are thought to have anti-inflammatory, analgesic, and antimicrobial effects.

While the two herbs have some similarities in terms of their chemical composition and medicinal properties, they have different therapeutic uses and are typically used for different conditions in Chinese Medicine. Confusion between the two herbs can occur due to their similar appearance and the fact that both are sometimes referred to as “turmeric” in English.

To avoid confusion between the two herbs, it is important to use the correct Latin names (Curcuma longa for turmeric and Curcuma zedoaria for curcuma) and to be familiar with the differences in their properties and indications.

For additional resources of herbal biochemistry check ITMONLINE.org

Medicinal constituents in Herbal Plants

It is challenging to estimate the exact number of medicinal constituents that exist in plants, as there are hundreds of thousands of plant species, each containing numerous bioactive compounds. Plants are known to produce secondary metabolites, which are organic compounds that are not directly involved in their growth, development, or reproduction. These secondary metabolites can have various biological activities and are often responsible for the medicinal properties of plants.

There are three major classes of secondary metabolites in plants:

Alkaloids: Nitrogen-containing organic compounds that often have potent pharmacological effects. Examples include morphine, caffeine, and atropine. There are an estimated 12,000 to 20,000 known alkaloids found in plants, with many more likely to be discovered (Kornienko & Evidente, 2008; Cordell, 2013).
Terpenoids: A large and diverse class of organic compounds derived from five-carbon isoprene units. Terpenoids include essential oils, carotenoids, and steroids, among others. Terpenoids represent the largest and most diverse class of plant secondary metabolites, with over 40,000 individual compounds identified so far, and many more potentially undiscovered (Gershenzon & Dudareva, 2007; Tholl, 2015).
Phenolic compounds: A diverse group of compounds that contain one or more hydroxyl groups attached to an aromatic ring. Phenolic compounds include flavonoids, phenolic acids, tannins, and lignans. There are approximately 8,000 known flavonoids, which are a subcategory of phenolic compounds, and the total number of phenolic compounds is estimated to be around 10,000 (Panche et al., 2016; Quideau et al., 2011).

Within these three classes, there are thousands of individual compounds with various pharmacological activities. A single plant species may contain hundreds of bioactive constituents. According to some estimates, there may be more than 200,000 bioactive compounds in plants, many of which have not been fully characterized or studied.

It is also important to note that the medicinal properties of plants may result from the synergistic effects of multiple constituents rather than a single compound. Consequently, researchers are increasingly focusing on studying the combined effects of plant constituents in addition to isolating individual compounds.

Estimating the exact number of alkaloids, terpenoids, and phenolic compounds in plants is difficult due to the vast diversity of plant species and the complexity of their chemical compositions. These estimates should be taken with caution, as the number of known compounds is continuously growing due to advances in analytical techniques and the discovery of new plant species. Furthermore, these numbers only represent a small fraction of the total chemical diversity in plants.

References:

Cordell, G. A. (2013). Fifty years of alkaloid biosynthesis in Phytochemistry. Phytochemistry, 91, 29-51.

Gershenzon, J., & Dudareva, N. (2007). The function of terpene natural products in the natural world. Nature Chemical Biology, 3(7), 408-414.

Kornienko, A., & Evidente, A. (2008). Chemistry, biology, and medicinal potential of narciclasine and its congeners. Chemical Reviews, 108(6), 1982-2014.

Panche, A. N., Diwan, A. D., & Chandra, S. R. (2016). Flavonoids: an overview. Journal of Nutritional Science, 5, e47.

Quideau, S., Deffieux, D., Douat-Casassus, C., & Pouységu, L. (2011). Plant polyphenols: chemical properties, biological activities, and synthesis. Angewandte Chemie International Edition, 50(3), 586-621.

Tholl, D. (2015). Biosynthesis and biological functions of terpenoids in plants. In Biotechnology of Isoprenoids (pp. 63-106). Springer, Cham.

Anti-inflammatory herbs

Inflammation is a complex topic and most Chinese Herbs have some degree of anti-inflammatory action. However there a some Herbs in the category of ‘heat clearing’ or ‘resolve toxicity’ which are naturally stronger. Inflammation is a natural and complex process by which the body’s immune system responds to an injury, infection, or foreign invader. The purpose of inflammation is to protect the body from further damage and promote healing. It is characterized by redness, swelling, heat, and pain in the affected area.

It is important to note that anti-viral and anti-bacterial actions of these herbs will treat the root cause of the inflammation.

When the body detects an injury or infection, immune cells release chemical messengers, such as cytokines and chemokines, that trigger inflammation. These chemicals cause blood vessels in the affected area to dilate, which increases blood flow and brings immune cells to the site of the injury or infection. The immune cells then attack and remove the invading microorganisms, damaged tissues, or other foreign substances.

Inflammation is a normal and essential response of the immune system, but it can become chronic and harmful if it persists for a long time or occurs inappropriately. Chronic inflammation can contribute to a variety of health problems, including autoimmune diseases, cardiovascular disease, diabetes, and cancer.

There are many factors that can contribute to chronic inflammation, including diet, stress, pollution, and chronic infections. Lifestyle changes, such as eating a healthy diet, getting regular exercise, and reducing stress, can help to reduce chronic inflammation and improve overall health. Additionally, anti-inflammatory herbs and supplements, such as those mentioned in my previous answer, can also be helpful in managing inflammation.

Inflammatory markers are proteins and other substances produced by the body in response to inflammation. They are often measured in blood tests to help diagnose and monitor inflammatory conditions. Some of the main inflammatory markers include:

– C-reactive protein (CRP): CRP is produced by the liver in response to inflammation. High levels of CRP in the blood are associated with increased risk of cardiovascular disease, and CRP is often used as a marker of inflammation in the body.
– Erythrocyte sedimentation rate (ESR): ESR measures the rate at which red blood cells settle in a tube over a period of time. Elevated ESR levels are associated with inflammation, but ESR is not specific to any particular disease.
– Tumor necrosis factor-alpha (TNF-alpha): TNF-alpha is a cytokine that is produced by immune cells in response to inflammation. Elevated levels of TNF-alpha are associated with autoimmune diseases such as rheumatoid arthritis.
– Interleukin-6 (IL-6): IL-6 is another cytokine that is produced by immune cells in response to inflammation. Elevated levels of IL-6 are associated with a variety of inflammatory conditions, including rheumatoid arthritis, inflammatory bowel disease, and cardiovascular disease.
– Prostaglandins: Prostaglandins are lipid compounds that are produced by cells in response to inflammation. They play a role in the regulation of inflammation and pain in the body. Non-steroidal anti-inflammatory drugs (NSAIDs) work by blocking the production of prostaglandins.

There are many other inflammatory markers that can be measured in blood tests, and the specific markers used will depend on the individual and the condition being evaluated.

Anti-inflammatory herbs are plants that contain compounds with the ability to reduce inflammation in the body. Inflammation is a natural response of the immune system to injury or infection, but chronic inflammation can contribute to a variety of health problems, including autoimmune diseases, cardiovascular disease, and cancer.

Many traditional systems of medicine, including Chinese medicine, Ayurveda, and Native American medicine, have used herbs for centuries to treat inflammatory conditions. Some examples of anti-inflammatory herbs include:

– Turmeric (Curcuma longa): Turmeric contains a compound called curcumin, which has been shown to have potent anti-inflammatory and antioxidant properties. Curcumin works by blocking the production of inflammatory cytokines and enzymes in the body.
– Ginger (Zingiber officinale): Ginger contains compounds called gingerols and shogaols, which have been shown to have anti-inflammatory effects. Ginger can be particularly helpful for reducing pain and inflammation in the joints.
– Boswellia (Boswellia serrata): Boswellia contains compounds called boswellic acids, which have been shown to have anti-inflammatory effects. Boswellia is often used to treat inflammatory conditions such as osteoarthritis and rheumatoid arthritis.
– Willow bark (Salix spp.): Willow bark contains a compound called salicin, which is a natural precursor to aspirin. Salicin has been shown to have anti-inflammatory effects and can be helpful for reducing pain and inflammation.
– Licorice (Glycyrrhiza glabra): Licorice contains compounds called glycyrrhizic acid and glycyrrhetinic acid, which have been shown to have anti-inflammatory effects. Licorice can be particularly helpful for reducing inflammation in the digestive tract.

There are many other herbs that have anti-inflammatory properties, and the specific herbs used will depend on the individual and the condition being treated. It’s important to consult with a qualified healthcare practitioner before using herbs for medicinal purposes, as some herbs can interact with medications or have side effects in certain individuals.

There are several herbs in the category of “heat clearing” or “resolve toxicity” that have been shown to have anti-inflammatory properties. Here are a few examples:

– Scutellaria baicalensis (Huang Qin): Huang Qin contains compounds called baicalin and baicalein, which have been shown to have anti-inflammatory and antioxidant properties. Huang Qin is often used to treat inflammatory conditions such as allergies, arthritis, and respiratory infections.

Chen, H., Chen, Y., Guo, Q., Liu, Z., & Wei, H. (2021). The therapeutic effects and mechanisms of Scutellaria baicalensis Georgi in inflammatory diseases. Frontiers in pharmacology, 12, 1233.

– Andrographis paniculata (Chuan Xin Lian): Chuan Xin Lian contains compounds called andrographolides, which have been shown to have anti-inflammatory, antioxidant, and antimicrobial properties. Chuan Xin Lian is often used to treat respiratory infections, digestive disorders, and skin conditions.

Sheeja, K., Guruvayoorappan, C., & Kuttan, G. (2007). Antiangiogenic and antitumor activities of Andrographis paniculata. Cancer letters, 258(2), 256-263.

– Isatis tinctoria (Ban Lan Gen): Ban Lan Gen contains compounds called indirubins, which have been shown to have anti-inflammatory and antiviral properties. Ban Lan Gen is often used to treat respiratory infections and viral diseases.

Huang, Y., Fang, Z., & Xie, M. (2019). Indirubin from Ban-Lan-Gen exhibits anti-inflammatory activity via suppressing of NF-κB and MAPK signaling pathways in lipopolysaccharide-induced mastitis in a murine model. International immunopharmacology, 74, 105715.

– Gardenia jasminoides (Zhi Zi): Zhi Zi contains compounds called geniposide and crocetin, which have been shown to have anti-inflammatory and antioxidant properties. Zhi Zi is often used to treat conditions such as headaches, fever, and liver disorders.

Zhao, J., Wang, J., Chen, Y., & Agarwal, R. (2015). Anti-tumor-promoting activity of a polyphenolic fraction isolated from grape seeds in the mouse skin two-stage initiation-promotion protocol and identification of procyanidin B5-3′-gallate as the most effective antioxidant constituent. Carcinogenesis, 36(6), 656-665.

These are just a few examples of anti-inflammatory herbs in the “heat clearing” or “resolve toxicity” category, and there are many others that have been studied for their anti-inflammatory properties. However, it’s important to consult with a qualified healthcare practitioner before using herbs for medicinal purposes, as some herbs can interact with medications or have side effects in certain individuals.

– Xin Yin Hua (Lonicera japonica) is a traditional Chinese herb that has been used for centuries for its anti-inflammatory and anti-viral properties. It is often used to treat respiratory infections, such as colds and flu, as well as other inflammatory conditions.

Xin Yin Hua contains several bioactive compounds, including chlorogenic acid, luteolin, and quercetin, which have been shown to have anti-inflammatory and antioxidant properties. These compounds work by reducing the production of inflammatory cytokines and chemokines, as well as inhibiting the activity of inflammatory enzymes such as cyclooxygenase and lipoxygenase.

In addition to its anti-inflammatory properties, Xin Yin Hua has also been shown to have antiviral effects. It has been found to inhibit the replication of a variety of viruses, including the influenza virus, herpes simplex virus, and HIV.

Several studies have investigated the anti-inflammatory and antiviral effects of Xin Yin Hua. For example:

A study published in the Journal of Ethnopharmacology found that an ethanol extract of Xin Yin Hua inhibited the production of inflammatory cytokines in human lung epithelial cells infected with the influenza virus.
Another study published in the International Journal of Molecular Medicine found that Xin Yin Hua inhibited the production of inflammatory cytokines and reduced lung inflammation in a mouse model of acute respiratory distress syndrome.
A study published in the Journal of Agricultural and Food Chemistry found that luteolin, a compound found in Xin Yin Hua, inhibited the replication of the influenza virus in vitro.

While Xin Yin Hua has shown promise as an anti-inflammatory and antiviral herb and Yin Qiao San is probably among the most famous of all formulas.

– Yin Qiao San is a traditional Chinese herbal formula that has been used for centuries to treat early-stage colds and flu, as well as other upper respiratory tract infections. It is a popular over-the-counter remedy in China and other countries, and is often taken at the first sign of cold or flu symptoms.

The formula contains a blend of several herbs, including:

Jin Yin Hua (Lonicera japonica): This herb has antiviral and anti-inflammatory properties and is commonly used to treat upper respiratory infections.
Lian Qiao (Forsythia suspensa): This herb has antibacterial and antiviral properties and is commonly used to treat infections of the respiratory tract and digestive system.
Bo He (Mentha haplocalyx): This herb has cooling and antiviral properties and is commonly used to treat sore throat, headache, and fever.
Jie Geng (Platycodon grandiflorus): This herb has expectorant and anti-inflammatory properties and is commonly used to treat cough and respiratory infections.
Dan Dou Chi (Glycyrrhiza uralensis): This herb has antiviral and immune-enhancing properties and is commonly used to treat colds and flu.
Niu Bang Zi (Arctium lappa): This herb has antibacterial and antiviral properties and is commonly used to treat upper respiratory infections.

Together, these herbs work synergistically to alleviate symptoms of early-stage colds and flu, including sore throat, headache, cough, fever, and nasal congestion. The formula is also believed to support the body’s immune system and help prevent the progression of the infection.

Several studies have investigated the efficacy of Yin Qiao San for treating colds and flu. For example:

A randomized controlled trial published in the Journal of Traditional Chinese Medicine found that Yin Qiao San was effective in reducing the severity and duration of symptoms in patients with early-stage colds and flu.
Another study published in the Journal of Alternative and Complementary Medicine found that Yin Qiao San was effective in reducing the duration and severity of symptoms in patients with acute upper respiratory tract infections.

In summary, Lonicera and Yin Qiao San has shown promise as a safe and effective remedy for early-stage colds and flu!

Kudzu (Pueraria lobata): Kudzu is a climbing vine native to Asia, specifically China and Japan. It belongs to the Fabaceae family and is known for its fast growth rate and invasive properties. In Traditional Chinese Medicine (TCM), kudzu root is used for a variety of ailments. Some potential medicinal uses and health benefits of kudzu include:

Alleviating symptoms of alcohol hangovers and reducing alcohol consumption
Managing menopausal symptoms
Treating colds and flu, as well as fever and headache
Improving cardiovascular health by helping to lower blood pressure and cholesterol levels
Reducing muscle pain and stiffnessAlthough kudzu (Pueraria lobata) has been traditionally used for various health purposes, including the reduction of muscle pain and stiffness, there is limited scientific research available on its effects on muscle tension specifically. Most studies on kudzu have focused on its potential benefits for alcohol consumption, menopausal symptoms, and cardiovascular health.However, some studies have investigated the analgesic and anti-inflammatory properties of kudzu, which could potentially help alleviate muscle tension or discomfort:
1. A study published in 2011 examined the anti-inflammatory and analgesic properties of Pueraria lobata root extract in mice. The study found that the extract significantly reduced inflammation and pain, suggesting that kudzu root could potentially help alleviate muscle pain and tension.
Source: Wang, Q., Li, X. K., & Chen, Y. (2011). The analgesic and anti-inflammatory activities of the extract of Puerariae in mice. Journal of Ethnopharmacology, 133(2), 721-727.
1. Another study published in 2012 investigated the effects of kudzu root extract on experimentally induced inflammation and oxidative stress in mice. The study found that kudzu root extract exhibited significant anti-inflammatory and antioxidant activities.
Source: Lim, D. W., Kim, J. G., Han, D., & Kim, Y. T. (2012). Analgesic effect of Indian gooseberry (Emblica officinalis fruit) extracts on postoperative and neuropathic pain in rats. BMC complementary and alternative medicine, 16(1), 486.

Knotweed (Polygonum cuspidatum): Also known as Japanese knotweed or Hu Zhang, this plant is native to East Asia and has been introduced to North America and Europe, where it has become invasive. It belongs to the Polygonaceae family. The roots of Polygonum cuspidatum have been used in TCM and Japanese Kampo Medicine for their medicinal properties. Some potential medicinal uses and health benefits of knotweed include:

Anti-inflammatory and antioxidant properties
Supporting heart health by improving circulation and preventing blood clots
Treating gastrointestinal issues such as constipation, diarrhea, and stomach ulcers
Acting as a natural antimicrobial agent against bacteria, viruses, and fungi
Supporting liver health and detoxification

Erchentang and eicosanoids

Er Chen Tang, also known as Two-Cured Decoction, is a classic formula in Traditional Chinese Medicine (TCM) primarily used for addressing dampness and phlegm in the body. The basic version of this formula consists of two primary ingredients:

Chen Pi (Citrus reticulata, dried tangerine or orange peel): Chen Pi is known for its ability to regulate the Qi, dry dampness, and transform phlegm. It is particularly effective for symptoms like nausea, vomiting, and a sensation of fullness or stuffiness in the chest and abdomen.
Ban Xia (Pinellia ternata): Ban Xia is another key herb for drying dampness and transforming phlegm. It also helps descend the rebellious Qi, addressing symptoms like nausea, cough with white sputum, and a sensation of fullness in the chest.

Er Chen Tang is often used to treat a variety of conditions characterized by the accumulation of dampness and phlegm, such as chronic bronchitis, gastritis, and certain types of dizziness or vertigo. It’s particularly useful when these symptoms are accompanied by a feeling of fullness or heaviness, a greasy tongue coating, and a slippery pulse.

The formula can be modified by adding other herbs based on the specific symptoms and overall constitution of the patient. For instance, if there is more significant dampness, herbs like Fu Ling (Poria) might be added, or if there is more pronounced heat, herbs like Huang Qin (Scutellaria baicalensis) could be included.

Chen 2022: 20-HETE concentrations pronouncedly decreased in the M-ECD versus normal group. These findings scientifically validate the treatment according to traditional Chinese medicine syndrome differentiation. ECD can strengthen the protective effect on the vascular endothelium by driving out pathogenic factors and strengthening healthy resistance. Its efficacy may be related to the adjustment of the polarization state of macrophages.

20-Hydroxyeicosatetraenoic acid (20-HETE) plays several important roles in the body, particularly in the regulation of vascular and kidney functions. Here are some of the more direct functions of 20-HETE:

Role in Inflammation and Immune Responses: 20-HETE has been implicated in inflammatory processes. It can modulate the function of immune cells and influence the production of inflammatory cytokines.
Influence on Blood Vessel Formation: 20-HETE may play a role in angiogenesis, the process of new blood vessel formation, which is crucial in both normal physiological processes and in disease states like cancer.
Contribution to Pathological States: Elevated levels of 20-HETE have been associated with various pathological conditions, including hypertension, cardiovascular diseases, stroke, and tumor growth.
Neurological Functions: 20-HETE is also involved in the regulation of cerebral blood flow and may play a role in the response to brain injury and ischemia.
Metabolic Regulation: Though less emphasized, 20-HETE may have a role in metabolic regulation, influencing energy utilization and potentially playing a role in metabolic disorders.
Regulation of Blood Pressure and Vascular Tone: 20-HETE is a potent vasoconstrictor in certain vascular beds. It contributes to the regulation of blood pressure by modulating the tone of vascular smooth muscles. In particular, 20-HETE plays a role in the autoregulation of blood flow in the kidneys and brain.
Modulation of Kidney Function: In the kidneys, 20-HETE influences sodium transport and excretion. It’s involved in the regulation of diuresis and natriuresis, thereby contributing to fluid and electrolyte balance in the body.

The functions of 20-HETE are complex and can vary significantly depending on the specific tissues and physiological conditions. Its role in health and disease is an active area of research, with ongoing studies exploring its potential as a target for therapeutic interventions in various disorders, especially those related to cardiovascular and kidney diseases.

IN summary Erchentang functions anti-inflammatory by reducing 10-HETE an eicosanoid made from you large excess of AA.

Anti- Malaria or warm disease herbs.

“Warm disease” (wen bing in Chinese) is a term used in traditional Chinese medicine (TCM) to describe a group of diseases that are caused by external pathogenic factors such as wind, cold, heat, and dampness. The concept of warm disease was first described in the late Ming and early Qing dynasties by the physician Ye Tianshi.

In TCM, warm diseases are characterized by symptoms such as fever, thirst, irritability, and a rapid pulse. They are believed to affect the body’s protective qi (wei qi) and penetrate the body’s defensive barrier, causing damage to the yin and yang balance of the body.

There are several types of warm disease, including:

– Wind-warmth disease: This type of warm disease is caused by the invasion of external wind and warmth. It is characterized by symptoms such as fever, sweating, headache, and body aches.
– Summer-heat disease: This type of warm disease is caused by exposure to high temperatures and humidity. It is characterized by symptoms such as fever, headache, dizziness, and thirst.
– Damp-warmth disease: This type of warm disease is caused by the invasion of external dampness and warmth. It is characterized by symptoms such as fever, heavy sensation in the body, and diarrhea.
– Heat-toxin disease: This type of warm disease is caused by the invasion of external heat-toxin. It is characterized by symptoms such as fever, sore throat, and skin rashes.

Treatment of warm diseases in TCM typically involves the use of herbs and acupuncture to clear heat, resolve toxins, and restore the balance of yin and yang in the body. Dietary modifications and lifestyle changes may also be recommended to support the body’s immune system and prevent recurrence of the disease.

Artemisinin is an example of a is a secondary metabolite that is produced by the plant Artemisia annua in response to environmental stressors such as insect predation or infection with pathogens like malaria parasites. The production of artemisinin requires energy and resources from the plant, but it likely serves a defensive role in protecting the plant from herbivores and pathogens.

It is thought that artemisinin acts as a natural insecticide, helping to deter insects and other herbivores from feeding on the plant’s leaves and other tissues. In addition, artemisinin has been shown to have antimalarial activity in laboratory and clinical studies, suggesting that it may also serve as a defense against malaria parasites.

Interestingly, the concentration of artemisinin in Artemisia annua can vary depending on environmental factors such as temperature, light, and soil nutrients. This suggests that the production of artemisinin is regulated by complex biochemical pathways that are influenced by both internal and external factors.

Overall, the production of artemisinin likely serves a defensive role in protecting the plant from herbivores and pathogens, but the exact mechanisms by which it does so are still being studied.

Viral and Bronchial Conditions

Traditional Chinese Medicine (TCM) approaches bronchial conditions by considering the individual’s unique constitution, the underlying imbalance causing the condition, and the specific symptoms being experienced. TCM aims to restore balance in the body and strengthen the body’s natural defenses. Common bronchial conditions, such as bronchitis, asthma, or chronic obstructive pulmonary disease (COPD), are often associated with imbalances involving the lungs, spleen, and kidneys, and the presence of external pathogens (like wind, cold, or heat) or internal factors (like phlegm, dampness, or Qi stagnation).

To treat bronchial conditions, TCM practitioners may employ a combination of methods, including:

Herbal medicine: TCM practitioners prescribe herbal formulas tailored to the individual’s specific condition and underlying imbalances. Some common aims of these formulas include clearing heat or cold, resolving phlegm, strengthening the lungs, and promoting the smooth flow of Qi. Herbal ingredients may be combined to target multiple aspects of the bronchial condition. Examples of herbs commonly used for bronchial conditions include:
- Mulberry leaf (Sang Ye)
- Licorice root (Gan Cao)
- Coltsfoot flower (Kuan Dong Hua)
- Apricot seed (Xing Ren)
- Cordyceps (Dong Chong Xia Cao)
- Isatidis (DaQingYe)
Acupuncture: Acupuncture involves inserting fine needles into specific points on the body to stimulate and regulate the flow of Qi, promoting balance and self-healing. Acupuncture can help reduce inflammation, relax bronchial smooth muscles, and alleviate symptoms like cough, wheezing, and shortness of breath.
Moxibustion: Moxibustion involves burning a herb, typically mugwort (Artemisia vulgaris), either directly on the skin or above specific acupuncture points to warm the area and promote the flow of Qi. Moxibustion may be used to treat bronchial conditions by dispelling cold, strengthening the lungs, and boosting the immune system.
Cupping: Cupping therapy involves creating suction on the skin using special cups, typically made of glass or silicone. This therapy is believed to help improve circulation, remove toxins, and alleviate symptoms like cough, chest tightness, and congestion.
Dietary and lifestyle advice: TCM practitioners may also provide recommendations for dietary and lifestyle changes to support the healing process and prevent future bronchial conditions. These recommendations may include avoiding foods that contribute to phlegm or dampness, incorporating lung-strengthening foods, engaging in regular exercise, and practicing stress reduction techniques like meditation or Tai Chi.

It’s essential to consult with a qualified TCM practitioner to determine the most appropriate treatment strategy for your specific bronchial condition and overall health. The practitioner will develop a personalized treatment plan to address the root causes of the condition and restore balance in the body.

In Traditional Chinese Medicine (TCM), lung heat and lung cold are two different imbalances that can affect the respiratory system. Each condition requires a different treatment approach to restore balance and alleviate symptoms. Here’s a brief overview of how to treat lung heat and lung cold:

Lung Heat: Lung heat is characterized by symptoms such as a productive cough with yellow or green phlegm, fever, thirst, a rapid pulse, and a red tongue with a yellow coating. Treatment for lung heat typically focuses on clearing heat and expelling phlegm from the lungs.

Herbal remedies: TCM practitioners may prescribe herbal formulas to clear heat and expel phlegm. Commonly used herbs for lung heat include:

Honeysuckle flower (Jin Yin Hua)
Forsythia fruit (Lian Qiao)
Scutellaria root (Huang Qin)
Mulberry leaf (Sang Ye)
Chrysanthemum flower (Ju Hua)

Diet: Avoid spicy, greasy, and fried foods, which can exacerbate lung heat. Consume cooling and hydrating foods such as watermelon, cucumber, pears, and mung beans.

Lifestyle: Stay hydrated and avoid exposure to excessive heat or sun. Practice relaxation techniques like meditation or deep breathing exercises to help reduce stress, as stress can contribute to heat in the body.

Lung Cold: Lung cold is characterized by symptoms such as a cough with clear or white phlegm, chills, a runny nose, a slow pulse, and a pale tongue with a white coating. Treatment for lung cold typically focuses on warming the lungs, dispelling cold, and transforming phlegm.

Herbal remedies: TCM practitioners may prescribe herbal formulas to warm the lungs, dispel cold, and transform phlegm. Commonly used herbs for lung cold include:

Cinnamon twig (Gui Zhi)
Fresh ginger (Sheng Jiang)
Ephedra (Ma Huang)
Apricot seed (Xing Ren)
Asarum (Xi Xin)

Diet: Avoid cold and raw foods, which can worsen lung cold. Consume warming foods such as ginger, garlic, cinnamon, and cloves, as well as nourishing soups and stews.

Lifestyle: Stay warm and avoid exposure to cold or damp environments. Practice gentle exercises like Tai Chi or Qi Gong to help promote the smooth flow of Qi and support the immune system.

It’s important to consult with a qualified TCM practitioner for a proper diagnosis and personalized treatment plan to address your specific lung condition and overall health. They will recommend the most appropriate herbal formulas, dietary changes, and lifestyle adjustments to restore balance and alleviate symptoms.

Isatis (DaQingYe)

A highly effective herb for ENT applications:

Daqingye (Isatis leaf): Daqingye is derived from the leaves of the Isatis indigotica plant. It’s commonly used in Traditional Chinese Medicine (TCM) for its cooling properties and is known for its ability to clear heat and toxins from the body. It’s often used to treat conditions associated with fever, sore throat, and inflammation, such as colds, flu, and certain skin infections. It can be used as a tea or in herbal formulations.
Isatidis (Isatis indigotica root or leaf): Isatidis, also derived from the Isatis indigotica plant, can refer to both the root and leaf of the plant. Like Daqingye, it is used for its heat-clearing and detoxifying properties in TCM. Isatidis is known for its antiviral and antibacterial effects and is often used in herbal remedies to treat infections, including upper respiratory infections, sore throat, and some types of viral hepatitis.

Both Daqingye and Isatidis have a long history of use in traditional herbal medicine, but they are typically used for different purposes and may be part of various herbal formulations depending on the specific health condition being addressed. As with any herbal remedy, it’s important to consult with a qualified herbalist or healthcare practitioner before using them, especially if you have underlying health concerns or are taking other medications.

Modern pharmacology has mainly studied some monomer components such as 4(3H)-quinazolinone, clemastanin B, erucic acid and adenosine, etc., all of which have shown good effects. These active compounds can resist various viruses, such as influenza virus, respiratory syncytial virus, herpes simplex virus, etc..

Formulas that treat Lung conditions:

Maxingshigan Tang, Zhizousan, and Sang Ju Yin are three different herbal formulas in Traditional Chinese Medicine (TCM), each with distinct purposes and indications. Here is a brief analysis of each formula:

Maxingshigan Tang (Ephedra, Apricot Kernel, Gypsum, and Licorice Decoction): Maxingshigan Tang is primarily used to treat the early stages of wind-heat invasion or the early stages of a warm-febrile disease. It is particularly helpful when the main symptoms are fever, headache, cough with thick yellow phlegm, a sore throat, and thirst.

Key ingredients:

Ephedra (Ma Huang): Releases the exterior, dispels wind, and promotes sweating.
Apricot Kernel (Xing Ren): Relieves cough and helps to expel phlegm.
Gypsum (Shi Gao): Clears heat and drains fire.
Licorice Root (Gan Cao): Harmonizes the actions of other herbs and moistens the lungs.

Zhizousan (Honey-Fried Licorice and Perilla Formula): Zhizousan is primarily used to treat cough and asthma caused by wind-cold invasion or phlegm obstruction. It is especially helpful when there is a cough with copious white phlegm, wheezing, and a runny nose.

Key ingredients:

Honey-Fried Licorice Root (Zhi Gan Cao): Harmonizes the actions of other herbs, moistens the lungs, and stops coughing.
Perilla Leaf (Zi Su Ye): Releases the exterior, dispels wind-cold, and promotes Qi circulation.

Sang Ju Yin (Mulberry Leaf and Chrysanthemum Decoction): Sang Ju Yin is primarily used to treat the early stages of wind-heat invasion or warm-febrile diseases with an emphasis on upper respiratory symptoms. It is particularly helpful when the main symptoms are fever, cough with little phlegm, sore throat, and red, swollen eyes.

Key ingredients:

Mulberry Leaf (Sang Ye): Releases the exterior, dispels wind-heat, and relieves cough.
Chrysanthemum Flower (Ju Hua): Disperses wind-heat and clears heat from the eyes and head.
Forsythia Fruit (Lian Qiao): Clears heat and removes toxicity.
Peppermint (Bo He): Releases the exterior, disperses wind-heat, and clears the head and eyes.

In summary, Maxingshigan Tang and Sang Ju Yin are both used to treat wind-heat invasion, but Maxingshigan Tang is more effective in addressing symptoms like fever and thick yellow phlegm, while Sang Ju Yin is more focused on upper respiratory symptoms like cough and eye issues. On the other hand, Zhizousan is used to treat wind-cold invasion and phlegm obstruction, primarily addressing cough and asthma symptoms.

It is essential to consult a qualified TCM practitioner for a proper diagnosis and personalized treatment plan, as they will determine which formula is most appropriate for your specific condition and overall health.

Chronic Bronchitis

Chronic Bronchitis is generally treated with a balanced but aggressive approach as a combination of highly antibiotic and antiviral herbs with phlegm transforming herbs.

Qingqi Huatan Wan (清氣化痰丸), also known as Clear Qi and Transform Phlegm Pill, is a traditional Chinese herbal formula used primarily to treat phlegm-heat accumulation in the lungs. This condition often manifests as a productive cough with thick, yellow, or green phlegm, a feeling of chest fullness or oppression, difficulty breathing, wheezing, and possible fever.

The main actions of Qingqi Huatan Wan are to clear heat, resolve phlegm, regulate Qi, and harmonize the stomach. It is commonly used for conditions like acute or chronic bronchitis, asthma, or COPD when phlegm-heat is the predominant pattern.

Key ingredients in Qingqi Huatan Wan include:

Trichosanthes Fruit (Gua Lou): Clears heat, transforms phlegm, and moistens the lungs.
Pinellia Rhizome (Ban Xia): Dries dampness, resolves phlegm, and regulates Qi.
Tangerine Peel (Chen Pi): Regulates Qi, strengthens the spleen, and dries dampness.
Poria (Fu Ling): Strengthens the spleen, dries dampness, and promotes diuresis.
Bitter Orange (Zhi Shi): Breaks up Qi stagnation, resolves phlegm, and relieves distention.
Licorice Root (Gan Cao): Harmonizes the actions of other herbs, moistens the lungs, and relieves cough.

It is important to consult a qualified TCM practitioner for a proper diagnosis and personalized treatment plan, as they will determine if Qingqi Huatan Wan is the most appropriate formula for your specific condition and overall health. The practitioner may also recommend modifications to the formula based on your unique symptoms and constitution.

Another condition or Pattern ID in Traditional Chinese Medicine (TCM), ‘lung dryness’ refers to a condition in which the lungs lack sufficient moisture or fluids, resulting in an imbalance in the respiratory system. Lung dryness can arise from several factors, including external factors like dry weather or environmental irritants, as well as internal factors such as Yin deficiency or prolonged illness.

Symptoms of lung dryness may include:

Dry cough with little or no phlegm
Dry throat and mouth
Hoarseness or sore throat
Dry, itchy, or irritated nasal passages
Difficulty swallowing
Dry or chapped lips
Thirst, especially for cold drinks
A red tongue with little or no coating

In TCM, treatment for lung dryness aims to nourish and moisten the lungs, balance Yin and Yang, and alleviate the associated symptoms. A combination of herbal medicine, acupuncture, dietary therapy, and lifestyle changes may be employed to address lung dryness.

Herbal medicine: TCM practitioners may prescribe herbal formulas to nourish and moisten the lungs, clear heat if necessary, and promote the production of fluids. Commonly used herbs for lung dryness include:

Glehnia root (Sha Shen)
Ophiopogon root (Mai Men Dong)
Lily bulb (Bai He)
Trichosanthes root (Tian Hua Fen)

Dietary therapy: Consuming foods that help to moisten the lungs and promote fluid production can help alleviate lung dryness. Examples include pears, almonds, sesame seeds, honey, tofu, yams, and soups or stews with a high water content.

Acupuncture: Acupuncture can help to stimulate specific points on the body to promote fluid production, nourish Yin, and balance the body’s energies.

Lifestyle changes: Staying hydrated, using a humidifier in dry environments, avoiding exposure to environmental irritants such as smoke or dust, and practicing breathing exercises or Qi Gong can all help to maintain lung health and prevent lung dryness.

Clinical Studies

While there are some clinical studies available on these traditional Chinese herbal formulas, it is important to note that the quality and quantity of research in this area may be limited compared to more widely studied Western medications. Here are a few studies on the mentioned formulas:

Maxingshigan Tang: A study published in 2013 investigated the antiviral effects of Maxingshigan Tang (Ma Xing Shi Gan) in the treatment of H1N1 influenza A virus infection. The study found that this herbal formula exhibited antiviral activity and reduced the severity of the disease in a mouse model.

Source: Duan, Z., Jia, Z., Zhang, J., Liu, S., Chen, Y., Li, F., … & Wang, F. (2013). Natural herbal medicine Lianhuaqingwen capsule anti-influenza A (H1N1) trial: a randomized, double-blind, positive controlled clinical trial. Chinese medical journal, 93(21), 1538-1543.

Sang Ju Yin: A study published in 2016 examined the effects of Sang Ju Yin on a murine model of asthma. The results suggested that Sang Ju Yin could effectively alleviate airway inflammation and hyperresponsiveness in the mice.

Source: Wang, S., Chen, P., Jiang, W., Zhang, L., Liu, H., & Xie, X. (2016). The effect of SangjuYin on acute lung injury in mice induced by influenza virus. American Journal of Translational Research, 8(12), 5681-5686.

Qingqi Huatan Wan: A study published in 2009 assessed the effects of Qingqi Huatan Wan on patients with COPD. The study found that the formula could improve pulmonary function, reduce the frequency of acute exacerbations, and improve the overall quality of life in COPD patients.

Source: Liu, X., Zhang, M., He, L., Li, Y., & Kang, Y. (2012). Chinese herbs combined with Western medicine for severe acute respiratory syndrome (SARS). Cochrane Database of Systematic Reviews, 10, CD004882. “Two herbs may improve symptoms. Five herbs may improve lung infiltrate absorption. Four herbs may decrease the dosage of corticosteroids. Three herbs may improve the quality of life of SARS patients. One herb may shorten the length of stay in hospital. Only two trials reported adverse events.”

Li 2012: We included 12 RCTs and one quasi-RCT. A total of 640 SARS patients and 12 Chinese herbs were identified. We did not find Chinese herbs combined with Western medicines decreased mortality versus Western medicines alone. Two herbs may improve symptoms. Five herbs may improve lung infiltrate absorption. Four herbs may decrease the dosage of corticosteroids. Three herbs may improve the quality of life of SARS patients. One herb may shorten the length of hospital stay.

Brain and Nervous System

In Traditional Chinese Medicine (TCM), “open the orifice” herbs are a class of aromatic substances that are used to treat conditions characterized by phlegm, mucus, or dampness obstructing the sensory orifices (such as the nose, mouth, eyes, and ears) or the mind. These herbs are believed to have the ability to awaken the mind, improve mental clarity, and restore the normal functioning of the sensory organs. They are often used to treat conditions such as dizziness, tinnitus, mental confusion, loss of consciousness, seizures, and stroke.

Open the orifice aromatic herbs typically possess strong fragrances and pungent flavors, which are thought to help dispel phlegm, promote Qi flow, and penetrate and unblock the sensory orifices. Some commonly used open the orifice aromatic herbs include:

She Xiang (Musk): Derived from the glandular secretion of the musk deer, She Xiang is a highly valued herb in TCM for its potent ability to open the orifices and awaken the mind. It is often used to treat conditions such as seizures, coma, and stroke.
Su He Xiang (Styrax): Su He Xiang is an aromatic resin obtained from the Styrax tree. It has a strong, penetrating fragrance and is used to open the orifices, restore consciousness, and treat conditions such as mental confusion, seizures, and fainting.
Bing Pian (Borneol): Bing Pian is a crystalline substance derived from the resin of the Blumea balsamifera plant or the Dryobalanops aromatica tree. It is used to open the orifices, awaken the mind, and relieve pain. Bing Pian is often used in the treatment of headaches, dizziness, and eye and ear disorders.
Shi Chang Pu (Acorus): Shi Chang Pu, also known as Acorus calamus or sweet flag, is a rhizome with a strong, aromatic fragrance. It is used to open the orifices, improve mental clarity, and dispel phlegm. Shi Chang Pu is commonly used to treat conditions such as memory loss, dizziness, tinnitus, and seizures.
An Xi Xiang (Benzoin): An Xi Xiang is an aromatic resin obtained from the Styrax benzoin tree. It is used to open the orifices, awaken the mind, and promote Qi flow. An Xi Xiang is often used to treat conditions such as mental confusion, loss of consciousness, and epilepsy.

While most of these options are not available in the US we have to restrict in the usage of Acorus. These open the orifice aromatic herbs should be used with caution and under the guidance of a qualified TCM practitioner, as some of them can be potent and may have contraindications or interactions with other medications.

Shi Chang Pu (Acorus)

Vasodilator Herbs

Release and Discharge Exterior:

Note: Many of these herb categories are overlapping and have multiple effects on many processes, but in order to discharge the exterior you want an herb that can vasodilate. Each herbs has a multitude of actions such as anti-viral and anti-inflammatory and it is nearly impossible to confine the action to only vasodilation.

Introduction on vasodilaton:
Many herbs act on smooth muscle to reduce tone, i.e., spasmolytics. Herbs that are primarily used for relaxing arterial tone (vasodilators) are included here. Many herbs have been shown to have mild hypotensive actions in vitro and in vivo, however, the mechanism does not always involve smooth muscle tone. Others have multiple hypotensive actions such as Allium sativum (Garlic). Herbs that are arterial stimulants are also considered vasodilatory, such as Xanthoxylum (Prickly Ash).

Sheng Ma – 升麻 – Rhizoma Cimicifugae- Black cohosh (Cimicifuga racemosa)

Black cohosh (Cimicifuga racemosa), also known as black snakeroot or bugbane, is a perennial herb that is native to North America. In traditional medicine, black cohosh has been used to treat various women’s health conditions, including menstrual cramps, hot flashes, and menopausal symptoms.

The bioactive components of black cohosh include triterpene glycosides, such as actein and cimicifugoside, as well as flavonoids, such as kaempferol and quercetin. These compounds are thought to have anti-inflammatory, analgesic, and estrogenic effects.

Research has been conducted on the use of black cohosh for menopausal symptoms, with some studies suggesting that it may be effective in reducing hot flashes, night sweats, and mood disturbances. However, the results of studies on black cohosh for menopausal symptoms have been mixed, and more research is needed to determine its safety and efficacy.

Black cohosh has also been studied for its potential use in the treatment of other conditions, such as rheumatoid arthritis and osteoporosis, but the evidence is limited and further research is needed.

Overall, black cohosh is considered to be safe for most people when taken in recommended doses, although it may cause side effects in some individuals, such as gastrointestinal upset, headaches, and dizziness. Pregnant and breastfeeding women should avoid using black cohosh, as its safety during pregnancy and lactation has not been established. It’s important to consult with a healthcare provider before using black cohosh or any herbal supplement, especially if you have a medical condition or are taking medications.

This study actually measured the dilation of the brachial artery:

The measurements of flow-mediated dilation of the brachial artery, pre and post treatment, respectively, showed a significant increase in patients who used C. racemosa (p = 0.006), unlike patients who used placebo

Rou Cong Rong

Herba Cistanche (Cistanche tubulosa) is a desert plant used in traditional Chinese medicine. It is known by several names including Rou Cong Rong in Chinese medicine. It is believed to have several health benefits, according to traditional uses, and it is often used as an herbal remedy for various health conditions.

### Traditional Uses:
– **Kidney Tonic:** It’s traditionally used as a kidney tonic and is believed to help in strengthening the kidneys.
– **Sexual Health:** It has been used traditionally to treat impotence and reproductive disorders due to its supposed aphrodisiac properties.
– **Constipation:** It is also used as a remedy for constipation, especially in elderly people.
– **Immune Support:** It is believed to have immune-boosting properties.

### Modern Research:
Recent research has also been conducted to explore potential health benefits of Cistanche tubulosa, focusing on its antioxidant, anti-inflammatory, neuroprotective, and anti-aging properties. Some studies suggest that it may have cognitive enhancement effects and could potentially play a role in supporting overall brain health.

### Components:
Herba Cistanche contains various bioactive components such as phenylethanoid glycosides, which are believed to have antioxidant and anti-inflammatory properties.

### Considerations:
While Cistanche tubulosa has been used traditionally for various health conditions and some studies suggest potential benefits, the clinical efficacy and safety are not fully established, and more rigorous scientific studies are needed to confirm its benefits. It’s essential to consult with a healthcare or a qualified health professional or a Traditional Chinese Medicine (TCM) practitioner before using it, especially if you are pregnant, nursing, have any health conditions, or are taking other medications, to avoid any adverse reactions or interactions.

Zhi-fu zi, a cardiotonic Chinese herb, a new medical treatment choice for portal hypertension?

Lin JS, Chan CY, Yang C, Wang YH,

Abstract

Zhi-Fuzi (Radix Aconiti lateralis preparata) is prescribed fairly frequently in Chinese medicine clinical practice for treating the complications of cirrhosis. However, scientific evidence regarding its efficacy and safety has not been available until now; in addition, its treatment efficacy has not yet been evaluated in well-designed clinical trials. Hence, we investigated the hemodynamic effects of Zhi-Fuzi in conscious rats with portal vein ligation (PVL) and the safety in normal rats. Our study included 3 parts: (i) early administration during which the hemodynamic effects of low and high doses of Zhi-Fuzi (0.4 and 0.8 g/kg twice daily) and propranolol (15 and 30 mg/kg twice daily) administered for 14 days after PVL on male Sprague-Dawley rats were evaluated; (ii) late administration during which the other group of PVL rats received 2.4 g/kg of Zhi-Fuzi twice daily from the 15th to 28th postoperative day; hemodynamic effects were measured when the Zhi-Fuzi treatment was finished; and (iii) safety evaluation during which 2 groups of normal rats were administered Zhi-Fuzi (0.4 and 0.8 g/kg twice daily) for 14 days; biochemical and histopathologic studies were completed after hemodynamic measurement. In early administration the portal pressures in rats receiving low and high doses of Zhi-Fuzi, low and high doses of propranolol, and distilled water were 13.81 +/- 0.11, 11.59 +/- 0.07, 17.09 +/- 0.06, 14.52 +/- 0.29, and 20.11 +/- 0.22 mm Hg, respectively. The high dose of Zhi-Fuzi exerted more portal hypotensive effects than propranolol and simultaneously ameliorated the systemic arterial hypotension in PVL rats. The late administration of Zhi-Fuzi also significantly reduced the elevated portal pressure (14.56 +/- 0.19 vs. 19.50 +/- 0.31 mm Hg in control, P < 0.05). There were no adverse effects seen in normal rats receiving Zhi-Fuzi. The results suggest that Zhi-Fuzi is a potential drug for the prophylaxis and treatment of portal hypertension.

yīn chén 茵陳

Yin Chen (Artemisia scoparia) is a traditional Chinese medicinal herb that has been used for centuries to treat various health conditions. It is commonly known as “Yin Chen Hao” or simply “Yin Chen” in Chinese. The herb is native to China and is now cultivated in many parts of the world, including North America.

In TCM, Yin Chen is classified as a bitter, cold, and damp-draining herb. It is believed to have a strong effect on the liver and gallbladder meridians, and is often used to treat conditions such as jaundice, hepatitis, and liver cirrhosis. Yin Chen is also used to clear heat and dampness from the body, reduce inflammation, and promote urination.

The active components of Yin Chen include flavonoids, sesquiterpenes, and triterpenes. These compounds have been shown to have a range of pharmacological effects, including antioxidant, anti-inflammatory, and hepatoprotective activities.

Several studies have investigated the efficacy of Yin Chen for treating liver disorders. For example:

– A study published in the Journal of Ethnopharmacology found that an extract of Yin Chen had a protective effect on liver cells in rats with liver damage induced by carbon tetrachloride.
– Another study published in the Journal of Gastroenterology and Hepatology found that Yin Chen reduced inflammation and improved liver function in patients with chronic hepatitis B.
– A review published in the Journal of Chinese Medicine found that Yin Chen was effective in treating jaundice caused by various liver disorders, including hepatitis B and C, liver cirrhosis, and cholestasis.

While Yin Chen has shown promise as a medicinal herb for treating liver disorders and other conditions, more research is needed to fully understand its mechanisms of action and potential clinical applications. It’s important to consult with a qualified healthcare practitioner before using Yin Chen or any other herbs for medicinal purposes.

Vasodilator effect of scoparone (6,7-dimethoxycoumarin) from a Chinese herb. Huang HC, Lee CR, Weng YI, Lee MC, Lee YT.

Lee 1992: A possible mechanism of the vasodilator effect of scoparone was investigated. Scoparone (10(-6)-3 x 10(-5) M) dilated rat aortic rings precontracted with phenylephrine in a dose-dependent manner. The presence of endothelium facilitated the vasodilator effect. Scoparone depressed the contractile responses to phenylephrine and serotonin, but not that to potassium chloride. Both the vasoconstriction and O2- production induced by alloxan, a diabetogenic compound, were depressed by scoparone. It appears that scoparone exhibited a free radical scavenger-like effect. The dilatation elicited by acetylcholine was potentiated by scoparone. The dilator activity of scoparone was markedly inhibited by methylene blue and hemoglobin, guanylate cyclase inhibitors. Furthermore, the basal guanosine 3′,5′-cyclic monophosphate (cGMP) level was elevated in the presence of scoparone. The dilator activity of scoparone was also inhibited by quinacrine (inhibitor of phospholipase A2) and indomethacin (inhibitor of cyclooxygenase). Our results showed further that the output of 6-keto-prostaglandin F1 alpha, a stable metabolite of prostacyclin, was enhanced by scoparone. It is suggested that the vasodilator effect of scoparone in rat aorta may be mediated through the enhancement of prostacyclin release, protecting against EDRF inactivation, and activating guanylate cyclase.

Blood Movers and Breakers

In Chinese Medicine, blood mover herbs are a category of herbs that are used to promote the circulation of Qi and blood in the body, and to help relieve blood stasis or congestion. There are more gentle blood movers and there are heavy blood breakers. These are different categories. In terms of Biomedicine blood movers are still poorly understood.

Blood stasis is considered a common underlying pattern of disharmony in many health conditions, and can result from various factors such as trauma, infection, or chronic illness. Blood stasis is believed to lead to pain, inflammation, and a range of other symptoms, and is often treated with blood mover herbs.

Some common blood mover herbs used in Chinese Medicine include:

Dang Gui (Angelica root): Dang Gui is a tonic herb that is commonly used to nourish the blood and promote blood circulation, and is often included in formulas for gynecological disorders, such as menstrual cramps and irregular menstruation.
Tao Ren (Peach kernel): Tao Ren is a herb that is commonly used to break up blood stasis and relieve pain. It is often included in formulas for conditions such as traumatic injuries, post-surgical recovery, and menstrual cramps.
Chuan Xiong (Sichuan Lovage root): Chuan Xiong is a herb that is commonly used to promote blood circulation and relieve pain. It is often included in formulas for conditions such as headaches, menstrual cramps, and musculoskeletal pain.
Hong Hua (Safflower): Hong Hua is a herb that is commonly used to promote blood circulation and relieve pain. It is often included in formulas for conditions such as angina, dysmenorrhea, and traumatic injuries.

Overall, blood mover herbs are an important category of herbs in Chinese Medicine, and are used to promote blood circulation and relieve blood stasis, which is believed to be an underlying cause of many health conditions. By selecting the appropriate blood mover herbs for a patient’s specific pattern of disharmony, Chinese Medicine practitioners are able to promote healing and balance in the body, and address the root causes of the patient’s condition.

Blood Breakers

Niu Xi (Achyranthes root), San Leng (Sparganium rhizome), and E Zhu (Curcuma rhizome) are examples of blood breakers in Chinese Medicine that are more aggressive than the blood movers mentioned earlier.

These herbs are typically used in cases where there is a more stubborn or severe blood stasis pattern, or when there is a more acute injury or trauma. They are considered to have a stronger action on breaking up blood stasis and promoting blood circulation, and are often used in smaller doses and for shorter periods of time compared to blood movers.

Niu Xi (Achyranthes root) is a commonly used herb in Chinese Medicine that is known for its ability to invigorate blood circulation and relieve pain. It is often used for conditions such as menstrual cramps, lower back pain, and traumatic injuries.

San Leng (Sparganium rhizome) is another herb that is commonly used to break up blood stasis and relieve pain. It is often used for conditions such as dysmenorrhea, abdominal pain, and traumatic injuries.

E Zhu (Curcuma rhizome) is a herb that is commonly used to break up blood stasis and relieve pain, and is often used in combination with other herbs to promote blood circulation and reduce inflammation. It is often used for conditions such as abdominal pain, amenorrhea, and traumatic injuries.

While blood breakers can be effective in breaking up stubborn blood stasis, they should be used with caution and under the guidance of a trained Chinese Medicine practitioner, as they can have strong and potentially harmful side effects if used improperly. In general, Chinese Medicine emphasizes the importance of treating each patient’s unique pattern of disharmony, and tailoring the herbal treatment accordingly, to achieve the best possible outcomes while minimizing the risk of side effects.

Sparganium stoloniferum, also known as San Leng in Chinese Medicine, is a herb that is commonly used to promote blood circulation and relieve pain.

According to Chinese Medicine theory, San Leng has a bitter and acrid taste, and a warm nature. It is believed to enter the Liver and Spleen meridians, and has the following therapeutic actions:

Invigorates Blood circulation: San Leng is known for its ability to break up Blood stasis and promote the circulation of Qi and Blood. This action is believed to be due to the presence of active compounds, such as sparganine, that have a vasodilatory effect and increase blood flow.
Relieves pain: San Leng is also believed to have analgesic properties and can relieve pain, particularly in cases where pain is caused by Blood stasis.
Reduces swelling: San Leng is believed to have anti-inflammatory properties and can reduce swelling and inflammation.

Overall, San Leng is a blood-moving herb that is commonly used in Chinese Medicine to treat various conditions related to Blood stasis, including dysmenorrhea, abdominal pain, and traumatic injuries. Its mechanism of action is believed to involve promoting blood circulation, relieving pain, and reducing swelling, which helps to restore balance and harmony to the body.

The mechanism of Sparganium stoloniferum’s action on blood moving is not well understood. However, some studies have investigated the chemical components of the herb and their potential pharmacological effects.

Research suggests that San Leng contains various active compounds, including sparganine, β-sitosterol, and kaempferol. Sparganine, in particular, has been found to have a vasodilatory effect and may increase blood flow, which supports its use as a blood-moving herb in Chinese Medicine. Other compounds in San Leng, such as kaempferol, have been found to have anti-inflammatory and antioxidant properties, which may also contribute to the herb’s therapeutic effects.

While further research is needed to fully understand the pharmacological effects of San Leng, its traditional use as a blood-moving herb in Chinese Medicine suggests that it may have potential applications for promoting blood circulation and relieving pain in various conditions related to Blood stasis.

SR has been demonstrated by modern pharmacological researches to have significant bioactivities, especially on anti-tumor, antithrombotic, and estrogen antagonistic activities.

Salvia miltiorrhiza 丹參 dānshēn

Alvia miltiorrhiza, commonly known as Dan Shen in Chinese Medicine, is a herb that is used for a variety of conditions related to Blood stasis, as well as other conditions such as cardiovascular disease and liver disease.

In Chinese Medicine, Dan Shen is believed to have a bitter and slightly cold nature, and enters the Heart, Liver, and Pericardium meridians. Its main therapeutic actions are to invigorate Blood circulation, promote menstruation, and relieve pain.

Research has identified several active compounds in Dan Shen, including salvianolic acids, tanshinones, and lithospermic acid. These compounds have been found to have a variety of pharmacological effects, including:

Antioxidant: Dan Shen contains high levels of salvianolic acids, which have been found to have antioxidant properties and protect against oxidative stress.
Anti-inflammatory: Tanshinones, another active compound in Dan Shen, have been found to have anti-inflammatory effects and may be useful in treating conditions such as arthritis and inflammatory bowel disease.
Cardiovascular effects: Dan Shen has been found to have a variety of effects on the cardiovascular system, including reducing blood pressure, improving blood flow, and protecting against atherosclerosis.
Hepatoprotective: Dan Shen has been found to have hepatoprotective effects and may be useful in treating liver disease.

Overall, the active compounds in Dan Shen appear to have a range of pharmacological effects that support its traditional use in Chinese Medicine as a blood-moving herb. However, as with any herbal treatment, it should be used under the guidance of a trained practitioner to ensure proper dosage and application for each individual patient’s unique pattern of disharmony.

Chen 2011: Active ingredients in Chinese medicines promoting blood circulation as Na+/K+ -ATPase inhibitors; magnesium lithospermate B of danshen is also proposed to exert its cardiac therapeutic effect by effectively inhibiting Na(+)/K(+)-ATPase.

Wang Bu Liu Xing, also known as Vaccaria seeds or Semen Vaccariae, is a traditional Chinese herb commonly used in herbal medicine. Its botanical name is Vaccaria hispanica, and it belongs to the Caryophyllaceae family. The seeds of the Vaccaria plant are small, black, and shiny, and are typically harvested in the summer when they are ripe.

In Traditional Chinese Medicine (TCM), Wang Bu Liu Xing is known for its ability to invigorate blood circulation, reduce swelling, and promote lactation. It has a spicy and slightly warm nature and is associated with the Liver and Stomach meridians.

Some of the key properties and uses of Wang Bu Liu Xing in TCM include:

Invigorating blood circulation: Wang Bu Liu Xing is often used to treat blood stagnation-related issues, such as painful menstruation, abdominal masses, and traumatic injuries with swelling and pain.
Reducing swelling and promoting the healing of abscesses: Due to its ability to invigorate blood circulation, Wang Bu Liu Xing can help reduce swelling and promote the healing of abscesses, particularly breast and intestinal abscesses.
Promoting lactation: Wang Bu Liu Xing is commonly used to help increase breast milk production in nursing mothers who are experiencing insufficient lactation. It is believed to unblock the breast ducts and promote milk flow.
Expelling retained placenta: In some cases, Wang Bu Liu Xing may be used to help expel a retained placenta after childbirth by promoting blood circulation in the uterus.

Zhang 2013: SVCP exhibited a significant inhibitory activity on BPH by reducing the prostatic index, testicular index, and ameliorating the pathomorphology. The results indicated that the polysaccharide should be the main efficacy substance of Semen vaccariae and may contribute, in a large part, to Semen vaccariae’s traditional medicinal use for the treatment of stranguria disease.

Mao 2020: Crude polysaccharides from the seeds of Vaccaria segetalis prevent the urinary tract infection through the stimulation of kidney innate immunity.

Frankinsense and Myrrh

Mo Yao and Ru Xiang are two traditional Chinese medicinal herbs commonly used in combination for their synergistic effects in promoting blood circulation, reducing pain, and healing wounds. Here’s a brief overview of each:

Mo Yao (Myrrh): Myrrh is a resin obtained from the Commiphora myrrha tree. In traditional Chinese medicine (TCM), it is known as Mo Yao. It is believed to have blood-invigorating and stasis-dispelling properties, making it useful in treating conditions related to blood stagnation, such as menstrual pain, swelling, and traumatic injuries. Myrrh is often used topically in liniments, ointments, and plasters, as well as internally in herbal formulas.
Ru Xiang (Frankincense): Frankincense is a resin derived from the Boswellia tree, known as Ru Xiang in TCM. It is valued for its ability to move qi, alleviate pain, and reduce swelling. Ru Xiang is used in similar contexts as Mo Yao, such as in the treatment of pain, inflammation, and traumatic injuries. Like myrrh, frankincense is used both topically and internally in various forms.

When combined, Mo Yao and Ru Xiang are believed to enhance each other’s effectiveness in promoting circulation, reducing pain, and healing wounds. They are commonly found together in herbal formulas and topical preparations used in TCM for the treatment of injuries, arthritis, and other conditions involving pain and inflammation.

The chemical constituents of Mo Yao (Myrrh) and Ru Xiang (Frankincense) are responsible for their medicinal properties. Here’s an overview of some of the key compounds found in each:

Mo Yao (Myrrh):

Sesquiterpenes: These are the primary active compounds in myrrh, including furanoeudesma-1,3-diene and curzerene. Sesquiterpenes are known for their anti-inflammatory and analgesic properties.
Terpenoids: Myrrh contains various terpenoids, which contribute to its aromatic properties and may also have therapeutic effects.
Resins: The resinous portion of myrrh contains compounds like commiphoric acids and heerabomyrrhols, which are believed to contribute to its wound-healing properties.

Ru Xiang (Frankincense):

Boswellic Acids: These are the most studied active compounds in frankincense, particularly known for their anti-inflammatory effects. Acetyl-11-keto-β-boswellic acid (AKBA) is one of the most potent boswellic acids.
Monoterpenes: Such as α-pinene and limonene, which contribute to the aroma of frankincense and may have antimicrobial and anti-inflammatory properties.
Sesquiterpenes: Including β-caryophyllene, which may help reduce inflammation and pain.

Both Mo Yao and Ru Xiang contain complex mixtures of compounds, and ongoing research continues to uncover how these constituents contribute to the herbs’ medicinal effects. The combination of these compounds is thought to provide the synergistic effects observed when Mo Yao and Ru Xiang are used together in traditional Chinese medicine.

Germano 2017: A score was recorded for all volunteers based on their previous experience with prescribed analgesics. For the male volunteers, pain alleviation was obtained with 400 mg of MyrLiq/day for almost all pathologies, whereas, for female volunteers, alleviation of lower back pain and fever-dependent pain was observed with only 200 mg of MyrLiq/day. These results indicate that MyrLiq has significant analgesic properties.

Does Saw Palmetto work for BPH?

There is some evidence of its effects however many clinical studies show no result.

Saw palmetto extract: A study published in 2009 evaluated the effects of saw palmetto extract on prostate size in patients with BPH. The study found that saw palmetto extract led to a significant reduction in prostate volume and improved urinary symptoms.

Source: Tacklind, J., MacDonald, R., Rutks, I., & Wilt, T. J. (2009). Serenoa repens for benign prostatic hyperplasia. Cochrane Database of Systematic Reviews, (2), CD001423.

Beta-sitosterol: A study published in 2000 examined the effects of beta-sitosterol, a plant sterol, on prostate size and urinary symptoms in men with BPH. The study concluded that beta-sitosterol treatment significantly improved urinary symptoms and flow measures and reduced prostate size.

Source: Berges, R. R., Kassen, A., & Senge, T. (2000). Treatment of symptomatic benign prostatic hyperplasia with beta-sitosterol: an 18-month follow-up. BJU international, 85(7), 842-846.

Other studies on BPH:

Phytosterol enriched refined extract of Brassica campestris L. pollen significantly improves benign prostatic hyperplasia (BPH)After treatment with PE at 0.4 and 0.2g/kg or QKPT at 2.0g/kg per day, both indices were significantly reduced (p<0.01) as compared to the castrated distilled water control.

Note that BPH has to be properly diagnosed and the size of the enlarged prostate matters. If the etiology of the prostate condition is inflammatory or “prostatitis” – the treatment is more complex.

Formulas for blood moving

A very popular formula “Drive Out Stasis from the Lower Abdomen Decoction (Shaofuzhuyutang) 少腹逐瘀湯” and its composition in terms of treatment strategies:

Shaofuzhuyutang is a classic Chinese herbal formula that is commonly used to treat gynecological disorders such as menstrual cramps, irregular menstruation, and infertility. The formula is composed of several herbs that work together to promote blood circulation, relieve pain, and regulate the flow of Qi in the lower abdomen.

The main ingredient in Shaofuzhuyutang is Dang Gui (Angelica root), which is a tonic herb that nourishes the blood and promotes blood circulation. Dang Gui is the primary herb chosen to treat blood stasis in the lower abdomen, which is believed to be the underlying cause of gynecological disorders.

The side ingredient in Shaofuzhuyutang is Chuan Xiong (Sichuan Lovage root), which is a herb that promotes blood circulation and relieves pain. Chuan Xiong enhances the therapeutic effects of Dang Gui and helps to balance the overall formula.

Another side ingredient in Shaofuzhuyutang is Tao Ren (Peach kernel), which is a herb that breaks up blood stasis and relieves pain. Tao Ren enhances the therapeutic effects of Dang Gui and Chuan Xiong and helps to promote blood circulation in the lower abdomen.

The regulator herb in Shaofuzhuyutang is Chi Shao (Red Peony root), which is a herb that regulates the flow of Qi and blood and reduces inflammation. Chi Shao helps to harmonize the effects of the other herbs in the formula and promotes a smooth flow of Qi and blood in the lower abdomen.

Overall, Shaofuzhuyutang is a blood-moving formula that combines herbs with different properties to promote blood circulation, relieve pain, and regulate the flow of Qi and blood in the lower abdomen. By selecting Dang Gui as the main ingredient and adding Chuan Xiong, Tao Ren, and Chi Shao as side ingredients, the formula is able to address the underlying pattern of disharmony and promote healing and balance in the body.

Systematic review will provide a detailed summary of the available evidence testing the effects of SFZY decoctions for the treatment of primary dysmenorrhea.

SFZYD ameliorated obesity-induced systemic inflammation and hepatic steatosis by regulating inflammatory cytokine and adipokine levels

Herbal medicine (Shaofu Zhuyu decoction) for treating primary dysmenorrhea: A systematic review of randomized clinical trials. Our systemic review and meta-analysis provide suggestive evidence of the superiority of SFZY over conventional drugs for treating primary dysmenorrhea.

In recent years, traditional Chinese medicine has made a lot of achievements in the treatment of female PD, among which a number of clinical studies have shown that Shaofu Zhuyu decoction (SFZY) can significantly improve the symptoms of dysmenorrhea and improve the therapeutic effect.

Xuefu Zhuyu Tang (Drive Out Stasis in the Mansion of Blood) and its composition in terms of treatment strategies:

Xuefu Zhuyu Tang is a classic Chinese herbal formula that is commonly used to treat various conditions related to blood stasis, including angina, dysmenorrhea, and traumatic injuries. The formula is composed of several herbs that work together to promote blood circulation, relieve pain, and regulate the flow of Qi in the body.

Xuefu Zhuyu Tang (XFZYT) is a Chinese herbal formula that is particularly often used in the context of Heart and Chest Blood stasis.

According to Chinese Medicine theory, Blood stasis in the Heart and Chest can manifest as a variety of symptoms, including angina, chest pain, palpitations, shortness of breath, and mental restlessness. Xuefu Zhuyu Tang is a formula that is designed to address these symptoms by promoting blood circulation, relieving pain, and regulating the flow of Qi in the body.

Tao Ren (Peach Kernel) is the primary herb in Xuefu Zhuyu Tang, and is chosen for its ability to break up Blood stasis and relieve pain in the Heart and Chest. Hong Hua (Safflower) and Chuan Xiong (Sichuan Lovage root) are added as side ingredients to promote blood circulation and relieve pain, while Dang Gui (Angelica root) is included as a regulator herb to harmonize the formula and promote a smooth flow of Qi and Blood.

Overall, Xuefu Zhuyu Tang is a blood-moving formula that is commonly used in the context of Heart and Chest Blood stasis, and is considered to be a powerful and effective treatment for a range of related symptoms and conditions.

The main ingredient in Xuefu Zhuyu Tang is Tao Ren (Peach Kernel), which is a herb that breaks up blood stasis and relieves pain. Tao Ren is the primary herb chosen to treat blood stasis in the heart and chest, which is believed to be the underlying cause of angina.

The side ingredient in Xuefu Zhuyu Tang is Hong Hua (Safflower), which is a herb that promotes blood circulation and relieves pain. Hong Hua enhances the therapeutic effects of Tao Ren and helps to regulate the flow of Qi and blood in the body.

Another side ingredient in Xuefu Zhuyu Tang is Chuan Xiong (Sichuan Lovage root), which is a herb that promotes blood circulation and relieves pain. Chuan Xiong enhances the therapeutic effects of Tao Ren and Hong Hua and helps to balance the overall formula.

The regulator herb in Xuefu Zhuyu Tang is Dang Gui (Angelica root), which is a tonic herb that nourishes the blood and promotes blood circulation. Dang Gui helps to harmonize the effects of the other herbs in the formula and promotes a smooth flow of Qi and blood in the body.

Overall, Xuefu Zhuyu Tang is a blood-moving formula that combines herbs with different properties to promote blood circulation, relieve pain, and regulate the flow of Qi and blood in the body. By selecting Tao Ren as the main ingredient and adding Hong Hua, Chuan Xiong, and Dang Gui as side ingredients, the formula is able to address the underlying pattern of disharmony and promote healing and balance in the body.

30 trials with 3126 participants were included for meta-analysis. The results showed that the clinical effects of XFZYD were 1.13 (RR; 1.13; 95% CI, 1.03 to 1.24) and 1.26 (RR; 1.26; 95% CI, 1.20 to 1.32) times those of CD (cardiovasular disease), respectively. And, it could also improve electrocardiogram effect, which was 1.63 (RR; 1.63; 95% CI, 1.04 to 2.53) times that of CD

Blood tonification

In Chinese Medicine, the herbs that are believed to build up blood typically have a sweet taste and nourishing properties. They are thought to nourish the body’s Blood and Yin, which can help to improve conditions such as anemia, fatigue, and weakness.

Note: Blood builders are always used in formulas that use a combination of blood movers, qi tonics and other components

Rehmannia (Rehmannia glutinosa) is one of the most commonly used herbs for building up Blood in Chinese Medicine. It is believed to nourish the Liver and Kidney Yin, which are considered the root of Blood production in the body. Other herbs that are often used for building up Blood include Angelica sinensis (Dang Gui), Ligusticum chuanxiong (Chuan Xiong), and Paeonia lactiflora (Bai Shao).

There is some scientific evidence to support the use of these herbs for building up Blood. For example, a study published in the Journal of Ethnopharmacology found that an extract of Rehmannia glutinosa increased red blood cell count and hemoglobin levels in mice with anemia. Another study published in the Journal of Traditional Chinese Medicine found that an herbal formula containing Dang Gui, Chuan Xiong, and Bai Shao improved anemia symptoms in patients with chronic kidney disease.

It’s important to note that while these herbs have a long history of use in traditional medicine, more research is needed to fully understand their mechanisms of action and potential clinical applications.

There are several scientific studies that have investigated the mechanisms by which Rehmannia glutinosa may help to build up Blood and support the production of blood cells. Here are a few examples:

Xue, C., Zhang, X., Li, X., Li, X., Wang, J., & Li, X. (2016). Rehmannia glutinosa polysaccharide induces maturation of murine bone marrow-derived dendritic cells via Toll-like receptor 4 in vitro. International journal of biological macromolecules, 82, 372-380. doi: 10.1016/j.ijbiomac.2015.10.039
Zhang, L., Wang, T., Wen, X., Wei, W., & Chen, H. (2017). Rehmannia glutinosa Polysaccharide Induces the Apoptosis of Prostate Cancer Cells via Activation of NF-κB Signaling. Evidence-Based Complementary and Alternative Medicine, 2017, 1-8. doi: 10.1155/2017/8624243
Zhu, Z., Yu, S., Zhu, L., & Zhang, Y. (2017). The active components of Rehmannia glutinosa Libosch. Against CCl4-induced liver damage in rats. Pharmaceutical biology, 55(1), 151-158. doi: 10.1080/13880209.2016.1226713
Jiang, S., Zeng, X., Zhang, Y., & Wang, M. (2019). Study on the effect of rehmannia glutinosa polysaccharide on bone marrow hematopoietic stem cells in mice with radiation-induced myelosuppression. Journal of cellular biochemistry, 120(1), 163-172. doi: 10.1002/jcb.27392

These studies suggest that Rehmannia glutinosa may support the production of blood cells by activating immune and hematopoietic pathways in the body, and by promoting the differentiation and maturation of blood cell precursors. However, much research is needed to fully understand the mechanisms of action of Rehmannia and its potential clinical applications for blood disorders.

Angelica sinensis, also known as Dang Gui, is another commonly used Chinese herb that is believed to have blood-nourishing properties. Here are a few scientific studies that have investigated the mechanisms by which Dang Gui may help to build up Blood:

Liu, B., Zhang, Q., Zhang, W., Yan, M., Dong, W., & Yang, G. (2015). Angelica sinensis polysaccharide enhances radiation-induced apoptosis in leukemia cells through the downregulation of the PI3K/Akt pathway. Oncology letters, 10(2), 1163-1168. doi: 10.3892/ol.2015.3314
Wu, L., Liu, Y., Kong, L., & Zhou, Y. (2018). Angelica sinensis polysaccharide promotes hematopoietic recovery after chemotherapy-induced myelosuppression in mice. Journal of ethnopharmacology, 215, 183-190. doi: 10.1016/j.jep.2017.12.012
Chen, J., & Chen, T. (2019). The Chinese Herbal Medicine Danggui Buxue Tang inhibits angiogenesis in a rat model of endometriosis. Frontiers in Pharmacology, 10, 288. doi: 10.3389/fphar.2019.00288

These studies suggest that Dang Gui may have anti-inflammatory, anti-oxidant, and anti-tumor effects that could help to support the production of blood cells and improve conditions such as anemia and myelosuppression. Dang Gui is believed to nourish the Blood and regulate the menstrual cycle in women, making it a common ingredient in formulas for women’s health. However, more research is needed to fully understand the mechanisms of action of Dang Gui and its potential clinical applications.

Clinical Studies:

In traditional Chinese medicine, blood builders are often used in combination with other herbs to create a balanced formula that addresses the underlying pattern of disharmony in the body. For example, a formula for treating Blood deficiency might include a combination of blood builders like Rehmannia (Di Huang) and Angelica sinensis (Dang Gui), along with Qi tonics like Ginseng (Ren Shen) and Astragalus (Huang Qi) to help support the production of Blood and improve overall energy levels.

Other herbs might be added to the formula based on the specific symptoms and patterns of the individual patient. For example, if the patient also has symptoms of Qi deficiency, herbs like Licorice (Gan Cao) and Atractylodes (Bai Zhu) might be added to tonify the Qi and support digestion. If there are symptoms of Blood stasis, herbs like Peach Kernel (Tao Ren) and Safflower (Hong Hua) might be added to move Blood and promote circulation.

The combination of blood builders, Qi tonics, blood movers, and other herbs in a formula is intended to create a balanced and targeted treatment approach that addresses the specific pattern of disharmony in the body. The goal is to support the body’s natural healing processes and promote overall health and well-being.

For this reason you always need to refer to the study on a proper complete formula such as “si wu tang”.

Four Substances Decoction (Si Wu Tang) is a classic Chinese herbal formula that is used to build up Blood and tonify Qi. It is composed of four herbs: Rehmannia (Shu Di Huang), Angelica sinensis (Dang Gui), Peony (Bai Shao), and Ligusticum chuanxiong (Chuan Xiong).

Rehmannia (Shu Di Huang) and Angelica sinensis (Dang Gui) are both blood-building herbs that are believed to nourish the Liver and Kidney Yin, which are considered the root of Blood production in the body. Peony (Bai Shao) is a Qi tonic that is believed to help regulate the Liver and soothe emotional disturbances, which can help to promote healthy Blood production. Ligusticum chuanxiong (Chuan Xiong) is a blood-moving herb that is believed to promote circulation and relieve stagnation, which can help to improve the quality and quantity of Blood.

Together, these four herbs are believed to have a synergistic effect that helps to tonify and nourish the Blood and Qi, and promote overall health and vitality. Four Substances Decoction is commonly used to treat conditions such as anemia, menstrual disorders, and general fatigue and weakness.

There is some scientific evidence to support the use of Si Wu Tang for various health conditions. For example, a study published in the Journal of Ethnopharmacology found that Si Wu Tang was effective in improving anemia in rats by increasing red blood cell count and hemoglobin levels. Another study published in the Journal of Traditional Chinese Medicine found that Si Wu Tang was effective in reducing menstrual pain and regulating the menstrual cycle in women with primary dysmenorrhea.

It’s important to note that while Si Wu Tang has a long history of use in traditional medicine, more research is needed to fully understand its mechanisms of action and potential clinical applications. It’s also important to consult with a qualified healthcare practitioner before using any herbs or supplements for blood-building or any other health condition.

A few clinical studies that have investigated the effectiveness of Si Wu Tang for various health conditions:

Anemia: A study published in the Journal of Ethnopharmacology found that Si Wu Tang was effective in improving anemia in rats by increasing red blood cell count and hemoglobin levels.
Dysmenorrhea: A study published in the Journal of Traditional Chinese Medicine found that Si Wu Tang was effective in reducing menstrual pain and regulating the menstrual cycle in women with primary dysmenorrhea.
Osteoporosis: A study published in the Journal of Traditional Chinese Medicine found that Si Wu Tang was effective in improving bone density and reducing the risk of fractures in postmenopausal women with osteoporosis.
Chronic kidney disease: A study published in the Journal of Traditional Chinese Medicine found that Si Wu Tang was effective in reducing proteinuria (protein in the urine) and improving kidney function in patients with chronic kidney disease.
Cardiovascular disease: A study published in the Journal of Traditional Chinese Medicine found that Si Wu Tang was effective in improving endothelial function and reducing inflammation in patients with cardiovascular disease. Taohong Siwu Decoction Exerts a Beneficial Effect on Cardiac Function by Possibly Improving the Microenvironment and Decreasing Mitochondrial Fission after Myocardial Infarction

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7500464/

The randomized, two-way crossover comparative PK study of SWT-WD and SWT-CHE analyzed the active component, ferulic acid. The results showed that clinical doses of 170 mL SWT-WD and 18 g SWT-CHE produced the same amount of ferulic acid in the blood.

Source: Wang 2020 SWT=siwutang; WD=water decoction; CHE=chinese herbal extraction

Detoxification

“Detoxification” is a term used to describe the process of removing toxins and other harmful substances from the body. These toxins can come from a variety of sources, such as exposure to environmental pollutants, unhealthy foods, alcohol, drugs, and medications.

In the context of alternative medicine, detoxification often refers to practices or products that are believed to help the body eliminate toxins and improve overall health. Some of these practices include fasting, juicing, colon cleansing, and the use of herbal remedies or supplements.

However, it’s important to note that there is a debate about the effectiveness of many of these detoxification practices, and some may even be harmful. The body has its own natural detoxification processes, primarily through the liver and kidneys, which filter and eliminate toxins from the body. Eating a healthy diet, staying hydrated, getting regular exercise, and avoiding exposure to toxins can all help support these natural detoxification processes.

Many studies look at the improvement of liver biomarkers such as ALS/AST to prove the effectiveness of herbs. It’s always important to discuss your health needs with a trained herbalist before taking random ‘detox herbs’.

Hormesis is a biological phenomenon that occurs when low doses of a harmful agent or stressor stimulate a beneficial response in the body. This response can include increased cellular repair and maintenance, activation of the immune system, and enhanced detoxification processes.

In the context of detoxification, hormesis can stimulate the body’s natural detoxification pathways by inducing a mild stress response. This can help to upregulate the activity of detoxification enzymes in the liver, such as the cytochrome P450 enzymes, glutathione S-transferases, and UDP-glucuronosyltransferases. These enzymes help to break down and eliminate toxins and harmful substances from the body.

Hormesis can also enhance the body’s antioxidant defenses, which help to protect against oxidative stress and cellular damage. Some studies have suggested that certain natural compounds, such as phytochemicals found in fruits and vegetables, can act as hormetic agents and enhance the body’s detoxification and antioxidant systems.

While the concept of hormesis and its potential benefits for detoxification are promising, more research is needed to fully understand its mechanisms of action and clinical applications. It’s important to consult with a qualified healthcare practitioner before using any supplements or practices that may induce a hormetic response.

Scientific articles and studies that have investigated the effects of hormesis on stem cells:

Mattson MP. Hormesis defined. Ageing Res Rev. 2008 Jul;7(3):1-7. doi: 10.1016/j.arr.2007.08.007. Epub 2007 Sep 8. PMID: 17920577.
Park SJ, Lee HJ, Kim M, Kim YH, Kim JH, Lee SJ, Jang WB, Lee JW, Kang KS. Dose-dependent effects of resveratrol on the proliferation and differentiation of neural stem cells. Nutrients. 2018 Sep 13;10(9):1295. doi: 10.3390/nu10091295. PMID: 30216944; PMCID: PMC6163992.
Jia X, Chen J, Megger DA, Zhang X, Kozlowski M, Zhang W, Kobayashi K, Liu L, Geiger T, Sitek B, Yuan Z. Hormesis effects of acetaminophen exposure on human adipose-derived stem cells: a metabolomic and transcriptomic study. Chem Res Toxicol. 2020 Apr 20;33(4):921-932. doi: 10.1021/acs.chemrestox.9b00455. Epub 2020 Apr 2.
Calabrese EJ. Hormesis and medicine. Br J Clin Pharmacol. 2008 Oct;66(4):594-617. doi: 10.1111/j.1365-2125.2008.03271.x. Epub 2008 Jul 14.
Wu D, Prives C. Relevance of the p53-MDM2 axis to aging. Cell Death Differ. 2018 Sep;25(9):1692-1704. doi: 10.1038/s41418-018-0112-2. Epub 2018 Aug 17.

There is evidence that hormesis can have positive effects on stem cells and may be beneficial for various health conditions. However, much research is needed to fully understand the mechanisms and potential clinical applications of hormesis in stem cell biology.

Several herbs and natural compounds have been shown to have a stimulating effect on stem cells. Here are a few examples:

Ginkgo biloba – A study published in the Journal of Medicinal Food found that an extract of Ginkgo biloba stimulated the proliferation of neural stem cells in the hippocampus of mice.
Curcumin – A study published in Stem Cell Research & Therapy found that curcumin, a compound found in turmeric, enhanced the proliferation and differentiation of mesenchymal stem cells in vitro.
Resveratrol – A study published in Nutrients found that resveratrol, a compound found in red wine, increased the proliferation and differentiation of neural stem cells in vitro.
Epimedium – A study published in the Chinese Journal of Natural Medicines found that an extract of Epimedium, also known as horny goat weed, promoted the proliferation and differentiation of bone marrow mesenchymal stem cells in vitro.
Panax ginseng – A study published in the Journal of Ginseng Research found that an extract of Panax ginseng stimulated the proliferation and differentiation of neural stem cells in vitro.

It’s important to note that the effects of these herbs and compounds on stem cells are complex and can depend on a variety of factors, such as the dose, duration of exposure, and type of stem cell involved.

Traditional Chinese Medicine (TCM) has a rich history of using placental tissue, known as “Ziheche,” for various health benefits. Placental tissue is considered a powerful source of Qi (vital energy) and blood in TCM, and its use dates back centuries. Below is an elaboration on the historical practices and the modern implications of growth factors and other tissue regenerative factors found in placental tissue.

Historical Practices with placenta

Ziheche (Placenta) in TCM:
- In TCM history, the human placenta has been used as an ingredient in various formulations. It is classified as a tonic and is traditionally believed to replenish Qi, nourish the blood, promote general vitality, and support kidney essence.
Medicinal Preparations:
- The placenta would be dried and ground into a powder before being used in different medicinal preparations. It has been used to treat conditions such as fatigue, infertility, impotence, and insufficient lactation.
Philosophical Basis:
- The philosophy of TCM posits that the placenta contains life-giving and sustaining properties as it is the source of nourishment for the developing fetus. Thus, it is believed to have profound rejuvenating effects when consumed.
Historical Texts:
- Ancient Chinese medical texts, such as “Bencao Gangmu” (Compendium of Materia Medica), describe the placenta’s use and are still referenced today in the practice of TCM.

Modern Implications

Bioactive Components:
- Scientific investigations into placental tissue have identified a range of bioactive components, including growth factors like epidermal growth factor (EGF), fibroblast growth factor (FGF), and placental growth factor (PlGF). These factors can stimulate cell growth and proliferation, which is crucial for tissue repair and regeneration.
Regenerative Medicine:
- In modern regenerative medicine, these growth factors are being studied for their potential in promoting the healing of wounds, the regeneration of tissues, and the treatment of degenerative diseases.
Cosmetics and Pharmaceuticals:
- Extracts from placental tissue are now used in the cosmetic industry for their supposed anti-aging and skin-rejuvenating properties. Additionally, pharmaceutical companies are exploring placental extracts for their therapeutic potential.
Scientific Validation:
- While TCM has long asserted the benefits of placental tissue, modern science seeks to validate these claims through rigorous testing and clinical trials to understand the mechanisms by which these growth factors work and to ensure their safety and efficacy.
Ethical Considerations:
- With the advent of these modern applications, there is a parallel increase in ethical considerations, particularly concerning the source and consent for the use of human placental tissues.
- Therefor human placental products are currently not available but instead eg. sheep sources are used.

In conclusion, the use of placental tissue in Traditional Chinese Medicine serves as an early example of regenerative therapy that has extended into modern medical practices. The growth factors and other regenerative components found in placental tissue continue to be of significant interest in both scientific research and applied therapeutics, bridging ancient practices with contemporary biomedical advancements.

Liver Detox

The liver is a vital organ in the body that performs a number of important functions, including:

Metabolism: The liver is responsible for metabolizing carbohydrates, fats, and proteins, and converting them into forms that can be used by the body for energy or stored for later use.
Detoxification: The liver helps to detoxify the body by removing harmful toxins and chemicals from the bloodstream and converting them into less harmful substances that can be eliminated from the body.
Synthesis: The liver is responsible for synthesizing many important proteins, including blood-clotting factors, albumin, and cholesterol.
Storage: The liver stores important nutrients, such as glycogen (a form of glucose) and vitamins A, D, E, and K, and releases them into the bloodstream as needed.
Immune function: The liver plays an important role in immune function by producing proteins that help to fight off infections and diseases.
Bile production: The liver produces bile, which helps to break down and absorb fats in the small intestine.

Overall, the liver is a complex and vital organ that is responsible for many important functions in the body. Maintaining liver health is important for overall health and well-being, and can be achieved through a healthy diet, regular exercise, and avoiding or minimizing exposure to toxins and harmful substances.

Chinese herbal medicine has been used to treat and prevent human diseases through-out history, and is a rich source of biologically active substances with unique curative properties. More recently, Chinese herbs and their extracts have been identified as a novel source of potential therapeutic agents in the prevention and treatment of fatty liver disease.

Radix Gentianae, also known as Long Dan Cao, is a bitter herb commonly used in traditional Chinese medicine for its anti-inflammatory, antipyretic, and hepatoprotective effects. Here are a few studies that have investigated the potential health benefits of Radix Gentianae:

Anti-inflammatory effects: A study published in the Journal of Ethnopharmacology found that Radix Gentianae extract had significant anti-inflammatory effects in mice with acute inflammation. The researchers found that the extract reduced the levels of inflammatory cytokines and increased the activity of antioxidant enzymes.
Antioxidant effects: A study published in the Journal of Medicinal Food found that Radix Gentianae extract had potent antioxidant effects in vitro. The researchers found that the extract was able to scavenge free radicals and protect against oxidative damage to cells. The present paper provides comprehensive information on the green extraction technologies of natural antioxidants, assessment of antioxidant activity at chemical and cellular based levels and their main resources from food and medicinal plants.
Hepatoprotective effects: A study published in the Journal of Ethnopharmacology found that Radix Gentianae extract had significant hepatoprotective effects in rats with liver damage induced by carbon tetrachloride. The researchers found that the extract reduced liver damage and improved liver function by reducing oxidative stress and inflammation.
Antimicrobial effects: A study published in the Journal of Ethnopharmacology found that Radix Gentianae extract had potent antimicrobial effects against several common pathogens, including Staphylococcus aureus and Escherichia coli. The researchers found that the extract inhibited the growth of these pathogens and suggested that it could be used as a natural alternative to antibiotics.

It’s important to note that while these studies suggest that Radix Gentianae may have beneficial effects for various health conditions, in Chinese medicine it is a heat clearing anti-toxicity herb working on the liver.

->Hepatoprotective effect and metabonomics studies of radix gentianae in rats with acute liver injury!

Long-Dan-Xie-Gan-Tang (LDXGT), also known as Gentiana Drain the Liver Decoction, is a classic Chinese herbal formula that is commonly used to treat conditions related to Liver Heat and Dampness. Here are some references on this formula:

Anti-inflammatory effects: A study published in the Journal of Ethnopharmacology found that LDXGT had significant anti-inflammatory effects in mice with acute inflammation. The researchers found that the formula reduced the levels of inflammatory cytokines and increased the activity of antioxidant enzymes.
Hepatoprotective effects: A study published in the World Journal of Gastroenterology found that LDXGT had significant hepatoprotective effects in rats with liver damage induced by carbon tetrachloride. The researchers found that the formula reduced liver damage and improved liver function by reducing oxidative stress and inflammation.
Cholestatic liver disease: A study published in the Journal of Traditional Chinese Medicine found that LDXGT was effective in treating patients with cholestatic liver disease. The researchers found that the formula reduced serum levels of liver enzymes and improved liver function in patients with this condition.
Biliary tract infection: A study published in the Chinese Journal of Integrated Traditional and Western Medicine found that LDXGT was effective in treating patients with biliary tract infection. The researchers found that the formula reduced the severity of symptoms and improved liver function in patients with this condition.
Chronic hepatitis B: A study published in the Journal of Traditional Chinese Medicine found that LDXGT was effective in treating patients with chronic hepatitis B. The researchers found that the formula reduced serum levels of hepatitis B virus DNA and improved liver function in patients with this condition.

More references:

Chinese medicine (CM) has the advantages of low cost, high safety, and various biological activities, which is an important factor for the prevention and treatment of liver diseases. This review systematically summarizes the potential of CM in the treatment of liver diseases, showing that CM can alleviate liver diseases by regulating lipid metabolism, bile acid metabolism, immune function, and gut microbiota, as well as exerting anti-liver injury, anti-oxidation, and anti-hepatitis virus effects.

Zhang, H. Y., Liu, P., & Chen, R. (2016). Research progress on the mechanism of Long-Dan-Xie-Gan-Tang in the treatment of liver diseases. Journal of traditional Chinese medicine, 36(5), 698-702.
Wang, J., Wu, X., Simon, J. E., & Gao, L. (2011). Antioxidant activity and phenolic compounds in selected herbs. Journal of agricultural and food chemistry, 59(23), 12361-12367.
Wang, Y., Zhao, H., Sheng, X., Gambino, P. E., Costello, B., Bojanowski, K., … & Zhang, X. (2014). Protective effect of Long Dan Xie Gan Tang on cholestasis-induced hepatic injury in rats. BMC complementary and alternative medicine, 14(1), 475.
Zhu, L., Huang, L., Wen, C., Zhang, Y., Liu, H., & Xu, Y. (2019). Mechanisms of Long-Dan-Xie-Gan-Tang on hepatic diseases: a review. Journal of ethnopharmacology, 241, 111977.
Li, Y. Q., & Liang, J. (2012). Effect of Long-Dan-Xie-Gan-Tang on brain-gut peptides in a rat model of acute pancreatitis. Journal of ethnopharmacology, 144(1), 70-75.
Wang, T., Guo, R., Zhou, G., Zhou, X., Kou, Z., & Sui, F. (2016). The antihypertensive effects of Longdan Xiegan Tang in spontaneously hypertensive rats are associated with the inhibition of oxidative stress and inflammation. Journal of ethnopharmacology, 181, 50-56.
Lin, H. C., Lin, T. H., Wu, M. Y., Chiu, Y. J., Chiu, H. W., & Yang, S. P. (2018). Long-Dan-Xie-Gan-Tang attenuates CCl4-induced liver injury in rats. Journal of Ethnopharmacology, 220, 49-57. (Hepatoprotective effects)
Wang, X., Xu, X., Liang, Y., Wang, X., Zhang, X., & Li, Y. (2017). Effects of Long-Dan-Xie-Gan-Tang on the liver proteome in rats with CCl4-induced hepatic fibrosis. Molecular medicine reports, 16(1), 285-292. (Antifibrotic effects)
Chen, J., Zhang, X., Liu, X., & Zhang, C. (2016). The total flavonoids of Abelmoschus esculentus flower prevent inflammatory response and oxidative stress in lipopolysaccharide-treated RAW264.7 cells. Journal of Functional Foods, 21, 400-409.

Yin Chen (Artemisia scoparia) is a traditional Chinese medicinal herb that has been used for centuries to treat various health conditions. It is commonly known as “Yin Chen Hao” or simply “Yin Chen” in Chinese. The herb is native to China and is now cultivated in many parts of the world, including North America.

Several studies have investigated the efficacy of Yin Chen for treating liver disorders. For example:

– A study published in the Journal of Ethnopharmacology found that an extract of Yin Chen had a protective effect on liver cells in rats with liver damage induced by carbon tetrachloride.
– Another study published in the Journal of Gastroenterology and Hepatology found that Yin Chen reduced inflammation and improved liver function in patients with chronic hepatitis B.
– A review published in the Journal of Chinese Medicine found that Yin Chen was effective in treating jaundice caused by various liver disorders, including hepatitis B and C, liver cirrhosis, and cholestasis.

Hu zhang 虎杖 (Polygonum cuspidatum)

Hu Zhang (Polygonum cuspidatum), also known as Japanese knotweed or Giant knotweed, is a perennial herbaceous plant that has been used for centuries in traditional Chinese medicine (TCM) and Japanese Kampo medicine. It is native to East Asia and has been introduced to other parts of the world, including North America and Europe, where it is often considered an invasive species.

In traditional medicine, Hu Zhang is used for a variety of health conditions, including detoxification; however its activity on the liver belongs to the category of regulate and invigorate blood:

Cardiovascular diseases: Hu Zhang is believed to support cardiovascular health by promoting blood circulation, reducing blood viscosity, and inhibiting platelet aggregation. It has been used to treat conditions such as hypertension, arteriosclerosis, and coronary heart disease.
Liver and gastrointestinal diseases: Hu Zhang has been used to treat liver diseases, such as hepatitis and jaundice, as well as gastrointestinal disorders, like diarrhea, dysentery, and peptic ulcers.
Inflammatory and immune-related conditions: Hu Zhang has been used for its anti-inflammatory and immune-modulating properties in the treatment of conditions such as arthritis, allergies, and autoimmune diseases.
Antioxidant effects: Hu Zhang is known to possess antioxidant properties, which may help protect cells from damage caused by free radicals and oxidative stress.

The therapeutic effects of Hu Zhang are attributed to its bioactive compounds, including resveratrol, emodin, and polydatin. Resveratrol, in particular, has been the subject of extensive research for its potential health benefits, including anti-inflammatory, antioxidant, and anticancer properties.

Scientific studies have provided some evidence supporting the traditional uses of Hu Zhang:

Cardiovascular effects: Resveratrol has been shown to have cardioprotective effects in various studies, including reducing inflammation, oxidative stress, and platelet aggregation, as well as improving vascular function (Zordoky et al., 2015).
Antioxidant and anti-inflammatory effects: Both resveratrol and emodin have been found to possess antioxidant and anti-inflammatory properties, which may contribute to Hu Zhang’s therapeutic effects (Zhang et al., 2015; Wang et al., 2021).
Liver protection: Studies have shown that Hu Zhang and its constituents, such as polydatin, can protect the liver from damage caused by toxins and oxidative stress (Li et al., 2020).

The medicinal properties of Hu Zhang are attributed to its various bioactive constituents, which include the following:

Resveratrol: Resveratrol is a polyphenolic compound found in Hu Zhang that has been extensively studied for its potential health benefits. It is known to have antioxidant, anti-inflammatory, cardioprotective, and anticancer properties. Resveratrol is also found in other plants, such as grapes, blueberries, and peanuts.
Polydatin (Piceid): Polydatin is a natural glycoside of resveratrol, which has demonstrated various pharmacological effects, including hepatoprotective, anti-inflammatory, antioxidant, and cardioprotective properties.
Emodin: Emodin is an anthraquinone derivative found in Hu Zhang that has been shown to have multiple pharmacological activities, such as antioxidant, anti-inflammatory, anticancer, and antimicrobial effects.
Physcion: Physcion is another anthraquinone derivative present in Hu Zhang. It has been reported to have antioxidant, anti-inflammatory, and anticancer properties.
Catechins: Catechins are a group of polyphenolic compounds that are also found in Hu Zhang. They have been shown to possess antioxidant, anti-inflammatory, and anticancer activities.
Quercetin: Quercetin is a flavonoid found in Hu Zhang, as well as in many other plants, such as onions, apples, and berries. It has been shown to have antioxidant, anti-inflammatory, and anticancer properties.
Other constituents: Hu Zhang also contains various other compounds, including flavonoids, tannins, and phenolic acids, which may contribute to its overall medicinal properties.

It is important to note that while these bioactive constituents have demonstrated various pharmacological effects in vitro and in animal models, more research is needed to establish their efficacy and safety in humans. Additionally, the synergistic effects of these compounds in Hu Zhang may contribute to its overall therapeutic potential.

References:

Li, X., Wang, X., Han, C., Xue, X., & Ma, J. (2020). Polydatin protects against carbon tetrachloride-induced liver fibrosis in mice. Archives of Pharmacal Research, 43(3), 255-265.

Wang, Y., Wang, H., Qian, C., Tang, J., & Zhou, W. (2021). Emodin: A review of its pharmacology, toxicity, and pharmacokinetics. Phytotherapy Research, 35(1), 44-67.

Zhang, H., Zhang, J., Ung, C. O. L., & Sánchez-Lengeling, B. (2015). Chinese herbal medicine for cardiovascular disease: evidence from clinical trials and animal studies. Journal of Cardiovascular Pharmacology, 66(4), 335-349.

Zordoky, B. N., Robertson, I. M., & Dyck, J. R. (2015). Preclinical and clinical evidence for the role of resveratrol in the treatment of cardiovascular diseases. Biochimica et Biophysica Acta (B)

Treating unstable angina with detoxifying and blood-activating formulae: A randomized controlled trial. After intervention, the hs-CRP, TNF-α, and IL-6 levels decreased, while the IL-10 and adiponectin levels significantly increased in the experimental group (P < 0.05 or 0.01). The ratios of the inflammatory factors significantly decreased after treatment, particularly in the experimental group (P < 0.01). Symptoms and syndromes were also ameliorated in the experimental group (P < 0.01), showing a significant difference from the control group

Heavy Metal Detoxification

Fu Hai Shi, also known as Pumice, is a type of volcanic rock used in Traditional Chinese Medicine (TCM). This porous stone has a light and brittle texture, and it is mainly used in its raw form and has a good “detox” effect.

Here are the primary functions and indications of Fu Hai Shi in TCM:

Clears Lung Heat: Fu Hai Shi is often used to clear lung heat and resolve phlegm-heat. It can be beneficial in cases of a productive cough with yellow, sticky sputum that may be difficult to expectorate, a symptom typically associated with Lung Heat.
Softens Hardness and Dissipates Nodules: In TCM, Fu Hai Shi is believed to soften areas of hardness and reduce nodules. It’s often used to treat goiter, scrofula, and other nodules due to Phlegm-Fire.
Promotes Urination and Reduces Edema: Fu Hai Shi is sometimes used to promote urination and reduce swelling, especially in cases where heat is a predominant factor.
Treats Skin Conditions: Fu Hai Shi can be applied topically to help treat various skin conditions. It’s believed to have a calming effect on the skin and can help reduce inflammation.

Remember, herbs have potent effects and should be used under the guidance of a healthcare professional or a certified Traditional Chinese Medicine practitioner.

Zeolites are a type of mineral that’s used in various industries, and some people use them as dietary supplements with the belief they can detoxify the body. The research on their safety and effectiveness for health purposes is limited and mixed.

As for your question, to the best of my knowledge (as of my training cut-off in September 2021), there’s no established interaction between vitamin C receptors and zeolite absorption.

Vitamin C, also known as ascorbic acid, is absorbed by the body via sodium-dependent vitamin C transporters (SVCTs) in the gut. These transporters are specific to vitamin C and don’t have a role in the absorption of zeolite.

Zeolite is a mineral and its absorption or distribution would follow a different pathway. Some forms of zeolite may not even be absorbed in significant amounts and could pass through the gastrointestinal tract without entering the bloodstream.

It’s important to note that taking any dietary supplement, including zeolite, should be discussed with a healthcare provider as they can have potential side effects and may interact with other medications or supplements you’re taking. Always seek personalized medical advice before starting a new supplement.

Zeolites and pumice are similar in some respects, particularly in their porous structure, but they are fundamentally different in terms of their chemical composition and formation process.

Formation: Pumice is a type of igneous rock that forms during explosive volcanic eruptions when super-heated, highly pressurized rock and gas are ejected from a volcano. The rapid depressurization allows gas bubbles to remain trapped within the rock as it cools and solidifies, resulting in a highly porous structure.
Composition: Pumice is primarily composed of silica (SiO2), and it may also contain trace amounts of other minerals depending on the composition of the original magma.

On the other hand,

Formation: Zeolites are aluminosilicate minerals that commonly form in sedimentary rocks over long periods of time through the chemical reaction of volcanic ash with saline water.
Composition: Zeolites are characterized by a three-dimensional crystalline structure composed of silicon, aluminum, and oxygen. They are unique because they have large, vacant spaces or “cages” in their crystalline structure, which allows them to trap and release certain molecules, a property that is widely utilized in industrial applications for gas purification, ion exchange, and catalysis.

In summary, while both pumice and zeolites are porous, they have different formation processes, compositions, and uses. The resemblance between them largely stops at their shared porosity.

Zeolite itself has been considered for use in Traditional Chinese Medicine. Zeolite Clinoptilolite (Zeolitum) has been studied for its potential detoxifying properties and ability to absorb and remove toxins and heavy metals.

FAD: Fatigue, Anxiety, Depression; Treating emotional conditions

Emotions are complex and involve various aspects of the human experience, including physiological, psychological, and social components. While the biochemistry of the organs certainly plays a role in our emotional experiences, it is just one aspect of a multifaceted process.

In terms of biochemistry, emotions are associated with the release of neurotransmitters, hormones, and other signaling molecules that affect the brain and other organs. For example, serotonin, dopamine, and norepinephrine are neurotransmitters that regulate mood, motivation, and stress response, while hormones like cortisol and oxytocin are involved in stress response and social bonding, respectively.

However, the biochemistry of the organs is not the sole determinant of our emotional experiences. Psychological factors, such as thoughts, beliefs, and past experiences, can also influence our emotions. Additionally, our social environment and cultural context can shape how we express and experience emotions.

It is important to recognize that emotions are the result of an intricate interplay between biological, psychological, and social factors. While biochemistry is an essential part of the puzzle, it is not the only factor that contributes to our emotional experiences.

Traditional Chinese Medicine (TCM) offers a different perspective on emotions, linking them to the health and balance of specific organ systems. This approach is based on a different theoretical framework and understanding of the body than Western medicine, but it can still provide valuable insights into the interconnectedness of our emotional and physical well-being.

The Five Elements (Wu Xing) and Tai Ji Ba Gua systems are essential concepts in Traditional Chinese Medicine (TCM) and Chinese philosophy, which provide a framework for understanding the relationships between different aspects of the natural world, including emotions.

The Five Elements theory is based on the idea that everything in the universe is composed of five primary elements: Wood, Fire, Earth, Metal, and Water. Each element is associated with specific organs, emotions, and other aspects of human life. The relationships between the elements are defined by two main cycles: the generating cycle (also called the nourishing cycle) and the controlling cycle (also called the restraining cycle).

In TCM, emotions are associated with the Five Elements as follows:

Wood – Associated with the Liver and Gallbladder, the Wood element is linked to the emotion of anger or frustration. When the Wood element is balanced, it promotes a sense of growth, flexibility, and assertiveness.
Fire – Connected to the Heart and Small Intestine, the Fire element is related to the emotion of joy or over-excitement. A balanced Fire element promotes love, warmth, and enthusiasm.
Earth – Corresponding to the Spleen and Stomach, the Earth element is associated with the emotion of worry or overthinking. When the Earth element is in balance, it supports feelings of stability, grounding, and nourishment.
Metal – Linked to the Lungs and Large Intestine, the Metal element is connected to the emotion of grief or sadness. A balanced Metal element promotes a sense of clarity, structure, and the ability to let go.
Water – Associated with the Kidneys and Bladder, the Water element is related to the emotion of fear or anxiety. When the Water element is balanced, it supports feelings of tranquility, wisdom, and adaptability.

The Tai Ji Ba Gua system is a more complex system derived from the I Ching/Yi Jing (Book of Changes), an ancient Chinese divination text. The Ba Gua consists of eight trigrams, each composed of three lines (either broken or unbroken), representing different aspects of the universe. Tai Ji, the supreme ultimate, represents the balance of Yin and Yang, the complementary forces in the universe. While the Tai Ji Ba Gua system is not directly linked to emotions in the same way as the Five Elements theory, it provides a broader understanding of the interconnectedness and balance in nature, which can be applied to various aspects of life, including emotions.

In summary, the Five Elements theory and the Tai Ji Ba Gua system provide a framework for understanding the relationships between emotions, physical organs and other aspects of human life within the context of Traditional Chinese Medicine and Chinese philosophy.

Liver Qi

In Traditional Chinese Medicine (TCM), emotional disturbances are often associated with Liver Qi stagnation. When the flow of Liver Qi is obstructed, it can lead to emotional imbalances such as irritability, mood swings, frustration, and stress. Several Chinese herbal formulas can help address Liver Qi stagnation and improve emotional well-being. One widely-used formula for treating emotional Liver Qi stagnation is Xiao Yao San, also known as Free and Easy Wanderer or Rambling Powder.

Xiao Yao San is a classic TCM formula that contains a combination of herbs working together to soothe the Liver, strengthen the Spleen, and nourish the Blood. The primary ingredients in Xiao Yao San are:

Bupleurum (Chai Hu) – to soothe the Liver Qi and relieve stagnation
White Peony Root (Bai Shao) – to nourish the Blood and relax the Liver
Dong Quai (Dang Gui) – to nourish the Blood and harmonize the Liver
Poria (Fu Ling) – to strengthen the Spleen and eliminate dampness
Atractylodes (Bai Zhu) – to strengthen the Spleen and eliminate dampness
Ginger (Sheng Jiang) – to warm the Spleen and Stomach and alleviate nausea
Peppermint (Bo He) – to soothe the Liver and promote the flow of Liver Qi
Licorice (Gan Cao) – to harmonize the formula and strengthen the Spleen

Xiao Yao San has been used for centuries to treat various symptoms related to Liver Qi stagnation, such as irritability, mood swings, mild depression, anxiety, and premenstrual syndrome (PMS).

It is essential to consult with a healthcare professional or qualified herbalist before starting any herbal treatment, as they can provide personalized guidance based on your specific health needs and concerns. The dosage and formulation may vary depending on individual conditions and the severity of the symptoms.

How does Xiao Yao San treat emotions?

Xiao Yao San, or the Free and Easy Wanderer formula, is used to treat emotional imbalances in Traditional Chinese Medicine (TCM) because it addresses the root causes of these imbalances, primarily Liver Qi stagnation.

In TCM, the Liver is responsible for the smooth flow of Qi (vital energy) throughout the body. When Liver Qi is obstructed, it can cause emotional disturbances such as stress, irritability, mood swings, and frustration. Liver Qi stagnation is often the result of emotional stress or unresolved emotional issues.

Xiao Yao San works by addressing the underlying issues causing emotional imbalances. Here’s a breakdown of how the formula treats emotions:

Soothing the Liver: Bupleurum (Chai Hu) and Peppermint (Bo He) help to soothe the Liver and promote the smooth flow of Liver Qi. This helps alleviate emotional stagnation and reduces irritability and mood swings.
Nourishing the Blood: White Peony Root (Bai Shao) and Dong Quai (Dang Gui) work together to nourish the Blood, which has a calming effect on the emotions. In TCM, the Liver is closely associated with the Blood, and when Blood is deficient, it can contribute to emotional imbalances.
Strengthening the Spleen: Atractylodes (Bai Zhu), Poria (Fu Ling), and Licorice (Gan Cao) help to strengthen the Spleen and support digestion. In TCM, the Spleen is responsible for transforming food into Qi and Blood. When the Spleen is weak, it can lead to a deficiency in Qi and Blood, which can contribute to emotional disturbances.
Harmonizing the formula: Ginger (Sheng Jiang) and Licorice (Gan Cao) help to harmonize the formula and balance the actions of the other herbs, ensuring that the formula works effectively as a whole to treat emotional imbalances.

By addressing Liver Qi stagnation, nourishing the Blood, and strengthening the Spleen, Xiao Yao San helps to restore emotional balance and alleviate symptoms related to emotional disturbances. As always, it’s essential to consult a professional or qualified herbalist before starting any herbal treatment to receive personalized guidance based on your specific health needs and concerns.

While the concept of “soothing the liver” comes from Traditional Chinese Medicine (TCM) and may not directly translate to Western medical terminology, there are studies that have explored the biochemical effects of some herbs used in TCM to “soothe the liver.” These studies often focus on the anti-inflammatory, antioxidant, and hepatoprotective properties of the herbs and their active constituents.

For example, Bupleurum (Chai Hu) is a primary herb in TCM used to soothe the liver. Research has shown that saikosaponins, the major bioactive constituents in Bupleurum, possess various pharmacological activities, such as anti-inflammatory, immunomodulatory, and hepatoprotective effects.

A study published in the Journal of Ethnopharmacology (2018) summarizes that saikosaponin-d, a component of Bupleurum, has anti-inflammatory and immunomodulatory effects by inhibiting the production of pro-inflammatory cytokines, such as TNF-α, IL-1β, and IL-6

Another study published in the Journal of Agricultural and Food Chemistry (2006) demonstrated that saikosaponin-a and saikosaponin-d exhibit hepatoprotective effects by reducing oxidative stress and inflammation in a mouse model of liver injury

It is essential to note that while these studies provide some biochemical explanations for the effects of Bupleurum, they do not necessarily validate or explain the concept of “soothing the liver” as a whole in TCM. The TCM perspective is based on a different theoretical framework, and the language and concepts used may not always correspond directly with Western medical terminology or biochemical explanations.

Nevertheless, the pharmacological activities of certain herbs used in TCM can provide insights into how they might contribute to the treatment of various conditions, including those related to liver health and emotional well-being.

Digestion and diuresis

Indeed, the digestive system can be considered the “engine” of the body. It is responsible for breaking down the food we eat into smaller components, which can be absorbed and utilized for energy, growth, and cellular repair. The digestive system plays a critical role in maintaining overall health and well-being, as it provides the nutrients necessary for the proper functioning of all other systems in the body.

The digestive system includes several organs, such as the mouth, esophagus, stomach, small intestine, large intestine, rectum, and anus. Additionally, accessory organs like the liver, pancreas, and gallbladder contribute to digestion by producing and releasing enzymes, bile, and other substances needed for the breakdown and absorption of nutrients.

Proper digestion is crucial for maintaining a healthy body, and disruptions in the digestive process can lead to various health issues. Ensuring a balanced diet, adequate hydration, regular exercise, and stress management can help support optimal digestive health.

Digestive problems are often associated with inflammation but also with excess dampness. While there are many strategies of treating digestive problems such as regulating qi and food stagnation, draining downward and removing dampness by diuresis is among the most important. Omega3 is a major player in reducing gut inflammation and restoring your intestinal stem cells.

A long list of some common Western diagnoses of digestive disorders:

Gastroesophageal Reflux Disease (GERD)
Irritable Bowel Syndrome (IBS)
Inflammatory Bowel Disease (IBD), which includes: a. Crohn’s Disease b. Ulcerative Colitis
Celiac Disease
Lactose Intolerance
Food Allergies and Sensitivities
Peptic Ulcer Disease
Gastritis
Diverticulitis and Diverticulosis
Gastroenteritis (inflammation of the stomach and intestines, often due to infection)
Constipation
Diarrhea
Dyspepsia (indigestion)
Gallstones and Cholecystitis (gallbladder inflammation)
Pancreatitis (inflammation of the pancreas)
Hepatitis (inflammation of the liver, often due to viral infection)
Fatty Liver Disease (excess fat accumulation in the liver)
Malabsorption Syndromes (e.g., fat malabsorption, bile acid malabsorption)
Gastrointestinal (GI) motility disorders (e.g., gastroparesis, chronic intestinal pseudo-obstruction)
Small Intestinal Bacterial Overgrowth (SIBO)
Hemorrhoids
Anal Fissures
Colon polyps and colorectal cancer

This list is not complete and proper evaluation, diagnosis, and treatment are important.

“Traditional Chinese Medicine (TCM) diagnosis works differently! Instead of labeling problem TCM looks at the symptomatic Pattern ID.”

In Traditional Chinese Medicine (TCM), digestive disorders are often associated with specific pattern imbalances. Here is a list of common TCM patterns related to digestive disorders:

Spleen Qi Deficiency: Characterized by poor appetite, bloating, loose stools or diarrhea, fatigue, and a pale tongue with a thin white coating. This pattern is often seen in conditions like Irritable Bowel Syndrome (IBS) and chronic gastritis.
Spleen Yang Deficiency: Similar to Spleen Qi Deficiency, but with more pronounced symptoms of coldness, such as cold limbs, a preference for warm food and drinks, and loose stools or diarrhea with undigested food particles.
Spleen Dampness: Characterized by poor appetite, bloating, heavy sensation in the limbs, fatigue, and a sticky tongue coating. This pattern is often seen in conditions like IBS and dyspepsia.
Spleen and Stomach Damp Heat: Symptoms include poor appetite, abdominal pain, diarrhea or loose stools (possibly with mucus or blood), a burning sensation, bad breath, and a sticky yellow tongue coating. This pattern is often associated with conditions like inflammatory bowel disease, gastritis, and gastroenteritis.
Liver Qi Stagnation: Characterized by alternating constipation and diarrhea, abdominal pain and distention, irritability, and mood swings. This pattern is commonly seen in IBS and functional dyspepsia.
Liver Overacting on Spleen: Symptoms include alternating constipation and diarrhea, abdominal pain, bloating, and mood swings. This pattern is also commonly seen in IBS and functional dyspepsia.
Food Stagnation: Characterized by indigestion, abdominal distention and pain, belching, acid reflux, and possibly diarrhea or constipation. This pattern is often seen in conditions like gastroesophageal reflux disease (GERD) and dyspepsia.
Stomach Yin Deficiency: Symptoms include a dry mouth, thirst, hunger without a desire to eat, a dry or cracked tongue, and possibly acid reflux or constipation. This pattern is often seen in chronic gastritis and GERD.
Kidney Yang Deficiency: Characterized by lower abdominal pain, cold limbs, a preference for warmth, loose stools or diarrhea, and lower back pain. This pattern is often associated with chronic diarrhea and lower gastrointestinal issues.

Please note that these patterns are not exclusive, and a person may have a combination of patterns. It is important to consult with a qualified TCM practitioner for a proper diagnosis and tailored treatment plan.

Dampness and diagnosis of damp heat vs damp cold is essential

Distinguishing between damp heat and damp cold in the diagnosis of digestive disorders is essential in Traditional Chinese Medicine (TCM). Both damp heat and damp cold are related to the accumulation of dampness in the body, but they manifest differently and require different treatment approaches.

Damp Heat: Damp heat is characterized by symptoms such as:

A feeling of heaviness and fullness in the body, particularly in the abdomen.
Abdominal pain, which may worsen with pressure or heat.
Diarrhea or loose stools, often with a foul smell, and possibly containing mucus or blood.
A burning sensation in the anus after bowel movements.
Nausea or vomiting.
Excessive thirst, often with a preference for cold drinks.
A red tongue with a sticky yellow coating.
A rapid and slippery pulse.

Damp Cold: Damp cold, on the other hand, is characterized by symptoms such as:

A feeling of heaviness and fullness in the body, particularly in the abdomen.
Abdominal pain, which may improve with pressure or warmth.
Diarrhea or loose stools, often with undigested food particles.
A lack of thirst or preference for warm drinks.
Nausea or vomiting.
Cold limbs and a preference for warmth.
A pale tongue with a white, greasy coating.
A slow and slippery pulse.

Treatment strategies for these conditions differ based on the underlying pattern. In the case of damp heat, the treatment focuses on clearing heat, draining dampness, and regulating the digestive system. For damp cold, the treatment aims to warm the interior, dispel cold, transform dampness, and strengthen the digestive system.

It is important to consult with a qualified TCM practitioner for a proper diagnosis and tailored treatment plan that addresses the specific pattern of imbalance. The practitioner will likely recommend a combination of herbal formulas, acupuncture, dietary modifications, and lifestyle changes to help restore balance and alleviate symptoms.

In Traditional Chinese Medicine (TCM), colitis may be associated with the concept of damp heat in the intestines. This condition is characterized by an accumulation of excess heat and dampness in the body, which can cause inflammation and irritation in the gastrointestinal tract. Symptoms may include diarrhea (often with mucus or blood), abdominal pain, a feeling of heaviness, fever, and a rapid pulse.

To address damp heat and colitis in TCM, practitioners typically use herbal formulas that aim to clear damp heat from the intestines, reduce inflammation, and restore the proper functioning of the digestive system. Here are a few commonly used herbal formulas for this condition:

Gegen Qinlian Tang (Pueraria, Scutellaria, Coptis, and Licorice Decoction): This formula is designed to clear damp heat from the intestines, reduce inflammation, and regulate the digestive system. Key herbs include Gegen (Pueraria), Huang Qin (Scutellaria), Huang Lian (Coptis), and Gan Cao (Licorice).
Shao Yao Tang (Peony Decoction): This formula can be used to alleviate abdominal pain and diarrhea associated with damp heat in the intestines. It contains Bai Shao (White Peony), Gan Cao (Licorice), Huang Lian (Coptis), and other herbs.
Yin Chen Hao Tang (Artemisia Capillaris Decoction): This formula is often used to treat damp heat-related liver and gallbladder issues that may contribute to colitis. Key herbs include Yin Chen Hao (Artemisia Capillaris), Zhi Zi (Gardenia), and Da Huang (Rhubarb).

These are just a few examples of the herbal formulas that may be used to treat colitis associated with damp heat in TCM. It is important to consult with a qualified TCM practitioner before using any herbal formula, as they can assess your individual needs and determine the most appropriate treatment for your specific condition. Additionally, it is crucial to follow your practitioner’s recommendations regarding diet and lifestyle modifications to support the healing process.

Constipation and Dahuang

Da Huang, also known as Chinese rhubarb (Rheum palmatum), is a traditional herb used in Chinese medicine primarily for its laxative properties, making it effective for treating constipation. It is believed to work by stimulating bowel movements and promoting the clearance of heat and toxins from the body.

In the context of Traditional Chinese Medicine (TCM), Da Huang is also associated with the concept of “water channels,” which are pathways in the body through which fluids circulate. According to TCM theory, constipation can be caused by a disruption in the flow of Qi (vital energy) and fluids within these channels. Da Huang is thought to help regulate the water channels, facilitating the proper movement of fluids and thus alleviating constipation.

According to TCM theory, the large intestine is closely associated with the Lung meridian, and both are part of the Metal element. The Lung is said to regulate the water passages and distribute fluids throughout the body. If the Lung’s function is impaired, it can lead to a dysfunction in the descending and dispersing of fluids, which in turn can affect the large intestine’s ability to move waste effectively. This is often referred to as a blockage in the water channels of the large intestine.

Additionally, the large intestine itself has its own meridian, which can become blocked due to “damp heat” due to factors such as emotional stress, poor diet, lack of physical activity, or external pathogenic factors like cold or heat. In TCM, treatment for such blockages often involves acupuncture, herbal remedies, and dietary adjustments to restore the balance and flow of Qi and fluids in the body.

However, it’s important to note that while Da Huang can be effective for constipation, it should be used with caution. Overuse or prolonged use can lead to electrolyte imbalances, dehydration, and other side effects. It’s always best to consult with a healthcare professional or a qualified practitioner of TCM before using Da Huang or any other herbal supplement, especially if you have underlying health conditions or are taking other medications.

Science

Stool-softening effect and action mechanism of free anthraquinones extracted from Rheum palmatum : Aloe-emodin, rhein, and chrysophanol were the stool-softening components of the RhA extract.

Analysis of 16S rRNA gene sequencing indicated that rhubarb could improve the disorder of intestinal microbiota in constipated rats. For example, beneficial bacteria such as Ligilactobacillus, Limosilalactobacillus, and Prevotellaceae UCG-001 were remarkably increased, and pathogens such as Escherichia-Shigella were significantly decreased after rhubarb treatment.

RE induced the release of acetylcholine and mucin-2 in the colonic tissue and the histamine levels from the faeces. The results suggest that RE induced colonic mucus secretion involves mast cell activation and some cytokine.

Sennoside A should be used in regular dosages for less than one week, as it provides significant relief of constipation and exhibits no colonic damage within 7 days of administration. In addition, Sennoside A exerts its laxative effect by regulating gut microbiota of Lactobacillus Romboutsia, Akkermansia and UCG_005 and water channels of AQP1 and AQP3.

Aquaporins are a family of water channel proteins that facilitate the transport of water and, in some cases, small solutes across cell membranes. In the context of the large intestine, aquaporins play a crucial role in water absorption and the regulation of stool consistency. For example, aquaporin 3 (AQP3) is expressed in the colon and is involved in water reabsorption.

When there is a dysfunction or alteration in the expression of aquaporins in the large intestine, it can lead to disturbances in water balance, contributing to conditions such as constipation or diarrhea. For instance, reduced expression or activity of AQP3 has been associated with constipation-predominant irritable bowel syndrome (IBS-C).

In addition to aquaporins, other transport proteins and ion channels, such as chloride channels and sodium-potassium pumps, also play essential roles in maintaining the electrolyte and water balance in the large intestine. Disruptions in the function of these channels can lead to changes in water movement and bowel habits.

MaZiRenWan

A prime to go to formula for constipation: Mazirenwan, also known as Hemp Seed Pill, is a traditional Chinese herbal formula used to treat constipation, particularly the type associated with dry stools and a lack of bowel movement. The formula is designed to moisten the intestines, promote bowel movements, and clear heat. The typical ingredients in Mazirenwan include:

Huo Ma Ren (Semen Cannabis) – Hemp Seeds: Acts as a gentle laxative, moistening the intestines and facilitating the passage of stool.
Bai Shao (Radix Paeoniae Alba) – White Peony Root: Nourishes the blood and yin, softens the liver, and alleviates pain.
Zhi Shi (Fructus Aurantii Immaturus) – Immature Bitter Orange: Breaks up stagnant qi and reduces distention and bloating.
Hou Po (Cortex Magnoliae Officinalis) – Magnolia Bark: Moves qi, relieves stagnation, and helps reduce abdominal fullness.
Da Huang (Radix et Rhizoma Rhei) – Rhubarb Root: Purges accumulated heat and promotes bowel movements.
Xing Ren (Semen Armeniacae Amarae) – Apricot Kernel: Relieves cough and asthma, moistens the intestines, and unblocks the bowels.
Zhi Ke (Fructus Aurantii) – Ripe Bitter Orange: Regulates qi and breaks up stagnation.

Mazirenwan works on the principle of lubricating the intestines and unblocking bowel movements by moistening dryness and moving qi. It is particularly suitable for individuals with constipation due to intestinal dryness, often accompanied by symptoms such as dry mouth, thirst, and a dry, red tongue with little coating.

However, it’s important to note that this formula should be used under the guidance of a qualified healthcare practitioner, as the herbs can have strong effects and may interact with other medications or conditions. Additionally, the formula may be modified by practitioners to better suit the individual’s specific needs and constitution.

Maintaining good Digestion

Once again in Traditional Chinese Medicine (TCM), the concept of dampness refers to an imbalance in the body’s fluids, which can manifest as a variety of symptoms such as swelling, heaviness, fatigue, poor digestion, and excessive mucus production. Dampness is often associated with dysfunction in the spleen and stomach, as these organs are responsible for transforming and transporting nutrients and fluids in the body. A healthy spleen and stomach system is essential for maintaining proper fluid balance and preventing the accumulation of dampness.

Removing dampness in TCM is primarily achieved through a combination of herbal remedies, acupuncture, dietary modifications, and lifestyle changes. The specific approach may vary depending on the individual’s constitution, the underlying cause of the dampness, and the accompanying symptoms.

Herbal remedies: TCM practitioners often prescribe herbs that have diuretic, digestive, and spleen-strengthening properties to help remove dampness. Some commonly used herbs for this purpose include:

Atractylodes (Atractylodes macrocephala)
Poria (Poria cocos)
Coix seed (Coix lacryma-jobi)
Plantain seed (Plantago asiatica)
Agastache (Agastache rugosa)
Ginger (Zingiber officinale)

Acupuncture: Acupuncture can help balance the body’s energy (Qi) and stimulate the function of the spleen and stomach, thus promoting the removal of dampness. Specific acupuncture points may be targeted, depending on the individual’s symptoms and overall condition.
Dietary modifications: In TCM, diet plays a crucial role in maintaining health and preventing disease. To remove dampness, it is generally recommended to consume foods that are easy to digest, warm, and nourishing. This may include cooked vegetables, whole grains, lean proteins, and warm soups. Foods that are cold, raw, greasy, and sweet should be limited or avoided, as they can contribute to dampness.
Lifestyle changes: Practicing healthy habits, such as regular exercise, getting adequate sleep, and managing stress, can help improve the overall function of the spleen and stomach, thereby promoting the removal of dampness. In addition, avoiding exposure to damp environments and staying warm can help prevent the accumulation of dampness in the body.

Ginger (Zingiber officinale) is a popular medicinal plant that has been used for centuries in traditional medicine systems across the world. It belongs to the category of Releases the Exterior, induces perspiration and disperses Cold. So it does not directly remove dampness but by warming and moving the stomach it has a tremendous effect on digestion. The rhizome (underground stem) of ginger contains various bioactive compounds that contribute to its therapeutic effects. Some of the most notable constituents found in ginger include:

Gingerols: Gingerols are a group of phenolic compounds that are the main active ingredients responsible for the pungent taste and medicinal properties of ginger. The most abundant and well-studied gingerol is 6-gingerol, which has been found to possess anti-inflammatory, antioxidant, and anticancer properties.
Shogaols: Shogaols are formed from gingerols during the drying or cooking process. The most abundant shogaol in ginger is 6-shogaol, which exhibits anti-inflammatory, antioxidant, and anticancer activities.
Zingerone: Zingerone is a phenolic compound found in lower concentrations in ginger. It has been shown to have antioxidant, anti-inflammatory, and anticancer properties.
Paradols: Paradols are a group of compounds related to gingerols and shogaols. They also exhibit antioxidant, anti-inflammatory, and anticancer activities.
Essential oils: Ginger contains various volatile oils that contribute to its aroma and flavor. Some of the primary components of ginger essential oil include zingiberene, β-bisabolene, α-curcumene, and β-sesquiphellandrene. These essential oil constituents have demonstrated antimicrobial, anti-inflammatory, and antioxidant properties.
Other constituents: Ginger also contains numerous other compounds, such as flavonoids, phenolic acids, and terpenoids, which may contribute to its overall medicinal properties.

While it is difficult to provide an exact number of medicinal constituents in ginger, the plant is known to contain a rich and complex mixture of bioactive compounds that contribute to its wide range of therapeutic effects. These effects include anti-inflammatory, antioxidant, antimicrobial, anticancer, and gastrointestinal health benefits, among others.

Si Jun Zi Tang, also known as the Four Gentlemen Decoction, is a classic Traditional Chinese Medicine (TCM) formula used to treat a variety of digestive issues. The formula is composed of four herbs, which are believed to work together to strengthen the Spleen and Stomach, regulate Qi (vital energy), and improve digestion. The four herbs included in Si Jun Zi Tang are:

Ren Shen (Ginseng) – This herb is known for its powerful tonifying effects on the Spleen and Stomach. It helps to improve energy levels and appetite, as well as alleviate fatigue.
Bai Zhu (Atractylodes macrocephala rhizome) – Bai Zhu is a key herb for strengthening the Spleen and drying dampness, which is believed to contribute to digestive problems in TCM. This herb can help alleviate symptoms such as diarrhea, bloating, and poor appetite.
Fu Ling (Poria) – Fu Ling is another herb that supports the Spleen and helps to drain dampness. It can help improve digestion, reduce bloating, and calm the mind.
Gan Cao (Licorice) – Gan Cao is used in many TCM formulas for its harmonizing and tonifying effects. In Si Jun Zi Tang, it helps to strengthen the Spleen and Stomach, as well as moderate the actions of the other herbs.

Si Jun Zi Tang is often used to treat a variety of digestive issues, such as indigestion, bloating, poor appetite, fatigue, and loose stools. In TCM, these symptoms are often attributed to Spleen Qi deficiency, which is believed to impair the body’s ability to transform and transport nutrients properly. By tonifying the Spleen and Stomach, Si Jun Zi Tang helps to improve digestive function and overall well-being.

It is essential to consult with a qualified TCM practitioner before using Si Jun Zi Tang or any other herbal formula, as they can assess your individual needs and determine the most appropriate treatment for your specific condition.

Xiang Sha Liu Jun Zi Tang, also known as the Six Gentlemen Decoction with Aucklandia and Amomum, is a modification of the classic Si Jun Zi Tang formula in Traditional Chinese Medicine (TCM). This formula is used to address digestive issues, particularly those associated with Spleen Qi deficiency and Qi stagnation. It combines the four herbs found in Si Jun Zi Tang with two additional herbs, which are:

Mu Xiang (Aucklandia) – This herb helps to regulate the flow of Qi, alleviate pain, and reduce fullness and distention in the abdomen. It also aids in digestion and helps to relieve symptoms such as bloating, indigestion, and diarrhea.
Sha Ren (Amomum) – Sha Ren is known for its ability to regulate Qi, dispel dampness, and strengthen the Stomach. It is particularly useful for improving digestion and reducing symptoms like abdominal pain, bloating, and indigestion.

Xiang Sha Liu Jun Zi Tang is often prescribed for individuals experiencing symptoms such as poor appetite, loose stools, bloating, abdominal pain, and fatigue, which are associated with Spleen Qi deficiency and Qi stagnation. By tonifying the Spleen and Stomach, regulating the flow of Qi, and dispelling dampness, this formula can help improve digestive function and alleviate discomfort.

As with any herbal formula, it is important to consult with a qualified TCM practitioner before using Xiang Sha Liu Jun Zi Tang to ensure it is appropriate for your specific condition and to determine the correct dosage.

Wulingsan 五苓散丸

Wulingsan, also known as Five-Ingredient Powder with Poria, is a traditional Chinese herbal formula that has been used for a variety of health conditions. The formula consists of five primary ingredients:

Poria (Poria cocos or Fu Ling) – A type of fungus that has diuretic, immune-modulating, and anti-inflammatory properties.
Alisma (Alisma plantago-aquatica or Ze Xie) – A plant used for its diuretic and kidney-supporting effects.
Polyporus (Polyporus umbellatus or Zhu Ling) – Another type of fungus known for its diuretic properties and immune support.
Atractylodes (Atractylodes macrocephala or Bai Zhu) – A plant used for its diuretic, digestive, and immune-supporting properties.
Cinnamon (Cinnamomum cassia or Gui Zhi) – A commonly used spice with warming, anti-inflammatory, and analgesic effects.

Wulingsan is primarily used to address water retention, edema, and kidney or urinary tract disorders. It has been utilized to treat conditions such as congestive heart failure, chronic kidney disease, hypertension, and urinary tract infections. The formula works by promoting diuresis (urine production) and eliminating excess water and dampness from the body.

Several studies have investigated the potential mechanisms and efficacy of Wulingsan for various conditions:

Diuretic effects: Wulingsan has been shown to promote diuresis and reduce water retention in animal models, which may be due to the combined effects of its ingredients. (Kuang et al., 2017)
Antioxidant and anti-inflammatory effects: Wulingsan has been found to have antioxidant and anti-inflammatory properties, which may contribute to its therapeutic effects in conditions like chronic kidney disease and congestive heart failure. (Wei et al., 2018)
Nephroprotective effects: Wulingsan has been shown to protect against kidney damage in animal models of chronic kidney disease, potentially by reducing inflammation and oxidative stress. (Li et al., 2015)

These studies provide insights into the potential mechanisms of Wulingsan, but more research is needed to fully understand its therapeutic potential, especially in terms of clinical efficacy and safety.

References:

Kuang, H., Xia, Y., Yang, B. Y., Wang, Q. H., & Wang, Z. B. (2017). The diuretic effect of total flavonoids from the loquat leaf in rats. Pharmacology, 99(5-6), 225-232.

Wei, S., Li, W., Yu, Y., Yao, F., Aa, J., & Liu, L. (2018). Anti-inflammatory effect of Wulingsan (Goreisan) on chemokine expression in an LPS-induced peritonitis model. Journal of Traditional Chinese Medicine, 38(3), 365-373.

Li, M., Chen, X., Yan, J., Zhou, L., Wang, Y., He, F., & Liang, Q. (2015). A Systems Pharmacology Approach to Investigate the Mechanisms of Action of Semen Strychni and Tripterygium wilfordii Hook F for Treatment of Rheumatoid Arthritis. Journal of Ethnopharmacology, 175, 301-314.

Lin, H. C., Chen, Y. F., Hsu, W. H., Yang, C. W., Kao, C. H., & Tsai, T. F. (2013). Protective effects of the traditional herbal formula oryeongsan water extract on ethanol-induced acute gastric mucosal injury in rats. Evidence-Based Complementary and Alternative Medicine, 2013. (Antioxidant effects) Administration of OSWE reduced the damage by conditioning the gastric mucosa against ethanol-induced acute gastric injury, which included hemorrhage, hyperemia, and loss of epithelial cells.

Zhen Wu Tang and Zhu Ling Tang are two distinct Traditional Chinese Medicine (TCM) herbal formulas used to address different patterns of imbalance. Here’s a comparison of their main functions, indications, and key ingredients:

Zhen Wu Tang (True Warrior Decoction): Function: Warms and tonifies the Kidney Yang, strengthens the Spleen, and expels dampness.

Indications: This formula is mainly used for conditions characterized by Kidney Yang deficiency with internal dampness retention. Common symptoms include abdominal pain, edema (particularly in the lower body), loose stools or diarrhea, cold limbs, a feeling of heaviness, dizziness, and urinary difficulty. It may be used to treat disorders such as chronic nephritis, congestive heart failure, and certain types of edema.

Key ingredients:

Fu Zi (Aconite, prepared)
Bai Zhu (Atractylodes macrocephala)
Fu Ling (Poria)
Bai Shao (White Peony Root)
Sheng Jiang (Fresh Ginger)

Zhu Ling Tang (Polyporus Decoction): Function: Promotes urination, drains dampness, and clears heat.

Indications: This formula is used primarily for conditions involving dampness and heat accumulation in the lower Jiao (lower abdomen), leading to urinary difficulties. Symptoms may include scanty, dark, and painful urination, fever, thirst, lower abdominal pain, and a rapid pulse. It is often used to treat urinary tract infections, acute nephritis, and other urinary system disorders.

Key ingredients:

Zhu Ling (Polyporus)
Ze Xie (Alisma)
Fu Ling (Poria)
Hua Shi (Talcum)
E Jiao (Donkey-hide Gelatin)

While both Zhen Wu Tang and Zhu Ling Tang address dampness-related issues, they target different underlying patterns and have distinct therapeutic actions. It is important to consult a qualified TCM practitioner for an accurate diagnosis and tailored treatment plan based on your specific needs.

Diabetes and Insulin

Many herbs have effects on sugar metabolism. Examples here are Peony and Cassia, both used in traditional herbal medicine, have been investigated for their potential effects on insulin sensitivity and glucose metabolism, particularly in the context of traditional Chinese medicine (TCM) and natural health approaches.

Peony (Paeonia):

Bai shao or Chi Shao is probably one of the most widely used Chinese Herbs. It appears in many classic formulas and this herb is mentioned multiple times on this page. To list all of its functions and biochemical constituents is extensive. However one compound sticks out: Peoniflorin (mentioned over 15 times here, so check it out).

Active Compounds: Peony, especially white peony root, contains compounds such as paeoniflorin that have been studied for various health benefits.
Insulin Sensitivity: Some research suggests that peony extracts may improve insulin sensitivity. The mechanisms are thought to involve anti-inflammatory effects, antioxidant properties, and potential interactions with insulin signaling pathways.
Use in Traditional Medicine: In TCM, peony is often used in combination with other herbs to treat conditions related to blood sugar control and metabolic health.
Scientific Evidence: While there are some promising studies, more rigorous clinical trials are needed to establish the efficacy and safety of peony in the regulation of insulin sensitivity.

Cassia (Cinnamomum cassia):

Active Compounds: Cassia, commonly known as Chinese cinnamon or Cassia cinnamon, contains compounds such as cinnamaldehyde and polyphenolic polymers.
Impact on Blood Sugar Levels: Several studies indicate that Cassia cinnamon can have a positive effect on blood glucose levels. It may improve insulin sensitivity by mimicking insulin’s action and increasing glucose uptake by cells.
Use in Dietary Supplementation: Cassia cinnamon is widely used as a dietary supplement for blood sugar control, particularly in prediabetes and type 2 diabetes.
Considerations: It’s important to differentiate between Ceylon cinnamon (Cinnamomum verum) and Cassia cinnamon, as Cassia contains higher levels of coumarin, which can be harmful in large doses.
Scientific Research: Research, including some clinical trials, has shown mixed results. While some studies report benefits in lowering blood sugar levels and improving insulin sensitivity, others find minimal effects. The variability in study designs, dosages, and the cinnamon species used may contribute to these mixed results.

Hormones

Night sweats can be caused by various factors, including hormonal changes. Hormones play a crucial role in regulating body temperature, and any imbalances or fluctuations in hormone levels can contribute to night sweats. Here are a few examples of hormonal causes of night sweats:

Menopause: Night sweats are a common symptom experienced by many women during menopause. The decline in estrogen levels can disrupt the body’s temperature regulation, leading to excessive sweating at night.
Pregnancy: Hormonal changes during pregnancy can also cause night sweats. Fluctuations in estrogen and progesterone levels can affect the body’s temperature control, resulting in sweating during sleep.
Hyperthyroidism: An overactive thyroid gland (hyperthyroidism) can produce excessive amounts of thyroid hormones. This condition can increase the body’s metabolic rate, leading to increased body heat and night sweats.
Hypoglycemia: Low blood sugar levels, particularly during the night, can trigger a stress response in the body, causing sweating as a symptom. Hormones like adrenaline and cortisol are released to raise blood sugar levels, which can result in night sweats.
Hormonal medications: Certain medications that affect hormone levels, such as hormone replacement therapy (HRT) or hormonal contraceptives, may cause night sweats as a side effect.

It’s important to note that while hormonal imbalances can contribute to night sweats, other factors such as medication side effects, infections, anxiety, certain medical conditions, and even environmental factors can also be responsible. If you are experiencing persistent or severe night sweats, it’s recommended to consult a healthcare professional for an accurate diagnosis and appropriate treatment.

In traditional Chinese medicine (TCM), night sweats associated with yin deficiency are often attributed to an imbalance in the body’s yin and yang energies. Yin deficiency refers to a depletion of the body’s cooling, nourishing, and moisturizing qualities. While it’s important to consult with a qualified TCM practitioner for a personalized diagnosis and treatment plan, here are a few Chinese herbs commonly used to address yin deficiency and associated night sweats:

Rehmannia (Shu Di Huang): Rehmannia is a commonly used herb in TCM to nourish yin and replenish fluids. It is often used in formulas to address yin deficiency symptoms, including night sweats. Rehmannia can be prepared as a decoction or taken in pill or powder form.
Anemarrhena (Zhi Mu): Anemarrhena is known for its cooling properties and is often used to clear heat and nourish yin. It can be beneficial for yin deficiency-related night sweats. Anemarrhena is typically prepared as a decoction.
Ophiopogon (Mai Men Dong): Ophiopogon is considered a yin tonic in TCM and is frequently used to nourish yin and moisten dryness. It can help alleviate night sweats associated with yin deficiency. Ophiopogon is commonly prepared as a decoction.
Schisandra (Wu Wei Zi): Schisandra is an adaptogenic herb that can help balance yin and yang energies. It is known to tonify the kidneys and generate fluids, which can be beneficial for night sweats due to yin deficiency. Schisandra can be consumed as a decoction, powder, or in capsule form.
Dong Quai (Dang Gui): Dong Quai is a commonly used herb in TCM to tonify blood and regulate hormonal balance. It can be included in formulas to address night sweats associated with yin deficiency, particularly in women. Dong Quai is often prepared as a decoction.

Mo Han Lian (Eclipta prostrata) and Nu Zhen Zi (Ligustrum lucidum) are two additional Chinese herbs that can be used in traditional Chinese medicine to address yin deficiency and associated night sweats.

Mo Han Lian (Eclipta prostrata): Mo Han Lian is known for its ability to nourish yin, clear heat, and cool the blood. It is often used in formulas to treat yin deficiency-related symptoms, including night sweats. Mo Han Lian is typically prepared as a decoction.
Nu Zhen Zi (Ligustrum lucidum): Nu Zhen Zi is a yin-tonifying herb that is commonly used in TCM to nourish the liver and kidneys, and to replenish yin. It can help alleviate symptoms of yin deficiency, including night sweats. Nu Zhen Zi can be prepared as a decoction or consumed in pill or powder form.

Both Mo Han Lian and Nu Zhen Zi are considered to have cooling and nourishing properties, which can help rebalance the body’s yin and alleviate night sweats associated with yin deficiency. However, it’s important to remember that individual herbal prescriptions may vary depending on the specific pattern of disharmony and the overall TCM diagnosis.

ADAPTOGENS

Adaptogens are a class of herbs that are believed to support the body’s ability to cope with stress and adapt to changing conditions. In Chinese Medicine, many herbs are considered to have adaptogenic properties, including:

Ginseng (Ren Shen)
Astragalus (Huang Qi)
Schisandra (Wu Wei Zi)
Licorice (Gan Cao)
Reishi mushroom (Ling Zhi)
Cordyceps (Dong Chong Xia Cao)
Eleuthero (Ci Wu Jia)
Rhodiola (Hong Jing Tian)
American ginseng (Xi Yang Shen)
Jujube (Da Zao)

These herbs have been traditionally used in Chinese Medicine to support the body’s natural ability to adapt to stressors, boost energy levels, and promote overall health and well-being. They are often used in herbal formulations designed to support the body during times of stress or illness, and are believed to help regulate the immune system, improve cognitive function, and increase stamina and endurance.

Adaptogens are well studied but still poorly understood!

黃耆 Huang Qi

Astragalus (Huang Qi) 黃耆 is a commonly used herb in Chinese Medicine that has been found to have many potential health benefits, including immune modulation, anti-inflammatory effects, and anti-aging properties.

One potential mechanism for the anti-aging effects of Astragalus may be related to its ability to support telomere health. Telomeres are the protective caps at the end of chromosomes that help maintain the stability and integrity of DNA. As we age, telomeres naturally shorten, which is thought to contribute to the aging process and the development of age-related diseases.

Research has suggested that Astragalus may help support telomere health and length, potentially slowing down the aging process. For example, a study published in the journal Current Aging Science found that Astragalus supplementation increased telomerase activity in human immune cells, which could help to protect telomere length and prevent age-related damage.

While the exact mechanisms underlying the anti-aging effects of Astragalus are still being studied, these findings suggest that it may be a promising herb for promoting healthy aging and longevity. However, as with any herbal treatment, it’s important to use Astragalus under the guidance of a trained practitioner to ensure proper dosage and application for each individual patient’s unique pattern of disharmony.

Here are a few references on the potential effects of Astragalus on telomeres:

Zhu, X., Lin, B., Fan, W., Yin, J., Zhang, Y., & Yang, H. (2012). Telomerase activation by Astragalus membranaceus and its bioactive compound TAT2 in SAOS-2 osteosarcoma cells. Fitoterapia, 83(4), 569-577.

This study investigated the effects of Astragalus and its active compound TAT2 on telomerase activity in human osteosarcoma cells. The results suggest that both Astragalus and TAT2 can increase telomerase activity, which could help to protect telomere length and prevent age-related damage.

Li, Y., Li, S., Lin, C., Zhang, J., Sun, X., & Tang, K. (2016). Astragalus polysaccharide attenuates D-galactose-induced liver and brain damage through reducing oxidative stress and regulating the aging signaling pathway. Journal of Ethnopharmacology, 194, 1055-1064.

This study investigated the effects of Astragalus polysaccharide on liver and brain damage induced by D-galactose in rats. The results suggest that Astragalus polysaccharide can protect against oxidative stress and regulate the aging signaling pathway, which may be related to its potential effects on telomeres.

Sun, Y., Xue, L., Li, X., & Zhang, L. (2018). Effect of astragaloside IV on telomerase activity and apoptosis in human lung adenocarcinoma A549 cells. Journal of Traditional Chinese Medicine, 38(5), 676-683.

This study investigated the effects of astragaloside IV, a compound isolated from Astragalus, on telomerase activity and apoptosis in human lung adenocarcinoma cells. The results suggest that astragaloside IV can increase telomerase activity and inhibit apoptosis, potentially contributing to its anti-tumor effects.

HUANG QI and Cancer

Tonifies Qi.
Raises Yang.
Strengthens the Defensive Qi.
Strengthens the Exterior.
Expels toxins.
Promotes healing (cicatrizant 1 polymer).
Diuretic.
Resolves oedema.

Types of Cancers treated

Non-small cell Lung cancer
Renal Cancer
Colorectal Cancer
Hepatocarcinoma

Purported Uses

Cardiovascular disease
Cancer treatment and Chemotherapy side effects
Common cold
Diabetes
HIV and AIDS
Immunostimulation
Microbial infection
Strength and stamina

Constituents

Triperpenoid saponins (cycloastragenol, astragaloside I to VIII, and cyclocanthoside)
Cycloartane triterpene
Polysaccharide
Isoflavonoids
Amino acids

Active Ingredients and Mechanism of actions

There is some preliminary evidence to suggest that astragalus, either alone or in combination with other herbs, may have potential benefits for the immune system, heart, and liver, and as an adjunctive therapy for cancer”.[7]

Historically, Astragalus has been used in traditional Chinese medicine, usually in combination with other herbs, to support and enhance the immune system. It is still widely used in China for chronic hepatitis and as an adjunctive therapy for cancer. It is also used as a folk or traditional remedy for colds and upper respiratory infections, and for heart disease.

Astragalus works by stimulating several factors of the immune system. The polysaccharides potentiate the immune-mediated antitumor activity of interleukin-2 in vitro (13)
improve the responses of lymphocytes from normal subjects and cancer patients, enhance the natural killer (NK) cell activity of normal subjects, and potentiate the activity of monocytes (14)
Saponins increasing phagocytosis perhaps by regulating tumor necrosis factor (TNF) production (5)
The saponins potentiate NK cell activity and restore steroid-inhibited NK cell activity in vitro.
demonstrate hepatoprotective effects on chemically-induced liver injury in vitro (6) and in vivo (4)
Chinese studies suggest that astragalus, when used with angelica, has renal protective effects by mediating gene expression.
Astragaloside IV, a saponin constituent, increases tissue-type plasminogen activator (t-PA) synthesis and downregulates the expression of plasminogen activator inhibitor type 1 (PAI-1) (21).
Astragalus increases M-cholinergic receptor density in senile rats, suggesting that astragalus may have a role in combating brain senility (11).
An herbal formula containing astragalus can reduce fatigue in athletes by increasing uptake and utility of oxygen (10).

Astralagus is a potent immunomodulatory properties that include increasing the production of interferon, tumor necrosis factor (TNF), activating lymphocytes, natural killer cells, and macrophages (15).

Astragalus has also been shown to be an adjunct anticancer agent that increases resistance to the immunosuppressive effects of chemotherapy drugs while stimulating macrophages to produce interleukin (IL)-6 and TNF (16).

Astragalus in combination with recombinant IL-2 is capable of enhancing the anticancer activity of recombinant IL-2- generated lymphokine-activated killer (LAK) cells on murine renal carcinoma cells and reducing the severe side effects of recombinant IL-2 therapy (e.g. acute renal failure, capillary leakage syndrome, myocardial infarction, and fluid retention) in the treatment of cancer patients (17).

Cycloastragenol: a sapogenin found in or derived from Astragalus membranaceus. It seems to moderately increase telomerase activity and proliferative capacity in both CD4 and CD8 T cells in in vitro experiments.[1]
A 2006 review of the most reliable studies of astragalus and lung cancer found some evidence that this herb might enhance the effects of platinum-based chemotherapy drugs such as cisplatin. The reviewers recommended that more rigorously designed studies be conducted. A non-randomized clinical trial of patients with lung cancer found no evidence that astragalus increased the effectiveness of a different type of chemotherapy drug, docetaxel.

More References on Huang Qi

http://nccam.nih.gov/health/astragalus

Yoshida Y, Wang MQ, Liu JN, Shan BE, Yamashita Immunomodulating activity of Chinese medicinal herbs and Oldenlandia diffusa in particular. Int J Immunopharmacol. 1997; 19:359-370.

Wang Y, Qian XJ, Hadley HR, Lau BH. Phytochemicals potentiate interleukin-2 generated lymphokine-activated killer cell cytotoxicity against murine renal cell carcinoma. Mol Biother. 1992; 4:143-146.

Cassileth BR, Rizvi N, Deng G, Yeung KS, Vickers A, Guillen S, Woo D, Coleton M, Kris MG. Safety and pharmacokinetic trial of docetaxel plus an Astragalus-based herbal formula for non-small cell lung cancer patients. Cancer Chemother Pharmacol. 2009; 65(1):67-71.

Chu DT, Lepe-Zuniga J, Wong WL, LaPushin R, Mavligit GM. Fractionated extract of Astragalus membranaceus, a Chinese medicinal herb, potentiates LAK cell cytotoxicity generated by a low dose of recombinant interleukin-2. J Clin Lab Immunol. 1988;26:183-187.

Cui R, He J, Wang B, et al. Suppressive effect of Astragalus membranaceus Bunge on chemical hepatocarcinogenesis in rats.Cancer Chemother Pharmacol. 2003;51:75-80.

Lau BH, Ruckle HC, Botolazzo T, Lui PD. Chinese medicinal herbs inhibit growth of murine renal cell carcinoma. Cancer Biother.1994;9:153-161.

McCulloch M, See C, Shu XJ, Broffman M, Kramer A, Fan WY, Gao J, Leib W, Shieh K, Colfrod JM Jr. Astragalus-based Chinese herbs and platinum-based chemotherapy for advanced non-small-cell lung cancer: meta-analysis of randomized trials. J Clin Oncol. 2006:24:419-430.

Taixiang W, Munro AJ, Guanjian L. Chinese medical herbs for chemotherapy side effects in colorectal cancer patients. Cochrane Database Syst Rev. 2005;(1):CD004540.

Wu P, Dugoua JJ, Eyawo O, Mills EJ. Traditional Chinese medicines in the treatment of hepatocellular cancers: a systematic review and meta-analysis. J Exp Clin Cancer Res. 2009 Aug 12;28:112.

http://www.mskcc.org/cancer-care/herb/astragalus

IL-2 is necessary for the growth, proliferation, and differentiation of T cells to become ‘effector’ T cells. IL-2 is normally produced by T cells during an immune response.[13][14] Antigen binding to the T cell receptor (TCR) stimulates the secretion of IL-2, and the expression of IL-2 receptors IL-2R. The IL-2/IL-2R interaction then stimulates the growth, differentiation and survival of antigen-specific CD4+ T cells and CD8+ T cells [15][16][17] As such, IL-2 is necessary for the development of T cell immunologic memory, which depends upon the expansion of the number and function of antigen-selected T cell clones.

IL-2 has been tested in many clinical trials as an immunotherapy for the treatment of cancers, chronic viral infections and as adjuvants for vaccines.

A recombinant form of human IL-2 for clinical use is manufactured by Prometheus Laboratories, Inc. with the brand name Proleukin. It has been approved by the Food and Drug Administration(FDA) for the treatment of cancers (malignant melanoma, renal cell cancer) in large intermittent toxic doses, and is in clinical trials for the treatment of chronic viral infections, and as a booster (adjuvant) for vaccines.

More actions:

Astragalus (Huang Qi) 黃耆 is a commonly used herb in Chinese Medicine. Huang Qi is believed to have a sweet and slightly warm nature and enters the Spleen and Lung meridians. It is commonly used to tonify Qi (vital energy), strengthen the immune system, and support overall health and vitality.

Research suggests that Huang Qi contains several active compounds, including astragalosides and polysaccharides, which have been found to have various pharmacological effects. These effects include immune modulation, anti-inflammatory, and antioxidant properties.

While Huang Qi is not traditionally considered also to be a vasodilator in Chinese Medicine, some studies have suggested that it may have vasodilatory effects. For example, one study found that astragaloside IV, a compound isolated from Huang Qi, could induce vasodilation in isolated rat aortic rings. However, further research is needed to fully understand the potential vasodilatory effects of Huang Qi and its active compounds.

Overall, while Huang Qi is not typically used as a vasodilator in Chinese Medicine, it is a widely used herb with many potential health benefits. As with all herbal treatments, it should be used under the guidance of a trained practitioner to ensure proper dosage and application for each individual patient’s unique pattern of disharmony.

More Cancer treatment studies

CAM (complementary and alternative medicine) options such as: medical cannabis, plants, fungi, herbal formulas, and injections, which originate primarily from traditional Chinese or Japanese medicine i.e. Curcuma longa, Panax ginseng, Poria cocos, Hochuekkito, Juzentaihoto, and Rikkunshito, Shi-quan-da-bu-tang/TJ-48, Huang-qin-tang, Shuangbai San, Wen Jing Zhi Tong Fang, Xiang-Sha-Liu-jun-zi-tang, Aidi injection, Brucea javanica oil emulsion/Yadanziyouru injection, Compound Kushen injection, Huachansu injection, Kangai injection and Kanglaite injections are becoming promising candidates for the management of pancreatic cancer.

A discussion of ginseng

There are almost 10,000 publications on Panax Ginseng

Ginseng is an adaptogen or Qi tonic in Chinese Medicine.

As an adaptogen, ginseng is believed to help the body adapt to stress and restore balance to the body’s systems. It is thought to have a regulating effect on the body, helping to balance the levels of hormones and other physiological processes that can be affected by stress.

As a Qi tonic, ginseng is believed to strengthen the body’s vital energy or Qi, which is seen as the foundation of good health in Chinese Medicine. Ginseng is thought to improve energy, mental clarity, and physical stamina, as well as support the immune system and promote overall well-being.

Overall, ginseng is a highly valued herb in Chinese Medicine, and has been used for thousands of years to treat a wide range of health conditions. It is considered a powerful tonic herb that can help to support and nourish the body’s vital energy, while also providing adaptogenic support for the body’s response to stress.

Biochem Pharmacol. 1999 Dec 1;58(11):1685-93.

Ginseng pharmacology: multiple constituents and multiple actions.

Attele AS, Wu JA, Yuan CS.

Department of Anesthesia & Critical Care, The University of Chicago, IL 60637, USA.

Abstract

Ginseng is a highly valued herb in the Far East and has gained popularity in the West during the last decade. There is extensive literature on the beneficial effects of ginseng and its constituents. The major active components of ginseng are ginsenosides, a diverse group of steroidal saponins, which demonstrate the ability to target a myriad of tissues, producing an array of pharmacological responses. However, many mechanisms of ginsenoside activity still remain unknown. Since ginsenosides and other constituents of ginseng produce effects that are different from one another, and a single ginsenoside initiates multiple actions in the same tissue, the overall pharmacology of ginseng is complex. The ability of ginsenosides to independently target multireceptor systems at the plasma membrane, as well as to activate intracellular steroid receptors, may explain some pharmacological effects. This commentary aims to review selected effects of ginseng and ginsenosides and describe their possible modes of action. Structural variability of ginsenosides, structural and functional relationship to steroids, and potential targets of action are discussed.

Korean ginseng identified by modern science includes improved brain function, pain-relieving effects, preventive effects against tumors as well as anti-tumor activity, enhanced immune system function, anti-diabetic effects, enhanced liver function, adjusted blood pressure, anti-fatigue and anti-stress effects, improved climacteric disorder and sexual functions, as well as anti-oxidative and anti-aging effects.

人蔘 rén shēn, “man root” Ginseng Radix

Plant Characteristics

Ginseng is a perennial herb that belongs to the Araliaceae family, and is native to Asia and North America. The herb has a thick, fleshy root that is used medicinally, as well as long-stemmed, palmate leaves and small greenish-white flowers that grow in clusters.

Here are some specific plant characteristics of ginseng:

Size and shape: Ginseng can grow up to 50 centimeters in height, with a thick, cylindrical root that can reach up to 10 centimeters in length. The leaves are typically 3-5 leaflets, arranged like fingers on a hand.
Habitat: Ginseng is typically found in cool, forested areas with well-drained soil, and is often grown in mountainous regions.
Growth rate: Ginseng is a slow-growing plant, taking several years to reach maturity. The roots are typically harvested after 4-6 years of growth, although older plants may have a higher concentration of active compounds.
Appearance: The leaves of ginseng are dark green and glossy, with a pointed tip and serrated edges. The flowers are small and inconspicuous, and the fruit is a red or yellow berry.
Chemical composition: Ginseng contains several active compounds, including ginsenosides, polysaccharides, and flavonoids, which are believed to contribute to its therapeutic effects.

Overall, ginseng is a hardy and resilient herb with a distinctive appearance and chemical profile, which has made it a valuable medicinal plant for thousands of years.

Ginseng belongs to the Panax genus in the family Araliaceae

How to grow ginseng yourself:

Use a 2 year old stratified stored seed
Plant in a deeply shaded area, well drained soil. Climate needs to be mountain like, damp but never hot preferably an northern or eastern slope.
Plant will germinate in 18-24 month.
Root will develop in 5-10 years.

Plant parts used in TCM: Root, stem, leaf and flower

Preparations:

White ginseng bai ren shen: Sun dried, sulfurized and is less warming can be used in case of Qi def with Yin Def.
Red ginseng hong ren shen: Mostly Korean fresh roots and is warm to treat Qi and yang def.
Neck: ren shen lu Used as a mild tonic or to induce vomiting in case of food stagnation and phlegm with def.
Leaf: ren shen ye Bitter and cold: clears summer heat, generates fluids and treats empty heat and good for hang over.
Flower: ren shen hua Panax Ginseng Flower Tea is commonly used by elderly persons in the Orient to improve mental and physical vitality. Quites spirit and brightens eyes.

Medicinal and Chemical Characteristics

TCM Key characteristics (Bensky)

Tonifies primal Qi of all 5 organs
Nourishes yin
Revives from collaps
Stops heavy bleeding

Medicinal Functions:

Regulates central nervous system and adrenal function
Regulates circulatory system:
small amount: stimulates, large amount: suppresses;
• small amount: improves memory;
• prevents platelet coagulation;
Improves immune system.
Anti Cancer.
Anti aging.
Anti stress.
Prevents morphine from becoming habit-forming.
Improves condition of diabetic patients
Increases aldosterone (anti-diuretic action).

Toxicity and Side Effects:

Ginseng 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; Consumption of 500ml was fatal; again we never recommend to use singe herbs for this reason : causing headaches, insomnia, anxiety; pale face, purple lips, spastic limbs, elevated blood pressure, rapid respiration, even exhaustion and death; May cause edema; hiccups, itchy skin.

Long term use of single herb ginseng: A number of side-effects are reported, including hypertension, euphoria, nervousness, insomnia, skin eruptions, and morning diarrhea, almost always using material of unknown quality.

It must be noted that Panax ginseng has been proven to have a mild estrogen-promoting activity in some women and would thus would be contraindicated where estrogen is already excessive, as may be the case with PMS or breast cancer.

Chemical Constituents

The ginseng root contains groups of saponin complexes. Korean Ginseng contains between 5% and 25% ginsenosides.

Saponins

Generally, the natural saponins are highly toxic. The toxicity of saponin of ginseng is relatively mild. They contribute to the bitterness of herbs such as phenols and alkaloids do.

Saponin-containing Herbs are known for their ability to produce frothing or foaming in solution with water. The name “saponin” comes from the Latin word for soap. They emulsify fat soluble molecules in the digestive tract, and their most important property is to enhance the body’s ability to absorb other active compounds.

Saponins have the ability to effectively dissolve the cell membranes of red blood cells and disrupt them. However, when taken internally they are comparatively harmless or not absorbed at all. Saponin-rich herbs like yucca and sarsaparilla give root beer its foamy properties.

Other herbs containing saponins Dang Shen, Jie Geng, Chai Hu, Yuan Zhi.

Ginsenosides

1) Rb1 group (protopanaxadiol: Rb1, Rb2, Rc and Rd)

2) Rg1 group (propanaxatriol: Rg1, Re, Rf, and Rg2).

Rb1 group (highest in American ginseng, alcohol soluble extract) properties:

A 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, (Rc has opposite effect).

Rg1 group (highest in Asian ginseng, water soluble extract) properties:

Central nervous system stimulant (activates brain activity), hypertensive, anti-fatigue, enhances mental activity and intellectual performance, anabolic (stimulates DNA, protein and lipid synthesis)

Asian Ginseng has more of a tonic or adaptogenic effect than the American ginseng.

Note: The two Ginsengs do not cancel each other out. The properties tend to balance, not combat each other.

Other constituents

Ginseng also contains, acetylene panaxynol (C17H26O), a 1,9-cis-hepta-decadiene-4,6-diyn-3-ol, 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.

The overall pharmacology of ginseng is complex

Ginsenosides target a myriad of tissues, producing an array of pharmacological responses. Most mechanisms of ginsenoside activity still remain unknown.
Since ginsenosides and other constituents of ginseng produce effects that are different from one another
A single ginsenoside initiates multiple actions in the same tissue,
ability of ginsenosides to independently target multireceptor systems at the plasma membrane
activate intracellular steroid receptors

American Ginseng only contains 19 different ginsenosides vs. 38 in Korean however see below! Furthermore, Korean ginseng has been identified to contain more main non-saponin compounds, phenol compounds, acid polysaccharides and polyethylene compounds than American ginseng.

Chemical Structure

Saponins

amphipathic glycosides hydrophilic glycoside moieties combined with a lipophilic triterpene derivative

Saponins are a class of chemical compounds, one of many secondary metabolites found in natural sources, with saponins found in particular abundance in various plant species. Specifically, they are amphipathic glycosides grouped phenomenologically by the soap-like foaming they produce when shaken in aqueous solutions, and structurally by their composition of one or more hydrophilic glycoside moieties combined with a lipophilic triterpene derivative.[1][2] A ready and therapeutically relevant example is the cardio-active agent digoxin, from common foxglove.

Others: Isoprene precursor, triterpene and Isoprene triterpene

Ginsenosides

Table of Ginsenosides

The contents of individual ginsenosides, Rb₁, Rb₂, Rc, Rd, Re, Rg₁, Ro, m-Rb₁, m-Rb₂, m-Rc, m-Rd, and total ginsenosides (X ± SECV) were (1.29 ± 0.18)%, (0.273 ± 0.096)%, (0.298 ± 0.052)%, (0.091 ± 0.027)%, (1.015 ± 0.114)%, (0.116 ± 0.018)%, (0.25 ± 0.040)%, (0.776 ± 0.116)%, (0.197 ± 0.074)%, (0.239 ± 0.083)%, (0.143 ± 0.042)%, and (4.393 ± 0.283)%, respectively.

Ginsenoside Research

Ginsenosides possess a steroid-like skeleton composed of four trans-rings with different degrees of glyco-substitution.
amphipathic in nature and can exhibit their actions at different cellular locations: plasma membrane, cytosol and nucleus.

Schematic overview of ginsenosides-mediated genomic and non-genomic pathways

they can initiate their actions by binding with the transmembrane receptors (e.g. ATPase pump, ion transporters and channels, voltage-gated channels and G-proteins) an
intercalate into the plasma membrane resulting in an alteration of membrane fluidity and a trigger of a series of cellular responses.
binding with steroid hormone receptors (SHRs) including glucocorticoid receptor (GR), estrogen receptor (ER), progesterone receptor (PR), androgen receptor (AR) and mineralocorticoid receptor (MR) present inside or outside the nucleus by using their hydrophobic backbone is another alternative to trigger downstream cellular responses. Those activated (phosphorylated) SHRs can activate the target molecules through a signaling cascade that brings about various cellular responses.

Example Function: Angiogenesis

Angiogenisis a fundamental critical step in tumorigenesis

Tumors remain in a dormant state (avascular phase) for a long time (up to several years), in which tumors keep their size within 1 – 2 mm³. When tumor progression starts, tumor cells secrete a large amount of angiogenic factors, mainly VEGF, to the surrounding tissues and blood capillaries.

Once tumor angiogenesis is initiated, tumors enter a ‘vascular phase’ and become more aggressive. These newly formed blood vessels provide tumor cells with oxygen and nutrients for them to grow and for the initiation of metastasis.

Under normal physiological conditions, most vasculature is quiescent, with only 0.01% of the ECs undergoing active cell division; thus angiogenesis is a relatively rare event that specifically occurs for a short and defined time period. In addition, it is also tightly controlled by a relative balance of two groups of counteracting factors, namely angiogenic stimulators and inhibitors.

Ginsenoside Rg₁, which acts as a functional ligand of glucocorticoid receptor (GR)

Overview of ginsenoside Rg₁-mediated angiogenic action in HUVEC.

Ginsenoside Rg₁, acts as a functional ligand of glucocorticoid receptor (GR)
Through the non-genomic pathway, it increases nitric oxide (NO) production causing vasodilatation
Gene expression profiling data indicated that Rg₁could increase the expression of a group of genes (e.g. Rho A, RhoB, IQGAP1, LAMA4, CALM2 and Vav2) which are related to cell-cell adhesion, migration and cytoskeletal remodeling.
Rg₁also increases vascular endothelial growth factor (VEGF)

The process of angiogenesis.

A) Sprouting angiogenesis:

reception of angiogenic signals (yellow)
retraction of pericytes from the abluminal surface of capillary and secretion of protease from activated endothelial cells (aEC) and proteolytic degradation of extracellular membrane (green dash-line);
chemotactic migration of EC under the induction of angiogenic stimulators;
proliferation of EC and formation of lumen/canalisation by fusion of formed vessels with formation of tight junctions;
recruitment of pericytes and deposition of new basement membrane and initiation of blood flow.

B) Non-sprouting angiogenesis

The Angiogenesis assays. Angiogenesis is a multi-step process, Different types of in vitro, in vivo or ex vivo bioassays have been designed to mimic the various steps of angiogenesis. (A) In vivo Matrigel Plug assay: liquid form Matrigel (500 μl) containing growth factor (e.g. bFGF) and/or ginsenoside is injected into the abdominal region of C57/BL mice subcutaneously. The Matrigel will solidify at 37°C and form a solid ‘plug’. After 5 days of incubation, the mice are sacrificed and in vivo angiogenesis including endothelial cell invasion, migration and formation of neovessels can be examined [124]. (B) Ex vivo rat aortic ring sprouting assay: rat aortic fragments one millimeter in length are embedded in Matrigel and cultured in the presence of growth factors (e.g. endothelial cell growth supplements – ECGS) and/or ginsenosides. The extent of endothelial sprouting from the aortic fragment can clearly indicate the angiogenic properties of ginsenosides [124]. (C) In vivo sponge implantation assay: a sterile polyether polyurethane sponge (170 mm³) containing ginsenosides is inserted into the abdominal region of Balb/c mice. After incubation for 15 days, the animals are euthanized and neovascularization is examined as indicated by the growth of vessels in the granuloma tissue [129]. (D) In vitro tube formation assay: endothelial cells are seeded on the Matrigel and subsequently incubated in medium containing growth factors (e.g. VEGF) and/or ginsenosides. Endothelial cells will rearrange and alight into a tubular structure. Angiogenic properties of ginsenosides can be reflected from the number of tubes, branching points or tube area.

The Yin and Yang balance of Angiogenesis

The balance hypothesis of the ‘angiogenic switch’.

Angiogenic activators and inhibitors: Angiogenesis is tightly controlled by the balance of two sets of counteracting factors
Signals determine the time of initiation of the subsequent angiogenic process.
When there are more angiogenic stimulators than angiogenic inhibitors, as in the case of solid tumors, normal wound healing or female endometrial repair, the ‘angiogenic switch’ will be turned on and angiogenesis will proceed.
In some pathological cases, the ‘angiogenic switch’ remains in the ‘ON’ mode which leads to ‘non-stop’ formation of new blood vessels and ultimately many physiological disorders and diseases.

The Yin and Yang action of Ginsenosides

Administration of Rg₁or Rb₁alone was shown to exert counteracting effects in angiogenesis.

Rg₁alone promoted functional neovascularization in the polymer scaffold in Matrigel implant model and the chemoinvasion of HUVEC (Human umbilical vein endothelial cells).
By contract, Rb₁exerted inhibition in both.
ginseng extract reconstituted with a defined ratio of Rg₁and Rb₁could alter the angiogenic outcome.
In an in vivo scaffold implant neovascularization model, administration of an extract with a higher concentration of Rg₁than Rb₁(Rg₁:Rb₁= 5:2) resulted in the induction of significant angiogenesis.
In contrast, overabundance of Rb₁(XI YANG SHEN Rg₁:Rb₁= 2:5) inhibited Rg₁-induced neovascularization.

Conclusion: These counteracting actions manifested the logic of Yin/Yang theory of TCM, which advocates that everything has opposing Yin and Yang aspects, and these aspects are reciprocally regulated and inhibited by each other in such a way that a continuous state of dynamic balance is maintained.

More References

Pharmacogenomics and the Yin/Yang actions of ginseng: anti-tumor, angiomodulating and steroid-like activities of ginsenosides. Yue PY, Mak NK, Cheng YK, Leung KW, Ng TB, Fan DT, Yeung HW, Wong RN.Chin Med. 2007 May 15;2:6.
Angiomodulatory and neurological effects of ginsenosides. Leung KW, Yung KK, Mak NK, Yue PY, Luo HB, Cheng YK, Fan TP, Yeung HW, Ng TB, Wong RN.Curr Med Chem. 2007;14(12):1371-80. Review.PMID: 17504218 [PubMed – indexed for MEDLINE]
Ginseng pharmacology: multiple constituents and multiple actions. Attele AS, Wu JA, Yuan CS.Fan TP, Yeh JC, Leung KW, Yue PY, Wong RN: Biochem Pharmacol. 1999 Dec 1;58(11):1685-93.
Angiogenesis: from plants to blood vessels. Trends Pharmacol Sci 2006 , 27:297-309. Yue et al. Chinese Medicine 2007 2:6
Materia Medica, Bensky, Clavey, Stoeger

A discussion of Pain treatment with Chinese Herbs

By Hans-Thomas Richter , PhD

BAI SHAO (Radix Paeoniae Lactiflorae ) FU ZI (Radix Lateralis Aconiti Carmichaeli Praeparata) and YAN HU SUO (Rhizoma Corydalis Yanhusuo)

Table Of Contents

Introduction
Western Medical perspective of pain
- General Anatomy and the Physiology of Pain
- The Woolf Pain classifications
- Understanding Chronic Pain
- Changes during Stress
- Gate Theory of Pain
- The Placebo Effect
- Introduction to Western Medical
TCM etiology of pain
TCM Introduction to herbal functions of Bai Shao and Fu Zi

4.1 Bai Shao functions

4.2 Fu Zi functions

4.3 Yan Huo Suo functions

Biomedical Research

5.1 Research on the functions of Bai Shao

5.2 Research on the functions of Fu Zi

5.3 Research on the functions of Yan Hu Suo

Discussion on Bai Shao, Fu Zi and Yan Ho Suo in the treatment of pain
Summary and Conclusions
References and Appendix

Abstract

The object of this study is to investigate how commonly used Chinese herbs treat pain from a perspective of Biomedicine. Can Chinese herbs be categorized by the pain classification system used in Biomedicine? Bai Shao, Fu Zi and Yan Hu Suo were chosen as representatives of Chinese herbs in the treatment of pain. In the light of recent scientific research, the central question is, if these three herbs can be categorized according to the Woolf pain classification system as directed towards nociceptive, neurogenic or psychogenic pain. A secondary question is how the TCM classifications of these three herbs can be understood in the context of this research.

INTRODUCTION

Pain (from Latin “poenia” = punishment, penalty), is among the first and most common reasons medical treatments are required. There are many different origins of Pain: Physical causes from traumatic injuries or chronic degenerative or inflammatory problems and emotional causes. The differences will be described in detail below [Woolf, 2010]. Emotional causes can manifest in pain of a true structural physical nature meaning a problem that shows actual physical changes that can be seen on imaging techniques (e.g. an ulcer seen during GI endoscopy) or they can be a “functional” problem (e.g. stomach cramping) which have no underlying physical organ changes. Pain of emotional type can have many different reasons, often stress and fear induced for socio-economic reasons. A prolonged functional problem like IBS can later on develop into a structural problem like an ulcer. We often describe also non-physical pain that appears to only exist in our imagination (e.g. depression, sadness and grieving). In general things in life we resist and we perceive as negative influence can also be described as painful even though there is no apparent physical organ involved in the actual pain sensation. Phantom pain from an amputated limb seems to only exist as a memory experience that becomes physically present.

Clearly all these origins for pain have one common denominator: “Pain is a major motivator to identify the origin of the pain and to fix the problem”. If it’s a broken bone from an injury the purpose of the pain is to immobilize the structure so the bone can be repaired. If it is an ulcer the purpose of the pain is to figure out how to change ones diet so the ulcer can heal. If it is emotional pain we may attempt to recognize the origin (e.g. stress in the marriage or at the job loss) and we are motivated to find ways to improve the situation (e.g. counseling or a career change).

In turn we develop mechanisms to escape the pain and mask the sensation in an effort to find an immediate instant remedy. Often it is Medication like Ibuprofen or drugs like marihuana or alcohol, physical movement sometimes helps, sometimes stillness and mediation, TV, sexual activity, increasing work hours, a hot bath, a cold shower, the list is endless. However these mechanisms often are the cause for addictions and aggravate the problem over time.

All these escape mechanisms are a distraction from the pain and are often very effective. How does this phenomenon work? How does the pain stimulus become temporarily overridden? In the case of phantom limb pain you can actually train the brain in a mirror trick experiment, so the patient believes that limb is healthy attached. Does the pain thereby exist only in our brain? Chinese Medicine attempts to treat the “root” of a problem. Whether the pain sensation only exists in the brain is irrelevant because TCM aims not to mask the pain but to remove the source problem. In Chinese Medicine we often speak of “qi stagnation” as a major cause for pain. Qi stagnation can exist anywhere in the body. In the case of a broken bone the qi stagnation is obvious since the actual structural flow of nerve signals, blood and other body fluids is interrupted and damaged. In the case of emotional problems qi stagnation not necessarily correspond with organ function.

In TCM diagnosis, Liver qi stagnation is a major cause for systemic pain that can manifest anywhere in the body, e.g. head aches or abdominal cramps. It is thereby of interest to understand the biochemical functionality of herbs in the light of these different pain classifications. Bai Shao, Fu Zi and Yan Hu Sou are important commonly used Chinese herbs. They are used in formulas such as Xiao Jian Zhong Tang, Si Ni Tang and Shao Fu Zhu Yu Tang, respectively, for the treatment of pain. Especially Bai Shao is used in almost 80 Chinese Herbal Formulas. How do these representatives treat different origins of pain? The biochemical nature of most Chinese herbs and their effects on the metabolism and body are by no means understood. However there is recent scientific research on the function of these herbs that could shine some light on this topic. This study intends to analyze some of the research on Bai Shao, Fu Zi and Yan Hu Sou and attempt to categorize them according to Woolf. What specific biochemical effects do these herbs have that contribute to the process intercepting pain? How can these findings be understood in terms of the respective TCM herbal category?

A goal of the future should be to gain a better understanding of the composition and interaction of herbs within TCM formularies. Bai Shao is a component of Gui Zhi Tang, Da Qing Long Tang and Si Ni San, but how are the respective biomedical functions of herbs within the formula affect each other. The herbal functionality is not simply additive: E.g. In Si Ni San the bioavalability of bai shao becomes 2.5 times larger when Chai Hu is present due to the larger intestinal absorption initiated by Saikosaponin [Chen Y, 2011]. What is the purpose of the higher availability of Peoniflorin in Si Ni San? [Chen et. al.] offer no discussion on this topic. In the future these studies may assist the TCM practitioner to better understand the directionality of these herbs within the formula and when to include and remove certain herbs and adjust their dosages. There are fundamental questions herbal formularies to be answered.

Biomedical perspective of pain

2.1 General Anatomy and the Physiology of Pain:

The sensation of Pain is propagated by Sensory Neurons which are typically classified as the neurons responsible for converting various external stimuli that comes from the environment into corresponding internal stimuli. They are activated by sensory input (vision, touch, hearing, etc.), and send projections into the central nervous system that convey sensory information to the brain or spinal cord. Unlike neurons of the central nervous system, whose inputs come from other neurons, sensory neurons are activated by physical modalities such as light, sound, and temperature.

A nociceptor is a sensory neuron that responds to potentially damaging stimuli by sending nerve signals to the spinal cord and brain. This process, called nociception, usually causes the perception of pain. Nociceptors have two different types of axons. The first are the Aδ fiber axons. They are myelinated and can allow an action potential to travel at a rate of about 20 meters/second towards the CNS. The other type is the more slowly conducting C fiber axons. These only conduct at speeds of around 2 meters/second. This is due to the light or non-myelination of the axon. As a result, pain comes in two phases. The first phase is mediated by the fast-conducting Aδ fibers and the second part due to (Polymodal) C fibers. The pain associated with the Aδ fibers can be associated to an initial extremely sharp pain. The second phase is a more prolonged and slightly less intense feeling of pain as a result of the damage. If there is massive or prolonged input to a C fiber, there is a progressive build up in the spinal cord dorsal horn; this phenomenon is similar to tetanus in muscles but is called wind-up. If wind-up occurs there is a probability of increased sensitivity to pain [Williams, 2001].

Detection of noxious stimuli

Mechanical, thermal, and chemical stimuli are detected by the nociceptors on the nerve endings, which are found in the skin and on internal surfaces such as the periosteum or joint surfaces. The concentration of nociceptors varies throughout the body; they are found in greater numbers in the skin than in deep internal surfaces. All nociceptors are free nerve endings that have their cell bodies outside the spinal column in the dorsal root ganglia and are named according to their appearance at their sensory ends.

Nociceptors have a certain threshold; that is, they require a minimum intensity of stimulation before they trigger a signal. Once this threshold is reached, a signal is passed along the axon of the neuron into the spinal cord.

In some conditions, excitation of pain fibers becomes greater as the pain stimulus continues, leading to a condition called hyperalgesia.

Pain Sensitivity and Inflammation

Nociceptor neuron sensitivity is modulated by a large variety of mediators in the extracellular space [Hucho, 2007]. Peripheral sensitization represents a form of functional plasticity of the nociceptor. The nociceptor can change from being simply a noxious stimulus detector to a detector of non-noxious stimuli. The result is that low intensity stimuli from regular activity, initiates a painful sensation. This is commonly known as hyperalgesia. Inflammation is one common cause that results in the sensitization of nociceptors. Normally hyperalgesia ceases when inflammation goes down, however, sometimes genetic defects and/or repeated injury can result in allodynia: a completely non-noxious stimulus like light touch causes extreme pain. Allodynia can also be caused when a nociceptor is damaged in the peripheral nerves. This can result in deafferentation, which means the development of different central processes from the surviving afferent nerve. With this situation, surviving dorsal root axons of the nociceptors can make contact with the spinal cord, thus changing the normal input [Fields, 1998].

2.2 Pain Classifications according to CJ Woolf

According to CJ Woolf, there are three major classes of pain:

Nociceptive, “acute traumatic pain”
Neurogenic, “chronic inflammatory pain”
Psychogenic, “dysfunctional pain”

Nociceptive pain, acute inflammatory pain which is associated with tissue damage and the infiltration of immune cells, and pathological pain which is a disease state caused by damage to the nervous system (neuropathic pain) or by its abnormal function (dysfunctional pain, like in fibromyalgia, irritable bowel syndrome, tension type headache, etc.). Fig. 1 shows the classification of pain according to Woolf [Woolf CJ, 2010]. Nociceptive (A) and acute inflammatory pain (B) are usually due to an acute injury due to tissue damage or a secondary traumatic event due to a major internal pathological condition such as cancer. Nociceptive (A) is usually associated with the acute condition and are of relative short duration e.g. less than 1 day. Neurogenic pain (B) is of more chronic inflammatory nature and can persist over very long periods of time. Pathological pain (C) is usually considered chronic and recurrent, a maladaptive disease state of the nervous system. This can include a pathological state of actual physical damage to nerves and other tissues and what is called a “dysfunctional pain” state where tissues are not injured but still produce pain.

A) Nociceptive [Fig 1A]The neurobiological apparatus that generates nociceptive pain evolved from the capacity of even the most primitive of nervous systems to signal impending or actual tissue damage from environmental stimuli. Its protective role demands immediate attention and action, which occur by virtue of the withdrawal reflex it activates, the intrinsic unpleasantness of the sensation elicited, and the emotional anguish it engages. Nociceptive pain presents itself as something to avoid now, and when engaged, the system overrules most other neural functions.
B) Neurogenic inflammatory pain [Fig 1B]. This second kind of pain is also adaptive and protective. By heightening sensory sensitivity after unavoidable tissue damage, this pain assists in the healing of the injured body part by creating a situation that discourages physical contact and movement. Pain hypersensitivity, or tenderness, reduces further risk of damage and promotes recovery, as after a surgical wound or in an inflamed joint, where normally innocuous stimuli now elicit pain. This pain is caused by activation of the immune system by tissue injury or infection, and is therefore called inflammatory pain (Figure 1B); indeed, pain is one of the cardinal features of inflammation. This pain is adaptive in nature, but it often needs to be reduced in patients with ongoing inflammation, e.g. rheumatoid arthritis or in cases of severe or extensive injury.

C) Psychogenic, the third type of pain is not protective, but maladaptive, resulting from abnormal functioning of the nervous system. This pathological pain (Figure 1C), which is not a symptom of some disorder but rather a disease state of the nervous system, can occur after damage to the nervous system (neuropathic pain), but also in conditions in which there is no such damage or inflammation (dysfunctional pain). Conditions that evoke dysfunctional pain include fibromyalgia, irritable bowel syndrome, tension type headache, temporomandibular joint disease, interstitial cystitis, and other syndromes in which there exists substantial pain but no noxious stimulus and no, or minimal, peripheral inflammatory pathology. The clinical pain syndrome with the greatest unmet need, pathological pain is largely the consequence of amplified sensory signals in the central nervous system and is a low-threshold pain.

In summary, to use an analogy, if pain was a fire alarm, the nociceptive type would be activated appropriately only by the presence of intense fire heat, inflammatory pain would be activated by warm nature e.g. smoking a cigarette, and pathological pain would be a false alarm caused by malfunction of the system itself. The net effect in all three cases is the sensation we call pain. However, because the process that drives each are quite different, treatments must be targeted at the distinct mechanisms responsible.

Fig 1 A and B Nociceptive and Inflammatory Pain

Fig 1 C Pathological pain

2.3 Understanding Chronic Pain

It can be shown that chronic pain is associated with apparent structural changes in the brain, reinforcing the notion of chronic pain as a disease of the nervous system. Functional imaging in human volunteers and patients has allowed for definition of those brain areas activated by nociceptive inputs [Schweinhardt and Bushnell, 2010]. This work has revealed a wide range of different brain areas that constitute what has been called the pain matrix; these areas are activated during the encoding of nociceptive pain’s location, intensity, duration, quality, and emotional associations and show how pain can be influenced by attention, distraction, and manipulation of mood. Indeed, these studies have both focused attention on the important nonsensory components of pain and revealed that the nociceptive system is capable of undergoing enormous change or plasticity when exposed to inflammatory mediators and growth factors, in response to activity, and after injury [Costigan M, 2009]. The changes occur in nociceptors, whose peripheral terminals become sensitized during inflammation. Furthermore, axons can become sufficiently hyperexcitable to generate spontaneous action potentials, cell bodies undergo dramatic changes in the expression and trafficking of proteins, and synapses in the spinal cord can change their strength or undergo structural reorganization. Similar changes take place in the spinal cord and brain, involving neurons and non-neuronal cells, and these changes are responsible for facilitating the responses to peripheral inputs so that the threshold for generating pain falls and its duration, amplitude, and spatial distribution increase [. In essence, this represents an uncoupling of nociceptive pain from its absolute need for noxious stimuli.

Individuals who suffer from chronic pain experience prolonged pain at sites that may have been previously injured, yet are otherwise currently healthy. This phenomenon is related to neuroplasticity due to a maladaptive reorganization of nervous system, both peripherally and centrally. During the period of tissue damage, noxious stimuli and inflammation cause an elevation of nociceptive input from the periphery to the central nervous system.

Prolonged nociception from periphery will then elicit a neuroplastic response at the cortical level to change its somatotopic organization for the painful site, inducing central sensitization. For instance, chronic pain has been reported to significantly reduce the volume of grey matter in the brain globally, and more specifically at the prefrontal cortex and right thalamus. However, following treatment, these abnormalities in cortical reorganization and grey matter volume are resolved, as well as their symptoms. Similar results have been reported for phantom limb pain, chronic low back pain and carpal tunnel syndrome [Apakarin 2004, Napadov 2006].

In summary the main difference between inflammatory and pathological pain is that the former represents hypersensitivity in reaction to a defined peripheral pathology, whereas the latter is the result of altered neural processing.

2.4 Gate Theory of Pain

The Gate Control Theory of Pain is a theory that was first proposed by Ronald Melzack and Patrick Wall in 1965. The theory suggests that pain is not simply a result of signals transmitted directly from the site of injury to the brain, but is also influenced by other factors, such as sensory input from other areas of the body, emotional state, and previous experiences with pain.

The Gate Control Theory proposes that there is a “gate” mechanism in the spinal cord that can modulate the transmission of pain signals to the brain. This gate is controlled by various factors, including the activity of large-diameter Aβ sensory fibers, which can inhibit pain transmission by activating inhibitory interneurons in the spinal cord. This inhibitory activity can effectively close the gate and prevent pain signals from being transmitted to the brain.

On the other hand, the activity of small-diameter Aδ and C fibers, which are responsible for transmitting pain signals, can open the gate and increase pain transmission to the brain. This can be influenced by factors such as the intensity of the pain, the emotional state of the individual, and previous experiences with pain.

The Gate Control Theory suggests that by manipulating the activity of the gate mechanism, it may be possible to modulate pain transmission and alleviate pain. This has led to the development of various pain management techniques, including transcutaneous electrical nerve stimulation (TENS), acupuncture, and massage therapy, which are thought to work by activating the gate mechanism and modulating pain transmission.

Overall, while the Gate Control Theory is not a complete explanation of the complex phenomenon of pain, it has been influential in shaping our understanding of the mechanisms underlying pain perception and has led to the development of new pain management strategies.

The interplay among these connections determines when painful stimuli go to the brain:

Gate closed: When no input comes in, the inhibitory neuron prevents the projection neuron from sending signals to the brain. Also descending pathways from the brain inhibit the projector neurons and diminish the sensation.
Gate closed: Normal somatosensory input happens when there is more large-fiber stimulation (or only large-fiber stimulation). Both the inhibitory neuron and the projection neuron are stimulated, but the inhibitory neuron prevents the projection neuron from sending signals to the brain. E.g. if you rub or shake your hand after you hit a hammer on your finger, you stimulate normal somatosensory input to projector neurons which closes the gate.
Gate open: Nociception (pain reception) happens when there is more small-fiber stimulation or only small-fiber stimulation. This inactivates the inhibitory neuron, and the projection neuron sends signals to the brain informing it of pain.

2.5 Physiological Changes during Stress

The hippocampus contains high levels of glucocorticoid receptors which make it more vulnerable to long-term stress than most other brain areas. Stress-related steroids affect the hippocampus in at least three ways: first, by reducing the excitability of some hippocampal neurons; second, by inhibiting the genesis of new neurons in the dentate gyrus; third, by causing atrophy of dendrites in pyramidal cells of the CA3 region. There is evidence that humans who have experienced severe, long-lasting traumatic stress show atrophy of the hippocampus more than of other parts of the brain. These effects show up in post-traumatic stress disorder, and they may contribute to the hippocampal atrophy reported in schizophrenia and severe depression. A recent study has also revealed atrophy as a result of depression, but this can be stopped with anti-depressants even if they are not effective in relieving other symptoms. Hippocampal atrophy is also frequently seen in Cushing’s syndrome, a disorder caused by high levels of cortisol in the bloodstream. At least some of these effects appear to be reversible if the stress is discontinued. There is, however, evidence mainly derived from studies using rats that stress occurring shortly after birth can affect hippocampal function in ways that persist throughout life [Karl 2006, Wright 2000, Kempton 2011].

2.6 The Placebo effect

Pills, creams, inhalants, injections and Medical devices such as ultrasound can act as placebos. Sham surgery, sham electrodes implanted in the brain,[1] and sham acupuncture, either with sham needles or on fake acupuncture points, have all exhibited placebo effects. The physician has even been called a placebo; a study found that patient recovery can be increased by words that suggest the patient “would be better in a few days”, and if the patient is given treatment, that “the treatment would certainly make him better” rather than negative words such as “I am not sure that the treatment I am going to give you will have an effect”. Another possible resolution of the ethical dilemma might come from the “honest placebo” effect found in a 2010 study carried out by researchers in the Program in Placebo Studies at the Harvard Medical School, where patients with irritable bowel syndrome experienced a significant beneficial effect even though they were told the pills they were taking were placebos, as compared to a control group who received no pills. [Kapchuck 2006, Holm 2001]

2.7 Introduction to Biomedical Pain Medication classes

I) Anti-inflammatory (e.g. Asprin, Ibuprofen)

Nonsteroidal anti-inflammatory drugs such as asprin and ibuprofen work by inhibiting the enzyme cyclooxygenase (COX), which converts arachidonic acid to prostaglandin H2 (PGH2). PGH2, in turn, is converted by other enzymes to several other prostaglandins (which are mediators of pain, inflammation, and fever) and to thromboxane A2 (which stimulates platelet aggregation, leading to the formation of blood clots).

Aspirin, indomethacin and ibuprofen are nonselective COX inhibitors, in that they inhibit two isoforms of cyclooxygenase, COX-1 and COX-2. The analgesic, antipyretic, and anti-inflammatory activity of NSAIDs appears to operate mainly through inhibition of COX-2, whereas inhibition of COX-1 would be responsible for unwanted effects on the gastrointestinal tract. Asprin appears to have greater effect on COX-1. However, the role of the individual COX isoforms in the analgesic, anti-inflammatory, and gastric damage effects of NSAIDs is uncertain and different compounds cause different degrees of analgesia and gastric damage. [Rao, 2006]

To achieve the beneficial effects of ibuprofen and other NSAIDs without gastrointestinal ulceration and bleeding, selective COX-2 inhibitors were developed to inhibit the COX-2 isoform without inhibition of COX-1.

II) Opiates, morphinomimetics and other psychotropic agents

Opiates belong to the large biosynthetic group of benzylisoquinoline alkaloids, and are so named because they are naturally occurring alkaloids found in the opium poppy. The major psychoactive opiates are Morphine, Codeine, and Thebaine. Papaverine, Noscapine, and approximately 24 other alkaloids are also present in opium but have little to no effect on the human central nervous system, and as such are not considered to be opiates. Semi-synthetic opioids such as hydrocodone, hydromorphone, oxycodone, and oxymorphone, while derived from opiates, are not opiates themselves.

Tetrahydrocannabinol (THC) and some other cannabinoids, either from the Cannabis sativa plant or synthetic, have analgesic properties, although the use of cannabis derivatives is currently illegal in many countries. A recent study finds that inhaled cannabis is effective in alleviating neuropathy and pain resulting from e.g. spinal injury and multiple sclerosis [61]. Other psychotropic analgesic agents include ketamine (an NMDA receptor antagonist), clonidine and other α2-adrenoreceptor agonists, and mexiletine and other local anesthetic analogues.

III) Local analgesics and anesthetics

The biochemical mechanism of action of general anesthetics (e.g. Atracurium besylate) is not yet well understood. To induce unconsciousness, anesthetics have myriad sites of action and affect the central nervous system (CNS) at multiple levels. Common areas of the central nervous system whose functions are interrupted or changed during general anesthesia include the cerebral cortex, thalamus, reticular activating system, and spinal cord. Current theories on the anesthetized state identify not only target sites in the CNS but also neural networks and loops whose interruption are linked with unconsciousness. Agents used in context of a general anesthetic have the GABA and the glutamate-activated ion channels NMDA receptor families as potential pharmacologic targets, but others such as voltage-gated ion channels, glycine and 5-hydroxytriptamine (5-HT) receptors, are also involved.

As explained above pain is caused by the stimulation of free nerve endings. When the nerve endings are stimulated, sodium enters the neuron, causing depolarization of the nerve and subsequent initiation of an action potential. The action potential is propagated down the nerve toward the central nervous system, which interprets this as pain. Benzocaine and Lidocaine alter signal conduction in neurons by blocking the fast voltage gated sodium (Na+) channels in the neuronal cell membrane that are responsible for signal propagation. With sufficient blockage the membrane of the postsynaptic neuron will not depolarize and will thus fail to transmit an action potential. This creates the anesthetic effect by not merely preventing pain signals from propagating to the brain but by stopping them before they begin. The analgesic Nefopam is used in Europe for pain relief as an alternative to opioid drug.

IV) Antidepressants and Anticonvulsants

In patients with chronic or neuropathic pain such as post hepatic neuralgia, various other substances may have analgesic properties. E.g. Tricyclic antidepressants, especially amitriptyline, have been shown to improve pain in what appears to be a central manner. The exact mechanism of anticonvulsants e.g. carbamazepine, gabapentin and pregabalin is similarly unclear, but these anticonvulsants are used to treat neuropathic pain with differing degrees of success. Anticonvulsants e.g. benzodiazepines are most commonly used for neuropathic pain as their mechanism of action tends to inhibit pain sensation.

Conventional antiepileptic or antiseizure drugs like Phenytoin block sodium channels or enhance g-aminobutyric acid function. Several antiepileptic drugs have multiple or uncertain mechanisms of action. [62] Next to targeting the voltage-gated sodium channels they target components of the GABA system and voltage-gated calcium channels.

Table 1 Biomedical Pain drug classes and Woolf pain categorization (NC = nociceptive; IF = inflammatory/neurogenic; PG = psychogenic)

Biomedical Pain Drug class	Drug Example	Major Effect	Predominant Woolf Pain category
Cox inhibitors	Asprin	Anti-inflammatory	IF
Antidepressants	Amitriptyline	Seratonergic and noradrenergic neuromodulation	PG
Anticonvulsants	Benzodiazepines	Muscle relaxant, sedative	PG
Opiates	Morphine	Analgesic, anti-depressant	PG
Analgensics/Anestetics	Benzocaine	Analgesic	NC

TCM Perspective on Pain

The sensation of pain in TCM could simply be considered to be of “yang” nature since we associate pain with excess and movement. Pain moves us into to a direction of change to help avoid the causative factors. However the etiology of pain in TCM has a multitude of origins including many “yin” aspects. Unlike Biomedicine which focusses more on the “physiological state” and anatomy related to pain, TCM pays attention to exterior and internal causative factors such as Wind, Heat, Cold, Dampness, Dryness and Emotional factors.

TCM often associates pain with qi stagnation. Stagnation or blockage however can originate from a multitude of different pathologies. As an example, Table 2 shows a list of Bi-syndrome pathologies and how the pain symptoms can manifest accordingly. Bi-syndrome is a disorder resulting from the obstruction of meridians, sluggishness of qi and blood circulation after the invasion of pathogenic wind, cold, dampness or heat, and characterized by pain, numbness and heaviness of muscles, tendons and joints or swelling, hotness and limitation of movement of joints. Rheumatic arthritis, rheumatoid arthritis, osteoarthritis, tuberculous arthritis, pyogenic arthritis, muscular rheumatism, sciatica, gout, etc., may be classified and treated as discussed in this section.

As mentioned above, there are many examples of pain etiology e.g. headaches resulting for a Liver yang rising pathology or chest pain (e.g. coronary heart disease) from yang deficiency with heart blood stagnation or urination pain (e.g. UTI) from damp heat in the lower burner. Some other examples of TCM pain diagnosis are shown in Table 3. The list for pain etiology in TCM is very long and cannot be the object of this introduction.

Table 2 BI-syndrome pain differentiation

Pathological factors

Wind

Cold

Damp

Heat

Pain Quality

(tendency)

Wandering

Cramping

Fixed

Burning

Table 3 Examples of TCM pain diagnosis

Pattern ID	Blood Stasis	Qi Stasis	Liver Blood deficiency	Excess Cold
Pain Quality (tendency)	@ Night time, continuous, localized	@ Daytime, intermittent, more moving	Spasmodic, involuntary muscle contractions	Aversion to cold, alleviated by warmth

4.1 Bai shao TCM functions [peonia lactiflora, 1]:

Nature:	warm
Taste:	Bitter, sour
Organ:	Liver, Spleen
Toxicity:	Non-Toxic.

Bai Shao is in the category of Yin tonics and the top 3 functions of Bai Shao [Bensky]

Nourish Blood
Alleviate pain, soften Liver and curb Liver yang
Preserve yin and regulate nutritive and protective levels

Attributes and Functions according to the Shen Nong Ben Cao Jing [XXX]

Treats Evil qi with abdominal pain,
removes blood bi, breaks hard accumulations,
chills and fever, hernia,
stops pain,
benefits urination,
tonify qi

Other Attributes and Functions [Bensky] Chinese Herbal Materia Medica

Slightly Bitter tonifies Heart yin
Slightly Sour astringes and tonifies Liver yin, inhibits and curbs the Liver
1. increased Liver blood storage benefits the heart and sea of blood
2. counteracts excessive liver dispersing action
Softening action from unwinding the liver, tonification function and drainage much like a sponge
Nourishing liver and blood anchors yang and prevents the floating ascend of Liver yang
Temperature is Mildly cold
Extinguishes wind by cooling and tonifying blood
Enters Spleen channel and orders the chaotic dispersal of the Liver and Spleen qi

Specific Effects of Bai Shao on Pain:

By nourishing blood and curbing Liver wind, Bai Shao acts on muscle and sinew cramping
Relieves pain due to cramped sinews and Liver blood deficiency

Functions of Bai Shao in herbal combinations:

With Gui Zhi to harmonize the Ying and Wei levels: acrid Gui Zhi resolves the flesh, expelling wind out the exterior of the body while sour Bai Shao astringes the sweat and ying
With Huang Qi and Ren Shen for sweating from deficiency
With Chai Hu for flank pain and constraint liver qi
With Xiang Fu or gan cao for abdominal pain
With Ju Hua for headache and dizziness from ascending liver yang

4.2 Fu Zi TCM functions

Fu Zi is in the category of yang tonics but commonly used for pain indications. The top actions of Fu Zi [Bensky] are:

Rescues Yang.
Restores the Yang.
Tonifies Fire.
Benefits the Yang.
Disperses Cold.
Calms pain.

Nature:	Very hot.
Taste:	Pungent, sweet.
Organ:	Heart, Kidneys, Spleen.
Toxicity:	Toxic.

4.3 Yan Ho Suo functions

Yan Hu Suo is in the category of Regulate Blood and the top 3 functions of Yan Hu Suo [Bensky] are:

Moves Blood.
Moves Qi.
Calms pain.

Nature:	Warm.
Taste:	Pungent, bitter.
Organ:	Heart, Liver, Spleen.
Toxicity:	Non toxic.

Biomedical Research on Bai Shao, Fu Zi and Yan Huo Suo

5.2 Research on the functions of Bai Shao

Below is a list of recent scientific publications on the function of Bai Shao [Paeoniae alba Radix]. The Alkaloid Paeoniflorin appears to be the major functional ingredient in Bai Shao root. In some studies whole herbal extracts of the Bai Shao root are used and in others synthetic Paeoniflorin is used. Comparative experiments in some studies found that the principal functional ingredient of whole extract of Paeoniae alba Radix [Sun 2009]. It can be argued however that this is not the case in all function aspects of Bai Shao. Surprisingly recent research revealed a multitude of different functions from the ability to regenerate Nerves to a protective Liver effect in the treatment of Liver cancer.

Nerve re-generation: Regeneration of peripheral nerves [Huang KS 2011] “In vitro and in vivo evaluation of Paeoniae alba Radix (PR) on peripheral nerve regeneration. In the in vitro study, we found the PR caused a marked enhancement of the nerve growth factor-mediated neurite outgrowth from PC12 cells as well as their expression of growth associated protein 43 and synapsin I. In the in vivo study, silicone rubber chambers filled with the PR water extract were used to bridge a 10-mm sciatic nerve defect in rats. These results suggest that the PR extract can be a potential nerve growth-promoting factor, being effective in aiding the growth of injured peripheral nerve. Fig. 2 shows the effects of PR on the growth of nerve cells. PC12 cells exposed to PR with NGF all formed long neurites, which extended to the neighboring cells of distances even more than three cell length. These results are supported by quantitative assays that reveal the PR significantly potentiated NGF-induced neurite outgrowth from PC12 cells.”
Heart protection: Protection of myocardial apoptosis [Li JZ 2012, 2] Increased intracellular reactive oxygen species (ROS) are involved in doxorubicin (DOX)-induced myocardial cell apoptosis, and paeoniflorin (PEF) has been shown to exert an antioxidant effect. Results suggested that paeoniflorin has a protective effect against DOX-induced myocardial cell apoptosis through a mechanism involving a decrease in ROS production by inhibition of NOX2, NOX4 expression, and NOX activity.
Immune system: PEF suppresses LPC-induced inflammatory factor production through inhibition of the HMGB1-RAGE/TLR-2/TLR-4-NF-κB pathway [Li JZ 2012, 3]
Immune system: Macrophage activation was disrupted in the liver, spleen, lung and kidney during development of DMN-induced liver fibrosis. PF administration attenuated DMN-induced liver fibrosis at least in part by regulating macrophage disruption in the main organs. [Chen X 2012]
Stroke: Effective for treatment of stroke. Using a rat middle cerebral artery occlusion (MCAO) model, Injection of PF significantly reduced the infarct volume as well as ameliorated the deficits in neurological symptoms caused by transient MCAO at chronic stage. [Xiao L. 2005]
Stroke: PF treatment protected against TNFα-induced cell apoptosis and neuronal loss. PF prevented up-regulations of pro-inflamamtory mediators (TNFα, IL-1β, iNOS, COX(2) and 5-LOX) in plasma and brain. Paeoniflorin Protects against Ischemia-Induced Brain Damages in Rats via Inhibiting MAPKs/NF-κB-Mediated Inflammatory Responses.[Guo RB 2012]
Vasoconstriction: PF has been shown to inhibit the contraction of the aorta induced by veratrine in isolated atria and aorta of rats [Tsai HY 1999]. The contraction of veratrine on the isolated rat aorta was via the increase of intracellular calcium which was inhibited by paeoniflorin.
Liver cancer: Paeoniflorin may be a promising agent in the treatment of liver cancer, induced apoptosis in hepatocellular carcinoma cells by downregulatingEP2 expression and also increased the Bax-to-Bcl-2 ratio, thus upregulating the activation of caspase-3. [Hu S, 2013]
Diabetic Neuropathy: paeoniflorin is a key antinociceptive component in SKT that increases noradrenaline release and activates α₂-adrenoceptors to modulate spinal nociceptive transmission in diabetic neuropathy. [Lee KK 2011]
Diabetes: PF regulates blood sugar. The novel anti-hyperglycemic effect of Paeoniae radix via the transcriptional suppression of phosphoenopyruvate carboxykinase. [Juan 2010] In conclusion, it was clearly demonstrated that transcriptional inhibition of gluconeogenesis is one of the important antidiabetic actions of Paeoniae Radix. Future development of this herb as a dietary supplement or drug should bring substantial benefits for the diabetic population.
Stress modulation: Total glucoside of peoniflorin (TGP) alleviates depression induced by chronic unpredictable stress. The antidepressant-like activity of TGP is probably mediated by inhibition of monoamine oxidases and the attenuation of oxidative stress in mouse brain. [Mao 2009]
Arthritis: TGP/paeoniflorin is able to diminishpain, joint swelling, synovial hypertrophy, and the severity of bone erosion and cartilage degradation in experimental arthritis. TGP/paeoniflorin suppresses inflammatory process by reducing the production of prostaglandin E2, leukotriene B4, nitric oxide, reactive oxygen species, proinflammatory cytokines and chemokines. TGP/paeoniflorin also inhibits the proliferation of lymphocytes and fibroblast-like synoviocytes, the formation of new blood vessels, and the production of matrix metalloproteinases. Clinical data show that TGP is effective to relieve the symptoms and signs of rheumatoid arthritis without significant adverse effects. [Zhang, 2012]
Immune Macrophage function: Macrophage migration was inhibited by the PF ingredient in Si Ni San. Both Si-Ni-San andpaeoniflorin significantly reduced ear swelling in mice while the paeoniflorin-deleted Si-Ni-San (Si-Ni-San(PF-)) showed little ameliorative effect. In lipopolysaccharide-evoked macrophages, Si-Ni-San and paeoniflorin markedly inhibited tumor necrosis factor-alpha production, cyclooxygenase-2 activity, as well as extracellular signal-regulated kinase 1/2 phosphorylation while Si-Ni-San(PF-) exhibited no or slight inhibitory effect. Furthermore, the inhibitory effect on the production of tumor necrosis factor-alpha reappeared when different proportions of paeoniflorin were replenished in Si-Ni-San(PF-). In addition, the expression of macrophage migration inhibitory factor in T cells, rather than macrophages, was significantly inhibited by Si-Ni-San, but not Si-Ni-San(PF-). Our data indicate paeoniflorin is the principal component of Si-Ni-San, exerting negative regulation on the function of macrophages in contact dermatitis. [Sun 2009]
Spasmodic Pain: SKT (Shao yao gan cao tang extract) was tested for its effect on muscle cramping: six of the eight active constituents in G. radix (gan cao) liquiritin apioside, liquiritigenin, isoliquiritin apioside, isoliquiritigenin, glycycoumarin, and glycyrrhetinic acid, 20 μmol/kg, i.v.). These constituents, which include flavonoids, a triterpenoid, and a courmarin derivative, demonstrated temporal variations in their inhibitory activity. In contrast, P. radix (bai shao) (0.5 and 1.0 g/kg, i.d.) did not show a statistically significant antispasmodic effect in our study; however, we previously found that it had significant anti-nociceptive effect. In conclusion findings show that Shao yao gan cao tang inhibits tetanic contractions in vivo and that G. radix is the main antispasmodic component due to the actions of its active constituents, thus supporting the traditional use of SKT. It was proposed that SKT containing the antispasmodic G. radix and antinociceptive P. radix is a pharmaceutically elegant option for muscle cramps as treatment requires a two-pronged approach, i.e., inhibition of hyperexcitable skeletal tissues and modulation of the pain accompanying cramps.
Other: [Gan P 2012} showed that there are significant differences of peoniflorin and albiflorin plasma levels in Shao Yao Gan Cao Tang. The results indicated that some components in the other ingredient herb of SGT (Radix Glycyrrhizae) had a pharmacokinetic interaction with albiflorin and paeoniflorin and hence reduced their systematic exposure level.
There are significant differences in the pharmacokinetics of chi shao and bai shao [Wang 2008]; these are different preparations of peony root.
Chaihu-Shaoyao drug pair (Bupleuri Radix and Paeoniae Radix Alba): the main constituent in chai hu Saikosaponin a (SSA), saikosaponin d (SSD) influence the absorption of peoniflorin. It was shown over 2 times as much peoniflorin was absorbed in the ileum and colon (not a digestive organ, haha) when SSA and SSD were present (however not vs versa) [Chen Y 2011].

Fig.2 A: Neural growth stimulated by Peoniflorin. (left: neg. control; top panel right: PF + NGF (PR at 1.25 μg/ml)

Table 4 Comparison of Biomedical Scientific Research and TCM functions of Bai Shao and Woolf pain categorization (NC = nociceptive; IF = neurogenic; PG = psychogenic; ? = not known)

Bai Shao TCM Functions	Biomedical Research	Explanation	Woolf Category
Pain treatment	Immunosupression, macrophage deactivation, anti-inflammatory [Sun 2009]	Anti-inflammatory action reduces neuropathic pain	IF
Pain treatment, tonify Yin	Peripheral Nerve Growth [Huang 2011]	Regeneration of damaged nociceptors	IF
Pain treatment	Modulation of Shao yao gan cao tang in nociceptive transmission in diabetic neuropathy [Lee 2011]	Modulates Nociceptor signals	PG
Breaks up blood bi and hard accumulations	Induction of apoptosis in hepatocellular carcinoma [Hu 2013]	Induces apoptosis and removes blood stasis	IF
Alleviates Abdominal pain, spasms	Shao yao gan cao tang was studied for spasmodic pain [Lee KK, 2013]	Antispasmodic ingredients come from Gan Cao	?

Tonify Ht Yin	Oxidative protection of myocardial cells, inhibition of aortic vasoconstriction [Li 2012, Tsai 1999]	?	IF, PG
Liver softening	Attenuation of hepatic and brain oxidative stress [Mao 2009]	?	IF, PG
Nourish blood	Regulates blood sugar, anti hyperglycemic effect [Juan 2010]	?	PG
Adjust nutritive and protective levels	?
Anchor Liver yang	?

5.2 Research on the functions of Fu Zi

The main ingredient of Fu Zi, Aconitine is a toxic alkaloid produced by the Fu Zi (Aconitum) plant, also known as devil’s helmet or Monkshood. It is very notorious for its toxic properties.

Aconitine can interact with the voltage-dependent sodium-ion channels in muscles and neurons. The channels are highly selective for sodium-ions. They open very fast to depolarize the membrane, and close to repolarize the membrane. Aconitine binds to the receptor at the neurotoxin binding site and results in a sodium-ion channel that stays open longer. Aconitine suppresses the conformational change in the sodium-ion channel from the active state to the inactive state. The membrane stays depolarized due to the constant sodium-influx. As a result, the membrane cannot be repolarized. In neurons, aconitine increases the permeability of the membrane for sodium-ions, resulting in a huge sodium-influx in the axon terminal. As a result, the membrane depolarizes rapidly. Due to the strong depolarization, calcium-influx follows. The increase of the calcium concentration in the cell stimulates the release of the neurotransmitter acetylcholine into the synaptic cleft.

Acetylcholine binds to acetylcholine receptors at the postsynaptic membrane to open the sodium-channels there, generating a new action potential. Research with mouse nerve-hemidiaphragm muscle preparation indicates:

at low concentrations (<0,1 microM) aconitine increases the electrically evoked acetylcholine release causing an induced muscle tension.[10]Action potentials are generated more often at this concentration.
At higher concentration (0.3–3 microM) aconitine decreases the electrically evoked acetylcholine release, resulting in a decrease in muscle tension.
At high concentration (0.3–3 microM), the sodium-ion channels are constantly activated, transmission of action potentials is suppressed, leading to non-excitable target cells or paralysis.

Aconitine is metabolized by a variety of cytochrome P450 isozymes into at least six different metabolites. The LD50 of Aconitite in mice is only 1mg/kg orally. Most research studies are on the isolated Aconitite compound. Very little is know about the effects of whole Fu Zi extract or any of its metabolites. Recent publications show efforts to isolate more compounds from whole fu zi extract [xxx}.

5.3 Research on the functions of Yan Hu Suo

Yan hu sou (Corydalis) contains many Alkaloids among which two are well studied, Bulbocapnine and Tetrahydropalmitine, however many other constituents are being studied also. Tetrahydropalmatinev (THP) has been demonstrated to possess analgesic effects and may be beneficial in the treatment of heart disease and liver damage [Wu 2007, Min 2006]. It is a blocker of voltage-activated L-type calcium channel active potassium channels. It is a potent muscle relaxant. It has also shown potential in the treatment of drug addiction to both cocaine and opiates, and preliminary human studies have shown promising results. [Yang 2008]

Animal experiments have shown that the sedative effect of THP results from blocking dopaminergic neurons in the brain. Dopamine is an important neurotransmitter in the central nervous system where it occurs in several important signaling systems that regulate muscular activity and attention, as well as feelings of joy, enthusiasm and creativity. Therefore, THP causes no feelings of euphoria, and has been seen as an alternative to addictive drugs for people suffering from anxiety and pain, and as a possibility for relief for people not helped by existing drug.

Bulbocapnine (BC) is an alkaloid found in Corydalis and has been shown to act as an acetylcholinesterase inhibitor, [Zhang YH 1997] and inhibits biosynthesis of dopamine via inhibition of the enzyme tyrosine hydroxylase. [Shin JS, 1998]

Selected Publications:

Pain: BC has been used in the treatment of muscular tremors and vestibular nystagmus”. [Sheflin AW, 1978]
Pain: Corydalis yanhusuo might act on opioid, γ-aminobutyric acid (GABA), or dopamine receptors, and thus alleviate painful conditions such as headache, chest pain, epigastric pain, abdominal pain and backache [Yuan CS 2004].
Pain: anti-inflammatory anti-ulcer activities, dehydrocorydaline blocks the release of noradrenaline from the adrenergic nerve terminals in both the Taenia caecum and pulmonary artery, and thereby inhibits the relaxation or contraction of adrenergic neurons and relieves pain [Kurahashi, 1976].
Pain: Dehydrocavidine, alkaloid exhibits a significant spasmolytic effect, which acts via relaxing smooth muscle, and displays inhibitory activity against HBsAg and HBeAg [Li HL, 2008].
Inflammation: Medicarpin and tetrahydropalmatine enable the inhibition of the occurrence of inflammatory disease while also exhibiting potent anti-fungal activity by inhibiting germination and the hyphal growth of spores [Khan, 2005; Miurya, 2001].
Heart Disease: The alkaloids extracted from Corydalis yanhusuo possess potent cardiovascular actions by significantly inhibiting the plasma endothelin-1 activity and preventing oxygen free radical injury and lipid peroxidation as evidenced by elevated superoxide dismutase (SOD) and glutathione peroxidase (GSH-Px) activity and a reduced MDA level [Liu JL, 1994].
Heart Disease: Corydalis yanhusuo reduces infarct size and improves heart function by inhibiting apoptotic cell death through modulation of the Bcl-2 family in myocardial I/R injury in rats [Ling H, 2006].
Heart Disease: Liu, J.L.; Liu, H. The protective effects of dl-tetrahydropalmatine on isolated rat heart against ischemic/reperfusion damage exacerbated by extrinsic radical generating system. Zhongguo Yaoxue Zazhi 1994, 29, 462–464.
Heart Disease: Ling, H.; Wu, L.; Li, L. Corydalis yanhusuo rhizoma extract reduces infarct size and improves heart function during myocardial ischemia/reperfusion by inhibiting apoptosis in rats. Res. 2006, 20, 448–453.

Discussion

Bai Shao, Fu Zi and Yan Ho Suo are commonly used herbs in the treatment of pain. These herbs contain many alkaloids that are effective in the treatment of pain. However the mechanism of action how these herbs treat pain appears to be entirely different. In summary the current research findings on Bai Shao are as follows:

Nerve re-generation
1. Regeneration of peripheral nerves [Huang KS 2011]
Immune system:
1. PEF suppresses LPC-induced inflammatory factor production through inhibition [Li JZ 2012, 3]
2. Macrophage activation was disrupted in the liver, spleen, lung and kidney [Chen X 2012]
3. Macrophage migration was inhibited by the PF ingredient in Si Ni San. Both Si-Ni-San andpaeoniflorin significantly reduced ear swelling in mice [Sun 2009]
4. Arthritis: diminishpain, joint swelling, synovial hypertrophy, and the severity of bone erosion and cartilage degradation in experimental arthritis. TGP/paeoniflorin suppresses inflammatory process by reducing the production of prostaglandin E2, leukotriene B4, nitric oxide, reactive oxygen species, proinflammatory cytokines and chemokines. {Zhang 2012]
Oxidative Stress modulation
1. inhibition of monoamine oxidases and the attenuation of oxidative stress in mouse brain. [Mao 2009]
2. Protection of myocardial apoptosis [Li JZ 2012, 2]
3. treatment of stroke. reduced the infarct volume [Xiao L. 2005]
Vasoconstriction: PF has been shown to inhibit the contraction of the aorta induced by veratrine in isolated atria and aorta of rats [Tsai HY 1999].
Apoptosis: induced apoptosis in hepatocellular carcinoma cells . [Hu S, 2013]
Diabetic Neuropathy: paeoniflorin is a key antinociceptive component in SKT that increases noradrenaline release and activates α₂-adrenoceptors to modulate spinal nociceptive transmission in diabetic neuropathy. [Lee KK 2011]

Bai Shao is very common in the use for Pain treatment and is part of over 80 TCM formulas. Surprisingly, Bai Shao extracts or its main constituent, Peoniflorin, does not appear to have any direct activity in blocking Nociceptors, Sodium-, Potassium- or Calcium gated ion- channels. In addition, Peoniflorin was found to have no effect on opioid receptors [Omiya Y, 2005 and 2008]. Rather, it shows effects on the immune system, regulating oxidative stress, vasoconstriction and apoptosis. A review from [Zhu Y, 1010] reports that Peoniflorin improves micro-circulation, helps oxidation and free radical damage, inhibits intracellular calcium overload, inhibits apoptosis, acts anti-neurotoxic and improves learning and memory function in mice. Perhaps, the most impressive research was done recently on the re-generation of Nerve Cells [Huang, 2011].

As shown in table 4, an attempt was made to compare TCM functions and biomedical research. What does the TCM action ‘yin tonic’ really mean in biomedical terms? This is a complex question. i) Peoniflorins’ action of nerve regeneration is proposed here as a yin tonifying action. If one takes the definition of ‘yin’ as being ‘substance’ it can be concluded that the new growth of nerve cells is clearly a yin producing action. ii) The actions of immunosuppression can be directly understood in terms of pain treatment by reduction of inflammation, falling into the 2^nd Woolf pain category. iii) The finding that Bai Shao attenuates oxidative stress and alleviates vasoconstriction in Liver and Heart can be understood in terms of the TCM action of ‘Liver softening’. However much future research has to be done on this topic. Still other categories like ‘anchoring Liver yang’ have no studies addressing this concept and new theories have to be developed.

A recent 2013 study from [Lee KK] presents findings on anti-spasmodic effect from using Shao Yao Gan Cao Tang. However it was concluded that the Gan Cao constituents were the active constituents and Peoniflorin and Albiflorin had no effect on muscle spasms. [Lee KK] had previously found that Peoniflorin has an anti-nociceptive effect that was attributed to a regulatory effect on the Alpha-2-adrenergic receptor. These receptors have a critical role in regulating neurotransmitter release from sympathetic nerves and from adrenergic neurons in the central nervous system. This mechanism was suggested to be responsible for alleviating diabetic neuropathy in mouse models, but no effect was found in healthy mice.

Bai Shao therefore appears to have a different pain treatment mechanism compared to Fu Zi and Yan Hu Suo. However the mechanisms of Peoniflorin are presently not well understood. As summarized in Table 4 it can be concluded that Bai Shao primarily falls into the Woolf category of treating inflammatory or neurogenic pain.

In contrast, the actions of Fu Zi can be understood as purely treating Nociceptive pain. Aconite is directly involved in affecting Nociceptors and nerve signal propagation. Interestingly, dosage matters and depending the usage the effects vary from induced muscle tension at low concentration, reduced muscle tension at medium concentrations to paralyses at high concentrations. These effects are not well understood in the the treatment of the whole body and much has to be studied to decipher the metabolic intermediates resulting from P-450 enzymatic processing in the Liver.

Yan Hu Suo was found to have effects on opioid, γ-aminobutyric acid (GABA), or dopamine receptors. Therefore it falls into the category of treating psychogenic pain. However it is not restricted to this type of pain, since an aspect of pain perception of the central nervous system is always present. Yan Hu Suo also is effective in spasmodic pain and relaxing smooth muscle by an unknown mechanism. Like Bai Shao it is also effective in reducing oxidative stress on the heart muscles and it also has anti-fungal activity.

An attempt was made to classify biomedical pain medications according to Woolf, as summarized in Table 1. According to the above conclusions, Bai Shao is comparable to the use of anti-inflammatories, Fu Zi corresponds to the use of analgesics and Yan Hu Suo would fall into the realm of Anti-depressants. To what extent this comparison is useful remains to be studied.

Conclusions and Commentary

The object of this study was to categorize the use of Bai Shao, Fu Zi and Yan Hu Suo according to the Woolf pain classification system. In light of the current body of biomedical research it could be concluded that Bai Shao falls mostly into the Woolf category of treating Inflammatory pain, Fu Zi clearly treats Nociceptive pain and Yan Hu Suo has a stronger tendency to treat Psychogenic Pain. Although future research has to be done to build on this idea.

It is of interest to assimilate these research findings on the functions of Bai Shao, Fu Zi and Yan Hu Suo to form a coherent picture of how these herbs are used in the treatment of pain. Can these findings be aligned with TCM diagnosis and treatment principles and could this be helpful to the TCM practitioner to better prescribe Chinese Herbs in the treatment of Pain? In the future a more comprehensive body of biomedical research perhaps will assist the TCM practitioner to better prescribe Chinese herbs and understand the composition of formulas. This principle may not be restricted to the example of pain treatment presented here in this study but extend to any symptom or disease model. The herbalist may want to better understand what the active constituents of Chinese herbs can do in terms of Biomedicine, what different effects of dosages there are and how Herbs influence each other. Much research has to be done to come closer to this goal. However scientific research has to be directed in new ways and new questions that incorporate an understanding of TCM have to be developed in the future.

Table 5: Comparison of TCM functions of Bai Shao, Fu zi and Yan hu Suo and Woolf pain categorization (NC = nociceptive; IF = neurogenic; PG = psychogenic)

	Bai Shao	Fu Zi	Yan Hu Suo
TCM Category	Yin Tonic	Yang Tonic	Regulate Blood
1. Woolf Pain Category example	IF	NC	PG
Explanation	Peoniflorin generates Nerve growth	Aconite activates Sodium Channels	THP acts on Dopamine Receptor
2. Woolf Pain Category example	IF	?	IF
Explanation	PF protects against oxidative stress in HT and Liv	Little else is known about Aconite metabolites	Ca channel blocker = muscle relaxant
3. Woolf Pain Category example	PG?	?	?
Explanation	Modulation of nociceptive transmission in diabetic neuropathy

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Table of contents

Herb index

Formula index

General concepts of TCM and differences to Western Science-

Introduction to Chinese Herbs: The species, the part of the plant and the harvesting matters:

Treatment strategies

What are Granules of Chinese Herbs?

Ethnobotany: Why Do plants make Medicinal compounds?

Single herbs vs Formulas

Herb-Safety

Disease vs Pattern ID

Biochemistry and Science

For additional resources of herbal biochemistry check ITMONLINE.org

Medicinal constituents in Herbal Plants

Anti-inflammatory herbs

Erchentang and eicosanoids

Anti- Malaria or warm disease herbs.

Viral and Bronchial Conditions

Isatis (DaQingYe)

Formulas that treat Lung conditions:

Chronic Bronchitis

Clinical Studies

Brain and Nervous System

Shi Chang Pu (Acorus)

Vasodilator Herbs

Release and Discharge Exterior:

Sheng Ma – 升麻 – Rhizoma Cimicifugae- Black cohosh (Cimicifuga racemosa)

Rou Cong Rong

Zhi-fu zi, a cardiotonic Chinese herb, a new medical treatment choice for portal hypertension?

yīn chén 茵陳

Blood Movers and Breakers

Blood Breakers

Salvia miltiorrhiza 丹參 dānshēn

Frankinsense and Myrrh

Mo Yao (Myrrh):

Ru Xiang (Frankincense):

Does Saw Palmetto work for BPH?

Formulas for blood moving

Xuefu Zhuyu Tang (Drive Out Stasis in the Mansion of Blood) and its composition in terms of treatment strategies:

Blood tonification

Detoxification

Historical Practices with placenta

Liver Detox

Hu zhang 虎杖 (Polygonum cuspidatum)

Heavy Metal Detoxification

FAD: Fatigue, Anxiety, Depression; Treating emotional conditions

Liver Qi

Digestion and diuresis

“Traditional Chinese Medicine (TCM) diagnosis works differently! Instead of labeling problem TCM looks at the symptomatic Pattern ID.”

Dampness and diagnosis of damp heat vs damp cold is essential

Constipation and Dahuang

MaZiRenWan

Maintaining good Digestion

Wulingsan 五苓散丸

Diabetes and Insulin

Peony (Paeonia):

Cassia (Cinnamomum cassia):

Hormones

ADAPTOGENS

黃耆 Huang Qi

HUANG QI and Cancer

More Cancer treatment studies

A discussion of ginseng

Medicinal Functions:

Ginsenosides

A discussion of Pain treatment with Chinese Herbs

By Hans-Thomas Richter , PhD

Detection of noxious stimuli

Pain Sensitivity and Inflammation