History and Principles of Chinese Herbal Medicine
History of Chinese Herbal Medicine
The history of Chinese herbal medicine combines tradition and innovation. It was formed not just by government bodies but also by countless individuals throughout history.
Early government-sponsored texts began emerging during the Tang dynasty (618–907 CE).
From the Song dynasty (960–1279 CE) to the Qing dynasty (1644–1912 CE), extensive state-endorsed encyclopedias of herbal medicine were produced.
These encyclopedias aimed to standardize herbal knowledge and enhance previous traditions, paving the way for future scholarly and clinical practices.
Historical Timeline of Chinese Herbal Medicine
Chronological Events and Developments:
25-220 BCE: Ma Wang Dui Manuscripts
This is the oldest physical evidence of herbal use, containing 170 prescriptions and 270 substances.
Displays shamanic influences.
305–204 BCE: Huang Di Nei Jing (Yellow Emperor’s Inner Classic)
This text establishes the philosophical foundations of Chinese medicine but includes minimal herbal detail (12 prescriptions, 28 substances).
2nd Century CE: Shén Nóng Běn Cǎo Jīng (Divine Farmer’s Classic of Materia Medica)
First organized materia medica; it classifies 365 substances based on their properties and actions.
3rd Century CE: Zhong Zhong Jing
Discusses Cold Damage and Jin Gui Lao Yue.
This work becomes the source of all prescription manuals at the end of the Han dynasty, providing treatments for internal, external, gynecological, and obstetric diseases.
452 CE: Tao Hongjing edits and expands the Ben Cao Jing
Introduces classifications and expands the text to include 730 substances, with detailed notes on sourcing and preparation.
657-659 CE: Tang Ben Cao
This is a government project during the Tang Dynasty that describes 850 substances along with illustrations; it represents the first official government pharmacopoeia.
960–1279 CE (Song Dynasty): Jing Shi Zheng Lei Ben Cao
Compiled by Tang Shenwei, this text includes 1,558 substances and standardizes herbal knowledge for widespread use.
1590 CE: Li Shizhen’s Ben Cao Gang Mu (Compendium of Materia Medica)
A monumental work containing 1,892 substances and 11,000 formulas, based on 27 years of research. It is regarded as one of the most influential texts in Chinese medicine.
1977 CE: Modern Expansion at Jiangsu College of New Medicine
Materia medica expands to over 5,767 entries through modern research and clinical applications.
Fundamental Concepts in Chinese Medicine
Yin-Yang and Five Phases (Wu Xing)
Definitions:
Yin-Yang: Describes how nature groups phenomena into pairs of opposites that are also complementary.
Five Phases: Refers to the dynamic movement and transformation of energy and matter.
These concepts form the foundation of Chinese medicine, natural science, and classical Chinese philosophy.
Yin and Yang
Key Characteristics:
Fundamental categories for all phenomena.
Divisible into subtleties (e.g., "Yin within Yang").
Rooted in each other; cannot exist independently.
Counterbalance each other to maintain dynamic equilibrium.
Transform into each other under specific conditions (mutual convertibility).
Applications of Yin-Yang in Chinese Medicine
Understanding anatomy
Describing physiological activity
Explaining pathologies and guiding diagnosis
Informing treatment principles and herbal strategies
Yin Characteristics:
Contraction, inward movement, darkness, femininity, fluidity
Yang Characteristics:
Expansion, outward movement, light, masculinity, ethereality
The Five Phases (Wu Xing)
Descriptive Overview: These phases represent the cyclical interactions of elements in various systems (e.g., seasons, organs, emotions).
Phase Descriptions:
Wood: Growth and expansion, associated with the Liver and Gallbladder; sour taste.
Fire: Heat and vitality, associated with the Heart and Small Intestine; bitter taste.
Earth: Nourishment and stability, associated with the Spleen and Stomach; sweet taste.
Metal: Purification and reformation, associated with the Lungs and Large Intestine; pungent taste.
Water: Moisture and coldness, associated with the Kidneys and Urinary Bladder; salty taste.
Phases and Organ Relationships:
Organ Relationships correspond to their associated phase and taste (e.g., Wood-Liver-Gallbladder).
Five Phase Cycles
Generating (Sheng) Cycle: Each phase gives rise to the next phase.
Controlling (Ke) Cycle: Each phase moderates another to maintain balance.
Insulting Cycle: Disturbance of balance leads to one phase overacting against another.
Vital Substances in Chinese Medicine
Qi, Blood, Essence, and Fluids
Overview: These vital substances are fundamental for physiological activities and represent the body’s dynamic interactions.
Qi (Vital Energy)
Definition: Qi is the dynamic force that propels, warms, and activates physiological processes; it is inherently Yang.
Sources and Forms:
Gu Qi: Grain and water derived from the digestion of food.
Da Qi: Air inhaled from the lungs.
Jing Qi: Innate vitality stored in the Kidneys.
Yuan Qi: Combination of all forms of Qi.
Types of Qi:
Organ Qi: Powers individual organ functions.
Channel Qi: Circulates through the meridians.
Construction (Ying) Qi: Nourishes organs and tissues with blood.
Defensive (Wei) Qi: Protects exterior and regulates bodily functions.
Ancestral (Zong) Qi: Governs respiration, circulation, and pulse.
Functions of Qi
Activation: Drives physiological activities.
Warming: Maintains body temperature and warmth of organs.
Defense: Protects against external pathogens.
Transformation: Aids in metabolic processes and fluid transformations.
Containment: Holds bodily fluids and organs in place.
Pathologies of Qi
Conditions:
Qi Deficiency: Lack of energy and function.
Qi Stagnation: Obstruction that hampers movement.
Qi Counterflow: Movement of Qi in the wrong direction.
Qi Collapse: Severe deficiency causing organ prolapse or fainting.
Blood (Xue)
Definition: Blood nourishes and moistens the body and is formed from Essential Qi by the Spleen and Stomach, undergoing transformation by Construction Qi and refinement by the Lungs.
Key Roles of Organs:
Heart: Governs and circulates blood.
Liver: Stores and regulates blood.
Spleen: Generates and contains blood.
Pathologies of Blood:
Blood Deficiency: Insufficient nourishment.
Blood Stasis: Stagnant blood flow leading to pain.
Blood Heat: Indicates heat in the blood leading to various clinical symptoms.
Essence (Jing)
Definition: Jing is the fundamental substance that governs life stages (birth, growth, maturation, etc.). It is more stable than Qi and Blood.
Types of Essence:
Congenital Essence: Inherited from parents at conception.
Acquired Essence: Derived from post-natal nutrients.
Reproductive Essence: Passed from parents to offspring.
Essential Qi: The active aspect of Jing sustaining life functions.
Fluids (Jin-Ye)
Definition: Body fluids that nourish internal organs and protect the body by maintaining hydration and lubrication.
Categories of Body Fluids:
Jin (Liquids): Thin, mobile fluids; Yang in nature.
Ye (Humors): Thicker, nourishing fluids; Yin in nature.
Pathologies of Fluids:
Damage to Fluids: Conditions leading to dehydration and dryness.
Water Swelling (Edema): Fluid retention issues.
Phlegm-Rheum: Pathological fluid accumulation affecting body functions.
The Zang-Fu System
Overview of Zang (Yin) and Fu (Yang) Organs
Zang Organs (Yin, Solid):
Liver: Stores blood, controls Qi flow, emotions (anger).
Heart: Governs blood, houses the spirit (Shen), emotions (joy).
Spleen: Governs digestion, generates blood, emotions (worry).
Lungs: Governs Qi and respiration, emotions (grief).
Kidneys: Store essence, govern growth, metabolism, emotions (fear).
Pericardium: Protects the heart from external pathogens and supports emotional balance.
Fu Organs (Yang, Hollow):
Gallbladder: Decision-making and bile storage.
Stomach: Digestion and food fermentation.
Small Intestine: Separates pure from turbid fluids.
Large Intestine: Governs waste elimination.
Bladder: Stores and releases urine.
San Jiao (Triple Burner): Regulates water pathways between organs.
Overview of Qi, Blood, Essence & Fluids: Quick Chart
Types of Qi:
Original (Yuan Qi)
Organ Qi
Channel Qi
Ying Qi
Wei Qi
Zong Qi
Types of Essence:
Congenital Essence
Acquired Essence
Reproductive Essence
Types of Fluids:
Jin (Liquids)
Ye (Humors)
Disease Causes in Chinese Medicine
Overview of Causes of Disease
Health is perceived as a dynamic balance of Yin-Yang, Qi, and Blood within life’s natural rhythms.
The Huang Di Nei Jing states:
“When Yin is calm and Yang is sound, the spirit is undisturbed.”
“If Blood and Qi fall into disharmony, a hundred diseases may arise.”
“Yin and Yang and the Four Seasons are the beginning and end of all things.”
Categories of Disease Causes
External Causes:
Environmental factors disrupting Yin-Yang balance, Qi movement, and organ harmony.
Influences from:
Six Excesses: Wind, Cold, Heat, Dampness, Dryness, Summer-Heat.
Pestilent (Evil) Qi: Highly contagious diseases from external sources.
Internal Causes:
Emotional disturbances disrupting internal balance (e.g., the Seven Affects).
Neutral (Miscellaneous) Causes:
Irregular lifestyle factors, trauma, and other non-emotional influences (e.g., poor diet).
Pestilent Qi (Li Qi)
Refers to contagious diseases invading through the mouth and nose, recognized for causing widespread epidemics.
Internal Causes of Disease Examples
Environmental Factors vs. When Balanced and Excessive:
Wind: Facilitates movement, excessive causes spasms or tremors.
Cold: Conserves warmth; excessive causes contraction and pain.
Heat: Warms Qi but excessive causes fever, dryness, inflammation.
Dampness: Moistens but excessive leads to fatigue and heaviness.
Summer-Heat: Necessary warmth; excessive causes dehydration.
Dryness: Supports cleansing; excessive leads to dryness of fluids.
Emotional Disturbances and Effects on Body
Emotions:
Joy: Slows Qi; excessive joy scatters Heart Qi.
Anger: Rises Qi; leads to headaches.
Anxiety: Knots Qi; stagnates Lung and Heart Qi.
Overthinking: Injures Spleen and leads to stagnation.
Grief: Dissolves Lung Qi.
Fear: Sinks Kidney Qi.
Fright: Deranges Heart Qi.
Neutral Causes of Disease
Examples:
Dietary Irregularities: Damaging to Spleen function leading to food stagnation and internal heat.
Sexual Intemperance: Damaging Kidney Essence.
External Injuries and Parasites: Damage to skin, flexes, blood vessels from trauma or clean food.
Secondary Pathological Products
Phlegm (Tan): Represents pathological fluid accumulations that congestion different body areas.
Symptoms: Vary based on location of affected organ.
Static Blood (Blood Stasis): Blood that becomes stagnant due to poor circulation leads to pain and potential bleeding.
Symptoms indicative of Blood stasis include sharp pains and a dark appearance.
Quick Chart of Excess and Symptoms:**
Wind: Sudden onset, migratory pain.
Cold: Aversion to cold, contraction of sinews.
Heat: High fever, irritability, dryness, thirst.
Dampness: Heavy body, fatigue, digestive issues.
Dryness: Dry cough and skin, thirst.
Summer Heat: Dehydration, fatigue.
Understanding Pathogenesis in Chinese Medicine
Core Concept: Health equates to the balance between Right Qi and Evil Qi. Strong Right Qi repels external pathogens.
Key Imbalances:
Right Qi vs. Evil Qi: The struggle between defenses and pathogenic factors.
Treatment: Involves restoring balance by addressing excess, supplementing deficiency, and harmonizing opposing forces.
Pattern Identification Techniques
Diagnosis focuses not on diseases but on understanding imbalances.
Four Diagnostic Examinations:
Inspection: Observe physical signs.
Listening and Smelling: Hear breath, voice patterns.
Inquiry: Ask about symptoms and history.
Palpation: Feel pulse and affected areas.
Eight Principles for Pattern Identification
Describes the nature and location of disease through four dichotomies:
Interior vs. Exterior
Cold vs. Heat
Deficiency vs. Excess
Yin vs. Yang
Qi and Blood Pattern Identification
Organ Functionality: Qi and Blood's smooth flow is essential.
Common Conditions:
Qi and Blood deficiency may lead to fatigue and weakness.
Qi stagnation may manifest as emotional tension.
Dual Patterns may present complex conditions (e.g., Qi Stagnation with Blood Stasis).
Treatment Overview
Integral components of treatment include:
Identifying root conditions, addressing symptoms, restoring internal harmony, and adjusting treatment based on observed patterns.
Treatment Principles
Chief and Deputy Roles: Different herbs play diverse roles.
Functional Actions of herbs guide the therapeutic process (e.g., sweating, clearing heat).
Methods: include harmonizing, warming, supplementing, and constraining.
Overview of Herbal Categories
Herbs are organized by their functions reflecting therapeutic actions.
Key categories:
Exterior-Releasing: Address wind-cold and wind-heat.
Clear Heat: Address symptoms of high fever, toxicity.
Downward Draining: Move bowels, purge heat.
Regulating Qi/Blood: Address stasis or stagnation issues.
Understanding Herbal Properties
Categories: Herb parts affect various body areas; named for functions, scents, and characteristics to match patient needs.
Taste Effects: Flavor impacts therapeutic actions (e.g., Acrid - disperses, Bitter - clears heat).
Temperature: Determines whether an herb warms or cools the body (e.g., Hot - disperses cold).
Channels Entered by Herbs
Each herb enters specific meridians via their therapeutic effects and considers their therapeutic action in treatment plans.
Safety and Special Considerations
Be cautious of 18 incompatibilities and 19 antagonisms. Knowledge of dietary considerations and special patient groups (e.g., pregnant women) is essential.
The history of Chinese herbal medicine is a narrative of both tradition and innovation, shaped by government initiatives and individual scholarship. Formal government-sponsored texts began to emerge during the Tang dynasty between 618 and 907 CE. From the Song dynasty (960–1279 CE) through the Qing dynasty (1644–1912 CE), the state produced extensive encyclopedias to standardize herbal knowledge and refine clinical practices. The chronological development of this field is marked by several seminal works. The Ma Wang Dui Manuscripts, dating between 25 and 220 BCE, represent the oldest physical evidence of herbal use with 170 prescriptions and 270 substances, reflecting early shamanic influences. This was followed by the Huang Di Nei Jing (Yellow Emperor’s Inner Classic) between 305 and 204 BCE, which established medicine's philosophical roots despite having only 12 prescriptions. By the 2nd Century CE, the Shén Nóng Běn Cǎo Jīng became the first organized materia medica, classifying 365 substances. Later, in the 3rd Century CE, Zhong Zhong Jing authored works on Cold Damage that became the basis for internal and gynecological medicine. Significant expansions continued with Tao Hongjing in 452 CE, who increased the known substances to 730, and the Tang Ben Cao in 657–659 CE, which served as the first official government pharmacopoeia with 850 entries. In 1590 CE, Li Shizhen published the Ben Cao Gang Mu (Compendium of Materia Medica), a monumental research effort covering 1,892 substances and 11,000 formulas. Modern research at the Jiangsu College of New Medicine in 1977 increased these entries to over 5,767.
The philosophical core of Chinese medicine is built upon the concepts of Yin-Yang and the Five Phases (Wu Xing). Yin-Yang describes phenomena as pairs of complementary opposites—such as contraction and expansion or femininity and masculinity—that are mutually rooted and maintain a dynamic equilibrium. These principles are applied to understand anatomy, physiology, and pathology. Complementing this is the Five Phases theory, which views energy and matter through a cyclical system involving Wood, Fire, Earth, Metal, and Water. Each phase is associated with specific organs, emotions, and tastes; for example, Wood is linked to the Liver and a sour taste, while Fire relates to the Heart and a bitter taste. These phases interact through Generating (Sheng), Controlling (Ke), and Insulting cycles, ensuring systemic balance.
Physiological health is maintained by vital substances: Qi, Blood (Xue), Essence (Jing), and Fluids (Jin-Ye). Qi is the Yang-natured dynamic force that warms, defends, and activates the body. It is derived from food (Gu Qi), air (Da Qi), and innate vitality (Jing Qi). Pathologies of Qi include deficiency, stagnation, counterflow, and collapse. Blood serves to nourish and moisten the body, governed by the Heart, regulated by the Liver, and generated by the Spleen. Essence (Jing) is the fundamental substance that governs life stages and is inherited or acquired through nutrition. Body fluids are categorized into Jin (thin, Yang liquids) and Ye (thick, Yin humors), which provide hydration and lubrication. Imbalances in these substances lead to conditions such as blood stasis, edema, or phlegm-rheum.
The Zang-Fu system further organizes the body into Yin (solid) and Yang (hollow) organs. The Zang organs—Liver, Heart, Spleen, Lungs, Kidneys, and Pericardium—store vital substances and are associated with specific emotions like anger, joy, and worry. The Fu organs—Gallbladder, Stomach, Small Intestine, Large Intestine, Bladder, and San Jiao—are involved in digestion, transformation, and waste elimination. Each organ pair works in harmony to regulate the flow of Qi and Blood. Disease arises when this harmony is disrupted by external causes like the Six Excesses (Wind, Cold, Heat, Dampness, Dryness, and Summer-Heat) or Pestilent Qi. Internal causes include the Seven Affects, where excessive emotions like grief or fear damage specific organ systems. Lifestyle factors, dietary irregularities, and trauma comprise the neutral causes of disease.
Diagnosis and treatment in Chinese medicine focus on pattern identification rather than just treating symptoms. Practitioners use the Four Diagnostic Examinations—Inspection, Listening and Smelling, Inquiry, and Palpation—along with the Eight Principles (Interior/Exterior, Cold/Heat, Deficiency/Excess, and Yin/Yang) to identify imbalances. Treatment aims to restore the balance between Right Qi and Evil Qi. Herbal therapy utilizes the properties of plants, including their taste (Acrid, Bitter, Sweet, Pungent, Salty), temperature (Hot, Cold, Warm, Cool, Neutral), and the specific channels they enter. Herbs are classified into categories like Exterior-Releasing or Downward Draining. Ensuring safety requires knowledge of the 18 incompatibilities and 19 antagonisms, protecting vulnerable patients and maintaining the body's internal harmony.