Herbs are used traditionally by the ancient Chinese to prevent, diagnose and treat diseases. These herbs are mainly originated from the nature. Nature is imbued with vitality and all kinds of herbs are being grown and flourished. Among them are plants herbs, animal herbs, mineral herbs and other processed drugs. Herbs are widely grown across China and the drugs have their unique regional growth characteristics. Among the herbs, some are specially cultivated and some are grown in the wild. For instance, the Northern East area of China are known to cultivate Ginseng人 参 Apart from the plant drugs, animal drugs and the mineral drugs, Chinese herbs also contain synthetic drugs. Following the scientific development and progress of Chinese herbs, synthetic drugs would enjoy bright prospects in the future. Classifying different types of Chinese herbs Herbal values classification: such as the detox drugs解毒药, clearing heat drugs清热药, soothing qi drugs理气药, activating blood and resolving stasis drugs活血化瘀药. Effective substance classification: such as drugs which contain alkaloids, drugs which contain volatile oil, drugs which contain glycosides and etc. Processing of herbs After the discovery of fire and inspired by how food can be processed by fire, the ancient people learned that after processing with fire, the medicinal characteristics of herbs can also be adjusted such as reducing its toxic effects. The invention of brewing technology during the Xia Yu夏禹 period opened the path for wine-processed herbs. More processing methods like Salt-processed, Vinegar-processed, Honey-processed started to emerge gradually and enriched the scopes of processing and effectively meeting clinical requirements. Types of herbs Animal herbs also highly figured in the entire Chinese herbs production. The ancient Chinese already paid close attention to animals. The earliest Chinese poetry collection, Shijing 诗经mentioned 160 types of animals. It is also during this time the ancient Chinese learned to classify animals according to their types and they recorded the animals with affix of ‘fish’, ‘insects’ ‘dogs’ and etc. Using the animals as herbs also began at an early stage. In addition, some of the animal stones such as bezoar of the cow, the horse and the dog are precious herbs. Bezoar of the ox and the buffalo’s gall bladder, bile duct or liver duct possess the functions of dissolving phlegm, soothing the gallbladder and relieving convulsion. They are normally used to treat Heat diseases and the symptoms are coma and unconsciousness, fits and rage, acute infantile convulsion and etc. Recently they are being used to treat epidemic encephalitis. Gall stones of the horses have the effects of cleansing heat, detox, arresting convulsion and dissolving phlegm. Gall stones of the dogs have the medicinal values of descending the adverse qi, dispersing stagnation and detoxification. Mineral drugs are also important components of the Chinese herbs literature. We often relate gold, stones and jades to wearing of jewelry and accessories. They also have medicinal values and can be employed to treat diseases. For example, gold can be used to stabilize the spirit and strengthen the bones and essence. Silver has the effects of calming the five organs and stabilizing the mental state. In addition, it can also be used to treat underarm odor. Quartz is effective in treating the evil energy that blocks the chest and the stomach. With the internationalization of Chinese herbs, the special effects and clinical values of mineral drugs also increasing prized and valued. The ancient doctors’ way of processing herbs and interpretation met scientific requirements, as evident by the outcome of modern medical research. For example, herbs processed with ginger possess the effects of warming and spreading; 姜制温散 processed with honey nourish dryness and supplement qi (honey has the effects to stimulate intestine and enhance nourishment); 蜜制润燥益元 processed the herbs with high temperature retained the pure inorganic constituents; “soaked Gan Cao甘草 in water to detox” , the mechanism is the hydrolyzation of Gan Cao would produce glycyrrhetic acid and in turn it would generate glucouronic acid to enhance the detoxing effects. Adjusting and Fine-tuning includes cleansing, cutting and grinding. “Water Processing水飞法” refers to using water and other liquid supplement to process and it includes wetting, rinsing and elutriating. “Fire Processing火制法” use fire or heat to process the herbs and it includes frying, baking, moxibusing and toasting. T he “Water-fire Processing水火共制法” includes cooking, steaming and shredding. The other processing methods are more specialized such as fermenting制霜, germinating发酵 and frosting发芽 and etc. Herbs are used traditionally by the ancient Chinese to prevent, diagnose and treat diseases. These herbs are mainly originated from the nature. Nature is imbued with vitality and all kinds of herbs are being grown and flourished. Among them are plants herbs, animal herbs, mineral herbs and other processed drugs. Preparations of herbs It is vital to note that different types of preparations each aim at treating different types of diseases. Hence, understanding their respective characteristics and therapeutic effects are of utmost importance. What’s Medicinal Therapy? It is prepared under the guiding principles of TCM fundamental theory and derived from there. It is developed as a separate entity of healthcare. Medicinal Therapy emerged together with the development of TCM. Differences between Medicinal Therapy & Dietary Therapy For herbal medicine, medicinal plant elements are by far the most commonly, but not solely used substances in TCM. Animal, human and mineral products are also utilized. Thus, the term "medicinal" (instead of herb) is usually preferred. One should eat a variety of foods in order to benefit from all the flavors, energies, and organic actions of a varied diet. Foods should be selected according to one's particular needs and physical constitution. Basic Differences between Western nutritional therapy and traditional TCM dietary therapy As used in the outpatient setting, modern Western nutritional therapy is most often used for weight loss whereas traditional Chinese nutritional therapy is used to treat a variety of health issues ranging from uncomplicated hypertension to skin disorders. The second main difference is that Western nutrition considers foods with regard to their protein, caloric, carbohydrate, vitamin, and other nutrient content. These measures were largely unknown in ancient China. Instead, TCM dietary therapy considers foods for their five flavors, five energies, movements, the common actions of foods (e.g., to lubricate dryness, soften hardness, or nourish blood), and organic actions (the specific internal organs on which certain foods can act). Differences between Dietary Therapy and Medicinal Therapy Dietary therapy does not surely manifest medical effects, but Medicinal therapy is sure to possess the functions of dietary therapy. Myths of Dietary Therapy 1. One-off Solution for all diseases: TCM health preservation involves internal preservation and external preservation. Internal preservation concerns with up-keeping and nourishment of one’s essence, qi and spirit. External preservation involves the strengthening of skin, flesh, muscle and tendon. TCM places emphasis on internal preservation. However, many health preservation tended to focus on external preservation and hence go great length to teach people how to eat and how to exercise. What they failed to realize is if internal preservation fails, it is pointless to know how to eat. Myths of Dietary Therapy 2. Follow Mechanically and Blindly TCM advocates customization and health preservation measures should vary from people to people. It is necessary to pay attention to one’s physical constitution before adopting the dietary therapy. Professional advice should be sought before adopting. What suit other may not suit us. Myths of Dietary Therapy 3. Think about health preservation only after falling ill: TCM advocates treating the disease before it occurs or one should adopt a preventive approach towards maintaining our health. TCM emphasizes on regulating and adjustment. Managing a healthy, balanced lifestyle is of paramount importance. Three Fundamental Principles of Dietary Therapy 1. The importance of identifying the syndrome It is crucial to identify accurately the characteristics of the disease, together with the knowledge of physical constitution. The choice of dietary therapy can then be prepared on this basis. 2. Holistic Selection of food As far as possible, efforts must be made to ensure balance of meat and vegetables in the diet. 3. Abstemious Dietary Habits Regular amount of meals at eat at regular interval. Characteristics of Medicinal Therapy Time honored and long history: As far as more than 2,000 years ago, during the Zhou dynasty. It continued to prosper and enriched following the development of TCM as an independent academic subject. Drug immersed in food: While taking the meals, patients also get treated by consuming the relevant drugs. The Tang dynasty well-known centenarian physician Sun Simiao stated in his <Thousand Gold Key Formula>:”When the emperor is ill, it is better to urge him to consider food therapy. Only when Food Therapy fails to heal, then Medicinal Therapy is applied.”孙思邈《千 金要方》:云“君父有疾,期先命食以疗之;食疗不愈,然后命 药”。 Characteristics of Medicinal Therapy Emphasizes on regulating and adjusting the body:The fundamental principle of Medicinal Therapy is to combine food and drugs to gradually adjust the body’s disorder, although it is supposed to be effective in treating certain diseases. Wide-spread and far-fetched effects: Medicinal Therapy possesses the effects of what the food therapy is incapable to perform. At the same time, it differs from treating diseases. Hence, it is appropriate for different age group, gender, disease type and lifestyle. Types of Medicinal Therapy 1. According to the effects: - Relieve the superficial discomfort - Clear heat and detox - Purge the internal heat - Warm the interior and expel cold - Expel wind and dissolve the pathologic factors Types of Medicinal Therapy - Promote fluids flow and dissolve swelling - Dissolve phlegm and stop the cough - Digest food and strengthen the stomach - Smoothen the block qi - Regulate the blood Types of Medicinal Therapy - Calming the mind and spirit - Stabilizing the liver and submerge the liver yang - Controlling and withholding - Replenishing and enhancing - health care and general health nourishment Types of Medicinal Therapy (2)According to the presentation - Vegetable - Porridge - Sweet dissert - drinks - Others like lotus powder, Chinese yam paste and etc Principles of Application Balance yin and yang Regulate the organs’ functions Enhance the immunity system and expel the pathologies Customization Take note of the appropriate applications’ do’s and don’ts. Fundamental Theory of Medicinal Theory Holistic approach based on the integrity of the five organs Guided by accurate syndrome differentiation and treatment principles Application of the TCM Yin-Yang and Five Elements Theory Consideration to the herbs’ medicinal characteristics TCM regards the properties of food just like the drugs. It is particular about the tastes , flavor and the relevant organs. As mentioned by the <Huangdi Neijing>, “ Sour nourishes the liver, spicy nourishes the lung, bitter nourishes the heart, salty nourishes the kidney, sweet nourishes the spleen. “ How To Prepare Hot Medicinal Dish Double-boiling Cooking Stewing Steaming Cook over a small fire How to prepare medicinal cold dish Mixing: After cutting the raw drug or cooked drug into certain shape, mix it with seasoning. It is cooling and crunchy and has the effects of boosting appetite. It can be prepared in both hot or cold. Boiling:Cut the materials into the desired shape and size, after heating it mix with seasoning or wild pepper. It can taste spicy or refreshing. How to prepare Medicinal Porridge Grind the drugs into powder and cook it with rice. Extract the ,medicinal liquid and cook it with rice. Use the meat stock or milk to cook with rice. How to prepare medicated liquor Using white wine or yellow wine as base material to soak or cook the relevant the drugs. Filter the dregs and drink. Medicated liquor has the effects of clearing the blood stream, warming the stomach and protect the body against cold. How to prepare Medicinal Drinks General Health-care drinks:using drugs, water and sugar as ingredients and extracted the liquid medicine by soaking, cooking and distillation the drugs. After precipitating, filtering and purifying, add rock sugar and honey to form. The features of such drink are generating fluid to preserve yin, nourishing dryness and quenching thirst . Medicinal Tea: Match the drugs with tea leaf and flush them with boiling water, braised it for 15 minutes before drinking. White sugar or honey may be added. Or cook the drugs with water and filter it as tea to drink. Or grind the drugs into powder and make it as small sachet and drink it by adding hot water. The features of such drinks are refreshing and quenching thirst. Properties & Flavours Each Herb is assigned its own property and flavour. Four Properties HOT, WARM, COOL and COLD Five Flavours Sour, Bitter, Sweet, Acrid (pungent, spicy) and Salty Four Properties They represent varying degrees of hot and cold. Warm less than hot, cool less than cold. Sorted out according to the different actions of the drugs on human body and their therapeutic effects. For example, drugs for heat syndrome have a cold and cool property. Five Flavours – Sour SOUR : astringent and prevent or reverse the abnormal leakage of fluids and Qi, stop perspiration. Indications: sweating due to debility, chronic cough, chronic diarrhoea, enuresis, frequent micturition and etc. Five Flavours – Bitter BITTER : drain and dry, descend, open channels. Indications: used for syndromes of pathogenic fire, cough with dyspnea, vomiting, constipation due to heat of excess type, damp-heat syndrome, and etc Five Flavours – Sweet SWEET : tonify, harmonize, moisten, supplement, relieve pain and spasms, generate fluids Indications: effective in treating syndromes of deficiency type, dry cough, constipation due to dry intestine, various pains, detoxication and etc. Five Flavours – Acrid ACRID : disperse and move Qi and blood, break up accumulations, raise Yang. Indications: superficial and mild illnesses due to affection by exopathogens, stagnation of vital energy, blood stasis and etc. Four Actions LIFTING, LOWERING, SINKING, FLOATING Refer to the upward, downward, outward or inward directions in which drugs tend to act on the body. Lifting means going up while lowering means the opposite; floating means going outward or sending to the surface, whereas sinking means going inside or purging away. Four Actions Lifting and floating: upward and outward actions are used for elevating Yang, relieving exterior syndromes by diaphoresis, dispelling, superficial wind and cold, inducing vomiting, causing resuscitation. Four Actions Lowering and sinking: downward and inward actions, used for clearing heat, purgation, promoting micturition, removing dampness, checking the exuberance of Yang, sending down an adverse flow of qi to stop vomiting, relieving cough and asthma, improving digestion, removing stagnated food, tranquilizing the mind with heavy properties. Channel Tropism Refers to a drug’s selective therapeutic effects on a certain part / system of the body. Based on the theory of viscera and the theory of channels and collaterals. Used in conjunction with the theories of four properties and five flavours. Five Flavors of Food The five flavors are: sour, spicy, sweet, bitter, salty. Each flavor links with a particular organ and the flavor will nourish it Sour connects with liver; Spicy connects with lungs; Sweet connects with spleen; Bitter connects with heart; Salty connects with kidney Five Colors of Food The five colors connects with five organs. Green – liver Yellow – spleen Red – heart Black – kidney White - lungs The herbal drugs possess both aesthetic and medicinal values. They are the rich reservoir of the Chinese herbs. Currently, of all the medicinal Chinese herbs, 90% of them are plants drugs. According to the medicinal component of the drugs, there are approximately 200 to 250 types of rootstalk; there are 180 to 230 types of fruits and seeds drugs. About 60 to 70 types of them are flowers and approximately 30 to 40 types are extracted from animal skins; 160 to 180 types are grass herbs and leaf types are 50 to 60 types. Types of herbs It is vital to note that different types of preparations each aim at treating different types of diseases. Hence, understanding their respective characteristics and therapeutic effects are of utmost importance. Types of herbs Decoction汤剂: It is prepared by boiling the prescribed drugs in a formula, skimming and extract the juice to prepare. Decoction has the advantages of quick absorption, responsive, flexible to add or minus and very focused. It is appropriate to handle the sudden and new disease or enhancing the body immune system. Types of herbs Pill丸剂: It is made by processing the various drugs which contained in a formula, mix them in accordance with the formulae’s specifications, mix and grind as powder. Honey, water or starch will be used to roll them as pill. The advantages are portable and convenient to bring and store and is a very common form of preparation. It is appropriate to treat the chronic or improving deficiency diseases. Types of herbs Plaster膏剂: There are two types of plasters: oral consumption and external use. The oral type further divides as Fluid Extract流浸膏, Extract 浸膏(Dry Extract and Sticky Extract) and Rich Paste暾膏剂或膏滋. They are mostly used for the chronic deficiency diseases when long term nourishments are required. The external pastes are the Hard Paste and the Soft Paste. They are mostly used for surgeries like ulcers/furuncles or rheumatism caused by wind, cold or damp evils. Types of herbs Powder Medicine:散剂 Grind the drugs in a particular formula into powder and mix evenly. Add Small amount of sugar and small amount of red sugar to the cold drugs and warm drugs respectively and mix them evenly. Powder medicine is most widely used during clinical diagnosis. Although it is less speedy than the decoction drug in terms absorbing by the body, it is convenient and portable and possesses reliable therapeutic effects. It is appropriate to treat diseases which are already formed and complicated diseases. Types of herbs Slice Medicine:片剂 The ancient people would slice the raw drug into slices and hence it is named. For example, slicing ginger to make it easier to boil and Renshen Slice is convenient to chew. Following the development of the TCM drugs preparations, many drugs are made as powder medicine or fluid extracts and added excipient such as starch and flattened it as slices. Slice medicine is convenience to consume to portable some of them are Ling Yang Gan Mao Pian 羚羊感冒片, Niu Huang Jie Du Pian牛黄解毒片 and etc. Types of herbs Distillated Medicine露剂: Add the prescription with water to distill it and drink the distilled water. Such as Jin Yin Hua Lu金银花露, Qiang Wei Hua Lu 蔷薇花露 and etc. the medicinal effect of distillated medicine is relatively mild and mostly made of fragrance drugs. It is mostly used for mild petraedric diseases or take it as summer drinks. Types of herbs In addition to the above common drug types, using the water to repeatedly boil and stew the animals’ skins, bones, shells and horns until they are clotted and solid. Some examples are A Jiao阿胶 (clotted donkey’s skin), Gui Ban Jiao龟板胶 (clotted stomach shell of the turtle). Blending the powder medicine with flour, fermented it and cut into pieces and became fermented medicine such as Liu Shen Qu六神曲 and Ban Xia Qu半夏曲. Stick the medicine powder on a roll of cloth or simply add starch to the powder medicine and rub it into a medicinal roll to make it convenient for inserting it to treat the wounded area. In recent years, liquid tonic 口服液taken orally and sachets冲剂 are also latest additions to the list of preparation. The variety assortments offered tremendous convenience to aid clinical treatment. TOXICITY OF THE DRUGS • Toxicity refers to the harmful effects of the drugs to the human body. • It is an important concern while managing the property of the drug. The pharmacological books of various ages distinguish the drugs’ toxicity by writing them as “mild toxicity” or “strong toxicity”. • Although some drugs are toxic, using the principle of ‘treating the ills with poison” would still work in certain situations. • It is still essential to control the dosage or specially processing it to reduce their toxicity in order to achieve the desired therapeutic effects. FUNDAMENTAL OF MATCHING DRUG • <Sheng Nong‘s herbal classic神农本草经> summarized the relationship of drugs composition as: • “Some are used singly单行, some are used with mutual promotion相须, some are used to complement each other相使, some are mutually restraint相畏; • some are mutually inhibited相恶, some are opposite 相反and some are mutually toxic相杀. FUNDAMENTAL OF MATCHING DRUG Using a single drug or use it singly refers to merely using a drug to treat a particular disease. Mutually promotion refers to combining the two drugs which shared identical therapeutic effects. By doing so the original effects of the drug can be further enhanced and it is one of the main manifestation of composing. Complementing each other is to use a drug as main and the other as supportive. By combining the two drugs, the supportive drug helps to increase the effects of the main drug. Mutually inhibition refers to the toxicity of one drug is being suppressed by the other.