Stuart Animal Hospital
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INTRODUCTION TO CHINESE MEDICINE
The interest and use of traditional Chinese herbs has increased tremendously over the last 10-15 years. Many people are searching for effective medications with less side effects that incorporate a more natural approach to healing.
Herbs have been used in Traditional Chinese Medicine (TCM) for several thousand years. The Huang Di Nei Jing,
( The Yellow Emperors Inner Classic) one of the first true
complete medical books, listed 12 herbal formulas. This book was written between 200-100 BC. The first true herbal medicine text was the Shen Nong Ben Cao Jing - written as a compilation between 300 BC- 200 AD. Dr. Zhang Zhong-Jing’s book, discussion of Cold Introduced Disorders (Shang Han Lun) was the first book to list formulas. This book was the first published in 220 AD.
Over the centuries Chinese physicians have added herbs and formulas that effectively link TCM theory to clinical observations. These herbal formulas have survived the bridge of time because of their effectiveness in the treatment of illness.
The materia medica is a category of published books that describe the strength, actions, energies and flavors, of individual herbs, insects, or minerals and the parts that have medical impact, i.e. wings, roots, etc. Many references list common herbs that combine with others to create formulas. Most formulas that are used today are based upon simple classic formulas that have been successfully used over the past 2000 years to treat specific syndromes. Herbalists will modify a classic formula to address the specific needs of an individual patient they are treating.
Chinese herbal medications are composed of individual ingredients that treat a specific TCM pattern. Animal, mineral, insect, plant, flowers, leaves, roots, resins and funji can all be used to create a formula. The method of preparation such as stir fry, boiling, charring, soaking or baking in wine will change the effects of the formula. Most classical herbal formulas are made in several forms- freeze-dried concentrated powders, capsules, liquids and patent formula tea pills.
Tea pills are concentrated powders that are covered in honey and baked in high pressures and heat. The honey seals the herbs and allows for long shelf life. They are often placed in boiling water and drunk as medicated tea. They are easily administered as pills to dogs and cats.
To get the best results with Chinese herbs, one needs to understand and master these four areas: Chinese Medical Theory, Strategy, the Formulas, and the Substances in the formulas.
TCM theory is based on the concept of Qi- ie the flow of energy, the Eight Principles; the Five Elements and Pathological Factors. The diagnosis of an illness or condition is primarily based on the Eight Principles: Yin/Yang; Exterior/Interior; Excess/Deficiency; and Hot/Cold. It is beyond the scope of this lecture to teach TCM theory, however, all patients that come to see us have characteristics that form a pattern of diagnosis. The challenge is to identify that pattern. Once the diagnostic pattern is determined, a strategy is derived from the pattern. As an example, a dog with a western diagnosis of pneumonia has clinical signs of fever, cough, shortness of breath and thirst with an excess lung heat pattern. The strategy is to use cooling, moistening lung herbs. This is a lung yin deficiency. Strategies are usually based on opposites- i.e. use cooling herbs to treat heat, drying herbs for damp conditions interior moving herbs to dry sweating. Herbal strategies can focus the action to a specific area in the body, such as stomach or liver etc.
The formula is derived from the strategy. For low energy and digestive weakness, one will use a formula for Spleen Qi deficiency which will address the pattern. If this patient also has a urinary bladder infection, several specific herbs can be added to move the action of the formula to the bladder and treat damp heat in the bladder. Chronic renal disease in a cat can be treated by identifying the pattern first: Kidney Qi, Kidney Yin or Kidney Yang deficiency. Each pattern has a specific strategy that is used to help treat the patient. Specific formulas are evaluated to individually fine tune the treatment. The fine tuning is based on the choice and use of specific herbal ingredients. Thus, Lui Wei Di Hung Wan is the classic formula for Kidney Yin deficiency patients.
Let me review a formula to illustrate these concepts. This formula is used to strengthen the liver. It has been the classic liver tonic herbal medicine formula since the year 1080. It is used for acute or chronic hepatitis or liver dysfunctions. It contains Bupleurum Chai Hu 14.3 %; Paeonia Bai Shao 14.3 %; Angelica Dang Gui 14.3 %; Atractylodes Bai Zhu 14.3 %; Poria Fu Ling 14.3 %; Zingiberis Sheng Jiang 14.3 %; Glycyrahiza Gan Cao 11.4 % and Mentha Bo He 2.7 %.
Bupleurum is an herb that cools the liver. It is a powerful herb that moves the heat out of the liver to the surface of the body. Paeonia and Angelica are blood tonic herbs for stagnation of liver blood. They move blood through the liver. Atractyloides is an immune strengthener. It stimulates immunity and energizes the body and is a Qi tonic. Poria acts as a diuretic and pulls toxins out of the body- but specifically in the liver due to the Bupleurum-the liver herb.
Zingiberis; ginger, warms the organs of the body to balance the Poria and the cooling action of the Bupleurum. Glycyrrhiza, or licorice, acts as a harmonizer. Chinese formulas use harmonizers to blend the actions of all herbs in the formula to allow a smooth, blended flow of all the energies of the ingredients. The Mentha, mint, slightly adds to the cooling action due to hot dysfunctional liver disease.
As you can see, there is usually a king or magisterial herb that is the director. In this case, Bupleurum. Then one or two queen herbs or assistants i.e. Paeonia and Angelica. TCM herbal medicine is not like western medicine. Western herbolists use herbs as drug-like natural products-Echinacea is used “ like an antibiotic.” TCM needs a pattern diagnosis, a strategy and groupings of herbs to complete the theory.
