Traditional Chinese Medicine is a comprehensive and holistic health system incorporating herbal medicine, acupuncture, diet, lifestyle, meditation, massage and exercises that appreciates the connection and interplay of mind, body and spirit and takes into account a person’s individual constitution and the unique presentation of their health condition.
It is based on a philosophy of binary forces, the most fundamental being yin and yang. This concept of polarity further extends to form the eight principles upon which TCM diagnosis is made (the ba gang bian zheng), which ask the questions: Is the condition in the interior or exterior? Is it hot or cold in its nature? Yin or yang? Excess or deficient? With this information, a herbal formula may be carefully constructed that aims, where possible, to address both the root (ben) and branch (biao) (i.e. the underlying cause and its symptomatic presentation) of a condition, to restore the individual to a state of physical, mental and spiritual equilibrium.
Traditional TCM terms
Blood (xue) The TCM concept of blood incorporates that substance which we understand in biomedicine, but extends further and is seen as the material substance that supports our mental and emotional functions. It is also seen to nourish the eyes, tendons, skin and hair.
Cold (han) May refer to environmental cold affecting the body or an absence of warmth within the body. This can occur for a variety of reasons, including poor circulation or a deficiency of yang energy. Also describes the thermal characteristics of a herb.
Damp-heat (shi re) Conditions of dampness with heat signs, often associated with offensive discharges. Conditions can include hepatitis, inflammatory conditions, skin conditions such as acne and boils and dysenteric disorders. May be internally-generated or externally-contracted from the environment or a diet rich in damp, hot substances (e.g. alcohol).
Dampness (shi) Excess fluids in the body manifesting in the likes of oedema, swellings, sensations of heaviness, aches, excessive discharges, bloating, fluid accumulation and loose stools. Also refers to climatic dampness which can penetrate the body or exacerbate existing damp pathologies.
Deficient (xu) a state of insufficient qi, blood, yin, yang, essence or fluids.
Essence (jing) Inherited, constitutional essence stored in the Kidneys that provides the substance for development and growth.
Excess (shi) A condition of too much of a particular substance/ energy (e.g. fluids, blood, yang) overall or in a particular location in the body, or of a pathogen in the body (e.g. wind, cold, damp).
External (biao) On the external and superficial aspects of the body (i.e. skin and muscles). Also refers to pathogenic factors which attack from the outside (e.g. wind-heat and wind-cold).
Five Palm Sweat Characteristic sweat associated with Yin deficiency appearing on the palms, the soles of the feet and chest.
Fu The hollow Yang organs of the body
Heat (re) Excess of warmth in the body, typically involving a sensation of heat, degree of inflammation and, or, hyperactivity (as in hyperthyroidism, behavioural hyperactivity etc). Heat may also lead to dryness manifesting in thirst, dry skin or constipation. Can be from excess (e.g. febrile disease) or deficient (e.g. yin deficiency leading to heat) causes and from external or internal origins, of which febrile disease and yin deficiency are also good examples, respectively.
Internal (li) Conditions of the interior of the body, affecting the internal organs. The cause of which may have arisen from either internal or external factors
Jiao The three jiaos are divisions of the trunk of the body into the upper (Heart, Lungs) middle (Spleen, Stomach) and lower (Liver,Kidneys) regions of functionality.
Jin Ye Body Fluids; Jin refers to the lighter fluids, Ye to the denser fluids
Jue Yin Arm and leg channels of the Pericardium and the Liver
Ke Cycle The cycle of mutual control in the Five Elements system
Kong Qi Qi derived in the lungs from the air
Liver yang rising (gan yang shang kang) A common presentation in modern clinics in the west where the yang energy of the Liver is unrestrained by Liver yin and is said to ascend causing ailments such as headache, irritability, anger, insomnia and hypertension.
Mingmen Fire The nature of the essential warming energy of Kidney Yang. Considered to be vital in maintaining the heat in the body.
Phlegm (tan) Accumulation of thick fluids anywhere in the body, in particular the respiratory and digestive systems. Broader than the western concept of phlegm, it can also result in symptoms as diverse as epilepsy and goitre. Can coexist with heat or cold signs.
Qi (chi) The Chinese term for the life force or vital energy of the universe, which is fundamental to all aspects of life. It permeates the whole body and concentrates in the channels.
Qi External In Chinese medicine, any factors influencing the body from outside.
Shao Yang San Jiao and Gall Bladder channels
Shao Yin Heart and Kidney channels
Spirit (shen) A broad concept referring to everything from our mental functions, thoughts, memory, emotions and sleep as well as the more ethereal concept of our ‘spirit’. As mind and body are inextricably linked in TCM, the Shen is believed to reside in the Heart and is nourished and supported by blood and yin.
Tai Yang The Small intestine and Bladder channels
Tan Yin The Lung and Spleen channels
Wei Qi Defensive Qi, which protects the body from invasion by external pathogenic factors. It flows just beneath the skin.
Wind (feng) A pathogenic factor typified by conditions with rapid onset, movement of symptoms, spasms and tremors. Can be internally-generated (e.g. from Blood or yin deficiency or severe heat) or externally-contracted as in common colds and viruses where environmental wind combines with cold, heat or damp.
Traditional TCM medicinal herbal actions
Aromatically Transform Damp (fang xiang hua shi) Fragrant medicinals that restore digestive function, for example in cases of bloating, indigestion, food poisoning and gastroenteritis, by strengthening digestion and alleviating dampness. Examples include huo xiang (Agastache rugosa) and cang zhu (Atractylodes lancea).
Aromatically clear the Orifices of the Heart (fang xiang kai qiao) Fragrant herbs that revive the senses and consciousness to treat conditions such as seizures, epilepsy and stroke by acting on the central nervous system (eg. bing pian (Bornoleum syntheticum) and shi chang pu (Rhizoma acori) which stimulate and inhibit it, respectively) and stimulating the cardiac (e.g. su he xiang (Liquidambar orientalis)) and respiratory systems.
Astringents: Stabilize and Bind (gu se) Return bodily structures to their intended positions and stop abnormal leakage and discharge of bodily substances. They address conditions such as prolapse, diarrhoea, cough, urinary incontinence and excessive sweating or menstruation. Examples include wu wei zi (Schisandra chinensis) and shan zhu yu (Cornus officinalis).
Calm the Shen (Spirit) (an shen) An unsettled shen, or spirit, may stem from a variety of disharmonies and result in symptoms such as palpitations, anxiety and insomnia. Suan zao ren (Ziziphus spinosa) and he huan pi (Albizzia julibrissin) are examples of herbs that calm the spirit via differing routes; by nourishing blood and yin (suan zao ren) and alleviating qi stagnation (he huan pi).
Cathartics (jun xia) are harsh, short-term use expellants such as gan sui (Euphorbia kansui) and da ji (Euphorbia pekinensis) that strongly expel excess fluids accumulating in the chest and abdomen, manifesting in the likes of oedema, severe constipation, pleurisy and ascites, via the stools and urination.
Clear Heat and Dry Damp (qing re, zhao shi) These herbs are cool, drying and bitter in nature, often with antibacterial, anti-inflammatory and anti-viral properties. They alleviate damp-heat conditions in the body, a common presentation in modern clinics in the west. These may manifest internally or externally. Common internal patterns include damp-heat in the Liver (eg. jaundice, hepatitis), Bladder (urinary tract infections) and intestines (gastritis). Eczema is a common external manifestation of damp-heat.Herbs include the ‘three yellows’ (huangs): huang qin (Scutellaria baicalensis), huang lian (Coptis chinensis) and huang bai (Phellodendron amurense) which alleviate damp-heat from the upper, middle and lower jiaos, respectively.
Clear and Relieve Summerheat (jie shu) Diuretic and antipyretic herbs (e.g. he ye (Nelumbo nucifera) that relieve thirst to treat ‘summerheat’, a condition of fever with sweating, thirst and diarrhea typical to the Summer.
Clear Heat and Relieve Toxicity (qing re, re du) Strongly clear heat to relieve ‘toxin’ (e.g. purulent infections, dysentery and some viral infections). Examples include jin yin hua (Lonicera japonica) and lian qiao (Forsythia suspense).
Cool the Blood (liang xue) Typically used in the more serious stages of febrile disease where heat from infection has led to symptoms such as bleeding (e.g. nosebleeds, vomiting of blood, bleeding under the skin) high fever, thirst, irritability and delirium. E.g. sheng di (Rehmannia glutinosa).
Cool and Transform Phlegm-Heat (qing re, hua tan re) Treat phlegm-heat conditions, especially cough with hot phlegm (ie. thick, difficult to expectiorate, yellow, brown or green sputum). In such cases a herb such as qian hu (Peucedanum praeruptorum) may be used. Herbs in this category may also relieve other conditions stemming from phlegm-heat including goitre, nodules and convulsions.
Dispel Wind-Damp (qu feng shi) Herbs such as du huo (Angelica pubescens) exert anti-inflammatory and analgesic effects that treat ‘bi zheng’ – acute or chronic pain (e.g. arthritis, sciatica), typically in the joints, tendons and muscles, caused by impaired flow of qi and blood due to internal (e.g. weak constitution, low immunity) and external (wind, damp or cold) factors.
Drain Dampness (xie shi) These herbs have a broad scope for all damp conditions but are commonly used to promote urination and fluid circulation to remove dampness, with or without heat, to alleviate issues involving fluid stagnation and retention including edema, painful or difficult urination, urinary stones and phlegm conditions. E.g. fu ling (Poria cocos)
Drain Fire (xie huo) Cold herbs that strongly purge ‘fire’ – a more severe heat, typically affecting the upper body, from febrile disease and other origins, resulting in symptoms such as high fever, red face and eyes, thirst, extreme headaches and pronounced irritability or possible delirium. E.g. zhi mu (Anemarrhena asphodeloides)
Expel Parasites (qu chong) Treat internal and external parasites such as roundworms and tapeworms and are often combined with purgative herbs. E.g. shi jun zi (Quisqualis indica)
Extinguish Wind and Stop Tremors (xi feng, zhi jing) Treat wind of internal origin stemming from yin deficiency, Liver yang rising, blood deficiency or high fever. Common examples include gou teng (Uncaria rhynchophylla) and tian ma (Gastrodia elata).
Invigorate the Blood (huo xue) herbs that treat blood stasis conditions such as stabbing pain, abscesses and ulcers, abdominal masses, angina and ischemia often via the cardiovascular and haematological systems by exerting vasodilatory (e.g. chuan xiong (Ligusticum wallichii)), antiplatelet (e.g. hong hua (Carthamus tinctorius)), anticoagulant (e.g. dan shen (Salvia Miltiorrhiza)) and thrombolytic (e.g. e zhu (Curcuma zedoaria)) effects.
Moisten the intestines (hua chang) huo ma ren (Cannabis sativa) and yu li ren (Prunus japonica) are the primary TCM medicinals for lubricating the intestines to guide out stools. The former gently nourishes yin and blood to achieve this and the latter relieves constipation from qi stagnation. They are especially appropriate for the weak or elderly. Other herbs, such as dang gui (Angelica sinensis), moisten the intestines as a subsidiary action.
Purgatives (gong xia) Bitter, cold herbs that strongly promote bowel movements, typically where excessive heat has caused stagnation. E.g. da huang (Rheum palmatum).
Regulate the Qi (li qi) Alleviate conditions where qi is not flowing leading to stagnation of digestive qi (i.e. gas, bloating, abdominal pain etc), Liver qi (depression, irritability, flank pain etc) or Lung qi (cough, wheeze, stifling sensation of the chest etc). E.g. chen pi (Citrus reticulata) is commonly used for stagnant digestive qi.
Release the Exterior (jie biao) Cooling and warming pungent herbs that treat conditions of exterior wind-heat and wind-cold, respectively, typically via promoting perspiration. These herbs stimulate the immune system and are commonly used in cases of the common cold and influenza. gui zhi (Cinnamomum cassia) warms and treats exterior wind-cold and bo he (Mentha haplocalyx) cools and relieves exterior wind-heat.
Relieve Food Stagnation (xiao shi) Promote digestion by stimulating gastric secretions and peristalsis, thus helping to relieve digestive complaints such as abdominal bloating and discomfort, belching, gas, diarrhoea, reflux, nausea and vomiting. E.g. shan zha (Crataegus pinnatifida)
Stop Bleeding (zhi xue) Arrest bleeding by astringing (i.e. contracting blood vessels) with herbs such as bai ji (Bletilla striata), clearing blood stasis (eg. san qi (Panax notoginseng), cooling the blood (e.g. da ji (Cirsium japonicum) or warming (e.g. ai ye (Artemisia argyi)). Used in cases of nosebleed, coughing blood, heavy periods, blood in the stool, uterine bleeding and trauma.
Tonify the Blood (yang xue) Herbs such as shu di huang (Rehmannia glutinosa) and dang gui (Angelica sinensis) nourish the blood to alleviate blood deficiency (which may or may not coincide with a diagnosis of anaemia) characterised by symptoms such as pallor, worry, palpitations, poor memory, dizziness, dry skin, insomnia, light periods or absent periods.
Tonify the Qi (bu qi) Boost overall bodily or organ (especially Lung and Spleen) function. Examples include ren shen (Panax ginseng) and dang shen (Codonopsis pilosula) and indicated symptoms may include fatigue, poor appetite, loose stools (Spleen qi deficiency) or shortness of breath, pallor and a weak voice (Lung qi deficiency).
Tonify the Yang (bu yang) Strengthen the warming, activating yang energy of the body, in particular of the Kidneys (the seat of all yin and yang energy in the body) but also of the Spleen and Heart, alleviating symptoms such as: exhaustion, cold extremities, sore low back, low libido, impotence, infertility (Kidney yang deficiency), fatigue, poor appetite, bloating after eating, loose stools (Spleen yang deficiency) and palpitations, sweating and discomfort in chest (Heart yang deficiency).
Tonify the Yin (bu yin) Nourish the cooling, moistening yin aspect of numerous organs where chronic illness, febrile disease or poor lifestyle choices have depleted it. In particular, these herbs nourish the yin of the Kidneys, Lungs, Liver and Stomach. Depending on the organ or organs affected, signs of yin deficiency may include: night sweats, insomnia, a sensation of heat in the palms and soles, a dry mouth at night (Kidneys), a dry cough (Lungs), dry eyes, scanty menstruation (Liver) or epigastric pain, constipation and thirst (Stomach).
Treat Cough and Stop Wheezing (zhi ke, ping chuan) Stop cough and wheeze from both exterior and interior conditions, depending on the herbs with which they are combined, by redirecting Lung qi downwards, transforming phlegm and moistening the Lungs. Common examples include xing ren (Prunus armeniaca) and pi pa ye (Eriobotrya japonica) which especially benefit externally-contracted coughs with wheezing and cough with difficulty expectorating, respectively.
Warm the Interior and Expel Cold (wen li, qu han) Herbs such as gan jiang (dried Zingiber officinalis) are used in cases of yang deficiency with concomitant cold signs. These may include cold extremities, loose stools and a pale complexion. Herbs in this category may also be used where external cold has penetrated the organs, predominantly disrupting digestive function (e.g. cold-type gastroenteritis).
Warm and Transform Phlegm-Cold (wen, hua tan han) Herbs such as ban xia (Pinellia ternata), are prescribed for cough and wheeze with phlegm of the cold type, i.e. coughs with copious, clear or white sputum and other cold signs. They also very often benefit the digestion as this is seen as the place of origin of phlegm, the lungs being the ‘storehouse’.
Some of the classifications here were created with the help of Chinese Herbal Medicine: Materia Medica by Dan Bensky and Chinese Medical Herbology and Pharmacology by John K. Chen and Tina T. Chen
Traditional Chinese herbal medicine treatment methods
TCM physicians use eight treatment methods (ba fa)
- Han fa – Sweating ‘When it is at the level of the skin, use sweating to discharge it!’
- Tu fa – Vomiting ‘When it is at the upper level, draw it up and out’ – (rarely used today)
- Xia fa – Draining downwards ‘When it is at the lower level, lead and draw it down’
- He fa – Harmonising a broad category used to integrate and bring a formula together.’
- Wen fa – Warming ‘Warm that which is cold.’
- Qing fa – Clearing ‘Clear that which is warm…treat hot with cold.’
- Xiao fa – educing ‘Pare away that which is firm, disperse that which is clumped.’
- Bu fa – Tonify ‘Tonify that which is deficient. Augment that which is injured.’
You can read more about TCM formulations and how they work in our article The art and science of herbal formulation: Traditional Chinese medicine.
Traditional Chinese herbal medicine energetics
- Temperature: Hot, Warm, Cold, Cool, Neutral
- Taste: Acrid, Sweet, Bitter, Sour, Salty, Astringent, Bland
- Acrid: Disperses and moves, travels in the qi, enters the Lungs
- Aromatic: Penetrate ‘turbidity’ (poorly digested food and drink or pathological states of bodily substances such as mucus and urine) to awaken digestion or cognitive functions.
- Astringent: Stops bleeding
- Bitter: Drain and dry, travels in the bones, enters the Heart
- Bland: Leech dampness and promotes urination
- Salty: Purge and soften, travels in the blood, enters the kidneys
- Sour: Astringe and prevent leakage of fluids and qi, travels in the sinews, enters the Liver
- Sweet: Tonify, harmonise, moisten, travels in the flesh, enters the Spleen
Bibliography
- Bensky, D. and Gamble, A. (1993) Chinese herbal medicine: Materia medica. Seattle: Eastland Pr.
- Chen, J.K., Chen, T.T. and Crampton, L. (2012) Chinese Medical Herbology and Pharmacology. City of Industry, CA: Art of Medicine Press, Inc.
