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Herbal Medicine Overview

TCM-Centered Modern Integrative View

History of Chinese Herbal Medicine

“Herbal Medicine” spans TCM (Traditional Chinese medicine), Ayurveda, Western herbalism, etc. This overview focuses on TCM’s history/modernization, properties, application/safety, training & regulation, and our practice at Eastern Medicine Center.

We combine pattern-based diagnosis with modern QC. Our formulary holds 400+ dried Chinese herbs (incl. Wisconsin ginseng), plus granules/extracts and selected international botanicals (e.g., Ashwagandha).

TCM dates back 3,000+ years. The Huangdi Neijing is often dated around the 2nd century BCE and established core frameworks in yin and yang, Zang-fu/meridians, and pattern diagnosis. While the Huangdi Neijing is a key text, the roots of TCM go back further. Some believe its origins are over 5,000 years old, with evidence found in Shang dynasty (1766 – 1122 BCE) oracle bones.

 

The text established crucial frameworks that remain central to TCM practice today:

  • Yin and Yang: Representing opposing yet complementary forces, yin and yang are seen as fundamental to health. Illness arises from their imbalance.
  • Zang-fu Organs and Meridians: TCM emphasizes the functional relationships of the zang (solid) and fu (hollow) organs, and the network of jing luo (meridians or channels) through which qi (vital energy) and blood flow.
  • Pattern Diagnosis: TCM diagnoses focus on identifying patterns of imbalance or disharmony, rather than just isolated symptoms, to guide treatment. 

In essence, TCM seeks to restore balance and harmony within the body and between the body and its environment through practices like acupuncture, herbal medicine, and lifestyle adjustments. 

2015 Nobel Prize: Traditional Clues × Modern Science

The 2015 Nobel Prize in Physiology or Medicine was awarded to Tu Youyou for her roundbreaking discovery of artemisinin a crucial drug used to treat malaria, Tu Youyou’s work focused on Traditional Chinese Medicine to find a cure for malaria, ultimately leading to the isolation of artemisinin from sweet wormwood (Qing Hao). This discovery has significantly reduced malaria mortality rates, particularly in regions with chloroquine-resistant strains.

Classical clue

“Qinghao” (Artemisia annua); low-temperature extraction preserved activity.

Modern R&D

large-scale screening (e.g., Project 523) identified artemisinin.

Global impact

dramatic drops in malaria mortality; Prof. Tu Youyou team awarded in 2015.

TCM principles of Herbal Medicine

In TCM, “Four Qi,” “Five Flavors,” and “Meridian Tropism” are part of fundamental concepts used to categorize and understand the properties of herbs and their effects on the body. They help practitioners determine how a substance will interact with the body’s energy and organ systems. 

Four Qi (Four Natures): This refers to the energetic nature of a substance, categorized as: 

  • Cold: Used to clear heat and reduce inflammation.
  • Cool: Like cold, but milder, also used to clear heat.
  • Warm: Used to warm the body and promote circulation.
  • Hot: Stronger than warm, used for conditions needing strong warming.

Five Flavors (Five Tastes): These are the five basic tastes of herbs, each associated with different actions: 

  • Pungent (Acrid): Disperses, moves Qi and blood.
  • Sweet: Tonifies, nourishes, harmonizes.
  • Sour: Astringes, consolidates.
  • Bitter: Drains, purges, dries dampness.
  • Salty: Softens hardness, purges downward.

This refers to the specific meridian or channel (pathway of Qi) that a substance influences within the body. Understanding meridian tropism helps determine which organs or parts of the body a particular herb or food will affect. For example, the herb Salvia militarize, associated with the heart meridian, is traditionally used to treat chest discomfort and heart pain. 

These three concepts, along with other TCM principles, are integrated to create a holistic picture of a person’s health and to formulate individualized treatment strategies. 

Whether an individualized prescription or a formula for common illnesses, composition must follow strict rules. As outlined in the classical canon and refined by later formulary theory, the roles of Chief, Deputy, Assistant, and Envoy structure a safe and effective formula. Adhering to these principles helps maximize efficacy while minimizing unnecessary side effects.

  • Chief (Jun): targets the primary mechanism/pattern sets the theme of the formula.
  • Deputy (Chen): supports the chief to intensify the main action, or addresses secondary mechanisms.
  • Assistant (Zuo): (i) augments chief/deputy to reinforce effect; or (ii) moderates toxicity/harshness and harmonizes the formula.
  • Envoy (Shi): has two functions—(i) channel-guiding (Yin Jing) to direct herbs to specific meridians/targets; (ii) harmonizing to balance the overall profile.
  • Dose & Order: typically expressed in relative dosage/position, Chief > Deputy > Assistant > Envoy.
  • Course & Constitution: acute patterns emphasize a decisive chief deputy pair; chronic cases balance tonification/draining and root/branch.
  • Formula follows pattern shifts: adjust chief/deputy and change guiding/harmonizing envoy as the pattern evolves to sustain efficacy and reduce adverse effects.
  • Mutual Reinforcement (相须): Two herbs used together produce a stronger or broader effect than either alone.
  • Mutual Assistance(相使): an assistant herb augments the chief’s action or helps “guide” it.
  • Mutual Restraint / Mutual Suppression (相畏): Herb A “fears” Herb B—B moderates A’s harshness/toxicity. — moderating toxicity or harshness
  • Mutual Suppression (相杀): Herb A “kills” (neutralizes) Herb B’s toxicity—A directly counteracts B’s adverse profile.
  • Mutual Antagonism (相恶): one herb weakens or counteracts another’s effect—often making the formula inefficient or off-target.
  • Incompatibility (相反): combining two specific herbs may trigger adverse reactions or toxicity; such pairings are contraindicated.
  • Single Use (单行, dān xíng) : a single herb used alone
  • Strictly exclude incompatible pairs: classical canons record the “Eighteen Incompatibilities” (十八反) and “Nineteen Antagonisms” (十九畏) as red-flag combinations.
  • Avoid antagonistic pairs when you need a clear, unified therapeutic direction.

For potential antagonism, either separate in time, adjust ratios, or choose a different assistant/guiding herb; for true incompatibility, do not combine.

Antagonism wastes therapeutic “signal”; incompatibility raises harm risk. Always check patient medications (e.g., anticoagulants) and organ function when designing formulas. Build a clear therapeutic “axis” e.g., one herb sets the theme (tonifying, clearing, moving), the partner amplifies it or improves targeting.

  • Pattern-based prescribing.
  • Seven Relationships and interactions (herb–herb, herb–drug, herb–food).
  • Dose by constitution, age, course, and preparation; decoction techniques matter.
  • Quality & safety: authentic/traced supply; monitor efficacy and adverse events.

Training, Regulation and Safety

  • In China, TCM doctors have six thousand+ hours of curriculum,   >2,000 clinical hours; TCM & Western basics; pharmacology/evidence study.
  • Licensure via national exams.
  • In China, Chinese medicines are regulated as pharmaceuticals by China FDA and NMPA; GMP/GSP compliance.
  • Standardization: GMP and heavy metals/pesticides/microbes testing in the US.
  • Dosage forms: decoctions → raw fresh dry herbs/granules/extracts/topicals.
  • Active-ingredient research: the artemisinin example.


Safety note (U.S.): many herbal products are regulated as dietary supplements in the U.S., not as prescription/OTC drugs. Avoid self-medicating with strong extracts or stacking multiple products; consult qualified practitioners, especially during pregnancy/breastfeeding, in children/elderly, or with chronic disease/polypharmacy.