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Herb Board Review

Herb Board Review

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Herb Board Review

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  1. Herb Board Review • Robert Hayden, AP, MSOM

  2. Basic Concepts of Chinese Herbal Medicine

  3. Thermal Properties (Qi) • Hot • Warm • Neutral • Cool • Cold

  4. TASTES (Wei) • Acrid (pungent, spicy) - disperses, moves, effuses sweat • Sour - contracts, tightens, astringes • Salty - moistens, softens and descends • Sweet - tonifies, moistens, harmonizes • Bitter - drains and dries

  5. Bland - leaches out Dampness and promotes urination • Astringent - astringes • Aromatic - penetrates turbidity

  6. Specific tastes often correspond to classes of chemical compounds. • Acids, which produce free hydrogen ions, are detected by the presence of a sour taste, and the strength of the acidity is roughly proportional to the intensity of the perception of sour.

  7. Metal salts containing sodium and potassium ions are detected as a salty taste. • Alkaloids, some of which are highly toxic, are generally bitter; this is why we have a natural aversion to bitter tasting plants as foods. • Terpenes and essential oils usually create an acrid or spicy taste.

  8. Sugars, polysaccharides and glycosides are detected as a sweet taste. • All the basic structural and energy-producing compounds of the body, including sugars and starches, fats, and proteins are sweet to taste, and sometimes bland. • It is for this reason most tonics are considered to be sweet.

  9. Sour, salty, astringent, bitter, and acrid, are normally present in the diet only in small quantities of the corresponding chemical constituents, but their importance lies in their ability to potently alter body functions.

  10. Herbs which guide into specific Organs or Meridians • Heart • Rz Coptidis (Huang Lian); • Hb Asari cum Radice (Xi Xin) • Small Intestine • Rz et Rx Ligustici Sinensis (Gao Ben); • Cx Phellodendri (Huang Bai)

  11. Kidneys • Rx Duhuo (Du Huo); • Rx Anemarrhenae (Zhi Mu); • Cx Cinnamomi (Rou Gui); • Hb Asari cum Radice (Xi Xin) • Urinary Bladder • Rz et Rx Notopterygii (Qiang Huo)

  12. Lungs • Rx Platycodi (Jie Geng); • Rz Cimicifugae (Sheng Ma); • Hb Allii (Cong Bai); • Rx Angelicae Dahuricae (Bai Zhi)

  13. Large Intestine • Rx Angelicae Dahuricae (Bai Zhi); • Rz Cimicifugae (Sheng Ma); • Gypsum (Shi Gao)

  14. Spleen • Rz Cimicifugae (Sheng Ma); • Rz Atractylodis (Cang Zhu); • Rx Puerariae (Ge Gen); • Rx Paeoniae Lactiflorae (Bai Shao)

  15. Stomach • Rx Angelicae Dahuricae (Bai Zhi); • Rz Cimicifugae (Sheng Ma); • Gypsum (Shi Gao); • Rx Puerariae (Ge Gen)

  16. Gall Bladder • Rx Bupleuri (Chai Hu); • Pc Citri Reticulatae Viride (Qing Pi) • Liver • Pc Citri Reticulatae Viride (Qing Pi); • Fr Evodiae (Wu Zhu Yu); • Rx Ligusitic Wallichi (Chuan Xiong); • Rx Bupleuri (Chai Hu)

  17. Triple Burner • Fr Forsythiae (Lian Qiao); • Rx Bupleuri (Chai Hu); • Upper Burner: Cx Lycii Radicis (Di Gu Pi); • Middle Burner: Pc Citri Reticulatae Viride (Qing Pi); • Lower Burner: Rx Aconiti Carmichaeli Praeparata (Fu Zi)

  18. PROCESSING OF HERBS • Cleaning • Pulverizing • Slicing • Washing • Soaking

  19. Heat Preparation • Dry-Frying (chao) • Dries herbs for storage and also increases Middle-Jiao strengthening effects • With salt = directs actions to Kidneys, nourishes Yin

  20. Liquid-Frying (zhi) • with honey = tonifying & moistening effects • with vinegar = analgesic, astringent, blood-invigorating, toxicity-relieving effects • with wine = clears channels, expels wind, alleviates pain • with ginger juice = protects stomach, stops vomiting

  21. Calcining (duan) - makes shells and minerals easier to pulverize • Quick-frying (pao) - reduces toxicity or harshness • Dry-curing/Baking (hong/bei) - mainly to dry flowers or insects

  22. Other methods: • Steaming • Boiling • Quenching • Simmering

  23. Preparing to Decoct • Decoct First: • Toxic substances: Chuan Wu, Fu Zi, Cao Wu • Shells & Minerals: Shi Jue Ming, Long Gu, Mu Li, Ci Shi, Zhen Zhu, Dai Zhe Shi, Gui Ban, Bie Jia, Shi Gao • Other: Shui Niu Jiao, Si Gua Luo

  24. Add Near End: • Bo He, Mu Xiang, Sha Ren, Bai Dou Kou, Qing Hao (all aromatics); Da Huang (to purge) • Wrap in gauze: • Xuan Fu Hua, Che Qian Zi, Hua Shi, Qing Dai • Decoct Separately: • Ren Shen, Xi Yang Shen, Lu Rong

  25. Dissolve In Strained Decoction • E Jiao, Yi Tang • Take With Strained Decoction • Chuan Bei Mu, San Qi, Niu Huang, Zhu Sha, Zhu Li

  26. Types of Administration • Water Decoctions (tang) - most common method • Tang implies decoction is taken warm; if it is to be taken at room temperature, it is called Yin (e.g.: Zuo Gui Yin) • Most active ingredients in Chinese Formulas are best extracted in water -- especially tonics • Ingredients can be tailored to each patient (vs pills) • Long shelf life of intact herbs, especially roots & barks (vs powders)

  27. Powders (san) - require less preparation time (no soaking) and less cooking time (increased surface area means active ingredients are extracted quickly); quality degrades quickly, short shelf life • Pills (wan) or tablets (pian) - easiest to administer, high compliance; disadvantage is that ingredients are fixed by manufacturer, so can not be customized

  28. Other internal methods: • Medicinal wines, Congees, Syrups • External • Ointments, Plasters, Liniments, Washes, Soaks

  29. Herb Combining • Traditional theory differentiates six principles involved in the combining of two herbs: mutual accentuation, mutual enhancement, mutual counteraction, mutual suppression, mutual antagonism, and mutual incompatibility.

  30. Mutual accentuation occurs whenever two substances with similar functions are combined; in cases where the disharmony requires emphasis of a certain type of action, rather than increase the dosage of one herb beyond the recommended maximum, another herb with similar functions is added. • The combination of Rx Scutellariae (Huang Qin) and Rz Coptidis (Huang Lian) to strongly clear Damp Heat would be one example.

  31. Mutual enhancement may result when two substances with slightly different but related functions are combined. • An example would be the combination of Rz Atractylodis Macrocephalae (Bai Zhu) with Poria (Fu Ling) to strengthen the Spleen Qi and drain Dampness. • Both herbs possess both functions to a certain degree, but Fu Ling emphasizes draining Dampness more, and Bai Zhu emphasizes strengthening the Spleen.

  32. Mutual counteraction and mutual suppression are the reduction of toxicity or side effects of one herb by combining it with another. • Mutual suppression describes interactions that actively neutralize toxicity, whereas mutual counteraction refers to interactions where toxicity is still present but whose effects are minimized. • Common example: using Rz Zingiberis Recens (Sheng Jiang) to reduce the toxicity of Rz Pinelliae (Ban Xia). • Rx Glycyrrhizae (Gan Cao) reduces the harshness of many herbs and "smoothes out the rough edges" of formulas.

  33. Mutual antagonism occurs when two substances reduce or neutralize each other's beneficial effects. • Mutual incompatibility occurs when two substances interact to create toxicity not present in either taken separately.

  34. Prohibited herb combinations19 Antagonisms & 18 Incompatibilities • Mutually antagonistic substance combinations are to be avoided, not necessarily because of dangerous interactions, but because the valuable properties of the substances may be diminished by such combinations. • Certain of these combinations consist of substances that are highly toxic individually, and are listed here only because the data appears in the traditional literature.

  35. Sulphur (Liu Huang) antagonizes Sal Glauberis (Po Xiao) • Hydrargyrum (Shui Yin) antagonizes Arsenicum (Pi Shuang) • Rx Euphorbiae (Lang Du) antagonizes Lithargyrum (Mi Tou Seng) • S Tigli (Ba Dou) antagonizes S Pharbitidis (Qian Niu Zi) • Nitrum (Ya Xiao) antagonizes Rz Sparganii (San Leng)

  36. Fl Caryophilli (Ding Xiang) antagonizes Tuber Curcumae (Yu Jin) • Rx Aconiti (Wu Tou) antagonizes Cornu Rhinoceri (Xi Jiao) • Rx Ginseng (Ren Shen) antagonizes Excrementum Trogopterori (Wu Ling Zhi) • Cx Cinnamomi (Rou Gui) antagonizes Halloysitum Rubrum (Chi Shi Zhi)

  37. Mutually incompatible substances that are prohibited for use in combination because of possibly dangerous, toxic or otherwise undesirable side-effects. • Rx Glycyrrhizae (Gan Cao) • incompatible with: • Rx Euphorbiae Kansui (Gan Sui) • Rx Euphorbiae seu Knoxiae (Da Ji) • Flos Daphnes Genkwa (Yuan Hua) • Hb Sargassi (Hai Zao)

  38. Rx Aconiti (all types - Wu Tou; Fu Zi) • incompatible with: • Bulbus Fritillariae (Bei Mu) • Fr Trichosanthis (Gua Lou) • Rz Pinelliae (Ban Xia) • Rz Ampelopsis (Bai Lian) • Rz Bletillae (Bai Ji)

  39. Rz et Rx Veratri (Li Lu) • incompatible with: • Rx Ginseng (Ren Shen) • Rx Glehniae (Sha Shen) • Rx Salviae Miltiorrhizae (Dan Shen) • Rx Sophorae (Ku Shen) • Hb Asari cum Radice (Xi Xin) • Rx Paeoniae Lactiflorae (Bai Shao)

  40. Materia Medica Review

  41. Herbs that Release the Exterior • Introduction to the Category

  42. Herbs that Release the Exterior • Used for Wind-Cold (Taiyang stage), or Wind-Heat (Wei level) invading Exterior. • Typically acute, but may also use for Exterior components of chronic disease. • Primarily act by diaphoresis (promote sweating). • Acrid tastes scatter and disperse; relatively light herbs "float" to the surface.

  43. Warm Acrid herbs generally either enter LU & UB, or LU & ST or SP. • LU - regulating the WEI Qi, governs Exterior. • UB - target head/neck • ST/SP - digestive upsets w/ External Evils.

  44. Cool Acrid herbs enter LU & LR. • LR - red, itchy eyes; • Wind-Heat + Blood Heat rashes (LR stores Blood).

  45. Warm Acrid Release Exterior

  46. Ma Huang - Ephedra / Hb Ephedrae • Warm, acrid, bitter LU, UB • A&I: Wind-Cold Exterior XS. Wheezing. Bi pain. Edema due to Wind-Cold. • Cautions: Causes heavy sweating. Caution in deficiency sweating or wheezing, HTN, insomnia • Dose: 3-9 g

  47. Gui Zhi - Cinnamon Twig / Rm Cinnamomi • Warm, acrid, sweet LU, UB, H • A&I: Wind-Cold Exterior Deficiency. Bi pain limbs & shoulders. Chest pain due to HT Yang Def. Ab pain, masses due to cold & blood stasis. • C&C: Contraindicated in warm febrile disease, Yin def + heat. Caution in pregnancy • 3-15 g

  48. Zi Su Ye - Perilla Leaf / Fm Perillae • Warm, acrid, aromatic LU, SP • A&I: Wind-Cold. Moves qi in chest & stomach: nausea, vomiting, morning sickness, seafood poisoning. • C&C: Do not boil long time • 3-9 g

  49. Jing Jie - Schizonepeta / Hb Schizonepetae • Sl. warm, acrid, aromatic LU, LR • A&I: Wind-Cold OR Wind-Heat. Vents wind from blood: skin eruption, itching. • Char to stop bleeding. • 3-9 g

  50. Fang Feng - Ledebouriella / Rx Ledebouriellae • Warm, acrid, sweet LR, UB, SP • A&I: Wind-Cold. Wind-Damp Bi pain. Spasms due to exterior Wind • C&C: Spasms due to blood deficiency. Contraindicated in yin def heat • 3-9 g