"What is the difference between a tonic in eastern versus western herbalism?"
This question, launched at me during our last seminar, was a good one that deserved more attention than I could give at that time so I decided to write a blog about it. However, the more I dug into this topic, the longer the response grew. Just the essentials are included here.
First, let’s take a look at the meaning of the word "tonic" as defined by various dictionaries: "A medicine producing a sense of well-being"; "A medicine that invigorates or strengthens"; "An invigorating, refreshing, or restorative agent or influence"; and "Increasing or restoring physical or mental tone."
The short answer to the difference between an eastern and western tonic is this:
Whether an herb is a tonic or not depends on its culture.
In other words, tonic herbs are culture-specific. In general, the main difference between eastern and western tonics is that eastern tonics add something to the body where there is a deficiency, while western tonics improve the function of an organ or system, which more often than not means clearing and cleansing rather than building.
Now down to the basics.
To the Chinese, a tonic is a substance that builds strength and function. As such, it increases Qi, Blood, Yin or Yang in particular organs and the entire body in general. These are as follows:
Qi tonics strengthen Qi, the vital life force that animates all sentient life. Qi provides immunity; transforms food and drink into usable energy, blood and other substances; holds the blood in the vessels and the organs in place; transports nutrients; warms the body; and provides metabolic power.
Deficient Qi occurs when there isn’t enough energy to perform the body’s various functions. Symptoms include low vitality, lethargy, shortness of breath, slow metabolism, frequent colds and flu with slow recovery, a low soft voice, spontaneous sweating, frequent urination, prolapsed organs, hemorrhoids, and palpitations. Herbs that tonify Qi include ginseng (Panax ginseng), codonopsis (Codonopsis pilosulae), astragalus (Astragalus membranaceus), jujube dates (Zizyphus sativa) and dioscorea (Dioscorea batatas) also known as Chinese wild yam).
Blood tonics nourish, moisten and provide nutrients to the cells, organs, brain, muscles, tendons, bones, skin, hair, eyes, sinews, tongue, and other body parts.
Deficient blood arises when there’s insufficient blood to perform its nourishing and moistening functions. Symptoms include dizziness, blurry vision, numbness, restlessness, anxiety, slight irritability, insomnia, scanty menses or amenorrhea, thinness or emaciation, dark spots in the visual field, dry skin, hair or eyes, lusterless, pale face and lips, tiredness, easily startled or overwhelmed, and poor memory. Blood tonics include dang gui (Angelica sinensis), lycii berries (Lycium barbarum), cooked rehmannia (Rehmannia glutinosa, shu di huang), white peony (Paeonia lactiflora) and longan berries (Euphoria longan).
Yang tonics provide energy and warmth, increasing the ability to circulate, transform and warm all aspects of the body. These aid such processes such as metabolism, libido, appetite, digestion and assimilation.
Deficient Yang arises when there isn’t enough metabolic heat, or fire, to warm the body, transform fluids or promote circulation. Symptoms include feelings of coldness, copious clear urination, white copious or runny discharges, pale frigid appearance, cold limbs, lassitude, fatigue, edema, loose stools or diarrhea, night-time urination, infertility, impotence, frigidity, and undigested food in the stool. Herbs that tonify Yang include dipsacus (Dipsacus asperi), morinda (Morindae officinalis), cordyceps (Cordyceps sinensis) and cuscuta (Cuscuta chinensis).
Yin tonics are cooling, moistening, lubricating, and build substance. They are good for dry, inflamed tissues. Deficient yin is often equated to "burn-out" where someone has "burnt the candle at both ends." This most often occurs from over-working physically or mentally, yet it may also arise from excessive dryness in the body, too much heat burning off fluids, and/or insufficient diet for the body’s needs.
Deficient Yinis a lack of cooling, moistening fluids with resulting depletion (fatigue, exhaustion, emaciation or thinness) along with the following specific heat and dryness signs: night sweats, malar flush (redness and burning heat along the cheeks and nose), burning sensation in the palms of the hands, soles of the feet and in the chest, afternoon fever or feelings of heat, restless sleep, dry throat or thirst at night, agitation, mental restlessness, dry cough, dry stools, and scanty dark urine. Herbs that tonify Yin include ophiopogon (Ophiopogon japonicas), raw rehmannia (Rehmannia glutinosa – sheng di huang;), or Chinese asparagus root (Asparagus cochinensis).
In Ayurveda there are also different types of tonics, yet like Chinese medicine, most of these are building and strengthening. Here are some of them.
Rasayanas are tonics that enhance the body’s strength and immunity. They are useful for those who are underweight, frail, or have weak muscles. Typically specially prepared foods are used such as figs, dates, walnuts, almonds, milk, and honey.
Tonic formulas are typically given to build blood and energy. Generally a large number of herbs are formulated together, and one takes them regularly in small doses for long periods of time. Chyavanprash (builds blood, energy and immunity) and Triphala (tones intestinal tissue and Qi) are good examples.
Tonic herbsare similar to Chinese medicine in building energy, blood, endurance and vitality. Examples include amalaki (Emblica officinalis), which rebuilds and maintains new tissues and increases red blood cell count; ashoka (Saraca asoca), which tones the uterus; ashwagandha (Withania somnifera) which rejuvenates the body from general debility, sexual debility and nervous exhaustion; and shatavari (Asparagus racemosus), which supports the female reproductive system and rejuvenates pitta.
Western herbalism defines tonics quite differently than Eastern medicines, for these herbs have normalizing and nurturing effects. The nurturing western tonics, categorized as adaptogens or trophorestoratives, are similar to Qi tonics in Chinese medicine, while the normalizing tonics have quite a different meaning altogether.
Adaptogens help the body adapt to environmental factors to avoid damage by them such as various environmental, physiological or psychological stressors. They can increase energy, vitality and endurance. This makes them closest to Qi and Yang tonics in Chinese medicine. Examples include eleuthero (Eleutherococcus senticosus), which increases energy, vitality, concentration and endurance, and helps the body better withstand stress; and rhodiola (Rhodiola rosea), which improves physical and mental performance and reduces fatigue.
Trophorestoratives build strength and function of specific organs or body systems. As nutritive restoratives, these are most similar to Yin and Blood tonics in Chinese medicine, although in some cases they fit the normalizing tonics category (see below). Trophorestoratives restore normal function to tissues that suffer from a vital deficiency. Example herbs include oats (Avena sativa) for the nervous system, nettle seed (Urtica spp.) for the kidneys, milk thistle (Silybum marianum) for the liver, and ashwagandha (Withania somnifera) for the endocrine system.
Normalizing tonics tone an organ or system or help it function better. For example, the famous bitter tonics (see below) are herbs that stimulate the release of bile, helping digestion of fats and protein and stimulating peristalsis of the intestines, aiding elimination. Hawthorn (Crataegus oxycantha) is a cardiovascular system (CVS) tonic because it tones the CVS while lowering blood pressure and dilating blood vessels. Gingko (Gingko biloba) is a tonic that improves cognition.
Normalizing tonics are quite a different concept than the Chinese tonics because they improve organs or systems not through increasing Qi, Blood, Yang or Yin, but by stimulating or activating certain functions in the body. In the case of what the West calls "bitter tonics," to the Chinese, bitter herbs dry dampness and clear heat, both of which are eliminating (cleansing) rather than building. For example, hawthorn is traditionally used by the Chinese to clear food stagnation and help digest protein. It improves the digestive system not through building, but through cleansing.
Blood tonicsreferred to by western herbalists are really alteratives, blood purifiers, or herbs high in iron. Generally, all of these herbs cleanse and detoxify the blood. Herbs high in iron increase hematocrit levels (the volume percentage of red blood cells in the blood) and so theoretically increase blood. However, they are also dry and bitter, which according to traditional Chinese medical theory, actually depletes blood. Examples include yellow dock (Rumex crispus), nettle (Urtica spp.), dandelion (Taraxacum mongolicum), burdock (Arctium lappa) and red clover (Trifolium pratense).
Once at an AHG conference I talked with Australian herbalist Isla Burgess about western blood tonics. We found that both of us had come to the same conclusion on opposite sides of the world: western blood tonics do not actually build the blood. They might cleanse it, but they do not create more blood. However, if they are combined with molasses, they do build blood because molasses is extremely high in iron (the herbs with iron do not have high enough levels by themselves to actually build blood). When using western bitter or drying herbs in someone who is Blood or Yin deficient, it is extremely important to add molasses to the formula.
In general, the main difference in tonics between eastern and western herbalism is that in the eastern tonics add something to the body where there is a deficiency, while in western tonics improve the function of an organ or system, which more often than not means clearing and cleansing.
It is important to note that when using western tonics (that aren’t adaptogens or trophorestoratives) for those who are Blood or Yin deficient, one should supplement clearing and cleansing tonics with cooling, moistening herbs and/or molasses. This is because clearing and cleansing herbs are generally drying and/or bitter, both of which clear dampness. As Yin and Blood are fluidic in nature, such herbs deplete both and so can make a Yin or Blood deficient person worse, or cause other health problems. This particularly applies to what western herbalists call "blood tonics," as here one would expect to make more blood while in fact, it is further depleted instead.