The most widely used Chinese herbal formula comes with the boastful name, “Curing Pills.” In North America and Europe any herbal preparation with such a name would be viewed with the same humorous disdain as “”snake oil”  was during the 19th century in North America. (Though if the real “snake oil” might have been an echinacea root preparation, also popularly called “snakeroot,” used by the Sioux Indians and early settlers to treat cold, flu, infection, inflammation, and even venomous bites and stings, one would be justified in considering it a virtual “cure-all.”)  “Curing Pills”!  Such a name is bound to tickle any Western rationalist’s mind as incredulous.

Still, the name “Curing Pills” could only arise in a population that culturally had or has a deep respect for the healing power for herbs, something people in the West have lost or are in the process of regaining.

“Cures what?” you might ask. Or, when are you most likely to be desperate enough to reach for a box or bottle of something called “Curing Pills”?

How about when you’re on vacation in an area where change of diet, water, hygiene and other factors leads to a sudden and most inconvenient bad case of the “runs,” or other gastrointestinal upset?

How about if you’re trapped on a boat with seasickness, nausea and vomiting?

Or how about during those agonizing hangover hours after a night of over-indulging?

In any of these scenarios you might be inclined to reach for anything for relief, and in such contexts the name “Curing Pills” takes on useful significance.

Curing Pills, also known in Chinese as Kang Ning Wan, meaning “Healthy Peaceful Pills,” has a time-earned respect for treating most acute gastrointestinal diseases. Chinese people who over centuries have traveled through the widely diverse climates and cultures throughout China have learned to bring their “Kang Ning Wan” pills with them; thus they came to be known as “Curing Pills.”

The herbs in this energetically balanced formula have many properties, including antibiotic, antiviral, digestive, antispasmodic, and carminative. You can use them for treating food- and water-borne pathogens, food poisoning, dietary sensitivities, nausea, vomiting, diarrhea, constipation, dizziness, motion sickness, alcohol and drug hangovers, fevers and even common cold and flu complaints.

Digestion and the stomach is considered the center, the place where health and disease emanates and is regulated. Curing Pills work to reestablish a “healthy and peaceful” GI tract. 

Considering their wide range of efficacious action Curing Pills are inexpensive. They are also light and easy to carry. I always keep a box of them in my luggage, making one less thing to think about when packing.

Consider them anytime you find yourself uncomfortable from overeating. To prevent or lessen the severity from a potential hangover, try taking them before imbibing and then the morning after.

If you are traveling to Central or South America or some parts of Asia or Africa where standards of hygiene are not always to be counted on, be sure have Curing Pills on hand to prevent what has come to be known as the dreaded “Montezuma’s Revenge.”

Many people are concerned about expiration dates and indeed for food items and other things such as pharmaceuticals expiration dates are important to consider. The consideration regarding packaged and sealed herbal products is not so strict however. I have found Curing Pills and other herbal products viable and effective long past the expiration date on the label.

A group of us are planning a month-long excursion to study herbal medicine and tour in China. While I expect Curing Pills will be widely available there, fortunately they are also available in the US. I will be gone for a month. I already have two boxes of Curing pills stashed in my luggage. Often when we come down with acute gastrointestinal distress we don’t have time and are certainly not in the mood to be looking for a place to buy Curing Pills.

So to paraphrase the old American Express Card ad in relation to herbal Curing Pills, “Don’t Leave Home Without Them!”


 

For those who may have questions regarding the quality of imported Chinese herbal products, Planetary Formulas manufactures Kang Ning Wan or Curing Pills in a product known as “Digestive Comfort.” It consists of Poria sclerotium, magnolia bark, Chinese giant hyssop leaf, Job's tears seed, bai-zhu Atractylodes rhizome, fragrant angelica root, kudzu root, leavened wheat, germinated rice, Trichosanthes root, chrysanthemum flower, Gastrodia tuber, and Chinese mint leaf and stem. Soon it will also be available in a convenient small tincture bottle.

 

Anyone who knows me knows that I believe the traditional Ayurvedic formula called Triphala is the greatest single herbal formula the world has ever known. That’s quite a statement, coming from an herbalist of 40 years experience, author of nine books on herbal medicine, and who knows and has regularly used hundreds of herbs and formulas in clinical practice. An old Indian adage goes, "No mother? No worry, so long as you have Triphala." For all intents and purposes, I agree.

A recent randomized clinically controlled study which included 90 subjects between 25-40 years old with chronic, generalized gingivitis years found Triphala mouthwash to be effective for the treatment of gingivitis. The study was sponsored by the Government Dental College and Research Institute, Bangalore, India and published in Clinical Trials.gov, which is part of the U.S. National Institute of Health.

The study found that the efficacy of triphala for the treatment of gingivitis was comparable to chlorhexidine (CHX). Why choose Triphala mouthwash over chlorhexidine? It so happens that chlorhexidine carries a wide range of potential risks and side effects that Triphala does not have. These include blistering, burning itching, peeling, skin rash, redness, swelling and other signs of skin irritation. Furthermore, rather nasty side effects can occur on the gastrointestinal tract as a result of using CHX including transient toothache, dental, gingival or oral pain, tenderness, aching, throbbing, soreness, discomfort and sensitivity.

Other than its unappealing taste, Triphala has absolutely no side effects or risks. In fact it has nearly miraculous benefits it can impart to the entire GI tract and the liver. 

I’ve written about this remarkable combination of three medicinal fruits many times (see The Wonders of Triphala, Triphala, Honey and Castor Oil for Eyes, and Preventing Seasonal Allergies with Neti, Triphala and Honey). In January 2013, I reported on my experience using Triphala on a 37 year-old male patient suffering for a decade from the worst case of ulcerative colitis I’ve ever seen. Over a year later, he is still virtually symptom-free and continues to take four Planetary triphala capsules three times daily. He now has two normal bowel movements a day with no pain, no bleeding and no diarrhea.

What is it about Triphala that makes it so special as a foundational healing formula? A recent article entitled "Scientific validation of the ethnomedicinal properties of the Ayurvedic drug, Triphala: A review," published in the December 2012 Chinese Journal of Integrative Medicine fully describes each of the three medicinal fruits of Triphala: Terminalia chebula (haritaki) which regulates the vata or nervous system; Terminalia bellirica (bibhitaki) which regulates the kapha or fluidic mucus system; and Phyllanthus emblica (amlaki), also known as Indian gooseberry, which regulates pitta including the liver and metabolic system of the body.

According to Ayurvedic philosophy, Triphala is ‘tridosha’ meaning that it treats the whole body by regulating the three basic life humors (doshas), vata, kapha and pitta which must be in balance with each other to manifest health. According to Ayurvedic theory, when the body is out of balance with these three doshas, the result is disease. Triphala being tridosha means that it is a virtual panacea for all diseases.

For more information on Triphala, see my previous blog posts linked above or visit:

http://www.shareayurveda.com/ayurveda-blogs/benefits-triphala/

Besides the ancient traditions of Traditional Chinese Medicine based on the Huangdi Neijing and the Nan Jing, there have been subsequent important schools of thought based on the practice of great masters that further defined TCM principles in unique ways. Each of these tends to deal with conditions that are complex and characteristic of the various kinds of problems that are seen in the modern clinic. These schools have added to the richness of the tradition. One great master who came from the Jin/Yuan dynasties (1115-1368 ACE) was Li Dong Yuan.

In his Pi Wei Lun (Treatise on the Spleen and Stomach), Li Dong Yuan based all diseases and imbalances, including Yin Deficiency, on deficiency of the Righteous Qi of the Spleen and Stomach, represented by the Earth element. His work offers a unique explanation for the nagging question of how to treat a combination of Spleen and Stomach Qi Deficiency – which by necessity require the use of warm, tonic herbs – along with Yin Deficiency, which by implication would aggravate attendant Fire or Heat conditions. Usually this type of imbalance is seen with the most complex and difficult cases, and Li’s theory offers a principle for treatment.

Yuan’s flagship formula representative of his approach are the many variations based Ginseng and Astragalus Combination (Bu Zhong Yi Qi Tang). This exemplifies how a great formula is more than a treatment for one specific condition, but represents an approach to treatment that can be modified in innumerable ways to accommodate the imbalances of various diseases. In this sense, the greatest Chinese herbalists do not use hundreds of different formulas, but after spending years studying them, tend to limit their practice to a handful of formulas that they understand and know very well, varying them sometimes down to using only one or two herbs from the representative formula. This creates a grounding frame of reference that is always useful when we are in the midst of battling various complex diseases. Students of Chinese medicine can inch toward mastery keeping in mind that after studying numerous formulas and herbs for several years or even decades, they may find a principled system such as Li Dong Yuan’s Bu Zhong platform sufficient for understanding and treating most diseases. 

Can immoderate food and emotions adversely affect our digestion?

The answer is yes. The Stomach and Spleen are responsible for receiving and transforming food and drink. Dietary irregularity and immoderate intake of excessively sweet, cold or warm foods are able to damage the Stomach and the Spleen. In addition, excessive joy, anger, worry and fear also adversely affect the original or Righteous Qi of the Stomach.

How can these cause disease throughout the body?

When the original or Righteous Qi of the Spleen and Stomach are injured, its weakened state does not allow for nourishment of the organs and extremities of the body. Food and drink then become a further stress and burden on the body. Without nourishment, the body struggles to function, but it does so by consuming its own inner resources, running on adrenal energy rather than food energy. This auto-consumptive condition is called Yin Deficiency and leads to burnout. It occurs as a result of over-stimulation of the sympathetic nervous system controlled by the adrenals, which are part of Kidney Qi, and it is said that Fire as a result of Yin Deficiency emanates from the Lower Burner. The stress to act and function during burnout is not part of the normal function of the body, but must be inspired as a result of the mind which is governed by the Heart in TCM. Thus the Yin Deficiency Fire that results from malabsorption in the Spleen and Stomach is said to emanate from the Heart, not directly, but by its minister, the Pericardium, which has a branch that communicates with the Lower Warmer (a clue as to why some texts used to call the Pericardium "Circulation-Sex"). When Yin Deficiency Fire rises, it further vanquishes the original Qi of the Spleen and Stomach, and instead of the Qi of the Spleen rising as it should, it descends into the Kidneys causing Kidney Yin Deficiency.

Thus, deficiency of the Spleen can be seen to be the root of Yin Deficiency and therefore to nourish Yin, one must supplement the Spleen. This is the basis of Li Dong Yuan’s Spleen School, which was formulated during the 12th century AD.

So what does this type of Yin Deficiency look like when it is caused by Spleen Qi Deficiency?

First, there is abnormal upsurging of Qi, causing symptoms in the upper regions of the body. This is a characteristic of Yin Deficiency and may include malar flush, facial skin conditions, headache, fever, irritability, anxiousness, etc. It could also manifest as shortness of breath because the Kidneys are unable to grasp and bring down the Qi of the Lungs. There would be a large and surging pulse and incessant thirst. Incessant thirst is a symptom of Yin Deficiency, but the large and surging pulse may be a sign of Heat.

The reason for these symptoms is that Grain Qi or Food Qi from the Spleen and Stomach must rise to the Lungs. This follows the pattern of the five elements where Earth (which rules the Spleen-Stomach) nurtures Metal (Lungs). Food energy gets stuck in the center causing bloating and swelling of the abdomen. Remember, this blocking of the Qi of the Spleen and Stomach is a result of excessively cold or hot food and drink and immoderate and irregular eating habits. The moving and transforming power of Yang Qi is blocked in the abdomen or Middle Warmer and descending and uprising energy is also blocked.

Because the energy is blocked and deficient in the center, this leaves the surface empty and vulnerable, possibly giving rise to various external invasions of Cold, Wind, Damp, etc. The problem is that in order to relieve external diseases, one usually promotes some type of eliminative or depleting therapy such as sweating. However, this will in turn deplete the already deficient Spleen. Death can result from either tonifying an Excess or depleting a Deficiency.

Treatment strategy is to warm and tonify the center with Spleen Qi tonics and Qi-moving herbs, while using cool herbs with an upbearing energy to drain Deficiency Fire. This is the basis of Ginseng and Astragalus Combination (Bu Zhong Yi Qi Tang), considered the major representative formula of Li Dong Yuan’s Spleen school.

Bu Zhong Yi Qi Tang Ingredients and Their Functions

The following support and boost Spleen Qi:

15 g astragalus (huang qi) – raises Spleen Qi and thus empowers the immune system
6 g prepared licorice (zhi gan cao)
9 g ginseng (ren shen) – this is generally removed if there are cough symptoms

9 g dang gui – tonifies Blood

The next two herbs have an upbearing energy and cool Fire from Yin Deficiency.

3-6 g cimicifuga (sheng ma)
6-9 g bupleurum (chai hu)

To assist the Spleen and Stomach Qi by helping to circulate it, add

3-6 g citrus peel (chen pi)

Bu Zhong Yi Qi Tang is normally recommended for prolapsed or sinking Qi, but it has a very wide range of application. In fact, it can be used as a tool for correcting the cause of Yin Deficiency symptoms without resorting to cloying, hard to digest Yin tonic herbs. Dozens of herbs can be added to this basic formula according to various symptoms. Some are listed below.

Abdominal pain: additional prepared 3 g licorice (zhi gan cao) and 9g white peony root (bai shao)

Abdominal pain with aversion to cold: 6g cinnamon twigs (gui zhi)

Abdominal pain with aversion to heat:9g  scutellaria (huang qin) and 9g white peony (bai shao)

Summer Heat symptoms: 9g scutellaria (huang qin) and 9g white peony (bai shao)

Abdominal pain with aversion to heat during cold season: 6g cinnamon twigs (gui zhi), 9g white peony (bai hao), raw licorice (gan cao)

Abdominal pain with no aversion to heat during cold season: cinnamon twigs 6g (gui zhi), 4 g raw licorice (gan cao), 4g alpiniae fruit (yi zhi ren) or 9g pinellia (ban xia), and 4g fresh ginger (sheng jiang).

Headaches: 6g Vitex fruit (man jing zi), 9g ligusticum (chuan xiong)

Pain at the top of the head: 9g Ligusticum sinensis (gao ben)

For various types of headaches all four of the above herbs can be added. (These are not effective for heat in the head. For heat in the head use Clear the Portals Paste, Qing Kong Gao).

Pain below the umbilicus: 10g prepared rehmannia (shu di). If the pain does not go away with shu di, add 6g cinnamon bark (rou gui).

Qi stagnation in the chest: 4g green citrus peel (qing pi)

Pain in the body caused by Dampness: Poria Five Herb Combination (Wu Ling San), minus cinnamon twigs

Generalized pain throughout the body caused by Wind and Dampness (some fibromyalgia cases may be in this category: do not use Wu Ling San, but use 3 g each Notopterygium (qiang huo), Ledebouriella (fang feng), Ligusticum sinensis (gao ben), and 6 g each cimicifuga (sheng ma) and black atractylodes (cang zhu).

Dry stools: add the body of dang gui (not the tails) 9-15 g. Boil the standard formula and take it with powders of 6g mirabilitum (mang xiao) and 4g licorice. This is stopped once the bowels start to move. Note: there are many instances of constipation caused not by Excess but by Qi and Yin deficiency.

Chronic coughing with phlegm: remove ginseng. For early stage coughing, keep ginseng as in original formula.

Cold Wind invasion during winter: Add 6g ephedra (ma huang). Note: this further exemplifies how one formula with a strong overarching principle can be adapted to treat practically all conditions, including superficial colds and flu, so long as the cause is seen as Spleen Qi and Yin Deficiency. (Personally I see this a lot in my clinic and the standard texts do not allow for treatment of Qi and Yin deficiency together).

Cold Wind invasion in very warm spring weather: 4g saxifrage and 6g tussilago flowers

Cough contracted in the summer months: 9g  schizandra berries (wu wei zi) and 3-6 g ophiopogon (mai men dong). If there is white glossy tongue fur, don’t add these.

Sensation of blockage just below the heart: coptis (huang lian), 3-6 g. Note: If there is an inability to ingest food along with this feeling of blockage, do not use coptis.

Flank and chest pains bupleurum (chai hu) 3-6 g

tummyacheIn Part I of this blog, I discussed the Five Stagnations in general along with some non-herbal treatments. Here are two general herbal formulas that can be used for all types of stagnation.

 

Stagnation Relieving Pills (Yue Qu Wan)

This formula can be found as a patent medicine easily from Chinese herb stores or herbal suppliers. As a bonus, for each Chinese herb ingredient I’ve included a substitution easily found in your spice cabinet!

 

Indications: This formula moves all five stagnations, treating symptoms of feeling congestion in the chest and abdomen, possible hypochondriac pain, bloating, belching, acid regurgitation, nausea, vomiting, mild coughing, and indigestion with a lack of appetite. It may be considered for nervous stomach, gastrointestinal ulcers, pain in the chest, hepatitis, cholecystitis, or gallstones.

Chinese herb pinyin Latin Kitchen equivalent
9-12g cyperus xiang fu  Cyperus rotunda citrus peel
9-12g black atractylodes cang zhu Atractylodes lancea cloves
9-12g ligusticum chuan xiong Ligusticum wallichii cayenne
9-12g medicated leaven shen qu Massa fermentata medicinalis hawthorn
9-12g gardenia fruit zhi zi Gardenia jasminoides  turmeric

Preparation: Grind into a powder. Slowly stir in enough water until the powder becomes workable enough so that you can roll the mixture into pills the size of an azuki bean. Or, take 6-9 g powered herbs with warm water. If using granulated extracts, take 3-6 g three times daily depending on body weight.

Variations:

1. For Cold with stagnant Qi, add galangal (gao liang jiang or Alpinia galanga).

2. For dysmenorrhea or mental depression, add curcuma root (yu jin or Curcuma longa)

3. For Heat and stagnation in the Liver with hypochondriac pain, yellow tongue coat, and a wiry, rapid pulse, add corydalis (yan hu suo or rhizome Corydalis yan hu suo)

 

Universal Stagnation-Dispersing Formula

This second formula was the first herbal treatment given to all his patents by a master Chinese herbalist. Michael later learned from Jeffrey Yuen (a famous Taoist acupuncturist and herbalist) that it was created and used by his Chinese herb teacher. This formula can be taken twice daily for a week prior to the use of any other formula and regardless of the presenting symptoms. Jeffrey said that it looks like a modified Five Accumulations Formula with Dang Gui and Magnolia Combination.

Chinese herb, properties and actions pinyin Latin

6 g cinnamon twig

(sweet, spicy, warm; moves Yang Qi, removes Cold stagnation)

gui zhi  Ramulus cinnamomi

4 g field mint

(spicy, cool; relieves Liver Qi stagnation)

bo he Mentha haplocalyx

6-9 g siler

(pungent, sweet, warm; removes Cold and Damp stagnation)

fang feng Ledebouriella seseloides

6-9 g white peony

(bitter, sour, cool; nourishes Blood, which can be depleted and dried from the use of too many strongly moving herbs; also moves Blood stasis)

bai shao yao Paeonia alba

6-9 g ligusticum

(pungent, warm; Moves Blood and Qi stagnation)

chuan xiong Ligusticum wallichii

6-9 g fu ling

(sweet to bland, neutral; dispels Damp stagnation)

fu ling Poria cocos

6-9 g Angelica dahurica

(pungent, warm; clears Heat and calms Wind)

bai zhi Angelica dahurica

6-9 g prepared pinellia

(pungent, warm; dispels Damp and removes Phlegm)

ban xia Pinellia ternata

3-6 g bitter orange (no seeds)

(sour, bitter, slightly cold; moves Qi and clears Heat)

zhi ke Citrus aurantium

6-9 g platycodon

(pungent, bitter, neutral; clears Phlegm, which is a type of Damp stagnation)

jie geng Platycodon grandiflorum

3-6 g mature tangerine peel

(pungent, bitter, warm; regulates Qi, dispels Dampness)

chen pi Citrus reticulata

6-9 g cyperus

(spicy, slightly bitter, neutral to warm; moves food, Qi and Blood stagnations)

xiang fu Cyperus rotundus

6-9 g dried ginger

(spicy, hot energy; removes Cold and Damp stagnations)

gan jiang Zingiberis officinalis

6 g American ginseng

(cool, tonifies Yin; protects the Yin that can be exhausted and depleted from the other strong-moving and drying herbs in the formula)

xi yang shen Panax quinquefolium

3-6 g honey-fried licorice

(warm; tonifies and protects the Qi from being exhausted due to the combined effects of the strong-moving herbs in the formula)

zhi gan cao Glycyrrhiza uralensis

          

 

I have treated a LOT of people for low back pain this past month -- far more than usual. Even people whose back pain was gone had it flare up again, though they had been exercising, eating well and taking their herbs. And I, who rarely experience back pain, started to feel it, too -- a very unusual experience for me -- and it didn't respond to my normal formula. What was going on?

The first thing I thought of was that being June, it is opposite the Kidney time of year, which means the Kidney-adrenal energy is at its lowest now -- and will remain so through the first week or so of August. What results is that anyone with low Kidney energy anyway, or who has over-worked too long (moi!) or not gotten enough sleep or rest, will experience Kidney symptoms stronger this time of year.

Not only can lower back pain occur, but also issues concerning the urinary system, night-time urination, poor memory (especially short-term), weak knees, joint problems, swollen ankles, leg edema, early morning diarrhea, teeth problems, brittle bones, senility, fear, paranoia, hormonal issues, thinning hair or loss of head hair, lack of will power, ear and hearing problems, premature aging, infertility and sexual problems. WHEW! What a list! As you can see, the Kidneys have a far-reaching affect on the whole body. But that's not all. As the Kidneys are the power behind the senses and the Organs, other issues with underlying Kidney involvement can worsen now, too.

So back to back pain. My usual favorite formula for this condition is Du Huo and Loranthus Combination (Duo Huo Ji Sheng Tang), also known as "Solitary Hermit" in the Plum Flower brand of patent medicines. I find this works brilliantly for low back and knee pain and it's normally the first formula I try (unless the person has obvious Heat signs). Yet even those who had had success taking it began to feel back pain again. What now?

This time I thought about the Kidney involvement in back pain. Lower back pain often begins in the kidneys -- although most people aren't aware of this -- and then it refers to other areas, such as the waist, sacrum, hips, knees and sciatic nerves. So what's one of the best formulas I know for the kidneys? Planetary Formulas' Schizandra Adrenal!

Schizandra Adrenal is fabulous for helping the Kidneys to filter and hold their energy better. This means the kidneys no longer hurt and weakness and pain disappear, no matter where it was felt -- the sacrum, hips, etc. So I gave this formula to my back pain patients and voila! -- pain released! In a few cases I gave both formulas together and for some, I increased the normal dose, which is usually important to do short-term in acute conditions to get results.

Schizandra Adrenal works well for both kidneys, but especially for left-sided pain since that is the Kidney Yin side. If the pain is more right-sided, then Kidney Yang needs to be tonified. This is easily done by adding in a small handful of walnuts daily (see Michael's newest blog!) and/or 1/4 - 1/2 teaspoon of cinnamon powder -- or take one Planetary Formula cinnamon tablet with the Schizandra Adrenal.

Of course regardless of what herbs are taken it's important to treat the Kidneys with their key remedy -- rest! The best way to strengthen the Kidney-adrenals is to rest and sleep followed by doing meditation, qi gong and other rejuvenating therapies. As well, those foods that easily and quickly deplete Kidney energy should be reduced or eliminated: sugar, excessive fruit juices, alcohol, caffeine (especially coffee), iced drinks, ice cream and other frozen treats.

So if you or someone you know is experiencing back pain now, get everyone back on track with your summer by taking these formulas and getting lots of rest! Happy summer to you all!


Du Huo And Loranthus (Du Huo Ji Sheng Tang): use for arthralgia, chronic sciatica, rheumatic arthritis, pain in the lumbar region and knees with a cold sensation and difficult joint movement, intolerance of cold and preference for heat, a light-colored tongue with a white coat, and a weak and feeble pulse.

  • poria (fu ling), 9 g
  • prepared rehmannia (shu di huang), 6 g
  • angelica (du huo), 6 g
  • loranthus (sang ji sheng), 6 g
  • angelica (dang gui), 3 g
  • white peony (bai shao), 3 g
  • ligusticum (chuan xiong), 3 g
  • ginseng (ren shen), 3 g
  • licorice (gan cao), 3 g
  • eucommia (du zhong), 3 g
  • gentian (qin jiao), 3 g
  • siler (fang feng), 3 g
  • cinnamon bark (rou gui), 1 g
  • asarum (xi xin), 1 g

NOTE: Loranthus is mulberry mistletoe

Schizandra Adrenal: This is basically Rehmannia Six Combination (Liu Wei Di Huang Wan) with several astringents added -- schisandra, plantain, and rubus -- along with the Blood and Yin tonic, lycii, and the Yang tonic, cuscuta.

As we are well into the season of late Summer, more cases are presenting at my clinic with Spleen and Stomach issues. One of my latest was a GERD client, whom I will call Bob. In his late 40s, Bob has had GERD for over 20 years and has tried everything. He currently is on two medications but still experiences terrible burning at night.

Most GERD cases I see are a combination of the patterns Cold Dampness in the Spleen and Liver Qi Stagnation. The Cold Dampness in the Spleen congests and slows digestion while the Liver Qi Stagnation attacks the Stomach, causing its contents to move upward instead of down. In this case we use Damp-dispelling and Qi-regulating herbs to clear the GERD.

Bob, however, presented with different patterns. He has Cold Dampness in the Spleen, yes, but with little Liver Qi stagnation, although he does lead a stressful life. Instead, he has many symptoms of Stomach Heat '" a thick yellow coat in the center of his tongue, a big and fast stomach pulse, easily bleeding gums, some bad breath and of course, the acid reflux.

This pattern combination represents a different treatment approach, one of clearing Cold Dampness in the Spleen along with clearing Damp Heat from the Stomach. The formula of choice for this is Pinellia Combination. It contains pinellia to dry the Cold Damp in the Spleen and scute and coptis to dry the Damp Heat in the Stomach. Further, it includes ginseng to tonify Spleen Qi so Dampness doesn't collect and congest.

After taking this formula for two weeks with excellent results, Bob ran out of the herbs. As he was on a camping vacation, he had to do without and his symptoms returned. Thus, we knew the formula was working effectively and could separate this from the other treatments we did in session together.

This case not only demonstrates how necessary it is to first make a differential diagnosis before automatically treating a health condition, but it further represents how important it is to treat the person who has the disease and not the disease itself. As has been so wisely stated before, 'One disease, many formulas; one formula, many diseases.' Further, it shows how one may treat a combination of Heat and Cold factors by simultaneously using herbs that clear Heat and dispel Cold.

As a further note on GERD, along with taking the appropriate herbal formula, it's important for long-term correction to make dietary changes of course, but also to 're-surface' the denuded linings of the stomach and esophagus. For the latter I recommend 'Gastric Soothe' by Source Naturals (a zinc-based supplement) instead of using slippery elm or marshmallow, because these herbs are dampening, contraindicated in patterns with Dampness.

PINELLIA COMBINATION

(Stomach Purging Decoction with Pinellia)

Pinellia (Rhizoma Pinelliae, Ban Xia)
9-12 g

Dried Ginger (Rhizoma Zingiberis, Gan Jiang)
9-12 g 

Ginseng (Panax ginseng, Ren Shen)
6-9 g 

Scutellaria (Radix Scutellaria, Huang Qin)
6-9 g 

Baked Licorice (Glycyrrhizae praeparatae, Zhi Gan Cao)
3-6 g 

Coptis (Rhizoma Coptidis, Huang Lian)
3-6 g 

Jujube (Fructus Ziziphus, Da Zao)
3 g or 3 pcs 

Japanese honeysuckle by William RaftiEach spring, the honeysuckle flowers gather at the end of their stems to trumpet their sweet, gentle scent of purification and renewal. When I lead an herb walk in my backyard, I always pause with my students in homage at the woodbine (honeysuckle vine). After a discussion of the powerful antibiotic, antiviral, anti-inflammatory and not least, anticancer properties of this gentle herb, I facetiously tell my students to pick a dry weight pound of honeysuckle blossoms as part of their initiation into the world of herbs.

The painstaking task I suggest to my students is something I've never personally undertaken. Generally, I don't pick honeysuckle flowers myself, with the excuse that it's too much work. Probably it is for this same reason that despite the herb's fantastic properties of purification and detoxification, it is seldom used by Western herbalists. (This moment does not pass with a feeling of silent gratitude for some poor Chinese peasant who invested hours of time and patience to pick a pound of jin yin hua for a pittance so that I could in turn purchase the flowers at a cost of just a few U.S. dollars.) It's impossible to only use herbs I personally grow or harvest in my clinic, but in an attempt to complete the cycle from nature to nurture, I always try to harvest some part of the herbs I use every year. This spring, I could not resist the temptation to pick some fresh honeysuckle flowers for personal use and for some clients in my clinic.

Honeysuckle flowers tend to grow in small clumps of up to eight or more blossoms. At first, they are luminescent white; then, as the heat of the sun bears down on them, they begin to yellow with age. I don't know it for certain, but I imagine that the white flowers are more potent. I single these out for harvest.

Well, in the space of 30 minutes I probably harvested eight to 10 ounces, that is fresh and wet, not dry! Still, the effort is worth it. I think of ascetic monks who charge themselves to the repetition of a mantra counted on a rosary (mala) of hundreds to thousands a day, how much more transcendent and connecting of heaven and earth would it be, if they were put to the task of picking honeysuckle flowers while quietly repeating their prayer? Imagine the even greater healing spiritual energy prayer-picked honeysuckle blossoms would take on!

Medicinal Applications of Honeysuckle Flowers and Leaves

Jin yin hua, the most common species of honeysuckle used in Asia, is Japanese honeysuckle (Lonicera japonica). With over a hundred species worldwide, ranging in a wide arrange of sizes and colors (including red!) the plants are all in the Caprifoliacea family along with Sambucus (elder). According to herbalist Christopher Hobbs, elder has chemistry and properties similar enough to be used interchangeably with honeysuckle flowers. Lonicera fruit can be red, blue or black and contain several hard seeds. In most species the berries are regarded as mildly poisonous with the notable exception of L. caerulea whose berries are edible. Nevertheless, it is not the berries, but the flowers and leaves that we are after when we look to honeysuckle as a medicinal.

Jin yin hua, which aptly translates as 'golden silver flower,' is one of the first herbs considered for the treatment of infections, inflammation, fevers and toxicity. It is an herbal antibiotic effective against a broad spectrum of bacteria including Staphylococcus, Streptococcus, Bacillus dysenteeriae, Vibrio cholera, Salmonella typhi, Diplococcus pneumonia, Diplococcus meningitides, Pseudomonas aeruginosa and Mycobacterium tuberculosis. Chlorogenic acid and isochlorogenic acid in the herb has the strongest antibiotic effects. According to Chen and Chen (Chinese Medical Herbology and Pharmacology, 2004, Art of Medicine Press Inc.), the fresh herb only soaked in water has a stronger antibiotic than an herbal decoction, with the leaves having an even stronger antibiotic properties than the flowers.

Honeysuckle flowers are classified as sweet and cold and enter the Lung, Stomach and Large Intestine meridians. They are effectively dosed anywhere from 10 to 60 grams and are used for the common cold with symptoms of fever and thirst, upper respiratory tract infections, boils, furuncles, enteritis and dysentery. For diarrhea and dysentery with watery stool, honeysuckle is taken dry fried and carbonized.

One of the most common formulas using honeysuckle is the famous Yin Qiao San, widely used for treating colds and influenza. However, its broader detoxifying and heat-clearing properties makes it useful for inflammatory skin conditions, inflammations of the upper respiratory tract and is taken both internally and externally for mastitis as well as lung and breast cancer. Several studies have shown that extracts of honeysuckle promote apoptosis and inhibit tumor growth. For more on the anticancer uses of Lonicera and other herbs, I recommend my book Treating Cancer with Herbs published by Lotus press.

The flowers are not the only part of Lonicera that are useful medicinally. While not specifically designated, the leaves have even stronger antibiotic effects than the flowers. This may inspire herbalists to personally harvest and try using more generous doses of Lonicera aerial parts for all infectious diseases. In this regard, though I've not tried it, one might consider the use of strong honeysuckle tea, perhaps with added fresh ginger and a little licorice for recalcitrant infections like Lyme's disease.

Traditional Chinese medicine (TCM) has a specific through similar anti-inflammatory use for Lonicera stems which are called jin yin teng or ren dong teng. This part of the plant has milder anti-toxin effects but is specific for arthritic and rheumatic conditions, described in TCM as bi pain or 'wind-dampness.'

While many contemporary western herbalists regard honeysuckle as exclusive to the domain of Chinese herbal medicine, the Roman naturalist writer Pliny recommended it mixed with wine for the treatment of 'disorders of the spleen.' This may suggest yet another possible use for honeysuckle: depression. In ancient Greek humoural medicine, the spleen is associated with the black bile humour which in turn is associated with melancholy, or depression. To my knowledge there is no contemporary use of honeysuckle flowers for the treatment of depression unless one considers its use as a homeopathic Bach flower remedy for a certain kind of depression associated with nostalgia.

I've always been eager to incorporate and use any herb or healing principle so long as it is safe and effective. This is why I came up with my own approach to herbalism, Planetary Herbology embodied in the East West Herb Course. If I were an Ayurvedic herbalist or a curandero living in the Amazon jungle, if I learned about the fantastic uses of an herb like Lonicera, I'd have a hard time not wanting to put it to immediate use. If you've got a honeysuckle vine giving its profuse blooms over a fence or trellis in your yard at this time of year, I hope you're inspired to snip some leaves and flowers for medicine; it'll come in handy later this year!

Students and clients often ask me, "When the best time is to take my herbs?" This is a very good question, and there are several different answers. (However, in truth, the best time to take herbs is when you remember to take them.)  

Often, when people try to follow rules, they invariably can't comply, or they forget, or some other thing happens and then before you know it, the time has passed and the time to take the herbs was missed. Then it's on to the next required time and if this is also missed, the day soon passes and the herbs are never taken at all.  

Taking herbs this way can be hit or miss. With such infrequent ingestion, they help very little or are entirely ineffective. This is why I say, take the herbs when you remember them! 

But if you want to know the real 'rules' for taking herbs '"- what will make them most effective in their use '"- here they are (and they are given in Lesson 9 of the East West Herb Course). Keep in mind that these 'rules' are not necessarily agreed upon by everyone, so you'll find herbalists who have other ideas instead. But these are generally the ones most acceptable. 

In general, the time herbs are taken has to do with efficiently getting them to the part of the body they most affect. Thus:  

  • Herbs treating the upper part of the body (heart/lungs/head) should be taken after meals so the food in the middle of the body slows their descent, and they stay in the upper part of the body longer.
  • Herbs treating conditions in the middle part of the body  (spleen/pancreas/stomach/liver/gallbladder) should be taken just before or during the early part of meals, so they stay in the middle part of the body for a longer time, along with the food being digested.
  • Herbal formulas targeted toward the lower part of the body (kidneys/bladder/intestines/genitals) should be taken between meals, when the stomach is empty, so they have a free passage to the lower part of the body.  

Of course, if the disease is urgent, herbs may '"- and should '"- be taken at any time and, in fact, they should generally be taken more frequently anyway. 

Further, if digestion is weak, herbs are best taken with meals, as this is when the digestive juices most strongly flow. 

If people continuously forget to take their herbs, even if told they can be taken anytime, help set a convenient location and schedule. Put the herbs in the kitchen by spice jars or some other obvious place, or put them in the bathroom by the toothbrush, or put them on the bedside table, wherever they will be easily seen at the appropriate times. 

Generally, when people are eating they can remember to take herbs. Most can take them with breakfast and dinner, but often miss lunch since they're gone all day. If this happens, the third dose can be taken at bedtime.  

If none of this works, and the person (or you!) keeps forgetting to take the herbs, remember that the herbs can be taken anytime!

The cold and flu season is still upon us. While Michael wrote about treating flu last fall, especially the swine flu, I want to address a different approach here. Cold/flu treatment usually falls into two main categories: wind-chill and wind-heat. Most flu formulas commonly available, western and Chinese, address wind-heat conditions as their symptoms are the most common: slight chills, stronger fever, thirst, sweating, restless, desire for cool drinks, mucus and phlegm that's yellow and a yellow-coated tongue with a redder body, especially the front third. A great Chinese patent equivalent that clears the chill but also treats the wind component beautifully (manifesting in the stuffy nose, tight neck and shoulders and body aches) is Chuan Xiong Cha Tiao Wan. It contains, mint (bo he), ligusticum (chuan xiong), schizonepeta (jing jie), notopterygium (qiang huo), licorice (gan cao), angelica (bai zhi), ledebourilla (fang feng) and asarum (xi xin). If taken at the first signs of chills and body aches, dull headache and tingly-ache along the nape of the neck and shoulders it can knock it right out. If a virus invades along with the wind chill, take the above with a lower dosage of any cooling anti-viral herbs such as elderberry, isatis or olive leaf. The combination is quite effective and quickly knocks out these nasty conditions. If there are signs of both heat and cold it's possible to take the typical western herbs for colds and flu along with adding strong ginger tea (or a smaller dosage of Ginger Warming Compound). Be sure to add in an anti-viral herb, as that is often the key to quickly knocking out any cold or flu.

Ophiopogon japonicus by KENPEIOphiopogon is a true blessing to those with Yin deficiency.

Sweet, cooling and moistening, it nourishes Yin and clears deficient heat while at the same time expectorating phlegm for the lungs. Those who have ever experienced Yin deficient heat (a dry condition) concurrent with phlegm (a wet condition) know how tricky treatment of this combined pattern can be. To have an herb that clears phlegm while moistening Yin is a gift indeed.

I first learned of the powers of ophiopogon years ago when I had a patient with a dry, non-productive cough (before I knew of Li Fei, which I wrote about in my last blog entry).

She had heat in the Lungs but dryness, too, along with low energy and spirits. I gave her Ophiopogon Combination (Mai Men Dong Tang) and within a day, her cough had become productive. Several days later, her phlegm cleared, energy returned and spirits rose.

The woman's cough had lingered about three weeks past the acute stage and she was back to work but she didn't fully feel normal. Many times this stage indicates the use of Minor Bupleurum Combination (Xiao Chai Hu Tang) but in her case, the cough was dry and non-productive with no coating on her tongue. If I had given her Minor Bupleurum Combination, she might have gotten worse from the cool, dry and bitter Bupleurum.

I recognized the Yin deficient signs, however -- the key one being the dry, non-productive cough -- and so Ophiopogon Combination did the trick.

I also use ophiopogon as a simple, giving the single herb to nourish Stomach, Lung and Heart Yin, to clear symptoms of dry, burning eyes, dry tongue, mouth and lips, burning in the five spaces (chest, palms and soles), weak lungs, chronic dry cough and thirsting and wasting disorders (pre-diabetic and TB-type conditions). As well, it is a major herb in the Liver/Kidney Yin tonifying formula, Yi Guan Jian, another favorite of mine.

When Yin is deficient, not only do deficient heat symptoms arise, but also the body's energy considerably weakens. While most people associate Qi with energy, energy can also be low due to deficient Blood, Yin and/or Yang. Ophiopogon is not only great for this, but in general for the aftermath of fevers or febrile disease with Yin deficiency. As well, it moistens the intestines for dry constipation, and moistens dry mouth, throat, lips and eyes.

What exactly does Yin deficiency look like in a patient? Deficient Yinis a lack of cooling, moistening Fluids with resulting depletion (fatigue, exhaustion, emaciation or thinness) along with specific types of Heat and Dryness signs, including: 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 (also known as 'five-palm heat'), 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.

I recently treated another patient with chronic Lung Yin deficiency, but she had also just taken coptis (like goldenseal) for several days to treat what she thought was an intestinal bacterial infection from food poisoning. When I saw her, the middle and lower parts of her tongue had a black coat. In TCM this means either extreme heat or extreme cold (In this case, extreme heat). She also had tremendously low energy. I gave her ophiopogon as a single herb; within a week, the black coat was gone and her energy had returned.

Ophiopogon can be purchased as an ornamental grass from nurseries, called "mondo grass" or "Japanese turf lily." We grow it on our land and one day Michael dug up some of the tubers to eat. They looked like small, white bubbles, and they tasted juicy and sweet -- wonderful!

Ophiopogon

Mai Men Dong

Sweet, slightly bitter, slightly cold

Enters heart, lung and stomach meridians

Dosage: 6 - 15 gm; frying in wine reduces its cold properties, which is used in tonifying formulas

Contraindications: Of course too much ophiopogon can actually cause coldness and dampness. As well, avoid if there's diarrhea due to cold from deficiency and congested fluids. Some traditional sources say not to take ophiopogon with Flos tussilago farfara (coltsfoot) and that it counteracts Radix Sophorae flavescentis (ku shen) and Fructificatio Tremellae fuciformis (bai mu er).

 

Ophiopogon Combination
(Mai Men Dong Tang)

Ophiopogon (mai men dong)
15-20 gm     

Pinellia (ban xia)
6-9 gm

Ginseng (ren shen)
6-9 gm

Rice (jing mi)
15-20 gm

Licorice (gan cao)
3-6 gm

Jujube dates (da zao)
5 pieces

Treats: nausea, vomiting, thirst, dry throat, mouth and skin, dry, non-productive cough, spitting of saliva, dry mouth and throat, hiccups, five palm heat, red tongue with no coat and a weak and rapid pulse.

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