Introduction
The Herbal Medicine of Traditional Chinese Medicine (TCM) is the study of sources, collections, properties, actions, indications, contraindications and clinical applications of Chinese natural herbal medicine based on basic theories of Traditional Chinese Medicine. It is one of the most important parts of Traditional Chinese Medicine. In China, 80% of TCM doctors work with herbal medicine, only 20% of them work with acupuncture.
According to a recent survey, the total number of Chinese herbal medicines used is 12,807, in which 11,146 are of plant origin, 1,581 are of animal origin and 80 are of mineral origin. Because most Chinese natural medicines are of plant origin, they are called “Chinese herbal medicines” or “herbs”.
In Chinese language, Chinese natural medicine is called “Zhong Yao Xue” 中药学, means “Chinese Herbal Medicine.” Among them “Zhong” 中means Chinese, “Yao” 药 means herbal medicine that can treat diseases, and “Xue” 学means -ology, a study of.
Western medicine came into China only about 100 years ago. From prehistoric times to the early 20th century, Chinese herbs played a leading role in preventing and treating diseases for Chinese people. They saved many lives. This is one of the important reasons that the population of China is the largest in the world.
In China there are about 30 public TCM universities and many TCM departments in western medical and pharmaceutical universities. There is a department of TCM pharmacology in every public TCM university. Graduates form these departments are pharmacists working for pharmaceutical company or pharmacies.
With the use of modern pharmacology techniques, Chinese herbal medicine is more scientific now. It can be divided into a series of branches:
1) Pharmacognosy: The branch of pharmacology that deals with drugs in their crude or natural state.
2) Phytochemistry: The chemistry of plants.
3) Pharmaceutics: The science of preparing and dispensing drugs.
4) Clinical pharmacology.
5) Formulations of TCM.
6) Herbal processing of TCM.
1. Origin and development of Chinese Herbal Medicine
Chinese Herbal Medicine originated in ancient times when people were looking for food.
There is legend that 5000 years ago there was a ruler called Shen Nong (divine husbandman) who taught his people how to cultivate grains as food so as to avoid killing animals. He tasted 70 herbs a day to test their medical value for his people. He is considered to be the father of Chinese agriculture and herbal medicine.
In the Shang Dynasty (16th - 11th century BC) the letter “Yao” (药) appeared, which means herbs that can treat diseases.
In the Zhou Dynasty (11th century BC - 221 BC) the position of doctor was named officially. Wan Wu (万物means everything in the world) was written. There are 70 herbs were described in it.
In the Qin and Han Dynasty (221 BC - 220) Divine Husbandman's Classic of Chinese Herbal Medicine (Shin Nong Ben Cao Jing) was written, which contains details of 365 herbs. It is the earliest and one of the most valuable books of Chinese Herbal Medicine. More than 200 herbs in current herbal text books are from this book.
In the Three Kingdoms Period, Jin Dynasty, Northern and Southern Dynasties (220 - 589) the important books entitled Ben Cao Jin Ji Zhu and Pao Jiu Lun were written.
In the Sui and Tang Dynasty (581 - 907), the book Newly Revised Chinese Herbal Medicine (Xin Xiu Ben Cao) was published.
In the Song dynasty the state owned pharmacies were established, In Song, Liao, Jin, and Yuan Dynasty (960 - 1368), total herbal medicines reached 1700 different kinds.
In the Ming Dynasty (1368 - 1644) Grand Chinese Herbal Medicine (Ben Cao Gang Mu) was written in 1590 AC. It contains details of 1892 Chinese herbal medications.
In the time of the Republic of China (1911 - 1949), the Encyclopedia of Chinese Herbal Medicine (Zhong Yao Da Chi Dian) was compiled, which included 4300 items.
During the People’s Republic of China (1949 – present), TCM universities have been established since 1956 and since then, departments of pharmacology of Traditional Chinese Medication were established in TCM universities. Pharmacology universities and Agriculture universities, and many books were published including Chinese Herbal Medicine (Zhong Hua Ben Cao), the 8534 herbal medicine listed.
2. Habitat and collection of Chinese Herbal Medicine
2.1 Habitat of Chinese herbal medication
Habitats of Chinese herbal medication are based on:
①. Soil
②. Water
③. Climate
④. Sunshine
⑤. Rainfall
Best quality herbs that come from a specific area are called “Dao Di Yao Cai” (道地药材). e.g.:
Best Ren Shen is from Northeast of China.
Best Fu Ling is from Yun Nan province.
Best Huang Lian is from Si Chuan province.
Best Di Huang is from He Nan province.
Best Er Jiao is from Shan Dong province.
2.2 Collection of Chinese medication
A. Plant origin herbs collection
Entire grass collected when their flower is in full bloom
Leaves are collected when their flowers are blooming
Flowers are collected when they are blooming
Fruits are collected when they are ripe (but some not)
roots are collected in late autumn or spring
Barks are collected in spring or early summer
B. Animal origin herbs are collected at different times.
C. Mineral origin medication herbs are collected at any time.
2.3 Storage of Chinese medication:
Preparation work for storage: to clean, dry, seal, absorb Dampness, chemical substance, reduce oxygen, increase carbon dioxide.
For extremely toxic medication, they are secured and only accessible by certain people.
3. Nomenclature of Chinese Herbal Medicine
1) Cao 草 means entire grass with or without root
2) Gen 根means root
3) Hua 花means flower
4) Pi 皮means bark, peel
5) Ren 仁means seed
6) Zi 子means seed
7) Shi 石means stone
8) Ye 叶means leaf
9) Zhi 枝means twig
10) Jiao 角means horn
11) Teng 藤means vine
12) Tan 碳means charred herbs
13) She 蛇means snake
14) Zhi 炙means processed (As an adj.)
4. Processing of Chinese Herbal Medicine
4.1 Purpose of processing
①. Purify herbs
②. Make active components easier to dissolve
③. Increase effect
④. Remove side effects or toxicity
⑤. Change property or action
⑥. Remove unpleasant taste
4.2 Processing Method
1). Mechanical method
①. Cleaning
②. Pulverizing
③. Slicing
2). Process with Water
①. Bleaching
②. Soaking
③. Trituration with water (Shui Fei 水飞)
3). Process with Heat
①. Frying with liquid (Zhi 炙)
②. Stir-frying (Chao 炒)
1) Stir-frying to yellow (炒黄)
2) Stir-frying to brown(炒焦)
3) Carbonizing（炒碳）
③. Roasting in ashes (Wei 煨)
④. Baking (Hong or Bei 烘焙)
⑤. Quick-frying (Pao炮)
⑥. Calcining (Duan煅)
4). Process with both Heat and water
①. Steaming (Zheng蒸)
a) Pure steaming
b) Steaming with other material
②. Simmering (Ao熬)
③. Boiling (Zhu煮)
④. Quenching (Cui 淬)
⑤. Scalding in hot water (Tang烫)
5). Other methods
①. Germination
②. Fermentation
5. Actions and indications of Chinese Herbal Medicine
5.1 Mechanism of the Actions of TCM medication
①. Expel pathogen and treat causes
②. Tonify Deficiency
③. Readjust function of Zhang Fu organs and meridians
5.2 Actions of TCM medication
①. To address the cause of the disease
②. To address the symptoms of the disease
6. The Properties of Chinese Herbal Medicine
6.1The Four Properties 四气
They are cool and Cold, warm and hot.
Cool or Cold, and warm or hot are only the different degrees. Cool is weaker than Cold, and warm is weaker than hot.
Herbs which are cool or Cold usually can clear Heat and resolve toxicity, cool Blood, Nourish Yin and purge Fire.
Herbs which are warm or hot properties can warm the interior, dispel Cold, and tonify Yang and Qi.
6.2 The Five Tastes 五味
A. Pungent/Acrid: expel, move Qi and Blood.
B. Sweet: tonify, harmonize, relieve spasm and pain.
C. Sour: keep, hold something to stop sweating, spontaneous emission or leukorrhagia, astringe Qi, stop bleeding and diarrhea.
D. Bitter: clear, drain to clear Heat toxicity, pur¬ge, and clear Dampness.
E. Salty: purge, soften hard masses.
F. Astringent: similar action to sour.
G. Tasteless: remove Dampness and promote urination.
6.3 Ascending and Descending, Floating and Sinking 升降浮沉
Ascending and floating: going upward or outward.
Descending and sinking: going downward and inward.
6.4 Channel Entering (Gui Jing归经)
Each herb has a selective action on one or several channels.
6.5 Toxicity 毒性
Chinese herbal medicine can be classified into non-toxic（无毒）and toxic（有毒）according to level of toxicity. Among toxic herbs, some are slightly toxic, some are moderately toxic and others are extremely toxic.
①. Non toxic herbs无毒LD50 > 50g/kg
②. Slightly toxic herbs小毒LD50 > 50g/kg
③. Moderately toxic herbs有毒LD50 = 6-15g/kg
④. Extremely toxic herbs大毒LD50 < 5g/kg
LD50 means Median Lethal Dose.
7. Herbal Combinations and Interactions
(1) Mutual accentuation (Xiang Xu相须): herbs with similar actions reinforce each other to increase their therapeutic actions.
(2) Mutual enhancement (Xiang Shi 相使): herbs with similar actions reinforce each other, acting as principal herb and an assistant herb.
(3) Mutual conteraction (Xiang Wei相畏): the toxicities or side effects of one herb can be reduced or eliminated by another herb.
(4) Mutual suppression (Xiang Sha相杀): one herb reduces the side effects of another herb.
(5) Mutual antagonism (Xiang Wu相恶): one herb reduces the therapeutic action of another herb.
(6) Mutual incompatibility (Xiang Fan 相反): two herbs used together can increase or give rise to side effect or toxicity.
(7) Single effect (Dan Xing 单行): Use the herb alone.
8. Nineteen Antagonisms and Eighteen Incompatibilities
8.1 Nineteen Antagonisms (Shi Jiu Wei)
①. Sulphur (Liu Huang) --- Sal Glauberis (Mang Xiao)
②. Hydrargyrum (Shui Yin) --- Arsennicum (Pi Shuang)
③. Radix euphorbiae (Lang Du) --- Lithargyrum (Mi Tuo Seng)
④. Crotonis Fructus (Ba Dou) --- Pharbitidis Semen (Qian Niu Zi)
⑤. Caryophylli Flos (Ding Xiang) --- Curcumae Radix (Yu Jin)
⑥. Niyrum (Ya Xiao) --- Rhizona Sparganii (San Leng)
⑦. Aconiti Radix preparata (Wu Tou including Chuan Wu and Cao Wu) --- Rhinocerotis Cornu (Xi Jiao)
⑧. Radix ginseng (Ren Shen) --- Trogopterori Faeces (Wu Ling Zhi)
⑨. Cinnamomi Cortex (Rou Gui) --- Halloysitum rubrum (Chi Shi Zi)
Translation of original Chinese saying:
1. Liu Huang fights Mang Xiao
2. Shui Yin should not meet Pi Shuang
3. Lang Du fears Mi Tuo Seng
4. Ba Dou does not like Qian Niu Zi
5. Ding Xiang can not meet Yu Jin
6. Ya Xiao does not cooperate with San Leng
7. Chuan Wu and Cao Wu do not work with Xi Jiao
8. Ren Shen fears Wu Ling Zhi
9. Rou Gui bullys Chi Shi Zi
Original saying in Chinese:
硫磺原是火中精，朴硝一见便相争，水银莫与砒霜见，狼毒最怕密陀僧，巴豆性烈最为上，偏与牵牛不顺情，丁香莫与郁金见，牙硝难合京三棱，川乌草乌不顺犀，人参最怕五灵脂，官桂善能调冷气，若逢石脂便相欺，大凡修合看顺逆，炮槛炙膊/浸莫相依。---《珍珠囊补遗药性赋》
8. 2 Eighteen Incompatibilities (Shi Ba Fan)
1). Wu Tou (The various forms of Radix Aconiti) is incompatible with:
Ban Xia (Rhizoma Pinelliae Ternatae)
Gua Lou (Fractus Trichosanthis)
Bei Mu (Bulbus Fritillariae)
Bai Lian (Radix Ampelopsis)
Bai Ji (Rhizoma Bletillae Striatae)
2). Gan Cao (Radix Glycyrrhizae Uralensis) is incompatible with:
Hai Zao (Herba Sargassi)
Da Ji (Radix Euphorbiae seu Knoxiae)
Gan Sui (Radix Euphorbiae Kansui)
Yuan Hua (Flos Daphnes Genkwa)
3). Li Lu (Rhizoma et Radix Veratri) is incompatible with:
Ren Shen (Radix Ginseng)
Xi Yang Shen (Radix panacis Quinquefolii)
Tai Zi Shen (Radix Pseudo-stellariae)
Dang Shen (Radix Codonopsis Pilosulae)
Sha Shen (Radix Adenophorae seu Glehniae)
Dan Shen (Radix Salviae Miltiorrhiae)
Ku Shen (Radix Sophorae Flavescentis)
Xuan Shen (Radix Scrophulariae)
Xi Xin (Herba cum Radice Asari)
Bai/Chi Shao (Yao) (Radix Paeoniae Lactiflorae)
Original saying in Chinese:
本草明言十八反，半蒌贝蔹芨攻乌，藻戟遂芫俱战草，诸参辛芍叛藜芦。--- 《珍珠囊补遗药性赋》
Pronunciation of original Chinese saying:
Ban (Xia), (Gua) Lou, Bei (Mu), (Bai) Lian, (Bai) Ji gong Wu (Tou);
Gong is a verb, means fight
(Hai) Zao, (Da) Ji, (Gan) Sui, Yuan (Hua), ju zhan (Gan) Cao;
Ju means completely. Zhan means fight.
Zhu Shen, (Xi) Xin, (Bai/Chi) Shao (Yao) pan Li Lu.
Zhu means all. Pan means rebel, fight.
9. Dosage of Chinese Herbal Medicine
9.1. Ancient Unit vs Modern Unit
Ancient unit: 1 Jin = 16 Liang = 160 Qian = 1600 Li
Ancient 1 Liang = modern 30g
Ancient 1 Qian = modern 3g
Ancient 1 Li = modern 0.3 g
With the exception of herbs that are toxic, strong, light or heavy, the typical dosage for most dry herbs is 3-10g a day, orally administered for adult.
9.2. Factors that Determine Dosage of Herbs
①. Property of herbs
②. Quality of herbs
③. Role of herbs in formula
④. Forms of formula
⑤. Condition of the disease
⑥. Condition of patients
⑦. Geographic and season factors
⑧. Purpose of using a certain herb
10. Administration of Chinese Herbal Medicine
10.1. Forms of Herbal Medicine
1) Decoctions (Tang 汤)
2) Pills (Wan 丸)
3) Powders (San 散)
4) Plasters (Gao膏)
①. Plaster medicine (Gao Yao膏药)
②. Herbal patch (Tie Gao贴膏)
5) Ointment (Ran Gao软膏)
6) Vermilion pills (Dan 丹)
7) Herbal wines (Yao Jiu 药酒)
10.2. Decocting Method
1) Utensils for decocting
2) Water
3) Type of Heat and decocting time
Military Fire (wu huo武火)
Civilian Fire (wen huo 文火).
4) Most formulas need to be decocted for 20-30 minutes.
5) Special methods for decocting
①. Decocted early (Xian Jian先煎)
②. Added later (Hou Xia 后下)
③. Wrapped in gauze (Bao Jian 包煎)
④. Separately decocted (Ling Jian 另煎or Ling Dun 另炖
⑤. Dissolved in hot decoction (Yang Hua烊化)
⑥. Taken with the hot decoction (Chong Fu 冲服 )
⑦. Use decoction as water
⑧. Boiled powders (Zhu San 煮散)
10.3 Times of Decocting
Most formulas are decocted two to three times.
10.4. Administration Method
A. Time of administration
①. Taken on an empty Stomach: to kill parasites, relieve food stagnation or drain downward
②. Taken before meals: for treating Stomach or intestinal diseases is beneficial for the maximum absorption.
③. Taken after a meal: with herbs that irritate the Stomach.
④. Taken before bedtime: to calm the spirit.
⑤. Taken at a certain time: for malaria.
⑥. Taken immediately: in emergency situation.
B. Frequency of taking
A daily dosage can be divided into two or three portions to be taken throughout the day. For serious or acute conditions, herbs can be taken every four hours until the patient's condition improves.
11. Special consideration of Herbal Treatment
①. Herbal treatment during pregnancy.
②. Herbal treatment during breast feeding.
③. Herbal treatment for neonatal and pediatric patients.
④. Herbal treament for geriatric patients.
⑤. Herbal taboo with food (dietetic restraint)
The Herbal Medicine of Traditional Chinese Medicine (TCM) is the study of sources, collections, properties, actions, indications, contraindications and clinical applications of Chinese natural herbal medicine based on basic theories of Traditional Chinese Medicine. It is one of the most important parts of Traditional Chinese Medicine. In China, 80% of TCM doctors work with herbal medicine, only 20% of them work with acupuncture.
According to a recent survey, the total number of Chinese herbal medicines used is 12,807, in which 11,146 are of plant origin, 1,581 are of animal origin and 80 are of mineral origin. Because most Chinese natural medicines are of plant origin, they are called “Chinese herbal medicines” or “herbs”.
In Chinese language, Chinese natural medicine is called “Zhong Yao Xue” 中药学, means “Chinese Herbal Medicine.” Among them “Zhong” 中means Chinese, “Yao” 药 means herbal medicine that can treat diseases, and “Xue” 学means -ology, a study of.
Western medicine came into China only about 100 years ago. From prehistoric times to the early 20th century, Chinese herbs played a leading role in preventing and treating diseases for Chinese people. They saved many lives. This is one of the important reasons that the population of China is the largest in the world.
In China there are about 30 public TCM universities and many TCM departments in western medical and pharmaceutical universities. There is a department of TCM pharmacology in every public TCM university. Graduates form these departments are pharmacists working for pharmaceutical company or pharmacies.
With the use of modern pharmacology techniques, Chinese herbal medicine is more scientific now. It can be divided into a series of branches:
1) Pharmacognosy: The branch of pharmacology that deals with drugs in their crude or natural state.
2) Phytochemistry: The chemistry of plants.
3) Pharmaceutics: The science of preparing and dispensing drugs.
4) Clinical pharmacology.
5) Formulations of TCM.
6) Herbal processing of TCM.
1. Origin and development of Chinese Herbal Medicine
Chinese Herbal Medicine originated in ancient times when people were looking for food.
There is legend that 5000 years ago there was a ruler called Shen Nong (divine husbandman) who taught his people how to cultivate grains as food so as to avoid killing animals. He tasted 70 herbs a day to test their medical value for his people. He is considered to be the father of Chinese agriculture and herbal medicine.
In the Shang Dynasty (16th - 11th century BC) the letter “Yao” (药) appeared, which means herbs that can treat diseases.
In the Zhou Dynasty (11th century BC - 221 BC) the position of doctor was named officially. Wan Wu (万物means everything in the world) was written. There are 70 herbs were described in it.
In the Qin and Han Dynasty (221 BC - 220) Divine Husbandman's Classic of Chinese Herbal Medicine (Shin Nong Ben Cao Jing) was written, which contains details of 365 herbs. It is the earliest and one of the most valuable books of Chinese Herbal Medicine. More than 200 herbs in current herbal text books are from this book.
In the Three Kingdoms Period, Jin Dynasty, Northern and Southern Dynasties (220 - 589) the important books entitled Ben Cao Jin Ji Zhu and Pao Jiu Lun were written.
In the Sui and Tang Dynasty (581 - 907), the book Newly Revised Chinese Herbal Medicine (Xin Xiu Ben Cao) was published.
In the Song dynasty the state owned pharmacies were established, In Song, Liao, Jin, and Yuan Dynasty (960 - 1368), total herbal medicines reached 1700 different kinds.
In the Ming Dynasty (1368 - 1644) Grand Chinese Herbal Medicine (Ben Cao Gang Mu) was written in 1590 AC. It contains details of 1892 Chinese herbal medications.
In the time of the Republic of China (1911 - 1949), the Encyclopedia of Chinese Herbal Medicine (Zhong Yao Da Chi Dian) was compiled, which included 4300 items.
During the People’s Republic of China (1949 – present), TCM universities have been established since 1956 and since then, departments of pharmacology of Traditional Chinese Medication were established in TCM universities. Pharmacology universities and Agriculture universities, and many books were published including Chinese Herbal Medicine (Zhong Hua Ben Cao), the 8534 herbal medicine listed.
2. Habitat and collection of Chinese Herbal Medicine
2.1 Habitat of Chinese herbal medication
Habitats of Chinese herbal medication are based on:
①. Soil
②. Water
③. Climate
④. Sunshine
⑤. Rainfall
Best quality herbs that come from a specific area are called “Dao Di Yao Cai” (道地药材). e.g.:
Best Ren Shen is from Northeast of China.
Best Fu Ling is from Yun Nan province.
Best Huang Lian is from Si Chuan province.
Best Di Huang is from He Nan province.
Best Er Jiao is from Shan Dong province.
2.2 Collection of Chinese medication
A. Plant origin herbs collection
Entire grass collected when their flower is in full bloom
Leaves are collected when their flowers are blooming
Flowers are collected when they are blooming
Fruits are collected when they are ripe (but some not)
roots are collected in late autumn or spring
Barks are collected in spring or early summer
B. Animal origin herbs are collected at different times.
C. Mineral origin medication herbs are collected at any time.
2.3 Storage of Chinese medication:
Preparation work for storage: to clean, dry, seal, absorb Dampness, chemical substance, reduce oxygen, increase carbon dioxide.
For extremely toxic medication, they are secured and only accessible by certain people.
3. Nomenclature of Chinese Herbal Medicine
1) Cao 草 means entire grass with or without root
2) Gen 根means root
3) Hua 花means flower
4) Pi 皮means bark, peel
5) Ren 仁means seed
6) Zi 子means seed
7) Shi 石means stone
8) Ye 叶means leaf
9) Zhi 枝means twig
10) Jiao 角means horn
11) Teng 藤means vine
12) Tan 碳means charred herbs
13) She 蛇means snake
14) Zhi 炙means processed (As an adj.)
4. Processing of Chinese Herbal Medicine
4.1 Purpose of processing
①. Purify herbs
②. Make active components easier to dissolve
③. Increase effect
④. Remove side effects or toxicity
⑤. Change property or action
⑥. Remove unpleasant taste
4.2 Processing Method
1). Mechanical method
①. Cleaning
②. Pulverizing
③. Slicing
2). Process with Water
①. Bleaching
②. Soaking
③. Trituration with water (Shui Fei 水飞)
3). Process with Heat
①. Frying with liquid (Zhi 炙)
②. Stir-frying (Chao 炒)
1) Stir-frying to yellow (炒黄)
2) Stir-frying to brown(炒焦)
3) Carbonizing（炒碳）
③. Roasting in ashes (Wei 煨)
④. Baking (Hong or Bei 烘焙)
⑤. Quick-frying (Pao炮)
⑥. Calcining (Duan煅)
4). Process with both Heat and water
①. Steaming (Zheng蒸)
a) Pure steaming
b) Steaming with other material
②. Simmering (Ao熬)
③. Boiling (Zhu煮)
④. Quenching (Cui 淬)
⑤. Scalding in hot water (Tang烫)
5). Other methods
①. Germination
②. Fermentation
5. Actions and indications of Chinese Herbal Medicine
5.1 Mechanism of the Actions of TCM medication
①. Expel pathogen and treat causes
②. Tonify Deficiency
③. Readjust function of Zhang Fu organs and meridians
5.2 Actions of TCM medication
①. To address the cause of the disease
②. To address the symptoms of the disease
6. The Properties of Chinese Herbal Medicine
6.1The Four Properties 四气
They are cool and Cold, warm and hot.
Cool or Cold, and warm or hot are only the different degrees. Cool is weaker than Cold, and warm is weaker than hot.
Herbs which are cool or Cold usually can clear Heat and resolve toxicity, cool Blood, Nourish Yin and purge Fire.
Herbs which are warm or hot properties can warm the interior, dispel Cold, and tonify Yang and Qi.
6.2 The Five Tastes 五味
A. Pungent/Acrid: expel, move Qi and Blood.
B. Sweet: tonify, harmonize, relieve spasm and pain.
C. Sour: keep, hold something to stop sweating, spontaneous emission or leukorrhagia, astringe Qi, stop bleeding and diarrhea.
D. Bitter: clear, drain to clear Heat toxicity, pur¬ge, and clear Dampness.
E. Salty: purge, soften hard masses.
F. Astringent: similar action to sour.
G. Tasteless: remove Dampness and promote urination.
6.3 Ascending and Descending, Floating and Sinking 升降浮沉
Ascending and floating: going upward or outward.
Descending and sinking: going downward and inward.
6.4 Channel Entering (Gui Jing归经)
Each herb has a selective action on one or several channels.
6.5 Toxicity 毒性
Chinese herbal medicine can be classified into non-toxic（无毒）and toxic（有毒）according to level of toxicity. Among toxic herbs, some are slightly toxic, some are moderately toxic and others are extremely toxic.
①. Non toxic herbs无毒LD50 > 50g/kg
②. Slightly toxic herbs小毒LD50 > 50g/kg
③. Moderately toxic herbs有毒LD50 = 6-15g/kg
④. Extremely toxic herbs大毒LD50 < 5g/kg
LD50 means Median Lethal Dose.
7. Herbal Combinations and Interactions
(1) Mutual accentuation (Xiang Xu相须): herbs with similar actions reinforce each other to increase their therapeutic actions.
(2) Mutual enhancement (Xiang Shi 相使): herbs with similar actions reinforce each other, acting as principal herb and an assistant herb.
(3) Mutual conteraction (Xiang Wei相畏): the toxicities or side effects of one herb can be reduced or eliminated by another herb.
(4) Mutual suppression (Xiang Sha相杀): one herb reduces the side effects of another herb.
(5) Mutual antagonism (Xiang Wu相恶): one herb reduces the therapeutic action of another herb.
(6) Mutual incompatibility (Xiang Fan 相反): two herbs used together can increase or give rise to side effect or toxicity.
(7) Single effect (Dan Xing 单行): Use the herb alone.
8. Nineteen Antagonisms and Eighteen Incompatibilities
8.1 Nineteen Antagonisms (Shi Jiu Wei)
①. Sulphur (Liu Huang) --- Sal Glauberis (Mang Xiao)
②. Hydrargyrum (Shui Yin) --- Arsennicum (Pi Shuang)
③. Radix euphorbiae (Lang Du) --- Lithargyrum (Mi Tuo Seng)
④. Crotonis Fructus (Ba Dou) --- Pharbitidis Semen (Qian Niu Zi)
⑤. Caryophylli Flos (Ding Xiang) --- Curcumae Radix (Yu Jin)
⑥. Niyrum (Ya Xiao) --- Rhizona Sparganii (San Leng)
⑦. Aconiti Radix preparata (Wu Tou including Chuan Wu and Cao Wu) --- Rhinocerotis Cornu (Xi Jiao)
⑧. Radix ginseng (Ren Shen) --- Trogopterori Faeces (Wu Ling Zhi)
⑨. Cinnamomi Cortex (Rou Gui) --- Halloysitum rubrum (Chi Shi Zi)
Translation of original Chinese saying:
1. Liu Huang fights Mang Xiao
2. Shui Yin should not meet Pi Shuang
3. Lang Du fears Mi Tuo Seng
4. Ba Dou does not like Qian Niu Zi
5. Ding Xiang can not meet Yu Jin
6. Ya Xiao does not cooperate with San Leng
7. Chuan Wu and Cao Wu do not work with Xi Jiao
8. Ren Shen fears Wu Ling Zhi
9. Rou Gui bullys Chi Shi Zi
Original saying in Chinese:
硫磺原是火中精，朴硝一见便相争，水银莫与砒霜见，狼毒最怕密陀僧，巴豆性烈最为上，偏与牵牛不顺情，丁香莫与郁金见，牙硝难合京三棱，川乌草乌不顺犀，人参最怕五灵脂，官桂善能调冷气，若逢石脂便相欺，大凡修合看顺逆，炮槛炙膊/浸莫相依。---《珍珠囊补遗药性赋》
8. 2 Eighteen Incompatibilities (Shi Ba Fan)
1). Wu Tou (The various forms of Radix Aconiti) is incompatible with:
Ban Xia (Rhizoma Pinelliae Ternatae)
Gua Lou (Fractus Trichosanthis)
Bei Mu (Bulbus Fritillariae)
Bai Lian (Radix Ampelopsis)
Bai Ji (Rhizoma Bletillae Striatae)
2). Gan Cao (Radix Glycyrrhizae Uralensis) is incompatible with:
Hai Zao (Herba Sargassi)
Da Ji (Radix Euphorbiae seu Knoxiae)
Gan Sui (Radix Euphorbiae Kansui)
Yuan Hua (Flos Daphnes Genkwa)
3). Li Lu (Rhizoma et Radix Veratri) is incompatible with:
Ren Shen (Radix Ginseng)
Xi Yang Shen (Radix panacis Quinquefolii)
Tai Zi Shen (Radix Pseudo-stellariae)
Dang Shen (Radix Codonopsis Pilosulae)
Sha Shen (Radix Adenophorae seu Glehniae)
Dan Shen (Radix Salviae Miltiorrhiae)
Ku Shen (Radix Sophorae Flavescentis)
Xuan Shen (Radix Scrophulariae)
Xi Xin (Herba cum Radice Asari)
Bai/Chi Shao (Yao) (Radix Paeoniae Lactiflorae)
Original saying in Chinese:
本草明言十八反，半蒌贝蔹芨攻乌，藻戟遂芫俱战草，诸参辛芍叛藜芦。--- 《珍珠囊补遗药性赋》
Pronunciation of original Chinese saying:
Ban (Xia), (Gua) Lou, Bei (Mu), (Bai) Lian, (Bai) Ji gong Wu (Tou);
Gong is a verb, means fight
(Hai) Zao, (Da) Ji, (Gan) Sui, Yuan (Hua), ju zhan (Gan) Cao;
Ju means completely. Zhan means fight.
Zhu Shen, (Xi) Xin, (Bai/Chi) Shao (Yao) pan Li Lu.
Zhu means all. Pan means rebel, fight.
9. Dosage of Chinese Herbal Medicine
9.1. Ancient Unit vs Modern Unit
Ancient unit: 1 Jin = 16 Liang = 160 Qian = 1600 Li
Ancient 1 Liang = modern 30g
Ancient 1 Qian = modern 3g
Ancient 1 Li = modern 0.3 g
With the exception of herbs that are toxic, strong, light or heavy, the typical dosage for most dry herbs is 3-10g a day, orally administered for adult.
9.2. Factors that Determine Dosage of Herbs
①. Property of herbs
②. Quality of herbs
③. Role of herbs in formula
④. Forms of formula
⑤. Condition of the disease
⑥. Condition of patients
⑦. Geographic and season factors
⑧. Purpose of using a certain herb
10. Administration of Chinese Herbal Medicine
10.1. Forms of Herbal Medicine
1) Decoctions (Tang 汤)
2) Pills (Wan 丸)
3) Powders (San 散)
4) Plasters (Gao膏)
①. Plaster medicine (Gao Yao膏药)
②. Herbal patch (Tie Gao贴膏)
5) Ointment (Ran Gao软膏)
6) Vermilion pills (Dan 丹)
7) Herbal wines (Yao Jiu 药酒)
10.2. Decocting Method
1) Utensils for decocting
2) Water
3) Type of Heat and decocting time
Military Fire (wu huo武火)
Civilian Fire (wen huo 文火).
4) Most formulas need to be decocted for 20-30 minutes.
5) Special methods for decocting
①. Decocted early (Xian Jian先煎)
②. Added later (Hou Xia 后下)
③. Wrapped in gauze (Bao Jian 包煎)
④. Separately decocted (Ling Jian 另煎or Ling Dun 另炖
⑤. Dissolved in hot decoction (Yang Hua烊化)
⑥. Taken with the hot decoction (Chong Fu 冲服 )
⑦. Use decoction as water
⑧. Boiled powders (Zhu San 煮散)
10.3 Times of Decocting
Most formulas are decocted two to three times.
10.4. Administration Method
A. Time of administration
①. Taken on an empty Stomach: to kill parasites, relieve food stagnation or drain downward
②. Taken before meals: for treating Stomach or intestinal diseases is beneficial for the maximum absorption.
③. Taken after a meal: with herbs that irritate the Stomach.
④. Taken before bedtime: to calm the spirit.
⑤. Taken at a certain time: for malaria.
⑥. Taken immediately: in emergency situation.
B. Frequency of taking
A daily dosage can be divided into two or three portions to be taken throughout the day. For serious or acute conditions, herbs can be taken every four hours until the patient's condition improves.
11. Special consideration of Herbal Treatment
①. Herbal treatment during pregnancy.
②. Herbal treatment during breast feeding.
③. Herbal treatment for neonatal and pediatric patients.
④. Herbal treament for geriatric patients.
⑤. Herbal taboo with food (dietetic restraint)
