The Hapless Herbalist

As a Chinese medicine practitioner, I frequently see misguided attempts by my patients to self-prescribe herbs for their conditions. While people can occasionally appropriately match their symptoms with a Western herb, I can say with confidence that I have never seen a lay person prescribe themselves Chinese herbs with any accuracy.
A frequent error that I see is in the use of warming herbs or moving herbs to address issues that appear to be rooted in a feeling of stuckness or of cold. While at first glance it would make sense that one would use warming herbs in conditions of cold and moving herbs in conditions of stuckness, it is more complicated than one might imagine to unwind the true nature of these conditions and apply the herbs appropriately. Lay people frequently get their wires crossed on how to approach these conditions.

Let’s take the question of cold…

In order for the body to be fully warm out the extremities, it requires three things in abundance:
• Yang (or yang qi)
• Blood
• Clear pathways of circulation

Yang (or yang qi) is the moving and warming aspect of the body’s physiology, while blood is the nourishing and warming aspect. Clear pathways of circulation (governed by the movement of the qi in general) are required to enable the yang and the blood to permeate all aspects of the body to create warmth and sensation, regularity and consistency of physiological transformation, and emotional equanimity. Disruption in any one of these three aspects can lead to sensations of cold and/or of uncomfortable physical (or emotional) stuckness.

Each of these three aspects has its own category of herbs: herbs to tonify the yang, to nourish the blood, and to move the qi. Sometimes while an herb may belong to one category, it may also have attributes of one (or more) of the others. And while the majority of herbs that tonify the yang and nourish the blood are warm, not all warm herbs necessarily perform those other strengthening functions that are critical to conditions that arise from their deficiency. Some herbs are just warm and just make things warm; however, they won’t address an underlying issue to truly treat the condition with any efficacy.

So when looking for the appropriate combination of herbs, the question always is, which of these is currently being affected? And it is this question that lay people are unable to answer for themselves being uneducated in the physiology and diagnostic systems of Chinese medicine.

An example I have frequently seen is that a person who is cold due to being deficient in their blood aspect will frequently chose herbs that are primarily moving to help push the weary circulation beyond its capabilities. Or they will use herbs that have a spicy and dispersing quality to again scatter the blood to create a false sense of warmth. Absent herbs to nourish the blood aspect itself, spicy and moving herbs will serve only to dry the blood further and will actually worsen the condition over time. The same can be said conditions marked by deficiencies of yang. Excessive moving and dispersing herbs that address only symptoms more at the channel level (as opposed to the yang itself) will eventually lead to a great weakness in the yang and a more complicated set of problems which are that much more difficult to recover from.

A second example is the use of warm and spicy herbs for conditions involving stuckness. Again, it is the spicy and dispersing nature of these herbs that leads people to believe they will remove the obstruction (or sense of obstruction) that is causing them discomfort. A more appropriate choice would be herbs that are truly moving in nature (of qi, blood and/or phlegm) to relieve the obstruction. Uitilizing warm and spicy herbs for this purpose may result in more hot and inflammatory conditions as the herbs are unable to disperse the obstruction, and their warm and spicy nature only serves to add further heat to an already inflammatory situation.

A further complexity to note (although not delve into here) is the utilization of herbs not in a cookbook symptom/herb match up game, but rather in a formula of multiple herbs to address a particular pattern. These patterns are based on a physiological diagnosis rooted in the philosophy of Chinese medicine and discovered with increasing accuracy through consistent clinical practice.

So often people either fear herbal medicine or scoff at herbal medicine, and unfortunately this can arise from their own hapless efforts to self-prescribe Chinese herbs. Before you dismiss Chinese herbal medicine as quackery, make a visit to an educated, experienced and thoughtful Chinese medicine practitioner. Allow them to use their knowledge, steeped in culture, history, philosophy, physiology and botany in the complex system of Chinese medicine to its greatest potential. What they can do with herbs will astound you.