Understanding Your Herbs

So, you’re considering working with an herbalist, but you’re not sure what to expect. Or maybe you’ve just been prescribed an herbal formula and you want to learn more about what you’re taking and why. If you’re looking to gain a deeper understanding of how herbal medicine works; how working with a trained clinical herbalist is different than taking an herb you read about in a book, or buying one your salesperson told you about, keep reading.

A caveat before we begin. I want to differentiate between herbs and supplements. Herbs are plants that grow in the ground and contain a complex, natural, and complete chemistry that our bodies understand. Supplements are vitamins, minerals, amino acids, etc. that are synthetic chemicals made in a lab based on what scientists think our bodies need. And to complicate the matter even more, with the rise of Functional medicine, there are now supplement companies that create combination products containing both herbs and supplements. Here is an article that goes deeper into this topic if you’re curious.

But today we are just talking about herbs, medicinal plants that have known benefits to humans. And we’re going to start by taking a tour of the varied ways humans have interacted with these plants throughout history.

Types of Herbalism

Instead of thinking about herbs and herbalism as one cohesive thing, it’s more accurate to understand how it evolved in different places and at different times, adjusting to the needs of the people and the culture where it’s practiced.

Currently, there are 3 major branches of herbalism being practiced today. Ayurvedic (Indian) herbalism, Western herbalism, and Chinese herbalism. Of course, there are many other types of folk herbalism being practiced around the world, and there are also many ways of practicing within these 3 schools.

Ayurveda is the traditional medical practice of India, and includes herbs, yoga, nutrition and more. There are a number of great Ayurvedic practitioners practicing traditional herbalism in this style. However, it’s not my training, so we won’t go too deep into this today.

Western herbalism uses herbs that are indigenous to Europe and the Americas. Many of the “mainstream” herbs, like black cohosh, St. John’s wort, and chamomile, are used by Western herbalists. Some are trained in a specific lineage that’s held by a family line, these tend to be more folk herbalists. And there are also clinical herbalists who take courses and learn more formally.  This style tends to be eclectic, using traditional methods taken from Chinese and Ayurvedic medicine, and mixing them with modern research. If you work with a clinical herbalist, Naturopath, or other health practitioner, they are probably using Western herbs, unless they specify otherwise.

Chinese herbalism is a branch of Chinese medicine, which also includes acupuncture, nutrition, qi gong, and more. This is the traditional medicine of China and has been practiced continuously for thousands of years. In China, it’s known as one of the “gems in the crown”, an important part of Chinese culture that needs to be preserved. There are several schools of herbalism that can be broken down into two major categories: Tradition Chinese Medicine (TCM) and Classical Chinese medicine. TCM is what many modern practitioners use, which is a collection of theories from past lineages to create a singular style that can be taught in schools, and that could be exported outside of China to the rest of the world. Whereas Classical herbalism is lineage based; there are a few schools with different thoughts on diagnosis and treatment that developed over time. Since this is the area of my formal training and experience, the rest of what we talk about today will be related to the Chinese herbal traditions.

The Alchemy of Good Herbalism

In Chinese herbal traditions plants aren’t used singularly, but instead combined into what we call formulas. Most formulas contain four parts, The Chief, Deputy, Assistant, and the Envoy.

The Chief(s) is the herb or herbs in a formula that get right to the heart of what you’re treating. They treat the main pattern of disharmony – which we’ll get into more later. The Deputy (or Deputies) supports the work of the Chief and can also address secondary symptoms or patterns. Assistants counteract any side effects of the Chief and Deputy herbs while balancing the formula. And the Envoy(s) guide the formula to a particular area of the body and harmonize the entire thing.

Think of it like baking a cake. Each ingredient has a specific purpose, and you need the right amount of each to make the cake rise, hold together, and taste good. You wouldn’t want to eat flour by itself, but add eggs, butter, sugar, and heat, and you get a chemical reaction that creates a delicious dessert.

This is how we write a formula that works and avoids negative side effects. But it’s also what makes herbalism harder to understand without a decent amount of studying. You can’t look at one herb individually and expect it to do the same thing in all circumstances. When you add other herbs, and then add heat, chemicals break down and recombine in new ways, creating a synergistic effect.

Traditional Diagnosis

Part of the challenge of creating a good herbal formula is understanding the theory and diagnoses of Chinese medicine. Unlike modern medicine which uses linear, cause and effect thinking to understand how the body works, Chinese medicine uses patterns and circular thinking. This is a huge topic that we don’t have space to get into fully here, but this article goes more in depth into the differences between these two types of medicine.

But what I do want to go over today is a primer on traditional diagnosis. Keep in mind that it takes many (many!) years to master the subtleties and complexity of this system – and we’re barely scratching the surface here. Just enough to give you an understanding of what your herbs are doing.

Chinese medicine sees connections between your symptoms, your physical and mental health, and your environment. Part of that connection is with the natural world, and that’s what this language reflects. Your symptoms might be hot or cold, damp or dry, deficient or excess, moving or stagnant. And it could be different depending on what body system we’re talking about. For example, you might have a lot of dampness in your mucous membranes leading to sinus congestion, and at the same time have dryness in your intestines causing constipation. In fact, this is common because when dampness congeals fluids in one area, it steals hydration from another area.

Let’s start with the basics. Each factor is listed, followed by specific symptoms you might experience if you have an imbalance in that area.

Heat: physically feeling hot, redness (rashes/skin, eyes, joints, etc), feeling restless, things speeding up (like your heartbeat or digestion), things that are smelly (stool, sweat, etc). Inflammation in general is related to heat. And some things could involve heat, but not necessarily, like things rising (headaches or reflux for example), or dryness because of excess heat.

Cold: physically feeling cold, fatigue, things slowing down (like digestion or metabolism), body stiffness, poor circulation, pain that’s better with heat, anything pale or blue-ish color (pale face, undereye circles, blue tint to tongue). There are also things that could be related to cold like diarrhea, and cold can lead to excess dampness, which can cause edema and other things (see below).

Damp/Phlegm: edema and fluid retention, mucus from nose/lungs/throat, bloating, mucus in stool or sticky stool, brain fog. When dampness congeals it becomes phlegm, which can be the cause of any masses or cysts (for example, uterine fibroids or a baker’s cyst). Phlegm can also congeal in the mind and cause dementia or mania. Dampness and phlegm combine with either cold or heat, so you might have mucus that’s yellow or blood tinged (heat) or clear and thin (cold).

Dryness: just like it sounds, anything that’s dry like a non-productive cough, constipation with dry, hard stool, dry eyes/mouth, dry skin/rashes that get flaky and dry. Dryness can be caused by heat, or it can be caused by blood deficiency (see below), in which case you might also have scanty menses, numbness and tingling, issues with tendons and ligaments, and insomnia.

Wind: there are 2 types of wind; external - an acute condition when you catch a virus or bacteria, and internal - which is more chronic. External wind can be cold or hot, and symptoms vary depending on that, but in general consist of fever and/or chills, body aches, sweating, coughing/wheezing, sore throat, and a stiff neck. Internal wind, on the other hand, involves symptoms that move and change, like pain in different joints depending on the day (or the hour even), or things like tremors, dizziness, or spasms. Wind can also combine with phlegm to create symptoms like headaches, loss of consciousness, or partial paralysis, like in Bell’s Palsy or a stroke.

In addition to the environmental effects listed above, part of Chinese medicine diagnosis involves assessing the strength of the qi and blood. Qi represents all the functional aspects of the body that don’t take physical form, like breathing, breaking down of food, distributing oxygen and nutrients to the entire body, and many other things. Blood is more tangible, obviously, but the blood in Chinese medicine nourishes, hydrates, and grounds us into the physical world. Both qi and blood can be excess (and therefore stagnant) or deficient, and each of these comes with its own set of symptoms.

Qi deficiency: tiredness, shortness of breath, bloating and diarrhea with undigested food in the stool, spontaneous sweating, getting sick a lot.

Qi stagnation: PMS, breast/rib/abdominal tenderness, cold hands and feet, moodiness/depression/frustration, sensation of something stuck in your throat, low appetite.

Blood deficiency: light periods (or very heavy periods which can cause blood deficiency), iron deficiency anemia, lightheaded or dizziness, numbness and tingling, anxiety, insomnia, blurred vision or floaters, dry skin/hair/nails, pale skin.

Blood stagnation: fixed stabbing pain, purple color (underside of tongue, veins or blotchy skin, lips, face, nails, etc), clots and/or dark blood with menstruation, very painful periods.

The last piece of the diagnostic puzzle I’ll add involves organ systems and their patterns. Unlike in Western medicine, where we consider each organ as its own sperate entity, Chinese medicine pairs organs together, and ascribes multiple functions to these pairs. So, instead of having a cardiovascular system, or a digestive system, Chinese medicine has a Liver/Gallbladder system, a Lung/Large Intestine system, and so on. Which means, when we talk about your Liver, it doesn’t necessarily mean there’s something wrong with your actual liver, it could just be an imbalance related to the Liver system.

All the pathologies we talked about above (heat, dampness, qi stagnation, etc.) can be happening in any organ system, and that would lead to specific symptoms related to the functions of that system. For example, you can have Spleen Qi Deficiency, Liver Fire Blazing, or Phlegm-Heat in the Lung. It’s these diagnoses that we base our herb choices on when creating a formula.

Making Sense of it All

As you can see, there’s so much more to herbalism than “take this herb for hot flashes”, or “here’s the formula for depression”. Any symptom or Western disease state can have many etiologies depending on the person and their constellation of symptoms. And one person can (and usually does) have several different patterns overlapping and intertwining.

On top of that, each herb has its own temperature (hot, warm, cool, cold, or neutral), specific actions (draining heat, moving qi, nourishing fluids, drying damp, etc.) and particular organ systems and channels that it guides to (for example: Liver, Kidney, Gallbladder). Each of these characteristics is considered when writing a formula.

Which means that it’s not so easy to Google the herbs in your formula to see what they treat. If you do, you’ll be confused at best, and at worst you may become convinced that your herbalist is an idiot and gave you all the wrong herbs! There are plenty of websites out there that will tell you that dang gui (angelica sinensis) lowers blood pressure (not true if you’re blood pressure is already low) or that chai hu (bupleurum chinense) is good for asthma (then why am I taking it for PMS?).

But you’re a smart, curious person, I get it. You want to know what your herbs are doing. You’re looking for a resource to learn about your particular herbs and formulas. So I will give you that. But please keep in mind that each herb has many functions on its own, and that it combines synergistically with the other herbs in your formula. And all the other stuff we just went over. And please, I beg of you, don’t believe everything you read on the internet!

With all that being said, my favorite online resource for Chinese herbal medicine is the website American Dragon. Every herb and formula you could possibly be curious about is there, and there’s lots of cross referencing. He includes all the herb properties, and even lists synergistic herb combos. I suggest using the search box at the top of the page to get started.

If you’ve made it to the end, I applaud you – there’s a lot of information here. Feel free to use this article as a reference to come back to anytime you need. I also urge you to reach out to me if you have specific questions, I love talking about this stuff. And if there’s anything else that you think should have been included in this article and wasn’t, leave a comment and let me know.