Questions Regarding the Phrasing Used to Describe the Actions of Herbal Formulas
By Tom Hurrle, LAc and Wen Xuan, LAc
Question #1: Teacher, your description of the actions of herbal formulas often seems to demonstrate a logic I do not find in the language of the books available in the United States.
Do these descriptions have some structure in Chinese that doesn't come across in English?
Answer: Yes, the Chinese structure can come across in Englis,h although it rarely does. We find few descriptions of herbal formulas in English as accurate as they are in Chinese.
Certainly, it is not easy for English-speaking writers to determine the proper English word or phrase that best corresponds to the original meaning in Chinese. This is because the original word or phrase used in traditional Chinese medicine (TCM) may have different meanings, requiring that the writer or translator first be able to recognize the different Chinese meanings and then to select alternative wording in English that most correctly reflects the original meaning. For example, the Chinese phrases "jin ye" and "yin ye" are frequently used in TCM, but both often translated into "body fluids" in English, which is incorrect. Why? Theoretically, the "jin ye" is a general term that intensively indicates all fluids in the human body, including secretions such as saliva, tears, perspiration, etc., while "yin ye" particularly refers to all kinds of nutrient fluid in the body, especially that of the internal organs such as the fluid of the liver. Therefore, the proper English translation for "jin ye" is "body fluids," and for "yin ye," "yin fluids."
Similarly, the actions of herbal formulas in Chinese need to be understood thoroughly before being translated into English. If we take one of the classic herbal formulas called, zhu sha an shen wan, as an example, we will find that the actions of this formula in Chinese are said to be "zhong zhen an shen, yang yin qing huo," which should be translated as "heavily repressing the fright and terror to tranquilize the mind while nourishing the yin and clearing away the fire from the heart." In contrast, a popular English-language textbook describes the actions of this formula as "sedate the heart, calm the spirit, drain fire, and nourish the yin" (Bensky, Formulas & Strategies, P. 384), which I believe is quite different from the original meaning.
Question #2: Formula actions seem to be originally derived from the Eight Methods (ba fa), or treatment strategies given by Cheng Zhong-Ling in the Qing dynasty. Do modern Chinese texts add to these strategies?
Answer: Yes. Here "fa" refers to "principle," not "method", in both Chinese and English. "Ba fa" in TCM refers to eight different principles for treatment, as generalized by Cheng Zhong-Ling in the Qing dynasty. These include causing perspiration (han), promoting bowel movements (xia), inducing vomiting (tu), facilitating dispersion and clear release/adjustment (he), warming (wen), clearing (qing), strengthening (bu) and gradually resolving or slowly dissipating (xiao).
Since then, many new principles have been recognized or established, and have been added to the "ba fa" in modern Chinese texts. Examples of the newly added principles are "astringing the lung qi to stop coughing" (lian fei zhi ke) and "astringing the bladder qi to stop nocturnal enuresis" (suo niao zhi yi).
Question #3: A formula to clear deficiency heat, artemesia annua and soft-shelled turtle decoction (qing hao bie jia tang) is said to nourish the yin and vent heat, using tonifying and clearing strategies. You state the actions as, "Nourish the yin to cool the blood and increase the body fluids, vent the heat." This clarifies the construction of the formula to aid my memory of the ingredients. Can you describe the process of making a more detailed description to improve my understanding of a formula's actions?
Answer: Theoretically, a formula's actions should be the same as the principle that has been determined for the treatment. However, a formula usually consists of many herbs with different and unique actions, which are not easily generalized in a phrase as short as the one used to describe the treatment principle. What's more, using a more detailed description covering the major actions of the herbs would greatly help students understand and remember the main actions of the formula. To do this, each herb's actions should be reviewed first. The common actions of the different herbs may then be generalized as the main actions of the formula. If we take qing hao bie jia tang as an example, we will find that the actions of each herb are as follows:
Nourish the yin to clear away the heat
Clear away the heat and vent the heat from the collaterals
Sheng di huang
Clear away the heat and cool the blood, nourish the yin to generate the body fluids
Clear away the heat and cool the blood, reduce the fire retained in the yin channels
Clear away the heat and reduce the fire, nourish the yin to moisten dryness
Since "nourish the yin, clear away the heat, and cool the blood" are actions in common for the majority of the herbs in this formula, these are the main actions for qing hao bie jia tang. In this way, we can easily describe the actions of the formula qing hao bie jia tang. The method is simple to apply, yet it yields a more complex description that is more easily remembered and more easily applied in treatment, compared with the more commonly used, simplified description, "nourish the yin and vent the heat."
Question #4: The actions of four-substance decoction (si wu tang) are given in Formulas and Strategies, by Bensky and Barolet, as "tonify the blood and regulate the liver." In contrast, Handbook of Chinese Herbal Formulas, by Him-che Yeung, gives the actions as "to nourish and replenish blood and to regulate the flow of blood circulation." How would you describe the actions of this formula?
Answer: Theoretically and practically, si wu tang is used nowadays as a basic blood tonic formula. Originally, it was derived from jiao ai tang, a formula recorded in a classic TCM text, Jin Kui Yao Lue, written by Zhang Zhongjing at the beginning of the 3rd century. Si wu tang was initially created to treat patients with trauma (see the book entitled Xian Shou Li Shang Xu Duan Mi Fang, written in Chinese). This implies that, in addition to tonifying the blood, this formula also, at least, has the action of promoting the blood circulation to remove blood stasis, for, as we know, trauma usually results in blood stasis. If we review the ingredients of the formula, we will find the main actions of each herb are as follows:
Shu di huang
Tonify the blood and nourish the yin
Tonify the blood and promote the blood circulation
Nourish the blood
Promote the circulation of both the blood and qi
As we can see, the main actions of the herbs in the formula are either to tonify the blood or to promote the blood circulation. Since si wu tang can clinically be used to treat patients with blood deficiency or blood stasis, I would describe the actions of this formula as tonifying the blood and promoting blood circulation.
Question #5: Are there other important formulas you can clarify by a more careful description of their actions?
Answer: Yes, there are many important formulas that I can clarify by a more careful description of their actions. Since the space here is limited, I only mention 10 of them as follows:
1. Ma huang tang (Formulas and Strategies by Bensky and Barolet, p. 33):
Dispel pathogenic wind-cold from the body surface by causing perspiration, and disperse the lung qi to stop wheezing.
2. Gui zhi tang (Formulas and Strategies, p. 35):
Dispel pathogenic wind-cold from the superficial muscle layer and body surface, and restore the balance between the defensive qi and the body fluids to stop spontaneous perspiration.
3. Ma xing shi gan tang (Formulas and Strategies, p. 88):
Acridly and coolly disperse the lung qi, and clear away the heat to stop wheezing.
4. Huang long tang (Formulas and Strategies, p. 122):
Swiftly promote bowel movements to release constipation due to accumulation of the heat, enrich the qi and nourish the blood.
5. Xiao chai hu tang (Formulas and Strategies, p. 136):
Disperse and clear away the pathogenic heat from the foot shao-yang channel.
6. Hao qin qing dan tang (Formulas and Strategies, p. 141):
Clear away the heat and eliminate the dampness from the Gallbladder channel, and regulate the stomach qi to resolve the phlegm.
7. Xiao yao san (Formulas and Strategies, p. 141):
Promote the flow of liver qi to remove accumulated qi within the liver, and nourish the blood to strengthen the spleen.
8. Tong xie yao fang (Formulas and Strategies, p. 149):
Enrich the spleen function and reduce the excess due to dysfunction of the liver, and resolve the dampness to stop diarrhea.
9. Si ni tang (Formulas and Strategies, p. 226):
Rescue the dying caused by deficient kidney-yang with pathogenic Cold entering the shao yin channel.
10. Zhi gan cao tang (Formulas and Strategies, p. 257):
Moisten the heart yin, nourish the heart blood, enrich the heart qi and warm the heart tang to restore normal pulse and stop palpitation.