Does Chinese medicine have the idea of “local medicines for local diseases?”
By Eric Brand
Western herbal medicine and Chinese herbal medicine have some intriguing overlapping theories, despite their dramatic differences. Both systems find common ground in ideas such as the “doctrine of signatures,” or the idea that the appearance of a substance sometimes offers clues as to its action on the body. Similarly, Western herbal medicine historically had a concept of heat and cold as they relate to herbs; for example, it was said that “ginger is hot in the third degree.” How much do the theories of these traditions overlap?
Clearly, Chinese and Western herbal medicine have dramatically different cultural and historical origins, yet they share some things in common. Many medicinal plants are common to both traditions; sometimes these items are used for similar indications, sometimes they are used completely differently. The same could be said for items that overlap in Ayurveda or Tibetan medicine. Plants do not read books nor do they have political affiliations, so it is particularly meaningful when multiple cultures see the same potential in a given plant (as in the case of ginger being warming and good for common cold). Likewise, it is particularly intriguing when the same plant is used for totally different things depending on the theoretical lens through which it is viewed (the dramatic differences between the use of He Zi between TCM and Ayurveda is a good example of this).
In the past, we have blogged about ideas related to Chinese and Western herbs, such as our recent blog on the TCM actions of nettles, or our earlier blog on the TCM actions of valerian. We’ve talked about growing Chinese herbs in the West, and we’ve covered other hot topics such as Siberian ginseng.
One question that frequently comes up in the East-meets-West discussion is the question of “local medicines for local diseases.” Many people that study Western herbal medicine have been exposed to the concept that the plants that exist naturally in a given ecosystem are well-suited to treating the people and problems of that ecosystem. I’m not sure if this is an orthodox theory or just a folk medicine idea, but it is prominent in discussions. Does Chinese medicine share a similar idea?
I can’t really speak with any authority on this subject, but in general I find relatively little evidence to support the idea that Chinese herbal medicine has an endemic concept that matches this theory. There are, however, many regional trends in Chinese herbalism that illustrate that people tend to prize items that are suited for diseases of their ecosystem. For example, hot places tend to prize cooling agents, and damp places tend to like spicy foods. However, ancient texts also utilize a wide number of herbs that came from far and wide, and the influence of trade and China’s long history of seeking exceptional medicines from all ecosystems make it hard to say whether this concept ever existed historically in TCM.
If we look at early texts such as the Shang Han Lun (“On Cold Damage,” written around 200 C.E.), we find evidence of many items that came from outside the author Zhang Zhong-Jing’s local environment. For example, Huang Lian and Fu Zi came from Sichuan and cinnamon came from southern regions like Guangxi or Vietnam. The presence of these agents in Zhang’s formulas illustrates the vast nature of the ancient Chinese empire and its sophistication with trade. The development of a unified system of writing, money, weights and measures gave the ancient Chinese an unprecedented trading advantage because communication and trade was possible across a wide region in the absence of a shared spoken language. If we look at Zhang’s prescriptions, one could argue that the selection of medicinals was based on which item was the best for a given therapeutic effect, with minimal regard to whether or not the plant came from the local ecosystem.
Nonetheless, we do find ample evidence of regional trends that center on given therapeutic principles. Most of these trends have to do with heat and cold, and illustrate the general Chinese cultural desire to balance the body’s temperature to suit the weather and environment. For example, in Taiwan watermelon and mung bean shakes dominate the summertime beverage selection, while hot ginger tea and longan drinks are favorites to beat the cold-damp winter. A local herb called Xian Cao (Mesonae Herba) is used to make a gelatin snack that is eaten for its flavor and cooling effect, and many household recipes for Qing Cao Cha (lit. “Green Herb Tea”) incorporate a variety of local cooling herbs to beat the summer heat.
In Hong Kong and Guangzhou, heat-clearing is taken to an art form. Gui Ling Gao, a gelatin made from turtle shells and Tu Fu Ling is a common street snack for general health and avoidance of damp-heat and summerheat. Cooling, yin-supplementing items like Shi Hu, Chuan Bei Mu, and Xi Yang Shen are mainstays of the Cantonese herbal environment, and a wide range of heat-clearing items like Xia Ku Cao, Sang Ye, Ju Hua, and Ji Gu Cao are prominent to the point that they can be found bottled up by Coca-Cola in 7-11s.
If we look at Sichuan and Hunan, the locals beat the damp, cloudy environment by favoring chili and acrid spices. Sichuan food is characterized by “ma la” flavor, which literally translates to “numbing and spicy,” a combination created by pairing Sichuan peppercorns (Hua Jiao) with chili peppers (La Jiao). By contrast, Hunan food is not numbing, just very spicy (“xiang la,” fragrant and spicy). In these regions, people often comment that the local diet is acrid and spicy because the local climate is so damp and oppressive.
Thus, there is clear evidence that principles of Chinese medicine have influenced culture to the point that laypeople choose their foodstuffs based on what items are thought to fit the environment. But the foodstuffs themselves come from far and wide, apparently with little regard as to whether they are natively produced or not. That said, the idea of regional food specialties is huge in China, and certainly there is a great cultural focus on eating things that can only be found in a certain area. However, I haven’t yet found anything that would convince me that Chinese medicine has an idea that parallels the Western concept of “local medicines for local diseases.” If anyone has any insight to add, please write us a comment because I’d love to round out my ideas with some new perspectives or evidence!