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— updated 2001-01-09

ANSWERS to: Test your knowledge of common herbs, clinical herbalism

Clinical TCM herbalism, quiz answers. Traditional Chinese health assessment (TCM) terminology (capitalized terms, i.e., "Deficiency of Yin") is used in the following answers and explanations, to show you how these terms help differentiate between beneficial and contraindicated (not-to-be-used) herbs. These examples also illustrate the importance and usefulness of inspecting the tongue (tissue color, presence or absence of fissures, coating color and thickness) to differentiate patterns of health imbalance.

by Roger W. Wicke, Ph.D.

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Copyright ©1996 by RMH-Publications Trust; all rights reserved.






1. B, D.

  • Conditions B and D are two types of Interior Heat, for which fresh ginger is contraindicated because of its warm and spicy nature. Condition B is called Damp Heat of Middle and Lower Burner.
  • Condition D is Deficiency of Stomach Yin. Fresh ginger used here would actually aggravate the nausea because this pattern is characterized by excessive dryness of the Stomach, and spicy warm herbs will tend to aggravate dry and inflamed mucosae.
  • Condition A is Liver Invading Spleen, and is a combination of Stagnation of Liver Qi plus Deficiency of Spleen Qi; for this condition, fresh ginger would help to harmonize the Spleen to relieve the nausea.
  • Condition C is Dampness of the Spleen, and fresh ginger would also alleviate the nausea of this pattern.

2. C, D.

3. A, B.

  • Arthritic symptoms are usually characterized by Stagnation of Qi and Blood, which accounts for the localized pain. All of the herbs listed have been used in various contexts for improving circulation of Qi and Blood. However, the woman's other major pattern is one of Deficiency of Yin which usually manifests as symptoms and clinical signs of dehydration and a tendency to feel excesively warm.
  • Warm, spicy herbs like cayenne and dry ginger would severely aggravate her overall condition, and may even aggravate the inflammation to which Yin-Deficiency arthritis is prone.
  • Gingko leaf and salvia, while also useful for improving blood micro-circulation, are cooler in property with a milder taste, and are much more compatible with the need to protect the woman's Yin.

4. D.

5. A.

6. C.

  • Tonic herbs should generally not be given to people with Excess (as contrasted with Deficiency, or depleted) conditions. ("Tonic" is used somewhat more narrowly in TCM usage than in Western herbology; rather than mean something that improves general Organ function, it is used to label herbs that help restore depleted nutrients.) This man really needs something to relieve, reduce, and clear out his abdominal bloating; this is what is meant by Excess in this case. You don't relieve an Excess condition by adding nutrients to it; that only aggravates the quality of Stagnation.
  • Rehmannia is a thick-tasting, sweet and moistening herb that tonifies Blood and Yin, and some people have difficulty digesting it, especially when taken as a single herb without "helpers". It is the opposite of what is needed here. Yet imagine the confusion of a health-food-store customer who reads the label on a product containing Rehmannia that says "an invigorating tonic". Such vagaries frequently get people into trouble. (Unfortunately, in the past the FDA has prohibited labelling that might educate herb users about the specific uses and contraindications.)
  • Likewise, ginseng tonifies the Qi, and would be useful for a person who has fatigue accompanied by pale complexion, poor appetite, and who has NO signs of Excess, such as abdominal distention, greasy tongue coating, etc.
  • Ephedra is a potent stimulant, analogous to caffeinated beverages, and, like coffee, gives people a buzz or rush of "energy". Longterm use, however, often leads to exhaustion. Ephedra is used by properly trained Chinese herbalists only to assist in opening the Lung Qi (as in asthma or other respiratory conditions with impeded breathing) and promoting sweating, as in the onset of chills and fever when the person does not sweat at all. When used improperly, it may lead to side-effects of palpitations, excessive sweating, nervousness, and tachycardia. Its use in health-food store "energy" supplements is grossly irresponsible and misleading, and eventually gives herbalists a bad reputation.
  • Daikon radish is spicy and warm, and strongly disperses digestive Qi, making it useful for stagnancy of digestive Qi due to excessive or improper consumption of foods.
  • Rhubarb root, a potent bowel purgative, is more appropriate for clearing Excess Heat from the body when accompanied by Intestinal Stagnation. Its purgative property might be useful in this case, but it's cold nature make it inappropriate, because the man already has a tendency toward Interior Cold, as suggested by his pale tongue tissue. Rhubarb root in such cases might provide temporary relief, if at all, at the risk of causing poor appetite and digestion.

7. A.

8. B, C.

9. D.

  • This pattern is one of Deficiency of Qi with Dampness (fatigue, pale tongue, greasy tongue coat, abdominal bloating) accompanied by sluggish intestinal peristalsis. The ideal herb choice for such a condition would be warm and spicy to help activate the Qi, but without depleting it. Certain of the more expensive grades of magnolia bark help to both activate Intestinal Qi and tonify the Spleen Qi (improve energy level, appetite, and stimulate digestive function); the lesser grades of magnolia bark predominantly help to circulate Stomach and Intestinal Qi.
  • Rhubarb root and senna are both strong purgatives with bitter-cold natures, and would risk depleting the Qi and cooling the Middle Burner Fire excessively. TCM theory describes the digestive function (Middle Burner) as being like a pot of rice cooking; the heat musty be adequate or the food will not be cooked. Intuitively, this should help you understand why many culinary spices and herbs are warm in property (ginger, pepper, cloves, allspice, cumin, etc.).
  • Prune juice is more appropriate for people with dry constipation due to Fluid Deficiency. It has a sweet moistening nature, and is inappropriate for Interior Damp conditions. This is why sweet fruit juices may aggravate candidiasis and other conditions characterized by pathogenic growth of yeasts or yeast-like organisms. In such conditions, the prune juice may temporarily increase bowel flow, while aggravating farting and abdominal distention.
 

Back to TEST YOUR KNOWLEDGE of herbs (questions).


To learn more

If you would like to learn more about the traditional Chinese method of analyzing and assessing patterns of health imbalance, see:

  • How to choose herbs using methods of Chinese herbology. Choosing herbs can often be a haphazard endeavor without some way to organize and make sense of the huge amount of information available to us. Find out how the traditional Chinese herbal sciences help us to choose herbs more precisely, without side effects.
  • HerbalThink-TCM: (self-study reference and self-quizzing software) for more information and how to order.
  • Traditional Chinese Herbal Sciences program curriculum. An intensive educational program for working health professionals who cannot relocate for full-time study. Clinical-case-oriented. Appropriate for acupuncturists and other health care providers preparing for professional certification exams.

References

  • Wicke, Roger; Traditional Chinese Herbal Science: volume 2, Herbs, Strategies and Case Studies (4th edition); Rocky Mountain Herbal Institute, Hot Springs, Montana, c1994.
  • Chinese Herbal Medicine: Materia Medica; Dan Bensky and Andrew Gamble, ed.; Eastland Press, Seattle, c1986.
  • A Clinical Guide to Chinese Herbs and Formulae; by Chen Song Yu and Li Fei, transl. by Jin Hui De; Churchill Livingstone, c1993.
  • Yeung, Him-che; Handbook of Chinese Herbal Formulas, vol. 1 [materia medica] and vol. 2 [formulas]; Los Angeles, c1983.