Salvia
Persica
Red peony
Cnidium
Carthamus
Crataegus
ORIENTAL PERSPECTIVES ON CARDIOVASCULAR DISEASES AND THEIR TREATMENT
Cardiovascular diseases encompass an immense category of disorders, because many things can go wrong with the heart and blood vessels. Nonetheless, it is a rather common classification term for the primary cause of death in the U.S. and in most countries. Cardiovascular diseases often involve accumulation (plaques in the arteries) and stagnated circulation (platelet stickiness, clots of blood, and restricted passage of blood through the arteries either by hypertensive constriction or plaques). The other major cause of death in the U.S., cancer, also involves accumulation (more rapid, with tumors rather than plaques) and increased stickiness of the blood.
It is well-known that major contributors to cardiovascular disease are diet (especially from a high fat and low fiber diet) and stress (especially low-exercise emotional tension). Persons who move from a part of the world with low incidence of cardiovascular disease to a part of the world with high incidence of this category of disease soon experience the higher risk themselves.
The Oriental view of cardiovascular diseases and their causes is influenced by certain circumstances in the Chinese culture which led to very low incidence of such diseases until quite recently. Modernization has thrust the hearts and vessels of the Chinese people into a condition not much different than their Western counterparts who have been suffering from cardiovascular problems for the past century.
Unlike the West, and until very recently, the Chinese diet was free of dairy products (which have been uniformly high in fat, until the recent introduction of fat-reduced products) and was generally low in all sources of fats, especially low in animal fats. Obesity was rare, and most people labored, which provides exercise, and cardiovascular disease was therefore very rare.
Cardiovascular disease is now a major topic of concern among Oriental doctors: not only because the people are exposed to more of the same disease-causing dietary and life style factors. Also, Chinese researchers have made a concerted effort to interest Westerners in their medical techniques, by focusing on this highly publicized health problem of the West.
Although many significant details about cardiovascular diseases have been elucidated by modern research efforts, an easily-understood designation for these problems is "poor circulation." Much of the work done in China with traditional methods of herbal prescribing has focused on the use of herbs that are said to promote normal circulation.
To treat poor circulation, there are two primary considerations. First, the blood flow can be sluggish because the vessels are contracted and/or the blood is sticky-there are herbs that simultaneously address both these conditions. Second, the blood flow can be restricted by the presence of excess fats, either circulating in the blood or attached to the vessel walls (plaques). Fat is considered by Chinese doctors to be in the same category as phlegm, because it is a thick soft, material.
The dominant herb in modern therapies for cardiovascular disease in China is salvia. This is the root of a Chinese "sage" plant, Salvia miltiorrhiza, of which the root is used. The Chinese name for it, danshen, indicates the color of the root, like the mineral cinnabar (a purplish red color), and the term shen suggests that it has an extraordinary effect (this is the same term used to describe sophora roots-kushen-which are used in cancer therapy and to treat infections).
It has been shown that salvia helps to reduce platelet aggregation (sticking of blood cells that can form artery-blocking clots), reduces the tension in the arteries (thus causing them to dilate, or open wider to allow blood cells to pass), and promotes the cardiac action (thus better pumping of the blood). The active components are a group of quinones, compounds of structure similar to a nutrient factor widely used in treating cardiovascular diseases-coenzyme Q10 (ubiquinone; so-named because it is ubiquitous, everywhere).
Two other herbs are especially noteworthy in regard to cardiac circulation. First, there is peony root. There are two species. One is called white peony, the Chinese name being baishao (bai = white; shao = peony), and the other is called wild peony or red peony, named chishao (chi = red; the color designations do not refer to the flower colors but to the relative colors of the root materials that are used for making the medicines).
Like salvia, the peony species reduce platelet aggregation and relax blood vessels, causing dilation and easier flow of blood (stress reaction causes the muscles surrounding the blood vessels to tighten, causing the pressure of the blood within the vessels to increase; this reaction is mediated by chemical messengers that are released under certain conditions). The white peony has a moderate taste that can be easily manipulated by other ingredients in a blend; it has been used in ancient Chinese cooking to make a sauce and in modern Chinese manufacturing to produce "Shaolin cola," a beverage tasting remarkably like the American cola drinks but having the purported advantage of promoting heart health.
The other herb of special interest is carthamus, honghua (hong = red: it is more commonly used to designate red than chi; hua = flower) which is known in the West (where the seeds are used as a food and a source of cooking oil) as safflower. The flower promotes the circulation of blood, helps reduce blood lipids, and breaks up blood clots.
According to Chinese doctrine, the motive force behind the blood circulation is the essential energy called qi (see the article Oriental perspectives on cancer for more about this concept). That is, if the qi is weak, the blood circulation can not be vigorous. Therefore, when the blood circulation is impaired, Chinese doctors try to overcome this by "loosening up" the blood, with the herbs just described, and by invigorating its circulation, using herbs that strengthen the qi. The two main herbs for this latter purpose include astragalus, well-known for its ability to enhance immune functions, and codonopsis, a root known to the Chinese as dangshen (dang refers to the original source of the herb in China, Shang Dang, and shen is the same term used in describing salvia and sophora; it has the meaning of being an herb of extraordinary effects).
Codonopsis is a substitute herb for the rarer and more costly ginseng, which may be used when it is available and afforded. Ginseng is known as renshen, or the herb of extraordinary effect that has the essence of man (ren = man; as in the generic meaning, human). The effect of qi tonic herbs are enhanced by using a small amount of licorice, which is itself a qi tonic.
To take a short detour, it may be of interest here to point out that Chinese doctors have asserted that there is an association with herb color and its particular actions. For example, several herbs with a reddish coloration-salvia, peony, and carthamus-promote the normal functions of the heart and invigorate the circulation of blood. The primary organ system for generating qi is called the spleen system, and herbs that have a yellowish color (ginseng, codonopsis, astragalus, licorice) promote the function of the system and boost the qi. While the association of herb color and herbal effect is certainly not universal (there are as many exceptions as cases that follow the rule), it is remarkable to see a collection of herbs that addresses each of the organ systems recognized by Chinese doctors and to observe the tendency of a certain color of the herbs to be dominant. Ginseng can be processed with other herbs to transform its color to red; it then becomes a superior treatment for disorders of the heart, yet it retains its essential nature as a tonic for the spleen system.
Chinese doctors can detect the problem of insufficient qi by feeling the pulse at the wrist (in such cases, it will feel quite weak compared to that of a healthy person), and by certain symptoms, such as general weakness (the weak pulse reflects this broader symptom) or becoming easily fatigued. In addition, it is common for the tongue of a person with qi deficiency to take on a bloated appearance, and one will see indentations along the edge where it has pressed against the teeth.
If as a result of using the blood circulating herb the blood becomes less sticky, and the vessels are less tightly constricted, and if through the use of qi tonic herbs the movement within the vessels is invigorated, then the person will no longer suffer from poor circulation-unless there is obstruction of the circulation by accumulated fatty masses.
The Chinese term "tan" (pronounced as tann) refers to thick fluids; in the medical field, the term is applied to mucus, fat, and substances of similar nature. A portion of this material is absolutely necessary for health, but it is also possible for too much to accumulate, in which case, it contributes to diseases and symptoms. The translated term is "phlegm," though this may not convey its meaning very well.
The ancient Chinese had developed a concept that "tan" spreads through the body as a fine mist, but under various pathological influences, the mist could obstruct the blood vessels and the "orifice of the heart," which is the connection between the physical body and the mind, the spiritual center. Today, we know that people with cardiovascular disease are susceptible to brain circulation problems, including stroke, poor memory, and dementia, and we also know that the outer membrane of the brain and nerve cells-a thick fatty material-is critical to proper function of the central nervous system. Modern medicine, which generally places the mind in the realm of the brain, has not yet elucidated the relationship of mind and the physical body. According to the Chinese concept, the effect of the "tan" mist occurring in excess is not only to obstruct the circulation of blood, but also to derange the normal functions of the mind. Hence, in modern terms, the "tan" disturbs the brain and central nervous system.
The fatty mist can arise from a few sources. First and foremost, there are fatty substances in the diet. If not completely digested, utilized, and eliminated, these can lead to harmful fat in the circulatory system and dispersed throughout the body. The digestion of these fats depends on the complete degradation of food by the stomach before it is sent to the small intestine, and then by the influence of bile secreted by the gallbladder. Bile forms complexes with the fats to make them easily assimilable. Persons with disorders of stomach or gallbladder functions may fail to properly process the fats, leading to the "tan" mist.
Two of the most favored substances for resolving the mist are of animal origin. There is the highly aromatic secretion of the musk deer, which we call musk and the Chinese call shexiang (she = strong, xiang = fragrance). It is the same material used in perfumes (since it is secreted by the male deer to attract the female, it is especially used in fragrances for men). There is not a large supply of this natural material, so synthetic replacements have been developed, mainly the chemical muscone, which is used both in perfumery and medicine. According to some laboratory and clinical trials of medicines, the synthetic compound works about the same as the original.
The powerful aromatic nature of the musk is deemed to be penetrating-it can thus enter the thickened fluid and help it dissolve. Musk also opens the vessels. It is shown to stimulate the nervous system, relax the blood vessels, and improve the circulation.
The other substance commonly favored is the gallstone of the water buffalo, or ox gallstone, which is called by the Chinese niuhuang (niu = ox, huang = yellow; the color of pure ox bile is yellow). The gallstones are more prevalent in oxen in Africa than in China, so many are imported from there, but the gallstones formed in American cattle are the brightest yellow and thus bring the highest price (African gallstones tend to be black). Still, there aren't many gallstones found in ox, so two methods have been developed to get more. Just like oysters are seeded to produce pearls, ox gallbladders can be seeded to produce stones (material must be injected into the gallbladder). Easier still, simple bile from ox gallbladders is mixed with various minerals to produce "man-made ox gallstone," (rengong niuhuang; ren = man, gong = to make) and this is currently used in producing most of the medicines in China that include ox gallstone. The material is quite valuable, and there have been news articles in the Chinese press about the arrests of people involved in faking the fake ox gallstone. The bile acids in the ox gallstone promote the functions of the gallbladder of those who ingest it, and the minerals also contribute to aiding the digestion of the fats that have caused a problem.
These two aromatic substances were originally used to treat the mist of the heart orifice that connects to the mind: utilized in therapies for coma and for extreme mental disease. Modern doctors have expanded the use of these substances to treat the obstruction of the blood carrying vessels. For example, a prepared formula Niuhuang Jiangya Wan (jiang = to lower, ya = blood pressure, wan = pills), is a modern preparation made with musk and ox gallstone, which won an award in China for its beneficial effects on cardiovascular patients.
There are also some plants that yield mist-resolving materials. One of the most fragrant plant substances is a camphorous crystal, called Borneo camphor, or borneol (named for its original source: the island of Borneo). Today, it is obtained from several plants; the Chinese call it bingpian (bing = ice, pian = slice; referring to its appearance, like a flat slice of ice). Its aromatic quality measures up well to that of musk and its influences are similar. Aromatic resins from various Styrax trees, also give rise to medicines for this purpose. One of the resins is a substance commonly used in the West, because it acts as a preservative, known as benzoin. The other, simply called styrax, is very high in a fragrant derivative of cinnamic acid-related to the spicy component of cinnamon. The Chinese name for styrax is suhexiang (su = from Vietnam, he = closed, xiang = fragrant); it is so-named because this fragrant material from Vietnam is used to treat severe obstruction or closure of the orifice.
Two other herbs are frequently relied on for relieving obstruction. One of these is called acorus. There are two species. Acorus gramineus is the more commonly used; it contains an essential oil rich in asarone, a very penetrating fragrant compound. The other is Acorus calamus, an herb that has been used by the American Indians to treat digestive disorders. This latter herb is somewhat toxic, and is usually not taken internally. These varieties are distinguished in their naming, the former is shichangpu (shi = stone) and the latter is shuichangpu (shui = water), making reference to the environment in which the plants grow (pu refers to the long narrow leaves like those used for weaving into mats). The other herb, usually combined with acorus in modern Chinese prescriptions, is called polygala. The Chinese name for it, yuanzhi, indicates that it benefits the mind (yuan = greater, zhi = memory), increasing wisdom.
When properly combined with other ingredients, these herbs for controlling the phlegm-mist are used for neurologic disorders that include fainting, loss of sensory acuity, paralysis, and convulsion. They may also address problems of severe mental distress such as deep depression and mania, or for mental deterioration associated with aging, such as loss of memory (Alzheimer's disease), Parkinson's disease, and confusion.
As was already mentioned, salvia and peony can relax the muscles surrounding the blood vessels, allowing the vessels to expand, and thereby lowering blood pressure. However, the primary role for these herbs in most cardiovascular formulas is to enhance the ability of blood cells to more easily traverse the primary vessels by reducing their stickiness. Chinese doctors have discovered some other herbs that are especially effective at lowering the pressure within vessels via an antispasmodic action affecting the vessel muscles.
It should be noted that hypertension is difficult to detect without use of the blood pressure cuff, which was unavailable to Chinese doctors prior to this century. Therefore, treatment of hypertension by Chinese medicine is a relatively new area of interest.
There are two fundamental types of hypertension. The most common, called essential hypertension, is a stress reaction which causes the vessels to contract, thus increasing the pressure within them, just as one can build up pressure in a water hose by squeezing it into a smaller diameter. This type of hypertension tends to be quite variable. Blood pressure builds up further during especially stressful times, and goes down somewhat during times of calmness. It has been shown that meditation, biofeedback, massage, and other relaxation methods help with this type of hypertensive problem. Persons who experience the stress reactions chronically may eventually develop hypertension that only moderately remits during periods of relative relaxation (e.g., when on vacation).
According to traditional Chinese medical thought, muscular tension, such as that which contracts the arteries, is a response to an internal phenomenon known poetically as "wind." It takes on this name for a number of reasons, but especially because wind can come up suddenly and it is erratic, as are certain disease symptoms, and because a person who is exposed to windy weather (without adequate protective clothing) will feel their muscles tighten up. Since the external wind (an environmental phenomenon) causes variable symptoms and muscular contraction, internal forces (e.g., emotions, stress reactions to events, etc.) that cause variable symptoms and muscular contraction are called "internal wind." Just as the wind gusts, the variable hypertension being considered here is surges at times of stress.
Describing internal processes with the same terms as environmental phenomena is an important part of Chinese medical thinking. According to the most ancient ideas, the human body is no more and no less than an integral part of the environment in which it exists. Though we have a boundary of skin separating the inside from the outside, in fact, the working of the inner body and the working of the outer world is the same and the influence of the environment on the body is continual. In ancient China, it was also thought that the actions of mankind could influence the environment. Since man's representative (from the Chinese perspective) was the Emperor, the actions of the Emperor were thought to determine, among other things, the weather, the fertility of the land, and the occurrence of earthquakes. If the environment became especially hostile, it would be taken as a sign that the Emperor had lost his mandate from heaven, was internally in turmoil, and would be replaced during the course of subsequent events.
Herbs that calm the internal wind are those that relax muscular spasms and convulsions. Since it is possible for tightening of muscles to proceed so far that one can not move (known as tonic paralysis), some cases of paralysis are also treated by these herbs.
There are two key plant materials for inhibiting internal wind. One is the hooked vine called uncaria, which the Chinese call gouteng (gou = hook, teng = vine). The sharp, curled hooks have long been deemed the most effective part, and it has been said that using them is like being able to hook tension and pain within the body and carry it out. Modern research confirms that the amount of the active component, an alkaloid called ryncophylline, is most concentrated in these hooks. The herb is traditionally used to treat nervousness and convulsions, and the isolated active component has been shown to do the same. It strongly lowers blood pressure that is due to vascular tension.
The other herb is obtained from the rhizome (rhizomes are the storage portion of plants, potatoes are a typical example, and they usually are high in starch), of gastrodia, which the Chinese call tianma (tian = heavenly, ma = hemp). Like uncaria, it was used traditionally to treat erratic conditions such as headache, dizziness, and convulsions. There is an interesting story about this plant. When its hypotensive (blood pressure lowering) properties were discovered several years ago, the herb became quite popular. The availability of the plant was limited, however, driving the price very high. Vigorous attempts to cultivate it in order to get adequate supplies were all unsuccessful. After long research, however, it was discovered that this plant only grows if it is cultured together with a symbiotic fungus, Armillaria. In such symbiotic relations, the plant provides essential nutrients to the fungus and the fungus provides essential nutrients to the plant. It thus became possible to cultivate gastrodia by combining the two. Further research showed that the active component for "calming internal wind" was, in fact, a component of the fungus. Therefore, one could grow the fungus in batch culture (a laboratory method in which a nutrient broth and temperature control can yield huge amounts in a relatively short time) and make it into tablets for medicinal purposes. This material is called mihuanjun (mi = dense, huan = ring, jun = mushroom; referring to the dense ring of mushroom mycelia that grows on the culture medium). Gastrodia and armillaria are now used as remedies for hypertension, alone or in complex formulas; armillaria is the more potent. These materials increase coronary and cerebral blood flow by reducing vascular resistance; they are used for treating vascular headaches as well.
Several animal substances are used to treat hypertension. Before describing these, it is worth pausing here and describing the role of animal medicines in the realm of Chinese herbalism. The term we use, "Chinese herbs," is a translation of the Chinese zhongyiyao. The word is comprised of three parts, zhong, comes from zhongguo, meaning central country, the name for China. Yi refers to the practice of medicine. For example, Western medicine is called xiyi (xi = Western). Yao refers to medicinal materials, the medicines themselves. Thus, "Chinese herbs" means materials used in the practice of Chinese medicine. There is no reference to any limitation of the source of materials, as might be conveyed by the term "herb" in English. In an attempt to make "herbs" seem more fitted to modern medicine, Western herbalists have called them phytomedicines (phyto = from plants) or other designations which suggest a plant nature, because most modern Western herbalists develop their art from an enthusiasm for plants. This is quite different than the situation in China.
Among the medicinal materials used by Chinese doctors over the centuries are those of plant, mineral, and animal origin. About 20% of the materials listed in Chinese medical books, whether an ancient reference from 2,000 years ago, or a modern one published last year, are derived from animals. Further, it is explained by Chinese doctors that since animals have a nature which is like that of humans, they are especially helpful in treating human-type problems: that is, problems which involve the muscles, nerves, and mind (as opposed to universal biological problems, such as infection, reactions to cold or hot weather, or physical injury). Two such substances mentioned already are ox gallstone and musk.
In the case of treatments for internal wind, there are two groups of animal substances used. One group is comprised of small creatures (Chinese: chong) that contain inhibitors of the nervous system. The method corresponds, very roughly, to the Western medical treatments using beta blockers (there are two nerve transmission systems labeled alpha and beta, these drugs block transmission of the beta system; a side-effect of such drugs is to lower other tension responses in the body, reducing sexual tension and overall sense of liveliness). Scorpions, centipedes, and earthworms all contain nervous system inhibitors. Scorpions and centipedes have toxic components, which injected into the body (by the insect or any other means) is quite dangerous, but when taken orally is safe. Earthworms contain substances that are non-toxic, and produce the blood pressure lowering effect through an indirect inhibition of the nervous system agitation that causes the hypertension. An advantage of these herbal compounds is that they do not produce the undesired side-effects of beta blockers.
The other animal substances are those rich in mineral components, especially calcium, which has a spasm-relieving action if the person being treated has low levels of calcium. Nutritional studies have shown that many Americans, perhaps the majority, have some degree of calcium deficiency, and this deficiency tends to worsen with age. It is a public health problem due to a combination of inadequate ingestion of the mineral coupled with poor absorption. Of the calcium sources used by Chinese doctors for treating hypertension, the most frequently relied upon item is haliotis, the shell of the abalone. The Chinese name for this material, shijueming, means the stone that brings brightness, and this is because another effect of using it is to clarify vision (an extract of haliotis, or some of the other sea materials rich in calcium, applied to the eyes of those suffering from cataracts will help to reduce the opacity of the cataracts). Sea shells are rich sources of calcium carbonates; oyster shell is often used as a nutritional resource and a Chinese medicine. In a similar way, the shells of turtles and tortoises, which are rich in both calcium carbonate and calcium phosphate, are used in some treatments for hypertension. It is likely that the tough proteins in the shells of these animals also contribute some of the hypotensive effect. Another calcium-rich material used by Chinese doctors is called dragon bone. It is actually the fossilized remains of various animals found in vast pits in certain parts of China. Like other fossils, they contain mostly calcium carbonate.
The second type of hypertension is one in which there is relatively little reduction of pressure accomplished through relaxation. One of the main causes of this type of hypertension is a failure of the kidney to remove water from the blood vessels, and the condition is called renal hypertension (renal = kidney). Even if the muscles surrounding the blood vessels are quite relaxed, the pressure within the vessels doesn't go down because the fluid content is too high. Diuretic drugs are often tried in such cases, but they often function for only a short time, until the body gets used to their presence, and then the hypertension returns.
From the Oriental viewpoint, there are several considerations that lead to developing a therapy for kidney problems. First, the kidneys are clearly failing to do their job of passing water to the bladder. Applying diuretic drugs will usually produce only a temporary benefit because they do not resolve the specific problem: poor blood circulation through the kidneys. Therefore, the Chinese medical treatment is to improve the overall kidney function and to enhance the circulation through the kidneys.
Treating the kidneys has a different meaning in the West and in the Orient. Western physicians focus their attention on the paired small organs that have been carefully analyzed and defined through microscopic and biochemical methods. Chinese physicians have been dealing with "kidney problems" for many centuries and they've done so without the assistance of any detailed analysis of the physical tissues. They have described a kidney system which is defined by functional attributes. It is much broader than that defined by the modern analysis. As an example, the kidney is seen as extending from the small tissues in the lower back to include the spinal cord and brain, the reproductive organs, and the bone marrow. As a result, the functions of the kidney described by Chinese doctors extend far beyond those defined by modern medicine.
Treatments for this broad kidney system are described differently than for the narrower "Western kidney." Describing the Oriental kidney system and the treatments for it in Western terms is one of the major undertakings of researchers in China. While much progress has been made, there is still much more work to be done and the implications may have a strong impact on the future of medical practice, both East and West.
For purposes of this section, the issue can be limited to a brief discussion of a treatment for the kidney system that was first described nearly two thousand years ago and is still used today. In an ancient text Prescriptions from the Golden Cabinet (Jin Gui Yao Lue), there is a formula called Ba Wei Di Huang Wan, meaning the Eight Ingredients Rehmannia Pill (rehmannia is the leading herb in the formulation of eight ingredients, usually prepared as a pill). This formula is so central to the practice of traditional Chinese medicine that it is also called "Golden Book Pill" (the main formula from the book called Golden Cabinet). In this ancient book about difficult-to-treat diseases, the Rehmannia Pill is described as having several applications, including "weakness and fatigue, lower back pain, and limited urination, water stagnancy that has to be eliminated through urination, and shift of the bladder that makes the patient incapable of urinating."
This formulation is not a simple diuretic. In fact, in the same book, it is described also as a treatment for frequent urge to urinate or frequent urination. It is a formula designed to restore the normal functions of the kidney system. The herb rehmannia is a heavy, rich tasting root, used in the majority of formulations, old and new, for treating the kidney system.
By combining the Golden Book Pill with herbs for invigorating the circulation of blood (e.g., salvia, red peony), one can begin to treat the renal hypertension. This type of disorder, which develops over a long period of time and is quite serious, must be treated for a long time in order to get some results. Even successful treatment with herbs may not be able to fully restore normal blood pressure, but it can help the individual lower the risks associated with constant very high blood pressure. Fortunately, gastrodia and amallaria have been found useful in treating renal hypertension as well as the vascular tension described above.
A heart which is exhausted, like a locomotive engine which has gone cold, leaves the blood circulation to the forces of gravity and osmosis. Water leaks from the vessels and causes edema, especially swelling of the legs; moisture may penetrate the lungs, to cause difficult breathing (cardiac asthma). In response to this type of disorder, Chinese doctors try to fire-up the heart using herbs that are said to have a strong heating quality. One of the main ones for this purpose is aconite, which the Chinese call fuzi, referring to the fact that it is the branch root (the son, zi, of the main root) of the plant that is collected for this application.
Aconite is extremely toxic in its raw state. Even two grams of the raw root can produce life-threatening reactions. Raw aconite is used extensively in China, mainly for treating arthritis pain, and it is the primary cause of side-effects and death from using orally ingested medicinal herbs in that country (serious side effects of herb use are relatively rare and are mostly the result of allergic reaction to herbs given by injection, but there are a few toxic materials employed which can be dangerous if used without adequate precaution). The active components, alkaloids of the aconitine series, can stop the breathing at moderate dosage. However, Chinese herbalists learned more than 2,000 years ago to process the root to make it essentially non-toxic. The processing, which includes soaking the herb in water or vinegar or other solution to remove some of the components, and cooking it in a broth of herbs to oxidize the remaining alkaloids, produces a safe and effective remedy.
The processed aconite can be used in quantities of up to 12 grams (dry weight) per daily dose by oral ingestion. It is also used in some Chinese hospitals, by intravenous drip, to treat cardiac insufficiency. When making herbal formulas, aconite is often combined with ginger (the same material used today as a spice in cooking). The sun dried ginger root has a more warming impact on the body metabolism than the fresh ginger roots. Additional warming effects are obtained by using the bark of cinnamon, rich in the spicy cinnamaldehyde.
These warming herbs, aconite, dry ginger, and cinnamon bark, are used to recapture, restore, and invigorate the fundamental energy of the body, called yang. This is one half of the duo of yin and yang, which is a critical concept underlying most of Chinese medical doctrine. In simplistic terms, the yang aspect of the body is the unbridled activity; while the yin aspect of the body is the cooling, calming, fluid counterbalance to the activity. As a model, if one considers an engine, the igniting fuel is the yang which provides the entire energy of movement; the lubricating oil and cooling water are the yin that prevent the engine from overheating and grinding to a halt. Both are necessary to keep going.
With aging, the human body begins to lose some of its total yin and yang, which is the cause of lower overall activity of the individual organs and the body as a whole, and also the cause of the drying and withering of the body tissues and fluids. Depending on many factors, the yin or the yang may be relatively more depleted with age. The "cold heart" is an example of extreme depletion of yang.
The herb mentioned in the previous section, rehmannia, is an example of one which nourishes the yin. The Golden Book Pill (also known as the Rehmannia Eight Formula) includes a high dose of rehmannia, with a small dose of cinnamon bark and aconite, which reinforce the yang. These three herbs together help to restore the depleted yin and yang. The formula is thus thought of as an antiaging prescription because it corrects the depletion of yin and yang that naturally occurs with aging and that is accelerated by various habits, by environmental influences, and by diseases. Cardiovascular diseases are an example of problems associated with aging. In fact, modern studies indicate that virtually everyone experiences cardiovascular disease if they live past the age of 50. In China, it is recommended that people who wish to live long and healthy lives undertake certain practices after the age of 50: this includes daily ingestion of Rehmannia Eight Formula or one of the many prescriptions that have a similar nature.
Another formula for cold conditions is called Aconite Combination (it was formulated by the same physician who developed the Rehmannia Eight Formula). It is made of five herbs, three of them mentioned already in this article: aconite, ginseng, and peony; the other two herbs have the property of alleviating edema. There are many variants of this formula and each of them may be considered in the treatment of coronary insufficiency in persons who experience chilliness due to weakening of the yang.
It is beyond the scope of this article to deal with every cardiovascular disorder. Among the many problems that are medically encountered are irregularities in the heart rate (e.g., tachycardia and bradycardia), valvular problems (e.g., mitrial valve prolapse), blockage of the vessels in the legs (e.g., peripheral arterial occlusion, deep vein thrombosis), and Reynaud's syndrome (an autoimmune disease that causes very poor circulation to the fingers and toes). Each disorder is analyzed by a complete examination of symptoms and signs, and then treated according to the imbalance of yin and yang, the presence or absence of internal wind, by regulating the circulation of blood, and other procedures, most of them already described here.
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Salvia |
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Persica |
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Red peony |
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Cnidium |
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Carthamus |
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Crataegus |
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Astragalus |
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Ginseng |
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Codonopsis |
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Licorice |
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Musk |
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Styrax |
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Ox gallstone |
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Acorus |
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Borneol |
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Polygala |
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Uncaria |
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Haliotis |
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Armillaria |
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Tortoise shell |
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Earthworm |
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Turtle shell |
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Scorpion |
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Oyster shell |
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Centipede |
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Dragon bone |
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Gastrodia |
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| Aconite |
| Dry ginger |
| Cinnamon bark (or twig) |
| Rehmannia |
| Ophiopogon |