CHINESE HERBAL MEDICINE: MATERIA MEDICA 3RD EDITION
Compiled and translated by Dan Bensky, Steven Clavey, Erich Stoger with Andrew Gamble.
Eastland Press, hardback, 1311 pages
It is a credit to the pioneering work of the first 1986 edition of this book that ‘Bensky’ is established in the student lexicon as being synonymous with the Chinese herbal materia medica. This 3rd edition is the fruition of 6 years work by Dan Bensky, and his new collaborators Steven Clavey and Erich Stoger, to update, improve and maintain the ‘usefulness’ of the earlier versions. In the preface the principal changes are introduced as belonging to four categories: Each herbal entry now has new sections including a commentary, discussion of key combinations and comparison of related herbs. Steven Clavey was primarily responsible for these inclusions and for expanding the familiar sections on contraindications, nomenclature and preparations. Secondly safety concerns have been highlighted. The comparative innocence of 20 years ago has been shattered by the Aristolochia tragedy and increasing concerns about herbal quality control and herb drug interactions. This new edition now has a cautionary section on toxicity and Erich Stoger has been responsible for new, and especially for the pharmacognostically minded, welcome information on proper herb identification which includes quality criteria, alternate species and adulterants. The information on the chemical constituents of the herbs has also been expanded and updated. The third change is that herbs which are for the moment considered to be obsolete because of CITES restrictions or unacceptable levels of toxicity have now been given their own chapter. This is a positive way of quarantining herbs such as Chuan Shan Jia ( Mantitis squama) so that, although their use is clearly unacceptable, knowledge of how to use them remains part of the herbal tradition in the West. Unfortunately transatlantic differences mean that noted herbal outlaws such as Mu Tong and the Aconites (surely a fine name for a rock band) are still included in the main text. Finally many new substances have been included in this edition which now describes 532 herbs in total and 478 in considerable detail. These are all welcome additions to an old friend. A rather sad loss is the decision to remove the pharmacological and clinical research from the text. The rationale for this (the burgeoning literature within this genre, combined with the ‘limited expertise’ of the authors and their commitment to grounding Chinese herbal medicine in traditional approaches) is understandable. However it is, to my mind at least, a serious shortcoming of this book. So, does this volume achieve these new objectives and how does it compare with its rivals in the market or on your book shelves? First of all there is no question that this edition is a considerable improvement on earlier versions. From the point of view of the practitioner the great strength of this book (formerly its great weakness) is the effort that has gone into describing the distinctive nature and activity of each herb. The fabulous commentary provided by Steven Clavey begins with a description of taste, temperature, directionality and channel propensity, which then provides the ‘energetic’ rationale for the precise medicinal actions of each herb. Tao Ren (Persicae Semen), for example is described as: “Bitter, and thus draining, heavy in weight, and thus sinking and downward directing, and moist in texture, the range of action of Persica Semen (Tao Ren) is determined by the channels it enters: Heart, Liver, Lung and Large Intestine. Its affiliation with the Heart and Liver indicates its action on the blood, but it also moistens the Intestines that are dry to relieve constipation, stops coughs and wheezing, moistens the skin, all of which relate to the Large Intestine and Lung. While it is generally conceded by most material medica texts that it is almost wholly attacking in nature - breaking up blood stasis - its status as a fruit kernel implies some life-giving generative force as well. In Persicae Semen (Tao Ren), this is expressed as the ability to assist in the generation of new blood following the expulsion of old, stagnant blood” (p625). The transposition of the nature of each herb into a rationale for its medical effects is consistently managed with deceptive ease and fluency. Traditional descriptions, which can so easily be turgid and seemingly unrelated to clinical practice, are brought alive so that their poetry and relevance combine to make a distinctive signature for each herb. References from classical texts are used to develop these understandings, explore contrasting opinions, and to place the use of herbs within a historical and intellectual context. The definitive quality of a herb and its clinical application is further refined by analysing how the herb synergistically combines or contrasts with a commonly used companion herb. Thus the account of the frequently used combination of Yuan Zhi (Polygale Radix) with Suan Zao Ren (Ziziphi CHINESE HERBAL MEDICINE: MATERIA MEDICA 3RD EDITION Compiled and translated by Dan Bensky, Steven Clavey, Erich Stoger with Andrew Gamble. Eastland Press, hardback, 1311 pages, £75 34 JOURNAL OF CHINESE MEDICINE • NUMBER 76 • OCTOBER 2004 Semen) “illustrates an important but rarely elucidated therapeutic principle: when treating the spirit, there must be a balance between sour-restraining herbs that contract, and acrid-dispersing herbs that free the movement of the spirit. Extroversion and introversion, in modern terms, describes the poles of this movement as the manifestation of the activity of the spirit … Over-expansion of the spirit may be mild as insomnia, or as extreme as psychosis or mania; over-contraction of the spirit may be mild as an inability to ‘open up’ with other people, or as extreme as withdrawal and catatonia” (p932). These are more than nuggets of herbal application or traditional wisdom. This is a reminder of the philosophical alphabet which forms the basis of Chinese herbal medicine which this book admirably succeeds in bringing to life and clinical relevance. There are, however several important shortcomings to this work. The sections on herbal toxicity are rather alarming. There is not enough distinction made between mild and usually transient common side effects, and rare cases of serious adverse reactions which are usually due to allergic reactions or overdoses of the herb. The current climate in the West, where, in the absence of ‘proven’ benefits, any incidence of serious abreaction to a herb is an unacceptable risk and may be sufficient to generate calls for a voluntary or even statutory ban, will not be calmed by the litany of vomitings, respiratory failures, convulsions, anaphylactic reactions and even deaths attributed to (usually massive overdoses) of commonly used herbs. Such cases are described but no source references are given which is an unwelcome and uncharacteristic lack of rigour from this book. In considering the toxicity of Huang Qi (Astragali Radix) for example: “Allegic (sic) reactions have also been reported, including skin eruptions, pruritis, and anaphylactic shock. For this reason, the herb should be used with caution in treating patients with allergies (p721).” Given that Huang Qi is one of the most commonly used herbs to treat and prevent allergic asthma and rhinitis this statement requires both a reference and a greater degree of clarification. Another limitation within this section has been the decision to omit references to herb-drug interactions. Whilst it is true that the data in this field is in its infancy, nevertheless including evidence of adverse interactions between warfarin and Dan Shen (Salviae miltiorrhizae Radix) and Dang Gui (Angelica sinensis Radix), or the potentially fatal consequences of combining Ma Huang (Ephedrae Herba) with MAOI anti-depressants and so on, would surely significantly contribute to the safe practice of herbal medicine. Other shortcomings are best revealed by a comparison with the other lead player in the materia medica field which, in my opinion, is the recently published Chinese Herbology and Pharmacology by JK and TT Chen (Art of Medicine Press). Both books contain similar accounts of the actions and indications of each herb which, I suspect, reflects a commonality of Chinese language source material. However the presentation in the Chen book is clearer and more accessible. The use of emboldened headings and subheadings and placing the symptom rather than the herb combination at the beginning of the sentence means that Chen is easier on the eye and better suited to quick referencing than the Bensky. Whilst Chen manages to group pharmaceutical, common and pinyin herbal names and conditions treated all together in one index, Bensky has retained the inconvenient and time wasting separate indexes for these items. Less cosmetically Chen combines traditional descriptions of the herbs with an account of related pharmacological and clinical research. Whilst some of this research is questionable (90%+ rates of success), of undetermined relevance (herbal injections and animal studies) and frankly weird (a daily dose of 60g of Fu Ling to treat 53 cases of chronic schizophrenia) some of it provides a vital insight into the application of herbs in the treatment of commonly presenting clinical conditions. Thus, taking Huang Qi (Astragali Radix) again as an example, Bensky is impoverished by the self-imposed rejection of research data supporting the use of this herb as an adjuvant treatment for nephritis, chronic hepatitis or chemotherapy induced leukopenia. Whilst many practitioners will welcome the poetry of the traditional understandings they may also hanker for the more prosaic but often incredibly practical insights acquired from the modern application and evaluation of these herbs. So, the moment of truth. Should you rush out and purchase the latest Bensky? I think there is no question that it is a vastly improved edition. The commentary, comparisons, and new data on nomenclature and quality control all add considerably to previous editions and other versions of the Materia Medica. In particular the descriptions of herbal individuality and applications which are rooted in traditional energetics and classical references are the great strength of this book. However, despite the firm foundations laid in this text, in my opinion, only half the story has been told. The reasons for this are understandable but regrettable. The 3rd edition of Bensky may still be synonymous with the materia medica but, as befits our age, I suspect the trend for double barrelled names will soon be adopted by Chinese herbal students and practitioners lugging their ‘Bensky-Chen’s’ from pillar to post.
Herbs that Release the Exterior .... 1
Herbs that Clear Heat .... 85
Downward-Draining Herbs .... 233
Herbs that Drain Dampness .... 265
Herbs that Dispel Wind-Dampness .... 321
Herbs that Transform Phlegm and Stop Coughing .... 371
Aromatic Herbs that Transform Dampness .... 465
Herbs that Relieve Food Stagnation .... 491
Herbs that Regulate the Qi .... 507
Herbs that Regulate the Blood .... 555
Herbs that Warm the Interior and Expel Cold .... 671
Tonifying Herbs .... 705
Herbs that Stabilize and Bind .... 853
Substances that Calm the Spirit .... 905
Aromatic Substances that Open the Orifices .... 943
Substances that Extinguish Wind and Stop Tremors .... 963
Herbs that Expel Parasites .... 993
Substances for Topical Application .... 1017
Obsolete Substances .... 1041
Herbs Associated with Pathologies
of the Five Yin Organs .... 1075
Summary Table of Herb Actions
and Indications .... 1079
Guide to Pinyin Pronunciation .... 1133
Table of Chinese Dynasties .... 1135
Glossary .... 1137
Adulterants & Quality Issues .... 1143
Table of Authors .... 1159
Historical and Source Text Bibliography .... 1161
Translator’s Bibliography .... 1171
Cross Reference of Pharmaceutical Names
with Previous Edition .... 1175
HERB & FORMULA INDEX 1187
PINYIN-PHARMACEUTICAL CROSS-REFERENCE 1217
ENGLISH-PHARMACEUTICAL CROSS-REFERENCE 1241
JAPANESE-PHARMACEUTICAL CROSS-REFERENCE 1251
KOREAN-PHARMACEUTICAL CROSS-REFERENCE 1257
BOTANICAL, ZOOLOGICAL AND MINERAL REFERENCE 1263
GENERAL INDEX 1279
ABOUT THE AUTHORS 1305
|Author||Dan Bensky, Steve Clavey, Erich Stï¿½ger|
|Number Of Pages||1311|
PREFACE TO 3RD EDITION
The first edition of Chinese Herbal Medicine: Materia Medica was published in 1986, and the revised edition in 1993. During the ensuing years there has been a huge increase in the use of Chinese herbal medicine in those Western countries where this book has served as a basic reference text. About six years ago we realized that some important changes had to be made if the book was to remain useful, and we have been working hard ever since to bring this new book to fruition.
To assist with this edition, two new co-authors were invited to contribute their special expertise. Steven Clavey, an author and practitioner from Melbourne, Australia, applied his clinical and scholarly expertise to expand the traditional background and usage of each herb. He was primarily responsible for in-depth discussions of the herbs in the Commentary, Mechanisms of Selected Combinations, Comparisons, Traditional Contraindications, and Nomenclature & preparation sections. Our other new co-author is Erich Stöger, from Austria, trained in both traditional Chinese and modern pharmacology. He has done extensive work in herb identification, which is reflected in this book, as well as his work translating and editing monographs on Chinese materia medica in German. He was primarily responsible for the identification section as well as Quality Criteria, Major known chemical constituents, Alternate species & local variants, Adulterations, Alternate names, and Additional product information.
The principal changes in this edition can be divided into four categories:
• First, our guiding principle has been to provide the type of information that enables the reader to practice Chinese herbal medicine more effectively. To this end, in each entry we added new types of information: commentaries, discussions of key combinations, comparisons of related herbs. This new material provides the reader with a more well-rounded picture of the herbs and how they are used from both contemporary and pre-modern perspectives. In addition, because one of the keys to successful practice is proper preparation of the herbs, we also added a section that describes the different methods of preparing individual herbs, and the advantages of each.
• Second, we address the issue of safety more directly. This has two aspects. The first concerns toxicology research. Much work has been done in this area since the previous editions of this work were published, and we now include a section on toxi"city" in each entry where it is warranted. The literature on this subject is in its infancy, and often raises more questions than it answers. This information should therefore only be used for cautionary purposes, and not as an excuse to ban herbs or limit their availability.
The second aspect of safety is proper herb identification. We can’t be sure that the herbs we give our patients are safe if we don’t even know what they are. This is a major issue in contemporary Chinese herbal medicine and is discussed at length in the Introduction. In this edition we have added new sections to each entry dealing with quality criteria, alternate species and local variants, and adulterants. We have also updated the information on the major known chemical constituents of each herb. In doing so, we have tried to balance the competing pulls of tradition, convenience, utility, and scientific taxonomy. It is our belief that a consensus is building around these important issues, primarily because of their impact on safety.
On the other hand, we have chosen not to directly address the thorny issue of herb-drug interactions, as the information available at this time on the subject is often too unclear to be useful.
• Third, we separated out those materia medica that we consider to be obsolete and put them in their own chapter (19). Some are derived from endangered species, as identified in the Convention on International Trade in Endangered Species of Wild Fauna and Flora (CITES), Appendix 1. Others have a level of toxi"city" that far outweighs their usefulness, rendering them unsuitable for use.
• Finally, there are many substances that are new to this edition. These either appear in textbooks from the People’s Republic of China or are in relatively common use outside of China. This now brings the total number of substances discussed in our book to approximately 532, of which 478 are discussed at some length. One aspect of prior editions that we elected to remove from this one is pharmacological and clinical research. This is a field that has exploded in recent years and deserves a multivolume work of its own. Given our own disposition — that the practice of Chinese herbal medicine must be grounded on traditional approaches — and our limited expertise, we felt that we simply could not do justice here to the vast amount of new research that has been published. Fortunately, however, there are a number of other books on this topic in English to which we can happily refer the reader, among them The Pharmacology of Chinese Herbs, 2d ed. (Huang Kee-Chang and W. Michael Williams, 1998), Pharmacology and Applications of Chinese Materia Medica (Chang Hson- Mou et al., 2000), and Chinese Materia Medica: Chemistry, Pharmacology and Applications (Zhu You-Ping, 1998). In preparing this book we consulted a wide range of sources. Except where otherwise indicated, all of the information is drawn from the Chinese sources listed in the Translators’ Bibliography. With respect to the Actions & Indications section, we relied primarily on three recent textbooks: Chinese Herbal Medicine (Yan Zheng-Hua, 1991), Clinical Traditional Chinese Herbal Medicine (Lei Dai-Quan and Zhang Ting-Mo, 1998), and Chinese Herbal Medicine (Gao Xue-Min, 2000). There is a high level of agreement on the basic actions of the herbs in modern materia medica texts, and these books were consulted for their relatively comprehensive treatment of the subject.
Our translation methodology remains largely unchanged from the previous edition. As always, our goal has been to translate Chinese medicine into English as clearly and transparently as we can. Yet, as our understanding of the medicine has improved, and the experience of our profession in transmitting information about Chinese herbal medicine into English has grown, we have made certain changes in our terminology, the most important of which are discussed in the Glossary.
Another change is the manner in which we refer to the herbs themselves. We have adopted the new standard in international pharmacognosy that places the genus and species (when relevant) in front of the part of the plant used. For example, what used to be rendered as Herba Ephedrae is now Ephedrae Herba. This change will allow readers to more easily cross reference our work with those of other authors. We continue to combine the pinyin transliteration of the standard name of an herb with its pharmaceutical name, as this is the clearest method of identification. A cross reference to the names used in the previous edition of our work is provided in Appendix 8.
While we use the standard pïnyïn transliteration system from the People’s Republic of China, we have modified it to better fit the needs of our audience. The standard transliteration system separates each word, while we separate each syllable (character). For example, we write jïn yïn huä instead of jïnyïn huä. We do this because much of our audience is untutored in Chinese, and separation by syllables is easier to read. We also modified the rendering of Chinese given names. In the standard method of transliteration, the two syllables (characters) of a given name are combined and placed after the surname, as in Zhang Zhongjing. In part to make things less confusing, and in part to emphasize to a Western audience that both parts of a two-syllable given name are important, we separate the two syllables with a hyphen, as in Zhang Zhong-Jing. We believe that this is clearer to our readers than the standard approach, and hope that Sinologists will forgive us this trespass.
Many people generously shared their knowledge and expertise on various aspects of this project. Among them are our colleagues Mazin al-Khafaji, Peter Deadman, Subhuti Dharmananda, Andy Ellis, Johann P. Gruber, Amy Hanks, Andreas Höll, Volker Scheid, and Nigel Wiseman. Christine Tani provided the bulk of the Japanese transliterations, with some contributions from Atsue Morinaga, Gretchen de Soriano, and Jacqueline Young. Jinwoong Kim, professor of pharmacognosy at Seoul National University, not only brought our transliteration of the Korean names for the herbs up to date, but also participated in our deliberations regarding herb identification. We would like to particularly thank our mentor and friend Yao Da-Mu in Beijing for all his encouragement and assistance with issues of herb identification. Michael Ellis in Australia did much of the basic work on the herb comparison tables. We wish to express our appreciation to the many Chinese authors whose works form the basis of our text. Given the focus of this book on herb identification, we especially pay tribute to some of the early pioneers of modern pharmacognosy in China who laid the foundations of this field, while laboring under extremely difficult circumstances. In particular, we honor the names of Lou Zhi-Cen, Cheng Jing-Rong, Xu Guo-Jun, Chen Jun-Hua, Zhao Da-Wen, Yao Da-Mu, and Xiao Pei-Gen.
We also thank John O’Connor for his perspicacious editing, Hans Bleicher for his help with the photos, and Gary Niemeier for his artful book design. All errors are ours alone.
We hope that this new edition will prove useful not only to you, our readers, but more importantly, to your patients.
— DAN BENSKY, STEVEN CLAVEY, ERICH STõGER