Medicine Is the Art of Coaxing Nature

Coaxing nature refers to the act of persuading or gently encouraging the natural world to behave or respond in a particular way, typically in a positive or beneficial manner. This can involve nurturing plants or animals, conserving natural resources, and promoting sustainable living practices – in other words, working in harmony with the environment to create a more balanced relationship between humans and the natural world. In the field of medicine, coaxing nature can refer to the use of natural remedies and therapies such as herbalism to support the body's innate healing processes.

Plants as Medicine

Did you know that plant extracts were used to produce almost every drug until relatively recently? Even aspirin comes from plant extracts. It wasn’t until after WWII that scientists started using molecular engineering to produce individual chemicals to mimic or control specific physiological functions. In Chinese hospitals, individual Chinese herbs and their extracts are commonly used as drug substances, and more recently they have been experimentally combined with more modern drugs for cancer, heart disease, post-stroke treatment, and even sepsis.  

Problems with Research on Herbal Treatments

That being said, many clinicians know that herbs that can be effective when drugs are not, and with fewer and less problematic side effects. Unfortunately, this can only be shown through anecdotal case-by-case analyses because although evidence exists to show that herbs are effective, the claims of results are usually deemed statistically inconclusive, mainly because of “poor" study design.  The correct use of combinations of whole plant substances does not fit well into the standard of empirical research design.

See this list of a few commonly used Chinese herbs with links to Natural Institutes of Health (NIH) resources.

Although analyses of single substances have been performed, this is not how we use herbs. It is tricky to try to see Chinese Herbal Medicine through the western scientific lens, because it distorts the actuality of the practice. Herbal substances are complex; we use whole parts of plants in practically infinite combinations. Each herb has hundreds of chemical compounds that could affect some aspect of physiology. When we combine 6-20 herbs, which is the average formula, the number of compounds is multiplied and the number of chemical and physical interactions is multiplied as well. The outcomes of studies by NIH and others only minimally reflect how practitioners decide which herbs to use when constructing individualized formulas for their patients because we use substances in Chinese Herbal Medicine far beyond the applications suggested by chemical constituent research. It would not be uncommon to use an herb that is listed as anti-cancer to prevent sweating and post-viral fatigue in one person, for headache in another, and for insomnia in a third.  

Example: Recognizing Functional Patterns.

Here is a fairly typical story that illustrates the use of herbs according to the principles of Chinese Herbal Medicine. I saw a patient who had a relapse of a phlegmy cough that I had previously treated with herbs to “resolve phlegm and stop cough.” The herbs worked for a while but the phlegm and cough returned when he had a stressful event and had not resolved for over a week. I felt his pulse to ascertain how the dynamics of his organ system might be causing this issue. My conclusion from the pulse was that the liver was congested, affecting the ability of the stomach and lung to descend. All of that energy and fluid stuck in his chest was causing the congestion and mucus (which is fluid being congealed by heat from stagnation) in his chest and head.  

I first treated this liver congestion pattern with acupuncture. Within ten minutes into the treatment, the phlegm congestion was significantly reduced, the coughing stopped, and the patient reported that his chest felt more open. I interpreted this as a confirmation that the principles of treatment applied when selecting the acupuncture points would also be useful if translated to herbal treatment. So I prescribed an herbal formula that followed the same principle. I gave him Bupleurum Resolve Liver formulation  for "alleviating stagnation of Liver Qi.” I suspected this was a better choice because the formula I had prescribed weeks earlier for “resolving phlegm and stopping cough” did not provide a complete resolution of his condition.

A Paradigm Shift is Required for More Complete Understanding

If the chemical constituent approach is correct, the formula I chose should not have worked. Firstly, this formula has a list of on-label indications. Cough and phlegm are not included. Furthermore, by merely looking at the studies done on the individual herbs that constitute the formula I used, it would be hard to see how it could possibly treat all of its indications, as the list includes irritability, fever, headache, mastitis, and colitis.  He had none of these, but it was still an effective treatment. (For reference, the main herb in the formula, Bupleurum, has been analyzed here.)  In addition, the characteristics attributed to Bupleurum are the same as a lot of other herbs, and, by the way, most of these characteristics are also attributed to ibuprofen.  

So how is using this formula different from prescribing Ibuprofen? And how would I choose from the multitudes of possible herbal formulas each used for a host of “on-label” conditions that don’t match the patients’ symptoms? Answering this question requires a paradigm shift. We will not find a suitable answer solely within pharmacology. This is because the way to best understand the use of Chinese Herbal Medicine is not through the lens of chemical constituents and their individual effects on human cells.

How Herbs Restore Function - A  Unique Strategy for Every Case

Here is some basic insight into how Chinese Herbal Medicine is actually practiced.  We help people with herbs by understanding the nature of the herbs, the nature of the illness, and the nature of the person. We select the herbs for their “energetics” and how their characteristics most effectively balance the principal characteristics that lie at the root of the person’s illness. Each herb has the effect of warming, cooling, supplementing or draining, harmonizing, circulating dispersing, astringing, or venting. They have affinities for certain organ systems and certain parts of the body.  Each is effective during various seasons and in different climates. When herbs are combined they gain even more targeted abilities to interact with the whole of the person's condition. The interactions of the substances have yet to be completely analyzed with biochemistry. However, if we look carefully at the dynamics of a person’s history and their environment and apply the discernable characteristics of the plants in their medicine, we can understand why a particular formula is the right choice for that person at that time regardless of the label or the individual functions of its constituents. This results in a treatment that is in agreement with the constitution of the individual and their condition at that particular time. So, in a sort of cooperative negotiation with the person, the plants help  restore health in a gentle and elegant fashion, and by creating harmony, function is restored.

Medicine is the art of coaxing nature. 

Jim Bloomfield L.Ac.

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