Qiang Huo (Notopterygium Root)

This episode will be exploring another interesting Chinese herb: qiāng huó, Notopterygii Rhizoma seu Radix, or notopterygium root. This herb is in the Chinese medical subcategory of warm, acrid herbs that release the exterior under the category of release the exterior herbs. It is helpful for certain types of colds and especially for alleviating pain and unblocking painful obstructions in many conditions such as some types of arthritis. And as usual, we will be exploring something a little different…we are going to discuss the very common condition of arthritis. Each episode of the podcast will go into great depth about a single herb or formula. Besides covering the basics of herbology including category, and functions, we will explore the history, quality, science, pharmacology, evidence, and any potential interactions of each herb or formula. Please join us, it is going to be another interesting rocket ship into the exciting solar system of herbs as we look at qiāng huó, Notopterygii Rhizoma seu Radix, or notopterygium!

Episode Transcript

Speaker 1 (00:03):
Angelica Sperb. Welcome to Sperbs Herbs, Episode eighty nine. Today
we are going to be talking about Chinese or chi
ho or no top tier gy. I like saying that word.
I don't know, no top tier gy or rhizoma souratix,

(00:27):
which means riisome or root, and the common name is
no top tiersrum root or rhizome. You can do that
as well. Today we will be exploring another interesting Chinese
herb we just went over all at si Ho. This
herb is in the Chinese medical subcategory of warm acriderbs
that released the exterior under the category of release the

(00:49):
exterior herbs. It is helpful for certain types of colds
and especially for alleviating pain and unblocking painful obstructions in
many conditions, such as some types of arthritis. And as usual,
we will be exploring something a little different. We're going
to discuss the very common condition of arthritis. If it
helps arthritis, why don't we talk about arthritis? So we're

(01:11):
gonna please join us for this intriguing episode. Before we
get into this, I just wanted to remind you that
I have been teaching for quite a while now on
a wide variety of topics. If you like this podcast
and want to explore more of my courses, they are
available at www dot Integrativemedicinecouncil dot org. That's Integrated Medicine

(01:32):
Council Council dot org and include a ton of different topics,
including my Drug Herb series looking at drugs and how
they interact with herbs and vice versa, several ethics and
safety courses, Chinese medical research, several treatment of condition courses
such as arthritis, neck and backpain, COVID and depression and anxiety,

(01:53):
and one of my favorite courses, the Chinese herbal First
Aid Kit. And they are all at reasonable cost full stop.
They're at reasonable costs, but you can get an additional
twenty percent off with the code SH two zero off
SSHS and sperbs herbs twenty off, and that is huge
because they're already reasonably caught, reasonably priced. All Right, today

(02:19):
we're going to be talking about an herb, which is
one of several Chinese medicinals used to treat arthritis. A
brief introduction of arthritis was warranted, and since I have
a course treating arthritis with Chinese medicine, here's the introduction
to that course modified of course, of course, of course.
According to MAO, clinic arthritis is the swelling and tenderness

(02:41):
of one or more joints. The main symptoms of arthritis
are joint pain and stiffness. It can also refer to
an infection of a joint and there are two common
types of arthritis, osteoarthritis and rheumatoid arthritis. We'renking into both
of those and many less common forms including anklosing, sponded
life gout, juvenile idiopathic arthritis, siatic arthritis. People with psoriasis

(03:07):
can get arthrisis, soriatic arthritis, react of arthritis, infectious arthritis,
and septic arthritis. So lots of arthritis. We're just gonna
talk about osteoithritis and rheumatari of fresh right now. So
what is our osteoithritis? Osteoarthritis A, also known as degenerative
joint disease or dj D, is a chronic arthropathy which

(03:30):
means pathology of the joint characterized by disruption and potential
loss of joint cartilage along with other joint changes, including
bone hyperchaphy that's overgrowth of the bone. In this case,
osteophyte formation. So osteophytes are the little formations when tenins

(03:52):
kind of pull on the bones, they can bonees first.
Osteopytes are bones first. There we go. That's an easy
way of saying it. So Osteophtes are bones. It is
the most common joint disorder, often becomes symptomatic in the
forties and fifties, and is nearly universal, though not always symptomatic.
By age eighty. Only half the patients with pathologic changes

(04:15):
of OA have symptoms, so half the people don't have symptoms.
Half the people do. Of course, we see a lot
of them in our practices, usually below age forty. Most
large joint OA osterearthritis occurs in men and often results
from trauma or anatomic variation, for example, hip dysplasias women

(04:38):
predominant from age forty to seventy, after which men and
women are equally affected, and symptoms include gradually developing pain
aggravated or triggered by activity, stiffness lasting less than thirty
minutes on awakening and after inactivity, and occasional joint swelling. Normally,

(05:00):
joints have little friction and do not wear out with
typical use or overuse or most trauma more often than not.
An initial trigger for austeroarthritis is not known. However, it
can begin with a mechanical injury, inflammation, or defects in cartilage,
metabolism obesity can actually involve several of these initiating factors,

(05:21):
so that is considered a pretty high risk factor for
austero withthritis. Chondrocytes, which are cells of car cartilage cells
are involved in the repair of cartilage, but also breakdown cartilage,
which can be exacerbated when inflammation is present. Eventually, several

(05:41):
articular and peri articular so that's articular is the joint
and perticular around the joint changes occur. Subchondrial bone stiff
and so bone underneath the cartilage stiffens. That undergoes infarction
which is lack of oxygen and develop subchondrial cysts, so
cysts came form there those are little holes basically attempts

(06:05):
up bony and repair caused subchondrial sclerosis or scarring, and
osteophytes at the joint. Margins from rostopytes are bone spurs.
The osteophytes seem to develop in an attempt to stabilize
the joint. The synovium which is the fluid in the
joint becomes inflamed and thickened and produces produces synovial fluid

(06:27):
with less viscosity and greater volume, so it becomes bigger
and less viscous, so it's it's more fluid Perry articular,
so these are around the joint. Tendons and ligaments become stressed,
resulting in tendinitis and contractures to Ennis's inflammation of the
tendons and contractors so they can to protect itself. They
will contract as the joint becomes less mobile, surrounding muscles

(06:52):
thin and become less supportive. Miniski fissure and may fragment.
So miniski are the cushions in the joints that are
are made up of cartilage, so meniscai will fissure, they
will split and may fragment that often happens in the knee.

(07:13):
Very common in the knee on site of austcar Athritis
is usually gradual, beginning with one or a few joints. Pain,
sometimes described as deep and achy, is the earliest symptom.
This is usually worsened by weight and relieved by rest,
but can become constant as it progresses joint range of

(07:34):
motion becomes restricted and crepitas may develop. Creptis are the
little cracks and creeks that you get when you move
a joint. They can also be felt, not just heard.
Development and remodeling of cartilage, bone ligament, tendon capsules, and synoviium,
along with varying amounts of joint effusion, which is fluid

(07:54):
in the joint, cause the joint enlargement characteristic of austrie arthritis.
And that's a brief overview of ostereothoris. Let's talk about
rheumatoid arthritis. So, rheumatoid earthritis is a chronic systemic autoimmune
disease that primarily involves the joints. R A. Rheumatoid athritis

(08:16):
causes damage mediated by cytokines, chemokines, and metalloproteases. These are
all parts of the immune system. These are all different
chemicals of the immune system. Characteristically, peripheral joints, for example,
wrists and metacarpophylangial joints. Those are the joints between the

(08:36):
wrists and the fingers are symmetrically inflamed. So these are
between they become inflamed, but side by side, so the
left side and the right side symmetrically inflamed, leading to
progressive destruction of articular structures. Joint structures usually accompanied by
systemic symptoms. This is key. Rhumatoiderthritis is a systemic disease

(08:59):
that have are joints. That is different from austerarthrias, which
is a joint disease and does not affect us systemically.
Rumataia athritis affects about one percent of the population, and
women are affected two to three times more often than men.
Onset may be at any age, most often between thirty
five years and fifty years, but can be during childhood

(09:22):
or old age. Although rheumatraidor arthritis involves autoimmune reactions, the
precise cause is unknown and many factors may contribute. A
genetic predispisition. The predisposition has been identified, unknown or unconfirmed
environmental factors, for example, viral infections cigarette smoking are thought

(09:43):
to play a role in triggering and maintaining joint inflammation.
Rheumatraid arthritis is characterized by synovial inflammation whether the synoviium
is the fluid in the joint, and hyperplasia are swelling
auto antibody production. So these are antibodies as we know

(10:05):
are part of our immune system that attack the things
that are invading in the body. Auto antibodies are things
that are attacking parts of the body, so that's part
of an autoimmune system reaction. And these anti antibody production
include rheumatoid factor and anti citulinated protein, antibioty or ACPA,

(10:26):
cartilage and bone destruction or deformity and deformity, and systemic
features including cardiovascular, pulmonary, psychological, and skeletal disorders, so it
can affect large amounts of the body. The signs and
symptoms of this disease are numerous and oft the systemic.

(10:49):
They usually start slowly and insidiously, with signs and symptoms
including the early morning stiffness of the affected joints, generalized
afternoon fatigue and malaise, anorexia or a loss of appetite,
generalized weakness, and occasionally low grade fever. Joint symptoms include pain, swelling,
and stiffness. Sometimes initiation may be rapid and abrupt, looking

(11:13):
like an acute viral infection. This can progress rapidly, especially
in the first year and into the first six years.
Within ten years, eighty percent of patients will develop permanent
joint abnormalities. Individual disease progression is highly individualistic and not predictable.

(11:35):
What often says ARI apart from other joint disorders is
the joints being affected symmetrically. That is key to ARA.
These joint signs and symptoms typically include stiffness last greater
than sixty minutes after rising in the morning, but may
occur after any prolonged inactivity. Involved joints may become tender
with air fema or redness, warmth, swelling, and limitation of motion.

(11:59):
Those are all the cardinal signs of inflammation, so redness,
warmth you know, redness, heat, swelling, limitation of motion, and pain.
Joints usually involved include the wrists in the index, second

(12:19):
and middle third metacarpal flangeal joints are most commonly involved.
Proximal interflangeal joints the pips. So these are the if
you go if you look at your fingers, you have
the dip is the first joint, is the last joint

(12:39):
and the finger and the PIP the proximal interflangeal joint
is the is the second joint on the finger, and
so the pips can be the proximal interflangial joints can
be involved mena taso filangeal joints. Those are in your foot, shoulders, elbows, hips, knees,
and ankles. Basically any joint can be involved, except for

(13:03):
the distal interflangeal dip joints that's the last joint on
your finger. Those are not involved in rheumatraia athritis. And
that's really interesting. With the exception of the upper cervical spine,
the axial skeleton is rarely involved, so you can't rarely
affect it. So the upper cervical spine may have some
rheumatraid athritis, though often that's OA as well, but the

(13:28):
axial skeleton, the rest of the spine and the and
the and the ribs and everything are rarely affected by
rheumatraid athritis. Fixed joint deformities can rapidly develop, and these
include flection contractors in which you flex the figures and
you can't unflex them, ulner deviation of the fingers with

(13:49):
an ULNER slippage of the extensor tenons off the metacarpal
flangel trait. So what that actually means so ulner deviation,
So the oulder direction is towards your pinky, and what
that what that can mean is that oner deviation of
the finger, So all of them are kind of deviating
a little bit towards that side, and the tenons can flip.
It can can kind of flip off to that side

(14:11):
as well. Joint instability due to stretching in the joint
capsule can occur, and then there are some specific deformities
that can occur. One is called the Swan Neck deformity,
and this includes hyper extension of the proximal interflangeal joint,
the PIP joint. So remember that's the if you're looking
at your fingertips, it's the second joint on your finger.

(14:33):
That's the PIP, so that's extended, hyper extended, and then
the DIP joint, which is the first is the last
joint on your finger is flexed. And sometimes there's a
flexion of the metacarpal flangeal joint, the MCP, which is
going to be the big knuckle there at the base
of your fingers. Your is your MCP. That a carp

(14:54):
flangel joint, so that's that can be flexed. The the
PIP is extended and the DIP is flexed. Again, that's
called the Swan neck deformity and if you can see
the slides, which most of you can't, there's a picture
of that. And then we also have another common deformity.

(15:16):
It's called the boot in ear deformity, and this includes
kind of the opposite, so it's flexion of the of
the pip joint rather than extension accompanied by hyper extension
of the distal the dip joint the hyper actension of
the distal interflangeal joint. So that's the first joint from
the end of the figure is extended and the second
joint is flexed. So normally we can't do that. So

(15:39):
I'm like, I'm trying to demonstrate it, but I can't
do it even with my thing. But I have again
a picture, okay. Carpal tunnel syndrome can result from wrist sinovitis,
which is inflammation of the synovium synovial food compressing the
media nerve, and also populati or Baker's system can develop.

(16:00):
These are around the knee, the populatium populateal areas behind
the knee. Those are actually relatively common kinds of cysts. Additionally,
many systemic or extra articular signs and symptoms can occur.
So remember extra articular means outside of the of the joint.

(16:20):
Subcutaneous rheumatoid nodules can occur in thirty percent of patients,
and they are exactly what they sound like. They're little
nodules under the skin. Subcutaneous means under the skin. Visceral nodules,
which are on the organs can occur in severe rheumatoidrothritis.
Vasculitis or inflammation of the vasculature causes leg ulcers or
mononeuritis multiplex, which is a very specific kind of disease.

(16:44):
Won't worry about it too much. System systemic signs and
symptoms can also include plural pericardial fusions, which can be
life threatening. This is fluid around the heart in the pericardium,
pulmonary infiltrates, or fibrosis. So fibrosis of the of the
lungs is actually a very serious condition. That's basically scarring

(17:07):
of the lungs, very serious. Paracarditis that's inflammation of the pericardium,
mild card ditis, that's inflammation of the heart, lymph fatten empathy,
limph fatten limp fatenopathy which is lymph node pathologies, Felty syndrome,
and that's an interesting is usually described as associated with

(17:27):
as a complication of rheumatraiter threatus. It's defined by the
presence of three conditions rheuma, traidorthritis and large spleens of
splenomegaly and a low white blood cell count or neutropenia.
So that is Felty syndrome organ syndrome which if you're
reading this it's s j O with the umlots on
a g R E N organ syndrome, and that is

(17:49):
an autoimmune disease. Of dryness usually there's a lot of
dryness with that dry mouth, tri mucous membranes thinks along
those signs scleromylation performs and episcleritis, so those are good stuff.
So episcleritis is around actually all of this, so let's
let's go with scermolation of performance is a rare severe

(18:13):
I disorder, developing an autoimmune damage of the episcleerals around
the scleros that's the white part of the eye and
scleral performing vessels, so it is autoimmune type disease. And
episcleritis is inflammation around the sclera as well. And then
finally involvement of the cervical spine can cause atlanto axial

(18:36):
sublxation and spinal cord compression, which can be very serious.
But atlano axial the first two vertebra C one and
C two at the very top of the head. One
you can't feel. One's actually in the skull, you can't
feel it. Usually the first vertebrae you can feel underneath
the skull is the atlantis, and the one on top
of that is the axial. So the lantis and axial

(19:01):
vertebrae and those can subject so those can shift off
where they should be and cause spinal cord compression, which
if severe enough, can be quite almost you know, debilitating.
It can be extremely almost entirely debilitating, so very serious there.
And that is our introduction to arthrities, both of our arthritis.

(19:23):
That's quite an introduction to us. So anything we can
do to help these things, they're very painful. I don't
know about it. You and if you have a practice.
In my practice, I see a lot of OA. Some
are a but a lot of OA and well fifty
percent of the people will have it, so very common.
So anything we can do to help with arthritis is

(19:45):
going to be useful. And one of the herbs I
do use frequently in treating arthritis or adding into other
you know, if they have other conditions, I might add
it in if they have for athritis is today's and
today's rve is. We've talked about this cham no top
tier g Rhizoma sous radix, and it comes from the
family Apiassia and the standard species. There's actually several standard

(20:08):
species here. We have no top tier drum incisom ting
x h T chog, So again those all refer to
the botanists. And this is chiang Huo. When we say
chiang huo, we are usually talking about no top tier
RM in size them. But there are other completely valid
substitutes for for this. One of them is no top

(20:29):
tier grum for forbes ci burns, and that's Chwan ye
chiang hu and no top tier grum Franchetti Franchetti I voice,
which is Chwan chiang huo. So we're actually gonna find
that Twan chwangpho is considered probably the best of these,
and so standard one is the in sisum, but there's

(20:53):
other ones that it can be as well. The medicinal
part is the root in the rhizome. Other names for
this are incise no top tier turigium Forbes, no top turgium,
chiang hu worret feeling it Q I A n G,
which is the opinion and is the correct way to
spell it at this point. But older days they used

(21:17):
to use way Giles as a way to put it
into Latin characters, and that is c H rather than Q,
and so sometimes you'll see Chiang Quo zack samur, but
with the H rather than the Q. Like I said,
the Q is correct, the CH is no longer correct.
For a while there mainland China was Pinion, which would

(21:40):
have been the Q, and Taiwan was Wade Giles, which
would have been the CH. But about ten years ago
Taiwan went to Pinion, so the CH is wholly wrong.
They'll still see it. There's still older names for it,
but it is not the correct It should be Q
at this point. Other names include Sean Chiang explain what

(22:00):
those are, dot to Chiang ju j Chiang Chuan, chiang
Ho Shi Chuang chiang Ho and in Japanese Kiyo katsu
and in Korean kang Hua kangwal Kangua. It has an
L here, but I wonder if that was a miss

(22:22):
copy and it should be an eye. So anyways, let's
talk about the ops and the appiyasi a family. The
Appias family is the partially or carrot family and includes
edible plants and spices such as the carrot and parsnip a,
nice celery, shervil, coriander, caraway, cumin, dill, and fenol. Poisonous

(22:42):
hemlock is also a member of this family. There are
about thirty four genera. Elpol actually says there are about
three hundred genera, so that's ten times difference. I don't
know which is crap and three thy seven hundred species.
They have apollow stems, tap roots, and flat topped flower

(23:04):
clusters known as umbols. A previous name for this family
was the umbula forray, referring to these umbols, which is
where the stems of the flower cluster radiate from a
single point at the end of the stock, kind of
like an umbrella. So getting back to Shanghuo Benski and

(23:25):
so remember we have three We have quite a few
texts that we look at, but three main ones. We're
going to talk about all three of them right now.
So Benski and his team is one of them, and
they say the dosage of the service three to nine grams.
Chen Chen is the is their second text then, and
they say three to ten grams with the maximum thirty grams.
And Brandon Wiseman is their third textbook would say the

(23:46):
doses three to twelve grams for the serbs. So they're
all in the ballpark of each other. The category, according
to Benski, as we've mentioned, put this. Benski and his
team put this herb in the warm acrid herbs that
released the exterior subcategory under Herbs that release the exterior.
Chen Chen say it is a wind cold releasing herb

(24:08):
herbs subcategory under the exterior releasing herbs category, and Brand
and Wiseman say it is a warm acrid exteri resolving
medicinal under the exteri resolving medicinals category. So they're all
seeing the same thing. That may be some slight differences
in how they translate in their perspective, but there's no
discrepancy about which category at least should be under. We've

(24:29):
had herbs where there's been discrepancies. Benski says it is acrid, bitter, aromatic,
and warm, and it enters the bladder and kidney channels.
Will neither Chen and Chen or Brand and Wiseman include
the aromatic property, so they agree with everything except the
aromatic portion of it history. Both Benski at All and

(24:52):
Chennan Chen say the original source for this herb is
the Shendong Ben sau Jing or the Divine Husbandsman's Classic
of the material Menica in the second ce. Having said this,
finding the serve in my translation of The Shadow Ben
Sajing was difficult. There were a couple mentions in footnotes
to the serve in combination with other herbs, though these
do not appear to be part of the original text.

(25:14):
The only other mentioned after word starts through an electronic
version of the text was an alternate name for Bajur
or Angelica to Hurrica ratis. So this original sourcing seem
is both correct and incorrect. And I'm going to explain
this in just a little bit. So hang on when
we get into the commentary of this or this is explained.
So we're gonna we're gonna see why this is a

(25:34):
little it's a little interesting, all right, We'll get there,
all right, So let's talk about herbs that release the
exture as a category. We've done this several times now,
but I repeat that. So we've discussed this cagoy subcatego
verbs several times during your adventures examining Chinese herbs, and
we'll repeat that information here just in terms of completeness. So,

(25:55):
according to Benski and his team, exterior releasing herbs are
those that release disorders lodged in the very superficial levels
of the body. When external pathogenic factors include when heat,
when cold, when dampness in summer heat invade the body,
they first attack its superficial exterior aspects. Symptoms associated with

(26:16):
the exterior then appear chills, fever, headache, stiff neck, and
general muscle aches. Sometimes sweating will appear, which resolves the condition,
in which case no treatment is necessary. At other times, however,
there will be an absence of sweating, or even though
there is sweating, it is not accompanied by any change

(26:36):
in the condition. At this juncture, herbs that release the
exterior are used. Most exterior releasing herbs are diaphoretics that
as they release or expel the external pathogenic influences through sweating.
There is a scene in Chinese medicine when the diseases
in the skin sweating will bring it out. When a

(27:00):
disease progresses slightly further in the body, it is said
to lodge in the muscle layer. The clinical presentation then
includes fever, general body aches, and profuse sweating. At this stage,
especially when the patient is sweated without any beneficial change
in their condition, it is appropriate to use the subset
of herbs that release the muscle layer. The most prominent

(27:23):
member of this group is cinema, rmulous or quad sure.
Some of the herbs that release the exture have additional
functions stopping coughs and wheezing, controlling pain or spasms, inventing
rashes such as measles. So that was the herbs that

(27:43):
release the exterior, and then there's the subgroub warm acroderbs
that release the exterior. And there's a short blurb here.
Benski at All continues to discuss the subcategory of warm
acroaderbs that release the exterior. Herbs that release the exteriere
can be further divided by character and function in to
warm acrid and cool acrid classes. The warm acrid herbs

(28:05):
dispel wind cold and are used for exterior disorders when
the fever is mild, the chill severe and there are
other signs and symptoms of wind cold, including a headache,
body and neck pains, and the absence of thirst. So
what is good quality no top ty regium. Benski and

(28:25):
his team say the best quality is sischwan no top turigium.
That's that chuan chiang quo that we mentioned earlier, with
short inner nodes forming dense emulations like a silkworm. This
it is also called silkworm no top turigium or san
cheog that's can cheong. The surface should be coarse and

(28:47):
dark brown. The roots aromatic and a cross section will
show many oily brown dots. Chinese Medicinal Identification and Illustrated
Approach which is a great book for looking at what
is good quality herbs, says chiang quo are cylindrical, slightly
curved with stem scars at the apex. Externally brown, The

(29:10):
outer skin easily falls off to reveal a yellow color.
Its texture is brittle and easily broken and lightened substance
with a fragrant odor and a slightly bitter and acrid taste.
Still in that book. According to traditional experience, superre medicinal

(29:30):
material is thick and has brown outer skin and abundant
oil spots on the fractured surface, as well as a
potent aroma. Cinnabar spots, which are classic with chian Quo,
are brown or yellowish orange oil spots seen on the
cross cut chian quo. Those are called cinnabar spots. That's

(29:55):
one of the things I love about this book in
particular is it has these very sort of of obscure
names that unless you're doing really serious Chinese herbal assessments,
you won't know these terms. And they're Chinese terms. This
is obviously an English translation of Chinese term, but cinnabar spots.

(30:16):
I love it. Chinese medical actions so credited Benski and
his team Chocohot releases the Exterior Dispersus Cold for exterior
cold patterns with such symptoms its chills, fever, headache, body aches,
and pains, most commonly used when accompanied by damness with
joint pain, a general feeling of heaviness, sleepiness, or when

(30:39):
there is pain in the occipital region that's the back
of the skull. It unblocks painful obstruction and alleviates pain
for wind, cold, damp, painful obstruction, especially in the upper
limbs and backs. This brings things up. It's often paired
with this child quote. It's often paired with dulho, which

(31:00):
brings things down. So together they're called the two holes.
And it relieves body pains of all over the body.
And finally, and this is where because it guides Cheated
the greater Young channel and governing vessel to direct other herbs.
In a prescription to the areas served by these two channels,
chen Chen say, it releases the experience, dispels cold, and

(31:24):
it eliminates wind, cold, and dampness to relieve pain. So
there's a lot of the pain stuff in this. Brandon
Wiseman say, it disperses when cold and dispels wind, dapt
and relieves pain, so almost the exact same thing. And
Chinese mean dismal identification illustrated approach say it scatters cold,
dispels wind, eliminates damness, and relieves pain. So that yeah,

(31:50):
it's good preparations. Benski and his team does not discuss
particular preparations of the serb and says this herb has
a strong acrid aroma, which is the vehicle for its
therapeutic effect. Because Fran would greatly reduce this aroma. It
is always used clinically in its unprepared form. So that

(32:12):
explains why there aren't any preparations in particular, because usually
Betsky will have several different preparations, but here it's saying
clearly like any preparations are going to destroy it. It's
its function, so we don't. This is unprepared, always used, unprepared.
Western uses of the serb appeers the service primarily a
Chinese herb and a websarch yield and no traditional Western uses.

(32:35):
The PDR for herbal Medicines likewise does not mention this herb.
That's a pretty comprehensive text. It doesn't have this herb
at all in it. Chiang Huo commentary so this is commentary.
Vinsky at all as usual has an excellent commentary on
this herb Acrid, bitter and warm. The clear strong aroma

(32:56):
of chiang hu has a powerful dispersing quality that can
strongly raise and discharge wind, cold, or damp pathogens in
the exterior. Entering the chia level of the greater young
bladder channel, it releases the superficial muscle air from the
from exterior wind, cold and cold damness with such symptoms

(33:18):
as headache, stiff neck and sore shoulders. As it enters
the chia level of the liver and kidney channels, it
vents and eases the joints, and is excellent for alleviating
deep pain by removing wind damness and wind cold damness
from between the sinews and bones. For these reasons, it

(33:41):
is a commonly used herb for painful obstruction, especially in
the upper body. Essentials to the Materia medica are the
bensu on Beiyo, written in sixteen sixty four, observes that
cho quo is most appropriate for governing vessel disorders involving
muscular tetany or jing when they're there is a damage

(34:01):
from wind. When there is damage from wind without sweating,
it is called hard muscular tetany, With sweating it is
called soft teenany. There's also blood deficiency tetany, and generally
both chiang huo and Angelica pubcentis radix or dulhuo are
appropriate for wind disorders, but are forbidden for blood deficiency tetany.

(34:26):
Treasury of words on the material medica are the Bensa
Hui hui Yan, written in the Ming dynasty sometime between
thirteen sixty eight sixteen forty four explains the use of
the acrid dispersing property of chiang Huo for sores and
boils as using its ability to expel pus and draw toxins,

(34:46):
bring lesions to a head, and regenerate tissues. So that's
the commentary on chuk Huo and actually gonna get out.
I said it was under the countrary it must be
under or something else explains why this. There is some
confusion with the with the sand events such an okay

(35:11):
So Chang Chen has an interesting commentary on this herb
as well as others. In regard to headaches. Optimal treatment
of headache requires use of channel guiding herbs to deliver
the therapeutic effect of the herbs to the affected area.
Chang Huo Radix no top tier, Triji Trijii, chwan Hung

(35:32):
Raisoma lagusta tree, twan hung by jur radix Angelica to Hurrica,
chaihu radix pruplury, and gal ben Raisoma lugustas he all
treat headaches. According to doctor Lee Shoh Sean, the differences
between these herbs are as followers. Chang Huo is more
specific to occipital headaches. Chwan Shang is more effective for

(35:55):
headaches related to menstruation by jur focuses on frontal headaches,
try who treats temporal or side headaches, and cal ben
is best for vertex or top of the head headaches. Okay.
Comparisons Benski and his team comparisons are with two others.

(36:16):
The first one is Angelica puba centens ratics or du Huo.
In ancient times, Chanquo and Angelica pubi centus rtix dujo
were not differentiated. This is the key for the shindang benslaging.
In fact, a passage in Divine Husbitant's classical Materimacu or
the chinam bed Sudging refers to one as just a
different name for the other, Duelho, also named chian Quo.

(36:40):
The actions of these turbs are indeed similar. Both expel
wind downness, eliminate painful obstruction, and alleviate pain. However, Chanquo
has a clear, strong aroma which travels best at the
chi level, which makes it better for treating the more
young or superficial aspects of the body. It is also
warmer and more drying than Angelica pubi centis radix or Duhuo,

(37:03):
which has a heavier aroma and more moderate warmth travels
more slowly and more readily enters the blood level. Because
this herb tends to move downward, it is better for
lower limb and lower back wind damness, which has penetrated
deeper into the body. This combination is thus able to
treat wind dowmnus at any level above or below, and

(37:25):
is better at relieving pain than is either herb by
itself herm and benefit. In the Materia medica, the bensall
highly makes the following comparison. Chang Huo is more purple,
masculine and harsh in nature, and better able to regulate
wandering wind and angelicut pubicentus radix. Du Huo is more yellow,

(37:47):
moderate and better able to regulate lurking wind. There you go,
So that's comparison well Duho and explains why I had
trouble finding chang Huo in the shatdown bensa Jing, which
I forgot to mention. Now, Bejing is the oldest book
I mentioned every time. A lot of our herbs are
from it. It's the oldest book that we have in
existence that it talks about individual herbs, So it's if

(38:09):
an individual herb is the shutdown about Sojing. It means
this mocks the oldest herbs around in Chinese medicine. Okay,
our next comparison is Lagusta chi riisoma or gal ben.
Chan Quo's powerful aroma rises to expel ambulatory wind in
the muscles and exterior. It is best for neck and
shoulder pain, but also for freeing the joints by venting

(38:32):
pathogens from between the sinews and bones. Chan Huo and
Lagusta chi raisoma gal ben both enter the governing vessel,
but chang Kuo's tendency to move upward is stronger. Well,
Lagusta chi riisoma gal ben can reach the vertex. It
is better than chiang kuo for treating lower body disorders.
Chang Quo's ability to enter the liver in kidney channels

(38:56):
refers primarily to its effect that the sinew, liver and
bone kidney levels of the joints. Okay, that's comparison with that.
Let's talk about combinations now. So Benski and All combines
this herb with only one other, and that is one
of my favorite herbs to pronounce. And I have no

(39:17):
idea why I like pronouncing the irb sepassionate Covia radix
or fung fung sepassionate covia. So there we go. Sempassionate
Kovia radix. Pung fung has thin chi and ascending nature
and is neither harsh nor drying. Is very effective for
dispelling wind. Chi Quo is very drying and effective in

(39:40):
dispersing an exterior cold with its focus on the upper
and more superficial aspects of the body. Combining these greater
young wind herbs provides a synergistic effect. It is particularly
helpful in dispelling wind, dispersing cold, and overcoming damness to
stop pain as in ex generally contracted wind dampness. In addition,

(40:04):
because both herbs ascend and dispersed by nature, when used
in a very small dosage, their combination can raise suckin
middle chi So that's our combination. And what are the
contents of Chiang? According to Benski and his team, the

(40:25):
contents of this herb include volatile oils, ferranocumerans, phenolic compounds,
amino acids, then ethyl ferrulate and glycosides. Chen adds p
hydroxy phenyl fen ethyl fen ethyl aniseate okay, and ferulic acid.

(40:50):
Now cumerants we talked. I talked about cumins in my
fino pharma cognitcy course. So cumerants consist of a pyone
ring attached to a benzing ring have to worry about that.
Cumberans have several potential health benefits including anti tumor, anti HIV,
human virus, antibacterial, anticoagulant, central nervous system stimulant, anti inflammatory,

(41:15):
photo chemotherapy both for light and chemotherapy, and anti hyper lipidemic.
So it actually helps control cholesterol in the blood, according
to Chin and So let's get into the science. So
that's the contents. Let's get into the science. According to

(41:39):
Chen and Chen, the pharmacological effects of chang quo include
the following actions. Anti pyretic, which means it helps reduce fevers, analgesic,
it helps reduce pain, and potentially beneficial the cardiovascular system,
especially a rhythmias. Based on on a mice study mice,

(42:00):
so you know, may help carcus. Assumably not just because
it helps in mice doesn't mean it's going to help
in humans. Tongue in his team adds anti inflammatory, anti rhythmic,
anti coagulant, anti bacterial, antioxidant and anti cancer effects on
the brain, heart, digestive system, and respiratory system. So it

(42:21):
adds a lot more effects. And that was from twenty
twenty four, so chen Chen is two thousand and four,
so it's getting a little long on the twenty years old.
It's still awesome information. But tongue was this year twenty
twenty four, so brand's making new looking at a lot
of the different functions of chiang quo. So, and there

(42:41):
are several more words discussed by chet Chen. They also
discussed a clinical study. This is che Chen also discussed
a clinical study chang Huo as part of the formula
joey Joe chang quo tongue or nine herb decoction with
no top turigium was infective one hundred and forty nine

(43:01):
patients for treating common colds or influenza due to extra
wind cold syndrome. So take this with a little bit
of gore in salt. So first of one hundred and
forty nine patients is not a small study. But one
of the results was ninety three percent effective, which finding
any that's great and all, but when a study from
China says that it means it's an older Chinese study,

(43:23):
because that is not how studies should be, can be,
should be summarized, and it's it's not an appropriate way
to describe a study. And what happened was, i'd say
about ten or twenty years ago, all the training studies,
they realized, hey, we need to up our study game,
and so they started really getting into how modern studies

(43:45):
are done. And so anything before that time is going
to have this like it's ninety percent effective, it's ninety
five percent of everything, you know, that sort of thing,
which is not appropriate. And then after that time they
don't say those things anymore. So it's a little bit
of an older study as soon as someone says ninety
three percent effective bowl because nothing's really that effective. And
the way they defined efficacy is usually not well defined

(44:07):
in these studies, which is weird. So the other reason
why I don't like this study is it's a formula,
so it doesn't actually tell us if chang quo is
helpful or not. It just says chang quoa with all
these other herbs was helpful in this specific case. The
one thing I do like about the study is it's
about extra wind cold syndrome, which is not something we

(44:29):
do in the West. Ever. We would have colds or influenza,
but we would not define a cold or influenza as
a wind cold syndrome. I like that. I'd love to
see more studies like that, So some positive negatives here
on the city in general. I don't know if it
really helps support Chuquo's efficacy, but it's an interesting setty nonetheless,
And I did do a Google scholar search which showed

(44:52):
several animal studies which I do not report here. I
prefer reporting reviews, systematic reviews. Sometimes it is a really
good randomly controlled trial, I'll do that, but it has
to be a clinical trial, not animal city. So because
I yes, as far as a doctor as we were

(45:12):
trained to assess studies, if it's not in humans, it
doesn't affect humans, it doesn't tell us what it does
or doesn't do to humans. It has to be in humans.
That's a clinical trial. And there were no clinical reviews
about chron Quo's effects for so we don't know. Okay,
drug grab interactions literature search did not find interactions between

(45:33):
tron quo and various sacrohone P for fifty ice desimes
or peak like approaching. In other words, none of the
major risk factors that we look at for drug of
interactions were showed anything. One paper did show a constituent
of chan quo no topter No top terol may inhibit
sacroone P for fifty two D six in vitro, which

(45:54):
means in class the study does not show clinical relevance
and should not affect clinical decisions. Iss struggle of interactions
all over the place. Cyclone pter fifty interactions. I like
hundred thousands and thousands and thousands of them when it's
in vitro. I've seen a lot of these in vitro
that play no role in clinical Just because something does

(46:17):
it in a test to which is technically what a
vitro means in glass, doesn't mean it will show the
same effect when it's actually given to humans. And so
until it's actually in humans, I would not say that
this is an actual potential interaction. Does this. What this
does do is say, okay, maybe we need to look
at it in humans. But the other issue I don't
like about this is it's a constituent of no top turroal.

(46:39):
It only looked at one constituent of chu quo and
chuan Quota has thousands of constituents, and who's to say
that other constituents might actually be may actually may actually
induce rather than inhibit this particular cycrolone peter for fifty.
In other words, when you look at one constituent, that
does not give you the full picture of what this
or may or may not do. So overall, I think

(47:00):
this is useless. I'm mentioning it here for complet completeness,
but if you ask my opinion, there are no known
ciachop for fifty effects at this point that I found
on research, And I would go spar looking at the
American Herbal Product Association's Botanical Safety Handbook, which I love.
It's a very well researched book. Puts this herb in

(47:22):
interaction Class A herbs for which no clinically relevant interactions
are expected. I one hundred thousand percent agree with that.
At this point, side says step wise, tomorrow they maybe
say that shows all kinds of interactions with this irb,
But as of today, I don't think there are any
interactions to be concerned about with this herb. That doesn't
mean there aren't concerns. So let's talk about some of

(47:42):
those concerns. Benski and his team notes several concerns with
chang quo. Under the heading of cautions and contra indications,
they say contradicated for blood deficient painful obstruction, which echoes
what we mentioned earlier with the blood deficient tetany. Under
the heading of traditional contra indications, they quote harmon benefit

(48:05):
in the Materia Medica or the Bensu highly written in
eighteen ninety three. Both chiang Huo and Angelica puban centis
ratex du ho are wind herbs important for expelling wind,
dispersing cold, and eliminating dampness. Both however, are forbidden for
internal injury, causing blood deficient headache and generalized pain resulting

(48:29):
in chills and hot flushes because these wind herbs can
try the blood. Chen and Chen have some concerns as well.
Use of chiang huo is contra indicated for patients having
febrile disorders, yin deficiency or muscle achs, and pain because

(48:50):
of blood deficiency. Is also contra indicated for patients with
bijong or painful obstruction syndrome who have red tongues with
little or no tongue coning Chindicatechian deficiency in our blood deficiency.
They also talk about over dosage of this herb. Overdoses
of chio quo may injure the stomach and causinougia and vomity.

(49:11):
This may be eliminated by decreasing the dosage or by
taking it with herbs that harmonize the stomach, such as
Dadzu fruitis jujube and shanjagats Chinese States, and Shanjiang raizoma
zinjibaras recens, which is fresh ginger, so you can take
fresh ginger with it to prevent over dosage. Brandon Wiseman

(49:35):
Warren's chio quo is very warm and drying, used with care,
and yin blood depletion and an end in internally exuberant
dryness heat. The American Herbal Products Association's Botanical Safety Handbook
puts this herb in safety Class one. Herbs that can
be safely consumed when used appropriately. So concerns especially around

(50:01):
yen and blood deficiency, but generally not a ton of
concerns with this cerb. Relatively say, just need to be
careful of that dryness, which is why you don't want
to do it yet of blood deficiency because those are
dry kind of conditions. Okay, summary Today, we started with
our discussion of arthritis and looked at both osteo and

(50:22):
rheumatoid arthritis. Then we looked at another single Chinese herb,
Changhu no top turgi rhizoma sourateis or no top trigium roots.
This herb is in the Chinese medical sulb category of
warm accurate herbs that released the exterior under the category
of release the exterior herbs. It is helpful for certain

(50:44):
types of colds and especially for alleviating pain and unblocking
painful obstructions in many conditions, such as some types of arthritis.
With this we conclude another exploration of a very useful
Chinese herb. Our next episode in two weeks, we'll be

(51:04):
looking at another Chinese verbal formula, song ju ying yan
or mulberry leaf and chrysanthemum drink. This is from the
formulas that release exteri wind heat subcategory of the formulas
that release the exterior category. It is a useful formula
for treating early stage colds with a cough. This is,

(51:27):
you know, if I have a bunch of formulas for colds.
This is if I have five formulas for cults. Is
definitely one of those five formulas, very useful for colds
with cough. Cough is the determined factor. As always, we
will do our deep dive into this herb formula and
look at its traditional uses and its preparation, interactions and cautions,

(51:49):
and as usual we will be adding something a little different.
It's going to be another interesting vacation to the exciting
continent of herbs. Please join us. I'd just like to
say thank you for listening very much up to this point.
If you'd like this podcast, please do us a huge favor.
Subscribe in your favorite podcast app, and we thank you

(52:12):
for even considering doing that. And you can get this
course as well as many others as continuing Education Units
and National Certification Commission of acupunction Oriental Medicine Professional Development
Activities at www dot Integrative Medicinecouncil dot org. That's Integrative
Medicine COUNCILCU Ncil dot org. And don't forget that twenty

(52:37):
percent off with the code sh twenty off or the
course Treating Our Thris with Chinese Messine. You combine the two,
you can get the course on Treating in Ourthris with
Chinese medicine for twenty percent off, so that's a great combination.
You can always get in touch with me at doctor
Greg at sperbserbs dot com or at our website www

(52:59):
dot sperbs herbs dot com. That's Sperbs Herbs s p
E r B s h E r b s dot com.
I have to pronounce that H for our Commonwealth friends.
I used to teach in Australia and whenever I say
the word herbs, I'd always have a cheeky student who
would say, excuse me, sir, do you mean herbs, and

(53:20):
I'd say, yes, I mean herbs. So yes, the H
is silent in the American version, and that concludes our
They are our podcasts for the day as usual. I
having a bibliography and thank you very much. The presidium

(53:41):
was presented by doctor Greg Sperber. We would like to
thank Janelle for Awler support and everybody else who contributed
to this program. Roger Campbell