Xi Xin (Asarum)

This episode we will be exploring another interesting Chinese herb: xì xīn, Asari Herba, or asarum or Chinese wild ginger. 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 can be an important herb in certain circumstances, especially as a potential substitute for some of the functions of the banned ma huang or ephedra…but is it safe? Is it readily available? We are going to find out! And as usual, we will be exploring something a little different…treating hypertension 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 as we look at xì xīn, Asari Herba, or asarum or Chinese wild ginger. It is going to be another interesting trek into the exciting universe of herbs…please join us!

Episode Transcript

Speaker 1 (00:03):
That angelicab. Welcome everybody to episode eighty one of Sperbs Herbs.
Today we're doing a Chinese herb si sheen or a
sorry erba, also known in English as a sarum or
a Chinese wild ginger, and it's going to be a

(00:25):
wild time, so it's going to be useful. Let's see
what we're doing today, and today we will be exploring
another interesting Chinese herb seation. I just said all this
as sorry a herba or a sarum or Chinese wild ginger.
This herb is in the Chinese medical subcategory of warm
acrid herbs that release the exterior under the category of

(00:46):
release the exterior herbs or is it One of our
books disagrees with this. Let's see what that means. It
can be an important herb in certain circumstances, especially as
a potential substitute for some of the functions of the
band ma huang or ephedra. But is it safe, is
it readily available or is it banned? We're going to

(01:07):
find out, and as usual, we will be exploring something
a little different. We're gonna talk about treating hypertension from
more of a biomedical point of view rather than a
Chinese medical point of view. Please stay tuned for this
intriguing episode. Before we get into this, I would like
to take a moment and remind y'all I've been teaching

(01:28):
for quite a while now on a wide variety of topics.
If you like this podcast and you want to explore
more of my courses, they are available at www dot
Integrative Medicine Council dot org. That's Integrative Medicine Council Council
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my Drug Herb series looking at drugs and how they

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So let's talk about treating hypertension before we get into
today's HERB. Just updated my Cardiac Drugs in Chinese Medicine
class and my drug RAB series based on my book
Integrated Pharmacology combining modern pharmacology with integrative medicine. In this course,

(02:55):
we discuss the definition of blood pressure and different pharmaceuticals
used to treat it when two elevated, which is known
as hypertension. And I thought it would make an excellent
little some different for SPERBS ORBS. So here we are.
So hypertension confounds many cardiac conditions, which is important because

(03:17):
cardiac deaths are the number one cause of deaths in
the US for sure, and I believe in most developed
nations so very very common. So we need to do this.
So hypertension confounds many cardiac conditions, and it's quite prevalent
in the population with elevated blood pressure, affecting approximately forty
five percent of adults in the US. Now that's huge.

(03:43):
Forty five percent of adults is a massive number of
people that might be affected by hypertension. However, it's elevated
blood pressure. It's not technically hypertension. And it seems to
me like they you know, when I started, hypertension was
over one forty, over ninety it is now this elevated
blood pressure is between nine and I believe eighty and

(04:07):
between eighty and ninety. So they've brought it down quite
a bit to make this definition of elevated blood pressure.
But it's based on science, so hopefully it does say something.
Anti hypertensive agents are used to lower blood pressure. Blood
pressure or BP, is determined by multiplying cardiac outputs CO

(04:27):
and total peripheral vascular resistance or TPR, so blood pressure
equals cardiac output times total peripheral resistance. Total peripheral resistance
is mostly based on blood vessel tone, the state of
the muscles and arteries, and capillary beds. To a lesser degree,

(04:48):
the total peripheral resistance is also determined by intravascular blood volumes.
More blood in the in the in the vasculature means
more back pressure to Total peripheral resistance is sort of
back pressure from what's what's out there. So if you're
those are arterials, those arteries, those small arteries and cabullary
beds are really tight. There's a lot of back pressure

(05:11):
that happens. Also, if there's more blood in the vessels,
it means higher total peripheral resistance. The cardiac output is
itself a product of stroke volume and heart rate, stroke
volume BNSV and her raving HR. So stroke volume is
how much blood is being pushed through contraction of the

(05:33):
heart and is determined by heart muscle contractility, which means
how hard the muscle squeezes and the amount of venus
blood that returns to the heart called preload. The HR
is simply how fast the heart is contracting, So how
hard it's contracting and how fast it's contracting is what

(05:56):
makes up the cardiac output. From these equations, there are
three main controllers of blood pressure in the body, the heart,
blood vessel tone, and the kidneys. The heart can control
blood pressure by regulating the speed and force of contraction,

(06:17):
blood vessel tone changes that total peripheral resistance, and the
kidneys control blood volume and therefore can affect stroke voume,
cardact output and total peripheral resistance. We didn't get into
stroke volume too much, but there's something or do we
talk about preload a little bit. No, we talked a
little bit about preload. So preload is if there's a

(06:38):
lot of blood volume and that goes to the heart,
the heart stretches a little bit, and with that little
bit of stretch, it contracts much harder than it would
without that little bit of stretched. So higher preload means
higher stroke volume. So that's why it can affect all
these things with the kidneys. And that's important because we
find when we start looking at drugs, the kidneys are

(06:59):
kind of the main thing we look at. So all
classes of drugs that affect blood pressure act on these
areas below, So that's the heart, the blood vessel tone,
and the kidneys. Those three areas. The most common anti
hypertensive agents are the diuretics, which work on the kidneys
to reduce intravascular blood vome and therefore stroke fiome and

(07:21):
total peripheral resistance. Beta blockers decrease contractility of the heart
muscle to reduce cardac output technically stroke voome, and affect
the reenin angiotensin system to reduce blood voume and therefore
stroke ume. Cardiac output and total peripheral resistance. Angiotensin converting
enzyme or ACE inhibitors cause phasodilation and affect the reenin

(07:46):
angiotensin system, causing changes in total peripheral resistance, stroke fiome
and cardiac output. Angiotensin two antagonists acts similarly to ACE inhibitors.
Calcium channel blockers are excuse me, are generally an alternative
choice for treating hypertension due to adverse reactions. They work

(08:06):
by reducing the contract cartam and thus stroke biome and
kardac output. So that's a really brief introduction to the
basics of hypertension and the basics of how we might
treat it. I talk a lot more about it, a
lot more about it in my course, but this is
a good little you know, amuse boosh, And then let's

(08:30):
get into today's herb. There's a lot to talk about,
which is why there wasn't a ton of a little
bit different. Let's talk about Let's start talking about today's
herb Chi shin or serum or Chinese wild ginger. It's
in the family Aristo Lokiosia, which we're gonna find out
is actually important for us to kind of know that
this family is there, Aristo Lassier. There are several standard

(08:55):
species that can happen here, and they have their different
Chinese names. So once species is a serum heterotropoides h
F R var man man shura coum so okay, so
I don't know what FR means. Var means variety. So
this is a sub variety of this species, and that

(09:17):
variety is called man suracum, and it was there's maxim
period in parentheses. That means that was the oldest bodanist
that classified this and key tag k I T A
G is the botanist that actually put it in its
current place, so that's where those names come from. The

(09:39):
Chinese name for this particular species is Beshi shin. Another
species is a Sumboldi so boldii, and this is mick
and a very var so it's a variant uh sulens
s c o U l E N s E and

(10:00):
Nakai is the is the botanist and the Chinese this
is Han chung Shei shin. And then there's that non
variant of the same species as Sarum sibowldiai mick but
no variant, so no subvariant of it. And this is
in Chinese Washi shin. So medicinal part is the whole herb.

(10:22):
The English translation is thin acrid. That's what she shin means,
thin acrid, and the thin refers to the little rootlets
that are there, the very thin uh, and it's spicy,
so acrid there are Okay, let's talk about some of
the names and then we'll talk about have a little
note about it. So other names for this is a
sara azaram a z a r r u M, cabaret,

(10:47):
false colt's foot, hazel war, public house plant, uh, snakeroot,
xiao shin, which literally translates as small acrod that came
from the Shandong Ben sub jing, which we're going to
talk about in just a minute. In Japanese it is
seishing and in Korean sasan, and I don't know how

(11:10):
to pronounce Japanese or Korean. And there are a lots
of different names for each species, which are too numerous
to list. Her like, each subspecies had like four or
five names in Chinese of it, so it got really
complicated really fast. So I kept it a little bit
simple here with all the different names. So let's talk
about that. Aristolo Lachie e Aristo Lachie Lachiasia family. The

(11:37):
Aristo lachiyasi or birthwart family, has seven genera and about
four hundred species of flowering plants. The plants are perennial,
with simple leaves which are spread out and grow alternately
along the stem on leaf stalks. They do not have stipules,
which are you know, little bulbs under the leaves. The

(12:01):
flowers are bizarre medium to large sized and are bilaterally
or radially symmetrical, and several members contain the toxin aristolocic
acid or aristolocic acid. So that's kind of the main
thing we need to be worried about, well, we think
it's one of the main things we need to be
worried about any herb that's in this family is this

(12:23):
aristolocic acid, which can't be quite harmful, and worldwide there's
definitely been quite a few deaths caused by aristolocic acid.
So the question becomes does she should have aristolocic acid
or not? And we're gonna be answering that question. So
let's keep that question in mind. And the reason why
I'm harping on it here as we're talking about the family.

(12:45):
The family is Aristolochiasia family, so it actually has that
Aristolochic in the name of the family. So that's why
it's important for us to talk about it in terms
of the family. Okay, So going back to the individual herbs, Chi,
Shin or a Sarum, Benski and his team, So we

(13:07):
have three main texts. One is by Benski and his team,
we have Chen and Chen, and then we have Brand
or Wiseman. So those are three texts we keep referring to.
There are some other texts we use quite frequently and
will be using in this context as well. So Benski
and his team say the dosage is one to three
grams Chen and Chen agree with one to three grams
in decoction or zero point five to two grams in powder,

(13:29):
and Brand and Wiseman also say the doses one to
three grams in decoction, zo point five to one gram
in powders, So the Chen Chen will go up to
two grams and powders. Brandon Wiseman says only one gram
in powder, so we're gonna dosing is really important for
the serbs. So this is much lower dosing than a
lot of herbs. Most herbs are anywhere from six to

(13:51):
fifteen grams, and commonly six to nine grams are very
commonly used for most herbs. So when it's definitely below
that and we're gonna see some warnings about dosing, than
it's a concern. So this is much lower dose than standard,
So the category is interesting. Benski and his team put

(14:11):
this herb in the warm acrid herbs that release the
exterior subcategory under herbs that release the exterior category. Chen
and Chen, however, differ, and they say it is in
the interior warming herbs category, and Brand and Wiseman say
it is warm acrid exter resolving medicinal under the exter

(14:31):
resolving medicinals category, so slightly different translation, but they basically
Benski and his team in Brann and Wiseman agree with
where this herb should be. Chen Chen says, no, it
actually is in interre warming herbs. It's not in the
release of the exterior bunching of verbs, and we're gonna
talk more about that when we talk about commentary from

(14:52):
Chen Chen. All three of our sources say it is
acrid and warm and enters the lung heart in kidney channels.
Chen Chen say it is slightly toxic, and Brand and
Wiseman similarly say it is mildly toxic. So right there,
we're starting to talk about the toxicity of it, and
that's an important thing conversation when we're talking about this herb,

(15:16):
the history of this herb. Both Benski and his team
in chen Chen say the original source for the serb
is the Shendong Ben Saljing or the Divine Husbandsman's Classic
of Material Medica in the second century CE. We discussed
this book a lot. It is the first written, first
written book that still exists on individual herbs, and so

(15:38):
if an herb is in this an individual herb is
in this book, it means it's among one of the
oldest books, one of the oldest herbs in the Materia medica.
So this is there. So let's talk about herbs that
release the exterior in general, and then we'll talk about
herbs that are warming and release the warm and acrid

(16:00):
and released exterio. So we've now discussed this category and
subcategory of verbs several times during our adventures examining Chinese herbs.
In fact, two episodes ago we did the same thing
we're going to repeat that information here just in terms
of completeness. So, 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

(16:25):
including wind, heat, when cold, when dampness in summer heat
invade the body, they first attack at superficial exterior aspects.
Symptoms associated with the exterior then appear chills, fever, headache,
stiff neck, and general muscle aches. Sometimes sweating will appear,

(16:47):
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 in the condition. At this juncture, herbs
that release the exterior are used. Most exterior releasing herbs
are diaphoretics, that is, they release or expel the external

(17:09):
pathogenic influences through sweating. There is a saying in Chinese
medicine when the diseases in the skin, sweating will bring
it out. When a disease progresses slightly further into the
body is said to lodge in the muscle layer. The
clinical presentation then includes fever, general body aches, and profuse sweating.

(17:31):
At this stage, especially when the patient is sweated without
any beneficial change in their condition, is it appropriate to
use the subset of herbs that release the muscle layer.
The most prominent member of this group is cinemamon rimulence
or guade jer. Some of the herbs that release the
exterior have additional functions stopping coffin and wheezing, controlling pain

(17:55):
or spasms, inventing rashes such as measles. Bensky at All
continues to discuss the sab sub category of warm acrid
herbs that release six stir, which the serb belongs to.
Herbs that release sixtier can be further divided by character

(18:15):
and function into warm acrid and cool acrid classes. The
warm acrid herbs dispel wind cold and are used for
exterior disorders when the fever is mild and chill, the
chills severe, and there are other signs and symptoms of
wind cold, including a headache, body and neck pains, and
absence of thirst. Okay, so that's a good start to everything.

(18:43):
Let's talk about good quality of the serb and then
we'll get into its functions. So good quality, according to
Benski at All, they say good quality has many elongated, slender,
grayish yellow roots, green leaves, and a hot, acrid taste.
We have another great textbook along these lines called the

(19:06):
Chinese Medicinal Identification, An Illustrated Approach by Jao and Chen,
and they say she shin are rolled into bundles and
have externally grayish brown rhizomes and grayish yellow roots. They
are brittle and easily broken, with an acrid an aromatic odor,
and an acrid and spicy taste that numbs the tongue.

(19:28):
Superior quality have many roots. The different species have different
average lengths and diameter is an intensity of taste and odor,
so depending on the species, these are variable. So with that,
let's get into the Chinese medical actions of the herb. So,
according to Benski and his team, sorry, I'm just some

(19:52):
wateror she shin disperses cold and releases the exterior an
adjunctive herb for any cear cold pattern, especially with the
addition of damness or underlying young deficiency. The serve is
often used for externally contracted wind cold with the dominant
symptoms are head and body aches. It dispels wind, disperses cold,

(20:15):
and relieves pain for pain due to wind and or
cold anywhere in the body, but particularly headache, painful obstruction,
abdominal pain, or toothache. Often the conditions are marked by wind,
cold and damnus having obstructed the muscles to the point
that there's no sweating, even the blood cannot flow smoothly.

(20:38):
It also warms the lungs and transforms thin mucus for
cough and chi with surges up which surges upward, as
well as fullness in the chest with continuous cough from
clumped chee in the chest and diaphragm. These patterns are
usually marked by coughing with copious watery spute. And finally,

(21:01):
it can act by unblocking and facilitating the orifices for
various types of nasal congestion, oral pathology, and some types
of loss of consciousness, all of which impair the clear
orifices of the head. Not suggesting that here in developed
nations we should be using it for loss of consciousness,

(21:22):
but that is one of the traditional uses, so Chen
and Chen say. It dispels wind, disperses cold, and relieves pain.
It dispels wind cold from the exterior. It also warms
the lung and resolves phlegm Additionally, it opens sensory orifices
and promotes healing of oral alteration, and finally it relieves toothache.

(21:45):
Branda Wiseman say, it dispels wind and dispers cold, relieves pain,
relieves pain, warms the lungs, and transforms room and opens
the orifices. The Divine Farmer's Material Medica say this is
a superior class herb, which I vehemently disagree with. But

(22:07):
then again, it's hard to think that a two thousand
year old book on herbs would be still absolutely correct today.
It's it's not, but it is. It is classifyed a
supire class, which are herbs that should be taken frequently
and don't have toxic effects and can be helpful for
long term use. This is not one of those herbs

(22:28):
from what we know today, and and the other thing
that happens in two thousand years which may have changed.
It may have been that way two thousand years ago,
but often with you know, selection and things like that,
herbs become much stronger over millennia, and so today's ab
may not probably isn't the same herb that they're talking
about in that of my Farmer's Materia Medica shud nong

(22:52):
ben sagme so it says this is a superior class.
Herb is acrid and a little warm. Most of the
the current thinking is it's not a little warm, it's warm.
It mainly treats coughing, counterflow, headache and shaking brain, hypertonicity
of the hundreds of joints, wind damp impediment and pain

(23:16):
and dead muscles. That's an interesting term. It brightens the
eyes and disinhibits the nine orifices. And here's that reason
why it's in the superior class. Protracted taking may make
the body light and prolonged life. So disagree with that.
But other than that, it's not bad. And I fronting

(23:37):
of that book. Chinese Medicinal Identification and Illustrated Approach is
also has some actions and they usually are very similar
to Brand Wiseman, because Brand was one of the editors
on this book. So they say it to spells, winds, scatters, cold,
frees the orifices, relieves pain, warms the lung, and transforms room.

(24:01):
When I say room, I use that in Brown Wiseman too.
That's our h eu, not r o O m so
room as in you know in the in the others.
Uh they they instead of room. Uh, they use the
term flam. So I think room is a nicer word
than flem, but a little bit less, a little bit

(24:21):
more obscure. Preparations. Benski has a good discussion of a
couple of preparations. The first one is this sarum powder
or she shian mole, dried well and powdered. This is
usually applied externally, including the oral cavity. And then there's
prepared to sarum or zuer sheishin. This sorm is fried
over a low flame with honey until the honey is absorbed.

(24:44):
This method of preparation is no longer common. The honting
frying reduces the herbs drying and dispersing properties so that
it warms the lungs and transforms thin mucus without injuring
the yin. It is thus appropriate for treating the elder
or those with weak constitutions. Western Us is hard to find.

(25:08):
The PDR for Herbal Medicines does not have an entry
for this. Herb ourx List, which is a website, says
it is used for bronchitis, bronchial spouses, and bronchial asthma.
So alcio used to treat coughs, pneumonia, chest pain, angina, migraines,
liver disease, and dehydration. Some people use it to cause vomiting.

(25:30):
Women use it to start their menstrual periods and cause
an abortion. Please take this list with little skepticism, as
it does not listen any specific species and can be
discussing a herb the same genera of a different species,
because you know, in Chinese medicine and anything I read,
there's nothing about the menstrual periods or abortion or vomiting

(25:50):
would be one of the signs of toxicity. So I'm
a little concerned about this list, but it's something which
there wasn't a lot of it out there. Darmananda he
has a great article and talk a lot about his
article a little bit, but he describes the Western use
of a similar but different species of his arm readily

(26:12):
growing in Europe and North America as stimulant, carmitative, diuretic,
and diaphoretic. So stimulant means stimulating kind of stimulates the
sympathetic nervous system. Carbonative means helping with cough, Diuretic means
promoting urination, and diaphratic means sweating, promoting sweating, so similar

(26:34):
to our Chinese, which makes sense because he's well versed
in Chinese herbs. All right, let's get in some commentary.
There's a lot of commentary here, So have a question,
what about the tianman go teg Are they good for
treating hypertension? Yes, they are really good. Those are kind
of my go tos for treating hypertension. This is I think,

(26:55):
going back to our original discussion and hypertension, which was
just an overview of it. If I'm gonna work on
hypertension from a Chinese point of view, I often will
consider Tan mount goteng Ti mont Goteng Yin is a
formula that's very good for hypertension. It's not always what
I go to, but certainly one of my first thoughts
to look at for the patient in front of me.

(27:17):
It's a good question, Lina, Thank you, okay Si Shan
commentary lots of commentary on this, so Benski and his team,
as usual, has an excellent and extensive commentary on this herb.
The ability of sorry Herba shi Shin to induce sweating
is rather weak, so it cannot serve as the chief
herb in an extra releasing formula. Similarly, when used to

(27:40):
warm the kidney young it is also generally used in
an adjunctive capacity. The perfect example of this is the
formula of fedra asarum and aconite accessory route to coctioner
mahuang si shan food Zitan, where externally it assists the
sweat inducing action of a federa herba or mahuang, while
internally helping aconid rate ex lateralis pepperare Jurafudza warm the kidneys.

(28:08):
Chen scher Chen sheer Dwo says that this herb it
benefits the orifices and clears phlegm, alleviates watery eyes from wind.
But sishin can only be used in small doses, not large,
and it can only be used in concert with other herbs,
not by itself and excessive dose, which will exhaust the

(28:30):
cheet and increase the pain. Used alone, it will finish
the chi and end life. There's no room for carelessness.
It might be asked, since sishin can warm the kidneys,
it must be tonifying. How then can it disperse chi?
The answer is that she shin is a young herb rising,
not sinking. Although it warms the fire of the kidneys below.

(28:53):
It does not warm the water of the kidneys. The
nature of fires to flare upward, she shin warms the
fire and thus causes it to ascend. This is why
it cannot be used in large doses. Others may inquire
if she should disperses chu chi, how can it be
effective for headaches? The answer is that the head is

(29:14):
the capital of true yong. If clear chi rises and
turbid chee descends, then the head and eyes are clear
and crisp. It is only if turbid che rises and
clear chee descends that the eyes and head are heavy,
aching and painful. She shin Chi is clear and not turbid.

(29:34):
Thus it brings down turbid chee and lifts clear chee.
This is why it cures headaches so miraculously. However, it favors.
Its flavor is acrid, and its nature is dispersing. One
must use it with herbs that toonify the blood so
that there is no blood, so that there is blood
to prevent chi from dispersing excessively. So, going back to

(30:01):
the commentary from that quote, there is an adage about
this herb to the effect that it should not be
used in dosage larger than one chian or about three grams. However,
this was taken out of context. The source of the adage.
Alternative statements of material medicare the Ben Salbie shwe Chuo
excuse me Ben Salbie Schwoh written in ten eighty six,

(30:25):
refers to the use of the herb by itself as
a powder. There are physicians who report good results in
difficult cases using a large doses of shei shin, but
those without extensive experience and the use of this herb
should be wary and err on the side of caution.
Some traditional urbal pharmacies use she shin as a non

(30:45):
toxic alternative to camphor for the preservation of herbs, especially ginseng.
Small portions are simply wrapped in a cotton cloth and
placed in the corners of the storage space. So that
was the commentary from Ben Scan and his team. Chen
Chen say shei shin has potent effect to dispel wind

(31:07):
cold from the exterior and warm the interior. Depending on
the reference, that has been classified as either an extra
releasing herb or an interwarming herb. So that's that's the
reason the other two books inter extra releasing herb. Chen
Chen classified as inter warming herb. I love when they disagree.

(31:29):
We learn a lot with that. Okay, let's talk about
some comparisons. Ben Scannings seem to do not compare this
herb with any others. However, Chen and Chen do, and
they compare Sheshan and mahuang orbophedra. Both function to warm
the body and spell wind cold. Chi Shin is penetrating

(31:51):
in nature and more strongly warms the body while mainly
relieving pain of headaches, body wide muscle eggs, and pain
caused by wind cold. Mahuang is dispersing in nature and
more effectively disperses wind and releases exterior conditions. It is
the strongest herb for treating wheezing and dyspnia and wind

(32:11):
cold invasions where there is no perspiration, so she should
can be useful when there is no persuasion, as we
talked about when it hits the muscle ayer. But mahwang
is much better. So one of our questions when we
started this was can she Shan help replace some of
the functions of Malwan? And I think the answer to
that is a little bit yes, not a lot, As

(32:33):
you can see here, not a lot across. There's really
no good substitution for ma wan. I wish there was,
because I can't tell you how many times I'm lecturing
in one of these courses mawang has called for in
a formula and I can't. I don't have any suggestions
because mawang is banned. It is not allowed in the US,
It's not allowed in most developed countries at this point.
And so you know, what do you use as a substitute. Well,

(32:55):
she shan might be able to substitute some little bit
of the function of the mahuang. Problem is si shin
is not readily available. Like, for example, I just had
to take it my my irlists. I don't ever treat myself.
That's one of my roles. I just had the flu
and then had a cough afterwards, and my herbalists wanted

(33:16):
to put she shin in my format. I couldn't find
it anywhere. I didn't go into Chinatown and ask for
it as a raw urb because I use I use
granules for the most part, and everything was granules and
this could not find the granule or anything with granules
that included she shin. So it's really kind of you
can get it. You can always ask for it, and
a lot of people go under the counter and get it,

(33:37):
even though it's a little questionable. It's not easy to
get in general. So she shin is not a great
substitution for mah wang one on the function end of it,
but also on the availability end of things as well. Okay,
that's comparison, So let's talk about some combinations. Benski and
his team combinances are with four others. There's a lot

(34:00):
to talk about with these. So the first one is
akonide rate x lateralis peparata or your foodza. So that
is a warm the anterior herb. So remember this can
be considered a warm interior herb. It is by chan chen.
So this pair is frequently used for dispersing cold and
stopping pain, as explained in rectification of the meaning of

(34:21):
materior medica or the ben sauas Young Yi rid in
nineteen fourteenth So relatively modern chi shiins aroma is most potent. Therefore,
it excels it opening clumchi and disseminating constraint. In stagnation.
It can reach the vertex, unblock the eyes and ears,
and reach laterally to the hundred articulations. That's the joints.

(34:43):
There's no subtle area. It does not reach internally. It
dredges the collaterals and channels in order to unlock the
joints exteriorly immobilizes the orifices of the pores in order
to directly vent the muscles and skin. So that's the quote.
When the two herbs are used together, their common warmth
combines their ambulatory nature facilitates movement, and the effect is

(35:07):
to disperse cold and alleviate pain Internally. Akiniti redix letter
aliics preprote are Gurefudza warms while she Shoin draws out
the cold and disperses it. Exteriorly, she Shoin dredges up
the pathogen lacinii redix latter alics Preparzrfuza encourages and supports

(35:31):
this action. Thus, cold at any level can be completely
eliminated clinically. Besides treating cold damage involving both the exterior
and interior marked by a version of cold headache and
generalized body aches with aching joints, the pair can also
be used in treating painful obstruction from wind, damnous and cold,
leading to spasms of the joints and intolerable pain. However,

(35:55):
caution must be exercised in the use of these herbs
due to potential side effects. If the condition is not
one of cold from excess, this pair should be used
only with considerable caution. So that's the combination of the
jurfuza with Shandra fruitus or wuwaedza. This herb is sour

(36:17):
warm and specifically used for contracting and preserving. That's the
Wuaedsa is particularly good at restraining the lungs and alleviating cough.
Together with shishin, whose acrid dispersing property opens the lungs.
The sour restraining quality of Shandra fructus wu waiedza preserves
the lung cheek. The first herb opens the lungs without

(36:37):
risk risk of exhausting its chie, while the second herb
closes the lungs without risk of mistakenly trapping the pathogenic chie.
Thus the pair is ideal for regulating the opening and
closing of the lungs, alleviating cough and calmon wheezing. It
is used for patients with existing thin mucus who are
further exposed to externally contracted wind cold leading to acute

(37:00):
wheezing and coughing up of clear sputum. The relative dosage
of each of the two herbs should be based upon
the duration of the disorder and the strength of the pathogen.
Generally speaking, recent or early stage disorders have a stronger pathogen,
in which case shi shin should be emphasized. In more
chronic cases, the pathogen will have weakened, but so will

(37:22):
the patient, and Shandra fruitus with waisa should be emphasized
in order to take advantage of its lung preserving action.
These rules are reflected in the adage for a new cough,
use more she shin. For an old cough, use more
Sheshandra wades up, and that's our combination with huades up.

(37:42):
Our next combinations with chuang shang rizoma or the Chinese
twang chiang chuang shang raisoma. Twangshang is acrid and ideal
for moving and dispersing. It can trovel upward to the head, eyes,
and vertex with relatively powerful wind expelling action to relieve pain.
It is considered an essential herb for headaches. Xi shin

(38:06):
also reaches the crown and excels it unblocking the nose
and ears, expelling when cold, and relieving pain. Together, the
pain relieving actions of these herbs are strengthened synergistically, especially
for wind cold headaches. This use has been extended to
pain from wounds, as described in Rectification of the Medium
Materia Medica. Quote twanshang Raizoma excels at dispersing and also

(38:32):
travels in the liver channel a chi herb that moves blood. Thus,
it disperses wind, cold, treats headache, and breaks up stagnation,
unblocks the blood vessels, releases clump chee, eliminates pain spells
plus dissolves swelling, drives out blood, and unblocks the channels.
Decocted together with she shin, it treats pain from wounds

(38:55):
caused by metal. This pair can treat swelling and pain
from swres and boils, or from trauma. Other herbs should
be added based on the nature of the disorder hot, cold,
excessive or deficient, and our fourth combinations with Angelica cuban
centus radis are dou hole Angelica pub centus rates or

(39:19):
duh is bitter, acrid and warm, dispels wind and damnness,
and disperses cold to stop pain. It also enters the
kidney channel and tends to treat the lower body. She
shin is acrid and warm with a powerful wind cold
dispersing action that tends to ascend and float upward, thus
acting on the upper body. Combined, the ability to expel

(39:45):
wind cold is strengthened. But more importantly, the actions of
Angelica Pubi centus radics are duho are elevated by the
she shin into the upper body, especially the head, face,
and teeth. Thus, this combination is frequently used when strong
externally contracted wind cold has caused a lesser headache with

(40:05):
splitting pain that involves the teeth and cheeks. As Jiang
Yuan Soon noted, with Shi Shin as chief and Angelica
Puba sentence rates to Whoa as deputy, the therapeutic effect
on lesser yon headaches is miraculous. This pair is also
used for other pain in the joints and bones due
to wind cold and damnness contents of the serb. According

(40:32):
to Benski at all, the contents of this herb include
several volatile oils with saffrol varying dramatically between species. Chen
Chin highlight essential oils two point three nine to three
point eight zero percent, including methyl eugenol, saffroil, saffroll a, saracen,
and eu carbone. There's also hygenamine and aristol aristolochic acid.

(41:00):
Aristol g acid is one of the things that they highlight,
which is a concern. We're gon't talk more about that
in a minute. Let's talk about the science. So cardia,
chin and chin. The pharmacological effects of s should include
the following actions. Reversal of morphine induced respiratory depression when
injected into rabbits. Okay, we don't know if that does

(41:22):
anything for humans or not. An alcohol extract increased heart
rate and cardac output. Generally we don't do alcohol extracts
of this. We either decocta in water or we do
the powder. So I don't know how relevant this is. Again,
I think it was an animal study, so and we
generally don't want to increase heart rate cardiac output. The

(41:42):
essential oil can be anti inflammatory, as shown after injection
into rats, and can be a local anesthetic as shown
in rabbit injections. Okay, so those are all animals. Those
were animal studies, and there have been several clinical studies.
Is knowned by Chen. These showed beneficial effects in topically
treating appithess ulcers within an end of one hundred and

(42:02):
six and means number of subjects, and generally we want
at least thirty to forty to be statistically valid, and
generally the more subjects are, the stronger the study. So
one O six is a horrible study. It's not a
tiny study. It isn't the largest study either. It's not bad.
So it had helped treating topically treating apphthus ulcers and

(42:25):
treating angina with an end of two hundred and eighty
one with chichian and borneolium. The Chinese are being beyond
so those two together was useful for trining. And the
way they did it was interesting. They did it with
alcohol and they sprayed it into the mouth so it
got supposedly absorbed quickly through the mucus the mucous membranes there.

(42:46):
Very interesting. Again, I don't think something we're gonna deal
with in the West particularly, but it's an interesting use
of this herb drug ERB interactions. In general, literature search
did not find any potential druger interact with this herb,
and the American Herbal Products Associations Botanical Safety Hambuk does
not have an entry on this herb, so there is

(43:07):
no obvious drug of interactions with this. It has enough
actions on its own for us to be concerned about
strong actions on the zone. We're talking about those coming
up next. When we talk about concerns, there's a lot
of concerns about this particular herbs. We're gonna get into
that in just a minute. Okay, let's do that now. Concerns.

(43:30):
So Benski and his team note several concerns with Si shin.
Under the heading of cautions and contraindications, they say contra
indicated whether there is profuse sweating from cheat efficiency, or
headaches or cough due to end deficiency. Under the heading
of traditional contra indications, they quote from harm and benefit
in the material medica or the bensu highly in eighteen

(43:51):
ninety three with its ascending drying and dispersing nature. Chi
shin should not be used for any disorder having internal
heat or fire flushing upward, upper excess and lower deficiency,
cheat efficiency with sweating, blood deficiency, headaches or yin deficiency, cough.
All the methods forbid it. So under the heading of toxicity,

(44:16):
they say overdosage of this herb, or too short a
boiling time during decoction can cause toxic effects. In one case,
fifteen grams of the year five times this suggestion maximum
does taken as a decoction caused headache, nausea, diaphoresis, sweating, restlessness,

(44:36):
red face to kidnia or rapid breathing, accelerated pulse, elevated temperature,
cardiac arrhythmia, hypertension, epistotonos This is when it's also kind
of it's when your back is arched and everything is extended.

(44:57):
Everything else is kind of extended. Not good thing. It
basically means the brainstem kind of is involved, pist of pistoos,
disturbed consciousness, convulsions, dilated pupils, urinary retention, and ultimately death
from respiratory paralysis. So that was an overdose, and it
wasn't that much of an overdose. I mean, fifteen grams

(45:19):
versus three graps. Like, like I said at the beginning
of this, when we're talking about dosing, fifteen grams is
kind of in the realm of normal dose for a herb,
not this herb. The toxic constituent of this herb is
thought to be saffrol, which has shown after long term
administration to cause liver cancer in various animals. We're gonna

(45:41):
talk a lot about sapprol in just a minute. There's
much more of a problem with the adulterans, which have
three to six times the amount of saftrol as the
standard substance. So again your source is important. Where are
you getting this from and is it a good Are
they giving you good quality stuff? Precise species identification and
the assay of saffral content is therefore necessary to avoid

(46:03):
toxic reactions. So this might be why it's very difficult
to get the serb in the US, because the toxic
constituent of the herb is part of the volatile oil.
For long boiling of the herb reduces its toxic effects.
The dosage of unboiled herb as in pills or powder
preparations should not exceed one point five grams per day.

(46:24):
So remember back to dosage. We said that brand Wiseman
said maximum one graund powdered per day and chen Chen
said maximum two grams powdered per day. So Benski is
right in between those two at one point five grams
per day. So there you go. That's the daily dosage.
So there we go. We got a range there, but

(46:45):
they're all on the ball Perkish. So that's the concerns
for Benski and his team. Let's talk about concerns from
Chen and Chen who have similar concerns. Shishin is extremely
dangerous when used in larger quantities than suggested or iffused
in powdered form. The saffrole is the essential oil of

(47:06):
she shin, is responsible for the toxicity of this herb,
which can be reduced or removed by cooking. So it
says the same thing as Metski, that's good. Chi Shin
is contraindicated in patients with febrile disorders, yin deficiency, young
excess cough or wheezing duty due to yin deficiency, headache
due to blood deficiency or wind heat and perspiration from

(47:29):
chee deficiency, and they discuss overdosage. Adverse reaction associated with
overdose of she shin is generally observed one to two
hours after ingestion, but may occur within thirty minutes. Early
symptoms include headache, increased pressure sensations in the head, nausea, vomiting, perspiration, thirst,

(47:50):
red face, restlessness, anxiety, stiff neck, dilated pupils, hurried respiration
rate up to fifty three times permittent. Normal respiritual rate
is about fifteen sixteen give or take. Elevated body tempature
up to forty five degree see again, normal body temperatures
thirty seven degrees CE. So that's a lot more so

(48:11):
if we're gonna I can't convert it in my head
to degrees. But we're talking a very high fever. Elevated
blood pressure up to one fifty to seventy over one
ten to one thirty, so that's considerably elevated blood pressure.
Tack a cardia up to one hundred and twenty three
beats per minute, and forceful rapid pulse as the reaction progresses.

(48:36):
Patients may also exhibit general tremors, muscle stiffness, clench, jaw mania, jaundice,
and in severe cases, anurea which means no urination, unconsciousness,
and respiratory depression. They do have this, and ten chen
do have instructions on how to treat an overdosage. However,

(48:57):
given its severity, emergency medical cares. So they have all
these herbs and you know what you should do, But
unless you have the herbs ready to go, and you're
gonna triumph for thirty seconds before you sit in the
emergency room. I wouldn't go near this with a thousand
foot poll. Is an emergency situation. Let the emergency team
handle it. Additionally, chen Chen State, under the heading of toxicology,

(49:20):
Chin belongs and the aristo Aristo lokiyas a family, Aristol
Lookiyasia family has been found to contain trace amounts of
aristo lookic acid. Again, that's considered quite toxic. And so
we're concerned about the risto locic acid, and I actually
think that is the main reason why it's been banned
in the US. However, this next article kind of disputes that,

(49:45):
and I kind of agree with it. So Sabuti Dormanonda.
If you're not famous, Subodi Dominonda. He is a very
proficient very He writes a lot in the US, and
I think he ran a school for many many years.
If I don't think he does anymore, I don't know.
I haven't heard. I don't know what his current state is.

(50:08):
But he has a really good article in the Toxics
she Shin, and so he says the Chinese RB she Shin,
commonly known as his Sarum is mainly derived from asarumboldy
eye and A. Sarum heterotropoids, and there have been no
reports of aristolocic acid in these plants. However, ristolocic acid

(50:30):
has been found in some other species of A. Sarum
and the normal other species of his arm, So that's
part of the issue is there doesn't seem to be
aristolochic acid in she shin, but adulterates and other herbs
that are sold as she shin may have a ristal
loca acid. So there's some thought that the US saying

(50:52):
there's aristolocic acid and we're banning she shin, maybe because
they looked at improper samples. So that's one of the
considerations here. Okay, Continuing back with Darmananda's article In the
Normal Practice of Traditional Chinese Medicine, about a dozen species
of Asarum are used as sources of shi shin, making
the presence of aristolocic acid in some of the raw

(51:14):
materials and the formulas produced with them a possibility. Also,
as detection methods of prove minute amounts of aristolocic acid
might be found in most or even all of the
Asarum species, this would be deemed reason enough for asarum
to become included in the list of verbs to be
banned from use, since no acceptable level of this compound

(51:36):
has been set or is likely to be established. The
main active ingredients of the various Issarum species are not
aristolochic acids. Instead, there are essential oils in A sarum,
including saffrol, which we've talked about a lot, saffrol, methyl eugenol,
and asorroon, which are understood to be the main act

(51:57):
of ingredients. Ethyl eugenol and sorrow have been suggested to
be carcinogenic based on laboratory animal studies. Risullocic acid is
also carcinogenic in laboratory and animal studies. So there you go.
So the real issue we may have here with these

(52:17):
with this herb is not the ristullochic acid mayor may
have mayor and I may not have some probably doesn't
if it's a good if you're getting good quality. But okay,
but we still need to be worried about some of
its active agreds. I mean, we saw earlier that safrol
is actually the higher level of saffral means the more
effect of this herb is. But saffral we know is

(52:40):
carcinogenic here. So there's a lot of question marks here
that we have to be worried about with this particular herb,
and so I don't necessarily agree with the banning of
any herbs, especially for US professionals who should know better
and know how to use this at an effect of
dosing and all that sort of stuff, and it should

(53:02):
be relatively safe. I don't know about you. When I
do use Shishian, I'm very cautious about it, but it
is also an important nerve. And like I said, I
was just prescribed it and I couldn't find it. The
others were fine. I got through what I needed to
get through. But still, so you know, I'd rather it
wasn't banned. But I understand why it was banned, even

(53:25):
though if the reason why it was banned was actually wrong,
because it was banned because of rust to local acid.
I don't think there's a lot of rust to local
acid in this particular herb. However, the other stuff may
be bad enough for it to be banned. So I'm
not horrified that this is banned. I just wish it weren't.
And that is our show for today. We started with

(53:49):
the discussion of hypertension, and then we did a deep
dive into an interesting Chinese herb she shin sorry herba
or sarum or Chinese wild ginger. We found the serb
is relative useful and powerful for treating colds and external attacks,
as well as for warming kidney young when combined with
other herbs. However, there are considerable safety concerns and proper

(54:11):
dosage is incredibly just as important, but incredibly important with
the herb. I would say this is one of the
more toxic herbs, even if Chen and Chen and Brand
Wiseman say it's mildly or slightly toxic. I just, you know,
knowing what I know about drugs, and the thing we're
concerned about with drugs is what we say is a

(54:34):
narrow therapeutic index, which is basically the the the ratio
between therapeutic dosing and harmful dosing. And if we look
at that as a measurement, this would definitely be a
herb with a neuro therapeutic index. And I would definitely
be very wary about using the serb. Having said that,

(54:55):
I've used it no problem safely. I've used it myself,
so I'm not opposed to its use, but it does
need to be used safely. That's the key thing. It
has to be done properly. And with that we include
another exploration of I don't know about a very useful
Chinese CRT, but definitely a useful Chinese R. So thank you.

(55:19):
In our next episode, we will be looking at another
Chinese erble formula. In fact, we're gonna look at probably
the first formula most of us learn in school songtured
tongue or scallion and prepared soybean decoction. This is a
mild formula for releasing the exterior. It may be easily

(55:42):
created most kitchens without any major herbal inventory. I love
this formula because when someone calls up and says, I'm
coming down with a cold, I don't want to come in,
so you don't have so you don't get exposed. But
do you have any suggestions? This is one of my suggestions.
They usually have everything they need right then and there
my suggestions. As always, we will do our deep dive

(56:03):
into this herb formula and look at its traditional uses
and its preparation, interactions and cautions, and as usual, we
will be adding something a little different. It's going to
be another interesting track into the exciting universe of verbs
in two weeks. Please join us, and as usual i'd

(56:25):
like to thank you very much for joining us today.
If you like this podcast, please do us a huge
favorite subscribe in your favorite podcast app that would just
do a rule the good for us. Thank you very much,
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(56:47):
very interesting courses at www at www dot Integrative Medicine
Council dot org. That's Integrative Medicine Council Council dot org.
And remember that twenty percent off code, that's uh sh
for Sperbs RBS twenty off so s H two zero
O f F and you get twenty percent off whatever

(57:08):
you want to take there and you can always get
in touch with me at doctor Greg at sperbserbs dot
com or at our website www dot sperbserbs dot com.
Ken thank you very much, and as usual, we have
a biblic Probably bibliography today wasn't super long, which was interesting. Well,

(57:31):
you know, there's a lot of concentrated information, so it's
a good in our textbooks, so good good bibliography. And
with that, thank you very much, Spurs. The proceeding was
presented by doctor Greg Sperber. We would like to thank
Janelle for allers support and everybody else who contributed to
this program. Rogeramble