There are many moments in translating the concepts of Chinese and Western medical language where ideas pass almost close enough to touch yet never truly merge. The subject of Tonification is no exception.
As defined in contemporary language, a medical tonic can be defined generally, as an agent that increases health and vitality, or more specifically, as one that stimulates the normal tension and responsiveness of tissue to stimuli. This disparity is indicative of the same kind of vagueness that surrounds the use of “tonics” in western herbalism. Colloquially and professionally, tonics are used to increase health, vitality, and well being. There isn’t a problem with this definition necessarily and since it is the most commonly used one, it does seem to make sense to embrace it. Yet, it is also helpful, I believe, to attempt a deeper specificity if we are to understand how to best administer herbs to people and understand their effects.
A definition of tonics used historically in Western herbalism that has lost most of its usage is “a medicinal substance that stimulates digestive function, effectively increasing tone or vitality of the digestive organs, with potential systemic vitalizing effects resulting”. Though Chinese tonics are not mere stimulants to function, here there is an overlap in theory when considering Qi in a broad sense, as vital function, and the specific role that the Spleen Qi plays in the generation of Grain Qi, which in cyclical consequence goes on to form a fundamental aspect of both True Qi and Blood in the body.
The use of the term “tonic”, as an agent that generally promotes vitality, differs considerably from the historical Western medical herbalist usage of the term, as well as from the Chinese concepts of Yin, Yang, Blood, and Qi tonics. The former usage tells us only that health is achieved from taking a medicinal, whereas the latter ones tell us how that health is achieved, whether by stimulating digestive vitality or from tonifying Yin, Yang, Blood, or Qi. To take this investigation into specificity a step further we can see how referring to a medicinal as a Yin tonic, for example, insinuates that such a tonic increases the vitality of the Yin. While this may be true it does not tell us how this happens. If we know something about Yin and Yang we might venture an educated guess on the mechanisms at work, but I still consider myself an amateur at understanding Yin and Yang and so I find this terminology to be a bit vague.
It seems that there are many ways to increase the vitality of Yin, but (from my understanding) a Yin “tonic” primarily uses one strategy to this end – it supplements the native Yin of the body with substances that are Yin in nature and that nurture Yin in the body. Therefore it seems sensible to call a medicinal that supplements Yin a Yin supplementing medicinal. Likewise a Yang tonic can be seen as bringing additional Yang into the body, to add to the body’s own. In accordance with the characteristics of Yang, being active and mobile, a Yang tonic is also stimulating to the body’s native Yang, therefore it not only supplements Yang but also stimulates it (which can be seen in itself as a Yang-y kind of supplementation).
While this type of specificity can seem irrelevant or tiring it is this kind of discussion that lends Chinese tonic herbs their elegance in herbal therapy. When compared to their Western counterparts, Adaptogens, a broad category of herbs with widely varying vitalistic actions, Chinese tonic herbal classification appears more cohesive and artful, not to mention just incredibly useful. A comparison of these two medicinal categories, which share some of the same constituent herbs, can begin with examining specificity, its usefulness, and its limits.
Adaptogens as Tonics
Theoretically, the understanding of Adaptogens is both simple and complex. While Adaptogens are defined generally as remedies that have a nonspecific normalizing affect on the body, increasing adaptation to stress, they are more specifically, “officially” viewed as working through the Hypothalamus-Pituitary-Adrenal axis to achieve this end. A given adaptogenic herb can have a myriad of very specific effects on the endocrine system and from there even more countless effects on the rest of the body (Aralia and related spp. are said to have a normalizing effect on pituitary sensitivity, decreasing the stress response which can influence the release of thyroid stimulating hormone, adrenaline, the release of glucose into the blood, insulin secretion, glucose uptake, and the functional prioritization of certain organ tissues).
Because Adaptogenic actions are also considered “nonspecific”, their usage can become overly general when attempting to address an individual’s “stress”. This combination of generality and specificity seems like it could confer a nuanced usage of Adaptogens, and indeed it does for herbalists who take time to understand the biomedical and vitalistic characteristics of each individual remedy. But sometimes these herbs suffer from the same troubles that “tonics” fall victim to: a vagueness in use, to which attaching a biomedical understanding only partially clarifies.
Thus there can be a lack of connection between biochemical causal relationships determined through lab animal experimentation and an understanding of the effects of those relationships on a infinitely complex human being. This lapse between scientific understanding and elegant clinical usage is mirrored in the lapse between the systemic nature in which plant remedies seem to work in the body and the reductionist nature in which scientific medicine tends to look into the ways plants work in the body. In other words, whereas scientific discoveries in herbal medicine are valuable they ultimately do not seem to prove as wholly useful in practice to many herbalists as time tested system-oriented vitalist models. These scientific revelations often make good addendum to a vitalist methodology, enhancing understanding in contemporary language, but they don’t seem to be an adequate replacement. One reason for this may be that when we view physiology vitalistically what we are seeing is the effects of effects on effects in the body. That is to say we are taking a step back in our observations and, intentionally or not, taking a systems approach to understanding the body.
Chinese medical theory has its specificity, as discussed above, but it is a systems theory with specific tendencies or characteristics (like Yin and Yang) that are isolated in order to allow an understanding of flux in the system. In the same way that internal Chinese Martial Arts uses the same theory as Chinese Medicine, so are the Chinese understandings of human physiology and herbal action congruent. It could be argued that it is this congruency that confers much of the elegance of Chinese herbal therapy. In turn, it could also be argued that, due to cataclysms of western culture brought on by christianity, capitalism, materialism, and reductionism, Western herbalism has not a continuos history of theory like Chinese Medicine and so lacks both an understandable, comprehensive systemic view of human physiology and a congruency between scientific medicine and the nature of plant medicine.
Major differences between Adaptogens and Chinese Tonics
-Adaptogens are considered safe with no significant side effects or contraindications. Chinese tonics are not considered universally safe or appropriate for use, but rather prescribed only in specific cases warranting their use.
– Adaptogens are seen as having general, nonspecific actions that improve resistance to stress, whereas Chinese Tonics are seen as having very specific actions on Yin, Yang, Blood, and Qi.
– Adaptogens are considered to have a balancing effect on functions, regardless of the cause of disruption or the direction in which homeostasis has been pushed off balance. Chinese Tonics are seen as having more unidirectional actions as they supplement Yin, Yang, Blood, and Qi – though the supplementation of these may result in a normalizing effect on homeostatic imbalance.
– Adaptogens are seen as enhancing general adaptation to stress through altering neuroendocrine pathways, while Chinese tonics locally and systemically supplement the four deficiencies that play a role in the hypo functioning of organ systems, with potentially increased adaptation to stress resulting, amongst many other health benefits.
-A Western herbalist may suggest an Adaptogen to a client because stress is prevalent in their life, whereas a Chinese herbalist would only prescribe a tonic if one or more of the four deficiencies were present.
– A Western herbalist may view Adaptogens as preventatives and suggest them for everyone because stress seems to be so prevalent in peoples lives, whereas a Chinese herbalist would only prescribe a tonic if one or more of the four deficiencies were present.
– Western herbalism has some individualized styles of Adaptogenic formulation that include using companion remedies that synergize the effects of what Donald Yance, author of Adaptogens in Medical Herbalism, calls Primary Adaptogens (remedies that fit all the criteria of Adaptogens and have scientific research backing their use) and Secondary Adaptogens (remedies that behave mostly like Primary Adaptogens but do not fit all the criteria above, specifically they may not act through the HPA axis and do not have scientific validation). Chinese herbalism in comparison has formalized ideas on tonic formulation that describe appropriate combinations of tonics with each other as well as with other categories of herbs (for example, avoiding over tonifcation and the creation of Qi stagnation with Qi supplements by combining them with herbs the regulate the movement of Qi, or combining Qi and Blood tonics for the purpose of Blood supplementation).
– A given herb, whether it falls into the Chinese Tonic or Adaptogen category, is still the same herb and holds true to its properties and actions regardless of how we might categorize it. Yet, because the understanding of these two categories are rooted in systems of physiology so different from one another, their usage can vary quite a bit and thus their eventual actions on an individual can vary as well.
Though the conceptualization of adaptogenic theory comes from reductionist medical science, the attempt at understanding and affecting health through its use is in fact a step in the direction of a systemic understanding of human health. As a kind of biological control board, the HPA axis plays many amazing and important roles in assessing stressors and determining bodily responses. The decision to focus the human mind through this prismatic paradigm when trying to see how and why the body works is, I believe, a step towards understanding how to integrate the specificity garnered from scientific medical study into herbal medicine.
The HPA axis affects the whole body in ways similar to Yin, Yang, Blood, and QI. Not that the two theories are analogous, but rather they both determine a fundamental nature of physiology and use that to understand the different permutations produced from interactions between the basic energies and substances. Some Western herbalists, Michael Moore notably, have worked towards a theory that integrates biomedical understanding of the HPA axis and elements of vitalism with North American regional herbs that can be administered in a way congruent with the theory, resulting in a relatively comprehensive and artful system of tonification.
That most americans today can relate to scientific and biomedical jargon better than they can to chinese medical jargon is one more reason that the work of these herbalists is so valuable. Scientific medicalism developed antagonistically along side medical herbalism and tried (and continues to try) to eradicate it from practice. These two western modalities are siblings torn from each other in their adolescence. One was coddled and given the best of educations. The other was ridiculed, persecuted, and left to fend for itself. Self educated, it keeps strange company and has strange ideas. Today these siblings are grown older and self actualized and time has yet to tell if they can truly rejoin and become a family again.
In comparison, Chinese medical theory evolved along side Chinese herbalism, being different aspects of one understanding. These are radically different histories and their effects on herbal practice today are pronounced. Western herbalists scrounge for pieces of theories to work with, some trying to fit plant medicine into a wholly biomedical perspective, others opting for a completely exotic or magical paradigm, while still more find some place in between. Ultimately it seems we are looking for a methodology that is discrete enough to allow our limited intelligences an understanding of the mechanisms at work while expansive enough to keep working even though we don’t and can’t know the complete story.