Northern Asia

In the history of medicinal plant use in eastern Asia and Siberia, a very important school of medical practice, traditional Chinese medicine, links practices from a number of traditions that have been handed down by word of mouth (as in Siberia or northern China) and for which written historical sources are very rare and poorly investigated (e.g., Mongolian traditional medicine and the Tibetan school).

The Chinese Materia Medico, has been growing throughout the last 2,000 years. This increase results from the integration of drugs into the official tradition from China’s popular medicine as well as from other parts of the world. The first major Materia Medica after Tao Hong Jing was the Xin xiu ben cao 659 ad, also known as Tang Materia Medica, which was the official pharmacopoeia of the Tang dynasty. It contained 844 entries and was China’s first illustrated Materia Medica. Zheng lei ben cao, 1108 ad, was the major medical treatise during the Song dynasty and contained 1,558 substances. However, China’s most celebrated medical book is represented by Li Shi-Zhen’s Ben cao gang mu, posthumously printed in 1596 ad, with 1,173 plant remedies, 444 animal-derived drugs and 275 minerals. This tradition has continued into the modern era with the publication in 1977 of the Jiangsu College of New Medicine’s monumental 25-year project entitled Encyclopedia of the Traditional Chinese Medicinal Substances (Zhongyao da cin dian) containing 5,767 entries. Traditional Chinese medicine and Chinese plant remedies are nowadays used throughout Western countries, whereas other botanico-medical traditions remain largely restricted to their regions of origin.

Chinese foxglove Rehmannia glutinosa / Scrophulariaceae

Although it belongs to the same family as European foxglove and is sometimes known as Chinese foxglove, Rehmannia glutinosa has a completely different usage in traditional Chinese medicine.

R. glutinosa represents the most widely used drug of the Pharmacopoeia of China, where the plant, called di huang, is one of the most popular tonic herbs and is considered to be one of the fifty fundamental herbs. The drug is found in the root, which is used in different ways (raw, dried, charcoaled). Charcoaled R. glutinosa root is used to stop bleeding and to tonify (a form of balancing the body) the spleen and stomach. The fresh root is used to treat thirst, the rash from infectious diseases, and bleeding due to pathological heat. The dried root is used to treat bleeding due to blood deficiency and to nourish the vital essence, and the prepared root is used to treat chronic tidal fever, night sweats, and dizziness and palpitations due to anaemia or blood deficiency.

The root of Chinese foxglove is one of the ingredients of the “Four Things Soup,” the most widely used woman’s tonic in China, the other three ingredients being Angelica sinensis, Ligusticum wallichii, and Paeonia lactiflora. Rehmannia root is another example of a food-medicine and it is eaten after having been boiled “nine times.”

Chinese rhubarb Rheum officinale, R. palmatum, and their hybrids / Polygonaceae

Chinese rhubarb originally grew wild in northwestern China, the best varieties coming from mountainous regions of Kansu Province, and in eastern Tibet. The dried roots of rhubarb have been used as a laxative for thousands of years, and it is known in the Chinese Pharmacopoeia by the name da huang.

Chinese rhubarb is mentioned in historical sources from 2700 bc and was cultivated for medicinal purposes. Wu, an emperor of the Liang dynasty (557-579), was advised to cure his fever, but only after being warned that rhubarb, being a most potent drug, had to be taken with great moderation. During the Yuan dynasty (1115-1234) a Christian sentenced to hard punishment was pardoned after using rhubarb to heal some soldiers. Marco Polo, who knew the Chinese rhubarb rhizome very well, talked about it at length in the accounts of his travels in China, while Chinese rhubarb was already widely used in European pharmacy, especially in the School of Salerno, possibly introduced through Arabic medicine. Later on, the Chinese emperor Guangzong (reigning from 1620 to 1621) was miraculously cured with rhubarb from a severe illness he contracted after having had a joyful time with four “beautiful women.” In 1828 the Daoguang emperor sent out an edict stating no more tea and rhubarb could be sold to Western merchants. Rhubarb has played an important role in the historical Western Pharmacopoeias of the last centuries and it is still used today for its peculiar phytotherapeutical properties: it acts as an astringent at low doses (0.1-0.2 g of dried drugs) and laxative at high doses (1.0-2.0 g).

Ephedra, Ma huang Ephedra sinica / Ephedraceae

Ephedra sinica represents one of the oldest medicinal plants in China, where it is known by the name of ma huang. It is estimated that its use began 4,000 years ago, particularly in northern China and Mongolia. Ephedra was used in ethnomedicine as a stimulant, to increase perspiration, and as an anti-inflammatory. In the Chinese school of medicine, a preparation called mimahuang, containing roasted honey and chopped dried aerial parts of this species, is claimed to be an effective treatment for flu and respiratory tract inflammations. Ephedra, which contains ephedrine and similar alkaloids, has been used extensively in the ancient pharmacy as an antihistaminic in the treatment of asthma and as a natural decongestant. It has become a very popular ingredient in herbal combinations for allergies and hay fever. Since it is a central nervous system stimulant and increases the metabolism and increases body temperature, it has been used to control weight and to help prevent sleep, and by athletes in order to improve their performance. One of the side effects of increased metabolism is an increased pulse rate and a potentially dangerous rise in blood pressure. Occasionally, ma huang has been mixed with other stimulants or food supplements and used as a narcotic stimulant. Dangers stemming from lack of knowledge about the pharmacological effects of the drug caused several American states to ban ephedra in 2003, followed by a federal ban in 2004 on sales of products containing ephedra. It is currently on the doping lists of banned substances and ingredients of all the international sport associations. E. equisetina in China and E. gerardiana, E. intermedia, and E. major in Pakistan have also been used in a similar way.

Dried aerial parts of several Ephedra species, including E. trifurca, are known in the US as “Mormon tea,” a very popular stimulant beverage made by Native Americans and the early settlers in the southwestern United States and Mexico.

Ginkgo Ginkgo biloba / Ginkgoaceae

The name ginkgo is thought to come from the Chinese word sankyo or yin-kuo, meaning “hill apricot” or “silver fruit.” This refers to the seeds, produced by female trees, which resemble apricots, but have a smell like rotting flesh or rancid butter (due to their content of butanoic and hexanoic acid). Ginkgo biloba was originally found in China and lapan, where it was cultivated as a temple tree. Fossilized leaf material from the Permian is remarkably similar to the modern Ginkgo biloba. Ginkgo had survived in China, where it was mainly found in monasteries in the mountains and in palace or temple gardens, where Buddhist monks cultivated the tree from about 1100 ad. It was spread by seed to lapan (around 1192 ad, linked with Buddhism) and Korea. Ginkgo is considered a sacred tree of the East and it is associated with longevity. In the 11th century (Sung dynasty) gingko is referred to in literature as a plant native to eastern China. Prince Li Wen-ho (first half of the 11th century), who came from the south, transplanted it to his residence, after which it became well known and was spread through propagation. Ginkgo has been depicted on Chinese paintings and appeared in poetry from that time onward. Scientists thought that it had become extinct, but in 1691 the German Engelbert Kaempfer discovered G. biloba trees in lapan, and it was brought to Europe (Utrecht) in 1730.

The earliest known medicinal use dates back to 2800 bc and is ascribed to the pseudofruits of G. biloba. They have been used as both food and medicine: the pseudofruit, prepared by fermentation and cooking, have been considered a delicacy during weddings and feasts, while ginkgo seeds are used in traditional Chinese medicine as a kidney “yang” tonic, to increase sexual energy, halt bed-wetting, and soothe bladder irritation. The seeds are boiled as a tea used to treat lung weakness and congestion (especially asthma), wheezing, coughing, vaginal candidiasis, frequent urination, cloudy urine, and excess mucus in the urinary tract. In Malaya, the seeds are popularly used for making desserts and are recommended for their beneficial effect on the brain, circulation, and eyes. Interestingly, the leaves are much less frequently used in eastern Asia and include the treatment of chilblains (reddening, swelling, and itching of the skin due to frostbite), and as a throat spray for asthma. Today, ginkgo leaf extracts have enjoyed worldwide popularity and have stepped into the “herbal spotlight.” This has been due to heavy media coverage and also to a number of very interesting clinical findings, recently supported by many pharmacological studies of its main constituents (diterpenes [ginkgolides], sesquiterpenes [bilobalide], and biflavonoids). G. biloba leaf derivatives have shown to be very effective in the treatment of intermittent limping due to chronic thickening of the arteries, senile dementia, vertigo, tinnitus, and hearing loss caused by severely reduced blood supply.

Qinghao Artemisia annua / Asteraceae

Artemisia annua has been used for hundreds of years in traditional medicine in China. The leaves were harvested in the summer, before the flowers appear, and dried for later use. The dried leaves are generally used in the treatment of fever, malaria, colds, diarrhea, as a digestive, and, externally, as a wound remedy. As recently as 1971 a Chinese research group isolated the active principle, the sesquiterpene lactone artemisinin, which proved to be very effective against the malarial parasite Plasmodium falciparum, and particularly towards chloroquine-resistant malaria.

In an attempt to overcome the frequent problem of many patients having a recurrence of the illness one month after the treatment, a number of derivatives of artemisinin have been developed (ethers, such as artemether and arteether, and esters, such as sodium artesunate and sodium artenlinate). Although artemisinin has been synthesized, this process is complex and not economically viable, and it is currently still extracted and isolated from the aerial parts of A. annua. Today artemisinin and its derivatives represent a promising group of antimalarial agents.

Korean ginseng Panax ginseng / Araliaceae

Korean ginseng is a small herbaceous plant growing wild in mountainous areas from Nepal to Manchuria, and from eastern Siberia to Korea. The earliest mention of it comes from a book of the Chien Han Era (33-48 bc), but by the 3rd century ad China’s demand for ginseng created international trade of the root which allowed Korea to obtain Chinese silk and medicine in exchange for wild ginseng. Long before Vasco da Gama opened up a sea route to Cathay (China) in 1497, the “Three Kingdoms” (the Koreas and part of Manchuria) had a thriving trade selling ginseng to China. Soon after, word began to filter through to Europe about the northern woodland plant that had miraculous healing and restorative powers. The first reference to ginseng in Europe dates from 1643 and is a traveller’s report published in Rome. In 1653, Hendrick Hamel of Holland and his fellow seamen were sailing from Formosa to Japan; during a lengthy storm they were blown off course and ran aground on Cheju Island, Korea. They were taken into custody by the Korean government and held on what was meant to be a permanent basis. In Hamel’s diary, he noted that Korea paid “tribute” to China entirely in the form of ginseng. Three times a year an envoy would arrive from China to collect it. In 1709, a Jesuit named Father Jartous returned to Europe from an assignment in China. In the Memoirs of the Royal Academy in Paris he wrote of the amazing medicinal ginseng root he had learned about. Later it was translated into English for the Philosophical Transactions of the Royal Society of London.

Although probably originally used as food, it quickly became revered for its strength-giving and rejuvenating powers, and its human shape became a powerful symbol of divine harmony on earth. Ginseng roots often resemble a human-like figure, which is why they are referred to as “human-root.” The more human-like the root appears, the higher its value. The age of the root plays an important factor in assuming this human-like shape — thus, older roots are more valuable than younger ones. For customers in China, the shape of the root is very important: a ‘skinny’ root does not have the beauty that a larger one has and, hence, is not as valuable. Chinese herbalists have prescribed ginseng root for centuries to treat problems of the digestive and pulmonary systems, nervous disorders, diabetes, and a low sex drive in men. It is said to increase energy and improve memory. Ginseng is mainly used in modern evidence-based Western phytotherapy as an “adaptogen” (a substance which helps the body to deal with, or adapt to, stress or adverse external conditions): to stimulate the central nervous system, increase resistance to fatigue and stress, and to improve memory.

Interestingly, in 1711, Father loseph Francois Lafitau, a lesuit, was sent from France to a mission near present-day Montreal, Canada. lartous’ writings eventually reached him in 1716. Realising that the local latitude was about the same as the area in China where ginseng grew, he wondered if some might grow in his vicinity. When he showed a drawing of the ginseng plant to the Indians, they immediately took him to a similar plant nearby, which was American ginseng, Panax quinquefolium, growing wild in the eastern half of North America. The Indians used it in ways somewhat different to those of the Chinese: as a tonic, for healing wounds, as a headache cure, to soothe eyes and muscular cramps, and to cure croup in children. Nowadays, American ginseng, together with other ginseng species (lapanese ginseng, P. japonicus; Himalayan ginseng, P. pseudoginseng; and San-chi ginseng, P. notoginseng) are sold widely in the United States and Europe, and are prescribed for similar medical conditions as the Korean ginseng.

Siberian ginseng Eleutherococcus senticosus / Araliaceae

Siberian ginseng is a thorny bush common in western Siberia, from the Amur to Sakhalin Island, and is commonly used in the popular medicine of Siberian populations. Russians in particular have used its roots as a cheaper substitute for the expensive Korean ginseng. Cosmonauts have relied on this nourishing herb to help them manage their rigorous training, while Olympic athletes have often used Siberian ginseng to maximize their potential. Siberian ginseng is considered by modern phytotherapy to be an “adaptogen” (a substance which helps the body to deal with, or adapt to, stress or adverse external conditions), as is Korean ginseng.