8/24/16

1

Food as Medicine – a TCM Perspective

藥食同源--中醫的飲食觀

“What should we have for dinner? When you can eat just about anything nature (or the supermarket) has to offer, deciding what you should eat will inevitably stir anxiety, especially when some of the foods might shorten your life. Today, buffeted by one food fad after another, America is suffering from a national eating disorder. As the cornucopia of the modern American supermarket and fast food outlet confronts us with a bewildering and treacherous landscape, what's at stake becomes not only our own and our children's health, but the health of the environment that sustains life on earth.”

桂枝三兩（去皮）芍藥三兩甘草二兩（炙）生薑三兩（切）大棗十二枚（擘）

上五味，㕮咀三味，以水七升，微火煮取三升，去滓，適寒溫，服一升。服已須臾，啜熱稀粥一升餘，以助藥力。溫覆令一時許，遍身漐漐微似有汗者益佳，不可令如水流漓，病必不除。若一服汗出病差，停後服，不必盡劑。若不汗，更取依前法，又不汗，後服小促其間，半日許，令三取盡。若病重者，一日一夜服，周時觀之，服一劑盡，病證猶在者，更作服。若不汗出，乃服至

二、三劑。禁生冷、粘滑、肉麵、五辛、酒酪、臭惡等物。

葛根四兩芍藥二兩生薑三兩（切）甘草二兩（炙）大棗十二枚（擘）桂枝二兩（去皮）上七味，以水一斗，先煮麻黃、葛根，減二升，去上沫，內諸藥，煮取三升，去滓，溫服一升，覆取微似汗，不須啜粥。餘如桂枝法將

息及禁忌。諸湯皆彷此。

8/24/16

2

小麥

補味甘微寒。養心除煩，利溲止血…麥，秋種夏熟，備受四時之氣。南方地暖下濕，不如北產者良。張仲景治婦人臟躁証，悲傷欲絕，狀若神靈，用甘麥大棗湯。…

面粉甘溫。補虛養氣，助五臟，濃腸胃，然能壅氣作渴，助濕發熱。陳者良（寒食日，紙袋盛，懸風處，名寒食面，年久不熱，入藥尤良）。…

麥麩醋拌蒸，能散血止痛，熨腰腳折傷，風濕痺痛，寒濕腳氣，互易至汗出良（麥之涼，全在皮，故面去皮即熱，凡瘡瘍痘瘡潰爛不能著席者，用麥麩裝褥臥，性涼而軟，誠妙法也）。

藥食同源？

• 藥物與食物有相同的起源

• 食物有藥物一般的性味功能

•  四氣五味

• 藥物與食物無本質的不同

•  有大約40種介於藥物與食物之間

Food as Medicine

• Food and medicinal herb share the same origin • Food has medicinal properties like herbs •  Four nature and five flavors

• There is no fundamental distinction between food and medicinal herbs •  About forty can be classified as either

黃帝內經-五常政大論

大毒治病，十去其六，常毒治病，十去其七，小毒治病，十去其八，無毒治病，十去其九。穀肉果菜，食養盡之，無使過之，傷其正也。

Origin of Food and Medicine

藥物與食物的起源

神農的故事

• 三皇之一

• 傳說在公元前2800年是天下（中國）的共主

• 可能是部落的名稱

8/24/16

3

The Story of Divine Farmer

• One of the Three August Ones (Demigods) • “Sovereigns” of Ancient China circa 2800 B.C. • Possibly name of a tribe personalized as Cultural Hero

神農的出身

• 母親感神龍而懷孕 • 又名炎帝，有火德 • 長大後成為部落的領袖 • 部落本來是游牧民族

Devine Farmer’s Backgound

• His mother gave birth to him after dreaming a dragon • Possibly God of Fire • Became leader of his tribe that was nomadic

神農嘗百草–農業的始祖

• 為了部落的生存而嘗百草 • 發明了耒(lei3)耜(si4) • 部落本來是游牧民族，後改為農業民族

As Founder of Agriculture

• Explored the Natural World for food • inventor of spade and plough • transformed a nomadic society into an agricultural one

神農嘗百草–醫學的始祖

• 身體是透明的 • 一日而遇七十毒 • 最後中毒而死

8/24/16

4

As Founder of Medicine • Has a transparent body • Poisoned 70 times a day • Saved by tea every time • Finally died after repeated poisoning

神農故事的啟示

• 在中國，醫學與農業是不可分的 • 中醫是由探索自然世界而發展的 • 醫生的內視是探索藥物的重要工具 • 藥物是在探尋食物中發現的，無法和食物分開

Morals of the Story of Divine Farmer

• Divine farmer is credited as the founder of Agriculture and Medicine in China • TCM begins as experimentation of natural world • Physician’s self-reflection and meditative self-examination are critical tools • Food and Medicine share the same origin

伊尹的故事

• 伊水，尹有治理的意思 • 公元前 1600年 • 桑樹下的孤兒 • 被王室收養而成為廚師

The Story of Yiyin

• 尹 means “to correct, to transform” • circa 16o0 B.C. • An orphan baby found under a mulberry tree • Raised by a small royal family as a cooking slave

伊尹的故事

• 成為陪嫁的奴隸 • 有莘氏的公主嫁給商的成湯 • 進食鵠(hu2)鳥之羹而得到成湯的召見

8/24/16

5

The Story of Yiyin

• part of the wedding escort of the princess • The princess was married off to King Tang of Shang • He was impressed by a Swan Stew prepared by Yiyin and summoned him.

治大國如烹小鮮

• 首先要了解材料的屬性（不要違反自然） • 五味調和 • 控制水火 （陰陽） • “鼎中之變，精妙微纖，口弗能言，志不能喻。若射禦之微，陰陽之化，四時之數。”《呂氏春秋》

The Way of Cooking

• First, know the properties of the ingredients (don’t fight nature) • Flavors must balance each others • Control of Fire and Water (Yin and Yang) is the ultimate • Harmony and Balance is beyond speech and understanding

由奴隸到宰相

• 被成湯聘為宰相 • 輔佐商湯滅夏 • 奉為阿衡（國師） • 相國攝政三代

From Slave to Prime Minister • The king hired him as his minister • orchestrated the military campaign to overthrown the despot • Prime Minister to four kings • Ruled as the teacher and protector of kings

伊尹的革命

• 第一個奴隸成為宰相 • 第一次武力改變政權 • 第一個權臣攝政 • 改單味用藥為方劑 • “伊尹以亞聖之才，撰用《神農本草》以為《湯液》”《針灸甲乙經》

8/24/16

6

Yiyin’s Revolution

• First slave to become prime minister • First time change of sovereignty using military power • First time a minister ruled as “King Protector” • First to use herbs in formula • “Yiyin, with talent next to sages, produced Herbal Formulae based on Divien Farmer’s Classic of Herbs.”

伊尹故事的啟示• 尊重自然，順天行道 • 以和為貴 （陰平陽秘 精神乃治） • 中道是超越言語的 • 世間的道理一以貫之 • 平衡與協調不但是方劑、中醫的追求也是最高境界

Morals of the Story of Yiyin

• Respect and utilize the power of nature • Balance and harmony is the ultimate goal for all aspects of life • It is beyond word and understanding • Yin-Yang and Five-phase can be applied to every knowledge • Credited as inventor of Formulae and Recipe

What is Traditional Chinese Medicine?

什麼是中醫？

What about Modern Medicine?

• Based on Pathological Dissection　以病理學為基礎 • Using bio-chemistry as framework 以生物化學做架構

• Reductionism (smaller part is fundamental to the whole)　還原論

8/24/16

7

黃帝曰：陰陽者，天地之道也，萬物之綱紀，變化之父母，生殺之本始，神明之府也.治病必求於本。

-黃帝內經素問 陰陽應象大論篇第五

陰陽

Yin and Yang

Yellow Emperor says, “Yin-yang is the way of heaven and earth, the order of everything, the progenitor of change, the origin of life and death, and the domain of Spirit. Treatment of any illnesses must seek this source.

-The Great Treatise on Yin-yang’s Manifestation on Phenomena, Chapter 5, Yellow Emperor’s Internal

Classics

TCM is a continuation of Chinese Analogous Reasoning •  Holistic •  Ambiguous •  Imaginative/Reasoning •  Comprehending •  Non-uniform

•  整體性

•  模糊性

•  聯想性/推理性

•  體悟性

•  個體差異性

中醫是中華文化象性思維的延伸

Feature of TCM •  Holism - Does not believe in reductionism

•  The body cannot be divided

•  The body cannot be separated its environment (geographic/climatic/seasonal/social/emotional)

•  Emphasize on harmony and balance

中醫的特色

•  整體觀 － 沒有還原論的思想

•  人體不可分

•  人體與環境（地理／氣候／季節／社會／情感）也不可分

•  注重和諧與平衡

中醫對藥性的理解

• 中醫的藥性認知與化學成分沒有直接聯系 • 中醫的藥性主要是從性味影響氣化而來 • 食物的藥性機制與藥物相同

8/24/16

8

Medicinal Property in Chinese Medicine

• Chinese do not believe in the chemical compounds • Chinese believe in the movement of Qi • Food works just like medicinal Herbs

Medicinal Property of Food

食物的藥性

食物與藥物的比較

食物 藥物

作用緩和 作用強

無毒、偏性小 有一定毒性、偏性大

提供營養 不一定有營養

滿足心理需求 不滿足心理需求

臨床效果低 臨床效果高

Comparison Between Food and Medicine

FOOD MEDICINE

mild in action strong in action

non-toxic different degree of toxicity

provide nutrient may not be nutritious

emotionally satisfying not emotionally satisfying

weak clinical effect direct clinical effect

陰陽應象大論

水為陰，火為陽，陽為氣，陰為味。味歸形，形歸氣，氣歸精，精歸化，精食氣，形食味。化生精，氣生形，味傷形，氣傷精，精化為氣，氣傷於味。陰味出下竅，陽氣出上竅。味厚者為陰，薄為陰之陽。氣厚者為陽，薄為陽之陰。味厚則泄，薄則通。氣薄則發泄，厚則發熱。壯火之氣衰，少火之氣壯。壯火食氣，氣食少火；壯火散氣，少火生氣。氣味辛甘發散為陽，酸苦湧泄為陰。

The Four Natures 四氣

• Hot 熱

• Warm 溫 • Moderate 平 •  Cool 涼

•  Cold 寒

8/24/16

9

Movement of Qi 氣機的運化

• ascending 升 - up • descending 降 - down • Rising 浮 - surface • Sinking 沉- deep

The Five Flavors 五味• Spicy/Pungent (辛/香) -Mental - Effervescent and Dissipate • Bitter (苦) - Fire - Cleansing, Drying, Hardening • Sour (酸) - Wood - Astringent, Moisturizing – astringent (澀) • Salty (鹹) - Water - Softening, • Sweet (甘) - Earth - Tonifying, Mellowing, Harmonizing – Bland (淡) - Percolating

Analysis of Properties Yang 陽

Yin 陰

Hot 熱

Warm 溫

Cool 涼

Cold 寒

Ascending

Descending

Rising

Sinking

Pungent 辛

Sour 酸/ Astringent 澀

Moderate 平

Sweet 甘/ Bland 淡

Bitter 苦

Salty 鹹

Meridian Targeting 歸經

• A relatively later theory • Not visible and detectable • Mostly determined through clinical functions • Often Debatable • Can be deducted from the properties

How to Use Herbology Reference 如何查藥性

• Nature 性 - Cold, Cool, Moderate, Warm, Hot • Flavor 味 - Sweet, Bitter, Sour, Salty, etc. • Meridian 歸經 - Bladder, Spleen, Stomach, etc. • Functions 功效 - How it works • Applications 應用 - How it is used clinically • Cautions 注意/禁忌 - no superfood!

Take a Guess 猜一猜

• If a food/herb is Hot and Pungent, what is it going to do? • 如果有一個藥物或食品是辛熱的，它的藥性應該是什麼？

8/24/16

10

example - fresh ginger 生薑

• Nature 性: Warm 溫

• Flavor 味: Pungent 辛

• Try to deduct: Meridians, Functions, Applications

生薑

性味、歸經: 辛，溫 。歸脾、肺、胃經。

功效: 發汗解表，溫中止嘔，溫肺止咳，散寒，殺蟲，解毒。

臨床應用: 1. 治感冒風寒 2. 治傷風咳嗽、痰多泡沫。 3. 用於胃寒的嘔吐、腹痛、口淡、多吐涎、反酸。 4. 預防魚蟹毒、食物中毒。 5. 治半夏、南星中毒。

用量、用法: 3-10 克。

使用注意: 生薑傷陰助火，不可多食。 臟腑有熱者慎用。 陰虛內熱、目疾、痔瘡等病人不宜。

Fresh Ginger • Meridian: Spleen, Stomach, Lung • Functions: induce sweat, relieve exterior syndrome, warms Spleen and Stomach, warms Lung • Applications:induces sweat to relieve external wind-cold condition, relieves vomiting due to coldness in Stomach, relieves cough due to cold phlegm in Lung, counters toxins of seafood • Cautions: impairs Yin and promote Fire. Not suitable for people with Heat or Yin-deficiency.