by Edward Dix
After the battle of
Sekigahara, Tokogawa Ieyasu sat on his camp-stool,
viewing the heads of his enemies and receiving the
reports of his generals. When Ii Naomasa approached,
with a bullet wound in his left arm, a grateful Ieyasu
bandaged it with his own hands. Reading the war tales
available in English, this is the only mention I’ve
found of battlefield first-aid by samurai. Usually the
teller of heroic tales is interested only in the final,
fatal encounters of the losers. With a few exceptions,
the winners ride away unscathed, their stature
undiminished by the necessity to treat their wounds.
Consider, however, that Yamamoto Kansuke went to his
last fight at Kawanakajima missing an eye and several
fingers due to previous encounters and we can conclude
that healing of battlefield injuries wasn’t left to
fate.
Kampo,
(the kanji are Nelson 2662 & 2082), traditional Japanese
medicine, is organized in theory and application, on the
Chinese model first recorded during the Han Dynasty (206
BC – 220 AD). The Han produced the earliest medical
classics, the
Yellow Emperor’s Manual of Corporal Medicine (Huang
Ti Nei Ching) and
The Pharmacopoeia
of Heavenly Husbandry (Shen
Nung Pen Ts’ao), by anonymous authors and the
Shang Han Lun
and Jin Kui Yao
Lue by Zhang Zing-jing. “Han medicine” came to Japan
through Korea sometime before 600 AD.
Herbs are the greatest part of the traditional
materia medica,
i.e. the sources of drugs for treating illness and
injury. Animal parts, minerals and some rather strange
ingredients, such as the urine of prepubescent boys, are
also used in kampo concoctions. But I’ll leave the
latter aside and focus on my own profession. As a
botanist, I’d really like to know what medicinal herbs
were carried in a samurai’s battlefield first-aid kit.
Ii
Naomasa’s treatment by Ieyasu may have included
Gynura pinnatifida.
Its Chinese name is
jin bu huan.
This perennial herb of the Daisy family grows to three
feet tall, with yellow flowers blooming in late summer.
The name jin bu
huan translates to “gold no trade” indicating the
high value placed on it for its healing qualities.
Jin bu huan is
cultivated in China and Japan and is the main ingredient
in Yunnan Bai Yao powder used to staunch heavy bleeding
and promote rapid healing. The grayish yellow roots of
jin bu huan contain bioactive glucosides. The
therapeutic effects include reduction of inflammation
(antiphlogistic), and contraction of tissues and blood
vessels to arrest bleeding (astringent, styptic and
hemostatic). The physician, often a Buddhist monk in the
Sengoku-jidai,
would cleanse the wound and sprinkle a liberal amount of
powered root on the bleeding area, then cover it with a
bandage.
In
modern times, Yunnan Bai Yao was standard issue to North
Vietnamese troops during their war against South Vietnam
and the United States. You may be able to find Yunnan
Bai Yao locally, in Chinese herbal shops and Asian
groceries. Gynura
pinnatifida doesn’t grow in North America but its
cousins, Indian plantain (genus
Cacalia), and
ragworts (genus
Senecio), are common wildflowers with us.
Other plants sometimes included in formulas for the
treatment of weapon wounds are:
Shirane-senkyu,
(Angelica
sinensis, of the Carrot family), to relieve pain
without suppressing consciousness;
Soboku, (Caesalpinia sappan, of the Pea family), to clear extravasted blood
thus healing bruises; and
Kôka, (Carthamus
tinctorius, Safflower, the source of safflower oil
used in cooking), helpful in reducing inflammation.
The
Tang Dynasty (618 – 907 AD) produced the
Chien Chin Fang
and Wai Tai Pi Yao Fang, explaining the use of acupuncture, moxibustion
and massage points. The Sung, Chin and Yuan Dynasties
(altogether from 960-1368 AD), saw the systematization
of the earlier discoveries by elucidation of the
“Yin/Yang” and the “Five Elements” theories. Together
these ideas have provided the theoretical structure of
both Chinese and Japanese traditional medicine through
succeeding generations. In this structure, disease is
not the result of an outside agent, but due to an
imbalance between yin principles (represented by
femininity, darkness, cold and water) and yang
principles (represented by masculinity, sun, heat and
fire) within the body. Only when the body’s system is
unbalanced can germs find an opportunity to effect our
health. If our equilibrium is disturbed by an excess of
one principle, illness results, and may be treated by
herbs prescribed to strengthen the opposite, deficient
principle and redress the imbalance. As the
Yellow Emperor’s
Manual puts it, “If it’s too hot, cool it down; if
it’s too cold, warm it up; If it’s too full, empty it;
if it’s too empty, fill it.”
The
Five Elemental Energies of wood, fire, earth, metal and
water, are functional manifestations of the yin and yang
principles, encompassing all the phenomena of nature.
All things contain all five elemental energies in
various proportions. The herb
Jin bu huan
discussed above, has both sweet and bitter flavors,
indicating a mixture earth and fire energies
respectively. The kidney system, which includes the
sexual organs in oriental medicine, expresses water
energy in its glands and fluids and fire energy as
sexual desire.
By
administering mixtures of herbs, a traditional physician
attempts to stimulate deficient energies or sedate those
in excess. For example, herbs which stimulate water
energy control conditions of excess fire, such as
inflammation or high blood pressure. Fire generates
earth and controls metal, metal creates water and
controls wood. By manipulating this complex system of
relationships among the major organs and bodily
functions, the physician maintains or reestablishes
healthy balance and harmony.
This
conceptual system requires that the physician view the
patient as a whole, including his mood and movements. In
kampo, a patient’s condition is described in terms of
Sho. His constitution is evaluated as
kyo-sho (weak), chukan-sho
(moderate) or
jitsu-sho (robust). His symptoms are categorized
into one of six stages. Three stages of
in-byo include
chronic and non-fever-producing illnesses. The three
yo-byo stages
characteristically produce fever.
Kampo
evolved greatly during the period from 1200 – 1600. In
addition to Buddhist monks and priests, Japanese
physicians such as Tashiro Sanki and his student, Manase
Dosan, modified the techniques learned in China by their
predecessors, and developed a Japanese clinical
tradition. Early in this period, the Japanese concept of
fukushin, the
examination of the abdomen by palpitation, was studied
by Chinese physicians.
By
the Edo period (1615 – 1867), two major schools of
medical practice were established. The
Gosei-ha
descended from Dosan and was based on his writings, the
Shuhokiku. The Koho-ha was
centered around Kyoto and was based on the text of the
Shang Han Lun, a Chinese classic of the third century BC describing
treatments for fevers and colds. In the Koho-ha
tradition, men such as Goto Konzan, favored moxibustion
and hot spring baths. His student, Yamawaki Toyo is
reputed to be the first physician in Japan to perform an
autopsy. Toyo’s work is preserved in his book titled
Zoshin,
(Internal Organs).
With
the transitions of the Meiji Period, European surgical
medicine and the industrial refinement of drugs
dominated Japanese practice. However, as in Europe, a
strong herbal tradition thrives alongside orthodox
practice. The Japan Toyo Medical Association created in
1950, is reputed to be the largest medical organization
in Japan today. Its headquarters are at the Asian
medicine Research Center at Chiba University Medical
Center.
Karate-ka have their own source-book of traditional
medicine. The
Bubishi, a work originally written in China, came to
Okinawa from Fuzhou with
gongfu in the
eighteenth century. It has been cited by many leading
figures in Okinawan karate-do. An English translation by
Patrick McCarthy was recently published by Tuttle. The
Bubishi contains a large section on herbal remedies
including a mixture of six plant ingredients useful for
“treating head injuries resulting from being traumatized
by iron objects.” (I imagine this formula has been very
useful to novices training with sai). Another formula
describes an ointment for treating weapon wounds which
contains fifty-one plants of various sorts including
orange, peach and white mulberry.
Gynura pinnatifida
is recommended in the
Bubishi for
wounds and burns and there are several formulas which
include ginseng.
Just
about everyone today has heard about ginseng, the best
known plant in the Chinese pharmacopeia. Although I have
not had the opportunity to study it, I would not be
surprised to find ginseng mentioned in the oldest known
Japanese medical text, the
Isshinho,
revised by Tamba Yasunori during the Heian Period (794 –
1192 AD). He incorporated much Chinese material and
expanded the original work to thirty volumes. Ginseng
had been in the Chinese medical literature for over 800
years by that time, having been described in 33 BC by
You Shi in his
Interpretation of Creatures.
In
the Bubishi,
ginseng is used in one decoction to treat loss of
consciousness. In another, it is fermented with other
ingredients in a bottle of aged wine and cooked over a
low flame to prepare a treatment for lower back and hip
pain. And in the
Ippondo-Yakusen, written by Kagawa Shuan in 1734,
ginseng is recommended for various acute diseases,
fatigue and weakness. I can imagine samurai chewing
ginseng root before battle to increase their endurance,
just as Olympic athletes do before competition today.
There are several species of ginseng plants.
Panax ginseng,
ninjin, grows in Korea and Manchuria.
Panax notoginseng, san chi,
is found in China.
Panax japonicus,
tochiba-ninjin,
grows in mountain forests in Japan. Wild Japanese
ginseng is relatively low in medicinal quality perhaps
due to the rocky, alkaline soils. The Japanese have
imported seed of Korean ginseng and now cultivate that
species. Panax quinquefolium, is North American ginseng. This species is
highly regarded in Asia, but is prescribed and
formulated differently than Asian species.
Clinical research on ginseng roots has isolated over a
dozen physiologically active saponins, referred to as
gensenosides, along with alkaloids, phytosterols,
polyacetylenes, essential oils, sugars, amino acids and
flavonoids. Effects documented in various studies
include regulation of blood sugar levels, blood
pressure, white blood cell count, red blood cell count
and central nervous system response. Other studies
indicate that ginseng increases cerebral circulation,
relieves fatigue, enhances alertness and cognitive
functions. Ginseng is reported to prevent alcohol
intoxication when taken prior to drinking and relieve
hangover after excess consumption.
Asian ginseng preparations come in two types, red and
white. Red ginseng is made from six-year-old roots that
are steamed and sun-dried. Red ginseng formulas are more
potent and much more expensive. White ginseng products
are made from younger roots which are peeled and dried.
I
have used ginseng between a long day at work and the
start an evening training session. I never fail to feel
invigorated, but whether it’s the ginseng or the effect
of training itself, I cannot be sure. Ginseng is widely
available as an ingredient in teas, tonics, capsules and
cosmetics, but usually there is no indication
how much ginseng is included in the product. I chew unaltered slices
of dried root, so I know how much I’m getting. Don’t
take this as a recommendation though. Everyone is
different and you may have different, and possibly
unpleasant, reactions. If you think you want to try
ginseng, consult an experienced herbal practitioner
first.
In
evaluating herbal medicine, practitioners focus on
synergistic effects of the various compounds in a whole
plant part or mixture of plants taken together. Orthodox
practice is to isolate each active ingredient and
clarify its impact in order to avoid side-effects and
complications. Traditional practitioners rely on the
accumulated experience of generations, while orthodox
researchers strive for clearly defined biochemical links
of cause and effect. As with martial arts, there are
worthy and spurious arguments and good and bad
practitioners in each school.
References
Keys, John D.
Chinese Herbs: Their Botany, Chemistry and
Pharmacodynamics. Charles E. Tuttle Company,
Rutland, Vermont and Tokyo, Japan, 1976.
Lee,
Florence C. Facts
About Ginseng: The Elixir of Life. Hollym
International Corp., 1992.
McCarthy,
Patrick. The Bible
of Karate: Bubishi. Charles E. Tuttle Company,
Rutland, Vermont and Tokyo, Japan, 1995.
Reid, Daniel. A
Handbook of Chinese Healing Herbs. Shambhala
Publications Inc., Boston, 1995.
Tsumura, Aikira.
Kampo: How the Japanese Updated Traditional Herbal
Medicine. Japan Publications, Inc., Tokyo and New
York, 1991.
