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.
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.