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Food and Medicine: Two is One in Chinese Culture

by Y.C. Kong

Food as Herbs, Health, and Medicine

Summer Volume: 1998 Issue: 5(2) page(s): 5, 6, and 18

It is evident that Chinese restaurants can be found in every part of the world and also true that people are cooking Chinese food everywhere, as well. However, what is less known is that the Chinese people attach a lot of importance to cooking for medicinal reasons.

Fresh food is delicious and nutritious in its natural state. Take for example crisp salads of all sorts, ripe fruits, rare beef and mutton, raw morsels of fresh fish, or live whole fish under-steamed in the Cantonese style. There is a school of health-keepers who advocate the consumption of uncooked food, not even marinated or fermented; but cooking adds value to food.

Cooking can kill the bacteria and parasites carried in raw food or neutralize some of the toxins produced in putrefaction (a well hung pheasant). This was an important hygiene consideration in the old days when foods were largely gathered from nature rather than the salubrious environment of the supermarket.

Cooking also tenderizes plant and animal parts otherwise difficult to consume, thus broadening food choice. Tripe, that some restaurants may disdain to serve, can be tasty if prepared as Tripe a la Mode a Caen, or better still as Ox Offal, Cantonese Style. The latter is thoroughly cleansed internal organs of ox or cow cooked with a regimen of spices, notably star anise and Sichuan pepper. It turns putrescence into a miracle dish, so to speak. Even without the use of condiments, cooking can bring out the best quality in food. There is nothing more satisfying than the waft of aroma when lifting the lid off a pot of rice just cooked. In Cantonese cooking, the degree of perfection in a dish is assessed by the presence of 'wok-flavor' of wok Hay, a mist of taste and odor rising up from a sizzling wok when the ingredients are thrown in, following a well-defined protocol. These olfactory enjoyments apply to the cephalic phase of digestion and release of digestive enzymes and gastro-intestinal hormones; they are a promise of palatal satisfaction and culinary delight.

There is more significance in cooking than gastronomic perfection. The Chinese people believe that cooking can bring out the medicinal value in food. As a matter of fact, there is no clear distinction between food and medicine in Chinese culture. One would argue that food provides energy and nutrition, whereas medicine is used to treat disease. But the Chinese people believe that all kinds of food have unique properties of their own and they affect the body differentially. Because cooking can change the properties of food, it is important that they are cooked in an appropriate manner enabling them to act in a positive way conserving health and maintaining longevity. It is not an exaggeration to say that Chinese medicine originated in the kitchen.

In Chinese philosophy, the yin-yang theory applies to every domain of cosmic, natural and human activity. These two opposing forces act on the body to achieve a dynamic equilibrium, the body a microcosmos forming an integral part of the universe subject to the stress of changing seasons and climatic conditions. The body reacts to off-set adverse influences (coldness, dryness), or absorb the beneficial elements (warmth, moisture). The body is able to do so because some foods can be more thermogenic than others supporting them to ward off the coldness. Other foods can act in the opposite direction.

Therefore, when the yang forces such as hot weather are dominant in the environment and the body is in a yin state and feeling cold, this discord can bring disease. Warm food such as mutton can restore the body warmth in winter so that it is less affected by cold weather. If warm food is not enough to help the body achieve this purpose, a thermogenic drug such as aconite will do. In this context, food and drug serve the same purpose except that the former nourishes the body while the latter only corrects its malfunction.

The central tenet in Chinese medical thinking, including diet and nutrition, is that no substance is absolutely neutral. It is either deviating towards the yin or the yang with respect to the body constitution. Noting this inherent tendency to deviate, it is possible to select an edible substance, be it food or drug, that can bring the body back from the opposite sphere of influence. Food is less deviating than drugs and can provide the body with nutrients.

It follows that treatment of disease, depending on the degree of severity, is first attempted with diet management, failing that, medication comes into play. Eminent clinical therapists like Zhang Zhong Jing (circa 2nd or 3rd century CE) and Sun Sie Miao (581 - 682 CE) advocated in their writings the virtue of diet therapy prior to any medical intervention.

The organic relationship between food property and cooking was first postulated by Yi Yin, a slave-turned-prime-minister serving the founding Emperor of the Shang dynasty (1520 - 1030 BCE). This was a time when China began the slow evolution towards a well-established feudal political structure implemented successfully in the long reign of the Zhou dynasty (1030 - 221 BCE).

Cogent to the origin of a cooking prime minister, dieticians figured among one of the six medical services in the Imperial Court. This is well documented in the Zhou Li (Records of the Rites of the Zhou). Although there is no evidence that Yi Yin actually said or wrote down any words, it was described in detail in The Spring and Autumn Annals by Master Lu (circa 200 BCE) that a wide selection of delicacies culled from every corner of the country were made available to the Imperial Court. A court dietician would know what he was talking about.

By comparison with Yi Yin, the conceptual framework of Chinese medicine was expounded in an anthology of essays collectively called The Canon of Internal Medicine, ascribable to the legendary Huang Di or Yellow Emperor, a tribal chief who pre-dated Yi Yin by a millennium, carried in-depth discussion of food properties and recommended special foods in each season for people living in different parts of the country. Besides preaching the virtue of a balanced diet by eating a diversity of foods, the book went on to elaborate the preference of a vital internal organ for a particular taste. The heart (including the mind) likes bitter taste; the liver--sour; the lung--pungent; the 'spleen' (a functional entity more than what is anatomically described today for this organ)--sweat; and the kidneys (including reproductive and adrenal functions)--salty. Thus by eating bitter tasting food, the heart sings with joy (invigorates the mind) while the lack of salt will compromise kidney function. It must be quickly added that drugs, too, have their peculiar tastes and hence show an affinity for a corresponding organ. By the same token, medicating with a drug of a certain 'taste' will improve the performance of the organ of affinity while an excess in the same vein will undermine its normal function. Cooking and a judicious food choice allows one to maneuver between insufficiency and excess.

It is apparent from this discussion that matching taste with an organ is an application of the 'five elements' concept in Chinese culture. This is not the place to ascertain the scientific rationale, or the absence of which, behind this kind of computation. It can be best compared with the 'doctrine of signature' which concerns only shape and form. It also applies in Chinese medical thinking, e.g.: The anthropomorphic suggestion of ginseng, or to a lesser degree, the Chinese cornbind (Polygonum multiflorum). But in Chinese medicine, it extends to include taste, color, weather, temperament etc. Suffice it to say that this a convention prevalent since the Han dynasty from circa 200 CE; it is the main tool of reasoning rationalizing relationships between different things natural and socio-ethical.

Besides matching taste with organ, another dimension is color pertinence. Thus, foods (or medicines) of a red color will affect the heart; by the same token, green will affect the liver, yellow--the 'spleen,' white--the lung, and black--the kidney. According to this color code, while pulses are generally nutritious, black beans (Glycine max) are good for the kidney, red adzuki beans (Phaseolus angularis) good for the heart, green mung beans (Phaseolus mungo) good for the liver, yellow soya beans (Glycine soya) good for the spleen, and white hyacinth beans (Dolichos lablab) good for the lung. The above rule also applies to cereals and rice and fruits and vegetables. Once the assignment is made, it is not difficult to find a reason to justify the application, the affinity strengthened by continuous use over the centuries.

It follows, that eating a combination of colors is better than a biased choice of a particular kind. A porridge made of five kinds of pulses are given to children during festival time and called 'hundred year porridge' underlying the health promoting quality inherent in this preparation. Another example is the fruit of Schisandra chinensis, the Chinese name is wu wei zi and means the 'grain of five tastes.' Many active ingredients are isolated from this and known for anti-oxidant and hepato-protective properties. It is considered a drug of the superior category (vide infra) because of its complement of five tastes and is believed good for all the internal organs. It serves as a tonic for general debility. This reminds one of the allspice (Pimento dioca), a popular condiment that lacks cultural background.

An important concept put forward in the above mentioned Canon, is the idea of bu, central to all efforts of maintaining good health. Bu (literally to patch up, repair, or replenish), refers to a subnormal physiological state described as the 'void.' Such voidness can be replenished with a suitable food, fine-tuned by cooking to replenish without excess. The idea of bu is so deeply ingrained in Chinese food culture that even today the first question one would ask of a novel cuisine or a new dish or even an exotic kind of food is whether it is bu. Foods ingested for the obvious reason of bu rather than daily sustenance are generally called 'tonic' to make sense to foreigners of a different language.

Drug knowledge was well documented by this time in a concise treatise called The Pandects of Materia Medica by Shen Nong (the Divine Ploughman)--the legendary God of Farming. Like the Taoists who formulated medical thinking in The Canon, this treatise summarized the practical experience of the concepts of longevity seekers. In their pursuit of immortality, they purposely avoid food in the proper sense such as cereals, and search for unconventional items such as roots or tubers or fungi or pollen that served as food substitutes to assuage hunger and the onset of senility. Based upon this, drugs were classified into superior, medium and inferior categories with respect to their suitability for health conservation or treating disease. The superior items were truly health foods of their time, e.g.: Solomon's seal (Polygonatum multiflorum). Even to-day, these are food-drugs we can take every day to conserve health rather than to treat disease.

The Pandects is the prototype of a long series of pharmaceutical literature called Ben Cao, literally roots and herbs (used as medicines). The Ben Cao is a special format in Chinese medical literature. It is characterized by an uninterrupted addition and refinement in successive editions. Since the appearance of its prototype, there are no less than three hundred editions, many commissioned by the Imperial Court in an effort to edit a national formulary. Closely following the trend of Ben Cao--lore, there was a branch of Ben Cao on Food Items that counted the same number of editions, spread along the same time span of the ben cao proper, and shadowed each of the important ben cao of the period by a comparable version in food property. For example, while Tang Ben Cao, the first official edition of ben cao published by Imperial order in the early Tang dynasty (657 CE), enjoyed an authoritative status in the domain of drug knowledge, there was a comparable Ben Cao for Diet Therapy by Meng Xin (621 - 713 CE), a disciple of the famous Sun Sie Miao mentioned above.

In the aforementioned work of Meng, the property of food and its contribution to health conservation was emphasized. Thus, it is well documented in Chinese food literature that a food is 'hot' or 'cold' with reference to its influence on body function rather than its gustatory sensation. Use hot food to warm up a cold body and vice versa, said Tao Hong Jing (456 - 536 CE), a Taoist who abandoned officialdom in order to seek longevity. He was the editor of the anonymous Pandects of Materia Medica by the legendary Shen Nong.

Authors of Ben Cao on food, although experienced clinical therapists in their own right, enjoyed less official status than those who penned the ben cao literature. But, there was a unique example of food literature by Horshoi, the Imperial Court dietician during the last years of the Yuan dynasty (1330 CE). He wrote the celebrated Essentials of Food and Drink (Yin Shan Cheng Yao; consult A Soup for the Qan by P.D. Buell and E.N. Anderson, Kegan Paul International, in press). It was a nutrition and health management guidebook intended to catch the attention of the celestial Qan who was known to indulge in every aspect of sensual pleasure.

Court dieticians were institutionalized since the Zhou dynasty (vide supra), but must wait till the Mongolians had settled in China for nearly a century, before they learned the finesse of Chinese food culture and its inherent medical significance. The book is a vivid description of Mongolian cuisine preaching, above all, moderation in food choice and stressing again, the importance of food property and the effect of cooking. It also borrowed substantially, relevant concepts of diet and nutrition from The Canon and applied them to special physiological conditions such as pregnancy and lactation. All-in-all, the concern over health-keeping through practicing judicious food habits puts any modern-day advocate of health food to shame. Because, like them, the Qan must exercise willpower of self control when foods, among all other earthly pleasures, were unlimited to him.

In summary, the Chinese people have enjoyed good food since the dawn of Chinese history, as far as the written record goes. They never ceased to explore new frontiers in food sources and in cooking. But the leitmotif of this endless excursion of palatial satisfaction is the conservation of health through diet management and proper cooking.

A) Metal----Lung-----Pungent--White-------Dry--------Sorrow
B) Wood---Kidney---Salty------Black------Cold--------Fear
C) Water---Liver------Sour------Green-----Windy------Anger
D) Fire------Heart-----Bitter------Red--------Hot---------Joy
E) Earth---Spleen---Sweet-----Yellow------Wet-------Longing

Note: The horizontal relationship is one of parallelism. The vertical relationship going downward is pro-active, whereas going clockwise in the following order is antagonistic, such as metal--wood--earth--water--fire--metal. This ruling is not inflexible; sometimes a pro-active element (and its parallel parameter in each verticle column) is so strong that the recipient element can not be overcome by its antagonistic element. The 'five elements' concept is a great help to relate one thing to another (e.g.: a symptom to a drug of choice, or the function of one organ to another. However, it requires a lot of experience to use it in a predictive manner.

Besides the five solid organs (zang organs), there are also six organs with lumen (fu organs). Each pair's functionally with one of the zangs. They are respectively: Lung--Large Intestine; Liver--Gall bladder; Kidney--Urinary bladder; Heart--Small intestine; Spleen--Stomach. An unpaired fu organ, the 'three burners,' could not be identified with a concrete anatomical structure. It deals with the dissipation of body fluids. Sometimes it is paired with the 'gate of life' which is again unidentifiable in anatomy, but is considered to be referring to adrenal function. For an introduction to the organ concept in Chinese medicine, see Liang Song Ming et al., Functional Concepts of Organ Theory (in Chinese), Chinese University of Hong Kong Press, 1998.
Y.C. Kong is a Professor in the Biochemistry Department and Chinese Medicine Programme at the Chinese University of Hong Kong. This paper was originally prepared for the second International Congress of Anthropology, Nutrition and Health held in Genoa in April 1998. It was modified by Kong for this issue of Flavor and Fortune.

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