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December 16, 2015

A tangential Christmas herbal - Glimpse of cinnamon as medicine

Written by: Matthew Wagner, L.Ac., M.S.O.M.

Christmas time is here again, and with it, those fantastic Christmas flavors. Smells and tastes hit the brain and open up hidden depths of memory and emotion. Some are profound enough to strike a chord of deep nostalgia. If Christmas spices fill you with a peculiar warmth, it’s with good reason. Not only do they warm the spirit, they warm the body, and when they do, they’re able to fill one with a sense of vitality, and heart-centered contentment. This is also why they make such essential medicine. Because it’s everywhere at the moment, let’s take a look at how extremely different cultures have used and thought of this herb. Let’s compare the usages of (modern and premodern) China herbalism, medieval Islamic Medicine, and finally, medieval European.

We may know Cinnamon most as that ubiquitous spice that makes an appearance in mulled apple cider, eggnog, Cinnabons, or the entrance of Hobby Lobby, but it’s far and away one of the most powerful and important herbs ever to be used medicinally. It’s no coincidence it’s such an important Christmas spice. After all, our Christmas traditions come from medieval Europe (mostly northern), and the winter weather in northern Europe is cold and damp. So, this gives us a pretty good impression of what Cinnamon does – it warms you up.

In a world with central heating, you may question what’s so important about being warm? After all, our modern world doesn’t tend to value warmth - We like ice in our soda. We wear shorts all year round. We don't’ zip up our coats.

I’m probably sounding like your grandmother now. After all, one could say if you’re cold, you can just turn the heat up. And, while that may be true, there is a reason that cultures have (consciously or unconsciously) valued warmth, and that it because… when you’re cold, you’re dead! So, cold is both a powerful metaphor, and a condition best to be avoided. Now, cold literally means cold, but, it also means hypo-function. This is another way of saying; things slow down, loose strength and tone, and become weak. Eventually, proper function stops, and death ensues.

Ancient China was a sun loving (if not sun worshipping) culture, and sought out and embraced warm substances to return vitality to the body (like the well known ginseng). Cinnamon is at the top of the list. So, what does Classical Chinese Herbology have to say about it?

Notes From the Chinese

Zhang Zhong Jing

Cinnamon (肉桂 Rou Gui, Cinnamomum Cassia) is an herb that slows the ravages of time by gently, yet strongly warming the core. It builds strength, and fills the body with warmth, which pushes lodged cold outwards. For this reason, it can simultaneously treat the atrophy of old age (lower body cold and weakness, loss of urogenital tone, impotence), dislodge cold from the joints (relieve certain types of arthritis pain), and shake superficial chill from the exterior. In this way, cinnamon is a unique herb that treats both the inside and the outside of the body, and is equally used for both chronic, severe illnesses, the passing annoyance of a cold, or simply the chill of shoveling snow for too long. It all depends on dosage.

Cinnamon (肉桂 Rou Gui, Cinnamomum Cassia) belongs in the category of revered medicinals. Some medicinals have historically been used to bring someone back from the edge of death, such as processed aconite root/Fu Zi 附子, (think hypothermia, or severe kidney disease) or rhubarb root/Da Huang大黃, (think extreme fever with delirium and constipation). BUT, while cinnamon may not be an edge of death medicinal, it certainly is a lifesaving one. It slows the ravages of time – the entropy of the body - and brings back a life-nurturing vitality. 

From a strict TCM (Traditional Chinese Medicine) point of view Cinnamon (肉桂 Rou Gui, Cinnamomum Cassia) warms the (TCM organ systems of the) heart, kidney, liver and digestion. So, it’s used for such Kidney symptoms of weak back, impotence, excessive urination, and profound cold. The digestive crossover is seen when such symptoms are accompanied by loose bowel movements and fatigue. There is a heart crossover occurs when these symptoms are accompanied by chest pain. (If you’re experiencing chest pain go to the emergency room! If there’s no western cause, then come see me.) It’s also used to “move the blood”, and is used in formulas for cold-type menstrual pain. Lastly, when it comes to the cold and flu, cinnamon is the defining herb to treat cold sweats (especially when paired with peony root).

That’s all very interesting. But, can we corroborate that experience with Western Herbal experience?

Usage in Medieval Islamic Medicine

Avicenna

Looking at the medicine of medieval Islam (undisputedly the most advanced medical system of the West at that time), we see similar uses. Avicenna [1] , one of the foremost thinkers of the Islamic Golden Age, described Cinnamon in his “Canon of Medicine, Vol II”[2] (a very significant text used in European medicine until the 1800s), as a hot medicinal, which is paradoxically constricting. This is paradoxical, because hot medicinals usually open – they make you sweat, or make your nose run. They open the pores and the mucosa.

This observation of constricting the tissues mirrors the Chinese understanding, as well, and is described as “closes the pores”, or “securing the exterior”(敛汗). In this aspect of closing the pores, we see that Cinnamon is the exact opposite of Ephedra, (Ma Huang, 麻黃) , the plant from which the decongestant “Ephedrine” is derived. Ephedra’s effect is to warm the exterior of the body to drive off a cold by promoting sweating. This contrast helps to explain its usage; Cinnamon constricts, so it is used when there is simultaneous cold and sweating, in other words, a fever with cold sweats. You might have experienced this before, if you’ve ever felt cold and sweaty, but the thermometer said you were hot. If you were to take Ephedrine in this situation, you would make yourself worse, and you might develop symptoms of constant cold, excessive cold sweat, or cramping muscle pain.

In regards to tissues and organs, Cinnamon specifically treats the head, eyes, respiratory organs, liver and stomach (where it is said to remove obstructions and fluids), and the bladder and kidneys. In terms of symptomology, we could see any of the following: common cold, dimming vision (associated with the common cold), chest congestion, back pain, and urinary retention (if associated with cold).

What About the Europeans???

Hildegard Von Bingen (1098-1179)‍

Well, it’s Christmas, after all, and it wouldn’t be complete without a nod to one of medieval Europe’s most prominent herbalists, the cloistered nun Hildegard Von Bingen (1098-1179), a true renaissance woman.

From a recent German translation of Causae et Curae, entitled “Ursprung und Behandlung der Krankheiten”;

Wenn jemand Bluttfluss hat: Nimm zwei Eidotter, verrühere sie und gibt Hälfte eines Dotters an Mutterkrautsaft dazu und so viel Essig, wie zwei Eierschalen fassen. Dan gebe er ein bisschen Zimtpulver dazu und weniger Zitwerpulver als Zimt und vermische es. Bereite daraus mit etwas Wasser einen ziemlich dicken Morgentrunk und gib ihn leicht erwärmt dem, der am Blutfluss leidet, sowohl nüchtern als auch nach dem Frühstück zu schlürfen, und tu das oft, und es wird ihm besser gehen.”

Translated: 

If someone has hemorrhoids, take two egg yolks, blend, give half a yolk with the juice of feverfew (Tanacetum parthenium) and the same amount of vinegar as could be held by two eggshells. Then give him a little cinnamon powder and less white turmeric (Curcuma zedoaria) powder and mix together. Mix with water to create a breakfast drink und serve lukewarm to the person with hemorrhoids, either fasting or with breakfast. Do this often, and he’ll get better.

That’s disgusting! I bet the formulas I give don’t sound so bad now, huh? But, as gross at that sounds, we can see the logic behind it. Hemorrhoids are a stagnation of blood. Stagnant blood is old and pretty much useless. So, it needs to be moved, to allow new blood to enter. The egg yolks help engender this new blood. The next three herbs are all moving. Feverfew is cold and aggressively moves the blood to break up stagnation. (Stagnation creates heat – think inflammation). Paired with white turmeric (E Zhu, 莪术)which is warm and blood moving, the effect is even stronger. Adding a little cinnamon helps to move the blood even more, and also warms to balance the cold Feverfew. Lastly, vinegar has a potentiating effect on the other herbs, and helps to increase their blood moving aspects. This concept of “moving the blood” is NOT metaphorical, and this herbal combination would therefore be CONTRAINDICATED during pregnancy or on blood thinners

You’ll notice that the doses of turmeric and cinnamon are “a little” and “a little less”. In Asian countries the dosage would be much higher, because it’s so readily available. One can assume that in Europe, in the 1200s, the spices were incredibly expensive, and reserved for wealthy nobility.

One will also notice that cinnamon is not mentioned as treating a common cold. Probably this is due to its price and availability. Nobody would waste 10 grams of cinnamon per day on a common cold. But, for painful hemorrhoids, a “little” powder per day was probably worth it.

Lets look at some more:

Der Mensch, den der Vich (L. Colica?) plagt, nehme ein bisschen Ingwer und sehr viel Zimt und pulverisiere das. Dann nehme er Salbei (weniger als Ingwer) und Fenchel (mehr als Salbei) und Rainfarn (weniger als Salbei). Das reibe er in einem Mörser zu Saft und siehe es durch ein Tuch. Dann koche er Honig und Wein und füge ihm ein wenig weißen Pfeffer hinzu (oder –wenn er diesen nicht hat – ein wenig Pfennigkraut) sowie das genannte Pulver und den erwähnten Saft. Dann nehme er Wasserlinsen und zweimal soviel Blutwurz wie Wasserlinsen und Senf, der auf dem Feld wächst, im gleichen Gewicht wie Blutwurz und von jenem Kraut, an dem die winzigen Kletten wachsen, weniger als Wasserlinsen. Er reibe dies in einem Mörser zu Saft, gebe das Zerriebene in ein Säckchen und gieße den erwähnten mit Honig und Pulver versetzten Wein darüber und mache daraus eine Art Läutertrank. Wer also an dieser Krankheit leidet, soll diesen Trank, soviel er mit einem Zug trinken kann, nüchtern trinken und in ähnlicher Weise auf die Nacht, wenn er sich ins Bett legt, und das soll er tun, bis er geheilt wird.
Der Vich entsteht nämlich durch warme und kalte schlechte Säfte, kommt aber mehr von kalten als von warmen Säften. Deshalb vermindern die Wärme des Zimts, die Wärme des Salbeis, die Wärme des Fenchels, die Wärme des Rainfarns, die Wärme des Honigs, die Wärme des Weins, die Wärme des weißen Pfeffers, die Wärme des Ackersenfs, und die Wärme der Kletten, gemischt mit der Kälte der Wasserlinsen und der Kälte der Blutwurz, die krankhaft warmen und krankhaft kalten Säfte, aus denen der Vich (L. Colica?) entsteht, wenn der Mensch das erwähnte Tränklein einnimmt, also nüchtern und wenn er schlafen geht; beim Nüchtern verhindert es, dass diese Säfte sich erheben, und beim Gesättigten hält es die schlechten Säfte der Speisen im Zaum.

Wow, what a run on sentence! So, what does it mean? Well, Vich is not a modern German word. Some translators have suggested that it could be „colic“. That would make sense when we look at the herbs used.  

Translated:

The person who is plagued by colic, (should) take a little Ginger, and a lot of Cinnamon, and powder them. Then take Sage (less than the ginger) and Fennel (more than the Sage), and Tansy (less than the Sage). Grate in a mortar until it becomes juice, and strain through a cloth. Then cook honey and wine with a little white pepper, (or, if you don’t have it, Moneywort/Creeping Jenny (Lysimachia nummularia)) and the aforementioned wine and juice. Then take Duckweed (Lemna aka pond scum) and twice as much Blutwurz (Potentilla Erecta) as Duckweed and (also) the mustard that grows in the fields, the same amount as the Blutwurz and (also) of the herb that burdock grows on, use less than the Duckweed. Grate this in a mortar until a pulp, put the pulp in a small bag und pour the wine-honey-powder mixture over it, and make a kind of purifying drink. Whoever is suffering from this sickness should take a drink of this solution on an empty stomach (in the morning), as much as they can in one gulp, and in a similar way at night in bed. The person should do this until they’re healed.

The Vich (colic) exists primarily because of cold and hot juices, but more from the cold. Therefore, the warmth of the Cinnamon, Sage, Fennel, Tansy, Honey, Wine, White Pepper, Mustard, and Burdock, mixed with the cold of the Duckweed, Blutwurz, reduces the morbid cold and hot juices from which the Vich is created, if one takes the aforementioned drink both fasting and before bed; while fasting, it prevents the juices from rising, and after eating, it keeps the bad juices in check.

Again, it’s pretty gross. It didn’t start off terribly; ginger and cinnamon are nice. Sage is maybe a questionable flavor, but the fennel probably covers it up. Tansy ups the risk factor, as it’s slightly toxic, especially raw (what’s life without a little risk? (I guess some would probably say“not dead”)). But, once we get to pond scum, it starts to sound like a terrible idea. Now, pond scum is used in Chinese Herbology as well, (Fu Ping, 浮萍). But, it‘s cooked. So, your chances of dying from dysentery are much less.

Nevertheless, let’s see if we can’t make sense of this. When you look at all of the herbs together, it does follow a clear logic, nicely summed up in the last paragraph. The overall effect is to both warm and cool, increasing digestive tone, relieving spasm, and cooling inflammation and irritability. The wine and honey in this case are both used as digestive tonics, with wine additionally relaxing muscle spasms, and acting as a medium to dissolve the other juices in. In this example, the ginger and cinnamon carry the bulk of the effect of improving digestive strength and tone, especially paired with sage. Fennel warms and moves the intestines (treats gas and spasm). Tansy also helps to relieve spasm and gas (and is generically antiparasitic). Mustard and white pepper are both strongly warming. In higher doses, pepper relieves spasm and drives out cold cramping abdominal pain. Mustard is acrid and piercing, and cuts through sticky mucus. The Creeping Jenny promotes urination to help drain water from the intestines. I’m not sure why the Duckweed is in this formulation. It could be that a small amount is used as a diuretic, and to relieve flu-type muscle aches and pains by promoting sweating. (But, you'd want to be careful with weak patients). The Blutwurz is a key herb to stop intestinal bleeding. This is, in part, why it is named Blutwurz (blood root), although it also has to do with the root itself being red. This is also an essential herb to astringe the intestines and stop chronic or severe diarrhea. Hence, its other name, Ruhrwurz - dysentery root.

In spite of its costs at the time, the Cinnamon in this case is much higher than in the previous example. There is a very good reason for this, and it relates to the idea that an illness can strike anywhere, but death always strikes the belly. The idea behind this is that one can get sick in any manner of ways, and through any number of pathogens. People can stay chronically sick for years. But, once a disease process affects the digestion, it becomes very serious. Appropriate care must be undertaken at once, or death may follow. This is not the time to be stingy with the spices!

So, now that we’ve travelled through both space and time, and seen how various cultures throughout the ages have treated Cinnamon, we can see some distinct similarities of usage, and we can confirm that the experiences and understandings of this spice have been fairly constant across the world. Cinnamon is a warming, preserving medicinal, used for both superficial chills, as well as long-standing, chronic illnesses. It’s the perfect winter spice for (almost) everyone. So by all means, when the weather gets cold, grab some cinnamon. After all, it’s Christmas!

Next month: The herbal logic behind Pfeffernüsse cookies.

[1] Abū ʿAlī al-Ḥusayn ibn ʿAbd Allāh ibn Al-Hasan ibn Ali ibn Sīnā أبوعليالحسينابنعبداللهابنسينا; c. (980 – 1037)

[2] al-Qānūn fī aṭ-Ṭibbالقانونفيالطب

Photo Credits

Zhang Zhong Jing Photo: http://www.theworldofchinese.com/wp-content/uploads/2012/01/zhang-zhongjing.jpg

Avicenna Courtesy Photo: http://www.wikiwand.com/de/Avicenna

Hildegard Von Bingen Photo: http://www.spiritualtravels.info/wp-content/uploads/2014/01/IMG_69492-715x1024.jpg