As modern medical standardization continues, the field of traditional Chinese medicine has the advantage of comprehensive personalization. For rare or complex cases, deeper consideration of constitution is invaluable. Proper constitutional assessment, especially with first-time clients, can guide desirable and predictable outcomes. This leads to a higher rate of return, and greater trust between you and your patient.
Updating the Medicated Diet
In order to achieve optimum effectiveness when using diet therapy, the first consideration is compliance. The main reason for the limited information available to the Western practitioner regarding food therapy is the obscure and often odd ingredients and flavors found in traditional recipes. By identifying the therapeutic combinations of ingredients, we can locate similar combinations in other styles of cooking.
For the novice, the use of dietary drugs will suffice. Dietary drugs are classified for individual use and may be prepared in decoctions or porridges as single herbs. Ginseng for shock or hawthorn berry for coronary artery disease can be used with no additional support from other herbs. For kidney stones, two ears of corn, either in porridge or steamed on the cob, may be used.
In more complex use of food herbs, we use a dietary drug as a chief herb and combine it with an envoy with complementary nature and flavors. A traditional example would a decoction of 250 g oxtail and 30 g red dates to treat spinal pain. Cut dressed oxtail into 3/4-inch sections. Combine with red dates in a pot with 750 ml water. Bring to boil. Reduce heat and simmer over low heat until reduced to 250 ml. Take warm in two doses. Oxtail is the chief ingredient. It is sweet and neutral, and activates the spleen, stomach and governing vessel. Its function in this recipe is to tonify the governing vessel and treat spinal pain. The envoy ingredient is red date. It is sweet and neutral, and activates the spleen and stomach. Its function is to speed absorption of the ingredients. A Western approach to the ingredients would be:
Barbecued Oxtail
2 oxtails
2 cloves garlic
1 can tomato sauce
1 cup catsup
3/4 cup brown sugar
1/2 tsp thyme
1 small onion
1/2 cup cider vinegar
1 tbs mustard
2 tsp Worcestershire
Salt and pepper
Cut dressed oxtail into one-inch sections. Set aside. Finely chop garlic and onion. Add to saucepan containing tomato sauce, catsup, brown sugar, thyme, mustard, vinegar, Worcester, salt and pepper. Bring to simmer over low heat and stir occasionally for five minutes. Place oxtails in a covered baking dish and bake at 350 degrees F for 45 minutes or until tender. Garlic, onion, tomato sauce, tomato catsup, table salt, black pepper, Worcester, cider vinegar, thyme and brown sugar are all envoys. Their function is to harmonize the recipe and encourage absorption of the ingredients. Both these recipes use a chief herb which is supplemented by envoys. The envoys support the chief by harmonizing the formula and aiding in its absorption.
There are also recipes with identical chief and deputy ingredients. The envoys may vary greatly but do nothing to interfere with the action of the formula. For treatment of deficiency of kidney yang and qi :
Fried Duck with Walnut
200 g walnut
150 g water chestnut
1 old duck
100 g minced chicken
1 scallion
3 g fresh ginger
1 egg white
16 ml shaoxing wine
2 tbs peanut oil
2 tbs cornstarch and water
Parboil whole duck 5 minutes. Halve duck and remove bones. Steam in basin with scallion, ginger, salt and wine until soft. Make a paste with the remaining ingredients after finely chopping walnut and water chestnut. Spread paste on inside of duck halves and fry in peanut oil until crisp. The chief ingredient is duck. It is sweet, spicy and neutral, and activates the lung spleen and stomach. Its function is to tonify kidney qi. Walnut is the deputy. It is sweet and warm, and activates the kidney and lung. Its function is to support the chief. Water chestnut is an envoy. It is sweet, slippery and slightly cold. It activates the lung, large intestine and stomach, and activates the middle burner. Minced chicken is another envoy. It is sweet, sour and neutral and activates the five organs. It harmonizes the ingredients and facilitates absorption of the formula. Scallion, ginger, wine, cornstarch and peanut oil are all envoys. Their function is to adjust and harmonize the flavors of the dish. There is a similar Persian dish:
Fasenjian
1 duck quartered
2 onions sliced
300 g ground walnuts
2 ½ cups water
4 tbs pomegranate molasses
2 tsp granulated sugar
2 tsp lemon juice
Salt and pepper to taste
Stew all ingredients in a covered pot over low heat for 45 minutes or until the duck is tender. The chief ingredient is duck. It is sweet, spicy and neutral, and activates the spleen, stomach and lung. Its function is to tonify kidney qi. Walnut is the deputy ingredient. It is sweet and warm, and activates the kidney and lung. Its function is to support the chief. Onion is an envoy. It is spicy, sweet and warm, and activates the lung and spleen. Its function is to activate the middle burner. Pomegranate molasses, lemon juice, sugar, salt and pepper are all envoy ingredients. Their function is to harmonize the recipe.
A similar pair of recipes combine the chief ingredient quail with radish for the deputy. It is a cornerstone of a longevity diet and should be taken in the evening.
Stir-Fried Quail
10 quail cleaned and dressed
1,000 g daikon radish
3 g fresh ginger
200 g canola oil
3 tbs cooking wine
Salt to taste
Heat oil in a very hot pan. Add ginger, radish and scallions. Stir and add seasoned quail. Stir fry until all ingredients are tender. The chief ingredient is quail. It is sweet and neutral, and activates the five organs. It tonifies the viscera and clears damp heat, promoting longevity. Radish is the deputy. It is spicy, sweet and cool, and activates the lung and stomach. It clears damp heat and supports the chief. Fresh ginger is an envoy. It is spicy and slightly warm, and activates the lung and spleen. It circulates the qi of the middle burner. Wine, canola oil and salt are all envoys and harmonize the recipe.
Grilled Quail with Horseradish Glaze
8 de-boned quail
1/4 cup pomegranate molasses
2 tbs grated horseradish
1 tbs Dijon mustard
Salt and black pepper
Grill quail until tender. Combine remaining ingredients and glaze quail. Cook quail until glaze is set. Quail is the chief ingredient. Horseradish is the deputy ingredient. It is spicy and cool, and activates the lung and stomach. It clears damp heat and supports the function of the chief. Pomegranate molasses, Dijon mustard, salt and pepper are envoys. They harmonize the recipe.
There are also instances where a "foreign" recipe can be more effective than the traditional ones. This can be attributed to combinations of foods with similar medicinal properties that are not normally considered in traditional recipes. An example is goose. In traditional recipes, it is boiled, steamed, or in decoction for strengthening muscles and bones, and to treat migratory arthralgia. It is paired with pine nuts and celery to treat the latter and chestnuts for the former. A traditional American approach offers a combination of all three important deputy ingredients in one dish:
Roast Goose With Chestnut and Pine Nut Stuffing
14-lb. goose
1 cup water
1/2 cup wild rice
1 cup white rice
1/2 cup diced onion
1 can mandarin oranges
1 cup chestnuts
1/2 cup pine nuts
1/2 cup celery
1/2 cube butter
Cook rice. Saute onions in butter with celery. Shell pine and chestnuts. Salt and pepper goose and trim fat. Stuff with mixture of mandarins, rice, nuts, onions and celery. Cover with a foil tent to prevent burning and roast at 375 F for four hours. Remove tent and roast 30 minutes longer. Goose, the chief ingredient, is sweet and neutral, and activates the lung, liver and kidney. It strengthens muscles and bones, and relieves migratory arthralgia. Chestnut is the deputy. It is sweet and warm, and activates the spleen, stomach and kidney. Its function is to help the chief strengthen muscles and bones. Celery is an assistant ingredient. It is sweet, bitter and cool, and activates the liver and stomach. It helps subdue migratory arthralgia. Pine nut is sweet and warm, and activates the liver, lung and large intestine. It also helps subdue migratory arthralgia. Mandarin orange is an envoy. It is sweet and cool, and activates the lung and spleen. It regulates the flow of qi. Onion is spicy and warm and activates the lung and stomach. It is an envoy and regulates qi. The rice activates the spleen and stomach. Butter is sweet and neutral, and activates the heart, lung and stomach. It is an envoy and harmonizes the recipe. Employing deputies which emphasize the different traditional functions of the chief, this dish can strengthen muscles and bones, expel wind or both. It is an example of utilizing all of the potential of the chief ingredient.
Medicated diet can be available to all regions of the world using any style of cooking. Dietary drugs are present in most common recipes and simply require identification. By combining them in manners specified by basic principles of TCM, sophisticated dietary treatments can be constructed from among the foods available to the common kitchen.