Cannabis use in traditional Chinese medicine

A recent study analyzed references to cannabis in the literature of traditional Chinese medicine

While medicinal cannabis may be an emerging area of study in Western societies, the plant has been recorded in Chinese medical texts for nearly 2000 years. A recent publication in Frontiers in Pharmacology takes a look at ancient medical literature to uncover what the Chinese have long understood about this plant.

For millennia, cannabis has been cultivated in China for use as a source of fibre, food and medicine.  References to cannabis can be found throughout classical Chinese literature, although they mainly focus on the use of its seeds and fiber. Most reports of the use of cannabis for its therapeutic effects occur specifically in medical texts.

The researchers in this study analyzed and reviewed multiple editions of the Complete Ben Cao (materia medica: Latin medical term for the body of collected knowledge about the therapeutic properties substances used for healing). The authors noted a few key points from their research. Mentions of the seeds became more prominent over time and less attention was given to the other parts of the plant. This trend suggests that cannabis was rarely applied in Chinese medicine. There was also enduring nomenclature confusion regarding the various parts of the plant, further inhibiting its use as traditional Chinese medicine. Lastly, although there are records suggesting intoxication and altered consciousness, little was known of the active cannabinoid compounds.

Some fundamental statements that were repeated about cannabis for centuries revealed interesting insights into the understanding of cannabis by the ancient Chinese. The following properties were described in the Divine Farmer’s Classic of Materia Medica from the 1st – 2nd century AD: “Flavor: acrid; balanced. Governs the five taxations and seven damages, benefits the five viscera, and descends blood and cold qi; excessive consumption causes one to see ghosts and run about frenetically. Prolonged consumption frees the spirit light and lightens the body.” To this initial description, it was later added that cannabis is “toxic” and used to “break accumulations, relieve impediment, and disperse pus.”

In the 6th century AD, cannabis was noted for its use in “relieving impediment,” a traditional disease known as “painful obstruction.” The application of cannabis to treat pain may go as far back as the 3rd century AD when the famous physician Hua Tuo was said to have developed an anesthetic formula known as ma fei san or cannabis powder. However, this is speculative since the ingredients used in the ancient formula for ma fei san are lost. In another pain-related application, a physician in the Tang Dynasty (581-683 AD) reportedly used the juice from crushed cannabis leaves to treat excruciating pain from fractured bones. By 1070 AD, a text from the Song Dynasty entitled Illustrated Classic of Materia Medica references a preparation method for cannabis to treat severe pain. The recipe requires that the seeds of cannabis be soaked in water, then the sediment collected from the bottom of the water, stir-fried until aromatic in a silver vessel, and ground into a fine white powder; this is then boiled with alcohol and taken internally on an empty stomach. It is possible that this preparation would yield cannabinoids, as resin glands would sink in water and the heat from the stir-fry would decarboxylate THC acids into bioavailable THC, which can then be extracted when boiled with alcohol.

In applications relating to mental effects and mental illness, the authors of a 6th century text note the following: “take cannabis flower with ginseng and know of things that have not yet come.” A later redaction suggests this may be an overstatement and instead suggests that the combination of cannabis and ginseng allows one to “know the affairs of the four directions” and also treats forgetfulness. In a text from the 7th century, cannabis was said to treat wind-withdrawal, a traditional term relating to mental illness.

Contemporary Chinese medicine texts were greatly influenced by these earlier statements. For example, in the Great Encyclopedia of Chinese Medicinals, it was said that cannabis “dispels wind, relieves pain, and settles tetany” (a traditional disease associated with severe spasm). It was therefore suggested that cannabis could be used in the treatment of “impediment patterns” (typically manifesting in pain and restricted movement), gout, withdrawal and mania, insomnia, and panting and cough. “Blood and cold qi” was interpreted as an indication that cannabis could “quicken” the blood. In the 1935 text Illustrated Analysis of Medicinal Substances, the author recommends cannabis for a variety of conditions including headache, menstrual irregularities, itching, convulsions, anemia, and dry cough.

In the context of modern pharmacology, cannabinoid-related research has attracted a great deal of attention in recent years. Meanwhile, this is considered ancient history in China. While modern technology allows for a deeper understanding of cannabis and its effects, we would all be remiss if we didn’t take time to look back at centuries-worth of knowledge accumulated in these ancient Chinese medical texts.

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  1. Tom Hennessy Reply

    I don't suppose you would have any idea as to its use in medicine before it was made illegal, in Western society?
    I've read in the early 1900's there were hash bars in New York city and so it must have been used in Western 'medicines', since mercury, arsenic and other 'concoctions' were commonplace?
    Reputable 'medicine manufacturers' would have recognised its' benefits, similar to heroins' obvious 'benefits', which led to its' use in medicines .. ?
    Are there repositories of old drugs, including their pharmaceutical ingredients?

  2. Cam Reply

    Check the current materia medicas in Chinese medicine that have tested cannabis on lab animals. Long-term and frequent use can cause mania as well as other side effects. Also did not mention forgetfulness here as in this article it mentions that it helps forgetfulness when used with ginseng (you did not state which type of ginseng). India has made a fermented beer with it and often medicinal use of the oils and inhalants are not the same as drinking it as a beer, smoking or eating it. Overall, this article mainly shows the positives and not the negatives so much. It is not using current materia medica sources or folk medicine sources from China (barefoot doctor sources may have some clinical evidence from villages that may have to use it at times). Hash also a product of cannabis is not mentioned here but is included in the Chinese materia medica sources as well as cannabis seeds. My materia medica states that cannabis tea can be used to treat Malaria. This is not mentioned here nor is the side effect of menorrhagia - prolonged bleeding caused in women after delivering babies who are frequent or heavy cannabis users. I have confirmed this with many midwives. There are plenty of other legal herbs that have the same positive effects, if not more, than the positive uses of cannabis that are stated here. Let's not glorify an herb over others until we can compare it accurately to others especially with those Chinese herbs that are safer and have less negative results over long-term or regular cannabis use. Ask yourself, over the 2,000+ years that Chinese medicine developed, why are there none or very few, if any, formulas that include it? I think the medical traditional scientists of the old would regard cannabis as an herb that had potential medicinal usages but who's negative side effects were more risky and unknown so they excluded it. Surgery was first developed in China so Chinese medicine was quite advanced before any others. I suggest to the author here to read Paul Unschuld's books on the history and development of Chinese medicine before and during communism. If Mao did not get sick and was not given the yin ciao formula that saved his life all of Chinese medical texts and history would have been completely destroyed or lost unless confiscated or already removed from China Another question here for every reader is 'why do you think cannabis makes people slow or move slow who use or smoke it? Could it have an effect on motorskills and cause slow thinking in users? Just observe people who use this herb as a drug regularly or who are dependent on it and you will find that this is probably correct, and then maybe you can understand why it is not commonly used in Chinese medicine or any traditional medicines in most cultures, except for Rastafarian or India. Perhaps Malaysia and Indonesia have a cultural history before Islam arrived... The God Shiva supoosedly smoked it to keep himself warm in the Himalayas as he only wore a loin cloth. The problem today is everyone wants some special power so maybe that is why they use cannabis to feel a sense of power in a world that makes them feel powerless... However, the medicinal use of cannabis and using it as a way to cope with the problems of life are 2 different matters. Every herb has a medicinal side but the only herbs in the world that have been proven over time and have gained a reputation for not having too many side effects due to how herbs are combined with each other to make them safer to use are Chinese herbal formulas. I have come across no Chinese formulas on the market today that include cannabis or is it in the history of Chinese formulas. Simple combinations such as ginseng and cannabis may be used for temporary relief but I have never known of any classical formulas that include cannabis. In India, maybe in Ayurveda, they do as the culture ferments cannabis as a beer for certain rituals or religious holidays but that is not my area or culture to really comment on here.