The Mysteries of Traditional Chinese Medicine Tonics: In-depth Analysis of the Ascending, Descending, Floating, and Sinking Properties of Drugs and the Theory of Four Natures and Five Flavors

Ascending, descending, sinking, and floating are the tendencies of drugs in the treatment of diseases. Ascending drugs mainly move upward and outward, and have the effects of inducing sweating to relieve exterior syndromes, dispelling cold wind, raising yang, and inducing vomiting. Sinking drugs mainly move downward and inward, and have the effects of lowering qi, suppressing yang, astringing sweat, clearing heat, purging, and stopping vomiting. (1) The relationship between ascending, descending, floating, and sinking and the location and progression of the disease. In terms of the location of the disease, in clinical practice, if the disease is located in the upper or superficial part of the body, ascending drugs should be used. For example, for the exterior syndrome of wind-cold, ascending drugs such as ephedra, cinnamon twig, and ginger should be selected for treatment. Conversely, if the disease is located in the lower or internal part of the body, sinking drugs should be used. For example, for the interior syndrome of constipation, sinking drugs such as rhubarb and Glauber's salt should be selected for treatment. If the disease is reversing upward, it is better to descend than ascend. For example, if the liver fire rises, the liver yang is hyperactive, and there is headache, dizziness, and red eyes, sinking drugs such as abalone shell, oyster shell, and gentian should be used to clear heat, reduce fire, calm the liver, and suppress yang. For diseases with a downward trend, it is better to promote upward movement than downward movement, such as chronic diarrhea, rectal prolapse, uterine prolapse, etc. In such cases, drugs with the function of raising yang and lifting prolapse, such as Astragalus membranaceus, Cimicifuga foetida, and Bupleurum chinense, are selected. (2) The relationship between ascending, descending, floating and sinking and the taste, texture and weight of drugs. Ascending, descending, floating and sinking are inseparable from the taste, taste, texture and weight of drugs. Drugs with a pungent or sweet taste and a warm or hot nature are mostly ascending and floating; drugs with a sour, bitter or salty taste and a cold or cool nature are mostly sinking and sinking. Drugs with a light texture, such as mulberry leaves and magnolia flowers and leaves, are mostly ascending and floating; drugs with a heavy texture, such as rhubarb, magnetite, and oyster shell, are mostly sinking and sinking. In commonalities, there are also special characteristics. For example, most flowers ascend, but Inula japonica flowers descend; most seeds are heavy and descend, but Xanthium sibiricum seeds ascend. (3) The relationship between ascending, descending, floating and sinking and processing and compatibility. The trend of ascending, descending, floating and sinking changes with processing and compatibility. In processing, herbs stir-fried with wine tend to ascend, those stir-fried with vinegar tend to astringe, those stir-fried with ginger juice tend to disperse, and those stir-fried with salt tend to descend. In drug combinations, a few ascending herbs will descend with a majority of descending herbs, and a few descending herbs will ascend with a majority of ascending herbs. However, some herbs can guide the ascent or descent of most herbs, such as the guiding herbs mentioned in meridian tropism; for example, Platycodon grandiflorus can carry herbs upward, while Achyranthes bidentata can guide herbs downward. In clinical practice, in addition to understanding the common properties of various herbs, it is also essential to grasp their individual characteristics to better guide medical practice.

In Traditional Chinese Medicine (TCM), the "Four Natures" refer to the four different medicinal properties of herbs: cold, hot, warm, and cool. Cold and cool, warm and hot, are merely differences in degree; slightly cold is equivalent to cool, and very warm is equivalent to hot. These four different properties were observed and summarized through long-term medical practice. Herbs that treat febrile diseases are mostly cold or cool in nature; herbs that treat cold diseases are mostly warm or hot in nature. Therefore, the cold, hot, warm, and cool properties of a herb are relative to the febrile or cold nature of the disease it treats. Cold and cool herbs often have effects such as clearing heat and purging fire, detoxifying and cooling the blood, such as honeysuckle, gypsum, and scutellaria. Warm and hot herbs often have effects such as warming the middle jiao and dispelling cold, tonifying yang and unblocking the meridians, such as dried ginger, aconite root, and cinnamon twig. In clinical treatment, for diseases with mixed cold and heat properties, cold and hot herbs are often used together. In addition, there are some neutral herbs whose cold or hot properties are not very pronounced, and their effects are relatively mild, but they also vary in their degree of warmth or coolness, hence they are still referred to as having the four natures. The five flavors of traditional Chinese medicine refer to pungent, sweet, sour, bitter, and salty. Different flavors of herbs have different effects. Pungent herbs disperse and promote circulation. Dispersing refers to the ability to release pathogens, as seen in herbs like ephedra and peppermint for dispersing exterior syndromes. Circulating refers to the movement of qi and blood, as seen in herbs like cyperus and costus root for relieving pain, and peach kernel and safflower for promoting blood circulation and removing blood stasis. Sweet taste is characterized by its nourishing, harmonizing, and relieving urgency properties. It is commonly used in tonifying and strengthening herbs for treating weakness, such as ginseng and rehmannia, as well as herbs like licorice and maltose for harmonizing other herbs and relieving pain. Bland taste has no distinct flavor. It promotes drainage and is often used to treat dampness obstruction, difficulty urinating, and edema. For example, poria and coix seed have a bland taste and promote diuresis and reduce swelling. Sour taste has astringent and constricting properties. Sour herbs are often used to treat symptoms such as excessive sweating, persistent diarrhea, seminal emission, and leukorrhea. For example, Schisandra chinensis has astringent and antiperspirant properties; Terminalia chebula and Prunus mume have astringent and antidiarrheal properties; and Rosa laevigata has astringent and antiperspirant properties. All these astringent herbs have a sour taste. Bitterness can purge, dispel dryness, and strengthen yin. Purge can mean to promote flow, descend, or clear. For example, rhubarb purges heat and promotes bowel movement; apricot kernel descends lung qi, stops cough, and relieves asthma; and Coptis chinensis clears heat and drains fire. Dryness refers to drying dampness; dampness syndromes are divided into cold-dampness and damp-heat. For example, the warm bitter herb Atractylodes lancea can treat cold-dampness syndrome; and the cold bitter herb Phellodendron chinense can treat damp-heat syndrome. Bitter herbs also have the effect of clearing heat, purging fire, and strengthening yin by preserving body fluids. Saltiness can soften hardness, disperse nodules, and purge. Salty herbs are commonly used to treat phlegm nodules, scrofula, abdominal masses, and constipation. For example, Glauber's salt purges and promotes bowel movement, treating constipation; and Ostrea gigas and Ostrea gigas can soften hardness and disperse nodules, treating phlegm nodules, scrofula, and abdominal masses. The effects of the four qi and the five flavors are interconnected; only by combining these two effects can the properties of a drug be reflected. Drugs with similar odors often have similar effects. For example, most pungent and warm drugs have the effect of inducing sweating and relieving exterior syndromes, which is a common characteristic of this type of drug. Drugs with different odors often have significantly different effects. Even drugs with the same odor but different tastes have different effects. For example, among drugs that are warm in nature, perilla is pungent and warm, inducing sweating and dispelling cold; astragalus is sweet and warm, tonifying qi; apricot kernel is bitter and warm, lowering qi and stopping cough and asthma; papaya is sour and warm, dispelling wind and dampness; and deer antler is salty and warm, tonifying the kidneys and assisting yang. Drugs with the same taste but different odors also have different effects. For example, asarum is pungent and warm, dispelling cold and relieving exterior syndromes; peppermint is pungent and cool, dispelling wind-heat; gypsum is pungent and cold, clearing heat and purging fire; croton is pungent and hot, purging and eliminating stagnation; and white mustard seed is pungent and neutral, resolving phlegm and eliminating dampness. There are also drugs that have multiple tastes, such as schisandra, which has a sour, sweet, and salty taste; angelica, which has a pungent and sweet taste; and atractylodes, which has a sweet and bitter taste. The complexity of drug tastes reflects the diversity of the effects of traditional Chinese medicine. Only by mastering all the properties of each drug, as well as the characteristics of similar and different effects, can one use traditional Chinese medicine correctly and skillfully.