Samgyetang as Korean medicinal food therapy and disease treatment

Yao Shan Within Korean Traditional Cuisine, Samgyetang

The objective of this paper is to provide an in-depth analysis of the origin and effectiveness of the Korean medicinal food therapy, Yao shan ( -- ). An example of Yao shan is the popular Korean traditional cuisine, Samgyetang (- -- ). This paper explores multiple works (ancient and modern) as well as scientific tests that evaluate the physiological benefits and effectiveness of Samgyetang in order to show that Yao shan can be a source of therapy to treat illnesses and ailments.

A systematic review method is employed. The theoretical framework of TCM (Traditional Chinese Medicine) is rooted in acknowledging the benefits of alternative modes of therapy, such as dietary intervention, as effective in the treatment of individuals suffering non-life-threatening ailments. The method here is used to 1) identify the relevant work (given the nature of the subject, this is literature spanning many centuries and of diverse forms); 2) assess the quality of the works (not all are equal in terms of modern scientific or academic approaches -- yet qualitatively speaking the variety and cultural impact of these works suggest that their merit is grounded in evidentiary effect); 3) summarize the evidence gathered from the review; and 4) interpret the findings. Searches for literature were conducted by accessing both Chinese and Korean scholarly databases as well as Western search engine tools such as Google Scholar. All Chinese literature was translated in English, while some Korean literature was not translated. In addition, published Korean medical journals were also used for this paper.

Results:

Scientific studies were examined to evaluate the benefits of samgyetang (- -- ). In conjunction with historical origins of food therapy and theoretical bases, this research paper found 3 studies that tested samgyetang on mice. Some of the tested mice had diseases and other health conditions. Research indicates that these mice received health benefits from samgyetang. The results of these tests specifically showed that the frequent intake of samgyetang may prevent gastric ulcers and hemorrhages and reduce stress levels as well. The positive influence that samgyetang had on mice, compared to the plethora of literature collected in Asian cultures over centuries, suggests that samgyetang indeed has positive benefits for the body. Findings suggest moreover that by exploring the benefits of samgyetang, researchers can find new pathways to Yao Shan as a suitable and effective form of therapy for diseases and health conditions.

Conclusion:

The study concludes with recommendations for future research as well as for general practice implementations of the findings. The recommendations include conducted a controlled experiment using samgyetang with patients suffering from non-life-threatening illnesses and assessing the dietary impact. General practice implementations include following the ancient cultural recipes for samgyetang in daily dietary intakes and making the recipes part of a natural, organic diet to promote health and well-being. As research shows that Yao Shan is indeed another form of therapy for diseases and health conditions, it is acknowledged that a beneficial treatment for many diseases and/or illnesses can be found in food itself and not just medicine alone.

Introduction

According to many health practitioners, a healthy diet with well-balanced foods is the basis of a well-functioning body (Ferguson et al., 2010). Food provides energy, which affects how our minds and bodies operate. Typically, a healthy diet is beneficial to maintain a high quality of life, prevent disease, and manage weight. Food provides energy in the form of calories, which is necessary for physical activity, healing, and growth.

On the other hand, a poor diet can lead to diseases such as heart disease, cancer, diabetes, and obesity (Davis, 2008). Moreover, too many saturated fats can cause atherosclerosis, a major risk factor for stroke and heart attack. Despite the health benefits of a well-balanced diet, many people do not understand the medicinal value of Yao shan ( -- ). This study attempts to address the problems by providing a better understanding of the benefits of the Yao shan and the pharmacological values associated with it.

A definition of Yao shan ( -- ) is simple: Yao stands for medicinal herbs/spices, while Shan stands for food and how it is prepared (the two go together in Chinese culture). Thus Yao shan translates as the food, itself, directly used as medicine. Shi liao ( -- ) or shi zhi ( -- ) are the terms used to describe food therapy or nutritional therapy, respectively. Yao shan shi liao (-- -- ) are designed with TCM diagnoses to develop, repair and balance the human body to prevent and treat diseases; they are important contributors to anti-aging and longevity. For several centuries, this traditional use of therapeutic food has been carried out as a method of treating various diseases. It is widely popular in Eastern cultures, and the traditional cuisines are tailored according to individual homes. Since the ancient period, people have maintained a belief that medicine and food are from the same origin; thus, they perform the same functions. This supports the idea that food is the best medicine. This research explains the pharmacological effects of the foods used as medicine in the Yao shan tradition and how the integration of herbal medicines with traditional Korean food in particular is effective. In addition, this research will explore some of the medicinal cuisines that are still popular in modern Korean society, the nature of the people's perspective on medicinal cuisine, and the actual benefits of this food therapy.

The foundation of yao shan shi liao starts with a diagnosis on the patient's condition and an overall analysis of the illness. An analysis of a patient's five zang organs, the current season, climate, geographic environment, state of emotion and lifestyle must be conducted in order to properly find the causes of disease, the nature of disease, and the external or internal location of the disease. In addition, the diagnosis depicts the right medicine and the necessary ingredients to cook the medicinal foods to treat or prevent the diseases. To determine which dietary measure should be taken for what condition is the task of TCM diagnostics. Physicians analyze the state of the patient's qi-flow, going beyond the obvious and immediate impressions. TCM diagnostics include tongue diagnosis, pulse analysis and abdominal palpation (Kohn, 2012, p. 120). After this inspection, the health practitioner recommends certain foods and herbal supplements while prohibiting others.

The sections that follow include the literature review proceeded by an evaluation of the works and a discussion of the findings. A conclusion is provided that includes recommendations for general practice as well as for future research that can be conducted so as to give more insight for individuals interested in the benefits of alternative therapy.

Literature

The literature in this section begins with the Origins of Yao Shan, proceeds with a survey of literature regarding the health benefits of food therapy (including a Five Flavors chart), follows that with an examination of the literature on TCM theory, provides an overview of the relevant literature on Yao Shan compared to Western medicine, and concludes with an overview of the various recipes and relevant literature related to Samgyetang.

Origins

The history of Yao shan begins with the discovery of oriental medicine. An ancient book, Divine Farmer's Materia Medica (Shennong Bencao Jing: -- ), introduces a total of 364 different kinds of herbs, and about 50 of the 364 are the culinary ingredients. Some examples are da zao, citrus, ginger, clam, red bean, yi yi ren, long yan rou, apricot seeds, gingko nuts and crabs (Yang, 2013, p.15). Another ancient book, Yellow Emperor's Inner Classic (Huangdi Neijing-- -- ), describes the ideal medicinal diet which includes maintaining the relationship between the five zang organs and the five flavors - bitter, sour, sweet, acrid and salty. Eating meat, grains, fruits and vegetables is an integral part of medicinal procedures (Yang, 2013)

In the Han dynasty, the famous doctor, Zhang Zhongjin (150-219) also often used medical liquor to treat diseases. In Zhang's medicinal books, Treatise on Cold Pathogenic and Miscellaneous Diseases (Shanghan Zabing Lun) and Formulas from the Golden Cabinet (Jin gui Yao lue), Zhang introduced the remedies of intaking hong lan hua jiu (safflower wine) and other medicated wines. In addition, Zhang explained in great detail on how to cook medicinal wine, how to prepare medicinal herbs with wine, and how to treat disease with medicinal wine. (Flaws14) In his book, Zhang used hong lan hua jiu (safflower wine) to treat sharp abdominal pain due to Qi and blood stagnation.

Tang Dynasty Era

The people in the Tang Dynasty recognized the importance of classifying all the medicines used in pharmacology. In 657, the Emperor Gao Zong of Tang (r. 649-683) commissioned Li chi, Su chiang and 20 other scholars to complete a pharmacopoeia book of Chinese herbs. This book was named Tang Hsin Hsin Ben Cao (Tang's Newly Revised Materia Medica). This book contained 54 chapters and the information on 850 different medicinal types and substances. These natural substances were from different minerals, plants, herbs, vegetables, animals, crops and cereal. (Huang 11), (Flaws). The diet therapy was officially classified for their pharmacological purposes.

A famous traditional Chinese medicine doctor of the Sui and Tang dynasty (581-682 AD), also known as the Medicine King, Sun Simiao (- -- ) presented food therapy (shi liao --), nutritional therapy (shi zhi --) in his book, Bei Ji Qian Jin Yao Fang --: Essential Formulas worth a Thousand in Gold to Prepare for Urgent Situations. (Kim 2010) In his book, he recorded over 80 medicated wine formulations, covering medical, surgical, gynecological and tonic aspects. He advised that diet therapy should be attempted prior to any use of medicine. He stated the food we typically eat supplies the nutrients necessary for the basic function of the body and consists of the positive effect that medicine would have. Moreover he is the first to discover that people with diabetes have excess sugar in their urine, and he is the first to recognize that diabetic patients should avoid consuming alcohol and starchy foods. (Temple 1986)

In "Bei Ji Qian Jin Yao Fang," Sun Simiao (- -- ) states: "The dietary therapy is the greatest method of the treatment; doctors should define the disease clearly and treat them with the food therapy first" (Sun 2003). This perspective summarizes the confidence placed in food therapy by these cultures for many years. Sun continues: "If the food therapy is not enough to treat the disease then use the medicine" -- the idea being that food therapy can go a long way to contain and/or solve the problem in the body -- but the recognition is clear that it is not in every case a cure-al: "The medicinal properties is strong like an army, the army destroys all furiously at the chance. The medicine is just like an army, it beats and pound randomly" (Sun 2003).

Sun Simiao (- -- ) states the golden principles of longevity in " Qian Jin Fang":

"To maintain a healthy mind and body, have a meal before you feel hungry, drink water before you feel thirsty. Eat smaller meals more often to the point of satiety, instead of eating heavier meals until you feel full. Fullness results in indigestion." (Sun 379). And again: "Heavy meals injure your lungs and starvation damages your Qi, and excess consumption of salty food hurts your tendons and ligaments. Overeating sour food weakens your bones, So you should maintain a simple and a mild flavor diet. Do not overeat during dinner. One full and heavy dinner devastates one day of your longevity" (Sun 380-381). These statements provide awareness about the effects that food can have on the body, which can mistakenly be characterized as illness requiring medicine, when the actual cure can be found in the diet.

According to Bei Ji Qian Jin Yao Fang: "Food has the function of eliminating evil influences and soothing the vital organs, cultivating one's mind and building up one's strength. You are a good doctor if you can treat a hunchback and expel all kinds of disease only with the food and make the person relieved from the symptoms and the disease" (Sun 2003). Thus in order to address the symptoms, the cause should be clearly identified and in many cases, the diet is the place to start. Sun elaborates with this maxim:

"To make a body comfortable, you must dependent to the food. If you do not know what kind of food is good for you and give you benefits, you are not enough to be survived." (Sun 2003).

Jin Dynasty Era

After the three countries within China divided, the Jin dynasty was established and the politics were stabilized up to the Tang Dynasty Era. Economical and medical developments advanced rapidly while the study of Yao shan successfully developed during this time as well. Ge Hong (283-343 or 363) was a Jin dynasty physician, pharmaceutical chemist, and naturalist, who developed the Taoism theory. Ge made a great contribution to literature, medicine, music, and the history of Chinese science and medicine. (Yang, 2013, p. 16)

Ge Hong's book, Zhou hou fang - --, it describes the mutual incompatibility of certain foods. When there is a combination of two incompatible substances, the consumption of this combination produces side effects or toxins; using either substance alone would not cause any of the side effects. For example, lamb liver and wu mei should not be eaten together, and tian men dong and carp should not be eaten together. Zhou hou fang also states that seaweed treats goiter (enlarged thyroid), lamb liver treats nyctalopia, pig intestines treats diabetes (Yang, 2013, p. 16).

Chen Shi ( -- )'s book, Yang lao feng qin shu, ( -- ) book on nourishing old age and taking care of one's parents) is the first specialized work devoted exclusively to the needs and practices of older people and thus opened an entirely new category of longevity literature. This book includes 162 recipes on food therapy that are used to maintain old age. (Kohn 81)

Hu Si hui (- --, 1314 -- 1330) was a court therapist and dietitian during the Yuan Dynasty era. He is known for his book Yinshan Zhengyao (Important Principles of Food and Drink), that became a classic in Chinese medicine and Chinese cuisine. He was the first to empirically discover and clearly describe deficiency diseases (Yang, 2013, p. 18). According to Yinshan Zhengyao, a significant number of diseases are caused by improper eating, and a significant part of diseases can be cured by proper eating. The book propagated moderation, regularity and variety in food, proper hygiene and food storage, and special diets for pregnant women and for children. This book was the first to describe how diseases are connected to the deficiency of certain components in food. It was the first book in China to discuss food poisoning as well. (Yang, 2013, p. 18)

Many recipes presented in this literature demonstrated a strong Han Chinese, Mongolian, Turkic and Persian influence. As Hu Si hui stated, a large variety of foods were known in the court since the time of Kublai Khan, and this circumstance called for a special research. Taken as a collection of recipes and ingredients alone, his book is tremendously important in its description of medicinal food of Eurasia. (Yang, 2013, p. 18)

It is difficult to find Korean medicinal foods from the first to seventh century B.C. in Korean literature. However, the pharmacological effects of Korean herbs such as Ren shen (-), Wu wei zi (- -- ), Xi xin (-), yin jin xie (- -- ), Kun Bu (-), and Kuan dong hua (- -- ) can be found in Chinese literature, such as Collected Commentaries to Divine Farmer's Materia Medica (-- -- ) and Additional Objects by Famous Physicians (- -- ).

Beginning of the 14th century, Korean had lost much of its power due to its subjugation under Mongol rule, which made it very difficult to obtain Chinese medicine. Many Koreans began to use their own domestic herbal medicine, known as Hyang-yak.

The famous doctor, Huh Jun (- -) (1539-1615) compiled TCM and traditional Korean medicine in one book, known as the Dong Eui Bo Gam (- -- -). Huh Jun wrote an entire chapter on medicinal food classified by taste, properties, characteristics and functions in recipes. (Huh 1998) 70% of Korea is covered by mountains, and this type of geographic environment positively affects the genesis of Korean herbal medicinal cuisine. Hence, lots of herbs are able to grow; these herbs are used as ingredients in Korean traditional cuisine. For example, well-known examples of Korean Yao shan cuisines are huang qi chicken soup, huang qi duck soup, huang qi and bei sha shen chicken soup, the medicinal beef short rib stew, ginger beef short rib, du chong sea cucumber stew etc. which passes down from generation to generation to this day (Yang, 2013, p 21). These elements are explored in the following sections.

Health Benefit -- The Five Flavors of Food

The five flavors - acrid, salty, sweet, bitter, and sour, are closely associated with the five zang organs and the wellbeing of the body. It is important to consume the right amount of each flavor to obtain the full health benefits and desired effects on the body.

The consumption of acrid food has the ability to deliver a warming function on the foods. Typically, the taste stimulates blood circulation, boosts energy, and increases lymphatic fluid, saliva, sweat and tears. Additionally, the spicy taste improves digestion by counteracting poor digestion, mucus production and poor blood circulation. The acrid flavor assists in distributing energy throughout the body. Individuals experiencing high levels of fatigue cannot consolidate the distribution of energy, so they should not consume high levels of acrid flavored food. Moreover, excessive intake of spicy foods should be avoided because it can exhaust reserved energy. Some examples of acrid foods are black pepper, ginger, garlic, green onion, peppers and jalapenos. (Dharmananda 2010)

The consumption of salty food regulates and stabilizes the fluid balance within the body and it reduces the body temperature. It also enhances softening effect and is beneficial to lymph nodes; however, excessive consumption of salt can damage the kidneys, increase blood pressure and cause water retention. People suffering from anemia and dehydration should avoid eating salty food. Some examples of salty foods are seafood, seaweeds, soy sauce, fish sauce, soy bean paste and salt.

The consumption of sweet food harmonizes a diet and strengthens individuals by providing energy boosts. Ultimately, the consumption of sweet food can make the glucose level fluctuate. However, excessive intake of sweets can lead to poor digestion, lethargy, and congestion. Some examples of sweet foods are raisins, honey, fruits and grains. Some examples of sweet medicinal foods are yi yi ren, long yan rou, da zao, and gou qi zi. (Dharmananda 2010)

The consumption of bitter food can detoxify with dry, cool and anti-inflammatory features. The intake of bitter food stimulates secretion of bile, helps with bowel movement, and assists in the digestion process. Bitter foods also assist in protecting the body against parasites and viruses. Moreover, the bitter substances assist in reducing cholesterol. Some examples of bitter foods are liquor, rye, escarole, rhubarb, romaine lettuce, quinoa, asparagus, mountain vegetables, such as wu jiao pi (Acanthopanax gracilistylus) baby leaves, ge gen, sha shen and qian cao. (Dharmananda 2010)

The consumption of sour food assists in reducing contraction of the tendons and ligaments. It also helps reabsorb fluids and restrain the leakage of any fluids such as excessive diarrhea, perspiration, frequent urination and bleeding. The sour taste helps to drain and remove excessive water from the liver. In addition, the intake of sour food stimulates metabolism and /digestion, helps the breakdown of fats, and facilitates fat absorption. The excessive consumption of sour food can cause constipation and digestion problems. Examples of sour foods are vinegar, citrus, and pickles. (Dharmananda 2010)

Five Flavors Chart (Loo 135-138)

Favors

Organs affected

Effects

Food samples

Pungent

(Loo

137-38)

Lung

Large intestine

1. It is a Yang flavor.

2. It warms the body.

3. It assists the circulation of qi and blood.

4. It stimulates the digestive process.

5. It disperses mucus.

6. It enters the lungs.

Fresh ginger, onion leeks, green onion, Sichuan peppercorn, garlic celery, coriander, Chinese chives, fennel, spearmint, radish lead and radish, turnips, taro, leaf mustard, shanghai cabbage, cinnamon, tangerine peel, kumquat, mustard seed and wine

Sweet

Stomach

Spleen

1. It is a Yang flavor.

2. It has a warming effect.

3. It moves qi upward & outward through the skin.

4. It builds tissues and fluids.

5. It strengthens Yin deficiency.

Rice, sweet rice, wheat, taro, sweet potatoes, potato, corn, shiitake mushroom, pumpkin, carrot, apple, pears, cherry, longan, dates, honey, peas, soybean, sugar cane, peanut, milk, chestnut, grapes, lotus seed, aril, carps and abalone.

Sour

(Loo 135-36)

Liver

Gall bladder

1. It is a Yin flavor.

2. It tends to cause contraction, which has an astringent effect on body fluids and energy.

3. It enters the liver and helps with digesting rich, greasy, fatty and high cholesterol foods.

Lemon, tomatoes, pineapples, apple, strawberry, papaya, pears, loquat fruit, oranges, tangerines, peaches, hawthorn fruits olives, pomegranate, plums, pomelo, mango, grapes, vinegar and royal jelly

Bitter

Kidney

Bladder

1. It is a Yin flavor.

2. It has a cooling effect that moves qi downward in the body.

3. A moderate amount of bitter foods can reduce excess fire conditions such as loudness, red complexion and aggressiveness; but too much can sometimes bring the opposite effect, such as dryness.

Amaranths, millet, barley, laver, preserved jellyfish, seaweed, kelp, sea clams, sea shrimps, oyster, crabs, sea cucumber, field snail, pork, pig's bone marrow, pig's blood, pig's organs, razor clam, dried mussel, ham, pigeons' egg, abalone, duck meat and cuttlefish.

TCM Theory

Traditional Chinese Medicine (TCM) Therapy is a tool whereby Chinese medicine classified food according to its flavors (energies, effects) already described above. Some foods have a warming effect, others a nourishing effect, and still others a cooling effect, and so on. TCM therapy does not, moreover, provide general guidelines of dietary goals in the same manner that Western culture does. For example, the West's Food Pyramid, taught in schools for many years, is based on the concept that everyone requires the same amount of grains, fruits, vegetables, dairy products, etc. Yet, in Chinese culture and in TCM therapy, the concept that a fruit and yogurt for breakfast has nutritional benefits is sound -- but that does not mean it would have a beneficial effect on all people across the board, because what has to be determined is the individual's bodily needs. For example, a breakfast of fruit and yogurt may have positive effects on a person described in TCM therapy as having a yin deficiency (symptoms of which could include insomnia, sore throat, lower back soreness, accelerated heart rate) -- but may have negative effects on someone who has a yang deficiency (spiritual fatigue, impotence, edema, cold limbs, poor circulation) (Betts, 2006).

TCM theory is thus grounded in the idea that food plays a major role in the dietary needs of individuals. This theory is not unique to Chinese culture; in fact, many cultures and societies throughout time in both the East and the West have held this to be true (Kyziridis, 2005). What makes TCM unique, however, is the way in which it categorizes and describes the body types. Yin and Yang deficiencies, for instance, are related to cultural ideals associated with Chinese philosophy, based on Tao, and referring to wholeness of mind, body and spirit. This "wholeness" is reflected in the philosophical approaches to health and well-being in other ancient cultures, such as the Grecian and Roman ones of antiquity, and it is Plato who observed that if mind and body are to be well (whole), one must first approach the soul and address its particular needs (Kyziridis, 2005). In TCM therapy, the idea is that a philosophical outlook rooted in Tao serves as the foundation for food/dietary therapy.

Western nutrition vs. Yao shan ( -- )

People seek Yao shan as a natural alternative to Western Medicine. However, many people do not know the scientific benefits of Yao Shan unlike that of Western Medicine. The focus will be on Traditional Chinese Medicine (TCM) dietary therapy within the context of Korean traditional food and lifestyle; the kinds of medicinal cuisines still popular in modern Korean society today; and the actual benefits of the Yao shan versus people's beliefs.

The biggest difference in Western Medicine and Yao shan is perception of the consumption of food in relation to the body. In Western Medicine Nutrition, food provides energy in the form of calories, which is necessary for physical activity, healing, and growth. The calorie allowance of food is according to a person's age and gender. For example, Western Medicine considers the number of ounces (grams) depending on the individual's size, age, and gender. The Western diet places emphasis on dividing food into five major nutrient groups: carbohydrates, fats, proteins, vitamins, and minerals. Western nutrition centralizes on the amount of calories and the nutrient groups when selecting food. Unlike Western nutrition, Yao Shan perceives freshness, time of harvest, flavors, and the effect of food on organ systems as the most important factors of nutrition (Loo 131). In fact, these are the essential building blocks of quality food and Qi. Yao shan values the more natural and holistic approach in preparing food since Qi comes from living things, such as vegetable and animal products..The preparation of these foods is also very important in optimizing Qi. For example, eating vegetables as soon as they are harvested and eating meat as soon as they are slaughtered would provide the maximum Qi from the food.

An example of Yao shan is a popular Korean medicinal cuisines, known as samgyetang (ren shen chicken soup). The paper includes detailed scientific research of this food on plasma lipids and glucose levels, and other benefits of this medicinal cuisine. Korean cooks have created various kinds of recipes with Samgyetang; these recipes consist of different types of herbs that make each recipe so unique.

More advantages of Yao shan over traditional Western medicine include the natural, organic approach to health that the TCM method allows. For instance, as Davis (2008) discovered in the Marshall Islands during his experiment in controlling and eliminating diabetes among the natives there, returning persons to a diet that is natural and organic can cure them of ailments they receive after consuming foods that are inorganic, unnatural, pre-packaged and not oriented towards the needs of those consuming them. Davis (2008) found that the Marshall Island natives had developed diabetes after importing pre-packaged Western diets and that when they returned to their traditional diet (living off the land and sea), their health improved and they eliminated their diabetes. TCM and Yao shan work the same way in the sense that they provide a natural and organic means of addressing ailments in the body -- whereas Western medicine typically relies upon synthetic and manufactured means of addressing symptoms. For example, instead of taking a dietary approach to curing diabetes, practitioners will give patients insulin injections, which is an unnatural method of treating the disease. According to the findings of Davis (2008) as well as to the ancient wisdom of TCM, all that is needed is a return of the individual to a traditional, healthy diet that is not based on synthetic foods or inauthentic recipes that endanger the health.

Yao shan also takes a holistic approach to the body's health in that it does not simply judge the body independently of the mind and spirit. Its approach is rooted in philosophy and spirituality just as much as it is in dietary nutrition. This means that, unlike in the West, it examines the whole issue of the human rather than aspects; whereas in Western medicine, bodily health is typically examined separately from psychological or spiritual health. In fact, because spirituality has been so politicized in the West (since the Protestant Reformation and the break-up of the realm known as Christendom in the Middle Ages), Enlightenment-influenced practitioners are hesitant to assess the spiritual impact or influences of individual beings and how it relates to their biological, nutritional or psychological needs. Only in recent years have more studies been undertaken that examine seriously the role and impact of spirituality in assessing the health of individuals (Smith, 2007).

For this reason, Yao shan stands as a more natural, organic, traditional and less-intrusive means of addressing the needs of persons than that of Western medicine which separates aspects of the human personality, examining them independently instead of holistically, and which depends upon synthetic drugs and interventions to effect positive results that may in fact only address the symptoms for a period of time and do not in actuality address the underlying issues related to the symptoms in the same way that a dietary approach such as TCM can affect (Davis, 2008). The oriental approach is significantly more holistic in terms of addressing the whole person than the often-times impersonal and generically dispensed health care of Western medicine in the modern era. Of the oriental TCM approaches, Samgyetang is one that can be particular beneficial. It is discussed more fully in the following section.

Material and Methods of Samgyetang

Samgyetang, Korean traditional Yao shan, contains chicken and traditional medicinal herbs. This food is highly treasured among the Koreans and has been taken both for nutritional and medicinal benefits for a long time. In samgyetang, Sam means renshen, gye means chicken, and tang means soup. The origin of cultivated renshen started from the wild renshen grown by humans, but left to grow naturally in the mountains. According to the historical research, the first Korean ginseng cultivation started from the Koryo Dynasty around A.D. 1000. (Ko & Leem, 169) However, the mass production of Renshen began to appear after the Korean War. The pharmacological effect of renshen became widely known to the public and the government; hence, they installed an enormous facility cultivating, farming, and processing renshen. The government aggressively produced the field-cultivated renshen; this led to the rising popularity of samgyetang to the general public. (Ko & Leem 169)

Now Koreans have a habit of eating Samgyetang to maintain and promote their health on specific dates like the beginning of summer --(-), the mid-summer-- (-) and the end of summer - (-). The ingredients of Samgyetang, such as renshen, garlic, and jujube are known to have health benefits. Renshen lowers blood pressure and glucose levels, reinforces insulin function, and prevents tumor and stress. Garlic reduces plasma lipids and glucose levels, prevents thrombosis, and enhances anti-mutation activity. Jujube (da zao) is known as a medicinal fruit in Asia. (Suzuki, 576)

The benefits of the ingredients in Samgyetang are supported scientifically. An experiment to determine the impact of the food on the plasma lipids and glucose level, the percentage of glycosylated hemoglobin and anti-stress activity were studied in mice. This was done to bring the focus on these foods and to determine as to whether the popular belief among the Koreans had a scientific basis or not. This study was done to bring the attention of the importance of this food in Korea. With all the beneficial ingredients samgyetang has, scientists wanted to see how samgyetang improves one's health. They were then fed on the control, Samgyetang I or Samgyetang II diet for 120 days. Samgyetang I diet corresponds to an intake of once per week (exactly 1.86 times/ week). Samgyetang II diet corresponds to an intake of 4.3 times per week. The Samgyetang was fed as the freeze-dried powder of the retort-pouched samgyetang. (Suzuki, 582)

Table 1. Contents and Nutritional Components of Retort-pouched Samgyetang (Suzuki 576)

Contents (a retort-pouched sample)

Mass (g)

Percentage

Net

Chicken tissue, sticky rice and garlic

46.3

Stock

39.4

Chicken bone and seed of jujube

71.5 + 7.2

8.3

Panax ginseng

27.9 + 3.7

3.3

Chestnuts

12.2 + 2.1

1.4

Jujube

11.5 + 1.8

1.3

Freeze-dried powder of edible portion

15.5

Nutritional Components

Mass (g/100 g)

Percentage in freeze-dried powder

Water

84.5

0

Protein

7.6

49

Lipid

3.7

23.9

Carbohydrate

3.6

23.2

Ash

0.6

3.9

Figure 1. Effect of Samgyetang feeding on plasma glucose concentrations and the percentage of glycosylated hemoglobin in mice (n-10). (Suzuki 582)

The average values of plasma glucose levels in samgyetang I and II diet groups were lower than those in the control diet group. Significant differences were found for the percentage of glycosylated hemoglobin between the samgyetang diet and control diet groups. (Suzuki 579-580) Most of glycosylated hemoglobin in normal human adults is hemoglobin A1C and is known as an indicator of the degree of glucose intolerance in diabetes. The present study suggests that samgyetang is beneficial medicinal food for the maintenance of health in people exposed to stress. Further study is needed to ascertain whether or not samgyetang is useful in treatment of patient with diabetes and other diseases. (Suzuki 582-583)

Table 2. Results of the Anatomical Observations of Gastric Lesions (Suzuki 581-582)

The following symbols represent the table below: -, no gastric ulcers or hemorrhage; +, 1~2 regions; ++, 3~5 regions; +++, 6 regions. *Incidence of gastric ulcer. A, b There are significant differences between values of different alphabet characters (P<0.001).

In Table 2, mice from both the samgyetang II and control group were put under extreme stress tests, such as placing both groups in a tank of water and forcing the mice to swim. Under this stress test, 8 out of 10 mice in the control diet group (no samgyetang) had gastric ulcer, and 4 out of 10 mice had hemorrhage. 3 out of 10 mice in the samgyetang group II had gastric ulcer, and 1 out of 10 mice had hemorrhage. (Suzuki 581) This shows that the frequent intake of samgyetang may prevent gastric ulcers and hemorrhages and reduce stress levels as well. (Suzuki 582)

Figure 2. Effect of Samgyetang feeding on plasma cholesterol, triglyceride, phospholipid, and free fatty acid concentrations in mice (n-10). (Suzuki 579)

In essence, garlic is effective in reducing the plasma cholesterol and triglyceride; however, from the results above, it appears that garlic in samgyetang has no marked influence on plasma lipids concentrations of mice. It may be that the intake of garlic is not sufficient quantity to affect plasma lipids. The study, "Effect of garlic on serum lipids: an updated meta-analysis," suggests garlic to be effective in reducing total serum cholesterol by 17 ± 6 mg/dL and low-density lipoprotein cholesterol by 9 ± 6 mg/dL in individuals with elevated total cholesterol levels (>200 mg/dL), provided garlic is used for longer than 2 months. An 8% reduction in total serum cholesterol is of clinical relevance, high-density lipoprotein cholesterol levels improved only slightly, and triglycerides were not influenced significantly. In another research, a "Double-blind Crossover Study in Moderately Hypercholesterolemic Men that Compared the Effect of Aged Garlic Extract and Placebo Administration on Blood Lipid," mice fed with 7.2 grams of aged garlic extract per day for a total period of 10 months showed a maximal decrease of 6.1% in total serum cholesterol levels and 4.6% in LDL cholesterol levels with garlic. In addition, there was a 5.5% decrease in systolic blood pressure and a modest reduction of diastolic blood pressure in response to aged garlic extract. (Steiner 1996)

Another research study regarding samgyetang determining the optimum addition level of medicinal herbs was conducted using the pH scale. Since pH 7 is neutral, anything above pH 7, alkalinity increases; anything below it, acidity increases. The pH (Hydrogen Exponent) of the herb samgyetang decreased the most with the Shi changpu addition group by 4.57 and the soluble solid content increased the most with the Bei Sha Shen addition group by 3.87. In the sensory analysis, the herb samgyetang with the highest Bei Sha Shen addition group had the highest score in color, flavor, taste, and overall preference. (Jeong 274) In the recent study, "Effect of Codonopsis lanceolata (Bei sha shen) with Steamed and Fermented Process on Scopolamine-Induced Memory Impairment in Mice," the extract of steam and fermented C. lanceolata (bei sha shen) showed significant anti-amnestic and cognitive-enhancing activities. (Woen 405) In conclusion, the optimum addition levels of medicinal herbs for the herb Samgyetang are as follows: jie Geng 4 g, bai Zhu 4 g, bei Sha shen 12 g, wu wei zi 6 g, shi chang pu 4 g, gan cao 4 g, and da zao 4 g. (Jeong 275)

Table 3. Additional ratio of medicinal herbs for herb Samgyetang (Unit: g) (Jeong 275)

Table 4. Sensory evaluation of herb samgyetang added with different levels of medicinal herbs (Jeong 275)

The Properties and the Pharmacological Effect of the Herbs Used in the Study Above.

In the study, "Effect of Samgyetang (- -- ). Feeding on Plasma Glucose Concentrations and the Percentage of Glycosylated Hemoglobin in Mice," mice fed with Samgyetang had a higher body mass than the body mass of mice that were not fed with Samgyetang. Although mice fed with Samgyetang (- -- ) had an increase in body mass, they had a significant increase in the percentage of glycosylated hemoglobin than the mice that were not fed with samgyetang (Suzuki 579). Based on these results, samgyetang is highly recommended in case of emaciation, lethargy, lack of strength and anemia. Also elders who suffering from kidney yang deficiency and have symptoms such as aversion to cold, short of breath, and fatigue. Moreover, Samgyetang (- -- ) is beneficial for people who suffering from pain and weakness on the lower back and knee, thinning of extremities, tinnitus, and frequent urination at night.

Furthermore, recent studies in "Effect of Samgyetang (- -- ) Feeding on Plasma Lipids, Glucose, Glycosylated Hemoglobin, and Stress-Induced Gastric Ulcers in Mice," suggest that Samgyetang (- -- ) is a beneficial medicinal food for health maintenance and stress prevention. Moreover, studies depict that Samgyetang (- -- ) promotes anti-stress activity in that it helps prevent gastric ulcers and hemorrhages. The intake of Samgyetang (- -- ) at least once a week may be useful for maintenance of a healthy stomach. (Suzuki 582-83)

Assessment, Analysis and Summary (as well as an overview of the Ingredients of Samgyetang)

The nature of the works and literature relevant to the subject of TCM, Yao Shan and Smagyetang is such that it must be inclusive of diverse writings and research. Some of it dates back centuries, while others are more recent and fall within the spectrum of modern academic research criteria (these are the studies performed with mice, specifically to assess the advantages of TCM). However, the ancient works are useful and in fact beneficial as foundations for researchers because they point the way like sign posts towards the ideas and practices that ancient cultures utilized in addressing the needs of health and well-being. To assume that only modern methods of intervention and prevention are appropriate is to enable a type of cultural bias that negates any possibility of positive assessment being made.

The analysis of the various works described and explored in the literature review reveals a wide range of concepts -- from food recipes to nutritional health and impacts to philosophical approaches -- all of which serve to make up the spectrum that is TCM all the way down to Samgyetang. It is helpful to summarize and review this spectrum in the terms below.

Yao Shan focuses on the properties of the five tastes, four temperatures, targeted meridians and its functions. However, it does not analyze the physical and chemical components of the ingredients. The table below summarizes the Yao Shan analyses and the pharmacological benefits of the individual herbs used in Samgyetang.

Jie Geng Platycodon grandiflorum

(Bensky 429)

LU

Neutral

Bitter, Acrid,

1. Open up Lu qi

2. Dispel phlegm

3. Benefit throat

It contains platycodin, platcodigenin, platycogenic acids, phytosterol, a-spinasterol and inulin. (Li 406)

stops coughing and expels sputum.

• Inhibits inflammation and strengthen the immune function.

• Inhibits gastric secretion and counteracts ulcers of the digestive system.

• Has a tranquilizing function, alleviates pain, abates fever, and reduces the levels of blood sugar and blood lipids.(Li 406)

Bai Zhu Atractylodeslancea

(Bensky 726)

SP, ST

Warm

Bitter, Sweet,

1. Tonify Sp qi

2. Dry damp & promote water metabolism

3. Stabilize the wei qi & stop sweating

4. Calm the fetus

It contains ß-Eudesmol and Hinesol inhibit the excitation in the central nervous system.

It enhance secretion of the digestive enzyme.

ß-Eudesmol works together with H2 Receptor and Hinesol.

• Inhibits the excessive secretion of the gastric acid.

• Contains Vitamin A, and helps the skin nourishment.

Reduce the glucose level.

(Park 2002)

Bei Sha Shen Codonopsis lanceolata

(Bensky 816)

LU, ST

Sl cold

Sweet,

Sl bitter

1. Nourish LU qi & CLR heat

2. Nourish ST Yin, & generate fluids

It contains psoralen, bergapten, xanthotoxol, xanthotoxin, imperatorin, cnidilin, marmesin, scopoletin, ß-sitosterol, volatile oils, alkaloids, triterpenic acids and polysaccharides. (Li 579)

• Acetic extracts from the peel and root of bei sha shen are effective in expelling sputum and calming wheezing.

• Inhibits gastric ulcers.

• The volatile oils contained in bei sha shen clear heat and alleviate pain. (Li 579)

Wu Wei Zischizandra chinensis

(Bensky 858)

HT,

K,

L

Warm

Sour

Sweet

1. Contain the leakage of LU qi & stop coughs

2. Tonify the kidney & bines up the essence & stop diarrhea

3. Inhibit sweating & generate fluids

4. Quiet the spirit while calming and contain the HT qi

It contains volatile oils (including a- and b-pinene, camphene, myrcene, a-terpinene, limonene, bornyl acetate, linalool and benzoic acid), saccharid, arginine, schisandrin, schisandrol, gomisins, carbohydrates, resin, tannin, and vitamins C. and E. (Li 612)

• Strengthens the process of inhibition and stimulation of the CNS.

• Regulates blood circulation in the cardiovascular system, dilates blood vessels and lowers blood pressure.

• Stimulates breathing, expels sputum and stops coughing

• Strongly inhibits mycobacterium tuberculosis and staphylococci.

• Oral intake of a powder of wu wei zi prepared with suan zao ren can lower the transaminase of patients suffering from chronic hepatitis. (Li 612)

Shi Chang Pu, Acorus gramineus

(Bensky 954)

HT

ST

Warm

Acrid

Bitter

Aromatic

1. Open the orifice, dislodge phlegm-deaf, dizziness, forgetful, a dull sensorium.

2. Transform damp, Strengthen SP & ST

3. Transform turbid damp, awaken SP & promote movement of qi-abdominal fullness & distention

4. Promote blood flow & reduce swelling

The essential oil of the root contains N-Methyl-D-aspartate (NMDA), and it inhibits the nerve toxicity.

The main substances of the essential oil, asarone protects the brain nerve cell.

• Contain oxalic acid, citric acid, succinic acid & formic acid. (Park 2002)

Gan Cao Glycyrrhiza uralensis

(Bensky 732)

All 12 channels

Warm

Sweet

(dry-fried)

Neutral (raw)

1. Tonify the spleen and augments qi

2. Moisten the lungs and stops cough -).

3. Clear heat and toxic fire (raw) - carbuncles, Alleviate pain and stops spasms

4. Often used to harmonize and/or moderate characteristics of other herbs.

5. Antidote for toxic substances (internally and topically).

Gan cao contains glycyrrhizin, glycyrrhizic acid, glucutornic acid, glycyrrhetic acid, liquorice saponins, liquiritin, licoflavone, isolicoflavonol, liquiritigenin, formononetin, betulic acid, and urease and sucrase enzymes.

(Li 523-24)

• Has a cortisone like function, inhibits inflammation and allergic reactions and promotes urination.

• Protects the functions of the liver and relieves spasms in the gastrointestinal tract.

• Inhibits the hepatitis virus and HIV.

• Stops coughing and promotes bronchial secretion, thus encouraging the discharge of sputum. (Li 524-25)

Da Zao Zizyphus jujube

(Bensky 731)

Sp

St

Sweet

warm

1. Tonify qi and blood

2. Generate fluids

3. Harmonize the spleen

4. Moderate the toxic effects of other herbs

5. Contain the leakage of LU qi & stop coughs

6. Tonify the kidney & bines up the essence & stop diarrhea

7. Inhibit sweating & generate fluids

8. Quiet the spirit while calming and contain the HT qi

It contains betulinic, oleanolic, malic and stearic acids, zizyphus saponins, vitamin B2, and C, carotene, sitosterol, stigmasterol, calcium, phosphorus, iron, catechol and tannin. (Li 532)

• Alcoholic extracts of da zao inhibits allergic reactions.

• Has a tranquilizing function, inhibits the production of carcinoma cells and strengthens the muscles.

• Lowers blood pressure.

The Basic Ingredients of Samgyetang

The basic samgyetang made with chicken, Ren shen (ginseng), da zao, garlic, chestnut, and sweet rice can be modified depending on the patient's condition. The research above shows more various medicinal herbs for samgyetang.

According to Shennong Bencao Jing, "the chicken is warm in nature, tastes sweet, and enters spleen and stomach meridians. It strengthens the digestive system, warms the middle jiao, boosts up the energy and tonifies the fatigue, and strengthens the muscles and bones." (Lee 32)

In addition, according to Suixiju yinshipu - --, "the chicken comforts the stomach, strengthens the bones and muscles, heals wounds, activates the blood and regulates the menstruation, eliminates the boils, stops the leucorrhea, treats the frequent urination, and benefits the recovery of postpartum mothers." (Lee 32)

The Pharmacological Effect of Herbs

Explanation in TCM

Da zao

(Park)

1. It contains glucose, calcium, Vitamin C, protein and fat.

2. It supplies the nutrition into the surface of the cells.

3. It enhances the activation of the cell metabolism.

4. Ethyl-α-D-Fructofuranosidei increases Cyclic AMP.

5. It strengthen the wall of the fat cell.

6. It has anti-allergy effect.

7. It inhibits the stress type ulcer.

8. It has mental sedative properties.

Da zao is sweet, has warm property, enters the spleen and the stomach meridians.

• Tonifies spleen qi - weakness, shortness of breath, reduced appetite, and loose stools.

• Nourishes the blood, calms the spirit - irritability, pale complexion, emotional disturbances, restlessness.

• Useful to harmonize the harsh properties of other herbs.

Ren Shen

(Park)

1. Ginsenoside Rb1 prevents from the cerebral thrombosis.

2. It also treats and prevents fatty liver from the excessive alcohol intake.

3. It reduces the cholesterol and develop the lymphocyte activation and immune-enhancement.

4. Ginsenoside Rb2, Re, Rg1 increases secretion of lipoprotein lipase activity, lipid synthesis.

5. It enhances the formation of red blood cells in bone marrow cellularity.

6. Ginsenoside Rb1 has a sedative effect for anti-stress activity.

Ren shen is bitter, sweet, has warm property, enters the lungs and spleen meridians

• Strongly tonifies yuan qi - extreme collapse of qi, shortness of breath, cold limbs, profuse sweating, and weak pulse (often used alone for this condition after severe blood loss).

• Tonifies lung qi - wheezing, shortness of breath, w/kidneys failing to grasp the qi.

• Strengthens the middle warmer - lethargy, no appetite, chronic diarrhea, prolapse of organs, distended chest/abdomen.

• Generates fluids, stops thirst - Xiao ke, damaged fluid due to high fever and profuse sweating.

• Benefits heart qi calms the spirit - palpitations, anxiety, insomnia, poor memory, restlessness due to qi and/or blood deficiency.

Garlic

Da Suan,

(Steiner et al. 1996).

It lowers the cholesterol and triglyceride levels.

Garlic is spicy, has warm property, and enters the spleen, stomach, lungs, and large intestine meridians.

• Resolves swelling.

• Arrests diarrhea.

• Removes toxicity and kill parasites.

Li Zi

Chestnut

(Kim )

It contains protein, fat, carbohydrate, potassium vitamin C, vitamin B-6

calcium, iron, and magnesium.

Chestnut is sweet, slightly salty, has warm property, and enters spleen, stomach and kidney.

• Tonifies qi, strengthen spleen.

• Tonifies kidney and strengthen the muscle.

• The chestnut skin stops bleeding.

The Various types of samgyetang and the recipe

The practice of Yao Shan is specifically tailored to each patient's conditions and environments. For instance, in Korea, there are several types of Samgyetang recipes that are modified to the needs of the individual who is consuming it. A patient who is suffering anemia will benefit from Black Samgyetang because Black Samgyetang is proven to increase the production of red blood cells and blood platelets.

Black Sam Gye Tang (Hwang 142)

The Ingredients:

A whole black chicken

Gou qi zi 10g

Ren Shen 1 root

Huang Qi 2 roots

Da Zao 3 pc

Whole Garlic 30g

Sweet Rice 1 cup (soak in the water for 30 min before cooking)

Black sesame seed

Roasted salt 1 ts

Function:

• Black chicken increases red blood cells, strengthens liver and kidney, helps neuralgia and bruises, and increases red blood cells and increases the production of blood platelets. Black sesame contains B1, b2, thymine, calcium, selenium and protein. It also helps anti-aging and activates brain functions, nourishes skin, and benefits thinning hair. (Hwang 146)

Huang Qi Gou qi Samgyetang

Huang Qi strengthens the exterior, facilitates urination, and reduces the edema. It contains astragalosides, daucosterol, b-sitosterol, palmitic acid, astragalus saponins, kumatakenin, choline, betaine, folic acid, formononetin, calycosin, cycloastragenol and glucuronic acid. (Li 518)

Directions

1. Stuff the black chicken with ren shen, huang qi, da zao and garlic --> put them in the pot and add just enough water to cover the chicken -- > boil it for 1 hour

2. Soak the sweet rice in the water for two hours. Grind them with black sesame seeds.

3. Start to cook the grinded sweet rice and the black sesame seeds with black chicken stock -- > when it starts boiling, simmer down the fire and keep stirring the porridge.

4. Serve the porridge with black chicken.

* Caution: Black chicken needs longer cooking time than the regular chicken. So please make sure it is well cooked.

Ai Ye Sam Gye Tang (Hwang 146)

The Ingredients:

A whole young Chicken

Ai Ye 20g

Wu Jia Pi 20g Fu pen zi 1 hand full

Ren Shen 1 root

Huang Qi 2 roots

Da Zao 2 pc

Whole Garlic 6 pc

Sweet Rice 1/2 cup (soak in the water for 30 min before cooking)

Chicken bone or Chicken feet 100g

Roasted salt 1 ts

Function:

• Wu Jia Pi treats joint pain due to the wind-damp. It is also useful in the treatment of impotence, scrotal dampness, genital itching, and flow of urine.

• Fu pen zi tonifies kidneys without causing dryness or heat and secures the essence without causing inappropriate congealing. Useful for urinary frequency, impotence etc.

• Ai ye warms the womb, disperse cold and useful for infertility due to cold womb.

• Ren shen protects deeper areas of the body and nourishes and protects the yin.

• Huang Qi strengthens the exterior, facilitating urination and reducing the edema.

• Da Zao is blood tonic.

Directions

1. Put the chicken bone or chicken feet into the boiling hot water to clean the leftover blood and bones. Then, take them out throw the water out.

2. Make the chicken soup base with garlic, green onion, Huang qi, the chicken bone and the chicken feet.

3. Stuff a chicken with sweet rice, da zao, ai ye, fu pen zi (mulberry). Then add the stuffed chicken into #2.

4. Cook in high heat for 10 min. Then simmer down for 30 min. Serve with sea salt or roasted salt.

Zi su zi samgyetang (Tvn 2015)

Ingredients: An organic range free chicken 1

The herb bag (huang qi, wu jia pi, Japanese raisin tree, da zao 10pc, ren shen), garlic 6pc, chestnut 6pc, roasted zi su zi 1T, Raw zi su zi 4T, Sea salt 1T, sweet rice 1.5cup

Direction:

1. Clean and soak the sweet rice in cold water for four hours.

2. If you do not use the pressure cooker, boil the herb tea bag in high heat. When it starts to boil, lower the heat and cook for one hour.

3. Trim the fat around the tail of a chicken cut the tip of the wing and make sure the chicken is empty inside.

4. Stuff the chicken with the following ingredients: garlic, da zao, chestnut and sweet rice.

5. Grind the sweet rice with 4 tbsp. of zi su zi.

6. Take out the herb tea bag. Put the stuffed chicken into the pot for 30 min to 45 min. Then add the ground sweet rice and zi su zi into the pot. Stir the soup until the soup gets thicker. Serve.

Zi su zi is aromatic, warm, acrid and moistening. It excels at directing rebellious qi downward. This actions disperses phlegm and calms wheezing, while moistening and facilitating intestinal movement. (Bensky 444)

Lu dou (Mung bean) samgyetang (O'live 2014)

Ingredients: An organic range free chicken 1, live octopus1, The herb tea bag1, Da zao 4pc. Whole garlic 5pc. Green onion1, onion 1/2.

Lu dou (Mung bean): sweet rice: rice (1:1:1 ratio)

• Lu dou is sweet and cold.

Enters Heart, Stomach

Clears summer heat, alleviate thirst, resolves toxicity.

Modern Research

Lu dou protects against phosphorus burns, prevents tumours, reduces the level of blood lipids. (Li 125)

A bag of herbs made with huang qi 15g, da zao 4g, dang gui 2g, zhi ju mu (- ) 10g, sang zhi 40g, wu jia pi 29g = total 100g)

Direction is same as the other samgyetang.

Contrary to modern Western practice, TCM analysis does not recommend cold drinks or food even during hot summer days because cold food or drinks can contract the stomach, slow down the digestive process and contract pores. Furthermore, they interfere with perspiration, resulting in mild fevers. (Loo 139). Because of the negative effects that cold drinks and food has upon the body, Koreans tend to eat warmer types of food, such as Samgyetang (- -- ).

Koreans eat Samgyetang (- -- ) even on the hottest days of summer because it helps to bring the body into harmony with the temperature of the environment. Consuming a moderate amount of warm or pungent flavored food can help trigger sweating in warmer temperatures. This is beneficial to the wellbeing of the body as induced perspiration carry the pathologic heat out of the body through the pores and decreases the body temperature. (Loo 139) Not only does perspiration allow bad pathogenic heat to exit out of the body, Samgyetang, itself, plays a huge role in securing the original Qi inside the body.

In addition, the ingredients in Samgyetang (- -- ): sweet rice, chestnuts, da zao and renshen have sweet flavors. Their natural sweet flavors help to moisten and strengthen lungs to prevent dryness and respiratory illness during fall. Since dryness often injures the lungs in the Fall, people can benefit from eating Samgyetang (- -- ). (Loo 140)

Because each patient has different dietary needs, samgyetang must be tailored with different herbs and ingredients. The genetic composition of patient's' needs, the patient's' condition, and an overall analysis of the illness must be taken into consideration when prescribing the dietary therapy. An analysis of a patient's five zang organs, the current season, climate, geographic environment, state of emotion and lifestyle must be conducted to accurately diagnose patients before prescribing any medicine.

While Samgyetang is one of the many yao shan available, there are many other healthy foods that can help treat diseases or illnesses. Before taking any medicine, the first procedure for patients should be to consider food therapies as a natural treatment to illnesses.

The studies on mice are very effective and efficiently conducted to bear out the concepts on effectiveness associated with Yao shan throughout history. They can best be described as modern science's take on ancient formulas, providing quantitative evidence of the qualitative assertions made in the ancient customs, cultures and directives of the TCM-based ideas that have emerged in the East over the centuries. What the studies indicate is that there is ample evidence to suggest that the dietary approach taken by TCM is in fact a legitimate approach that can be explored more fully and more deeply in terms of generating positive outcomes on patients to the extent that generic methods of medicine such as the typical, synthetic approach adopted in the West, can be dispensed and/or at least relied upon only in cases where the dietary approach proves insufficient to counteract the deficiencies.

In the next session, a discussion of these findings will provide an overview of what this assessment means in terms of modern medicine, practices, and improvement in the field of alternative care.

Discussion

Yao shan and Samgyetang in particular are ways in which TCM can be effectively applied in order to address illnesses and ailments according to the research, recipes, ancient customs of the Asian cuisine and medicinal approaches, and the studies discussed above. The evidence indicates that TCM is a viable alternative to generic Western medicinal approaches to health and well-being as they take extensive measures to identify the particular aspects of an individual's anatomy, psychology, spirituality and specific symptoms and illnesses, and then create a culinary recipe based on the Yao shan, such as Samgyetang, which is designed to address the particular deficiencies of that person. The deficiencies, as described in TCM, are in fact based on a holistic perspective that takes into consideration more than just the anatomic symptoms of the person (whether aches, pains, soreness, dry mouth, sleeplessness, etc.) and incorporates into the assessment all the aspects of that person's health from a Tao perspective.

In terms of Western medicine, a Tao foundation may be off-putting to some patients, especially if they are raised in the Christian tradition; therefore, it may be culturally problematic to expect that TCM can be applied to all persons universally without first providing some context, history, explanation, education or form of peremptory guidance so as to enable the individual patient a better understanding of the intervention. This would likely serve as a way for the patient to more fully embrace the alternative approach to medicine that is Yao shan and express a greater willingness to try out its basic principles in practice.

The studies, culture, recipes and philosophies indicate that Yao shan is a comprehensive strategy that can be effectively introduced into cultures around the world in ways that are conducive to the beliefs and customs already in place in those societies without having to displace any already formed notions of spirituality. The practical application of Yao shan is such that it does not depend upon the patient's orientation to Oriental concepts but rather to an acceptance of alternative methods of medicine that are based more in organic and all-natural directives than in synthetic and/or artificial/pharmaceutical approaches that can be more damaging to the body over time than a natural diet.

Implementation of these findings could range from being introduced to schools around the world, where obesity has already been identified as a major problem on an epidemic scale (Flynn et al., 2005), to governmental policy in cultures where health and well-being are promoted at the political level. A return to organic concepts and ideas of health and well-being is already a trending topic in developed worlds like the U.S., where works such as Fast Food Nation have exposed the role of the fast food industry in impacting the health of human beings as well as the planet. These types of popular works have raised awareness about dietary nutrition and the idea that what goes into the body via one's diet is important and actually has an impact on the individual psyche, physiognomy and spirit.

Thus, it can be viewed as vital that the findings of this study be implemented in a way that is positive and promoting. Cultures around the world are already preparing to embrace more traditional and orthodox methods of combating illness, especially as corporations like Monsanto, which uses genetically-modified organisms in its products, spread and force their business on countries that do not want it. A healthier approach to living that is more holistic, more organic, and more natural, as Davis (2008) points out may be exactly what societies around the world are looking for. To this extent, TCM and Yao shan and Samgyetang can be highly effective and influential in raising awareness and standards of living. These concepts may be explored more fully and deeply by way of future research on the matter. Ideas for more research into the efficacy of Samgyetang, Yao shan and TCM are provided in the next section and may be perceived as the outcome of reflection on the material provided above and the analysis performed via the TCM framework.

Finally, it can be seen that Yao shan emphasizes a more natural approach of diet to treat illnesses and to maximize the health benefits of the body. Diet is one of the most important contributors to longevity and a healthy life; thus, it can be considered a therapeutic alternative to medicine. For thousands of years in Asia, Yao shan has been a renowned practice used to increase treatment outcomes to individuals, as well as to increase the average life expectancy. The medicinal food therapy stabilizes patients' conditions and allows better assessment of patient's condition. In essence, the combination of diet and traditional medicine has become an ideal treatment therapy for patients. The medicinal food therapy also prevents the body from diseases in more sustainable ways and boosts the body's immune system.

In conclusion, Yao shan is designed with TCM diagnosis to develop, repair and balance the human body to prevent and treat diseases. In TCM, the balance of the Qi in the body is the most important factors for obtaining optimal health. In order for the body to be healthy, equilibrium is most important, which can be maximized through acupuncture and Yao shan ( -- ). Hence, the combination of acupuncture and Yao shan can optimize the wellbeing of the body and maximize health benefits as well as the longevity of the human body.

Recommendations for future research should focus on the efficacy of Samgyetang over a period of time (a substantial period may be of a year or more) among a considerable or significant sample among a variety of populations. It should be determined how well TCM applies to persons in bad health within specific parameters (such as back pain, insomnia, depression, etc.) and how well different persons of various ethnicities respond to the intervention of TCM, Yao shan, Samgyetang, etc. Other options of Yao shan could also be studied in order to see how effective they are in comparison to Samgyetang.

Moreover, a positive exploration into the ingredients gathered in diets like Samgyetang could produce results that may be favorable topics for further research as well. Questions to ask, for example, could include: Why are these ingredients in particular, gathered together in one recipe, or individually, effective in combating illnesses? To that end, what is the actual degree of effectiveness? Do patients experience a full recovery? Is recovery only temporary? Is the recommended practice to be transformative in the sense that patients are expected to make the diet part of their daily routine for the extent of the rest of their lives in order to recoup the benefits of the intervention? Is TCM a one-time treatment or more of a way of life? What are the potential risks and shocks that might accompany this intervention for persons unaccustomed to "warm" or "cold" diets -- particularly in the West, where food preparation is not based nearly on ancient customs and practices as it is in the West? Is there a potential for negative reactions from Western practitioners who wish to incorporate TCM into their methods of care giving? These questions should serve as appropriate guidelines for research and paths of inquiry into the subject in future works.

The final outcomes of this study show that TCM is a practical way of addressing health issues via a natural and organic approach to well-being. For modern science and academics, this method will require more exploration before it is promoted throughout the universal health care systems of the West. Moreover, because so much of Western medicine is affiliated with the pharmaceutical industry, one may retain a healthy amount of skepticism as to whether TCM would ever fully be embraced by Western practitioners, as there is every indication that in so doing their affiliated partners in the pharmaceutical industry would be essentially cut out from the business of providing care. This would require a separate inquiry into the nature and ethics of care giving in the West -- but such an inquiry may ultimately be necessary before any advancement can be made in terms of promoting TCM benefits across the board. In the end it may very well come down to individual preferences and awareness via the spread of information through alternative forms of media, communication and holistic doctors and practitioners. In an age of modern media, where mass and mainstream media outlets are forged within the same furnace as the entities which profit from generic medicine, it may be necessary for traditional approaches to continue on in the fringe of modern society till the modern framework of business and health is altogether re-evaluated.

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