Understanding the Seven Flavors

If you cannot easily recite the names of all seven flavors, falter in recalling the three actions of the sweet flavor, or never learned the seventh flavor, revisiting the fundamentals of the seven flavors is very useful. Out of all of the basic characteristics of medicinals—qi, flavor, channels entered, and actions and indications—the flavors are arguably the most important. To a great extent, the flavors determine how each medicinal is clinically used.

Correlating to the five viscera, it is not too difficult to remember the five key flavors of sweetness, acridity, sourness, bitterness, and saltiness (many English language sources translate acridity as pungency). Blandness is the sixth flavor, often taught in school, while the seventh flavor, astringency, is not as commonly introduced in Western education. Knowing all seven flavors, and thoroughly understanding their actions, is invaluable for mastering Chinese medicinal therapy.

Sweet

In terms of eating, sweetness is ubiquitous and can be found in most foods. In recent years, more and more people have decided to eliminate sugar from their diets but, as we explain to them, as unnecessary and avoidable as our concentrated sweeteners may be, we cannot live without the sweet flavor. Chinese medicine, in fact, maintains that sweetness is essential for human life.

The explanation lies in the fact that sweetness, whether in food or medicinals, has the chief action of supplementing qi and blood. We eat for sustenance, and the basic resources one needs to survive are qi and blood. Moreover, in accordance with the statement “blood and essence share the same source”, when blood is supplemented, yin-essence is engendered, and the yin and yang of the entire body is bolstered.

A second characteristic of the sweet flavor is its ability to engender fluids. Engendering bodily fluids may be likened to watering plants. A suitable amount of water, or fluid, is necessary to keep the plant, or person, adequately hydrated, but excess watering can lead to the organism becoming water logged. In the case of flora, plants will eventually die from over watering, but the human body will convert the superfluous fluids into dampness and, later, to phlegm, which we experience as adipose tissue. Ultimately, too much congealed fluid might be just as deadly to a person just as constantly soggy soil is to a plant.

Finally, sweetness moderates tension. This is a specific, technical action which needs to be clearly understood by clinicians. Tension primarily occurs in sinews, an anatomical category in Chinese Medicine that mainly corresponds to tendons, ligaments, and stringy, palpable muscles. Excess tension in these connective bands is often a function of liver pathologies. For example, the jaw tension of TMJ or the neck and shoulder tightness are common in those with higher levels of stress, where unfulfilled desires give rise to binding depression of liver qi.

Sweetness has the ability to relax and loosen tightness. In Chinese, the same ideograph used for “moderate” in moderate tension also describes the effect of the affect of joy on the qi. The sweet flavor’s capacity for creating feelings of joy and easing physical tension helps to explain why those suffering chronic physical and mental tension often crave sweets.

Bitter

In medicine, the bitter flavor is exceptionally useful. If, instead of swallowing, you chose to chew Western pharmaceutical drugs, you would find many to be extremely bitter. When one considers the prevalence of diseases that generate fevers or produce visible inflammation—both usually signs of heat—and the large number of illnesses which involve some swelling or fluid discharge, it is no surprise that the heat-clearing and damp-drying actions of the bitter flavor feature prominently throughout the medicines of the world.

In many respects, the bitter flavor also counterbalances sweetness. If sweetness engenders excessive fluids, bitterness can dry iatrogenic dampness. Since sweetness supplements the qi, which is innately warming, the right qi produced by the sweet flavor may transform into hot evil qi. Once again, the bitter flavor may be incorporated into a formula to offset the evil heat engendered by sweet medicinal agents. This strategy explains why the Europeans, who traditionally ate diets of fatty meat and glutinous bread and imbibed alcoholic beverages, favored “bitters”—i.e., tinctures of bitter herbs—to relieve their gastrointestinal symptoms.

Bitter medicinal agents, both Chinese formulas and Western drugs, also have the potential to inhibit bodily function (bitterness drains) and cause unusual dryness, leading to fatigue, digestive issues, dry mouth and nose, thirst, and constipation. When crafting formulas, one must consider how to harmonize different flavors to achieve good results without adverse effects. The best doctors know how to balance sweet and bitter flavors to create formulas that yield great results.

Acrid

Like bitterness, acridity is a common feature in medicines from most systems of healthcare. The acrid flavor dissipates, disperses, and moves, so it is typically used to treat stagnation and stasis and is the primary flavor used to relieve pain. The most frequently used drugs in Western medicine, from steroids to NSAIDS and antidepressants to antibiotics, are typically acrid.

Some Chinese doctors use the term windy-natured to describe some acrid medicinals with tropism for the upper body. Like climatic wind, acridity has the adverse effect of drying out the landscape of the human body, so clinicians must carefully assess the effects of strongly acrid agents. Although acridity can deliver rapid results, especially with acute pain, acrid flavor can also plunder yin, blood, and body fluids, leading to dryness and vacuity. Similar to using bitterness to temper sweetness, sweetness can be used in formulas to counterbalance acridity and prevent iatrogenesis. This principle can be applied both to prescribing Chinese formulas and to the use of Chinese medicinals to offset the negative effects of any Western supplements or drugs which feature potent dissipating and dispersive actions.

Sour

Everyone knows that intensely sour flavors make you pucker. In technical terms, we refer to the tightening in response to sourness as astringency, the primary action of this flavor. Also, the sour flavor has the ability to secure, so sour medicinal agents are described as securing and astringing.

The term “insecurity” appears in the names of the patterns of insecurity of the exterior and insecurity of kidney qi. In the first case, the patient will present with slight sweating and a propensity for the contraction of exterior conditions. Insecurity of kidney qi, on the other hand, is marked by enuresis and/or urinary incontinence. For patients who present these patterns, the sour flavor may be used to check spontaneous sweating and/or involuntary loss of urine by securing and astringing, respectively, the interstices of the skin and the posterior yin (the urethra).

Sourness is also incorporated in formulas that enrich yin to ensure that the yin engendered by the formula is properly retained and stored. This is exemplified by Liu Wei Di Huang Wan Six-Flavor Rehmannia Teapill in which securing and astringing shan zhu yu cornus is used to potentiate supplementation of the yin by increasing storage of yin-essence. This strategy is invaluable for ensuring effective yin supplementation.

Salty

Saltiness has the action of inducing moist precipitation. Precipitation is a technical, medical term that replicates the Chinese character 下 xia meaning “downward” or “move downward”. While this is translated by some sources as “move the bowels”, Chinese medicine does not focus on the laxative result but, rather, emphasizes restoration of the downbearing aspect of the qi dynamic. From a Chinese medical perspective, not only is constipation unhealthy and uncomfortable, congested bowels also disrupt the normal qi dynamic that is comprised of upbearing of the clear, downbearing of the turbid, floating of yang qi, and sinking of yin qi. When our qi dynamic becomes disordered, as in cases of fright, a wide range of physical function can be affected, possibly causing severe and intractable disease.

The salty flavor also softens hardness. Just as salting vegetables in the pickling process yields a softer texture, so saltiness can be employed to treat masses. The masses softened by saltiness are often blood stasis lumps. For example, concretions (above the umbilicus) and accumulations (below the umbilicus) are routinely treated with salty agents which soften hardness and disperse lumps. The seaweeds hai zao sargassum and kun bu kelp exemplify lump-dispersing, hardness-softening medicinals.

Bland

The bland flavor disinhibits water. While the term 不利水 bu li shui disinhibit water is often rendered as “promoting urination”, i.e. a diuretic effect, the Chinese expresses a meaningful distinction. Just as 活血 huo xue quicken the blood only denotes moving dead, malign blood—unlike Western anticoagulants which indiscriminately affect all blood—disinhibiting water also implies an action limited to retained fluids. In other words, both quickening the blood and disinhibiting water are relegated only to pathology, avoiding abnormal hemorrhaging or overly frequent urination caused by non-specific effects. From the perspective of Western biology, many bland agents are fungi.

Astringent

The sour flavor secures and astringes, but there is a seventh flavor, astringency, which can astringe without sourness. This flavor is exemplified by the properties of a banana peel. If one chews a banana peel, the mouth contracts and puckers, but there is no sharp sourness on the palate. Like the astringency of the sour flavor, these astringent medicinals and foods also reduce leakage and help contain and preserve righteous bodily resources.

Experts often point out that mastery is nothing other than mastery of the basics. In Chinese internal medicine, one of the core aspects of successful practice is a deep understanding of the seven flavors. To truly understand and appreciate Chinese formulas and medicinals, we should constantly hone and refine our basic knowledge of the seven medicinal flavors which, despite appearing simple, involve many subtle concepts and nuances.