The story of Apricot in Chinese Medicine




신윤복, <사시장춘(언제나 봄날)>, 18세기 조선, 국립중앙박물관


What comes to your mind when you look at this painting? It is a rather sensual themed painting, and I am not sure if you've noticed. This is a work by Shin Yun-bok, a famous genre painter from the Joseon Dynasty. This type of painting is called 春意圖. Literally translated, it means a painting containing the meaning of spring, but it actually represents paintings dealing with the love between men and women.

There are three interesting codes in this painting.

Firstly, the neatly arranged shoes of men and women in front of the door and the young tavern boy hesitating to enter.
Secondly, the words 四時長春 written on the right side.
Thirdly, the pink blossoms on the right side.

Firstly, the shoes and the boy depict a very embarrassing situation. What is happening inside is left to the imagination. The young boy, holding alcohol, seems to be hesitating whether he should enter as ordered, just turn around, or shout out loud. This fleeting moment is humorously and cleverly depicted. It is a quiet-feeling painting but subtly dynamic.
Secondly, the words 四時長春 are written on the right side of the door, meaning it's always like a spring day. In the East, the character 春, meaning spring, is used to represent love between men and women, especially physical love in one's younger days. When you say 春畵 (spring painting), it refers to a painting that explicitly depicts a physical relationship between men and women.
Thirdly, the blossoms blooming on the right side are apricot blossoms. Usually, apricot blossoms give a neat feeling, similar to cherry blossoms, with their pink color. In the past, apricot trees were often planted in front of taverns, so people knew it was a tavern if there was an apricot tree. The color of the apricot, reminiscent of a woman's flushed cheek, and its elegant flower shape, may have reminded people of well-educated courtesans of the tavern.

Apricots are tempting like spring days, with pretty flowers and delicious fruit. Additionally, apricot seeds are used as medicine to save people.

 University of Kumamoto, Medicinal Herb Garden (Photo by TH Tanaka)

Apricot  in Chinese medicine. 

Its kernel is called Xing Ren(Armeniacae Semen) and is used as a herb for respiratory diseases. It's referred to as Xing Ren in Mandarin, Hang Jan in Cantonese, Hengin in Korean, and Kyonin in Japanese, all sharing the same Chinese characters, 杏仁.

Apricot seed has warm nature and bitter taste. It enters into the Lung and Large intestine channels, and the recommended dosage is between 3 to 9 grams. 

The primary actions of Xing Ren in TCM are twofold:

Stops cough and calms wheezing: Xing Ren is known for its ability to alleviate coughs and calm wheezing. By targeting the Lung meridian, it can help to soothe irritated airways and promote easier breathing, making it a valuable remedy for respiratory issues.

Moistens the intestines to relieve constipation: In addition to its respiratory benefits, Xing Ren is also employed to address constipation. Its association with the Large Intestine meridian allows it to moisten the intestines, promoting smoother bowel movements and providing relief from constipation.


Two faces of  Apricot Kernel

Xing Ren(apricot kernel) contains a chemical called amygdalin, which is one of active ingredients and cause of side effects.  This cyanide reacts with the iron in the body to produce cyanide gas, which is toxic in large quantities. However, in small doses, apricot seed has been found to be effective in treating cough and other respiratory disorders. Amygdalin is commonly distributed in plants of the Rosaceae, such as peach, plum, loquat, apple, and bayberry, but most notably in the seeds of apricot. 

The market value of apricot kernel in pharmaceutical industries has grown rapidly, as it is used to create medicines for cardiovascular diseases, cancer, and more. Apricot kernel extracts are effective antifungal agents, while the oil promotes blood circulation and reduces pain and inflammation. Apricot kernel flour is used in herbal tea for various ailments, and the kernel's properties are beneficial in treating skin conditions such as acne, dandruff, and furuncles.

Amygdalin and its semi-synthetic form, laetrile, were once marketed as potential cancer treatments. However, subsequent research has shown that they offer no benefit in the fight against cancer. Neither amygdalin nor laetrile is approved by the US FDA for any use.

The primary concern regarding the consumption of apricot kernels is the potential for cyanide poisoning due to the amygdalin content, which can cause severe side effects such as seizures and even death. Pregnant and breastfeeding women should be particularly cautious, as consuming large quantities of apricot kernels may pose a risk of birth defects. Ingestion of apricot kernels by expectant mothers can lead to thyroid disease during pregnancy and expose them to cyanide and thiocyanate. Possible symptoms of amygdalin: nausea, fever, headache, insomnia, thirst, nervousness, joint and muscle pains, low blood pressure, and in severe cases, coma

Dosage:

It is essential to limit the intake of apricot kernels, you should not eat more than 0.37g per adult per day, which is the equivalent of 1-2 small kernels(European Food Safety Authority) According to Commission Regulation (EU) No. 2017/1237, apricot kernels (unprocessed whole, ground, milled, cracked or chopped) must not contain more than 20 mg/kg of hydrocyanic acid. Eating more than this amount could cause an acute health risk. Children should not eat apricot kernels. 

The safety of decoctions prepared in TCM or virgin apricot kernel oil remains uncertain, as they may still contain cyanide. In TCM, apricot seeds are typically prescribed in doses ranging from 3 to 9 grams. It is said that an overdose of apricot seeds, which is over 10 seeds for children and over 40 seeds for adults, can result in toxicity symptoms such as vomiting, abdominal pain, diarrhea, dizziness, and dyspnea.

 In Ben Cao Gang Mu, it is mentioned that "when using apricot seeds, soak them in hot water, remove the skin and the end part (embryo part), and roast until they turn yellow. Alternatively, roast with wheat bran." The toxicity in apricot seeds is mainly due to amygdalin, which is primarily contained in the embryo part. Amygdalin is vulnerable to heat and mainly found in the embryo part, so the end part is removed, and the seeds are thoroughly roasted before use in TCM.


"Spring is full in the apricot trees(杏林春滿)"

There is a famous saying, "Spring is full in the apricot trees(杏林春滿)" in Chinese medicine.

It comes from a legend about Dongfeng (董奉, 221-264 AD), who lived during the Wu dynasty. He was one of the three great doctors of Qian'an, along with Huatao, who was killed by Cao Cao, and Zhang Zhongjing (150-219), the author of Shang Han Lun. His legendary exploits are recounted in the book "Shen Xian Zhuan" (神仙傳) by Ge Hong (283-343).

Once upon a time, a kind-hearted doctor named Dongfeng lived during the Wu dynasty.  His clinic was always packed with patients because of his excellent skills and warm heart.

One day, a poor family came to his clinic seeking treatment for their fallen ill daughter. Dongfeng's skills and kindness cured the girl, but her parents had no money for the treatment.

Dongfeng thought for a while and said, "I have an idea. You can plant an apricot tree around my house to show gratitude." The family was happy to hear this and planted an apricot tree to symbolize gratitude. 

Since then, Dongfeng has let poor patient plant five trees for every serious illness cured and one for every mild illness. Years and years later, there were hundreds of thousands of apricot trees around Dongfeng's house. He also let wild beasts play in the apricot grove and guard it on his behalf. The people called the grove of apricot trees the "Godly Apricot Forest" (董仙杏林). Whenever the apricots were ripe, he let people exchange apricots for grain, and during bad harvests, he gave apricots and grain to people experiencing poverty.

He served in this way for more than 300 years. Then he became a ‘Xian(仙),' which refers to a person or similar entity having a supernatural ability and being immortal in Taoism.  

People respected and loved Dongfeng's story,  and the term 'apricot forest(杏林)' has come to represent medical doctors' noble and virtuous qualities in Chinese medicine.


Hyungsuk Choi, PHD