The Dual Medicinal-Edible Value of Hawthorn

Hawthorn is the ripe fruit of Crataegus pinnatifida, Crataegus pinnatifida var. major, and Crataegus cuneata of the Rosaceae family. It is both a Chinese medicinal herb and an edible fruit. Traditional TCM holds that hawthorn is sour and sweet in taste and slightly warm in nature. It enters the spleen, stomach, and liver meridians. It promotes digestion of food stagnation and resolves blood stasis and stagnation; it is used mainly for food accumulation, epigastric and abdominal distending pain, diarrhea and dysentery, blood-stasis dysmenorrhea, female amenorrhea, postpartum abdominal pain, lochiorrhea, hernia or testicular swelling and pain, and also treats hyperlipidemia.

Hawthorn ripens in the ninth and tenth lunar months. The ripe fruit is sweet and sour and palatable; it may be eaten directly, juiced, or used as an ingredient in cooking. It is also made into hawthorn powder, hawthorn slices, hawthorn cakes, or hawthorn preserves, most of which are sold in supermarkets.

The fruits of the commercial "northern hawthorn" (including Crataegus pinnatifida and its var. major) mainly contain flavonoids, ursolic acid, free sugars,citric acid, succinic acid, acetic acid, linoleic acid, linolenic acid, stearic acid, and oleic acid.

Hawthorn has a good digestive-promoting effect. It contains lipase, which promotes fat digestion, and increases the secretion of gastric digestive enzymes. TCM has long held that hawthorn excels at digesting food accumulation, especially greasy meat and infantile milk accumulation; this TCM view is supported by modern pharmacology. Eating hawthorn raw, or drinking hawthorn decoction or tea, both treat undigested meat.

However, TCM usually uses charred hawthorn as medicine: hawthorn is placed in a pot over low heat and stir-fried continuously until its color darkens, then removed and dried for later use. Stir-frying removes the sour taste and aids long storage without affecting its stomachic and digestive efficacy. Stir-fried hawthorn is called charred hawthorn (jiao shanzha), and is often used together with charred malt and charred medicated leaven; the three together are called the "charred three immortals" (jiao san xian), all stomachic and digestive herbs. Some doctors directly prescribe jiao san xian or san xian, referring to hawthorn, malt, and leaven.

Another stir-frying method is to stir-fry hawthorn with oven hearth earth; this prepared hawthorn is called earth-fried hawthorn. Besides digesting food accumulation, earth-fried hawthorn also warms the spleen and stops diarrhea, suiting patients with diarrhea caused by indigestion.

But stir-frying also destroys beneficial constituents such as flavonoids; the longer and hotter the stir-frying, the more total flavonoids are destroyed. Hawthorn has more than a stomachic-digestive action: modern pharmacological research finds it also activates blood and resolves stasis, lowers blood pressure and lipids, acts as an antioxidant and antibacterial, enhances immunity, promotes diuresis, and improves cardiovascular function. Therefore not every prescription uses charred hawthorn; some specifically call for raw hawthorn. Medicinal raw hawthorn is prepared by pitting southern or northern hawthorn and sun-drying thoroughly.

Hawthorn has anticarcinogenic effects. It markedly blocks and inhibits cell carcinogenesis induced by the carcinogens nitrosamines and aflatoxin; regular consumption helps prevent gastric and liver cancer. Hawthorn is also one of the common oncology herbs; TCM holds that raw hawthorn not only strengthens the stomach and digests food but also activates blood, resolves stasis, reduces swelling, and disperses nodules.

Yaoping Huayi says of hawthorn: "Together with zhu e (i.e., Curcuma zedoaria, Ezhu) and Sparganium (Sanleng), it attacks all accumulation masses, which it can naturally dissolve. After any blood loss, when qi and blood are both deficient, use it as an assistant to ginseng. It soothes the liver and regulates the spleen, and is a most excellent herb." Here Yaoping Huayi also points out another clever use of hawthorn: when weak patients take ginseng tonics, abdominal distension is a common side effect; using ginseng together with hawthorn supplements qi and blood without causing qi stagnation. If a patient mistakenly takes too much ginseng and develops ginseng-abuse syndrome, hawthorn together with radish can resolve it.

Hawthorn pulp also treats dysentery or chronic diarrhea of unknown cause. But hawthorn is not suitable for everyone, and even those who can eat it should not overindulge; too much hawthorn causes excess gastric acid secretion. Those with weak spleen and stomach, and pregnant women, should use hawthorn cautiously. Bencao Gangmu says hawthorn, "eaten raw in excess, causes gastric discomfort and easy hunger and damages the teeth"; Bencao Zheng also says: "Those with slippery intestines should use little of it."

There are also quite a few Chinese patent medicines made from hawthorn, such as hawthorn syrup, Mai'an syrup, compound lipid-lowering tablets, large hawthorn pills, hawthorn pills, appetite-promoting hawthorn pills, and pediatric antidiarrheal granules. These may be selected according to the patient's specific condition.