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A Clinical

Guide to
Chinese
Herbs and
Formulae
Foreword by Giovanni Maciocia
GM CAc (Nanjing)
Acupuncturist and Chinese Herbalist; Lecturer,
Chen Song Yu
Norsk Akupuncktur Skole, Oslo, Norway; Lecturer, Director of the Teaching and Research Section of Chinese
Acupuncture Foundation of Ireland, Dublin, Materia Medica,
Republic of Ireland; Honorary Lecturer, Nanjing
Nanjing College of Traditional Medicine,
College of Traditional Chinese Medicine, Nanjing,
Nanjing, People's Republic of China
People's Republic of China

Translated by Jin Hui De


Doctor of Chinese Medicine; Associate Professor,
International Acupuncture Training Centre and Head
of Interpreter Group, Nanjing College of Traditional
Chinese Medicine, Nanjing, People's Republic of
LiFei
China Director of the Teaching and Research Section of Prescription,
Nanjing College of Traditional Chinese Medicine, Nanjing,
Subject Editor: Francesca Diebschlag People's Republic of China
BAc MIROM MRCHM
Lecturer, The London School of Acupuncture and
Traditional Chinese Medicine, London, UK
LIF
Barclayy C-
, ga soogo

CHURCHILL LIVINGSTONE
EDINBURGH LONDON MADRID MELBOURNE NEW YORK
AND TOKYO 1993
A Clinical
Guide to
Chinese
Herbs and
Formulae
Foreword by Giovanni Maciocia
GM CAc (Nanjing)
Acupuncturist and Chinese Herbalist; Lecturer,
Chen Song Yu
Norsk Akupuncktur Skole, Oslo, Norway; Lecturer, Director of the Teaching and Research Section of Chinese
Acupuncture Foundation of Ireland, Dublin, Materia Medica,
Republic of Ireland; Honorary Lecturer, Nanjing
Nanjing College of Traditional Medicine,
College of Traditional Chinese Medicine, Nanjing,
Nanjing, People's Republic of China
People's Republic of China

Translated by Jin Hui De


Doctor of Chinese Medicine; Associate Professor,
International Acupuncture Training Centre and Head
of Interpreter Group, Nanjing College of Traditional
Chinese Medicine, Nanjing, People's Republic of
LiFei
China Director of the Teaching and Research Section of Prescription,
Nanjing College of Traditional Chinese Medicine, Nanjing,
Subject Editor: Francesca Diebschlag People's Republic of China
BAc MIROM MRCHM
Lecturer, The London School of Acupuncture and
Traditional Chinese Medicine, London, UK
LIF
Barclayy C-
, ga soogo

CHURCHILL LIVINGSTONE
EDINBURGH LONDON MADRID MELBOURNE NEW YORK
AND TOKYO 1993
Contents

Foreword vii 21. Herbs that activate Blood circulation


and stop bleeding 85
Subject Editor's Preface ix

Part 3:
Parti:
Application of herbs on the basis of the
A comparison of the actions and indications
differentiation of patterns of the Zang Fu
of some common Chinese herbs
22. The Lungs 91
1. Herbs that Release the Exterior 3
23. The Heart 95
2. Herbs that clear Heat 8
24. The Spleen, Stomach and Large
3. Herbs that purge and promote
Intestines 99
digestion 14
25. The Liver and Gall Bladder 104
4. Herbs that resolve Phlegm and stop
coughing and wheezing 16 26. The Kidneys and Bladder 108

5. Herbs that eliminate Wind-Damp 20


Part 4:
6. Herbs that resolve and drain Dampness 23
Combinations and comparisons of commonly
7. Herbs that warm the Interior and used formulae
regulate Qi 26
27. Formulae for Releasing the Exterior 113
8. Herbs that regulate Blood 31
28. Purgative formulae 119
9. Herbs that calm the Mind and the
29. Formulae for clearing Heat 124
Liver and extinguish Wind 36
30. Formulae for warming the Interior 130
10. Tonics 39
31. Formulae that tonify 135
11. Astringent herbs 47
32. Formulae that regulate Qi 142

Part 2: 33. Formulae that regulate Blood 148


Combinations of common Chinese herbs 34. Formulae that expel Dampness 152
12. Herbs that Release the Exterior and 35. Formulae that eliminate Phlegm 159
stop cough and wheeze 53
36. Formulae that expel Wind 165
13. Herbs that clear Heat 58
37. Formulae that calm the Mind 169
14. Purgative and digestive herbs 63
38. Formulae that reduce Food
15. Herbs that relieve Bi syndromes 65 Stagnation and dissipate masses 172
16. Herbs that resolve and drain Dampness 67 39. Astringent formulae 175
17. Herbs that resolve Phlegm 70

18. Herbs that subdue Wind and calm the Part 5:


Mind 72 The treatment of common disease based on
differentiation of syndromes
19. Tonics and Astringents 75
40. Diseases in internal medicine 181
20. Herbs that warm the Interior and
Regulate Qi 82 41. Gynaecological disorders 233
Contents

Appendix 1:
Pin Yin names of herbs with Latin
equivalents 252

Appendix 2:
Latin names of herbs with Pin Yin
equivalents 255

Appendix 3:
Pin Yin names of formulae with English
equivalents 258
Appendix 4:
English names of formulae with Pin Yin
equivalents 264

Appendix 5:
Formulae and constituent herbs 270

Index 289
Foreword

The essence of Chinese herbal medicine is in the to one's chosen treatment strategy. The book
art of adapting a formula to a particular does this admirably and fills a gap in the
patient's disharmony. An adapted formula is existing literature on Chinese herbal medicine.
like a mirror reflection of a particular imbalance The case histories are an invaluable part of the
of Qi. The harmonization of herbs within a book illustrating how formulae are adapted in
formula is comparable to the balancing of practice.

acupuncture points within a treatment. The authors of this book, Professors Chen
However, balancing the herbs within a Song Yu and Professor Li Fei are eminent
prescription is all the more intricate as careful teachers from the Nanjing College of
account should be taken of the tastes of the Traditional Chinese Medicine which is one of
herbs. the foremost institutions for the teaching of
After diagnosing the patient's disharmony Chinese medicine. Between them, they have
and deciding on a strategy of treatment with an accumulated over 60 years of clinical practice
appropriate formula, adapting it must take into and teaching, and they are the authors of many
account many different factors: the constitution important textbooks of Chinese herbal
of the patient, the state of his or her digestive medicine.
system, his or her mental-emotional state, the The translator of the book, Associate-
combination of tastes and energies within the Professor Jin Hui De is head of the interpreters'
formula, and the harmonization of herbs with group of the Nanjing College of Traditional
different movements (floating or sinking, Chinese Medicine. He was co-translator of the
ascending or descending). Taking all these now famous 'Essentials of Chinese
factors into account, to adapt the chosen Acupuncture' as well as many other Chinese
formula to the unique patient's disharmony is a medicine textbooks in English. He is uniquely
very delicate and intricate task. qualified to translate medical texts as he is also
Such a task can be carried out if one masters a doctor of Chinese medicine.
not only the action of herbs and formulae, but This book is therefore a welcome addition to
also the differentiation between herbs and the scanty literature on Chinese herbal
formulae with similar functions. The main medicine and one that deserves to be in every
emphasis of this book is exactly to illustrate practitioner's clinic.
how to combine herbs and how to differentiate
between single herbs and formulae in relation 1993 Giovanni Maciocia
Subject Editor's Preface

This book has five parts:

Part 1 points out similarities and differences


between herbs of a similar nature or action.

Part 2 describes combinations of two or more


herbs that commonly appear as a group within
larger formulae.

Part 3 analyzes individual herbs according to


their actions on the Zang Fu.

Part 4 sets forth guiding principles in formu


lating prescriptions according to the various
treatment methods, and compares formulae
within each such category.

Part 5 deals with specific pathological patterns


or diseases, demonstrating the clinical use of
formulae with case histories.

Throughout the text, words having a specific


meaning within the context of TCM are capital
ized {e.g. Qi, Blood, Wind-Cold), while words
used according to their usual English meaning
appear in lower case (e.g. blood, cold).
Each herb is identified by both its Pin Yin
name and its Latin name the first time it is
mentioned; thereafter, only the Latin name is
used. Each formula is identified by its Pin Yin
name and its English translation the first time it
is mentioned; thereafter, only the English name
is used. Appendices cross-index the Pin Yin and
Latin names of herbs, and the Pin Yin and
English names of formulae, for easy reference.
Formulae given within the text and case
histories are generally variations of classic
formulae, modified as they would be in clinical
practice. For the classic formulae themselves,
please refer to any standard reference work on
Chinese herbal formulae, such as Formulas and
Strategies by Bensky and Barolet.

1993 F.D.
Part 1:
A comparison of the
actions and indications
of some common
Chinese herbs

Comparing the actions and indications


of Chinese herbs facilitates both
familiarization with the herbs and their
correct selection in clinical work. Herbs
with similar actions and indications can
be substituted for each other.
Herbs that Release the Exterior

A. Herbs that disperse Wind- wheeze and promotes diuresis. It is thus


indicated for cough and wheeze in Excess
Cold
patterns due to impairment of the dispersing
function of the Lung and for oedema due to
■ HERBA EPHEDRAE and RAMULUS invasion of Wind.
CINNAMOMI Ramulus Cinnamomi is pungent, sweet and
warm in nature. In combination with Herba
• Ma Huang and Gut Zhi
Ephedrae it treats Exterior patterns of the
Excess type; in combination with Radix
Similarities
Paeoniae Alba it treats Exterior patterns of
— Both strongly disperse Wind-Cold due to
the Deficient type (see Fig. 1.1). It warms and
their pungent and warm nature. They are
invigorates Yang and removes obstructions
indicated for severe Exterior Cold
from the channels and collaterals. It is thus
syndromes in Winter. When used in combi
also indicated for oedema and dysuria due
nation these two herbs effectively induce
to blockage of Yang Qi by Phlegm and
diaphoresis.
retained fluids, Chest Bi syndrome, abdom
Differences inal pain due to Interior Cold complicated
— Herba Ephedrae is pungent, bitter and warm with deficiency of the Middle Burner, Cold
in nature. It promotes the dispersing Bi syndrome, irregular menstruation,
function of the Lungs, stops cough, soothes dysmenorrhoea and amenorrhoea.

In combination with In combination with


HERBA EPHEDRA RADIX PAEONIAE ALBA

Both herbs are pungent and Cinnamomi disperses the Defensive


disperse the Defensive level, level, while Paeoniae astringes
thus "Releasing the Exterior" Nutritive Qi, thus "Harmonizing
in Excess patterns of exterior Ying and Wei Qi" in Deficiency
invasion. patterns of exterior invasion.

Fig. 1.1 Actions of Ramulus Cinnamomi.


Part 1: Actions and indications of some common Chinese herbs

Exterior syndromes complicated with


■ FOLIUM PERILLAE, HERBA
Dampness, headache involving the Tai Yang
SCHIZONEPETAE and RADIX
channel and Wind-Damp Bi syndromes
LEDEBOURIELLAE
affecting the upper body.
• Zi Su Ye, Jing Jie and Fang Feng — Radix Angelicae Dahuricae eases the nose,
relieves carbuncles and clears vaginal
Similarities discharge by drying up Dampness. It is an
— All three disperse Wind-Cold. All are mild in important herb for headache involving the
nature and are commonly used in the treat Yang Ming channel and for various disor
ment of Exterior Wind-Cold patterns. They ders on the head and face.
can be used in combination, or may be — Herba Asari is pungent, warm and aromatic
substituted for each other. in nature. It disperses Cold, relieves pain,
resolves fluid retained in the Lungs and
Differences eases the nose. When taken in large doses,
— Folium Perillae is more effective in this herb consumes Qi and Yin, thus
dispersing Cold than Wind. It also circulates producing stuffiness of the chest and respi
Qi, harmonizes the Middle Burner, stops ratory paralysis; it is therefore not advisable
vomiting and prevents miscarriage. It is thus to administer doses of more than 3g,
indicated in Exterior patterns of Wind-Cold especially as a powder.
complicated with stagnation of Qi,
presenting with symptoms of distension and
fullness in the epigastrium and abdomen. ■ HERBA ELSHOLTZIAE and HERBA
— Herba Schizonepetae is more effective in AGASTACHIS
eliminating Wind than Cold. It expresses
• Xiang Ru and Huo Xiang
skin eruptions and stops bleeding. As it is
only mildly warm in nature, it can be used in
Similarities
combination with other herbs in the treat
— Both are pungent, warm and aromatic in
ment of Exterior Wind-Heat syndromes.
nature. Both clear Summer Heat and Release
— Radix Ledebouriellae is an important herb to
the Exterior and are thus indicated for the
eliminate Wind. It Releases the Exterior,
common cold due to Summer Heat or
eliminates Dampness, relieves pain, stops
Dampness during the Summer.
convulsion and relieves itching by elimi
nating Wind. It is thus indicated for
Differences
headache, Bi syndromes, tetanus and
— Herba Elsholtziae is a strong diaphoretic.
rubella, all of which are caused by invasion
There is a saying: 'Xiang Ru in Summer is
of External Wind.
like Ma Huang in Winter'. It also promotes
diuresis and is thus indicated for oedema.
■ RHIZOMA SEU RADIX NOTOPTERYGII, Herba Agastachis fragrantly resolves
RADIX ANGELICAE DAHURICAE and Dampness and thus also harmonizes the
HERBA ASARI Middle Burner to relieve vomiting.

• Qiang Huo, Bai Zhi and Xi Xin

■ FRUCTUS XANTHII AND FLOS


Similarities
MAGNOLIAE
— All disperse Wind-Cold and relieve pain,
and are thus indicated for Exterior • Cang Er Zi and Xin Yi Hua
symptoms such as headache and general
aching, headache due to Wind and Bi Similarities
syndromes due to Wind, Cold and — Both disperse Wind-Cold and ease the nose
Dampness. and are thus important herbs for rhinitis
(Fig. 1.2).
Differences — Fructus Xanthii not only expels Wind-Damp
— Rhizoma seu Radix Notopterygii is warm and relieves pain in Bi syndromes and
and dry in nature. It effectively disperses headache, but also expels Wind and relieves
Wind-Damp, and is thus indicated for itching in rubella and eczema.
Herbs that Release the Exterior

with
i Yang
romes

EYES
nose,

aginal Herba Menthae NOSE

: is an Periostracum Fructus
Cicadae Xanthii
ig the
Folium Mori Flos Magnoliae
disor-
Ftas Radix Angelicae
Chrysanthem Dahuncae
>matic
Fructus Vilici Herba Asari
pain,
s and
doses,
TAIYANG
thus THROAT CHANNa
respi- Herba Menthae Rhizoma seu
'isable Fructus Arctii Radix Notopterygii
» 3g, Penostracum Cicadae

Fig. 1.2 Herbs that eliminate Wind from the head and neck.

redness of the eyes, infantile convulsions


B. Herbs that disperse Wind-
and tetanus due to Wind-Heat in the Liver
Heat channel. It is used in large doses for the
treatment of convulsion, but in small doses
otherwise.
■ HERBA MENTHAE, FRUCTUS ARCTII
itic in
and PERIOSTRACUM CICADAE
.elease
• Bo He, Niu Bang Zi and Chan Tui ■ FOLIUM MORI and FLOS
or the
CHRYSANTHEMI
?at or
Similarities • Sang Ye and fu Hua
— All three disperse Wind-Heat, ease the throat
and express skin rashes. They are thus
Similarities
oretic. indicated for Exterior Wind-Heat patterns,
— Both expel Wind-Heat and clear Heat from
mer is sore throat, rubella and measles when the
the head and eyes. They also clear Heat from
imotes rash has not fully erupted. the Liver and improve vision. They are thus
■dema. indicated for Exterior Wind-Heat patterns
■solves Differences with headache and red eyes and for red eyes
es the — Herba Menthae is pungent and cool in and dizziness due to Heat in the Liver.
nature and strongly Releases the Exterior by
promoting diaphoresis. It also clears heat in Differences
the head and eyes and promotes the smooth — Folium Mori clears Heat from the Lung,
circulation of Liver Qi. This herb is usually moistens dryness and stops cough and is
added to a decoction in the last few minutes thus indicated for cough due to Dry Heat.
of cooking. — Flos Chrysanthemi clears Heat from the
— Fructus Arctii clears heat and toxins, relieves Liver, improves vision and expels Fire
swelling, stops cough, moistens the Large Poison. Yellow Flos Chrysanthemi is more
Intestine and relieves constipation. It is thus effective in dispersing Wind-Heat and
e nose
indicated for the Fire Poison of carbuncles expelling Fire Poison and is thus often used
■hinitis
and mumps, for cough due to Lung Heat in the treatment of Exterior patterns. White
and for Exterior Wind-Heat patterns compli Flos Chrysanthemi is more effective in
■Damp
cated with constipation. clearing Liver Heat and improving vision
s and
— Periostracum Cicadae expels Wind and and is thus often used to treat Interior
Sieves
treats convulsions. It is thus indicated for patterns.
Part 1: Actions and indications of some common Chinese herbs

Differences
■ FRUCTUS VITICISt RADIX ANGELICAE
— Radix Bupleuri and Radix Puerariae are
DAHURICAE and FLOS
often combined to Release the Exterior and
CHRYSANTHEMI
reduce fever. Radix Bupleuri enters the Shao
• Man Jing Zi, Bai Zhi and Ju Hua Yang channel and treats alternating fever
and chills due to Shao Yang disharmony.
Similarities Radix Puerariae enters the Yang Ming
— All are commonly used in the treatment of channel and treats a feverish sensation of the
headache due to invasion of External Wind body, with thirst and stiffness of the neck
(Fig. 1.3). and back.
— Radix Bupleuri and Rhizoma Cimicifugae
Differences both raise Central Qi and are thus often used
— Fructus Viticis acts similarly to Flos in the treatment of prolapse due to sinking of
Chrysanthemi in expelling Wind Heat and Central Qi.
clearing Heat from the head and eyes. — Radix Puerariae and Rhizoma Cimicifugae
However, Fructus Viticis strongly relieves both express skin eruptions and are thus
pain and is only slightly cold in nature. It can used in the early stage of measles or for any
thus be used to treat Wind-Cold headache skin rash which has not fully erupted.
when combined with Radix Angelicae — Radix Bupleuri also promotes the smooth
Dahuricae, Rhizoma seu Radix Notopterygii circulation of Liver Qi and is thus an impor
and Radix Ledebouriellae. tant herb for Stagnant Liver Qi. Radix
— Radix Angelicae Dahuricae expels Wind- Puerariae promotes Body Fluids and relieves
Cold and is thus indicated for Wind-Cold thirst, and is thus indicated for thirst
headache on the Yang Ming channel. during febrile diseases as well as for
Thirsting and Wasting syndromes. Rhizoma
Cimicifugae clears Heat and Poison, and is
thus indicated for swelling, pain and erosion
■ RADIX BUPLEURI, RADIX PUERARIAE of the gums, mouth ulcers and erysipelas on
AND RHIZOMA CIMICIFUGAE the face.

• Chai Hu, Ge Gen and Sheng Ma

Similarities
Questions
— All Release the Exterior, reduce fever and
raise the Qi of the Middle Burner. They are 1. Compare and contrast the actions of Herba
thus indicated for fever due to External Ephedrae and Ramulus Cinnamomi in
Invasion and for sinking of Central Qi. Releasing the Exterior. What other

FRONTAL

OCdPTTAL Radix Angelicae


Dahuncae
Rhizoma seu Radix /' >
Notopterygii
TEMPORAL
Rhizoma et Radix Folium Mori
Ligustici Sinenss ; \
Flos Chrysanthemi
Radix Puerariae
Rhizoma Ligustici
Chuanxbng

GENERALLY

Radix Ledebouriellae
Fructus Zanthyii
Fructus Viticus

Fig. 1.3 Herbs that treat headache due to Wind.


Herbs that Release the Exterior

actions do they have? What diseases do they


iriae are treat?
;rior and 2. Differentiate the actions of Radix
the Shao Ledebouriellae, Rhizoma seu Radix
ng fever Notopterygii, Radix Angelicae Dahuricae,
larmony. Folium Mori, Flos Chrysanthemi and
ig Ming Fructus Viticis in the treatment of headache.
on of the 3. Compare and contrast the actions and
the neck indications of Radix Bupleuri, Radix
Puerariae and Rhizoma Cimicifugae.
nicifugae
ften used
inking of

nicifugae
are thus
r for any
id.
: smooth
n impor-
'i. Radix
I relieves
or thirst
as for
Rhizoma
n, and is
d erosion
ipelas on

of Herba
nomi in
t other
2 Herbs that clear Heat

A. Herbs that clear Heat and ■ RHIZOMA PHRAGMITIS, RADIX


quell Fire TRICHOSANTHIS, FOLIUM
PHYLLOSTACHYOS, and HERBA
LOPHATHERI
■ GYPSUM FIBROSUM AND RHIZOMA
ANEMARRHENAE • Lu Gen, Tian Hua Fen, Zhu Ye, and Dan Zhu
Ye
• Shi Gao and ZhiMu

Similarities
Similarities
— All are sweet and cold in nature and clear
— Both clear Full Heat at the Nutritive (Ying)
Lung and Stomach Heat. They treat External
level, and Lung and Stomach Fire. They are
Heat at the Qi level, and Internal Heat
thus indicated for febrile disease at the
patterns of the Lung and Stomach with
Nutritive (Ying) level, for cough and wheeze
symptoms of fever and thirst.
due to Lung Heat and for headache,
toothache and Wasting and Thirsting
syndromes due to Stomach Heat. Differences
— Rhizoma Phragmitis is more effective in
clearing Lung Heat with symptoms of cough
Differences and lung abscess. It also clears Stomach
— Gypsum Fibrosum is extremely cold in Heat, stops vomiting, promotes Body Fluids
nature and has a strong action in clearing and alleviates thirst.
Full Heat. Calcined Gypsum Fibrosum is — Radix Trichosanthis clears Heat and
used externally to astringe skin ulcers and promotes Body Fluids. It is often used where
promote tissue regeneration. It is thus fluids have been consumed by febrile
indicated for boils, ulcers, burns and disease, and for Thirsting and Wasting
eczema. syndromes. It moistens the Lung and
— Rhizoma Anemarrhenae clears both Full and resolves Phlegm and is thus used to treat
Empty Heat. It nourishes Yin, quells Fire, productive cough due to Lung Dryness. It
promotes Body Fluids and moistens also relieves swelling and drains pus in cases
dryness. It is thus indicated for dry cough, of boils and carbuncles caused by Fire
tidal fever, night sweats and nocturnal Poison.
emissions due to Lung and Kidney Yin — Folium Phyllostachyos clears Heat, particu
deficiency. larly Heart Heat. It relieves restlessness
— Raw Gypsum Fibrosum is prescribed in and promotes diuresis. It is thus
large doses for oral administration. It should indicated for pathogenic Heat at the Qi
be broken into pieces and decocted prior to and Nutritive (Ying) levels, urinary disor
the addition of other ingredients of the ders due to Heat and mouth and tongue
prescription. Due to its extremely cold ulcers.
nature, it is contraindicated where there is — Herba Lophatheri is similar to Folium
Spleen Yang deficiency. Rhizoma Phyllostachyos in action, but is less
Anemarrhenae is also cold in nature, and effective in clearing Heart Heat and relieving
moistens the intestines. For this reason it is restlessness. However, it is more effective in
contraindicated where there is Spleen clearing Heat generally and in promoting
deficiency giving rise to loose stools. diuresis.
Herbs that clear Heat

Spea Prunellae
Rtieoma Belamcandrae
Semen Cassae
Radix Sophorae Rhizoma Coplidis
Subprostratae i— Radix Sophorae
Flavescentis
Cwtex Lyai Radios — Raflu Isatdis t Herba Taraxici
Radix Scrophularee Gypsum Fibrosum
Rhi2oma Phragmihs
r - Folium Radix Tnchosanihis
Radix Tnchosanthis - 1 Phyilostachyos Rhizoma Coplidis
Rhizoma Coptidis
\ Herba Lopnalhen Radix Scutellariae
Cortex PrieHodendn
Bhizcma Coplidis Spica Prunellae
- Flos Loncerae
Fructus
Semen Cassiae
Gardeniae Herba Taraxici
L. Fructus L Indigo Naturalis
Forsyihiae
Radix Gentianae
IX --Codex Fraxmi

[— Fructus Forsythiae

A Herba Tarawa

Herba Violas

Folium IsaWis
r Dan Zhu
Indigo Naturalis

L Herba Poiiuiacae

and clear
it External
Fig. 2.1 Differentiation of Herbs that clear Heat according to area of action.
rnal Heat
nach with
Radix Scutellariae clears Lung Heat, reduces
■ RHIZOMA COPTIDIS, RADIX
Gall Bladder Fire, clears Heat to prevent
SCUTELLARIAE and CORTEX
miscarriage, cools the Blood and stops
PHELLODENDRI
ffective in bleeding. It is thus indicated for cough and
ts of cough • Huang Lian, Huang Qin, and Huang Bat wheeze due to Lung Heat or Fire, Shao Yang
i Stomach syndrome with hypochondriac pain and
ody Fluids Similarities jaundice, threatened abortion due to Heat
— All are bitter and cold in nature and clear and spitting of blood and epistaxis due to
-feat and Heat, quell Fire, dry Dampness and clear Blood Heat.
ised where Poison. They are often combined in cases of Cortex Phellodendri reduces Empty Heat,
by febrile Heat and Fire in all three Burners (Fig. 2.1). clears Damp-Heat from the Lower Burner
i Wasting They all treat Damp-Heat, including Damp- and relieves jaundice. It is thus indicated
^ung and Heat in the intestines presenting with signs for nocturnal emissions and hypersexu-
;d to treat of dysentery, as well as Fire Poison patterns. ality due to Empty Fire in the Lower
Dryness. It Due to their cold and bitter nature, all three Burner, as well as for Damp-Heat giving
ius in cases can damage the Yang and digestive Qi; due rise to symptoms such as festering ulcers,
i by Fire to their bitter and dry nature, they can eczema, paralysis of the lower limbs, painful
consume Yin. They should be used carefully joints, turbid urine, leucorrhoea and
it, particu- in cases of Spleen Yang deficiency or Yin jaundice.
estlessness deficiency.
is thus
at the Qi Differences RADIX SOPHORAE FLAVESCENTIS
lary disor- — Rhizoma Coptidis strongly clears Heart,
Ku Shen
nd tongue Stomach and Liver Heat and Poison. It is
thus indicated for Heart Fire Blazing with Radix Sophorae Flavescentis is similar to
to Folium symptoms of restlessness, mouth and Cortex Phellodendri in its action of clearing
t is less tongue ulcers or coma, for retention of Heat and drying Dampness. It also kills
d relieving Damp-Heat with discomfort in the epigas parasites and relieves itching in the treat
effective in trium, for Liver Fire giving rise to eye disor ment of eczema, scabies, leucorrhoea, gener
promoting ders and for carbuncles and ulcers due to alized pruritus and pruritus vulvae. It
Fire Poison. promotes diuresis and is thus used for
10 Part 1: Actions and indications of some common Chinese herbs

oedema and urinary disturbance due to B. Herbs that clear Heat and
Damp-Heat. It is reported that this herb
Fire Poison
also treats cardiac arrhythmia. Due to its
very bitter and cold nature, it may
damage the digestion if taken in large ■ FLOS LONICERAE AND FRUCTUS
doses or over a long time. It is often used FORSYTHIAE
as an ingredient of patent remedies in the
• Jin Yin Hua and Lian Qiao
form of a pill or powder, or is applied exter
nally.
Similarities
— Both herbs clear Heat and Poison and are
thus indicated for all Fire Poison patterns
■ RADIX GENTIANAE, FRUCTUS including febrile disease, boils, carbuncles
GARDENIAE, SPICA PRUNELLAE and and ulcers.
SEMEN CASSIAE
Differences
• Long Dan Cao, Zhi Zi, Xia Ku Cao and Jue
— Flos Lonicerae also clears Summer Heat and
Ming Zi
treats dysentery with bleeding due to Fire
Poison. Caulis Lonicerae is similar to Flos
Similarities
Lonicerae in clearing Heat and removing
— All four clear Liver Heat and improve vision
obstructions in the channels. Both treat
and are thus indicated for headache and eye
Febrile Bi syndrome.
disorders due to Liver Fire.
— Fructus Forsythiae clears Heart Fire and
disperses masses. It is thus indicated for
Differences
febrile disease at the Nutritive (Ying) level
— Radix Gentianae has a strong action in
and Heat in the Heart, as well as for
reducing Liver Fire and clearing Damp-Heat
carbuncles, boils and ulcers due to Fire
in the Liver Channel. It is thus indicated for
Poison, and tuberculosis of the lymph
high fever, convulsions and headache due to
nodes. It is especially useful for skin
Heat or Fire in the Liver Channel, and for
disease.
Damp-Heat in the Lower Burner giving rise
to symptoms such as swelling in the pubic
region, swelling and pain of the scrotum,
pruritus vulvae and a thick yellow vaginal
■ HERBA TARAXACI AND HERBA
discharge.
VIOLAE
— Fructus Gardeniae clears Heart Heat,
relieves restlessness, clears Damp-Heat and • Pu Gong Ying and Zi Hua Di Ding
Poison, cools Blood and stops bleeding. It is
thus indicated for stuffiness of the chest and Similarities
restlessness due to Heart Heat, jaundice and — Both clear Heat and Poison, and are thus
urinary disturbance due to Damp-Heat, indicated for carbuncles, boils and ulcers
spitting of blood, epistaxis and haematuria due to Fire Poison.
due to Heat in the Blood, and for carbuncles
and ulcers due to Fire Poison. Differences
— Spica Prunellae clears Liver Heat and — Herba Taraxaci is especially effective in
Stagnation and is thus indicated for treating mastitis. It also clears Heat in
headache, dizziness, and redness of the eyes the Liver and Gall Bladder and Damp-Heat.
due to Liver Fire and Liver Yang Rising, as It is thus indicated for hypochondriac pain
well as for tuberculosis of the lymph nodes and jaundice due to Damp-Heat in the Liver
and simple goitre. and Gall Bladder, epigastric pain due to
— Semen Cassiae is more effective in clearing Stomach Heat and urinary disease due to
Liver Heat and improving vision and is Heat.
thus indicated for eye disorders due to — Herba Violae is especially effective in
Liver Heat and Fire. It also moistens the treating carbuncles, boils and ulcers due to
intestines and relieves constipation with dry its strong action in eliminating Fire Poison. It
stool. also cools Blood and stops bleeding.
Herbs that clear Heat 11

and ■ FOLIUM ISATIDIS, RADIX ISATIDIS ■ HERBA HOUTTUYNIAE, RHIZOMA


AND INDIGO NATURALIS BELAMCANDAE AND RADIX
SOPHORAE SUBPROSTRATAE
• Da Qing Ye, Ban Lan Gen and Qing Dai
'US • Yu Xing Cao, She Gan and Shan Dou Gen
Similarities
— AH these medicines come from the same Similarities
plant and are thus similar in their action. — All three herbs clear Lung Heat and are thus
All three clear Heat and Poison and cool indicated for cough and sore throat.
Blood. They are indicated for febrile
n and are Differences
disease with Fire Poison, as well as for
n patterns
carbuncles, boils and ulcers due to Fire — Herba Houttuyniae is primarily used to treat
:arbuncles cough and lung abscess due to Heat in the
Poison.
— Folium Isatidis is often used in the treat Lung.
ment of febrile disease. It has a strong — Rhizoma Belamcandae and Radix Sophorae
action in cooling Blood and eliminating Subprostratae are primarily used to treat sore
■ Heat and throat. Rhizoma Belamcandae also resolves
Poison and it promotes the healing of skin
ue to Fire Phlegm and regulates Qi, and is thus
eruptions.
ar to Flos indicated for cough with profuse sputum
— Radix Isatidis is also commonly used in the
removing and wheeze. Radix Sophorae Subprostratae
treatment of febrile disease and is especially
3oth treat has a strong action in clearing Heat and
effective for viral infections. It is more effec
tive than Folium Isatidis in eliminating Fire relieving swelling and is thus indicated for
Fire and inflammation of the throat, and for cancer.
Poison, relieving swelling and easing the
icated for
throat.
ilng) level
— Indigo Naturalis cools Blood, stops bleeding
ell as for ■ HERBA PORTULACAE, RADIX
and clears Liver Fire. It is thus indicated
le to Fire PULSATILLAE AND CORTEX FRAXINI
for bleeding due to Blood Heat, headache
ne lymph
due to Liver Fire and convulsions due to
for skin • Ma Chi Xian, Bai Tou Weng and Qin Pi
Liver Heat. It is often applied to Fire
Poison lesions externally in the form of a
Similarities
powder.
— All three herbs clear Heat in the intestines
and are thus indicated for diarrhoea and
dysentery.

■ HERBA ANDROGRAPHITIS AND Differences

RHIZOMA PARIDIS
— Herba Portulacae also treats eczema, carbun
cles, swelling and uterine bleeding.
• Chuan Xin Lian and Zao Xiu — Radix Pulsatillae treats dysentery with
5 are thus
bleeding due to Fire Poison. It is effective
ind ulcers Similarities against both bacillary dysentery and
— Both herbs clear Heat and Poison and amoebic dysentery.
are thus indicated for all Fire Poison — Cortex Fraxini clears Damp-Heat and is thus
patterns. indicated for Damp-Heat leucorrhoea. It also
ffective in
clears Liver Heat and improves vision and is
i Heat in Differences thus indicated for eye disorders due to Liver
amp-Heat. — Herba Andrographitis is widely used in Fire.
idriac pain the treatment of various infections, particu
n the Liver larly of the intestinal tract and respiratory
iin due to system. It is similar to Rhizoma Coptidis in
■ CAULIS SARGENTODOXAE AND
ise due to nature and action. Rhizoma Paridis is
HERBA PATRINIAE
indicated for poisonous snake bites and
^ective in cancer. It clears Heat and stops convul • Hong Teng and Bai Jiang Cao
:ers due to sions, and is thus indicated for infantile
e Poison. It convulsions or any convulsion due to high Similarities

fever. — Both clear Heat and Poison and move Blood


12 Part 1: Actions and indications of some common Chinese herbs

and are thus indicated for appendicitis, as bleeding, relieves skin eruptions, clears
well as abdominal pain in women due to Heat and expels Wind, and is thus indicated
stagnation of Qi and Blood. for bleeding and skin eruptions due to
Blood Heat, as well as for Liver Wind due
Differences to Heat. Cornu Bubali can be substituted,
— Caulis Sargentodoxae is more effective in but must be prescribed in larger doses
moving Blood and is thus indicated for (15-30 g).
contusions and sprains, irregular menstrua — Calculus Bovis is more effective in clearing
tion and Wind-Damp Bi syndrome. Heart Heat and opening the orifices, as
— Herba Patriniae is more effective in clearing well as in clearing Heat and Fire Poison,
Heat and draining pus and is thus indicated and is thus indicated for coma in febrile
for carbuncles, boils and ulcers due to Fire diseases, and Fire Poison patterns.
Poison. Calculus Bovis Factitius can be substi
tuted.

■ HERBA HEDYOTIS DIFFUSAE, HERBA


SCUTELLARIAE BARBATAE AND
RHIZOMA SMILACIS GLABRAE
■ RADIX REHMANNIAE, RADIX
• Bat Hua She She Cao, Ban Zhi Lian and Tu SCROPHULARIAE, CORTEX MOUTAN
Fu Ling RADIOS AND RADIX PAEONIAE
RUBRA
Similarities
• Sheng Di Huang, Xuan Shen, Mu Dan Pi,
— All three clear Heat and Poison and elimi
and Chi Shao
nate Dampness and are thus indicated for
cancer and syphilis.
Similarities
— All clear Heat and cool Blood and are
Differences
thus indicated for pathogenic Heat at
— Herba Hedyotis Diffusae and Herba
the Nutritive (Ying) and Blood levels,
Scutellariae Barbatae are often used in the
and for haemorrhagic patterns due to
treatment of cancer and poisonous snake
Heat.
bite. Rhizoma Smilacis Glabrae is often used
in the treatment of venereal diseases such as
Differences
syphilis.
— Radix Rehmanniae and Radix Scrophulariae
are both sweet and cold in nature. They
nourish Yin and promote Body Fluids and
are thus indicated for Yin Deficiency. Radix
C. Herbs that clear Full Heat Rehmanniae is more effective in cooling
and Empty Heat and cool Blood and stopping bleeding (Fig. 2.2).
Radix Scrophulariae is more effective in
Blood nourishing Yin and clearing Fire and Fire
Poison, and is thus indicated for sore throat,
■ CORNU RHINOCERI ASIATIC! AND tuberculosis of the lymph nodes and
CALCULUS BOVIS carbuncles, boils and ulcers due to Fire
Poison.
• Xi Jiao and Niu Huang
— Cortex Moutan Radicis and Radix Paeoniae
Similarities Rubra also invigorate Blood circulation
— Both clear Heart and Liver Heat, cool Blood and treat Blood Stasis, and are thus indicated
and clear Fire Poison and are thus indicated for Blood Heat complicated by Stasis.
for coma and convulsion due to pathogenic They also clear Liver Fire. Cortex Moutan
Heat at the Nutritive (Ying) and Blood Radicis clears Empty Heat and is thus
levels. indicated for tidal fever. Radix Paeoniae
Rubra is more effective in moving Blood
Differences and treating Stasis, but does not stop
— Cornu Rhinoceri Asiatici cools Blood, stops bleeding.
Herbs that clear Heat 13

s, clears
Radix Rehmanniae Radix Rehmanniae Praeparata
indicated
due to Cold Warm
Vind due
bstituted, Cools Blood (and stops bleeding) Tonifies Blood

er doses
Clears Heat

i clearing Tonifies Yin (and promotes Body Fluids) Tonifies Yin


ifices, as
e Poison, Fig. 2.2 Actions of Radix Rehmanniae.
in febrile
patterns.
e substi-
3. Flos Lonicerae, Fructus Forsythiae, Herba
■ HERBA ARTEMISIAE CHINGHAO,
Taraxaci, Folium Isatidis, Herba
CORTEX LYCII RADICIS, RADIX
Houttuyniae, Radix Pulsatillae and Cortex
AMPELOPSIS AND RADIX
Fraxini are all herbs that clear Heat and Fire
STELLARIAE
Poison. How do their indications differ?
• Qing Hao, Di Gu Pi, Bai Wei and Yin Chat 4. Compare and contrast the actions and
)UTAN Hu indications of Radix Gentianae, Fructus
Gardeniae, Spica Prunellae and Semen
Similarities Cassiae.
— All clear Empty Heat and are thus 5. Of the herbs that clear Heat, which ones also
an Pi,
indicated for fever and tidal fever due to a. nourish Yin?
Yin Deficiency and for persistent low- b. clear Empty Heat?
grade fever in the late stage of febrile c. move Blood and treat Blood Stasis?
disease.
and are
Heat at
Differences
>d levels,
— Herba Artemisiae Chinghao clears both
; due to
Full and Empty Heat, as well as Summer
Heat. It is indicated in the treatment of
malaria.
— Cortex Lycii Radicis clears Lung Heat and is
>phulariae
thus indicated in haemoptysis due to Lung
ure. They
Heat. It also treats hypertension and
luids and
diabetes.
ncy. Radix
— Radix Ampelopsis cools Blood and is thus
n cooling
indicated in the treatment of Blood Heat in
(Fig. 2.2).
women.
■fective in
— Radix Stellariae is more effective in clearing
: and Fire
Empty Heat. It also treats malnutrition and
ore throat,
fever in children.
odes and
ie to Fire

< Paeoniae
Questions
circulation
s indicated 1. Compare and contrast the actions and
by Stasis. indications of Gypsum Fibrosum and
;x Moutan Rhizoma Anemarrhenae.

d is thus 2. Compare and contrast the actions and


: Paeoniae indications of Rhizoma Coptidis, Radix
'ing Blood Scutellariae and Cortex Phellodendri.
not stop Explain their side-effects and the precau
tions for their use.
14

3 Herbs that purge and promote


digestion

A. Purgative herbs — Natrii Sulfas is salty and cold in nature and


thus softens and resolves masses as well as
purging. It is indicated for dry stool and
■ RADIX ET RHIZOMA RHEI, NATRII
mastitis. External application resolves hard
SULFAS AND FOLIUM CASSIAE
lumps and inhibits lactation.
• Da Huang, Mang Xiao and Fan Xie Ye — Folium Cassiae is indicated for habitual
constipation. It is also used to cleanse the
Similarities intestines.
— All are purgative and are thus indicated for
constipation due to accumulation of Heat,
constipation with fullness of the abdomen
■ FRUCTUS CANNABIS AND SEMEN
due to high fever, and acute abdomen. They
PRUNI
also clear Heat and Fire.
• Huo Ma Ren and Yu Li Ren
Differences
— Radix et Rhizoma Rhei is bitter and cold in Similarities
nature. It clears Heat and Fire, stops — Both moisten and purge the intestines and
bleeding, clears Fire Poison, invigorates are thus indicated for constipation due to
Blood and disperses Stasis. It is thus deficiency of Fluids and Blood, and dryness
indicated for Fire Poison in the upper of the intestines.
body, haemorrhagic patterns due to Blood
Heat, carbuncles and furuncles due to Differences
Fire Poison, jaundice due to Damp- — Fructus Cannabis relieves constipation
Heat, urinary dysfunction, amenorrhoea due solely by moistening the intestines.
to stagnation of Qi and Blood, palpable — Semen Pruni also promotes diuresis and
abdominal masses and contusions and relieves swelling and is thus indicated for
sprains. oedema (Fig. 3.1).

Radix et Rhizoma Rhei clears Heat and Fire Poison purges the intestines

Natrii Sulfas softens masses

Folium Cassiae

Fructus Cannabis moistens the intestines

Semen Pruni promotes diuresis

Fig. 3.1 Differentiation of purgative herbs.


Herbs that purge and promote digestion 15

urinary and biliary tracts. It also promotes


B. Herbs that promote
te
the function of the Stomach and is thus
digestion indicated for poor digestion due to Stomach
weakness.

■ FRUCTUS CRATAEGI, MASSA ' Semen Raphani resolves Phlegm and


FERMENTATA, FRUCTUS HORDEI regulates Qi and is thus indicated for
GERMINATUS, FRUCTUS ORYZAE
retention of food due to Qi Stagnation and
GERMINATUS, ENDOTHELIUM for other patterns of stagnant Qi and
CORNEUM GIGERIAE GALLI, SEMEN Phlegm.

RAPHANI AND SEMEN ARECAE ■ Semen Arecae regulates Qi and dispels


parasites and is thus indicated for retention
• Shan Zha, Shen Qu, Mai Ya, Gu Ya, fi Nei of food due to Qi Stagnation and abdominal
ature and
Jin, Lai Fu Zi and Bing Long pain due to parasites.
is well as
stool and
Similarities
lves hard
— All promote digestion and are thus indicated
for retention of food, with symptoms of Questions
habitual
epigastric distension, abdominal pain,
eanse the
belching, acid regurgitation and abnormal 1. Compare and contrast the actions and
indications of Radix et Rhizoma Rhei and
bowel movement.
Natrii Sulfas.
2. In addition to promoting digestion, what are
Differences
the other actions of Fructus Crataegi,
rtEN — Fructus Crataegi promotes digestion,
strengthens the Spleen and disperses Blood Fructus Hordei Germinatus, Semen Raphani
Stasis. It is indicated for poor digestion of and Endothelium Corneum Gigeriae Galii?
meat (Fig. 3.2), lack of gastric acid,
dyspepsia and stagnation of Blood.
— Massa Fermentata Medicinalis is more
itines and effective in promoting the digestion of rice,
Dn due to wheat flour and alcohol (Fig. 3.2). It harmo
id dryness
nizes the Middle Burner and stops diarrhoea
and is indicated for retention of food accom
panied by fever, diarrhoea or dysentery.
— Fructus Hordei Germinatus and Fructus
instipation
Oryzae Germinatus promote the digestion of
rice and wheat flour (Fig. 3.2), assist the
iresis and Stomach and harmonize the Middle Burner.
licated for Fructus Hordei Germinatus also inhibits
lactation and promotes the Liver's function
of regulating the free flow of Qi.
— Endothelium Corneum Gigeriae Galli
astringes seminal emission and dissolves
stones, and is thus indicated for spermator
rhoea, nocturnal enuresis and stones in the

stines
Fructus Crataegi meat

Massa Fermentata Medicinalis v alcohol

Fructus Hordei Germinatus ^-^X. wheat

itestines
Fructus Oryzae Germinatus -^^^ rice

Fig. 3.2 Differentiation of digestive herbs by type of


food.
16

4 Herbs that resolve Phlegm and


stop coughing and wheezing

A. Herbs that resolve Phlegm Differences


— Rhizoma Arisaematis also dries Dampness
■ RHIZOMA PINELLIAE and RHIZOMA and resolves Phlegm and is thus indicated
ARISAEMATIS for patterns of Damp Phlegm. Rhizoma
Typhonii is mainly used for disorders of the
• Ban Xia and Tian Nan Xing head and face.

Similarities
— Both are pungent, warm and toxic in nature
■ SEMEN SINAPIS ALBAE
and resolve Cold Phlegm by warming or
drying Dampness. They are thus indicated • BaiJieZi
for patterns of Cold Phlegm or Damp
— This herb is similar to Rhizoma Pinelliae in
Phlegm. External application relieves
resolving Cold Phlegm with warmth. It is
swelling and pain and they are used in the
treatment of boils and ulcers.
more effective in promoting the circulation
of Qi and dispersing masses and is indicated
Differences for Phlegm between the skin and muscles,
retention of fluid in the hypochondrium and
— Rhizoma Pinelliae conducts Rebellious Qi
Yin-type jaundice.
downward and stops vomiting and is thus
indicated for vomiting due to Rebellious
Stomach Qi. It also relieves fullness and
disperses lumps and is thus indicated for a ■ RADIX PLATYCODI, RADIX
distressing sensation of fullness in the PEUCEDANI, RHIZOMA CYNANCHI
epigastrium and for Plum-Stone Qi (the STAUNTONII AND FLOS INULAE
sensation of a foreign body in the throat).
• fie Geng, Qian Hu, Bai Qian and Xuan Fu
— Rhizoma Arisaematis eliminates Wind Hua
Phlegm and stops convulsions, and is thus
indicated for Wind Phlegm patterns such as Similarities
dizziness and vertigo, deviation of the — All resolve Phlegm and stop cough and are
mouth and eye, hemiplegia and tetanus. It thus indicated for cough with profuse
is bitter and cool in nature and also cools sputum.
Heat.

Differences
— Radix Platycodi and Radix Peucedani both
■ RHIZOMA ARISAEMATIS AND promote the Lung's function of dispersing
RHIZOMA TYPHONII and are thus indicated for cough due to an
impairment of the Lung's dispersing
• Tian Nan Xing and BaiFuZi function following an invasion of the Lung
by pathogenic factors. Radix Platycodi also
Similarities
eases the throat and drains pus and is thus
— Both eliminate Wind Phlegm and stop indicated for sore throat and lung abscess.
convulsion and are thus indicated for Radix Peucedani also conducts Rebellious
pattern? ur Wind Phlegm, including tetanus
Qi downward and is thus indicated for
and deviation of the mouth and eye.
cough and wheeze when Lung Qi fails to
Herbs that resolve Phlegm 17

descend due to retention of Phlegm in the more effective in opening the chest and

d lungs.
— Rhizoma Cynanchi Stauntonii and Flos
regulating Qi. Semen Trichosanthis is more
effective in moistening the lungs and
Inulae both conduct Rebellious Qi intestines and relieving constipation.
downward and resolve Phlegm. They are Bulbus Fritillariae is more effective than
thus indicated for cough with profuse Fructus Trichosanthis in moistening the
sputum, and wheeze due to failure of the lungs and stopping cough. It also clears Heat
Lung Qi to descend. Flos Inulae also sends and disperses masses and is indicated for
Stomach Qi downward and is thus indicated tuberculosis of the lymph nodes, abscess and
for vomiting and hiccup due to Rebellious swelling. It is sweet and moist in nature and
Stomach Qi. is often used in the treatment of Yin
deficiency and Lung dryness due to chronic
illness. Bulbus Fritillariae Thunbergii is
ampness
■ FRUCTUS TRICHOSANTHIS AND bitter and discharging in nature and is often
ndicated
BULBUS FRITILLARIAE used in the treatment of Fire Poison patterns
Rhizoma
due to External Invasion.
?rs of the • Gua Lou and Bei Mu

Similarities ■ CAULIS BAMBUSAE IN TAENIAM AND


— Both clear Heat, resolve Phlegm and moisten
SUCCUS BAMBUSAE
the lungs and are thus indicated for patterns
of Heat Phlegm and Dry Phlegm. • Zhu Ru and Zhu Li

nelliae in Differences Similarities


nth. It is — Fructus Trichosanthis opens the chest, — Both clear Heat and resolve Phlegm and are
rculation relieves stagnation, moistens the intestines thus indicated for cough due to Phlegm
indicated and relieves constipation. It is thus indicated Heat.
muscles, for patterns of Chest Bi due to stagnation
rium and arising from Deficient Yang in the chest and Differences
for constipation due to dryness of the — Caulis Bambusae in Taeniam clears Stomach
intestines. Pericarpium Trichosanthis is Heat and stops vomiting and is thus

JCHI Rhizoma Arisaematis


Radix Platycodi
.E Rhizoma Typhonii —
Sargassum Radix Peucedani
Semen Sinapis Albae
Succus Bambusae
uanFu Thallus Laminariae Rhizoma Cynanchi
Staunlonii
Flos Inulae
Fructus
Rhizoma Pinelliae ~i Trichosanthis
and are Semen Sinapis Albae
Bulbus Fritiilariae

profuse Flos Inulae


Fructus Perillae

Radix Asteris
Caulis Bambusae '
L Fbs Farfarae

iani both
ispersing
iue to an
ispersing
the Lung
codi also
id is thus
; abscess.
Rebellious
cated for
Fig. 4.1 Local actions of herbs that resolve Phlegm.
)i fails to
18 Part 1: Actions ami indications of some common Chinese herbs

indicated for vomiting due to Stomach


Heat. ■ RADIX STEMONAE, RADIX ASTERIS
AND FLOS FARFARAE
— Succus Bambusae expels Phlegm and opens
the orifices and is thus indicated for Wind • Bat Bu, Zi Wan and Kuan Dong Hua
Stroke with gurgling in the throat and
unconsciousness due to Phlegm Heat. Similarities
— All moisten the lungs and stop cough and
are indicated for both acute and chronic
■ SARGASSUM AND THALLUS cough.
LAMINARIAE
Differences
• Hai Zao and Kun Bu
— Radix Stemonae also kills insects and lice. It
Similarities is applied externally to treat head and body
— Both resolve Phlegm and soften hard masses lice and Trichomonas vaginalis and adminis
tered as an enema to treat pinworms.
and are thus indicated for goitre, tubercu
losis of the lymph nodes and subcutaneous — Radix Asteris and Flos Farfarae both resolve
nodules (Fig. 4.1). They also promote Phlegm and stop cough. The former is more
diuresis and relieve swelling and are used in effective in stopping cough and the latter
the treatment of beri-beri, oedema and more effective in resolving Phlegm. They are
often used in combination.
dysuria. They are often used in combination
and can be substituted for each other. They
are used in dietary therapy to treat hyperten
sion and arteriosclerosis. ■ FOLIUM ERIOBOTRYAE and FRUCTUS
ARISTOLOCHIAE

• Pi Pa Ye and Ma Dou Ling

B. Herbs that stop coughing Similarities

and wheezing — Both clear Lung Heat and stop cough and
are thus indicated for cough due to Lung
Heat.
■ SEMEN ARMENIACAE AMARUM AND
FRUCTUS PERILLAE Differences

• Xing Ren and Su Zi — Folium Eriobotryae clears Stomach Heat,


conducts Rebellious Qi downward and stops
Similarities vomiting and is thus indicated for vomiting
due to Stomach Heat.
— Both conduct Lung Qi downward to stop
— Fructus Aristolochiae calms the Liver and
cough and wheeze and are thus indicated for
lowers blood pressure and is thus indicated
cough and wheeze due to Rebellious Lung
for hypertension due to Liver Yang Rising.
Qi. They also moisten the intestines and
relieve constipation and are thus indicated
for constipation due to dryness of the
intestines. CORTEX MORI RADICIS AND SEMEN
LEPIDII SEU DESCURAINIAE
Differences Sang Bai Pi and Ting Li Zi
— Semen Armeniacae Amarum is effective in
sending Qi downward and promoting the
Lung's dispersing function. It is thus an Similarities
important herb for stopping cough and — Both clear Lung Heat, soothe wheeze,
wheeze. It treats various kinds of cough and promote diuresis and relieve swelling. They
asthma in combination with other herbs. are thus indicated for cough and wheeze due
— Fructus Perillae also resolves Phlegm and is to Lung Heat and for oedema.
thus more effective when Lung Qi fails to
descend due to blockage by Cold Phlegm or Differences
Damp Phlegm. — Cortex Mori Radicis is more effective in
Herbs that resolve Phlegm 19

clearing Heat and Fire from the lungs.


:RIS Semen Lepidii seu Descurainiae is more
effective in eliminating water from the
Lungs and soothing asthma. This herb has
a potent action and renders good therapeutic
results in the treatment of pulmonary heart
jgh and
disease with dyspnoea and pulmonary
chronic
oedema, but it is a harsh cathartic and
should be used with extreme caution.

■ HERBA EPHEDRAE, SEMEN LEPIDII


d lice. It
nd body SEU DESCURAINIAE AND SEMEN
idminis- GINKGO

• Ma Huang, Ting Li Zi and Bai Guo


i resolve
■ is more Similarities
he latter — All soothe asthma and are thus indicated for
They are cough and wheeze.

Differences
— Herba Ephedrae promotes the dispersing
ICTUS function of the Lung and is thus indicated
for asthma when the dispersing function of
the Lung is impaired due to an Excess
pattern.
— Semen Lepidii seu Descurainiae reduces
ugh and
Lung Fire and soothes asthma and is thus
to Lung
indicated for cough and wheeze due to Lung
Fire and the retention of Phlegm Fluid.
— Semen Ginkgo astringes the lungs and
soothes asthma, and is thus indicated for
:h Heat,
chronic cough and wheeze due to Lung Qi
ind stops Deficiency.

vomiting

iver and
ndicated Questions
Rising. 1. Rhizoma Pinelliae, Rhizoma Arisaematis,
Fructus Trichosanthis and Bulbus Fritillariae
all resolve Phlegm. Compare and contrast
EMEN their other actions and indications.
2. Compare and contrast the actions and
indications of Radix Platycodi, Radix
Peucedani, Rhizoma Cynanchi Stauntonii
and Flos Inulae.
3. What are the differences in action of Semen
Armeniacae Amaru m, Fructus Perillae,
wheeze,
Herba Ephedrae and Semen Lepidii seu
ng. They
Descurainiae?
leeze due

ective in
20

5 Herbs that eliminate Wind-


Damp

■ RADIX ANGELICAE PUBESCENTIS, dissolves fishbones lodged in the throat and


RHI2OMA SEU RADIX NOTOPTERYGII treats oesophageal cancer.

AND RADIX CLEMATIDIS

• Du Huo, Qiang Huo and Wei Ling Xian


■ RADIX GENTIANAEMACROPHYLLAE,
RADIX STEPHANIAE TETRANDRAE,
Similarities
HERBA SIEGESBECKIAE AND FOLIUM
— All are warm in nature and eliminate Wind- CLERODENDRI
Damp and relieve pain. They are thus
indicated for Bi syndromes involving Wind, • Qin Jiu, Fang Ji, Xi Xian Cao and Chou Wu
Cold and Dampness. Tong

Similarities
Differences
— All are cold in nature and eliminate Wind
— Radix Notopterygii and Radix Angelicae Damp. They are thus indicated for Wind
Pubescentis are warm and dry in nature and Damp Bi syndromes with signs of heat.
are more effective in eliminating Cold
Damp. They are thus indicated for Bi Differences
syndromes in which Cold Damp predomi — Radix Gentianae Macrophyllae eliminates
nates. Radix Notopterygii goes upward and Wind Damp without drying and is thus
is thus used for Bi syndromes involving the referred to as a moist herb for eliminating
upper body. It also strongly Releases the Wind. It also clears Empty Heat and is thus
Exterior and so is used for Exterior patterns used for Bi syndromes with heat signs due to
complicated with Dampness. Radix Blood and Yin Deficiency. It also treats fever
Angelicae Pubescentis is less effective in and tidal fever due to Yin Deficiency, and
Releasing the Exterior, but it strongly elimi Damp-Heat-type jaundice.
nates Wind-Damp and so is commonly used — Radix Stephaniae Tetrandrae is more effec
in the treatment of Bi syndromes. Its action tive in eliminating Dampness and is thus
goes downward and it is more effective for indicated for Damp Bi syndromes. It also
treating the lower body. If Bi syndromes promotes diuresis and relieves swelling and
affect the entire body, these herbs are used in thus treats oedema.
combination.
— Herba Siegesbeckia and Folium Clerodendri
— Radix Clematidis is more effective in elimi eliminate Wind Damp, remove obstruction
nating Wind, removing obstructions from from the channels and lower blood pressure.
the channels, and relieving pain. It is thus They are thus indicated for Wind Damp Bi
indicated for Wandering Bi, in which syndromes, numbness of the limbs and
pathogenic Wind predominates. It also body, hemiplegia and hypertension.
Herbs that eliminate Wind-Damp 21

Caulis Piperis Futokadsurae is warm in


■ FRUCTUS CHAENOMELIS, RAMULUS
nature. It eliminates Wind and removes
MORI, CAULIS TRACHELOSFERMI
obstruction from the channels and is thus
AND CAULIS PIPERIS
indicated for Cold Bi syndromes with
FUTOKADSURAE
pathogenic Wind predominating.
• Mm Gua, Sang Zhi, Luo Shi Teng and Hai
Feng Teng

Similarities ■ AGKISTRODON ACUTUS AND


— All relax the muscles and tendons and
ZAOCYS
remove obstruction from the channels. They
are thus indicated for Wind-Damp Bi • Bat Hua She and Wu Shao She
roat and syndromes, muscle contracture and limited
motion of the joints. Similarities
— Both eliminate Wind, remove obstruction

Differences from the channels, relieve pain and stop


IfLLAE, — Fructus Chaenomelis eliminates Dampness convulsion and are thus indicated for
fcAE, and harmonizes the Stomach and is stubborn Wind-Damp Bi syndromes, infan
DLIUM indicated for beri-beri and for cholera with tile convulsion and tetanus.
vomiting, diarrhoea and tenesmus.
— Ramulus Mori removes obstruction from the Differences
tou Wu
channels and benefits the joints of the four — Agkistrodon is potent and toxic and is thus
limbs, and is thus indicated for painful joints used in small doses, administered as a
of the limbs. tincture, pill or powder.
— Caulis Trachelospermi clears heat and — Zaocys has a weaker action and is not toxic
Xe Wind
removes obstruction from the channels and and is thus used in large doses, administered
or Wind
is thus indicated for Febrile Bi syndromes. as a decoction or tincture.
aat.

iminates
is thus
ninating
d is thus
Rhizoma Cyboti
ns due to
ats fever
ncy, and Rtaoma seu

Radix

ire effec- Nolopterygn


l is thus
;. It also
lling and

rodendri
struction
pressure.

Damp Bi Radix Angeteae

nbs and Rubescenlis

Fig. 5.1 Differentiation of herbs that eliminate Wind-Damp according to area of action.
22 Part 1: Actions and indications of some common Chinese herbs

■ RAMULUS LORANTHI, CORTEX


ACANTHOPANACIS RADIOS AND
RHIZOMA CIBOTII

• Sang Ji Sheng, Wu Jia Pi and Gou ]i

Similarities
— All eliminate Wind-Damp, tonify the Liver
and Kidney and strengthen the tendons and
bones, and are thus indicated for chronic Bi
syndromes, weakness of the tendons and
bones and lumbar pain with atrophic
debility of bones.

Differences
— Ramulus Loranthi tonifies the Kidney,
prevents miscarriage and lowers blood
pressure and is thus used for Restless Fetus
due to Kidney Deficiency and for hyperten
sion.
— Cortex Acanthopanacis Radicis promotes
diuresis and relieves swelling and is thus
indicated for oedema. Acanthopanax (Nan
Wu ]ia) is more effective in eliminating
Wind-Damp and strengthening the bones
and tendons while Periploca Sepium (Bai
Wu ]ia) is more effective in promoting
diuresis and relieving swelling.
— Rhizoma Cibotii is more effective in
tonifying the Kidneys and is thus indicated
for back pain (Fig. 5.1), frequent urination
and leucorrhoea due to Kidney Deficiency.

Questions
1. How do Rhizoma seu Radix Notopterygii
and Radix Angelicae Pubescentis differ in
their actions?
2. How do Radix Gentianae Macrophyllae and
Radix Stephaniae Tetrandrae differ in their
actions?
3. How do Fructus Chaenomelis, Ramulus
Loranthi, Ramulus Mori and Agkistrodon
Acutus differ in their actions and indica
tions?
23

Herbs that resolve and drain 6


Dampness

A. Herbs that resolve ■ HERBA AGASTACHIS AND HERBA

dampness EUPATORII

• Huo Xiang and Pei Lan

■ RHIZOMA ATRACTYLODIS AND Similarities


CORTEX MAGNOLIAE — Both are aromatic in nature and resolve
OFFICINALIS Dampness and eliminate Summer Heat.
• Cang Zhu and Hou Po They are indicated for retention of
Dampness in the Middle Burner and for

Similarities patterns of Summer Heat and Dampness.


— All are pungent, bitter, warm and dry in
nature and thus have a drying effect on Differences

Dampness. They are indicated for — Herba Agastachis also Releases the Exterior

patterns of Dampness invading the and stops vomiting, and is thus indicated for

Spleen and Stomach, giving rise to Exterior patterns of Summer Heat and

symptoms of distension and fullness in Dampness and for vomiting due to Turbid

the epigastrium and abdomen, diarrhoea Damp.

and a sticky tongue coating. Because — Herba Eupatorii is more effective in elimi

bitter and dry herbs consume Body nating Summer Heat, resolving Dampness

Fluids they are contraindicated in cases of and regulating the function of the Stomach.
Yin Deficiency and consumption of Body It is thus used for poor appetite with a sweet

Fluids. taste and stickiness in the mouth due to


Summer Heat and Dampness invading the

Differences Stomach.

— Rhizoma Atractylodis dries Dampness,


invigorates the Spleen and eliminates Wind-
Damp. It is indicated for diarrhoea and
■ FRUCTUS AMOMI AND SEMEN
loose stools due to impairment of the
AMOMI CARDAMOMI
Spleen's function of transportation and
transformation as a result of an invasion of • Sha Ren and Bai Dou Kou
Dampness. It is also used for Exterior
Dampness patterns and for Wind-Damp Bi Similarities
syndromes. — Both resolve Dampness, regulate Qi, warm
— Cortex Magnoliae Officinalis treats the Middle Burner and stop vomiting. They
Interior Dampness but also circulates Qi, are thus indicated for stagnation of Qi and
conducts Rebellious Qi downward and Dampness giving rise to distension and pain
soothes asthma. It is thus indicated for in the epigastrium and abdomen, vomiting
epigastric distress and abdominal distension and a sticky tongue coating.

due to stagnation of Qi and retention of


Dampness in the Middle Burner, as well Differences
as for cough and wheeze due to Phlegm- — Fructus Amomi is more effective in treating

Damp. stagnation of Qi and Dampness in the


24 Part 1: Actions and indications of some common Chinese herbs

Middle and Lower Burners. It also invigo for urinary disturbances due to Damp-Heat
rates the Spleen, regulates Qi and prevents in the Lower Burner.
miscarriage.
— Semen Amomi Cardamomi is more effective Differences
in treating stagnation of Qi and Dampness in — Semen Plantaginis clears Liver Heat and
the Middle and Upper Burners. improves vision, and clears Lung Heat and
resolves Phlegm. It is thus indicated for
redness, swelling and pain in the eyes due to
Heat and Fire in the Liver and for productive
B. Herbs that drain dampness cough due to Lung Heat. This herb tends to
float on the surface of a decoction and
■ PORIA, POLYPORUS UMBELLATUS, should therefore be wrapped before
RHIZOMA ALISMATIS AND SEMEN cooking.
COICIS — Talcum clears Summer Heat and is thus
indicated for patterns of Summer Heat and
• Fu Ling, Zhu Ling, Ze Xie and Yi Yi Ren
Dampness. It should be wrapped before
adding to a decoction to avoid making the
Similarities
decoction turbid.
— All are bland in nature and eliminate
— Caulis Clematidis Armandii clears Heart
Dampness by diuresis. They are thus
Fire, removes obstruction from the channels
indicated for oedema, dysuria, diarrhoea
and promotes the secretion of milk. It is thus
and retention of Phlegm and Fluid.
indicated for mouth and tongue ulcers due
to Heart Fire, as well as for Febrile Bi
Differences
syndromes and obstruction of milk secre
— Poria and Semen Coicis both invigorate the tion.
Spleen and are thus indicated for retention
— Caulis Aristolochiae Manshuriensis (Guan
of Dampness due to Spleen Deficiency.
Mu Tong) is toxic and it is therefore advisable
Poria also calms the Mind. Semen Coicis
not to administer it in large doses.
treats Bi syndromes by draining Dampness
and treats lung abscess and appendicitis
by clearing Heat and draining pus. Poria Warm herbs that DRY Damp
peel (Fu Ling Pi) is more effective in
promoting diuresis. Poria cum Ligno Rhizoma Atractylodis
Hospite (Fu Shen) is more effective in Cortex Magnoliae Officinalis
Pericarpium Citri Reticulatae
calming the Mind.
— Polyporus Umbellatus and Rhizoma Aromatic herbs that RESOLVE Damp
Alismatis strongly promote diuresis (Fig.
6.1). This is the sole action of Polyporus Herba Agastachis
Herba Eupatorii
Umbellatus, while Rhizoma Alismatis also Fructus Amomi
clears Heat from the Kidneys and Bladder Semen Amomi Cardamomi
and is thus used to treat Damp-Heat in the Pericardium Citri Reticulatae
Lower Burner. It is also indicated for dizzi
ness and vertigo due to retention of Phlegm Bland herbs that DRAIN Damp
and Fluid.
Poria, especially the peel
Polyporus Umbellatus
Rhizoma Alismatis
■ SEMEN PLANTAGINIS, TALCUM and Semen Coicis
Semen Plantaginis
CAULIS CLEMATIDIS ARMANDII
Talcum

• Che Qian Zi, Hua Shi and Chuan Mu Tong Caulis Clematidis Armandii
Herba Lysimachiae
Spora lygodii
Similarities Folium Pyrrosiae
— All clear heat, drain Dampness and relieve
urinary disturbance and are thus indicated Fig. 6.1 Three ways that herbs eliminate Damp.
Herbs that resolve and drain Dampness 25

mp-Heat 4. How do Semen Plantaginis, Caulis


■ HERBA LYSIMACHIAE, SPORA
Clematidis Armandii, Herba Lysimachiae,
LYGODII AND FOLIUM PYRROSIAE
Rhizoma Dioscoreae Septemlobae and
• Che Qian Zi, Hua Shi and Chuan Mu Tong Herba Artemisiae Capillaris differ in their
leat and actions and indications?
-feat and Similarities
:ated for — All clear heat, drain Dampness, dissolve
es due to stones and relieve urinary disturbance and
■oductive are thus indicated for urinary disturbance
tends to due to heat or complicated by stones. They
tion and are commonly used in the treatment of
before stones in the urinary tract.

. is thus Differences
rleat and — Herba Lysimachiae and Spora Lygodii are
d before major herbs for stones. Herba Lysimachiae
iking the and Caulis Lygodii (Hai Jin Sha Teng) also
clear heat, drain Dampness and relieve
rs Heart jaundice and are thus indicated for Damp-
channels Heat jaundice.
It is thus — Folium Pyrrosiae also clears Lung Heat,
leers due stops cough and wheeze, cools Blood
ebrile Bi and stops bleeding. It is thus indicated for
ilk secre- cough and wheeze due to Lung Heat, and
for Blood Heat giving rise to haemop
■is (Guan tysis, epistaxis, haematuria and uterine
advisable bleeding.

RHI2OMA DIOSCOREAE
SEPTEMLOBAE AND HERBA
ARTEMISIAE CAPILLARIS

Bi Xie and Yin Chen Hao

Herba Artemisiae Capillaris clears heat,


drains Dampness and relieves jaundice. It is
an important herb for jaundice.
Rhizoma Dioscoreae Septemlobae drains
Turbid Damp and is a major herb for turbid
urine. It also eliminates Wind-Damp and is
thus indicated for Wind-Damp Bi
syndromes.

Questions
1. Compare and contrast the actions and
indications of Rhizoma Atractylodis and
Cortex Magnoliae Officinalis.
2. How do Herba Agastachis, Herba Eupatorii
and Fructus Amomi differ in their actions?
amp. 3. How do Poria, Polyporus Umbellatus,
Rhizoma Alismatis and Semen Coicis differ
in their actions?
26

■7 Herbs that warm the Interior


and regulate Qi

A. Herbs that warm the recapturing Collapsed Yang. Radix Aconiti,


however, is toxic and should be adminis
interior
tered only with caution.
Cortex Cinnamomi and Ramulus
■ RADIX ACONITI PRAEPARATA, Cinnamomi come from the same plant. Both
RADIX ACONITI, CORTEX warm the Interior and disperse Cold, warm
CINNAMOMI AND RAMULUS the channels and relieve pain. Cortex
CINNAMOMI Cinnamomi enters the Interior and the
Lower Burner and is thus more effective in
• Fu Zi, Wu Tou, Rou Gui and Gui Zhi
warming Kidney Yang, while Ramulus
Cinnamomi goes to the Exterior and the four
Similarities
limbs, and is more effective in Releasing the
— All warm the Interior, disperse Cold and
Exterior and invigorating Yang (Fig. 7.1).
\ relieve pain. They are indicated for abdom
inal pain due to Interior Cold and for Cold Bi
syndromes.

DIFFERENTIATION OF CORTEX CINNAMOMI


\ < AND RAMULUS CINNAMOMI
Differences
— Radix Aconiti Praeparata and Cortex
Cinnamomi both warm Kidney Yang and are
thus indicated for patterns of Deficient RAMULUS CINNAMOMI
Kidney Yang. They also warm Heart Yang goes to the Exlenor.
to Release the Exterior
and Spleen Yang and are thus indicated for and warm the channels.
pain and a cold sensation in the cardiac and
abdominal regions.
— Radix Aconiti Praeparata recaptures
Collapsed Yang and is a main herb for
Collapse of Yang. It warms the Yang of the
entire body and thus treats various patterns
of Yang Deficiency. CORTEX CINNAMOMI
goes lo the Interior,
— Cortex Cinnamomi enters the Blood. It treats to warm Kidney Yang
abdominal pain, dysmenorrhoea and irreg
ular menstruation due to a Cold and
Deficient Lower Burner.
— Radix Aconiti Praeparata and Radix Aconiti
come from the same plant. Both warm the
Interior, disperse Cold and relieve pain, but
Radix Aconiti is more effective in dispersing
Cold, relieving pain and eliminating Wind-
Damp, while Radix Aconiti Praeparata is Fig. 7.1 Differentiation of Cortex Cinnamomi and
more effective in warming Yang and Ramulus Cinnamomi.
Herbs that warm the Interior and regulate Qi 27

Differences
■ RHIZOMA ZINGIBERIS, BAKED
— Fructus Evodiae and Fructus Foeniculi both
GINGER, RHIZOMA ZINGIBERIS
warm the Liver and disperse Cold and are
RECENS AND RHIZOMA ALPINIAE
indicated for periumbilical colic due to
OFFICINALIS
invasion by Cold. Fructus Evodiae also
• Can Jiang, Pao Jiang, Sheng Jiang and Gao warms the Middle Burner and conducts
Liang Jiang Rebellious Qi downward and is thus
indicated for epigastric pain and vomiting
Similarities due to Cold in the stomach, and for epigas
— AH warm the Middle Burner and disperse tric pain and acid regurgitation due to
Cold and are thus indicated for Cold disharmony between the Liver and Stomach.
patterns of the Middle Burner. It is also used to treat Jue Yin headache with
< Aconiti,
vomiting of Phlegm due to upward perver
adminis-
Differences sion of Liver Qi with Turbid Phlegm. Fructus
— Rhizoma Zingiberis is a major herb to warm Foeniculi is indicated only for periumbilical
Ramulus
Spleen Yang. It also recaptures Collapsed colic due to invasion of Cold.
lant. Both
Yang, warms the Lungs and resolves — Flos Caryophylli and Pericarpium
ild, warm
retained Fluid. Zanthoxyli both warm the Middle Burner,
i. Cortex
— Baked ginger is more effective in warming relieve pain and stop vomiting and are thus
and the
the channels and stopping bleeding. It is indicated for epigastric pain and vomiting
Ifective in
indicated for haemorrhagic patterns due to due to Cold in the Stomach. Flos Caryophylli
Ramulus
failure of the Spleen to hold the Blood within is more effective in conducting Rebellious Qi
d the four
the vessels, with an underlying pattern of downward, and is an important herb for
casing the
Spleen Yang Deficiency. vomiting and hiccup. It also warms Kidney
5.7.1).
— Rhizoma Zingiberis Recens is more effective Yang and is indicated for impotence due to
in warming the Middle Burner, stopping Kidney Yang Deficiency (Fig. 7.2).
vomiting and Releasing the Exterior. Pericarpium Zanthoxyli also kills parasites
— Rhizoma Alpiniae Officinalis is more effec and is thus indicated for abdominal pain due
tive in warming the stomach and relieving to ascariasis.
pain and is thus indicated for epigastric pain
due to Cold in the stomach.
— Rhizoma Zingiberis and Radix Aconiti
Praeparata both recapture Collapsed Yang B. Herbs that regulate Qi
and warm Spleen Yang, but Radix Aconiti
Praeparata is more effective in warming
■ PERICARPIUM CITRI RETICULATAE
Kidney Yang and recapturing Collapsed
AND PERICARPIUM CITRI
Yang while Rhizoma Zingiberis is more
RETICULATAE VIRIDE
effective in wanning Spleen Yang. Rhizoma
Zingiberis has the additional actions of • Chen Pi and Qing Pi
warming the Lungs and resolving retained
Fluid, warming the channels and stopping Similarities
bleeding. — Both herbs come from the same plant. The
first is ripe tangerine peel while the second is
the unripe fruit or its green peel. Both
regulate Qi and resolve Phlegm.
■ FRUCTUS EVODIAE, FRUCTUS
FOENICULI, FLOS CARYOPHYLLI AND
Differences
PERICARPIUM ZANTHOXYLI — Pericarpium Citri Reticulatae has a mild
• Wu Zhu Yu, Xiao Hui Xiang, Ding Xiang action in dispersing stagnation of Qi in the
and Hua Jiao Spleen and Stomach but it also resolves
ami and Dampness and Phlegm. It is primarily used
Similarities for patterns of Damp Phlegm.
— All warm the Interior, disperse Cold and — Pericarpium Citri Reticulatae Viride has a
relieve pain and are indicated for pain in the stronger action in promoting the smooth
epigastrium and abdomen due to Cold. circulation of Liver Qi and dispersing
28 Part 1: Actions and indications of some common Chinese herbs

Exterior and channels | Ramulus Cinnamomi


Baked ginger
Rhizoma Zingiberis

Upper burner Radix Aconiti Praeparata


Cortex Cinnamomi
Rhizoma Zingiberis

Middle burner (Spleen/Stomach) Radix Aconiti Praeparata


Cortex Cinnamomi
Rhizoma Zingiberis
Rhizoma Zingiberis Recens
Baked ginger
Rhizoma Alpiniae Officinalis
Flos Caryophylli
Pericarpium Zanthoxyli
(Liver) Fructus Evodiae
Fructus Foeniculi

Lower Burner (Kidney Yang) Radix Aconiti Praeparata


Cortex Cinnamomi
Flos Caryophylli

Note that Radix Aconiti Praeparata and Cortex Cinnamomi go to all three Burners.

Fig. 7.2 Differentiation of warming herbs by area of action.

stagnation, and it is thus indicated for — Fructus Aurantii Immaturus, Fructus


abdominal masses and Food Retention Aurantii and Pericarpium Citri Reticulatae
patterns. all relieve stagnation in the Spleen and
Stomach, but Fructus Aurantii Immaturus
and Fructus Aurantii are more effective in
■ FRUCTUS AURANTIIIMMATURUS regulating Qi than Pericarpium Citri
AND FRUCTUS AURANTII Reticulatae. Pericarpium Citri Reticulatae is
• Zhi Shi and Zhi Qiao warm in nature and acts primarily to dry
Dampness and resolve Phlegm while
Similarities Fructus Aurantii and Fructus Aurantii

— Both circulate Qi, resolve Phlegm and relieve Immaturus are Cold in nature and disperse
Food Retention.
stagnation and are thus indicated for stagna
tion of Qi and Phlegm and Retention of
Food. They activate the smooth muscles of
the stomach, intestines and uterus and are ■ FRUCTUS CITRI SARCODACTYLIS and
FRUCTUS CITRI
indicated for prolapse of the internal organs.
They are administered by injection in the • Fo Shou and Xiang Yuan
treatment of shock.

Similarities
Differences — Both disperse stagnation of Qi in the Liver
— Fructus Aurantii Immaturus is more effec and Stomach and resolve Phlegm and are
tive in relieving Qi stagnation in the Middle indicated for epigastric pain due to dishar
and Lower Burners and is thus indicated for mony between the Liver and Stomach.
distension and pain in the epigastrium and
abdomen. Differences
— Fructus Aurantii is more effective in — Fructus Citri Sarcodactylis acts gently to
relieving Qi stagnation in the Middle and harmonize the Stomach and stop vomiting.
Upper Burners and is thus indicated for — Fructus Citri has a stronger action and is
distension and fullness in the epigastrium similar to Pericarpium Citri Reticulatae
and chest. Viride in promoting the smooth circulation
Herbs that warm the Interior and regulate Qi 29

irata
Pencarpwm Olri ■ Pencarpium Ciln
Rebculatae Retculatae Vinde
Fructus AuranlH Fruclus Citn
Immaturus
arata Rhizoma Cypen
Fructus AuranUi
Fructus Meliae
Fructus Crtri Toosendan
Sarcodactylis
Recens FlosMume
Radix AucWandiae
Flos Rosae
Lignum Aquilanae Rugosae
ifficinalis
Resinalum
Rhizoma Ligustici
Cfiuanxong
xyli

arata

Fig. 7.3 Differentiation of herbs that regulate Qi according to areas of action.

Fructus
teticulatae of Liver Qi and dispersing stagnant Qi Spleen and Stomach. It is used raw to
jleen and (Fig. 7.3). regulate Qi and roasted to invigorate the
tnmaturus Spleen and stop diarrhoea.
ffective in — Radix Linderae warms the Lower Burner
urn Citri ■ RHIZOMA CYPERI, RADIX and is indicated for pain and a cold sensa
iculatae is AUCKLANDIAE, RADIX LINDERAE tion in the lower abdomen.
ily to dry AND LIGNUM AQUILARIAE — Lignum Aquilariae Resinatum warms the
;m while RESINATUM Interior, disperses Cold, regulates Qi and
Aurantii conducts Rebellious Qi downward. It
• Xiang Fu, Mu Xiang, Wu Yao and Chen
d disperse stops vomiting by warming the Stomach
Xiang
and conducting Rebellious Stomach Qi
downward, and treats asthma by conduc
Similarities
ting Rebellious Lung Qi downward and
— All are pungent and warm in nature, and
tfLIS and wanning the Kidneys so they receive
regulate Qi and relieve pain. They are
the Qi. It is added to a decoction at the
indicated for pain in the epigastrium
end of cooking or is administered as a
and abdomen due to stagnation of Qi and
powder.
Cold.

i the Liver Differences


■ FRUCTUS MELIAE TOOSENDAN and
ti and are — Rhizoma Cyperi promotes the smooth circu
RHIZOMA CORYDALIS
to dishar- lation of Liver Qi and regulates menstrua
lach. tion and is an important herb for patterns of • Chuan Lian Zi and Yan Hu Suo
Liver Qi Stagnation, irregular menstruation
and dysmenorrhoea. Similarities
gently to — Radix Aucklandiae regulates Spleen and — Both regulate Qi and relieve pain and are
vomiting, Stomach Qi, invigorates the Spleen and indicated for epigastric and abdominal pain
ion and is stops diarrhoea, and is thus indicated for due to stagnation of Qi in the Liver and
Reticulatae epigastric and abdominal pain, diarrhoea Stomach. They are often used in combina
circulation and dysentery due to stagnation of Qi in the tion.
Purl I: Actions ami indications of some common Chinese herbs

Differences
indicated for irregular menstruation and
— Fructus Meliae Toosendan clears Liver Heat dysmenorrhoea due to Qi and Blood
and promotes the smooth circulation of Stagnation resulting from Stagnation of
Liver Qi and is indicated for pain and a Liver Qi.
sensation of heat. It also expels parasites.
— Rhizoma Corydalis is more effective in
relieving pain as it also invigorates the circu
lation of Blood. It is indicated for pain due to Questions
Qi and Blood Stagnation.
1. How do Radix Aconiti Praeparata and Radix
Aconiti differ in their actions and indica
tions?
■ BULBUSALLIIMACROSTEMIAND
FRUCTUS TRICHOSANTHIS 2. How do Radix Aconiti Praeparata, Rhizoma
Zingiberis and Cortex Cinnamomi differ in
• Xie Bai and Gua Lou
their actions and indications?
3. How do Rhizoma Zingiberis, Rhizoma
Similarities
Zingiberis Recens and Baked ginger differ in
— Both regulate Qi, open the chest and invigo
their actions and indications?
rate Yang and are thus indicated for Chest Bi 4. How do Cortex Cinnamomi and Ramulus
syndromes due to retention of Turbid
Cinnamomi differ in their actions and
Phlegm and hindrance of Heart Yang. indications?
5. Compare and contrast the actions of Fructus
Differences
Evodiae, Rhizoma Alpiniae Officinalis and
— Bulbus Allii Macrostemi is pungent and Flos Caryophylli.
warm in nature and is more effective in
6. Compare and contrast the actions and
invigorating Yang than Fructus
indications of Pericarpium Citri Reticulatae
Trichosanthis. It also circulates Qi and and Pericarpium Citri Reticulatae Viride.
disperses stagnation and is indicated for
7. Compare and contrast the actions and
dysentery with symptoms of abdominal
indications of Fructus Aurantii Immaturus
pain and tenesmus.
and Fructus Aurantii.
'C — Fructus Trichosanthis is more effective in Radix Aucklandiae, Rhizoma Cyperi, Radix
resolving Phlegm than Bulbus Allii
Linderae, Lignum Aquilariae Resinatum,
Macrostemi. It also moistens the lungs and
Fructus Meliae Toosendan and Rhizoma
stops cough and moistens the intestines and
Corydalis all regulate Qi and relieve pain.
relieves constipation.
How do they differ?

■ FLOS MUME and FLOS ROSAE


RUGOSAE

• Lu E Mei and Mei Gui Hua

Similarities
— Both promote the smooth circulation of
Liver Qi and are indicated for stuffiness of
the chest, hypochondriac pain and mental
depression due to Liver Qi Stagnation. They
regulate Qi without injuring Qi and Yin but
do not have a strong action.

Differences
— Flos Mume is more effective in relieving
depression and is thus indicated for depres
sive patterns.
— Flos Rosae Rugosae activates Blood circula
tion and regulates menstruation and is thus
31

Herbs that regulate Blood 8


ion and
1 Blood
ation of

nd Radix
i indica-

A. Herbs that stop bleeding ■ FOLIUM CALLICARPAE, CACUMEN


Rhizoma BIOTAE AND RADIX BOEHMERIAE
differ in
■ HERBA SEU RADIX CIRSIIJAPONICI • Zi Zhu, Ce Bai Ye and Zhu Me Gen
Rhizoma AND HERBA CEPHALANOPLORIS
Similarities
r differ in
• Da Ji and Xiao Ji — All cool Blood and stop bleeding and are
indicated for various haemorrhagic patterns
Ramulus
Similarities
due to Heat.
ions and — Both cool Blood, stop bleeding and clear Fire
Poison. They are thus indicated for bleeding
)f Fructus Differences
due to Blood Heat and for ulcers and boils
— Folium Callicarpae is more effective in
nalis and due to Fire Poison. They also lower blood stopping bleeding in various haemorrhagic
pressure and are thus indicated for hyper
ions and patterns. It also clears Heat and Fire Poison
tension. and is thus indicated for carbuncles, boils,
eticulatae
/iride. ulcers and burns.
Differences
— Cacumen Biotae is more effective in
ions and — Herba seu Radix Cirsii Japonici is more
stopping bleeding in the digestive and respi
nmaturus
effective in treating haemoptysis and
ratory tracts. It also resolves Phlegm
haematemesis. It has a strong action in
and stops cough. It can be combined with
eri, Radix
clearing Fire Poison
esinatum,
herbs that warm the channels and stop
— Herba Cephalanoploris is more effective in
Rhizoma
bleeding to treat bleeding due to deficiency
treating haematuria.
ieve pain. and cold.
— Radix Boehmeriae stops bleeding and
prevents miscarriage and is thus indicated
■ RADIX SANGUISORBAE AND FLOS for uterine bleeding and threatened
SOPHORAE abortion.

• Di Yu and Huai Hua

■ RHIZOMA BLETILLAE, HERBA


Similarities AGRIMONIAE AND NODUS
— Both cool Blood and stop bleeding and are NELUMBINIS RHIZOMATIS
indicated for bloody stool or bleeding due to
haemorrhoids. • Bai ]i, Xian He Cao and Ou fie

Differences Similarities
— Radix Sanguisorbae cools Blood and stops — All stop bleeding by astringing and are
dysentery, and clears Fire Poison and acts on indicated for various haemorrhagic patterns.
the skin. It is thus indicated for bloody
dysentery, carbuncles, boils, ulcers and Differences

burns.
— Rhizoma Bletillae effectively stops bleeding
— Flos Sophorae is more effective in stopping in various haemorrhagic patterns. It also
bleeding due to haemorrhoids. It also clears relieves swelling and promotes healing
Liver Fire and is indicated for headache and and is thus indicated for haemoptysis due
redness of the eyes. to cavernous pulmonary tuberculosis and
32 Part 1: Actions a?id indications of some common Chinese herbs

for chronic festering abscesses, ulcers and Blood and pain due to trauma. It is also
boils. indicated for various patterns of Blood
— Herba Agrimoniae is indicated for Stagnation in internal medicine and gynae
pulmonary tuberculosis with cough and for cology.
Food Retention with diarrhoea, Blood — Radix Rubiae cools and moves Blood, stops
Deficiency due to overwork and stress, and bleeding and regulates menstruation. It is
cancer. thus indicated for haemorrhagic patterns
— Nodus Nelumbinis Rhizomatis is used in its due to Blood Heat complicated with Stasis,
raw form to cool Blood, dispel Blood Stasis as well as amenorrhoea and dysmenorrhoea
and stop bleeding. It is charred to stop due to Blood Stasis, contusions and sprains
bleeding by astringing. and Wind-Damp Bi syndromes.
— Pollen Typhae resolves Blood Stasis and
promotes diuresis and is thus indicated for
■ PETIOLUS TRACHYCARPI urinary disorders with haematuria. In its
CARBONISATUS AND CRINIS raw form it is more effective in resolving
CARBONISATUS Blood Stasis and relieving pain, while its
stir-baked form is more effective in stopping
• Zong Lu Tan and Xue Yu Tan
bleeding.

Similarities
—- Both stop bleeding by astringing and are
indicated for haemorrhagic patterns. ■ FOLIUM ARTEMISIAE ARGYI, BAKED
YELLOW EARTH AND BAKED
Differences GINGER
— Petiolus Trachycarpi Carbonisatus is
• Ai Ye, Zao Xin Tu and Pao Jiang
strongly astringent and can thus aggravate
Blood Stasis. It is often used in the treatment
Similarities
of uterine bleeding.
— All warm the channels and stop bleeding
— Crinis Carbonisatus not only astringes to
and are thus indicated for Deficient and
stop bleeding but also treats Blood Stasis
Cold haemorrhagic patterns.
and is thus more widely used. It is often
used in the treatment of uterine bleeding,
Differences
haemoptysis, haematemesis, epistaxis and
— Folium Artemisiae Argyi warms the uterus
bloody stool.
and regulates menstruation and is thus
indicated for uterine bleeding and dysmen
orrhoea due to Deficiency and Cold. It
■ RADIX NOTOGINSENG, RADIX
treats infertility due to Cold in the Uterus
RUBIAE AND POLLEN TYPHAE
and prevents miscarriage. It also soothes
• San Qi, Qian Cao and Pu Huang asthma and is thus used in the treatment of
asthma due to Cold. It is also used for
Similarities moxibustion.
— All treat Blood Stasis and stop bleeding — Baked yellow earth warms the Middle
and are thus used for haemorrhagic Burner and stops bleeding and diarrhoea. It
patterns. They are most effective in the treat is thus indicated for bleeding due to a failure
ment of bleeding complicated with Blood of Spleen Yang to control the Blood and for
Stasis. vomiting and diarrhoea due to a cold and
Deficient Spleen and Stomach. Halloysitum
Differences Rubrum (Chi Shi Zhi) may be used as a
— Radix Notoginseng not only effectively substitute.
stops bleeding but also resolves Blood Stasis — Baked ginger warms the channels and stops
and stops pain. It thus stops bleeding bleeding and is a major herb in the treatment
without causing Stasis and treats Stasis of bleeding due to a failure of Spleen Yang to
without injuring Upright Qi. In addition control the Blood (Fig. 8.1). It also treats
to treating haemorrhagic patterns it is a abdominal pain and diarrhoea due to a Cold
major herb for the treatment of Stagnant and Deficient Middle Burner.
Herbs that regulate Blood 33

t is also Cause of bleeding What to do


>f Blood
Heat
i gynae- Cool Blood:
Blood becomes reckless and escapes from vessels
Herba seu Radix Cirsii Japonici
)d, stops Herba Cephalanoploris
Radix Sanguisorbae
on. It is
Flos Sophorae
patterns
Flos Callicarpae
:h Stasis, Cacumen Biotae
lorrhoea Radix Boehmerae

1 sprains
Stasis
Blood cannot flow within vessels so flows outside them Activate circulation of Blood within the vessels:
asis and Crinus Carbonisatus
:ated for Radix Notoginseng

a. In its Radix Rubiae


Pollen Typhae
esolving
while its
Deficiency
stopping The Spleen fails to hold the Blood within the vessels Strengthen the Spleen's function of holding the
Blood; warm the channels:
Baked yellow earth
Halloysitum Rubrum
Baked ginger

AKED
Any cause
Astringents will stop bleeding, but treat only
the Biao:
Rhizoma Bletillae
Herba Agrimoniae
Nodus Nelumbinis Rhizomatis
Petiolus Trachycarpi Carbonisatus
Crinus Carbonisatus

bleeding
ient and Fig. 8.1 Treatment of bleeding.

for headache. Because it relieves stagnation


B. Herbs that invigorate in the Middle, it is indicated for costal and
le uterus Blood circulation and resolve hypochondriac pain and abdominal pain
is thus
dysmen-
Blood Stasis due to Stagnation of Qi and Blood. Because it
removes obstruction from the channels and
Cold. It
collaterals of the four limbs, it treats Wind-
e Uterus ■ RHIZOMA LIGUSTICICHUANXIONG
Damp Bi syndromes.
soothes AND RADIX SALVIAE MILTIORRHIZAE
— Radix Salviae Miltiorrhizae cools Blood and
tment of
• Chuan Xiong and Dan Shen calms the Mind and is thus indicated for
used for
restlessness and coma due to Heat at the
Similarities Nutritive (Ying) level, and restlessness and
Middle
— Both are important herbs to invigorate Blood insomnia following a long-term illness. It
Thoea. It
circulation and resolve Blood Stasis. They also treats carbuncles, boils and ulcers.
a failure
relieve pain and regulate menstruation and
1 and for
are thus indicated for various patterns of
cold and
Blood Stagnation including amenorrhoea,
loysitum ■ RADIX CURCUMAE, RHIZOMA
dysmenorrhoea, palpable masses and CURCUMAE LONGAE, RHIZOMA
;ed as a
cardiac and abdominal pain due to SPARGANII AND RHIZOMA
Stagnation of Blood. ZEDOARIAE
Lnd stops
reatment
Differences
• Yu Jin, Jiang Huang, San Leng and E Zhu
i Yang to
— Rhizoma Ligustici Chuanxiong also
so treats
regulates Qi and eliminates Wind. It acts on Similarities
to a Cold — All primarily invigorate Blood circulation
the head and eyes and is an important herb
34 Part 1: Actions and indication* of some common Chinese herbs

and secondarily regulate Qi and are thus


■ RADIX ACHYRANTHIS BIDENTATAE,
indicated for patterns of Stagnant Blood and
RHIZOMA POLYGONI CUSPIDATI AND
Qi.
HERBA LEONURI

• Niu Xi, Hu Zhang and Yi Mu Cao


Differences
— Radix Curcumae soothes the Liver and
Similarities
Gall Bladder, cools Blood, relieves
— All invigorate Blood circulation, resolve
Stagnation and opens the orifices. It is
Blood Stasis and eliminate Dampness. They
thus indicated for Stagnation of Liver Qi,
are indicated for patterns of Blood
Damp-Heat in the Liver and Gall Bladder,
Stagnation, oedema due to Dampness in the
Phlegm and Stagnant Blood Misting the
Lower Burner and urinary disorders with
Heart and rising of Stagnant Qi and Fire
turbid urine.
with symptoms of haemoptysis and
epistaxis.
Differences
— Rhizoma Curcumae Longae removes
— Radix Achyranthis Bidentatae tonifies the
obstruction from the channels and
Liver and Kidneys, strengthens tendons and
relieves pain and is thus indicated
bones and conducts Fire and Blood
for pain in the chest, hypochondrium
downward. It is indicated for pain in the
and limbs and for Wind-Damp Bi
lower back and knees, headache, dizziness
syndromes.
and vertigo due to rising of Fire, and
— Rhizoma Sparganii and Rhizoma
haemoptysis and epistaxis.
Zedoariae both break Stagnant Qi and
— Rhizoma Polygoni Cuspidati eliminates
Blood and are thus indicated for palpable
Dampness, relieves jaundice and clears
abdominal masses. Rhizoma Sparganii is
Heat and Fire Poison. It is indicated for
more effective in breaking Stagnant
jaundice, cough due to Lung Heat, burns,
Blood. Rhizoma Zedoariae is more effective
urinary and biliary stones, abscess and
in moving Stagnant Qi and also treats
swelling due to Fire Poison, and Wind-
cancer.
Damp Bi syndromes.
— Herba Leonuri invigorates Blood circulation
and regulates menstruation and is thus
indicated for dysmenorrhoea, irregular
menstruation and postpartum abdominal
■ RESINA OLIBANI AND RESINA pain due to Blood Stagnation. It is
MYRRHAE commonly used in gynaecology.

• Ru Xiang and Mo Yao

Similarities ■ SEMEN PERSICAE, FLOS CARTHAMI


— Both invigorate Blood and Qi circulation, AND CAULIS SPATHOLOBI
relieve pain and swelling and promote
• Tao Ren, Hong Hua and }i Xue Teng
healing. They are thus indicated for pain
due to Stagnation of Qi and Blood, carbun
Similarities
cles, boils and ulcers, and contusions and
— All invigorate Blood circulation and resolve
sprains. They are important herbs in the
Blood Stasis and are thus indicated for
treatment of skin diseases and trauma and
patterns of Stagnant Blood.
are often used in combination. They should
not be prescribed in large doses, especially in
Differences
cases of weakness of the Spleen and
— Semen Persicae and Flos Carthami are
Stomach.
commonly used to invigorate Blood circula
tion and resolve Stasis. Semen Persicae also
Differences moistens the intestines to relieve constipa
— Resina Olibani is more effective in moving tion and resolves abscess, and is thus
Qi while Resina Myrrhae is more effective in indicated for both internal and external
resolving Blood Stasis. abscess and for constipation due to dry
Herbs that regulate Blood 35

intestines. Flos Carthami invigorates Blood Eupolyphaga seu Steleophaga promotes the
iTAE,
circulation and regulates menstruation, and healing of fractures and torn tendons and is
FIAND
is thus often used in gynaecology. thus an important herb in traumatology.
— Caulis Spatholobi moves both Qi and Blood, Hirudo strongly dispels Blood Stasis. It is
nourishes Blood and relaxes the mudcles and reported to be useful in the treatment of
tendons, and is thus indicated for Stagnation intracranial haematoma and thrombocytosis
and Deficiency of Blood, Wind-Damp Bi (Fig. 8.2).
resolve syndromes and numbness.
ss. They
Blood
ss in the ■ FAECES TROGOPTERORUM, SQUAMA Questions
?rs with MANITIS, EUPOLYPHAGA SEU 1. In what ways do Herba Cephalanoploris,
STELEOPHAGA AND HIRUDO Rhizoma Bletillae, Radix Notoginseng and
• Wu Ling Zhi, Chuan Shan Jia, Di Bie Chong Folium Artemisiae stop bleeding? What are
and Shui Zhi their other actions?
ifies the
2. Apart from stopping bleeding, what are the
Ions and
Similarities actions and indications of Radix Boehme-
Blood
— All act strongly to invigorate Blood circula riae, Cacumen Biotae and Herba Agrimo-
n in the
tion and resolve Stasis and are thus niae?
lizziness
indicated for severe Blood Stasis and 3. Compare and contrast the actions and
ire, and
palpable abdominal masses. indications of Rhizoma Ligustici
Chuanxiong, Radix Salviae Miltiorrhizae,
iminates
Differences Semen Persicae, Flos Carthami and Radix
i clears
— Faeces Trogopterorum is more effective in Achyranthis Bidentatae.
ated for
resolving Stasis and relieving pain. It also 4. How do Resina Olibani and Resina Myrrhae
t, burns,
stops bleeding. It is often combined with differ in their actions?
ess and
Pollen Typhae. 5. How do Radix Curcumae, Rhizoma
i Wind-
— Squama Manitis is effective in promoting the Sparganii and Rhizoma Zedoariae differ in
secretion of milk, draining pus and relieving their actions?
rculation
swelling.
is thus
irregular
idominal
Rhizoma Ligustei
l. It is Chuanxiong

Radix Curcumae

Rhizoma Curcumae ■ Rhizoma Liguslo


[AMI Chuanwong
Longae
Radix Curcumae
Rhizoma Ligustd - Rhizoma Curcumae
Chuanxiong
■ Longae
Radix Satoae
Mifiiorrhizae

Rhizoma Sparganii
i resolve
Rhizoma Zedoanae
ated for
Radix flchyranthis Bidenlala

Rhizoma Pdygoni Cuspdaii

Herba Leonun

Ftos Carthami
ami are Semen Persicae
1 circula- Faeces Trogopterorum

iicae also Pollen Typhae


constipa-
is thus
external
= to dry Fig. 8.2 Differentiation of herbs that invigorate Blood and resoive Stasis according to area of action.
36

9 Herbs that calm the Mind and


the Liver and extinguish Wind

A. Herbs that calm the amenorrhoea and for painful and difficult

mind urination.

■ CINNABARIS,MAGNETITUM, OS
■ SEMEN ZIZIPHI SPINOSAE AND
DRACONIS AND SUCCINUM
SEMEN BIOTAE
• Zhu Sha, Ci Shi, Long Gu and Hu Po
• Suan Zao Ren and Bai Zi Ren
Similarities
— All soothe the Heart and calm the Mind and Similarities
are thus indicated for Excess patterns giving — Both nourish the Heart and calm the Mind
rise to palpitations, insomnia and manic and and are thus indicated for Deficiency

depressive disorders. patterns giving rise to palpitations and


insomnia.
Differences
— Cinnabaris strongly calms the Mind. It also Differences
clears Heart and Liver Fire and Fire Poison. — Semen Ziziphi Spinosae also nourishes Yin
It is thus indicated for restlessness due to and astringes sweating and is thus indicated
Heart and Liver Fire and for carbuncles, for night sweats due to Yin Deficiency.
boils, ulcers and swelling and pain in the Semen Biotae also moistens the intestines to
mouth and throat due to Fire Poison. It is relieve constipation and is thus indicated for
used to coat and dye other herbs that dry constipation due to Yin and Blood
calm the Mind before they are decocted and Deficiency.
to coat pills to enhance their effect in
calming the Mind. It also prevents putrefac
tion.
■ RADIX POLYGALAE AND CORTEX
— Cinnabaris is, however, toxic and should be
ALBIZIAE
administered only in small doses and for a
short time. • Yuan Zhi and He Huan Pi
— Magnetitum calms the Liver and
suppresses hyperactive Yang, and assists Similarities
the reception of Qi and soothes asthma. It is — Both calm the Mind and resolve Phlegm and
thus indicated for headache, dizziness, are indicated for insomnia due to restless
vertigo and tinnitus due to hyperactive ness.

Liver Yang and for asthma due to Kidney


Deficiency. Differences
— Os Draconis calms the Liver and suppresses — Radix Polygalae is more effective in
hyperactive Yang, and astringes discharges. resolving Phlegm and is thus indicated for
It is thus indicated for Liver Yang Rising and cough with profuse sputum and for uncon
for spontaneous sweating, night sweating, sciousness due to Phlegm Misting the Heart.
spermatorrhoea and leucorrhoea. Succinum — Cortex Albiziae resolves Stagnation, invigo
is most effective in calming the Mind but rates Blood circulation and resolves abscess
also resolves Blood Stasis and relieves and is indicated for mental depression and
urinary disorders. It is thus indicated for lung abscess.
Herbs that calm the Mind and the Liver 37

B. Herbs that calm the Liver ■ CORNU ANTELOPIS, RAMULUS

d and extinguish Wind UNCARIAE CUM UNCIS AND


RHIZOMA GASTRODIAE

d
■ CONCHA HALIOTIDIS, CONCHA1 • Ling Yang Jiao, Gou Teng and Tian Ma

OSTREAE, MARGARITA, CONCHA


MARGARITIFERA USTA AND Similarities

HAEMATITUM
— All calm the Liver and extinguish Wind
and are indicated for headache, dizziness
• Shi Jue Ming, Mu Li, Zhen Zhu, Zhen Zhu and vertigo due to Liver Yang Rising and
Mu and Dai Zhe Shi for dizziness and convulsion due to Liver
Wind.
difficult Similarities
— All calm the Liver and suppress hyperactive Differences
Yang and are thus indicated for headache, — Cornu Antelopis strongly clears Liver Fire,
dizziness and vertigo due to Liver Yang suppresses hyperactive Liver Yang and
Rising. extinguishes Liver Wind. It also clears Liver
Heat and improves vision, and clears Heat
Differences and Fire Poison.
— Concha Haliotidis is more effective in — Ramulus Uncariae cum Uncis clears Liver
calming the Liver and suppressing hyperac Heat and extinguishes Liver Wind and is
tive Yang. It also clears Liver Heat and thus indicated for stirring of Liver Wind due
tie Mind
improves vision. It is thus indicated for to Heat or excessive Yang. It is added at the
jficiency
redness, swelling and pain of the eyes due to end of a decoction.
>ns and — Rhizoma Gastrodiae extinguishes Wind
flaring of Liver Fire and for blurring of
vision due to Deficiency of Liver Yin. and removes obstruction from the
— Concha Ostreae soothes the Heart, calms the channels and is thus indicated for Wind-
Mind, astringes discharges and softens hard Damp Bi syndromes, numbness and
shes Yin
masses. It is thus indicated for restlessness, tetanus.
ndicated
spontaneous sweating, night sweats,
:ficiency.
spermatorrhoea, leucorrhoea and tubercu
stines to
losis of lymph nodes.
rated for
— Margarita and Concha Margaritifera Usta
i Blood ■ FRUCTUS TRIBULI AND FOLIUM
both soothe the Heart, calm the Mind and
APOCYNIVENETI
improve vision. Margarita also stops convul
sion and astringes ulcers and is thus • Ci Ji Li and Luo Bu Ma
indicated for infantile convulsions, epilepsy
EX and chronic festering ulcers and boils. Similarities
Concha Margaritifera Usta is more effective — Both suppress hyperactive Liver Yang and
in soothing the Heart, calming the Mind, extinguish Liver Wind and are thus
calming the Liver and suppressing hyperac indicated for headache, dizziness and
tive Yang. vertigo due to Liver Yang Rising and
— Haematitum conducts Rebellious Qi upward stirring of Liver Wind.
egm and
downward, stops vomiting, relieves asthma,
restless-
soothes the Heart and calms the Mind. It also Differences
stops bleeding by sending Qi and Fire — Fructus Tribuli expels External Wind,
downward. Os Draconis and Concha improves vision and soothes the Liver. It is
Ostreae both calm the Liver and suppress thus indicated for eye disorders due to
:tive in
hyperactive Yang, soothe the Heart and calm Wind-Heat and hypochondriac pain due to
:ated for
the Mind. Os Draconis is more effective in Stagnation of Liver Qi.
r uncon-
soothing the Heart and calming the Mind, — Folium Apocyni Veneti promotes diuresis,
le Heart.
while Concha Ostreae is more effective in relieves swelling and stops cough and
i, invigo-
calming the Liver and suppressing hyperac wheeze. It is indicated for hypertension,
5 abscess
tive Yang. Concha Ostreae also astringes bronchitis, oedema and heart disease with
sion and
discharges and softens hard masses. palpitations.
38 Part 1: Actions and indications of some common Chinese herbs

■ scorpio, scolopen6ra, bombyx Herbs that Suppress Liver Yang and/or


batryticatus and lumbricus Extinguish Liver Wind

• Quan Xie, Wu Gong, Jiang Can and Cinnabaris


DiLong Magnetitum
Os Draconis
Succinum
Similarities
Concha Haliotidis
— All extinguish Wind and stop convulsion Concha Ostreae
and are thus indicated for convulsions due Concha Margaritifera Usta
to Liver Wind, Wind-Stroke due to Heat Haematitum
Cornu Antelopis
stirring Liver Wind, infantile convulsions,
Ramulus Uncaria cum Uncis
epilepsy and tetanus. Rhizoma Gastrodiae
Fructus Tribuli
Differences Scorpio
— Scorpio and Scolopendra have a strong Scolopendra
Bombyx Batryticatus
action in extinguishing Liver Wind and
Lumbricus
stopping convulsion. They also remove
obstruction from the channels, relieve pain, Herbs that Nourish Heart Blood and Yin

clear Fire Poison and disperse masses. They


Semen Ziziphi Spinosae
are thus indicated for stubborn Wind-Damp Semen Biotae
Bi syndromes, chronic or unilateral
Herbs that Resolve Phlegm
headache, hemiplegia, tuberculosis of the
lymph nodes, carbuncles, boils, ulcers and Radix Polygalae
cancer. Scorpio is more effective in extin Cortex Albiziae
guishing Wind while Scolopendra is more Bombyx Batryticatus

effective in clearing Fire Poison. Herbs that Resolve Stagnation


— Bombyx Batryticatus eliminates Wind-Heat, Cortex Albiziae
resolves Phlegm and disperses masses. It Fructus Tribuli
Radix Polygalae
is thus indicated for Wind-Heat patterns
with symptoms of sore throat, rubella,
redness of the eyes or headache and for
subcutaneous nodules or tuberculosis of the Fig. 9.1 Herbs that calm the Mind: a comparable
l >
table of actions.
lymph nodes.
— Lumbricus clears Heat, soothes asthma,
4. Compare and contrast the actions and
removes obstruction from the channels and
indications of Rhizoma Gastrodiae and
promotes diuresis. It is thus indicated for
Ramulus Uncariae cum Uncis.
asthma with sputum due to Lung Heat,
5. Compare and contrast the actions and
Febrile Bi syndromes and dysuria and
indications of Scorpio, Scolopendra, Bombyx
oedema due to retention of Heat in the
Batryticatus and Lumbricus.
Bladder.

Questions
1. Cinnabaris, Semen Biotae and Semen
Ziziphi Spinosae all calm the Mind. In what
different ways do they do this? What other
actions do each of them have?
2. Compare and contrast the actions and
indications of Os Draconis and Concha
Ostreae.
3. Compare and contrast the actions and
indications of Magnetitum and
Haematitum.
39

Tonics 10

A. Qi Tonics Deficiency. Radix Pseudostellariae is less


effective in tonifying Qi than Radix
Codonopsis Pilosulae, but it is neutral in
■ RADIX GINSENG, RADIX PANACIS
nature and also produces Body Fluids and is
QUINQUEFOLII, RADIX CODONOPSIS
thus indicated for patterns of combined Qi
PILOSULAE, RADIX
and Yin Deficiency.
PSEUDOSTELLARIAE AND RADIX
Radix Astragali seu Hedysari is similar to
ASTRAGALI SEU HEDYSARI
Radix Codonopsis Pilosulae in tonifying Qi.
• Ren Shen, Xi Yang Shen, Dang Shen, Tai Zi It also lifts Yang, promotes diuresis, consoli
Shen and Huang Qi dates the Exterior and promotes the
drainage of pus and tissue regeneration. It is
Similarities thus indicated for Sinking of Qi and oedema
— All tonify Spleen and Lung Qi and are thus due to Spleen Deficiency, spontaneous
indicated for Spleen Qi Deficiency, Lung Qi sweating in Deficiency-type Exterior
Deficiency and other patterns of Qi patterns, frequent invasion by External
Deficiency. By tonifying Qi they also pathogenic factors due to Qi Deficiency,
produce Blood and are thus indicated for chronic carbuncles due to Qi and Blood
Blood Deficiency. Deficiency, and Fire Poison at a deep level.
Its raw form goes to the surface and thus acts
Differences to consolidate the Exterior, promote diuresis
parable
— Radix Ginseng strongly tonifies Source and the draining of pus and speed tissue
(Yuan) Qi and is used to treat Collapse of Qi. regeneration. Its treated form goes to the
It is the strongest of the Qi tonics and is an Interior and thus acts to tonify the Middle
tions and
important herb for shock. It also produces Burner, benefit Qi and lift Yang (Fig. 10.1).
xliae and
Body Fluids, calms the Mind and improves
rtions and intelligence and is thus indicated for thirst
due to consumption of Body Fluids, Wasting ■ RHIZOMA ATRACTYLODIS
■a, Bombyx
and Thirsting syndromes, palpitations, poor MACROCEPHALAE, RHIZOMA
memory and insomnia. By tonifying Qi it DIOSCOREAE AND SEMEN
also controls Blood and is thus indicated for DOLICHORIS

haemorrhagic patterns.
• Bai Zhu, Shan Yao and Bian Dou
— Radix Ginseng Rubra (Hong Shen) is warm in
nature, while Radix Ginseng Alba (Bai Shen)
Similarities
is neutral. Radix Ginseng should be — All tonify Qi and invigorate the Spleen and
decocted separately from other ingredients
of a prescription by simmering.
— Radix Panacis Quinquefolii strongly
Raw Toasted
nourishes Yin. It also clears Fire and is thus
indicated for Empty Fire due to Lung and Consolidates the Tonifies the Middle
Stomach Yin Deficiency. Exterior Burner

— Radix Codonopsis Pilosulae and Radix Promotes tissue Lifts Yang

Pseudostellariae are similar to Radix regeneration

Ginseng in action but are weaker. They are


indicated for patterns of general Qi Fig. 10.1 Actions of Astragali seu Hedysari.
40 Part 1: Actions and indications of some common Chinese herbs

are thus indicated !for diarrhoea, loose harmonize the ingredients of a prescription.
stools and leucorrhoea due to Spleen Qi Radix Glycyrrhizae also tonifies Heart Qi
Deficiency. and stops cough. Its treated form (Zhi Gan
Cao) tonifies the Middle Burner and benefits
Differences Qi; its raw form (Sheng Gan Cao) clears
— Rhizoma Atractylodis Macrocephalae is dry Fire and Fire Poison. Fructus Ziziphi
in nature. It dries Dampness, promotes Jujubae tonifies the Spleen and nourishes
diuresis, stops sweating and prevents Blood.
miscarriage. It is indicated for retention of — Mel and Saccharum Granorum both moisten
fluid and Dampness due to Spleen the Lung and stop cough. Mel is more effec
Deficiency and for spontaneous sweating tive in providing moisture; it also moistens
and threatened abortion. Both Rhizoma the intestines to relieve constipation.
Atractylodis and Rhizoma Atractylodis Saccharum Granorum is more effective in
Macrocephalae dry Dampness and invigo tonifying the Middle Burner and relieving
rate the Spleen, but Rhizoma Atractylodis spasm and is thus often used in the treat
Macrocephalae is more effective in ment of abdominal pain due to deficiency of
tonifying Qi and invigorating the Spleen the Middle Burner.
while Rhizoma Atractylodis is more effec
tive in drying Dampness. The latter also
disperses External Dampness and Wind-
Damp.
— Rhizoma Dioscoreae is moist in nature and
nourishes Lung and Kidney Yin. It is thus 6. Blood tonics
indicated for patterns of Lung and Kidney
Yin Deficiency such as diabetes.
■ RADIX ANGELICAE SINENSIS AND
— Semen Dolichoris eliminates Summer Heat
RADIX PAEONIAE ALBA
and Dampness and is thus indicated for
diarrhoea due to Summer Heat and • Dang Gui and Bai Shao
Dampness. It is less effective in tonifying Qi
and invigorating the Spleen than Rhizoma Similarities
Atractylodis Macrocephalae and Rhizoma — Both tonify Blood and are thus indicated
Dioscoreae. for Deficient Blood patterns. They also tonify
Qi and relieve pain and are thus indicated
for abdominal pain due to deficiency of
the Middle Burner. In addition, they
■ RADIX GLYCYRRHIZAE, FRUCTUS
regulate Blood and stop dysentery and are
ZIZIPHIJUJUBAE, MEL AND
thus indicated for dysentery with bloody
SACCHARUM GRANORUM
stool.
• Gan Cao, Da Zao, Feng Mi and Yi Tang
Differences
Similarities — Radix Angelicae Sinensis activates Blood
— All tonify the Middle Burner and relieve circulation, regulates menstruation, relieves
spasm and are thus indicated for weakness pain and moistens the intestines. It is
of the Spleen and Stomach and abdominal indicated for various gynaecological
pain due to deficiency of the Middle patterns of Blood Deficiency; Blood Stasis,
Burner. Because they can cause fullness pain due to Qi and Blood Stagnation, and
and Dampness in the Middle Burner, they dry constipation.
are contraindicated in cases of stuffiness — Radix Paeoniae Alba nourishes and
of the chest and abdominal distension astringes Yin, stops sweating, nourishes and
due to Stagnation of Qi and excessive calms the Liver and relieves spasm. It is
Dampness. indicated for Liver Yin Deficiency, Liver
Yang Rising, spontaneous sweating, night
Differences sweats, spasmodic pain, hypochondriac
— Radix Glycyrrhizae and Fructus Ziziphi pain due to Liver Blood Deficiency and
Jujubae both regulate the Middle Burner and constraint of Liver Qi.
Tonics 41

icriptkm. Lung and Stomach Yin, and consumption of


■ RADIX REHMANNIAE PRAEPARATA,
rieart Qi Body Fluids.
COLLA CORII ASINI AND RADIX
(Zhi Gan
POLYGONI MULTIFLORI
I benefits Differences
o) clears • Shu Di, E Jiao and He Shou Wu I — Radix Glehniae is more effective in
Ziziphi nourishing Yin while Radix Adenophorae
lourishes Similarities also resolves Phlegm.
— All tonify Blood and Liver and Kidney Yin — Radix Ophiopogonis nourishes Heart Yin
1 moisten and are thus indicated for patterns of Blood while Radix Asparagi nourishes Kidney Yin.
ore effec- Deficiency and Liver and Kidney Yin — Herba Dendrobii is more effective in
moistens Deficiency. nourishing Stomach Yin and promoting
stipation. Body Fluids. It also improves vision and
:ective in Differences strengthens tendons and bones and is thus
relieving — Radix Rehmanniae Praeparata is more effec indicated for eye disorders due to Liver
the treat- tive in tonifying Liver and Kidney Yin and is Deficiency and for muscular atrophy and
iciency of a major herb for tonifying Kidney Yin. motor impairment due to Kidney Deficiency.
— Radix Rehmanniae and Radix Rehmanniae — Rhizoma Polygonati Odorati and Rhizoma
Praeparata both tonify Yin. Radix Polygonati are similar in their action of
Rehmanniae Praeparata is slightly warm in nourishing Lung and Stomach Yin, but
nature and also tonifies Blood. Radix Rhizoma Polygonati Odorati is more effec
Rehmanniae is cold in nature and cools tive in nourishing Yin while Rhizoma
Blood, stops bleeding, clears heat and Polygonati also benefits Qi and invigorates
promotes Body Fluids. the Spleen. At present Rhizoma Polygonati
— Colla Corii Asini is an important herb for Odorati is used similarly to Radix
Blood tonification. It also nourishes Yin, Ophiogonis in the treatment of cardiac insuf
VND
moistens dryness and stops bleeding and is ficiency with symptoms of Heart Yin
thus indicated for dryness arising from Lung Deficiency.
and Kidney Yin Deficiency and for haemor-
rhagic patterns. It is either stir-baked to
pearls before adding to a decoction or is z
indicated melted and administered separately from
2
X
ilso tonify other ingredients of a prescription. z
>-
z

indicated — Radix Polygoni Multiflori in its treated form


>-
I— 3 >-
LU
o <r 5 cc

s
z LU
ciency of tonifies the Liver and Kidneys, while its raw o 9
_l X to Zi
on, they form moistens the intestines, relieves consti

1= 1 -
y and are pation, clears Fire Poison and treats malaria. Radix Glehniae

:h bloody Radix Adenophorae

Radix Ophiopogonis

C. Yin tonics (Fig. 10.2) Radix Asparagi


tes Blood
Herba Dendrobii
n, relieves
■ RADIX GLEHNIAE, RADIX
les. It is Rhizoma Polygonati OdoratJ
ADENOPHORAE, RADIX
ecological
OPHIOPOGONIS, RADIX ASPARAGI, Rhizoma Polygonati
>od Stasis,
HERBA DENDROBII, RHIZOMA Fructus Comi
ation, and
POLYGONATI ODORATI AND
Fructus Lyeii
RHIZOMA POLYGONATI
;hes and
Fructus Lkjustri Lucidi
rishes and • Bei Sha Shen, Nan Sha Shen, Mai Dong,
asm. It is Tiati Dong, Shi Hu, Yu Zhu and Huang Jing Herba Ecliptae
ncy, Liver
Plastrum Testudinis
ing, night Similarities
>chondriac — All are sweet and cold in nature and nourish Carapax Trionycis

iency and Lung and Stomach Yin and promote Body


Fluids. They are thus indicated for Deficient Fig. 10.2 Yin tonics.
42 Part 1: Actions and indications of some common Chinese herbs

Plastrum Testudinis in clearing Empty Heat.


■ FRUCTUS CORNI, FRUCTUS LYCII,
It also softens hard masses and is thus
FRUCTUS LIGUSTRI LUCIDI AND indicated for palpable abdominal masses,
HERBA ECLIPTAE and malaria with splenomegaly.
• Shan Zhu Yu, Gou Qi Zi, Nu Zhen Zi and
Mo Han Liati

Similarities
D. Yang tonics
— All nourish Liver and Kidney Yin and are
thus indicated for patterns of Deficient Liver
and Kidney Yin. ■ CORNU CERVI PANTOTRICHUM,
CORNU CERVI AND COLLA CORNUS
Differences CERVI
— Fructus Corni strongly nourishes Liver and
• Lu Rong, Lu Jiao and Lu Jiao Jiao
Kidney Yin, but especially Liver Yin. It is an
important astringent herb and is indicated
Similarities
for spermatorrhoea, nocturnal enuresis,
— All tonify Kidney Yang, invigorate Yang,
spontaneous sweating, night sweats and
benefit Essence CJing) and Blood and
shock due to excessive sweating.
strengthen tendons and bones. They are
— Fructus Lycii nourishes the Liver and
indicated for Kidney Yang Deficiency,
improves vision. It is an important herb for
impotence, infertility, sore and weak back
eye disorders due to Liver Blood and Yin
and knees, osteoporosis, muscular weakness
Deficiency. and atrophy and Deficiency of Kidney
— Fructus Ligustri Lucidi and Herba Ecliptae
Essence with resulting Blood Deficiency.
both have a slow action in nourishing Liver
and Kidney Yin. Fructus Ligustri Lucidi is
Differences
more effective in nourishing the Liver and
— Of the three, Cornu Cervi Pantotrichum has
Kidney while Herba Ecliptae also cools
the strongest action and is often adminis
Blood and stops bleeding.
tered in the form of pills or powder. Cornu
Cervi also has a strong action; it activates
Blood circulation and reduces swelling and
■ FLASTRUMTESTUDINISAND is indicated for Yin jaundice and swelling
CARAPAX TRIONYCIS due to Stagnation of Blood.
— Colla Cornus Cervi is similar to Cornu Cervi
• Gui Ban and Bie }ia and is more effective in nourishing Essence
and Blood. It also stops bleeding and is thus
Similarities indicated for haemorrhagic patterns due to
— Both nourish Yin, clear Empty Heat and Deficiency and Cold.
suppress hyperactive Yang and are thus
indicated for tidal fever due to Liver and
Kidney Yin Deficiency, dizziness and ■ RADIX MORINDAE OFFICINALIS,
blurring of vision due to Yin Deficiency and HERBA CISTANCHIS AND HERBA
hyperactive Yang, tremor due to Liver Wind, CYNOMORII
and a deep red tongue.
• Ba ]i Tian, Rou Cong Rong and Suo Yang
Differences
— Plastrum Testudinis strongly nourishes Similarities
Kidney Yin. It strengthens bones, consoli — All tonify Kidney Yang and are indicated for
dates the Chong and Ren channels and stops impotence and premature ejaculation due to
bleeding and is thus indicated for atrophic Kidney Yang Deficiency and for infertility
debility of bones due to Kidney Deficiency, due to retention of Cold in the uterus.
delayed closure of fontanelles, chondro-
pathy and uterine bleeding due to weakness Differences

of the Chong and Ren channels. — Radix Morindae Officinalis tonifies Yang,
— Carapax Trionycis is more effective than strengthens tendons and bones and elimi-
Tomes 43

pty Heat, nates Wind-Damp. It is thus indicated for thus indicated for chronic Wind-Damp Bi
is thus chronic Wind-Damp Bi syndromes, osteo syndromes, osteoporosis, muscular
masses, porosis and muscular weakness and weakness and atrophy, and lumbago due to
atrophy. . Kidney Deficiency.
— Herba Cistanchis and Herba Cynomorii also
moisten the intestines and are thus indicated Differences
for dry constipation complicated with — Cortex Eucommiae tonifies the Kidneys,
Kidney Yang Deficiency. prevents miscarriage and lowers blood
pressure. It is thus indicated for threatened
abortion or hypertension due to Kidney
■ RHIZOMA CURCULIGINIS AND Deficiency.
HERBA EPIMEDII — Radix Dipsaci is similar to Cortex
RNUS
Eucommiae but is more effective in treating
• Xian Mao and Yin Yang Huo
injury to the tendons and bones. It also stops
bleeding and is thus indicated for uterine
Similarities
bleeding or threatened abortion with
— Both warm the Kidneys, invigorate Yang,
bleeding.
eliminate Cold-Damp and strengthen
ate Yang, — Rhizoma Drynariae is similar to Radix
tendons and bones. They are indicated for
ood and Dipsaci in treating injury to the tendons and
impotence, infertility and urinary frequency
They are bones, and similar to Fructus Psoraleae in
)eficiency,
due to Kidney Yang Deficiency and for
tonifying the Kidneys and strengthening the
'eak back
chronic Cold-Damp Bi syndromes and weak
lumbar region.
weakness tendons and bones.

t Kidney
Differences
iency. ■ FRUCTUS PSORALEAE AND FRUCTUS
— Rhizoma Curculiginis is warm and dry in
ALPINIAE OXYPHYLLAE
nature and has a strong action in eliminating
Cold-Damp. • Bu Gu Zhi and Yi Zhi Ren
chum has
adminis-
— Herba Epimedii strongly tonifies Yang. It
also lowers blood pressure and treats Similarities
ler. Comu
Deficiency-type asthma. — Both tonify the Kidneys, invigorate Yang,
: activates
warm the Spleen and stop diarrhoea. They
elling and
are indicated for diarrhoea due to Spleen
I swelling
■ PENIET TESTES CALLORHINI AND and Kidney Yang Deficiency.
HIPPOCAMPUS
irnu Cervi
Differences
ig Essence • Hai Gou Shen and Hai Ma
— Fructus Psoraleae is more effective in
nd is thus
wanning the Kidneys. It also tonifies the
■ns due to Similarities
Kidneys and invigorates Yang, assists recep
— Both tonify the Kidneys and invigorate Yang
tion of Qi to relieve asthma and strengthens
and are indicated for impotence and lack of
the lumbar region.
libido.
— Fructus Alpiniae Oxyphyllae is more effec
US,
tive in warming the Spleen and astringing
Differences
— Hippocampus also activates Blood circula
discharges and is thus indicated for
diarrhoea due to Spleen Deficiency and for
tion and resolves Blood Stasis and is thus
o Yang excessive salivation and nocturnal enuresis.
indicated for palpable abdominal masses.

iicated for ■ CORTEX EUCOMMIAE, RADIX DIPSACI ■ GECKO, CORDYCEPS AND SEMEN
ion due to JUGLANDIS
AND RHIZOMA DRYNARIAE
infertility
• Du Zhong, Xu Duan and Gu Sui Bu • Ge Jie, Dong Chong Xia Cao and Hu Tao
rus.
Rou

Similarities
— All tonify the Liver and Kidneys and Similarities
ifies Yang,
strengthen the tendons and bones. They are — All tonify the Kidneys and benefit the Lungs
and elimi
44
P<i<! 1 ■ Action- .inJ indication* of some common Chinese herbs

Radix Ginseng
———*—-^

Radix Panads Quinquefol


~

Radix Codonopsis Pilosulae


— i—

Radix Pseudostellariae

Radix Astragali seu Hedysari


— —:——
Rhizoma Atractytodis Macrocephalaei
Rhizoma Dioscoreae
.I—

Semen Dolichoris

Radix GlycyrThizae

Fructus Ziziphi Jujubaa

Mel

Saccharum Granomm

Radix Angelicaa Sinensis

Radix Paeontae Alba

Radix Rahmanntae Praeparata

Colla Corii Asinj

Radix Polygoni MuWftori

I 'C Radix Glehniae


■■■ in

Radix Adenophorae

Radix Ophiopogonis

Radix Asparagi

Herba Dendrobii

Rhizoma Polygonati Odorati


Rhizoma Polygonati
■ ^-^^^-^

Fructus Comi

Fnjctus Lycii
i

Fructus Ligustri Luddi

Herba Ecl'iptae
■'

Plastrum Testudinis

Carapax Trionycis

Fig. 10.3 Tonic herbs: a comparable table of actions.


Tonics 45

Fructus Alpiniae Oxyphyliae

Semen Astragali Complanati


46 Part 1: Actions and indications of some common Chinese herbs

and thus assist reception of Qi to relieve is more effective in nourishing the Liver and
asthma. They are indicated for Deficiency- improving vision.
type asthma and chronic cough due to Lung
and Kidney Deficiency.

Differences Questions
— Gecko is more effective in assisting reception
of Qi to relieve asthma. It also benefits 1. Compare and contrast the actions and
Essence and invigorates Yang and is thus indications of Radix Ginseng and Radix
Astragali seuHedysari.
indicated for impotence and spermator
2. How do the actions of Radix Ginseng and
rhoea.
— Cordyceps is more effective in tonifying the Radix Panacis Quinquefolii differ?
3. How do the actions of Radix Glehniae and
Lungs and is indicated for pulmonary tuber
culosis. It also invigorates Yang and benefits Radix Adenophorae differ?
Essence.
4. Compare and contrast the actions and
— Semen Juglandis also strengthens the indications of Rhizoma Atractylodis
lumbar region and moistens the intestines to Macrocephalae and Rhizoma Atractylodis.
relieve dry constipation. 5. Compare and contrast the actions and
indications of Rhizoma Atractylodis
Macrocephalae and Rhizoma Dioscoreae.
6. How do the actions of Radix Rehmanniae
■ PLACENTA HOMINIS AND UMBILICAL
CORD Praeparata and Radix Rehmanniae differ?
7. What are the differences in the actions of
• Zi He Che and Qi Dai Radix Angelicae Sinensis and Radix
Rehmanniae Praeparata?
Similarities 8. What are the differences in the actions of
tl
— Both tonify the Kidneys, benefit Essence and Radix Angelicae Sinensis and Radix
assist reception of Qi. Paeoniae Alba?
9. Compare and contrast the actions and
Differences indications of Radix Glycyrrhizae and
— Placenta Hominis is more effective in Fructus Ziziphi Jujubae.
nourishing Essence and Blood and 10. What are the differences in action of Radix
benefiting Qi, while umbilical cord is more Ophiopogonis, Radix Asparagi and Herba
effective in assisting reception of Qi to Dendrobii?
relieve asthma. 11. What are the differences in action of
Fructus Corni, Fructus Lycii, Plastrum
Testudinis and Carapax Trionycis?
■ SEMEN CUSCUTAE AND SEMEN 12. Compare and contrast the actions of Cornu
ASTRAGALI COMPLANATI Cervi Pantotrichum, Cornu Cervi, Herba
• Tu Si Zi and Tong Ji Li Cistanchis and Herba Epimedii.
13. Compare and contrast the actions of Cortex

Similarities Eucommiae and Radix Dipsaci, and


— Both tonify the Kidney, consolidate the Fructus Psoraleae and Fructus Alpiniae
Oxyphyllae.
Essence, nourish the Liver and improve
vision. They tonify both Yin and Yang and 14. Compare and contrast the actions of Gecko
are indicated for lumbago, tinnitus, spermat and Cordyceps, and of Semen Cuscutae
and Semen Astragali Complanati.
orrhoea and urinary frequency due to
Kidney Deficiency, and for impaired vision
and dizziness due to Liver and Kidney
Deficiency.

Differences
— Semen Cuscutae is more effective in
tonifying the Kidneys and consolidating the
Essence while Semen Astragali Complanati
47

Astringent herbs 11
Aver and

ons and
id Radix

seng and

iniae and for spontaneous sweating and night


■ FRUCTUS SCHISANDRAE, FRUCTUS
sweats.
MUME AND GALLA CHINENSIS
ons and
actylodis • Wu Wei Zi, Wu Mei and Wu Bei Zi
Differences
ctylodis.
— Radix Ephedrae stops sweating only.
ons and Similarities
Fructus Tritici Levis also nourishes the Heart
actylodis — All astringe in various ways, e.g. they stop
and relieves restlessness. Normal wheat
jcoreae. sweating, stop coughing by astringing the
grain is similar to Fructus Tritici Levis in
imanniae lungs and stop diarrhoea by astringing the
action; the latter stops sweating more effec
s differ? intestines. They are thus indicated for
tively while the former is more effective in
ictions of spontaneous sweating, night sweats, chronic
nourishing the Heart and relieving restless-
i Radix cough and wheeze and chronic diarrhoea
and dysentery.

ictions of
i Radix Differences
— Fructus Schisandrae benefits Qi and
■ SEMEN MYRISTICAE, FRUCTUS
ions and promotes Body Fluids, consolidates
CHEBULAE AND HALLOYSITUM
.zae and Essence, soothes the Heart and calms the
RUBRUM
Mind. It is thus indicated for collapse due to
of Radix Qi and Yin Deficiency, thirst due to • Rom Dou Kou, He Zi and Chi Shi Zhi
:\d Herba consumption of Fluids, diabetes, spermator
rhoea, nocturnal enuresis, palpitation and Similarities
iction of insomnia. — All astringe the intestines and stop diarrhoea
Plastrum — Fructus Mume promotes Body Fluids, and are thus indicated for chronic diarrhoea
7 relieves thirst and sedates roundworm. It is and dysentery.

of Cornu indicated for thirst due to consumption of


A, Herba Fluids, diabetes and abdominal pain due to
Differences
ascariasis.
— Semen Myristicae warms the Middle
of Cortex — Galla Chinensis consolidates Essence,
Burner and regulates Qi and is thus
aci, and astringes Blood, clears Fire Poison and
indicated for Stagnation of Stomach and
Alpiniae promotes the healing of skin eruptions. It
Spleen Qi due to Deficiency and Cold. Both
is indicated for spermatorrhoea,
Semen Cardomomi Rotundi and Semen
of Gecko nocturnal enuresis, haemorrhagic patterns,
Myristicae warm the Middle Burner and
Cuscutae ulcerative gingivitis and carbuncles, boils
regulate Qi, but the former is more effec
and ulcers.
tive in resolving Dampness while the
latter is more effective in astringing the
intestines.
■ RADIX EPHEDRAE AND FRUCTUS
— Fructus Chebulae astringes the Lungs to
TRITICI LEVIS
stops cough and eases the throat and
• Ma Huang Gen and Fu Xiao Mai voice. It is indicated for chronic cough
due to Lung Qi Deficiency and for
Similarities sore throat and hoarseness due to Lung
— Both stop sweating and are thus indicated Fire.
48 Part 1: Actions am! indications of some common Chinese herbs

■ CORTEX AILANTHI AND are indicated for spermatorrhoea and


PERICARPIUM GRANATI nocturnal enuresis due to Kidney Deficiency
and for chronic diarrhoea and leucorrhoea
• Chun Gen Pi and Shi Liu Pi
due to Spleen and Kidney Deficiency.

Similarities
Differences
— Both astringe the intestines to stop
— Semen Euryales is more effective in invigo
diarrhoea, and clear Damp-Heat and dysen
rating the Spleen to stop diarrhoea while
tery. They are indicated for chronic
Semen Nelumbinis is more effective in
diarrhoea and dysentery, Damp-Heat in the tonifying the Kidneys and nourishing the
intestines and prolapse of the anus due to Heart.
Spleen Deficiency.
— Fructus Rosae Laevigatae is more effective in
consolidating Essence and is thus indicated
Differences
for nocturnal emission and spermatorrhoea
— Pericarpium Granati is more effective in (Fig. 11.1).
killing intestinal parasites while Cortex
Ailanthi is more effective in astringing
bleeding and leucorrhoea and is thus also ■ OOTHECA MANTIDIS AND FRUCTUS
indicated for uterine bleeding and leucor RUBI
rhoea.
I < • Sang Piao Xiao and Fu Pen Zi

■ SEMEN EURYALES, SEMEN Similarities

NELUMBINIS AND FRUCTUS ROSAE — Both tonify and astringe the Kidneys and
LAEVIGATAE are thus indicated for spermatorrhoea
and nocturnal enuresis due to Kidney
• Qian Shi, Lian Zi and Jin Ying Zi Deficiency.

Similarities Differences
— All consolidate Essence, control urination — Ootheca Mantidis invigorates Yang and is
and stop diarrhoea and leucorrhoea. They thus indicated for impotence. Fructus Rubi

Fruclus Chebulae
Fruclus SchisarxKae
- Gate Cfiinenas

Semer Mynslicae
UTERINE BLEEDING,
Frue:us Che LEUCORRHOEA AND
SPERMATORRHOEA
Haiiovsiiur,
flubmii Cortex Aiianthi

(Cortex Ailanthr Semen Euryales


Percarpium Granali Semen Nelumhres
Semen Euryales
Fruclus Rosae Laevigaiae
:Sefnen Nelumbinis
Os Sepiae
Frucius Rosae Laevigaiae
Concha Oslreae
Gaila Chmensis Galia Chinensis

Oolneca ManMis

Fruclus Rubi

Fig. 11.1 DifT.-rentation or astringent herbs according to area of action.


Astringent herbs 49

?a and improves vision and can be substituted for


■ficiency Fructus Corni and Fructus Lycii.
:orrhoea

■ OS SEPIAE AND CONCHA OSTRE'AE


• Wu Zei Gu and Mu Li
i mvigo-

:a while
Similarities
ctive in
— Both are astringent, and inhibit the secretion
ling the
of gastric add. They are thus indicated for
leucorrhoea and spermatorrhoea in
ective in
Deficient patterns and for epigastric pain
ndicated
due to gastritis.
torrhoea

Differences
— Concha Ostreae stops sweating, calms Liver
Yang and softens hard masses. Os Sepiae
CTUS
stops bleeding and promotes the healing of
skin diseases.

leys and Questions


torrhoea
1. How do Fructus Schisandrae, Fructus
Kidney
Mume, and Fructus Corni differ in their
actions?
2. Compare and contrast the actions and
indications of Radix Ephedrae, Os Draconis
g and is
and Concha Ostreae.
tus Rubi
3. How do Semen Myristicae, Semen Amomi
Cardamomi and Fructus Chebulae differ in
their actions?
4. Compare and contrast the actions of
Halloysitum Rubrum, Cortex Ailanthi and
iulae Pericarpium Granati.
andrae 5. How do Fructus Rosae Laevigatae, Ootheca
Mantidis and Os Sepiae differ in their
actions?
5LEEOTG,
HOEAAND
DRRHOEA
intfti

ryates

lumbinis

jsae Laevigatae

Istreae

lensis
Part 2:
Combinations of
common Chinese herbs

The actions and indications of


individual herbs change according to
the way in which they are combined
within a formula. It is essential for a
practitioner of Chinese medicine to
have a good command of the
combination of herbs.
53

Herbs that release the exterior


and stop cough and wheeze

When the dosage of Radix Paeoniae Alba is


HERBA EPHEDRAE AND RAMULUS
larger than that of Ramulus Cinnamomi, this
CINNAMOMI
combination warms the Middle Burner and
Ma Huang and Gui Zhi relieves pain. It is used to treat abdominal
pain due to deficiency of the Middle Burner
Both of these herbs Release the Exterior; they
(Fig. 12.1).
induce diaphoresis, disperse Cold and
relieve pain.
In combination, these actions are potenti
HERBA SCHIZONEPETAE AND RADIX
ated. They are thus indicated for severe
LEDEBOURIELLAE
Exterior Wind-Cold patterns of the Excess
type, i.e. marked by absence of sweating, Jing fie and Fang Feng
and for Cold Bi syndromes. In treating Bi
Both of these herbs disperse Wind-
syndromes, if there is severe pain due to
Cold, relieve pain and itching, and
Cold, Radix Aconiti may be added to further
express skin rashes, and these actions are
strengthen the action of dispersing Cold to
potentiated when they are used in combina
relieve pain.
tion.
The combination is indicated for invasion
of Wind-Cold with symptoms of the
■ RAMULUS CINNAMOMI AND RADIX
common cold. For Wind-Cold headache,
PAEONIAE ALBA
their action may be strengthened further
• Gui Zhi and Bai Shao by the addition of Radix Angelicae
Dahuricae.
— When combined in equal dosages, these
They are also used in combination to expel
herbs harmonize Nutrient (Ying) Qi and
Wind from the skin, in the treatment of
Defensive (Wei) Qi and regulate Yin and
pruritus, rubella and other skin rashes.
Yang. Ramulus Cinnamomi goes to the
Defensive level and disperses Excess while
Radix Paeoniae Alba goes to the Nutritive
level and astringes in order to tonify RHIZOMA SEU RADIX NOTOPTERYGII
Deficiency. This combination dispels AND RADIX ISATIDIS OR FOLIUM
pathogenic factors from the superficial ISATIDIS
muscles and reduces Heat. It is indicated for
Qiang Huo and Ban Lan Gen or Da Qing Ye
Exterior Wind-Cold patterns of the Deficient
type, i.e. marked by spontaneous sweating Together, these herbs Release the Exterior
which does not expel the pathogen. and clear Heat. Rhizoma seu Radix

Ramulus Cinnamomi = Radix Paeoniae Alba Ramulus Cinnamomi < Radix Paeoniae Alba
Harmonizes Nutritive and Defensive Qi Warms the Middle Burner and relieves pain

Indicated for Deficiency patterns of Wind-Cold Indicated for abdominal pain due to Deficiency
(see Fig. 1.1) of the Middle Burner

Fig. 12.1 Combined actions of Ramulus Cinnamomi and Radix Paeoniae Alba in different relative dosages.
1
54 Part 2: Combinations of common Chinese herbs

Notopterygii induces diaphoresis to Release they are calming and are used to treat night
the Exterior, expel Wind and relieve pain, crying in children.
while Radix Isatidis clears Heat and Fire
Poison. They are used in combination in the
treatment of influenza with headache and FOLIUM MORI AND SEMEN
fever. ARMENIACAE AMARUM

Sang Ye and Xing Ren

Both disperse Wind-Heat, moisten the Lung


HERBA MENTHAE AND HERBA and stop cough. In combination they stimu
SCHIZONEPETAE late the descending function of Lung Qi and
are thus indicated for cough due to Wind-
Bo He and )ing }ie
Heat, External Dryness or Lung Yin
Both Release the Exterior and express rashes. Deficiency.
Herba Menthae is pungent and cool in
nature while Herba Schizonepetae is
pungent and slightly warm. When used in HERBA EPHEDRAE AND SEMEN
combination, their actions are potentiated, ARMENIACAE AMARUM
and they are indicated for Exterior Wind-
Ma Huang and Xing Ren
Heat patterns and the early stages of measles
and rubella. Both stimulate the dispersing function of the
Lung to stop cough and wheeze. In combi
nation this action is potentiated and they are
thus indicated for cough due to invasion of
FOLIUM MORI AND FLOS Wind-Cold. They are used in combination
CHRYSANTHEMI with Herba Asari and Rhizoma Pinelliae for
cough due to retention of Cold-Phlegm, and
Sang Ye and fu Hua
in combination with Gypsum Fibrosum,
Both disperse Wind-Heat and clear Heat Rhizoma Anemarrhenae and Radix
from the head and eyes. Folium Mori is more Scutellariae for cough and wheeze due to
effective in clearing Wind-Heat from the Lung Heat.
Lung channel to stop cough while Flos
Chrysanthemi is more effective in clearing
Heat from the Liver and improving vision. RADIX BUPLEURI AND RADIX
When used in combination, their actions are PUERARIAE
potentiated and they are used to treat
Chai Hu and Ge Gen
Exterior Wind-Heat, especially with
headache and redness of the eyes, and Liver Both reduce Heat and dispel pathogenic
Yang Rising or Liver Heat with symptoms of factors from the muscles. Radix Bupleuri
headache, dizziness and vertigo, and enters the Shao Yang Channel and treats
redness of the eyes. alternating chills and fever. Radix Puerariae
enters the Yang Ming Channel and treats
fever, headache and neck rigidity due to
External Invasion.
HERBA MENTHAE AND In combination, their actions of reducing
PERIOSTRACUM CICADAE Heat and dispelling pathogenic factors
from the muscles are potentiated and
Bo He and Chan Tui
they are indicated for headache, fever,
Both disperse Wind-Heat, express rashes and neck rigidity due to invasion of Wind-
and ease the throat and voice. They are Heat, and for persistent fever after
indicated for redness of the eyes, sore throat sweating.
and hoarseness due to invasion of Wind- Both of these herbs also raise Yang Qi and
Heat and for the early stages of measles and they are used in combination to treat
rubella. diarrhoea and loose stools due to sinking of
Because they also clear Heart and Liver Heat Spleen Qi.
Herbs that Release the Exterior 55

They are used in combination to treat


reat night RADIX BUPLEURI AND RADIX
cough.
SCUTELLARIAE

Chai Hu and Huang Qin


RADIX ASTERIS AND FLOS
Radix Bupleuri clears External Heat from
FARFARAE
Shao Yang and Radix ScuteJlariae clears
Internal Heat from Shao Yang. In combina Zi Wan and Kuan Dong Hua
tion they thus harmonize Shao Yang and are
the Lung Both are warm but not drying in nature and
indicated for alternating chills and fever, and
ey stimu- moisten the Lung, resolve Phlegm and stop
fullness and discomfort in the costal and
ng Qi and cough. Radix Asteris is more effective in
hypochondriac regions due to Shao Yang
to Wind- resolving Phlegm and benefiting Lung Qi
disharmony (Table 12.1).
ung Yin while Flos Farfarae is more effective in
stopping cough.
Combining these herbs reinforces their
HERBA ELSHOLTZIAE AND SEMEN
actions in the treatment of productive
DOLICHORIS
N cough.
XiangRu and Bian Dou

Herba Elsholtziae is pungent and warm in


nature and thus Releases the Exterior and SEMEN ARMENIACAE AMARUM AND
ion of the disperses Cold, but it is also aromatic and RADIX PEUCEDANI

In combi- thus dispels Summer Heat and resolves Xing Ren and Qian Hu
d they are Dampness. Semen Dolichoris dispels
ivasion of Summer Heat and eliminates Dampness. Both herbs stimulate the Lung's descending
nbination In combination they are indicated for the and dispersing functions to stop cough.
lelliae for common cold and diarrhoea due to invasion Semen Armeniacae Amarum is more effec
legm, and of Summer Heat, or of Dampness in the tive in sending Lung Qi downward while
Fibrosum, Summer and Autumn. Better therapeutic Radix Peucedani is more effective in stimu
Radix results may be obtained with the addition of lating the Lung's dispersing function. In
;e due to Herba Agastachis and Cortex Magnoliae combination their antitussive action is

Officinalis. potentiated and they are indicated for cough


and wheeze due to a failure of Lung Qi to
disperse and descend.
RADIX STEMONAE AND RADIX
PLATYCODI
SEMEN PERILLAE AND SEMEN
Bat Bu and Jie Geng
ARMENIACAE AMARUM
athogenic Radix Stemonae moistens the Lung and
Su Zi and Xing Ren
Bupleuri stops cough. Radix Platycodi resolves
nd treats Phlegm, stimulates the Lung's dispersing Semen Perillae stops cough and wheeze by
Puerariae function, stops cough and eases the throat. stimulating the Lung's descending function
md treats
y due to
Table 12.1 Actions and indications of Radix Bupleuri in combination with other herbs

reducing
Radix Bupleuri This combination has two actions:
c factors + Radix Puerariae a. it reduces Heat and dispels Indicated for headache, fever, and
ited and pathogenic factors from the neck rigidity due to invasion of
le, fever, muscles Wind-Heat

of Wind b. it raises Yang Qi Indicated for diarrhoea and loose


stool due to Sinking of Spleen Qi
ier after

Radix Bupleuri This combination harmonizes Indicated for alternating chills


ig Qi and
+ Radix Scutellariae Shao Yang and fever, and fullness and
to treat discomfort in the costal and
sinking of hypochondriac regions
Pn>I 2: loml>nidtu>iif.of\<»iwion Chineeherlv

of Semen Armeniacae Amarum in combination with other herbs


Semen Armeniacae Amarum This combination stimulates the Stops cough and wheeze due
I U'rba Ephedrae
dispersing function of the Lungs
to invasion of Wind-Cold
to stop cough and wheeze

Seme,, Armemacae Amarum Semen Armeniacae Amarum


Stops cough and wheeze due
T K<ldlx Peuc^!™' stimulates the descending function, to failure of Lung Qi to
while Radix Peucedani stimulates disperse and descend
the dispersing function

?£mcn Znur Am<irLim STen Armt'niCT/marUm Stimul'^eS


JSP"811* and descending; Semen
*°P* cough and wheeze due
to retention of Cold and
enllae stimulates the descending Phlegm in the LunKs
function and resolves Phlegm

and resolving Phlegm. Semen Armeniacae


Amarum stops cough and wheeze by stimu ! CORTEX MORI RADIOS AND SEMEN
lating the Lung's dispersing and descending LEPIDII SEU DESCURAINIAE
functions. The combination of the two is Sang Bai Pi and Ting Li Zi
indicated for cough and wheeze due to
retention of Cold and Phlegm in the Lungs These herbs combine to clear Lung Heat and
(Table 12.2). 5 soothe wheeze and are indicated for cough
I't and wheeze due to Phlegm Fire and
pulmonary oedema.
I SEMEN PERILLAE AND SEMEN LEPIDII
SEU DESCURAINIAE
Su Zi and Ting Li Zi
CORTEX MORI RADIOS AND RADIX
- These herbs combine to stimulate the
. 'C
SCUTELLARIAE
descending function of the Lung, clear Lung
Heat and soothe wheezing. They are Sang Bai Pi and Huang Qin
indicated for shortness of breath, cough
These herbs combine to clear Lung Heat and
and wheeze due to retention of Phlegm
Fluid. stop cough and are indicated for cough due
to Heat or Fire in the Lung.

Table 12.3 Actions and indications of Herba Ephedrae in combinat.on with other herbs
Herba Ephedrae This combination Releases the
+ Kamulus Cinnamomi Indicated for Wind-Cold
Exterior, induces diaphoresis,
invasion with absence
disperses Cold and relieves
of sweating, and for
pain
Cold Bi Syndrome
Herba Ephedrae This combination stimulates the
+ Semen Armeniacae Indicated for cough due
dispersing function of the Lungs
Amarum to invasion of Wind-Cold
to stop cough and wheeze
Herba Ephedrae Herba Ephedrae stimulates the dispersing
+ Semen Ginkgo Indicated for cough,
function of the Lungs while Semen Ginkgo wheeze and dyspnoea
astnnges the Lungs and resolves
Phlegm

Herba Ephedrae
Herba Ephedrae stimulates the dispersing Indicated for cough and
+ Lumbricus function of the Lungs while
wheeze due (o retention of
Lumbricus clears Heat and resolves
Phlegm-Heat in the Lungs
Phlegm
Herbs that Release the Exterior 57

HERBA EPHEDRAE AND RADIX


:edue SCUTELLARIAE
:oid
Ma Huang and Huang Qin

:edue Herba Ephedrae is pungent and warm in


to nature and stops cough and wheeze by
I stimulating the Lung's dispersing function.
Radix Scutellariae is bitter and cold in nature
:edue and stops cough by clearing Lung Heat.
nd When used together, Radix Scutellariae
modifies the warm nature of Herba
Ephedrae and the common action of both
herbs in stopping cough and wheeze is
potentiated. This combination is especially
appropriate for cough and wheeze when
there is Exterior Cold and Interior Heat.
■EMEN

■ HERBA EPHEDRAE AND LUMBRICUS

• Ma Huang and Di Long


Heat and
for cough — In combination, these substances stimulate
Fire and the Lung's dispersing function, clear Heat
and resolve Phlegm. This combination is
thus indicated for cough and wheeze due to
Retention of Phlegm Heat in the Lung.

LADIX
■ HERBA EPHEDRAE AND SEMEN
GINKGO

• Ma Huang and Bai Guo


Heat and
— Herba Ephedrae stimulates the Lung's
ough due
dispersing function, while Semen Ginkgo
astringes the Lung and resolves Phlegm. In
combination, they are indicated for cough,
wheeze and shortness of breath (Table 12.3).

Zold
leeze

ion of
.ungs
58

13 Herbs that clear Heat

GYPSUM FIBROSUM AND RHIZOMA GYPSUM FIBROSUM AND RHIZOMA


ANEMARRHENAE CIMICIFUGAE

Shi Gao and Zhi Mu Shi Gao and Sheng Ma

- Both substances clear Full Heat from the Qi Gypsum Fibrosum clears Stomach Fire.
level. Gypsum Fibrosum is extremely cold in Rhizoma Cimicifugae clears Fire and Fire
nature. It clears Heat and Fire, particularly Poison. In combination they are indicated
from the Lung and Stomach, and relieves for painful and swollen gums or mouth
restlessness. Rhizoma Anemarrhenae not ulcers due to Stomach Fire.
only clears Heat and Fire but also nourishes
Yin and promotes Body Fluids. When
combined, their action of clearing Heat from
the Qi level is potentiated and they are
indicated for: RHIZOMA ANEMARRHENAE AND
1. pathogenic Heat at the Qi level with BULBUS FRITILLARIAE
symptoms of high fever, restlessness,
Zhi Mu and Bei Mu
. '\ thirst and profuse sweating
2. cough and wheeze due to Full Heat in the Both herbs clear Lung Heat; Bulbus
Lungs Fritillariae also moistens dryness, resolves
3. toothache, haematemesis and epistaxis Phlegm and stops cough. In combination
due to Stomach Heat or Fire they are indicated for cough due to
4. consumption of Body Fluids due to Lung Heat or Yin Deficiency with Empty
Full Heat in the Lung and Stomach Heat.
with symptoms of thirst, a desire to
drink large quantities and loss of body
weight.

RHIZOMA ANEMARRHENAE AND


CORTEX PHEIXODENDRI
GYPSUM FIBROSUM, HERBA ASARI
Zhi Mu and Huang Bai
AND RADIX ANGELICAE
DAHURICAE - Rhizoma Anemarrhenae nourishes Yin and
Shi Gao, Xi Xin and Bai Zhi clears Fire while Cortex Phellodendri clears
Empty Fire. In combination they are
■ Gypsum Fibrosum clears Stomach Heat indicated for spermatorrhoea and tidal fever
and Fire. Herba Asari and Radix due to Kidney Yin Deficiency with Empty
Angelicae Dahuricae are pungent and Fire.
scattering in nature and relieve pain. With the addition of Cortex Cinnamomi,
The three substances in combination this combination nourishes the Kidneys,
relieve pain due to Heat or Fire in the stimulates the transformation of Water
Stomach. They are indicated for tooth and promotes diuresis and is thus
ache and headache due to Stomach Heat indicated for urinary dysfunction and
and Fire. oedema.
Herbs that clear Heat 59

epigastric pain and acid regurgitation


RHIZOMA COPTIDIS AND RADIX
due to disharmony between the Liver and
SCUTELLARIAE
Stomach.
Huang Lian and Huang Qin

Both herbs clear Heat, Fire, Fire Poison


RADIX SCUTELLARIAE AND RADIX
and Damp-Heat. Radix Scutellariae works
PAEONIAE ALBA
on the Upper Burner while Rhizoma
Coptidis works on the Middle Burner. They Huang Qin and Bai Shao
are often used in combination to treat
Radix Scutellariae clears Heat from the
retention of Heat and Fire in the Upper
intestines to stop diarrhoea and dysentery
and Middle Burners, Retention of Damp-
while Radix Paeoniae A3ba harmonizes the
Heat in the intestines and retention of Fire
:oma Blood and relaxes spasm. In combination
Poison.
they are indicated for abdominal pain
and dysentery, especially with blood in the
stool.
■ RHIZOMA COPTIDIS AND RADIX
ich Fire, AUCKLANDIA
and Fire
indicated • Huang Lian and Mu Xiang RADIX SCUTELLARIAE AND

>r mouth RHIZOMA ATRACTYLODIS


— Rhizoma Coptidis clears Heat, dries
MACROCEPHALAE
Dampness and stops dysentery while Radix
Aucklandia regulates Qi, relieves pain and Huang Qin and Bai Zhu
stops dysentery. In combination the action of
Radix Scutellariae clears Heat and prevents
clearing Heat from the intestines and
miscarriage while Rhizoma Atractylodis
stopping dysentery is potentiated and they
Macrocephalae tonifies Qi, invigorates the
ND are indicated for dysentery and abdominal
Spleen and prevents miscarriage. In combi
pain due to retention of Damp-Heat in the
nation their action of preventing miscarriage
intestines.
is potentiated and they are thus indicated for
threatened abortion.
Bulbus
resolves
RHIZOMA COPTIDIS AND CORTEX
nbination
CINNAMOMI CORTEX PHELLODENDRI AND
due to
FRUCTUS GARDENIAE
h Empty Huang Lian and Rou Gui

Rhizoma Coptidis clears Heart Fire while Huang Bai and Zhi Zi

Cortex Cinnamomi warms Kidney Yang and Both herbs clear Damp-Heat and relieve
conducts Ming Men Fire to its source. In jaundice. Cortex Phellodendri strongly
combination they harmonize the Heart and clears Heat and dries Dampness
while
Kidneys and are indicated for insomnia due Fructus Gardeniae drains Dampness and
ND
to disharmony between the Heart and relieves urinary disturbance. In combination
Kidneys. they are indicated for jaundice due to reten
tion of Damp-Heat and for urinary distur
bance with turbid urine due to Damp-Heat
i Yin and
RHIZOMA COPTIDIS AND FRUCTUS in the Lower Burner.
dri clears
they are EVODIAE
idal fever
Huang Lian and Wu Zhu Yu
RADIX GENTIANAE, FRUCTUS
;h Empty
Rhizoma Coptidis is bitter and cold in GARDENIAE AND RADIX
nature; it clears Stomach Heat and stops REHMANNIAE
inamomi,
Kidneys, vomiting. Fructus Evodiae is pungent and
Long Dan Cao, Zhi Zi and Sheng Di
rf Water hot in nature; it enters the Liver Channel and
conducts Rebellious Qi downward to stop Radix Gentianae and Fructus Gardeniae
is thus
vomiting. This combination is indicated for clear Liver Fire. Radix Rehmanniae not only
:ion and
vomiting due to Stomach Heat and for clears Heat but also nourishes Yin, thus
60 Part 2: Combinations of common Chinese herbs

preventing the first two herbs from


damaging the Yin. This combination is FLOS LONICERAE AND FRUCTUS
FORSYTHIAE
indicated for Liver Fire with symptoms
of headache, red eyes, hypochondriac pain Jin Yin Hua and Lian Qiao
and jaundice and for Damp-Heat in the
Lower Burner with symptoms of leucor- Both herbs clear Heat and Fire Poison and
rhoea and urinary disturbance with turbid this action is potentiated when they are used
urine. in combination. They are indicated for Heat
and Fire Poison at the Defensive (Wei) and
Qi levels and for carbuncles, boils and
ulcers.
CORTEX MOUTAN RADICIS AND
FRUCTUS GARDENIAE

Dan Pi and Zhi Zi ■ FOLIUM ISATIDIS OR RADIX ISATIDIS


AND RADIX GENTIANAE
- Both of these herbs clear Liver Fire and
cool Blood. This combination is thus • Da Qing Ye or Ban Lan Gen and Long Dan
indicated for Liver Qi Stagnation turning to Cao

Fire, or retention of Heat in the Liver — Folium and Radix Isatidis clear Heat and
Channel, with symptoms of hypochondriac Fire Poison and are antiviral. Radix
pain, a bitter taste in the mouth, red eyes
Gentianae clears Heat and Fire and stops
and headache, and for Heat in the Blood convulsion. This combination is indicated
with symptoms of haematemesis and
for febrile diseases with Fire Poison,
epistaxis.
headache, convulsion and spasm due to
high fever.

SPICA PRUNELLAE AND FLOS


CHRYSANTHEMI
HERBA VIOLAE AND HERBA
Xia Ku Cao and Ju Hua TARAXACI

■ Both herbs clear Liver Heat, pacify the Liver Zi Hua Di Ding and Pu Gong Ying
and improve vision. This combination is
Both clear Heat and Fire Poison and are thus
thus indicated for Liver Fire with symptoms
indicated for sores and ulcers due to Fire
of headache and eye disease, or Liver Yang
Poison and for various infections.
Rising with symptoms of headache, dizzi
ness and vertigo.

CAULIS SARGENTODOXAE AND


HERBA PATRUBIAE, AND RADIX ET
I SPICA PRUNELLAE, RADIX RHIZOMA RHEI AND CORTEX
SCROPHULARIAE, BULBUS MOUTAN RADICIS
FRITILLARIAE, SARGASSUM AND
Hong Teng and Bat Jiang Cai, and Da
THALLUS LAMINARIAE SEU
Huang and Dan Pi
ECKLONIAE

Xia Ku Cao, Xuan Shen, Bei Mu, Hai Zao These combinations clear Heat and Poison.
and Kun Bu They are indicated for acute appendicitis
and pelvic inflammation.
■ Spica Prunellae clears Liver Fire and
disperses masses. Radix Scrophulariae
nourishes Yin and clears Fire and Poison. ■ RADIX PULSATILLAE, CORTEX
Bulbus Fritiliariae, Sargassum and FRAXINI AND RHIZOMA COPTIDIS
Thallus Laminariae seu Eckloniae resolve
• Bai Tou Weng, Qin Pi and Huang Lian
Phlegm and soften hard masses. The combi
nation of these herbs is indicated for tuber — This combination clears Heat and Fire
culosis of the lymph nodes, goitre and Poison from the intestines, cools Blood and
tumours. stops dysentery. It is indicated for dysentery
Herbs that clear Heat 61

Table 13.1 Actions and indications of Rhizoma Coptidis, in combination with other herbs
JS
Rhizoma Coptidis Rhizoma Coptidis clears Heat from Indicated for Heat in the Upper
+ Radix Scutellariae the Middle Burner; Radix Scutellariae and Middle Burners, Damp-Heat in
clears Heat from the Upper Burner the intestines and Fire Poison

ison and
Rhizoma Coptidis Rhizoma Coptidis clears Heat and Damp; Indicated for dysentery or abdominal
are used Radix Aucklandiae regulates Qi and pain due to Damp-Heat in the
+ Radix Aucklandiae
for Heat relieves pain; both treat dysentery intestines
tVei) and
Rhizoma Coptidis Rhizoma Coptidis clears Heart Fire; Cortex Indicated for insomnia due to
oils and
+ Cortex Cinnamomi Cinnamomi warms Kidney Yang and disharmony between the Heart
conducts Ming Men Fire back to its source and Kidneys

Rhizoma Coptidis Rhizoma Coptidis clears Stomach Heat Indicated for vomiting due to Stomach
ATIDIS + Fructus Evodiae and stops vomiting; Fructus Evodiae enters Heat, epigastric pain and acid reflux
the Liver and regulates Rebellious Qi due to disharmony between the
Liver and Stomach

tgDan
Rhizoma Coptidis All three herbs cool Blood, and clear Indicated for dysentery with bloody
+ Radix Pulsatillae Heat and Fire Poison from the intestines stool due to Fire Poison
+ Cortex Fraxini
teat and
. Radix
Rhizoma Coptidis Both herbs clear Heat and Damp Indicated for epigastric and abdominal
nd stops + Cortex Magnoliae distension and pain due to
ndicated Officinalis Damp-Heat and for Damp-Heat
Poison, febrile disease

due to

with blood in the stool due to Fire Poison


RADIX REHMANNIAE AND RADIX
{Table 13.1).
SCROPHULARIAE

Sheng Di and Xuan Shen


INDIGO NATURALIS AND POWDER This combination clears Heat, cools Blood,
OF CONCHA MERETRICIS SEU
nourishes Yin and promotes Body Fluids. It
i are thus CYLINAE
is thus indicated for febrile disease at the
e to Fire
Qing Dai and Ge Fen Nutritive (Ying) and Blood levels and for
constipation due to Liver and Kidney Yin
Indigo Naturalis clears Liver Fire and
Deficiency.
cools Blood. Powder of Concha Meretricis
D seu Cylinae clears Phlegm Heat. In combina
XET tion they clear Lung Heat and Liver Fire
and cool Blood to stop bleeding. This combi HERBA ARTEMISIAE CHINGHAO AND
nation is indicated for cough and haemopt CARAPAX TRIONYCIS
hi
ysis due to invasion of the Lung by Liver
Qing Hao and Bie Jia
Fire.
This combination nourishes Yin and clears
i Poison.
Heat and is thus indicated for tidal fever and
>endicitis ■ CORNU RHINOCERIASIATICI AND night sweats due to Yin Deficiency with
RADIX REHMANNIAE Empty Heat.

• Xi Jiao and Sheng Di

— This combination clears Heat and cobls


[DIS Blood and is thus indicated for febrile HERBA ARTEMISIAE CHINGHAO AND
disease at the Blood level and for RADIX SCUTELLARIAE
haematemesis and epistaxis due to Heat in
Qing Hao and Huang Qin
md Fire the Blood. Its action is further strengthened
lood and by the addition of Cortex Moutan Radicis This combination clears Heat and harmo
[ysentery and Radix Paeoniae Rubra. nizes Shao Yang and is indicated for alter-
62 Part 2: Combination* of common Chinese herb:

nating fever and chills, severe fever and mild


chills, or fever without chills.

RADIX STELLARIAE AND CORTEX


LYCII RADIOS

Yin Chai Hu and Di Gu Pi

This combination clears Empty Heat and is


thus indicated for Yin Deficiency with
Empty Heat and tidal fever.

RADIX GENTIANAE MACROPHYLLAE


AND CARAPAX TRIONYCIS

Qin ]iao and Bie jia

Both herbs clear Empty Heat and this action


is potentiated when the two are used in
combination. In addition, Radix Gentianae
Macrophyllae eliminates Wind-Damp, and
Carapax Trionycis nourishes Yin. This
combination is indicated for Yin or Blood
Deficiency with Empty Heat, tidal fever and
painful joints due to Wind and Dampness.

■ -c
63

Purgative and digestive herbs

the two changes the action of Rhei from


■ RADIX ET RHIZOMA RHEI AND
purging by Cold to purging by Warmth. The
NATRII SULFAS
combination is thus indicated for constipa
• Da Huang and Mang Xiao tion due to stagnation of Cold.

— Radix et Rhizoma Rhei clears Heat and Fire


and purges accumulation. Natrii Sulfas RADIX ET RHIZOMA RHEI, SEMEN
softens hardness and promotes the PERSICAE AND CORTEX MOUTAN
discharge of dry faeces. Their mutual action RADIOS
of clearing Heat and relieving constipation is
potentiated when they are used in combina Da Huang, Tao Ren and Dan Pi

tion. These herbs combine to invigorate Blood


— This combination is indicated for febrile circulation and resolve Blood Stasis. This
disease with high fever and constipation due combination is thus indicated for various
to retention of Heat in the intestines. These patterns of Blood Stagnation, including
two herbs are also applied externally in the appendicitis, pain due to trauma and
form of a powder to treat appendicitis, abdominal pain due to stagnation of Qi and
carbuncles, boils and ulcers. Blood.

RADIX ET RHIZOMA RHEI AND RADIX RADIX ET RHIZOMA RHEI AND


ACONITI PRAEPARATA EUPOLYPHAGA SEU STELEOPHAGA

Da Huang and Fu Zi Da Huang and Di Bie Chong

Rhei purges stagnation while Aconiti warms Both substances invigorate Blood circulation
the Interior and disperses Cold. Combining and resolve Blood Stasis in the collaterals.

Table 14.1 Actions and indications of Radix et Rhizoma Rhei in combination with other herbs

Radix et Rhizoma Rhei Radix et Rhizoma Rhei clears Heat Indicated for febrile disease with
+ Natrii Sulfas and purges accumulation; Natrii constipation due to retention of
Sulfas softens hardness and Heat in the intestines
promotes discharge of faeces

Radix et Rhizoma Rhei Radix et Rhizoma Rhei purges Indicated for constipation due to
+ Radix Aconiti Praeparata stagnation; Radix Aconiti Praeparata stagnation of Cold
warms the Interior and disperses Cold

Radix et Rhizoma Rhei All three herbs invigorate Indicated for various patterns of
+ Semen Persicae Blood and resolve Stasis Blood Stagnation, especially in the
+ Cortex Moutan Radicis Lower Burner

Radix et Rhizoma Rhei Eupolyphaga seu Steleophaga Indicated for amenorrhoea and
+ Eupolyphaga seu resolves Blood Stasis and promotes palpable abdominal masses and for
Steleophaga the healing of sprains and traumatic injury
fractures; Radix et Rhizoma Rhei
invigorates Blood and resolves Stasis
64 Part 2: Combinations of common Chinese herbs

Eupolyphaga seu Stelelophaga also promotes harmonizes the Stomach, stops diarrhoea
the healing of sprains and fractures and and clears Heat.
disperses palpable masses due to Blood — This combination promotes digestion and
Stasis. harmonizes the Middle Burner and is
This combination is indicated for amenor- indicated for Retention of Food with
rhoea and palpable abdominal masses symptoms of diarrhoea, dysentery, epigas
due to Blood Stasis and for swelling and tric distension, abdominal pain, foul
pain due to stagnation of Blood following belching and fever.
traumatic injury (Table 14.1).

■ RADIX AUCKLANDIAE, SEMEN


I FRUCTUS CANNABIS, SEMEN PRUNI, ARECAE AND FRUCTUS AURANTII
RADIX ANGELICAE SINENSIS AND IMMATURUS
RADIX REHMANNIAE
• Mu Xiang, Bing Long and Zhi Shi
Huo Ma Ren, Yu Li Ren, Dang Gui and
ShengDi — Radix Aucklandiae regulates Qi while
Semen Arecae and Fructus Aurantii
- Fructus Cannabis, Semen Pruni and Radix Immaturus promote digestion and resolve
Angelicae Sinensis moisten the intestines Stagnation. This combination is indicated for
and relieve constipation; Radix Angelicae Retention of Food and Stagnation of Qi
Sinensis and Radix Rehmanniae nourish marked by abdominal distention and pain,
Blood and Yin and moisten dryness. Their and dysentery.
action of moistening the intestines to relieve
constipation is potentiated when they are
used in combination.
■ This combination is indicated for dry consti
pation due to old age, weak constitution and
h\ deficiency of Blood and Body Fluids. If
constipation is caused by weakness in trans
mission due to Spleen Qi Deficiency, add
large doses of Rhizoma Atractylodis
Macrocephalae.

FRUCTUS ORYZAE GERMINATUS


AND FRUCTUS HORDEI
GERMINATUS

Gu Ya and Mai Ya

These herbs combine to promote digestion


and harmonize the Stomach and are thus
indicated for poor appetite, Retention of
Food and dyspepsia.

FRUCTUS CRATAEGI, MASSA


FERMENTATA AND FRUCTUS HORDEI
GERMINATUS

Shan Zha, Shen Qu and Mai Ya

Fructus Crataegi promotes the digestion of


meat, invigorates the Stomach and stops
dysentery- Massa Fermentata and Fructus
Hordei Ccrminatus promote the digestion of
rice and wheat. Massa Fermentata also
65

iarrhoea

ion and
Herbs that relieve Bi syndromes
and is
d with
epigas-
i, foul

Til
RHIZOMA SEU RADIX NOTOPTERYGII ■ RAMULUS CINNAMOMI, RADIX

AND RADIX ANGELICAE PAEONIAE ALBA AND RHIZOMA


PUBESCENTIS ANEMARRHENAE

i while Qiang Huo and Du Huo • Gui Zhi, Bai Shao and Zhi Mu
Aurantii
Both herbs Release the Exterior, expel Wind — This combination clears Heat, removes
resolve
and disperse Cold and Dampness. Rhizoma obstruction from the channels and relieves
:ated for
seu Radix Notopterygii is more effective in pain. It is thus indicated for Febrile Bi. If
i of Qi
treating Bi syndromes of the upper body Heat is severe, add Gypsum Fibrosum and
id pain,
while Radix Angelicae Pubescentis is more Cortex Phellodendri. If both Heat and Cold
effective in treating Bi syndromes of the are combined, add Radix Aconiti
lower body. When used in combination their Kusnezoffii (Oman Cao Wu) and Herba
effectiveness in treating Bi syndromes is Ephedrae.
enhanced.
This combination is indicated for Cold-
Damp Bi. It is also combined with herbs that FRUCTUS CHAENOMELIS AND RADIX
Release the Exterior to treat Exterior patterns ACHYRANTHIS BIDENTATAE
complicated with Dampness, and headache
Mu Gua and Niu Xi
due to invasion of Wind, Cold and
Dampness. This combination relaxes the tendons,
activates Qi and Blood circulation and elimi
nates Dampness. It is indicated for Bi
RADIX GENTIANAE MACROPHYLLAE syndrome affecting the lower limbs.
AND RADIX CLEMATIDIS

Qin Jiao and Wei Ling Xian


RADIX LEDEBOURIELLAE AND RADIX
This combination removes obstruction in the STEPHANIAE TETRANDRAE
collaterals and stops pain and is indicated
Fang Feng and Fang Ji
for Wandering Bi syndromes.
Radix Ledebouriellae expels Wind and
relieves pain while Stephandrae Tetrandrae
■ RADIX GENTIANAE MACROPHYLLAE, expels Dampness and relieves joint pain.
RADIX STEPHANIAE TETRANDRAE, This combination is indicated for Wind-
RADIX REHMANNIAE AND RAMULUS Damp Bi syndromes.

LORANTHI

• Qin Jiao, Fang Ji, Sheng Di and Sang Ji HERBA SIEGESBECKIAE AND FOLIUM
Sheng
CLERODENDRI TRICHOTOMI
— This combination treats Bi syndrome and
Xi Xian Cao and Chou Wu Tong
clears Heat and is thus indicated for Febrile
Bi. A stronger therapeutic effect will be This combination treats Bi syndrome and
obtained with the addition of Lumbricus lowers blood pressure. It is indicated for
and Rhizoma Anemarrhenae. Damp Bi syndrome and for hypertension,
66 Part 2. Combination* of common Chim^c herbs

headache, dizziness and vertigo, numbness of the limbs and particularly the upper
of the limbs and hemipilegia. limbs.

ZAOCYS AND SCOLOPENDRA

Wu Shao She and Wu Gong

■ This combination expels Wind and removes


obstruction from the channels. It is indicated
for chronic and stubborn Bi syndromes. A
stronger action will be obtained if Bungarus
Parvus (Bui Hua She) is substituted for
Zaocys. Scorpio, Eupolyphaga seu
Stcieophaga and Lumbricus may be substi
tuted for Scolopendra.

I RADIX ANGELICAE PUBESCENTIS


AND RAMULUS LORANTHI

Du Huo and Sang Ji Sheng

- This combination treats lower back pain and


chronic Bi syndrome complicated with
deficiency of Defensive (Wei) Qi. The thera
peutic action is strengthened by the addition
of Radix Dipsaci, Rhizoma Cibotii and
Cortex Acanthopanacis Radicis. For concur
rent Qi and Blood Deficiency, add Radix
Astragali seu Hedysari and Radix Angelicae
Sinensis.

I RADIX ANGELICAE PUBESCENTIS,


RAMULUS LORANTHI, ZAOCYS AND
SCOLOPENDRA

Du Huo, Sang }i Sheng, Wu Shao She and


Wu Gong

- This combination tonifies the Liver and


Kidneys, strengthens tendons and bones,
removes obstruction from the channels and
eases the joints. It is indicated for chronic Bi
syndromes with deficiency of Defensive
(Wei1) Qi and for rheumatoid arthritis with
deformity of the joints.

RADIX GENTIANAE MACROPHYLLAE,


RAMULUS CINNAMOMI AND
RAMULUS MORI

Qin Jiao, Gui Zhi and Sang Zhi

This combination goes to the tour limbs,


removes obstruction from the channels and
relieves pain. It is indicated for Bi syndromes
67

Herbs that resolve and drain


upper

Dampness

Cortex Phellodendri dries Dampness and


HERBA AGASTACHIS AND HERBA
clears Heat, especially from the Lower
EUPATORII
Burner. This combination is indicated for all
Huo Xiang and Pei Lati Damp-Heat patterns of the Lower Burner,
including flaccidity and motor impairment
This combination fragrantly resolves
of the lower limbs, Damp-Heat Bi syndrome,
Summer Heat and Dampness, and is thus
Damp-Heat leucorrhoea, suppurating skin
indicated for Summer Heat, Dampness and
infections and eczema on the lower body.
Damp-Heat patterns.

RHIZOMA ATRACTYLODIS, GYPSUM


RHIZOMA ATRACTYLODIS AND
FIBROSUM AND RHIZOMA
CORTEX MAGNOUAE OFFICINALIS
ANEMARRHENAE
Cang Zhu and Hou Po
Cang Zhu, Shi Gao andZhiMu
The bitter, warm and dry nature of this
Rhizoma Atractylodis dries Dampness and
combination dries Dampness, invigorates
treats Bi syndrome; Gypsum Fibrosum and
the Spleen and relieves distension and
Rhizoma Anemarrhenae clear Heat and Fire.
fullness. It is indicated for fullness and
This combination is indicated for Damp-
distending pain in the epigastrium and
Heat febrile diseases and Damp-Heat Bi
abdomen and for diarrhoea due to invasion
syndromes (Table 16.1).
of the Middle Burner by External Dampness.

RHIZOMA ATRACTYLODIS AND ■ CORTEX MAGNOLIAE OFFICINALIS


CORTEX PHELLODENDRI AND RHIZOMA COPTIDIS

Cang Zhu and Huang Bai • Hou Po and Huang Lian

Rhizoma Actractylodis dries Dampness; — This combination clears Heat and dries

Table 16.1 Actions and indications of Rhizoma Atractylodis in combination with other herbs

Rhizoma Atractylodis Both herbs dry Damp, invigorate Indicated for epigastric and
+ Cortex Magnoliae Officinalis the Spleen and relieve fullness abdominal fullness, and diarrhoea
and distension due to External Damp invading
the Middle Burner

Rhizoma Atractylodis Rhizoma Atractylodis works Indicated for Damp-Heat patterns

+ Cortex Phellodendri on the Middle Burner and dries of the Lower Burner
Damp; Cortex Phellodendri works
on the Lower Burner and clears
Heat and Damp

Rhizoma Atractylodis Rhizoma Atractylodis dries Damp; Indicated for febrile disease
+ Gypsum Fibrosum Gypsum Fibrosum and Rhizoma or Bi Syndromes due to
+ Rhizoma Anemarrhenae Anemarrhenae clear Heat Damp-Heat
Part 2: Combination* of common Chinese hrrb*

dampness. It is indicated for distension and


patterns of Heat, Dampness and Summer
discomfort in the epigastrium and abdomen,
Heat with a sensation of heat and deep
epigastric pain due to Damp-Heat and yellow urine.
Damp-Heat febrile disease.

SEMEN BENINCASAE AND SEMEN I CAULIS AKEBIAE, RADIX


COICIS REHMANNIAE AND HERBA
LOPHATHERI
Deng Gua Ren and Yi Yi Ren
1 MuTong, ShengDi and Zhu Ye
- This combination drains Dampness and Fire
Poison. It is indicated for carbuncles, lung - Caulis Akebiae clears Heat and Fire,
abscess and appendicitis. promotes diuresis and opens the urinary
passages; Herba Lophatheri clears Heat
and promotes diuresis; and Radix
SEMEN PLANTAGINIS AND RADIX Rehmanniae nourishes the Yin, thus
ACHYRANTHIS BIDENTATAE preventing Caulis Akebiae from
damaging Body Fluids. This combination
Che Qian Zi and Niu Xi
is indicated for painful urination with
This combination promotes diuresis and scanty deep yellow urine and restlessness,
relieves swelling. It is indicated for oedema and for mouth and tongue ulcers due to
and dysuria. Heat in the Heart, Small Intestine and
Bladder.

■ POLYPORUS UMBELLATUS, PORIA


AND RHIZOMA ATRACTYLODIS HERBA LYSIMACHIAE,
MACROCEPHALAE SPORA LYGODII AND
• Zhu Ling, Fu Ling and Bai Zhu ENDOTHELIUM CORNEUM GIGERIAE
GALLI
— This combination promotes diuresis and
relieves swelling. It is indicated for oedema Jin Qian Cao, Hai fin Sha and Ji Net Jin
and dysuria.
This combination resolves stones and
open the urinary passages. It is indicated
for stones in the urinary and biliary
I PORIA, RHIZOMA ATRACTYLODIS tracts.

MACROCEPHALAE AND RAMULUS


CINNAMOMI

Fu Ling, Bai Zhu and Gui Zhi I HERBA ARTEMISIAE SCOPARIAE


FRUCTUS GARDENIAE, RADIX
- Poria promotes diuresis and drains retained
BUPLEURI AND RHIZOMA POLYGONI
Water; Rhizoma Atractylodis Macrocephalae CUSPIDATI
promotes diuresis and invigorates the
Spleen; and Ramulus Cinnamomi promotes 1 Yin Che Hao, Zhi Zi, Chat Hu and
diuresis, drains retained Water and warms Hu Zhang
the Yang. This combination is indicated
- Herba Artemisiae Scopariae clears Damp-
for oedema and retention of Water and
Phlegm. Heat, soothes the Gall Bladder and relieves
jaundice; Fructus Gardeniae clears Heat and
Dampness and relieves jaundice; Radix
GYPSUM FIBROSUM AND RADIX
Bupleuri enters the Liver and Gall Bladder
GLYCYRRHIZAE
and soothes the Liver; and Rhizoma
Poiygoni Cuspidati clears Heat and Fire
Hua Shi and Gan Cao Poison, drains Dampness and relieves
jaundice.
This combination clears Summer Heat
This combination is indicated for Damp-
and drains Dampness. It is indicated for Heat jaundice.
Herb* thai resolve and drain Dampness 69

Summer ■ RHIZOMA DIOSCOREAE


nd deep SEPTEMLOBAE, PORIA, FRUCTUS
ALPINIAE OXYPHYLLAE AND RADIX
LINDERAE
I
• Bi Xie, Fu Ling, Yi Zhi Ren and Wu Yao

— Rhizoma Dioscoreae Septemlobae drains


Turbid Dampness and separates the clear
from the turbid; Fructus Alpiniae
Oxyphyllae warms Kidney Yang; Radix

id Fire, Linderae strengthens the Bladder's function


urinary of controlling urine.

irs Heat — This combination is indicated for turbid


Radix urine due to Yang Deficiency, as in chyluria.

n, thus If turbid urine is due to Damp-Heat, replace

from Fructus Alpiniae Oxyphyllae with Cortex

ibination Phellodendri, Semen Plantaginis and

on with Gypsum Fibrosum.

lessness,
; due to
ine and

;eriae

i fin

les and
ndicated
biliary

E,

; Damp-
relieves
leat and
; Radix
Bladder
^hizoma
ind Fire
relieves

Damp-
70

'\rJ Herbs that resolve Phlegm

Succus Bambusac or Caulis Bambusae in


RHIZOMA PINELLIAE AND
Taeniam it is indicated for patterns of Damp
FERICARPIUM CITRI RETICULATAE
Phlegm and Cold Phlegm.
Ban Xia and Chen Pi

Rhizoma Pinelliae dries Dampness, resolves


Phlegm and conducts Rebellious Qi RHIZOMA PINELLIAE, RHIZOMA

downward to stop vomiting; Pericarpum GASTRODIAE AND RHIZOMA

Citri Reticuiatae dries Dampness, resolves ATRACTYLODIS MACROCEPHALAE

Phlegm, regulates Qi and harmonizes the Ban Xia, Tian Ma and Bai Zhu
Stomach.
This combination is indicated for all Damp Rhizoma Pinelliae dries Dampness and
Phlegm patterns and for epigastric pain, resolves Phlegm; Rhizoma Gastrodiae calms
vomiting and belching due to retention of Liver Wind; Rhizoma Atractylodis
Dampness and Stagnation of Qi. Macrocephalae invigorates the Spleen. This
combination is indicated for dizziness and
vertigo due to Damp Phlegm.
RHIZOMA PINELLIAE AND RHIZOMA
ARISAEMATIS
RHIZOMA PINELLIAE AND BULBUS
Ban Xia and Tian Nan Xing
FRITILLARIAE
This combination dries Dampness and
Ban Xia and Bei Mu
resolves Phlegm. It is indicated for Closed
Wind-Stroke due to Wind Phlegm. When Rhizoma Pinelliae dries Dampness and
combined with Fructus Aurantii Immaturus, resolves Phlegm; Bulbus Fritillariae

Table 17.1 Actions and indications of Rhizoma Pinelliae in combination with other herbs

Rhizoma Pinelliae Both herbs dry Damp and resolve Indicated for all Damp-Phlegm
+ Pericarpium Citri Reticuiatae Phlegm; Rhizoma Pinelliae regulates patterns and for epigastric pain,
Rebellious Qi, while Pericarpium vomiting and belching due to
Citri Reticuiatae moves Qi and retention of Damp and
harmonizes the Stomach stagnation of Qi

Rhizoma Pinelliae Both herbs dry Damp and resolve Indicated for Wind-Stroke due to
+ Rhizoma Arisaematis Phlegm Wind-Phlegm

Rhizoma PinelJiae Rhizoma Pinelliae dries Damp and Indicated for dizziness and vertigo
+ Rhizoma Gastrodiae resolves Phlegm; Rhizoma Gastrodiae due to Damp-Phlegm
+ Rhizoma Atractylodis calms Liver Wind; Rhizoma
Macrocephalae Atractylodis Macrocephalae
invigorates the Spleen

Rhizoma Pinelliae Rhizoma Pinelliae dries Damp and Indicated for cough with profuse
+ Bulbus Fritillariae resolves Phlegm; Bulbus Fritillariae sputum
moistens the Lungs, resolves Phlegm
and stops cough

rE COLLEGE-LIBRARY — —
3S Barclay CAro'te
.rietta, GA 3D060
Herbs that resolve Phlegm

moistens the Lungs, resolves Phlegm and


■ SEMEN SINAPIS ALBAE, FRUCTUS
stops cough. Combining these herbs treats PERILLAE AND SEMEN RAPHANI
the Lungs and Spleen concurrently and
potentiates the action of both herbs in • Bai Jie Zi, Su Zi and Lai Fu Zi
resolving Phlegm to stop cough. I — This combination resolves Phlegm and
This combination is thus indicated for cough conducts Rebellious Qi downward. It is
with profuse sputum (Table 17.1).
indicated for cough and dyspnoea due to
Cold Phlegm.

RHIZOMA ARISAEMATIS AND


RHI2OMA TYPHONII
SEMEN SINAPIS ALBAE, RADIX
ibusae in Tian Nan Xing and Bai Fu Zi EUPHORBIAE KANSUI AND RADIX
. of Damp EUPHORBIAE PEKINENSIS
This combination resolves Wind-Phlegm
and stops convulsion. It is indicated for Bai fie Zi, Gan Sui and Da fi
tetanus and for deviation of the mouth and
Semen Sinapis Albae resolves Phlegm
eye due to invasion by Wind-Phlegm. A
between the skin and the muscles; Radix
stronger therapeutic action will be obtained
Euphorbiae Kansui and Radix Euphorbiae
with the addition of Radix Ledebouriellae
ALAE Pekinensis resolve retained Water. This
and Scorpio.
combination is indicated for retained Water
in the hypochondrium (pleural effusion). It

ness and is administered in the form of powder or


BULBUS FRITIIXARIAE AND FRUCTUS
[iae calms pills.
TRICHOSANTHIS
ractylodis
leen. This Bei Mu and Gua Lou
iness and SEMEN SINAPIS ALBAE AND
Both herbs clear Heat Phlegm, moisten the
RAMULUS CINNAMOMI
Lungs and stop cough, and these actions are
potentiated when the herbs are combined. Bai fie Zi and Gui Zhi
This combination is indicated for patterns of
This combination resolves Phlegm, warms
LBUS Heat Phlegm and Dry Phlegm, including
the channels and removes obstruction from
cough with thick yellow sputum, chronic
the collaterals. It is indicated for painful
dry cough and tuberculosis of the lymph joints and numbness of the limbs and body
nodes.
due to stagnation of Cold Phlegm.
ness and
~ritillariae

■ SARGASSUM AND THALLUS


LAMINARIAE SEU ECKLONIAE

'hlegm • HaiZao and KunBu


stric pain,
; due to — This combination resolves Phlegm and
1 softens hard masses. It is indicated for goitre,
soft masses and tuberculosis of the lymph
nodes.
:edue to

nd vertigo ALUMEN AND RADIX CURCURMAE

Bai Fan and Yu fin

Alumen resolves Phlegm while Radix


Curcumae resolves Stagnation and opens
. profuse the orifices. This combination is indicated
for manic-depressive disorders due to
Turbid Phlegm Misting the Mind. It also
soothes the Gall Bladder and resolves stones.

./*!
72

18 Herbs that subdue Wind and


calm the Mind

CONCHA HALIOTIDIS AND CONCHA convulsion, removing obstruction from the


OSTREAE collaterals and relieving pain are potentiated
when they are used in combination.
Shi Jue Ming and Mu Li
— This combination is indicated for Excess-
- Both substances are shells that subdue type Liver Wind, giving rise to convulsions,
hyperactive Liver Yang and this action is as in tetanus, Wind-Stroke and infantile
potentiated when they are used in combina convulsion.
tion. They are indicated for Liver Yang — For Deficiency-type Liver Wind, decrease
Rising giving rise to headache, dizziness and the dosage and add tonics to the prescrip
vertigo, or Liver Wind. tion. If Liver Wind is due to Yin Deficiency,
add herbs that nourish the Yin. For chronic
convulsion in children due to Spleen
I CORNU ANTELOPIS AND RAMULUS Deficiency, add herbs that tonify and invigo
UNCARIAE CUM UNCIS rate the Spleen.

Ling Yang Jiao and Gou Teng

-Cornu Antelopis clears Heat, calms and I FRUCTUS LYCII AND FLOS
cools the Liver and subdues Wind; these CHRYSANTHEMI
actions are potentiated when it is combined
I <( Gou QiZi andJuHua
with Ramulus Uncariae cum Uncis.
■ This combination is indicated for convul - Fructus Lycii nourishes Liver and Kidney
sion, dizziness and vertigo, headache and Yin and improves vision. Flos Chrysanthemi
red eyes due to Liver Fire, Liver Yang Rising clears Wind-Heat and Liver Heat, calms the
and Liver Wind. Liver and improves vision.
■ This combination is indicated for eye disor
ders due to Liver and Kidney Yin Deficiency
RHIZOMA GASTRODIAE AND and for headache, dizziness and vertigo due
RAMULUS UNCARIAE CUM UNCIS to Kidney and Liver Yin Deficiency leading
to Liver Yang Rising and Liver Wind.
Tian Ma and Gou Teng

■ This combination calms the Liver and


subdues Wind. It is indicated for headache, ■ CONCHA OSTREAE, PLASTRUM
dizziness and vertigo due to Liver Yang
TESTUDINIS, CARAPAX TRIONYCIS,
Rising and for convulsion, dizziness and RADIX REHMANNIAE AND RADIX
vertigo due to Liver Wind.
PAEONIAE ALBA

• Mu Li, Gni Ban, Bie }ia, Sheng Di and Bai


■ SCORPIO, SCOLOPENDRA AND Shao

BOMBYX BATRYTICATUS
— Ostreae, Plastrum Testudinis and Carapax
• QuanXie,Wu Gong and Jiang Can Trionycis are three shells that subdue hyper
active Yang. Plastrum Testudinis and
— All of these substances are insects that Carapax Trionycis are salty and cold in
subdue Wind, and their actions of stopping nature and nourish (he Yin; this action is
Herbs thai subdue Wind and calm the Mind 73

potentiated when they are combined with Fire and improves vision. It is indicated

i Radix
Alba.
Rehmanniae and Radix Paeoniae for red eyes and headache due to Liver
Fire.
This combination is indicated for consump
tion of Body Fluids at the late stage oi! febrile
disease and for tremor of the hands and
feet due to Yin Deficiency leading to Liver
CORNU ANTELOPIS, FRUCTUS LYCII
Wind.
AND HERBA DENDROBII

Ling Yang Jiao, Gou Qi Zi and Shi Hu


RHIZOMA GASTRODIAE, CORTEX
This combination nourishes Yin, clears Liver
EUCOMMIAE AND RAMULUS
from the Heat and improves vision. It is indicated for
LORANTHI
itentiated blurred vision and other eye disorders due
Tian Ma, Dm Zhong and Sang Ji Sheng to Liver and Kidney Yin Deficiency with
r Excess- Empty Heat.
Rhizoma Gastrodiae not only calms the
vulsions,
Liver and subdues Wind but also removes
infantile
obstruction from the collaterals and treats Bi
syndromes. Cortex Eucommiae and
decrease ■ HAEMATITUM, CONCHA OSTREAE
Ramulus Loranthi tonify the Liver and
prescrip- AND RADIX ACHYRANTHIS
Kidneys, strengthen the lower back and
eficiency,
knees and lower blood pressure. BIDENTATAE
r chronic
This combination is indicated for sore and
> Spleen • Zhe Shi, Mu Li and Niu Xi
weak lower back and knees, Bi syndromes,
d invigo- — Haematitum and Concha Ostreae calm the
and hypertension due to Kidney Deficiency
with symptoms of lumbar soreness, dizzi Liver and subdue hyperactive Liver Yang
ness and vertigo, and numbness of the limbs and Liver Wind. Radix Achyranthis
and body (Table 18.1). Bidentatae assists Haematitum to conduct
Fire downward.
— This combination is indicated for headache,
CORNU ANTELOPIS, RADIX dizziness and vertigo, burning pain in the
GENTIANAE AND CONCHA head, tinnitus, redness of the face and
1 Kidney HALIOTIDIS restlessness due to Yin Deficiency, Liver
santhemi Yang and Liver Wind. A stronger thera
Ling Yang Jiao, Long Dan Cao and Shi Jue
:alms the peutic action will be obtained with the
Ming
addition of Magnetitum and Radix Paeoniae
■ye disor- This combination clears Liver Heat and Alba.
>eficiency
rtigo due
y leading Table 18.1 Actions and indications of Rhizoma Gastnxliae in combination with other herbs
d.
Rhizoma Gastrodiae Rhizoma Pinelliae dries Damp Indicated for dizziness and
+ Rhizoma Pinelliae and resolves Phlegm; Rhizoma vertigo due to Damp-Phlegm
+ Rhizoma Atractylodis Gastrodiae calms Liver Wind.

\ Macrocephalae Rhizoma Atractylodis Macrocephalae


invigorates the Spleen
YCIS,
DIX Rhizoma Gastrodiae Both herbs calm the Liver and Indicated for headache, dizziness
+ Ramulus Uncariae cum Uncis subdue Liver Wind and vertigo due to Liver Yang
Rising; and for convulsion,
nd Bai dizziness and vertigo due to
Liver Wind

Carapax Rhizoma Gastrodiae Rhizoma Gastrodiae calms the Indicated for sore and weak lower
ae hyper- + Cortex Eucommiae Liver and subdues Wind, and back and knees, Bi syndromes and
+ Ramulus Loranthi removes obstruction from the hypertension due to Kidney
nis and
collaterals; Cortex Eucommiae Deficiency
cold in
tonihes the Liver and Kidneys
action is
74 Part 2: Combinations of common Chinese herbs

OS DRACONIS AND CONCHA


OSTREAE

Long Gu and Mu Li

This combination astringes discharges,


calms the Liver and subdues hyperactive
Yang. It is indicated for spontaneous
sweating, night sweats and thin leucorrhoea,
and for headache, dizziness and vertigo,
palpitations and insomnia due to Liver Yang
Rising.

CINNABARIS AND MAGNETITUM

Zhu Sha and Ci Shi

This combination soothes the Heart and


calms the Mind. It is indicated for insomnia,
dream-disturbed sleep, absent-mindedness,
manic-depressive disorders and red eyes
and tinnitus due to Liver Fire.

SEMEN ZIZIPHI SPINOSAE AND


SEMEN BIOTAE

Suan Zao Ren and Bai Zi Ren

This combination nourishes the Heart and


calms the Mind. It is indicated for palpita
tions and insomnia. A stronger therapeutic
action will be obtained with the addition of
Poria cum Ligno Hospite (Fu Shen) and Os
Draconis.

RADIX GLYCYRRHIZAE, WHEAT AND


FRUCTUS ZIZIPHI

Gan Cao, Fu Xiao Mai and Da Zao

All three are sweet herbs that relax the Liver;


wheat also nourishes the Heart and relieves
restlessness. This combination is indicated
for hysteria, neurosis and schizophrenia. Its
actions of nourishing Heart Yin, clearing
Heart Fire, resolving Stagnation and calming
the Mind can be strengthened by the
addition of Radix Ophiopogonis and Cortex
Albiziae.
75

Tonics and astringents 19

indicated for Collapse of Yin. In small doses


RADIX GINSENG AND RADIX
it treats deficiency of Qi and Yin with
ASTRAGALI SEU HEDYARI
symptoms of thirst, profuse sweating, lassi
Ren Shen and Huang Qi tude, chronic cough, shortness of breath, a
red tongue and a thready and weak
This combination strongly tonifies Source
pulse due to consumption of Qi and Yin by
(Yuan) Qi; it also tonifies Qi generally
Heat.
and thus stimulates the production of
Blood. Both herbs are important Qi tonics
and their action of tonifying Qi is
potentiated when they are used in com RADIX GINSENG AND RADIX
bination. REHMANNIAE PRAEPARATA
This combination is indicated for
Ren Shen and Shu Di
Deficiency of Defensive (Wei) Qi, weakness
of Source Qi and Deficiency of both Qi and Radix Ginseng tonifies Source Qi; it also
Blood. tonifies Qi generally and stimulates the
production of Blood. Radix Rehmanniae
Praeparata nourishes Blood and Yin.
■ RADIX GINSENG AND RADIX This combination strongly tonifies Qi and
ACONITI PRAEPARATA Blood and is indicated for severe weakness
of Essential (Jing) Qi and Deficiency of Qi
• Ren Shen and Fu Zi
and Blood.
— Radix Ginseng strongly tonifies Source Qi
and also tonifies Qi generally and treats
Collapse of Qi. Radix Aconiti Praeparata RADIX GINSENG AND RADIX
restores devastated Yang and treats Collapse POLYGONIMULTIFLORI
of Yang.
Ren Shen and Shou Wu
— This combination tonifies Qi and recaptures
Yang and is indicated for Collapse of Yang. Radix Ginseng tonifies Qi; Radix Polygoni
In small doses it also treats general patterns Multiflori tonifies the Liver and Kidneys and
of Qi and Yang Deficiency. nourishes Yin and Blood.
This combination tonifies Qi, Blood and
Yin and is indicated for patterns of
RADIX GINSENG, RADIX concurrent Qi and Yin Deficiency, Qi and
OPHIOPOGONIS AND FRUCTUS Blood Deficiency, senility and chronic
SCHISANDRAE malaria marked by deficiency of Defensive
Qi.
Ren Shen, Mai Dong and Wu Wei Zi

Radix Ginseng tonifies Qi and treats


Collapse of Qi, Radix Ophiopogonis RADIX GINSENG AND GECKO OR

nourishes Yin and Fructus Schisandrae SEMEN JUGLANDIS


astringes and treats patterns of Collapse.
Ren Shen and Ge fie or Hu Tao Rou
This combination tonifies Qi, nourishes Yin
and treats patterns of Collapse. It is This combination tonifies the Lungs and
76 Part 2: Combinations of common Chinese herbs

Kidneys and stimulates the reception of Qi. people with deficiency of Yang and Qi
It is indicated for chronic cough and (Table 19.1).
dyspnoea due to deficiency of both the
Lungs and Kidneys marked by failure of the
Kidneys to grasp the Qi. ■ RADIX CODONOPSIS PILOSULAE AND
RHIZOMA ATRACTYLODIS
MACROCEPHALAE
RADIX GINSENG AND CORNU CERVI
• Dang Shen and Bai Zhu
PANTOTRICHUM
— This combination tonifies Qi and invigorates
Ren Shen and Lu Rong
the Spleen. It is indicated for Spleen Qi
Radix Ginseng strongly tonifies Source Qi; Deficiency.
Cornu Cervi Pantotrichum warms and
tonifies Kidney Yang and benefits Essence ■ RHIZOMA ATRACTYLODIS
and Blood. MACROCEPHALAE AND PORIA
This combination tonifies Source Qi and
• Bai Zhu and Fu Ling
benefits Essence and Blood and is
indicated for Deficiency patterns of Kidney — This combination tonifies Qi, invigorates the
Yang, Essence, Blood and Qi and Blood Spleen and resolves Dampness. It is
concurrently. It can be taken during the indicated for Spleen Qi Deficiency with or
winter as a general tonic by elderly without oedema and diarrhoea.

Table 19.1 Actions and indications of Radix Ginseng, in combination with other herbs

Radix Ginseng This combination tonifies Source Indicated for deficiency of Source Qi,
+ Radix Astragali seu Hedysari Qi, and Qi generally Defensive Qi or Qi and Blood.

Radix Ginseng
+ Radix Aconiti Praeparata Radix Ginseng tonifies Qi and treats Indicated for Collapse of Yang
Collapse of Qi; Radix Aconiti
Praeparata treats Collapse of
Yang

Radix Ginseng Radix Ginseng treats Collapse Indicated for Collapse of Yin
+ Fructus Schisandrae of Qi; Fructus Schisandrae
+ Radix Ophiopogonis astringes and treats patterns
of Collapse; Radix Ophiopogonis
nourishes Yin

Radix Ginseng Radix Ginseng tonifies Qi Indicated for deficiency of Essential


+ Radix Rehmanniae Praeparata and stimulates the production Qiorof Qi and Blood
of Blood. Radix Rehmanniae
Praeparata nourishes Blood
and Yin

Radix Ginseng Radix Ginseng tonifies Qi; Indicated for deficiency of Qi and
+ Polygoni Multiflori Polygoni Multiflori nourishes Blood or of Qi and Yin
Yin and Blood

Radix Ginseng Radix Ginseng tonifies Qi; Indicated for chronic cough and
+ Gecko or Semen juglandis Gecko and Semen Judlandis dyspnoea due to Lung and Kidney
stimulate reception of Qi Qi Deficiency

Radix Ginseng Radix Ginseng tonifies Source Qi; Indicated for Deficiency patterns
+ Cornu Cervi Pantotrichum Cornu Cervi Pantotrichum warms of Kidney Yang, Essence, Qi and
and tonifies Kidney Yang Blood
Tonics and Astringents 77

and Qi to tonify Qi and consolidate the Exterior.


RHIZOMA ATRACTYLODIS
Radix Astragali seu Hedysari assists Radix
MACROCEPHALAE AND RHIZOMA
Ledebouriellae to tonify Qi, Release the
DIOSCOREAE
Exterior and expel Wind.
VEAND Bat Zhu and Shan Yao In combination they tonify Qi, consolidate
the Exterior and stop sweating. With a
This combination tonifies Qi and invigorates
relatively large dose of Radix Astragali seu
the Spleen. It is indicated for diarrhoea and
Hedysari the combination is indicated for
leucorrhoea due to Spleen Deficiency.
spontaneous sweating due to Qi Deficiency.
vigorates With a relatively large dosage of Radix
pleen Qi Ledebouriellae the combination is indicated
RHIZOMA ATRACTYLODIS
for Qi Deficiency complicated with External
MACROCEPHALAE AND FRUCTUS
Invasion (Fig 19.1).
AURANTIIIMMATURUS

Bai Zhu and Zhi Shi

This combination tonifies Qi, invigorates the RADIX ASTRAGALI SEU HEDYSARI
AND RADIX ACONITI PRAEPARATA
Spleen, regulates Qi and relieves fullness. It
)rates the is indicated for poor appetite and for disten Huang Qi and Fu Zi
s. It is sion and pain in the epigastrium and
' with or Radix Astragali seu Hedysari tonifies Qi and
abdomen due to deficiency of the Middle
stops sweating; Radix Aconiti Praeparata
Burner with stagnation of Qi.
warms the Yang.
This combination tonifies Qi and Yang and
RADIX ASTRAGALI SEU HEDYSARI, stops sweating. It is indicated for sponta
RHIZOMA CIMICIFUGAE AND RADIX neous sweating and lassitude due to Qi and
BUPLEURI Yang Deficiency.

Huang Qi, Sheng Ma and Choi Hu

lource Qi, Radix Astragali seu Hedysari tonifies Qi and RADIX ASTRAGALI SEU HEDYSARI
lood. lifts Yang; Rhizoma Cimicifugae and Radix AND CONCHA OSTREAE
Bupleuri lift the Qi of the Middle Burner.
Huang Qi and Mu Li
This combination tonifies Qi and lifts Yang.
It is indicated for prolapse of the internal Radix Astragali tonifies Qi, consolidates the
organs or anus and for chronic diarrhoea Exterior and stops sweating. Concha Ostreae
due to Sinking of Spleen Qi. The therapeutic stops sweating by astringing.
action is strengthened by the addition of This combination tonifies Qi and stops

Fructus Aurantii Immaturus. sweating. It is indicated for spontaneous


sweating due to Qi Deficiency.

RADIX ASTRAGALI SEU HEDYSARI


AND RADIX LEDEBOURIELLAE RADIX ASTRAGALI SEU HEDYSARI
essential
AND RADIX ANGELICAE SINENSIS
Huang Qi and Fang Feng
Huang Qi and Dang Gui
Radix Ledebouriellae assists Radix Astragali
seu Hedysari to go to the surface of the body Radix Angelicae Sinensis tonifies Blood;

3i and

Radix Astragalus Seu Hedysari > Radix Radix Ledebouriellae > Radix Astragalus seu
Ledebouriellae Hedysari
i and Primary function of this combination is Primary function of this combination is elimination
id Kidney Qi tonification of External Wind

It is indicated for spontaneous sweating due It is indicated for external invasion due to
tterns to Qi Deficiency Qi Deficiency
Qi and

Fig. 19.1 Dose-related differences in the actions of Radix Astragali seu Hedysari and Radix Ledebouriellae.
78 Part 2: Combiiuilioiif of common Chinese herbs

Radix Astragali seu Hddysari tonifies Qi and treats abdominal pain due to deficiency of
thus indirectly stimulates the production the Middle Burner.
and control of Blood.
- This combination tonifies Qi and Blood. It is
indicated for Blood Deficiency, Qi and Blood RADIX PAEONIAE ALBA AND RADIX
Deficiency and haemorrhagic patterns due GLYCYRRHI2AE
to failure of the Qi to control Blood
Bai Shao and Gan Cao
(Table 19.2).
For numbness of the limbs and body and Radix Paeoniae Alba is sour in nature; it
systemic painful joints due to failure of the astringes, nourishes Yin, eases the Liver and
Blood to nourish the tendons, add Ramulus relieves pain. Radix Glycyrrhizae is sweet in
Cinnamomi and Caulis Spatholobi. nature; it relaxes spasm and relieves pain.
For haemorrhagic patterns due to failure of This combination produces Fluids by its
the Qi to control Blood, add Rhizoma combination of the sweet and sour tastes; it
Zingiberis {baked), Arillus Longan and also harmonizes the Blood, relaxes spasm
Radix Ginseng. and relieves pain. It is indicated for
cramping abdominal pain, hypochondriac
pain due to Liver Deficiency, spasm of
RADIX ANGELICAE SINENSIS AND musculus gastrocnemius and spontaneous
RADIX PAEONIAE ALBA and night sweats due to Yin Deficiency.

Dang Giti and Bai Shao

Radix Angelicae Sinensis tonifies and moves RADIX REHMANNIAE PRAEPARATA


Blood; Radix Paeoniae Alba tonifies Blood AND FRUCTUS CORNI
and nourishes Yin.
Shu Di and Shan Yu Rou
This combination tonifies Blood and is
indicated for patterns of Blood Deficiency This combination tonifies Liver and Kidney
and disorders of menstruation and labour. Yin and is thus indicated for Liver and
With the addition of Ramuius Cinnamomi, it Kidney Yin Deficiency.

Table 19.2 Actions and indications of Radix Astragali seu Hedysarj in combination with other herbs

Radix Astragali sen Hedysari Both herbs tonify Qi Indicated for Qi Deficiency or Qi and
+ Radix Ginseng Blood Deficiency

Radix Astragali seu Hedysari Radix Astragali seu Hedysari Indicated for Spleen Qi Sinking
+ Rhizoma Cimicifugae tonifies Qi and lifts Yang;
+ Radix Bupleuri Rhtzoma Cimicifugae and Radix
Bupleuri lift the Qi of the
Middle Burner

Radix Astragali seu Hedysari Radix Astragali seu Hedysari Indicated for deficiency of
+ Radix Ledebouriellae consolidates the Exterior; Radix Defensive Qi
Ledebouriellae expels Wind

Radix Astragali seu Hedysari Radix Astragali seu Hedysari tonifies Indicated for spontaneous sweating
+ Radix Aconiti Praeparata Qi and stops sweating; Radix Aconiti and lassitude due to Qi and Yang
Praeparata warms the Yang Deficiency

Radix Astragali seu Hedysari Radix Astragali seu Hedysari stops Indicated for spontaneous sweating
+ Concha Ostrcae sweating by tonifying Qi; Concha due to Qi Deficiency
Ostreae stops sweating by astringing

Radix Astragali seu Hedysari Radix Astragali seu Hedysari tonifies Indicated for bleeding due to Qi and
+ Radix Angelicas Sinensis Qi and stimulates the production Blood Deficiency
and control of Blood. Radix Angelicae
Sinensis tonifies Blood
Tonics and Astringents 79

iency of restlessness, insomnia and palpitations due


RADIX REHMANNIAE PRAEPARATA
Yin Deficiency with Empty Fire.
AND FRUCTUS AMOMI

Shu Di and Sha Ren


■ RADIX OPHIOPOGONIS, RADIX
— Radix Rehmanniae Praeparata nourishes Yin REHMANNIAE AND RHIZOMA
and Blood but is sticky in nature and can COPTIDIS
impair the function of the Stomach. Fructus
Amomi regulates Qi and invigorates the • Mai Dong, Sheng Di and Huang Lian
lature; it Spleen and Stomach to modify the sticky — This combination nourishes Heart Yin and
,iver and nature of Radix Rehmanniae Praeparata. clears Heart Fire. It is indicated for febrile
sweet in — This combination thus nourishes Yin and disease with high fever, irritability and coma
pain. Blood without impairing the function of the and for Flaring of Heart Fire with mouth and
s by its Stomach and is indicated for Yin and Blood tongue ulcers.
tastes; it Deficiency complicated with poor appetite.
s spasm

ited for HERBA DENDROBII AND RADIX


hondriac ■ RADIX GLEHNIAE AND RADIX OPHIOPOGONIS
Dasm of OPHIOPOGONIS
itaneous
Shi Hu and Mai Dong
• Bet Sha Shen and Mai Dong
icy. This combination nourishes the Stomach
-— Both herbs nourish Yin and produce Body and stimulates the production of Body
Fluids and this action is potentiated when Fluids. It is indicated for consumption of
;ata they are used together. This combination is Stomach Yin due to febrile disease, with
indicated for: symptoms of low grade fever, thirst and
1. Cough due to Lung Yin Deficiency dryness of the tongue, and for Stomach Yin
2. Stomach Yin Deficiency giving rise to Deficiency with symptoms of retching, dull
I Kidney thirst, an empty and uncomfortable burning stomach pain and an empty uncom
ver and sensation in the Stomach and dull fortable feeling of the stomach.
burning pain in the epigastrium
3. Lung and Stomach Heat with consump
tion of Body Fluids (diabetes), with ■ HERBA DENDROBII, FRUCTUS LYCII
symptoms of a desire to drink large AND FLOS CHRYSANTHEMI
quantities and loss of weight.
• Shi Hu, Gou Qi Zi and Ju Hua

jt Qi and — This combination nourishes the Liver and


■ RADIX OPHIOPOGONIS AND RADIX improves vision. It is indicated for blurred
ing ASPARAGI vision due to Liver and Kidney Yin
Deficiency and for chronic eye disorders due
• Mai Dong and Tian Dong
to Yin Deficiency.
— Both herbs nourish Yin, moisten the Lungs
and stop cough, and these actions are poten
tiated when they are used together. ■ FRUCTUS LIGUSTRI LUCIDI AND
HERBA ECLIPTAE
— This combination is indicated for chronic
non-productive cough due to Lung Yin • Nu Zhen Zi and Han Lian Cao
Deficiency or Lung and Kidney Yin
weating
— Both herbs tonify Liver and Kidney Yin, but
id Yang Deficiency.
Fructus Ligustri Lucidi is more effective in
tonifying Kidney Yin while Herba Ecliptae
weating
RADIX OPHIOPOGONIS, RADIX is more effective in tonifying Liver Yin.
REHMANNIAE AND SEMEN ZIZIPHI Herba Ecliptae also cools Blood and stops
SPINOSAE bleeding.
oQi and — This combination is indicated for patterns of
Mai Dong, Sheng Di and Suan Zao Ren
Liver and Kidney Yin Deficiency and for
This combination nourishes Heart Yin haemorrhagic patterns due to Yin
and calms the Mind. It is indicated for Deficiency.
Part 2: Combinations of common Chinese herbs

RHIZOMA CURCULIGINrS AND in nature; it strongly tonifies Kidney Yin,

HERBAEPIMEDII nourishes Yin generally and reinforces the


Ren channel. Cornu Cervi is sweet, salty and
Xian Mao and Yin Yang Huo
warm in nature; it warms the Kidney,
This combination warms and tonifies tonifies Yang, benefits Essence and Blood
Kidney Yang, disperses Cold Damp and and reinforces the Du channel.
relieves Bi syndromes. It is indicated for: - This combination thus tonifies both Yin and
1. Kidney Yang Deficiency with symptoms Yang and reinforces the Ren and Du
of impotence and infertility channels as well as the other Extraordinary
2. chronic Cold Damp Bi syndrome with a channels. It is indicated for deficiency of
cold sensation and pain in the lumbar both Yin and Yang, and of Essence and
region and knees Blood, and for severe Deficiency patterns
3. menopausal hypertension. due to Emptiness of the eight Extraordinary
With the addition of Rhizoma channels. It is often administered in the form
Anemarrhenae, Cortex Phellodendri and of a liquid extract.

Radix Angelicae Sinensis, these herbs lower


blood pressure by regulating Yin and Yang.
■ FRUCTUS ALPINIAE OXYPHYLLAE
AND RADIX LINDERAE
I HERBA EPIMEDII AND RAMULUS
• Yi Zhi Ren and Wu Yao
LORANTHI
— Fructus Alpiniae Oxyphyllae warms and
Yin Yang Huo and Sang Ji Sheng
astringes the Kidneys while Radix Linderae
- Herba Epimedii warms Kidney Yang, warms the Lower Burner and eliminates
disperses Cold and Dampness and removes Cold from the Bladder.
obstruction from the channels. Ramulus — This combination thus warms the Kidneys,
Loranthi tonifies the Liver and Kidneys, eliminates Cold and astringes urine. It is
strengthens the tendons and bones and indicated for urinary frequency or inconti
relieves Bi syndrome. nence, or enuresis due to Kidney Deficiency,
■ This combination tonifies the Liver and and for weakness of the Bladder with
Kidneys, strengthens tendons and bones and stagnation of Cold.

relieves paralysis and Bi syndrome. It is


indicated for chronic Bi syndrome, Wei
syndrome and infantile paralysis. ■ FRUCTUS PSORALEAE AND SEMEN
MYRISTICAE

• Bu Gu Zhi and Rou Dou Kou


CORTEX EUCOMMIAE AND RADIX
DIPSACI — Fructus Psoraleae warms Kidney Yang and
tonifies Ming Men Fire, while Semen
Du Zhong and Xu Duan
Myristicae warms the Spleen, regulates Qi
- This combination tonifies the Liver and and astringes the intestines to stop
Kidneys, strengthens the lower back and diarrhoea.
knees, promotes the healing of sprains and — This combination warms both the Spleen
fractures and prevents miscarriage. It is and Kidneys and astringes the intestines to
indicated for lower back pain due to Kidney stop diarrhoea. It is indicated for chronic
Deficiency, chronic Bi syndrome, osteo diarrhoea and dysentery due to Spleen and
porosis, contusions and sprains and threat Kidney Yang Deficiency.
ened abortion.

FRUCTUS ROSAE LAEVIGATAE AND


PLASTRUM TESTUDINIS AND CORNU SEMEN EURYALES
CERVI
Jin Ying 7A and Qian Shi
Gui Ban ami Lit fiao
Rosae Laevigatae is sour and astringent in
Plastrum Testudinis is saltv, sweet and cold nature; it consolidates Essence and stops
Tonics and Astringents 81

ney Yin, diarrhoea and leucorrhoea. Euryales is


irces the sweet, neutral and astringent in nature; it
ialty and primarily invigorates the Spleen and tonifies
Kidney, the Kidneys, but also consolidates Essence to
d Blood stop diarrhoea and leucorrhoea.
When they are used together, their mutual
Yin and action of astringing the Essence is strength
md Du ened and this combination is thus indicated
ardinary for spermatorrhoea, enuresis, leucorrhoea
tency of and diarrhoea.
nee and
patterns
ordinary RADIX EPHEDRAE AND FRUCTUS
the form TRITICI LEVIS

Ma Huang Gen and Fu Xiao Mai

■ This combination stops sweating and is thus


\E indicated for spontaneous sweating and
night sweats. For Yin Deficiency, add Yin
tonics such as Radix Ophiopogonis and
Radix Paeoniae Alba. For Qi Deficiency, add
ms and Qi tonics such as Radix Astragali seu
jnderae Hedysari and Rhizoma Atractylodis
minates Macrocephalae.

Cidneys,
le. It is
inconti-
ficiency,
sr with

[EN

ing and
Semen
lates Qi
d stop

Spleen
tines to
chronic
?en and

lND

igent in
i stops
82

20 Herbs that warm the Interior


and regulate Qi

■ RADIX ACONITI PRAEPARATA AND Dampness. It is indicated for abdomina


RHIZOMA ZINGIBERIS distension and loose stools due to Spleen
Yang Deficiency with retention of Cold
• Fu Zi and Gan Jiang
Damp and for general aching due to
— Rhizoma Zingiberis strengthens the action of invasion by Cold Damp.
Radix Aconiti Praeparata in restoring
Collapsed Yang and moderates its toxicity.
— This combination restores Collapsed Yang, ■ FRUCTUS EVODIAE AND RHIZOMA
warms the Interior and disperses Cold. It is ZINGIBERIS RECENS
indicated for Collapse of Yang, and Yang
• Wu Zhu Yu and Sheng Jiang
Deficiency with Internal Cold.
— For abdominal pain and diarrhoea due to — This combination warms the Middle Burner,
Spleen Yang Deficiency, add Radix relieves pain and conducts Rebellious Qi
Codonopsis Pilosulae and Rhizoma downward to stop vomiting. It is indicated
Atractylodis Macrocephalae. for pain, retching and spitting of saliva due
to retention of Cold in the Stomach and for
hiccup.
1 RADIX ACONITI PRAEPARATA AND
\'t CORTEX CINNAMOMI

Fu Zi and Rou Gui ■ FLOS CARYOPHYLLI AND CORTEX


CINNAMOMI
- This combination warms Kidney Yang. It is
• Ding Xiang and Rou Gui
indicated for soreness of the lower back and
knees, cold limbs due to Kidney Yang — Both herbs are pungent, aromatic and warm
Deficiency, and decline of Ming Men Fire. in nature and combine to warm the Middle
The action of tonifying Yang is strengthened Burner and relieve pain.
by the addition of herbs that tonify Kidney — This combination is indicated for a cold
Yin. To tonify both Yin and Yang, add sensation and pain in the heart and
Radix Rehmanniae Praeparata and Fructus abdomen. It is administered by mouth or
Corni.
ground to a powder and applied to the
umbilicus as a medicinal plaster.

RHIZOMA ATRACTYLODIS MACRO


CEPHALAE AND RADIX ACONITI ■ CORTEX CINNAMOMI AND RADIX ET
PRAEPARATA RHIZOMA RHEI
BaiZhu andFu Zi Rou Gui and Da Huang

■ Rhizoma Atractylodis Macrocephalae invig ■ Cortex Cinnamomi warms the Interior and
orates the Spleen and dries Dampness. disperses Cold. Radix et Rhizoma Rhei
Radix Aconiti Praeparata warms Yang, activates Blood circulation, clears Poison
disperses Cold and relieves pain. and stops dysentery
This combination warms Yang, disperses This combination disperses Cold and
Cold, invigorates the Spleen and eliminates stops dysentery. It is indicated for chronic
Herbs that warm the Interior and regulate Qi 83

Table 20.1 Actions and indications of Cortex Cinnamomi in combination with other herbs

Cortex Cinnamomi Both herbs warm Kidney Yang Indicated for Kidney Yang
+ Radix Aconiti Praeparata Deficiency

Cortex Connamomi Both herbs warm the Middle Indicated for a cold sensation and
+ Flos Caryophylli Burner and move Qi to relieve pain pain in the heart and abdomen

Cortex Cinnamomi Cortex Cinnamomi warms the Interior Indicated for chronic dysentery due
+ Radix et Rhizoma Rhei and disperses Cold; Radix et to Spleen Yang Deficiency
Rhizoma Rhei purges the intestines

dysentery due to Spleen Yang Deficiency


iminal RHIZOMA ZINGIBERIS (BAKED) AND
(Table 20.1).
Spleen FOLIUM ARTEMISIAE ARGYI

Cold Pao Jiang and Ai Ye


ue to RHIZOMA ALPINIAE OFFICINALIS
Both herbs stop bleeding. In addition, Baked
AND RHIZOMA CYPERI
Rhizoma Zingiberis warms the Spleen
Gao Liang Jiang and Xiang Fu while Folium Artemisiae Argyi warms the
uterus.
IA Rhizoma Alpiniae Officinalis warms the
This combination warms the channels and
Stomach and disperses Cold. Rhizoma
stops bleeding. It is indicated for bloody
Cyperi regulates Qi and relieves pain
stools and uterine bleeding due to
This combination warms the Stomach and
Deficiency with stagnation of Cold.
urner, regulates Qi. It is indicated for epigastric
If bleeding is caused by a failure of Qi to
us Qi pain due to stagnation of Qi and Cold.
control Blood, add herbs that tonify Qi and
icated
control Blood, such as Radix Astragali seu
'a due
Hedysari.
nd for FLOS CARYOPHYLLI AND CALYX KAKI

Ding Xiang and Shi Di

Both herbs warm the Middle Burner, RHIZOMA CYPERI AND FOLIUM
conduct Rebellious Qi downward and ARTEMISIAE ARGYI

stop vomiting and hiccup, and these Xiang Fu and Ai Ye


actions are potentiated when they are used
together. Rhizoma Cyperi regulates Qi and menstrua
This combination is indicated for hiccup and tion while Folium Artemisiae Argyi
warm

vomiting due to stagnation of Cold in the disperses Cold and warms the channels and
liddle
Stomach. uterus.
This combination warms the uterus and
i cold
regulates Qi and menstruation. It is
and
RHIZOMA ZINGIBERIS, HERBA ASARI indicated for dysmenorrhoea due to stagna
ith or
o the AND FRUCTUS SCHISANDRA tion of Qi and Cold and for irregular
menstruation and infertility due to retention
Gan Jiang, Xi Xin and W« Wei Zi
of Cold in the uterus.
Rhizoma Zingiberis and Herba Asari are
pungent and hot in nature; they warm the
KET
Lungs to resolve retained Water. Fructus PER1CARPIUM CITRI RETICULATAE
Schisandrae is sour in nature and astringes VIRIDE AND PERICARPIUM CITRI
the Lungs to stop cough. RETICULATAE
This combination warms the Lungs, resolves
>r and Qing Pi and Chen Pi
retained Water and stimulates the Lungs'
Rhei
function of governing respiration. It is thus Pericarpium Citri Reticulatae Viride harmo
'oison
indicated for chronic cough and dyspnoea nizes the Liver, breaks Qi stagnation and
due to retention of Cold and Water in the resolves masses. Pericarpium Citri
and
Lungs. Reticulatae regulates Qi and harmonizes the
ironic
84 Port 2: Combinations of common Chinese herbs

Stomach. Their action of regulating Qi and RADIX AUCKLANDIAE AND FRUCTUS


relieving pain is potentiated when they are
AMOMI
used together.
— This combination harmonizes the Liver and Mu Xiang and Sha Ren
the Stomach and regulates Qi. It is indicated Radix Aucklandiae regulates Qi, invigorates
for distension and pain in the epigastrium the Spleen, warms the Middle Burner,
and hypochondrium due to stagnation of Qi relieves pain and stops diarrhoea. Fructus
in the Liver and Stomach. Amomi promotes the circulation of Qi,
resolves Dampness and conducts Rebellious
Qi downward to stop vomiting.
FRUCTUS MELIAE TOOSENDAN AND This combination regulates Qi and harmo
RHIZOMA CORYDALIS nizes the Stomach. It is indicated for patterns

Chuan Li an Zi and Yati Hu Suo of stagnation of Stomach and Spleen Qi.

Fructus Meliae Toosendan harmonizes the


Liver and clears Heat while Rhizoma FRUCTUS AURANTII AND RADIX
Corydalis activates Qi and Blood circulation PLATYCODI
and relieves pain.
Their actions of harmonizing the Liver, Zhi Qiao and Jie Geng
regulating Qi and relieving pain are potenti Fructus Aurantii regulates Qi and conducts
ated when they are used together and this Rebellious Qi downward while Radix
combination is thus indicated for pain due to Platycodi stimulates the Lungs' dispersing
Qi Stagnation or Liver Qi Stagnation turning function and lifts Sinking Qi.
to Heat. This combination is indicated for discomfort
and stuffiness in the chest and epigastrium
due to stagnation of Lung and Stomach Qi.
FRUCTUS TRICHOSANTHIS AND
BULBUS ALL1I MACROSTEMI

Gua Lou and Xie Bai

Both herbs open the chest. In addition,


Fructus Trichosanthis resolves Phlegm
while Bulbus Allii Macrostemi regulates
Qi, invigorates Yang and disperses
masses.

This combination invigorates Yang,


resolves Phlegm, regulates Qi and relieves
pain. It is indicated for obstruction of Qi in
the chest marked by chest pain due to
deficiency of Yang and retention of Turbid
Phlegm.

■ RHIZOMA CYPERI AND FLOS


INULAE

• XiangFu and Xuan Fit Hua

— Rhizoma Cyperi regulates Qi and relieves


stagnation while Flos Inulae resolves
Phlegm, disperses masses and harmonizes
the collaterals.
— This combination regulates Qi, harmonizes
the collaterals and relieves pain. It is
indicated for costal and hypochondriac pain
and stuffiness in the chest.
85

CTUS
Herbs that activate Blood 21
j»orates
Burner,
circulation and stop bleeding
:ructus
of Qi,
lellious

harmo-
atterns for pain and palpable abdominal masses due
RADIX ANGELICAE SINENSIS AND
to stagnation of Qi and Blood.
RHIZOMA LIGUSTICI CHUANXIONG

Dang Gui and Chuang Xioitg


SEMEN PERSICAE AND FLOS
Both herbs activates Blood circulation. In
CARTHAMI
addition, Radix Angelicae Sinensis tonifies
Blood, while Rhizoma Ligustici Chuanxiong Tao Ren and Hong Hua
activates Qi circulation.
inducts Semen Persicae breaks Blood Stasis while
This combination tonifies Blood, activates
Radix Flos Carthami activates Blood circulation
Blood circulation, regulates menstruation
versing and regulates menstruation.
and relieves pain. It is indicated for disor
This combination breaks Blood Stasis
ders of menstruation and labour due to
omfort and activates Blood circulation. It is
Blood Deficiency and Blood Stagnation and
istrium indicated for patterns of Blood Stagnation
for patterns of Stagnant Qi and Blood.
:hQi. such as dysmenorrhoea, amenorrhoea,
postpartum abdominal pain, Bi syndrome,
abscess, swelling and pain due to trauma,
RHIZOMA LIGUSTICI CHUANXIONG
and abdominal pain due to stagnation of
AND RADIX ANGELICAE DAHURICAE
Blood.
Chuan Xiong and Bai Zhi

Both herbs eliminate Wind and relieve pain;


in addition, Rhizoma Ligustici Chuanxiong HERBA LEONURI AND HERBA LYCOPI

activates Blood circulation. Yi Mu Cao and Ze Lan


This combination eliminates Wind and
relieves pain and is indicated for chronic Both herbs activate Blood circulation,

intermittent headache due to Wind in the regulate menstruation, promote diuresis

head. and relieve swelling, and these actions


are strengthened when they are used
together.

■ RHIZOMA SPARGANII AND RHIZOMA This combination is indicated for amenor


rhoea due to stagnation of Blood and for
ZEDOARIAE
oedema due to retention of Water and
• San Leng and E Zhu stagnant Blood.

— Both herbs break stagnation of Qi and Blood,


but Rhizoma Sparganii is more effective in
breaking Blood Stagnation while Rhizoma RESINA OLIBANI AND RESINA
Zedoariae is more effective in breaking Qi MYRRHAE
Stagnation. Their action of breaking Stasis
Ru Xiang and Mo Yao
and resolving Stagnation is strengthened
when they are used together. Both herbs resolve Blood Stasis and relieve
— This combination breaks Qi and Blood pain, but Resina Olibani is more effective in
Stagnation, relieves pain and disperses circulating Qi while Resina Myrrhae is more
palpable abdominal masses. It is indicated effective in dispersing stagnant Blood.
86 Part 2: Combinations of common Chinese herbs
'I

This combination is indicated for pain due to


stagnation of Qi and Blood and for non- ■ COLLA CORII ASINI AND POWDER
healing carbuncles, boils and ulcers. OF CONCHA MERETRICIS SEU
CYCLINAE

• A }iao and Ge Fen Colla Corii


I RADIX SALVIAE MILTIORRHIZAE,
LIGNUM SANTALI AND RHIZOMA — Colla Corii Asini nourishes Yin and stops
LIGUSTICI CHUANXIONG bleeding while Concha Meretricis seu
Cyclinae clears Lung Heat and resolves
Dan Shen, Tan Xiang and Chuan Xiong Phlegm.

- Radix Salviae Miltiorrhizae activates Blood — This combination nourishes Yin, clears
circulation; Lignum Santali circulates Qi and Empty Fire and Lung Heat and stops
opens the chest; Rhizoma Ligustici bleeding. It is indicated for haemoptysis
Chuanxiong activates the circulation of both due to Lung Yin Deficiency with Empty
Qi and Blood. Fire.

- This combination activates Qi and Blood


circulation and relieves pain. It is indicated
for stabbing pain and a feeling of suffocation RADIX SANGUISORBAE AND FLOS
in the heart and chest due to stagnant Qi SOPHORAE
and Blood obstructing the vessels of the
heart. Di Yu and Huai Hua

This combination cools Blood, stops


bleeding and clears heat from the intestines.
I POLLEN TYPHAE AND FAECES It is indicated for bloody stool and for
TROGOPTERORUM bleeding due to haemorrhoids.
Pu Huang and Wu Ling Zhi

- Both substances resolve Blood Stasis, stop


RADIX SANGUISORBAE AND
bleeding and relieve pain, but Pollen Typhae
CACUMEN BIOTAE
is more effective stopping bleeding while
Faeces Trogopterorum is more effective in Di Yu and Ce Bat Ye
relieving pain.
This combination cools Blood and stops
- Their actions of resolving Blood Stasis,
stopping bleeding and relieving pain are bleeding. It is indicated for bleeding from
the digestive tract due to Heat.
potentiated when they are used together.
This combination is indicated for patterns of
pain due to stagnation of Blood, such as
dysmenorrhoea, postpartum abdominal CACUMEN BIOTAE AND RHIZOMA
pain, cardiac pain and abdominal pain, and ZINGIBERIS (BAKED)
for haemorrhagic patterns due to stagnation
Ce Bai Ye and Pao Jiang
of Blood.
This combination warms the channels
and stops bleeding. It is indicated for
I COLLA CORII ASINI AND POLLEN Deficient and Cold patterns with bloody
TYPHAE stools due to failure of the Spleen to control
Blood.
A Jiao and Pu Huang

- Co!la Corii Asini nourishes and astringes


Blood to stop bleeding while Pollen Typhae
HERBA CEPHALANOPLORIS AND
enters the Lower Burner, cools Blood and
RHIZOMA IMPERATAE
resolves Blood Stasis.
Together, these substances nourish Blood Xiao Ji and Bai Mao Gen
and stop bleeding, and this combination is
This combination cools Blood and stops
thus indicated for uterine bleeding, menor-
bleeding and is indicated for haematuria
rhagia and haematuria.
and epistaxis.
Herb* that activate Blood circulation and flop bleeding 87

Table 21.1 Types of blood disorder and combinations of herbs that treat them
R
Menstrual disorders due to Blood Deficiency and Stagnation Radix Angelicae Sinensis
Rhizoma Ligusrici Chuanxiong

Uterine bleeding or haematuria due to Blood deficiency and Stagnation Colla Corii Asini
Pollen Typhae
stops
5 seu
Bloody stool due to Spleen not controlling Blood Cacumen Biotae
Baked ginger
■solves

Menstrua] disorders, postpartum pain, Bi syndrome, abdominal pain or Semen Persicae


clears traumatic injury involving Blood Stasis Flos Carthami
stops
Amennorhoea and oedema due to Stagnant Blood Herba Leonuri
iptysis
Herba Lycopi
Empty
Cardiac or abdominal pain due to stagnation of Blood Pollen Typhae
Faeces Trogopterorum

Haematemesis or haemoptysis due to Stasis Rhizoma Bletilla


Radix Notoginseng

Palpable abdominal masses due to Qi and Blood Stagnation Rhizoma Sparganii


Rhizoma Zedoariae

stops Non-healing carbuncles, boils and ulcers due to stagnation of Qi and Blood Resina Olibani
stines. Resina Myrrhae
id for
Stabbing pain and feeling of suffocation in the chest due to stagnation of Radix Salviae Miltiorrhizae
Qi and Blood Lignum Santali
Rhizoma Ligustici Chuanxiong

Haemoptysis due to Lung Empty Fire Colla Corii Asini


Concha Meretricis seu Cyclinae

Haemorrhoids or bloody stool due to Heat Radix Sanguisorbae


Flos Sophorae

stops
Bleeding from gastrointestinal tract due to Heat Radix Sanguisorbae
from Cacumen Biotae

Haematuria or epistaxis due to Heat Herba Cephalanoploris


Rhizoma Imperatae

RHIZOMA BLET1LLAE AND RADIX


NOTOGINSENG
annels
Bat Ji and San Qi
■d for
)loody Rhizoma Bletillae stops bleeding by
ontrol astringing the Blood and promotes healing.
Radix Notoginseng stops bleeding by
resolving Blood Stasis and relieves pain.
When used together, the haemostatic action
of these herbs is potentiated, but without
producing Blood Stagnation. This combina
tion is indicated for haemoptysis and
haematemesis.

stops
Part 3:
Application of herbs on
the basis of the
differentiation of
patterns of the
Zang Fu

The differentiation of Zang Fu patterns


is the most important method of dealing
with disorders arising from internal
imbalance. It is necessary for the
practitioner to have a good command of
the selection of the appropriate herbs
when a diagnosis based on Zang Fu
patterns has been made.
This section is focussed on the
classification of herbs in terms of Zang
Fu patterns, explaining their actions,
characteristics and indications. It also
covers the interaction and therapeutic
combination of herbs acting on the same
organs.
91

The Lungs 22

A. Actions, characteristics Herbs which are effective in moistening the

and indications of common Lungs and stopping cough include:

herbs Bulbus Fritillariae Bet Mu


Fructus Trichosanthis Gua Lou
Mel Feng Mi
1. HERBS THAT STIMULATE THE
DISPERSING FUNCTION OF THE Other herbs not only moisten the Lungs but

LUNGS also nourish Yin and promote Body Fluids,


and are thus more suitable for dryness of the
— Most of these herbs are pungent and either Lungs complicated with consumption of
warm or cool in nature. They are indicated Body Fluids. These include:
for retention of pathogenic factors in the
Lungs with symptoms of cough and wheeze. Colla Corii Asini A Jiao
Radix Glehniae Bei Sha Shen
Representative herbs include:
Radix Adenophorae Nan Sha Shen
Herb a Ephedrae Ma Huang Radix Ophiopogonis Mai Dong
Radix Platycodi Jie Geng Radix Asparagi Tian Dong
Radix Peucedani Qian Hu
Semen Armeniacae Amarum Xing Ren

4. HERBS THAT PURGE THE LUNGS

— These herbs are usually bitter and cold in


2. HERBS THAT CLEAR LUNG HEAT
nature and have a strong therapeutic action.
— These herbs are often cold and either bitter They are indicated for Lung Fire and reten
or sweet in nature. They are indicated for tion of Water in the Lungs. Representative
retention of Heat in the Lungs with herbs include:
symptoms of cough, dyspnoea, fever, a
Radix Scutellanae Huang Qin
yellow tongue coating and a rapid pulse.
Semen Lepidii seu Descurainiae Ting Li Zi
Commonly used herbs include:
Cortex Mori Radicis Sang Bai Pi
Radix Scutellanae Huang Qtn Cortex Lycii Radicis Di Gu Pi
Gypsum Fibrosum Shi Gao
— Radix Scutellariae is more effective in
Rhizoma Anemarrhenae Zhi Mu
purging Lung Fire while Semen Lepidii is
Cortex Mori Radicis Sang Bai Pi

Cortex Lycii Radicis Di Gu Pi


more effective in purging Water from the
Herba Houttuyniae Yu XingCao Lungs. Cortex Mori Radicis and Cortex Lycii
Flos Lonicerae Jin Yin Hua Radicis are applicable in both conditions but
Fmctus Forsythiae Lian Qiao have a milder action.
Rhizoma Phragmitis huGen

5. HERBS THAT STIMULATE THE


3. HERBS THAT MOISTEN THE LUNGS DESCENDING FUNCTION OF THE
LUNGS
— Most of these herbs are sweet, cold and
moistening in nature. They are indicated for — These herbs are descending in nature and
dry ness of the Lungs and damage to Body conduct Rebellious Lung Qi downward.
Fluids generally. They are indicated for cough and dyspnoea
92 Part 3: Application of herbs on the basis of patterns of the Zang Fu

due to upward perversion of Lung Qi, Rhizoma Cynanchi Bai Qian


Representative herbs include: Stauntonii
Radix Peucedani Qian Hu
Cortex Magnoliae Hou Po
Radix Polygalae Yuan Zhi
Officinalis
Lignum Aquilariae Chen Xiang — Herbs that stop cough and wheeze include:
Resinatum
Semen Armeniacae Amarum Xing Ren Semen Armeniacae Amarum Xing Ren
Radix Stemonae Bai Bu
Flos Inulae Xuan Fu Hua
Herba Ephedrae Ma Huang
Rhizoma Cynanchi Bai Qian
Stauntonii Semen Lepidii seu Descurainiae Ting Li Zi
Semen Cinkgo Bei Guo
Fructus Perillae Su Zi

6. HERBS THAT WARM THE LUNGS 8. HERBS THAT TONIFY LUNG QI

— These herbs are pungent, and warm or hot in — These herbs are sweet and warm in nature
nature. They are indicated for retention of and are indicated for deficiency of Lung Qi
Cold in the Lungs and for retention of Cold with symptoms of dyspnoea, lassitude and a
Damp in the Lungs with symptoms of low and feeble voice. Commonly used herbs
cough, watery white sputum and a pale include:

tongue with a white coating. Commonly Radix Ginseng Ren Shen


used herbs include: Radix Codonopsis Pilosulae Dang Shen
Radix Astragali seu Hedysari Huang Qi
Rhizoma Zingiberis Gan Jiang
Rhizoma Polygonati Huang )ing
Herba Asari Xi Xin
Radix Panacis Quinquefolii Xi Yang Shen
Ramulus Cinnamomi GuiZhi
Bulbus Lilii Bai He

7. HERBS THAT RESOLVE PHLEGM AND


9. HERBS THAT TONIFY LUNG YIN
STOP COUGH AND WHEEZE
— These herbs are sweet and cold in nature and
— These herbs are either pungent and warm or
are indicated for deficiency of Lung Yin with
cool and moist in nature.
symptoms of malar flush, tidal fever, night
— Herbs that resolve Phlegm and are pungent,
sweats, cough and haemoptysis. Commonly
warm and dry in nature are indicated
used herbs include:
for retention of Cold and Phlegm in the
Lungs, characterized by profuse white Radix Panacis Quinquefolii Xi Yang Shen
sputum. Commonly used herbs of this type Radix Glehniae Bei Sha Shen
include: Radix Adenophorae Nan Sha Shen
Radix Ophiopogonis Mai Dong
Rhizoma Pinelliae Ban Xia Radix Asparagi Tian Dong
Rhizoma Arisaematis Tian Nan Xing Rhizoma Polygonati Odorati YuZhu
Semen Sinapis Albae Bai Jie Zi Rhizoma Polygonati Huang Jing
Pericarpium Citri Chen Pi Bulbus Lilii Bai He

- Herbs that are cold or cool and moist in


nature are indicated for Phlegm Heat charac
terized by thick yellow sputum. Repre 10. HERBS THAT ASTRINGE THE LUNGS
sentative herbs of this type include: — These herbs are sour and astringent in
Bulbus Fritillariae Bet Mu nature. They are indicated when Lung Qi
Fructus Trichosanthis Gua Lou is scattered and attenuated by chronic
Succus Batnbusae Zhu Li cough and wheeze. Representative herbs
include:
Herbs that primarily stop cough and relieve
dyspnoea and secondarily resolve Phlegm Fructus Schisandrae Wu Wei Zi

include: Fructus Mume Wu Mei


Fructus Chebulae HeZi
Radix Asteris Zi Wan Galla Chinensis Wu Bei Zi
Flos Farfarae Kuan Dong Hua Pericarpium Papaveris Ying Su Ke
The Lungs 93

herbs do not tonify, and thus treat the Biao


B. Interactions and
without treating the Ben.
combinations of herbs — To treat both Biao and Ben, herbs that
astringe the Lungs are combined with herbs

iclude: 1. HERBS THAT CLEAR LUNG HE^T, that tonify Lung Qi, e.g. Radix Ginseng and
MOISTEN THE LUNGS AND NOURISH Radix Astragali seu Hedysari are combined
ing Ren with Fructus Schisandrae, Fructus Mume
LUNG YIN
aiBu
and Semen Ginkgo.
fa Huang —- Herbs that clear Lung Heat are indicated for
— Clinically, patterns of Lung Qi Deficiency
ng Li Zi retention of Heat or Fire in the Lung,
often appear concurrently with patterns of
ei Guo presenting with a Full Heat pattern. Herbs
Lung Yin Deficiency and thus Lung Qi tonics
that moisten the Lungs and nourish Lung
are often combined with Lung Yin tonics,
Yin are indicated for dryness and /or
e.g. Radix Ginseng and Rhizoma Polygonati
deficiency of the Lungs, presenting with
are combined with Radix Adenophorae,
Deficiency patterns. Since pathogenic
n nature Radix Ophiopogonis and Radix Glehniae.
dryness and Heat tend to consume Body
Lung Qi — Lung Qi Deficiency may lead to Lung Yang
Fluids and damage Yin, these patterns often
de and a Deficiency, resulting in retention of Phlegm
ed herbs
exist concurrently Fluid in the Lungs. For this pattern, herbs
— Where Lung Dryness due to invasion by
that tonify Lung Qi are combined with herbs
pathogenic dryness and Heat is complicated
that warm the Lungs and resolve retained
ihen with symptoms of consumption of Body
Water, e.g. Radix Astragali seu Hedysari and
■Shen Fluids and Yin Deficiency, herbs that clear
Radix Codonopsis Pilosulae are combined
'gQ' Lung Heat are combined with herbs that
with Ramulus Cinnamomi, Rhizoma
tgjing moisten the Lungs and tonify Lung Yin. For
ngShen Zingiberis, Herba Asari, Poria, Radix Asteris
example, Folium Mori, Cortex Mori Radicis
le and Flos Farfarae (Fig. 22.2).
and Rhizoma Anemarrhenae are combined
with Bulbus Fritillariae, Radix Glehniae,
Radix Adenophorae and Radix 3. HERBS THAT RESOLVE PHLEGM AND
Ophiopogonis. STOP COUGH AND WHEEZE, AND
ture and ■— Where the Yin has been damaged by febrile OTHER TYPES OF HERBS
Yin with disease, or in cases of Yin Deficiency with
a. Herbs that stimulate the dispersing
er, night Empty Fire, with symptoms of tidal fever,
function of the Lungs and herbs that
mmonly night sweats, cough, malar flush and
resolve Phlegm
haemoptysis, herbs that nourish Yin are
combined with herbs that clear Lung Heat — This combination is indicated when Phlegm
ng Shen
(Fig. 22.1). blocks the Lungs' dispersing function.
ha Shen
Sha Shen
Herba Ephedrae, Semen Armeniacae

Oong Amarum and Radix Platycodi are often


2. HERBS THAT TONIFY LUNG QI, combined with Radix Peucedani, Rhizoma
Dong
ASTRINGE THE LUNGS, WARM THE Pinelliae and Radix Stemonae.
LUNGS AND NOURISH LUNG YIN
le b. Herbs that clear Lung Heat and herbs that
— Herbs that astringe the Lungs are indicated
resolve Phlegm
for chronic cough and wheeze due to exces
sive scattering of Lung Qi. However, these — This combination is indicated for retention
JNGS

igent in
.ung Qi
chronic Pathological (Full) Heat in Lungs Damage to Lung Yin
e herbs
Lung Yin Deficiency — Lung Empty Heat

Zi
In either case, combine:
herbs that clear Lung Heat + herbs that nourish Lung Yin, and moisten the Lungs

U
Ke Fig. 22.1 Patterns of combined Lung Heat and Lung Yin Deficiency.
94
Part .3; Application of herb* on the basis of patterns of the Zang Fu

Lung Yin Deficiency:


combine with Lung Yin tonics
i ;
til!

Lung Yang Deficiency Retention of

lljjli
i Phlegm-Fluid:
combine with herbs that
warm the Lungs and
resolve Fluid

CHRONIC COUGH : use herbs that astringe the Lungs

LUNG QI DEFICIENCY • use herbs that tonify Lung Qi


Iff

ii
Fig. 22.2 Complications of chronic cough.

of Phlegm Heat in the Lungs. Radix


all resolve wheeze. How do they differ in
Scutellariae, Cortex Mori Radicis and their actions and indications?
Rhizoma Anemarrhenae are often combined
2. Herba Ephedrae, Radix Scutellariae, Radix
with Bulbus Fritillariae and Fructus
Glehniae and Radix Adenophorae all stop
Trichosanthis.
cough. How do they differ in their natures,
actions and indications?
c. Herbs that warm the Lung and herbs that
3. What is the relationship between herbs that
resolve Phlegm
clear Lung Heat, herbs that nourish Lung
— This combination is indicated for retention Yin and herbs that resolve Phlegm? How are
of Phlegm Fluid, Cold Phlegm or Phlegm they combined clinically?
Damp in the Lungs. Herba Ephedrae, Herba 4. What are the differences and similarities
Asari and Rhizoma Zingiberis are often between herbs that tonify Lung Qi, herbs
combined with Rhizoma Pinelliae, Fructus that warm the Lung and herbs that resolve
Periliae and Semen Sinapis Albae. Phlegm?

d. Herbs that stimulate the descending


function of the Lung and herbs that resolve
Phlegm

— This combination is indicated for Turbid


Phlegm blocking the Lungs with a resulting
failure of Lung Qi to descend.
— For Cold Phlegm, Fructus Perillae, Semen
Armenicae Amarum and Cortex Magnoliae
are combined with Rhizoma Pinelliae,
Pericarpium Citri Reticulatae and Rhizoma
Cynanchi Stauntonii.
— For Phlegm Heat, Semen Lepidii seu
Descurainiae, Cortex Mori Radicis and
Folium Eriobotryae are combined with
Bulbus Fritillariae and Fructus
Trichosanthis.

Questions
1. Herba Ephedrae, Fructus Perillae, Semen
Lepidii seu Descurainiae and Semen Ginkgo
95

The Heart 23
>s that
nd

A. Actions, characteristics Radix Rehmanniae ShengDi


Colla Corii Asini A Jiao
and indications of common Arillus Longan Long Yan Ron
herbs

4. HERBS THAT TONIFY HEART YIN


1. HERBS THAT TON1FY HEART Ql
lifter in
— Most of these herbs are sweet and cold in
— Most of these herbs are sweet and warm in
nature. They are indicated for Heart Yin
, Radix nature and are indicated for Heart Qi
Deficiency with symptoms of palpitations, a
all stop Deficiency with symptoms of palpitations
red tongue and a thready and rapid pulse.
latures, and shortness of breath. Commonly used
Commonly used herbs include:
herbs include:
rbs that Radix Rehmanniae Sheng Di
Radix Ginseng Ren Shen
h Lung Radix Ophiopogonis Mai Dong
Radix Codonopsis Filosulae Dang Shen
low are Colla Corii Asini A ]iao
Radix Pseudostellariae Tai Zi Shen
Rhizoma Polygonati Odorati Yu Zhu
Radix Astragali seii Hedysari Huang Qi
ilarities Radix Glycyrrhizae Zhi Gan Cao
, herbs
5. HERBS THAT CLEAR HEART FIRE
resolve
2. HERBS THAT WARM HEART YANG — These herbs are primarily bitter and cold
— These herbs are pungent and warm or hot in and secondarily sweet in nature. They are

nature. They are indicated for Heart Yang indicated for Heart Fire Blazing with
Deficiency, with symptoms of palpitations, symptoms of restlessness, mouth and
cold limbs, sweating with a cold sensation of tongue ulcers, coma and a red tongue tip.

the body, cyanosis and a pulse that is feeble, Representative herbs include:

thready and fading, deep and hidden, or Radix Coptidis Huang Ltan
knotted. Commonly used herbs include: Fructus Forsythiae Lian Qiao
Fructus Gardeniae ZhiZi
Radix Aconiti Praeparata Fu Zi
Calculus Bovis Niu Huang
Rhizoma Zingiberis Gan Jiang
Radix Rehmanniae ShengDi
Ramulus Cinnamomi Gut Zhi
Herb a Lophatheri Zhu Ye
Caulis Akebiae Mm Tong
Plumula Nelumbinis Lian Xin
3. HERBS THAT TONIFY HEART BLOOD Cortex Moutan Radicis Dan Pi

— These herbs are sweet, nourishing and sticky


in nature; they may be warm, neutral or
6. SUBSTANCES THAT SOOTHE THE
cold. They are indicated for deficiency of
HEART AND CALM THE MIND
Heart Blood with symptoms of dizziness
and vertigo, palpitations, a pale tongue and — Substances which strongly settle and calm
a thready pulse. Commonly used herbs the Mind are mostly minerals or fossils,
include: while those which calm the Mind by
Radix Angelicae Sinensis Dang Gui nourishing the Heart are mostly seeds. Both
Radix Rehmanniae Shu Di types of medicinal are indicated for restless
Praeparata ness, insomnia, palpitations, irritability,
96 Part 3: Application of herbs on the basis of patterns of the Zang Fu

depression and mania. Commonly used and are indicated for stagnation of Heart
substances which settle and calm the Mind Blood with symptoms of cardiac pain, palpi
include: tations and oppression of the chest.
Cinnabaris Zhu Sha Commonly used herbs include:
Os Draconis Long Gu
Radix Salviae Miltiorrhizae Dan Shen
Magnetitum Ci Shi
Rhizoma Ligustici Chuan Xiong
Hi! Margarita Zhen Zhu
Chuanxiong
Concha Margaritifera Usta Zhen Zhu Mu
Ramulus Cinnamomi Gui Zhi
Succinum HuPo
Semen Persicae Tao Ren
Haematitum ZheShi Flos Carthami Hong Hua
Concha Ostreae Mu I i
Radix Paeoniae Rubra ChiShao
Herbs that calm the Mind by nourishing the Eupolyphaga seu DiBieChong
Heart include: Steleeophaga
Hirudo Shui 7hi
Semen Biotae Bai Zi Ren
Semen Ziziphi Spinosae Suan Zao Ren
Caulis Polygoni Multiflori Ye Jiao Teng
Radix Polygalae Yuan Zhi
B. Interactions and
Cortex Albiziae He Huan Pi combinations of herbs
Poria cum Ligno Hospite Fu Shen

1. HERBS THAT TONIFY HEART QI AND


HERBS THAT WARM HEART YANG
7. SUBSTANCES THAT OPEN THE
ORIFICES — Heart Yang Deficiency is often complicated
with Heart Qi Deficiency, and herbs that
— These substances are aromatic, pungent and
warm Heart Yang are thus often used in
penetrating in nature. They are indicated for
combination with herbs that tonify Heart Qi.
delirium or coma due to high fever, or
For example, Radix Ginseng is combined
sudden collapse and syncope in Wind
with Radix Aconiti Praeparata, and Ramulus
Stroke, convulsion or epilepsy. Commonly
Cinnamomi is combined with treated Radix
used substances include:
Glycyrrhizae.
Moschus She Xiang
Bomeolum Syntheticum Btng Pian
Calculus Bovis Niu Huang 2. HERBS THAT TONIFY HEART BLOOD
Rhizoma Acori Graminei Shi Chang Pu
AND HERBS THAT NOURISH HEART
Styrax Liquidus Sm He Xiang
YIN
Benzoinum An Xi Xiang
Radix Curcumae Yu Jin — With the exception of Radix Angelicae
Radix Polygalae YuanZhi Sinensis and Arillus Longan, the herbs that
Venenum Bufonis Chan Sm
tonify Heart Blood also nourish Heart Yin.
Some of the herbs that nourish Heart Yin -
With the exception of Rhizoma Acori
such as Radix Rehmanniae, Radix
Graminei, Radix Curcumae and Radix Rehmanniae Praeparata and Colla Corii
Polygalae, all of these substances are admin Asini - also tonify Heart Blood.
istered in the form of pills or powders for
— Since deficiency of Heart Blood and Heart
first aid, e.g.:
Yin often appear concurrently, these
Bolus of Calculus Bovis Niu Huang Wan categories of herbs are often used in combi
Bolus of Precious Drugs Zhi Bao Dan nation.
Bolus of Styrax Su He Xiang
Wan

3. HERBS THAT TONIFY HEART QI AND


HERBS THAT NOURISH HEART BLOOD
HERBS THAT ACTIVATE BLOOD AND HEART YIN
CIRCULATION AND RESOLVE BLOOD
STASIS IN THE VESSELS — In patterns of Heart pathology, it is quite
common that both Qi and Blood, or both Qi
These herbs are pungent or bitter in nature and Yin, are deficient.
The Heart 97

: Heart
Heart Yin Deficiency Heart Empty Heat
, palpi-
chest. Febrile disease — damage to Heart Yin

In either case, combine: I


herbs that clear Heart Fire + herbs that nourish Heart Yin
aong

Fig. 23.1 Patterns of combined Heart Heat and Heart Yin Deficiency.

9 — Herbs that tonify Heart Qi are thus often Angelicae Sinensis, Radix Ophiopogonis
hong used in combination with herbs that nourish and Colla Corii Asini.
Heart Blood or Heart Yin.
c. Herbs that clear Heart Fire, resolve Phlegm
and open the orifices
4. COMBINATIONS OF HERBS FOR
— Mental disturbance due to obstruction of the
MIXED CONDITIONS OF EXCESS AND
Heart orifices can arise either from Turbid
DEFICIENCY
Phlegm or from exterior Heat invading the
a. Herbs that nourish Heart Yin and clear Pericardium. Since these two conditions
Heart Fire may coexist, herbs that clear Heart Heat are
often combined with herbs that open the
— Heart Yin Deficiency is likely to lead to
orifices (Fig. 23.2).
Heated Empty Heat in the Heart; on the other hand,
— For example, Rhizoma Coptidis, Fructus
)s that febrile disease at the Nutritive (Ying) level Forsythiae, Cornu Rhinoceri Asiatici and
sed in may damage Heart Yin.
Calculus Bovis are combined with
art Qi. — Herbs that nourish Heart Yin are thus
Moschus, Borneolum Syntheticum,
nbined often combined with herbs that clear Heart
Rhizoma Acori Graminei and Radix
imulus Fire. For example, Colla Corii Asini and
Curcumae.
Radix Radix Ophiopogonis are combined with
— Similarly, herbs that resolve Phlegm are
Rhizoma Coptidis and Fructus Forsythiae
combined with herbs that open the orifices.
(Fig. 23.1). For example, Radix Polygalae, Succus
Bambusae and Bulbus Fritillariae are
OD b. Herbs that tonify Heart Blood and Yin and
combined with Rhizoma Acori Graminei,
RT herbs that calm the Mind Radix Curcumae and Borneolum
— When Heart Blood and Yin are deficient, the Syntheticum.

jjelicae Heart is not nourished; this leads to restless — For restlessness with insomnia due to Heart
os that ness from Deficiency. In this case, herbs that Fire Blazing with Phlegm-Fire harassing the
rt Yin. calm the Mind are combined with herbs that Heart, herbs that clear Heart Fire are used in
: Yin- tonify Heart Blood and Yin. For example, combination with herbs that clear Phlegm
Radix Semen Biotae, Semen Ziziphi Spinosae, Os and herbs that calm the Mind. For example,
Corii Draconis and Cinnabaris-coated Poria cum Rhizoma Coptidis and Caulis Bambusae in
Ligno Hospite are combined with Radix Taeniam are combined with Cinnabaris-
Heart
these
rombi-

Turbid Phlegm
Obstruction of the
orifices of the Heart
ND Heat invading
.OOD the Pericardium

Use herbs that resolve Phlegm herbs that open


or clear Heart Heat the orifices
quite
othQi
Fig. 23.2 Patterns of obstruction of the orifices of the Heart.
98
Part 3; Application of herbs on the basis of patterns of the Zang Fu

coated Poria cum Ligno Hospite, Semen


Biotae and Os Draconis.

Questions
1. Compare and contrast herbs that tonify
Heart Qi and herbs that warm Heart Yang
How do they interrelate?
2. Compare and contrast herbs that nourish
Heart Yin, herbs that clear Heart Fire and
herbs that calm the Mind. How do they
interrelate?
99

The Spleen, Stomach and Large 24


Intestines

A. Actions, characteristics Radix Astragali seu Hedysari Huang Qi


Rhizoma Cimicifugae Sheng Ma
and indications of common
Radix Bupleuri Chat Hu
herbs Radix Puerariae Ge Gen

1. HERBS THAT TONIFY SPLEEN AND


STOMACH QI
4. HERBS THAT RESOLVE DAMPNESS
— These herbs are sweet and warm in nature
and are indicated for Spleen and Stomach Qi — These herbs are pungent, bitter, warm, dry
Deficiency with symptoms of poor appetite, and aromatic in nature. They are indicated
loose stools and lassitude. Commonly used for retention of Dampness in the Middle
herbs include: Burner with symptoms of epigastric and
abdominal distension and fullness and a
Radix Ginseng Ren Shen
sticky tongue coating. Commonly used
Radix Codonopsis Pilosulae Dang Shen
herbs include:
Radix Astragali seu Hedysari HuangQi
Rhizoma Atractylodis Bai Zhu Rhizoma Atractylodis Cang Zhu
Macrocephalae Cortex Magnoliae Hou Po
Rhizoma Dioscoreae Shan Vao Officinalis
Radix Glycyrrhizae Zhi Gan Cao Herba Agastachis Huo Xiang
Herba Eupatorii Pei Lan
Fructus Amomi Sha Ren

2. HERBS THAT WARM SPLEEN YANG Fructus Amomi Cardamomi Bai Dou Kou
Herba Elsholtziae Xiang Ru
— These herbs are pungent and warm or hot. Rhizoma Acori Graminei Shi Chang Pu
They are indicated for Spleen Yang
Deficiency with symptoms of poor appetite,
loose stools, cold limbs and a cold sensation
and pain in the epigastrium and abdomen.
5. HERBS THAT REGULATE SPLEEN AND
Commonly used herbs include:
STOMACH QI
Rhizoma Zingiberis Gan Jiang
— These herbs are pungent, warm and
Radix Aconiti Praeparata Fu Zi
aromatic in nature. They are indicated for
Cortex Cinnamomi Rou Gui
stagnation of Spleen and Stomach Qi with
Ramulus Cinnamomi Gui Zhi
Fructus Alpiniae Oxyphyllae Yi Zhi Ren symptoms of distension and pain in the
epigastrium and abdomen. Commonly used
herbs include:

3. HERBS THAT RAISE CENTRAL QI Radix Aucklandiae Mu Xiang


Fericarpium Citri Reticulatae Chen Pi
— These herbs are ascending in nature and
Fructus Aurantii Immaturus Zhi Shi
are indicated for patterns of Spleen Qi Fructus Aurantii Zhi Ke
Sinking with symptoms of chronic Cortex Magnoliae Officinalis HouPo
diarrhoea, or prolapse of the anus or Caulis Perillae Su Geng
internal organs. Commonly used herbs Fructus Amomi Sha Ren

include: Pericarpium Arecae Da Fu Pi


100 Part 3: Application of herbs on the basis of patterns of the Zang Fu

6. HERBS THAT CLEAR STOMACH FIRE 9. HERBS THAT CONDUCT REBELLIOUS


STOMACH QI DOWNWARD
— These herbs are cold and either bitter or
sweet in nature. They are indicated for — These herbs are descending, pungent and
Stomach Heat or Fire with symptoms of warm, or bitter and cold, or sweet and cold
thirst, vomiting, burning epigastric pain, in nature. They are indicated for upward
haematemesis and swelling and pain of the disturbance of Stomach Qi with symptoms
gums. Commonly used herbs include: of vomiting and hiccup. Commonly used
herbs that warm the Stomach and conduct
Rhizoma Coptidis Huang Lian
Gypsum Fibrosum
Rebellious Qi downward include:
Shi Gao
Rhizoma Anemarrhenae Zhi Mu Rhizoma Zingiberis Recens Sheng Jiang
Radix et Rhizoma Rhei Da Huang Flos Caryophylli Ding Xiang
Rhizoma Phragmitis Lu Gen Lignum Aquilariae Resinatum Chen Xiang
Rhizoma Pinelliae BanXia
For high fever and thirst due to Full
Fructus Evodiae Wu Zhu Yu
Heat in the Stomach, Gypsum Fibrosum
and Rhizoma Anemarrhenae are most effec — Herbs that clear Stomach Heat and conduct
tive. Rebellious Qi downward include:
For vomiting and haematemesis due to
Rhizoma Coptidis Huang Lian
Stomach Fire, Rhizoma Coptidis and Radix Caulis Bambusae in Taeniam Zhu Ru
et Rhizoma Rhei should be used. Rhizoma Phragmitis Lu Gen

— Herbs that conduct Rebellious Qi downward


7. HERBS THAT NOURISH STOMACH and stop vomiting include:
YIN Haematitum ZheShi
FlosInulae Xuan Fu Hua
These herbs are sweet and cold in nature and
are indicated for Stomach Yin Deficiency
with symptoms of retching, an uncomfort
able and empty sensation in the Stomach 10. HERBS THAT ASSIST DIGESTION

and a red tongue with scanty coating. AND INVIGORATE THE STOMACH
Commonly used herbs include: — These herbs relieve Food Retention, assist
Herba Dendrobii Shi Hu digestion and invigorate the Stomach. They
Radix Ophiopogonis Mai Dong are indicated for Retention of Food with
Radix GlehniaeBei Sha Shen symptoms of distending epigastric and
Radix Adenophorae Nan Sha Shen abdominal pain, vomiting, diarrhoea, poor
Rhizoma Polygonati Odorati Yu Zhu appetite and indigestion. Commonly used
Rhizoma Dioscoreae Shan Yao
herbs include:

Fructus Cralaegi Shan Zha

HERBS THAT DISPERSE COLD FROM Fructus Oryzae Germinatus Gu Ya

THE SPLEEN AND STOMACH Fructus Hordei Germinatus Mai Ya


Massa Fermentata Medicinalis Shen Qu
These herbs are pungent and hot or warm in Endolhelium Comeum JiNeiJin
nature. They are indicated for retention of Gigeriae Galli

Cold in the Middle Burner with symptoms Semen Raphani Lai Fu Zi

of a cold sensation and pain in the epigas


trium and abdomen. Commonly used herbs
include: 11. SUBSTANCES THAT MODERATE ACID
SECRETION
Rhizoma Alpiniae Gao Liang Jiang
Officinalis — These herbs neutralize or stop acid secretion
Rhizoma Zingiberis Recens Sheng Jiang and are thus indicated for hyperacidity with
Rhizoma Zingiberis Gan Jiang
symptoms of epigastric pain and acid regur-
Ramulus Cinnamomi Gui Zhi
gitation. Commonly used substances
Flos Caryophylli Ding Xiang
include:
Peri carpi um Zanthoxyli Huang Jiao
Fructus Evodiae Wu Zhu Yu Os Sepiellae seu Sepiae Wu Zei Gu
The Spleen, Stomach and Large Intestines 101

Concha Arcae XVa heng Zi haemorrhoids due to retention of Damp-


tous Concha Ostreae MuLi Heat in the Large Intestine. Commonly used
herbs include:
:nt and Rhizoma Coptidis Huang ttan
nd cold 12. PURGATIVE HERBS |
Radix Scutellariae Huang Qin
lpward — These herbs resolve obstruction in the Cortex Phellodendri Huang Bai
nptoms Cortex Fraxini Qin Pi
intestines and promote the discharge of
y used Radix Pulsatillae Bai Tou Weng
faeces. They are divided into three types:
:onduct Herba Portulacae Ma Chi Xian
1. herbs that purge by eliminating Fructus Bruceae Ya Dan Zi

pathogenic factors Radix Sophorae Flavescentis Ku Shen


g Jiang
2. herbs that purge by moistening
• Xiang For bleeding haemorrhoids due to Heat in
3. harsh cathartics that dispel retained
i Xiang the Large Intestine, use Radix Sanguisorbae
Water.
Xia and Flos Sophorae.
ZhuYu — Herbs that purge by eliminating pathogenic
factors are bitter and cold in nature. They are
onduct
indicated for stagnation in the intestinal 14. HERBS THAT ASTRINGE THE

tract, high fever, constipation with abdom INTESTINES TO STOP DIARRHOEA


ng Liart
inal distension and fullness, and acute — These herbs are sour and astringent in
Ru
abdomen. Commoniy used herbs include: nature and are indicated for chronic
Radix et Rhizoma Rhei Da Huang diarrhoea and dysentery due to deficiency of
mward MangXiao Large Intestine Qi. Commonly used herbs
Natrii Sulfas
Folium Cassiae Fan Xie Ye include:

Herbs that purge by moistening are sweet Fructus Mume Wu Mei

and neutral, moist and oily in nature. They Fructus Schisandrae Wu Wei Zi
Semen Myristicae Rou Dou Kou
are indicated for constipation due to
Semen Euryales Qian Shi
deficiency of Body Fluids and Blood.
Semen Nelumbinis Lian Zi
Commonly used herbs include:
Fructus Chebulae HeZi
:h
Fruchis Cannabis Huo Ma Ren Pericarpium Granati Shi Liu Pi
, assist Semen Pruni Yu Li Ren Cortex Ailanthi Chun Gen Pi

i. They Fructus Trichosanthis Gua Lou Ren Halloysitum Rubrum Chi Shi Zhi

i with Semen Armeniacae Xing Ren Limonitum Yu Yu Liang

c and Amarum
Radix Angelicae Sinensis Dang Gui
i, poor
Herba Cistanchis Ron Cong Rong
y used
Harsh cathartics that dispel retained Water B. Mutual interaction and
are toxic and purge very strongly; they
■ha combinations of herbs
should therefore be used with extreme
caution. They are indicated for patterns of
>u Retention of Water in the chest and abdomen 1. HERBS THAT TONIFY SPLEEN QI,
Hn characterized by excessive pathogenic HERBS THAT WARM SPLEEN YANG
factors and strong Zheng Qi. Commonly AND HERBS THAT LIFT CENTRAL QI
Zi used herbs include:
— Spleen Yang Deficiency is often complicated
Radix Euphorbiae Kansui Gan Sui with a general deficiency of Qi. Herbs that
Radix Euphorbiae Pekinensis Da }i warm Spleen Yang are thus often combined
ACID Flos Genkwa Yuan Hua with herbs that tonify Spleen Qi. For
Semen Pharbitidis Qian Niu Zi
example, Radix Codonopsis Pilosulae and
cretion Rhizoma Atractylodis Macrocephalae are
y with combined with Rhizoma Zingiberis and
13. HERBS THAT CLEAR DAMP-HEAT
regur- Radix Aconiti Praeparata in the treatment of
FROM THE LARGE INTESTINE
;tances deficiency of the Middle Burner with stagna
— These herbs are bitter and cold in nature and tion of Cold.
are indicated for diarrhoea, dysentery and — Sinking of Central Qi is essentially a
102
\i1 Part 3: Application of herbs on the basis of patterns of the Zang Fu

Deficient transportation
ana transformation of fluids resulls in
stagnation of flucfe and leads Jo
the tormatfon of

DAMPNESS

QI
DEFICIENCY DAMPNESS

Pathogenic Dampness is viscous;


blocks the circulation of Qi and
hinders transportation and
Iransformalion

Use herbs that regulate Q, + herbs that resolve Dampness


Fig. 24.1 The relationship between Qi circulation and Dampness.

ill'
manifestation of Spleen Qi Deficiency. Thus
Dampness and Qi Stagnation are closely
in the treatment of Sinking of Central Qi, related pathological patterns (Fig. 24.1).
herbs that lift the Qi such as Rhizoma — Herbs that resolve Dampness and herbs that
Cimicifugae and Radix Bupleuri are
regulate Qi are similar in nature, being
combined with herbs that tonify Spleen Qi
pungent, warm and aromatic. Some herbs
such as Radix Astragali seu Hedysari and that resolve Dampness also regulate Qi, such
Radix Codonopsis Pilosulae.
as Cortex Magnoliae Officinalis and Fructus
Amomi.

2. HERBS THAT RESOLVE DAMPNESS


AND HERBS THAT REGULATE QI 3. HERBS THAT REGULATE QI AND
— Pathogenic Dampness is characterized by HERBS THAT TONIFY QI
viscosity and stagnation and thus tends to — Herbs that regulate Qi are indicated for
obstruct the circulation of Qi. Stagnation of stagnation of Spleen and Stomach Qi, which
Spleen and Stomach Qi with weakness of is an Excess pattern. Herbs that tonify Qi are
transportation and transformation (YunHtta) indicated for Spleen and Stomach Qi
results in the stagnation of Internal
Deficiency, which is a Deficiency pattern.
Dampness. Retention of Dampness leads to These patterns often appear concurrently, as
further Qi Stagnation; conversely, free circu stagnation results from a weakness of the
lation of Qi resolves Dampness. Hence circulatory function of Qi (Fig. 24.2).

toniltcairon of 6 therefore
necessary to regulate
0 may add to the
Qi whiter tonrtying
Stagnation

Fig. 24.2 The relationship between Qi tonification and Qi regulation.


The Spleen, Stomach and Large Intestines 103

However, herbs that tonify Qi are like to Damp-Heat in the Large Intestine and reten
aggravate Qi Stagnation in patients with tion of Dampness in the Spleen and
weakness of the Middle Burner. To provide Stomach. In the treatment of chronic
tonification without worsening stagnation, diarrhoea and dysentery due to deficiency of
Qi tonics are combined with a small|dose of the Large Intestine, herbs that stop diarrhoea
herbs that regulate Qi. For example, Radix by astringing the Large Intestine are
Codonopsis Pilosulae, Radix Astragali, combined with herbs that invigorate the
Rhizoma Atractylodis Macrocephalae and Spleen and warm Spleen Yang. For example,
treated Radix Glycyrrhizae may be Radix Codonopsis Pilosulae, Rhizoma
combined with Radix Aucklandiae, Fructus Atractylodis Macrocephalae, Rhizoma
Amomi and Pericarpium Citri Reticulatae. Dioscoreae, Fructus Alpiniae Oxyphyllae
and Rhizoma Zingiberis are often used
together.
4. HERBS THAT NOURISH STOMACH YIN
AND CLEAR STOMACH FIRE

— Herbs that nourish Stomach Yin are


indicated for Stomach Yin Deficiency. Herbs Questions
that clear Stomach Fire are indicated for
1. Rhizoma Atractylodis Macrocephalae,
Stomach Heat or Fire. These patterns often
closely Rhizoma Coptidis, Rhizoma Zingiberis and
occur concurrently as Heat and Fire tend to
-1). Fructus Mume are all indicated for
damage Body Fluids, while Yin Deficiency
trbs that diarrhoea. How do they differ in nature,
can lead to Empty Heat. These two types of
', being actions and indications?
herb are thus often used together.
ie herbs 2. What is the clinical relationship between
Qi, such herbs that tonify Spleen Qi, herbs that warm
Fructus Spleen Yang, herbs that resolve Dampness in
5. DIFFERENTIATION OF HERBS FOR THE
the Spleen and Stomach and herbs that
SPLEEN AND HERBS FOR THE
regulate Spleen and Stomach Qi?
STOMACH
3. Compare and contrast herbs for disorders of
— Qi Deficiency, Yang Deficiency and Qi the Spleen and those for disorders of the
Stagnation often affect both the Spleen and Stomach.
Stomach. However, the Spleen is a Yin
ited for organ; it likes Dryness and dislikes
i, which Dampness. Conversely, the Stomach is a
y Qiare
Yang organ; it like moisture and dislikes
ach Qi Dryness. When the Spleen functions
pattern, properly, Spleen Qi ascends; when the
^ntly, as Stomach functions properly, Stomach Qi
i of the descends.
— Disorders of the Spleen are treated by the
methods of tonifying Qi, lifting Qi, warming
Yang and resolving Dampness with bitter
and dry herbs. Disorders of the Stomach are
treated by the methods of nourishing Yin,

^
moistening dryness and promoting Body
Fluids with sweet and cold herbs, and of
conducting Rebellious Qi downward and
relieving constipation.

6. HERBS THAT CLEAR DAMP-HEAT


FROM THE LARGE INTESTINE AND
HERBS THAT RESOLVE DAMPNESS IN
THE SPLEEN AND STOMACH

— Similar herbs are used for retention of


104

25 The Liver and Gall Bladder

A. Actions, characteristics Haematitum Zhe Shi

and indications of common Magnetitum d Shi

herbs
Herbs
Ramulus Uncariae cum Gou Teng
1. HERBS THAT CLEAR LIVER HEAT Uncis
Rhizoma Gastrodiae Tian Ma
— These herbs are bitter and cold in nature and Folium Apocyni Veneti Luo Bu Ma
are indicated for Liver Heat and Liver Fire
with symptoms of headache, red eyes,
irritability or mania and a red tongue with a
yellow coating. Commonly used herbs 3. HERBS THAT CALM LIVER WIND

include: — These herbs are indicated for Stirring of


Radix Gentianae Long Dan Cao Liver Wind with symptoms of spasm,
Spica Pranellae Xia Ku Cao convulsions, dizziness, numbness of the
Rhizoma Coptidis Huang Lion limbs and hemiplegia. Commonly used
Fructus Gardeniae ZhiZi herbs include:
Radix Scutellariae Huang Qin
Cornu Antelopis Ling Yang Jiao
Cortex Moutan Radicis Dan Pi
Rhizoma Gastrodiae Tian Ma
Indigo Naturalis QingDai
Ramulus Uncariae cum Gou Teng
Flos Chrysanthemi JuHua
Uncis
Semen Cassiae JueMingZi
Fructus Tribuli CiJiLi
Scorpio Quan Xie
Scolopendra Wu Gong
Lumbricus DiLong
2. SUBSTANCES THAT SUPPRESS Bombyx Batryticatus Jiang Can
HYPERACTIVE LIVER YANG

— These substances are shells, minerals, or


herbs which are cold and descending in 4. HERBS THAT NOURISH LIVER YIN
nature. They are indicated for Liver Yang
Rising with symptoms of headache, dizzi — These herbs are sweet, cold or slightly
] 1
ness and vertigo, flushed face, irritability warm, nourishing and sticky in nature.

and dream-disturbed sleep. Commonly used They are indicated for Liver Yin
substances include: Deficiency with symptoms of dizziness,
blurred vision and a dry red tongue with
Shells scanty coating. Commonly used herbs
Concha Haliotidis Shi Jue Ming include:
Concha Ostreae MuLi
Radix Rehmanniae ShengDi
Concha Margaritifera Zhen Zhu Mu Radix Rehmanniae ShuDi
Usta
Praeparata
Plastrum Testudinis Gui Ban Fructus Lycii Gou Qi Zi
Carapax Trionycis Bie Jia
Radix Paeoniae Alba BaiShao
Fructus Comi Shan Zhu Yu
Minerals Radix Polygoni Multiflori He Shou Wu
Os Draconis Lnnv Gu Carapax Trionycis Bie )ia
The Liver and Gall Bladder 105

5. HERBS THAT TONIFY LIVER BLOOD 8. HERBS THAT ACTIVATE BLOOD


CIRCULATION AND RESOLVE BLOOD
— These herbs are sweet and slightly warm,
STASIS
and nourishing and sticky in nature. They
are indicated for Liver Blood Deficiency — These herbs are bitter, pungent and
with symptoms of dizziness, blurred vision, dispersing in nature. They are indicated for
pale complexion, irregular menstruation stagnation of Liver Blood with symptoms of
with a scanty flow of pale blood, or palpable abdominal masses, stabbing pain,
amenorrhoea. Commonly used herbs amenorrhoea, dysmenorrhoea and a purple
include: tongue. Commonly used herbs include:

Radix Angelicae Sinensis Dang Gui Radix Salviae Miltiorrhizae Dan Shen
Radix Rehmanniae Praeparata Shu Di Rhizoma Ligustici Chuan Xiong
Radix Paeoniae Alba Bat Shao Chuanxiong
Colla Corii Asini A Jiao Radix Angelicae Sinensis Dang Gui
Radix Polygoni Multiflori He Shou Wu Flos Carthami Hong Hua
Fructus Corni Gou Qi Zi Semen Fersicae Tao Ren
Rhizoma Sparganii San Leng
Rhizoma Zedoariae EZhu
Herba Leonuri YiMu Cao
6. HERBS THAT HARMONIZE THE
Radix Paeoniae Rubra Chi Shao
LIVER
Radix et Rhizoma Rhei Da Huang

These herbs are pungent and dispersing in Cortex Moutan Radicis Dan Pi

nature and are indicated for stagnation of Resina Olibani Ru Xiang


Resina Myrrhae Mo Yao
ring of Liver Qi with symptoms of distending
Eupolyphaga seu Di Bie Chong
spasm, hypochondriac pain, mental depression or
Steleophaga
of the irritability and irregular menstruation.
Hirudo ShuiZhi
y used Commonly used herbs include:

Radix Bupleuri Chai Hu

Uao Rhizoma Cyperi Xiang Fu 9. HERBS THAT CLEAR HEAT FROM THE
Pericaipium Citri QingPi
GALL BLADDER
Reticulatae Viride
Fructus Meliae Toosendan Chuan Liatt Zi — These herbs are bitter and cold in nature.
Radix Curcumae Yu Jin They are indicated for retention of Heat in
Rhizoma Ligustici Chuan Xiong the Gall Bladder channel with symptoms of
Chuanxiong
hypochondriac pain, alternating chills and
Fructus Citri Xiang Yuan
fever, and jaundice. Commonly used herbs
Fructus Citri Sarcodactylis Fu Shou
include:
Flos Mume Albus Lu E Mei
Flos Rosae Rugosae Mei GuiHua Radix Gentianae Long Dan
Cao
:n Radix Scutellariae Huang Qin

7. HERBS THAT WARM THE LIVER Fructus Gardeniae ZhiZi


slightly
Herba Artemisiae Chinghao QingHao
nature, — These herbs are pungent and hot or Herba Artemisiae Scopariae Yin Chen Hao
•r Yin warm in nature. They are indicated for reten Rhizoma Polygoni Cuspidati Hu Zhang
zziness, tion of Cold in the Liver channel with Herba Taraxaci Pu Gong Ying
le with abdominal pain. Commonly used herbs
herbs include:
10. HERBS THAT BENEFIT THE GALL
Fructus Evodiae Wu Zhu Yu
Fructus Foeniculi Xiao Hui Xiang BLADDER

Semen Litchi LiZhiHe


— These herbs are bitter and cold in nature and
Fructus Litseae Bi Cheng Qie
are indicated for patterns of Gall Bladder
Zi Lignum Aquilariae Chen Xiang
Damp-Heat with symptoms of jaundice,
o Resinatum
m Yu Radix Linderae WuYao
hypochondriac pain, cholecystitis and
Cortex Cinnamomi Rou Gui cholelithiasis. Commonly used herbs
Herba Asari XiXin include:
106 Part 3: Application of herbs on th$ basis of patterns of the Zang Fu

Liver Fire

Liver Yin Deficiency - Liver Yang Rising - Liver Wind

Use herbs that nourish herbs that clear


Liver Yin Liver Fire or herbs that calm Liver
subdue Liver Yang Wind

Fig. 25.1 Complications of Liver Yin Deficiency.

Herba Artemisiae Scopariae Yin Chen Hao For Liver Heat without Fire, less powerful
Fructus Gardeniae ZhiZi herbs such as Flos Chrysanthemi,
Radix Curcumae Yu Jin Folium Mori and Concha Haliotidis are
Radix Scutellariae Huang Qin
indicated.
Herba Lysimachiae Jin Qian Cao
Spora Lygodii Hai Jin Sha
Radix et Rhizoma Rhei Da Huang
3. HERBS THAT NOURISH LIVER YIN,
Natrii Sulfas Mang Xiao
Endothelium Comeum Ji Nei Jin
CLEAR LIVER HEAT, SUPPRESS LIVER
Gigeriae Galli YANG AND CALM LIVER WIND

— Liver Yin Deficiency can lead to Liver Yang


Rising, Liver Fire and the development of
Liver Wind. Herbs that nourish Liver Yin are
B. Interactions and thus often combined with herbs that clear
combinations of herbs Liver Fire, suppress Liver Yang and calm
Liver Wind (Fig. 25.1).

1. HERBS THAT CLEAR HEAT FROM THE


LIVER AND GALL BLADDER
4. HERBS THAT HARMONIZE THE LIVER
— The Gall Bladder is closely associated with AND HERBS THAT COOL OR WARM
the Liver. Herbs that clear Liver Heat also THE LIVER
clear Gall Bladder Heat. The therapeutic
— When Stagnant Liver Qi turns to Heat and
effect of these herbs may be enhanced by
Fire, herbs that harmonize the Liver are
combining them with herbs that harmonize
combined with herbs that clear Liver Heat
the Liver and herbs that benefit the Gall
and Fire (Fig. 25.2).
Bladder.
— If retention of Cold in the Liver channel
produces stagnation of Qi, herbs that warm
the Liver are combined with herbs that
2. HERBS THAT CLEAR LIVER HEAT AND
harmonize the Liver and regulate Qi
LIVER FIRE
(Fig. 25.3).
— Clearing Liver Heat is essentially the same
as purging Liver Fire, and both categories of
herbs are applicable in the treatment of
patterns of Fire or Heat in the Liver channel.
Questions
— Herbs which strongly clear Liver Heat —
such as Radix Gentianae and Fructus 1. What are the indications for herbs that
Gardeniae — will also purge Liver Fire. nourish Liver Yin, herbs that suppress Liver

Stagnant Liver Qi Liver Fire

Use herbs that harmonize herbs that clear Liver Fire


the Liver

Fig. 25.2 Combination of herbs to treat Liver Fire.


The Liver and Gall Bladder 107

owerful LIVER CHANNEL


nthemi,
dis are
Use herbs that harmonize herbs that warm
the Liver and regulate Qi the Liver

Fig. 25.3 Combination of herbs to treat Stagnation of Cold in the Liver Channel.
IN,
IVER
Yang and herbs that calm Liver Wind? How
do these categories of herbs interrelate?
er Yang 2. Compare and contrast herbs that harmonize
merit of the Liver, herbs that benefit the Gall Bladder
■ Yin are and herbs that clear Heat from the Liver and
at clear Gall Bladder.
id calm

LIVER
RM

eat and
ver are

er Heat

channel
it warm

bs that
ate Qi

bs that
3S Liver
108

26 The Kidneys and Bladder

A. Actions, characteristics c. Herbs that tonify the Kidneys and

and indications of common stimulate the reception of Qi

herbs — These herbs are indicated for a weakness of


the Kidneys' function of receiving the Qi,
with symptoms of chronic cough or asthma.
1. HERBS THAT TONIFY KIDNEY YANG
Commonly used herbs include:
— These herbs are pungent and hot, or
Gecko Ge ]ic
sweet, salty and warm in nature. They Semen Juglandis Hu Tao Rou
consist of; Umbilical cord Qi Dai
Fructus Schisandrae Wu Wei Zi
Fructus Psoraleae Eu Gu Zhi
a. Herbs thai warm the Kidneys and
Cordyceps Dong Cliong Xia Cao
strengthen Yang
Lignum Aquilariae Chen Xiang
Resinatum
— These herbs are indicated for Kidney Yang
Deficiency with symptoms of cold limbs,
lower back pain, impotence, spermatorrhoea
and lack of libido. Commonly used herbs 2. HERBS THAT TONIFY KIDNEY YIN
include:
— These herbs are sweet, cold or slightly
Radix Aconiti Praeparata FuZi
warm, nourishing and sticky in nature.
Cortex Cinnamomi Rou Gui
They are indicated for Kidney Yin Deficiency
Cornu Cervi Pantolrichum Lu Rong
Comu Cervi
with symptoms of soreness and weakness
Lu ]iao
Rhizoma Curculiginis Xian Mao
of the lumbar region and knees, tinnitus
Herba Epimedii Yin Yang Huo and tidal fever. Commonly used herbs
Herba Cistanchis Rou CongRong include:
Radix Morindae Officinalis Ba Ji It an
Radix Rehmanniae Praeparata Shu Di
Peni et Testes Callorhini Hai Gou Shcrt
Radix Rehmanniae Shetig Di
Hippocampus Hai Ma
Radix Polygoni Multiflori He Shou Wu
Fructus Corni Shan Zhu

b. Herbs that tonify the Kidneys and Yu


Fructus Ligustri Lucidi N;< Zhcn Zi
strengthen tendons and bones
Plastrum Testudinis Gui Ban
— These herbs arc indicated for soreness Radix Scrophulariae Xutin Shen
and weakness of the lumbar region and
knees due to Kidney Yang Deficiency and
for osteoporosis, chronic Bi syndromes
3. HERBS THAT STOP ENURESIS AND
and hemiplegia. Commonly used herbs
SPERMATORRHOEA
include:
— These herbs are sour and astringent in
Cortex Eucommiae Du Zhong
nature and are indicated for patterns of
Radix Dipsaci Xtt Duaii
Rhizoma Cibotii Gou ]i Kidney Qi Not Finn, with symptoms of
Ramuius Loranlhi Sang)i SUeng spermatorrhoea, diuresis and clear
Cortex Aeanthopancis Radicis Wu }ia Pi watery leucorrhoea. Commonly used herbs
Os Tigris Hit Git include:
The Kidneys and Bladder 109

Os Draconis Long Gu Herba Lysimachiae Jin Qian Cao


Concha Ostreae MuLi Spora Lygodii Haijin Sha
Fnictus Rosae Laevi fin Ying Zi Folium PyiThosiae Shi Wei

Semen Euryales Qian Shi Herba Dianthi QuMat


Semen Nelumbinis Lian Zi i
Ootheca Mantidis Sang Piao Xiao
Fnictus Schisandrae Wu Wei Zi
Fructus Comi Shan Zhu Yu B. Interactions and
combinations of herbs
4. HERBS THAT CLEAR EMPTY KIDNEY
1. HERBS THAT CLEAR KIDNEY FIRE
FIRE
AND HERBS THAT TONIFY KIDNEY
— These herbs are bitter and cold in nature and YIN
are indicated for Empty Kidney Fire with
kness of — Herbs that clear Kidney Fire are indicated
sexual hyperfunction. Commonly used
the Qi, for Empty Heat due to Kidney Yin
herbs include:
asthma. Deficiency. Herbs that clear Kidney Fire,
Rhizoma Anemarrhenae ZhiMu such as Rhizoma Anemarrhenae and Cortex
Cortex Phellodendri Huang Bat
Phellodendri, are thus often combined with
Cortex Moutan Radicis Dan Pi
herbs that tonify Kidney Yin, such as Radix
Rhizoma Alismatis Ze Xie
Rehmanniae and Fructus Corni.

5. DIURETIC HERBS
ia Cao 2. HERBS THAT TONIFY KIDNEY YANG
— These herbs are sweet and bland in nature AND HERBS THAT TONIFY KIDNEY
and are indicated for dysuria and oedema. YIN
Commonly used herbs include:
— Because Yin and Yang have the same root,
Poria Fu Ling Kidney Yang cannot flourish without the
IN Polyporus Umbellatus Zhu Ling support of Kidney Yin. In the treatment of
Rhizoma Alismatis Ze Xie
Kidney Yang Deficiency, herbs that tonify
slightly Semen Plantaginis Che Qian Zi
Kidney Yang are often combined with herbs
nature,
that tonify Kidney Yin.
ificiency
eakness 6. HERBS THAT OPEN THE WATER
tinnitus PASSAGES
3. HERBS THAT STRENGTHEN TENDONS
i herbs
— These herbs are cold in nature and are AND BONES, HERBS THAT STIMULATE
indicated for urinary disturbance due to THE RECEPTION OF QI AND HERBS
Di retention of Heat and for haematuria, THAT TONIFY KIDNEY YIN AND
ngDi KIDNEY YANG
urolithiasis or turbid urine. Commonly used
ihou Wu
herbs include:
nZ.hu — Weakness of the tendons and bones due to
u Caulis Akebiae Mu Tong Liver and Kidney Deficiency is rooted in
Zhen Zi
Ban
n Shen
Kidney Yang Deficiency

Kidney Yin Deficiency or

^^ Empty Kidney Fire

Use herbs that tonify + herbs that clear


gent in Kidney Fire
Kidney Yin
erns of or

oms of herbs that tonify


Kidney Yang
clear
d herbs
Fig. 26.1 Complications of Kidney Yin Deficiency.
110 Part 3: Application of herbs on the basis of patterns of the Zang Fu

deficiency of Kidney Yin and Kidney Yang.


Questions
Dysfunction of the Kidneys' reception of Qi
is also rooted in deficiency of Kidney Yin 1. What is the clinical relationship between
and Yang. herbs that tonify Kidney Yin and Kidney
Herbs that strengthen the tendons and Yang, herbs that promote diuresis and open
bones, and herbs that stimulate the Kidney's the water passages and herbs that stop
reception of Qi, are therefore often combined spermatorrhoea and enuresis?
with herbs that tonify Kidney Yin and 2. What is the clinical relationship between
Kidney Yang (Fig. 26.1) herbs that tonify Kidney Yin and herbs that
clear Empty Kidney Fire?

4. HERBS THAT STOP


SPERMATORRHOEA AND ENURESIS
AND HERBS THAT TONIFY KIDNEY
YIN AND KIDNEY YANG

— Nocturnal emission and spermatorrhoea


are signs of a weakness of the Gate of
Essence; enuresis is caused by failure of
the Bladder to control urine; and clear
watery leucorrhoea is due to weakness of
the Dai channel in controlling vaginal
discharge.
— All of these patterns are rooted in Kidney
Deficiency. Herbs that stop spermatorrhoea,
enuresis and leucorrhoea are therefore often
combined with herbs that tonify the
Kidneys.

5. HERBS THAT OPEN THE WATER


PASSAGES AND PROMOTE DIURESIS
AND HERBS THAT TONIFY KIDNEY
YIN AND KIDNEY YANG

— When Kidney Yang is deficient, Qi does not


transform Water, and this leads to retention
of Water and Dampness with symptoms of
oedema and dysuria. The treatment
principle in such cases is to warm Yang and
promote diuresis with herbs that open the
water passages and warm Kidney Yang at
the same time. For example, Polyporus
Umbellatus, Poria and Rhizoma Alismatis
are combined with Radix Aconiti Praeparata
and Cortex Cinnamomi.
— On the other hand, when urinary distur
bance is due to retention of Damp-Heat in
the Bladder, the Heat will eventually
damage Kidney Yin. Even if symptoms of
Kidney Yin Deficiency are not apparent,
diuretic herbs are themselves likely to
deplete Fluids. Herbs that clear Heat and
open the water passages are therefore
combined with herbs that tonify Kidney
Yin.
2tween

<idney
Part 4:
d open

Combinations and
it stop

stween
bs that

comparisons of
commonly used
formulae
113

Formulae for Releasing the 27


Exterior

symptoms of mild aversion to cold, mild


A. GUIDING PRINCIPLES FOR
fever, nasal obstruction and runny nose, are
FORMULATING PRESCRIPTIONS TO
treated with Bulbus Allii Fistulosi and
RELEASE THE EXTERIOR
Semen Sojae Praeparatum, which gently
1. Formulae for Releasing the Exterior are disperse pathogenic factors from the
indicated for invasion of the surface of the Defensive level.
body (i.e. the skin, hair, muscles and Severe exterior patterns of the Excess type,
channels) by any of the Six Pathogenic with symptoms of fever, aversion to cold,
Factors. Symptoms of such a pattern include absence of sweating, dyspnoea and a tense
aversion to cold, fever, headache, nasal superficial pulse, are treated with Herba
obstruction, a superficial pulse and a white Ephedrae and Ramulus Cinnamomi, which
tongue coating. eliminate Wind-Cold more vigorously.
2. Formulae for Releasing the Exterior are If Wind-Cold is complicated with
prescribed when the treatment method Dampness, with symptoms of fever,
consists of inducing diaphoresis to Release aversion to coid, headache, lethargy and
the Exterior and eliminate pathogenic general aching, herbs are chosen which not
factors. only Release the Exterior but also eliminate
3. The main ingredients of these formulae are Dampness and relieve pain. Representative
herbs which are pungent in nature. The herbs include Rhizoma seu Radix
selection of formulae and herbs is based on Notopterygii, Radix Ledebouriellae and
the type of Exterior pattern, the method of Radix Angelicae Dahuricae.
treatment and the particular characteristics Once the principal herbs have been selected
of individual herbs. according to these principles, combinations
of secondary herbs are then prescribed
according to the signs and symptoms of the
particular case. For example:
B. FORMULATING PRESCRIPTIONS FOR
RELEASING THE EXTERIOR - for cough and dyspnoea add Semen
Armeniacae Amarum and Fructus
1. Formulae for Releasing the Exterior with
Perillae
pungent and warm herbs
- for stagnation of Qi with fullness of the
— Formulae for Releasing the Exterior with chest, add Rhizoma Cyperi and
pungent and warm herbs disperse Wind- Pericarpium Citri Reticulatae
Cold and are thus indicated for patterns of - for Interior Heat with irritability, add
Exterior Cold. Gypsum Fibrosum, Radix Rehmanniae
— Excess-type external patterns vary in and Radix Scutellariae
severity They may consist exclusively of - for Food Retention with abdominal
Wind-Cold, or of Wind-Cold complicated distension, add Fructus Crataegi and
with External Dampness, or the retention of Massa Fermentata Medicinalis
Phlegm, or stagnation of Qi. - for retention of Phlegm-Fluid, add
— Deficiency-type external patterns may be Rhizoma Pinelliae, Rhizoma Zingiberis
complicated with Yang Deficiency or Qi and Herba Asari
Deficiency. - to prevent warm and dry herbs from
— Mild patterns of the Excess type, with damaging Yin and consuming Lung Qi,
114 Part 4: Combinations ami comparisons of commonly used formulae

add Radix Paeoniae Alba and Fructus — Representative formulae include:


Schisandrae.
- Gui Zhi Tang
- Commonly used formulae include: Cinnamon Twig Decoction
- Gui Zhi jia Ge Gen Tang
- Cong Chi Tang
Cinnamon Twig Decoction plus Kudzu
Spring Onion and Prepared Soybean
- Gui Zhi Jia Hou Po Xing Zi Tang
Decoction
- Cinnamon Twig Decoction plus Mag
- Cong Chi jie Ccng Tang
nolia Bark and Apricot Kernel
Spring Onion and Prepared Soybean
- Gui Zhi Fit Zi Tang
Decoction with Platycodon
- Cinnamon Twig Decoction plus Prepa
- Ma Huang Tang
red Aconite
Ephedra Decoction
- Gui Zhi Jia Ren Shen Tang
- Jiu Wei Qiang Hu Tang
- Cinnamon Twig Decoction plus
- Nine-Herb Decoction with Notoptery-
Ginseng
gium
- Xiao Qing Long Tang
- Small Green Dragon Decoction 2. Formulating prescriptions for
- Da Qing Long Tang Releasing the Exterior with pungent and
Major Blue-Green Dragon Decoction cool herbs
- Xiang Su San
— Formulae for Releasing the Exterior with
Cyperus and Perilla Leaf Powder
pungent and cool herbs disperse Wind-Heat
- Deficient-type Exterior patterns manifest and are indicated for Exterior Heat patterns.
when there is a weak defensive response to This type of pattern can present in several
pathogenic factors. Invasion of the Defen different ways and these require different
sive level leads to disharmony between methods of treatment.
the Defensive (Wei) Qi and Nutritive (Ying) — If the pattern is one of Wind-Heat at the
Qi with symptoms of aversion to Wind, Defensive level with pronounced signs of
spontaneous sweating and a superficial and Heat, the method of treatment is to disperse
slow or weak pulse. The method of treat Wind-Heat with pungent and cool herbs
ment is to regulate Defensive Qi and such as Flos Lonicerae and Fructus
Nutritive Qi with Ramulus Cinnamomi Forsythiae, assisted by herbs such as Semen
paired with Radix Paeoniae Alba, and Sojae Praeparata, Herba Menthae and
Rhizoma Zingiberis Recens paired with Fructus Arctii.
Fructus Ziziphi Jujubae, to disperse the — If the Heat enters the Lung channel and
pathogenic factors and at the same time produces severe coughing, herbs are
astringe the Nutrient Qi. employed which not only disperse Wind-
■ Deficient-type Exterior patterns may be Heat but also promote the Lungs' functions
complicated with disorders of the Tai Yang of descending and dispersing, such as
channel, with symptoms of rigidity and stiff Folium Mori and Flos Chrysanthemi,
ness of the neck and back. There may be assisted by Semen Armeniacae Amarum,
impairment of the Lung functions of Radix Platycodi and Radix Glycyrrhizae.
dispersing and descending, with symptoms — Pathogenic Wind-Heat is Yang in nature
of cough and wheeze. There may also be and tends to consume Body Fluids and
Yang Deficiency with cold limbs, or Qi Yin; it can easily affect the throat and
Deficiency with a feeble pulse. the Nutritive level. In this case, herbs such
For these complications, additional herbs are as Radix Adenophorae, Radix Ophio-
chosen such as: pogonis, Rhizoma Phragmitis, Radix
Trichosanthis, Rhizoma Anemarrhenae and
- Radix Puerariae, to promote the smooth
Gypsum Fibrosum should be added to the
circulation of Qi in the muscles
formula.
- Coriex Magnoliae Officinalis and Semen
— Representative formulae are:
Armeniacae Amarum to conduct
Rebellious Lung Qi downward - Yin Qiao San
- Radix Aconiti Praeparata to assist Yang Honeysuckle and Forsylhia Powder
- Radix Ginseng to tonify Qi. - Sang jit Yin
Formulae for Releasing the Exterior 115

Mulberry Leaf and Chrysanthemum — Measles is caused by Yang toxins which


Decoction rapidly turn to Heat. The onset of measles
presents as an Exterior Heat pattern with
Wind-Cold may turn to Heat, thus trans
symptoms of a mild rash, fever, aversion to
forming an Exterior Cold pattern into an
cold, cough, runny nose and a superficial
udzu Exterior Heat pattern. Once this transforma and rapid pulse. The correct method of treat
tion takes place, the pathogenic factor will be ment is Releasing the Exterior with pungent
Mag- transmitted inward to the Shao Yang and and cool herbs, with attention to promoting
Yang Ming channels. The result will be that
the expression of the rash and clearing
all three Yang channels will be affected, but
toxins. Thus the prescription should consist
Prepa- primarily the Yang Ming channel. Signs and primarily of herbs such as Rhizoma
symptoms will then include high fever, mild
Cimicifugae, Radix Puerariae, Periostracum
aversion to cold, a bitter taste and dry
Cicadae, Fructus Arctii and Herba Menthae,
plus mouth, headache, eye pain, dry nose, a
plus one or two pungent and slightly warm
yellow dry tongue coating and a slightly
herbs such as Herba Schizonepeta and
surging pulse. Ramulus Tamarix Chinensis (Cheng Liu)
■ Alternatively, the heat produced may block
which promote the expression of the rash.
the Lung channel, producing symptoms of
— The toxic Qi of measles often invades the
and
cough and dyspnoea and a rapid pulse.
Spleen and Lung, damaging Yin and Blood
- To treat this pattern, a prescription must be
and producing symptoms of fever, thirst,
r with formulated which addresses the mixed
yellow urine, irritability, restlessness, cough,
i-Heat nature of the pathological pattern. Attention
dyspnoea, poor appetite and a dark-red
tterns. should be given to the relative proportion of
rash. In this event, combinations of herbs
ieveral pungent/warm and cold or cool herbs
should be added to the formula such as:
fferent according to the presenting symptoms and
signs. - Semen Armeniacae Amarum, Radix
- For example, when the three Yang channels Platycodi and Radix Peucedani
at the
are involved, the method of treatment is - Gypsum Fibrosum and Rhizoma Anem-
5ns of
primarily to Release the Exterior with arrhenae
sperse
pungent and cool herbs and secondarily to - Radix Paeoniae Rubra and Radix Salviae
herbs
clear internal Heat, using herbs such as Miltiorrhizae
ructus
Radix Bupleuri, Radix Puerariae, Rhizoma - Flos Lonicerae, Fructus Forsythiae and
Semen
seu Radix Notopterygii, Radix Angelicae Herba Lophatheri.
and
Dahuricae, Radix Scutellariae and Gypsum
— Representative formulae are:
:1 and Fibrosum.
- In the treatment of Heat blocking the - Sheng Ma Ge Gen Tang
) are
Lungs, the treatment method is to promote Cimicifuga and Kudzu Decoction
Wind-
ctions the function of the Lungs with pungent - Zhu Ye Liu Bang Tang
and cool herbs and to clear Lung Heat, Lophatheri-Tamarix-Arctii Decoction
ch as
:hemi, using herbs such as Herba Ephedrae,
Gypsum Fibrosum and Semen Armeniacae 3. Formulation of prescriptions to Release the
arum,

Amarum. Exterior and strengthen resistance to


le.

- If the Heat has consumed Yin, add Radix disease


lature
i and Paeoniae Alba and Radix Rehmanniae to
— Formulae which both Release the Exterior
t and nourish the Yin. and promote resistance to disease are indi
; such - Attention should be given to the relative cated for Exterior patterns with Wei Qi
)phio- proportions of pungent/warm herbs and
Deficiency. External pathogens can be either
Radix cold or cool herbs. Wind-Cold or Wind-Heat, and internal
e and - Representative formulae are:
Deficiency may involve Qi, Blood, Yin or
to the Yang, and these factors determine the selec
- Chai Ge Jie }i Tang
Bupleurum and Kudzu Decoction to tion of herbs.
Release the Muscle Layer — In most cases, Wind-Cold or Wind-Cold
- Ma Xing Shi Gan Tang complicated with Dampness are likely to
Ephedra-Prun us-Gyp sum-Glycyrrhiza invade where there is Qi Deficiency or Yang
Decoction Deficiency. The pattern thus produced is
116
Part 4: Combinations and comparisons of commonly used formulae

II cold in nature and the prescription will


Radix Platycodi, Radix Glycyrrhizae and
consist of:
Fructus Arctii should be added.
a. pungent and warm herbs that Release the Representative formulae include:
Exterior such as Herba Ephedrae, Ramu- - ]ia]ian Wei Rui Tang
lus Cinnamomi, Rhizoma seu Radix
Modified Polygonatum Odoratum
Notopterygii, Radix Ledebouriellae and Decoction
Herba Asari
- Cong Bai Qi Wei Yin
and
Spring Onion Decoction with Seven
b. herbs that tonify Qi such as Radix Gin Ingredients
seng and Radix Astragali seu Hedysari
or

- herbs that tonify Yang such as Radix Aco- C. POINTS TO REMEMBER IN


niti Praeparata and Cortex Cinnamomi.
FORMULATING PRESCRIPTIONS FOR
— The dosage of each herb depends upon the RELEASING THE EXTERIOR
relative severity of symptoms.
1. The actions of herbs that Release the Exterior
— Commonly used formulae include:
are modified by dosage. For example, Radix
- Ma Huang Fu Zi Xi Xin Tang Bupleuri in large doses Releases the Exterior
Ephedra, Asarum and Prepared Aconite and lowers fever; in moderate doses it
Decoction harmonizes the Liver and relieves stagna
- Ren Shen Bai Du San tion; and in small doses it raises the Yang.
Ginseng Powder to Overcome Patho — Folium Mori does not work in small doses,
genic Influences but only in large doses.
- Zai Zao San — Herba Asari in small doses stops cough but
Renewal Powder in large doses it may cause respiratory paral
ysis.
— When there is an underlying pattern of Yin
— Dosage will also be dictated by individual
and Blood Deficiency, Wind-Heat is more
variations in sensitivity to herbs due to
likely to invade than Wind-Cold. In this case,
constitutional differences, and by the
the prescription consists of
severity of the Exterior pattern itself.
a. pungent and coo] herbs that Release the 2. Herbs that Release the Exterior are pungent
Exterior such as Radix Puerariae, Herba and scattering in nature, and their active
Menthae and Folium Mori ingredients are volatile. It is therefore not
or advisable to decoct them for a long time over
- pungent and slightly warm herbs that low heat, but rather to cook them quickly
gently Release the Exterior such as using strong heat.
Bulbus Allii Fistulosi and Semen Sojae — Such a decoction is taken warm, twice daily.
Praeparata To increase its diaphoretic action, the patient
and should eat hot porridge and be covered with
b. herbs that nourish Yin such as Rhizoma thick bedclothes after taking the decoction.
Polygonati Odorati, Radix Ophiopogonis, — However, while absence of sweating does
Radix Adenophorae and Radix Glehniae not allow the elimination of pathogenic
or factors, excessive sweating consumes Body
- herbs that tonify Blood such as Radix Fluids and can lead to Collapse of Yang. It is
Angelicae Sinensis and Radix Rehman- best to induce moderate sweating only.
niae Praeparata. 3 . It is necessary to make an accurate diagnosis

of the Exterior pattern before selecting a


— Yin and Blood Deficiency can produce prescription. The book Insight into Medicine
internal Heat which combines with External says:
Wind-Heat to impair the Lungs' descending
To conclude, in case of deficiency of Yang,
function. Symptoms may then include
the treatment method of invigorating the
restlessness, five-palm heat, thirst, dry throat
Middle Burner and promoting diaphoresis is
and cough. If this occurs, herbs such as
adopted. If signs of Heat are present, the
Radix Ampelopsis, Rhizoma Anemarrhenae, method of clearing Heat and promoting
Radix Trichosanthis, Gypsum Fibrosum,
diaphoresis is adopted. If signs of Cold are
Formulae for Releasing the Exterior 117

present, the method of warming the and Fructus Ziziphi Jujubae. Its diaphoretic
ae and
channels and promoting diaphoresis is action is therefore weak, but it regulates
adopted. In case of Retention of Food, the Defensive and Nutritive Qi. This formula is
method of promoting digestion and indicated for Wind-Cold patterns of the
promoting diaphoresis is adopted. If Deficiency type with symptoms of sweating,
oratum and a superficial and weak pulse in addition
symptoms and signs are severe and the
patient's constitution is strong, the method to other symptoms of invasion of Wind-
of producing vigorous sweating is adopted. Cold.
Seven If symptoms and signs are mild and the
2. - Da Qing Long Tang
patient's constitution is weak, the method of
Major Blue-Green Dragon Decoction
causing mild sweating is adopted.
- Xiao Qing Long Tang
- Small Green Dragon Decoction

FOR D. A COMPARISON OF COMMONLY USED — Both formulae contain Herba Ephedrae,


FORMULAE FOR RELEASING THE Ramulus Cinnamomi and Radix Glycyrrhi
EXTERIOR (TABLE 27.1) zae and are indicated for Exterior Cold pat
ixterior
terns of the Excess type.
, Radix
1. - Ma Huang Tang
— Major Blue-Green Dragon Decoction also
ixterior Ephedra Decoction
contains Semen Armeniacae Amarum,
oses it
- Gut Zhi Tang
Rhizoma Zingiberis Recens and Fructus
stagna- Cinnamon Twig Decoction
Ziziphi Jujubae to strengthen the effect of
ang.
— Both formulae contain Ramulus Cinnamomi Releasing the Exterior, and Gypsum
doses,
and treated Radix Glycyrrhizae. Fibrosum to clear Internal Heat. It is thus
— Ephedra Decoction also contains Herba indicated for Exterior Cold complicated with
igh but
Ephedrae and Semen Armeniacae Amarum Interior Heat, with symptoms of thirst,
' paral-
and thus strongly promotes diaphoresis and restlessness and irritability.
controls wheeze. This formula is indicated — Small Green Dragon Decoction also con
ividual
for Exterior patterns of the Excess type with tains Radix Paeoniae Alba, Herba Asari,
iue to
symptoms of aversion to cold, fever, Rhizoma Zingiberis, Rhizoma Pinelliae and
y the
headache and general aching, with an Fructus Schisandrae, to warm the Lungs
absence of sweating and a superficial tense and resolve Phlegm-Fluid. It is indicated
ungent
pulse. for Exterior Cold patterns complicated
active
— In Cinnamon Twig Decoction, Ramulus with Interior Phlegm-Fluid, with symptoms
>re not
Cinnamomi and Radix Paeoniae Alba are of cough, dyspnoea and profuse clear
ie over

|uickly combined with Rhizoma Zingiberis Recens sputum.

? daily. Table 27.1 Comparison oi formulae for Releasing the Exterior


Datient
Formula Actions Indications
d with
:tion. Ephedra Decoction Strongly promotes diaphoresis Wind-Cold patterns of the Excess
5 does Controls wheeze type

ogenic
Cinnamon Twig Decoction Regulates Defensive and Wind-Cold patterns of the Deficiency
; Body
Nutritive Qi type
ig. It is
/.
Major Blue-Green Dragon Releases the Exterior Wind-Cold complicated with Interior
gnosis Decoction Clears Internal Heat Heat

ting a
Small Green Dragon Decoction Warms the Lungs Wind-Cold complicated with Interior
edicine Resolves Phlegm-Fluid Phlegm-Fluid

Yang, Mulberry Leaf and Disperses Wind-Heat Mild patterns of Wind-Heat

ig the Chrysanthemum Decoction Promotes the dispersing function


of the Lungs
resis is
it, the More strongly Releases the More severe patterns of Wind-Heat
Honeysuckle and Forsythia
noting Powder Exterior and clears Heal
>ld are
118 Par! 4: Combination* mid comparisons ot commonly used formulae

3. - Sangju Yin
Mulberry Leaf and Chrysanthemum
Decoction
- Yin Qiao San
Honeysuckle and Forsythia Powder

— Both formulae are pungent and cool in


nature, and are indicated for the initial
stages of Warm Disease. Both contain:

- Herba Menthae to eliminate Wind and


clear Heat
- Frucrus Forsythiae to clear Heat and Fire
Poison
- Radix Platycodi and Radix Glycyrrhizae
to ease the throat and resolve Phlegm
and
- Rhizoma Phragmitis to clear Heat and
promote Body Fluids.

— Mulberry Leaf and Chrysanthemum Dec


oction also contains Folium Mori, Flos
Chrysanthemi and Armeniacae Amarum
and is thus more effective in promoting the
dispersing function of the Lungs to stop
cough.

— Honeysuckle and Forsythia Powder also


contains Herba Schizonepeta, Semen Sojae
Praeparata, Fructus Arctii, Flos Lonicerae
and Herba Lophatheri and is thus more
effective in Releasing the Exterior and
clearing Heat.
— The former is a mild formula and is
indicated for mild Wind-Heat patterns,
while the latter is a moderately strong
formula and is indicated for more severe
Wind-Heat patterns with symptoms of a
sensation of heat, thirst and sore throat.

Questions
1. What principles should be observed in
formulating prescriptions to Release the
Exterior?
2. How would you formulate a prescription for
the treatment of Deficient-type patterns of
invasion by external pathogenic factors?
119

Purgative formulae 28

Blood. The pattern may be complicated with


A. GUIDING PRINCIPLES FOR
accumulation of Water or stagnation of
FORMULATING PURGATIVE
Blood. The disorder is most often located in
PRESCRIPTIONS
the Middle and Lower Burners but occasion
1. Purgative formulae are prescribed when ally in the Middle and Upper Burners. If the
there is substantial accumulation due to accumulation of Heat blocks the circulation
pathogenic factors in the gastrointestinal of Qi or Blood, herbs that regulate Qi or
tract with symptoms of abdominal pain, Blood and resolve Blood Stasis are added to
constipation and a forceful and full pulse. promote bowel movement and relieve
2. These formulae arc prescribed when the abdominal pain. Examples are Fructus
treatment method of choice is that of Aurantii Immaturus and Cortex Magnoliae
purging to remove obstruction in the Officinalis in formulae such as Da Cheng Qi
Interior. Tang (Major Order the Qi Decoction) and
3. The formulae consist of purgative Xiao Cheng Qi Tang (Minor Order the Qi
substances that relieve constipation and Decoction).
dispel substantial accumulation from the — Semen Persicae, Radix Paeoniae Rubra and
Interior. The selection of formulae depends Semen Raphani are similarly deployed in
upon the type of Excess pattern and the formulae such as Fu Fang Cheng Qi Tang
actions of individual herbs. (Revised Major Order the Qi Decoction).
— If Full Heat and stagnant Blood combine to
block the intestinal tract and produce appen
B. FORMULATING PURGATIVE dicitis with localized masses, herbs that
PRESCRIPTIONS activate the Blood, resolve Blood Stasis,
relieve pain, disperse masses and relieve
1. Formulating cold purgative formulae
swelling are added.
— Cold purgative formulae consist primarily of — For Fire Poison with severe pain, herbs that
cold and cool purgatives. They remove activate the Blood, relieve pain and clear
obstruction from the Fu organs, clear Heat Heat and Fire Poison are even more impor
and dispel accumulation of Heat. They are tant. Herbs such as Semen Persicae, Cortex
thus indicated for patterns of accumulation Moutan Radicis and Semen Benincasae are
of Heat in the Interior. used for this purpose in formulae such as Da
— The pathogenesis of such patterns is the Huang Mu Dan Tang (Rhubarb and Moutan
retention of dry faeces in the intestinal tract Decoction), to which Flos Lonicerae and
due to Heat, which blocks the Qi of the Large Herba Taraxaci can be added.
Intestine. Clinical manifestations include — If Water and Heat combine and are retained
constipation, distension, abdominal fullness in the chest and abdomen with symptoms of
and pain, tidal fever, a yellow tongue constipation, dryness of the mouth and
coating and a forceful full pulse. tongue, and epigastric and abdominal
— The main ingredients of such formulae are hardness, fullness and pain, strong purga
cold and bitter or salty substances such as tives that dispel retained Water should be
Radix et Rhizoma Rhei and Natrii Sulfas. added. An example of this type of combina
— The accumulation of Full Heat tends to tion is that of Radix et Rhizoma Rhei and
cause stagnation of Qi, or of both Qi and Natrii Sulfas with Radix Euphorbiae Kansui
120 Part 4: Combinations and comparisons of commonly used formulae

in Da Xian Xiong Tang (Major Sinking into accumulation of dry faeces and the
the Chest Decoction). consumption of Body Fluids due to Full
Heat, Empty Heat or damage to Essence and
2. Formulating warm purgative prescriptions Blood following a prolonged illness or child
birth.
— These formulae are indicated for constipa
tion with abdominal pain due to retention of — In cases where Full Heat has consumed
Full Cold. Body Fluids, resulting in dry constipation,
the nature of the pattern is Excess com
— The two factors of this pattern are the
accumulation of faeces and pathogenic Cold. plicated with Deficiency. Here, the method
Pathogenic Cold is resolved by warming of moistening the intestines is combined
and the accumulation of faeces is relieved by with the method of purging by combining
moist purgatives with herbs that nourish
purging. Warm purgative formulae therefore
consist of herbs that warm the Interior and the Yin and harmonize the Interior and
with herbs that clear Heat, regulate Qi and
dispel Cold, and purgative herbs. Warm
relieve constipation. An example is the
purgative herbs may be used, or a combina
tion of warm and hot herbs with cold purga combination of Fructus Cannabis, Semen
tives. Armeniacae Amarum, Radix Paeoniae Alba
— For sudden distending and boring pain in and Mel with Fructus Aurantii Immaturus,

the heart and abdomen, lockjaw and sudden Cortex Magnoliae Officinalis and Radix et
syncope, powerful hot purgatives are
Rhizoma Rhei in Ma Zi Ren Wan (Hemp
Seed Pill).
combined with herbs that warm the Interior
and dispel Cold, or with cold purgatives. An — If dry constipation is caused by a deficiency
example is the combination of Fructus of Essence and Blood, the correct treatment
method is to relieve constipation gently with
Crotonis (Ba Dou) with Radix et Rhizoma
Rhei and dried Rhizoma Zingiberis in San warm and moist herbs, using herbs that
Wu Bet Ji Wan (Three-Substance Pill for warm the Kidneys, moisten the intestines
Emergencies). and tonify Essence and Blood. However,
— If the onset of the disorder is gradual, and moist herbs can produce stagnation, and
pathological changes are not severe but purgatives may cause sinking of Qi in a
weak person. Therefore, herbs that regulate
consist of constipation, abdominal pain, a
thick white tongue coating and a deep tense Qi and herbs that raise Yang should be
added.
pulse, the correct method of treatment is
— An example of such a formula is Ji Chuan
warming the Interior, dispelling Cold and
fiart (Benefit the River Decoction) in which
gently relieving constipation. In this case,
herbs that warm the Interior are combined Herba Cistanchis tonifies Kidney Essence,
with cold purgatives, and Qi tonic herbs are moistens the intestines and relieves consti
pation; Radix Angelicae Sinensis tonifies
added to the formula. Examples are the
combination of Radix et Rhizoma Rhei with Blood and moistens the intestines; Radix
Radix Aconiti Praeparata and Herba Asari in Achyran this Bidentatae tonifies the Kidneys
Da Huang Fu Zi Tang (Rhubarb and and strengthens the lumbar region; Fructus
Prepared Aconite Decoction) and the Aurantii relaxes the intestines and sends Qi
downward; and Rhizoma Cimicifugae raises
combination of Radix et Rhizoma Rhei with
the clear Yang and conducts the turbid Yin
Radix Aconiti Praeparata, dried Rhizoma
downward
Zingiberis, Radix Ginseng and treated Radix
Glycyrrhizae in Wen Pi Tang (Warm Ihe
Spleen Decoction). 4. Formulae that drive out excess waler

— Formulae for driving out water consist


3. Formulating moist purgative prescriplions
primarily of herbs that dispel water and
— Moist purgative formulae consist of moist relieve swelling. They are indicated for
and oily mild purgatives which relieve accumulated water in (he chest and
constipation by moistening the intestines. abdomen and for oedema with symptoms of
They are thus indicated for constipation due distension and fullness.
to intestinal drvness. — Herbs commonly used for this purpose
— The two factors in this pattern are the include Radix Euphorbiae Kansui, Flos
Purgative formulae 121

nd the Genkwa, Radix Euphorbiae Pekinensis, constipation, the correct formula is Zeng Ye
to Full Semen Pharbitidis and Radix Phytolaccae, Cheng Qi Tang (Increase the Fluids and
■nee and all of which dispel water via urine and Order the Qi Decoction). In this formula,
jrchild- stool. herbs such as Radix Scophulariae, Radix
— However, such herbs are powerful and Rehmanniae and Radix Ophiopogonis,
nsumed somewhat toxic cathartics, and Fructus which nourish the Yin and promote Body
:ipation, Ziziphi Jujubae or other Spleen tonics are Fluids, are combined with cold purgatives
ss com- generally added to these formulae to protect such as Radix et Rhizoma Rhei and Natrii
method the Middle Burner, as in Shi Zcta Tang (Ten- Sulfas.
imbined Jujube Decoction}. If constipation is due to accumulation of
mbining — If the pathological pattern includes Cold with Spleen Yang Deficiency, purgative
nourish oedema which blocks Qi circulation, as well herbs are combined with herbs that warm
ior and as Full Heat with thirst, coarse breathing, a the Interior and tonify Qi. An example is
Qi and hard abdomen and constipation, herbs Wen Pi Tang (Warm the Spleen Decoction),
is the that regulate Qi should be added. An in which Radix et Rhizoma Rhei is combined
Semen example of such a formula is Zhou Che with Radix Aconiti Praeparata, Rhizoma
lae Alba Wan (Vessel and Vehicle Pill), in which Zingiberis, Radix Ginseng and treated Radix
na turns, Radix Euphorbiae Pekinensis, Radix Glycyrrhizae.
ladix et Euphorbiae Kansui, Flos Genkwa and
(Hemp Semen Pharbitidis are combined with
Pericarpium Citri Reticulatae Viride,
C. POINTS TO REMEMBER IN
■ficiency Pericarpium Citri Reticulatae, Radix
eatment
FORMULATING PURGATIVE
Aucklandiae, Semen Arecae and Radix et
PRESCRIPTIONS
itly with Rhizoma Rhei.
rbs that 1. Purgative formulae work in different ways,
ites tines depending upon the dosage and the method
5. Formulating prescriptions to purge and
owever,
of decoction and administration. For
tonify simultaneously
on, and example, Major Order the Qi Decoction and
Qi in a — These formulae consist of purgative herbs Minor Order the Qi Decoction have different
regulate and tonic herbs in combination. They are actions and indications despite having
ould be indicated for an accumulation of pathogenic similar ingredients. If Fructus Aurantii
factors in the gastrointestinal tract compli Immaturus and Cortex Magnoliae
i Chuan cated with a deficiency of the Upright Offidnalis are prescribed in large dosages
n which (Zheng) Qi of the body. In such cases, purga and Radix et Rhizoma Rhei is added toward
Essence, tive herbs alone will further damage the the end of the cooking time, the purgative
i consti- Upright Qi, while tonic herbs alone will effect will be strong. If Fructus Aurantii
tonifies strengthen the pathogenic factors. Immaturus and Cortex Magnoliae
;; Radix — Interior patterns of Excess can consist either Officinalis are used in small dosages and the
Kidneys of accumulation of Heat or accumulation three herbs are cooked together, the purga
Fructus of Cold. Internal deficiency may involve tive effect will be weaker.
ends Qi Yin, Yang, Qi or Blood. The selection of — Fructus Crotonis, an ingredient of Three-
ae raises formulae thus depends upon the individual Substance PHI for Emergencies, is a
rbid Yin case. powerful cathartic and should be adminis
— If accumulation of Heat is severe, and Qi and tered in small doses, in the form of pills or
Blood are deficient, the method of clearing powder with the oil removed in order to
Heat with powerful purgatives is combined reduce its irritant effect on the stomach and
with the method of tonifying Qi and intestines.
consist Blood. An example of such a formula is — Similarly, if Radix Euphorbiae Kansui is
ter and Huang Long Tang (Yellow Dragon taken in large doses it will effectively drive
ited for Decoction), in which Major Order the Qi out excess water but is likely to damage
■st and Decoction is combined with Qi and Blood Stomach Qi. This side-effect is largely
)toms of tonics such as Radix Ginseng and Radix avoided if it is taken in small doses and
Angelicae Sinensis. combined with jujube, as in Ten-Jujube
purpose — If there is an accumulation of Heat in Yang Decoction, in order to minimize its
ji, Flos Ming which consumes Yin, producing dry toxicitv.
122 Part 4: Combinations and comparisons of commonly used formulae

2. Purgative formulae dispel accumulated - Xiao Cheng Qi Tang


pathogenic factors, but tend to damage Minor Order the Qi Decoction
Upright Qi. They are therefore contraindi- - Tiao Wei Cheng Qi Tang
cated in cases of:
Regulate the Stomach and Order the Qi
- extreme deficiency of Qi and Blood with a Decoction
hesitant and feeble pulse - These are known as Three Purgative
- Kidney Yang Deficiency with cold limbs Decoctions. All of them use Radix et
- Exterior patterns in which the pathogenic Rhizoma Rhei to dispel accumulated Heat in
factors have not entered the Interior the gastrointestinal tract and all are thus
- internal deficiency and Rebellious Qi indicated for Yang Ming Fu patterns of Full
with nausea, vomiting and hiccup Heat.
- dryness of the stool followed by loose - In preparing Major Order the Qi Decoction,
stools.
the herbs are cooked for a short time and
— In his book A Medical Text for Confudanists to Radix et Rhizoma Rhei and Natrii Sulfas are
Serve Family Members and Relatives, Zhang added toward the end of the cooking time.
Zihe says, 'Purgatives are prohibited in case Fructus Aurantii Immaturus and Cortex
of diarrhoea due to Cold, in case of Cold Magnoliae Officinalis are used in large
invasion with a superficial pulse, in case of doses. These factors make this formula a
deficiency of both the Exterior and the powerful purgative and it is often prescribed
Interior and in case of cyanosis of the lips in the treatment of severe Yang Ming Heat,
and cold limbs.' characterized by distress, fullness and
— In his book Insight into Medicine, Cheng dryness.

Zhongling points out, 'Constipation can be - Minor Order the Qi Decoction does not
the result of dryness of Blood in old age, contain Natrii Sulfas, and Radix et Rhizoma
exhaustion of Blood following childbirth, Rhei is cooked together with smaller doses
consumption of Body Fluids and Blood due of Fructus Aurantii Immaturus and Cortex
\i
to prolonged illness.... Pathological condi Magnoliae Officinalis. The formula is thus
tions will deteriorate if purgatives are taken milder in its action and is used in the treat
carelessly.' ment of less severe Yang Ming Heat, charac
terized by distress and fullness without
dryness.

D. A COMPARISON OF COMMONLY USED Regulate the Stomach and Order the Qi


PURGATIVE FORMULAE (TABLE 28.1) Decoction does not contain Fructus Aurantii
Immaturus and Cortex Magnoliae
1. - Da Cheng Qi Tang Officinalis. Radix et Rhizoma Rhei and
Major Order the Qi Decoction Radix Glycyrrhizae are cooked together and

Table 28.1 Comparison of purgative formulae

Formula Actions Indications

Major Order the Qi Decoction Purges strongly Yang Ming Heat (severe) with distress,
fullness, dryness

Minor Order the Qi Decoction Purges less strongly Yang Ming Heat (less severe) with
distress and fullness onlv

Regulate the Stomach and Order Purges mildly Yang Ming Heat (mild) with no

B
theQi Decoction
Qi stagnation

Yellow Dragon Decoction Clears Heal Interior Full Heat complicated with
Dispels accumulation Qi and Blood Deficiency
Tonifies Qi and Blood

Increase the Fluids and Order the Qi Clears Heat Acute febrile disease or Yang Ming
Decoction Nourishes Yin and Fluids Heat with Yin deficiency
Relieves constipation
Purgative formulae 123

Natrii Sulfas is added later. These factors


make this formula even gentler in its action
and it is often used in the treatment of mild
theQi cases of Yang Ming Heat with no signs of Qi
Stagnation. I
rgative 2. - Huang Long Tang
dix et Yellow Dragon Decoction
Heat in - Zeng Ye Cheng Qi Tang
■e thus Increase the Fluids and Order the Qi
of Full Decoction

oction, — Both of these formulae combine purgation

ne and with tonification and contain Radix et


Rhizoma Rhei and Natrii Sulfas. They are
Ifas are
g time. indicated for the accumulation of pathogenic
factors in the Interior complicated with
Cortex
i large
deficiency of Upright Qi.
— Yellow Dragon Decoction combines Natrii
nula a
Sulfas and Radix et Rhizoma Rhei with
scribed
y Heat,
Fructus Aurantii Immaturus and Cortex

s and Magnoliae Officinalis in order to clear Heat,


relieve constipation and dispel accumulation
from the gastrointestinal tract. The formula
>es not
also contains Radix Ginseng, Radix
lizoma
r doses
Glvcyrrhizae and Radix Angelicae Sinensis
to tonify Qi and Blood. It is thus indicated
Cortex
for Interior Full Heat patterns complicated
is thus
with deficiency of Qi and Blood, with
e treat-
charac-
symptoms of constipation, abdominal

vithout
distension, fullness and pain, a feverish
sensation of the body, thirst, lassitude, a
burnt yellow or dark tongue coating and a
the Qi
.urantii
deficient pulse.
— Increase the Fluids and Order the Qi
gnoliae
Decoction combines Natrii Sulfas and Radix
ei and
et Rhizoma Rhei with Radix Scrophulariae,
\er and
Radix Ophiopogonis and Radix Rehmanniae
to nourish Yin, clear Heat, increase Body
Fluids and relieve constipation. This formula
is thus indicated for acute febrile diseases
and Yang Ming Heat with Yin Deficiency,
listress, with symptoms of constipation, thirst, dry
lips, a dry and burnt yellow tongue coating
and a thready and rapid pulse.
ith

Questions
with 1. What are the indications for purgative
formulae?
2. How are cold purgative prescriptions
ling formulated?
124

29 Formulae for clearing Heat

A. GUIDING PRINCIPLES FOR - Bai Hu Tang

FORMULATING PRESCRIPTIONS TO White Tiger Decoction


CLEAR HEAT - Zhi Zi Don Chi Tang
Gardenia and Prepared Soybean
(i* 1. Formulae for clearing Heat are indicated for Decoction
Interior Heat patterns caused either by-
invasion of pathogenic Heat into the Interior
- Since Full Heat consumes Body Fluids, and
or by Empty Heat in the Zang Fu. Symptoms
residua] Heat is often accompanied by
include fever, restlessness, thirst with a
deficiency of both Qi and Yin, herbs
preference for cold drinks, flushed face, a
that tonify Qi and nourish Yin should be
red tongue with yellow coating and a
added. Examples are Radix Ginseng in Bai
surging rapid pulse.
Hu ]ia Ren Shen Tang (White Tiger plus
2. These formulae are prescribed when the
Ginseng Decoction), and Radix Ginseng
treatment method consists of clearing
Interior Heat.
and Radix Ophiopogonis in Zhu Ye Shi
Gao Tang (Lophatherus and Gypsum
3. The mam ingredients of these formulae are
Decoction).
herbs that clear Interior Heat.
- If Qi level Heat is not resolved it may
enter the Blood level, in which case herbs
that clear Heat and cool Blood should
B. FORMULATING PRESCRIPTIONS FOR be added. An example of such a formula is
CLEARING HEAT Hua Ban Tang (Decoction for Relieving
Feverish Rash), which contains Cornu
1. Formulating prescriptions for clearing Qi
Rhinoceri Asiatici and Radix Scrophulariae.
level Heat
The Heat may stir up Liver Wind, in
— Qi level Heat is caused by the invasion of which case herbs should be added that calm
pathogenic factors into the Interior, where the Wind and stop convulsion, as in Ling
they then transform to Heat, or by the reten Ma Bai Hu Tang (White Tiger Decoction
tion of residual Heat after an illness. The with Antelopis and Gastrodia), which
Heat tends So involve the Lungs and contains Cornu Antelopis and Rhizoma
Stomach. Gastrodiae.
— If the pattern is caused by the invasion of Qi level Heat may also be complicated with
pathogenic factors, symptoms will include pathogenic Dampness, in which case herbs
high fever, restlessness, profuse sweating that clear Heal and resolve Dampness
and a surging and forceful pulse. should be added, as in Bui Hu Jin Cnng Zhu
— If the pattern is caused by the retention of Tang (White Tiger Decoction with
residua] Heat after an illness, symptoms will Atractylodis), which contains Rhizoma
include restlessness, dry mouth and lips, a Atractylodis. If Qi level Heat is complicated
red tongue with scanty coating and a with Yang Ming Fu syndrome, herbs that
deficient pulse. purge Heat and relieve constipation should
— Commonly used herbs include Gypsum be added, as in Bai Hu Cheng Qi Tang (White
Fibrosum, Rhizoma Anemarrhenae, Fructus Tiger Decoction for Ordering the Qi},
Gardeniae and Herba Lophatheri. which contains Radix et Rhizoma Rhei and
Commonly used formulae include: Natrii Sulfas.
Formulae for clearing Heat 125

2. Formulating prescriptions for clearing Rhizoma Acori Graminei and Radix


Nutritive level Heat and cooling Blood Curcumae

— These formulae consist primarily of herbs


Cornu Antelopis and Ramulus Uncariae
that clear Nutritive level Heat and cool
cum Uncis
Blood. They are indicated for invasion of the
or
Nutritive and Blood levels by pathogenic
Purple Snow Special Pill (Zi Xue
Heat.
Dan) and Calm the Palace Pill with
— Heat at the Nutritive level is a further devel
Cattle Gallstone (An Gong Niu Huang
opment of Heat at the Qi level and is the
Wan).
beginning of the pattern of Heat at the Blood
level. Nutritive Qi communicates with the
3. Formulating prescriptions for clearing
Heart and pathological changes at the
Heat and Fire Poison
Nutritive level are characterized by
consumption of Yin and disturbance of the — Formulae for clearing Heat and Fire Poison
Heart and Mind. The symptoms of Heat at consist primarily of herbs that clear Heat
the Nutritive level include a feverish sensa and Fire Poison. They clear Heat and Fire
tion which is worse at night, delirium, indis Poison, purge Fire and treat skin ulcers and
tinct skin eruptions, a deep-red dry tongue are thus indicated for severe deep-rooted
ds, and
and a thready and rapid pulse. Once the Fire Poison such as infectious epidemic
ted by
pathogen has entered the Nutritive level, it diseases, acute febrile diseases, and ulcers,
herbs
may return to the Qi level or travel deeper to boils and furuncles.
iuld be
invade the Pericardium or stir up Liver — Their main ingredients include Radix
in Bai
Wind. Formulae for clearing Nutritive level Scutellariae, Rhizoma Coptidis, Cortex
:r plus
Heat consist of: Phellodendri, Fructus Gardeniae, Flos
jinseng
Lonicerae, Fructus Forsythiae, Radix Isatidis
Ye Shi - salty and cold herbs that clear Nutritive and Herba Andrographitis (Chuan Xin Lian).
ypsum
level Heat and cool Blood, such as Cornu — Other herbs should be added according to
Rhinoceri Asiatici, Radix Scrophulariae the areas affected by Fire Poison and other
it may
and Radix Rehmanniae clinical manifestations.
2 herbs
and — If the Fire Poison invades the Triple Burner,
should
- bitter and cold herbs that clear Heat, such with symptoms of a feverish sensation of the
mula is
as Radix Scutellariae, Rhizoma Coptidis body, restlessness, irritability, haemoptysis,
lieving
and Fructus Gardeniae epistaxis or skin eruptions, the method of
Cornu
and clearing Heat and purging Fire should be
ulariae.
- sweet and cold herbs lhat nourish Yin, followed by combining bitter and cold herbs
ind, in
such as Radix Ophiopogonis and Herba such as Radix Scutellariae, Rhizoma
at calm
Dendrobii Coptidis and Cortex Phellodendri with
in Ling
or
Fructus Gardeniae and Radix et Rhizoma
coction
- herbs that clear Nutritive level Heat Rhei. The representative formula is Huang
which
through the Qi level, such as Flos Lian fie Du Tang (Coptis Decoction to
hizoma
Lonicerae, Fructus Forsythiae and Herba Relieve Toxicity).
Lophatheri — If Fire Poison is retained in the head and
?d with
or face, presenting with redness, swelling and a
e herbs
- herbs that cool and activate Blood such as hot sensation of the head and face, red eyes,
mpness
Radix Salviae Miltiorrhizae and Radix mouth ulcers and a painful swollen throat,
ng Zhu
PaeoniaeRubra. the method of clearing is combined with the
with
method of dispersing. This is done by
hizoma — The representative formula for this pattern is
prescribing:
plicated Qing Ying Tang (Clear the Nutritive Level
■bs that Decoction). - herbs that purge Fire and clear Fire
should — If pathogenic Heat at the Nutritive level goes Poison in the Upper Burner, such as
(White deeper and results in delirium, or if it Radix Scutellariae, Rhizoma Coptidis,
ie Qi), damages the Yin and stirs up Liver Wind, Radix Scrophulariae, Lasiosphaera seu
hei and causing convulsions, the formula should be Calvatia {Ma Bo), Fructus Forsythiae and
augmented with: Radix Isatidis
126
Part 4: Combinations and comparisons of commonly used formulae

and
prescribed according to the functions of the
- pungent and cool herbs that clear and
affected organs, their related channels,
disperse Heat, such as Fructus Arctii,
related organs and the actions of individual
Bombyx Batryticatus and Herba herbs.
Menthae.
— For example, before formulae for clearing
— The representative formula is Pu Ji Xiao Du Heat in the Heart are prescribed it must be
Yin (Universal Benefit Decoction to known that the Heart houses the Mind,
Eliminate Toxin). dominates the blood vessels, opens into the
— If the Fire Poison moves to the pubic region tongue, is externally - internally related to
or if Blood Stasis and Heat combine in the the Small Intestine and has a Fire-Water
lower limbs, presenting with large carbun relationship to the Kidneys. It must also be
cles in the pubic region and gangrene of the known that Heart Fire can disturb the Mind,
toes, herbs that clear Heat are combined damage the Blood, cause Blood Stasis and
with: move upward to affect the tongue or
downward to affect the Small Intestine.
- herbs that drain Dampness through the
Symptoms of Heart Fire can thus include a
urine, such as Semen Plantaginis, Caulis heat sensation in the heart and chest,
Akebiae and Rhizoma Alismatis
restlessness, tongue ulcers, scanty deep-
and/or
yellow urine, insomnia, haemorrhage and
- herbs that nourish and activate Blood suppurating skin conditions.
such as Radix Angelicae Sinensis and - The herbs used to treat such a pattern
Radix Salviae Miltiorrhizae. include:
— The representative formulae are Long Dan
- bitter and cold herbs that enter the Heart
Xie Gan Tang (Gentiana Draining the Liver
channel and clear Heat, such as Rhizoma
Decoction) for scrotal abscess and swelling
Coptidis and Fructus Gardeniae
of lymph nodes in the groin due to venereal
- herbs that nourish Yin and Blood, such as
disease and Si Miao Yong An Tang (Four-
Radix Rehmanniae, Radix Scrophulariae
Valiant Decoction for Well-being) for and Colla Corii Asini
gangrene of the toes.
- herbs that clear Heat through the urine,
— If Fire Poison is retained in the vessels and
such as Herba Lophatheri, Caulis
muscles, forming boils, ulcers and furuncles,
Akebiae and Semen Plantaginis
herbs that clear Fire Poison and treat suppu - herbs that clear Heat in the Heart and
rating skin conditions, such as Flos
calm the Mind such as Cinnabaris and
Lonicerae, Fructus Forsythiae, Herba Succinum
Taraxaci, Herba Violae and Flos - herbs that cool Blood and stop bleeding
Chrysanrhemi are used. These are combined
such as Rhizoma Imperatae and Herba
with herbs that activate Blood, relieve Cephalanoploris.
swelling and soften hard masses, such as the
Mil tail of Radix Angelicae Sinensis, Resina - The representative formulae are Dao Chi San
Olibani, Resina Myrrhae, Squama Manitis, (Eliminating Redness Powder) and Xie Xin
Spina Gleditsiae and Bulbus Fritillariae. Tang (Drain the Epigastrium Decoction).
— The representative formulae are Wu Wei Xiao - Before prescribing formulae for clearing
Du Yin (Five-Ingredient Decoction to Liver Heat it must be understood that the
Eliminate Toxin) and Xian Fang Huo Ming Liver stores Blood, promotes the free flow of
Yin (Sublime Formula for Sustaining Life). Qi, opens into the eyes, is externally - inter
nally related to the Gall Bladder, has a Wood
4. Formulating prescriptions for clearing - Earth relationship with the Spleen and has
Heat in the organs a common origin with the Kidney; and thai
the Liver channel encircles the pubic region,
— Each of the Zang Fu has its own physiolog
passes through the hypochondrium, links
ical functions, channel and location and its
with the eye system and reaches the vertex.
own symptoms and signs of disease-
It must also be understood that excessive
Patterns of disease may involve a singie
Heat in the Liver channel can damage Liver
organ or two or more organs simultaneously.
Blood, impair the function of promoting the
Formulae for clearing Heat in the organs are
free flow of Qi, affect the Gall Bladder,
Formulae for clearing Heat 127

disturb the head and eyes, invade the Spleen the secondary treatment method is clearing
i of the
and Stomach and consume Kidney Yin, Heat with cold and cool herbs.
annels,
producing hypochondriac pain, acid regur- — Patterns of Interior Heat may involve the Qi,
ividual
gitation, a bitter taste in the mouth, poor Blood, Zang and/or Fu; clinical manifesta
appetite, headache, red eyes and! turbid tions will vary according to the location of
learing
vaginal discharge. the disease and the method of treatment
lust be
■ To clear Liver Heat, the primary herbs used must be adapted accordingly.
Mind,
are those which clear Heat in the Liver — The severity of the pattern also determines
nto the
channel, such as Radix Gentianae, Radix which herbs are selected. Severe Interior
ated to
Scutellariae, Rhizoma Coptidis, Indigo Heat will not improve if only mild herbs are
-Water
Naturalis, and Aloe. These are combined used. Conversely, if strong herbs are used to
also be
with:
treat mild Interior Heat patterns, patterns of
: Mind,
Cold will be created.
sis and - herbs that nourish Liver Blood such as — The constitution of the patient is another
pie or
Radix Angelicae Sinensis, Radix Paeoniae relevant factor in the selection of herbs.
testine.
Alba and Radix Rehmanniae Strong herbs should be used if the patient
:lude a
or has a strong constitution and Interior Full
chest,
- herbs that clear Damp-Heat such as Heat; even if the action of the herbs is too
deep- Caulis Akebiae, Rhizoma Alismatis and strong, it will not cause serious problems.
ge and
Semen Plantaginis However, if the patient has a weak constitu
or tion (e.g. women in the postpartum period),
pattern
- herbs that harmonize the Liver and cold and cool herbs should not be prescribed
disperse Fire such as Radix Bupleuri and in large doses even if there is high fever. In
b Heart Radix Ledebouriellae. these cases, the Heat should be cleared
nizoma - The representative formulae are Long Dan gradually to avoid the situation wherein
Xie Gan Tang (Gentiana Draining the Liver 'Heat is not cleared, but internal Cold is
such as Decoction), Zuo )in Wan (Left Metal Pill), produced'.
ulariae
and Dang Gui Long Hui Wan {Dang Gui, 2. Therapeutic results are also related to
Gentian and Aloe Pill). dosage and the method of decoction and
• urine, administration. For example, Gypsum
Caulis Fibrosum is a mineral and its active ingredi
ents are not easily extracted by cooking. It is
irt and C. POINTS TO REMEMBER IN therefore often prescribed in large doses and
ris and FORMULATING PRESCRIPTIONS FOR decocted for a long time before adding other
CLEARING HEAT herbs.
leeding
1. Interior Heat patterns may be patterns of — Flos Lonicerae and Herba Houttuyniae
Herba Excess or Deficiency.
should not be decocted for a long time as this
— Patterns of Excess are characterized by disperses their active ingredients.
abrupt onset, short duration, severe — Extremely bitter and cold herbs such as
Zhi San
symptoms and rapid pathological changes. Radix Scutellariae, Rhizoma Coptidis,
Xie Xin
They tend to consume Qi and Body Fluids Cortex Phellodendri and Radix Gentianae
on),
and can cause the Blood to move recklessly. can easily damage the Stomach and Spleen.
learing
The main clinical manifestations include They should therefore not be prescribed in
hat the
high fever, restlessness, flushed face, yellow large doses, nor taken for a long time.
flow of
urine, dry stool, a rapid and forceful — Radix Rehmanniae is cold, nourishing and
- inter-
pulse and a red tongue with yellow coating sticky in nature and when taken in large
i Wood.
or thorns. In severe cases, there may be doses for a long time may impair the
md has
convulsions, mania and haemorrhage. function of the Spleen and Stomach.
nd that
The correct treatment method is clearing 3. Formulae for clearing Heat are contraindi-
region,
cated in cases of persisting Exterior patterns,
i, links Heat.
— Patterns of Deficiency are characterized by deficiency of the Spleen and Stomach with
vertex,
slow onset, long duration, slow pathological stagnation of Cold, Yang Deficiency with
cessive
changes, Yin Deficiency and excess of Yang. fever, and patterns of True Cold and False
e Liver
The primary treatment method is that of Heat.
ing the
nourishing Yin with sweet and cold herbs; — Patterns of Deficient Fire are treated by
ladder,
128 Par! 4: Combinations and comparisons of commonly used formulae

tonification rather than clearing. For patterns of Qi level Full Heat. Typical
example, Empty Fire due to Kidney Yin symptoms include high fever, profuse
Deficiency is treated by strengthening Water sweating, restlessness, severe thirst and a
to control Fire. Floating Yang due to Kidney large and surging pulse.
Yang Deficiency is treated by returning the — Lophatherus and Gypsum Decoction clears
Fire to its origin. Heat more gently, but also nourishes Qi and
— In these cases, the method of clearing Heat Yin, harmonizes the Stomach and stops
would aggravate the pathological condition. vomiting. It is thus indicated for the late
stage of febrile disease marked by damage to
Qi and Body Fluids and retention of residual
D. A COMPARISON OF FORMULAE FOR
Heat. Typical symptoms include a feverish
CLEARING HEAT (TABLE 29.3)
sensation, profuse sweating, restlessness,
1. - BaiHu Tang thirst with desire to drink, a red tongue with
White Tiger Decoction scanty coating and a thready and rapid
- Zhu Ye Shi Gao Tang pulse.
Lophatherus and Gypsum Decoction — White Tiger Decoction is an extremely cold
formula used in the treatment of severe Full
— Lophatherus and Gypsum Decoction is
Heat patterns. Lophatherus and Gypsum
White Tiger Decoction with Rhizoma
Decoction clears Heat but tonifies at the
Anemarrhenae removed and Radix Ginseng,
same time and is used in the aftermath of
Rhizoma Pinelliae, Radix Ophiopogonis and
febrile disease to clear Heat from Deficiency.
Herba Lophatherus added. Both formulae
clear Heat and promote Body Fluids and are 2. - Qing Ying Tang
indicated forQi level Heat. Clear the Nutritive level Decoction
— White Tiger Decoction is more powerful in - Xi Jiao Di Huang Tang
clearing Heat and promoting Body Fluids Rhinoceros Horn and Rehmannia
and is thus indicated for Yang Ming Heat or Decoction

Table 29.1 Comparison of Formulae for clearing heat

Formula Actions Indications

While Tiger Decoction Strongly clears Heat Yang Ming Heat


Promotes Body Fluids Qi level Full Heat

Lophatherus and Gypsum Clears Heat more gently Late stage febrile disease with
Decoction Nourishes Qi and Yin residua] Heat and damage to Fluids
Harmonizes the Stomach

Rhinoceros Horn and Rehmannia Clears Heat from Nutritive Blood level Heat
Decoction and Blood levels
Stops bleeding
Resolves Stasis

Clear the Nutritive Level Decoction Clears Heat from Nutritive Nutritive level Heat
and Blood levels
ClearsQi level Heat
Nourishes Yin

Clearing the Stomach Powder Clears Stomach Fire Stomach Fire


Cools Blood

Jade Woman Decoction Clears Stomach Heat Stomach Heat complicated with Yin
Nourishes Yin Deficiency

Expelling Whiteness Powder Clears Lung Heat 1 ung Heat which has damaged Yin,
Nourishes the Stomach but Fire not severe

Reed Decoction Clears Lung Heat l.unp abscess due to retention ot


Dispels Blood Stasis and pus stagnant P1n"d and Heat
Formulae for clearing Heat 129

— These are the representative formulae for ingredients, both clear Stomach Heat.
Typical
clearing Nutritive level Heat and cooling Clearing the Stomach Powder clears
irofuse
Blood. Both contain Cornu Rhinoceri and Stomach Fire and cools Blood and is thus
and a
Radix Rehmanniae to clear Heat from the indicated for toothache due to Stomach Fire
Heart, clear Fire Poison, cool Blood and and bleeding gums due to Heat damaging
i clears
nourish Yin. Both are indicated for Heat at the blood vessels. Jade Woman Decoction
3i and
the Nutritive and Blood levels, with clears Stomach Heat and nourishes Yin and
'S
symptoms of fever which is more is thus indicated for toothache, epistaxis,
le late
pronounced at night, mild thirst, restless restlessness and thirst due to Stomach Heat
rage to
ness, insomnia, delirium, a deep-red tongue complicated with Yin Deficiency.
;sidual
;verish and a rapid pulse.
4. - Xie Bai San
— Rhinoceros Horn and Rehmannia
ssness, Expelling Whiteness Powder
e with Decoction consists of herbs that act only on
- Wei ]ing Tang
rapid the Blood level such as Cornu Rhinoceri,
Reed Decoction
Radix Rehmanniae, Radix Paeoniae and
Cortex Moutan Radicis. It is thus more effec — Expelling Whiteness Powder consists of
y cold
tive in cooling Blood and stopping bleeding; Cortex Lycii Radicis, Cortex Mori Radicis,
re Full
it also resolves Blood Stasis. It is indicated Radix Glycyrrhizae and non-glutinous rice.
/psum

for Blood level Heat with symptoms of Reed Decoction consists of Rhizoma
at the
haemoptysis, haematemesis, epistaxis, Phragmitis, Semen Coicis,
Semen
ath of
haematuria, bloody stools, dark-purple Benincasae and Semen Persicae. Both
:iency.
ecchymoses and petechiae and a deep-red or formulae clear Lung Heat and stop cough
purple tongue. and are thus indicated for cough and
— In addition to Cornu Rhinoceri and Radix dyspnoea due to Lung Heat.
Rehmanniae, Clear the Nutritive Level — Expelling Whiteness Powder clears Heat as
Decoction also contains Radix Salviae its primary function and nourishes the
Miltiorrhizae, Radix Scrophulariae, Radix Stomach as a secondary function, in accor
Ophiopogonis, Rhizoma Coptidis, Herba dance with the concept of nourishing the
Lophatheri, Flos Lonicerae and Fructus Earth to strengthen Metal. It is indicated
Forsythiae. Because it contains herbs that when Lung Heat has damaged the Yin, and
clear Qi level Heat as well as herbs that clear when Qi fails to descend properly, but
Heat from the Nutritive and Blood levels, Upright Qi is not severely damaged and Fire
this formula is more effective in clearing is not severe.
Heat from the Nutritive level via the Qi — Reed Decoction not only clears Lung Heat
level, and nourishing Yin. It is thus indicated but also dispels Blood Stasis and pus and is
-luids for Heat at the Nutritive level, with thus indicated for lung abscess formed by
symptoms of fever which is more retention of stagnant Blood and Heat in the
pronounced at night, restlessness, insomnia, Lung, with symptoms of chest pain, foul
possible delirium and an indistinct skin sputum or spitting of purulent blood.
rash, a deep-red dry tongue and a thready — Both formulae treat patterns involving
and rapid pulse. pathogenic Heat, but Expelling Whiteness
Powder is prescribed where there is a
3. - Qing Wei San deficiency of Upright Qi, while Reed
Clearing the Stomach Powder Decoction is prescribed when the patient's
- Yu Nu Jian constitution is strong.
Jade Woman Decoction

— Clearing the Stomach Powder consists of


Radix Angelicae Sinensis, Rhizoma Cop
Yin tidis, Radix Rehmanniae, Cortex Moutan Questions
Radicis and Rhizoma Cimicifugae. Jade
1. Compare and contrast formulae for clearing
Women Decoction consists of Gypsum Heat at the Qi level and formulae for
fin,
Fibrosum, Radix Rehmanniae Praeparata,
clearing Heat at the Blood level.
Radix Ophiopogonis, Rhizoma Anemar-
2. What are the guidelines for prescribing
rhenae and Radix Achyranthis Bidentatae.
formulae for clearing Heat?
— Although the two formulae have different
130

30 Formulae for warming the


Interior

A. GUIDING PRINCIPLES FOR Burner, such as Rhizoma Zingiberis, Rhi-


FORMULATING PRESCRIPTIONS TO zoma Alpiniae Officinalis, Fructus Evodiae,
WARM THE INTERIOR Pericarpium Zanthoxyli and Fructus Piperis
Longi.
1. Warming formulae are used to treat patterns — However, Cold tends to damage Yang Qi,
of Interior Cold. Clinical manifestations of
and deficiency of the Spleen and Stomach
such patterns include absence of thirst or a
with stagnation of Cold may lead to Kidney
preference for hot drinks, cold limbs,
Yang Deficiency, Blood Deficiency, Qi
copious clear urine, loose stools, a deep and
Stagnation and the production of internal
slow pulse and a pale tongue with a moist
Cold-Damp, and these complications must
coating.
also be addressed.
2. The treatment method is warming the
— For Spleen and Stomach Qi Deficiency with
Interior and dispersing Cold.
symptoms of shortness of breath, lassitude,
3. These formulae consist primarily of herbs
weak voice and a soft and weak pulse, Radix
that warm the Kidneys and Spleen and
Ginseng, Radix Astragali seu Hedysari,
disperse internal Cold.
Radix Codonopsis Pilosulae, Rhizoma
Atractylodis Macrocephalae and treated
Radix Glycyrrhizae are added to provide
B. FORMULATING PRESCRIPTIONS TO both warmth and tonification. Representa
WARM THE INTERIOR
tive formulae include Li Zhong Wan (Regu
1. Formulating prescriptions to warm the lating the Middle Decoction), Wu Zhu Yu
Middle Burner and disperse Cold Tang (Evodia Decoction) and Da Jian Zhong
Tang (Major Strengthening the Middle
— These formulae warm and tonify the Spleen Decoction)
and Stomach and disperse Cold from the — For Kidney Yang Deficiency with symptoms
Middle Burner. They are indicated for of aversion to cold, cold limbs and more
deficiency of the Middle Burner with stagna severe diarrhoea, add Radix Aconiti
tion of Cold.
Praeparata and Cortex Cinnamomi to invig
— If the Spleen and Stomach are constitution orate the Spleen and Stomach. The represen
ally deficient and cold, or they are invaded tative formula is Fu Zi Li Zhong Wan
by External Cold, or if the'Yang of the (Prepared Aconite Pill to Regulate the
Middle Burner is damaged by cold and raw Middle).
food or incorrect herbal treatment, the — For Blood Deficiency with symptoms of
Spleen's functions of transformation and lingering abdominal pain, pale complexion,
transportation will be impaired and stagna
palpitations, restlessness and a thready and
tion of Cold will occur. Clinical manifesta wiry pulse, add Saccharum Granorum,
tions will include pain and a cold sensation
Radix AngeJicae Sinensis, Radix Paeoniae
in the epigastrium and abdomen, vomiting, Alba and Radix Rehmanniae Praeparata to
diarrhoea, gustatory impairment, absence of warm the Middle Burner, harmonize
thirst, cold limbs and a pale tongue with a Nutritive Qi and moderate acute pain. The
moist white coating.
representative formulae include Xiao Jian
— To treat such patterns, the primary herbs are Zhong Tang (Minor Strengthening the
those that warm and invigorate the Middle Middle Decoction) and Dang Gin jian Zhong
Formulae for warming the Ulterior 131

Tang (Angelica Strengthening the Middle and


Decoction). - inability of the Kidneys to receive Qi,
— For obstruction of the Middle Burner by with symptoms of dyspnoea and stuffi
Cold Damp with symptoms of distension, ness of the chest.
fullness, epigastric and abdominal pain,
The core formula of Radix Aconiti
loose stools or constipation and a white
Praeparata and Rhizoma Zingiberis must
sticky tongue coating, add Cortex Magnoliae
therefore be augmented with other herbs
Officinalis, Pericarpium Citri Reticulatae,
which address the actual combination of
Semen Alpiniae Katsumadai, Fructus Tsaoko
pathologies in the individual patient.
and Rhizoma Cyperi to warm the Middle
For example, to restore Yang and at the same
Burner, disperse Cold, circulate Qi and
time benefit Qi, herbs such as Radix
resolve Dampness. The representative
Ginseng, Radix Astragali seu Hedysari,
is, Rhi- formula is Hou Po Wen Zhong Tang
Rhizoma Atractylodis and treated Radix
/vodiae, (Magnolia Bark Decoction for Warming the
Glycyrrhizae should be added. Represen
Piperis Middle).
tative formulae include Si Ni Tang (Four-
2. Formulating prescriptions for restoring Rebellious Decoction), Si Ni Jia Ren Shen
ang Qi,
Collapsed Yang Tang (Four-Rebellious Decoction with Gin
■tomach
seng) and Shen Fu Tang (Panax-Aconitum
Kidney — These formulae warm and tonify Heart,
.cy, Qi
Decoction).
Spleen and Kidney Yang. They treat
For severe Internal Cold with exhaustion of
internal Collapse of Yang and thus deal with the
Yang Qi, manifesting as Yin walling off
is must decline of Yang Qi, retention of Cold in the
Yang, or True Cold and False Heat, the three
Interior and patterns of False Heat above
basic warming herbs should be prescribed in
cy with
and True Cold below.
large doses and combined with Radix
ssitude, — Critical symptoms include cold limbs,
Ginseng, Rhizoma Atractylodis Macroce-
?, Radix aversion to cold, lying with the body curled
phalae, treated Radix Glycyrrhizae, Fructus
:dysari, up, diarrhoea with undigested food, feeble
Schisandrae and Moschus to restore Col
hizoma breathing, a pale tongue with white coating
lapsed Yang, tonify Qi and restore the pulse.
treated and a deep, feeble and fading pulse.
Representative formulae include Tong Yang
provide — This pattern may appear as the result of
Si Ni Tang (Unblock the Yang Four-
■esenta- incorrect treatment, prolonged illness, or
Rebellious Decoction) and Si Ni ]iu Ji Tang
(Regu- acute illness which damages Heart and
(Four-Rebellious Restore Collapsed Yang
Zhu Yu Kidney Yang, producing Interior Cold. It is
Decoction).
Zhong treated with strong pungent and hot herbs
For Collapse of Yang with profuse sweating,
Vliddle
such as Radix Aconiti Praeparata, Rhizoma
add calcined Os Draconis, calcined Concha
Zingiberis and Cortex Cinnamomi, to restore
Ostreae, Fructus Corni, Radix Rehmanniae
iptoms
Collapsed Yang.
Praeparata and Radix Paeoniae Alba to stop
i more — However, Yang Deficiency rarely appears
the sweating, restore the Yang and benefit
Aconiti without complications and these must be
Yin. The representative formula is Shen Fu
) invig-
addressed as well. Long Mu Tang (Panax-Aconitum Decoction
presen-
— Yang and Qi are closely related and
with Long Mu and Mu Li).
^ Wan deficiency of Yang inevitably involves Qi
For stagnation of Blood, add Semen Persicae
te the Deficiency. Severe Yang Deficiency also
and Flos Carthami to warm the Yang and
produces Internal Cold, or a pattern of True
activate the Blood. The representative
>ms of Cold and False Heat. Severe deficiency of
formula is Hui Yang }iu Ji Tang (Restore
•lexion, Heart and Kidney Yang gives rise to related
Collapsed Yang Decoction).
dy and
pathological patterns such as:
For retention of Internal Water and
riorum,
- leakage of Heart fluid, which causes Dampness with symptoms of dysuria and
leoniae
profuse sweating oedema of the body and limbs, add Poria
rata to
- stagnation of Blood with symptoms of and Rhizoma Atractylodis Macrocephalae to
nonize
painful limbs and cyanosis warm the Yang and drain Water.
in. The
- cold Water in the Interior with symptoms Representative formulae include Zhen W»
w Jian
of oedema, palpitations, dizziness and Tang (True Warrior Decoction) and Restore
g the
vertigo Collapsed Yang Decoction.
Zhong
132 Part 4. i ombinations and comparisons of commonly used formulae

3. Formulating prescriptions for warming the Cervj, plus smaller doses of baked Rhizoma
channels and dispersing Cold Zingiberis, Cortex Cinnamomi, Herba
— These formulae warm the channels, remove Ephedrae and Semen Sinapsis Albae to
obstruction from the collaterals, disperse warm the Yang, tonify Blood, disperse Cold
Cold and relieve stagnation. They are and relieve stagnation. The representative
indicated for Yang Deficiency and invasion formula is Yang He Tang (Yang-Heartening
of the channels and collaterals by Cold. Decoction).

— When Yang and Blood are deficient, Blood


may stagnate and the channels and collat
erals are vulnerable to invasion by C. POINTS TO REMEMBER IN
pathogenic Cold. If this occurs, the Blood FORMULATING PRESCRIPTIONS FOR
cannot circulate freely and Yang Qi cannot WARMING THE INTERIOR
reach the four limbs. This produces
symptoms such as cold limbs, painful joints 1. Herbs for warming the Interior are all
and a purplish-blue skin tone. pungent, sweet and warm or extremely hot

— Retention of Cold-Phlegm in the muscles, in nature. They warm the Interior and
tendons and bones produces generalized disperse pathogenic Cold but they also
swelling with more soreness than pain and consume Yin and damage Body Fluids.
absence of discoloration. Incorrect application of these formulae may
— In cither case, the treatment method is to cause side-effects and a correct diagnosis is
vital.
warm the channels, disperse Cold, nourish
the Blood and remove obstruction from the — The book insight into Medicine says:
vessels with two main groups of herbs: For Cold invasion of the body surface in
Winter, the method of providing warmth
- Ramulus Cinnamomi, Herba Asari, and
and dispersing Cold is adopted. For
Herba Ephedrae

! and
- Radix Angehcae Sinensis, Radix Paeoniae
Wind invasion of the body in Winter, the
method of providing warmth and
dispersing Wind is adopted. For retention
Alba, Radix Rehmanniae Praeparata and
of Cold Phlegm, the method of providing
Colla Cornus Cervi.
warmth and resolving Phlegm is
— Other herbs must then be added according adopted. For injury to the Spleen and
to the pattern of the individual patient. Stomach by cold food, the method of
— For example, for severe blockage of channels providing warmth and assisting diges
and collaterals with symptoms of cold limbs, tion is adopted. For a weak constitution
localized purplish-blue discoloration and complicated with stagnation of Cold, the
numbness and pain in the lower back, hips method of providing warmth and tonifi-
and feet, add Medulla Tetrapanacis and cation is adopted.

Caulis Spatholobi to assist in removing — The method of providing warmth and


obstruction from the vessels. The representa dispersing is not adopted in cases of Yin
tive formula is Dang Gui Si Ni Tang Deficiency with hyperactive Yang or in Heat
(Angelica Four-Rebellious Decoction). patterns with false Cold, as it may stir up
— For chronic Internal Cold complicated with Fire and damage Yin, thus aggravating the
upward Rebellion of Qi, add Fructus original condition.
Evodiae and Rhizoma Zingiberis Recens to 2. Dosage and the method of decoction and
assist in warming the Middle Burner, administration can modify the therapeutic
dispersing Cold and conducting Rebellious effects of formulae for warming the Interior.
Qi downward to stop vomiting. The repre For example, Radix Aconiti Praeparata is
sentative formula is Dang Gui Si Ni Jin IV//
toxic and correct dosage is important. To
Zhu Yu Slwng Jiang Tano (Angelica Four- reduce its toxicitv it must be decocted for a
Rebellious Decoction with Evodia and long time, often before other herbs are
Ginger).
added. Overdose or improper preparation
— For Cold-Phlegm in the muscles, tendons, may cause poisoning or even death.
bones and joints, add large doses of Radi\ — On the other hand. Cortex Cinnamomi, Flos
Rehmanniae Praeparata and Colla Cornus Caryophylli, Fructus Foenieuii and Fructus
Formulae for warming the Interior 133

Piperis Longi all contain volatile oils and — The main ingredient of Regulating the
hizoma
their effects will be reduced if they are Middle Pill is Rhizoma Zingiberis, which is
Herba
decocted at high temperatures or for a long combined with Radix Ginseng, Rhizoma
bae to
time. Atractylodis Macrocephalae and treated
se Cold
Radix Glycyrrhizae. This formula warms
■ntative
and invigorates Spleen Yang and dries
rtening
D. COMPARISON OF COMMON Dampness, which makes it effective in
FORMULAE FOR WARMING THE warming the Spleen and stopping diarrhoea.
INTERIOR (TABLE 30.1) It is indicated for deficiency of the Middle
Burner with stagnation of Cold marked by
1. - LiZhong Wan
abdominal pain, diarrhoea and poor
FOR Regulating the Middle Pill
appetite.
- WuZhu Yu Tang
— The main ingredient of Evodia Decoction is
Evodia Decoction
Fructus Evodiae, which is combined with
are all - Xiao Jian Zhong Tang
Radix Ginseng, Fructus Ziziphi Jujubae and
ely hot Minor Strengthening the Middle
a large dose of Rhizoma Zingiberis Recens.
nr and Decoction
This formula disperses Cold, warms the
•y also
— All three of these formulae consist of herbs Stomach and conducts Rebellious Qi
Fluids,
that warm the Interior and tonify Qi. They downward to stop vomiting. It is indicated
ae may
warm the Middle Burner, eliminate Cold, for deficiency of the Middle Burner with
nosis is
tonify Qi and invigorate the Spleen and are stagnation of Cold marked by vomiting,
thus indicated for deficiency of the Middle epigastric pain, acid regurgitation and an
Burner with stagnation of Cold. Symptoms empty uncomfortable sensation in the
■face in include abdominal pain, cold limbs, poor stomach. It is also used to treat Jue Yin
varmth appetite, gustatory impairment, absence of headache, retching and spitting of saliva,
d. For thirst, a pale tongue with white coating and and for Shao Yin syndrome with vomiting,
ter, the a deep and slow pulse. diarrhoea and cold limbs.
i and
tention Table 30.1 Comparison of formulae for warming the interior
>viding
Formula Actions Indications
;m is
;n and Regulating the Middle Pill Warms and invigorates Spleen Yang Deficiency of Middle Burner with
hod of Dries Damp Stagnation of Cold (abdominal
diges- pain and diarrhoea)

itution Deficiency of Middle Burner with


Evodia Decoction Disperses Cold
)ld, the Warms the Stomach Stagnation of Cold (vomiting,
tonifi- Regulates Rebellious Qi epigastric pain)
Jue Yin headache
Shao Yin syndrome
h and
Minor Strengthening the Harmonizes Yin and Yang Deficiency of Middle Burner with
of Yin
Middle Decoction Relieves abdominal pain Stagnation of Cold (intermittent
nHeat abdominal pain)
stir up Fever due to disharmony of Yin and
ing the Yang
Palpitations and restlessness due to
Qi and Biood Deficiency
)n and
ipeutic True Warrior Decoction Warms the Interior to eliminate Spleen and Kidney Yang Deficiency
nterior. Water and Damp with retention of Water and Damp

rata is
Prepared Aconite Decoction Strongly warms and tonifies to Spleen and Kidney Yang Deficiency
wit. To with retention of Cold Damp
eliminate Cold Damp
d for a
bs are Four-Rebellious Decoction Restores Devastated Yang Yang Deficiency (cold limbs)

a ration
Angelica Four-Rebellious Warms the channels Blood Deficiency and stagnation of
Decoction Disperses Cold Cold in channels and collaterals
li, Flos Nourishes and invigorates Blood (cold extremities)
;ructus
134 Part 4: Combinations and comparisons of commonly used formulae

— The main ingredient of Minor in which the four limbs are not warmed and
Strenglhening the Middle Decoction is nourished due to the decline of Yang Qi. It
Saccharum, which is combined with uses powerful pungent and hot herbs to
Ramulus Cinnamomi, Radix Paeoniae Alba restore Collapsed Yang. It is indicated for
and treated Radix Glycyrrhizae. The combi coldness of the entire limb accompanied by
nation of Ramulus Cinnamomi and Radix systemic signs of deficiency and Cold.
Paeoniae treats disharmony of Yin and Yang — Angelica Four-Rebellious Decoction treats
while the combination of Radix Paeoniae a pattern in which the limbs are not warmed
and Radix Glycyrrhizae relieves abdominal and nourished due to a deficiency of Yang Qi
pain- This formula is thus indicated for and deficiency and stagnation of Blood. It
deficiency of the Middle Burner with stagna uses the method of warming the channels,
tion of Cold marked by intermittent abdom dispersing Cold, nourishing Blood and
inal pain. It is also used to treat palpitations removing obstruction from the vessels. This
and restlessness due to deficiency of both Qi formula is indicated for patterns of Blood
and Blood and for fever due to disharmony Deficiency and stagnation of Cold in the
of Yin and Yang. channels and collaterals; the coldness of the
limbs is relatively mild and is limited to the
2. - Zhen Wu Tang
areas below the knees and elbows, with
True Warrior Decoction
possible localized purplish-blue discol
- Fu Zi Tang
oration and a deep thready pulse.
Prepared Aconite Decoction

— Both of these formulae consist of Radix


Aconiti Praeparata, Rhizoma Atractylodis
Macrocephalae, Poria and Radix Paeoniae Questions
Alba. They are effective in warming the
1. Why do formulae for warming the Middle
Interior, relieving pain and eliminating
Burner and eliminating Cold contain Qi
Dampness and are indicated for Spleen and
tonics such as Radix Ginseng and treated
Kidney Yang Deficiency with retention of
Radix Glycyrrhizae in addition to herbs that
Water and Dampness in the Interior.
eliminate Cold? Give examples.
— True Warrior Decoction contains Rhizoma
2. Explain the main principles for formulating
Zingiberis Recens but not Radix Ginseng. It
prescriptions to restore Collapsed Yang.
is thus more effective in warming and
dispersing to eliminate Water and
Dampness and is indicated for Spleen and
Kidney Yang Deficiency with retention of
Water and Dampness marked by sluggish
ness and oedema.
— Prepared Aconite Decoction contains Radix
Ginseng, but not Rhizoma Zingiberis
Recens, and double the dosage of Radix
Aconiti Praeparata and Rhizoma
Atractylodis Macrocephalae. It is thus more
effective in warming and tonifying to elimi
nate Cold Damp and is indicated for Spleen
and Kidney Yang Deficiency with retention
of Cold Damp marked by body and joint
pain.

3. - Si Ni Tang
Four-Rebellious decoction
- Dang Gui Si Ni Tang
Angelica Four-Rebellious Decoction

— Both of these formulae treat cold limbs, but


from different causes.
— Four-Rebellious Decoction treats a pattern
135

ned and
ig Qi. It
lerbs to
ited for
Formulae that tonify 31
nied by
i.
n treats
warmed
YangQi
ilood. It
nannels,
?d and
Shen Ling Bai Zhu San (Panax-Poria-Atrac-
2ls. This A. GUIDING PRINCIPLES FOR
tylodis Powder).
■f Blood FORMULATING TONIC
— For Damp-Phlegm, add herbs that dry
in the PRESCRIPTIONS
Dampness and resolve Phlegm, such as
is of the
1. Tonic formulae are used for Deficiency Rhizoma Pinelliae in Liu Jun Zi Tang (Six
d to the
patterns with symptoms of lassitude, palpi Gentlemen Decoction). For Sinking of
'S, with
tations, shortness of breath, dizziness, Central Qi, add herbs that lift the Qi such
discol-
blurred vision, a sallow or pale complexion, as Rhizoma Cimicifugae and Radix Bupleuri
malar flush, deficiency-type obesity or in Bu Zhong Yi Qi Tang (Tonifying the
emaciation, cold limbs, five-palm heat, Middle and Benefiting Qi Decoction).
spontaneous sweating, night sweats, a — Because Spleen Deficiency includes a
swollen and delicate or pale tongue and a weakness of transportation and transforma
thready and weak pulse. tion, herbs that regulate Qi are added to
Middle 2. The treatment method is tonification. counter the tendency of tonic herbs to
tain Qi 3. These formulae consist primarily of herbs produce stagnation. Examples include
treated that are sweet and warm, neutral or cold in Fructus Amomi in Panax-Poria-Atrac-
■rbs that nature. tylodis Powder and Pericarpium Citri
Reticulatae in Tonifying the Middle and
lulating Benefiting Qi Decoction.
B. FORMULATING TONIC — Herbs that regulate Qi are also added where
PRESCRIPTIONS Qi Stagnation is already evident. An
example is the use of Radix Aucklandiae,
1. Formulating prescriptions to tonify Qi
Fructus Amomi and Pericarpium Citri
— Formulae to tonify Qi consist mainly of Reticulatae in Xiang Sha Liu Jun Zi Tang (Six
sweet and warm herbs which tonify Qi and Gentlemen Decoction with Aucklandia
strengthen resistance to disease. They are and Amomum).
indicated for Spleen and Lung Qi Deficiency. — If Lung Deficiency is complicated with Yin
— Qi Deficiency usually refers to Spleen and Deficiency, herbs that nourish Yin and
Lung Qi Deficiency. astringe the Lungs are added, such as Radix
— Spleen Qi Deficiency refers to a dysfunction Ginseng combined with Radix
of transportation and transformation which Ophiopogonis and Fructus Schisandrae in
exhausts the source of Qi and Blood, Sheng Mai San (Generating the Pulse
produces Internal Dampness and causes a Powder), which clears and astringes while
sinking of Central Qi. tonifying.
— The Lungs dominate Qi. Lung Qi Deficiency — For cough or dyspnoea, or in cases of dishar
refers to a dysfunction of dispersing and mony between the Lungs and Kidneys, it is
descending and a weak resistance to external necessary to add herbs that tonify the
pathogenic factors. Kidneys, stimulate the reception of Qi and
— In treating Dampness due to Spleen stop cough and wheeze. Examples are
Deficiency, herbs that resolve or drain Semen Armeniacae Amarum, Gecko, Bulbus
Dampness are included in the formula. Fritillariae and Cortex Mori Radicis in Ren
Examples are Poria in Si ]un Zi Tang (Four Shen Ge ]ie San (Ginseng and Gecko
Gentlemen Decoction) and Semen Coicis in Powder).
136 Part 4: C oinhiiintioiis and companions of commonly used formulae

2. Formulating prescripfions to tonify Blood used in large doses, as in Dang Gui Bu Xue
Tang (Angelica Decoction to Tonify the
— Blood tonic formulae consist primarily of Blood), which contains five times as much
herbs that tonify and nourish Blood but Radix Astragali seu Hedysari as Radix
musi be adapted according to the actual Angelicae Sinensis. When Qi flourishes, it
condition of the patient. produces sufficient Blood.
— When there is a deficiency of Heart Blood,
the Heart and Mind are deprived of
nourishment, producing symptoms of palpi
3. Formulating prescriptions to tonify Yin
tations, insomnia, poor memory and a — Yin Deficiency can refer either to deficiency
thready and weak pulse. Herbs that nourish of Liver and Kidney Yin or deficiency of
the Heart and calm the Mind must be Lung and Stomach Yin.
included in the formula. An example is Gui — Deficiency of Lung and Stomach Yin implies
Pi Tang (Tonifying the Spleen Decoction), a deficiency of Body Fluids, manifesting as
which contains Radix Angelicae Sinensis thirst and shortness of breath. Deficiency of
and Arillus Longan to tonify Blood and Liver and Kidney Yin implies a deficiency of
nourish the Heart and Semen Ziziphi Blood, manifesting as dizziness, blurred
Spinosae, Poria cum Ligno Hospite and vision and tinnitus.
Radix Polygalae to soothe the Heart and — Lung Yin Deficiency can also produce dry
calm the Mind. cough and a dry sore throat. Stomach Yin
— For deficiency of Heart Qi with symptoms of Deficiency can manifest as spitting of white
an intermittent pulse and palpitations, the sticky foam. Liver Yin Deficiency often
method of treatment is primarily to tonify produces hypochondriac discomfort,
Blood and nourish the Heart and secon restlessness and irritability. Kidney Yin
darily to tonify Qi and restore the pulse. The Deficiency often results in sore and weak
representative formula is Zhi Gan Cao Tang lower back and knees, nocturnal emissions
(Glycyrrhiza Decoction), which combines and cloudy urine.
Radix Rehmanniae, Colla Corii Asini, Radix — All Yin tonics tonify Yin, but some are more
Ophiopogonis, treated Radix Glycyrrhizae, effective in tonifying the Yin of the Lung and
Radix Ginseng and Fructus Ziziphi Jujubae Stomach while others are more effective in
to tonify both Qi and Blood. tonifying the Yin of the Liver and Kidneys.
— When there is a deficiency of Liver Blood, — Herbs that are more effective in tonifying
the Liver's function of promoting the free Lung and Stomach Yin include Radix
flow of Qi and Blood is impaired and the Adenophorae, Radix Glehniae, Radix
eyes are deprived of nourishment. This Ophiopogonis, Bulbus Lilii, Herba
produces symptoms of hypochondriac pain, Dendrobii and Rhizoma Polygonati Odorati.
blurred vision, dry eyes and a scanty and These are combined with other herbs
pale menstrual flow. Because the circulation according to the actual condition of the
of Blood is impaired, formulae to tonify patient.
Blood often include herbs that regulate — For example, deficiency of Lung Yin may
Blood. The representative formula is Si Wit produce Empty Heat, which damages blood
Tang (Four-Substance Decoction), which vessels and gives rise to cough, wheeze,
contains Radix Angelicae Sinensis, Radix blood-tinged sputum, a thready and rapid
Rehmanniae Praeparata and Radix Paeoniae pulse and a red tongue with scanty coating.
Alba to tonify Blood and nourish the Liver, In this case, herbs that clear Lung Heat, stop
and Rhizoma Ligustici Chuanxiong to bleeding, resolve Phlegm and stop cough are
activate the Blood and resolve stagnation. added to the formula, such as Colla Corii
Because this formula tonifies without Asini combined with Fructus Aristolochiae,
causing stagnation, it is much used for Fructus Arctii and Semen Armeniacae
tonifying Blood and regulating menstrua Amarum in Bit Fei F. jiao Tang (Tonifying the
tion. Lung Decoction with Ass-Hide Gelatin).
— If the Spleen is deficient, the source of Qi and — In treating Kidney Yin Deficiency with
Blood will be exhausted. Formulae for symptoms of dry sore throat and tidal fever,
tonifying Blood therefore often include it is necessary to tonify the Yin of both the
herbs thai (onify Qi and these are ?omi>times Lungs and Kidneys. An example is Bai He
Formulae thai tonifu 137

iu Xue Gu }in Tang (Lily Bulb Decoction to Rising, with symptoms of pain in the chest,
fy the Preserve the Metal), which contains: epigastrium and hypochondrium, acid
much regurgitation, a bitter taste in the mouth and
Radix - Bulbus Lilii, Radix Ophiopogonis, Radix
a deficient wiry pulse, herbs that harmonize
Rehmanniae, Radix Rehmanniae Prae-
hes, it the Liver and regulate Qi should be added.
parata and Radix Scrophulariae to tonify
An example is Yi Guan Yin (Linking
Lung and Kidney Yin
Decoction), in which a large dose of Radix
- Radix Angelicae and Radix Paeoniae
Rehmanniae is combined with Radix
in Alba to nourish Blood
Glehniae, Radix Ophiopogonis, Radix
and
ciency Angelicae Sinensis, Fructus Lycii and
ncy of - Radix Platycodi and Bulbus Fritillariae
Fructus Meliae Toosendan.
Thunbergii to clear Lung Heat, resolve
- For Yin Deficiency with hyperactive Yang,
mplies Phlegm and stop cough.
producing symptoms of dizziness and
:ing as - If Lung and Kidney Yin Deficiency is blurred vision, the method of nourishing Yin
■ncy of complicated with Fire Poison, giving is combined with the method of suppressing
•ncy of symptoms of a red, swollen sore throat or a Yang. An example is Zhen Can Xi Feng Tang
-lurred white coating on the throat, herbs that clear (Pacifying the Liver and Subduing Wind
Heat and Fire Poison are added. An example Decoction), which employs Plastrum
ce dry is Yang Yin Qing Fei Tang (Nourish the Yin Testudinis, Radix Scrophulariae, Radix
:h Yin and Clear the Lungs Decoction), which Asparagi and Radix Paeoniae Alba to
white combines Radix Rehmanniae, Radix nourish Yin and clear Heat, and Radix
often Scrophulariae and Radix Ophiopogonis with Achyranthis Bidentatae, Haematitum, Os
•mfort, Herba Menthae, Cortex Moutan Radicis and Draconis and Concha Ostreae to conduct
y Yin Radix Glycyrrhizae. In severe cases, Radix Blood downward, suppress Yang and calm
weak Scutellariae and Fructus Forsythiae may be Liver Wind.
issions added. ■ Kidney Yin Deficiency is often complicated
■ Simple deficiency of Stomach Yin may be with Empty Fire, and herbs that tonify Yin
treated either with Yi Wei Tang (Benefiting are therefore often combined with herbs that
igand the Stomach Decoction), which consists of clear Heat and Fire. For simple deficiency of
tive in Radix Adenophorae, Radix Ophiopogonis, Kidney Yin with symptoms of dizziness and
leys, Rhizoma Polygonati Odorati, Radix blurred vision, sore and weak lumbar region
lifying Rehmanniae and crystalized brown sugar and knees, nocturnal emissions, night
Radix (Bing Tang), or with Wu Zhi Yin (Five-juice sweats, a red tongue with scanty coating and
Radix Decoction), which consists of pear juice, a thready pulse, sweet herbs that nourish
Herba lotus root, Radix Ophiopogonis, water- Yin are used to embrace the Yang, as in Zuo
dorati. chestnut and Rhizoma Phragmitis. Gui Yin (Restoring the Left Decoction) and
herbs If deficiency of Stomach Yin is complicated Zuo Gui Wan (Restoring the Left Pill).
3f the with Qi Deficiency and Heat, herbs that If Yin Deficiency is complicated with Raring
tonify Qi and clear Heat are added. An of Empty Fire with symptoms of five-palm
i may example is the combination of Herba heat, loose teeth, sore throat, a dry red
blood Dendrobii and Radix Ophiopogonis with tongue with scanty coating and a thready
heeze, Radix Panacis Qinquefolii, Rhizoma rapid pulse, herbs that clear Heat and Fire
rapid Coptidis, Herba Lophatheri, Rhizoma should be added. An example is Liu Wei Di
>ating. Anemarrhenae and watermelon peel in Qing Huang Wan (Six-Fiavour Rehmannia Pill),
t, stop Slut Yi Qi Tang (Clear Summer Heat and in which Radix Rehmanniae Praeparata,
gh are Augment the Qi Decoction). Rhizoma Discoreae and Fructus Corni are
Corii Herbs that are more effective in tonifying combined with Cortex Moutan Radicis,
ichiae, Liver and Kidney Yin include Radix Rhizoma Alismatis and Poria.
niacac Rehmanniae, Radix Rehmanniae Praeparata, If Liver and Kidney Yin Deficiency is
ng the Plastrum Testudinis, Carapax Tnonycis, complicated with more severe signs of Fire
in). Fructus Ligustri Lucidi and Fructus Corni. such as tidal fever, haemoptysis, irritability,
with These are combined with other herbs restlessness and burning pain in the feet and
fever, according to the condition of the patient. knees, the dosage of herbs that clear Heat
th the For Liver or Kidney Yin Deficiency compli and Fire should be increased, as in Da Bit Yin
Sai He cated with Liver Qi Stagnation or Liver Yang Wan (Great Tonify the Yin Pill), in which
138 Part 4: Cowhtniiticns and comparisons of commonly used formulae

Radix Rehmanniae Praeparata and Plastrum is accomplished primarily via the Heart and
Testudinis are combined with Rhizoma Liver and secondarily via the Spleen and
Anemarrhenaeand Cortex Phellodendri. Stomach. The Spleen and Kidneys are
involved in Yang Deficiency, which is treated
4. Formulating prescriptions to tonify Yang by warming and tonifying these organs to
benefit the source of Fire. The Liver,
— Deficiency of Kidney Yang implies a lack of
Kidneys, Lungs and Stomach are all
warmth. Symptoms may include soreness of
the lumbar region and knees, aversion to
involved in Yin Deficiency, which is treated
with sweet and cold Yin tonics to benefit the
cold, impotence, premature senility and
Stomach, moisten the Lung, nourish the
copious clear urine. If the 'holding in'
Kidneys and strengthen the Liver.
function of the Kidneys is impaired, there
— For conditions of extreme deficiency,
may be nocturnal emissions and enuresis; if
powerful tonics should be used in large
the transformational function of the Kidneys
doses and first aid should be administered
is impaired, there may be dysuria and
for Collapse.
oedema.
— For chronic conditions of deficiency, tonifica-
— Yin and Yang share a common root and Yin
tion should be achieved gradually, using
tonics are often added to Yang tonic
mild herbs.
formulae both to support the Yang and to
— For Yang Deficiency with Internal Cold,
counter the warmth and dryness of Yang
sweet and warm tonic herbs are used and
tonic herbs. Examples include Shen Qi Wan
herbs that clear Heat or moisten are
(Kidney Qi Pill) and You Gui Wan
contraindicated.
(Restoring the Right Pill), in which a large
— For Yin Deficiency with Empty Heat, sweet
dose of Radix Rehmanniae Praeparata is
and cool tonic herbs are used and pungent
combined with Rhizoma Dioscoreae and
and dry herbs are contraindicated.
Fructus Corni.
— If Kidney Yang Deficiency leads to oedema,
2. Qi, Blood, Yin and Yang are the four essen
herbs that drain Dampness and open the
tial factors sustaining the vital activities of
Waterways are added, such as Poria and
the human body.
Rhizoma Alismatisis in Kidney Qi Pill and
Semen Plantaginis in // Sheng Shen Qi Wan
— These factors are interrelated. For example,
(Invigorate the Kidney Qi Pill).
Qi and Blood share a common origin; Yin
and Yang share a common root. Vigorous Qi
— For nocturnal or spontaneous emissions due
produces Blood and abundant Yang
to Kidney Deficiency and weakness of the
produces Yin.
seminal gate, astringent herbs that consoli
■— When one of these factors is diseased, the
date the Essence should be added, such as
others are affected. This produces compli
Semen Astragali Complanati, Semen
cated conditions, such as Qi Deficiency
Euryales, calcined Os Draconis and calcined
Concha Ostreae in Jin Suo Gu ]ing Wan
leading to Blood Deficiency, loss of Blood
leading to Qi Deficiency, Yin Deficiency
(Metal Lock Pill to Stabilize the Essence).
leading to hyperactivity of Yang and Yang
Deficiency leading to weakness of Qi.
— Spleen Deficiency affects the Lungs, as Earth
C. POINTS TO REMEMBER IN
fails to produce Metal. Kidney Yang
FORMULATING TONIC
Deficiency causes Spleen Qi Deficiency, as
PRESCRIPTIONS
Fire fails to warm Earth. Kidney Yin
1. Patterns of deficiency involve Qi, Blood, Yin Deficiency produces Liver Fire, as Water
or Yang and their related Zang Fu. For fails to nourish Wood.
example, the Spleen and Lungs arc involved — These relationships are significant in the for
in Qi Deficiency and it is treated with sweet mulation of tonic prescriptions. For example,
and warm Qi tonic herbs which tonilv the Yin tonics are added to Yang tonic formulae
Spleen and Lungs. to support transformation; herbs that clear
— The Heart and Liver are involved in Blood Heat are added to Yin tonic formulae to
Deficiency, which is treated either bv strengthen the Root and clear Empty Heat;
tonifving Blood directly or, indirectly, by Qi tonics are added to Blood tonic formulae
tonifving Qi in order (d produce Blood. This to stimulate Qi to produce Blood.
Formulae that tonify 139

art and — For Lung Deficiency with Spleen weakness, pathogenic factors and both conditions
en and Earth should be strengthened to produce should be treated at the same time.
ys are Metal. For Yang Deficiency with stagnation
treated of Cold in the Spleen, Fire should be tonified 4. The Spleen and Kidneys play an important
gans to to warm Earth. For Deficiency of Waier with role in the treatment of deficiency patterns,
Liver, hyperactivity of Fire, Water should be but medical scholars of all ages have held
ire all nourished to produce Wood. different views as to which should be
treated tonified.
lefit the 3. The Spleen and Stomach are the source of Qi — Sun Simiao of the Tang Dynasty held, 'It is
ish the and Blood. Tonic herbs tend to cause stagna less effective to tonify the Kidneys than to
tion of Spleen and Stomach Qi, thus tonify the Spleen', because the Spleen is the
idency, impairing the functions of transportation source of Qi and Blood and sufficient Spleen
n large and transformation. Qi makes it possible to transmit Essence to
listered — If the Spleen and Stomach are weak, they the various parts of the body.
cannot easily digest tonic herbs, and atten — Xu Shuwei of the Song Dynasty held, 'It is
onifica- tion should therefore be given to invigora- less effective to tonify the Spleen than to
, using tion of the Spleen in tonic formulae, using tonify the Kidneys', because the Kidneys are
herbs that regulate Qi. the origin of the congenital constitution, the
1 Cold, — It is also necessary to determine whether Yin and Yang of the Zang Fu all rely on the
ed and residual pathogens are present. When a Kidneys and sufficiency of Kidney Qi
en are weakness of Upright Qi is complicated with ensures normal functioning of all the other
residual pathogens, tonification should be organs.

:, sweet combined with the method of elimination of — However, it is incorrect to overemphasize


mngent

Table 31.1 Comparison of tonic formulae

Formula Actions Indications


r essen-

'ities of
Four Gentlemen Decoction Tonifies Qi Spleen Qi Deficiency
Invigorates the Spleen
cample,
Regulating the Middle Pill Tonifies Qi Deficiency of the Middle Burner
;in; Yin
Invigorates the Spleen with Stagnation of Cold
rous Qi
Warms the Middle Burner and
Yang eliminates Cold

;ed, the Panax-Poria-Atractylodis Powder Tonifies Spleen and Lung Qi Spleen Deficiency complicated with
Eliminates Damp Damp
compli-
Harmonizes the Stomach
ficiency
f Blood Generating the Pulse Powder Benefits Qi Prostration due to Qi and Yin
ficiency Promotes Body Fluids Deficiency (Yin Collapse)

d Yang
Frigid Extremities Powder Rescues Devastated Yang Prostration due to Yang Deficiency
(Yang Collapse)
is Earth
Yang Tonifying the Middle and Benefiting Tonifies Qi Spleen Deficiency

■ncy, as
Qi Decoction Raises sinking Qi Fever due to Deficiency
Restores function of conducting Sinking of Central Qi
ey Yin
the clear up and the turbid
Water down
Tonifying the Tonifies the Heart and Spleen Heart and Spleen Qi Deficiency
the for- Spleen Decoction Restores the function of Weakness of Spleen function of
producing and controlling controlling Blood
<ample,
Blood
irmulae
at clear Six-Flavour Tonifies Kidney, Spleen and Kidney Yin Deficiency
ulae to Rehmannia Pill Liver Yin

y Heat;
Kidney Qi Pill Tonifies Kidney Yin and Yang, Kidney Yang Deficiency
»rmulae
but mainly Yang
140 Part 4: Lombinations and comparisons of commonly used formulae

the importance of any one organ, insight into sallow complexion, lassitude, weak voice,
Medicine says, 'It must be understood that if poor digestion, loose stools, a pale tongue
the Spleen is weak but the Kidneys are not and a deficient pulse.
deficient, the Spleen should be tonified; if — Four Gentlemen Decoction is a basic
the Kidneys arc weak but the Spleen is not formula for Spleen and Stomach Qi
deficient, the Kidneys should be tonified; Deficiency with impairment of the functions
and if both the Spleen and Kidneys are of transportation and transformation.
deficient, thev should both be tonified.' Panax-Poria-Atractylodis Powder has a
stronger and more comprehensive action. It
tonifies not only Spleen Qi but also Lung Qi;
D. A COMPARISON OF COMMON TONIC it also eliminates Dampness and harmonizes
FORMULAE <TABLE 31.]) the Stomach. It is thus indicated for Spleen
1. ~ Si jun Zi Tang and Stomach Qi Deficiency complicated
with Dampness.
Four Gentlemen Decoction
- Li Zhang Wan 3. - Shcng Mai San
Regulating the Middle Pill Generating the Pulse Powder
- 5/ Ni Tang
— Four Gentlemen Decoction is a basic Qi
Frigid Extremities Decoction
tonic formula and only one ingredient differ
entiates it from Regulating the Middle Pill. — Both formulae are often used as first aid for
— Both formulae tonjfy Qi and invigorate the prostration but from different causes.
Spleen with Radix Ginseng, Rhizoma — Generating the Pulse Powder is indicated
Atractylodis Macroeephalae and treated for Yin Collapse, with symptoms of a hot
Radix Glycyrrhizae. sensation and profuse oily perspiration
— Because Four Gentlemen Decoction uses which is salty and sticky. The body and
Radix Ginseng as its Emperor (Jim) herb and limbs are warm, or the body is warm but the
combines it with Poria, it is more effective in limbs cold; the face is flushed and the tongue
tonifying Qi and invigorating the Spleen. It red and dry.
is thus indicated for Spleen and Stomach Qi — Frigid Extremities Decoction is indicated
Deficiency with impairment of transporta for Yang Collapse, with symptoms of a cold
tion and transformation, manifesting as sensation and profuse watery perspiration
sallow complexion, reduced appetite, a pale which is not salty or sticky. The body and
tongue with white coating and a weak pulse. limbs are cold, the complexion pale and the
— Regulating the Middle Pifl uses Rhizoma tongue pale and moist.
Zingiberis as its Emperor herb. It is thus — Generating the Pulse Powder benefits Qi
more effective in warming the Middle and promotes Body Fluids and is thus also
Burner and eliminating Cold and is indicated for deticiency of both Qi and Yin
indicated for deficiency of the Middle with symptoms of lassitude, shortness of
Burner with stagnation of Cold marked by breath, thirst, profuse sweating, dry mouth
aversion to cold, cold limbs, abdominal pain, and throat and a rapid deficient pulse.
loose stools, a pale tongue with white — Frigid Extremities Decoction rescues
coating and a deep thready pulse. Devastated Yang and is thus indicated for
2. - Shot Ling Bai Zhu San extreme Yang Deficiency with cold limbs,
abdominal pain, lassitude, somnolence,
Panax-Poria-Atractylodis Powder
aversion to cold, lying with the body curled
- Si inn Zi Tang
Four Gentlemen Decoction up, absence of thirst and a deep, thready and
feeble pulse.
— Panax-Poria-Atractylodis Powder is made
4. - Bu yiiougYi Q.ltino
up o) Four Gentlemen Decoction plus
Tonifying the Middle and Benefiting Qi
Rhizoma Dioscoreae, Semen Doltchnris
Decoction
Album, Semen Nelumbinis, Semen Coieis,
- Ctii Pi Tew;:
Fructus Amomi and Radix Platycodi.
— Both formulae tonify Qi and invigorate the Tonifying the Spleen Decoction

Spleen and are indicated for Spleen and — Both formulae km: Radix Ginseng, Radix
Stomach Qi Deficiency with symptoms ot Astragali sen I ledvsari, Rhizoma
Formulae thai touify 141

; voice, Atractylodis Macrocephalae and Radix Deficiency with symptoms of lumbago,


tongue Glycyrrhizae to benefit Qi and invigorate the weak legs, a cold sensation in the lower half
Spleen and Radix Angelicae Sinensis to of the body, dysuria or copious urination, a
i basic nourish Blood. '. pale and swollen tongue and a weak pulse.
ich Qi — Tonifying the Middle and Benefiting Qi It also treats beriberi and oedema.
motions Decoction is composed of herbs that tonify
mation. Qi and raise Yang, such as Rhizoma
has a Cimicifugae and Radix Bupleuri, and is thus
ction. It intended to tonify Qi, raise sinking Qi and Questions
,ung Qi; restore the function of conducting the clear
1. Why do formulae for tonifying Spleen Qi
nonizes upward and the turbid downward.
often include herbs that eliminate Dampness
1 Spleen — Tonifying the Spleen Decoction is
and regulate Qi? Give examples.
plicated composed of herbs that tonify Qi, plus herbs
2. Why are Qi tonic herbs often added to
such as Arillus Longan, Semen Ziziphi
formulae for tonifying Blood? Give
Spinosae, Radix Polygalae and Poria cum
examples.
Ligno Hospite, which nourish the Heart and
3. Why are herbs that clear Heat sometimes
calm the Mind. It is intended to tonify the
added to Yin tonic formulae? Give an illus
Heart and Spleen and restore the function of
trative example.
producing and controlling Blood.
: aid for — The former is indicated for Spleen and
Stomach Qi Deficiency with symptoms of
idicated lack of energy, dislike of speaking and fever
if a hot from deficiency, or for Sinking of Central Qi
piration with symptoms of prolapse or chronic
dy and diarrhoea.
but the — The latter is indicated for deficiency of Heart
■ tongue and Spleen Qi and Blood with symptoms of
palpitations, poor memory and insomnia or
idicated for weakness of the Spleen's function of
tf a cold controlling Blood with symptoms of bloody
piration stool or uterine bleeding.
>dy and
5. - Liu Wei Di Huang Wan
and the
Six-Flavour Rehmannia Pill
- Shen Qi Wan
efits Qi
Kidney Qi Pill
ms also
and Yin — Both formulae consist of Radix Rehmanniae,
ness of Rhizoma Dioscoreae, Fructus Corni, Cortex
■ mouth Moutan Radicis, Rhizoma Alismatis and
Poria. Six-Flavour Rehmannia Pill is
rescues Kidney Qi Pill minus Ramulus Cinnamomi
ited for (or Cortex Cinnamomi) and Radix Aconiti
I limbs, Praeparata. It tonifies Liver, Spleen and
tolence, especially Kidney Yin and is thus indicated
/ curled for Kidnev Yin Deficiency with symptoms of
adyand sore and weak lower back and knees, dizzi
ness, blurred vision, tinnitus, deafness, night
sweats, nocturnal emissions, emaciation-
-thirst syndrome, a red tongue with scanty
iting Qi
coating and a deep, thready and rapid pulse.
It is also used to treat slow closure of
fontanelles in infants.
— Kidney Qi Pill tonifies both Yin and Yang,
, Radix but mainly warms and tonifies Kidney Yang.
Ihizoma It is thus indicated for Kidney Yang
142

32 Formulae that regulate Qi

— Stagnation of Spleen and Stomach Qi is


A. GUIDING PRINCIPLES FOR
marked by distension and fullness of the
FORMULATING PRESCRIPTIONS TO
REGULATE QI
epigastrium and abdomen, belching, acid
regurgitation, nausea, vomiting and reduced
— Formulae that regulate Qi treat patterns of appetite. Herbs which treat this pattern
Qi Stagnation or Rebellious Qi. These include Pericarpium Citri Reticulatae, Radix
patterns may affect the upper or lower body, Aucklandiae, Fructus Aurantii, Cortex
they may involve the Liver, Stomach or Magnoliae Officinalis, Fructus Amomi and
Lungs and they may be complicated with Semen Amomi Cardamomi.
Cold, Heat, Phlegm-Dampness, Food — Qi is the commander of Blood. Circulation
Retention or Blood Stagnation. of Qi leads to circulation of Blood and
— It is necessary at the outset to determine: 1) stagnation of Qi leads to stagnation of
whether pathological changes are due to Blood. Prolonged stagnation of Qi is thus
stagnation or rebellion of Qi; 2) where the often complicated with stagnation of
disease is located; and 3) the nature and Blood, and in this event herbs that invigorate
severity of any complications. Blood and resolve Blood Stasis should be
added (o formulae which invigorate circula
tion of Qi. An example is Chat Hu Shu Gan
B. FORMULATING PRESCRIPTIONS TO San {Bupleurum Soothing the Liver
REGULATE QI Decoction), which uses Radix Bupleuri,
Pericarpium Citri Reticulatae, Rhizoma
1. Formulating prescriptions to invigorate the
Cyperi and Fructus Aurantii to harmonize
circulation of Qi
the Liver, relieve stagnation, invigorate Qi
— Formulae that invigorate Qi circulation and relieve pain, and Rhizoma Ligustici
consist primarily of herbs that invigorate Qi Chuanxiong and Radix Paeoniae to invigo
circulation, relieve stagnation, harmonize rate Blood and resolve Blood Stasis. This
the Liver and relieve depression. These formula is commonly used in the treatment
formulae regulate Qi, relieve stagnation and of stagnation of Liver Qi and Blood with
remove obstruction from the channels and symptoms of alternating chills and fever and
collaterals. pain in the costal and hypochondriac
— Such formulae treat Qi Stagnation, which regions.
can be differentiated as either Liver Qi — Yuc In \\!iw (Gardenia-Ligusticum Pill) is a
Stagnation or stagnation ot Spleen and representative formula for activating Qi
Stomach Qi. circulation and relieving stagnation, ft treats
— Liver Qi Stagnation manifests as distending Qi Stagnation which is complicated with
pain in the costal and hypochondriac Phlegm, Fire, Dampness, Food Retention
regions, irritability, restlessness, hernia and and Blood Stasis. This formula uses
irregular menstruation or dysinenorrhoe.i. Rhizoma Cyperi as the Emperor herb and
Herbs which treat this pattern include Radix combiner it with RhUoma Ligustici
Bupleuri, Fructus Meliae Toosendan, Radix Chuanxiong to activate Blood circulation
Linderae, Rhizoma Cypen, Radix and promote the smooth circulation ot Qi.
Curcumae, Pencarpium Citri Reticulatae — Another such formula is }in Lni£ Zi San
Wide and Semen Citri Reticulatae. (Melia Toosendan Powder), which consists
Formulae thai regulate Qi 143

of equal doses of Fructus Meliae Toosendan dry in nature and use of these herbs over a
and Rhizoma Corydalis. Fructus Meliae long time or in large doses will also damage
Toosendan is the Emperor herb, acting to Yin and Blood. Herbs that nourish Yin and
harmonize the Liver, clear Heat, activate Qi Blood should therefore be added to formulae
and relieve pain. Rhizoma Corydalis for harmonizing the Liver and regulating Qi.
activates Blood circulation and promotes Examples include the use of Radix Angelicae
smooth circulation of Qi to reinforce the Sinensis and Radix Paeoniae Alba in Xiao
analgesic effect of the formula, which Yao San (Free and Relaxed Powder) and
promotes the smooth circulation of both Qi Radix Rehmanniae or Radix Rehmanniae
and Blood. Praeparata in Hei Xiao Yao San (Black Free
■ When Qi circulates smoothly, Dampness is and Relaxed Powder).
resolved. Retardation of Qi circulation — Both Liver Qi Stagnation and stagnation of
Qi is Spleen and Stomach Qi may impair the
produces Dampness, which accumulates to
di the functions of transportation and transforma
form Phlegm. For patterns of Qi Stagnation
, acid tion, producing a deficiency of Spleen Qi. In
complicated with Dampness and Phlegm,
duced this case, herbs that tonify Qi and invigorate
herbs that resolve Dampness and Phlegm
attern the Spleen should be added to the formula.
should be added. An example is Ban Xia Hou
Radix Examples include the use of Rhizoma
Po Tang (Pinellia and Magnolia Bark
Cortex Atractylodis Macrocephalae and treated
Decoction), which is the main formula for
ti and Radix Glycyrrhizae in Free and Relaxed
treating Plum-stone Qi. This formula utilizes
the combinations of Cortex Magnoliae Powder and the use of Radix Ginseng,
lation Rhizoma Atractylodis Macrocephalae and
Officinalis and Folium Perillae to activate Qi
1 and treated Radix Glycyrrhizae in Six
and relieve stagnation, and Rhizoma
on of Gentlemen Decoction with Aucklandia
Pinelliae, Poria and Rhizoma Zingiberis
i thus and Amomum.
Recens to resolve Phlegm and disperse
n of
masses. The entire formula relieves Plum-
^orate
stone Qi by regulating Qi, relieving stagna 2. Formulating prescriptions to conduct
[Id be
tion and resolving Phlegm. Rebellious Qi downward
rcula- ■ Another example is Gardenia-Ligusticum
u Gan — Formulae that conduct Rebellious Qi
Pill, which uses Rhizoma Cyperi to activate
Liver downward consist primarily of herbs that
Qi and relieve stagnation and Rhizoma
jleuri, conduct Qi downward and either soothe
Atractylodis (which is bitter and warm in
izoma asthma or stop vomiting. Such formulae
nature) to resolve Dampness.
ionize stop cough and wheeze, harmonize the
■ Cold is characterized by contraction. When
ite Qi Stomach and stop vomiting in patterns of
stagnation of Qi is complicated with Cold, it
justici Rebellious Qi of the Lung or Stomach, either
produces disorders such as hernia and cold
ivigo- of which may involve underlying Cold or
epigastric pain. For this pattern, herbs that
, This Heat, Deficiency or Excess.
disperse Cold and warm the Interior should
tment
be added. An example is Liang Gu Wan
with (Galangal and Cyperus Pill), which treats a. Formulae that conduct Rebellious Qi downward
?r and epigastric pain, using one ingredient to and soothe asthma
idriac — Formulae that conduct Rebellious Qi
activate Qi and the other to disperse Cold.
■ Another example is Nuan Gan jian (Warm downward and soothe asthma treat
1) is a Rebellious Lung Qi. The Lungs' function of
the Liver Decoction), which treats hernia
'g Qi presenting as a cold sensation and pain in dispersing can be impaired either by
treats invasion of the Lung by external pathogenic
the lower abdomen. This formula combines
with factors or by dysfunction of the Kidneys'
Radix Linderae and Lignum Aquilariae
»ntion reception of Qi, giving rise to symptoms of
Resinatum with Cortex Cinnamomi and
uses
Fructus Foeniculi. cough, dyspnoea, stuffiness of the chest and
b and coarse breathing.
- The Liver is a Yin organ and stores a Yin
justici — These formulae often consist of herbs such
substance (Blood), but Liver Yang tends to
lation as Fructus Perillae, Semen Armeniacae
rise. Severe stagnation of Liver Qi or trans
Qi. Amarum, Radix Asteris, Flos Farfarae,
formation of stagnant Qi into Fire may
i San Cortex Mori Radicis and Lignum Aquilariae
damage Blood. In addition, herbs that
■nsists Resinatum, with the addition of other herbs
activate Qi circulation are often aromatic and
144 Part 4: Cc ns mid comparisons of commonly used formulae

according to (he condition of the individual


downward and stop vomiting treat
patient.
Rebellious Stomach Qi. When the Stomach
— For retention of Turbid Phlegm in the Lungs
functions properly, Stomach Qi descends.
with impairment of dispersing and Improper diet or retention of pathogenic
descending, herbs that dry Dampness and
factors impair the descending function of the
resolve Phlegm should be added. An
Stomach and gives rise to symptoms of
example is Sit Zi Jiang Qi Tang (Perilla Seed
vomiting, hiccup, belching and retching.
Lowering Qi Decoction), in which Fructus — These formulae consist primarily of herbs
Perillae is the Emperor herb. This formula
such as Flos Inulae, Haematitum, Rhizoma
uses Cortex Magnoliae Officinalis to Pinelliae, Rhizoma Zingiberis Recens, Caulis
promote the Lungs' function of dispersing
Bambusae in Taeniam and Calyx Kaki.
and descending in order to stop cough and
Because the causes of Rebellious Stomach Qi
wheeze, and Rhizoma Pinelliae and Radix differ, other herbs are added according to the
Peucedani to dry Dampness and resolve condition of the individual patient.
Phlegm.
— In cases of pathogenic Cold, the correct treat
— For retention of Phlegm-Heat in the Interior ment method is to warm the Middle Burner
which impairs the Lungs' descending
and conduct Rebellious Qi downward. An
function, herbs that clear Lung Heat and
example is Ding Xiang Shi Di Tang (Clove
resolve Phlegm should be added. An
and Persimmon Calyx Decoction), which
example is Ding Oman Tang (Arrest
uses Flos Caryophylli to warm the Stomach,
Wheezing Decoction), which uses Herba
disperse Cold and conduct Rebellious Qi
Ephedrae and Semen Ginkgo to soothe
downward and Calyx Kaki to conduct
wheeze, Radix Scutellariae and Cortex Mori
Rebellious Qi downward and stop hiccup.
Radicis to clear Lung Heat and soothe
— If Rebellious Qi is due to retention of Empty
wheeze and Rhizoma Pinelliae to resolve Heat in the Stomach, herbs that clear Heat
Phlegm.
should be added, such as Pericarpium Citri
— The Kidneys are responsible for reception of Reticulatae, Rhizoma Zingiberis Recens and
Qi. If retention of Turbid Phlegm in the
Caulis Bambusae in Taeniam in Ju Pi Zhu Ru
Lungs is complicated with deficiency of the
Tang (Tangerine Peel and Bamboo Shaving
Kidneys' reception of Qi, there will be Decoction).
dyspnoea on exertion with more difficulty — If Rebellious Qi is due to Stomach Qi
on inhalation than exhalation. In this case,
Deficiency and is complicated with retention
herbs that warm the Kidneys and assist
of Turbid Phlegm, herbs that resolve Phlegm
reception of Qi should be added, such as
should be added. An example is Xuan Fit
Lignum Aquilariae Resinatum, Cortex
Dai Zhc Tang (Inula and Haematite
Cinnamomi and Gecko. An example is the Decoction), in which Flos Inulae and
use of Cortex Cinnamomi and Lignum
Haematitum are combined with Rhizoma
Aquilariae Resinatum in Perilla Seed
PIneliiae and Rhizoma Zingiberis to conduct
Lowering Qi Decoction, which is indicated Rebellious Qi downward, resolve Phlegm
for patterns in which the excess in the upper and stop vomiting.
body (i.e. retention of Turbid Phlegm and — Failure of Stomach Qi to descend is closely
Rebellious Qi) is more pronounced than the related to deficiency of Stomach Qi. The
deficiency in the lower body (Kidney Yang
foregoing formulae therefore often include
Deficiency with failure to receive Qi). herbs (hat tonify Qi, invigorate the Spleen,
— If asthma is caused simply by deficiency of
harmonize the Stomach and produce Body
the Lungs and Kidneys, the treatment Fluids, such as Radix Ginseng, treated Radix
method should be primarily
Glycyrrhizae or Fructus Ziziphi jujubae.
tonification.Representative formulae include
Ren Slwn Hit Tno Tang (Ginseng and Walnut
Decoction) and Rni Shcn Gc Jic Sim (Ginseng
and Gecko Powder). C. POINTS TO REMEMBER IN
FORMULATING PRESCRIPTIONS TO
b. Formulae the', conduct ReMIiou* Qi do\cinnm1 REGULATE QI
and star ^»ui:in<>
1. Disorders of Qi can arise from either
— Formulae which conduct Rebellions Qi deficiency or excess. Formulae tor regulating
Formulae that regulate Qi 145

Qi are indicated for Qi disorders of the resolves Dampness and assists digestion as
g treat
excess type. If tonification is used to treat Qi secondary actions. It is thus indicated for Six
Stomach
Stagnation of the excess type, the condition Stagnations (i.e. stagnation of Qi, Blood,
lescends.
will be aggravated. On the other hand, if Phlegm, Fire, Dampness and Food), with
thogenic •JO |

distension and fullness due to deficiency are symptoms of distress and stuffiness in the
on of the
treated by invigorating the circulation of Qi chest and diaphragm, epigastric and abdom
>toms of
rather than tonifying, Qi will be further inal pain, acid regurgitation, vomiting and
ling,
damaged and deficiency will be aggravated. poor digestion. It is necessary to determine
of herbs
— In the treatment of patterns of combined which of the six stagnations is the most
Rhizoma
excess and deficiency, a small dose of Qi pronounced before additional ingredients of
is, Caulis
tonic herbs is added to formulae that the formula can be selected.
'x Kaki.
activate the circulation of Qi in order to treat — Bupleurum Soothing the Liver Decoction
imach Qi
both Ben and Biao. consists of Radix Bupleuri, Rhizoma Cyperi,
ng to the
2. Formulae to regulate Qi consist primarily of Pericarpium Citri Reticulatae, Fructus
herbs that are pungent, warm, aromatic and Aurantii, Rhizoma Ligustici Chuanxiong,
ect treat-
dry in nature. These herbs tend to consume Radix Paeoniae and treated Radix
e Burner
Qi and Yin and must be prescribed in the Glycyrrhizae. It is indicated for Liver Qi
rard. An
correct dosage.
Stagnation and stagnation of Blood with
? (Clove
— Such herbs are contraindicated in cases of Qi symptoms of alternating chills and fever,
), which
Deficiency and Empty Fire due to Yin hypochondriac pain, a pale purplish tongue
itomach,
Deficiency. They should be used with with white coating and a wiry pulse.
lious Qi
conduct caution in the treatment of Qi Stagnation
2. - Tian Tai Wu Yao San
iccup. complicated with Yin Deficiency, and in Top-Quality Lindera Powder
>f Empty
pregnant women, and should be balanced
- Nuan Gan }ian
;ar Heat by herbs that are sweet and cold in nature Warm the Liver Decoction
urn Citri and promote Body Fluids or nourish Blood.
3. Because most herbs that regulate Qi are — Both formulae contain Radix Linderae and
:ens and
aromatic and pungent in nature, their active Fructus Foeniculi, and both formulae
: Zhu Ru
ingredients will evaporate and be lost if they activate Qi circulation and disperse Cold.
Shaving
are decocted for a long time or if the lid of They are otherwise quite different.
the cooking pot is removed from time to — In Top-Quality Lindera Powder, Radix
tach Qi
time during cooking. Aromatic herbs such as Linderae is combined with herbs that
etention
Radix Aucklandiae and Lignum Aquilariae strongly relieve Qi Stagnation, such as Radix
Phlegm
Resinatum should be added in the last 4 or 5 Aucklandiae, Pericarpium Citri Reticulatae
iuan Fu
minutes of cooking. Viride and Semen Arecae, and the action of
tematite
invigorating Qi circulation is therefore more
ae and
pronounced. Fructus Meliae Toosendan,
ihizoma
D. A COMPARISON OF COMMONLY USED though bitter and cold in nature, is prepared
conduct
FORMULAE TO REGULATE QI with Fructus Crotonis (which is removed
Phlegm
(TABLE 32.1)
from the formula after preparation), thus
intensifying its action of warming and
; closely 1. - Yue }u Wan dispersing; Rhizoma Alpiniae Officinalis
Qi. The Gardenia-Ligusticum Pill and Fructus Foenicuii combine to treat long
include - ChaiHu Shu Gan San standing accumulated Cold.
Spleen, Bupleurum Soothing the Liver
— This formula is commonly used in the treat
:e Body Decoction ment of Cold-type hernia with symptoms of
d Radix
— Both formulae activate Qi circulation, relieve hardness and swelling of the scrotum and
stagnation and stop pain. violent pain radiating to the lower abdomen.
— Gardenia-Ligusticum Pill consists of Because all the ingredients of this formula
Rhizoma Cyperi, Rhizoma Ligustici eliminate pathogenic factors, this formula
Chuanxiong, Rhizoma Atractylodis, Fructus treats excess-type patterns only.
iTO Gardeniae and Massa Fermentata — In addition to Radix Linderae and Fructus

Medicinalis. It activates Qi circulation and Foeniculi, Warm the Liver Decoction


relieves stagnation as its primary action and contains Lignum Aquilariae Resinatum,
either
activates Blood circulation, clears Heat, Cortex Cinnamomi, Radix Angelicae
;ulating
146 Part 4: Combinations and companions of commonly used formulae

Table 32.1 Comparison of formulae that regulate Qi

Formula Actions Indications

Gardenia-Ligusticum Pill Activates Qi circulation and Six Stagnations


relieves stagnation
Activates Blood circulation
Clears Heat
Resolves Damp
Assists digestion

Bupleurum Soothing the Liver Activates Qi circulation and Liver Qi Stagnation


Decoction relieves stagnation Blood Stagnation

Top-Quality Lindera Powder Activates Qi Circulation Excess-type patterns of Cold


Strongly warms and disperses accumulation (especially hernia)
pathogenic Cold

Warm the Liver Decoction Activates Qi circulation Liver and Kidney Deficiency
Disperses Cold complicated with invasion of Cold
Tonifies Liver and Kidneys

Perilla Seed Lowering Qi Conducts Rebellious Qi downward 'Excess above and Deficiency below',
Decoction Warms and resolves Cold Phlegm i.e. cough and wheeze due to
Assists Kidney reception of Qi Kidney Deficiency and Phlegm

Arrest Wheezing Decoction Stimulates Lung functions of Recurrent asthma, due to Wind-Cold
descending and dispersing with underlying Internal Phlegm-
Resolves Phlegm Heat

Inula and Haematite Decoction Conducts Stomach Qi downward Rebellious Stomach Qi due to Stomach
Tonifies Qi Qi Deficiency and retention of
Resolves Phlegm Turbid Phlegm

Tangerine Peel and Bamboo Clears Heat Rebellious Stomach Qi due to Empty
Shaving Decoction Conducts Stomach Qi downward Stomach Heat
Tonifies Qi
Nourishes the Stomach

Clove and Persimmon Calyx Warms the Stomach Hiccup or vomiting due to Stomach
Decoction Conducts Stomach Qi downward Deficiency with Stagnation of Cold
Activates Qi circulation

Sinensis, Fructus Lycii, Poria and Rhizoma — Perilla Seed Lowering Qi Decoction
Zingiberis Recens. This formula is indicated consists of Fructus Perillae, Rhizoma
for Liver and Kidney Deficiency and BJood Pinelliae, Cortex Magnoliae Officinalis,
Deficiency complicated with invasion of Radix Peucedani, Cortex Cinnamomi, Radix
Cold, as seen in Cold-type hernia marked by Angelicae Sinensis and Radix Glycyrrhizae.
deficiency complicated with excess. It conducts Rebellious Qi downward,
Symptoms include a cold sensation and pain soothes wheeze and warms and resolves
in the scrotum, inability to attain an erection, Cold Phlegm as its primary actions and
pale complexion, cold feet, a white tongue warms the Kidneys to assist reception of Qi
coating and a deep pulse.
as its secondary action. It is indicated for
3. - Su Zi }ian$ Qi Tang cough and wheeze due to retention of
Perilla Seed Lowering Qi Decoction profuse Phlegm marked by excess in the

- Ding Chunn Tang upper body (i.e. the Lungs) and deficiency of
Arresl Wheezing Decoction the lower body (i.e. the Kidneys).
— Arrest Wheezing Decoction consists of
— Both formulae are indicated for asthma but Semen Ginkgo, Herba Ephedrae, Fructus
their use requires a differentiation of the Perillae, Rhizoma Pinelliae, Fios Farfarae,
underlying pattern. Semen Armeniacae Amarum, Cortex Mori
Formulae that regulate Qi 147

Radicis, Radix Scutellariae and Radix tonifies Qi and nourishes the Stomach. It is
Glycyrrhizae. This formula is a collection of indicated for Rebellious Stomach Qi due to
many different types of herbs that treat Empty Heat in the Stomach, with symptoms
wheeze, including cold herbs, warm herbs, of hiccup, vomiting, a tender red tongue and
herbs which stimulate the dispersing a rapid deficient pulse.
function of the Lungs and herbs which Clove and Persimmon Calyx Decoction
astringe the Lungs. It stimulates the consists of Flos Caryophylli, Calyx Kaki,
functions of dispersing and descending, Radix Ginseng and Rhizoma Zingiberis
soothes wheeze and resolves Phlegm and is Recens. Using Flos Caryophylli and Calyx
thus indicated for recurrent asthma due to Kaki as the Emperor herbs, this formula
exposure to external Wind-Cold with warms the Stomach and conduct Rebellious
Internal Phlegm-Heat. Symptoms include Qi downward. It is effective in warming the
profuse sticky yellow sputum, a sticky Middle Burner, activating Qi circulation and
lia)
yellow tongue coating and a rolling and stopping hiccup.
rapid pulse. There may also be fever and This formula is indicated for hiccup due to
aversion to cold. Stomach Deficiency with stagnation of Cold
Cold
and Rebellious Stomach Qi. It also treats
4. - Xuan Fu Dai Zhe Tang
vomiting due to stagnation of Cold in the
Inula and Haematite Decoction
Stomach. In either case, symptoms include
- ]u Pi Zhu Ru Tang
hiccup, vomiting, clear and dilute sputum,
Tangerine Peel and Bamboo Shaving
epigastric distress, a pale tongue with white
Decoction
Cold
coating and a slow pulse.
- Ding Xiang Shi Di Tang
:gm-
Clove and Persimmon Calyx Decoction

— All three formulae conduct Stomach Qi


omach
f downward, stop belching and hiccup, tonify Questions
Qi and harmonize the Stomach. All are
1. Why are herbs that activate Blood circulation
indicated for Stomach Deficiency with
added to formulae that activate Qi circula
npty
symptoms of hiccup and belching but have
tion? Illustrate this with a prescription.
important differences.
2. For which pattern are herbs that warm the
— Inula and Haematite Decoction consists of
Kidneys and assist reception of Qi added to
Flos Inulae, Haematitum, Rhizoma Pinelliae,
formulae for conducting Rebellious Qi
ach Rhizoma Zingiberis Recens, Radix Ginseng,
downward and soothing wheeze?
Cold
Radix Glycyrrhizae and Fructus Ziziphi
Jujubae. Using Flos Inulae and Haematitum
as the Emperor herbs, this formula elimi
nates Phlegm and conducts Rebellious Qi
oction downward.
izoma — This formula is indicated for Rebellious
inalis, Stomach Qi due to Stomach Qi Deficiency
Radix and retention of Turbid Phlegm with
■hizae. symptoms of epigastric distress, frequent
iward, belching, vomiting, a white slippery and
solves sticky tongue coating and a deficient wiry
s and pulse. It is very effective in relieving epigas
of Qi tric distress and nausea.
?d for — Tangerine Peel and Bamboo Shaving
on of Decoction consists of Pericarpium Citri
m the Reticulatae, Caulis Bambusae in Taeniam,

ncy of Rhizoma Zingibens Recens, Radix Ginseng,


Fructus Ziziphi Jujubae and Radix
its of Glycyrrhizae. Using Pericarpium Citri
ructus Reticulatae and Caulis Bambusae in Taeniam
■farae, as the Emperor herbs, this formula clears
Mori Heat, conducts Rebellious Qi downward,
148

33 Formulae that regulate Blood

A. GUIDING PRINCIPLES FOR — To assist in resolving Blood Stasis, herbs


FORMULATING PRESCRIPTIONS THAT that activate Qi are often added to formulae
REGULATE BLOOD that activate Blood and resolve Blood
Stasis. One example is the use of Radix
— Formulae that regulate Blood treat Blood
Stagnation and haemorrhage.
Bupleuri and Fructus Aurantii in Xue Fu
Zhu Yu Tang (Blood Mansion Eliminating
— The formulation of prescriptions that
Stasis Decoction). Another is Dan Shen Yin
regulate Blood is based on the constitution of
(Salvia Decoction), in which Radix Salviae
the patient, the location of the disease, the
Miltiorrhizae is the Emperor herb and
duration and severity of pathological condi
Lignum Santalum and Fructus Amomi are
tions and the actions and characteristics of
included to activate Qi and relieve pain.
the herbs. The primary treatment method is
This formula is indicated for pain in the
activating Blood circulation and resolvine
Stasis. b heart and stomach due to stagnation of
Blood and Qi.
— When the aetiology, pathogenesis and
— If Blood Stagnation is caused by Cold, herbs
complications have been determined,
that warm the channels and disperse Cold
secondary treatment methods such as'
should be added. An example is Wen {ing
clearing Heat, warming, tonifying
purging may be selected.
Tang (Warm the Menses Decoction), in
which Radix Angelicae Sinensis, Radix
— Haemorrhage is treated primarily by the
Paeoniae and Rhizoma Ligustici Chuan-
method of stopping bleeding, but haemor-
xiong are the Emperor herbs, acting to acti
rhagic patterns vary in nature, location and
vate Blood circulation and resolve Stasis,
severity. Herbs that stop bleeding should
while Fructus Evodiae and Ramulus Cinna-
therefore be combined with herbs that clear
momi assist by warming the channels and
Fire, invigorate the Spleen, warm (he Yang
dispersing Cold. This formula is indicated
or resolve Stasis, as appropriate to the
patient's condition.
for stagnation of Blood with deficiency and
coldness of the Chong and Ren channels;
symptoms include irregular menstruation,
dysmenorrhoea, uterine bleeding and infer
B. TYPES OF FORMULA THAT REGULATE tility.
BLOOD
— Chronic Blood Stagnation prevents the pro
1. Formulae that activate Blood circulation duction of new Blood, thus leading to defici
and resolve Blood Stasis ency of Qi and Blood. Conversely, Qi and
Blood Deficiency can lead to stagnation of
— Formulae that activate the Blood and resolve
Blood. When stagnation is complicated with
Stasis smooth the circulation of Qi and Blood
deficiency,, herbs that nourish Blood and
in the channels and collaterals and disperse
stagnant Blood.
tonily Qi should be added as appropriate.
For example, Blood Mansion Eliminating
— Qi and Blood are intimately related.
Stasis Decoction includes Radix Rehmanni-
Circulation of Qi leads to circulation of
ae and Radix Angelicae Sinensis to nourish
Blood, stagnation of Qi leads to slagnation of
Blood; Bu YtJ,,g Hum: W,/ Tnng (Tonify (he
Blood and stagnation of Blood can retard the
circulation of Qi.
Vang to Restore Five-Tenths Decoction),
which is indicated for hemipiegia due to Qi
Formulae that regulate Blood 149

Deficiency and Blood Stasis, includes a large ■ For fresh blood in the stool, the correct treat
dose of Radix Astragali sen Hedysari. ment method is to clear Heat from the
— If Blood Stagnation is complicated with intestines and stop bleeding with Huai Hun
pathogenic Heat which gives rise to disor San (Sophora Japonica Flower Powder).
ders in the lower body, bitter and| cold This formula uses Flos Sophorae to clear
purgative herbs should be added, such as Damp-Heat from the intestines and stop
Radix et Rhizoma Rhei and Natrii Sulfas. Tao bleeding and includes Cacumen Biotae and
Ren Cheng Qi Tang (Peach Pit Decoction to charred Herba Schizonepetae to enhance its
Order the Qi), which is indicated for a haemostatic effect.
combination of Blood Stagnation and Heat - For urinary disturbance with haematuria,
in the Lower Burner, is made up of Tiao Wei the method of treatment is to cool Blood,
Cheng Qi Tang (Regulate the Stomach and stop bleeding, promote urination and open
. herbs Order the Qi Decoction) plus Semen the Waterways. The representative formula
rmulae Persicae and Ramulus Cinnamomi. is Xiao )i Yin Zi (Cephalanoplos Decoction),
Blood — If stagnant Blood forms paipable abdominal in which Herba Cephalanoploris and Radix
Radix masses, herbs that activate the Blood gener Rehmanniae are combined with Nodus
(ue Fu ally will not be effective and substances that Nelumbinis Rhizomatis and Pollen Typhae
nating break stagnation and resolve masses will be to cool Blood, stop bleeding and resolve
mn Yin needed. Such substances include Hirudo, Blood Stasis.
Salviae Tabanus, Eupolyphaga seu Steleophaga, - In Cold deficient patterns, haemorrhage is
b and Rhizoma Sparganii and Rhizoma Zedoariae. caused by Spleen deficiency with impair
mi are The representative formula is Bie jia jian Wan ment of the Spleen's function of controlling
; pain, (Turtle Shell Pill). Blood, and deficiency of the Chong and Ren
in the channels. The treatment method is to warm
ion of and tonify to stop bleeding. Huang Tu Tang
2. Formulae that stop bleeding
(Yellow Earth Decoction) is a formula
, herbs — Formulae that stop bleeding treat both commonly used in the treatment of bloody
e Cold internal and external bleeding. stool, haemoptysis and epistaxis due to
m jing Haemorrhagic patterns can arise from excess deficiency of the Middle Burner with stagna
tn), in or deficiency and may involve different tion of Cold. This formula contains Terra
Radix Zang Fu, and these factors will determine Flava Usta or Halloysitum Rubrum which
-huan- the selection of herbs. warm the Yang to stop bleeding, and
:o acti- — The most common cause of haemorrhagic Rhizoma Atractylodis Macrocephalae, Radix
Stasis, patterns is Fire, which damages blood Aconiti Praeparata and Radix Glycyrrhizae
Cinna- vessels and causes the Blood to leave the which warm the Yang and invigorate the
1s and vessels. Symptoms include haemoptysis, Spleen to restore the Spleen's function of
licated epistaxis, haematemesis, uterine bleeding controlling Blood.
:y and and bloody stool. The treatment method is to Jiao Ai Tang (Ass-Hide Gelatin and
innels; clear Heat, cool Blood and stop bleeding. Mugwort Decoction) is indicated for uterine
lation, — Shi Hui San (Ten Partially-Charred bleeding. It contains Colla Corii Asini and
infer- Substance Powder) is a commonly used Folium Artemisiae Argyi to stop bleeding
formula which cools Blood and stops and nourish Blood, and Radix Rehmanniae
ie pro- bleeding with Herba seu Radix Cirsii Praeparata, Radix Paeoniae Alba, Radix
defici- Japonici, Herba Ccphalanoploris, Folium Angelicae Sinensis and Rhizoma Ligustici
|)i and Nelumbinis, Cacumen Biotae, Radix Rubiae, Chuanxiong to nourish Blood and regulate
ion of Rhizoma Imperatae and Cortex Trachycarpi. menstruation. It treats both the Biao and the
i with It also includes Frucfus Gardeniae, Cortex Ben of bleeding due to deficiency of the
i and Moutan Radicis and Radix et Rhizoma Rhei Chong and Ren channels.
priate. to clear Heat and Fire and conduct Heat Blood coagulates on exposure to Cold;
nating downward. The haemostatic effect of the warmth causes it to circulate. Large doses of
nanni- formula is enhanced by charring the ingredi herbs that cool Blood and stop bleeding tend
ourish ents to ash. It is indicated for haemoptysis, to cause stagnation of Blood and herbs that
fy the haematemesis, bloody stool and haematuria activate the Blood and resolve Stasis should
ction), caused by reckless movement of Blood due be added to formulae that stop bleeding
■ to Qi to Heat. to counter this effect. An example is the
150 Part 4: Combinations ami com patron-. o< commonly used formulae

inclusion of Radix Rubiac and Cortex


D. A COMPARISON OF COMMONLY USED
Moutan Radicis in Ten Partially-Charred
FORMULAE THAT REGULATE BLOOD
Substance Powder.
(TABLE 33.1)

i. - Xue Fu Zhu Yu Tang


C. POINTS TO REMEMBER IN Blood Mansion Eliminating Stasis
FORMULATING PRESCRIPTIONS TO Decoction
REGULATE BLOOD - Fu Yuan Huo Xue Tang
Revive Health by Invigorating the
1. In using formulae to regulate Blood, it is
Blood Decoction
necessary to identify the cause, location and
duration of the disease. In an acute case, the — In both formulae, herbs that activate the
Biao is treated; in a chronic case, both the Blood and resolve Stasis are combined with
Biao and Ben are treated. Simply treating the herbs that harmonize the Liver and activate
symptoms of Stasis or bleeding is not thera- Qi, such as Semen Persicae, Flos Carthami,
peutically effective. Radix Angelicae Sinensis, Radix Bupleuri
2. Formulae that activate Blood circulation and Radix Glycyrrhizae.
or resolve Stasis tend to consume Blood and — Blood Mansion Eliminating Stasis
Qi; formulae that stop bleeding may Decoction also contains Rhizoma Ligustici
produce stagnation of Blood. Herbs that Chuanxiong, Radix Paeoniae Rubra, Radix
benefit Qi and nourish Blood are therefore Achyranthis Bidentatae, Radix Rehmanniae,
often added to formulae that activate Blood Radix Platycodi and Fructus Aurantii to
and resolve Stasis in order to avoid damage enhance the effect of activating Qi and Blood
to the Upright Qi, and herbs that activate and resolving Stasis.
Blood and resolve Stasis are often added — Revive Health by Invigorating the Blood
to formulae that stop bleeding in order to Decoction also contains Squama Manitis,
avoid producing Stasis. Formulae that Radix et Rhizoma Rhei and Radix
activate Blood and resolve Stasis should Trichosanthis, making it even more effective
be used with caution on pregnant women in activating Blood and resolving Stasis.
and patients with profuse menstrual — Although both formulae are indicated for
bleeding. stagnation of Blood, the former is more effec-

Table 33.1 Comparison of formulae (hat regulate Blood

Formula Actions Indications

Blood Mansion Eliminating Activates Qi and Blood Stagnation of Blood in the chest
Stasis Decoclion Resolves Stasis

Revive Health by Invigorating the More strongly activates Blood and Stagnation of Blood in the
Blood Decoction resolves Stasis hypochondrium due to
traumatic injury

Cephalanoplos Decoction Clears 1 leal Haematuria due to stagnation of


Cools Blood Blood and Heat in the Lower
Promotes urination Burner

Eliminating Redness Decoction Clears Heart Heat Urinary disturbance due to Heart
Promotes urination Heat

Sophora Japonica Flower Decoction Cools Blood and slops bleeding Bloody stool due to Wind and
Fire Poison or Damp-Heat at the
Blood level of the Spleen and
Stomach

Yellow Earth Decoction Warm Yang Bloody stool due to Spleen Yang
Invigorates the Spleen and Deficiencv
promotes the control oi Blood
Formulae that regulate Blood 151

LY USED tive in treating stagnation of Blood in the Flava Usta, Rhizoma Atractylodis Macroce-
JLOOD chest with symptoms of chest pain, palpita phalae, Radix Aconiti Praeparata and Colla
tions, insomnia, dream-disturbed sleep, Corii Asini. The formula warms Yang, invig
irritability and afternoon fever; the latter is orates the Spleen and stimulates the control
more effective in treating stagnation of of Blood. It treats bloody stool due to Spleen
asis
Blood in the hypochondrium due to Yang Deficiency with an impairment of the
traumatic injury, with the symptom of intol Spleen's function of controlling the Blood;
erable hypochondriac pain. the key symptom is a dribbling discharge of
the
dark or pale blood following the stool.
2. - Xiao ]i Yin Zi
Accompanying symptoms include a sallow
Cephalanoplos Decoction
tivate the complexion, pale tongue with white coating
- Dao Chi San
ined with and a deep, thready and weak pulse.
Eliminating Redness Powder
d activate
Carthami, — Both formulae clear Heat and promote
Bupleuri urination and are thus indicated for urinary
disturbances. Questions
; Stasis — Cephalanoplos Decoction is made up of
1. Give examples to illustrate why herbs that
i Ligustici Eliminating Redness Powder plus Herba
activate Qi circulation are often added to
>ra, Radix Cephalanoploris, Pollen Typhae, Nodus
formulae that activate Blood and resolve
imanniae, Nelumbinis Rhizomatis and Radix
Blood Stasis.
urantii to Angelicae Sinensis to cool Blood and stop
2. What are the functions of Fructus Gardeniae
and Blood bleeding, and Fructus Gardeniae and
and Radix et Rhizoma Rhei in Ten Partially-
Talcum to clear Heat and Fire and promote
charred Substance Powder?
lie Blood urination. It is thus more effective in clearing
i Manitis, Heat and cooling Blood and is indicated for
d Radix urinary disturbance with haematuria due to

e effective stagnation of Blood and Heat in the Lower

•tasis. Burner, with symptoms of haematuria,


icated for hesitant burning and painful urination, a red

note effec- tongue and a rapid pulse.


— Eliminating Redness Powder clears Heart
Heat and promotes urination and is thus
indicated for urinary disturbance due to
Heart Heat moving down to the Small
Intestine, with symptoms of painful and
hesitant passage of dark urine with mild
ie chest haematuria.

3. - Huai Hua San


Sophora Japonica Flower Powder
- Huang Tu Tang
Yellow Earth Decoction

lation of
— Both formulae are indicated for bloody stool,
Lower
but one treats a Full Heat pattern while the
other treats a Cold deficient pattern.
to Heart — The main ingredients of Sophora Japonica
Flower Powder are Flos Sophorae and
Cacumen Biotae. The formula cools Blood
i and
ieatatthe and stops bleeding; it treats bloody stool
en and resulting from an invasion of pathogenic
Wind and Fire Poison or Damp-Heat into the
Blood level of the Spleen and Stomach, with
=n Yang
the key symptom of an explosive discharge
of bright red blood before or after stools.
— Yellow Earth Decoction consists of Terra
152

34 Formulae that expel Dampness

purgatives may be used. If the patient has a


A. GUIDING PRINCIPLES FOR
weak constitution, the treatment method
FORMULATING PRESCRIPTIONS THAT
must be combined with strengthening
EXPEL DAMPNESS
Upright Qi.
— The formulation of prescriptions that expel — If pathogenic Dampness is complicated with
Dampness is based on the nature and pathogenic Wind, herbs that eliminate
location of the disease, the particular Zang Wind-Damp must be included.
Fu involved and whether there are other
pathogenic factors complicating the condi
tion. B. TYPES OF FORMULA THAT EXPEL
— As a general rule, if pathogenic Dampness DAMPNESS
affects the upper or exterior parts of the
1. Formulae that dry Dampness and
body, herbs that induce diaphoresis are
harmonize the Stomach
primarily used to eliminate the pathogen by
mild sweating. If pathogenic Dampness — Formulae that dry Dampness and harmo
affects the lower or interior parts of the body, nize the Stomach consist primarily of bitter
diuretic herbs arc primarily used to drain and warm herbs that dry Dampness and
Dampness through urination. aroma tics that resolve turbidity. These
— In the treatment of interior Dampness, formulae not only dry Dampness and
especially Damp-1 leat, the location of the resolve turbidity but also invigorate the
pathology within the Triple Burner must be Spleen's function of transportation and
determined. For example, if Dampness transformation. They are indicated for reten
affects the Upper Burner and the Lung tion of Turbid Dampness and disharmony
channel, pungent herbs are used to promote between the Spleen and Stomach.
the Lungs' dispersing function so that — The Spleen and Stomach receive food, and
Dampness can be resolved. transport and transform Water and
— If Dampness affects the Middle Burner, Dampness. They like dry ness and the
aromatic herbs are used to resolve aromatic smell, and dislike Dampness.
Dampness and regulate the Spleen, or bitter These formulae therefore consist largely of
and dry herbs are used to dry Dampness and aroma tics that dry Dampness, such as Herba
invigorate the Spleen's function of trans Agastachis, Herba Eupatorii and Rhizoma
portation and transformation. Atractylodis.
— If Dampness affects the Lower Burner and — Dampness is a Yin pathogen and tends to
involves the Kidneys and Bladder, diuretic consume Yang Qi; it obstructs Qi circulation,
herbs that relieve oedema or open the prevents Stomach Qi from descending and
Waterways are used to eliminate Water and may be complicated with external pathogens
Dampness. thai invade the surface of the body. These
— If Dampness transforms to Cold, one must factors determine the auxiliary herbs to be
also adopt the method of warming; if used in formulae to expel Dampness.
Dampness transforms to Heat, then the Heat — When retention of Dampness m the Spleen
must be cleared. and Stomach obstructs the circulation of Qi
— If a patient with a strong constitution has and gives rise to epigastric and abdominal
an excess of Water or Dampness, harsh distension and fullness, poor appetite and a
Formulae that expel Dampness 153

sticky white tongue coating, herbs that Gardeniae and Herba Artemisiae

SS activate Qi circulation should be included in Scopariae


the formula, as in Ping Wei San (Balancing b. Herbs that drain Dampness through
the Stomach Powder), where ! Cortex urination, such as Poria, Polyporus
Magnoliae Officinalis and Pericarpium Citri Umbellatus, Rhizoma Alismatis, Semen
Reticulatae assist the Emperor herb Rhizoma Coicis and Medulla Tetrapanacis, and
Atractylodis in activating Qi and resolving diuretic herbs that open the Waterways,
Dampness. such as Talcum, Semen Plantaginis,
— If Stomach Qi fails to descend, producing Herba Dianthi, Herba Polygoni
symptoms of nausea and vomiting, one Avicularis, Folium Pyrrosiae and Herba
must harmonize the Stomach and conduct Lysimachiae
Rebellious Qi downward as well. An c. Aromatics that resolve Dampness, such
;nt has a
example is Bu Huan jin Zheng Qi San (Rectify as Herba Agastachis, Herba Eupatorii,
method
the Qi Powder Worth More Than Gold), in Fructus Amomi Cardamomi and
;»thening
which Rhizoma Atractylodis and Herba Rhizoma Acori Graminei
Agastachis are combined with Rhizoma d. Bitter and warm herbs that dry
ted with
Pinelliae and Rhizoma Zingiberis Recens. Dampness, such as Rhizoma
eliminate
— If internal Turbid Dampness is complicated Atractylodis, Rhizoma Pinelliae and
with invasion of External Cold-Wind, the Cortex Magnoliae Officinalis.
method of resolving Dampness must be
The way in which these herbs are combined
combined with the method of Releasing the
•L depends upon the relative severity of
Exterior. An example is Huo Xiang Zheng Qi
Dampness and Heat and the location of the
San (Agastache Upright Qi Powder), in
disease. As a general rule, if Dampness is
which the Emperor herb, Herba Agastachis,
more severe than Heat, the primary treat
is combined with Radix Angelicae
ment method is to expel Dampness and the
Dahuricae to disperse Wind-Cold and with
harmo- secondary method is to clear Heat. An
Cortex Magnoliae Officinalis, Pericarpium
of bitter example is San Ren Tang (Three-Nut
Citri Reticulatae, Pericarpium Arecae,
less and Decoction), which employs Semen
Rhizoma Pinelliae and Poria to resolve
. These Armeniacae Amarum, Fructus Amomi
Dampness and regulate Qi.
ess and Cardamomi, Semen Coicis, Rhizoma
rate the 2. Formulae that clear Damp-Heat Pinelliae and Cortex Magnoliae Officinalis to
on and resolve Dampness and regulate Qi, and
— Formulae that clear Damp-Heat are made up
or reten- Herba Lophatheri, Medulla Tetrapanacis
of herbs that clear Heat and either resolve
larmony and Talcum to clear Heat and drain
Dampness or drain Dampness through
Dampness. This formula treats Damp-Heat
urination. They are indicated for patterns of
>od, and in all three Burners at the same time.
Dampness turning to Heat, or combined
er and If Heat is more severe than Dampness, the
patterns of Dampness and Heat.
and the primary treatment method is to clear Heat
— The combination of pathogenic Dampness
mpness. and the secondary method is to expel
and Heat is characterized by slow onset and
irgely of Dampness. An example is Bai Hu jia Cang
long duration and the resulting pathological
as Herba Zhu Tang (White Tiger plus Atractylodis
changes are difficult to treat. Simply clearing
?hizoma Decoction), which employs Gypsum
Heat will not eliminate Dampness and
Fibrosum and Rhizoma Anemarrhenae to
simply eliminating Dampness will not clear
tends to clear Heat and Fire, and Rhizoma
Heat. Dampness is a Yin pathogen and
culation, Atractylodis to dry Dampness.
cannot be resolved without using warm
ling and If Dampness and Heat are of equal severity,
herbs; Heat is a Yang pathogen and cannot
ithogens the methods of clearing Heat and expelling
be cleared without using cool herbs.
y. These Dampness are given equal emphasis. An
Formulae that clear Damp-Heat are thus
bs to be example is Can Lu Xiao Du Dan (Sweet
complex and can be classified into four
Dew Special Pill to Eliminate Toxin), in
categories:
e Spleen which the main herbs, Talcum, Herba
on of Qi a. Herbs that clear Heat and Dampness, Artemisiae Scopariae and Radix Scutellariae,
domina! such as Radix Scutellariae, Rhizoma are combined with Fructus Forsythiae,
'.te and a Coptidis, Cortex Phellodendri, Fructus Caulis Akebiae, Rhizoma Acori Graminei,
154 Part 4: Combination? and comparisons of commonly used formulae

Herba Agastachis and Fructus Amomi Defensive Qi, the correct treatment method
Cardamomi. consists of benefiting Qi and promoting
— If the pathological changes are most diuresis. The representative formula is Fang
apparent in the Middle Burner, with ]i Huang Qi Tang {Stephania and Astragalus
symptoms of epigastric distress and poor Decoction), in which Radix Stephaniae
appetite, the treatment method is to resolve Tetrandrae is combined with Radix Astragali
Dampness and harmonize the Middle seu Hedysari, Rhizoma Atractylodis
Burner. An example is Three-Nut Macrocephalae and Radix Glycyrrhizae to
Decoction, which contains Fructus Amomi promote diuresis without damaging the
Cardamomi, Cortex Magnoliae Officinalis Upright Qi.
and Rhizoma PInelliae. — When Dampness obstructs Qi, giving rise to
— If the disease is located in the Upper Burner, symptoms of oedema with distension and
with symptoms of dizziness, sore throat, fullness in the epigastrium and abdomen,
fever and aversion to cold, herbs that the correct treatment method consists of
promote the Lungs' dispersing function activating Qi circulation and promoting
should be added, for example Semen diuresis. The representative formula is Wu
Armeniacae Amarum in Three-Nut Pi San (Five-Peel Powder), which combines
Decoction. Poria peel, Cortex Mori Radicis and ginger
— If the Damp-Heat moves downward to the peel with Pericarpium Arecae and
Lower Burner, giving rise to symptoms of Pericarpium Citri Reticulatae to activate Qi
urinary disturbance and leucorrhoea, the in order to activate fluid circulation.
treatment method is to clear Damp-Heat in — When the Bladder's function of controlling
the Lower Burner. Examples include the use urine is impaired, causing retention of Water
of Talcum, Semen Plantaginis, Herba in the Lower Burner with symptoms of
Dianthi and Herba Polygoni Avicularis in Ba oedema and dysuria, the correct treatment
Zheng San (Eight-Herb Powder for method consists of strengthening Qi and
Rectification), and the use of Cortex promoting diuresis. The representative
Phellodendri and Rhizoma Atractylodis in formula is Wu Ling San (Five 'Ling'
Er Miao San (Two-Marvel Powder). Powder), which combines Rhizoma
Alismatis, Polyporus Umbellatus, Poria and
3. Diuretic formulae that drain Dampness Rhizoma Atractylodis Macrocephalae with
Ramulus Cinnamomi or Cortex Cinnamomi
— Formulae that expel Dampness through the to strengthen the Bladder's function of
urine consist primarily of herbs that are controlling urine.
sweet and bland in nature. They are — If Water and Dampness turn to Heat which
indicated for retention of excess Water and damages Yin, giving rise to symptoms of
Dampness with symptoms of oedema and dysuria, fever and thirst, the correct treat
retention of urine.
ment method consists of clearing Heat,
— Oedema and urinary retention due to excess nourishing Yin and promoting diuresis. The
Water and Dampness are treated with the representative formula is Zhu Ling Tang
method of draining Water and Dampness (Polyporus Decoction), whichcombines
through urination. There is a saying, 'If Polyporus Umbellatus, Poria and Rhizoma
urination is not promoted in the treatment of Alismatis with Colla Corii Asini and Talcum
Damp syndromes, the method is wrong.' to drain Dampness, clear Heat and nourish
— These formulae consist primarily of herbs Yin simultaneously.
such as Polyporus Umbellatus, Poria,
Rhizoma Alismatis and Semen Coicis.
Complications such as overflow of Water to 4. Formulae that warm and expel Water and
Dampness
the muscles, obstruction of Qi circulation in
the Inferior or impairment of the Bladder's — Formulae that warm and expel Water and
function of controlling urine require the Dampness act to warm Yang, disperse Cold
addition of other herbs. and drain Dampness through urination.
— If Water and Dampness are retained in the They are indicated for patterns of transfor
muscles due to invasion of external mation of Dampness into Cold and patterns
pathogenic Wind and deficiency of of Spleen and Kidney Yang Deficiency with
Formulae that expel Dampness- 155

nethod impairment of transportation and transfor remove obstruction from the collaterals.

moting mation of fluids. Symptoms include oedema, Herbs that activate Qi, eliminate Dampness

is Fang urinary disturbance and turbid urine- and relax the tendons, or tonify and astringe

ragalus Patterns of Cold Damp are characterized by the Kidneys, are therefore added to formulae
jhaniae Internal Cold, retention of Water and for these patterns. The representative

stragali Dampness in the Interior, and Spleen and formulae are:

:tylodis Kidney Yang Deficiency. Pathogenic Cold - Shi Pi San (Strengthening the Spleen
cannot be eliminated without warming; Decoction), which uses Radix Auck-
izae to
ng the Water and Dampness cannot be eliminated landiae, Cortex Magnoliae Officinalis,
without diuresis; and Spleen and Kidney Semen Arecae and Fructus Tsaoko

; rise to Yang Deficiency cannot be rectified without - Ji Ming San (Powder to Take at Cock's

on and tonification. Crow), which uses Fructus Chaenomelis


3 omen, - Patterns of Cold Damp are therefore treated and Semen Arecae

jists of by combining the methods of warming and and

moting invigorating the Spleen and Kidneys with - Bei Xie Fen Qing Yin (Dioscorea
the methods of dispelling Cold and Hypoglauca Decoction to Separate the
is Wu
mbines activating fluid circulation. Formulae Clear), which uses Fructus Alpiniae
include: Oxyphyllae and Radix Linderae.
ginger
• and
- herbs that warm Yang and disperse Cold,
vate Qi such as Ramulus Cinnamomi, Radix 5. Formulae that expel Wind-Damp
Aconiti Praeparata and Rhizoma
trolling — Formulae that expel Wind-Damp treat Bi
Zingiberis
f Water syndromes and relieve pain. They are
- herbs that drain Dampness, such as Poly-
ams of indicated for invasion of the muscles,
porus Umbellatus, Poria and Rhizoma
jatment
channels and collaterals, tendons, bones and
Alismatis
Qi and
joints by Wind-Damp; symptoms include
- herbs that invigorate the Spleen and
mtative
aversion to cold, fever, a heavy sensation
benefit Qi, such as Radix Codonopsis
'Ling'
and pain in the head and body, lumbago,
Pilosulae, Rhizoma Atractylodis Macro-
pain in the knees and numbness.
hizoma cephalae and Radix Glycyrrhizae.
— Disorders of Wind-Damp vary in location
■ria and
le with The representative formulae include Ling and complications and the selection of herbs
lamomi Gui Zhu Gan Tang (Poria-Ramulus will vary accordingly.
tion of Cinnamomi- Atractylodes-Glycyrrhiza — If the upper body (i.e. the head, face and
Decoction) and Zhen VJu Tang (True Warrior muscles) are affected, giving rise to pain in

t which Decoction). The former is more effective in the head, shoulders and back, or if there is
warming Yang and resolving retained fluid; fever and aversion to cold, herbs such as
oms of
:t treat- it is thus indicated for retention of Phlegm Rhizoma seu Radix Notopterygii, Radix
and fluid with symptoms of palpitations, Ledebouriellae, Rhizoma Ligustici
; Heat,
dizziness and vertigo, cough and dyspnoea. Chuanxiong and Radix Angelicae Dahuricae
sis. The
The tatter is more effective in warming the are selected.
8 Tan&
mbines Kidneys and promoting diuresis; it is thus — If the lower body (i.e. the lower back, knees

hizoma indicated for oedema due to Kidney Yang and ankles) are affected, with symptoms of
Deficiency. lumbago, pain in the knees and reduced
Talcum
Retention of Cold-Damp in the Interior mobility of joints, herbs such as Radix
nourish
obstructs the circulation of Qi, giving rise to Angelicae Pubescentis, Radix Stephaniae
abdominal distension. Invasion of the lower Tetrandrae and Fructus Chaenomelis are
body by Dampness affects the channels and chosen.
rand collaterals, causing the ankles to swell. — Qiang Huo Sheng Shi Tang (Notopterygium
Urinary disturbance with turbid urine is Dispelling Dampness Decoction) is a
related to Kidney Deficiency. When there is commonly used formula for the treatment of
ter and
Qi stagnation, one should activate the Qi; invasion by external Wind-Damp. In this
se Cold
when there is Kidney Deficiency, one should formula, Rhizoma seu Radix Notopterygii
ination.
astringe in order to tonify the Kidneys; when and Radix Angeiicae Pubescentis are the
'ansfor-
the channels and collaterals are invaded by Emperor herbs, to disperse Wind-Damp
jatterns
Dampness, one should relax the tendons and from all parts of the body. Radix
cv with
156 Part 4. Combinations and comparisons of commonly used formulae

Ledebouriellae and Rhizoma Ligustici are and warm herbs also damages Body Fluids
the Minister, to relieve headache by and consumes Yin.
expelling Wind-Damp; Rhizoma Ligustici — Excessive use of bitter and cold herbs to
Chuanxiong and Fructus Viticis are the clear Damp-Heat damages not only Yin but
Assistant, to eliminate Wind and relieve also Yang Qi. If Yang Qi is damaged,
pain; and Radix Glycyrrhizae is the pathogenic Dampness will persist. If Yin is
Messenger, to harmonize the ingredients of consumed, Dampness will turn to Heat.
the formula. The overall formula promotes — The method of clearing Damp-Heat will
diaphoresis, expels Dampness and relieves further damage Yin; the method of
pain. nourishing Yin will then aggravate
- Chronic painful joints due to invasion by Dampness.
Wind-Damp often affect the Liver and — Attention should therefore be given to
Kidneys, giving rise to Qi and Blood protecting Qi and Yin when using formulae
Deficiency. Herbs that nourish Blood, that expel Dampness.
activate Blood circulation, tonify Qi, invigo
rate (he Spleen and tonify the Liver and
Kidneys are therefore added. The represen
tative formula is Du Huo ]i Sheng Tang D. A COMPARISON OF COMMONLY USED
(Angelica Pub escens-Loran thus Decoc FORMULAE THAT EXPEL DAMPNESS
tion). (TABLE 34.1)

1. - Huo Xiang Zheng Qi San


Agastache Upright Qi Powder
- Ping Wei San
C. POINTS TO REMEMBER IN
Balancing the Stomach Powder
FORMULATING PRESCRIPTIONS TO
EXPEL DAMPNESS — Both formulae dry Dampness, activate Qi
and harmonize the Stomach; they are thus
1. Patterns of Dampness vary in location and
indicated for retention of Dampness in the
according to the Zang Fu affected and treat
Middle Burner with symptoms of distension
ment must be adapted to the actual condi
and fullness in the epigastrium and
tion of the patient. Pathological conditions
abdomen, and abdominal pain.
will be aggravated if Dampness affects the
— Agastache Upright Qi Powder is more effec
Exterior but the Interior is treated, or if
tive in activating Qi and resolving
Dampness affects the upper body but the
Dampness as it combines Herba Agastachis
lower body is treated, or if the Spleen is
affected but the Kidney is treated. with Rhizoma Pinelliae, Cortex Magnoliae
2. Pathogenic Dampness in the body may turn Officinalis, Pericarpium Citri Reticulatae,
Pcricarpium Arecae and Poria. It also
to Cold or Heat; it may combine with other
pathogenic factors to form Cold-Damp, Releases the Exterior and disperses Cold
Damp-Heat, Summer Heat-Damp or Wind- with Folium Periliae and Radix Angelicae
Damp. Dahuricae.

— If Dampness turns to Cold, the correct treat — Balancing the Stomach Powder is more
effective in drying Dampness and invigo
ment method consists of warming and
rating the Spleen as it combines a large dose
resolving Dampness. If Dampness turns to
Heat, the correct treatment method consists of Rhizoma Atractylodis with Cortex
of clearing Heat and expelling Dampness. If Magnoliae Officinalis and Pericarpium Citri
pathogenic Dampness combines with Reticulatae. It does not Release the Exterior.
pathogenic Wind, the treatment method — The first formula is thus indicated for
invasion of external Wind-Cold complicated
consists of eliminating Wind-Damp. If
with retention of interior Dampness; the
pathogenic Dampness combine? with
second is indicated for Dampness invading
Summer Heat, the treatment method
consists of clearing Summer Heat and elimi
the Spleen and Stomach with stagnation of
Qi.
nating Dampness. If exterior symptoms are
present, they must be addressed as well. 2. - Can Lu Xiao Du Dan
3. Dampness is a Yin pathogen and tends to Sweet Dew Special Pill to Eliminate
damage >ang Qi. Excessive use of bitter, dry Toxin
formulae that expel Dampness 157

' Fluids Table 34.1 Comparison of formulae that expel Dampness

Formula Actions Indications


erbs to
Yin but Agastache Upright Qi Powder Activates Qi Invasion of Wind-Cold complicated
maged, Resolveb Damp with Interior Damp
Releases the Exterior and disperses
i Yin is
Cold
;at.
?at will Balancing the Stomach Powder Dries Damp Damp invading the Spleen and
lod of Invigorates the Spleen Stomach with stagnation of Qi

;gravate
Sweet Dew Special Pill to Clears Heat and Fire Poison Febrile disease due to invasion of
Eliminate Toxin Expels Damp Damp and Heat in equal degrees
iven to
jrmulae Three-Nut Decoction Regulates Qi Invasion of Damp-Heat, with
Resolves Damp Heat more Damp than Heat

Five 'Ling' Powder Invigorates Qi and Yang Dysuria due to impairment of the
Invigorates the Spleen Bladder's control of urine
Promotes diuresis
fUSED
JESS Polyporus Decoction Clears Heat Dysuria due to combination of
Promotes diuresis Water and Heat, complicated
Nourishes Yin with Yin Deficiency

- San Ren Tang indicated for the early stages of patterns of


Three-Nut Decoction Damp-Heat, when Dampness is more
vate Qi pronounced than Heat. The key to their
Both formulae clear Heat and expel
ire thus differentiation is the relative severity of
Dampness with Talcum and Fructus Amomi
s in the Dampness and Heat.
Cardamomi and are indicated for
stension
pathogenic Damp-Heat at the Qi level. 3. - W« Ling San
m and
Sweet Dew Special Pill to Eliminate Toxin Five 'Ling' Powder
contains more bitter and cold herbs that - Zhu Ling Tang
re effec-
eliminate Heat, Dampness and Fire Poison, Polyporus Decoction
?solving
e.g. large doses of Herba Artemisiae
astachis
Scopariae and Radix Scutellariae combined — Both formulae promote diuresis to drain
ignoliae
with Fructus Forsythiae and Herba Dampness and are indicated for Internal
culatae,
Menthae. Water and Dampness with dysuria.
It also
Three-Nut Decoction contains more pun — Five 'Ling' Powder treats dysuria due to
;s Cold
gent and dry herbs that resolve Dampness impairment of the Bladder's function of
ngelicae
and regulate Qi. In this formula, Semen controlling urine, with retention of Water in
Armeniacae Amarum and Semen Coicis are the Lower Burner. In this formula, Rhizoma
is more
combined with Rhizoma Pinelliae, Cortex Alismatis, Polyporus Umbellarus and Poria
invigo-
Magnoliae Officinalis, Herba Lophatheri are combined with Ramulus Cinnamomi to
ge dose
and Medulla Tetrapanacis to regulate Qi and invigorate Yang and produce Qi, and
Cortex
drain Dampness through urination. Rhizoma Atractylodis is added to invigorate
lm Citri
The first formula effectively clears Heat and the Spleen and promote diuresis.
xterior.
Fire Poison, expels Dampness and resolves — Polyporus Decoction treats dysuria due to
ted for
turbidity. The second promotes the smooth combined Water and Heat, complicated with
plicated
circulation of Qi and clears Damp-Heat; it is Yin Deficiency. In this formula, Poria,
ess; the
more effective in resolving Dampness and Polyporus Umbellatus and Rhizoma
-wading
regulating Qi. Alismatis are combined with Talcum to clear
ation of
Sweet Dew Special Pill to Eliminate Toxin Heat and relieve urinary disturbance, and

is indicated for febrile disease due to Colla Corii Asini is added to nourish Yin and
invasion of seasonal pathogenic Damp-Heat; moisten dryness.
iminate in this pattern, Dampness and Heat are of — The first formula is indicated for dysuria
equal severity. Three-Nut Decoction is with clear urine, fullness in the lower
158 Part 4: Cotnbuiutwiis and ami pardons of commonly \wd formulae

abdomen but no pain on urination, and a


pale tongue with white coating. The second
formula is indicated for dysuria with deep-
yellow urine, burning pain on urination,
restlessness, insomnia and a red tongue with
scanty coating.

Questions
1. Why are herbs that activate Qi circulation
added to formulae that dry Dampness and
harmonize the Stomach?
2. How do Three-Nut Decoction and Sweet
Dew Special Pill to Eliminate Toxin differ
in their actions and indications?
159

Formulae that eliminate Phlegm 35

Spleen, resolve Phlegm and regulate Qi.


A. GUIDING PRINCIPLES IN
They are indicated for Phlegm-Damp
FORMULATING PRESCRIPTIONS TO
patterns.
ELIMINATE PHLEGM
— Patterns of Phlegm-Damp are caused by
— Phlegm is a pathological product of the impairment of the Spleen's function of trans
body, arising from a dysfunction of the Zang portation and transformation, leading to
Fu, particularly the Spleen and the Lungs. retention of Turbid Damp. They are charac
There is a saying, The Spleen produces terized by cough with profuse white sputum
Phlegm and the Lungs store it.' which is easy to expectorate, stuffiness of the
— Before deciding upon a treatment method chest, poor appetite and a slippery or sticky
and selecting a formula to treat a Phlegm white tongue coating.
pattern, it is important to clarify the nature — Rhizoma Pinelliae and Rhizoma Arisaematis
of the pattern. are often used as the main herbs in these
— Phlegm is Biao, i.e. a symptom, not the Ben formulae; they are combined with herbs that
of disease. The book Complete Collection of Jin expel Dampness and invigorate the Spleen,
Yue's Treatises says, 'Good doctors treat the such as Poria and Rhizoma Atractylodis
source of Phlegm.' One must not only elimi Macrocephalae, to treat the source of
nate Phlegm but also treat the source of Phlegm.
Phlegm. — Because retention of Phlegm leads to stagna
— Phlegm tends to move with Qi, affecting tion of Qi, herbs that activate Qi, such as
various parts of the body including the Pericarpium Citri Reticulatae, Fructus
chest, diaphragm, intestines, stomach, Aurantii and Fructus Aurantii Immaturus,
channels and collaterals, and the four limbs. are often added. Examples include the use of
Stagnation of Qi causes accumulation of Pericarpium Citri Reticulatae in Er Chen
Phlegm and smooth circulation of Qi is Tang (Two Old Decoction) and the use of
necessary in order to eliminate Phlegm. Pericarpium Citri Reticulatae and Fructus
Herbs that regulate Qi must therefore be Aurantii Immaturus in Wen Dan Tang
included in formulae that eliminate Phlegm. (Wanning the Gall Bladder Decoction).
— In addition, the organs involved in Phlegm — If Phlegm production is due to Spleen
patterns must be treated, e.g. the Spleen Deficiency, herbs that tonify Qi and invigo
must be invigorated, the Lungs regulated rate the Spleen should be added, e.g. Radix
and the Kidneys tonified. Codonopsis Pilosulae, Rhizoma Atractylodis
Macrocephalae and treated Radix
Glycyrrhizae in Liu Jun Zi Tang (Six
Gentlemen Decoction).
B. TYPES OF FORMULA THAT ELIMINATE
PHLEGM 2. Formulae that clear Heat and resolve
1. Formulae that dry Dampness and resolve Phlegm

Phlegm
— These formulae consist primarily of herbs
— Formulae that dry Dampness and resolve that clear Heat and herbs that resolve
Phlegm consist primarily of bitter, warm and Phlegm. They eliminate Turbid Phlegm and
dry herbs that eliminate Phlegm. Such clear Internal Heat, and are indicated for
formulae dry Dampness, invigorate the Phlegm-Heat patterns.
160 Part 4: Combination* ami comparisons of commonly used formulae

— Patterns of Phlegm-Heat are caused by the Interior. They resolve Phlegm and
Internal Heat acting on the Lungs to retained Fluid, warm the Interior and
condense Body Fluids into Phlegm. disperse Cold, and are indicated for
Symptoms include cough with thick sticky patterns of Cold-Phlegm with retained
yellow sputum which is difficult to expecto Fluid.
rate, a red tongue with sticky yellow coating — Patterns of Phlegm-Fluid are marked by
and a rolling rapid pulse. cough with clear watery sputum, dyspnoea,
— These formulae consist of a combination of: recurrent acute episodes provoked by

- herbs that clear Heat and resolve Phlegm, exposure to cold, a pale tongue with a

such as Fructus Trichosanthis, Radix slippery white coating and a deep slow
Platycodi, Arisaemae cum Felle Bovis, pulse. Such patterns affect the Spleen and
Bulbus Fritillariae and Chlorite-schist Stomach primarily and the Kidneys secon
and darily.

- herbs that clear Heat, such as Radix — The patliogenesis is Spleen Yang Deficiency
Scutellariae, Rhizoma Coptidis, Fructus with retention of Internal Cold and Fluid, or
Gardeniae and Flos Lonicerae. retention of Cold and Fluid in the Lung; it is
sometimes also related to Kidney Yang
— The representative formula is Qing Qi Hua Deficiency. In any event, the Lungs are
Tan Wan (Clearing Heat-Resolving Phlegm always involved.
Decoction), in which herbs that activate Qi — The book Synopsis of the Golden Cabinet says,
circulation (Fructus Aurantii Immaturus and 'In the treatment of retention of Phlegm and
Pericarpium Citri Reticulatae) are combined Fluid, warm herbs are used to mediate the
with Poria, which drains Dampness and condition.' Formulae that treat Phlegm-Fluid
invigorates the Spleen. consist of:
— Phlegm-Heat patterns tend to be compli
cated. In addition to cough with sticky - herbs that warm the Lungs and Spleen,
yellow sputum, they may present with other such as Rhizoma Zingiberis, Herba Asari,
and Ramulus Cinnamomi
symptoms, such as an accumulation of
pathogens in the chest. In this event the - herbs that dry Dampness and resolve
treatment method consists of using pungent Phlegm, such as Rhizoma Pinelliae and
herbs to open the chest, combined with Semen Sinapis Albae
and
bitter herbs to send Rebellious Qi
downward, resolve Phlegm and disperse - herbs that invigorate the Spleen and
masses. The representative formula is Xiao resolve Dampness, such as Poria and
Xian Xiong Tang (Small Sinking Chest Rhizoma Atractylodis Macrocephalae.
Decoction), in which Rhizoma Pinelliae is — The representative formulae are Ling Gui
combined with Hcrba Trichosanthis and Zlm Gau Tang (Poria-Ramulus Cinnamomi-
Rhizoma Coptidis. Atractylodes-Glycyrrhiza Decoction) and
— If Phlegm and Heat cloud the Mind they Ling Gnu Wit Wei Jiang Xin Tang (Poria-
may produce manic-depressive disorders; Glycyrrhiza-Schisandra-Zingiber-Asarum
if they disturb the Heart they may Decoction).
produce palpitations and insomnia. The — If Food Retention, or impairment of trans
representative formula for this pattern is portation and transformation, give rise to
Meng Shi Gun Tan Wan (Chlorite-Schisl Pill poor appetite and abdominal distension,
for Chronic Phlegm Syndromes), in which herbs that promote digestion and invigorate
Chlorite-schist and Nitrum are combined the Stomach should be added. An example is
with Radix et Rhizoma Rhei, Radix San Zi Yung Qin Tang (Three-Seed
Scutellariae and Lignum Aquilariae Nourishing Parents Decoction), which
Resinatum.
employs Fructus Perillae and Semen Sinapis
Albae lo resolve Phlegm and soothe asthma
3. Formulae thai warm and resolve Phlegm- and Semen Raphani to promote digestion
Fluid and relieve stagnation. When Qi circulates
smoothly, Phlegm and Retained Food are
— These fornulae consist primarily of herbs resolved and cough and asthma will disap
that eliminate Phlegm and herbs that warm pear spontaneously.
Formulae thai eliminate Phlegm 161

4. Formulae that moisten dryness and resolve Decoction), which includes Folium Mori
n and
r and Phlegm and Semen Sojae Praeparata to promote the
Lungs' function of dispersing and eliminate
;d for
— Formulae that moisten dryness and resolve
stained pathogenic Dryness; Semen Armeniacae
Phlegm consist of herbs that clear Heat and Amarum and Bulbus Fritillariae Thunbergii
resolve Phlegm, and herbs that nourish Yin
to stop cough and resolve Phlegm; Radix
;ed by
and moisten the Lungs. Such formulae
Adenophorae and pear peel to promote
pnoea,
moisten the Lungs, resolve Phlegm, nourish
Body Fluids and moisten dryness; and
k! by
Yin and promote Body Fluids. They are
Aith a
Fructus Gardeniae to clear Lung Heat.
indicated for patterns of Dry-Phlegm.
— If Phlegm is due to Empty Fire arising from
j slow
— Patterns of Dry-Phlegm primarily involve
Lung and Kidney Yin Deficiency, herbs that
in and the Lungs. The pathogenesis is invasion of
nourish Yin and clear Fire should be added.
secon-
the Lungs by Dryness and Heat, which cause
The representative formula is Bai He Gu Jin
Body Fluids to condense into Phlegm.
Tang (Lily Bulb Decoction to Preserve the
iciency
Symptoms include thick sticky sputum
Metal), which includes Radix Rehmanniae,
uid, or which is difficult to expectorate, and Lung
Radix Rehmanniae Praeparata, Radix
ig; it is Yin Deficiency with dry throat, choking
Ophiopogonis, Bulbus Lilii, Radix
Yang
cough and hoarse voice. To treat such
gs are
Scrophulariae, Radix Paeoniae Alba and
patterns, Lung Dryness should be moist
Radix Angelicae Sinensis to nourish Yin and
ened, Phlegm should be resolved and clear Heat; and Radix Platycodi and Bulbus
•t says,
pathogenic Heat should be cleared.
Fritillariae to clear Heat and resolve Phlegm.
in and
Formulae that treat Dry-Phlegm therefore
— When the Lungs and Kidneys are nourished,
ate the
consist of: Empty Fire is reduced and Phlegm-Heat is
i-Fluid
resolved, patterns of Dry Phlegm will
- herbs that nourish Yin and moisten the
resolve spontaneously.
Lungs, such as Radix Adenophorae,
Jpleen,
Radix Ophiopogonis, Radix Asparagi
Asari,
and Bulbus Lilii 5. Formulae to expel Wind and resolve
and Phlegm
- herbs that clear Heat and resolve Phlegm,
je and — Formulae that expel Wind and resolve
such as Bulbus Fritillariae, Fructus
Phlegm consist primarily of herbs that expel
Trichosanthis, Radix Platycodi and
Phlegm and herbs that subdue Wind. They
Succus Bambusae.
n and are indicated for patterns of Wind-Phlegm.
a and — Because Phlegm follows the movement of Qi
— The representative formula is Bei Mu Gua
lae. Lou San (Fritillaria-Trichosanthes Powder), and the smooth circulation of Qi resolves
which uses Bulbus Fritillariae, Fructus Phlegm, herbs that regulate Qi must be
8 Gui
Trichosanthis, Radix Platycodi and Radix included in such formulae.
nomi-
Trichosanthis to moisten dryness and — Wind-Phlegm patterns are related not only
l) and
resolve Phlegm, and Exocarpium Citri to the Liver but also to the Spleen. If Wind-
Poria-
Grandis and Poria to regulate Qi and resolve Phlegm disturbs the clear Yang, giving rise
sarum
Phlegm. When the Lungs' function of to dizziness, vertigo and headache, further
descending is restored, dry cough and additions must be made:
trans-
rise to sputum will be relieved.
- herbs that dry Dampness and resolve
:nsion, — However, patterns of Dry Phlegm can Phlegm, such as Rhizoma Pinelliae
gorate also be caused by invasion of External Heat - herbs that invigorate the Spleen and
nple is and Dryness damaging Lung Yin, or by eliminate Dampness, such as Rhizoma
?-Seed Empty Fire due to Lung and Kidney Yin
Atractylodis Macrocephalae and Poria
which Deficiency which condenses Body Fluids
and
■inapis into Phlegm.
- herbs that subdue Wind, such as
sthma — If Phlegm is due to damage by External Heat
Rhizoma Gastrodiae.
;estion and Dryness, herbs that promote the Lungs'
dispersing function and eliminate — The representative formula is Ban Xia Bai
:ulates
pathogenic Dryness should be added. The Zhu Tian Ma Tang (Pinellia-Atractylodes-
x3 are
representative formula is Sang Xing Tang Gastrodia Decoction).
disap-
(Mulberry Leaf and Apricot Kernel — If Internal Phlegm-Heat stirs up Liver Wind
162 Part 4: Combinations and comparisons of commonly used formulae

and clouds the Mind, producing symptoms - However, herbs that expel Phlegm differ in
of epilepsy, the formula must include: nature; they may be warm, dry, cool or
- herbs (hat clear Heat and resolve Phlegm, moist. It is essential to identify the nature of
such as Bulbus Fritillariae, Arisaemae the Phlegm in formulating prescriptions to
cum Felle Bovis and Succus Bambusae expel Phlegm.

- herbs that subdue Wind, such as


Rhizoma Gastrodiae, Scorpio and
Bombyx Batryticatus D. A COMPARISON OF COMMONLY-USED
- herbs that clear Heat such as Rhizoma FORMULAE THAT ELIMINATE
Coptidis and Radix Ophiopogonis PHLEGM (TABLE 35.1)
and 1. - Er Chen Tang
- herbs that open the orifices and calm the Two Old Decoction
Mind, such as Rhizoma Acori Graminei, - Bei Mu Gua Lou Tang
Radix Curcumae, Radix Polygalae, Fritillaria-Trichosanthes Powder
Cinnabaris and Succinum.
— Both formulae contain Pericarpium Citri
The representative formula is Ding Xian Wan Reticulatae and Poria to regulate Qi, expel
(Arrest Seizures Pill). Dampness and resolve Phlegm; both are
indicated for Phlegm patterns.
— Two Old Decoction is a representative
C. POINTS TO REMEMBER IN formula for patterns of Phlegm-Damp. In
FORMULATING PRESCRIPTIONS TO addition to Pericarpium Citri Reticulatae
EXPEL PHLEGM and Poria, it features Rhizoma Pinelliae as
the Emperor herb to dry Dampness, resolve
1. Phlegm is the result of an accumulation of Phlegm and conduct Rebellious Qi
Body Fluids. Qi is the motive force in the downward to stop vomiting; Radix
circulation of Body Fluids. The formation of Glycyrrhizae is included as the Messenger
Phlegm is thus often related to disorders of herb, and to invigorate the Spleen and
Qi, and Qi must be regulated in order to treat harmonize the Middle Burner. The whole
Phlegm patterns. formula dries Dampness, resolves Phlegm,
— The production of Phlegm is also related to regulates Qi and harmonizes the Middle
the Lungs, Spleen and Kidneys. Dysfunction Burner. It is indicated for patterns of
of the Lungs in dispersing, descending and Phlegm-Damp with symptoms of cough
regulating the Waterways, dysfunction of with profuse thin sputum, distension and
the Spleen in transportation and transforma fullness of the chest and diaphragm, nausea,
tion of Water and Dampness, and dysfunc vomiting, dizziness, palpitations and a pale
tion of the Kidneys in dominating water tongue with a slippery white coating.
metabolism can all lead to retarded circula — Fritillaria-Trichosanthes Powder is a repre
tion of Water and Dampness and Phlegm sentative formula for patterns of Dry
will be produced as a consequence. Phlegm. In addition to Pericarpium Citri
— In formulating prescriptions to eliminate Reticulatae and Poria, it features Bulbus
Phlegm, attention must therefore be given to Fritillariae as the Emperor herb. It also
regulating Qi and to the functions of the contains Fructus Trichosanthis and Radix
Lungs, Spleen and Kidneys. Platycodi to clear Heat, resolve Phlegm,
2. Phlegm easily combines with Cold, Heat, moisten the Lungs and stop cough, and
Dampness, Dryness and Wind. As a rule, Radix Trichosanthis to promote Body Fluids
Phlegm is the Biao of the disease, while and moisten dryness.
the cause of Phlegm is the Ben. Formulae — The whole formula moistens drvness,
that eliminate Phlegm often treat Biao and resolves Phlegm, regulates Qi and stops
Ben simultaneously, with emphasis on the cough. It is indicated for Phlegm
Ben.
patterns due to Lung Dryness with
— When the causes of Phlegm are resolved, the symptoms of a choking cough with difficult
Phlegm itself will resolve. Focusing on the expectoration, a dry sore throat, thirst,
Phlegm itself in the treatment yields poor dry lips and a thin, dry, white fongue
results. coating.
Formulae that eliminate Phlegm 163

iffer in Table 35.1 Comparison of formulae that eliminate Phlegm


:ool or
Formula Actions Indications
iture of
ions to Two-Old Decoction Dries Damp Patterns of Phlegm-Damp
Resolves Phlegm
Regulates Qi and harmonizes the
Middle Burner

-USED
Fritillaria-Trichosanthes Moistens dryness
Powder Resolves Phlegm
Regulates Qi and stops cough Phlegm patterns due to Lung
Dryness

Poria-Glycyrrhiza-Schisandra- Warms the Lungs to resolve Patterns of Phlegm-Fluid


Zingiber-Asarum Decoction retained Fluid
Invigorates the Spleen and
drains Damp
i Citri
, expel Small Green Dragon Releases (he Exterior and Invasion of Wind-Cold complicated
Decoction disperses Cold with retention of fluid
tth are
Dries Damp and resolves Phlegm
Harmonizes Nutritive and
ntative Defensive Qi
mp. In
culatae Chlorite-Schist Pill for Chronic Clears Fire Phlegm-Heat patterns, especially
Iliae as Phlegm Patterns Expeis long-standing Phlegm affecting the Mind

resolve
Clearing Qi - Resolving Phlegm Clears Heat Internal Heat and Phlegm (cough
is Qi
Decoction Resolves Phlegm with thick yellow sputum)
Radix Regulates Lung Qi
isenger

n and
whole
hlegm,
2. - Ling Gan Wu Wei Jiang Xin Tang cated with retention of fluid. Symptoms
Middle
Poria-Glycyrxhiza-Schisandra-Zingiber include aversion to cold, fever, absence of
rns of
-Asarum Decoction sweating, cough, dyspnoea, profuse thin
cough
- Xiao Qing Long Tang sputum, a moist and slippery tongue coating
m and
Small Green Dragon Decoction and a tense superficial pulse. This formula
lausea,
also contains Herba Ephedrae and Ramulus
a pale — Both formulae use Rhizoma Zingiberis,
Cinnamomi, to Release the Exterior and
Herba Asari, Fructus Schisandrae and Radix
promote the Lungs' dispersing function;
repre- Glycyrrhizae to warm the Lungs and resolve
Rhizoma Pinelliae to dry Dampness and
f Dry retained Fluids. Both are indicated for reten
resolve Phlegm; and Radix Paeoniae Alba to
i Citri tion of Cold in the Lungs with symptoms of
nourish Blood and astringe Yin; in combina
Bulbus cough, profuse sputum and dyspnoea.
tion with Ramulus Cinnamomi it harmo
[t also — Poria-Glycyrrhiza-Schisandra-Zingiber
nizes Nutritive and Defensive Qi.
Radix -Asarum Decoction is more effective in
hlegm, warming the Lungs and resolving retained 3. - Mang Shi Gun Tan Wan
i, and Fluids; it is thus indicated for patterns of Chlorite-Schist Pill for Chronic Phlegm
Fluids Phlegm-Fluid with symptoms of cough with Patterns
occasional expectoration of thin sputum, - Qing Qi Hua Tan Wan
ryness, fullness in the chest, dyspnoea, a slippery Clearing Qi-Resolving Phlegm
stops white tongue coating and a deep slow pulse. Decoction
'hlegm Poria is used in this formula to invigorate
with the Spleen and drain Dampness. —- Both formulae contain Radix Scutellariae to
ifficult — Small Green Dragon Decoction is also clear Fire in the Upper Burner; both are
thirst, effective in Releasing the Exterior and indicated for Phlegm-Heat patterns.
:ongue dispersing Cold and is thus indicated for — Chlorite-Schist Pill for Chronic Phlegm
invasion by External Wind-Cold compli Patterns is aimed at treating Internal Heat
164 Part 4: Combinations and comparieons of commonly used formulae

and long-standing retained Phlegm. In this


formula, Chlorite-schist and Natrium are
calcined to expel long-standing Phlegm;
Radix et Rhizoma Rhei relieves substantial
stagnation and, together with Radix
Scutellariae, treats the source of Phlegm;
Lignum Aquilariae Resinatum regulates Qi
to assist in resolving Phlegm.
— The whole formula clears Fire and expels
Phlegm and is thus indicated for patterns of
Heat and Phlegm with symptoms of manic
and depressive mental disorders, palpita
tions, coma, cough with profuse thin
sputum, dyspnoea, stuffiness of the chest,
dizziness and vertigo.
— Clearing Qi-Resolving Phlegm Decoction
is a representative formula for Phlegm-Heat
patterns. This formula contains Radix
Scutellariae, Arisaemae cum Felle Bovis and
Fructus Trichosanthis to clear Heat and
resolve Phlegm; Fructus Aurantii
Immaturus and Pericarpium Citri
Reticulatae to circulate Qi in order to resolve
Phlegm; Poria to drain Dampness and invig
orate the Spleen; Semen Armeniacae
Amarum to send Qi downward and stop
cough; and Rhizoma Pinelliae to resolve
Phlegm and conduct Rebellious Qi
downward.
— The whole formula clears Heat, resolves
Phlegm, regulates Qi and stops cough. It is
indicated for Internal Heat and Phlegm with
symptoms of cough with thick sticky yellow
sputum, distress and fullness in the chest
and epigastrium, dyspnoea, nausea, deep-
yellow urine, a sticky yellow tongue coating
and a rolling rapid pulse.

Questions
1. Why are herbs that regulate Qi added to
formulae that expel Phlegm? Give an illus
trative example.
2. Compare and contrast formulae for clearing
Heat and resolving Phlegm, and formulae
for moistening Dryness and resolving
Phlegm.
165

Formulae that expel Wind 36

— Patterns of External Wind are caused by a


A. GUIDING PRINCIPLES FOR
weakness of Defensive Qi complicated with
FORMULATING PRESCRIPTIONS TO
invasion of pathogenic Wind. These patterns
EXPEL WIND differ from Wind patterns such as the
— In treating patterns involving Wind, it is common cold, which are the
of result
necessary at the outset to determine whether invasion of the skin and hair by pathogenic
Wind is external or internal, whether it is Wind and present with mainly exterior
complicated with Cold or Heat and whether symptoms; such patterns can be relieved by
it is due to Excess or Deficiency. herbs that Release the Exterior.
— In cases of External Wind, the treatment — In the External Wind patterns discussed
method consists of dispersing it with here, Defensive Qi is weak and pathogenic
pungent herbs; in cases of Internal Wind, Wind invades deeper layers of the body such
the treatment method consists of subduing as the head, face, muscles, channels and
it. collaterals, joints, tendons and bones, giving
— If pathogenic Wind is complicated with rise to more severe pathological conditions.
Cold, Dampness, Heat, Phlegm or Stagnant Commonly used herbs that eliminate
Blood, the treatment method must include External Wind include Rhizoma Ligustici
eliminating these additional pathogenic Chuanxiong, Rhizoma seu Radix
factors. Notopterygii, Radix Ledebouriellae, Radix
— In cases of mixed Excess and Deficiency, the Angelicae Dahuricae, Herba Schizonepetae,
method of promoting Upright Qi is Rhizoma Typhonii and Radix Gentianae
combined with the method of eliminating Macrophyllae.
pathogenic factors in order to treat both Biao — Wind tends to combine with other
and Ben. pathogenic factors. For invasion of External
— External and Internal Wind may influence Wind-Cold with symptoms of headache,
each other. External Wind may induce Chitan Xiong Cha Tiao San (Ligusticum-
Internal Wind; Internal Wind may be Green Tea Regulating Powder) is a repre
complicated with External Wind. In the sentative formula. Rhizoma Ligustici
treatment of such complicated conditions, Chuanxiong, Radix Angelicae Dahuricae
first priority is given to the predominating and Rhizoma seu Radix Notopterygii are
pattern, while still considering the jointly the Emperor herbs; these are
secondary pattern in the formulation of a combined with Herba Schizonepeta and
prescription. Radix Ledebouriellae to expel Wind and
relieve pain; Herba Asari to disperse Cold
and relieve pain; Herba Menthae to clear
B. TYPES OF FORMULA THAT EXPEL Heat from the head and eyes; and treated
Radix Glycyrrhizae to harmonize all the
WIND
ingredients of the formula.
1. Formulae that disperse External Wind — If External Wind is complicated with Damp-
— Formulae that disperse External Wind Heat, herbs that expel Dampness and clear
consist primarily of herbs that expel Wind, Heat should be added. An example is Xiao
relieve itching and pain and expel Feng San (Eliminate Wind Powder), in
which Herba Schizonepeta, Radix
Dampness.
166 Part 4: Combinations and comparison? of commonly used formulae

inl
Ledebouriellae, Fructus Arctii and a. Formulae that suppress Liver Yang and subdue
CO.
Periostracum Cicadae are jointly the Wind
co:
Emperor herbs, to expel Wind and Release — These formulae are indicated for patterns of
an
the Exterior; these are combined with Liver Yang Rising with stirring of Liver
Bu
Rhizoma Atractylodis, to expel Wind and Wind. They consist primarily of herbs that
Ca
dry Dampness; Radix Sophorae suppress Liver Yang, such as Concha
He
Flavescentis, to clear Heat and dry Haliotidis, Os Draconis, Concha Ostreae and
Dampness; Caulis Akebiae to drain Damp- Haematitum.
c. Foi
Heat through the urine; and Rhizoma — Because Liver Yang Rising is closely associ
— Th
Anemarrhenae and Gypsum Fibrosum to ated with Liver and Kidney Yin Deficiency,
tio
clear Heat and Fire. This formula is herbs that nourish Yin are added. An
sta
commonly used in the treatment of rubella example is Zhen Can Xi Feng Tang (Pacifying
Wi
and eczema.
the Liver and Subduing Wind Decoction),
pri
— Invasion of the channels and collaterals by which contains Haematitum, Os Draconis
Bio
pathogenic Wind retards the circulation of and Concha Ostreae to conduct Rebellious
Rat
Qi, Blood and Body Fluids, resulting in Qi downward, suppress hyperactive Yang
Rat
stagnation of Blood and the formation of and calm Liver Wind, and Plastrum
Col
Phlegm-Damp. When this occurs it is even Testudinis, Radix Paeoniae Alba, Radix
— To:
more difficult to expel Wind, and herbs that Scrophulariae and Radix Asparagi to
sioi
activate Blood and relieve pain must be nourish Yin and Blood.
sub
added. There is a saying, 'To treat Wind, — If Liver Yang Rising is complicated with
E),
treat Blood first. Smooth circulation of Blood pronounced Internal Heat, herbs that clear
anc

extinguishes Wind.' Heat and quell Fire should be added to clear


Zhu
— The representative formula for this Heat from the Liver Channel. An example is
whi
pattern is Xiao Huo Luo Dan (Minor Van Ma Gou Teng Yin (Gastrodia-Uncaria
Rac
Invigorate the Collaterals Special Pill), Decoction), which contains Fructus
to
which contains Resina Olibani and Resina Gardeniae and Radix Scutellariae.
Ost:
Myrrhae.
b, Formulae thai cool the Liver and subdue Wind hyp
— If pathogenic Wind combines with Phlegm-
Damp to obstruct the channels and collat — These formulae are indicated when extreme
erals, it may produce deviation of the mouth pathogenic Heat in the Liver Channel gives CPOI
and eye. In this event, herbs that expel Wind rise to Wind. They consist primarily of herbs FOI
and resolve Phlegm such as Rhizoma that cool the Liver and subdue Wind, such as EXF
Arisaematis and Rhizoma Typhonii should Cornu Antelopis, Ramulus Uncariae cum
Uncis, Folium Mori and Flos Chrysanthemi. 1.
be added. The representative formula is
Qian Zheng San (Lead to Symmetry — Wind and Fire combine to consume Body
Powder). Fluids; the tendons are deprived of Blood
and nourishment, and this is the cause of
convulsions. This condition requires the use
2. Formulae that subdue Internal Wind of herbs that nourish Yin and relax the
— Formulae that subdue Internal Wind consist tendons, such as Radix Rehmanniae, Radix
primarily of herbs that pacify Liver Wind; Paeoniae Alba, Radix Scrophulariae and
they may also contain herbs that nourish Yin Radix Ophiopogonis.

and Blood. Such formulae subdue Wind and — Ling Jiao Gou Teng Tang (Antelope Horn and
stop convulsions. Uncaria Decoction) is a formula commonly
— Patterns of Internal Wind are caused by used in the treatment of extreme Heat
Liver Wind, which may originate from Liver producing Wind. In this formula, Cornu
Yang Rising, extreme Heat producing Wind, Antelopis and Ramulus Uncariae are jointly
or Blood Deficiency giving rise to Wind. the Emperor herbs; they are combined with
Symptoms include dizziness, vertigo, Folium Mori and Flos Chrysanthemi, to cool
tremor, slurred speech, motor impairment, the Liver, subdue Wind, clear Heat and stop
fits, toss of consciousness, deviation of the convulsions; and Radix Rehmanniae and
mouth and eye, and hemiplegia. The Radix Paeoniae Alba to nourish Yin,
methods of treatment vary according to the promote Body Fluids and relax the tendons.
cause of the condition. — Excess Heat tends to condense Body Fluids
Formulae that expel Wind 167

into Phlegm; Wind and Phlegm may then type. Herbs must be selected according to
combine and move upward to worsen the the nature of the pattern.
condition. In this case, herbs that clear Heat 2. In the treatment of External Wind, the treat
and resolve Phlegm are added, such as ment method consists of dispersing. In the
Bulbus Fritillariae Cirrhosae and (fresh) treatment of Internal Wind, the treatment
Caulis Bambusae in Taeniam, as in Antelope method consists of pacifying, and pungent
Horn and Uncaria Decoction. dispersing herbs should be avoided.
Pungent herbs that disperse Wind are
c. Formulae that nourish Yin and subdue Wind
usually warm and dry in nature and can
— These formulae are indicated for consump
consume Body Fluids and produce Fire.
tion of Yin, Blood and Body Fluids in the late
They should be used with caution where
stage of febrile disease, with stirring of Liver
there is deficiency of Body Fluids, or Yin
Wind of the Deficient type. They consist
Deficiency with Empty Heat or hyperactive
primarily of herbs that nourish Yin and Yang.
Blood and promote Body Fluids, such as
Radix Rehmanniae, Radix Paeoniae Alba,
Radix Ophiopogonis, Plastrum Testudinis,
D. A COMPARISON OF COMMONLY USED
Colla Corii Asini and egg yolk.
FORMULAE THAT EXPEL WIND
— To strengthen their effect in stopping convul
(TABLE 36.1)
sion, herbs that suppress the Liver and
subdue Wind are added. Examples include 1. - Ling jiao Gou Teng Tang
E Jiao ji Zi Huang Tang (Ass-Hide Gelatin Antelope Horn and Uncaria Decoction
and Egg Yolk Decoction) and Da Ding Feng - Zhen Gan Xi Feng Tang
Zhu (Major Arrest Wind Pearl), both of Pacifying the Liver and Subduing Wind
which contain Colla Corii Asini, egg yolk, Decoction
Radix Rehmanniae and Radix Paeoniae Alba - Da Ding Feng Zhu
to nourish Yin and Blood, and Concha Major Arrest Wind Pearl
Ostreae and Concha Haliotidis to suppress
— All three formulae pacify Internal Wind.
hyperactive Yang.
— Antelope Horn and Uncaria Decoction is
more effective in clearing Heat, cooling the
Liver and stopping convulsion. It features
C. POINTS TO REMEMBER IN
Cornu Antelopis and Ramulus Uncariae
FORMULATING PRESCRIPTIONS THAT
cum Uncis as the Emperor herbs, to clear
EXPEL WIND
Heat, cool the Liver, pacify Wind and
1. Wind patterns tend to be complicated and to stop convulsions. These are combined
change quickly. It is essential to determine with Folium Mori and Flos Chrysanthemi
whether the Wind is external or internal, to assist in clearing Heat and pacifying
whether it is complicated with Cold, Heat, Wind.
Dampness, Phlegm or Stagnant Blood and — This formula is indicated for Wind due to
whether it is of the Deficiency or Excess excess Heat in the Liver channel, with

Table 36.1 Comparison of formulae that subdue Liver Wind

Formula Actions Indications

Antelope Horn and Uncaria Clears Heat Liver Wind due to extreme Heat
Decoction Cools the Liver
Stops convulsion

Pacifying the Liver and Subduing Suppresses hyperactive Yang Wind-Stroke due to Liver Yang
Wind Decoction Conducts Qi and Blood Rising with Liver Wind
downward
Pacifies Wind

Major Arrest Wind Pearl Nourishes Yin and Blood Deficiency-type Liver Wind due to
Suppresses hyperactive Yang consumption of Yin
Pacifies Wind
168
Part 4: Combinations and comparisons of commonly used formulae

symptoms of high fever, irritability, restless


ness and convulsions.
— Pacifying the Liver and Subduing Wind
Decoction combines Radix Achyranthis
Bidentatae, which conducts Blood
downward and tonifies the Liver and
Kidneys, with Haematitum, Os Draconis
and Concha Ostreae, which suppress Liver
Yang and pacify Liver Wind. This formula is
thus more effective in suppressing hyperac
tive Yang, conducting Rebellious Qi
downward and pacifying Wind and is
indicated for Wind-Stroke due to Liver Yang
Rising with Liver Wind.
— Major Arrest Wind Pearl has as its main
ingredients herbs that nourish Yin and
Blood, in combination with herbs that
suppress Liver Yang. It includes (among
other ingredients) Colla Corii Asini, egg
yolk, Radix Rehmanniae, Radix Paeoniae
Alba, Radix Ophiopogonis, Plastrum
Testudinis and Carapax Trionycis. This
formula is thus more effective in nourishing
Yin, suppressing hyperactive Yang and
pacifying Wind of the deficiency type. It is
indicated for stirring of Wind in the late
stage of febrile disease due to extreme
consumption of Yin.

Questions
1. Why do formulae that pacify Internal Wind
contain herbs that nourish Yin?
2. What is the difference between formulae that
cool the Liver and pacify Wind and formulae
that nourish Yin and pacify Wind? Give
illustrative examples.
169

Formulae that calm the Mind 37

— If Empty Fire in the Heart and Liver


A. GUIDING PRINCIPLES FOR
consumes Yin and Blood, herbs that clear
FORMULATING PRESCRIPTIONS TO
Heat are combined with herbs that nourish
CALM THE MIND
Yin and Blood, such as Radix Angelicae
— Formulae that calm the Mind are indicated Sinensis, Radix Rehmanniae Praeparata and
for restlessness, which may be caused by Radix Ophiopogonis. An example is the use
fear, shock, emotional stress, pensiveness or of Radix Angelicae Sinensis and Radix
deficiency of Qi and Blood. The Heart, Liver Rehmanniae Praeparata in Cinnabar Pill to
and Kidneys are affected, producing Calm the Spirit.
symptoms of palpitations, insomnia, dream- — Empty Fire in the Heart and Liver may
disturbed sleep, anxiety and irritability. condense Body Fluids and produce Phlegm-
— Restlessness may be due to patterns of Fire which moves upward to cause manic
Excess or Deficiency. The Excess type is and depressive mental disorders. In this
treated by the method of soothing the Heart case, herbs that clear Heat and resolve
and calming the Mind. The Deficiency type Phlegm are added, such as Arisaemae cum
is treated by the method of nourishing the Felle Bovis, Bulbus Fritillariae Cirrhosae
Heart and calming the Mind. In complicated and bamboo fungus. The representative
cases of both Excess and Deficiency formula is Sheng Tie Luo Yin (Iron Filings
involving Heat and Phlegm, the treatment Decoction).
method consists of nourishing and soothing
the Heart as the primary action and clearing 2. Formulae that nourish the Heart and calm
Heat and resolving Phlegm as a secondary the Mind
action. Both Biao and Ben must be treated.
— These formulae consist primarily of herbs
that nourish the Heart and calm the Mind.
B. TYPES OF FORMULA THAT CALM THE They are indicated for restlessness due to
MIND deficiency of Yin, Blood and Heart Qi. The
Heart dominates Blood and the Liver
1. Formulae that soothe the Heart and calm
stores it, and deficiency of Yin and Blood
the Mind deprive the Heart and Liver of nourishment.
— These formulae consist of herbs that soothe This is the most common cause of restless
the Heart and calm the Mind. They are ness.

indicated for restlessness of the Excess type — For this pattern, herbs that nourish Yin
caused by fear, shock or other emotional and Blood are 'used. An example is Tian
factors. Wang Bu Xin Dan (Heavenly Emperor
— If there is Empty Fire in the Heart or Liver, Tonifying the Heart Pill), which combines
with signs of hyperactive Yang, herbs that herbs that nourish the Heart and calm
clear Heat and quell Fire are added, such as the Mind, such as Semen Ziziphi
Rhizoma Coptidis, Radix Rehmanniae and Spinosae, Semen Biotae, Poria, Radix
Cornu Antelopis. The representative Polygalae and Fructus Schisandrae, with
formula for clearing Heat and calming the herbs that nourish Yin and Blood, such as
Mind is Zhu Sha An Shen Wan (Cinnabar Pill Radix Angelicae Sinensis, Radix
to Calm the Spirit), which contains Rehmanniae, Radix Asparagi and Radix
Cinnabaris and Rhizoma Coptidis. Ophiopogonis.
Part 4: Combinations and comparisons of commonly used formulae

— Yin and Blood Deficiency tends to produce D. A COMPARISON OF COMMONLY USED


Empty Heat, and some herbs that clear FORMULAE THAT CALM THE MIND
Heat should therefore be included in (TABLE 37.1)
such prescriptions. Examples include the — Bo
use of Radix Scrophulariae in Heavenly 1. - Zhu Sha An Shen Wan
Mi
Emperor Tonifying the Heart Pill, and Cinnabar Pill to Calm the Spirit
— So
the use of Rhizoma Anemarrhenae in - CiZhu Wan
no

Suan Zao Ren Tang (Sour Jujube Magnetite and Cinnabar Pill
Li-*
Decoction). Lii
— In both formulae, Cinnabaris is used to
db
soothe the Heart and calm the Mind.
am
— In Cinnabar Pill to Calm the Spirit,
C POINTS TO REMEMBER IN — He
Cinnabaris is combined with Rhizoma
FORMULATING PRESCRIPTIONS THAT is i
Coptidis, Radix Angelicae Sinensis, Radix
CALM THE MIND Kit
Rehmanniae and treated Radix
Yir
1. Formulae that soothe the Heart and calm the Glycyrrhizae. This formula clears Heart
pa]
Mind contain substances that are heavy and Heat, nourishes Yin and Blood and calms the
drt
descending in their action and difficult to Mind. It is indicated for Heart Fire
ulc
digest. They can only be administered for a consuming Yin and Blood, with symptoms
atl
short time. of restlessness, palpitations, insomnia,
— Some of these substances are also toxic, and dream-disturbed sleep, a sensation of heat in
should be administered with caution, the chest, a red tongue with yellow coating
especially to patients with abnormal liver and a thready and rapid pulse.
and kidney function. For example, a large — In Magnetite and Cinnabar Pill, Cinnabaris
Qut
dosage of Cinnabaris may cause mercury is combined with Magnetitum and Massa 1. Bot
poisoning. Fermentata Medicinalis. This formula Ma
— These substances are also hard, and it is thus harmonizes the Heart and Kidneys, tha
more difficult to extract their active ingredi improves vision and calms the Mind. It is Wr,
ents. They should be broken into pieces and indicated for disharmony between the Heart Gl>
cooked for some time before adding other and Kidneys with symptoms of palpitations, Me
ingredients of the formula. insomnia, blurred vision, tinnitus and 2. Wh
2. Restlessness is often linked to emotional deafness. cah
problems and herbal treatment should be Yin
combined with psychotherapy to achieve 2. - Suan Zao Ren Tang Giv
better therapeutic results. Sour Jujube Decoction

Table 37.1 Comparison of formulae that calm the Mind

Formula . Actions Indications

Cinnabar Pill to Calm Clears Heart Heat Heart Fire consuming Yin and Blood
the Spirit Nourishes Yin and Blood
Calms the Mind

Magnetite and Harmonizes the Heart and Disharmony between the Heart and
Cinnabar Pill Kidney Kidneys
Improves vision
Calms the Mind

Sour Jujube Decoction Nourishes Liver Blood Liver Blood Deficiency and
Clears Heat hyperactive Liver Yang
Calms the Mind

Heavenly Emperor Nourishes the Heart and Yin and Blood Deficiency
Tonifying the Heart Pill Kidneys
Tonifies Yin and Blood
Clears Heat
Calms the Mind
Formulae that calm the Mind 171

- Tian Wang Bu Xin Dan


Heavenly Emperor Tonifying the Heart
Pill

Both formulae nourish the Heart, calm the


Mind and clear Heat.
Sour Jujube Decoction is more effective in
nourishing Liver Blood. It is indicated for
Liver Blood Deficiency and hyperactive
Liver Yang with symptoms of insomnia,
dizziness, vertigo, blurred vision, dry mouth
and throat and a thready and wiry pulse.
Heavenly Emperor Tonifying the Heart Pill
is more effective in nourishing the Heart and
Kidneys and tonifying Yin. It is indicated for
Yin and Blood Deficiency with symptoms of
palpitations, insomnia, poor memory,
dream-disturbed sleep, dry stool, mouth
ulcers, a red tongue with scanty coating and
a thready and rapid pulse.

Questions
1. Both Cinnabar Pill to Calm the Spirit and
Magnetite and Cinnabar Pill are formulae
that soothe the Heart and calm the Mind.
Why do both contain treated Radix
Glycyrrhizae and Massa Fermentata
Medicinalis?
2. Why do formulae that nourish the Heart and
calm the Mind contain herbs that nourish
Yin and Blood, and herbs that clear Heat?
Give illustrative examples.
172

38 Formulae that reduce Food


Stagnation and dissipate masses

A. GUIDING PRINCIPLES FOR Magnoliae Officinalis and Fructus Aurantii


Imma turns.
FORMULATING PRESCRIPTIONS THAT
REDUCE FOOD STAG