CHINESE HERBAL MEDICINE

Formulas & Strategies

CHINESE HERBAL MEDICINE

Formulas & Strategies
Compiled and translated by Dan Bensky and Randall Barolet

Copyright @ 1990 by Eastland Press, Incorporated P.O. Box 12689, Seattle, Washington, 98111. A l l rights reserved. No part of this book may be reproduced or transmitted in any form or by any means without the prior written permission of the publisher. Library of Congress Catalog Card Number: 89-81674 International Standard Book Number: 0-939616-10-6 Printed in the United States of America.

Book design by Gary Niemeier Brush calligraphy by Kou Hoi-Yin Small brush calligraphy by Ma Shou-Chun Illustrations adapted by Lilian Lai Bensky

To Lilian Lai, Miles Kuiling, and Jordan Vishka Sufan for love, understanding, and joy past and future.
DAN BENSKY

To James of Hong Kong, Ted of Brooklyn, Xu of Nanjing, and Paul of Vermont for showing me four directions from among the infinite possibilities.
RANDALL BAROLET

Abbreviated Contents
CHAPTER CONTENTS ......................... PREFACE . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . m t t
CHAPTER

13

...

Formulas that Calm the Spirit . . . . . . . . . . . . . . 377
CHAPTER

H O W TO U S E T H I S B O O K . . . . . . . . . . . . . . . . . .

mii
3

14 15

INTRODUCTION ...............................

Formulas that Expel Wind . . . . . . . . . . . . . . . . . . 393
CHAPTER

CHAPTER

1 2

Formulas that Release the Exterior . . . . . . . . . . .31
CHAPTER

Formulas that Open the Orifices . . . . . . . . . . . . 415
CHAPTER

16

Formulas that Clear Heat . . . . . . . . . . . . . . . . . . . . 69

Formulas that Treat Phlegm . . . . . . . . . . . . . . . . . 431
CHAPTER

3 Formulas that Drain .Downward . . . . . . . . . . . . 115
CHAPTER CHAPTER

17

Formulas that Reduce Food Stagnation . . . . .455
CHAPTER

4
5

18

Formulas that Harmonize . . . . . . . . . . . . . . . . . . . 135
CHAPTER

Formulas that Expel Parasites . . . . . . . . . . . . . . 465 .

Formulas that Treat Dryness . . . . . . . . . . . . . . . . 157
CHAPTER

APPENDIX AP P E N D I X APPEND IX

1 2
3

Guide to Pinyin Pronunciation Glossary of Technical Terms

. . . . . . . .471

6

. . . . . . . . . .473

Formulas that Expel Dampness . . . . . . . . . . . . . 173

Pinyin-English Cross Reference of Actions . . . . . . . . . . . . . . . . . . . . . . . . .477 Cross Reference of Pharmaceutical Names with first edition of Chinese &bd ~edicine:~ a t e ~ai a . . . . . . . . . 481 Pinyin-English Cross Reference of Formula Names . . . . . . . . . . . . . . . . . .

7 Formulas that Warm Interior Cold . . . . . . . . . . 215
CHAPTER

AP P E N D I X

4 5 6
7

CHAPTER

8

APPEND I X

Formulas that Tonify . . . . . . . . . . . . . . . . . . . . . . . . 235

485

9 Formulas that Regulate the Q i . . . . . . . . . . . . . . 289
CHAPTER

APPEND IX

Japanese-English Cross Reference of Formula Names . . . . . . . . . . . . . . . . . . 499 Formulary for Symptoms and Disorders . . . . . . . . . . . . . . . . . . . . . . . . .

APPENDIX

- C H A P T E R 10
Formulas that Invigorate the Blood . . . . . . . . . 311
CHAPTER

511

11 12
vii

B I B L I O G R A P H Y O F S O U R C E T E X T S . . . . . . . 527 TRANSLATORS' BIBLIOGRAPHY . . . . . . . . . . . FORMULA INDEX . . . . . . . . . . . . . . . . . . . . . . . . . . . GENERAL INDEX . . . . . . . . . . . . . . . . . . . . . . . . . . . .

Formulas that Stop Bleeding . . . . . . . . . . . . . . . . 335
CHAPTER

531 533 543

Formulas that Stabilize and Bind . . . . . . . . . . .351

Chapter Contents

CHAPTER

I

Formulas that Release the Exterior. . . . . . . .31
1. Formulas that Release Early-Stage Exterior Disorders

Scallion and Prepared Soybean Decoction
(cong chi tang). . . . . . . . . . . . . . . . . . . . . . . . . . . .32 Scallion and Prepared Soybean Decoction from Book to Safeguard Lifi (huo ren cong chi tang). . . . . . . . . . . . . . . . . . . . . .33 Scallion and Platycodon Decoction (cong bai jie geng tang) . . . . . . . . . . . . . . . . . . . . .33 2. Formulas that Release Exterior Cold

Combined Cinnamon Twig and Ephedra Decoction (gui zhi ma hang ge ban tang) . . . . . .38 Two-parts Cinnamon Twig Decoction with One-part Maidservant from Yue Decoction (gui zhi er yue bi yi tang) . . . . . . . . . . . . . . . . . . .38 Aconite and Cinnamon Twig Decoction (wu tou gui zhi tang). . . . . . . . . . . . . . . . . . . . . ..38

Minor Bluegreen Dragon Decoction
(xiao qing long tang). . . . . . . . . . . . . . . . . . . . . . .38 Minor Bluegreen Dragon Decoction plus Gypsum (xiao qing long jia shi gao tang) . . . . . . .39 BeIamcanda and Ephedra Decoction (she gun ma huang tang) . . . . . . . . . . . . . . . . . . ..39

Nine-Herb Decoction with Notopterygium
(jiu wei qiang huo tang). . . . . . . . . . . . . . . . . . . .40 Nine-Herb Decoction with Notopterygium from the Analytic Colkction Cjiu wei qiang huo tang). . . . . . . . . . . . . . . . . . . . .40 Major Notopterygium Decoction (da qiang huo tang) . . . . . . . . . . . . . . . . . . . . . . . .40

Ephedra Decoction (ma huang tang) . . . . . . . . .33
Ephedra Decoction plus Atractylodes (ma hang jia zhu tung) . . . . . . . . . . . . . . . . . . . . .34 Major Bluegreen Dragon Decoction (da qing long tang) . . . . . . . . . . . . . . . . . . . . . . . .34 Three-Unbinding Decoction (san ao tang) . . . . .35 Canopy Powder ( h a gai san). . . . . . . . . . . . . . . .35 Ephedra, Apricot Kernel, Coicis, and Licorice Decoction (ma xing yi gan tang) . . . . . .35 Cinnamon Twig Decoction (gui zhi tang) . . . . .35 Cinnamon Twig Decoction plus Peony (gui zhi jia shao yao tang) . . . . . . . . . . . . . . . . ..37 Cinnamon Twig Decoction minus Peony (gui zhi qu shao yao tang) . . . . . . . . . . . . . . . . . . .37 Cinnamon Twig Decoction plus Magnolia Bark and Apricot Kernel (gui zhi jia hou Po xing zi tang). . . . . . . . . . . . . . .37 Cinnamon Twig and Prepared Aconite Decoction (gui zhi fu zi tang) . . . . . . . . . . . . . . .37 Cinnamon Twig Decoction plus Kudzu (gui zhi jia ge gen tung) . . . . . . . . . . . . . . . . . . . . .37

Cyperus and Perilla Leaf Powder
(xiang su sun) . . . . . . . . . . . . . . . . . . . . . . . . . . . .41 Cyperus, Perilla Leaf, Scallion, and Prepared Soybean Decoction (xiang su cong chi tang) . . . . . . . . . . . . . . . . . . . . .41 Augmented Cyperus and Perilla Leaf Powder @a wei xiang su sun). . . . . . . . . . . . . . . .41

Elsholtzia Powder (xiang ru sun). . . . . . . . . . . . .42
Four-Substance Decoction with Elsholtzia (si wu xiang ru yin) . . . . . . . . . . . . . . . . . . . . . . .43 Five-Substance Decoction with Elsholtzia (wu wu xiang ru yin) . . . . . . . . . . . . . . . . . . . . . .43 Six-Ingredient Decoction with Elsholtzia (liu wei xiang ru yin) . . . . . . . . . . . . . . . . . . . . . .43

Chapter Contents
Ten-Ingredient Decoction with Elsholtzia (shi wei xiang ru yin) . . . . . . . . . . . . . . . . . . . . . .43 Newly-Augmented Elsholtzia Decoction (xin jia xiang ru yin) . . . . . . . . . . . . . . . . . . . . . . .43

3. Formulas that Release Exterior Wind-Heat

Mulberry Leaf and Chrysanthemum Decoction (sang ju yin) . . . . . . . . . . . . . . . . . . . .44 Honeysuckle and Forsythia Powder bin qiao sun). . . . . . . . . . . . . . . . . . . . . . . . . . . . .44 Honeysuckle and Forsythia Decoction (yin qiao tang). . . . . . . . . . . . . . . . . . . . . . . . . . . .46 Bupleurum and Kudzu Decoction to Release the Muscle Layer ( c h i ge jie ji tang) . . . . . . . .46 Bupleurum and Kudzu Decoction to Release the Muscle Layer from Medical Revelations (yi wu c h i ge jie ji tang). . . . . . . . . . . . . . . . . . . .47 Cimicifuga and Kudzu Decoction (sheng ma ge gen tang) . . . . . . . . . . . . . . . . . . . . .47 Dissipate Toxin and Release the Exterior Decoction (xuan dufa biao tang). . . . . . . . . . . . .48 Notopterygium and Isatis Root Decoction (qiang lan tang) . . . . . . . . . . . . . . . . . . . . . . . . . .49 4. Formulas that Release Exterior Disorders with Head and Neck Symptoms Ligusticum Chuanxiong Powder to be Taken with Green Tea (chuan xiong cha tiao sun) . . .49 Chrysanthemum Powder to be Taken with Green Tea Cju hua cha tiao san) . . . . . . . . . . . . . .51 Xanthium Powder (cang er zi sun) . . . . . . . . . . .51 Magnolia Flower Powder (xin yi san) . . . . . . . . .51 Kudzu Decoction (ge gen tang) . . . . . . . . . . . . . .51 Kudzu Decoction plus Pinellia (ge gen jia ban xia tang) . . . . . . . . . . . . . . . . . . . .52 5. Formulas that Release Exterior Disorders with Iliterior Deficiency Ginseng Powder to Overcome Pathogenic Influences (ren shen bai du sun) . . . . . . . . . . . .53 Honeysuckle and Forsythia Powder to Overcome Pathogenic Influences (yin qiao bai du san) . . . . . . . . . . . . . . . . . . . . . . .54 Schizonepeta and Ledebouriella Powder to Overcome Pathogenic Influences Cjing fang bai du san) . . . . . . . . . . . . . . . . . . . . . .54 Ginseng and Perilla Leaf Decoction (shen su yin) . . . . . . . . . . . . . . . . . . . . . . . . . . . . .54 E~hedra, Asarum, and Prepared Aconite Decoction (ma huang xi xinfu zi tang). . . . . . .55 Ephedra, Prepared Aconite, and Licorice Decoction (ma huang fu zi gan cao tang) . . . . . . .55

Renewal Powder (mi mo sun) . . . . . . . . . . . . . . .56 Scallion Decoction with Seven Ingredients (cong bai qi wei yin) . . . . . . . . . . . . . . . . . . . . . . .56 Modified Polygonatum Odoratum Decoction (jiajian wei m i tang). . . . . . . . . . . . . . . . . . . . . .57 Polygonatum Odoratum Decoction (wei rui tang) . . . . . . . . . . . . . . . . . . . . . . . . . . . .58 6. Formulas that Release Exterior-Interior Excess Ledebouriella Powder that Sagely Unblocks (fangfeng tong sheng sun) . . . . . . . . .58 Greatest Treasure Special Pill to Dispel Wind (qufeng zhi bao dan) . . . . . . . . . . . . . . . . .60 Kudzu, Coptis, and Scutellaria Decoction (ge gen huang lian huang qin tang) . . . . . . . . . .60 Gypsum Decoction (shi gao tang) . . . . . . . . . . . .61 Three-Yellow and Gypsum Decoction (san huang shi gao tang) . . . . . . . . . . . . . . . . . . . .62 Five-Accumulation Powder (wu ji sun) . . . . . . .62 Comparative Tables of Principal Formulas . . . . .63

CHAPTER

2

Formulas that Clear Heat . . . . . . . . . . . . . . . .69 I. Formulas that Clear Heat from the Qi Level
White Tiger Decoction (baihutang) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 70 White Tiger plus Ginseng Decoction (bai hu jia ren shen tang) . . . . . . . . . . . . . . . . . . . .71 White Tiger plus Cinnamon Twig Decoction (bai hu jia gui zhi tang). . . . . . . . . . . . . . . . . . . . .71 White Tiger plus Atractylodes Decoction (bai hu jia cang zhu tang) . . . . . . . . . . . . . . . . . . .72 White Tiger with Antelope and Rhinoceros Horn Decoction (ling xi bai hu tang) . . . . . . . . . . . . . . . . . . . . . . .72 White Tiger and Order the Qi Decoction (bai hu cheng qi tang) . . . . . . . . . . . . . . . . . . . . . .72 Bupleurum White Tiger Decoction (chi hu bai hu tang) . . . . . . . . . . . . . . . . . . . . . . .72 White Tiger Decoction to Suppress Rebellion (zhen ni bai hu tang) . . . . . . . . . . . . . .72 Lophatherus and Gypsum Decoction (zhu ye shi gao tang) . . . . . . . . . . . . . . . . . . . . . . .72 Gardenia and Prepared Soybean Decoction (zhi zi dou chi tang) . . . . . . . . . . . . . .73 Gardenia, Licorice, and Prepared Soybean Decoction (zhi zi gan cao chi tang) . . . . . . . . . . .74 Gardenia, Fresh Ginger, and Prepared Soybean Decoction (zhi zi shengjiang chi tang) .74

Bitter Orange, Gardenia, and Prepared 4 Soybean Decoction (zhi shi zhi zi chi tang) . . . . 7 Gardenia and Ginger Decoction (zhi zi gan jiang tang) . . . . . . . . . . . . . . . . . . . . . .74 Gardenia and Magnolia Bark Decoction (zhi zi hou po tang). . . . . . . . . . . . . . . . . . . . . . ..75 Gardenia and Rhubarb Decoction (zhi zi da hang tang) . . . . . . . . . . . . . . . . . . . . . .75 2. Formulas that Clear Heat from the Nutritive Level and Cool the Blood

4. Formulas that Clear Heat from the Organs

Honeysuckle, Forsythia, and Puffball Powder b i n qiao ma bo sun). . . . . . . . . . . . . . . .87 Ephedra, Apricot Kernel, Gypsum, and Licorice Decoction (ma xing she gun tang) . . .88
Maidservant from Yue Decoction (yue bi tang) . . . . . . . . . . . . . . . . . . . . . . . . . . . . .89 Maidservant from Yue Decoction plus Atractylodes ('yue bi jia zhu tang) . . . . . . . . . . . .89 Five-Tiger Decoction (wuhutang) . . . . . . . . . . . . . . . . . . . . . . . . . . . . .89

Clear the Nutritive Level Decoction
(qing ying tang). . . . . . . . . . . . . . . . . . . . . . . . . . .75 Rhinoceros Horn and Rehmannia Decoction (xi jiao di huang tang). . . . . . . . . . . .76 Magical Rhinoceros Special Pill (shen xi dan) . . . . . . . . . . . . . . . . . . . . . . . . . . . . .77 3. Formulas that Clear Heat and Relieve Toxicity

Drain the White Powder
(xie bai sun). . . . . . . . . . . . . . . . . . . . . . . . . . . . . .90 Drain the White Powder from the Wondrous Lantern (xie bai san). . . . . . . . . . . . . . . .91 Drain the White Powder from the Standards (xie bai san) . . . . . . . . . . . . . . . . . . . . ..91 Mulberry Leaf and Moutan Decoction to Drain the White (sang dan xie bai tang). . . . .91 Descurainia and Jujube Decoction to Drain the Lungs (ting li da zao xie fei tang) . . . .91

Coptis Decoction to Relieve Toxicity
(huang lian jie du tang) . . . . . . . . . . . . . . . . . . . .78 Cattle Gallstone Pill to Ascend and Clear (niu huang shang qing wan) . . . . . . . . . . . . . . . . . .79

Drain the Epigastrium Decoction
(xie xin tang) . . . . . . . . . . . . . . . . . . . . . . . . . . . . .79 Prepared Aconite Decoction to Drain the Epigastrium (fu zi xie xin tang) . . . . . . . . . . . . .80 Internal Dispersing Decoction with Coptis (mi s h hang lian tang) . . . . . . . . . . . . . . . . . . . .80

Reed Decoction
(wei jing tang). . . . . . . . . . . . . . . . . . . . . . . . . . . .91

Drain the Yellow Powder
(xie huang sun) . . . . . . . . . . . . . . . . . . . . . . . . . ..92

Clear the Stomach Powder
(qing wei sun) . . . . . . . . . . . . . . . . . . . . . . . . . . ..93 Clear the Stomach Decoction (qing wei tang) . . . . . . . . . . . . . . . . . . . . . . . . . . .94

Universal Benefit Decoction to Eliminate Toxin (pu ji xiao du yin) . . . . . . . . .80 Clear Epidemics and Overcome Toxin Decoction (qing wen bai du yin). . . . . . . . . . . . .81
Transform Blotches Decoction (hua ban tang) . . . . . . . . . . . . . . . . . . . . . . . . . ..82

Jade Woman Decoction
(junujian) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 94

Guide Out the Red Powder
(duo chi sun) . . . . . . . . . . . . . . . . . . . . . . . . . . . ..95 Drain the Epigastrium and Guide Out the Red Decoction (xk xin dao chi tang) . . . . . .96

Sublime Formula for Sustaining Life
(xian fang huo ming yin) . . . . . . . . . . . . . . . . . . .83 Flush and Harmonize Decoction (chong he tang) . . . . . . . . . . . . . . . . . . . . . . . . . . .84

Gentiana Longdancao Decoction to Drain the Liver (long dun xie gun tang) . . . . . . . . . . .96
Drain the Green Pill (xie qing wan). . . . . . . . . . . . . . . . . . . . . . . . . . ..97 Clear the Gallbladder and Drain Fire Decoction (qing clan xie huo tang) . . . . . . . .97 Tangkuei, Gentiana Longdancao, and Aloe Pill (dang gui long h i wan). . . . . . . . .98 Bupleurum Decoction to Clear the Liver (chi hu qing gan tang) . . . . . . . . . . . . . . . . . . . ..98

Five-Ingredient Decoction to Eliminate Toxin (wu wei xiao du yin) . . . . . . . . . . . . . . . . .84
Reduce Inflammation and Relieve Toxicity Pill (xiao yan jie du wan) . . . . . . . . . . . .85 Honeysuckle Decoction to Relieve Toxicity ('yin hua jie du tang) . . . . . . . . . . . . . . . . . . . . . ..85

Four-Valiant Decoction for Well-Being
(si miao yong an tang) . . . . . . . . . . . . . . . . . . . . .85 Miraculous Powder for Supporting the Interior (shen xiao tuo li san) . . . . . . . . . . . .86 Five-Miracle Decoction (wu shen tang) . . . . . . . . . . . . . . . . . . . . . . . . . ..86

Left Metal Pill
(zuo jin wan) . . . . . . . . . . . . . . . . . . . . . . . . . . . ..98 Fifth and Sixth Heavenly Stem Pill (wu ji wan) . . . . . . . . . . . . . . . . . . . . . . . . . . . . .99 Aucklandia and Coptis Pill (xiang lian wan) . . . . . . . . . . . . . . . . . . . . . . . . . .99

Six-Miracle Pill
(liu shen wan) . . . . . . . . . . . . . . . . . . . . . . . . . . ..87

. . . . . . . . . . . . . . . . . . Formulas that Moisten the Intestines and Unblock the Bowels Cinnamon and Poria Sweet Dew Decoction (gui ling gun lu yin). . . . . . . . . .. . . . . . .I06 Yellow Dragon Decoction (huang long tang) . . . .I25 Benefit the River [Flow] Decoction (jichuanjian) . . . . . . .125 3.I01 Ginseng and Astragalus Decoction (ren shen hang qi san) . . . . . . . . . . . . . . .I07 Master Lei's Decoction to Clear. . . . . . .I15 Minor Order the Qi Decoction (xiao cheng qi tang) . . . . . .I23 2. . . . . . . . . . . . . . . . . . .I17 Ten-Jujube Decoction (shi ULO tang) . . . . . . . . . . . . . . . . .I02 Rhubarb and Moutan ~ e c o h i o n (da huang mu dun tang). . . . . . . . . . . Prepared Aconite. . . . . .. . . . . . . . . . . . .I19 Cool the Bones Powder (qing gu sun) . . . . . . .I05 Peppermint Powder Cjisusan) . . . . . . . .I19 Coicis Decoction from the Standards (yi yi ren tang). . . . . . . . . . . .I21 Clear the Collaterals Decoction (qing luo yin) . .I27 White Powder (bai san) . . . . . .. .I00 5. . . . . . . . . . . . . . . . . . .I17 Rhubarb and Licorice Decoction (da huang gan cao tang) . . . . .I26 Warm the Spleen Decoction (wenpitang) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .I28 4. . . . . . . . . . . . .. . . . . . . . . . . . . . . . . .I22 Six-to-One Powder (liu yi sun) . . . . . . . .I00 Augmented Pulsatilla Decoction Cjia wei bai tou weng tang) . . . . . . . . . . . . . . . . . . .I04 Major Sinking Into the Chest Decoction (da xian xiong tang) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .I02 Clear the Menses Powder (qing jing san) . . . . . Formulas that Warm the Yang and Guide Out Accumulation CHAPTER 3 Rhubarb and Prepared Aconite Decoction (da huang fu zi tang) ..I18 Increase the Fluids and Order the Qi Decoction (zeng ye cheng qi tang) .127 Formulas that Drain Downward. .I18 Coicis. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .I17 Regulate the Stomach and Order the Qi Decoction (tiao wei cheng qi tang) .I03 6. . . . 106 Jasper Powder (bi yu san) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .I25 Moisten the Intestines Pill from Discussion of the Spleen and Stomach (run chang wan) . . . . . . . . . . . . and Remove Summerheat (lei shi qing liang di shu tang) . . . . . . . . . .I02 Gentiana Qinjiao and Soft-Shelled Turtle Shell Powder (qin jiao bie jia san) . . . . . . . . . . .I28 . . . . . . . . . . .99 Pulsatilla Decoction plus Licorice and Ass-Hide Gelatin (bai tou weng jia gan cao e jiao tang) . . . . . . . . . . . . . . . . .. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .105 Benefit the Basal Powder (yiyuansan) . . . . . . and Baijiangcao Powder (yi yi fu zi bai jiang san) . . . . . . . . . . . . . . . . . . . . . . . .122 Newly-Augmented Yellow Dragon Decoction (xin jia huang long tang) . . . . . . . . . . . . . . . . . . . . . . . . .I19 Clear the Heart and Cool the Diaphragm Powder (qing xin liang ge san) . . . . . . . . .I06 Clear Summerheat and Augment the Qi Decoction (qing shu yi qi tang). . . . . . . . . . . . .I06 Master Li's Decoction to Clear Summerheat and Augment the Qi (li shi qing shu yi qi tang) . .I24 Moisten the Intestines Pill from Master Shen's Book (run chang wan). . . . . Formulas that Relieve Summerheat Cool the Diaphragm Powder (liang ge sun) . . . . . .I15 1. . . . . . . . . . . . Cool. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .I08 Hemp Seed Pill (ma zi ren wan) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .xii Pulsatilla Decoction Chapter Contents Three-Substance Decoction with Magnolia Bark (hou Po san wu tang) . . . . . . . . . . . . Formulas that Clear Heat from Deficiency Artemisia Annua and Soft-Shelled Turtle Shell Decoction (qing hao bie jia tang) . . . . . . . . . . . . . . . . . . . . . . . . .I23 Five-Seed Pill (wu ren wan) . . . . . . Formulas that Purge Heat Accumulation Three-Substance Pill for Emergencies (sun wu bei ji wan) . . . . . . . . . . .. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .I03 Lycium Root Bark Decoction (di gu pi yin) . . . Formulas that Drive Out Excess Water Major Order the Qi Decoction (da cheng qi tang) . . . . . . . . . . . . . . . .I17 Revised Major Order the Qi Decoction (fu fang da cheng qi tang).lo8 Comparative Tables of Principal Formulas . . . . . .I18 (bai tou weng tang). .I21 Pill Requiring a Change of Clothes (geng yi wan) . . . . . . . . . . . . . . . . . . . .I21 Major Sinking Into the Chest Pill (da xian xiong wan). . .

. . . . . . . . . . . . .129 Stephania. .. .I38 Bupleurum. . . . .I61 2.. .Chapter Contents Control Mucus Special Pill (kong xian dan) . . . . . . . . . . .I30 Comparative Tables of Principal Formulas . . . . . . . . . . . . . . . . . . . . . . . . . . . and Ginger Decoction ( c h i hu gui zhi gan jiang tang) . . . . . . .I39 Bupleurum and Calm the Stomach Decoction ( c h i ping tang) . . . . . . . . . . . . . . .. . . . . . . . . . . Formulas that Enrich the Yin and Moisten Dryness Frigid Extremities Powder (si ni sun). . . . . . . . . . . . . . . .I44 2. .I44 Clear the Spleen Decoction (qing pi tang) . Formulas that Reeulate and Harmonize the Liver and Spleen Apricot Kernel and Perilla Leaf Powder (xing su sun) . . . . . . . . .135 1. . . . . . . . . . . . . . . .I46 Unblock the Qi Powder (tong qi san) . . . . . . . . . . . . .I38 Bupleurum. .. . . . . .I39 Bupleurum Decoction to Clear Dryness (chi hu qing zao tang) . .I41 Clear the Pancreas Decoction (qing yi tang). .149 3. . . . . . . . . . . . . . . Descurainia. . . . . .131 Bupleurum Powder to Spread the Liver (chi hu shu gan san) . . . . . .I52 Fresh Ginger Decoction to Drain the Epigastrium (sheng jiang xie xin tang) . . . . . .I60 Glehnia and Ophiopogonis Decoction (sha shen mai men dong tang) . . . . . . . ..I49 Spread the Liver and Regulate the Spleen Decoction (shu gan li pi tang) . . . . . . . . . .. .I48 Black Rambling Powder ( h i xiao yao san) . . . . . . . . . . . . . .I58 Mulberry Leaf and Apricot Kernel Decoction (sang xing tang) . . . . . . . . . . . . . . . . . . .I41 CHAPTER 5 Formulas that Treat Dryness. . . . . . . . . . . .. . .I57 1. . . . . . . . .I39 Important Formula for Painful Diarrhea (tong xie yao fang). .. and Rhubarb Pill Cji jiao li hang wan) . . . . . . . . . . . . . . . . .. . . . . . . . .I45 Lily Bulb Decoction to Preserve e gu jin tang). . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . Zanthoxylum. . . . . . . . . . . . . . . . . . Vessel and Vehicle Pill (zhouchewan) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . Cinnamon Twig.I29 xzzz . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .I63 . . . . . . . . . . . . . . . . . . .I41 Reach the Membrane Source Decoction (da yuan yin) . Formulas that Gently Disperse and Moisten Dryness Artemisia Annua and Scutellaria Decoction to Clear the Gallbladder (huo qin qing dun tang) . . .I61 the Metal (bai h Tonify the Lungs Decoction with AssHide Gelatin (bufei e jiao tang) . . . . . . . . . . . .I52 Coptis Decoction (hang lian tang) . . . . . . .. . . . Formulas that Harmonize Lesser Yang-stage Disorders (xiaoyaosan) . . . . . . . . . . . . . . . . . . . . . .. . . . . . . . . . . . .I49 Minor Bupleurum Decoction (xiao chai hu tang) . . . Bitter Orange. . . . . . . . . . . . . . . . . Formulas that Harmonize the Stomach and Intestines Pinellia Decoction to Drain the Epigastrium (ban xia xie xin tang) . . . . . . . . . . .I52 Comparative Tables of Principal Formulas. . . .I46 Moutan and Phellodendron Powder for Frigid Extremities (dan huang si ni san). ..I39 Seven-Substance Decoction with Magnolia Bark (hou Po qi wu tang) . . . . . . . . . . . .I44 Seven-Treasure Decoction to Check Malarial Conditions Cjie nue qi bao yin). ... . . . . . . . .. . . .I50 Licorice Decoction to Drain the Epigastrium (gan cao xie xin tang). . . . . . . . . . . . . . . . . . and Platycodon Decoction (chi hu zhi jie tang) . .147 Augmented Rambling Powder Cjia wei xiao yao san) . ... .I42 Bupleurum Decoction to Reach the Membrane Source ( c h i hu da yuan yin) . . .I47 Rambling Powder CHAPTER 4 Formulas that Harmonize . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .I36 'Bupleurum and-cinnamon Twig Decoction ( c h i hu gui zhi tang). . . .I38 Bupleurum and Four-Substance Decoction (chi hu si wu tang) . . . . . . . . . . . . . . . . . . . . .I59 Eliminate Dryness and Rescue the Lungs Decoction (qing zao jiu fei tang) . . . . . . . .I38 Bupleurum Decoction plus Mirabilite ( c h i hu jia mang xiao tang) . . . . . . . . . . . . . . . . . .I46 Restrain the Liver Powder (yi gan san).l52 Major Bupleurum Decoction (da c h i hu tang).

. . . .I92 Eight-Herb Powder for Rectification (bazhensan) . . . . . .I63 Sweet Dew Decoction (gan lu yin) . . . . . . . . . .I78 Five-Peel Decoction (wu pi yin) . . . . . . . . . . . . . . . . . . . . . .. . . . . . . Magnolia Bark. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .I91 Separate and Reduce Fullness in the Middle Decoction (zhong man fen xiao tang). . . . . . . . . . . . . . . . .I87 Apricot Kernel and Talcum Decoction (xing ren hua shi tang) . . . . . . . . . . . . . . . . . . . . . . .. . . . . .167 Comparative Tables of Principal Formulas. . .I85 Fifth Modification of Rectify the Qi Powder (wu jia jian zheng qi san) . . . . . . . . . . . . . . . . . . . . . . . . .. . . . . . . . . . . . . . . .. . . . . . . . . . and Prepared Aconite Decoction b i n chen zhu fu tang) . . . . . . . . . . . . . . . . . . . . .. . . . . . .I66 Benefit the Stomach Decoction (yi wei tang) . . . . . . .I79 Stephania and Astragalus Decoction vang ji huang qi tang) . . . . . . . . . . . . . . . . . . . . . . . . . . . . .I76 Polyporus Decoction (zhu ling tang) . . . . . . . . . . .. . . . . . . . . . . . . . . .I77 Polyporus Decoction from Comfiehensive Recording (zhu ling tang) . . . . . . . . . . .I76 Calm the Stomach and Poria Decoction (wei ling tang). . . . . . . . .I90 Gardenia and Phellodendron Decoction (zhi zi bai pi tang) . . . . . . . .I76 Artemisia Yinchenhao and Five-Ingredient Powder with Poria (yin chen wu ling san) . . Formulas that Transform Damp Turbidity Calm the Stomach Powder (ping wei san) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .I63 Nourish the Yin and Clear the Lungs Decoction bang yin qing fei tang) . . . . .I76 Polyporus Decoction from Master Shen (shen shi zhu ling tang). . . . . . . . . .I82 Agastache Powder to Rectify the Qi (huo xiang zheng qi sun). . . . . . . . . . . . . . . .I82 Separate and Reduce Decoction Cfen xiao tang) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .I79 Stephania and Poria Decoction Cfang ji fu ling tang) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .. . . .I82 Eliminate Dampness Decoction by Combining Calm the Stomach and Five-Ingredient Powder with Poria (chu shi wei ling tang) . . . Formulas that Promote Urination and Leach out Dampness Five-Ingredient Powder with Poria (wu ling san) . . . ..I76 Spring Pond Decoction (chun ze tang) . . . . . . . . . . . . . . . . . . . . . . . . . . .I90 Artemisia Yinchenhao. . 189 Artemisia Yinchenhao Decoction for Frigid Extremities (yin chen si ni tang). . . . . . . . . . . . . .I89 Artemisia Yinchenhao Decoction binchen hao tang) . . . . . . . . . . . . . . . . . . . . . . . Pinellia. .192 Moonlight Pill (yw hua wan) . . . . . . . . . . . . . . . . . . . . . . ling tang) . . . . . . . . .I64 Ophiopogonis Decoction (mai men dong tang). . . . . . . . . . . . . . . . . .I68 Formulas that Expel Dampness . . . . . . . . . . . . . . .I85 Fourth Modification of Rectify the Qi Powder (si jia jian zheng qi san) . . . . . . .I85 Harmonize the Six Decoction (liu he tang) . . . . . . . . . . . .I81 . .I78 Five-Peel Powder (wu pi sun). . . . . . . . . . . . .I66 Increase the Fluids Decoction (zeng ye tang) . . . . . . . . . . and Poria Decoction (huo po xi. . . . . . . .I87 Coptis and Magnolia Bark Decoction (lian Po yin) . . . . . .xiu Chpter Contents Rectify the Qi Powder Worth More than Gold (bu huan jin zheng qi san) . . . . .I84 Second Modification of Rectify the Qi Powder (er jia jian zheng qi san). . . .I85 Third Modification of Rectify the Qi Powder (san jia jian zheng qi san) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .I74 Four-Ingredient Powder with Poria (si ling san) . .I83 First Modification of Rectify the Qi Powder (yi jia jian zheng qi san). . . . . . . . . . . . . . . . . . . . . . . Atractylodes. . . . . . .. . . . . . . . . . . . . . . . . . . . .I65 Augmented Ophipogonis Decoction (jia wei mai men dong tang). . . . . . . . .I87 Scutellaria and Talcum Decoction (hang qin hua shi tang). . .. . . . . . . . . . . .I80 2. .I82 Cyperus and Amomum Powder to Calm the Stomach (xiang sha ping wei san) .I73 1. . . . . . . . . . .I85 3. . . . . . . . . . . . . . . . .I91 Separate and Reduce Fullness i n the Middle Pill (zhong man fen xiao wan). . . . . .I79 Seven-Peel Decoction (qi pi yin) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .I86 Agastache. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .I67 Jade Fluid Decoction &ye tang) . . . . . . . . . . .I87 Sweet Dew Special Pill to Eliminate Toxin (gan lu xiao du dun) . . . . . . . . . . . .. . Formulas that Clear Damp-Heat Three-Nut Decoction (san ren tang). . . . . . . . . . . . . . .

. . . . . . . . . . .220 Cinnamon and Prepared Aconite Decoction to Regulate the Middle (bei xi. . . . . Formulas that Warm the Channels and Dis~erse Cold Tangkuei Decoction for Frigid Extremities (dang gui si ni tang) . . . . . . . .I94 Augmented Five-Ingredient Powder for Painful Urinary Dysfunction (jia wei wu lin san). . . . . . . . . . . . . . . . . . . . .218 2.I96 Cure Discharge Pill (yu dai wan) . . . . .205 Coicis Decoction from Enlightened (gui fu li zong tang) . . . . . . . . . . .203 Remove Painful Obstruction Decoction from Medical Revelations (juan bi tang) . . . . . . . . . . . . . . . .206 Angelica Pubescens and Sangjisheng Decoction (du huo ji sheng tang) . . . . . . . . . . . . . .I96 Four-Marvel Pill (si miao wan) . . . . . . . . . . . . . . . .. .209 Disperse Wind and Invigorate the Blood Decoction (shu feng huo xue tang) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .222 Astragalus Decoction to Construct the Middle (hang qi jian zhong tang) . . . . . Formulas that Dispel Wind-Dampness Notopterygium Decoction to Overcome Dampness (qiang huo sheng shi tang) . . . . . .217 Astragalus and Cinnamon Twig Five-Substance Decoction (huang qi gui zhi wu wu tang). .I97 4. . . .220 Prepared Aconite Pill to Regulate the Middle ( f u zi li zhong wan) . .I96 Augmented Two-Marvel Pill XU Major Ledebouriella Decoction (da fang feng tang).I97 Prepared Aconite Decoction (fuzitang) . . . . . . . . . . .: . . . . . . .224 Tangkuei Decoction to Construct the Middle (dang gui jian zhong tang) . .. . . . . . . . . . . . Formulas that Warm and Transform Water and Dampness True Warrior Decoction (zhen wu tang). . . . . . . . . . . . . . . . . . .221 Cinnamon Twig and Ginseng Decoction (gui zhi ren shen tang) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .. . . . . . . . . . . . . . . . . .201 Dioscorea Hypoglauca Decoction to Separate the Clear from Medical Revelations (dang gui si ni jia wu zhu yu sheng jiang tang) . . . . . . . . . . . . . . . . . . .201 5. . . . . . . .204 Cinnamon Twig. . . . . . . . . . . . .219 Coptis Decoction to Regulate the Middle (lian li tang) . . . . . . . .199 Dioscorea Hypoglauca Decoction to Separate the Clear (bei xie fen qing yin) . . . . . . . .207 Three Painful Obstruction Decoction (san bi tang) . . . . . . . . . . . . . . .. . . . . . . . . . . . . .209 CHAPTER / Formulas that Warm Interior Cold . . . . . .221 Evodia Decoction (wuzhuyutang) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .. . . . . I 9 4 Peony Decoction (shao yao tang) . . . . . . . . . . . . . . .215 1. . . . .. . . . . . . . . . . . . . . . . .208 (an zhong san) . . . . . . .217 Yang-Heartening Decoction bang he tang) .216 Tangkuei Decoction for Frigid Extremities plus Evodia and Fresh Ginger 7 Cjia wei er miao wan) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .224 Calm the Middle Powder Physicians (yi yi ren tang) . . . . . . .217 Middle-Heartening Decoction (zhong he tang) . . . . . . . . . . . . . . . . . . .Chatter contents Five-Ingredient Powder for Painful Urinary Dysfunction (wu lin san) . . . . . .208 Major Gentiana Qinjiao Decoction (da qin jiao tang). . . . . . . . . . . . . . . . . . .. . . .I95 Two-Marvel Powder (er miao san) . . . . .204 Remove Painful Obstruction Decoction from Selected Formulas (juan bi tang). . . . . . . .220 Regulate the Middle and Transform Phlegm Pill (li zhong hua tan wan) . . . . . . . . . . Formulas that Warm the Middle and Dispel Cold Regulate the Middle Pill (li zhong wan) . . . . . . . . . . . . . . . . . . . . . . . .. . . . . . . .199 Bolster the Spleen Decoction (shipiyin) . . . . . . . . . . . . . . . . . . . . . .201 Powder to Take at Cock's Crow (jimingsan) . . . . . . .. . fen qing yin) . . . . . . . . . . . .220 Immature Bitter Orange Pill to Regulate the Middle (zhi shi li zhong wan) . . . . . . . .I94 Scutellaria Decoction (hang qin tang). . . . . . . ..I94 Three-Gold Decoction (san jin tang). . . . . . . . . . . . and Anemarrhena Decoction (gui zhi shao yao zhi mu tang) . .I95 Three-Marvel Pill (san miao wan) . . . . . . . . . . . . . . . . . . . . . . . . . .224 . . . . . . . . . . . Peony. . . . . . . . . . . .206 Disband Painful Obstruction ~ecoction (xuan bi tang). . .221 Minor Construct the Middle Decoction (xiao jian zhong tang). . . . .209 Comparative Tables of Principal Formulas . . . . . . .220 Clove and Evodia Decoction to Regulate the Middle (ding yu li zhong tang). . . . . . . . . . . . . . . . . . . .

.250 . . . . . . . . . .224 Licorice and Ginger Decoction (gan cao gan jiang tang) . . . . . . .247 2. . . . . . . .239 Preserve the Basal Decoction (bao yuan tang) . . .241 Protect the Fetus and Aid Life Pill (bao tai zi sheng wan) . . . . . . . . . . . . . . . . . .228 Ginseng and Prepared Aconite Decoction (shen_fictang) . .246 Tonify the Lungs Decoction (bufei tang) . . . .xui Chapter Cc Ginseng. . .250 Tonify the Liver Decoction (bu gan tang) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .229 Atractylodes and Prepared Aconite Decoction (zhu ju tang). . . . . . . . . . . . . . . . . . . . . . . . . . .249 Sage-like Healing Decoction ( h n g yu tang) . . . . . . . . . . . . . . . . . . . . . . . . .250 Mugwort and Prepared Aconite Pill for Warming the Womb (ai ju nuan gong wan) . . . . . . . . . .238 Six-Miracle Powder from Standards o f Patterns and Treatments (liu shen san) . . . . . . . . . . . . . . . . . . . .245 Modified Generate the Pulse Powder (jia jian sheng rnai sun) . . . .226 Frigid Extremities Decoction plus Ginseng (si ni jia ren shen tang). . . . . . . . . . . . . . . . .243 Regulate the Middle and Augment the Qi Decoction (tiao zhong yi qi tang) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .228 White Penetrating Decoction (bai tong tang). . . .. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .. . .244 Raise the Sinking Decoction (sheng xian tang) . . . . . . . . . . . . . . . . . . . . . . . . . . . .244 Generate the Pulse Powder (sheng mai san) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . Formulas that Tonify the Blood Four-Substance Decoction (si w u tang) . . . . . . . . . . . . . . . . . . . . .249 Four-Substance Decoction with Scutellaria and Coptis (qin lian si wu tang) . .239 Tonify the Middle and Augment the Qi Decoction (bu zhong yi qi tang) . .246 Ginseng and Walnut Decoction (ren shen hu tao tang).. .. . . . . . . . .. . . . . . . .238 Six-Gentleman Decoction with Aucklandia and Amomum (xiang sha liu jun zi tang) . . . . . . . . . . .241 Major Construct the Middle Decoction (da jian zhong tang) . . . . Poria. . .238 Nourish the Stomach Decoction with Aucklandia and Amomum (xiang sha yang wei tang). . . . . . . . . . . . . . . . . . . . . .. . . . . . .246 Ginseng and Gecko Powder (ren shen ge jie san) . . . . . . . . . . . . .239 Stabilize the True Decoction (gu zhen tang) .235 I. . . . . . . and Atractylodes Macrocephala Powder from the Analytic Collection (shen ling bai zhu sun). . . . . . . . . . . . . . . 228 Unaccompanied Ginseng Decoction (du shen tang) .250 Jade Candle Powder (yu zhu san) . . . . .250 Four-Substance Decoction with Safflower and Peach Pit (tao hong si wu tang) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .230 Comparative Tables of Principal Formulas.229 Lead Special Pill (hei xi dan) . . . . . . .239 Ginseng. . . . . . . . . . . .225 Fresh Ginger and Licorice Decoction (sheng jiang gan cao tang). . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .244 Augment the Qi and Increase Acuity Decoction (yi qi cong ming tang) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .244 Lift the Source Decoction Cju yuan jian) . . . . . . . . . . . . . . . . . . . . . . . . . . . .243 Raise the Yang and Benefit the Stomach Decoction (sheng yang yi wei tang) . . . . . . . . . . . . . . . . . . .236 Extraordinary Merit Powder (yi gong san) . . .240 Seven-Ingredient Powder with Atractylodes Macrocephala (qi wei bai zhu san) .231 Formulas that Tonify . . . . . Poria. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .249 Delayed Menstruation Decoction (guo qi yin). . . . . . . . . . . . . . . . . . .226 3. . . . . .238 Six-Gentleman Decoction (liu jun zi tang).248 Three-Yellow and Four-Substance Decoction (san hang si wu tang) . . . .228 Restore and Revive the Yang Decoction ( h i yang jiu ji tang) . . . .241 Modified Tonify the Middle and Augment the Qi Decoction Cjia jian bu zhong yi qi tang) . . . . . . . . . . . . . . . . . . . . . . . . . . .249 Warming and Clearing Decoction (wen qing gin). .228 Unblock the Pulse Decoction for Frigid Extremities (tong rnai si ni tang) . .. . . . . and Atractylodes Macrocephala Powder (shen ling bai zhu san). . . . . . . . . . . . . . . . . . . . . Formulas that Rescue Devastated Yang Frigid Extremities Decoction (si ni tang) .. . . . . . . . . . . . . . . .. Formulas that Tonify the Qi Four-Gentleman Decoction (si jun zi tang). . . . . . . . .. . . . . . . . . . .

. . . . . .265 Restore the Left [Kidney] Decoction (zuoguiyin) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .265 Improve Vision Pill with Rehmannia (ming mu di hang wan) . . .265 Pill for Deafness that is Kind to the Left [Kidney] (er long zuo ci wan) .270 Eight-Treasure Decoction (bazhentung) . . . . . . . . . .278 Restore the Right [Kidney] Decoction bou gui yin) . .275 5. . . .271 Preserve Vistas Pill (zhu jing wan) . . . . . . . . . . . . Formulas that Tonify the Qi and Blood Eight-Immortal Pill for Longevity (ba xian chang shou wan). Formulas that Nourish and Tonify the Yin Six-Ingredient Pill with Rehmannia (liu wei di huang wan) . . . . . . .253 3. . . . . . .264 Anemarrhena. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .275 Kidney Qi Pill from Formulas to Aid the Living Gi sheng shen qi wan). . . . . .. . . . . . . . . . . .274 Mulberry Leaf and Sesame Seed Pill (sang ma wan) . . . . . . . . . . . . . ..261 Great Creation Pill (da zuo wan) . . . . . . . . . . . . .273 Seven-Treasure Special Pill for Beautiful Whiskers (qi bao mei ran dun) . . . . . . . . . . . . . . . . . . . . . . . . .. . . . . . . . . . . . . 266 Restore the Left [Kidney] Pill (zuo gui wan) . . . .. . .268 Tangkuei Decoction to Tonify the Blood (dung gui bu xue tang) . . . . . . . . . . . . . . . . . . . . . .265 Tangkuei and Rehmannia Decoction (dang gui di hang yin) . . .280 Tortoise Shell and Deer Antler Syrup (gui lu er xian jiao) . . . . . . .255 Restore the Spleen Decoction (gui pi tang). . . . . . .261 Powder that Gives the Stability of Mount Tai (tai shan pan shi san) . . . . . . . . . . . . . .254 Discharge Pus Powder (tou nong san) .251 Tangkuei Powder (dang gui san).265 Augmented Six-Ingredient Pill with Rehmannia @ . . . . . . . . . . . . . . . . . . . . . . . Licorice. . .259 Eight-Treasure Pill to Benefit Mothers (ba zhen yi mu wan) . . . . . . . . . . . . . . . . . . and Prepared Aconite Decoction (shao yao gan cao ju zi tang) . . . . . . . . . . . . . . . . . . . . . . .261 4. . . . . . . . . . . .264 Lycium Fruit. . . . . . . .252 Peony. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .268 Hidden Tiger Pill from the Analytic Colbction (hu qian wan) . . . . .. . .263 Capital Qi Pill (du qi wan) . . . . . . . . . . . . . . . . . . . . . . . . . . . .. . . . . . . . . . . . . . . . . Formulas that Warm and Tonify the Yang Kidney Qi Pill from the Golden Cabinet Cjin zui shen qi wan). . . .260 Ginseng Decoction to Nourish the Nutritive Qi (ren shen yang ying tang) . . . . . . . . . . . . . .255 Stabilize the Root and Stop Excessive Uterine Bleeding Decoction (gu ben zhi beng tang). . . . . . . . . . . . . . . . . . . . . . . .267 Great Tonify the Yin Pill (da bu yin wan) . . . . . . . . . . . . . .267 Stabilize the Yin Decoction (guyinjian) . .257 Honey-Fried Licorice Decoction (zhi gun cao tang) . . . . . . . .252 (shuo yao gun cao tang) . .. . . . . . . . . . .270 Linking Decoction b i guan jian) . . . .. . . . . . . . . . . . . . . . . . . .260 Cyperus and Fritillaria Decoction to Nourish the Nutritive Qi (xiang bei yang ying tang) .. . . . . . . . . . . . . .. .272 Dendrobium Pill for Night Vision (shi hu ye guang wan) . . . . . . . . . . . . . . . . . . Phellodendron. . .260 All-Inclusive Great Tonifying Decoction (shi quan da bu tang). . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .267 Enrich the Kidneys and Open the Gates Pill (zi shen tong guan wan) . . . . . . . . . . . . .273 Two-Ultimate Pill (er zhi wan). . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .251 xvii Tangkuei and Peony Powder - (dung gui shuo yao sun) . . . . . . . . . . . . .278 Ten-Tonic Pill (shi bu wan) . . . . . . . . . . . . a wei liu wei di hang wan) . . . . . . . . . . . .267 Great Tonify the Basal Decoction (da bu yuan jian) . . . . . . .265 Restore the Right [Kidney] Pill bou gui wan). . .. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . Chrysanthemum.. . . . . . . . . . . .280 Young Maiden Pill (qing e wan) . . . . . . . . . . . . . . . . .. . . . . . . . .259 Hidden Tiger Pill (hu qian wan) . . . . . . . and Rehmannia Pill (qi ju di hang wan) . . . . . . . . . . . .265 Eight-Ingredient Pill with Rehmannia (ba wei di h n g wan) . . . . . . . . . . . . .253 Peony and Licorice Decoction Mutton Stew with Tangkuei and Fresh Ginger (dung gui sheng jiang yang rou tang). . . . . . . . . . . . . . .278 Polygonum Multiflorum Root and Ginseng Decoction (he ren yin) . . . . . . .280 . . . . . . . . .Chapte9r Contents Augmented Four-Substance Decoction Cjia wei si wu tang). . . . . . . . . . . . . . . . . . . . .261 Intestinal Serenity Decoction (chang ning tang). . . . . . . . . . . and Rehmannia Pill (zhi bai di hang wan) . . . . . . . . . . . . . . . . . . . . . . . . . . . . .. . . .257 Modified Restore the Pulse Decoction Cjia jian ju m i tang) . . . . . .251 Tangkuei and Jixueteng Decoction (dang gui ji xue teng tang) . . . . . . . . . . . .

. . . . . . . . . . . . . .304 Tangerine Peel Decoction Cjupitang) . . . . . . . . . . .295 Running Piglet Pill (ben tun wan). . . . . . . . . . . . . . . . . . . . . .290 Discharge Gas Decoction (pai qi yin) . . . . . . . . . . . . . . . . . . . . . . . .297 Conduct the Decoction (dao qi tang) . . . . . . . . . . . . . . . . . . . . . . . . . .313 Drive Out Blood Stasis i n the Mansion of Blood Decoction (xue f u zhu yu tang) . . . . . . .305 Newly-formulated Tangerine Peel and Bamboo Shavings Decoction (xin zhi ju pi zhu ru tang) . . . . . . . . .302 Inula and Haematite Decoction (xuanfu dai zhe tang) . . . . . . . . . . . . . . . . . . . . . . . . .297 Warm the Liver Decoction (nuan gun jian) . .316 Drive Out Blood Stasis in the Lower Abdomen Decoction (shao fu zhu yu tang) . . . . . . . . . . . . . . .297 Tangerine Seed Pill GU he wan) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .301 Six Milled-Herb Decoction ( h m o tang) . . . . .303 Tangerine Peel and Bamboo Shavings Decoction Gu pi zhu ru tang) . . . . . . . .315 Drive Out Blood Stasis Below the Diaphragm Decoction (ge xia zhu yu tang). . . . . . . . . . . . . . . . . . . . . . . . . . . . . and Pinellia Pill (gan jiang ren shen ban xia wan) . . . . . . . .306 Comparative Tables of Principal Formulas .291 Four-Ingredient Decoction for the Seven Emotions (si qi tang) . . . . . . . . . . . . . . . . . . . . . . . . . . . .291 Pinellia and Magnolia Bark Decoction (ban xia hou po tang) . . .xviii Chapter Contents Four Milled-Herb Decoction (si mo tang) . . . . . . . . . . . . . . . . . . . Chinese Chive. Ginseng. . . . . . Formulas that Promote the Movement of Oi Escape Restraint Pill (jmejuwan). .305 Persimmon Calyx Decoction (shi di tang) . . . . . . . . . . . . . .316 Sudden Smile Powder (shi xiao sun) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .292 Trichosanthes Fruit. . .292 Trichosanthes Fruit. . . . . . . . . . . . . . . . . . . . . . . and Pinellia Decoction (gua lou xie bai ban xia tang). . . . . . .305 Clove and Persimmon Calyx Decoction (ding xiang shi di tang) . 302 Five Milled-Herb Decoction (wu mo yin zi) . . .312 Resistance Decoction (di dang tang) . . . . . . . . . . . . . . Formulas that Invigorate the Blood and Dispel Blood Stasis Peach Pit Decoction to Order the Qi (tao h e cheng qi tang) . . . Trichosanthes Fruit. . . . .293 Galangal and Cyperus Pill (liangfu wan) . . . . . . . . . . Formulas that Direct Rebellious Oi Downward Perilla Fruit Decoction for Directing Qi Downward (su zi jiang qi tang). . .. . . . . . . . . . . . . . . . .289 1. . . . . . . .294 Melia Toosendan Powder Gin ling zi sun) . .. . . .. . . . . . . . . . . . .314 Unblock the Orifices and Invigorate the Blood Decoction (tong qiao huo xue tang) . . . . . . . . . . .318 . .293 Magnolia Bark Decoction for Warming the Middle (hou Po wen zhong tang) . . . . . . . . . . 300 Mysterious Decoction (shen mi tang) . . . . . . . . . . . . . .304 Tangerine Peel and Bamboo Shavings Decoction from Formulas to Aid the Living Cju pi zhu ru tang) . . . . . . . . . . . . . . . . . . . . . .317 Pinch Powder (shou nian san) . . . . . . . . . . . .298 2. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .299 Arrest Wheezing Decoction (dingchuantang) . . . . . . . . .296 Top-Quality Lindera Powder (tian tai wu yao sun). . . . . . .280 Special Pill to Aid Fertility (zanyudan) . . . . . . . . Chinese Chive. . . . . .301 9 CHAPTER 10 Formulas that Invigorate the Blood. . . . . . . . . . . . . . .311 1. . . . . . . .318 Salvia Decoction (dun shen yin) . . and Cinnamon Twig Decoction (zhi shi gua lou gui zhi tang) . . .283 CHAPTER Formulas that Regulate the Qi . . . . . . . . . . . . . . . . . . .. . . . . . . . . . . . . . . . . .316 Corydalis Decoction (yan hu suo tang) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 281 Two-Immortal Decoction (er xian tang). .. . . . . . . . . . . . . . . . . . . . . . . . . . .306 Cuscuta Seed Pill (tu si zi wan) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .316 Drive out Blood Stasis from a Painful Body Decoction (shen tong zhu yu tang). . . . . .302 Ginger. . . . . . . . . . . . . . . . . . .282 Comparative Tables of Principal Formulas . . . . . . . . . . . . . . . . . .296 Augmented Lindera Decoction Cjia wei wu yao tang). . . .293 Immature Bitter Orange. . . . . . and Wine Decoction (gua lou xie bai bai jiu tang) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

326 Seven-Thousandths of a Tael Powder (qi li sun) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .360 3. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .342 True Man's Decoction to Nourish the Organs (zhen ren yang m g tang) . . . . Formulas that Restrain Leakage from the Intestines CHAPTER 11 Formulas that Stop Bleeding. . . . . . . . . . . . . . . . . . . . . . .360 Benefit the Yellow Powder (yi h a n g san) . . . .327 Trauma Pill (die d a wan) . . . . . . . . . . .. . . . . . . . . Formulas that Invigorate the Blood in the Treatment of Traumatic Injury Revive Health by Invigorating the Blood Decoction (fu yuan huo xue tang). .329 Comparative Tables of Principal Formulas . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .360 Water and Earth Immortals Special Pill (shui lu er xian d m ) . . . . . . . . . . . . . . . . . . . . . . .346 CHAPTER 12 Formulas that Stabilize and Bind . . . . . . Formulas that Warm the Menses and Dispel Blood Stasis Cinnamon Twig and Poria Pill (gui zhi fu ling wan) .336 Sanguisorba Powder (di yu san) . . . . . . . .330 xix 2. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . Ass-Hide Gelatin. . . . . . . .340 Cephalanoplos Decoction (xiao ji yin zi) . . . . . . . . . . .341 Clear Heat and Stop Excessive Uterine Bleeding Decoction (qing re zhi beng tang) . . . . . . . .353 Tangkuei and Six-Yellow Decoction (dung gui liu huang tang) . . . . . . . . . .. . . . . . .320 Relax the Channels and Invigorate the Blood Decoction (shu jing huo xue tang) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . Formulas that Stabilize the Kidneys Metal Lock Pill to Stabilize the Essence (jin suo gu jing wan) . 359 Four-Miracle Pill from the Tranquil Hut (dan liao si shen wan) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .. . . . . . . . . . . . . . . . .. . . . . . . . . . . . . . . . . . . .345 Clove. . . . . . 343 . . . Formulas that Clear Heat and Stop Bleeding Ten Partially-Charred Substances Powder ( s h i h u i s a n ) .355 2. . . .363 Cinnamon Twig Decoction plus Dragon Bone and Oyster Shell (gui zhi jia long gu m u li tang) .. . . . . .362 Poria and Cuscuta Special Pill ( f u t u d a n ) . . . . .343 Ass-Hide Gelatin and Mugwort Decoction (jiao ai tang) . . . . . . . . . . . .357 Peach Blossom Decoction ( t a o h u a t a n g ) . . . . . . . .337 Quiet the Blood Decoction (ning xue tang) . . . . . . . . . . .Chapter Contents Rhubarb and Eupolyphaga Pill (da huang zhe chong wan) . . . . . . . . . . . . . . . . .335 1. . . . . . . . . . . . . . . . . . . . . . . . . . . . .322 Generation and Transformation Decoction (shenghuatang) . . . . . . . . .364 .338 Sophora Japonica Flower Powder ( h u a i h u a s a n ) . . . . . . 352 Oyster Shell Powder (mu li sun) . . . . . . . . . . . . . . . . .321 2. . . . . . . . . . . . . . . . Formulas that Tonify and Stop Bleeding Biota Twig Decoction ( b a i y e t a n g ) .351 I. . . . . .346 Comparative Tables of Principal Formulas . . . . . .324 3. . . . . . . . . . . . . . . . . .338 Smooth the Menses Decoction (shun jing tang) . . . . . . . . . . . . . . . . . . . . . . . . . . . Yellow Earth Decoction (huang t u tang) . . . . . . . . . . . . . . . . . . . . . 358 Four-Miracle Pill ( s i s h e n w a n ) . . . . . .363 Shut the Sluice Pill ( s u o q u a n w a n ) . . . .354 Nine-Immortal Powder (jiu xian sun). . . . . . . . . . . . . . .342 Cool the Menses and Stop Bleeding Decoction (qing jing zhi xue tang) . . . . . . . . . . . . . . . . . . . . . . . . . .328 Fantastically Effective Pill to Invigorate the Collaterals (huo luo xiao ling dun) . . . . . . . . . . . . . . . 323 Warm the Menses Decoction (wen jing tang) . . . . . . . .339 Sophora Japonica Fruit Pill (huai jiao wan) . . . . . . .337 Four-Fresh Pill (si sheng wan) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .318 Tonify the Yang to Restore Five [Tenths] Decoction (bu yang huan w u tang) . . . . . . . . . . Formulas that Stabilize the Exterior and the Lungs Jade Windscreen Powder (yupingfengsan) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .338 Coughing of Blood Formula (ke xuefang) . . .361 Mantis Egg-case Powder (sang piao xiao sun) . . . . . . . . . and Mugwort Decoction (ding xiang jiao ai tang) . . . . . . . . . . . . . .

. . . . . . . . . . . . . . . . .399 True Jade Powder ( j u zhen sun).405 Gastrodia and Uncaria Decoction (tian ma gou teng yin) . . .396 Eliminate Wind Decoction with the Four Substances (si wu xiao feng yin) . . . . . .398 Minor Invigorate the Collaterals Special Pill (xiao huo luo dun) . . . Wheat. . . . . . . . .369 Clear Discharge Decoction (qing dai tang) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . Formulas that Release Wind from the Skin and Channels Eliminate Wind Powder from True Lineage (xiao feng sun) .365 4. . . . . . . . .403 Uncaria Decoction (gou teng yin) . . . . . . . . . . . . . . . . . . . . . .399 Five-Tiger Powder to Pursue Wind (wu hu zhui feng san) . . . . . . . . . . . . . . . . . .401 CHAPTER 13 Formulas that Calm the Spirit . . . . . . . . . . . . . . . .395 Eliminate Wind Powder from Effective Formulas (xiao feng sun). . . . . . . . . . . . . . . . . . . . . . . . . . . .397 Aconite Decoction (wu tou tarig) . . . . . . . . . . . . . . . . . . . . . . . . . . . .387 Comparative Tables of Principal Formulas . .403 Antelope Horn and Uncaria Decoction (ling jiao gou teng tang). . . . . . . . . . . . .383 2. . . . . . . . . . . . . . . .. . . . . . Licorice. . . . . . . . . . . . . . . . . .401 Stop Spasms Powder (zhi jing sun) . . . . . . .. .368 End Discharge Decoction (wandaitang) . . . . . . . . . . . . . . . . . . . . ..386 Bupleurum plus Dragon Bone and Oyster Shell Decoction ( c h i hu jia long gu mu li tang) . . . . . . . . . . . . . . . . . . . . . . . . . . . .405 Ass-Hide Gelatin and Egg Yolk Decoction (e jiao ji zi huang tang) . . . . . . . . . .396 Minor Prolong . . . . . . . . .. . . . .389 CHAPTER 14 Formulas that Expel Wind. . .381 Coptis and Ass-Hide Gelatin Decoction (huang lian e jiao tang) . . 366 Stabilize the Menses Pill (gu jing wan). . . . . .397 Lindera Powder to Smooth the Flow of Qi (wu yao shun qi san) . . . . . . . . . . . . . . . . . . . . . Formulas that Stabilize the Womb Stabilize Gushing Decoction (guchongtang) . . . . . . . . . . . . . . . . . . . . .Life Decoction (xiao xu ming tang). . . . . . . . . . . .378 Nourish the Heart Decoction bang xin tang) . .398 Lead to Symmetry Powder (qian zheng sun) . . . . . . . . . . . .393 1. . .385 Iron Filings Decoction (sheng tie luo yin) . . Formulas that Nourish the Heart and Calm the Spirit Emperor of Heaven's Special Pill to Tonify the Heart (tian wang bu xin dun) . . . Dragon Bone. . . . . . . . and Jujube Decoction (gun mai da zao tang). . . . . . . . . . .365 Fetus Longevity Pill (shou tai wan) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .367 Rouse the Spirit Special Pill (zhen ling dun) . . . . . . . . . . . . . . . . . . . .. . .. . . . . . . .381 Settle the Emotions Pill from the Wondrous Lantern (ding zhi wan) . . . . . . . . . . . .370 Comparative Tables of Principal Formulas. . .371 Magnetite and Cinnabar Pill (ci zhu wan). . . . . . . . .. . . . . . . . . . . . . . . . .Chapter Contents Cinnamon Twig. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . ..396 Prolong Life Decoction (xu ming tang) . . Formulas that Extinguish Internal Wind Sedate the Liver and Extinguish Wind Decoction (zhen gun xi feng tang). . . . .394 Eliminate Wind Powder from Imfierial Grace Formulary (xiao feng san) . . .379 Sour Jujube Decoction (suan zao ren tang) . . . . . . . .405 Three-Shell Decoction to Restore the Pulse (sun jia f u mai tang) . . . . .379 Mother-of-pearl Pill (zhen zhu mu wan) . . . . .402 Construct Roof Tiles Decoction ('jian ling tang) . . . . . .370 Change Yellow [Discharge] Decoction (jihuangtang) . . . . . . . . . Formulas that Sedate and Calm the Spirit Cinnabar Pill to Calm the Spirit (zhu sha an shen wan) . . . . . . . . . . . . . . . . . . .382 Grand Communication Pill ('jiao tai wan) . . . .384 2. . . and Oyster Shell Decoction (gui zhi gan cao long gu mu li tang) .. . . . . . . . . . . . . . . . . . .. . . . . . . . . . . . . . . . . . . . . . . . . . . . .. . . . . . . . . . . .377 1. . . . . . . .382 Licorice. . . . . . . .381 Marvelously Fragrant Powder (miao xiang san) . . . .380 Settle the Emotions Pill (ding zhi wan) . . . . . . . . . . . . . . . . . . . . ..407 . . . .. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .. . . .379 Biota Seed Pill to Nourish the Heart (bai zi yang xin wan) . . . . . . . . . . . .

. . . . . . . Ginger. . . . . . . . . . . . . . . . . . . . .417 Cattle Gallstone Pill to Clear the Heart (niu huang qing xin wan) . . . .438 Bupleurum Decoction for Sinking Into the Chest ( c h i hu xian xiong tang). and Atractylodes Macrocephala Decoction (gan cao gan jiang fu ling bai zhu tang) .. .. . . . .. . . . Formulas that Dry Dampness and Expel Phlegm Two-Cured Decoction (er chen tang). . .443 Licorice. . . . . . . . . . . Ginger. . . . . . . . . . .444 Poria. . . . . . . . . . . . . . . . . . . . . .Chapter Contents xxi Major Arrest Wind Pearls (da ding feng zhu) . . . .. . . . . . . . . . . . . . . . .. Formulas that Clear Heat and Transform Phlegm Warm the Gallbladder Decoction . . . Atractylodes Macrocephala. . . . . . . .. . . . . . . . . . . . . . . Poria. . . . . . . . . .441 Prunella Syrup (xia ku cao gao) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . Schisandra. . . . . . .. . . . . . . . . . . . . . . . . . . . . . . .. .410 Cyperus and Inula Decoction (xiang fu xuan fu hua tang). . . . . . . . . .407 Rehmannia Decoction (di huang yin zi) . . . . . . . . . . .408 Comparative Tables of Principal Formulas. .. . . Formulas that Transform Phlegm and Dissipate Nodules Reduce Scrofula Pill (xiao luo wan) . . . . . . .419 Return of Spring Special Pill (hui chun dan). . . . . . . . . . . . . . . . . . . . . Formulas that Moisten Dryness and Transform Phlegm Fritillaria and Trichosanthes Fruit Powder (bei mu gua lou san) . (wendantang) . .. . . . .441 Sargassum Decoction for the Jade Flask (hai zao yu hu tang) . . . . . . . . . . . .433 Six-Serenity Decoction (liu an jian) . . . Formulas that Warm and Transform Cold-Phlegm Formulas that Treat Phlegm . . . . . . . . . . . .445 Three-Seed Decoction to Nourish One's Parents (san zi yang qin tang). . . and Asarum Decoction (ling gan wu wei jiang xin tang) . . . . . . . .437 Clear the Qi and Transform Phlegm Pill (qing qi hua tan wan) . . . . . . . .439 Fritillaria and Anemarrhena Powder (er mu san) . .415 1. . . . . . . . . . . . . Cinnamon Twig. . . . . . . . . . . . . . . . .437 Trichosanthes Fruit and Immature Bitter Orange Decoction (gua lou zhi shi tang). . . . .422 3 . Licorice. . . . . . . . . . . . . . . . . . . . . . .434 Augmented Two-Cured Decoction Cjia wei er chen tang). . . . . Formulas that Scour Phlegm and Open the Orifices Scour Phlegm Decoction (di tan tang) . . . . . . . . . . . . .416 Cattle Gallstone Decoction to Order the Qi (niu hang cheng qi tang) . . . . . . . . . . . . . . . . . . . . . . . . . . .. . . . . . . . . . .438 Minor Sinking Into the Chest Decoction (xiao xian xiong tang). . . . . . . .444 Cinnamon Twig. . . . . . . . . Schisandra. . . . . . . . . ..434 2. . .432 Six-Gentleman of Metal and Water Decoction Gin shui liu jun jian) . . . . .439 3. . . . . . 424 Open the Gate Powder (tongguansan) . . Formulas that Clear Heat and Open the Orifices Calm the Palace Pill with Cattle Gallstone (an gong niu huang wan) . . . . . . .434 Poria. . . . . . . . . . . .. . . . . . . . . . . . .417 Greatest Treasure Special Pill (zhi bao dan) . . . . . . . . .. . . . . . . . . . . . .420 2. . . . . . and Licorice Decoction (ling gui zhu gan tang). . . . . . . . Poria. . . . . .. . . . . . . . and Licorice Decoction (gui ling wu wei gan cao tang). . . . . . . . . . .436 Eleven-Ingredient Decoction to Warm the Gallbladder (shi yi wei wen dan tang) . . . . . . . . . . .424 Vaporize Phlegm Pill (guntanwan) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .425 Comparative Tables of Principal Formulas . . .. . . . . . . . . . . . .. . . . . . . .. . . . . . . . . .. . . . . . . . .445 . . . . . . .427 5. . . . . . . . . . . . . . . .442 CHAPTER 15 Formulas that Open the Orifices . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .434 Clear Dampness and Transform Phlegm Decoction (qing shi h a tan tang). . . . . . . .436 Ten-Ingredient Decoction to Warm the Gallbladder (shi wei wen dan tang) . . . . . . . . . . . . . . . 435 Coptis Decoction to Warm the Gallbladder (hang lian wen dan tang) . . . . . .. . . . .417 Purple Snow Special Pill (zi xue dan) . .431 1. . . . . . . . . . . . . Formulas that Warm and Open the Orifices Liquid Styrax Pill (su he xiang wan) . . . . .440 4. . . . . . . . .

. . . . . . . . . 469 Cloth Sack Pill (bu dai wan) . . . . . . . . . 455 Preserve Harmony Pill from the Precious Mirror (bao he wan) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 451 Immature Bitter Orange Pill to Reduce Focal Distention (zhi shi xiao pi wan) . . . . . . . . . . . . . .466 Regulate the Middle and Calm Roundworms Decoction (li zhong an h i tang) . . . . . . . .465 Mume Pill (wu mei wan) . . . . .458 Aucklandia and Betel Nut Pill from Zhu Dan-Xi (mu xiang bing lang wan) . . . . . . . . . . . . . . . . . . . . 459 Medicated Leaven. . . . . . . . . . . . . . . . . . . . . . . . . . . . Immature Bitter Orange.457 Aucklandia and Betel Nut Pill from the Analytic Collection (mu xkng bing lang wan) . . . . 458 Reduce Infantile Stagnation Pill (xiao ru wan) . and Atractylodes Macrocephala Pill (xiang sha zhi zhu wan) . . . . . . . 7 . . . . . . . . . . . . . . . . . . . . . . . . . . . .450 Melon Pedicle Powder from the Systematic Differentiation (gua di san) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 450 Comparative Tables of Principal Formulas . . . . . . and Atractylodes Macrocephala Pill (qu mai zhi z h wan) . . . . . . . . . . . . . . . . .457 Great Tranquility Pill (da an wan) . . . . . . . Guide Out Phlegm Decoction (dao tan tang) . . . . 470 . . . . . . . . . . . Barley Sprout. . . . . . . . . . . . . . 462 CHAPTER 17 Formulas that Expel Parasites . . . . . . 458 Fat Baby Pill vei er wan) . 467 Picrorhiza and Mume Decoction to Calm Roundworms (lian m i an h i tang) . . . . . . 458 Immature Bitter Orange and Atractylodes Macrocephala Pill (zhizhuwan) . . . 468 Cnidium Powder (she chuang zi san) . . . . . .469 Comparative Table of Principal Formulas . . . . . . . 468 Expel Tapeworms Decoction (qu tiao tang) . . . . . . . . . . . . . . . . . .449 Melon Pedicle Powder from the Arcane Essentials (gua di san) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . and Gastrodia Decoction (ban xia bai zhu tian ma tang) . . . . . . . . . . . . . . . . . . Formulas that Transform Phlegm and Extinguish Wind Chapter Contents Stop Coughing Powder (zhi sou san) . . . . . . . Immature Bitter Orange.xxii 6 . . . Amomurn. 460 Immature Bitter Orange Pill to Guide out Stagnation (zhi shi dao zhi wan) . Formulas that Induce Vomiting to Discharge Phleem Melon Pedicle Powder (gua di san) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 450 Three-Sage Powder (san sheng san) . . . 455 Preserve Harmony Pill (bao he wan) . . . . . . . . . . . . . . . . . . . . 467 Formulas that Reduce Food Stagnation . . . . Atractylodes Macrocephala. . . . . .460 Pinellia. . . . . . . . . . . . . . . . . . . . . . . . . . . . 461 Comparative Tables of Principal Formulas . . . . . . Strengthen the Spleen Pill (jian Pi wan) . . . .468 Aucklandia and Betel Nut Pill (mu xiang bing lung wan) . . . . . . . . . . . . . .467 Dissolve Parasites Pill from the Analytic Collection ( h a chong wan) . . . . . .460 Aucklandia. . . . . .457 Dissolve Parasites Pill (hua chong wan) . . . . . . . Arrest Seizures Pill (ding xian wan) . . . . .468 Drive Roundworms from the Biliary Tract Decoction (dan dao qu h i tang) . . . . . . . . . . . . . . . .460 Immature Bitter Orange and Atractylodes Macrocephala Decoction (zhi zhu tang) . . . . .

you must understand the formulas and the strategies that underlie them. Some clarification has been added where we thought it necessary. our intention is to reflect as accurately as possible the understanding of contemporary Chinese practitioners. our selection of formulas follows the selection in these works. Although they are based on the Chinese tradition (the formulas of Zhang Zhong-Jing. none of our sources provided certain information about a particular formula. familiarizing yourself with the medicinal substances. our decision was governed by considerations of the utility of a certain formula in the clinic. Additional information was drawn from many other books (listed in the translators' bibliography). but otherwise all of the information comes directly from the original Chinese sources. or its value in illuminating an important aspect of traditional Chinese medicine. we have never ventured beyond that by adding material. corresponds to accumulating a sufficient vocabulary. In compiling this book. we have used what we believe are the best books from modern China about the formulas. are revered in all three countries). and distilled them into a single volume. edited by the Hubei College of Traditional Chinese Medicine. and Elaboration of Medical Formulas. you must understand the rules of syntax and grammar. We never presumed to add this information. and investigation of China's medical tradition in the West. there are xxiii . utilization. which provides basic information about the medicinal substances or "vocabulary" of traditional Chinese herbal medicine. edited by Fu Yan-Kui and You Rong-Ji. And before you can "talk" to the body with Chinese herbal medicine. To that end. we were fortunate in being able to use many excellent Chinese texts. Where we had to choose among different formulas. in a number of cases neither the tongue nor pulse signs associated with the formulas are mentioned. This is because these signs are often so variable that to list all the possibilities would serve no useful purpose. For example.Preface Studying Chinese herbal medicine is an arduous task that is similar to learning a language. edited by the Guangzhou College of Traditional Chinese Medicine. In some cases. edited by Xu Ji-Qun. Our goal here is to provide a similar level of information about the formulas so that they can be used in a responsible and effective manner. although some can be found in only one or two. By and large. As was stated in the first book. In these cases. it is rare in Chinese herbal medicine to prescribe individual substances outside of their context in a formula. Formulas. The impetus behind both of these works is the same: to contribute to a deeper understanding. Just as individual words are rarely used outside of their context in a sentence. The vast majority of the formulas included in this book were listed in most of our sources. Elaboration of Famous Ancient and Contemporary Formulas. But words alone are not enough. Some of these differences are reflected in our book. Japan and Korea each has its own herbal medicine tradition. Before you can speak a language. The reader should be aware that there are many differences of opinion about the formulas among the literally hundreds of thousands of practitioners in China today. The first step. four of which are the foundation of this work: Formulas. although we may refer to the omission in the text. for example. This book is the companion volume to Chinese Herbal Medicine: Materia Medica. This is the syntax and grammar of Chinese herbal medicine. but these four were our principal sources.

Chief among them are Ma ShouChun of the Chongqing Institute of Traditional Chinese Medicine. For this reason. a literal translation of some disorders would be meaningless. and Jeremy Ross for their helpful criticism of the manuscript. deficiency. but clarity is certainly more important than aesthetics in the practice of medicine. dampness. readable translation that is faithful both to the spirit of the medicine and the realities of the clinic.. We have attempted in this book to provide a clear. and yet one that continues to grow. It reveres and utilizes the past. but also incorporates innovations based on clinical experience and scientific investigation. etc. Ten to fifteen percent are from each of the principal dynasties in between: the Song. The translation of symptoms and traditional disorders also requires a flexible approach that is both faithll to the original and accessible to the practitioner. First and foremost are the many Chinese scholars and practitioners whose words we are privileged to translate for an English-speaking audience. burner. Andrew Gamble (coauthor of Chinese Herbal Medicine: Materia Medica) gave us the benefit of his uniquely penetrating insight . with the assistance of Anne Kubota and Stephen Brown. Herbal medicine in modern China is at once a truly traditional medicine. excess. This is often a question of taste for which there is no one right approach. This goal is an elusive one. traditional Chinese medical) sense... His advice was especially helpful in writing the introduction and chapters one. some of them are not currently used in that country. we have elected to use semi-equivalent terms. And when it is clear from the context that an organ is referred to in its modern. Because this type of question should not arise with respect to such terms as yin. known as Sino-Japanese medicine or Kamp6.into traditional Chinese herbal medicine. We also use a different capitalization scheme than we have in the past. we have chosen to include them because they appear on a major state examination in the United States. and 'frigid extremities' instead of 'four rebellions' for si ni. yang. we have included a brief overview of this tradition in the introduction. The reader's patience with our efforts is appreciated.xxiv significant differences among them. Technical terms have been translated literally in most cases. We realize that even capitalizingjust the organs may still be distracting to some of our readers. biomedical sense. Most of them arose at opposite ends of the imperial era. qi.g. but are nonetheless popular in Korea or Japan. e. On the other hand. and nine. cold. Several people contributed their technical expertise to this project. but have sometimes felt obliged to perhaps overtranslate in order to make the meaning as clear as possible. capitalization resolves the question of which heart we are talking about. we have used the lower case as well. slightly more are from the Qing dynasty (1644-1911) during which this culture crumbled. 'hernial disorder' for shiin qi. two. Thus. as this generally gives the best sense of the word. since 1949. Mark Sherwood was also a great help in the early stages of this project. As the community of Chinese medical practitioners in the West has become more sophisticated. this practice has become unnecessary.' because it gives a better sense of what the disorder is about. and the best that we can hope is that we have come a bit closer to reaching it. The point of capitalizing certain terms is to alert the reader that such terms are being used in their technical (i.of 'cholera' or 'cholera-like disorder. Yuki Karsten. instead of the more common renderings . i. This is reflected in the proportion of formulas in our book that originated in different historical periods of Chinese medicine. We would also like to thank our colleagues Paul Karsten. some of which differ from those used in earlier books published by Eastland Press.. Although not discussed at length. For example.e. he also contributed the calligraphy for the formulas. the twelve organs of traditional Chinese medicine. The remainder were devised during the modern epoch. We therefore only capitalize those terms for which there is still a fair chance of confusion. Shen De-Hui and Wu Xiu-Fen of the Beijing College of Traditional Chinese Medicine provided information about the derivation of formula names when our source texts were not helpful. i. has had a significant impact on the practice of Oriental herbal medicine in the West. Jin-Yuan. presently a visiting faculty member at the Northwest Institute of Acupuncture and Oriental Medicine in Seattle. A glossary of select terms is provided at the back of the book. About a quarter of the formulas are from the eastern Han (25-220) and Tang dynasties (618-907). Examples include 'painful urinary dysfunction' instead of 'dripping disorder' for lin. heat. We usually translate these literally. Furthermore. The Japanese form of herbal medicine.e. pro- . and Ming. we use 'sudden turmoil disorder' for hub luhn. We have profited enormously from the time and talents of a great number of people in completing this book. Not only did he provide valuable information on many technical points. which was the formative period of imperial Chinese culture. Subhuti Dharmananda. in such cases.e. A disorder of the Heart in traditional medicine is not necessarily the same thing as heart disease in modern biomedicine.. we no longer capitalize them. Stuart Kutchins. while all but one of the formulas in our book originated in China.

Dan would especially like to thank Lilian for her tireless love and support. Joanne Harnish for her loving kindness and help with the initial research in China. with the assistance of Cyong Jong-Chol. We would also like to acknowledge the editorial m u skill of John O'Connor at Eastland Press. forgiveness. We deeply appreciate the patience and enthusiasm of our students. and particularly Dee for her boundless acceptance. All errors in this book are due to our own deficiencies and limitations. who made this book as clear and understandable as possible. particularly Don Butterfield and Diane EggIeston. . also contributed background information for the section on Japanese herbal medicine in the introduction. Anne Kubota. Randy would especially like to thank Ted Kaptchuk for encouragement at crucial moments. which helped make our work more worthwhile.Preface vided the Japanese transliterations for the formula names which appear in Appendix VI. and for attempting to keep him in line throughout this long project. and Erwin Fuchs for his proofreading. and love.

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on the other hand.. and that it is not intended as a substitute for learning other aspects of traditional Chinese medicine. method of preparation. information about related formulas is provided in over 350 variations and associated formulas. ginger. we still recommend that practitioners read at least the introduction to the chapter and section in which any given formula appears. we have chosen the one that is most frequently used in our sources. we have tried as much as possible to make each formula stand on its own. Ledebouriella. and modifications.. accurate diagnosis is of paramount importance. Scutellaria). actions. The discussion of each of the 254 principal formulas in the book is divided into ten sections or categories. xxuii . we translate su zi jiang qi tang as Perillia Fruit Decoction for Directing Qi Downward. each group will use the book in a different way. If only one species of the herb is used in Chinese medicine. If two genera are used in Chinese medicine. The part of the plant is noted only if more than one part of the plant is commonly used in Chinese medicine and is specified in the name. only the genus is given (e. only the name of the most common one is given (e. Agastache). or is widely available in supermarkets or health food stores under a common name (e..g. and pinyin transliteration. indications. For example.g. ingredients. Nevertheless. kudzu). and an analysis of how the individual ingredients fit together in the formula. Students can use it as a textbook in conjunction with lectures to learn the basics about herbal formulas. the full name is given (e. Where the meaning of the name is not obvious. licorice. if more than one herb of the species is used. Moreover. because both the fruit and leaves of perilla are commonly used.. The information in these pages will only be useful to a practitioner who has a good foundation in traditional theory and practice. Bearing in mind that this book is a reference text. However. In addition. apricot kernels). Below is a discussion of the information contained under each of the headings in this book. except when the substance is commonly known by another name in North America (e. The remaining sections will likely be of more interest to experienced practitioners: commentary. NAME: The name of each formula is provided in English. We wish to remind the reader that the subject of this book is herbal formulas. we have included a brief explanation of its derivation. Students will be primarily concerned with these aspects of the formulas. Platycodon. source. Where the formula is known by more than one name in Chinese.g. Atractylodes Macrocephala).g. and we therefore suggest that they read these sections carefully to prepare for class. are more likely to use it as a reference for finding particular formulas in the clinic. We use anglicized Latin names for the medicinal substances. One should not assume that he or she can competently treat a patient by simply prescribing a formula from this book.. cautions and contraindications. Practitioners. The "core" sections are concerned with the most basic information about the formula: its name. Chinese. Translating the names of the formulas was difficult because there are so many acceptable solutions.g. our choices reflect as closely as possible the meaning and syntax of the original Chinese. For this reason.How to Use this Book This book is designed for both students and practitioners of Chinese herbal medicine. Should you experience less than optimal success in treating a patient. Ligusticum Chuanxiong. first review the diagnosis.

Approximately half of the formulas 4n this book are commercially available as prepared medicines. However. We feel this is important. We have therefore provided a cross reference to the names of the formulas from pinyin to English in Appendix V. Following a list of the signs and symptoms is an explanation of what this information tells you about the patient. i. ACTIONS: These are the strategies embodied by the formula. the original name and dosage of each of the substances in the formula. This will enable a reader who uses prepared medicines to learn more about the formulas on which they are based.) When there is a significant difference between the original ingredients. The supplement is cross referenced from pinyin to the various English names used by commercial manufacturers.. This is because the information has been updated in accordance with more recent sources. and the United States. INGREDIENTS: In this section we have used. no special instructions are provided. This bibliography includes the characters of the book titles as well as the authors and dates. we refrained from adding anything of our own to the signs and symptoms. (These changes will be reflected in the aspects of preparing the formula. In such cases. We have generally taken the liberty of translating measurements that were stated in terms of volume or number of pieces into comparable weights. Taiwan.. was first described. it will be noted in this section. the more common method of preparation at present is a decoction.e.g. drawn from the source text. It is noted at the end of the preparation section whether the formula is available in prepared form. while also providing the original terms of measurement. how and why the diagnosis fits this presentation. but in some cases is a compilation of the formulas of many practitioners.xxviii How to U s e this Book second edition of that work. It is not unusual that while the original formulation was a pill or a powder. When the common form of decoction is used. as it is presently recognized. we have identified (e. the reader is referred to the enclosed resource guide to prepared medicines. They are thus the link between the clinical indications and the ingredients. No matter how scanty the information INDICATIONS: . Japan. This is because measurement by weight is now the form of measurement used by pharmacies and other vendors for most medicinal substances. we usually refer to the change by noting that the ingredients should be used with an appropriate reduction in dosage. this would be a book authored by the originator of the formula or his disciples. The information provided in this section is what one normally finds in formula books. as much as possible. . Readers of the first edition of Chinese Herbal Medicine: Materia Medica will note that the pharmaceutical names for many of the ingredients there are different from those used in this text. Occasionally there is a discussion of how a patient develops this type of problem. The amount of information provided about the indications varies widely from formula to formula. Sometimes there is very little information. and from the English names back to pinyin. These are the signs and symptoms of the conditions for which the formula is indicated. Those readers seeking more information about the source texts should consult the bibliography of source texts near the back of this book. dosage. Where the source text did not identify the particular substance in the manner in which it is now s h a o yao]). which are only sometimes related to the original names of the formulas. and sometimes it is quite comprehensive. It is generally. These differences are reflected in almost all of the source texts. as it gives the reader a sense of the original formula. we turned to supplementary works to flesh out the indications and discussion. this can lead to much confusion. The companies that manufacture these prepared medicines are located in China. If the reader is unfamiliar with the normal range of dosage for a particular substance. past and present. For the names of various prepared ("patented") versions of the formulas. The reader should be aware that both the composition and dosage of ingredients in many of the prepared medicines differ from those in the original formulas. The importance of this information is that it helps the reader understand the nature of the pathogenic mechanisms underlying the disorder.) We have provided a cross reference for those names that have changed in Appendix IV. (The reader is referred to the introduction for additional information about decoctions. We have therefore provided a resource guide to available prepared medicines as a supplement to this book. Generally speaking. or method of preparation and those used at present. With this understanding. Radix Paeoniae [ followed the original. the formula can be used to treat a wide variety of problems. When little information could be found in our principal sources. SOURCE: This is the title of the book in which the formula. a materia medica should be consulted. PREPARATION: This section describes the practical Many readers will be unfamiliar with the names of the formulas as they are translated here. Readers interested in the pinyin transliteration of these terms should refer to Appendix 111. and from Japanese to English in Appendix VI. but not always. Because each company uses its own brand names.

We have occasionally included commentary by contemporary practitioners. This will help the reader pronounce the names of the formulas. and should be particularly helpful to students seeking a greater understanding of the materia medica. xxix important that the practitioner adjust or fine tune a formula to fit the specific requirements of the patient. Professional journals of traditional Chinese medicine published in China are full of interesting and varied ways in which the formulas can be used. However. The discussion is arranged in accordance with the hierarchy of the ingredients. There are many different ways in which a formula can be modified. The fifth and sixth appendices provide cross but is certainly worth bearing in mind. This type of modification is called a variation.How t o Use this Book in this section appears to be. only the names of the additional ingredients are identified. together with the name of the formula and its source. their differences from the principal formulas are more pronounced than is the case with variations. To make the information in this section more accessible. VARIATIONS: Sometimes merely adding or subtracting a few ingredients in a formula will change it enough to warrant a different name. This information supplements the basic information about the functions of individual substances found in materia medica textbooks. usually about the source. 2) those that combine the principal formula with other formulas. and to underscore the point that their indications are only intended to serve as guidelines. We have included some of those mentioned in our sources to give the reader a sense of the flexibility of the formulas. the dosage of ingredients or method of preparation is quite different from the principal formulas with which they are associated. For this reason. we often compare them with their principal formulas. The first of these is a guide to the pinyin transliteration system. and the method of preparation. This will help readers who are familiar with Chinese or translation schemes other than our own to overcome the apparent conspiracy among CAUTIONS AND CONTRAINDICATIONS:T~~~ medical translators to use as many different translations section provides cautionary advice about using the as possible. e. At the very least. Furthermore. why particular substances were chosen to treat the disorder for which the formula is indicated. and 3) those that focus the formula on treating a biomedicallydefined disorder. depending on the presentation.. but each disorder can be treated by a variety of formulas. ASSOCIATED FORMULAS: These are formulas which are related to the principal formulas either because they contain many of the same ingredients. it should be enough to use the formula responsibly. references to the Chinese (Mandarin) and Japanese names of the formulas. the commentary concludes with a note on the biomedically-defined disorders for which the formula has been used. and not as absolute limitations. are the same as those of the principal formula. ANALYSIS OF FORMULA: This section discusses the composition of the formula. Thus. a formula medicinal substances since the publication of the first for treating a heat-induced disorder should not be used edition of Chinese Herbal Medicine: Materia Medica. MODIFICATIONS: In Chinese medicine it is very . indications. there for treating a cold-induced disorder. We have generally omitted advice from our botanical and zoological research into Chinese sources that we believe to be self-evident. Obviously. The second and third appendices are cross references for terminology.g. and such differences reflect the experiences and viewpoints of the individual practitioners. Some actions will only occur when particular ingredients are combined. the have been some changes in the pharmaceutical names. These were gleaned from our Chinese sources and are not in any way meant to be all-inclusive. and analysis of the formulas. Their significance lies in showing that. i. starting with the chief ingredients and working down to the envoys. and that the formulation of the whole is more than merely the sum of the ingredients' individual functions or actions. changes. we have arranged the modifications in the following order: 1) those that accommodate changes in the symptomology. At the back of the book are a number of appendices to assist the reader in understanding and using the material in this book. The dosage of the additional ingredients is also in line with that of the ingredients in the principal formula. The modifications provided in this section are examples taken from our sources that illustrate how this can be done. C0MMENTARY:This section provides a variety of supplemental information. or noted unconventional applications of the formulas in recent times. as a result of the ongoing formulas. The dosage of the remaining ingredients. or because they are used in treating similar disorders. This often takes the form of alternative explanations or usages of the formulas through the ages. not only can a single formula be used for treating a variety of biomedicallydefined disorders. In most cases. It should be apparent to the reader that the relationships among the constituent ingredients are quite complex.. cautionary advice in this section is not the only thing The fourth appendix provides a cross reference to those to be concerned about when prescribing the formula.e.

it is designed to serve as a handy shortcut for finding an appropriate formula. These are arranged by English name and include the authors and dates of publication. There are also two indices. In addition to the appendices. However. it is no substitute for a firm grounding in internal medicine. The final appendix is a summary table of the various disorders treated by the formulas in this book. The first is a formula index arranged by English name. there are two bibliographies. The second is a translators' bibliography of works specifically used in the preparation of this book. Arranged alphabetically by symptom and disorder. this is intended only as a starting point and reference. which will allow the reader to quickly find all references to a formula in this book. The first is a bibliography of historical . when they are known. The second is a general index.XYX How t a Use this Book sources for the formulas.

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a thorough understanding of the formulas has been essential to the practice of traditional Chinese herbal medicine. It is this functional aspect of the formulas that is at the heart of traditional Chinese herbal medicine. and the specific herbs that constitute the formula for that particular patient will naturally follow.. and substances (lz'fiifiing ydo). Discussion of Cold-induced Disorders (Shang han lun). i. This means that once one identifies a patient's problem. The process of treating disease in traditional Chinese medicine is defined as differentiating patterns and instituting treatment (bihn zhkng shi zhi). . the strategy of treatment.e. fang ji. Since the pre-Han era these words have referred to separate but complementary aspects of medical and esoteric practices. Since that time. As an integral part of this process. and not merely concepts or intellectual exercises.INTRODUCTION Traditional Chinese Medical Formulas N CHINESE T H E TERM MEANING formulas (also known as recipes or prescriptions) consists of two words. i.. the formula that incorporates that strategy. and even more precisely by the formula used to treat it. Thus. the patterns of disharmony) and the strategies or methods underlying the formulas that treat them..ok is upon understanding how the particular configurations of substances in the formulas work I together to effectively treat disease. strategy. The wordji refers to the practice of the technique itself.e. the written recipe. It is often said that Chinese herbal medicine consists of understanding and mastering theory. formulas. which is among the oldest sources of herbal medicine in China. the pattern of disharmony itself can be defined in terms of the treatment strategy. the act of preparing and administering the written recipe.e. This introduction will explain the relationship between the traditional descriptions of pathological conditions in Chinese medicine (i. fiing ji are formulas that are put into practice. The word fiing refers to the document on which a technique is recorded. the formulas are specific groupings or configurations of medicinal substances that serve as tools for instituting treatment. Conversely. The focus of this bo. This identification of a formula with a disorder dates back to the thirdcentury classic.

In the course of his editing. Wang Tao compiled Arcane Essentials from the Imperial Library (Wai . among which are decoctions. organs. and many other commonly-used formulas are variations on those which were first devised by Sun. Many modern practitioners of Oriental medicine do just that. instead of saying that a patient is suffering from a lesser yang disorder. this book features the use of simple and inexpensive. The text does contain rather specific instructions for preparing the formulas. Jin. which was originally sealed in 168 B. or channels.C. there is a discussion about the actions of the different tastes: "Acrid [taste] disperses. By the time of the Yellow Emperor's Inner Classic (Huang di nei jing). one could also describe it as a Minor Bupleurum Decoction (xiao c h i hu tang) disorder.C. Only the most basic elements of this strategy are set forth in this book. approximately 20 per cent of the formulas in our book (which were selected from texts written during the past 1700 years) are drawn from these works by Zhang Zhong-Jing. sour retains. His two books. Thirteen formulas are described. and salty softens. Qin and Han Dynasties (3rd Century B. and Tang Dynasties (3rd to 10th Centuries) The most important formulary of the Jin dynasty was written by Ge Hong. Entitled Emergency Formulas to Keep Up One's Sleeve (Bei ji zhou houfang). The nature of the text itself is very shamanistic and includes incantations and exorcistic practices. have had a major impact on later generations of physicians.D." There is also some discussion of how the tastes relate to the organs and the relationships among them. Wang divided the book into two parts. These books have had a tremendous influence on Chinese herbal medicine (and traditional medicine throughout East Asia) to the present day. In fact. and how to use them in the clinic to the best effect. For example. There is no mention of the five phases. While the principles of the five phases do not appear in these works. but none of them is commonly used today. There are few references to any of the theories which we now associate with traditional Chinese medicine. which is primarily concerned with internallygenerated disorders. Thousand Ducat Formulas (Qianjin yaofang) and Supplement to the Thousand Ducat Formulas (Qhnjin yi fang). and further development did not occur until a thousand years later during the Jin-Yuan period when the theories of the Inner Classic were more fully integrated into the practice of herbal medicine. author of the Pulse Classic.. which is now thought to have been basically compiled by the first or second century A. this text is almost exclusively concerned with acupuncture. They are far and away the greatest single source of formulas in traditional Chinese medicine. This text was among the silk manuscripts found in the Ma Wang Tui tomb in Hunan. In addition. written at the end of the later Han dynasty by Zhang Zhong-Jing. In other words. This book was edited about 50 years thereafter by Wang Shu-He. it is important to understand the nature of this development in order to clearly appreciate how the formulas came to be. Like other aspects of traditional Chinese medicine.) The earliest of the formularies extant dates to the end of the third century B. Later in the eighth century. Discussion of Cold-induced Disorders (Shang han lun). and little evidence of the utilization of yin and yang. it is quite rudimentary by present standards. bitter strengthens. Basic Questions (Su wen). For example. In terms of therapeutic techniques. they have developed into sophisticated therapeutic tools. yet effective formulas.D. to 3rd Century A. Named Formulasfor F$ytwo Ailments (Wu shi er bingfang) by its discoverers. Starting out as fairly crude potions with magical overtones. in the twentysecond chapter of the first volume. which deals with externally-contracted diseases. the theoretical foundations of traditional Chinese medicine were in place.C. Many of the formulas have a distinct air of sympathetic magic. The formulas are not provided with names. Sui.Introduction A BRIEF HISTORY OF HERBAL FORMULAS IN CHINA The art of formulas in traditional Chinese herbal medicine has undergone significant change through the centuries. the name of the formula itself is another way of stating the diagnosis. and they are very simple in structure. The leading medical figure of the Tang dynasty was Sun Si-Miao. drafts. and pills. and Essentials from the Golden Cabinet g i n gui yao he). each of the formulas is given a name. there is a detailed system of diagnosis which focuses on the six stages of disease. and discovered in the early 1970s. sweet moderates. there is an outline of the rudiments of a therapeutic strategy which is based on the tastes of the substances. and the dosage and method of preparation of the herbs are specifically indicated. Many of the formulas in these books are still in use (ten are included in our selection). More importantly for our purposes. The true ancestor of all formularies is the D i s m s h of Cold-induced Disorders and Miscellaneous Diseases (Shang han za bing lun). Zhang was the first to identify the condition of a patient (the diagnosis) with a particular formula used to treat that condition.

Xu Yin-Zong. 47 of which are included in our book. by luck. and Formulas Related to the Unification of the Three Etiologies (Sanyin ji yi bing zheng fang lun) divided the causes of disease into three categories: internally-generated. in Gleanings from the Materia Medica (Ben cao shiyi). pathogenic (qi). This encouraged the practice of symptomatic medicine in which there was no theoretical structure to enable the practitioner to adapt and fine tune the formulas for a particular patient. the understanding of treatment strategy became inseparable from diagnostics. and miscellaneous. observed: "Nowadays people are unable to differentiate the pulses. about fifty of which are included in our book. in Extension ofthe Materia Medica (Ben cao yan yi). and formulas in particular. and sixteen to Zhu Zhen-Heng. This is like hunting for rabbits by sending out many men and horses to surround the area in the hope that. thirtyfour to Li Ao. In our book approximately six formulas are attributed to Liu Yuan-Su. Ming and Qing Dynasties (14th to 19th Centuries) In terms of understanding the formulas. was the categorization of substances and formulas.e. hot. normal (qi). In the northern Song dynasty a state dispensary was established and compilations of formulas and other medical texts were published under imperial auspices. many of the formulas are loosely constructed. Among the categories were deficiency. and methods of treatment more practical. and Yuan Dynasties (10th to 14th Centuries) This was a period during which all aspects of Chinese culture were both catalogued and reexamined. or deficient) and location (organ. heat. They base decisions on their feelings and use many medicinal substances. was representative of the ferment in medicine that occurred during the Jin-Tartar and Yuan dynasties. One aspect of reform. Chen's system of categorization later came to be known as the ten types of formulas (shi ji) (see p. This book contains 16. For example. excess. T h e early Tang-dynasty physician. qi. and in part because a certain level of knowledge was presumed of the readers. under each disorder there are as many as 20 formulas listed. Each school emphasized a particular etiology of disease and its corresponding strategy of treatment.834 entries. Song. especially the latter two because of their bias toward tonification. they contain too many herbs. In part this is due to the fact that they are compilations. excessive. During the latter part of the twelfth century an attempt was made to correct this tendency by devising schemes that would help make disease processes more understandable. cold.A Brief History of Herbal Formulas in China 5 tai bi yao). In a similar vein. Due to developments in medical theory. A l l of these works are notable for the sheer volume of formulas they contain. this period was one in which the theories and achievements of the past were built upon and further refined. These were the cooling school (hcin licing phi) of Liu Yuan-Su. Wang categorized the formulas according to the type of disorder they were designed to treat. Chen Yan in Discussion of Illnesses.. centered around four great figures of medicine. externally-generated. During this time several schools of thought emerged. i. three to Zhang Cong-Zheng. Six of these formulas are included in our text. 12). Imperial Grace Formulary of the Tai Ping Era (Tai ping h i min hejijufang). the earth-tonifying school (bii tii phi) of Li Ao. the purging school (gong xi. Moreover. This was first done by the eighth-century author. Chen Cang-Qi. phi) of Zhang Cong-Zheng. and the relative lack of discrimination. Jin. T h e plethora of formulas for different complaints had a tendency to stretch or even break the connection between the formulas and the theoretical understanding of the conditions for which they were indicated. internal. without any indication as to which of them is most effective in a particular situation. was compiled between 982 and 992. The idea that differentiation of the pattern requires that the nature (cold. or blood) of the disease be ascertained became firmly established as the . The most famous of these. one of them will stumble upon the rabbit. Treating like this is really negligent. For example. and the yin-enriching school (ciyin phi) of Zhu Zhen-Heng. yet still grounded in theory. This shift toward a more rational understanding of herbal therapeutics in general. The lack of diagnostic information in these books also encouraged the practice of overly symptomatic treatment. Patterns. It also led to some confusion as more than one formula often shared the same name. nor do they recognize the origins of disease. which is based on previously-published Chinese works as well as some foreign texts. which did not really pick up steam until much later. Each of these schools made a significant contribution to the literature on formulas. and external. Kou ZongShi devised a system of categories called the eight essentials (bii yho) into which the various aspects and stages of disease could be placed. This consisted of refining and simplifying the theoretical understanding of disease and its treatment.'?) Measures to rectify this situation were already beginning to occur during this time. The compilation of formularies containing great numbers of formulas did have some adverse sideeffects. Many other formulas were devised by disciples of these schools.

Suffice to say that both of these schools of practice have their strong and weak points. One of the important figures of this era was Wang Ken-Tang.6 Introduction They believed that these diseases were not due to injury from cold (shiing hdn). Until the Ming dynasty. expanded on Ye's work by developing the three-burner system of diagnosis. Fifteen of the formulas in our book are derived from this text. Some of these diseases were similar to those described in the Discussion of Cold-induced Disorders. Over one-third of the formulas in our book were devised during this period in history. Twenty-four formulas from the latter text are included in our book. 'Classical' refers to the formulas in the books of Zhang Zhongjing. in which he organized and classified the information from the Yellow Emperor's Inner Classic. they say. externally-contracted diseases were treated according to the theories and formulas set forth in the Discussion of Cold-inducedDisorders. Zhang's contributions are discussed at greater length below. Although the term warm disease (wen bing) dates back to the Discussion of Cold-induced Disorders. Not only will such formulas fail to help patients. and the Collected Treatises of [ZhangjJing-Yue Wing yue pan shu). Although these formulas may be popular with the average practitioner. are included in ours. or to tell whether the effect is the result of the formula as a whole. Another very important figure was the early seventeenth-century physician. the books he wrote about materia medica and formulas became favorites among clinicians for their easily-applied knowledge and systems of classification. Y e developed the four-level system of differentiating disease. The impact of these developments on the practice of traditional Chinese medicine in modern times cannot be overstated. He wrote two books: the Classijied Classic. Systematic Diflerentiation of Warm Diseases (Wen bing tiao bian). Most of the works discussed in the following section which detail the relationship between strategies and formulas date from this period. Unfortunately. and is doomed to failure. the Discussion of Cold-induced Disorders and Essentials from the Golden Cabinet. that book does not discuss its treatment. During the Ming dynasty many epidemics swept through China. but rather to a special form of heat which they called warmth (wen). these formulas will be effective. This led many practitioners to develop new concepts and formulas to deal with these new diseases. This book contains rather detailed differentiations of patterns. Thirty-five formulas from his book. Trying to force modern diseases to fit the pattern of ancient ones is like trying to fit round pegs in square holes. In Standards of Patterns and Treatments (Zheng zhi zhun sheng). We cannot basis of treatment in traditional Chinese medicine. Y e Tian-Shi. With so many ingredients it is difficult to distinguish the effect of any one. Practitioners of the latter-day school reply that diseases and clinical standards have changed during the seventeen centuries since the Discussion of Cold-induced Disorders was written. The ferment and reexamination of the medical tradition that occurred during the Qing dynasty led to the formation of two broad schools of thought: the classical formula Ging fiing) school and the latter-day formula (shi fiing) school. which were recorded by his students. the formulas prescribed in that book for most of these diseases were ineffective. and particularly those developed by practitioners of the warm-febrile disease school. they are not very effective in treating a patient who is really sick. is another individual who had a strong influence on the course of traditional Chinese medicine. Partisans of the classical formula school believe that the formulas of Zhang Zhong-Jing are more focused in their effect because they contain fewer ingredients. Because these new concepts formed the nucleus for a school of practice. By this they mean that such formulas consist of too many ingredients. Fifteen formulas from his Analytic Collection of Medical Formulas (Yi fangjijie) can be found in our book. Perhaps the most important development in traditional Chinese medicine during the Qing dynasty was the appearance of the warm-febrile disease school. Wang's writings emphasized the relationship between medicinal substances and the organs and channels. and that the dosage of each ingredient is too small. While not a practitioner himself. Zhang Jing-Yue. They criticize the latter-day formulas for being complicated and disorganized. who lived in the late sixteenth and early seventeenth centuries. . but others were quite different. The late eighteenth-century physician. Wang Ang. The most important exponent of this new school of practice was the early eighteenth-century physician. it became known as the warm-febrile disease school. which covers all aspects of internal medicine. had a major impact on the treatment of externally-contracted disorders. Zhang was a representative of the earthtonifying school and was a great force in compiling and integrating the knowledge of previous ages. as do the major categorization schemes for the formulas. The late seventeenth-century author. The treatment principle is likewise based on these findings. As long as the diagnosis is correct. Wang developed a synthesis of the approaches of the various schools by utilizing concepts from both the Yellow Emperor's Inner C h i c and the Discussion of Cold-induced Disorders. 'Latter-day' refers to formulas which were devised from the Song dynasty onward. and lacking any clear methodology. they may actually cause them serious harm. each with a relatively large dosage. and his teachings. Wu Ju-Tong.

Relationship o f Formulas to Strategies 7 get caught up in worshipping the past.. a formula used for clearing heat from the qi level. and a flooding. in acute conditions such as this the focus of treatment is clearly on the . and any secondary complications are the manifestation. With respect to the location of a disease the internal aspect is the root." Principles of Treatment Before discussing strategies that are specific to Chinese herbal medicine. such as the utilization of different ingredients. he could misdiagnose the pattern as a yang brightness channelstage disorder and prescribe White Tiger Decoction (bai hu tang). the thirst is for warm beverages. In such cases the symptoms will disappear only when the root cause has been effectively treated. the etiology and pathogenesis of disease).e. These principles in turn are based on a certain understanding of how people get sick (i. thirst. primary disorder is the root. the condition will not improve and may even worsen. and its presentation (symptoms) is the manifestation. treatment must both direct the rebellious qi downward (manifestation) and restore the Kidneys' ability to grasp the qi (root). Both types of formulas need to be understood if one is to practice effectively. However. The latter-day formulas represent an advance in some areas. If the pattern of a disorder is misdiagnosed. There are many examples of this approach. the most common of which occur in cases wherein the constitution of the patient is weak and the pathogenic influence is strong. A formula is comprised of medicinal substances. the treatment strategy will be incorrect. it is important to distinguish the root from the manifestation of a disease so that treatment can be directed accordingly and fine tuned to the precise needs of the patient at a particular time. If the practitioner ignores the fact that the fever is low. Clinically. The following distinctions are useful in making this determination: The strength of the patient's normal qi is the root. which tonifies the qi in order to augment the blood. Root and Manifestation of Disease To maximize the benefit of a treatment and minimize its side-effects it is very important to determine which aspects of a disorder in a particular patient are most significant. During the course of a disease the underlying. In such cases the treatment strategy is a bit more complex. Examples include acute bleeding or vomiting where it is vitally important to promptly alleviate the symptoms irrespective of their cause. The classical formulas show us how much can be done with elegantly formed prescriptions that are honed for a specific condition. No matter how cleverly the formula is modified. yet we need to understand it and to be open-minded about applying knowledge from all sources. "The formula is derived from the strategy. and the pulse is also deficient. Similarly. RELATIONSHIP OF FORMULAS TO STRATEGIES As previously noted. For chronic disorders treat the root. the results will be disappointing because the patient is really suffering from consumptive fatigue. it is a relatively rare case where treatment is directed only at the root without regard to the symptoms. although both the root and manifestation are treated simultaneously. The basic rules governing treatment of the root and manifestation are as follows: For acute disorders treat the manifestation. In such cases. the particular configuration of which is dictated by the organizing principles of the treatment strategy. In traditional Chinese medicine this is known as distinguishingthe manifestations (biio) of a disorder from its root cause (bin). Examples include lower back pain due to Kidney deficiency. a red face. irritability. a patient presents with fever. formulas. the formula chosen must be consistent with the strategy of treatment. and edema due to yang deficiency. and the strategy arises from the pattern. the practice of traditional Chinese herbal medicine consists of theory. big pulse. and its derivative formula will be ineffective. To be successful. an appropriate formula would be Tangkuei Decoction to Tonify the Blood (dang gui bu xue tang). It is helpful to remember the adage. The etiology (cause) of a disease is the root. the focus of treatment is still on one or the other aspect. and the recognition of new methods for dealing with new diseases. and substances. which is shared by other therapeutic modalities in traditional Chinese medicine such as acupuncture. The manifestation is also the focus of treatment for a recently-contracted acute disorder in a patient with an underlying chronic condition. and the strength of the pathogenic influence is the manifestation. we should review some of the fundamental principles of treatment in Chinese medicine as a whole. Simultaneous treatment of the root and manifestation. If it is not. However. For this condition. as discussed below. For example. Take for example the coughing and wheezing associated with cold phlegm obstructing the Lungs in a patient suffering from underlying Kidney deficiency which leads to rebellious qi. and the external aspect is the manifestation. They free us to observe carefully in the clinic with a minimum of preconceptions. strategy.

Depending on the intensity of the heat. The first consists of using a formula whose nature appears to be similar to that of the disease. flushed face. For example. manifestation. but simply represents an apparent departure from the norm of antagonistic treatment. For example. or directly draining the heat from deficiency (manifestation). Thus. More commonly. distention. i. and a faint pulse. one can eliminate the pathogenic influence by tonifying the normal qi. the proper treatment is instituted even if the major symptoms suggest otherwise. i. conversely. this type of obstruction will resolve itself. leakage is treated by stabilizing and binding. it is treated by tonification (which normally causes blockage). for example. as well as the perspective of the practitioner. On further examination. For example. the tongue is pale and swollen. This is known as normal treatment (zh8ng zhi). such strategies would appear to violate the normal principles of treatment. This is known as facilitating flow when the cause is too much flow (tong yin tong ybng). The second type of contrary treatment does not involve false or misleading symptoms. An example is the use of Peony Decoction (shao yao tang) or Aucklandia and Betel Nut Pill (mu xiang bing lan wan) for treating dysenteric diarrhea. whether the nature of the disorder requires that the normal qi (the constitutional strength of the person) be supported. it utilizes strategies and substances that are opposite in nature to the disease. but in fact are indicative of severe deficiency. however. such as pain. which on first glance appear to be due to heat. the diarrhea is treated by purging. occasions when treatment is characterized as being contrary (fin zhi) because it appears to depart from the general rule of direct treatment. however. there is true deficiency and false excess. In this case. and the loss of blood by a strategy that invigorates the blood. the pain responds favorably to warmth and pressure. In this case. stagnation is treated by promoting movement. This approach is known as using blockage when the cause is blockage (scii yin siii ybng). At first glance. rather than the apparent but false symptoms of heat. For example. there are signs of irritability. the patient is actually suffering from cold. This would include. Another aspect of root and manifestation revolves around the most basic strategy of treatment. but when the obstruction is due to deficiency (usually of the Spleen). it is noted that all the symptoms improve when the patient is rested. the presence of distention. and vice versa. see Perillia Fruit Decoction for Directing Qi Downward [su zi jiang qi tang] in chapter 9. restlessness. an appropriate warming formula. one generally stabilizes or binds up diarrhea or loss of blood. However.) Another example is heat from yin deficiency. a stifling sensation. or that the pathogenic influence be eliminated.e. and pain in the abdomen accompanied by irritability. by eliminating the pathogenic influence through a strategy of attack. one generally disperses obstruction. Which strategy treats the root and which the manifestation will depend on the specific presentation of the patient. would be directed at the underlying cold nature of the disorder. and tenesmus. which is called tonification. Although the nature of such formulas would appear to be contrary to the disorders for which they are prescribed. Distinguishing between the root and manifestation in such cases can be problematic. Normal and Contrary Treatment The treatment of disease in traditional Chinese medicine is generally said to be antagonistic to the disease process. this is not the case when the disorders themselves are characterized by false or misleading symptoms. heat is treated with cold. watery diarrhea. and constipation might lead the practitioner to think that the condition is one of excess. Similarly. the type of diarrhea for which AucMandia and Betel Nut Pill (mu xiang bing l m wan) is indicated is marked by various signs of stagnation. when both the normal qi and the pathogenic influence are weak. as in the case of a weak patient who requires purging (see chapter 3). when the leakage is due to retention of a pathogenic influence in the body. which is evidenced by the 'true' signs of cold extremities. such as Cold Extremities Decoction (si ni tang). The patient may present with symptoms that appear to be excessive.e. one can indirectly support the normal qi by allowing it to rest and recuperate. both the root and manifestation are addressed. a warming strategy is appropriate in treating a patient with 'false' . There are. but appearances can be deceiving.. and sometimes a sore throat. when the underlying cause of a disorder is understood. It is therefore entirely 'normal7 to treat this problem with a formula which facilitates flow. which is called attack. As is always the case in traditional Chinese medicine. Contrary treatment in herbal medicine is of two types. however. Thus. In some circumstances a strategy of simultaneous attack and support is required. In fact. (For further discussion of this process.. For example. and the pulse is frail and forceless. the appropriate strategy would either be to focus almost entirely on enriching the yin (root). cold is treated with heat. however. When the deficiency is rectified. prescribing a formula composed primarily of hot ingredients for treating a disorder which is apparently due to heat. or one composed of cold ingredients for treating a disorder apparently due to cold. in the example above. A similar problem arises at the extremes of excess and deficiency.8 Introduction fire and 'true' cold.

Whether defined in traditional terms or as a biomedical entity. it can be used for treating any problem associated with acute damp-heat in the lower burner. Each of these etiologies requires a completely different treatment strategy. The type and dosage of herbs used during the summer.' ' The salient features of each of the eight methods of treatment are summarized below. and thus has had a tremendous influence on traditional Chinese medicine." (Bmic Questions. in a cold climate. the nutritive and protective qi are harmonized. not only might the treatment fail to help the patient. including urogenital disorders. The treatment strategy in turn is based upon the underlying cause of a disease. whenever the same pathogenic mechanisms are involved. and for a weak or debilitated patient should be considerably less potent than those used for treating the same disorder during the winter. and for a strong or robust patient. As Cheng himself observed. Rather it is a sign that tells the practitioner that the pores have opened. and the pathogenic influences (which may include water) have been dispelled. REFERENCE IN INNER CLASSIC: "When it is at [the level of] the skin. Same Treatment for Different Diseases Treatment in traditional Chinese medicine is not disease-oriented. wind-heat. While they are not identical. Although this formula was originally designed for dysenteric disorders. Treating Disease According to the Season. Pulsatilla Decoction (bai tou weng tang) is used for treating acute damp-heat in the lower burner. Otherwise. Traditional Strategies The use of particular strategies or methods of treatment has been an integral part of traditional Chinese medicine for at least two thousand years. dysenteric disorders are variously due to wind-colddamp. Conversely. damp-heat. Likewise. the Qingdynasty physician Cheng Zhong-Ling organized the various strategies into a simplified scheme which he called the eight methods (biifii). The eight methods of treatment serve as the foundation for all current discussion of herbal strategies. the environment in which the patient lives. even though the disease (a dysenteric disorder) is the same. "The eight methods exist in any single method. the treatment will be similar no matter how different the diseases and their symptoms appear to be. For example. Sweating (hiin3ca) MECHANISM: Induces sweating by stimulating and disseminating the Lung qi. Cheng is also credited with giving final form to' the eight parameters of diagnosis (bii giing). chapter 5) APPLICATIONS: externally-contracted exterior excess conditions measles and similar rashes acute edema which is more severe above the waist early-stage pain and swelling from wind-damp skin disorders caused by wind (with itching) diseases which are working their way out from the interior STRATEGIES: acrid and warming to release the exterior acrid and cooling to release the exterior COMBINED STRATEGIES: benefit the qi and release the exterior warm the yang and release the exterior nourish the yin and release the exterior drive out fluids and release the exterior release the exterior and cool the interior COMMENTS: Remember that sweating itself is not the goal of this strategy. it may actually cause further harm. and the particular characteristics of the individual. in a hot climate. or cold of the Kidneys and Spleen from deficiency. This strategy must be combined with tonification if used in treating weak patients. heat toxin. a myriad of methods exist within the eight methods. and Individual The effective practice of Chinese herbal medicine requires more than simply selecting the proper treatment strategy and formula. and while their number is not exhaustive. Like other aspects of traditional medicine in China. 1. Treatment must also be adapted to the time of year. the categorization of the treatment strategies serves as the basis for the categorization of the formulas. Environment. these strategies have undergone considerable change and development during that time. they are the building blocks for other strategies as well. but is strategy-oriented. . use sweating to discharge it. regulating and facilitating the interaction between the nutritive and protective qi so that the pores open and pathogenic influences in the exterior or other superficial levels of the body can be released with the sweat.Relationship of F o r m h to Strategies 9 Different Treatments for the Same Disease. ' In Medical Revelations (Yi xue xin wu). The use of formulas that induce sweating to release an exterior disorder is a good illustration of this problem. For example. the same disease will be treated in different ways depending on the particular pathogenic mechanisms involved.

harmonizing those functions which are at odds with one another. thereby restoring the functions of the yang qi. 6..." (Basic Questions.. fire. half-interior (lesser yang) disorders malarial disorders depression dysmenorrhea epigastric focal distention STRATEGIES: harmonize the lesser yang vent the membrane source harmonize the Liver and Spleen regulate the Stomach and Intestines COMBINED STRATEGIES: harmonize and release harmonize and purge COMMENTS: This is perhaps the most nebulous of the eight methods. REFERENCE IN I N N E R CLASSIC: "Warm that which is cold . chest. REFERENCE IN I N N E R CLASSIC: "When it is at the upper [levels]. For that reason. 2. It is called harmonizing (or mediating) because it doesn't focus solely on attacking or tonifying. 3. but rather on aspects of both. this method is often combined with tonification. chapter 74) APPLICATIONS: phlegm stuck in the throat phlegm accumulating in the chest food stagnating in the Stomach ingestion of poisons STRATEGY induce vomiting to reduce phlegm COMMENTS: This is a strong strategy used for ejecting substantive pathogenic influences from the body. REFERENCE IN I N N E R CLASSIC: "When it is at the lower [levels]. drain internally. and easily injures the Stomach qi (in part because it can be regarded as iatrogenic rebellious Stomach qi).10 Introduction REFERENCE IN I N N E R CLASSIC: none APPLICATIONS: half-exterior. Clearing (qTng3ca) MECHANISM: Clears heat and drains fire to eliminate heat." (Basic Questions. chapter 74) APPLICATIONS: cold in the channels cold attacking the middle burner cold with devastated yang STRATEGIES: warm the channels and disperse cold warm the middle and dispel cold restore and revive the yang COMBINED STRATEGIES: warm the yang and guide out accumulation warm and transform cold-phlegm warm and transform water and dampness COMMENTS: The cold disorders for which warming is appropriate usually have some aspect of deficiency.'' (Basic 4. 5.T reat hot [disorders] with cold. . lead and draw it down. or stomach cavity can be expelled through the mouth.T reat cold [disorders] with warmth. REFERENCE IN I N N E R CLASSIC: "Clear that which is warm . in part because it has become a grab-bag of methods that do not fit anywhere else. Draining Downward (xi2 f i ) MECHANISM: Induces defecation to cleanse the bowels and expels substantive pathogenic influences through the rectum. Harmonizing (he' f i ) MECHANISM: Harmonizes or regulates the functions of different levels or organs. stagnant food. generally of the yang. or toxic matter stuck in the throat.. The inducement of vomiting usually causes sweating.When the middle is full. chapter 74) APPLICATIONS: constipation dried feces in the Intestines hot accumulation cold accumulation water build-up blood build-up STRATEGIES: purge heat accumulation warm the yang and guide out accumulation moisten the Intestines and unblock the bowels drive out excess water COMBINED STRATEGIES: simultaneously purge and tonify invigorate the blood and drain downward COMMENTS: This is a strong strategy used for ejecting substantive pathogenic influences from the body. and their associated toxicity from the body. Vomiting ( t c f i ) MECHANISM: Stimulates the Stomach so that phlegm.." (Basic Questions. It should therefore only be used for treating acute disorders in relatively robust patients.. Warming (wZn f i ) MECHANISM: Warms the interior and unblocks the channels to dispel cold from the interior or the channels. lead it up and out.

they did not describe with particularity all of the strategies that were actually used in practice. Specifically.e. chapter 74) APPLICATIONS: interior heat heat in any organ STRATEGIES: clear heat from the qi level clear the nutritive level and cool the blood clear heat and relieve toxicity clear heat from the organs COMBINED STRATEGIES: clear heat and augment the fluids clear heat and benefit the qi clear heat and enrich the yin COMMENTS: The clearing method is only used for interior heat without any sign of clumping or accumulation. chapter 74) APPLICATIONS: qi stagnation blood stasis food stagnation phlegm parasites abscesses STRATEGIES: eliminate food stagnation reduce accumulation transform phlegm eliminate childhood nutritional impairment kill parasites reduce sores and disperse abscesses COMBINED STRATEGIES: reduce stagnation and drain downward simultaneously reduce and tonify COMMENTS: In contrast to the downward-draining method. the scope of the reducing method was thought to be too broad. and be flexible in selecting the appropriate methods of treatment. writers through the centuries have described the various treatment strategies in different ways. reducing is a gradual reduction of the accumulation or clumping. Even parasites are transformed into something relatively harmless (i. that many disorders are too complex to be effectively treated with one method alone. Although formulas which incorporated these strategies date back to at least the third-century works of Zhang Zhong-Jing. It should be emphasized.. all of the eight methods are commonly used today. yin. 11 7. To be effective in the clinic. With the exception of vomiting. it was not until the Ming and Qing dynasties that they came into full flower. nourishing. all of these strategies can be incorporated within the broad framework of the eight methods. yin. i. For example. or yang deficiency of any organ STRATEGIES: tonify the qi nourish the blood tonify the yang enrich the yin COMBINED STRATEGIES: tonify the qi." (Basic Questions. These included regulating the qi.. Reducing ( x i z o f i ) MECHANISM: Gradually reduces or eliminates clumping or accumulation due to the stagnation of food or other causes. chapter 74) APPLICATIONS: deficiency of qi. 8. Wang Qing-Ren's Correction of Errors among Physicians (Yi lin gai cuo) was the first book which clearly articulated the manifold uses of invigorating the blood. and release the exterior support the normal and purge enrich the yin and moisten dryness tonify the qi and invigorate the blood COMMENTS: Generally speaking. and other dispersing strategies were therefore added to amplify this category. and expelling phlegm. blood. augmenting. or even four methods are used concurrently. regulating the blood. and downward-draining methods would be appropriate. however. blood. Nonetheless.Disperse that which is clumped. one should avoid using this method by itself in treating disorders with an active pathogenic influence as this may aggravate the disorder. In this case.. Tonifying (bii $5) MECHANISM: Tonifies by enriching.. REFERENCE IN I N N E R CLASSIC: "Pare away that which is firm . Although the eight methods of treatment were broad enough. the practitioner must carefully discern the underlying mechanism of a disorder. the concurrent use of tonifying. for 'formless' heat.Relationship o f Formulas to Strakggies Questions. three. REFERENCE IN I N N E R CLASSIC: "Tonify that which is deficient. reducing." (Basic Questions. As previously noted. Take the case of a patient whose long-standing deficiency leads to stagnation and eventually to acute accumulation. . eliminating dampness. and also involves transformation instead of just expulsion. chapter 20) "Augment that which is injured.e. killed) before they are eliminated from the body. or yang." (Basic Questions. or replenishing those aspects of the body that are weak or deficient. Sometimes two.

there is some discussion about the types of formulas in chapter 74 of Basic Qmtions. For example. the location and progression of the disease. There are systems based upon the nature of the disease. most formularies settled on around twenty categories. those for treating summerheat. Materia Medica ofthe Da Guan Era Classified and Trerifiedfromthe Classics and Histories Uing shi zheng lei da guan ben cao). promoting." In Clarification of the Theory of Cold-induced Disorders (Shang han ming li lun) the twelfth-century author. and the need for treatment. pacifying. warming. Such . Cheng Wu-Ji. form of application. in one passage it says that there are many substances in a large formula. For example.) This is the first system to group the medicinal substances and formulas by functional categories tied to specific types of clinical presentations. Kou Zong-Shi. cooling." Other passages in this chapter describe the nature of the formulas: "Tonifying the upper to treat the upper [part of the body] requires a slow-acting or mild ( f i n ) formula. TEN TYPES OF FORMULAS FORMULAS THAT disseminate (xu* unblock @ng) tonify (bii) drain (x2) clear (qing) weigh down (zMng) bind (sk) lubricate ( M ) dry (zho) moisten (shi) ELIMINATE: clogging stagnation weakness obstruction excess anxiety abandoned disorders sticky retentions in the body dampness dryness Because the ten categories did not fully account for the variety of formulas used in the clinic. (This table is based on a description from the early twelfth-century work. even-numbered.. Furthermore. treatment strategy (now the most widely used). other categories were added later. as well as various combinations of these systems. It is true that this book alludes to many different aspects of disease. One chief. the constitutional strength of the patient. such as Formulasfor Fifty-Two Ailments (Wu shi er bing fang) and most of the works recorded in the second-century Book ofthe Han (Han shu).. organ. which are listed together with their functions in the table below. and provided instructions for the use of each category. that portion which described the ten categories was preserved in Li Shi-Zhen's Systematic Materia Medica (Ben cao gang mu). releasing. In Extension of the Materia Medica (Ben cao yan yi) the Song-dynasty writer. mild. bland. and nine assistants comprise a large formula .. After this time.Cheng Wu-Ji referred to these categories as the ten types of formulas (shiji). But while each of these aspects is important. In the earliest books. small. odd-numbered. Although the Yellow Emperor's Inner Classic does not focus on herbal medicine. the formulas were arranged according to disease. Xu Zhi-Cai. a careful examination of the passages from Basic Questions upon which this system is based reveals some problems. including the strength of the pathogenic influence." Thus. For example. mild. some of the instructions seem to have no rational basis whatsoever. calming. to drain downward do not use an odd-numbered [formula]. This is considered to be the earliest system for classifying the formulas. and many in a small. This practice was continued for a long time. added heating and cooling. those for treating fire. they are not presented in a manner which is either comprehensive or directly related to a particular type of formula. Liao Zhong-Chun added ascending and descending. This discussion revolves primarily around the number of substances in the formulas. The forerunner of the classification system that has been used for the past few hundred years was devised by the Tang-dynasty author. (It was mistakenly attributed by Li Shi-Zhen to the sixth-century physician. and composite types. tonifying the lower to treat the lower [part of the body] requires a quick-acting or urgent (ji) formula. While the book itself was subsequently lost.. yet in another passage it says that there are few substances in a large formula. and clearing. Two chiefs and four deputies comprise an even-numbered formula . Chen Cang-Qi. while these passages from Basic Questions could conceivably be used as a basis for classifying the formulas. There is also some inconsistency in the number of substances which the formulas should contain.. "One chief and two deputies comprise a small formula . devised a system based in part upon these passages which he called the seven types of formulas (qifing): large. branch of medicine. urgent. guiding. However. pattern. Another fourteen categories were added by Xu Si-Huo in his Complete Book ofMedicine (Yi xue quan shu): regulating. In the Ming dynasty. Chen organized the substances and formulas into ten categories. they are not well-suited for this purpose. etiology. harmonizing. three deputies. Two chiefs and three deputies comprise an odd-numbered formula. "To induce sweating do not use an even-numbered [formula]..Introduction Categorization of the Formulas Over the course of the past two thousand years the Chinese have devised a variety of systems for classifying the combinations of medicinal substances that we call formulas. and few in a small.

Relationship of Formulas to Strategies 13 important works as Imperial Grace Formulary of the Tai Ping Era (Tai ping hui min hejijufang). What was needed was a system that was easy to learn. stabilize (gh). Like Zhang Jing-Yue. Although this system has undergone some modification. with a few modifications. the most common categories were those dealing with diseases of women and children. heat (r?). This occurred as early as the Book of the Han. Zhang's background was in the military. and that placed similar formulas within the same category for comparison. He observed that in older books where the formulas were arranged by disease. and he had a very organized mind. and all systems based upon it (including that used in this book) involve some inconsistency. disperse (siin). Classifying the formulas according to their underlying actions or strategies is such a method. Where the formulas were arranged according to a branch of medicine.516 ancient and 186 contemporary formulas under the headings of tonify (bii). and external medicine (391 formulas). Even this method is not perfect. and most of the books ended up using a mixture of systems. another comprehensive classification scheme was devised by Wang Ang. the order in which the categories are presented varies from book to book. Wang's system also combined categories based on the actions or treatment strategies underlying the formulas with other categories that focus on specific branches of medicine. The formularies used in contemporary China list around twenty major categories. Fcnmhs of Universal Benefit from My Practice (Pu ji ben shi fang). it would often be difficult to find the formula. If each formula was listed under every disease it could treat. the books usually differ in only a few categories. which he called the eight battle arrays (bii zhin). hui) (chi than) (xiiio ddo) (shou si) (shii chdng) (ming mh) b L % yhng) Ging chiin) Gih ji) This book had a major influence on subsequent formularies. This is because most formulas can be used for treating a variety of diseases. even Zhang was unable to completely dispense with the previous systems. and patternspecific bin). A variation on the ten types of formulas. In general. and Investigations of Medical Formulas (Yifang h) adopted this system. cool (hhn). In the Collected Treatises of [Zhang]Jing-Yue Uing yue quan shu). it was often difficult to find a particular formula.) (@ Fng) (qii hhn) (qing shii) (li shi) (rin zho) (xi. However. Zhang sought to resolve this problem by organizing the formulas into eight categories. Although there is no officially-sanctioned standardization. In Analytic Collection of Medical Formulas (Yifang ji jie). The problem of categorizationbecame most acute during the Ming dynasty. and Convenient Reader of Established Formulas (Chengfang bian du) by Zhang BingCheng in the early part of our century. However. The Thousand Ducat Formulas (Qianjinyaofang) and Arcane Essentialsfrom the Imperial Library (Wai tai bi yao) classified the formulas based upon the affected organ. Our book is organized in the same manner. but they lacked a convenient method of finding what they needed. During the early part of the Q h g dynasty. these parallel the categories under which the actions of individual medicinal substances are organized. Physicians had access to more information than ever before. he classified 1. pediatric disorders (171 formulas). Each of these systems was found to be either too complex and unwieldy. Because there are only a handful of formulas for summerheat. if it was only listed under the most important disease. convenient to reference. we have placed these . harmonize (hi). however. Wang divided the formulas into the following twenty-two categories: tonify and nourish disperse the exterior induce vomiting attack the interior simultaneous treatment of the exterior and interior harmonize and relieve regulate the qi regulate the blood dispel wind dispel cold clear summerheat resolve dampness moisten dryness drain fire eliminate phlegm eliminate and guide out stagnation preserve and bind kill parasites improve the vision abscesses and sores menstruation and childbirth emergencies (bii yting) ( f biiio) i bing th) (gong 11') (biiio 11') (hi jit') (12' qi) (12' xu. The popularization of books during this era was reflected in the large number of works published in the field of herbal medicine. A representative figure of this era was Zhang Jing-Yue. or overly simplified. attack (ggng). there would be a tremendous amount of repetition. and was the basis for such important works as Practical Formulas (Chengfang qie yong) by Wu Yi-Luo in the late eighteenth century. it still serves as the model for the classification of formulas in modern times. None of these systems was all encompassing. rashes (174 formulas). His book also contains categories for women's disorders (186 formulas). However.

and the assistant and envoy follow. which revolved in the first instance around the emperor and his court. 2 . associate). would lead to Chief (also known as monarch. the combination of Ramulus Cinnamomi Cassiae (gui zhi) and Radix Paeoniae Lactiflorae (bai shao) regulates the relationship between the protective and nutritive qi in treating exterior cold from deficiency. Li Ao. observed in Discussion ofthe Spleen and Stomach (Pi wei lun): "That [ingredient] which treats the primary disorder is called the chief.'' He also noted that "The dosage of the chief herb is the greatest. we believe that this strains the connection between them and have therefore placed them in separate chapters. Additional information about particular treatment strategies is provided in the introduction to each chapter. They are complex recipes of interrelated substances. and has the greatest effect upon. Chinese Herbal Medicine: Materia Medica.e. or mutual incompatibility. however. there is no need for a chapter devoted to this specific category." This was amplified by later practitioners. some books devote a separate chapter to formulas that treat abscesses and sores. One needs an organizing principle to guide the construction so that the ingredients are combined in an optimal fashion. and that which is bound to the deputy is the envoy.. Zhang Yuan-Su. the terms used to signify the importance or rank of the ingredients in a formula reflect those used at court. This combination is an important building block in Cinnamon Twig Decoction (gui zhi tang) and Minor Construct the Middle Decoction (xiao jian zhong tang). adjutant. principal). The concept of hierarchy was first suggested in a passage from chapter 74 of Basic Qwtiom: "That [ingredient] which primarily treats the disease is the chief. The [dosage of the] deputy cannot be allowed to be greater than the chief. The combination of substances in a formula creates a new therapeutic agent that can treat much more effectively and completely than can a single substance.Serves as the main ingredient directed against a coexisting pattern or disease. and envoy (shi)." Traditional Chinese society was always very conscious of rank. This is an essential part of constructing a formula. it also warms and tonifies the middle burner. ruler. assistant (zu. mutual suppression.14 Introduction mutual counteraction. Deputy (also known as minister. It is this complex interaction which makes the formulas so effective. Conversely. We will discuss each of these in turn. When other disorders are present. We have therefore placed it in the chapter with the other formulas that treat phlegm. The reader is referred to the table of contents for the order of chapters in our book.). and it is used for phlegm.Aids the chief ingredient in treating the principal pattern or disease. deputy (chin). the reader should consult a basic textbook of materia medica. One must also become familiar with particular combinations.' The four ranks of ingredients in the hierarchy of a formula are the chief Cjiin). There is really only one principal formula in that category. which can be viewed as the building blocks of the formulas. Hierarchy of Ingredients Constructing an effective formula involves more than simply putting ingredients together to obtain a certain effect. their treatment is divided between the assistant and the envoy. formulas in a subcategory under heat. For this reason. Refers to two different functions: 1 . The ingredient that is directed against. For this type of information. . Every medicinal substance has its strengths and its shortcomings. such as the companion volume to this book. An effective formula is one in which the substances are carefully balanced to accentuate the strengths and reduce the side-effects." Another renowned physician of that period. mutual antagonism. To understand how the substances interact with each other. The orderly arrangement of ingredients in a formula is called a hierarchy. the deputy next. A knowledge of herbal combinations also implies an awareness of when a particular combination would be inappropriate. the principal pattern or disease. king. each of which affects the actions of the others in the formula. that which aids the chief is the deputy. i. This ingredient is absolutely indispensable to the formula. noted that "The [ingredient] with the greatest power is the chief. but also makes them more difficult to study. one must first understand the actions and other characteristics of the individual substances. emperor. In this book we have used slightly different terms to make things a bit clearer and perhaps less 'feudal. For example. a prominent physician of the Jin-Tartar era who had a great influence on the course of Chinese herbal medicine. Finally. Because our book is basically concerned with formulas used in internal medicine. although most sources list formulas that invigorate the blood in the same category with formulas that stop bleeding. COMPOSITION OF THE FORMULAS The formulas in Chinese medicine are not mere collections of medicinal substances in which the actions of one herb are simply added to those of another in a cumulative fashion. Some texts also have a separate chapter for formulas that induce vomiting.

The assistant ingredient. and envoys. Refers to two different functions: 1 . wheezing. a particularly strong diaphoretic that also disseminates the Lung qi and treats wheezing. This is known as a corrective assistant (zuo' zhi). This disorder affects the Lungs and outer layer of the body. conductant).Harmonizes and integrates the actions of the other ingredients. One of the deputies is Ramulus Cinnamomi Cassiae (gui zhi). Sometimes the chief ingredient focuses on the level and location of the disorder. a thin. An example is Cinnamon Twig. the position of an ingredient in the hierarchy will vary depending on the particular circumstances for which the formula is used. head and body aches. There has been . Cortex Moutan Radicis (mu dun pi). Peony. and a floating. This is known as an opposing assistant (zuo'fiin). there is no need in this formula for an envoy to guide the actions of the ingredients toward the locus of the disorder.Diseases (Wen bing tiao bian) called Artemisia Annua and Soft-shelledTurtle Shell Decoction (qing hao bie jia tang). 2 . An example is Four-Substance Decoction (si wu tang) in which the relative dosage of the ingredients varies depending on whether its tonifying or invigorating actions are emphasized. which enriches the yin and thereby reduces the fever from deficiency. The only proper course of treatment is to simultaneously nourish the yin and vent the heat. Because both Herba Ephedrae (ma huang) and Semen Pruni Armeniacae (xing ren) enter the Lungs. It assists the chief ingredient in treating one of the secondary symptoms. ingredients are accorded equal status. or even the condition for which the formula is indicated. Refers to three different functions: 1-Reinforces the effect of the chief or deputy ingredients. wheezing. Many formulas consist of only a chief and one or two deputy ingredients. The other deputy. which enriches the yin. This tells us that while both of the chief ingredients are indispensable. This formula is indicated for a condition of heat from deficiency where the heat has settled in the body. there is no need for corrective assistants. It serves as a corrective assistant by moderating the diaphoretic actions of the chief and deputy ingredients. This formula is used for externally-contracted windcold which leads to an exterior excessive cold presentation characterized by chills. or directly treats a less important aspect of the pattern or disease. white tongue coating. Radix Rehmanniae Glutinosae (sheng di hung) and Radix Anemarrhenae Asphodeloidis (zhi mu).Composition of the Formulas 15 Assistant (also known as adjutant). Honey-fried Radix Glycyrrhizae Uralensis (zhi gan cao) harmonizes the actions of the other herbs. If the chief and deputies are not toxic. This potent herb directly attacks the disorder. cold Carapax Amydae Sinensis (biejia). Envoy (also known as messenger.Has an effect that is opposite that of the chief ingredient and is used in very serious and complex disorders. the actions of Carapax Arnydae Sinensis (biejia). Such disagreement arises from different understandings of the underlying mechanism of the formula. The classic example of how the hierarchy of ingredients works in a formula is Ephedra Decoction (ma huang tang) from the Discussion of Cold-induced Disorders. The deputy ingredients. In practice. One of the chief ingredients is salty. obviating the need for an envoy. not quite so classic example is a formula from the Systematic Difjerentiation of Warm. the hierarchy of ingredients is not always so clear-cut. There are two chief ingredients in this formula because both of their actions are indispensable in treating the disorder. That this ingredient is regarded as an assistant means that its actions are less important than those of the deputies. for several of the formulas in our book there has been intense debate over the centuries regarding which of the herbs is the chief ingredient. another diaphoretic that releases the exterior (especially the muscle layer) and warms and facilitates the flow of qi in the channels. unblocks the flow of Lung qi. assistants. it would be quite unusual for a formula to include all the various types of deputies. or moderates their harsh properties. tight pulse. Because the chief ingredients focus directly on the diseased aspect of the body. In this capacity. The other chief ingredient is aromatic Herba Artemisiae Annuae (qing hao).Moderates or eliminates the toxicity of the chief or deputy . guide. 3 . assist in nourishing the yin and thereby clearing the heat from deficiency. Examples are FiveHerb Decoction to Eliminate Toxin (wu wei xiao duyin) and Five-Peel Powder (wu pi san) in which all of the . It assists the chief ingredient in releasing the exterior. and helps the chief and first deputy expel the pathogenic influences. In addition. are of primary importance. While all formulas require a chief ingredient. it is known as a helpful assistant (zuo' zhh). Another. Semen Pruni Armeniacae (xing ren). and Anemarrhena Decoction (gui zhi shao yao zhi mu tang). fever. 2 . The chief ingredient is warm. Not all formulas contain the full hierarchy of ingredients. ingredients.Focuses the actions of the formula on a certain channel or area of the body. acrid Herba Ephedrae (ma huang). In fact. drains heat from the blood and assists Herba Artemisiae Annuae (qing hao) in venting the heat from the body. which vents the heat through the yang or external aspects of the body. sometimes the formula is so well-balanced that it is difficult to distinguish the function served by each of its constituent ingredients. In other cases. there is no need in this formula for an envoy. an absence of sweating.

However. because the dosage of these ingredients in the two formulas is different. strong disagreement about whether the formula was intended primarily for hot or cold disorders. both Minor Order the Qi Decoction (xiao cheng qi tang) and ThreeSubstance Decoction with Magnolia Bark (hou $0 san wu tang) are composed of Radix et Rhizoma Rhei (da huang). which is used for a condition in which the yang is deficient and the yin is ascendant with internal cold. or the means of adrninistration. However. the strength of a formula and even its indications may be altered. An example is Ligusticum Chuanxiong Powder to be Taken with Green Tea (chuan xiong cha tiao san). the reader should note that most of the formulas used as examples are Modification of the Dosage By modifying the dosage of ingredients. In some cases the modification may be significant enough to warrant consideration as a different formula. by doubling its dosage the modified formula can be used in treating the same presentation for which Cinnamon Twig Decoction (gui zhi tang) is indicated. Both formulas contain 6g of honey-fried Radix Glycyrrhizae Uralensis (zhi gan cao) together with Radix Aconiti Carmichaeli (shengfu zi) and Rhizoma Zingiberis Officinalis (gan jiang). Because one of this herb's major functions is to alleviate abdominal pain. This formula is identical to Cinnamon Twig Decoction (gui zhi tang) except that the dosage of Radix Paeoniae (shao yao) has been doubled. Cornu Rhinoceri (xijiao). If 9g of the first and 18g of the second is used in a particular formula. An example in which modifying the dosage affects the strength of a formula is reflected in the difference between Frigid Extremities Decoction (si ni tang) and Unblock the Pulse Decoction for Frigid Extremities (tong mai si ni san). the method of preparation.16 Introduction f Cold-induced Disorders. is much less in absolute terms than the other ingredients because of its potency. This ability to modify a formula to fit a particular patient at a particular time is what distinguishes the very good practitioner from the mediocre. with the addition of abdominal fullness and pain. the dosage of the latter two ingredients is less in Frigid Extremities Decoction (si ni tang). An example is Clear the Nutritive Level Decoction (qing ying tang) where the dosage of the chief ingredient. and other environmental factors. It also requires considerable flexibility in tailoring the formula to fit the specific needs of the patient. Sometimes this occurs because of different interpretations of the underlying mechanism of the formula. Modification of the Ingredients This is the most common type of modification. On the other hand. the strength of the patient. In other cases. the relative dosage of the first would be greater than the second. and that formula is accordingly used for the more severe condition in which the yang has separated from the yin. The dosage of the individual ingredients in a formula also plays a part in determining the hierarchy. and Fructus Immaturus Citri Aurantii (zhi shi). and that of the second is 18-24g. Many commentators designate the herb with the largest dosage. Rhizoma Atractylodis Macrocephalae (bai zhu). Modifying the relative dosage of the ingredients can also have a more radical effect on a formula by changing its entire therapeutic scope. but this refers to its dosage relative to its own normal dosage. Cinnamon Twig Decoction plus Peony (gui zhi jia shao yao tang) is an example of modifying the dosage of an herb to alter the scope of a formula's indications. and thus the hierarchy of its ingredients. It is often said that the chief ingredient must have the largest dosage. climate. As a result. Modifications in Composition The art of constructing a formula requires more than a good grasp of the hierarchical principles discussed above. Herba Menthae Haplocalycis (bo he). An example is the herb Radix Platycodi Grandiflori (jie geng) in Five-Accumulation Powder (wu ji san). In the discussion which follows. this too can be problematic. yet it conveys an . and it would therefore more likely be the chief ingredient. "Formulas are composed of medicinal substances" is a simple truism. one of the individual deputy or assistant ingredients may nonetheless have the largest single dosage. both the indications of the formulas and the hierarchy of their ingredients are quite different (see table on following page). The adage. Cortex Magnoliae Officinalis (hou Po). This drawn from the Discussion o is a reflection of the tremendous influence which this book has exerted on traditional Chinese medicine. Take for example two herbs for which the normal dosage of the first is 3-6g. although the chief ingredients as a group may dominate the formula. Ramulus Cinnamomi Cassiae (gui zhi). Radix Anemarrhenae Asphodeloidis (zhi mu). For example. Adjustments must be made for changes in the pattern. However. the season. there are a few formulas where the dosage of the ingredient generally considered to be the chief is less than that of other ingredients in the formula. as a deputy. Herba Ephedrae (ma huang). The dosage of these ingredients in Unblock the Pulse Decoction for Frigid Extremities (tong mai si ni san) is approximately twice as much. and Radix Lateralis Aconiti Carmichaeli Praeparata (fu zi) has each been identified as the chief herb in the formula. This may involve altering the selection of herbs or their relative dosage.

and actions are completely different. a floating and moderate pulse). One of the best examples is the transformation . For example. but also presents with wheezing. hot Cortex Cinnamomi Cassiae (rou gui) which warms the yang. Radix Paeoniae Lactiflorae (bai shao). hierarchy. vomiting. For example. the primary signs and symptoms of the disorder would persist. warm Fructus Evodiae Rutaecarpae (wu zhu yu) which directs rebellious qi downward. one changes the actions of the formula.Composition of the F o r m h - 17 EFFECTS OF MODIFYING THE RELATIVE DOSAGE OF INGREDIENTS FORMULA: Minor Order the Qi Decoction (xiao chenp. an 'old-looking' (dirty and dry). if a patient with a Cinnamon Twig Decoction (gui zhi tang) presentation also has marked nasal congestion. 12g DEPUTY Fructus Immaturus Citri Aurantii. rapid pulse Three-Substance Decoction with Magnolia Bark (hou t o san wu tang) Cortex Magnoliae Officinalis. 6g INDICATIONS: Relatively mild yang brightness organ-stage disorder (heat clumping) with tidal fever. The third type of modification occurs when an alteration in the ingredients (sometimes only one ingredient) changes the formula so fundamentally that its character. yellow tongue coating. This type of modification can also take the form of subtracting an ingredient. focal distention and abdominal fullness. When one changes the ingredients. In the second type of modification. if Rhizoma Coptidis (huang lian) is combined with acrid. however. this type of modification does not change the name of the formula. 3 pieces ASSISTANT/ENVOY Cortex Magnoliae Officinalis. Finally. and a slippery. sweating. would be omitted from the formula. if a patient presents with symptoms for which Cinnamon Twig Decoction (gui zhi tang) is indicated (aversion to drafts. then Cortex Magnoliae Officinalis (hou $0) and Semen Pruni Armeniacae (xing ren) would be added. If this herb is combined with acrid. and is therefore used for dysenteric disorders due to damp-heat. but all or most of the other ingredients are changed so that the action of the formula is also changed. In this case. Most of the modifications and variations listed in our text are of this type. which is a slightly cool and sour substance. Radix Ledebouriellae Divaricatae (fang feng) and Flos Magnoliae (xin yi h a ) would be added without changing the name of the formula. The first type occurs when the chief ingredient in the formula and the formula's primary action do not change. It is used for constrained fire in the Liver channel with nausea. 12g Q stagnation causing constipation and unremitting pain and fullness in the epigastrium and abdomen important message. abdominal pain that does not increase with pressure. but would now be accompanied by an irregular pulse and fullness in the chest. This formula clears and drains fire from the Liver. if a patient with a Cinnamon Twig Decoction (gui zhi tang) presentation was improperly treated by purging. fever. and thereby stops vomiting. This formula clears and dries dampheat and promotes the movement of qi. 5 pieces Radix et Rhizoma Rhei. but minor ingredients are added or subtracted to fine tune the formula for a specific condition. if it is combined with Radix Aucklandiae Lappae (mu xiang) which promotes the movement of qi. Usually. Take for example the twoingredient formulas in which Rhizoma Coptidis (huang lian) is the chief ingredient. rather than adding one. headache. 24g Fructus Immaturus Citri Aurantii. the result is Grand Communication Pill (jiao tai wan). This formula opens up communication between the Heart and Kidneys and is used for persistent palpitations and insomnia due to lack of communication between the Heart and Kidneys. The formulas are effective in treating disease precisely because of the nature and composition of their ingredients. because the yang qi has been injured. the result is Left Metal Pill (zuojin wan). On the other hand. qi tang) CHIEF: Radix et Rhizoma Rhei. and hypochondrial pain and distention. For example. There are three types of ingredient modifications. In this case. constipation. the result is Aucklandia and Coptis Pill (xiang lian wan). the chief ingredient remains the same. another formula is created which is called Cinnamon Twig Decoction plus Magnolia Bark and Apricot Kernel (gui zhi jia hou Po xing zi tang).

and usually badtasting. Powders (Gn ji) The ingredients are ground up and sifted into a relatively uniform powder. The development of new types of formulations has continued down to the present day.. It is therefore administered as a decoction for relatively acute problems. which is indicated for cold in the exterior. the end of the practitioner's responsibility. Powders can be finely or coarsely ground. followed by a liquid. the dosage of Herba Ephedra (ma huang) and honey-fried Radix Glycyrrhizae Uralensis (zhi gan cao) is increased. In this section we will discuss the more common types of formulations and their applications in the clinic. and Licorice Decoction (ma xing shi gan tang). which is indicated for spasmodic pain in the abdomen due to consumptive deficiency. or as a draft (zhii sin). In addition. however. difficult to prepare. The form of administration is an important factor in the practice of traditional Chinese herbal medicine in the West. which is indicated for heat in the Lungs. It is difficult. Taking a powder as a draft means to boil the powder for a short time in a relatively small amount of water (usually one to oneand-a-half cups). Types of Formulations Over the course of the past two thousand years medical practitioners in East Asia have developed many different types of formulations to administer herbal medicine to their patients. Decoctions @Zingji) The ingredients are placed in water. its effects are strong and immediately perceived by the patient. One of the primary advantages of a decoction is that it is rapidly absorbed by the body. and then boiled for a specified period of time. Such practical aspects must be carefully handled.In this transformation. while that of Semen Pruni Armeniacae (xing ren) is reduced. such as chronic epigastric pain. we can still practice effectively. and lower cost. perhaps more than in any other aspect of traditional Chinese medicine. For example. ability to store for long periods of time. that the influence of modern technology has been felt. The advantages of powders versus decoctions include convenience in preparation. to persuade many of our patients to use decoctions. which in turn are stronger than pills. or a mixture of wine and water. If. Decoctions usually have a stronger effect than drafts. The liquid is strained from the dregs and ingested through the mouth. Gypsum. The preparation and administration of decoctions is discussed in the following section. it is easy to modify the formulation to fit a particular patient at a given time. Compared with pills and other forms of prepared medicines. for example. or as a means of reviving a patient from a coma (e. In fact it is here. They can also be blown into the nose or throat for treating localized disorders. and we must therefore resort to other forms such as powders a. As long as we are aware of the types of problems that truly require a particular form of administration. the wrong form of medicine is used or the patient does not prepare the formula correctly or simply refuses . This problem is discussed at greater length in the following section. of Ephedra Decoction (ma hang tang). . it is indicated for a disorder without a trace of exterior symptoms. timeconsuming. without drawbacks: decoctions are relatively expensive. Another example is the addition of maltose (yi tang) to Cinnamon Twig Decoction plus Peony (gui zhi jia shaoyao tang). Until recently. powders are relatively easy to prepare and can be formulated PRACTICAL ASPECTS Understanding the pattern of disharmony and prescribing an appropriate formula is not. How to administer the medicine in the most effective manner is also an important consideration. as modern formulations and means of extraction are now used on a wide scale. Gypsum (shi gao) is substituted for Ramulus Cinnamomi Cassiae (gui zhi) as the deputy ingredient. these advantages have made decoctions the preferred method of dispensing Chinese herbal medicine. even the most skillful practitioner will not obtain good clinical results. such as oral sores due to cold in the middle burner. if not impossible.nd prepared medicines. when taken as a pill. If the same herbs are taken as a decoction. particularly when it is a long-term problem. Matching the appropriate type of formulation to the patient and disease is an important aspect of good practice. however. Open the Gate Powder [tong gum san]). Because one of the chief herbs in this formula is the tonic maltose (yi tang).g. the effect is much stronger and more immediate. Powders can be applied externally for treating skin conditions. Modification of the Form of Administration The form in which a formula is administered is also of some consequence. Regulate the Middle Pill (li zhong wan) is used for treating cold from deficiency of the Spleen and Stomach. Apricot Kernel. then either ingested or applied externally. unfortunately. and ingesting the liquid that is strained from the dregs. They can be taken directly.18 Introduction to take it. It is not. into Ephedra. In addition. This addition forms Minor Construct the Middle Decoction (xiao jian zhong tang).

and are the most common type of prepared medicine from China. usually starch or the dried and powdered dregs from the decoction. and finally cooking with the addition of honey or sugar to make into a syrup or gel-like extract. Usually l g of an extract contains the active ingredients of 2-5g of a normal ingredient. These are easy to take. such as those used in Vessel and Vehicle Pill (zhou che wan). water. water or wine may be added at certain times during the processing. of ground herbs and processed honey. SYRUPS FROM PROLONGED DECOCTION (jiiin gEo): These are made by repeatedly decocting the ingredients to a specified concentration. Pills are also the formulation of choice when a formula calls for ingredients that should not be decocted. Compared with other types of pills. PILLS MADE WITH HONEY (mi wdn): These are made decoction of a formula with the addition of a filler.' PILLS MADE WITH LIQUIDS (shui wdn): These are made of ground herbs and a liquid. liquid extraction. which is made by adding the powdered ingredients to a heated mixture of oil and beeswax. The extracts are either fashioned into tablets or pills. the plaster is heated prior to placing on the skin. and adding beeswax. Honey makes the pills moist and lubricating. sweet in flavor. however. and very toxic ones. usually water. the three most common types of soft extracts are those made from prolonged decoction. and pills made from honey are usually tonics. or from concentrates. SEMI-SOLID EXTRACTS (jin giio): These are made in the same manner as liquid extracts. They are easy to swallow. further concentrating the strained liquid. Soft Extracts (giio ji) The ingredients are simmered with water or vegetable oil until a concentrate with a syrupy or gummy consistency forms. In general. wine. For this reason. PILLS MADE FROM CONCENTRATES (ndng suG wdn): These are made of a concentrate from the strained . It is then spread on paper or cloth. but makes it easier to work with. and has a moderating effect on the actions of other ingredients in the formulas. or are put into capsules. pills are absorbed slowly and over a long period of time. Depending on the particular formulation. Liquid extracts are similar to tinctures. 19 Pills (w6n ji) T h e ingredients are finely ground or pulverized. They are applied externally as plasters for skin disorders or the effects of trauma. This is an effective and convenient way to dispense medicine and does not have the side-effects associated with the solvent. Soft extracts can be used internally or externally. LIQUID EXTRACTIONS (lihjin gEo): These are made by soaking the ingredients in a solvent (usually alcohol) to extract the active ingredients. except that they are heated until all of the solvent is gone. and pills made with pastes break up in the digestive tract and are absorbed more slowly than any other type. This makes them very convenient to use. This enables the practitioner to adjust the formula to fit the individual. This type of pill is sometimes referred to as a 'bolus. and are less expensive. They are most commonly used for treating chronic disorders associated with deficiency.Practical Aspects specifically for a particular patient. vinegar. quickly digested. or a strained decoction. PILLS MADE WITH PASTES (hzi wdn): These are com- posed of ground herbs and a paste made from either rice or wheat flour. Honey itself is a tonic. and semi-solid extraction. When taken internally. These include extremely aromatic substances. more concentrated so that less alcohol needs to be ingested to get the same amount of active ingredient. ranging between 1-2cm in diameter. such as those used in Calm the Palace Pill with Cattle Gallstones (an gong niu hang wan). A mixture of beeswax and sesame oil is often added to the honey to prevent it from sticking to the utensils. The other common type is called medicinal plaster (yho giio). The size of pills is specified as either large. and have the effect of enriching and tonifying. or small. or paste. discarding the residue. these are small (usually 2-5mm in diameter). They are traditionally rather large in size. but can also be stored for quick use in treating acute disorders when there is little time to prepare decoctions or powders. Usually lml of a liquid extraction contains the active ingredients of l g of a normal ingredient. they are. which is prepared by slowly simmering the ingredients in a vegetable oil (usually sesame). The most common types of pills are those made with honey. If stored. One common type of external plaster is called plaster medicine (giio yho). Pastes are extremely viscous. they are also known as 'enriching soft extracts' (giio zi). The honey is heated to a temperature that preserves its adhesive characteristics. and round pills are formed. or is described in terms of a common edible substance such as mustard seeds or soybeans. medium. These pills have the advantage of containing a relatively large amount of the active ingredients per volume. This prolongs the effect of a formula (in a 'time-release' manner) and reduces irritation to the digestive tract. a liquid or other viscous medium is added. Pills are more easily stored and ingested than decoctions. and then heating the result to dispose of a specified percentage of the solvent.

the ground up dregs of the decoction. Lozenges can be ingested or applied externally. invigorate the blood. Medicinal Wines (jiii j i or yiio jiii) These are made by soaking the ingredients in rice or sorghum wine or other spirits. Syrups are sweet and are principally used in treating children. but instead are a form of pill. or Radix Dioscoreae Oppositae [shan yao]) is added and thoroughly mixed with the concentrate. They are more quickly absorbed and stronger-acting than most pills and tablets. paste. In Discussion of the Origin and Development of Medicine (Yi xue yuan liu lun). Wine itself is considered to nourish. the eighteenth-century author Xu Ling-Tai observed. or the strained liquid from a decoction. the practitioner must prepare and administer the formula. but how they are prepared. we will discuss it at length here. These are finely ground herbs that are pressed together in tablet form. This type of formulation is therefore most commonly used in treating chronic deficiency. Syrups (tting jiiing j i ) These are made by taking the strained liquid from a decoction and adding a specified quantity of cane sugar. the result depends not only on the ingredients. adding a filler. This type of preparation is becoming increasingly popular in China. In the West it is not uncommon to find households in which there are no nonmetallic pots. and forming the result into tablets (usually under pressure). whether the medicine is effective or not completely depends on this. Preparation and Administration of Decoctions Once one has decided which formula to use and the form in which it is to be administered. can cause unknown chemical reactions when herbs are decocted in them. The ingredients are ground into a fine powder. an enteric coating can be added. or other excipient. and are more convenient and require less medicine per volume than decoctions or syrups. the methods for preparing and administering the different types of formulations were described above. a sugar coating can be added. Because the preparation of decoctions is a rather complex task. Particularly in a hospital setting. The resulting mixture is made into granules or powder by sifting through a series of sieves.' Injections (zhifnjji) These are made by extracting the active ingredients with modern methods and preparing a sterile solution that can be administered by injection. and unblock the channels. the dregs are discarded. using the alcohol as a solvent. The term is also used in Taoist alchemy where different metals are made into pills to promote longevity or spiritual attainment. Special Pills (diin j i ) These are not a distinct type of formulation. Then a stabilizer (usually starch. The powder or granules are then dried. or rolled like pasta dough through a series of rollers. if the ingredients are especially bitter or malodorous. This type of formulation is actually a variant of the powders discussed above. If properly packaged and stored. The advantage of this method is that the delivery of the active ingredients is precise. particularly iron or aluminum. after which it is cut up or crushed. Equipment The pots used for decocting should be ceramic or earthenware. The wine is warmed. if the ingredients are adversely affected by the acidic environment of the stomach. concentrated semi-liquid remains. or intravenously. and then formed into pills. and the resulting liquid can be used internally or externally. and unaffected by any interaction with the digestive system or foods. There is another type of formulation that is also called a tablet. but most are made by decocting the ingredients until a thick. Most of the formulas whose names include this term contain specially processed and/or expensive ingredients. and are thus called special pills. mixed with water.20 Introduction the decoction and syrup. Lozenges (ding j i ) These are made by grinding the ingredients into a powder which is formed into ingot-shaped tablets. like all types of cooking. These are injected subcutaneously. This is not unusual because. intramuscularly. Before taking. This is because metals.'' Tablets (#i&n j i ) These are made by processing or otherwise extracting the active parts of the ingredients. Except for decoctions. The tablets are a relatively standardized formulation and can be easily coated. this type of formulation is more convenient than decoctions. sometimes with the addition of paste. honey. Through the centuries practitioners have always stressed the importance of correctly decocting the formulas. It is the experience of many Granules (chting fii j i ) This is a modern formulation that is based upon . "It is most appropriate to discuss the method of decoction in depth. For example. the lozenge is ground into a thick liquid in a similar way that ink is ground. fast. There are many different types of granules. or the pain associated with wind-dampness or trauma. This type of formulation is therefore also called an 'elixir. granules can retain their potency for long periods of time.

the pots must have a tight-fitting lid and be clean. usually right before meals. Radix Aconiti Kusnezoffii (cao wu). turn the heat down. This translates into anywhere from 200-300ml of water for 30g of herbs. leaves. none will be ineffective. There are times when this is impractical. Where special types of water are required. If a formula is overcooked or burnt. the herbs are discarded. or when the ingredients may irritate the digestive tract. Usually the decoction is brought to a boil using a high flame. However. never add water to cook it again. The water should generally cover the herbs by about one-half inch. If [decoctions are] prepared in this manner.Practical Aspects practitioners that stainless steel pots can be used without any untoward effects because there is no reaction between the metal and the ingredients of the formulas. to be most effective. clear heat. COMMONLY USED SUBSTANCES REQUIRING SPECIAL TREATMENT FOR DECOCTING DECOCTED FIRST Radix Aconiti Carmichaeli (chuan wu) Radix Lateralis Aconiti Carmichaeli (fu zi) Radix Aconiti Kusnezoffii (cao wu) Concha Haliotidis (shi jue ming) 0 s Draconis (long gu) . 21 Proper . distilled or clean bottled water may be substituted. In areas where the tap water is polluted or has a high mineral content. or two-thirds of a cup is taken three times a day (upon awakening. The most common method is to decoct the ingredients twice. but in relatively more water and for a longer period of time. or contain herbs with volatile oils should be cooked over a relatively high flame for a shorter period of time (10-15 minutes). Some of these are regional variations. Some herbs must be specially treated during the decocting process (see table below). The two cups of liquid are then combined. the decoction is generally divided into smaller doses and taken frequently throughout the day. and the low flame or 'civilian fire' (win hui). Tonics and other formulas that contain rich. Both times the herbs are boiled down until only one cup (about 200ml) of liquid remains. and flowers will absorb more. Do not lift the lid to look at the herbs too often. This is also a good practice for anyone who has trouble taking a full cup of the decoction at a time. such as Mulberry Leaf and Chrysanthemum Decoction (sangjuyin).Water At present. they are specifically noted under the method of preparation for the particular formula. the formulas should be taken after meals. After the second cooking. allow them to soak for awhile. acrid formulas that treat exterior wind-heat. When these special treatments are required. Amount of Water This varies depending on how the formula is decocted and the type of ingredients used. This permits the maximum absorption to occur quickly. Once the herbs have come to a boil. but other differences are related to the nature of what is being decocted. Minerals and shells absorb very little water." Method of Decoction When the herbs have been put in the pot and covered with an appropriate amount of water. tonic formulas are often cooked only once. Radix Lateralis Aconiti Carmichaeli (fu zi). When instructing a patient on how to make a decoction at home. remember that one cup of water is approximately 200ml. and one cup is taken twice a day (usually morning and evening). and then an hour before lunch and dinner). This will facilitate the extraction of the active ingredients during the process of decoction. For children or the seriously ill. Decoctions are generally taken before meals. There are many different ways in which decoctions are prepared in China. Whatever the material. For example. tap water is usually good enough for decoctions. In such cases. using slightly less water the second time. formulas that release the exterior. as this may diminish their effect by allowing the 'flavor' of the herbs to escape. This idea was originated by Wu Ju-Tong and is at some variance with the methods of decoction described in the Discussion o f Cold-induced Disorders. The liquid is then divided into three doses and taken on an empty stomach. while roots. Type of Heat The Chinese traditionally distinguish two types of heat for cooking herbs: the high flame or 'military fire' (wii huo'). cloying substances should be cooked over a relatively low flame for a longer period of time (45-60 minutes) to extract as much from them as possible. Most formulas are cooked for 20-30 minutes. An example of a regional variation is the practice in Guangdong of cooking all decoctions just once for 30-40 minutes. and then cooked on a lower flame. and then taking the resulting cup of strained liquid on an empty stomach before a meal. unless the formula requires some special type of water. they should be noted on the prescription that is given to the pharmacist. This was succinctly stated by Li Shi-Zhen in Systematic Materia Medica: "Start with a military [fire] and then use a civilian [fire]. Radix Aconiti Carmichaeli (chuan wu tou). This is particularly true of cool. and other toxic substances should be cooked for at least 45 minutes to reduce their toxicity.

The second are minerals and shells that must be cooked longer to obtain any effect. They are cooked 10-20 minutes before adding the other ingredients. and the solution is then added to the strained decoction. and some minerals. the formulas should be taken irrespective of the time.) Some expensive. but can be decocted with the other ingredients if the practitioner wants to mute this particular effect. Formulas for malarial conditions should be taken two hours before an attack.Introduction Concha Ostreae (mu li) Magnetitum (ci shi) Magarita (zhen zhu) Haematitum ( h i zhe shi) Plastrum Testudinis (gui ban) Carapax Amydae Sinensis (bie jia) Gypsum (shi gao) Cornu Bubali (shui niu jiao) Fasciculus Vascularis Luffae (si gua lou) ADDED NEAR END: 4-5 minutes before the end. This is because they themselves will stick to the pot and burn. In addition. When taking prepared Aromatic herbs should be added to the decoction . Formulas that contain ingredients that irritate the stomach should be taken after meals. followed (or 'chased') by the strained decoction. If this is not desired. Formulas should generally be taken about an hour before meals. and the resulting liquid is used to decoct the other ingredients. Precious horns are often shaved or filed into a powder and ingested. Formulas that calm the spirit should be taken before going to bed. cloying tonics should be taken on an empty stomach. Added near end ( h i h xi. In an emergency. This prevents their volatile oils from wafting away instead of remaining in the strained decoction. Decocted i n gauze (biio ji8n) Herba Menthae Haplocalycis (bo he) Radix Aucklandiae Lappae (mu xiang) Fructus seu Semen Amomi (sha ren) Fructus Amomi Kravanh (bai dou kou) Herba Artemisiae Annuae (qing hao) Radix et Rhizoma Rhei (da huang) (when desired) DECOCTED IN GAUZE: Flos Inulae (xuan fu hua) Semen Plantaginis (che qian zi) Halloysitum Rubrum (chi shi zhi) Six-to-One Powder (liu yi san) Jasper Powder (bi yu san) SEPARATELY DECOCTED OR SIMMERED: Some ingredients should be packaged in a gauze or cheesecloth sack before cooking. hair-like structures). if the timing is regular. the purgative action of Radix et Rhizoma Rhei (da huang) is much greater when it is added near the end. These substances are therefore separately dissolved in a small bowl. or they may stick to the other ingredients and thereby reduce the effect of decocting. The manner and timing of administration also influences the effect of the formula on the body. These are often sliced very thin and then cooked in a double boiler for a long time (usually 2-3 hours) so that every last drop of active ingredient can be extracted. small seeds. The first are toxic herbs that are cooked for 30-45 minutes before adding the other ingredients. For this reason. Some herbs will have a much stronger effect if added near the end. Taken with the strained decoction ( c h a n g f i ) There are three types of substances that should be decocted first before adding the other ingredients. For example. Rich. however. Dissolved i n the strained decoction (r6ng hu. aromatic substances are ground into a powder and then taken first. Included are herbs with cilia (fine. some formulas which are ground before they are decocted are also prepared in this manner. Separately decocted or simmered (ling jiiin or ling diin) Radix Ginseng (ren shen) Radix Panacis Quinquefolii (xi yang shen) Cornu Cervi Parvum (lu rong) DISSOLVED IN THE STRAINED DECOCTION: Some rare and very expensive substances must be separately decocted or simmered to obtain the maximum effect. they are decocted first for about 20 minutes.) Gelatinum Corii Asini (e jiao) Maltose (yi tang) TAKEN WITH THE STRAINED DECOCTION: Bulbus Fritillariae Cirrhosae (chuan bei mu) Radix Notoginseng (san qi) Calculus Bovis (niu huang) Cinnabaris (zhu sha) Succus Bambusae (zhu li) Decocted first (xiEn jiiin) Highly viscous or sticky substances cannot be decocted with the other ingredients. There is simply no room in most pots to decoct them with the other ingredients. The third are the lightweight substances when they are used in large dosages. the herb should be decocted together with the other ingredients. followed by the strained decoction. Otherwise they will stimulate the throat or digestive tract with adverse effect.

For example. the dosage of most of the ingredients is reduced by two-thirds. The dough is formed into long. For example.g. Other pills made in the United States are simply ground up substances that have been pressed into pills.. or a combination of both.to two-thirds less than that specified in the source texts for the formulas. This has certain advantages. Even when a disorder is due to heat. the most important being assurance that the formulas actually contain the substances for which they are labeled. the great majority of Western practitioners rely on prepared or 'patent7 medicines which are convenient and easy to take. more of the herb is extracted than is true of the traditional formulations. Powder to Take at Cock's Crow (ji ming sun) should be taken on an empty stomach as soon as one awakens for maximum effect. For example. time-consuming to prepare. there is a definite problem in using these formulas. but the dosage of Fructus Evodiae Rutaecarpae (wu zhu yu) is reduced from 9g to only lg. or over the course of the day. Commonly Used Chinese Herb Formulas with Illustrations. it is important that they be taken at a specified time for maximum effect. to our knowledge none are prepared by this method. However. through a combination of water and alcohol processing. The second type of prepared medicine that is popular in the West is a type of granule originally developed in Japan. and that of Radix Puerariae (ge gen) from 9g to 8g. This is especially true for exterior disorders since taking the decoction warm helps stimulate sweating. as is that of Herba Ephedra (ma huang). instead of the normal amount in just two or three doses. This is confirmed by the fact that many patients in China now also resist the use of decoctions. Most of these come from China (primarily the mainland) and correspond in form to the pills and tablets discussed above. in which case it should be taken cool. and then a dough is made by adding a starch filler. Decoctions are usually taken warm. There are three commonly-used types of prepared medicines in the West. Certain formulas have special times for administration. The effects of such pills can therefore be quite different from those described for the more traditional types of preparations. As with the granules described above. the dosage of Ramulus Cinnamomi Cassiae (gui zhi) is reduced from 6g to 3g. That is that the dosage of the herbs specified by the Japanese government is usually one. Different types of fillers (including the dregs from the processing) are also used. In some cases. Other solutions to this problem include having the patient take a small amount of Pericarpium Citri Reticulatae (chen ~)or ground ginger before drinking the decoction. All of these powders are made according to standards promulgated by the government of Japan. administration of the formula should be discontinued. There is also considerable variation in the reduction of dosage from one ingredient to the next. For this reason. Editors' Note on Prepared Medicines In the West it is difficult to persuade most of our patients to use decoctions. Some of the pills from China are high-level extracts of what are considered to be the active ingredients of the herb. This is a very convenient and popular form of prepared medicine in both Japan and the West. While tinctures have been used in China for . the dregs of the decoction. The first are pills.Practical Aspects medicines. in Cinnamon Twig Decoction (gui zhi tang). This means starting with a small dose. the dosage of Ramulus Cinnamomi Cassiae (gui zhi) is reduced from 9g to 4g7 as is the dosage of Radix Paeoniae (shao yao). While some of these problems are due to cultural differences. then slowly increasing the dosage until the desired effect is obtained. The exception is when taking the medicine warm causes nausea or vomiting. published by the Oriental Healing Arts Institute). have an unpleasant odor to most. noodle-like strands which are either cut into granules or crushed into powder. in Ephedra Decoction (ma hang tang). 23 . these Japanese-style powders are made from large batches of decoctions from which the liquid is strained off. For this reason. the best way to be sure of the proper dosage for ingredients in any of the Japanese-style prepared formulas is to refer to a text that gives the specifics of the Japanese standards for formulas (see. Great care must be exercised in administering very toxic formulas. at least in the context of traditional Chinese medicine. without any apparent rationale. However. These are made a little differently from the traditional methods of preparation. instead of crude extracts of the entire herb. the decoction is usually taken warm. And in Kudzu Decoction (ge gen tang). that of Herba Ephedra (ma huang) from 9g to 4g. or take smaller amounts of the decoction more frequently throughout the day. The reduction in dosage of the same herb can also vary from formula to formula. The third type of prepared medicine is the tincture. and an unpleasant taste to almost everyone. but now made in both Japan and Taiwan. e. others have to do with the pressures of modern life. inconvenient to take. When this occurs. Some formulas can be taken many times a day. like a tea. There are also pills manufactured in the United States from imported herbs. This is because they are relatively expensive. in the prepared form of Warm the Menses Decoction (wen jing tang). the dosage of Ramulus Cinnamomi Cassiae (gui zhi) is reduced from 6g to 5g. It is important to note that while some of these granules are said to have been freeze-dried. and are usually less expensive than decoctions.

In such cases. liing. The frequency of administration is dependent on the same factors as those discussed above. The powder is kept in the refrigerator to preserve its freshness. This ranges from a heaping teaspoon to a heaping tablespoon. To our knowledge. Two or three times a day a specified amount is prepared either as an infusion (steeped in boiling water like a tea) or a draft (boiled and then simmered for 5-10 minutes). generally about 20 minutes to grind up each batch of herbs. but because they are weaker. These powders generally are also less expensive than commercially-made prepared medicines. it seems to have been settled for now. The other reason is that using the traditional measurements of weight and volume can be confusing because they have changed over time. Nonetheless. but have yet to become very popular. One is that this book is a compilation of modern Chinese sources. There are two reasons for this. The system established during the Song has been followed until recently.. if the patient must take the formula at work. and we use them ourselves in appropriate circumstances. The dosage also varies. First. Sometimes this is because they are too soft. This was done so that the measurement of medicinal substances would be consistent with all other measurements used in medicine. however. it is often impossible to prepare as a draft). Preparing the medicine in this fashion gives the practitioner some control over the quality of the ingredients used. they have usually been restricted to formulas that treat painful obstruction.Introduction millennia. etc. One type of preparation that we think is seriously underused is the traditional powders (sin). We would. Which type is most effective is still unclear. There are also some disadvantages. sheng.) instead of the traditional Chinese style (qian. milliliters. such as Gypsum (shi gao) and Concha Ostreae (mu li). decoctions appear to be the best form of administration. At that time the measure fen was added and the ratios of one measure to another were as follows: 10 shii 6 zhii 4 fin 16 liing = = = = 1 zhii 1 fin 1 lidng 1 jin By the Song dynasty (960-1279) some different measures were introduced. For example. There are some important advantages to this method. By the Ming dynasty (1368-1644)there was definite confusion about the meaning of traditional . Tinctures of many of the formulas have recently been used in China. The ratios among these measures are: 10 hdo 10 li 10 fin 10 qidn 16 liing = = = = = 1 li 1 fin 1 qicin 1 lidng 1 jin Similar changes have occurred in the measurements for volume. These are usually made by taking a package of herbs (the dosage of which is usually increased by 30-50% above that used in a decoction) and grinding them into powder using a coffee grinder. before the Jin dynasty (265-420) the measures of weight were the shii. the primary one being that it allows the practitioner to tailor a formula to a particular patient's needs without the expense and inconvenience of a decoction. however. some substances are very difficult if not impossible to grind in the grinders available for home use. All of these forms of prepared medicines are useful. While there was considerable debate about this issue at the time. andjh. Formulas containing these substances cannot be made into powders unless one has a very strong grinder made especially for this purpose. The major unit was the shkng.g. making powders in this manner requires some work by the patient. etc. Standards of Measurement In this book measurements are expressed in the metric system (grams. Furthermore. the actual volume of which changed over the course of imperial history. including the qidn. liang. Whether they should be taken as an infusion or a draft depends on the nature of the formula and the limitations of the patient (e. The patient must also have a coffee grinder (and be prepared to replace it if it breaks). none of the tinctures used in the West come from China. like to emphasize that there are times when the situation demands a fast and strong . and sometimes it is because they are too hard. all of which since the early 1980shave been based on the metric system. and that they are a viable option to decoctions and prepared medicines. we still believe that using these types of powders can be beneficial. or some types of tonics where the ability of alcohol to promote movement is used to mitigate the cloying properties of the tonifying ingredients as well as aid in the delivery of the tonic.).treatment. and this question requires much more research before it can be answered with authority. zhii. they are usually taken 2-3 times a day even for chronic problems. but is usually that which gives the infusion or draft the same flavor as a decoction of the same ingredients. such as Radix Rehmanniae Glutinosae Conquitae (shu di hang) and Arillus Euphoriae Longanae (long yan rou).

It has undergone continuous transformation as it has been adapted to the character and culture of the Japanese people. wrote that "The liiing of the ancients equals six of today's qicin. while there is still quite a bit of discussion about the metric equivalents of ancient units of measurement. Abdominal diagnosis is favored over pulse diagnosis. as it is considered easier to learn. you should write 6 qidn. First. 'We would like to thank Anne H. Herbal medicine entered Japan in part directly from China. which looks to the third-century Discussion of Cold-induced Disorders as its principal text. Some of the formulas in this book are included not because they are commonly used in China. you should use the traditional measurements. We hope to correct this omission in future editions. In our book we have followed the majority of our sources. is more distinctively Japanese and represents the break which occurred between the medical systems of China and Japan. the Chinese government in 1979 promulgated a rule that all standards of measurement be expressed in the metric system. Kubota for her contribution to this section which is based on the book by Otsuka Keisetsu. For example. liiing 1 qicin 1 fin = = = 31. It was declared that 1j?n would equal 500g and that a l l other measurements would follow accordingly: 25 example. the traditional standards of measurement are still often used in pharmacies outside of China.Japanese Herbal Medicine: History and Current Use measurements. as it extensively utilizes the theories of the five phases and the channels. To determine these measurements. However. one shing at the time of Discussion of Cold-induced Disorders would equal about 200ml or one cup. In addition. if the dosage in our book specifies 18g. The difference of opinion is most striking when applied to measurements of volume. will be helpful to our readers.* A similar process has occured in Korea resulting in the development of a unique form of herbal medicine with a distinctively Korean character. JAPANESE HERBAL MEDICINE: HISTORY AND CURRENT USE The Japanese variation of Chinese herbal medicine is known as Sino-Japanese herbal medicine. although based on an ancient Chinese book. 1. Unfortunately we have not been able to locate sources that would allow us to present a discussion of Korean herbal medicine." It should therefore be obvious that the measure for liiing in a third-century work such as Discussion of Cold-induced Disorders is a different and smaller unit of measurement than the liiing in a seventeenth-century work such as Analytic Collection of Medical Formulas. the tools used to weigh herbs have been fairly primitive. simply divide the number of grams by 3 or 30. the latest textbook on the Discussion of Cold-induced Disorders from China states that one shing equals 60-80ml. Tokyo. The other is the Koho ("ancient formulas") school. but because they are considered important in Japan and therefore often used in the West. The first of these is the Gosei ("later development") school. there is a simplification of the theories with an emphasis on the empirical knowledge of practitioners. which is based on the theories presented in the Inmr Classic and incorporated into Chinese herbal medicine during the 12th-14th centuries. according to most of our sources. The Gosei school bears a closer resemblance to traditional Chinese medicine as practiced in modern China. We hope that this discussion of the background and development of Sino-Japaneseherbal medicine. and in its present form is a unique medical system that has had a significant impact on the West. and in part from Korea." Another physician of this period. The Koho school. if it specifies 60g. and her discussions with Cyong Jong-Chol of the Kitasato Institute in Tokyo. There are two major branches of traditional herbal medicine in present-dayJapan. For . Moreover. However.125g 0. The two Japanese schools do have several points in common which distinguish them from Chinese herbal medicine. In addition. for example. Sogensha Publishing Company. Although the metric system is now the standard within China. or Kamp6. we have followed the majority view and assigned a value of 39 to the liiing of the Discussion of Cold-induced Disorders. To simplify and standardize this aspect of traditional medicine. and studies have shown that they were far from standardized. however brief. Zhang Jie-Bing. Sino-Japame Herbal M e d i c i n e (Kampo I Gaku). and later imported into Japan.2 times the size of the liiing used in the market. Since Song times the liiing used in medicine has been roughly 1. the standards of measurement used in medicine were always slightly different than those used in the market. For that reason.25g 3. the shdng of the ancients equals two-and-a-half liiing today. Li Shi-Zhen.31258 In this book we have followed the convention used in our sources of rounding off these numbers so that 1 liiing = 30g and 1 qicin = 3g. the reader may wish to take this difference into consideration when preparing formulas derived from the Discussion of Coldinduced Disorders. noted that "The liiing of the ancients is the qidn of today. if you write a prescription that is to be filled in the herbal pharmacies of North America or Europe. you should write 2 liiing.

When the more direct. theoretical medicine of the Song (960-1279) dynasty was imported to Japan.26 Introduction segments of educated society in China as well as Japan.1696). In Myriad Diseases . Sanki Tashiro (1465-1537). regarded wind. There are fewer commonly-used medicinal substances and formulas than in China. which incorporated the theories of the five phases and the channels intd herbal medicine. or water). When the body is affected by one or more of these influences. and possessing less theoretical entanglements. three for the yang stages of disease. who were versed in the Chinese medical classics (especially the Inner Classic and the Classic of DifficultieS). many of which are imported from China. did not merely imitate Chinese herbal medicine. disease is divided into six stages. in terms of medicine. blood. Before the Nara period (710-793) medical knowledge was largely transmitted to Japan via Korea. Fewer medicinal substances were used. This influx of knowledge culminated in the compilation of the Ishimpo during the Heian period (794-898). However. and led to a major split between the two forms of herbal medicine. particularly those of the warming and tonifying school associated with Li Ao. For example. the strength of the body. The Discussion of Cold-induced Disorders is accordingly divided into six sections. During the Kamakura period (1185-1333) the more dense. The founders of the Koho school held the Discussion of Cold-induced Disorders in high esteem. Dosan Manase. He stated that knowing how to treat disease was simply a matter of learning the formulas in Discussion of Cold-indued Disorders. one of the founders of the school. Dosan Manase was also the person primarily responsible for the development of abdominal palpation into a major form of diagnosis. and improper diet or overwork. The disciples of this school. The rise of the Koho school during the Tokugawa period (1603-1867) truly marked the emergence of a new and unique system of herbal medicine in Japan. This may be due to the penchant for simplification. dampness. the movement of qi. This difference may be due in part to constitutional differences between the two peoples. The severe restrictions on foreign trade led to a marked reduction in the availability of herbs from China and other countries. and water. Geni Nagoya (1628. it offered practical. This radical philosophical movement was contemporaneous with the seclusionist policies of the Tokugawa shogunate. as well as the relative difficulty in obtaining herbs. not to evaluate the affected organs). Finally. It is only in this classification system that the words yin and yang are used. as they enable one to treat all ailments. and the aspect of the body which was affected (qi. he asserted that all diseases stem from toxin in the body.618) and Tang (618-907) dynasties. the nature of the disease-causing agent. the movement in Japan was much more radical than that in China. Symptoms of disease arise when any of these stagnate. Although this school maintained the theoretical basis of Jin-Yuan medicine. the names of which correspond to the six categories of acupuncture channels. heat. who studied in China. easily-applied treatments and therefore became a very popular school. but simplified it. in part because fewer herbs were available in Japan. This tendency was taken a step further by Todo Yoshimasu (1702. The founders of the Koho school understood the Discussion of Cold-induced Disorders in the following way. it was increasingly imported through direct contacts with China. Beginning in this period. palpation of the abdomen. The qi is particularly important because stagnation of the qi impedes the circulation of blood and water. He grandly dismissed the five disease-causing agents as well as the role of qi. This school advocated a return to the third-century text. Sanki's student. and in part because the deep influence of Buddhism gave the Japanese a distaste for formulas which utilized animal products. the dosage for individual substances in the formulas is only onethird to one-half the amount used in China. An appropriate formula was selected based upon the stage of the disease. or the theory of the yin and yang organs. as the basis for herbal medicine. There are five causes of disease: wind. which summarized the essentials of Chinese medical knowledge during the Sui (581. blood. Although their view of this book is considered by some to be overly simplistic. cold. Depending on where in the body the stagnation occurs and the strength of the body's resistance. The return to the classics affected . Discussion of Cold-induced Disorders. Many disciples of the Koho school regarded the five disease-causing agents in the Discussion of Cold-induced Disorders as one. Diagnosis was performed by observation and inquiry concerning the presenting symptoms. accurate. brought back the theories of the Jin-Yuan schools of medicine. Notable for their absence is any vestige of the five-phase theory. cold. they simplified its system even more. and dampness as being forms of cold. It was not until the Muromachi period (1333-1573) that Japanese medicine began to assume a distinct character of its own. actively promulgated this form of medicine and founded a school of medical thought in Japan which was known as the Gosei school. blood.1773).One Toxin. and palpation of the pulse (to determine the location and nature of the disease. primarily by Buddhist monks. as during the previous eras its use had been restricted to the nobility. or water (which includes the fluids in traditional Chinese medical parlance) is in turn affected. and three for the yin stages. It was during this period that Chinese medicine became popularized in Japan.

rapid. although some Koho practitioners have adapted the Discussion. The above is evidence that many different theories coexist within the Koho school. and help those of us in the West to slowly develop our own tradition of Oriental medicine. of Cold-induced Disorders to acupuncture. Cinnamon Twig Decoction (gui zhi tang) is used for stagnant qi. This is because the theories of the five phases and the channels are considered to be integral to the practice of acupuncture. . Todo Yoshimasu's ideas were amplified by his students. In addition. submerged. blood. and water.Japanese Herbal Medicine: History and Current Use pattern (zheng. it was impossible to determine the state of the five yin organs through the pulse. For example. slippery. He advocated his method of abdominal diagnosis as a means of streamlining the diagnostic process. the information in our book. This means that the formulas are understood and utilized in a somewhat different manner in each country. Nevertheless. Peach Pit Decoction to Order the Qi (tao he cheng qi tang) for stagnant blood. There has also been a recent surge in translations of current Chinese texts into Japanese. It should be clear from this brief discussion that China and Japan have each gone their separate ways in developing traditional herbal medicine. is a blending of both schools that utilizes the formulas and approaches of each. known in Japanese as sh6) of signs and symptoms associated with a disease disappears. The resulting liquid is divided into three 100rnl doses which are taken before meals. and irregular) could be discerned. and Five-Ingredient Powder with Poria (wu ling san) for stagnant water. Herbal extracts (usually in the form of powders) are by far the most common form of herbal medicine in Japan today. he believed that while some pulse qualities (such as floating. Crude herbs are used less frequently. however. and are prepared in a somewhat different manner than in China. Nangai Yoshimasu (1750-1813) reinstated the theory of the qi. They are usually cooked in 600ml of water for a period of 30-40 minutes until it is reduced to 300rnl. especially among those practitioners who use both acupuncture and herbal medicine. which is derived from modern Chinese sources. These ideas had an enormous impact on the world of Sino-Japaneseherbal medicine which can still be felt today. Perhaps the most common method. should help all who utilize Chinese herbal formulas in their practice. slow. This has given the modern practice of traditional Chinese medicine a direct influence on Sino-Japanese herbal medicine. Yodo Odai (1799-1870) in particular is credited for having further developed Todo's teachings. Skeptical of pulse diagnosis. and many practitioners of the Koho school today classify the formulas according to their effectiveness in relieving stagnation of these factors. the disease is cured. there are many adherents of the Gosei school in Japan today.

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those involving cold as well as those involving heat. This is unfortunate because the odds of preventing the development of a serious condition are always better when intervention occurs at the early stage of an illness: f l k . The following are also regarded as exterior disorders: earlystage measles and incompletely expressed rashes. carefully-balanced formulas for treating disorders of excess in both the exterior and interior. . was first described in chapter 5 of Basic Questions: "When it is at [the level of] the skin. and acute. etc. This requires the use of a strategy that releases (jie') the pathogenic influence from the exterior." Sweating is the first of the eight methods of treatment. When treating [at the level of] the five yin organs. head and body aches. No other strategy will prevent the pathogenic influence from penetrating deeper into the body. it is involved in all exterior conditions. neck. Others. W Some of the formulas discussed in this chapter address specific complaints or sites of distress in the body (head.' which refers primarily to the method of inducing sweating. half . It is best to treat [diseases at the level of] the skin and hair. the next best is to treat [them at the level of] the five yin organs. the next best is to treat [them at the level of] the muscles and flesh. throat. require special attention since the pathogenic influence ' 1 ' must be released without causing more internal disharmony. the next best is to treat [them at the level of] the six yang organs.CHAPTER ONE Formulas that Release the Exterior HEN A PATHOGENIC influence first penetrates the body. Exterior disorders are characterized by fever and chills. and a floating pulse. . Since wind is the vehicle by which all other external pathogenic influences enter the body. The term 'release. Many practitioners underestimate the importance of formulas that treat disorders of the exterior. the next best is to treat [them at the level of] the sinews and vessels. it will cause a disorder of the exterior. such as those which treat exterior disorders with interior deficiency. superficial edema. the initial stage of carbuncles and sores accompanied by fever and chills. The last section of this chapter discusses some important. use sweating to discharge it.).

9 For pronounced fever with a sore and swollen throat. . Because individuals rarely seek attention until after the condition has worsened. . Semen Sojae Praeparata ( d m dou chi) releases externallycontracted disorders from the exterior as well as interior constraint. Scallion And Prepared Soybean Source: Emergency Formuh to Keep Up O n e ' s SLem (Zhou hou bei ji fang) . add Radix et Rhizoma Notopterygii (qiang hua). and contracts an illness during the spring or summer requires only mild treatment. The formula and dosage should be adjusted to suit the individual's constitution. .12-30g Preparation: Decoction. e For pronounced chills and headache. stuffy nose. Formulas taken hot after meals will provide the best results. . . and that it requires one or another of the formulas discussed in this section. The Lungs govern the exterior as well as the skin and nasal passages. These formulas should be prescribed in one or two doses only. expressed rashes. a thin. . . add Radix Puerariae (ge gen) and Rhizoma Cimicifugae (sheng ma). a person feels as if the outer layer of protection has been "stripped off." This sensation is called aversion to wind (wi$ng). add Herba Ephedrae (ma huang) (source text). a stronger formula is needed. Since this is the earliest stage of the disorder. Excessive sweating injures the qi and fluids. They contain substances that are light and volatile in nature which. If there is still no sweating. or edema due to deficiency. . . Only a slight sweat over the entire body is needed to release the exterior.Formulas that Rebase Early-Stage Exkrwr Disorders the patients die and the other half survive. if subjected to too much heat. Most of these formulas treat acute disorders. . . lose their efficacy. Radix Ledebouriellae Divaricatae (fangfend and Herba seu Flos Schizonepetae Tenuifoliae (jing jie). and season. climate. and contracts an illness in the autumn or winter requires stronger treatment. . most practitioners use it for wind-cold. a person who does not sweat easily. It is useful for the treatment of mild exterior conditions. . add Rhizoma Zingiberis Officinalis Recens (shengjiang) and brown sugar. . add Radix Scutellariae (huang gin). . an indication that the pathogenic influences are struggling in the exterior. this formula is most often prescribed with additional herbs. If ineffective. MODIFICATIONS: e If formula fails to induce sweating. all of the signs and symptoms are mild. These herbs gently release the exterior and are therefore used for early-stage or mild exterior disorders. lives in a cold climate. Basic Questions. white tongue coating. . chapter 5 Accurate diagnosis is essential. INDICATIONS: Mild fever and slight chills without sweating. . * For pronounced cold with abdominal pain. ANALYSIS O F FORMULA: Bulbus Allii Fistulosi (cong bai) is a warm. If an interior disorder develops before the exterior has been released.3-5 stalks (9-12g) Semen Sojae Praeparata (dan dou chi). and are prepared as decoctions or powders. This is the first stage of an externally-contracted wind-cold or wind-heat disorder. SECTION 1 Bulbus Allii Fistulosi (cong bai) . and can be treated by a simple infusion of Bulbus Allii Fistulosi (cong bai). the practitioner must choose between releasing the exterior first. . a person who sweats easily. When wind-cold attacks the exterior or wind-heat attacks the Lungs directly. The presence of fever and chills indicates that the condition has progressed slightly. . or treating the exterior and interior simultaneously. and a floating pulse. this formula may be used for the biomedically-defined disorder of upper respiratory tract infection. While it can be used for wind-cold or wind-heat. Actions: Unblocks the yang qi in the exterior and induces sweating. the formulas in this chapter are inappropriate for treating interior disorders alone. Dosage is adjusted depending on whether the diagnosis is one of wind-cold or wind-heat. Cook no more than 5-10 minutes. lives in a warm climate. headache. the first symptoms are fever and chills. COMMENTARY: This is a rather neutral formula which will not dry out or injure the fluids. With the appropriate presentation. . On the other hand. . However. Sweating can be further encouraged by instructing the patient to bundle up after taking the medicine. . acrid herb that unblocks the flow of yang qi in the exterior and induces sweating. especially those marked by headache and nasal congestion. . . For example. Fructus FORMULAS THAT RELEASE EARLYSTAGE EXTERIOR DISORDERS In the first stage of an externally-contracted disorder. .

. Cold causes the interstices and pores to close and prevents sweating. . . . . and a floating pulse. and the result is decocted until approximately 2. headache. . rapid pulse.3-4. .3-4. . . . . . The battle between the external pathogenic influence and the normal qi causes fever and makes the skin warm to the touch. . wheezing. . . thirst. . . . . Once sweating occurs. . . . . . . and clears heat from the Lungs. . .70 pieces (9-12g) Honey-fried Radix Glycyrrhizae Uralensis (zhi gan cao) . . . head and body aches.3g Preparation: The source text advises to first decoct Herba Ephedrae (ma huang) in approximately 9 cups of water until 7 cups remain. . There are many types of wind-cold disorders and all require the use of formulas that without sweating. . It is taken hot to induce significant sweating. . Actions: Releases exterior cold and arrests wheezing. . . add Periostracum Cicadae (chn tui). . . . . . . . . . . releases the exterior. and a floating. . . .6-9g Herba Menthae Haplocalycis (bo he) . . . . . The froth is removed. add Herba Agastaches seu Pogostemi (huo xiang) and Herba Eupatorii Fortunei (pei lan). . Radix Platycodi Grandiflori (jie geng) and Fructus Arctii Lappae (niu bang zi). . . . . . . . upper and lower back pain. It also interferes with the flow of nutritive qi. . .l c6ng b6i jii gZng tiing Source: Revised Popular Guide to the Discussion of Cold-induced Disorders (Chong ding tong su shang han lun) Bulbus Allii Fistulosi (coni bai) . . loss of taste. . Available in prepared form. the formula should not be taken again. but it must be accompanied by appropriate regulation of the protective and nutritive qi so that the sweating will have a therapeutic effect. ASSOCIATED FORMULA: 2g Ephedra Decoction B* iiib mh huhng tiing Source: Discussion (Shang han lun) of Cold-induced Disorders Scallion and Platycodon Decoction % 49 $3 4 t i4.Efihedra Decoction Gardeniae Jasminoidis (zhi zi) and Fructus Forsythiae Suspensae (lian qiao). . . . . . . . .5 cups remain. generalized body aches. . . .5g Radix Glycyrrhizae Uralensis (gan cao) . . . . . . . . . .3-5 pieces (9-12g) Semen Sojae Praeparata (dan dou chi) . white tongue coating. .5-3g) Scatters wind. . . . . tight pulse. In such instances. . . . sore throat. and a tight pulse. . Such patients require a formula that strongly induces sweating.9-15g Radix Platycodi Grandiflori (jie geng) . This is because the protective qi is too weak to force out the pathogenic influence. treatment still requires sweating. clear or white secretions (nasal discharge. . a red-tipped tongue with a white coating. . . INDICATIONS: Fever and chills (chills predominant) SECTION 2 FORMULAS THAT RELEASE EXTERIOR COLD Wind-cold disorders are marked by fever and chills (chills predominant). . . . . . a stifling sensation in the chest.1. . . a slight aversion to wind. and a thick. . .30 leaves (1. . . . The head is the meeting place of the yang channels and an attack of wind-cold on the superficial (yang) aspects of the body results in headache. . . . . For the early stages of a warm-febrile disease characterized by fever. . . . When wind-cold attacks an individual whose protective qi is strong. The bottling-up of the exterior leads to constraint of . .6g Semen Pruni Armeniacae (xing ren) . . . . . . @ For pronounced coughing and hoarseness. which produces generalized body aches. . This inhibits the flow of the yang qi in the exterior. greasy tongue coating.8-2. . . . . . . VARIATION: 33 Scallion and Prepared Soybean Decoction from Book to Safeguard L$e release pathogenic influences from the exterior by inducing sweating. . This is wind-cold attacking the exterior where it constrains or bottles up the protective qi. . . . . . . sputum). . . neck pain. . . .9g Ramulus Cinnamomi Cassiae (gui zhi) . coughing. headache. the cold can close up the interstices and pores and prevent sweating. a thin. . . . . . .3-4. . and a floating. . .5g Fructus Forsythiae Suspensae (lian qiao) . . . . 3 13 hu6 r i n c6ng chz' tang Source: Book to Safeguard Lij Arranged According to Pattern (Lei zheng huo ren shu) Add Herba Ephedrae (ma huang) and Radix Puerariae (ge gen) for a one-to-two day old wind-cold disorder with no chills or sweating. . . . . .4g Fresh Herba Lophatheri Gracilis (xian dan zhu ye) . @ For concurrent turbid dampness with nausea. . . . . . but with headache. . . the other ingredients are added. . Herba Ephedrae (ma huang) . . . Today all of the ingredients are decocted together and it is thought that they should not be cooked for more than 20 minutes. . .5g Charred Fructus Gardeniae Jasminoidis (jiao zhi zi) . . . there will be sweating but the condition will not improve. . which produces chills. . . The strained decoction is taken warm in 3 doses. . If the protective qi is weak. . .

. . unblocks the flow of Lung qi and helps the chief ingredient arrest wheezing and expel the pathogenic influence. . and a floating. add Fructus Perillae Frutescentis (su zi) and Pericarpium Citri Reticulatae (chen pi). . . . . . bronchial asthma. . is also a diaphoretic that releases the exterior (especially the muscle layer) and warms and facilitates the flow in the channels. . . . . Apricot Kernel. Xia Xiao-Nong. take with Four-Substance Decoction (si w u tang). . discussed later in this section. This is the narrow meaning of the term. . . . . . .34 F o r m h that Release Exterior Cold CAUTIONS & the Lungs. and the tight pulse indicates the presence of cold. . . . . . COMMENTARY: This is the classic formula for * For exterior cold with interior heat. . The floating pulse indicates that the pathogenic influence is in the exterior. . . and Ephedra. usually due to Spleen deficiency. watery sputum. acute bronchitis. . . tight pulse. The envoy.9g Fructus Zizyphi Jujubae (da zao) . . . . . . which results in rebellious Lung qi manifested as wheezing. In this case. This is a specific type of nosebleed due to cold. and for patients who are prone to bleeding (especially from the nose). which rebels upward and causes nosebleed. . .18g Semen Pruni Armeniacae (xing ren) . . VARIATIONS: Ephedra Decoction plus Atractylodis % i% &&+ treating cold excess in the exterior. * For concurrent yang deficiency. It appears at least nine times in Discussion of Cold-induced Disorders for treatment of greater yang-stage disorders where the presentation is referred to as injury from cold (shiing hdn). . . . . and acute glomerulonephritis. . . and Gypsum Decoction (ma xing gan shi tang). warm. The deputy. . irritability. . . . . and the deputy pushes out the pathogenic influence. The assistant. For exterior cold with interior heat characterized by severe fever and chills without sweating. . . . * For childhood'psoriasis. a sensation of tightness in the chest. . . . . . Ephedra Decoction (ma huang tang) is the foundation for a number of other formulas that are used in treating disorders associated with wind in the Lungs including Minor Bluegreen Dragon Decoction (xiao qing long tang). . . . body aches. . . With appropriate modification. It is also used for nosebleeds with an absence of sweating and a floating. May also be used for acute floating edema. this formula may be used in treating such biomedically-defined disorders as upper respiratory tract infection. . ANALYSIS OF FORMULA: The chief herb. Licorice. . . . . influenza. . . When combined with the chief herb. CONTRAINDICATIONS: In Discussion of Cold-induced Disorders this formula is contraindicated for patients with debility and copious urination. . . tight pulse. harmonizes the actions of the other herbs and moderates the diaphoretic action of Herba Ephedrae (ma hang). . . This is an exterior condition only. add Gypsum (shi gao). . as its broader meaning encompasses all cold-induced disorders. and coughing of white. mh huhng jiii zhii tiing Source: Essentials from the Golden Cabinet Uin gui yao he) Add Rhizoma Atractylodis Macrocephalae (bai zhu) for pronounced body aches with irritability due to dampcold in the exterior or invasion of wind-dampness in patients with chronic dampness. . Semen Pruni Armeniacae (xing ren). . . Today the dosage of Herba Ephedrae (ma huang) . is a particularly strong diaphoretic that also disseminates the Lung qi and treats wheezing. . add Radix Astragali Membranacei ( h a n g qi). ASSOCIATED FORMULAS: Major Bluegreen Dragon Decoction A%&.6g Gypsum (shi gao). . . and for painful obstruction due to wind-cold-dampness. . . . . . . it strengthens the diaphoretic effect of the formula. . . Ramulus Cinnamomi Cassiae (gui zhi). . . One way that this may be explained is that the chief herb unblocks the interstices and pores. . . * For sore throat. . . . . With the appropriate presentation. reduce the dosage of Ramulus Cinnamomi Cassiae ( p i zhi) by half. . .60 pieces (6-9g) Ramulus Cinnamomi Cassiae (gui zhi) . . .12 pieces Releases the exterior and clears interior heat. . . . discussed in chapter 2. and the tongue is therefore not affected.$ d6 q h g king tang Source: Discussion of Cold-induced Disorders (Shang han lun) Herba Ephedrae (ma huang) . and add Radix Trichosanthis Kirilowii (tian hua fen) and Rhizoma Belamcandae Chinensis (she gan). This is based on the experiences of the modern physician. Because of the adrenergic effects of Herba Ephedrae (ma huang). . this formula may be used for wheezing due to cold. . . . lobar pneumonia. . . . . this formula should be used with caution in cases with hypertension.6g Honey-fried Radix Glycyrrhizae Uralensis (zhi gan cao) . honey-fried Radix Glycyrrhizae Uralensis (zhi gan cao). MODIFICATIONS: acrid Herba Ephedrae (ma hang). . . This combination is very effective in releasing the exterior. . . . * For wheezing. . Its primary focus is to stimulate sweating. . . . . wind-cold bottles up the exterior and constrains the yang. 1 piece the size of an egg yolk (12-30g) Rhizoma Zingiberis Officinalis Recens (sheng jiang) .

wheezing. . . Actions: Releases pathogenic influences from the muscle layer and regulates the nutritive and protective qi. . . The reduced dosage of the herbs. . . . reflects the mild nature of the disorder.9g Rhizoma Zingiberis Officinalis Recens (sheng jiang) . Today usually prepared as a decoction with the dosage specified in parentheses. copious white. . . . . (6-9g) Radix Glycyrrhizae Uralensis (gan cao) . . . . . . . Coicis. . . . . . . . The patient should bundle up to help induce mild sweating. . . . Ephedra. This is externally-contracted wind-cold leading to an exterior cold deficient condition. . . and a floating pulse that is either moderate or frail. Ramulus Cinnamomi Cassiae (gui zhi) . . . . . .5g Radix Glycyrrhizae Uralensis (gan cao) . . . . . . . . . Apricot Kernel. . .15g Grind into powder and take in 9g doses as a draft. . . Available in prepared form. and the nutritive qi (associated with yin) nourishes and INDICATIONS: . . According to the source text. Today this formula is prepared as a decoction and is cooked no more than 20 minutes. . For externally-contracted wind-cold characterized by head and body aches. . The protective qi (associated with yang) guards the exterior. the two regulate each other. . . . .3g Releases the exterior and dispels wind-dampness. 35 Three-Unbinding Decoction z P83 iG scin 60 tting Source: Imperial Grace Formulary of the Tai Ping Era (Tai ping hui min he ji ju fang) Herba Ephedrae (ma huang) . Its diaphoretic effect is not as strong as that of the principal formula. aversion to wind. . . . . slight aversion to wind. . . thin sputum. . .30g Semen Pruni Armeniacae (xing ren) . expels phlegm. . . . and a sensation of fullness in the chest. .3g Semen Coicis Lachryma-jobi ( y i yi ren) . Cinnamon Twig Decoction # . . . . .12 pieces Honey-fried Radix Glycyrrhizae Uralensis (zhi gan cao) . . May also be used for a similar presentation in patients recovering from serious illness or after childbirth. . . . . . . . . . repeat once or twice. .309Sclerotium Poriae Cocos Rubrae (chifu ling). . . . . no particular thirst. . . . . . . . . . . . . . . . . . . . If there is little sweating.Cinnamon Twig Decoction and Fructus Zizyphi Jujubae (da zao) is reduced. . . . or greasy foods is prohibited during medication. (3-6g) The source text advises to coarsely grind equal amounts of the ingredients and take 15g as a draft with five slices of Rhizoma Zingiberis Officinalis Recens (sheng jiang). . the consumption of alcohol and raw. . . .30g Cortex Mori Albae Radicis (sang bai pi) . . . . . . . .9g Radix Paeoniae (shao yao) . and Licorice Decoction k&t$4-i6 m6 xing yc' gcin tcing Source: Essentials from the Golden Cabinet g i n gui yao h e ) Herba Ephedrae (ma huang) . . and fever that worsens in the afternoon. .30g Pericarpium Citri Reticulatae (chen pi). . . except for Radix Glycyrrhizae Uralensis (gan cao). . . and stops coughing. Once sweating occurs. . . . . . . . . . .6g Preparation: The source text advises to coarsely grind the ingredients and decoct over a low flame in about seven cups of water until about three cups of liquid remain. . . . . .1. . . . releases the exterior. coughing. . . . . a thin. . . . . . Under normal circumstances. . . . . . . dry heaves. . . then taken hot. . externally-contracted wind-dampness characterized by mild. . . . . . . . . Available in prepared form. . . . . (6-9g> Semen Pruni Armeniacae (xing ren) . . . . . . . . . .30g Fructus Perillae Frutescentis (xu zi) .9g Fructus Zizyphi Jujubae (da zao). . . . . . headache. . . . . . . . the patient should go to bed and stay under the covers until there is slight sweating. . progressively reducing the interval between doses. . . . generalized body aches. Disseminates the Lung qi. white. . . . Radix Paeoniae Lactiflorae (bai shao) is the type of Radix Paeoniae (shao yao) that is generally used. . . . If the first cup is successful. nasal congestion. . For Fever and chills unrelieved by sweating. . After taking the formula. . . . . . . . . . .30g Radix Glycyrrhizae Uralensis (gan cao) . .Kr i9 gui zhZ tiing Source: Discussion (Shang han lun) of Cold-induced Disorders + & 44 Canopy Powder hu6 g6i s2n Source: Imperial Grace Formulary of the Tai Ping Era (Tai ping hui min he ji jufang) Herba Ephedrae (ma huang). . . . . nasal congestion. . . Disseminates the Lung qi and releases the exterior. .5g Semen Pruni Armeniacae (xing ren) . . . stop administering the formula. . . . stiff neck. . . . . . . . . . . . . . . . . . . . . Today only four pieces of Fructus Zizyphi Jujubae (da zao) are used. . . . The peculiarities of this condition are due to disharmony between the nutritive and protective qi. . . do not administer a second cup. . . . . and moist tongue coating. . . . . This is often seen in patients who have phlegm and then suffer an attack of wind-cold. For wind-cold attacking the Lungs characterized by coughing with copious sputum and a stifling sensation in the chest. . . . One cup is taken hot with hot rice gruel to induce sweating. . . . May also be used for coughing and loss of voice due to wind-cold. . spicy. . . . cold. . .1. . . . . . .

which is reflected in a relaxation of the pulse. the envoy. acrid Ramulus Cinnamomi Cassiae (gui zhi). The Lungs control the qi and are associated with the skin. some of the formulas that treat interior cold (chapter 7). for the past thousand years it has also been regarded as a very cloying herb. Sweating opens up the superficial levels of the body. but this should not be confused with the moderate pulse that refers primarily to speed. the protective qi is slightly weak. which constrains or bottles up the exterior. COMMENTARY: This is one of the most important stabilizes the interior. which leads to an aversion or sensitivity to wind. sweating. When wind-cold invades the muscles and the exterior. Ephedra Decoction (ma hang tang).e. With the appropriate presentation. Cinnamon Twig Decoction (gui zhi tang) is ideally suited for conditions where the protective qi is unable to guard the exterior and the nutritive qi is unable to nourish and stabilize the interior. which leads to dry heaves. using it as the foundation for many other formulas in the treatment of a wide array of disorders. The two assistants benefit the middle qi (Spleen) which rises to regulate the nutritive and protective qi. which causes nasal congestion. which benefits the yin and contains the weak nutritive qi. which can severely injure the fluids. This takes all of its strength and it is unable to adequately perform its other functions. Later generations of physicians also considered it to be a very important formula. ANALYSIS O F FORMULA: The chief herb. childbirth. One of the assistants. It has always been thought to tonify the normal qi.. As many as twenty variations and associated formulas are described in that text alone. and nose. there is no particular thirst. known as injury from cold (shfing hhn). as well as formulas that restrain abnormal leakage (chapter 12). or in patients with a weak constitution. warm. and thus does not lead to any improvement in the condition. To prevent this. The impaired qi mechanism of the Lungs and the loss of mutual regulation between the nutritive and protective qi disrupts the Stomach qi. Cinnamon Twig Decoction (gui zhi tang) is indicated for a pattern of exterior cold characterized by the presence of sweating. It is combined with the deputy. Loss of mutual regulation between the nutritive and protective qi can also occur after a serious illness. Cinnamon Twig Decoction should be used to prevent excessive sweating that might injure the fluids. one that causes fullness and distention in the middle burner. is indicated for a pattern of exterior cold characterized by the absence of sweating. For this reason. Rhizoma Zingiberis Officinalis Recens (sheng jiang). This is known as attack by wind (zhhgfing). In such cases. Warm. However. Fructus Zizyphi Jujubae (da zao). on the other hand. there may still be fever. even though there may be no externallycontracted wind-cold. the formula is said to regulate both the protective and nutritive qi. The nutritive qi therefore becomes unstable and is unable to contain the fluids. For example. it impedes the flow of qi in the channels (especially the greater yang channels). releases externally-contracted wind-cold from the muscle layer. The opening of the interstices and pores (during sweating) makes the person more sensitive to the environment. When it rises to the surface to fend off wind-cold. its dosage has been reduced. The thin. Together they simultaneously enhance the ability of the protective qi to dispel pathogenic influences while strengthening the nutritive qi. this formula may be used in treating such biomedically-defined . as are cold and bitter formulas. body hair. however. and strong diaphoretic formulas. such as guarding the nutritive qi. helps the deputy nourish and harmonize the formulas in Discussion of Cold-induced Disorders. The reduction in dosage of Fructus Zizyphi Jujubae (da zao). are variations of this formula. for an individual with a weak constitution suffering injury from cold. The pulse is moderate in the sense that it is unlike the tight pulse associated with exterior cold excess. helps the chief ingredient release the exterior while also treating the nausea and vomiting. to tonify the middle burner and harmonize the actions of the other herbs. The other assistant. i. T h e formula elegantly tonifies while releasing the exterior and thus effectively treats this condition. and an aversion to wind. Here. The resulting sweating does not have the full force of the protective qi behind it. such as Minor Construct the Middle Decoction (xiaojian zhong tang) and Tangkuei Decoction for Frigid Extremities (dang gui si ni tang). Radix Paeoniae Lactiflorae (bai shao). Fructus Zizyphi Jujubae (da zao) helps honey-fried Radix Glycyrrhizae Uralensis (zhi gan cao). are inappropriate in such cases. acrid. which leads to headache and stiff neck. also impairs the qi mechanism of the Lungs. However. is due to a different understanding of how best to utilize this herb. fever and chills are produced. which may cause the pathogenic influences to remain in the exterior. such as Cinnamon Twig Decoction plus Dragon Bone and Oyster Shell (gui zhi jia long gu mu li tang). Wind-cold. As is typical of fever due to exterior cold.36 Formulas that Release Exterior Cold nutritive qi and blood. which has occurred with many of the other formulas listed in the books of Zhang Zhong-Jing. white tongue coating and floating pulse are also characteristic of exterior wind-cold.

. severe thirst. . VARIATIONS: Cinnamon Twig Decoction plus Peony & 4 $ + ~d ib gui zhZ jia s K o yao tiing Source: Discussion of Cold-induced Disorders (Shang han lun) Double the dosage of Radix Paeoniae (shao yao) for greater yang-stage disorders which were improperly treated with purgatives and consequently advanced to the greater yin stage. . add Radix et R h i z o m a N o t o p t e r ~ g i i (qiang huo) a n d Radix Ledebouriellae Divaricatae (fang feng). there is no thirst or nausea. which is then accompanied by slight wheezing. . characterized by generalized aches and pains. . . and add Pericarpium Citri Reticulatae (chen pi) and Cortex Magnoliae Officinalis (hou $ 0 ) For joint pain in the extremities accompanied by fatigue (symptoms of dampness). sweating. . . . If prescribed in cases with heat. . characterized by an irregular pulse and a feeling of fullness in the chest. eczema. . For greater yang-stage disorders characterized by stiff neck and upper back. nosebleed may result. and add Rhizoma et Radix Ligustici (gao ben). . Available in prepared form. . MODIFICATIONS: 37 Cinnamon Twig Decoction minus Peony #%kd&ib gui zhZ qii s K o yZo tang Source: Discussion of Cold-induced Disorders (Shang han lun) Omit Radix Paeoniae (shao yao) for greater yang-stage disorders improperly treated with purgatives with injury to the yang of the chest. 1% Honey-fried Radix Glycyrrhizae Uralensis (zhi gun cao) . add Flos Chrysanthemi Morifolii (ju hua)and Periostracum Cicadae (chan tui). . . . * For marked nasal congestion with sneezing.6g Rhizoma Zingiberis Officinalis Recens (sheng jiang) . ASSOCIATED FORMULAS: * * * Cinnamon Twig Decoction plus Kudzu tl & d o %dib of Cold-induced Disorders (Shang han lun) gui zhZ jia g Z gEn tang Source: Discussion Ramulus Cinnamomi Cassiae (gui zhi) . . . Rhizoma Zingiberis Officinalis Recens (shyjiang). .6g Radix Paeoniae Lactiflorae (bai shao) . . and rough pulse. . . .9g Fructus Zizyphi Jujubae (da zao). allergic rhinitis. . For severe headache. . . and honey-fried Radix Glycyrrhizae Uralensis (zhi gun cao). .6g Radix Puerariae (ge gen) . . . . . . . . . . If incorrectly ~rescribed. . . I t should be used with caution in the summer or during spells of hot weather. . increase the dosage of Radix Paeoniae Lactiflorae (bai shao) and Rhizoma Zingiberis Officinalis Recens (shengjiang). . . Available in prepared form. . . C A U T I O N S & C O N T R A I N D I C A T I O N S : Contraindicated in cases with exterior cold and interior heat. . . . add Cortex Magnoliae Officinalis (hou $0) and Semen Pruni Armeniacae (xing ren). . Available in prepared form. relaxes and moistens the sinews. 3 pieces Releases the muscle layer. cerebrovascular spasm. . characterized by abdominal fullness. . . add Radix Ledebouriellae Divaricatae (fangfeng) and Flos Magnoliae (xin yi h a ) . . . . I n such cases. For a swollen. . . . deficient. and reduce by one-third the dosage of Ramulus Cinnamomi Cassiae (gui zhi). . . .ren) for a Cinnamon Twig Decoction (gui zhi tang) presentation plus wheezing. . For shortness of breath and rough breathing. . . . . influenza. post partum fever. . * * * Cinnamon Twig and Prepared Aconite Decoction w 4 F w 3 J gui zhZ@ d tiing Source: Discussion of Cold-induced Disorders (Shang han lun) Add Radix Lateralis Aconiti Carmichaeli Praeparata ( f u zi) fof painful obstruction due to pathogenic influences battling in the channels. . . . . . . . . . substitute Radix Paeoniae Rubrae (chi shao) for Radix Paeoniae Lactiflorae (bai shao). . . . profuse sweating. characterized by fever and thirst or sore throat with a rapid pulse. . . and urticaria. . high fever. . Because this disorder has not affected the interior. increase the dosage of Radix Paeoniae Lactiflorae (bai shao). White Tiger plus Ginseng Decoction (bai hu jia ren shen tang) should be prescribed to cope with the side-effects. difficulty in rotating the trunk. and a floating. . . . . palpitations and irritability may result. . .or if the dosage is too strong. angioedema. . . . . . and sensitivity to wind. . or where improper treatment with purgatives has failed to release an exterior disorder. heavy sensation in the head.Cinnamon Twig Decoction disorders as upper respiratory tract infection. . . . Cinnamon Twig Decoction plus Magnolia Bark and Apricot Kernel #24+4'?WjZrb gui zhZ jiii h5u $5 xing d tiing Source: Discussion of Cold-induced Disorders (Shang han lun) Add Cortex Magnoliae Officinalis (hou Po) and Semen Pruni Armeniacae (xing . For profuse sweating. . . For severe vomiting. Also add Radix Astragali Membranacei (huang qi) and Radix Ledebouriellae Divaricatae (fang feng).

. . . and for stimulating them to produce rain. . . . . . . . . . .24 pieces (3-6g) Honey-fried Radix Glycyrrhizae Uralensis (zhi gan cao) . or other herbal remedies. . . Available in prepared form. . . . . . . . . . This condition is characterized by a flushed face and generalized itching. .9g Honey-fried Radix Glycyrrhizae Uralensis (zhigancao) . . . .3g Radix Paeoniae Lactiflorae (bai shao) . thirst. . . . . This is characterized by fever and chills (fever predominant). . . . . Combined Cinnamon Twig and Ephedra Decoction 44 & & & & ? % g u i zh%mii hucng g i ban tiing Source: Discussion of Cold-induced Disorders (Shang han lun) Ramulus Cinnamomi Cassiae (gui zhi) . . . . Available in prepared form. . . . . . . . . . . . . . . . . transforms congested fluids. . . . . . . numb hands and feet. . . . The wood spirit from the east. . . . . . . . . . and a floating.9g Radix Paeoniae Lactiflorae (bai shao) . . . . . . . . . . . . . . . . . 4 pieces Warms the interior. . and generalized body aches. . . there may be floating edema or considerable difficulty in breathing when lying down. .9g Honey-fried Radix Glycyrrhizae Uralensis (zhi gan cao) . . . warms the Lungs. INDICATIONS: Fever and chills (chills predominant) Aconite and Cinnamon Twig Decoction &A$*&% wfi t6u g u i zh%tang Source: Essentials from the Golden Cabinet (jin gui yao lue) Ramulus Cinnamomi Cassiae (gui zhi) . . . . . . . .3g Herba Ephedrae (ma huang). . stringy. slight irritability. .9g Fructus Zizyphi Jujubae (da zao) . Minor Bluegreen Dragon Decoction -1- % & 531 xi50 qZng king tcing The name of this formula is thought to be derivedfrom Chinese folk religion. . . . . coughing. . .3g Honey-fried Radix Glycyrrhizae Uralensis (zhi gan cao) . . . . . . . . . .9g Preparation: Decoction to be taken hot. . . Actions: Releases the exterior. . . . . . . . .3g Semen Pruni Armeniacae (xing ren) . . . . . . . . . . . . . . . . wheezing. . . .5g Radix Paeoniae Lactiflorae (bai shao) . . . . . . . . . . . . . This will limit the toxic effect of Radix Aconiti ( w u tou). . . produces sweating like the dragon produces rain. . . . . . . . . . . . . . . . . . . . . . no particular thirst. . . .38 Formulas that Release Exterior Cold disorder characterized by abdominal pain. . . . . . . causing the interstices and pores to close. . . . . . . . . . . . . . . the fluids and the cold are locked in battle. .3g Rhizoma Zingiberis Officinalis Recens (sheng jiang) . . . . and releases the exterior. known as the bluegreen dragon.9g Fructus Schisandrae Chinensis ( w u wei zi) .9g Radix Aconiti ( w u tou) . . . . . Available in prepared form. . . . . For persistent greater yangstage disorders in which the pathogenic influences have not been fully released and the normal qi has become slightly weakened. . . . . When the Lung qi is constrained by wind-cold. . .9g Herba cum Radice Asari (xi xin). . . . . cold extremities. . and a floating. induces sweating. a moist tongue coating. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . and releases the exterior. . . . . . . a generalized sensation of heaviness and body aches. This formula transforms congested f luids and expels pathogenic influences like the dragon which manijists i n the power of the waves. . Major Bluegreen Dragon Decoction (da qing long tang). . moxibustion. . .3g Herba Ephedrae (ma huang). . . . . . and directs rebellious qi downward. 4 pieces Regulates the nutritive and protective qi. . . . . . . Because of the potency of this formula. . . .3g Fructus Zizyphi Jujubae (da zao) . . . . . . . . . . . . This results in fever and chills without sweating. . . . . discussed above. . . For interior cold due to yang deficiency accompanied by wind-cold which gives rise to a cold hernial without sweating. . . .6g Rhizoma Zingiberis Officinalis Recens (sheng jiang) . . . . white. and forceful pulse. . . . . . . . . . . . .3g Fructus Zizyphi Jujubae (da zao) . . Source: Discussion (Shang han lun) of Cold-induced Disorders Two-parts Cinnamon Twig Decoction and One-part Maidservant from Yue Decoction # K =@*-% g u i zh%ir yui b i Source: Discussion tang of Cold-induced Disorders (Shang han lun) Ramulus Cinnamomi Cassiae (gui zhi) . big. . . . . . . . . . is present in the billowing ocean waves and is responsible for generating clouds. . sputum that is copious. . a stifling sensation in the chest. . . . . . Herba Ephedrae (ma huang) . . . . Patients with chronic water metabolism problems and congested fluids usually have weak Lungs and Spleen. . . . . . . In severe cases. . . . .6g Radix Paeoniae Lactiflorae (bai shao). . .3g Rhizoma Zingiberis Officinalis Recens (shengjiang) .3g Gypsum (shi gao). . . . . . . . . . . . . . . . . . . as soon as it takes effect administration should cease. . . . . . . . . . . . . . . . . . . . . . . . . . . It is said that this condition will not respond to acupuncture. . . 4 pieces Induces sweating and clears interior heat. . . . reinforces the yang.9g Ramulus Cinnamomi Cassiae (gui zhi). . . . When they contract external wind-cold. . . . Today the dosage of Rhizoma Zingiberis Officinalis (gan jiang) and Herba cum Radice Asari (xi xin) is reduced to 3g because of the very hot nature of these herbs. . The Lungs control the qi and the exterior and facilitate the flow in the water pathways.9g Rhizoma Zingiberis Officinalis (ganjiang) . . . . . .9g Rhizoma Pinelliae Ternatae (ban xia) . and difficult to expectorate. . . For persistent exterior disorders that have become constrained and are accompanied by mild interior heat. . . tight pulse. . . . . . . . .

Use with caution in cases with hypertension. the assistant herbs Fructus Schisandrae Chinensis (wu wei zi). Ephedra Decoction (ma huang tang) and Cinnamon Twig Decoction (gui zhi tang). . and congested fluids accumulate in the epigastric region and attack the Lungs from below. and Asarum Decoction (ling gan wu weijiang xin tang). . . The envoy. Ginger. while tightness reflects cold. coughing of blood.12g Fructus Zizyphi Jujubae (da zao) . . . I n such cases. redirects rebellious qi. arrests wheezing. One of the chief herbs. . . and irritability. substitute Rhizoma Zingiberis Officinalis Recens (shengjiang) for Rhizoma Zingiberis Officinalis (gun jiang). bronchial asthma. . white.3g Rhizoma Zingiberis Officinalis Recens (sheng jiang) .9g Fructus Schisandrae Chinensis (wu wei zi) . . . . k $ 4. . increase the dosage of Herba cum Radice Asari (xi xin) and Rhizoma Pinelliae Ternatae (ban xia). . . a stifling sensation in the chest. . For severe exterior cold disorders. MODIFICATIONS: mula is attributed to its ability to simultaneously release wind-cold from the exterior and transform congested fluids in the interior. . . Schisandra. . acrid herbs whose function is to scatter and dry may injure the qi and fluids.E. . Herba cum Radice Asari (xi xin) also stops the coughing by facilitating the flow of qi throughout the body. and is most often used for acute attacks of wind-cold in cases with chronic congested fluids or Spleen deficiency. ANALYSIS O F FORMULA: The efficacy of this forCAUTIONS 39 & CONTRAINDICATIONS: This formula should not be used long-term. Rhizoma Zingiberis Officinalis (gan jiang) and Herba cum Radice Asari (xi xin). . It acts to warm the interior and transform congested fluids. transforms cold and congested fluids lingering in the chest. . . augments the qi and harmonizes the interaction of the acrid and sour herbs. . For pronounced nasal congestion. . . . & . $$ xi50 q k g 16ng jici shi giio tang Source: Essentials from the Golden Cabinet (Jin gui yao he) Add Gypsum (shi gao) for coughing. Fluids entering the superficial levels of the body can cause floating edema. . . . and stops coughing. Herba Ephedrae (ma huang). With the appropriate presentation. . and moves water by facilitating the flow of Lung qi. and in very severe cases. Licorice. . thoracic and abdominal distention. the deficiency of which is the primary cause of congested fluids.Minor Bluegreen Dragon Decoction the qi mechanism is further impeded. . or coughing due to yin deficiency.giberis Officinalis (gan jiang) is particularly effective in warming the Spleen. . copious sputum. . . . This process leads to coughing and wheezing (with copious. . .9g Herba cum Radice Asari (xi xin) . . For this reason. . . warm the interior. . . . together with Poria. . are added. nor for conditions with heat. . works with Herba Ephedra (ma hang) to release the exterior. and influenza. . Treating rebellious qi with warm. . + For marked congestion. honey-fried Radix Glycyrrhizae Uralensis (zhi gan cao). . and a wiry and tight or wiry and slippery pulse. The floating nature of the pulse indicates an exterior condition. . . . . . transform congested fluids. . . stringy sputum that is difficult to expectorate). . another assistant. .12g Radix Asteris Tatarici (zi wan) . . . . The deputies. . . acute exacerbation of chronic bronchitis. .9g Flos Tussilaginis Farfarae (kuan dong hua) . . . . . . 9 g Herba Ephedrae (ma huang) . which nourishes the blood and nutritive qi. . . The absence of thirst and the moist tongue coating indicate a surfeit of fluids. . . Ramulus Cinnamomi Cassiae (gui zhi). a generalized sensation of heaviness and body aches. . transforms congested fluids and harmonizes the Stomach. which prevents the leakage of Lung qi. difficultly in breathing while lying down. T h e other chief ingredient. difficulty in breathing while lying down. . and add Rhizoma Zingiberis Officinalis Recens (sheng jiang) . . . releases the exterior. runny nose. .9g Rhizoma Pinelliae Ternatae (ban xia) . . . . ASSOCIATED FORMULA: Belamcanda and Ephedra Decoction $43 i6 shi giin m6 hu6ng tiing Source: Essentials from the Golden Cabinet (Jin gui yao he) Rhizoma Belamcandae Chinensis (she gun) . and Radix Paeoniae Lactiflorae (bai shao). . . and help the chief herbs release the exterior. increase the dosage of Herba Ephedrae (ma huang) and Ramulus Cinnamomi Cassiae (gui zhi). . . . . . . a slippery and wet tongue coating. . . . Rhizoma Zin. . . . . . . . honey-fried Herba Ephedrae (zhi ma hang) is often substituted for Herba Ephedrae (ma huang) . . For pronounced coughing and wheezing with a rattling sound. wheezing. . . substitute Radix Paeoniae Rubrae (chi shao) for Radix Paeoniae Lactiflorae (bai shao). . this formula may be used in treating such biomedically-defined disorders as acute bronchitis. its focus is on treating a more severe cough with mild or no exterior symptoms. . . and add Radix Ledebouriellae Divaricatae (fayfeng) and Herba seu Flos Schizonepetae Tenuifoliae (jing jie). . In contrast to the principal formula. . COMMENTARY: This formula is basically a combination of two formulas that release the exterior. . and headache. . . . . . . 3 pieces Warms the Lungs. Rhizoma Pinelliae Ternatae (ban xia). VARIATION: Minor Bluegreen Dragon Decoction plus Gypsum "1. . .

.4. . . .5g Radix Ledebouriellae Divaricatae (fang feng) . .9g Radix Angelicae Pubescentis (du huo) . sinusitis. . .9g . . Actions: Releases exterior dampness and clears interior heat. . . .4. . .3g Radix Glycyrrhizae Uralensis (gan cao) . omit Radix Scutellariae (hang gin) and Radix Rehmanniae Glutinosae (sheng di hang). INDICATIONS: Fever and chills (chills predominant) by Zhang Yuan-Su during the Song dynasty. . . This is externally-contractedwind-cold-dampness with concurrent internal accumulation of heat characterized by fever and chills (chills predominant) without sweating. . Nine-Herb Decoction with Notopterygium from the Analytic Collection ad%%% jiii we'i qiiing hu6 tang Source: Analytic Collection of Medical Formlas (Yifang ji jie) Add Rhizoma Zingiberis Officinalis Recens (sheng jiang) and Bulbus Allii Fistulosi (cong bai) to increase the diaphoretic action of this formula. add Radix Platycodi Grandiflori (jie geng). . . and a floating pulse. . . headache. a bitter taste in the mouth. and rheumatic fever.3g Preparation: Decoction. The source text advises to coarsely grind the herbs. * For pronounced thirst and irritability. . . . Herba cum Radice Asari (xi xin). . . *Where there is no thirst or bitter taste in the mouth.5g Herba cum Radice Asari (xi xin) . Today it is primarily used for exterior damp-cold with heat in the interior characterized by the indications above. . a white tongue coating. The predominance of chills and the generalized aches and pain are the primary indicators of externally-contracted dampness.4. . . . . . The other deputies. . . .3g Radix Angelicae Dahuricae (bai zhi) . . . . 1. . . . . ASSOCIATED FORMULA: Major Notopterygium Decoction $ %%%.3g Radix Rehmanniae Glutinosae (sheng di huang). stiff neck.Formulas that Release Exterior Cold a 4 k %% ii5 jiii we'i qiiing hu6 tiing Nine-Herb Decoction with Notopterygium COMMENTARY: Although this formula was devised Source: Hard-won Knowledge (Ci shi nan zhi) Radix et Rhizoma Notopterygii (qiang huo) . . omit Radix Rehmanniae Glutinosae (sheng di hang) and add Herba Agastaches seu Pogostemi (huo xiang) and Rhizoma Pinelliae Ternatae (ban xia). is the principal substance in the materia medica for dispersing exterior wind-cold-dampness. . . .9g Radix Ledebouriellae Divaricatae (fang feng) . . . . *For coughing up of thick sputum. and Radix Angelicae Dahuricae (bai zhi). . . . Heat accumulating internally produces slight thirst and a bitter taste in the mouth. With the appropriate presentation. . . . . . . . . . acute lower back sprain. . Radix Scutellariae ( h n g gin) and Radix Rehmanniae Glutinosae (sheng di hang). . . The assistants. Two of the deputies. . . . . . . harmonizes the middle burner and the actions of the other herbs. add Radix Gentianae Qinjiao (qin jiao). . . and a stiff neck. . Radix Ledebouriellae Divaricatae (fang feng) and Rhizoma Atractylodis (cang zhu). MODIFICATIONS: without sweating. clear qi and blood-level interior heat respectively. . .6 dii qGng hu6 tiing Source: Hard-won Knowledge (Ci shi nan zhi) Radix et Rhizoma Notopterygii (qiang huo) .5g Rhizoma Atractylodis (cang zhu) . it was not recorded until the Yuan dynasty. Radix Glycyrrhizae Uralensis (gan cao). . . .3g Radix Scutellariae (huang qin) . . It was originally prescribed for any greater yang-stage disorder (exterior cold) with or without sweating. ANALYSIS O F FORMULA: The chief herb. . influenza. add Gypsum (shi gao) and Radix Anemarrhenae Asphodeloidis '(zhi mu). . headache. . Radix Ligustici Chuanxiong (chuan xiong). . . . slight thirst. Fructus Arctii Lappae (niu bang zi) and Herba Menthae Haplocalycis (bo he). which eliminated the need to choose between Ephedra Decoction (ma hang tang) and Cinnamon Twig Decoction (gui zhi tang). *For a dry or sore throat. aromatic * For upper back and shoulder pain. and also prevent the dry nature of the other herbs from injuring the fluids. assist the chief herb in releasing the exterior and treating the head and body aches. . treat the thirst and bitter taste in the mouth. . * For epigastric discomfort and distention with a greasy tongue coating. . The envoy. . . add Semen Pruni Armeniacae (xing ren) and Radix Peucedani (gum hu) .5g Radix Ligustici Chuanxiong (chuan xiong) . . . VARIATION: Radix et Rhizoma Notopterygii (qiang h o ) . . . . assist the chief herb in releasing the exterior and eliminating dampness. It may also be used for toothache with exterior symptoms. . . . generalized aches and pain. . . this formula may be used in treating such biomedically-defined disorders as upper respiratory tract infection. The white tongue coating and floating pulse indicate that the pathogenic influences are still in the exterior. .

. . . . . . . . . . . . . . . May also be used in pregnant women for exterior wind-cold. . With the appropriate presentation. . When wind-cold constrains the exterior the Lung qi cannot spread. . . Available in prepared form.4. headache. . . . . . . poor appetite. . . . . . . . . . Together these two herbs address the major complaint. . . . . . this formula may be used in treating such biomedically-defined disorders as upper respiratory tract infection and stomach flu. . . the assistant. . . . . . . . . add Fructus Perillae Frutescentis (su z i ) and Rhizoma Pinelliae Ternatae (ban xia). . . . which i n turn obstructs the qi mechanism of the Spleen and Stomach (especially in patients with preexisting constraint). . ANALYSIS OF FORMULA: The chief ingredient. . . .Cyperus and Perilla Leaf Powder Herba cum Radice Asari (xi xin) . . . . . . . Scatters wind-cold.8-2. . . The arm greater yin Lung channel arises from the middle burner. .1. and irritability. . May also be prepared as a decoction with the dosage indicated in parentheses. For severe headache. . strengthens the Stomach.(6-9g) Rhizoma Cyperi Rotundi (xiang fu) . . . helps regulate the qi. . . . and prevents the qi-regulating herbs from depleting the qi. .30g Radix Rehmanniae Glutinosae (sheng di huang) . The deputy. . . . . . . . .9g Honey-fried Radix Glycyrrhizae Uralensis (zhi gan cao) . . belching. . . . . .f. .9g Radix Anemarrhenae Asphodeloidis (zhi mu) . . . MODIFICATIONS: @ Cyperus and Perilla Leaf Powder xiiing sii s6n Source: Imperial Grace Formulary of the Tai Ping Era (Tai ping hui min he ji ju fang) Folium Perillae Frutescentis (zi su ye). regulates the qi. . . . . .4. . . . its focus is on clearing more severe interior heat and expelling dampness. . . . expels dampness. . .9g Radix Aristolochiae Fangchi (guang fang ji) . . . . . . . releases constraint and disperses stagnation. . . INDICATIONS: Fever and chills without sweating.2-3 pieces Semen Sojae Praeparata (dan dou chi) . . . . . a dry mouth. this is intended for more severe exterior wind-cold. . The former is more common. . . . The thin. . I n contrast to the principal formula. . . . prepare as a decoction. . Exterior wind-cold causes fever and chills (without sweating) and headache. . . . . . . xiiing sii c6ng chz' tiing Source: Revised Popular Guide to the Discwsion of Cold-induced Disorders (Chong ding tong su shang han lun) Folium Perillae Frutescentis (zi su ye) . . . . . . . and Prepared Soybean Decoction ASSOCIATED FORMULAS: %% $4 headache. . . . . Because the effects of the ingredients are mild and their dosage is rather small. thirst. . . . .9g Rhizoma Coptidis (huang lian). . . . . Augmented Cyperus and Perilla Leaf Powder 750 o. a thin.5-9g Rhizoma Cyperi Rotundi (xiang fu) . . .30g Coarsely grind the ingredients. . . . Rhizoma Cyperi Rotuny di (xiang ju). . . . . . . .9-12g Releases the exterior. .4. COMMENTARY: This formula is indicated both for patients with constitutionally constrained qi who suffer from exterior wind-cold. . . and a floating pulse. . . . and take in 15g doses. . . .5-6g Honey-fried Radix Glycyrrhizae Uralensis (zhi gan cao) . . . . . Scallion. . . acrid Folium Perillae Frutescentis ( z i su ye). add Fmctus Viticis (man jing zi). Pericarpium Citri Reticulatae (chen Pi). . . . . . . . . . .120g (6-9g) Pericarpium Citri Reticulatae (chen pi). . . . . . . . . as well as in cases of externally-contracted wind-cold with simultaneous qi stagnation. . . and calms the fetus. .5-6g Pericarpium Citri Reticulatae (chen pi) . and focal distention and a stifling sensation in the chest and epigastrium. . . . . . * For coughing with copious sputum. . and clears heat. . . . . Actions: Regulates the qi and releases the exterior. : 1209. the formula is inappropriate for treating severe conditions. . For exterior wind-cold-dampness with interior heat characterized by fever and chills (fever predominant). . .30g Radix Ligustici Chuanxiong (chuan xiong) . . . the envoy. This is a combination of exterior wind-cold together with qi constrained in the interior. This produces such symptoms as lack of appetite. Honey-fried Radix Glycyrrhizae Uralensis (zhi gan cao). . . . . .9g Rhizoma Atractylodis (cang zhu) . 41 releases exterior wind-cold and facilitates the flow of qi in the interior.9g Rhizoma Atractylodis Macrocephalae (bai zhu) . . white tongue coating and floating pulse reflect the presence of cold in the exterior. . . . white tongue coating. Perilla Leaf. . . . . . . . warm. . . . .60g (3-6g) Honey-fried Radix Glycyrrhizae Uralensis (zhi gan cao) .30g (3-6g) Preparation: Grind into powder and take as a draft in 3-6g doses three times a day. . . . . . . . . . . Cyperus. . This is an illustration of how a simple and elegant formula can effectively treat a specific problem. . . . I n contrast to the principal formula. . 4 $ & jiii we'i xiiing sii siin . .9g Radix Scutellariae (huang qin) . . belching. . . . . . harmonizes the actions of the other herbs. . . . . . .4g Bulbus Allii Fistulosi Recens (xian Gong bai) . . focal distention and a stifling sensation in the chest and epigastrium. . . . . .

.1g Herba seu Flos Schizonepetae Tenuifoliae (jing jie) . . . . . . . . . vomiting. Traditionally. . . harmonizes the ascending and descending functions of the Spleen. . They also attack the Spleen. .2. . . . The white. . a stifling sensation in the chest. . . the source text makes no mention of summerheat. causing abdominal pain. . . . body aches. . abdominal pain. . runny nose. . . . . regardless of the season. . . . . The combina- . Induces sweating and releases the exterior. . greasy tongue coating reflects the presence of cold and dampness. The cold and dampness condense in the abdomen. and the clear to ascend. acrid. . . . . . The chief herb. It also strengthens the Spleen. headache. . . acrid nature of the constituent herbs. Actions: Releases the exterior. . . . its focus is on releasing the exterior. . . and harmonizes the middle burner. . . . . attacks the major aspects of this condition. . was believed by Li Shi-Zhen to be the summer equivalent of Herba Ephedrae (ma huan~) because of its ability to stimulate sweating and release exterior cold. . and disperses stagnant fluids by dispelling cold and dampness from the middle burner. cannot support them when it is encumbered by cold and dampness. . which governs the extremities. . .5g Rhizoma Zingiberis Officinalis Recens (sheng jiang). Semen Dolichoris Lablab (bai bian dm). It releases the exterior.480g (9-12g) Semen Dolichoris Lablab (bai bian dou) . In Medical Revelations. primarily by causing the turbid fluids and products of food transformation to descend. . . . . . The hot weather and interior dampness join in constraining the yang qi. . assists the chief herb by ameliorating the effects of summertime dampness on the Spleen. . advice which is not only mistaken. but if followed could very well prove harmful to the patient.6g Radix Glycyrrhizae Uralensis (zhi gan cao) .6g Pericarpium Citri Reticulatae (chen pi) . . . Today it is usually prepared as a decoction. .3. simultaneous treatment of the exterior and interior. . . . . COMMENTARY: This formula is designed for treating damp-cold contracted during the summertime. . . . . . while the floating pulse reflects an exterior condition. . . . a sensation of heaviness in the head. . . . .3g Radix Ledebouriellae Divaricatae (fangfeng). . . . . . Herba Elsholtziae seu Moslae (xiang ru). . . . . . transforms dampness.2409-(6-9g) Cortex Magnoliae Officinalis (hou Po) . a warm. . . tion of exterior cold and interior dampness causes a heavy. . . . It is especially useful in those patients with vomiting and diarrhea. . . . . . . This function is reflected in the warm. .240g (6-9g) Preparation: Grind into a coarse powder and take 9g as a draft.3g Radix Gentianae Qinjiao (qin jiao) . leading to chills. . Cortex Magnoliae Officinalis (hou Po). . The assistant. . . . . . . . 1. . . For this reason. . almost burning sensation in the skin. In contrast to the principal formula. . . painful sensation in the head. Its strongly aromatic nature can cause vomiting (particularly when taken warm) in patients with turbid dampness in the interior. and a warm. . . . . expels dampness and disperses fullness.Formulas that Rebase Exterior Cold Source: Medical Revelatiom (Yi xue xin wu) Folium Perillae Frutescentis (zi su ye) . . an aversion to cold. . . . .3g Radix Ligustici Chuanxiong (chuan xiong) . . and a floating pulse. . . The Spleen. and a floating pulse. cool breezes. May also be prepared as a decoction with the dosage indicated in parentheses. and the interior may be injured by overconsumption of cold food or beverages. . . . which disrupts the ascending and descending mechanism of qi. . . . an absence of sweating. . stiff neck. 3 slices The source text advises to grind the herbs into a coarse powder and take as a draft. a small amount of wine (equal to about one-tenth of the liquid in the draft) is added and the mixture is taken cold. The deputy. . Cheng Guo-Peng prescribes this formula as a substitute for ~ p h e d r a e Decoction (ma huang tang) in patients with relatively mild exterior windcold. This is exterior cold with interior dampness contracted in the summer. .3. . . a white.3g Fructus Viticis (man jing zi) . in the past some writers have suggested that this formula could also be used for treating summerheat. . . nasal congestion. . . . . scatters cold. . . which is an exterior-interior condition. . . The chief herb in this formula. . . .5g Rhizoma Cyperi Rotundi (xiang fu) . . . During the summer. . Nevertheless. . Herba Elsholtziae seu Moslae (xiang ru).4. . . fatigued extremities. This formula may be considered appropriate for any patient with a presentation of exterior cold and interior dampness. . For externallv-contracted disorders characterized by fever and chills or sensitivity to wind without sweating. . . . . . the draft or decoction should be allowed to cool INDICATIONS: Aversion to cold with skin that is warm to the touch. headache. . . . white tongue coating. greasy tongue coating. . a thin. This loss of support causes fatigue in the extremities. . the exterior may be affected by exposure to sudden. Qi dysfunction and dampness produce a stifling sensation in the chest. causing nausea and vomiting or diarrhea. . ANALYSIS OF FORMULA: This condition requires Elsholtzia Powder xiiing rii sEin Source: Imperial Grace Formulary of the Tai Ping Era (Tai ping hui min he ji jufang) Herba Elsholtziae seu Moslae (xiang ru). . and aromatic substance. . . In fact. . diarrhea. .

. . . . .L5g * . . . sweating. . I . . Four-Substance Decoction with Elsholtzia & 3 +k bQ%&%& si wii xiiing rii yZn Source: Book to Safeguard Lij Arranged According to Pattern (Lei zheng huo ren shu) Add ginger juice-fried Rhizoma Coptidis (jiang zhi chao huang lian) for interior dampness transformed into heat characterized by thirst and irritability. increase heat in the body. . .1. . . and sore throat. . . MODIFICATIONS: @ For a stronger exterior presentation. . With the appropriate presentation. . . VARIATIONS: Newly-Augmented Elsholtzia Decoction %ia. . this presentation corresponds to the protective level. . and significantly aggravate the condition. . . .Elsholtzia Powder before ingestion. a sense of tightness in the chest.1. . @ For severe cold with nasal obstruction. . take with Scallion and Prepared Soybean Decoction ( c q chi tang). . . . . . . . . . The source text prescribes it for conditions contracted during the summertime.> 4 7 3 k shi we'i xiiing rii yZn Source: Restoration of Health from the Myriad Diseases (Wan bing hui chun) Herba Elsholtziae seu Moslae (xiang ru) . . . . . L5g Cortex Magnoliae Officinalis (hou $0). . . . May also be prepared as a decoction. . . . . . . . . .9g Cortex Magnoliae Officinalis (hou Po) . . . Releases exterior cold. . . . . . . . . . . . . . . . T h e tongue coating is white or slightly yellow (indicating that heat has not penetrated deeply enough to cause a purely yellow coating). Among the four-level differentiation of the patterns of disease. . augments the qi. Ten-Ingredient Decoction with Elsholtzia 3-G. . . . . . . headache. . . . . . . . .5g Rhizoma Atractylodis Macrocephalae (bai zhu) . .6g Semen Dolichoris Lablab (bai bian dm) . rapid pulse. . . . . . . . . . 43 Radix Ginseng (ren shen) . . a white. . .5g Sclerotium Poriae Cocos ( f u ling). . and then another half dose if sweating does not occur. . . . . . thirst. . . . . a slight aversion to wind or slight chills. . . add Herba Artemisiae Annuae (qing hao). . . . . . . Five-Substance Decoction with Elsholtzia =%% %+& wii wii xiiing rii yZn Source: Analytic Collection of Medical Formulas (Yi fang ji jie) Add Sclerotium Poriae Cocos (fu ling) and Radix Glycyrrhizae Uralensis (gan cao) for severe dampness in the interior characterized by abdominal distention and diarrhea. . . . . There may also be a cough or redness of the eyes. . . and strengthens the Spleen. . . and a floating. . . . . . Repeat the procedure if this still fails to induce sweating. . . . . . . . . . . . . .5g Honey-fried Radix Glycyrrhizae Uralensis (zhi gan cao) .1. . early-stage summerheat with superimposed contraction of cold characterized by fever and chills without sweating. . .5g Semen Dolichoris Lablab (bai bian o h ) . . . . . . Releases exterior summerheat conditions.5g Fructus Chaenomelis Lagenariae (mu gua) . . . . . . Six-Ingredient Decoction with Elsholtzia +$*$& liii we'i xiiing rii yZn Source: Analytic Collection of Medical Formulas (Yi fang ji jie) Further add Fructus Chaenomelis Lagenariae (mu gua) to the previous formula if there is also stiffness in the calves. For externally-contracted dampcold characterized by mild fever and chills and relatively profuse sweating. . . headache. . This condition is common during the summertime due to changes in weather and diet. . . . . . . . .6g Decoction. .6g Flos Lonicerae Japonicae (jin yin hua) . Take a half dose. . gastroenteritis. . . .6g Honey-fried Radix Astragali Membranacei (zhi huang qi) . . . . .5g Pericarpium Citri Reticulatae (chen pi) . . . . . . . . . . . ASSOCIATED FORMULAS: SECTION 3 FORMULAS THAT RELEASE EXTERIOR WIND-HEAT Externally-contracted wind-heat disorders a r e characterized by fever. . .1. . . . . . . . . flushed face.5g Grind into a coarse powder and take as a draft. For severe. . . . CAUTIONS & CONTRAINDICATIONS: T h e use of this formula in patients with summerheat will severely injure the fluids and qi.9g Fructus Forsythiae Suspensae (lian qiao). . .1. . . which is the most superficial. . . . . . . x k jiii xiiing rii yZn Source: Systematic Dijjerentiation of Warm Diseases (Wen bing tiao bian) Herba Elsholtziae seu Moslae (xiang ru) . . . . . . . . greasy tongue coating. . . thirst. and the pulse is floating and rapid. bacillary dysentery. transforms interior dampness. . and cholera. this formula may be used in treating such biomedically-defined disorders as u p p e r respiratory tract infection. . .1. . . .

. The floating. Herba Menthae Haplocalycis (bo h) [add near end] . .the chief herbs. @ For sore throat. . which stops the coughing. a thin. cough. . . . which has a descending action-assist the chief herbs by facilitating the flow of Lung qi. this formula may be used in treating such biomedically-defined disorders as upper respiratory tract infection. superficial stage of a warmfebrile disease. . Honeysuckle and Forsythia Powder (yin qiao san) is a stronger formula for releasing the exterior and clearing heat. The normal tongue coating indicates that the condition is still in the exterior. . yellow sputum that is difficult to expectorate. add Pericarpium Trichosanthis (gua lou pi) and Bulbus Fritillariae Thunbergii (zhe bei mu). . . . For heat entering the blood. . Semen Pruni Armeniacae (xing ren). Available in prepared form. Actions: Releases exterior wind-heat and stops coughing by facilitating the flow of Lung qi. Radix Rehmanniae Glutinosae (sheng di huang). . white tongue coating. omit Rhizoma Phragmitis Communis (lu gen) and Herba Menthae Haplocalycis (bo he). . which contains many of the same ingredients. . This is the early. This type of disorder enters through the nose and mouth and then attacks the Lungs. . Semen Cassiae (jue ming zi) and Spica Prunellae Vulgaris (xia ku cao). Radix Glycyrrhizae Uralensis (gan cao). With the appropriate presentation. this formula is more effective for treating cough. @ For pronounced thirst. For blood-streaked sputum. . . influenza. . add Radix Scrophulariae Ningpoensis (xuan shen) and Cornu Rhinoceri (xi jiao) (source text). and a floating. . . @ For viscous.30g (9-15g) . . . Fructus Forsythiae Suspensae (lian qiao) and Herba Menthae Haplocalycis (bo he). Rhizoma Polygonati Odorati (yu zhu) and Cortex Moutan Radicis (mu dan pi) (source text). while Flos Chrysanthemi Morifolii (ju h a ) disperses upper burner wind-heat. $n qiho stin Source: Systematic Differentiation of Warm Diseases (Wen bing tiao bian) Flos Lonicerae Japonicae (jin yin hua). . early-stage acute bronchitis. . . Two other deputies-Radix Platycodi Grandiflori (jie geng).30g (9-15g) Fructus Forsythiae Suspensae (lian qiao) . and a hacking cough due to exterior dryness. . . . . clears heat and generates fluids. Fructus Forsythiae Suspensae (lian qiao). and acute conjunctivitis. which has an ascending action. Do not cook for more than 20 minutes. Rhizoma Imperatae Cylindricae (bai mao gen) and Nodus Nelumbinis Nuciferae Rhizomatis (ou jie). thereby reducing thirst. . . @ For nutritive-level heat with a dark-red tongue. and Semen Pruni Armeniacae (xing ren). Radix Platycodi Grandiflori (jie geng) . ANALYSIS OF FORMULA: Folium Mori Albae (sang ye) and Flos Chrysanthemi Morifolii (ju hua). release exterior heat. . Preparation: Decoction. . Radix Glycyrrhizae Uralensis (gan cao) . . It is also used for eye disorders due to wind-heat. Although closely related to Honeysuckle and Forsythia Powder (yin qiao san). helps clear heat and harmonizes the actions of the other herbs. . @ For wind-heat affecting the eyes.Formulas that Release Exterior Wind-Heat Mulberry Leaf and Chrysanthemum Decoction siing jii yin Source: Systematic Differentiation of Warm Diseases (Wen bing tiao bian) Folium Mori Albae (sang ye) . Rhizoma Phragmitis Communis (lu gen) . For labored breathing or slight wheezing. add Fructificatio Lasiosphaerae seu Calvatiae (ma bo) and Fructus Arctii Lappae (niu bang zi). . . slight thirst. Folium Mori Albae (sang ye) also clears heat from the Lungs and stops the coughing. . . INDICATIONS: Slight fever. Flos Chrysanthemi Morifolii (ju hua) . Two of the deputies. rapid pulse. . . add Gypsum (shi gao) and Radix Anemarrhenae Asphodeloidis (zhi mu) (source text). . . . acute tonsillitis. . add Radix Trichosanthis Kirilowii (tian huafen) (source text). The mild fever and slight thirst reflect the presence of mild exterior heat. add Radix Scutellariae (hang qin) (source text). . . producing coughing. The assistant. the envoy. . . . add Fructus Tribuli Terrestris (bai ji li). 6 For severe Lung heat. . Rhizoma Phragmitis Communis (lu gen). . Honeysuckle and Forsythia Powder 4 ? 1 4 k COMMENTARY: This is the classic formula for earlystage warm-febrile diseases or other mild exterior heat disorders in which coughing is the dominant symptom. add Gypsum (shi gao) and Radix Anemarrhenae Asphodeloidis (zhi mu). including that which affects the eyes. strengthen the formula's exterior-releasing properties. . MODIFICATIONS: For qi-level dryness. . . . rapid pulse also reflects exterior heat. and add Tuber Ophiopogonis Japonici (mi men dong). add Cortex Moutan Radicis (dan pi). .

clear heat. . Flos Lonicerae Japonicae (jinyin hua) and Fructus Forsythiae Suspensae (lian qiao). The modern physician. . With the appropriate presentation. help the chief herbs release exterior heat. Two of the deputies. the tongue coating will be normal (thin and white). . . 1% (6-959 Herba Lophatheri Gracilis (dan zhu ye) . . . unless this formula is modified it will be ineffective. acute bronchitis. .18g (3-6g) Fructus Arctii Lappae (niu bang zi) . . . . . ..12g (3-6g) Rhizoma Phragmitis Communis Recens (xian l u gen) . This is a n early-stage warm-febrile disease which enters through the nose and mouth and attacks the Lungs.15g (3-6g) Herba seu Flos Schizonepetae Tenuifoliae (jing jie) . . generates fluids and alleviates thirst. .15-30g Radix Glycyrrhizae Uralensis (gan cao) . add Semen Pruni Armeniacae (xing ben) (source text). . and relieves toxicity. a red-tipped tongue. Today the formula is usually prepared as a decoction with the dosage indicated in parentheses. . . It is a popular formula (often in modified form) due to its ability to treat disorders of the upper burner without injuring the middle burner. slight or no chills. 18g (3-6g) Semen Sojae Praeparata (dan dou chi). deliberately chose these herbs in naming the formula to alert practitioners to the fact that cold herbs should be the primary constituents of formulas that treat the early stages of warm-febrile disease. and relieve toxicity. headache. . Available from many manufacturers in tablet and powdered form. rapid pulse reflects the presence of superficial heat. add Radix Trichosanthis Kirilowii (tian hua fen) (source text). . sore throat. the sweating method. . thirst. . . Herba Menthae Haplocalycis (bo he) should be added 5 minutes before the end. spread the Lung qi and improve the functioning of the throat .15g (3-6g) Preparation: The source text advises to prepare a decoction of Rhizoma Phragmitis Communis Recens (xian lu gen). . . Yet the formula is named after Flos Lonicerae Japonicae (jin yin hua) and Fructus Forsythiae Suspensae (lian qiao). Qin believed that the formula's author. @ For pronounced coughing. sore throat. . Herba Menthae Haplocalycis (bo he) and Semen Sojae Praeparata (dan dou chi). rapid pulse. epidemic parotitis. MODIFICATIONS: @ For a stifling sensation in the chest. CAUTIONS & CONTRAINDICATIONS: I n cases with damp-heat. and a floating. which is cooked just long enough for the aroma to become strong. . . . acrid diaphoretic. Rhizoma Phragmitis Communis Recens (xian lu gen). some tablets have been significantly modified and may contain modern pharmaceuticals. influenza. a red-tipped tongue. If the pathogenic influence is still in the exterior. . Herba Lophatheri Gracilis (dan zhu . proper treatment of wind-heat requires venting the wind and releasing the heat from the exterior. . T h e other deputies. namely Semen Sojae Praeparata (dan dou zhi). .18g (9-12g) Herba Menthae Haplocalycis (bo he) .Honeysuckle and Forsythia Powder Radix Platycodi Grandiflori (jie geng) . . . . . . had a unique view of the dynamics of this formula. . Although it is a warm. According to Ye Tian-Shi. Actions: Disperses wind-heat. ANALYSIS OF FORMULA: T h e chief herbs. Radix Platycodi Grandiflori (jie geng) and Fructus Arctii Lappae (niu bang zi).e. add Herba Agastaches seu Pogostemi (huo xiang) (source text). . T h e floating. and a white or yellow tongue coating. . . @ For severe thirst. . and Radix Glycyrrhizae Uralensis (gan cao). COMMENTARY: This is the classic formula for protective-level warm-febrile disease. . cough. measles. The combination of three other assistants. . . - ow ever. a thin. . this formula may be used in treating such biomedically-defined disorders as upper respiratory tract infection. . . i. release heat from the exterior. . INDICATIONS: Fever. Herba seu Flos Schizonepetae Tenuifoliae (jingjie) is used here to boost the exterior-releasing action of the formula without producing dryness. To him it seemed logical that since the focus of the formula was on the exterior. Their dosage is greatest because their actions are the focus of the formula. . The combination of Radix Glycyrrhizae Uralensis (gan cao) and Radix Platycodi Grandiflori (jie geng) is very effective for treating sore throat. heat in the superficial aspect of the Lungs results in fever with or without chills. and early-stage encephalitis or meningitis. add Fructificatio Lasiosphaerae seu Calvatiae (ma bo) and Radix Scrophulariae Ningpoensis (xuan shen) (source text). . Q h Bo-Wei. . . Proper treatment of wind-dampness requires leaching out dampness and dispelling heat through the lower burner (urine or stool). . one of the founders of the school of warm-febrile disease. When heat injures the fluids it causes thirst. . . most practitioners followed the school of cold-induced disorders in using warm herbs for treating exterior disorders. cough. . Do not cook for more than 20 minutes. Herba Menthae Haplocalycis (bo he). . . . @ For severe sore throat. . Depending on how much the protective qi is involved. . . acute endometritis. This was significant because until the eighteenth century. white or thin. clears heat. and Herba seu Flos Schizonepetae Tenuifoliae (jing jie). Wu Ju-Tong. the chief herbs should be those that release the exterior. 45 ye). yellow tongue coating. . . The other herbs are then ground into powder and taken in 9g doses with the decoction.

. . T h e pathogenic influence which remains in the exterior (greater yang) causes headache. . . slightly flooding pulse. . 12g Enriches the yin and vents exterior heat. . . For nosebleed. omit Radix Glycyrrhizae Uralensis (gan can) and Herba Lophatheri Gracilis (dan z h ye). . . . . and add Fructus Gardeniae Jasminoidis (zhi zi). The interior heat (yang brightness) causes irritability. . . dry nasal passages. . . . add Herba Taraxaci Mongolici cum Radice (pu gong ying) and Folium Daqingye (da qing ye). . . . . ANALYSIS OF FORMULA: This condition requires the use of cool. acrid herbs to release the pathogenic influence from the muscle layer while concurrently clearing heat.3-9g Radix Puerariae (ge gen). . Radix Bupleuri ( c h i h ) and Radix Puerariae (ge gen). Do not cook for more than 20 minutes. . For the remnants of a yang brightness-stage warm-febrile disease that has been incompletely purged. . 33 i6 yin q z o king Source: Systematic Dijjerentiation of Wa~m Diseases (Wen bing tiao bian) Flos Lonicerae Japonicae (jin yin hua) . Radix Anemarrhenae Asphodeloidis (zhi mu) and Fructus Gardeniae Jasminoidis (zhi zi) (source text). . . omit Herba seu Flos Schizonepetae Tenuifoliae (jing jie) and Semen Sojae Praeparata (dan dou chi). . dry nasal passages.3g Tuber Ophiopogonis Japonici ( m i men dong). . and a slightly flooding pulse. .5-15g Radix Platycodi Grandiflori (jie geng) . . T h e modest dosage of the latter ingredient indicates that the pathogenic influence * * * hang lian hang gin tang). . . . .5 Fructus Forsythiae Suspensae (lian qiao). . . . . and add Rhizoma Imperatae Cylindricae (bai mao gen) and Fructus Gardeniae Jasminoidis (zhi zi) (source text). . . In modern texts the dosage of this substance ranges from 3-30g. . Available in prepared form.3-6g Radix Scutellariae (huang qin) . . . . . . . Two of the deputies. add Periostracum Cicadae (chan tui) and Herba Lemnae seu Spirodelae ( f u ping). . . . focus on the other aspect of the problem. The other deputies. . . . . stiffness of the extremities. It is also known as simultaneous greater yang and yang brightness-stage disorder.3-6g Radix Paeoniae Lactiflorae (bai shao). . For early-stage measles with incomplete expression of rash. help the chief ingredients release the exterior and alleviate pain. . . irritability. . . 15. . . . . . . . The chief ingredients.6g Radix Glycyrrhizae Uralensis (gan cao) . . . . . . . . . Radix Scutellariae (huang gin). . take with Kudzu. . . . . . . . .4. . . . . and a floating pulse. . * For acute endometritis. . .3-6g Fructus Zizyphi Jujubae (da zao). . . . . . . . Radix Ledebouriellae Divaricatae (fang feng) and Radix Rehmanniae Glutinosae (sheng di huang). .6-12g Radix et Rhizoma Notopterygii (qiang huo) . . Although purging has eliminated the accumulation. . Bupleurum and Kudzu Decoction to Release the Muscle Layer . . . . . . . accomplish this task. some of the pathogenic influence remains in the exterior and the yin has been injured. . insomnia. . . .6-9g Gypsum (shi gao) . Actions: Releases pathogenic influences from the muscle layer and clears interior heat. The deeper the level of penetration of the pathogenic influence. . . .yellow tongue coating. . . . . . .3-6g Radix Angelicae Dahuricae (bai zhi) . . . . . . and Scutellaria Decoction (ge gen * Source: Six Texts on Cold-induced Disorders * (Shang han liu shu) Radix Bupleuri (chi hu) . . . . orbital and eye pain. . and a floating. . .2-3 pieces Preparation: Decoction. . . . . . For a yellow tongue coating and diarrhea. . .6-9g Radix Glycyrrhizae Uralensis (gan cao) . add Herba Agastaches seu Pogostemi (h xiang) and Tuber Curcumae (yujin). the larger the dosage. . . The source text does not specify dosage. . add Radix Rehmanniae Glutinosae (sheng di hang). For dampness causing a tight. . . This is unresolved. . . . . . a t h i n . Coptis.3-6g Rhizoma Zingiberis Officinalis Recens * (sheng jiang) . . . . exterior wind-cold which has become constrained and is transforming into heat. . . . Radix Scutellariae (huang qin) and Gypsum (shi gao). while Gypsum (shi gao) clears heat from the yang brightness channel. reflected in the increasing fever and decreasing chills. For early-stage carbuncles. . .9g Herba Lophatheri Gracilis (dm zhu ye) . . . . . . .Formulas that Release Exterior Wind-Heat For heat entering the interior with scanty urine. . . . . . . stifling sensation in the chest and epigastrium. .12g Radix Rehmanniae Glutinosae (sheng di huang) . This causes a lack of sweating and a floating pulse. INDICATIONS: An exterior wind-cold presentation characterized by increasing fever and decreasing chills accompanied by headache. . . . . . . . . . . insomnia. . . . Tuber Ophiopogonis Japonici ( m i men dong). . except that 3g of Gypsum (shi gao) should be used. . . . . orbital and eye pain. . . clearing interior heat: Radix Scutellariae (huang gin) clears heat from the Lungs and upper burner. ASSOCIATED FORMULA: Honeysuckle and Forsythia Decoction 4f. Radix et Rhizoma Notopterygii (qiang huo) and Radix Angelicae Dahuricae (bai zhi). . . . stiffness of the extremities. . . . . . . . .

. . . . . The inclusion of Radix Bupleuri (chi hu) in a formula designed for treating a disorder without any lesser yang signs or symptoms has been the source of much debate. Today it is usually prepared as a decoction with the dosage indicated. .Cimicifiga and Kudzu Decoction has just entered the yang brightness channel. 47 9 For cases without chills or headache. . During the summer and fall. sour and cold Radix Paeoniae Lactiflorae (bai sho). discussed later in this chapter. . . . . . . add 9g of Gypsum (shi gao). . Radix Glycyrrhizae Uralensis (gan cao). . most commentators believe that Radix Bupleuri (chi hu). . . substitute Folium Perillae Frutescentis (zi su ye) instead (source text). . . harmonizes the actions of the other herbs. and thirst. . . when combined with Radix Puerariae (ge gen). . this herb helps clear heat from the upper burner. . . . T h e other assistant. . . . . . . . .3-6g Radix Puerariae (ge gen) . . T h e other envoys. prevent the development of a lesser yang-stage disorder. . . . . If there is incoherent speech. . . . . . . @ For coughing of viscous sputum. . . For a dry mouth and tongue. . . . . . . . in fact. . . . . . is a n appropriate herb for this level of disorder and will. . . . . . . .12g Cortex Moutan Radicis (dun pi) . . . . . . . . I n concert with Radix Platycodi Grandiflori (jie geng). . . . an assistant. . . . . . For externallycontracted warm-febrile disease with constrained interior heat characterized by fever with no chills. . . . . . . . . . especially from the throat. . . . . : . . . . . Fei Bo-Xiong in Discussion of Medical Formulas argues that this formula should not be used at all. . . . . T h e present name is used to avoid confusion with the more wellknown formula by the same name from Discussion of Cold-induced Disorders. . . Do not cook for more than 20 minutes. regulate the protective and nutritive qi to facilitate the release of the pathogenic influence. CAUTIONS & CONTRAINDICATIONS: This formula is inappropriate for simple exterior wind-heat disorders. . . . . . . . . substitute Herba Ephedrae (ma hang) for Radix Scutellariae (hung qin). . . . preserves the yin by preventing the exteriorreleasing herbs from causing excessive sweating. . . . . add Radix Anemarrhenae Asphodeloidis (zhi mu) and Radix Trichosanthis Kirilowii (tian hua fen). . . . In contrast to the principal formula which focuses on releasing the muscle layer. . . . . .9g Radix Anemarrhenae Asphodeloidis (zhi mu) . . . . . . . . . . . . . Because this is a simultaneous greater yang and yang brightness-stage disorder. . Actions: Releases the muscle layer and vents rashes. . Available in prepared form. . headache. . . . the heat symptoms are milder than is typical of a purely yang brightness channel-stage disorder. this formula may be used in treating such biomedically-defined disorders as influenza and toothache. . . . . .6g Radix Rehmanniae Glutinosae (sheng di huang) . . . . . . . facilitates the flow of Lung qi and helps scatter the pathogenic influence from the exterior. . * ASSOCIATED FORMULA: Bupleurum and Kudzu Decoction to Release the Muscle Layer from Medical Revelations LR%%tifwa yi wii ch&i gi jie'jZ t6ng Source: Medical Revelations (Yi xue xin wu) Radix Bupleuri (chi hu) . . Cimicifu~a and Kudzu Decoction shzng m6 gi gzn tiing Source: Craft o j Medicinal Eeatment for Childhood Disease Patterns (Xiao er yao zheng zhi jue) Rhizoma Cimicifugae (sheng ma). . . . . . . .3g Releases the muscle layer and clears heat. . . . . . . . . T h e indications for this formula have been expanded to include toothache due to wind-heat. .6g Radix Puerariae (ge gen) . . Radix Glycyrrhizae Uralensis (gan cao) is generally substituted for honey-fried Radix Glycyrrhizae Uralensis (zhi gun cao). . . . the reader is referred to the discussion of White Tiger Decoction (bai hu tang) in chapter 2. . 3g Radix Paeoniae Rubrae (chi shao) . . and reducing the dosage in the spring. . MODIFICATIONS: @ For severe chills without sweating. COMMENTARY: T h e source text refers to this formula as Kudzu Decoction (ge gen tang). . . . . Among others. . However.3-9g Honey-fried Radix Glycyrrhizae Uralensis (zhi gun cao) . . . .6g Radix Glycyrrhizae Uralensis (gun cao) . increasing the dosage in the winter. . . . . . add Pericarpium Trichosanthis (gu lou Pi) and Bulbus Fritillariae Thunbergii (zhe bei mu). One of the envoys. . .6-9g Preparation: The source text advises to grind equal amounts of the herbs into powder and take in 12g doses. . because it is so poorly formulated. Rhizoma Zingiberis Officinalis Recens (sheng jiang) and Fructus Zizyphi Jujubae (dazao). . . . . .9g Radix Paeoniae Rubrae (chi shao) . . For more information about yang brightness channel-stage disorders. . . . . this formula focuses on clearing interior heat. . . This condition is common in warm-febrile diseases contracted in the spring that surface in the summer. . Radix Platycodi Grandiflori (jie geng). . . With the appropriate presentation. . .9g Bulbus Fritillariae (bei mu) . . .6g Radix Scutellariae (huang qin) . . omit Radix et Rhizoma Notopterygii (qiang huo) and Radix Angelicae Dahuricae (bai zhi). . .

. . . and wheezing. . . Radix Paeoniae Rubrae (chi shao) cools the blood and attacks the problem from the interior. headache. rapid pulse. . . . . . . sore throat. . . . . . . which is reflected in an uneven surfacing of the rash. @ For viral rashes. . . The assistant. . . thirst. . .6g Dry-fried Herba Lophatheri Gracilis (chao dun zhu ye) . . thirst. add Radix Arnebiae seu Lithospermi ( z i cao).3-9g Radix Peucedani (qian hu) . . or when the rash does not develop smoothly.3g Radix Ledebouriellae Divaricatae (fang fend . . headache. . . . . . . For early-stage measles in which the surfacing of the rash is blocked characterized by fever. . . disperses wind in the yang brightness channel. or for dysenteric diarrhea.3g Herba Menthae Haplocalycis (bo he) . The fever and headache will be severe if the heat is not released smoothly.3-6g Fructus Forsythiae Suspensae (lian qiao). Stomach. . . rapid pulse. . . . . . . . . . . . . @ For swollen and sore throat. augments the qi and relieves toxicity. . . . . . . . .3-6g Radix Glycyrrhizae Uralensis (gan cao) . . and a floating. tearing. or causing it to surface. . . . . . irritability. . . . . 9 i% xu6n d&fi bZo t6ng Source: Golden Mirror o f the Medical Tradition (Yi zong jin jian) Rhizoma Cimicifugae (sheng ma) . . . This formula ensures a smooth resolution of early-stage measles and similar rashes. . . ASSOCIATED FORMULA: Dissipate Toxin and Release the Exterior Decoction INDICATIONS: Early-stage measles or rashes that do not surface evenly. . .48 Formulas that Release Exterior Wind-Heat CAUTIONS & CONTRAINDICATIONS: Contraindicated for rashes that surface evenly. . . This type of heat is usually due to an epidemic disorder and is therefore very contagious. . . Also inappropriate in cases of measles toxin sinking internally with shortness of breath. In contrast to the principal formula. . Heat attacking the Lungs produces fever and chills. . Radix Puerariae (ge gen). lack of sweating. coughing. sneezing. vents rashes. . . . . Venting the rash. . fever and chills. . . Measles and similar rashes are caused by externally-contracted heat collecting in the Lungs and Stomach. . . and a floating. . With the appropriate presentation. less balanced formula for more severe exterior symptoms with sore throat. . .3-6g Radix Puerariae (ge gen) . . . disperses and stimulates activity in the superficial levels of the body. . . . . . . . . Periostracum Cicadae (chan tui). the disease will become troublesome or even dangerous. . . this is a stronger. substitute Radix Paeoniae Lactiflorae (bai shao) for Radix Paeoniae Rubrae (chi shao). . . . . . The substitution of untreated Radix Glycyrrhizae Uralensis (gan cao) is common because its ability to relieve toxicity is much greater than that of the honeyfried variety. . @ If the rash is dark-red. . Otherwise. . . . . it also raises the fluids to expel heat. . . .% %' $. is seen as a way of releasing heat. . this formula may be used in treating such biomedically-defined disorders as influenza and acute exanthematous diseases. and thereby helps the chief and deputy herbs to clear heat and vent the rash. . . . . . . stops coughing. . Heat attacking the Stomach injures the fluids and produces thirst and a dry. . . . . . .3g Herba seu Flos Schizonepetae Tenuifoliae (jing jie) . The use of this formula has been expanded to include all early-stage warm-febrile diseases. . . . . . . coughing. . red tongue. as this may cause exterior deficiency. and vents rashes. MODIFICATIONS: @ For more pronounced exterior heat. . . thirst. . rough breathing. . . . add Herba Menthae Haplocalycis (bo he). . . . . . . . . . . Radix ScrophulariaeNingpoensis ( m a n shen) and Fructificatio Lasiosphaerae seu Calvatiae (ma bo). add Radix Platycodi Grandiflori ('jie geng). . and improves the functioning of the throat. add Radix Arnebiae seu Lithospermi ( z i cao) and Cortex Moutan Radicis ( d m $9. . *For exterior yang brightness-stage disorders characterized by fever.1. Rhizoma Cimicifugae (sheng ma). . . . . . honeyfried Radix Glycyrrhizae Uralensis (zhi gan cao). Fructus Arctii Lappae (niu ban8 z i ) and Flos Lonicerae Japonicae (jin yin hwl). such as measles and scarlet fever. . sneezing. ANALYSIS OF FORMULA: The chief herb.3-6g Semen Pruni Armeniacae (xing ren) . . . . . cough. . raises the clear yang of the Stomach. .6g Dry-fried Fructus Arctii Lappae (chao niu bang zi) . . . . and dark urine. . The combination of Radix Glycyrrhizae Uralensis (gan cao) and Radix Paeoniae Rubrae (chi shao) prevents the dispersing properties of the chief and deputy herbs from injuring the qi and yin. generalized body aches. . especially herpes zoster. . . . a red and dry tongue.6g Radix Platycodi Grandiflori (jie geng) . . red eyes. . . . . The deputy. .3g Caulis Mutong (mu tong) . thereby unblocking the interstices and pores to help vent the rash. . . . . . . . . . COMMENTARY: Measles and similar rashes are relatively superficial disorders caused by heat in the Lungs. .3-6g Fructus Citri seu Ponciri (zhi ke) . and dry nasal passages.5-3g Releases the exterior. . . . . . . . . Drawing out the heat by venting the rash is the most effective method of treatment. coughing. . . and blood. . .

add Pericarpium Citri Reticulatae (chen pi). . . influenza. . @ For cough with sputum that is difficult to expectorate. headache. . . . . . cold Radix Isatidis seu Baphicacanthi (ban lan gen) clears heat and is very effective in relieving toxicity. and sore. Actions: Disperses wind and alleviates pain. ANALYSIS OF FORMULA: Radix et Rhizoma Notopterygii (qiang huo) is a warm. .60g Preparation: Grind the ingredients into a fine powder and take 6g twice daily after meals with green tea. add honey-fried Herba Ephedrae (ma h a n g ) and Semen Pruni Armeniacae (xing ren).Ligusticum Chwlnxiong Powder to be Taken w i t h Green Z a 49 Notopterygium and Isatis Root Decoction qiiing lhn tang Source: Taditional Chinese Medical Formulas (fang ji xue) Radix et Rhizoma Notopterygii (qiang huo) . . . generalized soreness. . . . . Radix Sophorae Tonkinensis (shun dou gen) and Radix Scrophulariae Ningpoensis (xuan shen).45g Radix Glycyrrhizae Uralensis (gun cao) . @Forsevere sore and swollen throat. 1209Radix Angelicae Dahuricae (bai zhi) . May also be prepared as a decoction by reducing the dosage of the ingredients by about 90 per cent. . . . MODIFICATIONS: @ For a more severe presentation. add Radix Peucedani (qian h ) and Fructus Arctii Lappae (niu bang zi). . . this formula may be used in treating such biomedically-defined disorders as upper respiratory tract infection. Rhizoma Pinelliae Ternatae (ban xia) and Caulis Bambusae In Taeniis (zhu ru). . . . and relieves toxicity. . i20g Radix Ledebouriellae Divaricatae (fang fend . Wind-heat disorders often settle in the head. . acute pharyngitis. . . . . . . . . . . . . acrid herb that effectively disperses exterior wind and alleviates pain. . . . . @ For a stifling sensation in the chest and nausea. those that affect the exterior or yang aspects of the body. Available in prepared form. . . . . . . . . . This is externally-contracted heat affecting the head and neck. . add Fructus Xanthii Sibirici (cang er z i ) and Herba Menthae Haplocalycis (bo he). . The formulas in this section are designed to focus on these areas. . . add Fructus Hordei Vulgaris Germinantus (mai ya) and Fructus Oryzae Sativae Germinantus ( g u ya). The head and neck. COMMENTARY: This formula was devised by the Pediatric and Internal Medicine Divisions of Longhua Hospital. . . . . SECTION 4 FORMULAS THAT RELEASE EXTERIOR DISORDERS WITH HEAD AND NECK SYMPTOMS Exterior disorders are. . . . .240g Radix Ligustici Chuanxiong (chuan xiong) . . . being the furthest from the earth and therefore the most yang. swollen throat and glands reflect the presence of heat toxin. @ For reduced appetite. . With the appropriate presentation. . . . . Actions: Releases the exterior. For example. . . . Ligusticum Chuanxiong Powder to be Taken with Green Tea chuiin xihg chh tiho stin Source: Imperial Grace Formulary of the Tai Ping Era (Tai ping hui min he ji ju fang) Herba Menthae Haplocalycis (bo he). .30g Herba seu Flos Schizonepetae Tenuifoliae (jing jie) . . see Universal Benefit Decoction to Eliminate Toxin ( F j i xiao duyin) discussed in chapter 2.9-i2g Radix Isatidis seu Baphicacanthi (ban lan gen) . . . INDICATIONS: Fever and chills. . are often the parts of the body where the principal exterior symptoms appear. and sore. Do not cook for more than 10 minutes.60g Herba cum Radice Asari (xi xin). a teaching hospital of the Shanghai College of Traditional Chinese Medicine. add Radix Platycodi Grandiflori (jie geng) and Radix Glycyrrhizae Uralensis (gun cao). . by definition. . . . It is a good example of how formulas are devised in modern China. . . add Fructificatio Lasiosphaerae seu Calvatiae (ma bo).15-30g Preparation: Decoction. @ For cough with wheezing. . . . .609Radix et Rhizoma Notopterygii (qiang huo) . Bitter. @ For blocked nasal passages and runny nose. . . . . and epidemic parotitis. The generalized soreness. swollen throat with or without swollen glands. and not the pain from wind-damp painful obstruction for which it is more commonly used. . . . acute tonsillitis. . . . . In this formula it is used to treat the pain of sore throat and generalized soreness. . . 9 For cough and scratchy throat. . clears heat. . sometimes even after the pathogenic influences have penetrated beyond the exterior. add 30g of Herba Taraxaci Mongolici cum Radice (pu gong ying). .

Zhu Dan-Xi stated that it was designed for wind-heat headache. and occurs at irregular intervals. and is especially effective in treating headaches along the lesser yin channel (orbital). Wang Ang. *To alter the focus of the formula in addressing headache along specific channels. alleviates pain. Radix Ligustici Chuanxiong (chuan xiong). and for headache due to qi and blood deficiency. nasal congestion. cold and bitter green tea. Radix Glycyrrhizae Uralensis (gan cao). clears heat from the eyes and moderates the undesirable side-effects caused by the warm. Herba Menthae Haplocalycis (bo he). This is headache due to externally-contracted wind. stated in Comprehensiue Medicine According to Master Zhang that it should be used for headache due to wind that has gradually transformed into fire. is resistant to treatment.also disperse wind and thereby relieve headache. The lingering of wind in the body causes severe headache. white tongue coating. MODIFICATIONS: @ For wind-cold headache. which leads to chills. If the pain is localized. add Flos Carthami Tinctorii (hong h a ) . dizziness. and Radix Angelicae Dahuricae (bai zhi) along the yang brightness channel (frontal). The other envoy. drying properties of some of the other ingredients. and causing headache and dizziness. Radix et Rhizoma Notopterygii (qiang huo) along the greater yang channel (occipital). Some reports also mention its usefulness in treating post-concussion headache. Semen Persicae (tao ren). disperse wind from the head and release the exterior. which is manifested as a floating pulse. as early as the fourteenth century. assigning to the herb with the largest dosage. omit Herba Menthae Haplocalycis (bo he) and add Rhizoma Zingiberis Officinalis Recens (sheng jiang) and Folium Perillae Frutescentis (su ye). omit Radix et Rhizoma Notopterygii (qiang huo) and Herba cum Radice Asari (xi xin). scatters cold. wrote in Analytic Collection $Medical Formulas that it is intended for wind-heat in the upper part of the body. Most modern texts state that it is primarily for wind-cold. and clears heat. When wind invades the exterior it battles with the normal qi. a thin. Radix Ledebouriellae Divaricatae (fangfeng)also alleviates generalized body aches. Herba seu Flos Schizonepetae Tenuifoliae (jingjie) and Radix Ledebouriellae Divaricatae (fang feng). Radix Ligustici Chuanxiong (chuan ximg) alleviates headaches along the lesser yang and terminal yin channels (temporal and vertex). The deputies. The normal qi forces the pathogenic influence outward. disperses wind from the exterior. the mutual regulation of the nutritive and protective qi is impaired.50 Formulas that Release Exterior Disorders with Head and Neck Symptoms due to wind-cold or wind-heat. @ For chronic headache. * For wind-heat headache. Herba cum Radice Asari (xi xin). benefits the head (especially the eyes). Perhaps the best interpretation is that found in the source text which notes that this is a wellbalanced formula that can be used in treating any externally-contracted wind disorder wherein headache is the principal symptom. Others. It should be administered in small doses and cooked no more than 1-3minutes when taken as a powder. This pattern is referred to in chapter 29 of Basic Questions: "Injury from wind is suffered first in the upper body. add the following: Rhizoma et Radix Ligustici (gao ben) for greater yang (occipital) headache. The Lungs are the most superficial of the organs and are therefore most easily affected by wind. COMMENTARY: There has been considerable debate over whether this formula is best suited for headache . More specifically. Bombyx Batryticatus (jiang can) and Buthus martensi (quan xie). harmonizes the actions of the other herbs. and Radix et Rhizoma Notopterygii (qiang huo). With the appropriate presentation. and add Flos Chrysanthemi Morifolii (ju h a ) and Fructus Viticis (man jing zi). the status of deputy. CAUTIONS & CONTRAINDICATIONS: This formula contains a relatively large number of warm. tension headache. acrid substances and is therefore inappropriate for treating headache from ascendant Liver yang due to Liver and Kidney deficiency. ANALYSIS OF FORMULA: Herba Menthae Haplocalycis (bo he). which produces fever. Zhang Lu-Xuan. Radix Bupleuri (chi hu) for lesser yang (temporal) headache. and acute and chronic rhinitis or sinusitis. Radix Puerariae (ge gen) INDICATIONS: Headache in any part of the head accompanied by fever and chills. Radix Angelicae Dahuricae (bai zhi). Because the nose is governed by the Lungs. and a floating pulse. an envoy. the chief herb (note the large dosage). obstructing the clear yang qi. If the headache persists. such as the late seventeenth-century physician. The assistants. neurogenic headache. This formula is also effective in treating this condition. However. this formula may be used in treating such biomedically-defined disorders as upper respiratory tract infection. The head is the meeting place of the yang channels. The last of the deputies. the dosage of the corresponding herb should be increased. this leads to nasal congestion. And his contemporary. When wind invades the body it follows the course of the channels upward to the head and eyes. it is said to be due to wind in the head (tdu fins). migraine headache." When wind attacks the exterior.

. . dizziness. and promotes the discharge of pus. . . . and unblocks the nose. . and foul-smelling nasal discharge. . This condition is known as profuse nasal discharge (biyuiin) and is caused by wind-heat attacking the head. . For very copious and purulent nasal discharge. and a floating. . . . . . Today only 4 pieces of Fructus Zizyphi Jujubae (da zao) are used. . . . .6g Preparation: The source text advises to place Radix Puerariae (ge gen) and Herba Ephedrae (ma huang) in about 10 cups of water and decoct until 8 cups remain. T h e acute attack with copious discharge. . Today it is often prep_ared as a decoction with the dosage indicated in parentheses. . chronic. . . . . . For nasal congestion and pain. . . Herba Menthae Haplocalycis (bo he). . and Fructus Evodiae Rutaecarpae (wu zhu y u ) and Lumbricus (di long) for terminal yin (vertex) headache. . . Radix Paeoniae Lactiflorae (bai shao) .30g (6-9g) Herba Menthae Haplocalycis (bo he) [add near end] . . . . .6g Rhizoma Zingiberis Officinalis Recens (sheng jiang) . ajaafl-tis j G huci chii tic50 s i h Source: Analytic Collection of Medical Formulas ( Y i fangji jie) Add 120g of Flos Chrysanthemi Morifolii ( j u hua) and 45g of Bombyx Batryticatus (jiang can) for headache and dizziness primarily due to wind-heat. . . . releases wind-heat from the exterior and clears the eyes and head.9g Ramulus Cinnarnomi Cassiae (gui zhi). . . . . . .9g Fructus Zizyphi Jujubae (da zao). . . or allergic rhinitis. . . this formula may be used in treating such biomedically-defined disorders as acute or chronic sinusitis and acute. . . . With the appropriate presentation. * ASSOCIATED FORMULA: Magnolia Flower Powder Xanthium Powder 4 ySF& i sZn xTn 3 * ciing ir zz' siin Source: Formula to Aid the Living ( j i sheng fang) Fructus Xanthii Sibirici (cang er z i ) . . Disperses wind-cold and unblocks the nasal passages. . . frontal headache. . . .5g (3-6g) Preparation: The source text advises to grind the herbs into a fine powder and take in 6g doses with a tea made from Bulbus Allii Fistulosi (cong bai) and green tea. releases the exterior and opens u p the orifices. . . . . . . nasal obstruction. . . . and headache due to wind-cold. . . . disperses winddampness. yellow tongue coating. . . and floating pulse reflect the presence of wind. purulent. . . . . . loss of smell. . alleviates pain. l 2 pieces Radix Glycyrrhizae Uralensis (gun cao). . Kudzu Decoction gi gEn tiing Source: Discussion of Cold-induced Disorders (Shang han lun) Radix Puerariae (ge gen) . . . . . Radix Angelicae Dahuricae (bai zhi). . add Flos Lonicerae Japonicae (jin yin hua). . . foul-smelling nasal discharge. MODIFICATIONS: e For more pronounced heat in the Lungs. . . . unblock the nasal passages and are frequently used in treating profuse nasal discharge. . Actions: Disperses wind. . . . . . . . rapid pulse. . .1. . Fructus Xanthii Sibirici (cang er z i ) and Flos Magnoliae (xin yi h a ) . . . . . . . . . . . . . . . frontal headache.7. persistent. . .15g (3-6g) Radix Angelicae Dahuricae (bai zhi) . T h e other deputy. . . . INDICATIONS: Copious.12g Herba Ephedrae (ma huang) . . T h e profuse. Source: Formulas to Aid the Living ( j i sheng fang) Flos Magnoliae (xin yi hua) Radix Ligustici Chuanxiong (chuan xiong) Caulis Mutong (mu tong) Herba cum Radice Asari (xi xin) Radix Ledebouriellae Divaricatae (fang feng) Radix et Rhizoma Notopterygii (qiang huo) Rhizoma et Radix Ligustici (gao ben) Rhizoma Cimicifugae (sheng ma) Radix Angelicae Dahuricae (bai zhi) Honey-fried Radix Glycyrrhizae Uralensis (zhi gun cao) Grind equal amounts of the ingredients into a fine powder and take 6g with tea after meals. .Kudzu Decoction for yang brightness (frontal) headache. . . . . O n e of the deputies. . . . a normal or yellow tongue coating. .6g Radix Paeoniae (shao yao) . . . .. copious nasal discharge.5g (6-9g) Flos Magnoliae (xin yi hua) . This practice is rarely followed today and the formula is decocted in the normal manner. . . then add the other herbs and decoct until 3 cups remain. VARIATION: 51 Chrysanthemum Powder to be Taken with Green Tea COMMENTARY: Profuse nasal discharge usually appears after an unresolved case of the common cold. dizziness. . ANALYSIS OF FORMULA: The chief herbs. . . . . . . and rapid pulse reflect the presence of heat. add Cortex Mori Albae Radicis (sang bai pi) and Cortex Lycii Radicis (di g u Pi) or Radix Scutellariae (huang qin).

The other assistants. and early-stage polio or encephalitis. uses this decoction for chronic pediatric diarrhea with considerable success. stomach flu. releases the muscle layer (especially of the upper back and neck) by drawing fluids to the affected area. preserves the yin by preventing the exteriorreleasing herbs from causing excessive sweating. white tongue coating. C 0M M E N TARY: * For severe nasal blockage. Ramulus Cinnamomi Cassiae (gui zhi). Flos Magnoliae (xin yi hua)and Radix Platycodi Grandiflori (jie geng). VARIATION: Kudzu Decoction plus Pinellia $ 4 5 Pu 4j ia g i gzn j G bhn xiii tcing Source: Discussion of Cold-induced Disorders (Shang han lun) Add Rhizoma Pinelliae Ternatae (ban xia) for a simultaneous greater yang and yang brightness-stage disorder. protecting that organ from injury. Together with Radix Paeoniae Lactiflorae. Deng Shao-Xian. It is the most powerful herb for releasing excess from the exterior. This is a condition of exterior excess in a person with deficient fluids. MODIFICATIONS: INDICATIONS: Fever and chills without sweating. @For severe facial pain. allergic rhinitis. regulate the protective and nutritive qi and harmonize the Stomach. and sensitivity to dust and cold drafts. and releases the exterior. Together with Ramulus Cinnamomi Cassiae (gui zhi). Herba Ephedrae (ma huang). a thin. This is one type of externally-contracted windcold at the greater yang stage. With the appropriate presentation. This is usually explained by the formula's ability to help the Stomach qi rise. Actions: Releases the exterior and muscle layer. Radix Paeoniae Lactiflorae (bai shao). In this case. it also relieves muscle spasms and is therefore useful in the treatment of neck and back stiffness. * For urticaria. while the latter clears heat after the pathogenic influence has advanced into the interior.between acute and chronic rhinitis or sinusitis characterized by mucosal swelling. it regulates the protective and nutritive qi and assists in the expulsion of the pathogenic influences. ANALYSIS O F F O R M U L A : The chief herb. honey-fried Radix Glycyrrhizae Uralensis (zhi gan cao). The other deputy. In Essentialsfrom the Gohn Cabinet this formula is indicated for a greater yang-stage disorder with a lack of sweating and scanty urination. This is defined as a greater yang-stage disorder in which there is also vomiting but no diarrhea. This formula may also be used in treating the transitional stage . induces sweating. For this reason. add Periostracum Cicadae (chan tui). tendonitis or bursitis of the shoulder. this formula may be used in treating such biomedically-defined disorders as upper respiratory tract infection. add Radix Angelicae Pubescentis (du huo) and Peach Pit Decoction to Order the Qi (tao he cheng qi tang).52 F o m h that Release Exterior Disorders with Interior Deficiency is the type of Radix Paeoniae (shao yao) that is generally used. influenza. in that they combine herbs that release the excess from the exterior with . While both Kudzu Decoction (ge gen tang) and Kudzu. The envoy. Available in prepared form. harmonizes the actions of the other herbs. Rhizoma Zingiberis Officinalis Recens (shg jiang) and Fructus Zizyphi Jujubae (da zao). and generates fluids. Radix Scutellariae (huang qin). some practitioners use the formula as a foundation in formulas that treat allergic rhinitis. Radix Puerariae (ge gen). a prominent modern physician from Chengdu. Coptis. and Scutellaria Decoction (ge gen huang lian huang qin tang) are used for treating acute diarrhea. the qi pours upward into the chest and prevents one from opening the mouth to speak. and a floating. one of the assistants. The distinguishing feature is the stiff and rigid neck and upper back. the former releases cold from the exterior while it is still in the greater yang stage. acute cervical myositis. one of the deputies. stiff and rigid neck and upper back. The complexity of these disease patterns requires the use of formulas which are themselves complex." This is caused by wind-cold which binds the upper portion of the greater yang channel and prevents the fluids from reaching the area. tight pulse. In Discussion of Cold-induced Disorders (chapter 32) it is noted that this formula can also be used for a simultaneous greater yang and yang brightness-stage disorder with diarrhea. It is also very effective for acute stiff neck. SECTION 5 FORMULAS THAT RELEASE EXTERIOR DISORDERS WITH INTERIOR DEFICIENCY The formulas in this section address those cases in which a person suffering from interior deficiency contracts a disease of external origin. helps the chief herb release the exterior and relieve the muscle layer. the appearance of which the source text likens to "a small bird that strains its neck and upper back in an attempt to fly. add Radix Ligustici Chuanxiong (chuan x k ) . congestion. urticaria.

focal distention and fullness of the chest. . The ascending action of Radix Platycodi Grandiflori Cjie geng) and the descending action of Fructus Citri seu Ponciri (zhi ke) is a very effective combination for regulating the flow of qi in the chest.30g Radix Bupleuri ( c h i hu) . Because the formula is designed for acute. . soggy quality of the pulse reflects the deficiency of qi which is the salient aspect of this disorder. . absence of sweating. . . . . externally-contracted disorders. these two classes of herbs would rarely be used together.30g Radix Peucedani (qian hu). (If the qi were strong. tonifying herbs are ordinarily contraindicated for exterior conditions. a productive cough. producing a greasy. sonorous breathing. especially in the head and neck. Together they are particularly effective in releasing pathogenic influences from the muscle layer. . one of the deputies. . .30g Radix Ginseng (ren s h n ) . Radix Peucedani (qian hu) is used with Sclerotium Poriae Cocos (ju ling). . . an assistant. . . reduce the fever. .30g Radix Glycyrrhizae Uralensis (gan cao) . which is discussed in chapter 8. . Radix Bupleuri (chi hu) and Herba Menthae Haplocalycis (bo he). . . . . . and Rhizoma Zingiberis Officinalis Recens (sheng jiang) to treat both the manifestation and root of this disorder. soggy pulse. . Sclerotium Poriae Cocos (ju ling).30g Radix Platycodi Grandiflori (jie geng) .collects in the Lungs is produced in the Spleen. and a floating. dispels wind and dampness. dispel wind-cold from the exterior. . . This produces a high fever. a greasy. These two herbs also interact with Radix Peucedani (qian hu) to improve the circulation of Lung qi. . . and stop the coughing. . . . . . . . . .Ginseng Powder to Overcome Pathogenic Inflmmes herbs that tonify the deficiency in the interior. The tonifying herbs in this formula include Radix Ginseng (ren shen). and dispels wind. . Radix Ginseng (ren shen). which enhances the painrelieving action of the formula. . release the exterior. headache. helps the chief herbs release the exterior. . . . . . . . Radix Ligustici Chuanxiong ( c h n xiong). . and generalized pain and soreness. . . . . . T h e chief herbs.30g Radix Angelicae Pubescentis (du huo) . INDICATIONS: High fever and severe chills with shivering. . . T h e deficiency of qi allows dampness to penetrate rather quickly. . . T h e particular formulation of herbs in-theseprescriptions is based on whether the underlying deficiency is one of qi. reflect the twin strategies of expelling the pathogenic influences and strengthening the deficient qi. The other deputies. thereby relieving the symptoms of discomfort in the chest. Two-to-three times the dosage of Radix Codonopsis Pilosulae (dang shen) is usually substituted for Radix Ginseng (ren shen). . . the emphasis is on expelling the pathogenic influences. which transforms phlegm and strengthens the Spleen. . . and a productive cough. .30g Radix Ligustici Chuanxiong (chuan xiong) . pain and stiffness of the head and neck. moves the blood. . . Lingering dampness causes focal distention and fullness in the chest. . Today this formula is often prepared as a decoction. . Actions: Releases the exterior. . . . a n absence of sweating. .) The attack of wind-cold on the Lungs disrupts the circulation of qi. and dampness at the level of the muscles produces generalized soreness and pain and a floating pulse. nasal congestion with sonorous breathing. . . and augments the qi. . although generally rendered as toxin. These herbs address the primary symptoms of fever and chills without sweating. . . . soreness and pain of the extremities. and pain and stiffness of the head and neck. . serves three functions . . The phlegm that. as are exteriorreleasing herbs in cases of interior deficiency. or yang. . T h e floating. Radix et Rhizoma Notopterygii (qiang huo) and Radix Angelicae Pubescentis (du huo). white tongue coating. . . yin. Available in prepared form. . . refers here to externally-contracted pathogenic influences. . and expel the pathogenic influences. . cold. These are three of the four herbs in Four-Gentlemen Decoction (si jun zi tang). All of these serve as assistants. The name s u ~ e s t sthe ability of this formula to strengthen the normal qi and thereby enabb the body to overcome pathogenic influences. . . expel phlegm. ANALYSIS O F FORMULA: The herbs in this formula Source: Craft of Medicinal Treatment for Childhood Disease Patterm (Xiao er yao zheng zhi jue) Radix et Rhizoma Notopterygii (qiang huo) . . . . with the dosage of the ingredients reduced by about 80 per cent. Rhizoma Zingiberis Officinalis Recens (sheng jiang) also helps release the exterior. For this reason. . . . which is unable to expel the pathogenic influences. 53 Ginseng Powder to Overcome Pathogenic Influences +v&%* ri?n shSn biii dii stin The word dd in the name of this formula. .30g Sclerotium Poriae Cocos ( f u ling). . . .15g Preparation: The source text advises to grind the above into a fine powder and cook 6g together with a small amount of Rhizoma Zingiberis Officinalis Recens (sheng jiang) and Herba Menthae Haplocalycis (bo he). . . the tongue coating would remain thin and white. . . . . and alleviate pain.30g Fructus Citri seu Ponciri (zhi ke) . Except in such cases. . . . . white tongue coating. blood. . . causing nasal congestion. T h e presence of wind. dispel dampness. . severe chills with shivering. . This is externally-contracted wind-cold-dampness battling the body's deficient normal qi. and Radix Glycyrrhizae Uralensis (gun cao). . . .

. swollen. . unlike the tonic herb Rhizoma Atractylodis Macrocephalae (bai zhu). . Sclerotium Poriae Cocos ( f u ling). . . . . modified this formula to treat early-stage. . . . . . . . . . . .5g Radix Bupleuri ( c h i hu) . . promotes urination. . it is important t o remember that this formula is indicated only for externally-contracted wind-colddampness.5g Radix Ligustici Chuanxiong (chuan xiong). . and strengthens the Spleen. early-stage measles. . . . . . . . . . . . . and those recovering from a debilitating illness. .4. . . . .5-3g of Herba Menthae Haplocalycis (bo he). . . . . .5g Radix Platycodi Grandiflori (jie geng) . . . .4. . .15g Radix Aucklandiae Lappae (mu xiang) . . . . .54 Formulas that Release Exterior Disorders w i t h Interior Deficiency Add Flos Lonicerae Japonicae (jin yin hua) and Fructus Forsythiae Suspensae (lian qiao) for early-stage abscesses and sores which are red. . . . . . . . .5g Ginger juice-fried Rhizoma Pinelliae Ternatae (jiang ban xia) . .1.22. . . . releases the exterior. .5g Folium Perillae Frutescentis (zi su ye) . . . . . . which he believed were caused by a sinking of the pathogenic influences into the Intestines. . . . . . . . . . . . . . . . which prevents a relapse. . . loose stools. . . . . . . . generates fluids so that sweating becomes possible. . .4.4. . . . . . . . . . . . . . . . increase the dosage of Radix Bupleuri ( c h i hu). . . . .5g Radix et Rhizoma Notopterygii (qiang huo) . . . .5g Radix Platycodi Grandiflori (jie geng) . .22. . . . and a thin.4. and is contraindicated for cases with heat. For externally-contracted wind-cold-dampness characterized by fever and chills without sweating. usually with the addition of 1. . . . .5g Rhizoma Zingiberis Officinalis Recens (sheng jiang) . transforms phlegm. . wind-cold-damp dysenteric disorders with exterior symptoms. . . . . Also for exterior conditions with redness and swelling of the eyes.22. . . . . . . . . . . . CAUTIONS & CONTRAINDICATIONS: Because of the warm. . Later the application of this formula was expanded to include all cases of wind-cold-dampness in patients with underlying qi deficiency. . It tonifies without causing stagnation or retention of pathogenic influences. .15g The source text advises to grind the ingredients into a coarse powder and cook 12g with seven pieces of Rhizoma Zingiberis Officinalis Recens (sheng jiang) and one piece Honeysuckle and Forsythia Powder to Overcome Pathogenic Influences &4 3 4K& 4k @ n qiho b G dii sZn Source: Analytic Collection of Medical Formulas (Yi fang ji jie) . a strategy was required which would tonify the qi in order to expel the pathogenic influences. . post partum women. Ginseng and Perilla Leaf Decoction +%& shcn ssii yin Source: Imperial Orace Formulary of the Tai Ping Era (Tai ping hui min he ji ju fang) Radix Ginseng (ren shen) . . . and occurs in those with no underlying qi deficiency. weak pulse. . and add Radix Scutellariae (huang qin) and Semen Arecae Catechu (bing lang). . . . . . . . .5g Sclerotium Poriae Cocos (fu ling) . . Radix Glycyrrhizae Uralensis (gan cao) assists Radix Ginseng (ren shen) in tonifying the qi. . . . . . . . .5g Radix Ledebouriellae Divaricatae (fang feng) . . . . . . . . . . . . . Another assistant. . . . and harmonizes the actions of the other ingredients. . pain and stiffness of the head and neck. .4. . . . a white tongue coating. . 15g Radix Puerariae (ge gen) . . . . including the aged. . . .5g Pericarpium Citri Reticulatae (chen pi). . .5g Radix Peucedani (qian hu) . . . . . . . . . . . . . . . The Qing dynasty physician. MODIFICATION: 9 For malarial disorders. . . leaches out dampness. . . . This is a more severe presentation than that for which the principal formula is indicated.4. .22. . . . . . . . . . . . . . and alleviates pain. . . . and a floating pulse. . ASSOCIATED FORMULAS: here: it strengthens the normal qi to expel the pathogenic influences. . . . . . With the appropriate presentation. . . . . . . Yu Jia-Yan. .4. . T h e principal formula is also used for very early-stage measles (before the rash has begun to surface) characterized by moderate fever and chills. . . early-stage dysentery. . . . drying properties of many of the ingredients. . . . . . VARIATION: Schizonepeta and Ledebouriella Powder to Overcome Pathogenic Influences $1 itx ak%& j h g fhng blii diL sZn Source: Marvelous Formulas for the Health of the Multitudes (She sheng zhong miao fang) Herba Schizonepetae Tenuifoliae (jing jie) . . . . .4. . . epidemic parotitis. . . . . . white tongue coating. .5g Radix Peucedani (qian hu) . a thin. .22. 15g Radix Glycyrrhizae Uralensis (gan cao) . and early-stage abscesses or sores. .5g Radix Angelicae Pubescentis (du huo) . dispels wind. . . .5g Radix Glycyrrhizae Uralensis (gan cao) . . no significant thirst.5g Sclerotium Poriae Cocos ( f u ling) . . . . . .22. . . . . . . . . . . . .5g Fructus Citri seu Ponciri (zhi ke) . . . influenza. . . . . . . . . . . and painful accompanied by symptoms of an exterior condition. . . . . . .4. . T h e envoy. generalized body aches and pain. 3 pieces Grind the ingredients into powder and take as a draft. this formula may b e used in treating such biomedically-defined disorders as upper respiratory tract infection. . . . . . . . . This application remains popular today. . Because the source qi in children is not fully developed. and surgical infections. . . . and strengthens the body's resistance to invasion. . . . . . Induces sweating. . . . . COMMENTARY: This formula was originally devised for children suffering from externally-contracted windcold-dampness. . . . .

. . . acrid Herba Ephedrae (ma hang). . nasal congestion. . . . . . . helps the chief herb release the exterior. and Licorice Decoction kAtri. The assistant. Actions: Assists the yang and releases the exterior. The deputy. Asarum. . . Available in prepared form. Additional clothing or covers will not relieve the sensation of cold in a patient suffering from exterior cold. . It is a classic example of a formula designed to treat both the manifestation and the root. and its use could lead to devastated yang. . and the deputy herb scatter interior cold. I n terms of the six stages of disease. . . . or cold attacking the brain and teeth. and a frail pulse. . and transforms phlegm. ANALYSIS OF FORMULA: The sweating method. VARIATION: Ephedra. . . thus expelling the pathogenic influence from within while protecting the yang.9g Herba cum Radice Asari (xi xin). laryngitis.J-+f$ib m h huhng fi i i giin ciio tiing . This is exterior cold in a patient with preexisting yang deficiency. faint pulse. a white tongue coating. Although the tongue coating is white and slippery (suggesting a n exterior condition). . * For chronic wheezing due to cold deficiency. which releases the exterior and dispels externally-contracted cold. deficiency in a patient suffering from an excessive exterior disorder. However. T h e absence of sweating also points to yang Ephedra. Augments the qi. MODIFICATIONS: * For wind-cold headache. slight fever and severe chills. . Where the deficiency is more severe (characterized by undigested food in the stool and a faint. and chronic coughing or wheezing. a white. a stifling sensation in the chest. T h e proper approach must therefore include stimulating the yang. headache. This formula may also be used for headache due to cold from deficiency with sore throat and a raspy voice. According to Standards of Patterns and Treatments this formula can be used in treating Kidney coughing characterized by pain penetrating to the back. . For this reason.). . Available in prepared form. . Prepared Aconite. .6g Preparation: The source text advises to first decoct Herba Ephedrae (ma huang) in about 10 cups of water until 8 cups remain. if the exterior itself were deficient there would be sweating. the chief herb is warm. this is a simultaneous greater yang (exterior cold) and lesser yin (interior yang deficiency) stage disorder. . and a submerged. Today it is prepared as a decoction with a proportionate reduction in dosage and with the addition of three pieces of Rhizoma Zingiberis Officinalis Recens (sheng jiang) and three pieces of Fructus Zizyphi Jujubae(da zao). . releases the exterior. . . although the appropriate strategy for treating "pure" greater yang-stage disorders. . stimulates the yang and warms both the interior and the channels. add Radix Ligustici Chuanxiong ( c h a n xiong) and Rhizoma Zingiberis Officinalis Recens (shng jiang). . . . this formula is contraindicated. add the other ingredients. and a submerged pulse are the chief indications for this formula. . almost imperceptible pulse). . . harmonizes the Stomach. For externally-contracted wind-cold with congested fluids in the interior in patients with a weak constitution characterized by fever and chills. . T h e fact that in this case it will demonstrates the presence of interior cold. Asarum. . . a slight fever without sweating. COMMENTARY: Exhaustion. will by itself lead to devastated yang in cases where there is also interior deficiency. and cook until 3 cups remain. because this is a n acute condition. . . A sensation of extreme cold may be attributed to either internal cold or externallycontracted wind-cold. and Prepared Aconite Decoction 55 of Fructus Zizyphi Jujubae (da zao). CAUTIONS & CONTRAINDICATIONS: This formula may safely be used to release the exterior only in those cases where the underlying yang deficiency is mild.Ephedra. the pulse is faint and submerged instead of floating. . Radix Lateralis Aconiti Carmichaeli Praeparata (fuzi). take with Two-Cured Decoction (er c h n tang. The strained decoction is taken warm in three l l of the doses over the course of a day Today a ingredients are cooked together. . . . . . It also serves as the envoy by entering the lesser yin Kidney channel where it helps focus the actions of the formula on the lesser yin-stage symptoms. . where it causes headache and toothache. . I n this case the presence of fever indicates a n externally-contracted pathogenic influence. . and Prepared Aconite Decoction mb hubng xi x'tn fii 5 tiing 5g$~lf&ib Source: Discussion of Cold-induced Disorders (Shang han lun) Herba Ephedrae (ma huang) . A l l of the major signs and symptoms reflect aspects of both types of disorders. . . exhaustion. slippery tongue coating. the focus of the formula is on releasing the exterior. . This is a clear sign of internal yang deficiency. Remove the froth. . . . . . Herba cum Radice Asari (xi xin).6g Radix Lateralis Aconiti Carmichaeli Praeparata ( f u z i ) . . . . . INDICATIONS: Sensation of extreme cold and severe chills (relieved by wearing more clothing or adding covers). productive cough.

The deputies. . . . Also for mild edema with shortness of breath.3g Radix Ligustici Chuanxiong (chum xiong) . . the chief herbs. . . . . . which are those in which the deficiency of yang is so severe that the use of stronz diaphoretics could prove fatal. . . . . . Actions: Tonifies the yang. . . . . . 2 pieces Preparation: Decoction to be taken warm. . augments the qi. . drying actions of the other herbs without hindering their ability to induce sweating. absence of sweating. . . Source: Six Texts on Cold-induced Disorders (Shang han liu shu) Radix Astragali Membranacei (huang qi) . . T h e forceless pulse reflects the debilitated state of the patient and the body's inability to rally against the invasion of wind-cold. The source text does not specify dosage. . . Slight fever with strong chills. . . . . . . . . . . .3g Radix et Rhizoma Notopterygii (qiang huo) . . . . . . . Radix Ligustici Chuanxiong (chuan xiong). reinforce the formula's exterior-releasing. . . induces sweating. . . . Most noteworthy is the use of roasted Rhizoma Zingiberis Officinalis Recens (wei shngjiang). . . and headache are signs of exterior wind-cold. Radix Glycyrrhizae Uralensis (gan cao) also moderates the sweat-inducing actions of the other ingredients. cold-dispersing actions. weak voice. . which may be viewed as a modification of Cinnamon Twig Decoction (gui zhi tang). . . . . . . forceless or a floating. . . . 43 k 4. . . . . . . . . . . . . big. . . . and a small. . dry-fried Radix Paeoniae Rubrae (chao chi shao). . . . . . absence of sweating. and a submerged. . Scallion Decoction with Seven Ingredients g. Ramulus Cinnamomi Cassiae (gui zhi).1. . . . . . T h e envoys. . . . . . .6-9g Rhizoma Zingiberis Officinalis Recens (sheng jiang) . . . . pallid complexion. sk cling b6i q Z w2i $n Source: Arcane Essentials from the Imperial Library (Wai tai bi yao) Bulbus Allii Fistulosi (cong bai) . . . . . . . release the exterior by tonifying the yang and scattering cold. . . . . . . . tonify the source qi and stabilize the exterior.3g Radix Lateralis Aconiti Carmichaeli Praeparata ( f u z i ) . . . . . . .3g Radix Ledebouriellae Divaricatae (fangfeng) . urinary difficulty. . . . Radix Paeoniae Rubrae (chi shao) is the type of Radix Paeoniae (shao yao) that is generally used. .9-12g Radix Rehmanniae Glutinosae (sheng di huang). . . . . .. . . . . . . . . . . . . . weak voice. This is externally-contracted wind-cold with qi and yang deficiency. . . . . . headache. . . fatigue with a constant desire to lie down. . . . which is roasted to enhance its Stomach-warming actions.3g Fructus Zizyphi Jujubae (du zao) . . . The slight fever and strong chills. . . . . . . nourish and revive the Spleen and Stomach qi. It moderates the warm. .3g Dry-fried Radix Paeoniae Rubrae (chao chi shao). and Herba cum Radice Asari (xi xin). INDICATIONS: branacei (huang qi) and Radix Ginseng (ren shn). Radix et Rhizoma Notopterygii (qiang huo). . . . . . . .3g Ramulus Cinnamomi Cassiae (gui zhi) . . . . . and Radix Paeoniae Rubrae (chi shao). . COMMENTARY: T h e composition of this formula. . . . Another assistant. is well-balanced. . . . . . which is dry-fried to moderate the drying properties of the other substances without impairing their ability to induce sweating. . Radix Lateralis Aconiti Carmichaeli Praeparata (fu zi). .3g Radix Glycyrrhizae Uralensis (gan cao) . They provide the energy to drive out the pathogenic influences and prevent the exteriorreleasing herbs from causing the collapse of yang. .Formulas that Rebase Exterior Disorders with Interior Deficiency Source: Discussion of Cold-induced Disorders (Shang han lun) Substitute Radix Glycyrrhizae Uralensis (gan cao) for Herba cum Radice Asari (xi xin) for milder exterior conditions (less severe fever and chills).3g Herba cum Radice Asari (xi xin). submerged pulse. and forceless pulse. . . . .5g Roasted Rhizoma Zingiberis Officinalis Recens (wei sheng jiang) . . . . . The assistants. roasted Rhizoma Zingiberis Officinalis Recens (wei jiang) and Fructus Zizyphi Jujubae (da zao). . . T h e cold extremities. . . . . . .9-12g Radix Puerariae (ge gen). and regulate the nutritive and protective qi. . a pale tongue with a white coating. Note that some formulations omit Fructus Zizyphi Jujubae (da zao) and dry-fried Radix Paeoniae Rubrae (chao chi shao). As the name suggestq the appropriate use of this formula can bring a person back from the edge of death. . . . . . . . and Radix Ledebouriellae Divaricatae Cfangfeng). . . . . . . . . cold extremities. . and pallid complexion are signs of qi and yang deficiency. .9-12g Semen Sojae Praeparata (dun dou chi). . 9-15g . . . . . and releases the exterior. It is a very effective formula for treating externallycontracted wind-cold with underlying qi and yang deficiency.6g Radix Ginseng (ren shen) . . . . . fatigue. . ANALYSIS O F FORMULA: Radix Astragali Mem- Renewal Powder This formula was designed by Tao Hua for treating ')angless" conditiom. . .6-9g Tuber Ophiopogonis Japonici ( m i men dong) . cools the blood and disperses blood stasis. .

. 4 For strong fever. For this reason. . Only the water near the surface is used. . which is prepared by repeatedly ladling water in and out of a pail until bubbles cover the surface. Although most INDICATIONS: and sweat (both of which are fluids associated with yin) and the problems of treating conditions such as this was recognized very early in Chinese medicine.3-4. dry throat. Traditionally. the yin and bloodnourishing herbs are also relatively light and therefore non-cloying. . . the chief herb in this formula. I n chapter 18 of the Vital Axis it is noted that. fever. . . Modified Polygonaturn Odoraturn Decoction Although exterior disorders require sweating to release the exterior.. Semen Sojae Praeparata (dm dou chi). . This formula is carefully balanced to avoid excessive releasing action (which would exhaust the blood o r yin) and excessive tonification (which would cause retention of the pathogenic influences). .9-12g Herba Menthae Haplocalycis (bo he) . fever. . T h e dry throat. slight chills. . bleeding [method] is forbidden in those with exhaustion of sweat.5g Semen Sojae Praeparata (dan dou chi) . . . There is a n absence of sweating not only because of the nature of this exterior disorder (wind-cold).Modified Polygonaturn Odoraturn Decoction Preparation: Decoction. . and rapid pulse indicate that the externallycontracted condition has begun to transform into internal heat. . and Rhizoma Zingiberis Officinalis Recens (sheng jiang). the relatively mild. * For continuous bleeding with a n exterior condition. and the blood and yin-nourishing Radix Rehmanniae Glutinosae (sheng di hang) and Tuber Ophiopogonis Japonici (mai men dong) are used.e. CAUTIONS 57 & CONTRAINDICATIONS: Only the slightest amount of sweating is desirable. lose blood] do not have sweat. .e. . . Actions: Nourishes the blood and releases the exterior. . clears heat. Rhizoma Imperatae Cylindricae (mao gen). Today the water used to make this decoction is not prepared in any special way. . add Flos Lonicerae Japonicae (jin yin h a ) and Fructus Forsythiae Suspensae (lkn qiao). Source: Revised Popular Guide to the Discussion of Coldinduced Disorders (Chong ding tong su shan han lun) Rhizoma Polygonati Odorati (yu zhu) . . . . ANALYSIS O F FORMULA: COMMENTARY: The relationship between the blood Rhizoma Polygonati Odorati (yu zhu). . . . irritability. . . . . thick sputum is produced that is difficult to expectorate. sweat profusely] do not have blood. . The mild.6g Radix Platycodi Grandiflori (jie geng) . "Those from whom blood flows [i. and cough are signs of wind-heat. . This is externally-contracted wind-heat in a patient with underlying yin deficiency. add Rhizoma Bletillae Striatae (bai ji). Nodus Nelumbinis Nuciferae Rhizbmatis (ou jie) and Gelatinum Corii Asini (e jiao). . This is a n exterior wind-cold disorder with simultaneous blood or yin deficiency due to a long-term illness or significant blood loss. INDICATIONS: Headache. . headache. . . and a rapid pulse. . .'' . . . thirst. Fever and slight chills.. . a darkred tongue. . cough. . induces sweating. and those from whom sweat flows [i. little or no sweating. . . . darkred tongue. This relatively quick transformation is due to the underlying yin deficiency. . . This was considered to be the seventh ingredient.6-9g Bulbus Allii Fistulosi (cong bai). . . exterior-releasing Bulbus Allii Fistulosi (cong bai). . . fever. . a condition which usually involves some degree of injury to the fluids. . . T h e "worked water" is said to gently focus the formula on the upper burner and assist in releasing the exterior. and chills are the classic presentation of wind-cold.3-4. . . . . .5g Radix Cynanchi Baiwei (bai wei). . The headache. little or no sweating. Pronounced sweating will aggravate the condition. . . and slight chills without sweating following a long-term illness or significant blood loss. . . .5-3g Honey Honey-fried Radix Glycyrrhizae Uralensis (zhi gan cao) . is also known as wei mi. irritability. . sputum which is difficult to expectorate. add Folium Perillae Frutescentis (suye) and Herba Schizonepetae Tenuifoliae (jingjie). but also because it is more difficult for the body to sweat when the blood o r yin is deficient. The headache. . . "Sweating [method] is forbidden in those with exhaustion of blood. . . the sweating method was contraindicated in cases of blood deficiency.1. ." The Discussion of Cold-induced Disorders also states that. Actions: Nourishes the yin. and releases the exterior. . the presence of blood deficiency complicates the situation since blood and sweat share the same source (see commentary below). add Pericarpium Citri Reticulatae (chen pi). * For accompanying indigestion. . . . The body is debilitated and therefore does not have the strength to produce strong chills. The source text advises to cook the ingredients in special aerated or "worked water" (1% shui). .5g Fructus Zizyphi Jujubae (da zao) . .2 pieces Preparation: Decoction. when combined with wind-heat. . . exteriorreleasing herbs also generate fluids.1. . . MODIFICATIONS: 4 For strong chills. . . . . Radix Puerariae (ge gen).

. . and purges without injuring the interior. . . clears heat. . Source: Formulasfrom the Discussion Illuminating the Yellow Emperor's Basic Questions (Huang di su wen man ming lun fang) Radix Ledebouriellae Divaricatae (fang jng) . . MODIFICATIONS: * For more severe exterior disorders. . . . . . . . dry mouth. . Formulas for treating exterior excess with interior deficiency are discussed in the previous section of this chapter. T h e other assistant. assist Rhizoma Polygonati Odorati (yu z h ) in moistening dryness and harmonizing the actions of the other ingredients. This formula is stronger than the principal formula and is indicated for cases with less pronounced deficiency. .60g Radix Ligustici Chuanxiong (chum xiong) . and a rapid pulse. . mildly release the exterior and dispel wind-heat. . . .15g Herba Ephedrae (ma huang) . . . . . . the pathogenic influences will remain in the body. . . . Radix Cynanchi Baiwei (bai wei). and a floating pulse at the proximal and distal positions. . . . and nourishes the yin. Radix Platycodi Grandiflori.60g Radix Cynanchi Baiwei (bai wei) . Bulbus Allii Fistulosi ( c q bai). and Herba Menthae Haplocalycis (bo he). . wheezing. . . .60g Gypsum (shi gao). . . . This formula is based on Polygonatum Odoratum Decoction (wei rui tang) from the Tang-dynasty classic.60g . * For cough. . . . . add Fructus Arctii Lappae (niu bang zi) and Pericarpium Trichosanthis (gua hu pi). . there is little or no sweating in cases with yin deficiency. . .90g The source text advises to grind the herbs into a coarse powder and take as a draft three times a day. T h e envoys. SECTION 6 FORMULAS THAT RELEASE EXTERIOR-INTERIOR EXCESS I n externally-contracted diseases there is often a stage where the pathogenic influence remains lodged in the exterior while also affecting the interior. . If the exterior is released without treating the interior. . . COMMENTARY: T h e principal indications for this Radix Glycyrrhizae Uralensis (gan cao) . .60g Semen Pruni Armeniacae (xing ren) . The herbs that nourish the yin and clear internal heat do not impede the releasing of the exterior. dry throat. . those that release the exterior do not injure the yin. . . . . . . . . . add Radix Ledebouriellae Divaricatae (fang feng) and Radix Puerariae (ge gen). no desire to sleep. . the condition will worsen. . . . . .60g Radix Aristolochiae Qingmuxiang (qing mu xiang) . hence the name.Formulas that Release Exterior-Interior Excess cases of wind-heat are characterized by considerable sweating. . . . * For more pronounced thirst and irritability. a sullen demeanor. . . . . . Semen Sojae Praeparata (dan dou chi). a dark-red tongue. . . . . . . . . T h e formulas in this section address these patterns of excess in both the exterior and interior simultaneously. . . . The deputies. . . . . . . . . . . . accurate diagnosis is imperative. its location (interior or exterior). . . . . . To obtain the best results. . and the extent of its development (level or stage) before the appropriate formula can be selected. . . . formula are fever with slight chills. and generates fluids. Radix Platycodi Grandiflori (jie geng). . . . T h e practitioner must identify which pathogenic influence is involved. ANALYSIS O F FORMULA: The chief herb. Scatters wind. . thereby treating the irritability and thirst. . . . . a sensation of heaviness in the body. . Rhizoma Polygonati Odorati (yu zhu). . . (jie geng). For wind-heat disorders characterized by sweating. . . . . . . . . . . cools the blood and clears heat without injuring the yin. Thousand Ducat Fur& (see associated formula below). . . . . . . honeyfried Radix Glycyrrhizae Uralensis (zhi gan cao) and Fructus Zizyphi Jujubae (da zao). Today it is prepared as a decoction with a proportionate reduction in dosage. . clears heat. . . It is especially useful for its ability to tonify without being cloying. . . . . . . . disseminates the Lung qi to stop the coughing and expel the phlegm. . . . . add Radix Trichosanthis Kirilowii (tian huafen) and Herba Lophatheri Gracilis (dan zhu ye). . irritability. . . if the interior is treated without releasing the exterior. . .60g Herba Ephedrae (ma huang). . and sputum which is difficult to expectorate.6g Radix Angelicae Pubescentis (du huo) . releases the exterior. Its ability to unblock is sage-like in its subthty. . . . . . . . . . thirst. ASSOCIATED FORMULA: Ledebouriella Powder that Sagely Unblocks fiingfing t6ng she'ng sZin This formula induces sweating without injuring the exterior. These are relatively acute disorders where both the exterior and interior require urgent attention. one of the assistants.15g Polygonatum Odoratum Decoction m&% wZi rui tcing Source: Thousand Ducat Formulas (Qian jin yao fang) Rhizoma Polygonati Odorati (yu zhu) . nourishes the yin of the Lungs and Stomach. . .60g Bulbus Allii Fistulosi (cong bai) . . . .

. a bitter taste in the mouth. ( p g ye) . . . . Actions: Disperses wind. . . l5g Fructus Gardeniae Jasminoidis (zhi zi) . . . the other assistant. . and unblocks the bowels. . dark. is reflected in the bitter taste in the mouth. . and heat rash. it also improves the functioning of the throat to alleviate difficulty in swallowing. rapid or wiry. . . . . It also attacks the Lungs and causes difficulty in swallowing and nasal congestion with thick and sticky nasal discharge and saliva. . which helps to disperse wind. . .. . slippery pulse. . accumulating primarily in the Lungs and Stomach. Because wind-dispersing and heat-clearing ingredients can injure the Spleen. . sore eyes. . . This is heat excess in both the exterior and interior. . this formula treats a disorder which simultaneously affects the greater yang (exterior). . . Interior heat. Radix Ledebouriellae Divaricatae Cfangfeng)and Herba Ephedrae (ma huang). . . Such combinations are frequently used in treating complex exterior and interior disorders. . . . . red and sore eyes. and lesser yin (focal distention with a stifling sensation in the chest and diaphragm). and a flooding. . greasy tongue coating. . indirectly protects the Spleen by harmonizing the actions of the other ingredients. Fructus Gardeniae Jasminoidis (zhi zi) and Talcum (huashi) drain heat through the urine. . . . .90g Gypsum (shi gao) . . . is added to strengthen this organ. . Rhizoma Atractylodis Macrocephalae (bai zhu). . a powerful combination.Ledebouriella Powder that Sagely Unblocks Wine-treated Radix et Rhizoma Rhei (jiu d a huang) . slippery pulse. . T h e ascending nature of Radix Platycodi Grandiflori (jie geng) complements the descending nature of the purgatives in their separate actions of expelling heat. .. . yellow tongue coating. greasy. dry mouth. 15g Mirabilitum (mang xiao). . . . . . . nasal congestion with thick and sticky nasal discharge and saliva. . . . .30g Fructus Forsythiae Suspensae (lian qiao) . a variation of Cool the Diaphragm Powder (liang ge san). . manic behavior. dark. . . either from wind-heat invading a patient with preexisting internal accumulation of heat. . light-headedness. . . the other deputies. a yellow. . . . and red. constipation. . . . . . since such conditions can progress to internally-generated wind with stiff tongue or clenched jaw. . . . . COMMENTARY: This formula. . . . . . drains heat. Because it tends to attack the upper parts of the body. Radix Glycyrrhizae Uralensis (gun cao). . and flooding. . . Many modern practitioners use . are added to clear heat from these organs. INDICATIONS: Strong fever and chills. . Because heat has settled primarily in the Lungs and Stomach. . sore eyes. Fructus Forsythiae Suspensae (lian qiao). rough urination. Although quite hot in nature (moderated by the other herbs). wind-heat causes dizziness and red. 15g Herba seu Flos Schizonepetae Tenuifoliae . . . . . . . . Radix Scutellariae (huang qin). . Intestinal wind. . . . . .15g Radix Scutellariae (huang qin). . Available in prepared form. . Among the assistant herbs. . . constipation.30g Radix Platycodi Grandiflori (jie geng) . . . . but may also include some types of carbuncles. . . . releases the exterior. . . T h e other envoy. rapid or wiry. . . . Treating Radix et Rhizoma Rhei (da hang) in wine strengthens its effect on the circulation while mitigating its purgative properties. . . . . strengthens the Stomach to prevent the other ingredients from causing stomach upset. and Radix Platycodi Grandiflori (jie geng). focal distention with a stifling sensation in the chest and diaphragm.l5g Radix Angelicae Sinensis (dung gui) . . . . Rhizoma Zingiberis Officinalis Recens (sheng jiang). rough urination. difficulty in swallowing. . . . T h e indications for this formula today are not limited to those discussed above. . . . . . . . . . . 15g Herba Menthae Haplocalycis (bo he). focal distention with a stifling sensation in the chest and diaphragm. Among the deputies. . I n concert with Radix Platycodi Grandiflori. . . . . . . . . . wine-treated Radix et 59 Rhizoma Rhei (jiu da hang) and Mirabilitum (mang xiao). . . . Herba Ephedrae (ma huang) has strong exterior-releasing properties. . May also be prepared as a decoction with a proportionate reduction in dosage. . . rough urination. . or from a n invasion of wind-heat which causes heat to lodge in both the exterior and interior simultaneously. . 15g Radix Paeoniae Lactiflorae (bai shao) .609Preparation: Grind into powder and take 6-9g as a draft with three pieces of Rhizoma Zingiberis Officinalis Recens (sheng jiang). .15g Talcum (hua shi) . . . . . This is important because too strong of a purgative will cause the exterior disorder to penetrate more deeply into the body. . . . . . yang brightness (interior heat). . . T h e other chief herbs. . . . dark. T h e strong fever and chills are a sign of exterior wind-heat. . . disperse wind and release the exterior by inducing sweating. From the perspective of the six stages of disease. dizziness. . .15g Radix Glycyrrhizae Uralensis (gan cao) . . . The source text recommends this formula for all wind-heat disorders with constipation. . . . . expel heat through the stool. . . . . . Radix Ligustici Chuanxiong (chuan xiong). facial sores.15g Rhizoma Atractylodis Macrocephalae (bai zhu) . . . . . . . a n envoy. is used for excess heat in both the exterior and interior. . . ANALYSIS OF FORMULA: Two of the chief herbs. and Radix Paeoniae Lactiflorae (bai shao) harmonize the blood. . . . . . . . Herba seu Flos Schizonepetae Tenuifoliae (jing jie) and Herba Menthae Haplocalycis (bo he) assist Ledebouriellae and Ephedrae in releasing the exterior. . . . . dry mouth. . . . . . Gypsum (shi gao).30g Radix Ligustici Chuanxiong (chuan xiong) . Radix Angelicae Sinensis (dang gui). . .

. . . . . and Scutellaria Decoction gt gZn huhng lihn huhng qin tiing Source: Discussion of Cold-induced Disorden (Shang han lun) Radix Puerariae (ge gen) . . .ii $ng zhi b6o diin Source: Wondrous Lantern for Peering into the Origin and Deuelopmnt of Miscellaneous Diseases (Za bing yuan liu xi zhu) Talcum (hua shi) .15g Cortex Phellodendri (huan~ Herba cum Radice Asari (xi xin) . . . . . . . . . ASSOCIATED FORMULA: Greatest Treasure Special Pill to Dispel Wind +&FLzg-s q. . . . .15g Radix et Rhizoma Notopterygii (qiang huo) . . . . . . 15g Herba Menthae Haplocalycis (bo he) . it causes 'steaming' of the muscle layer which manifests as sweat. . . . . . .37. . . . .45g Radix Ligustici Chuanxiong (chuan xiong) . carbuncles. .15g Radix Ginseng (ren shen) . . paraplegia or hemiplegia. clears heat (especially yang brightness-stage heat) and harmonizes the Stomach. . . . possible wheezing. . . . . . .6g Preparation: Decoction. . . . . . . .5g Radix Angelicae Sinensis (dang gui) . . . . . . omit wine-treated Radix et Rhizoma Rhei (jiu da h a n g ) and Mirabilitum (mang xiao). . . . . . . . . . . . . . . . . this formula may be used in treating such biomedically-defined disorders as influenza. There is also a sensation of irritability and heat in the chest. . . . . . . . . .15g bai).5g Herba seu Flos Schizonepetae Tenuifoliae (jing jie)' . . a practice which is not commonly followed today. . . . . . . . . . . . . and a rapid pulse. . . .15g Rhizoma Gastrodiae Elatae (tian ma) . . . . . . . . . . . . . sweating.6g Honey-fried Radix Glycyrrhizae Uralensis (zhi gan cao) . . . . . . is reflected in its relatively large dosage. . .5g Gypsum (shi gao) . . . . . . . . . . I n this pattern. thereby assisting the deputy in stopping the diarrhea. . . .15g Fructus Gardeniae Jasminoidis (zhi zi) . . When fire in the interior attacks the Lungs. . . . urticaria. . . . wheezing results. . a sensation of irritability and heat in the chest and epigastrium. . . . . . thereby stopping the diarrhea. the red tongue with a yellow coating. . . . . The presence of interior heat is reflected in the fever.15g Mirabilitum (mang xiao) . . . . . omit Gypsum Kudzu. . . . . . . . . . . . . . . . . . . . . . . . .30g Radix Paeoniae Lactiflorae (bai shao) . While the principal formula is indicated for invasion of wind-heat with accumulation of heat in the interior. . . . Coptis. . . clears heat. . . . omit Herba Ephedrae (ma h a n g ) . . . Treats organ-type wind-stroke characterized by facial asymmetry. .9g Rhizoma Coptidis (huang lian) . . . . . . Puerariae (ge gen). . . .60 Formulas that Release Exterior-Interior Excess the formula in cases of obesity with exterior-interior heat. . . Radix Scutellariae ( h a n g qin). . . . . . . . . . Purging drives the pathogenic influence into the yang brightness stage where it gives rise to dysenteric diarrhea with heat. . . . . . . . . . . . . . . impaired consciousness. Dispels wind. . . . . . . characterized by especially foul-smelling stools and a burning sensation around the anus. . . . . . . . 6 For cases without constipation. . . . . . . . and treats dysenteric diarrhea by raising the clear yang of the Spleen and Stomach. . . Honey-fried Radix Glycyr- . . . . . . . . . . . . . . . . . . . . .7. this can be caused by improper treatment of an exterior disorder with purgatives. As noted in the source text. . .15g Radix Scutellariae (huang qin) . . . . . this formula is indicated for wind-stroke with internally-generated wind and heat. . . . 15g Buthus martensi (quan xie) . . . The assistant. . . . . . . thirst. . . . . . .15g Radix Platycodi Grandiflori (jie geng) . . . . . . The deputy. Like the deputy. . . . .5g Radix Glycyrrhizae Uralensis (. . . . . . The source text advises to cook Radix Puerariae (ge gen) first. . .9g Fructus Forsythiae Suspensae (lian qiao) . . and the rapid pulse.15g Radix et Rhizoma Rhei (da huang) . . the exterior has not been completely released but the interior is already ablaze with heat. . . . . . . . . . This herb releases the exterior. . . . food poisoning. . . . . . . . a red tongue with yellow coating. . . . . . . . . . . . . . . .37. . . thirst. . . . . . . . and unblocks the bowels. . . . . Rhizoma Coptidis ( h a n g lian). Take 1-2 pills (approximately 6g each) once a day with tea or warm wine. . . . . . . . . . . . . . . . Here it is used to clear heat from the Lungs and to stop the wheezing (if present).15g Radix Rehmanniae Glutinosae Conquitae (shu di huang) . . . 15g Rhizoma Coptidis (huang lian) . . . . . . . . . .19. .15-24g Radix Scutellariae (huang qin). ANALYSIS O F FORMULA: The importance of Radix (shi gao). . . . . . . . MODIFICATIONS: 6 For cases without strong chills. . . . INDICATIONS: Fever. . dysenteric diarrhea characterized by especially foul-smelling stools and a burning sensation around the anus. . . . . . . . . .21g Rhizoma Atractylodis Macrocephalae (bai zhu) . . . . . 15g Radix Angelicae Pubescentis (du huo). . . . . . . . . the chief herb. . . . . . . . . . . . . . dermatitis. . . . . . Actions: Releases the exterior and clears heat. . Available in prepared form. . . . . . . . or sudden loss of consciousness with strong heat symptoms. . . . . . . . . . . . . . . . . clears heat. As the condition progresses inward from the exterior. . With the appropriate presentation. . . . . . . . . . 15g Grind the ingredients into powder and form into pills with honey. . .21g Radix Ledebouriellae Divaricatae (fangfeng) . and acne. . . . . . . . is useful for treating problems in the relatively superficial levels of the body. For cases without strong fever. . 15g Herba Ephedrae (ma huang) . .an cao) . erysipelas. . . . . . . . . . it is bitter and cold in nature and is indicated for clearing heat and drying dampness. .

. flooding pulse. ANALYSIS OF FORMULA: Although this formula is designed for conditions of excess in both the exterior and interior. This condition is identified as lower burner damp-heat with lingering exterior symptoms. . . headache. a burning sensation in the anus. . . relieves toxicity. add Radix Aucklandiae Lappae (mu xiang) and Radix Paeoniae Lactiflorae (bai s h ) . 6g Herba Ephedrae (ma huang) . . . red face and eyes. . .9g Rhizoma Coptidis (huang lian) . The other deputies. its focus is on clearing the particularly severe interior heat. . . . . . can be used if the heat is not severe. . Gypsum Decoction Source: Arcane Essentials from the Imperial Library (Wai tai bi yao) Gypsum (shi gao) . "The pathogenic influence being driven into the interior is seven-tenths [of the condition]. . . * For high fever and stools containing blood or pus. . bland Semen Sojae Praeparata ( d m dou chi). when it should have been treated with the exterior-releasing Cinnamon Twig Decoction (gui zhi tang). . . and a rapid pulse. it can now be regarded as a simultaneous greater yang and yang brightness-stage disorder. clears heat and eliminates irritability. delirious speech.Gypsum Decoction rhizae Uralensis (zhi gan cao) harmonizes the actions of the other herbs and protects the middle burner from further injury. Another commonly-used formula for dysenteric disorders is Pulsatilla Decoction (bai tou weng fang) which is used for interior patterns with blood and pus in the stool and no chest or abdominal symptoms. . slow pulse. . slippery or rapid. . . or skin blotches. With the appropriate presentation. . . Cortex Phellodendri (huang bai). COMMENTARY: Although this formula treats both the interior and exterior. . a passage from Analytic Collection of Medical Formuh notes. dry nasal passages. Today the usual dosage of Gypsum (shi gao) is 15-30g. Agastache Powder to Rectify the Qi (huo xiang zheng qi san). . strong and warm Herba Ephedrae (ma huang). A variation of the formula. . * For more prominent exterior signs and symptoms. . .' ' The Discussion of Cold-induced Disorders (chapter 34) observes that this condition is due to improperly treating a greater yang-stage disorder by purging. One of the deputies. COMMENTARY: Coptis Decoction to Relieve Toxicity (huang lianjie du tang) is a constituent of this formula. MODIFICATIONS: * For abdominal pain. its lingering in the exterior is three-tenths. this formula may be used in treating such biomedically-defined . . thirst. . . and a rapid. . . . Radix Scutellariae (huang qin). . and releases the exterior. . irritability and insomnia (leading in severe cases to delirium). The aim of the formula is to induce mild sweating. . . and bacillary dysentery. . also releases the exterior and relieves irritability. coughing up blood. irritability. headache. . add Cortex Mori Albae Radicis (sang bai pi). * For pronounced dampness indicated by a greasy tongue coating and a slippery pulse. . . . . and Fructus Gardeniae Jasminoidis (zhi zi). . . and rapid pulse reflect blazing heat in the interior. With the appropriate presentation. .6-9g Preparation: Decoction. . this formula may be used in treating such biomedically-defined disorders as acute gastroenteritis. add Flos Chrysanthemi Morifolii (ju h a ) . . . early-stage poliomyelitis. foulsmelling stools. . a red tongue with a yellow coating. . . and sensation of heaviness and tightness reflect severe greater yang-stage injury from cold. add Flos Lonicerae Japonicae (jin yin hua)and Semen Plantaginis (che qian zi). . . . . . .6g Radix Scutellariae (huang qin). add Radix Pulsatillae Chinensis (bai tou weng) and Cortex Fraxini (qin pi). Referring to this condition. . . . insomnia. releases the exterior by inducing sweating. . . Another deputy. . For this reason. . . The strength of the fever. . dry nasal passages. . . This is injury from cold in which heat blazes in the interior while the exterior condition still lingers. . Irrespective of the prior treatment history. . . . . . . that formula can be combined with the principal formula. . . possible nosebleeds. . . . . a generalized sensation of heaviness and tightness. acute enteritis. . . Under the proper circumstances. . . The chief ingredient. . . . relieve toxicity and are a very effective combination for clearing blazing heat from the interior. cold-natured Gypsum (shi gm). . The fever and chills. thirst. measles. . . .9g Semen Sojae Praeparata (dm d m chi) . . the use of this formula has been expanded to include any earlystage dysenteric disorder characterized by fever. . Actions: Clears heat. . The presence of bleeding or skin blotches indicates that the heat has caused reckless movement of hot blood. * For pronounced wheezing.6g Fructus Gardeniae Jasminoidis (zhi zi) . absence of sweating. CAUTIONS & CONTRAINDICATIONS: Contraindicated for dysenteric disorders without fever and a submerged. red face and eyes.69Cortex Phellodendri (huang bai) . . Rhizoma Coptidis (huang lian). INDICATIONS: Strong fever and chills without sweating. its primary focus is on clearing interior heat. . .

and phlegm. .90g (1. . and acute pelvic inflammatory disease. . Honey-fried Radix Glycyrrhizae Uralensis (zhi gan cao) harmonizes the actions of the other herbs and strengthens the middle burner. . .90g (1. and Four-Substance Decoction (si wu tang) (chapter 8). phlegm. . . . .120g (1. . .5g) Pericarpium Citri Reticulatae (chen pi). .360g (3-9g) Fructus Citri seu Ponciri (zhi 4. . erysipelas. .90g (3-9g) Radix Platycodi Grandiflori (jie geng) . . vomiting. . Fry the remaining ingredients over low heat until the powder changes color. . . . Radix Paeoniae Lactiflorae (bai shao). . Herba Ephedrae (ma huang) and Radix Angelicae Dahuricae (bai zhi). . - . . .5g) Radix Paeoniae (bai shao) . and Sclerotium Poriae Cocos (fu ling) strengthen the Spleen and transform phlegm. which causes it to descend.5-4. . . Rhizoma Zingiberis Officinalis (gan jiang) and Cortex Cinnamomi Cassiae (rou gui). . . . . . This is reflected in the sensation of fullness in the chest and abdomen. . . release cold from the exterior. . qi. . The fever and chills without sweating.720g (3-9g) Cortex Magnoliae Officinalis (hou PO). This is externally-contracted wind-cold with internal injury due to cold (usually caused by improper diet). T h e other symptoms are manifestations of interior cold excess due to consumption of foods of a cold or damp-cold nature. and set Cortex Cinnamomi Cassiae (rou gui) and Fructus Citri seu Ponciri (zhi ke) aside. and Radix Angelicae Sinensis (dang gui). . . .5-4. . . body aches and stiff neck and back reflect the presence of exterior wind-cold. phlegm. . . . dampness. . .5-4. headache. Add the powder made from the other two ingredients and take 9g as a draft with three pieces of Rhizoma Zingiberis Officinalis Recens (sheng jiang). . . and diarrhea with borborygmus. invigorates the blood j and reduces accumulation. .5g) Radix Angelicae Sinensis (dang gui) . . . . .5g) Radix Angelicae Dahuricae (bai zhi) . body aches. . T h e synergistic action of these four herbs addresses cold in both the exterior and interior. .5g) Rhizoma Zingiberis Officinalis (gan jiang) . . . . . . . . . . Available in prepared form. . . l80g (1. . . abdominal pain. . . . appendicitis. . . and Fructus Citri seu Ponciri (zhi ke). . . . warm the interior and expel cold.90g (1. warming the interior. . and diarrhea with borborygmus. transforms phlegm. . and green tea for heat in a l l three burners with generalized pain.5-4. When cold (which is contractile in nature) invades the exterior. . Two-Cured Decoction (er chen tang) (chapter 16). ANALYSIS OF FORMULA: Two of the chief herbs. . . . . . and Radix Ligustici Chuanxiong (chuan xiong) nourish and invigorate the blood. . . . vomiting. which leads to accumulation of cold. .180g (1. Radix Platycodi Grandiflori (jie geng). . . Fructus Zizyphi Jujubae (da zao). Source: Imperial Grace Formulary of the Tai Ping Era (Tai ping hui min he ji ju fang) Herba Ephedrae (ma huang) . Pericarpium Citri Reticulatae (chen Pi). headache. . . May also be prepared as a decoction with the dosage indicated in parentheses. The ingredients for the supporting strategies are basically those that comprise Calm the Stomach Powder (ping wei san) (chapter 6). Actions: Releases the exterior. . which causes the qi to ascend. .5g) Preparation: Grind the ingredients into a coarse powder. pancreatitis. . .90g (1. T h e other herbs treat the accumulation: Rhizoma Atractylodis (cang zhu) and Cortex Magnoliae Officinalis (hou $0) dry dampness and eliminate its stagnation. . . . smoothing the flow of qi. . . .5-4. and blood. . . blood. . . . stiff neck and back. cholecystitis. . .5g) Rhizoma Atractylodis (cang zhu) . qi. . . . resolve qi stagnation. . This pattern is usually found in patients who are predisposed to interior cold who suffer an attack of externallycontracted wind-cold. .5-4. abdominal pain and cold. and blood. . .5-4. the other chief herbs. . . . a sensation of fullness in the chest and abdomen.5g) Cortex Cinnamomi Cassiae (rou gui). .5g) Radix Ligustici Chuanxiong (chum xiong) .5-4. . . dampness. . . nausea and aversion to food. disorders as acute infections (including abscesses). . .62 Formulas that Release Exterior-Interior Excess INDICATIONS: Fever and chills without sweating. . . .5-4. . . smooths the flow of qi. Five-Accumulation Powder This formula treats disorders associated with the five types of accumulation: cold. and reducing accumulation-are of a dispersing nature and focus on the qi. Rhizoma Pinelliae Ternatae (ban xia). COMMENTARY: The main strategies incorporated in this formula-releasing the exterior.5g) Honey-fried Radix Glycyrrhizae Uralensis (zhi gan cao) . .90g (1. . . . . . .% siin huiing shi giio tiing Source: Six Texts on Cold-induced Disorders (Shang han liu shu) Add Rhizoma Zingiberis Officinalis Recens (sheng jiang). and assist in the transformation of phlegm. and then allow to cool.120g (1. T h e supporting strategies address the dampness. .5-4. . warms the interior. .180g (3-9g) Rhizoma Pinelliae Ternatae (ban xia) . VARIATION: Three-Yellow and Gypsum Decoction L-&Z*. .90g (3-9g) Sclerotium Poriae Cocos ( f u ling) . .90g (1. . nausea and aversion to food. it increases internal stagnation.

At the present time. add Fructus Evodiae Rutaecarpae (wu zhu yu). bitter taste in the mouth Minor Bluegreen Dragon Decoction (xiao qing long tang) Exterior wind-cold with congested fluids Nine-Herb Decoction with Notopterygium fiiu wei qiang huo tang) Exterior wind-colddampness with concurrent internal accumulation of heat Also for toothache with exterior symptoms. aversion to wind. @ For irregular menstruation with epigastric and abdominal pain due to cold. tight pulse Absence of sweating. is usually insignificant. tight pulse REMARKS Also for cold causing sneezing or nosebleeds. this formula may be used in treating such biomedically-defined disorders as recurrent upper respiratory tract infection and mild gastritis. wheezing. and add Rhizoma Cyperi Rotundi (xiangfu) and Rhizoma Corydalis Yanhusuo (yan hu suo). damp-cold is the primary pathological mechanism of this condition and Rhizoma Atractylodis (cang zhu) is the chief herb. white. This can be due to either of the above mechanisms. moist tongue coating. @ For qi deficiency with weakness. white tongue coating. a stifling sensation in the chest. no particular thirst. a thin.Five-Accumulation Powder 63 According to the source text. stiff neck. stringy. floating pulse. nasal congestion. In severe cases there may be floating edema or considerable difficulty breathing when lying down. It may also be used for irregular menstruation with epigastric and abdominal pain due to cold. C O M P A R A T I V E TABLES O F P R I N C I P A L F O R M U L A S FORMULA THAT RELEASES EARLY-STAGE EXTERIOR DISORDERS F O R M U L A NAME Scallion and Prepared Soybean Decoction (cong chi tang) DIAGNOSIS Early-stage exterior disorders INDICATIONS Mild fever and slight chills without sweating. floating pulse REMARKS May be used for either windcold or wind-heat. Clinically. moderate or frail pulse Absence of sweating. and for painful obstruction due to wind-colddampness. wheezing. slight thirst. The different interpretation provided in the analysis section is the modern view. generalized heaviness and body aches. FORMULAS THAT RELEASE EXTERIOR COLD COMMON INDICATIONS: fever and chills (chills predominant). omit Herba Ephedrae (ma huang) and Radix Angelicae Dahuricae (bai zhi). Also for a similar presentation in patients recovering from serious illness or after childbirth. dry heaves. stiff neck. headache. headache. the use of this formula has been expanded in recent times to include treatment of the acute exacerbation of bronchial asthma. this formula is used primarily for treating the accumulation of food in the interior with externally-contracted wind-cold.With the appropriate presentation. and externally-contracted damp-cold. normal tongue F O R M U L A NAME Ephedra Decoction (ma hvang tang) DIAGNOSIS Exterior cold excess (injury from cold) INDICATIONS Absence of sweating. which is reflected in the size of its dosage. @ For severe cold with intense abdominal pain. substitute Ramulus Cinnamomi Cassiae (gui zhi) for Cortex Cinnamomi Cassiae (rou gui). and difficult to expectorate. headache. All five types of accumulation need not be present. cough. headache. . * For deficient exterior disorders with sweating. omit Herba Ephedrae (ma huang) and Rhizoma Atractylodis (cang zhu). generalized aches and pains. For example. sputum that is copious. stuffy nose. the difference between externallycontracted wind-cold with internal injury due to cold. generalized body aches. Cinnamon Twig Decoction (gui zhi tang) Exterior cold from deficiency (attack by wind) Sweating that does not improve the condition. and add Radix Ginseng (ren shen) and Rhizoma Atractylodis Macrocephalae (bai zhu). and indeed would be very rare. MODIFICATIONS: @ For more acute exterior cold. omit Fructus Citri seu Ponciri (zhi ke) and Pericarpium Citri Reticulatae (chen pi).

absence of sweating. Exterior wind-cold (greater yang) that is transforming into interior heat (yang brightness) Externally-contracted heat collecting in the Lungs and Stomach Increasing fever and decreasing chills accompanied by headache.64 FORMULAS THAT RELEASE EXTERIOR COLD. stifling sensation in the chest. fever and chills. I . dry nasal passages. headache. Absence of sweating. Also for wind in the head. yellow tongue coating -- Relatively strong for releasing the exterior and clearing heat. cough. sweating. orbital and eye pain. FORMULAS THAT RELEASE EXTERIOR DISORDERS WITH HEAD AND NECK SYMPTOMS W COMMON INDICATIONS: floating pulse I FORMULA NAME Ligusticum Chuanxiong Powder to be Taken with Green Tea (chum xiong chu tiao san) I DIAGNOSIS Headache from externally-contracted wind I INDICATIONS Headache in any part of the head. a thin. thirst. generalized body aches. swollen throat with or without swollen glands Also for toothache due to wind-heat. a thin. floating and rapid pulse FORMULA NAME Mulberry Leaf and Chrysanthemum Decoction (sang j u yin) Honeysuckle and Forsythia Powder (jnn qiao san) Bupleurum and Kudzu Decoction to Release the Muscle Layer (chai ge jie ji tung) DIAGNOSIS Early. Cimicifuga and Kudzu Decoction (sheng ma g e gen tang) Also for all early-stage warmfebrile diseases. FORMULA NAME Cyperus and Perilla Leaf Powder (xiang s u san) Elsholtzia Powder (xiang r u san) DIAGNOSIS Exterior wind-cold with interior qi constraint Exterior cold with interior dampness INDICATIONS cont. dizziness. Especially useful in cases with vomiting and diarrhea. a redtipped tongue. slight fever and thirst. yellow tongue coating. irritability. a red. FORMULAS THAT RELEASE EXTERIOR WIND-HEAT COMMON INDICATIONS: fever. dry tongue Generalized soreness. greasy tongue coating Originally for summertime problems. thirst. focal 'distention and a stifling sensation in the chest and epigastrium. a sore. abdominal pain. vomiting. headache. tearing. insomnia. Notopterygium and Isatis Root Decoction (qiang Ian tang) Externally-contracted heat affecting the head and neck Modern formula. REMARKS Also for wind-cold disorders during pregnancy. headache. diarrhea. white tongue coating REMARKS Focuses on the Lungs but is also used for eye disorders due to wind-heat. white tongue coating I REMARKS Depending on modifications can be used for either windcold or wind-heat disorders. sore throat. poor appetite Aversion to cold with skin that is warm to the touch. nasal congestion. sneezing. sensation of heaviness in the head. a thin. superficial stage of a warmfebrile disease INDICATIONS Cough. a thin. a white. white or thin. Protective level warmfebrile disease Headache. coughing. red eyes. slightly flooding pulse Early-stage measles or rashes that do not surface evenly.

headache. fatigue. Scallion Decoction with Seven Ingredients (cong bai qi wei yin) - Exterior wind-cold with preexisting blood and/or yin deficiency Exterior wind-heat with preexisting blood and yin deficiency Modified Polygonatum Odoratum Decoction (jia jian wei rui tang) Headache. normal or yellow tongue coating. productive cough. heat rashes. Ephedra. cont. I FORMULA NAME I DIAGNOSIS - ( INDICATIONS Copious. absence of sweating. rough urination. frontal headache. greasy tongue coating. a thin. slippery pulse REMARKS Also for carbuncles. slight chills with little or no sweating. absence of sweating. a greasy. soggy pulse Extreme cold and chills. Exterior wind-cold with preexisting qi and yang deficiency Slight fever with strong chills. nasal obstruction. slight chills. and forceless pulse Fever. a yellow. Asarum. a submerged. stiff and rigid neck and upper back. absence of sweating. rapid pulse Fever and chills without sweating. slight fever. and Prepared Aconite Decoction (ma huang xi xin fu zi tang) Renewal Powder (mi zao san) Exterior excess cold with preexisting yang deficiency Also for Kidney coughing and headache due to cold from deficiency. pale tongue with white coating. FORMULAS THAT RELEASE EXTERIOR DISORDERS WITH INTERIOR DEFICIENCY FORMULA NAME Ginseng Powder to Overcome Pathogenic Influences (ren shen bai du san) DIAGNOSIS Exterior wind-colddampness with preexisting qi deficiency INDICATIONS High fever and severe chills with shivering. Wind-heat attacking the head Kudzu Decoction (ge gen tang) Externally-contracted wind-cold at the greater yang stage Also for the same pattern causing diarrhea or scanty urination. cold extremities. fever. white tongue coating. tight pulse I REMARKS This is known as profuse nasal discharge (bi yuan). FORMULAS THAT RELEASE EXTERIOR-INTERIOR EXCESS FORMULA NAME Ledebouriella Powder that Sagely Unblocks (fangfeng tong sheng san) DIAGNOSIS Heat excess in both the exterior and interior INDICATIONS Strong simultaneous chills and fever. stifling sensation in the chest. Intestinal wind. . red and sore eyes. big. white tongue coating. a floating. pain and stiffness of the head and neck. and obesity. bitter taste in the mouth. irritability. and for measles. constipation and dark. dizziness. a rapid pulse Usually follows a long-term illness or significant blood loss. a submerged. dark-red tongue.FORMULAS THAT RELEASE EXTERIOR DISORDERS WITH HEAD AND NECK SYMPTOMS. nasal congestion. thick and sticky nasal discharge and saliva. purulent. faint pulse REMARKS Also for early-stage dysenteric disorders from wind-colddampness. thirst. exhaustion. and absence of sweating after a prolonged illness or loss of blood This condition requires great delicacy in treatment. and foul-smelling nasal discharge. and a flooding. pallid complexion. focal distention and fullness of the chest. forceless or floating. rapid or wiry.

diarrhea with borborygmus May also have coughing of blood. cont. May be due to food accumulation with exterior wind-cold. FORMULA NAME Kudzu. rapid pulse Exterior cold excess with interior blazing heat Cold excess in both the exterior and interior Strong fever. irritability and insomnia. chills with no sweating. and Scutellaria Decoction (ge gen huang lian huang qin tang) Gypsum Decoction (shi gao tang) DIAGNOSIS Incompletely resolved exterior with heat excess in the interior yellow coating. stiff neck and back with generalized body aches. sensation of fullness in the chest and abdomen. thirst. Coptis.66 FORMULAS THAT RELEASE EXTERIOR-INTERIOR EXCESS. cold and painful abdomen. skin blotches. Also for irregular menstruation due to cold. INDICATIONS REMARKS Five-Accumulation Powder (wu ji san) . or nosebleeds. rapid pulse that is also slippery or flooding Fever and chills without sweating.

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We have grouped the formulas in this chapter under six major strategies. and red eyes. the words heat and fire are often used interchangeably. When prescribing heat-clearing formulas. and is also called 'empty fire. and to identify the location (level and organ) of the disorder.).'' Among the eight methods of treatment. The fourth strategy focuses on clearing heat from particular organs. clearing heat from the qi level and clearing the nutritive and blood levels. which usually has a more localized presentation than is true of other heat disorders. as well as formulas that release the exterior and dispel windheat (chapter 1). It is also used to describe conditions with grossly visible manifestations of heat such as bleeding. Formulas that relieve toxicity are used for suppurative disorders or other conditions that present with the traditional manifestations of toxin. This occurs when the blood or yin is severely depleted. Fire is a more intense form of heat. The use of the word 'clear' suggests purification and transformation. In traditional Chinese medicine. The difference between them is one of degree and manifestation. It distinguishes this strategy from others that address heat. The first two. it is important to clearly distinguish whether the condition is deficient or excessive in nature. and may lead .' The last strategy is relieving the particular presentations that are caused by summerheat. flushed face. . Heat-clearing formulas are used for problems due to heat where there is neither an exterior condition nor internal clumping. The same idea is echoed in the Divine Husdandmn's Classic of the Materia Medica: "Use cold medicines to treat heat. the formulas in this chapter utilize the clearing method (qingf. primarily purging that treats the accumulation or clumping of heat in the interior (chapter 3). The fifth strategy is clearing heat from deficiency. are intimately associated with the theories of externally-contracted disease as set forth in the T Discussion of Cold-induced Disorders and later by the school of warm-febrile disease. even when the systemic level of heat is not particularly severe. "Use clearing to treat warmth'' and "Use cold [substances] to treat heat" (chapter 70). Failure to do so will bring minimal results at best.CHAPTER TWO Formulas that Clear Heat HE GENERAL STR used in this chapter were first mentioned in the following passages from Basic Questions: "Cool what is hot'' and "Use cold [substances] for hot causes" (chapter 74).

or the qi level of the four levels of disease. The yang brightness channels contain an abundance of qi and blood. labored breathing. . . . . . . . . May also include headache.30g . . . Note that the presentation in both of these disorders includes thirst and irritability. or simply letting the decoction cool. . . qi. severe thirst and irritability. . it is important to include ingredients which protect the functions of the Stomach. . In such cases. it remains in the relatively superficial level of the channels. This same presentation occurs in the yang brightness stage of the six-stage system of differentiation. . sweet. It assists Gypsum (shi . . . . or bleeding of the gums and nose. . . . Available INDICATIONS: High fever with profuse sweating and SECTION 1 FORMULAS THAT CLEAR HEAT FROM THE QI LEVEL In the four-level system of differentiation (protective. It forces out the fluids in the form of profuse sweating. resulting in injury to both the qi and the yin. great (profuse) sweating. and a flooding. . This is blazing heat in the yang brightness channel-stage of the six stages of disease. . a yellow tongue coating. . . . . . Cold substances easily injure the yang qi and produce cold. . toothache. and dries the fluids in the upper yang brightness organ (the Stomach). And because the heat has entered the interior. . . . . . the simultaneous fever and chills which are the hallmark of exterior conditions is absent. . . rapid pulse. In this case. heavy. . This condition is similar to blazing heat at the same level of the body. . qi-level disorders are marked by high fever. and a sensation of constraint in the chest. Therefore the heat primarily affects the superficial and upper aspects of the body. and extremely cold properties clear heat and drain fire. . . and a flooding.9g to complications. To avoid these side-effects. Most of the herbs in these formulas are cold in nature. is bitter. There may also be a yellow. . . . huge. . great thirst.70 Formulas that Clear Heat from the Qi Level . sweating. great care must be exercised in treating a patient with longstanding yang deficiency who contracts a warm-febrile disease. . It is also important to take the patient's overall condition or constitution into account. Most of these formulas are designed for treating relatively acute problems. Stomach fire can cause problems along the upper course of the Stomach (yang brightness) channel in the form of headache. will usually alleviate the problem. irritability. nutritive. . The flooding pulse reflects the presence of a strong pathogenic influence in the channels. 3g . forceful or slippery. ANALYSIS O F F O R M U L A : Gypsum (shi gao) is the Cold-induced Disorders (Shang han lun) chief ingredient in this formula. and bleeding of the gums. . Some patients with vigorous. Radix Anemarrhenae Asphodeloidis (zhi mu). .9-15g the liquid. . The deputy. and moistening. . . delirious speech. . a White Tiger Decoction an aversion to heat. . Its acrid. . Because the yang brightness channels traverse the head and face. and a dry mouth and tongue. replaced by the high fever which is characteristic of interior heat. a red face. the cold ingredients in the formula must be used with utmost caution in order to prevent further injury to the yang. . Manifestations include irritability. thirst. The presence of thirst is often a clue for distinguishing this type of pattern from those that are lodged in either a deeper or more superficial level of the body. . . the result is a disorder of extreme ferocity characterized by the 'four greats': a great (high) fever. . and in severe cases. . . profuse sweating. . irritability. . . . fever. and blood). Although this is regarded as an interior condition. . severe heat in these channels causes headache and a red face. . When a strong pathogenic influence attacks the yang brightness channels in a person of robust health. cold. Another type of qi-level disorder occurs when heat is not cleared during the recovery stage of a febrile disease. For example. blazing heat will vomit up orally-administered heat-clearing formulas. . . and rapid pulse. dry tongue coating. . . This leads to severe thirst. Their use should be discontinued once the heat has been successfully treated. . the addition of a small amount of ginger juice. and a great (flooding and big) pulse. toothache. .

thirst. add Bulbus Allii Fistulosi (cong bai). benefit the Stomach and protect the fluids. considering it to be both unnecessary and inadvisable to tonify the Stomach qi in conditions of heat excess. If treatment is ineffective after 6-7 doses. irritability. This is because of the belief that Gypsum (shi gao) is very harmful to the yang qi. and lobar pneumonia. honey-fried Radix Glycyrrhizae Uralensis (zhi gan cao) and nonglutinous rice. forceless pulse. and enriches the yin. and insomnia associated with febrile disease and heat toxin. sweating. Careful follow-up is advised. A normal course of treatment is 2-4 doses. irritability. or heat that severely injures the fluids resulting in thirst. thirst. Available in prepared form.White Tiger Decoction gao) in clearing heat from the Lungs and Stomach to alleviate irritability. Such variations from the classical norm demonstrate that what is important is to grasp the underlying mechanism of the pattern. and periodontitis. take with Coptis Decoction to Relieve Toxicity (huang lian jk du tang). only one dose is needed. however. For this reason. subjective sensations of cold. Side-effects of an overdose include icy-cold limbs. a dry mouth. icy-cold limbs. or impairment of mental faculties occur. However. swollen eyes and excruciating headache. add Rhizoma Coptidis Chinensis ( h n g lian) and Radix Scutellariae Baicalensis ( h a n g qin). floating pulse. For example. meningitis. moistens dryness. *For the subcutaneous blotches (petechiae). headache. They also prevent the extremely cold properties of the other ingredients from injuring the middle burner. For example. In fact. and constipation due to Lung heat and Stomach fire. many modern-day practitioners do not use nonglutinous rice. * For red. add Radix Trichosanthis Kirilowii (tian h a fen). and therefore use it only rarely. This formula is appropriate in both cases. spontaneous sweating. agitated movement of the limbs in an otherwise subdued patient. Rhizoma Phragmitis Communis (lu gen) and Tuber Ophiopogonis Japonici ( m i men dong). it is properly prescribed for any case which presents with severe heat in the yang brightness stage where the fluids are injured. thirst with no desire to-drink. labored and difficult breathing. diabetes mellitus. aversion to wind. and insatiable hunger. COMMENTARY: Some physicians are overly cautious in prescribing this formula. This formula is frequently modified. The assistant and envoy ingredients. and a rapid pulse. and a large. Herba Dendrobii (shi h ) is often used as a substitute. profuse sweating. substitute Radix Dioscoreae Oppositae (shun yao) for nonglutinous rice. the practitioner must carefully reevaluate the situation. add Radix Ginseng (ren shen). Use of this formula should immediately stop if signs of headache. With the appropriate presentation. sometimes in yang brightness channel disorders there is an absence of sweating because the heat is slightly constrained. this formula may be used in treating such biomedically-defined infectious diseases as encephalitis. but there is no interior clumping. MODIFICATIONS: * For concurrent Stomach qi deficiency. Radix Panacis Quinquefolii ( x i yang shen) is often substituted for Radix Ginseng (ren shen). Other than misdiagnosis. extreme fatigue. Semen Sojae Praeparata ( d m dou chi) and Herba cum Radice Asari (xi xin). or there may be profuse sweating with sensitivity to cold in the upper back. CAUTIONS & CONTRAINDICATIONS: This formula is contraindicated in cases of fever due to Spleen and Stomach deficiency characterized by fever. if the diagnosis is accurate this formula can be used without causing any unpleasant side-effects. * For concurrent wind-cold in the exterior. and a deficient. nosebleed. a white tongue coating. It is the conventional wisdom that the presence of the 'four greats' is a prerequisite to using this formula. pain and swelling of the joints. White Tiger plus Cinnamon Twig Decoction 6 fL+v i% b6i hii jiii gui zhr tiing Source: Essentialsfrorn the Golden Cabinet g i n gui yao he) & * For wind-damp-heat painful obstruction characterized by high fever. add Radix et Rhizoma Rhei (da huang). * For pain and swelling of the gums. the primary cause of deleterious side-effects is an inordinately large dosage of Gypsum (shi gao). unprepared Radix Glycyrrhizae Uralensis (gan cao) is often used for its ability to generate fluids and thereby quench thirst. VARIATIONS: White Tiger plus Ginseng Decoction 6 $ 6 ~/1% b6i hii jiii re'n shzn tiing Source: Discussion of Cold-induced Disorders (Shang han lun) For injury to the qi and fluids characterized by fever. as well as heat stroke. and a . disorientation. generalized weakness. thirst. * For wasting and thirsting disorder. It should also be avoided in 71 cases of true cold and false heat characterized by fever with a desire for warmth. irritability and restlessness. in some cases. and a flooding but weak pulse. stiffness of the neck. Also. not blind allegiance to diagnostic cliches.

. sweating. . This is a concurrent yang brightness and lesser yang-stage disorder that is more commonly seen when the condition is near resolution (on the way out) than during its early stages (on the way in). . ASSOCIATED FORMULAS: Lophatherus and Gypsum Decoction 44. . . . . . . . . . thirst. . . . . . . Cook in five cups of water until reduced to three cups. . . . and a wiry.9-18g Rhizoma Pinelliae Ternatae (ban xia) . . . . irritability. . . . White Tiger and Order the Qi Decoction &p. . . . thirst. . .30g Radix Ginseng (ren shen) . . Take one cup warm. . . . . . . . . irritability. . . impaired consciousness. . . . . . and rapid pulse. . . .9-15g Gypsum (shi gao) . . . . . . . add Radix et Rhizoma Rhei (da huang) and Mirabilitum (mang xiao). thirst (with large consumption of fluids). . . . . take another cup (warm). . . . . cold feet. . . . . . 1% Nonglutinous rice (geng mi) . . . . . . . . . . .9g Honey-fried Radix Glycyrrhizae Uralensis (zhi gun cao) . . . and harmonizes the Stomach. Available in prepared form. . . . . scanty and painful urination. . . . . . and yet another two hours later. White Tiger plus Atractylodis Decoction .6g Tuber Ophiopogonis Japonici (mai men dong) . . . . . Clears Stomach heat and regulates the Stomach qi. and a wiry. . . . . profuse sweating. . rapid pulse. . . . . . . . rapid pulse. .&itc-$B b6i hii jiii ccing zhii tiing Source: Book to Safguard L i j Arranged herding to Pattern (Lei zhong huo Ten shu) For damp-warm-febrile disease or damp painful obstruction which has transformed into heat characterized by fever. . . . . . delirious speech or manic behavior.45g Rhizoma Pinelliae Ternatae (ban xia) . . . . . Actions: Clears heat. . . . . . . . . .9g Radix Scutellariae (huang qin). . . . . . . . . . . . . . . 1 leaf Harmonizes the lesser yang and clears yang brightnessstage heat.4g . .90g Radix Anemarrhenae Asphodeloidis (zhi mu) . irritability. . . Should not be taken 'again if the condition improves significantly within two hours. .3-6g Nonglutinous rice (geng mi) . mild chills. . . stifling sensation i n the chest. . . . . . add Cornu Antelopis (ling yang jiao) and Cornu Rhinoceri (xi jiao). . . . . occasional vomiting. . or warm-febrile diseases with heat entering the Stomach causing rebellious Stomach qi characterized by fever. . . . . . . . . . White Tiger Decoction to Suppress Rebellion & & 4 %% zhe'n ni b6i hii tcing Source: Records of Heart-felt Experiences in Medicine with Reference to the West (Yi xue zhong zhong can xi lu) Gypsum (shi gao). . . other yang brightnessstage symptoms. . . . . . .24g Caulis Barnbusae in Taeniis (zhu ru). White Tiger with Antelope and Rhinoceros Horn Decoction ~~c~~ ling xC b6i hhii tcing Source: Warp and W o o f of Warm-febrile Diseases (Wen re jing wei) For febrile diseases characterized by high fever. . . . epigastric distention. . . . aching joints. . . . . .3g Gypsum (shi gao). pain in the joints. . forceful. add Ramulus Cinnamomi Cassiae ( p i zhi). . . constipation (with clumping of dry stool in the intestines). . generates fluids. . . . . dark. . . . . . . . . . . . . . if necessary. . . . This is a concurrent yang brightness channel and organ-stage disorder. . . . . . . . . . . . . and in severe cases. . parched mouth. . add Rhizoma Atractylodis (cang zhu). . . . a n d throat. .4. . . a generalized sensation of heaviness. . . w-f i5 $53 zhii ye' shi giio tiing Source: Discussion of Cold-induced Disorders (Shang han lun) Herba Lophatheri Gracilis (dan zhu ye). . For severe fever that alternates with mild chills. . . . . . . augments the qi. . . . lips. . and a feeling of fullness and stifling oppression in the epigastrium. . INDICATIONS: Lingering fever (from a febrile disease) accompanied by vomiting. . . . . . . . . . . . j%s. If the condition does not improve. 189Decoction. a red tongue Bupleurum White Tiger Decoction $ 44 4 Ka ch6i hii bhi hii tiing Source: Revised Popular Guide to the Discussion of Cold-induced Disorders (Chong ding tong su shang han lun) Radix Bupleuri ( c h i hu) . . . . . . . For cold-induced disorders. . . The liquid drained from the cooked rice is ingested. a choking cough. . .5g Radix Anemarrhenae Asphodeloidis (zhi mu) . Also used for warm malarial disorders with intense internal heat and mild external cold characterized by high fever. . . . . . . . . . . . . thirst. greasy tongue. . . Folium Nelumbinis Nuciferae Recens (xian he ye) . . . and a red. .24g Radix Trichosanthis Kirilowii (tian huafen) . . . . . . . . . .9!3 Radix Glycyrrhizae Uralensis (gun cao) . . . . . irritability and thirst. .12-15g Preparation: Decoction. . . .2. and convulsions due to injury of the qi and blood. . ( . profuse sweating. .&L% b6i hii che'ng q i tiing Source: Revised Popular Guide to the Discussion of Cold-induced Disorders (Chong ding tong su shang han lun) For high fever. . . . . . . . . . . .Formula that Clear Heat from the Qi Level wiry.

. it "changes an extremely cold formula into a clearing and tonifying one. COMMENTARY: Originally. it is very important to ascertain whether the pathogenic influence has in fact been cleared from the body. Gardenia and Prepared Soybean Decoction z h X zi d6u chi tiing Source: Discussion (Shang han lun) of Cold-induced Disorders Fructus Gardeniae Jasminoidis (zhi zi) . Each reinforces the actions of the other. Lingering of the pathogenic influence in the qi level is a very common problem. irritability.9g Semen Sojae Praeparata (dan dou chi) . Today it is usually prepared as a decoction with both ingredients cooked the same amount of time. add Radix Trichosanthis Kirilowii (tian hua fen) and Herba Dendrobii (shi hu). The pulse is also indicative of heat and depleted fluids. . MODIFICATIONS: Herba Lophatheri Gracilis (dan zhu ye) and Gypsum (shi gao). @ For intense. . The stifling sensation in the chest is due to heat obstructing the flow of qi. This formula is also effective in such cases. or a strong. a stifling sensation in the chest with a soft epigastrium. administration should be stopped.9g Preparation: The source text advises to first put the Fructus Gardeniae Jasminoidis (zhi zi) in about four cups of water and cook it down to two-and-ahalf cups. Radix Ginseng (ren shn) and Tuber Ophiopogonis Japonici ( m i men dong). INDICATIONS: Fever. this formula was pre- For insufficient Stomach qi and yin with only mild or no Stomach heat signs. profuse sweating. dryness.Gardenia and Prepared Soybean Decoction with little coating. and a rapid pulse which is also deficient or thin. blazing Stomach fire with persistent hunger. and nausea. vomiting. When treating a patient who has had a febrile disease. it invigorates the Spleen qi and reduces the cloying. As noted in the Golden Mirror of the Medical Tadition. add Radix Trichosanthis Kirilowii (tian huafen) and Radix Anemarrhenae Asphodeloidis (zhi mu). This is qi-level heat lingering in the Lungs and Stomach where it injures the qi and fluids. and a choking cough indicate disharmony of qi flow in the Stomach and Lungs. but a low-grade fever with sweating remains. dry tongue. . It is a warm and acrid substance and may therefore appear to be inappropriate in this formula. severe thirst. and a slightly rapid pulse. T h e assistant. a red and dry tongue. . omit Gypsum (shi gao). . The deputy ingredients. 73 and may lead to a condition characterized by high fever. the other ingredient is then added and the decocting is continued until one-and-a-half cups remain. honey-fried Radix Glycyrrhizae Uralensis (zhi gan cao) and nonglutinous rice. a dry mouth and lips.directs rebellious qi downward and thereby stops the vomiting. and a red. floating pulse at the distal position. rapid pulse. stagnating properties of Tuber Ophiopogonis Japonici (mai men dong). It usually occurs during the recovery stage or in the aftermath of a febrile disease. Some patients experience restlessness and insomnia. T h e envoys. . and a deficient. it can be used anytime during the course of a febrile disease where there is evidence of injury to the qi and yin characterized by unabated fever with sweating. They assist Radix Ginseng (ren shn) in tonifylng the qi. insomnia with tos- scribed only in the aftermath of a febrile disease. in concert with the heat-clearing and fluid-generating ingredients. Summerheat readily injures the qi and fluids and sing and turning in bed. The more pronounced symptoms of heat have subsided. and they harmonize the middle burner and nourish the Stomach. Heat constrained in the chest causes irritability and . thirst. . However. ." With the appropriate presentation. . . . . This is qi-level heat lingering in the superficial aspects of the yang brightness stage (the muscles and chest). Nausea. Regarded as a variation of White Tiger Decoction (bai hu tung). this is an excellent example of how a relatively slight modification can change the entire focus of a formula. However. . @ For deficient Stomach yin with oral ulcerations and a red. nephritis. Rhizoma Pinelliae Ternatae (ban xia). The heat has disturbed the spirit. thereby protecting the Stomach against injury from Gypsum (shi gao). Actions: Clears heat and alleviates restlessness and irritability. . serve two functions. ANALYSIS OF FORMULA: The chief ingredients. The formula's ability to simultaneously clear the remnants of heat and tonify the deficiency of qi is due to the combined actions of Gypsum (shi gao) and Radix Ginseng (ren shen). a slightly yellow tongue coating. . Heat constrained in the qi level leads to fever. Thirst. resulting in irritability and insomnia. extreme fatigue. If this formula induces vomiting. work together to clear yang brightness heat and alleviate irritability. Available in prepared form. this formula may be used in treating such biomedically-defined disorders as pharyngitis. tonify the qi and generate fluids. . This formula is very useful in treating this type of condition. or diabetes mellitus. dry tongue with little or no coating reflect injury to the yin and fluids.

. and weakness that follow in the aftermath of treating a disease by sweating. . a greasy tongue coating. He cannot verbalize the condition. . There are a few other formulas by Zhang ZhongJing that address accumulation in the chest characterized by fever. irritability. add Radix Scutellariae (hang qin) and Fructus Forsythiae Suspensae (lian qiao). add Fructus Arctii Lappae (niu bang zi) and Herba Menthae Haplocalycis (bo he).6g Clears heat and harmonizes the middle burner. is the chief herb in the formula. Gardenia.. This condition is described as one of 'formless accumulation': although constraint causes the heat to accumulate in the chest and epigastrium. . and diarrhea due to improper treatment by purging. but some left-over heat lingers in the areas of the chest and diaphragm. and Prepared Soybean Decoction + > 3 +k$ 3 3 zhi shi zhi. in the epigastrium vomiting. and Prepared Soybean Decoction #&J. and varying degrees of chest discomfort. add Rhizoma Zingiberis Officinalis Recens (sheng jiang). When the heat is released. . . Bitter Orange. add Fructus Immaturus Citri Aurantii (zhi shi). and other symptoms of dampness. This formula and its variations (see below) are all used to treat irritability due to lingering heat. . In the rather severe case when heat increases. a bitter. . . e For a bitter taste in the mouth. The slightly yellow tongue coating and vigorous pulse at the distal position also indicate qi-level or superficial yang brightness-stage heat. For nausea. VARIATIONS: #. lingering heat. d giin ciio chi tang Source: Discussion of Cold-induced Disorders (Shang han lun) For shortness of breath. These symptoms are regarded as the consequence of relatively severe. yellow tongue coating. Gardenia. slight irritability. . and Prepared -Soybean Decoction zhi. In this case. . . . and very restless sleep thereafter. Minor Sinking into the Chest Decoction (xiao xian xiong tang) (chapter 16) is indicated when there are tender and hard areas in the epigastrium. but will be restless and unable to lie down.9g Rhizoma Zingiberis Officinalis (gan jiang) . is indicated when there is firm focal distention. This causes [the patient] to suffer irritability and insomnia. vomiting. they remain soft and pliable with no evidence of palpable lumps or distention. vomiting. Fresh Ginger. or purging. Drain the Epigastrium Decoction (xie xin tang). COMMENTARY: The source text recommends this formula for the stifling and burning sensation in the chest and epigastrium. vomiting.33 zhi. d chi tiing Source: Discussion of Cold-induced Disorders (Shang han lun) For fever and epigastric distention associated with a recurrence of disease due to overexertion or improper diet during convalescence. the irritability will disappear. cold herb that clears heat and thereby alleviates irritability. add Radix Glycyrrhizae Uralensis Gardenia.Formulas that Clear Heat from the Qi Level insomnia. borborygmus. . . They are usually indicated in the aftermath of a febrile disease or during a relapse.+tqg4n (gan cao). . irritability. . [the patient] will exhibit more irritability and constraint in the area of the Heart. insomnia. this formula may be used in treating such biomedically-defined disorders as upper respiratory tract infection. after [inducing] sweating. Fructus Gardeniae Jasminoidis (zhi zi). constrained heat in the chest. and autonomic dystonia. and in the abdomen purging. the pathogenic influence with form has been eliminated. Shen Yao-Feng. add Rhizoma Pinelliae Ternatae (ban xia) and Herba Agastaches seu Pogostemi (huo xiang).3-3. and other symptoms of severe interior heat. . T h e late eighteenth-century physician. discussed later in this chapter. .a zhf d s E n g jiiing chi tang Source: Discussion of Cold-induced Disorders (Shang han lun) For vomiting. abdominal pain. With the appropriate presentation. The insomnia is characterized by tossing and turning before falling asleep. For fever. cogently described this process in Readingsfinn Discussion of Cold-induced Disorders: When a pathogenic influence is in the exterior it requires sweating. fever of unknown origin. . or purging. Semen Sojae Praeparata ( d m dou zhi) spreads and drains the unformed. ANALYSIS OF FORMULA: The irritability and other symptoms of this disorder are due to constrained heat.* & $ i . d giin jGng tang Source: Discussion of Cold-induced Disorders (Shang han lun) Fructus Gardeniae Jasminoidis (zhi zi) . . Licorice. MODIFICATIONS: For externally-contracted heat with lingering exterior symptoms. . . This is called vexation. ASSOCIATED FORMULAS: Gardenia and Ginger Decoction +h 4.

. and a thin. . and cold Cornu Rhinoceri (xi jiao). o r has moved to the nutritive level. . . . . there will be a high fever. some delirious. . . . rapid pulse. . . which makes it a useful substance for treating . T h e presence or absence of thirst is an indication of whether heat remains in the qi level. relieves fire toxin. . . . . . . Some patients are thirsty. . Actions: Clears the nutritive level. . . . . . distinct rashes or hemorrhage appears. . . Also for relapse of fever and constipation associated with a recurrence of disease due to improper diet during convalescence. causing irritability. . . . T h e scarlet. . . . . . . . salty. . Sometimes there is delirious speech.9g Radix Rehmanniae Glutinosae (sheng di huang) . .5g Herba Lophatheri Gracilis (dan thu ye) .6g Preparation: Decoction. . . . . it causes fever that worsens at night. rapid pulse are important signs of heat in the nutritive level. indistinct rashes. the thirst will disappear. . and the thin. . the heat in these cases not only causes bleeding. .6g Rhizoma Coptidis (huang lian) . High fever that worsens at night. . . . ANALYSIS O F FORMULA: The chief ingredient. alleviates irritability.4. . . . .9-12g Fructus Immaturus Citri Aurantii (zhi shi) . .9g Radix Scrophulariae Ningpoensis (xuan shen) . . . and reduces fullness and distention. . Since most of these disorders begin in the qi level. INDICATIONS: 463 k 4 3 Gardenia and Rhubarb Decoction z h T d d2 huhng tang Source: Essentials from the Golden Cabinet g i n gui yao lue) Fructus Gardeniae Jasminoidis (zhi zi) . 12g Fructus Immaturus Citri Aurantii (zhi shi) . .159Tuber Ophiopogonis Japonici ( m i men dong) . . For this reason. herbs that clear heat from the qi level should also be prescribed. and reduces accumulation. If Cornu Rhinoceri (xi jiao) is used. but may also scorch the blood. .6-9g Clears heat. . . . and nourishes the yin.3g Radix Salviae Miltiorrhizae (dan shen). . . . . . . . It is cold but does not cause obstruction.3g Clears heat. . . it is strongly recommended.9-12g Cortex Magnoliae Officinalis (hou $0) . . . . . . . Because this substitution is effective and the rhinoceros is an endangered species. Furthermore. . . . . This is heat entering the nutritive level. It is powdered or shaved and should be cooked separately for 15-20 minutes before adding the other ingredients. . . T h e faint. . Its presence indicates that heat remains in the qi level. . dry tongue. .6-9g Radix et Rhizoma Rhei (da huang) . . When heat enters the nutritive level. . . . . Proper treatment of nutritive and blood-level disorders requires more than simply clearing the nutritive level and cooling the blood. delirious speech. . . . clears heat from the nutritive level. Thirst results from a 'plundering' of the Stomach fluids. . and in extreme cases. . . H 5a3 ++ % Clear the Nutritive Level Decoction Source: Systematic Difierentiation of Warm Diseases (Wen bing tiao bian) Cornu Rhinoceri (xi jiao) . SECTION 2 FORMULAS THAT CLEAR HEAT FROM THE NUTRITIVE LEVEL AND COOL THE BLOOD T h e nutritive (ying) and blood (xu. . restlessness. the fever worsens at night. and there may also be faint.Clear the Nutritive Level Decoction 75 Gardenia and Magnolia Bark Decoction ihT d h& p i t6ng Source: Discussion of Cold-induced Disorders (Shang han lun) Fructus Gardeniae Jasminoidis (zhi zi) . . and calms the spirit. Cornu Bubali (shui niu jiao) may be substituted for Cornu Rhinoceri (xijiao) with a 30-120g dosage. severe irritability and restlessness. it should be taken in powdered form and then followed by the strained decoction. . When a strong pathogenic influence enters the nutritive level. . bit- ter. . dry tongue. . . . This is often accompanied by manic behavior and a reddish-purple tongue with prickles. . . A yellow tongue coating may also be found in patients where heat lingers in the qi level. . . . . . . . When heat enters the blood level. and insomnia. Once the heat has almost completely moved to the nutritive level. irritability. . . . . ingredients that invigorate the blood are often added to the formulas. . . . . . .) levels are the deepest of the four levels of disease. indistinct rashes indicate that heat is on the verge of entering the blood level. . . . because the yin (associated with night) is affected. . Heat also scorches the Heart and disturbs the spirit. For jaundice with distress and irritability sometimes accompanied by fever and generalized pain. .9-12g Semen Sojae Praeparata (dan dou chi) . . . .9g Fructus Forsythiae Suspensae (lian qiao) . . . . . a scarlet. For irritability and abdominal distention after purging. . and some exhibit faint and indistinct erythema and purpura. which can lead t o blood stasis. . unblocks the bowels. . . drains heat. clears the Heart. .9g Flos Lonicerae Japonicae (jin yin hua) . . . alleviates irritability. . . . .

. . . . * For heat sinking into the Pericardium with high fever. . conditions with heat that has plunged into the interior. . dispels blood stasis. cold [substances] with the assistance of bitter. . blood in the stool or urine.'' Not all cases of heat entering the nutritive level are acute in nature. it will prolong the condition. . especially when the normal qi is strong. and a thin. cools the blood. With the appropriate presentation. and Tuber Ophiopogonis Japonici ( m i men dong). . It is powdered or shaved and should be cooked separately for 15-20 minutes before adding the other ingredients. Flos Lonicerae Japonicae (jin yin hua). nourishes the yin. . . and rashes). black and tarry stools. Cornu Bubali (shui niu jiao) may be substituted for Cornu Rhinoceri (xi jiao) with a 30-120g dosage. abdominal distention and fullness. and Radix Cynanchi Baiwei (bai wei). T h e modern physician. convulsive spasms. The strategy for treating this type of disorder is explained in Basic Questions (chapter 74): "When the hot pathogenic influence is in the interior. Rhizoma Imperatae Cylindricae (bai mao gen). thirst k i t h a n inability to swallow. . . . . relieves fire toxin. which cools the blood and nourishes the yin. If Cornu Rhinoceri (xi jiao) is used. reinforces those ingredients which cool the blood. When heat enters this level. Today it is usually prepared as a decoction without grinding the ingredients. . . Once these symptoms have subsided. . I n the modified formula. . . Rhizoma Coptidis (huang lian). These three ingredients enhance the actions of the chief ingredient. Radix Rehmanniae Glutinosae Recens (xian di huang) (with a threefold increase in dosage) is preferred whenever possible over the dried form of the herb. Some patients become delirious. various types of bleeding (including vomiting of blood. . . . . But once it does. . . it should be taken in powdered form and then followed by the strained decoction. Actions: Clears heat. . . which nourishes the yin and generates fluids. INDICATIONS: Fever.6g Preparation: The source text advises to coarsely grind and decoct the ingredients for a long period of time. . . the blood level. . . Wang Shan-Hui. it is strongly recommended. . Sometimes. . Radix Rehmanniae Glutinosae (sheng di huang). . and leukemic crisis. . . . . use the principal formula. septicemia. . . . and also prevents blood stasis. treat with salty. Fructus Forsythiae Suspensae (lian qiao). . the dosage of those herbs which treat qi-level heat should be increased. If used in cases with dampness. meningitis. .24g Radix Paeoniae (shao yao) . . . . The assistants. This is heat entering the deepest of the four levels of disease.76 Formulas that Clear Heat from the Nutritive Level and Cool the Blood Radix Adenophorae seu Glehniae (sha shen) and Fructus Lycii (gou qi zi). it will take longer for the heat to reach this level. . this formula may be used in treating such biomedically-defined disorders as pneumonia. MODIFICATIONS: For severe depletion of the yin and fluids. . Radix Paeoniae Rubrae (chi shao) is the form of Radix Paeoniae (shao yao) most commonly used. and impaired consciousness. Cornu Antelopis (ling yangjiao) and Lumbricus (di long). . rapid pulse. effectively clear heat from the qi level and relieve toxicity. sweet [substances] . begin the treatment with Calm the Palace Pill with Cattle Gallstone (an gong niu huang wan).'' If qi-level heat is more prominent. . a scarlet tongue with prickles. . COMMENTARY: The general purpose of this formula is summed u p in a statement attributed to Ye TianShi in the Warp and Woof of Warm-febriL Diseases: "Disturbances from [heat] entering the nutritive level can be [treated] by venting the heat through the qi [level]. . . . . It also cools the blood and breaks up stasis. . it will linger there. he replaced the assistant herbs with Cortex M o u t a n Radicis (mu dan pi). . . . but increasing the dosage by 20-30 per cent. . which clears heat and nourishes the yin. . encephalitis. Because this substitution is effective and the rhinoceros is an endangered species. and stops bleeding. . * For severe qi-level fire. T h e remaining assistant.3g Radix Rehmanniae Glutinosae (sheng di huang) . . add Gypsum (shi gao). Radix Salviae Miltiorrhizae (dan shen). . . .9g Cortex Moutan Radicis (mu dun pi). . . . . . CAUTIONS & CONTRAINDICATIONS: The source text cautions that this formula is contraindicated in cases with a white and slippery tongue coating. add @ Rhinoceros Horn and Rehmannia Decoction Source: Thousand Ducat Formulas (Qian jin yao fang) Cornu Rhinoceri (xi jiao) . . Cornu Bubali (shui niu jiao) is an excellent substitute. used a modification of this formula in successfully treating a chronic case of night sweats that had recurred at the beginning of every winter for twelve years. . nosebleed. . which is an indication of dampness. . and Herba Lophatheri Gracilis (dan zhu ye). add Rarnulus cum Uncis Uncariae (gou teng). The deputy ingredients are Radix Scrophulariae Ningpoensis (xuan shen). * For tremors and spasms.

. . cools the blood. substitute Radix Paeoniae Lactiflorae (bai shao) for Radix Paeoniae Rubrae (chi shao). . . This leads to black and tarry stools together with distention and fullness in the abdomen.450g Flos Lonicerae Japonicae (jin yin hua) . . * For high fever and impaired consciousness. . . . .270g Radix Scutellariae (huang qin) . nourishes the yin. . . a type of thirst peculiar to this condition arises when heat enters the deep (yin) levels of the body where it causes a bubbling and upward-boiling of the fluids. . . . . . . Cornu Bubali (shui niu jiao). 18Og Radix Rehmanniae Glutinosae (sheng di huang) . . . . . . . stops bleeding. . . . add Radix Arnebiae seu Lithospermi (zi cao) and Indigo Pulverata Levis (qing h i ) . . . . . . .180g Semen Sojae Praeparata ( d m dou chi). . . Take 9g with cool water twice a day. Leakage into the skin results in maculopapular or other types of rash. this formula may be used in treating such biomedically-defined disorders as septicemia. . ASSOCIATED FORMULA: Magical Rhinoceros Special Pill * #* s h h 4%diin Source: Warp and Woof of Warm-febrileDiseases (Wen re jing wei) formula is limited to the treatment of externallycontracted disorders that have not been properly released by sweating. . . . . and relieves fire toxin. . CAUTIONS & CONTRAINDICATIONS: Contraindicated in cases of bleeding due to yang deficiency or Spleen and Stomach deficiency. . * For vomiting of blood. . epidemic summerheat. cools the blood. . and clears heat. . . . . clears Heart fire. irritability. and have therefore penetrated to the interior and affected the blood. 180g Rhizoma Acori Graminei (chang pu) . Radix Rehmanniae Glutinosae (sheng di huang) cools the blood.210g Radix Arnebiae seu Lithospermi (zi cao) . . In contrast to the principal formula which primarily cools and invigorates the blood. . thrombocytopenic purpura. .450g Fructus Forsythiae Suspensae (lian qiao). . . . uremia. glaucoma. add Rhizoma Imperatae Cylindricae (bai mao gen) and Herba Cephalanoplos (xiao ji). pediatrics. . take with Calm the Palace Pill with Cattle Gallstone (an gong niu huang wan). invigorate the blood. . .120g Radix Scrophulariae Ningpoensis (man shen). Heat generally causes thirst. toxemia. . . . l20g Grind ingredients into powder mixed with rehmannia juice and'form into pills. * For rashes. and relieves fire toxin. add Radix Astragali Membranacei (huang qi) and Radix Ginseng (ren shen). this manifests as nosebleed and vomiting of blood. A scarlet tongue body with prickles is a classic sign of heat in the blood level. * For a bad temper due to constraint. When the heat is severe the combination of bleeding and stasis will cause the rashes to turn purple. . hepatic coma. Blood forced into the Intestines by heat accumulates and stagnates. It is now used for all types of bleeding accompanied by fever and a purple tongue. . ANALYSIS O F FORMULA: Cornu Rhinoceri ( x i j h ) 77 or its substitute. .300g Radix Isatidis seu Baphicacanthi (ban Ian gen) . . . . Injury to the yin from severe heat and loss of blood requires that the yin be nourished. in the lower part. . . * For severe injury to the yin and blood. . . the use of this qin) and Radix et Rhizoma Rhei (da huang) (source text). . . encephalitis. Radix Scutellariae (huang gin) and Fructus Gardeniae Jasminoidis (zhi zi). . With the appropriate presentation. . MODIFICATIONS: * For manic behavior. . redness of the eyes. . . * For severe bleeding. . meningitis. . opens up the orifices. . blood or pus in the anterior chamber of the eye. add Cacumen Biotae Orientalis (ce bai ye) and Rhizoma Imperatae Cylindricae (bai mao gen). . .) COMMENTARY: In the source text. . this formula focuses on relieving toxicity and opening the orifices. . . add powdered Radix Notoginseng (san qi). In the upper part of the body. . This results in a type of thirst in which the patient may wish to rinse his mouth with water. Radix Paeoniae Rubrae (chi shao) and Cortex Moutan Radicis (dm pi) cool the blood. . add Radix Bupleuri (chi hu). and acute leukemia. * For blood in the stool. * For bleeding due to simultaneous reckless movement of hot blood and the inability of deficient qi to control the blood. as blood in the urine and stool. . . drain heat. . . . . . However.240g Radix Trichosanthis Kirilowii (tian huafen) . . Heat disturbing the Heart causes delirious speech. . deep-purple rashes. It is also widely used in gynecology. e For blood in the urine. delirious speech. but has no desire to swallow it. . causing nosebleed or vomiting of blood. . . and disperse blood stasis. add Radix Sanguisorbae Officinalis (di yu) and Flos Sophorae Japonicae Immaturus (huai hua mi). . Clears heat. . and poxes characterized by severe heat toxin. . add Radix Scutellariae (huang Cornu Rhinoceri (xi jiao) . . . . and ophthalmology for problems due to both heat and blood stasis. . .Rhinoceros Horn and Rehmannia Decoction it causes the blood to move recklessly and leave its normal pathways. . . . . . . . . For warm-febrile diseases. and a scarlet tongue (sometimes with a black coating). . . . (The stasis of blood may be caused by severe heat or as a side-effect from the use of cold ingredients. See the principal formula for a discussion of substitutes for Cornu Rhinoceri (xi jiao).

Today the dosage of Rhizoma Coptidis (huang lian) is generally one-half to one-third the amount specified. Also for nosebleed or vomiting of blood due to heat excess. . can give rise to many complications. Actions: Drains fire and relieves toxicity. which pervades both the interior and exterior. Injury to the blood vessels can result in leakage to the skin and the formation of purpura or rashes. nausea or vomiting. boils. The other assistant. or various types of sores. . a red tongue with a yellow coating. These formulas focus on heat toxin in the middle and upper burners. A red tongue with a yellow coating and a fast. the accumulation of heat in the chest and diaphragm. not the toxicity of a substance. formulas which treat toxic sores characterized by localized redness. The word toxin ( d ~ can ) mean different things depending on the context. With the appropriate presentation. . Cortex Phellodendri (huang bai). urinary tract infection. carbuncles. . . . and dysenteric disorders or jaundice due to damp-heat. a dry mouth and throat. pain. . The searing heat injures the fluids and dries the mouth and throat. irritability. . insomnia. Because the Heart corresponds to the phase of fire. pneumonia. . . . . . Available in prepared form. or from the accumulation of internallygenerated heat. . forceful pulse reflect the presence of fire toxin. this formula may be used in treating such biomedically-defined disorders as septicemia. . Chinese medicine also differentiates between yin and yang toxin. CAUTIONS & CONTRAINDICATIONS: Because it is very bitter and cold. .6-12g Preparation: Decoction. incoherent speech and insomnia. . . Radix Scutellariae (huang gin). strong pulse. Toxin is generally distinguished from heat by the presence of pustular lesions such as sores. Fructus Gardeniae Jasminoidis (zhi zi). . and malaise are included. deep-rooted boils. . irritability. Rhizoma Coptidis (huang lian). the toxin will disappear. . nosebleed. . . incoherent speech. . . toxin refers to the etiology or clinical presentation. . a region of the body which. This manifests as high fever. and a rapid. . and purulent skin lesions. this formula should only be prescribed in cases of excess for patients of robust constitution. . toxic bacillary dysentery. In addition. INDICATIONS: High fever. . . it should not be taken long-term. ANALYSIS OF FORMULA: Effective treatment of this condition requires that the heat (or fire) is drained from the entire body. . This herb is particularly helpful in relieving the irritability. the chief herb in this formula. In this chapter. . drains heat from the three burners through the urine. . and is sometimes used interchangeably with the term for pathogenic influence (xi. . . . dark urine. if not attended to. does just this.6g Cortex Phellodendri (huang bai) . irritability.6g Fructus Gardeniae Jasminoidis (zhi zi). encephalitis. If prescribed for conditions FORMULAS THAT CLEAR HEAT AND RELIEVE TOXICITY The formulas in this section are used in treating heat toxin with vigorous heat in the three burners characterized by fever. or the toxicity of a substance. . It may refer to the cause of a disease. . forceful pulse. and in severe cases. . In some cases. The fire toxin that ensues in turn pervades the three burners and disturbs the spirit. . clears heat from the lower burner. . irritability. COMMENTARY: This formula is suitable for all types of fire toxin obstructing the three burners characterized by high fever. . the pathological mechanism of a disease. a red tongue with a yellow coating. incoherent speech. or by the general 'sickness' of the patient. Severe heat may also induce reckless movement of blood (especially in the upper part of the body) which causes nosebleed or vomiting of blood. . which may develop from constrained pathogenic influences generating heat.F o r m h that Clear Heat and Relieve Toxicity SECTION 3 This is severe obstruction of the three burners by fire toxin (also known as heat toxin). swelling. Since it can easily injure the yin. . . and other toxic swellings. a dry mouth and throat. The deputy. Heat obstructing the muscle layer produces carbuncles. . . .9g Radix Scutellariae (huang qin). Toxin can develop when an external pathogenic influence is transformed by constraint.). and other types of suppurative swellings. clears heat from the upper burner. fire toxin from constraint may cause damp-heat dysenteric disorders or jaundice. or wind-heat epidemic toxin attacking the head or face. It is also very useful in draining fire from the middle burner. Coptis Decoction to Relieve Toxicitv huiing liiin jig dG tiing Source: Arcane Essentials from tb Imperial Library (Wai tai bi yao) Rhizoma Coptidis (huang lian) . one of the assistants. . The formulas in this section address yang toxin. Once the fire is effectively drained. and a rapid. a substance that effectively drains fire from the Heart can cause an abatement of fire in all the other organs. . rashes. . .

. . . . . Cortex Moutan Radicis (dan pi) and Radix Scrophulariae Ningpoensis (xuan shen). . yellow tongue coating. . . . . . . . This is damp-heat excess with interior clumping. . . . Together the herbs in this formula drain heat from the three burners. . . . . . . . . . . . . . . . a greasy. . . . . . . . . . . .24g Radix Angelicae Sinensis (dang gui) . . . Radix Scutellariae (huang qin) and Rhizoma Coptidis (huang lian). . . . . . . . The deputies.120g Fructus Forsythiae Suspensae (lian qiao). . . redness of the eyes. Fever. . . . . primarily through the stool. . purging will drain the heat and break up the clumping. Semen Arecae Catechu (bing lang) and Cortex Fraxini (qin pi) @ For damp-heat in the lower burner with urinary frequency. . . . . . . . .75g Gypsum (shi gao) . . . For headache. . . . . . . . . . . . . . . . INDICATIONS: Fever. . . ASSOCIATED FORMULA: Cattle Gallstone Pill to Ascend a n d Clear +-k. . add Radix Rehmanniae Glutinosae (sheng di h a n g ) . .120g Flos Chrysanthemi Morifolii (ju hua) . . . . For purulent lesions such as deep-rooted boils. .24g Disperses wind-heat and drains and relieves fire toxin.3g dampness. . flushed face. . . . . . @ For nosebleed. or vomiting of blood or nosebleed. delirious speech. . .6g . Rhizoma Alismatis Orientalis (ze xie) and Semen Plantaginis (che qian zi). . . . . . . . pain and swelling of the throat and gums. . . . . . . . . . . especially in the upper part of the body. . . . . . . .15g Herba Menthae Haplocalycis (bo he) . . .75g Cortex Phellodendri (huang bai). . . . . . . . . red eyes. diarrhea. Also for epigastric focal distention. .3g . . . . vomiting of blood. . . . . . . . ulcerations of the mouth and tongue. . . . or ulcerations of the tongue and mouth. . . . . . . . . . . . . . . . . . . . .. which contains Fructus Gardeniae Jasminoidis (zhi zi). . . . . . . . . . . . . . . . . . urgency. . . . . .24g Herba Schizonepetae Tenuifoliae (jing jie) . this presentation does include signs of clumping. flushed face. . . . dark urine. . . Vomiting of blood and nosebleed are caused by the reckless movement of hot blood. . . . . . . . this herb enters the blood level and is useful in the treatment of bleeding. add Radix et Rhizoma Rhei (da 1g Drain the Epigastrium Decoction & > 3 brig). . .75g Calculus Bovis (niu huang) . COMMENTARY: This formula should be distinguished from Coptis Decoction to Relieve Toxicity (huang lianjie du tang). . and in severe cases. . . . . . .15g Radix Paeoniae Rubrae (chi shao) . . and discomfort. . . . . . . . . . . add Caulis Mutong (mu tong). . . dark urine. . . . . . . In addition. . . . . . . However this . . . constipation. .24g Radix Platycodi Grandiflori (jie geng) . . .60g Radix Ledebouriellae Divaricatae (fangfeng). drain heat from the upper and middle burners. . . . add Herba Artemisiae Yinchenhao (yin chen) and Radix et Rhizoma Rhei (da huang). . . . take with Five-Ingredient Decoction to Eliminate Toxin ( w u wei xiao du yin). . . . . . @ For jaundice due to obstruction from heat. . . . . . . . di huang tang). is also on draining heat from the three burners. diarrhea. . . . . ANALYSIS OF FORMULA: Radix et Rhizoma Rhei (da hang). or erythema and purpura. . . . . . . . . . . and ulcerations of the mouth and tongue due to fire. . . . irritability and restlessness. . . . 15g Radix et Rhizoma Rhei (da huang) . add Radix Aucklandiae Lappae (mu xiang). .24g Radix Scutellariae (huang qin) . . . . . . . . . if accompanied by diarrhea or dysenteric disorders. . . 1% Fructus Gardeniae Jasminoidis (zhi zi) . .24g Radix Glycyrrhizae Uralensis (gan cao) . . Available in prepared form. . red eyes. . MODIFICATIONS: @ For constipation. . . . and dysenteric disorders are manifestations of dampheat excess and interior clumping. . and abscesses are associated with fire toxin. . . . . . yellow tongue coating. . . the chief herb in this formula. . . . . . constipation. . or take with Rhinoceros Horn and Rehmannia Decoction (xi jiao 'opening of the Heart' (xin kdu). . . . . a greasy.~$$h niiL huhng shiing qq'ing wiin Source: National Collection of Chinese Herbal Prepared Medicines (Quan guo zhong cheng yao chu fang ji) Rhizoma Coptidis (huang lian). . . . or red and swollen eyes and ears. or abscesses. . . . . . .Drain the Epigastrium Decoction of heat in the nutritive or blood levels. .24g Radix Ligustici Chuanxiong (chuan xiong) . . . . . . . . . . jaundice. . For dysenteric disorders with blood and mucus in the stool and tenesmus. . However. . . . . . . . . . . epigastric focal distention. .60g Realgar (xiong huang). . . . it may easily injure the yin. . irritability and restlessness. is used more for its action in draining fire than for purging. . . . . .249Radix Angelicae Dahuricae (bai zhi) .jaundice. . . . . .75g Plumula Nelumbinis Nuciferae (lian xin) . . Red and swollen eyes and ears. .3g Borneo1 (bing pian) . and dysenteric disorders. . . . The focus of that formula. . . .

6g Clears heat and relieves toxicity. . . was considered by its author lo be a welltested formula that could saue many lives. . . . . . . . . . . . . .6g Pericarpium Citri Reticulatae (chm pi) . . dryness and thirst. .6g Radix Glycyrrhizae Uralensis (gun cao) . .1. . . . . . . . vascular headache. . . . . and the Sajguarding of L$ as Discussed in the Basic Questions (Su wen bing ji qi yi bao ming ji) Rhizoma Coptidis (huang lian). . . and burning pain of the head and face. cold extremities. . . . . . . . . . . . . . . this formula may be used in treating such biomedically-defined disorders as acute gastroenteritis. . . . . . . It is the severity and rapaciousness of the effects on the body of the underlying pathogenic influences that accounts for the use of the word toxin. . . . . . . . . . .9g Herba Menthae Haplocalycis (bo he) . . . . . .3g Fructus Forsythiae Suspensae (lian qiao) . . . . .6g Semen Arecae Catechu (bing lang) . . . . . . . . . or form into pills with honey. .6g Radix Platycodi Grandiflori (jie geng) . .15g Fructus Arctii Lappae (niu bang zi) . . . irritability bordering on delirium. Here it festers and causes the redness.9g Radix Aucklandiae Lappae (mu xiang) . . . excessive pulse. . rapid. . . . .3g Herba Menthae Haplocalycis (bo he). . . . . . . . . . dry heaves. . . . .6g Rhizoma Cimicifugae (sheng ma) . . . . . I n severe cases the swelling may include the entire upper body. . . . . . . . . . . . . .6g Radix Angelicae Sinensis (dang gui) . . . Available in prepared form. . trigeminal neuralgia. . . . . Suitability of Qi. . For abscesses due to interior heat characterized by swelling with no change in skin color. ASSOCIATED FORMULA: Wine-fried Radix Scutellariae (jiu chao huang qin). . . reduced urination. . . . . . . . *For both yang brightness and terminal yin headache. . . . . . . . . . . . . . . . .9g Radix Scutellariae (huang qin) . . . . .9g Radix Paeoniae Lactiflorae (bai shao) . . . . . . . . . hence the name. .Bupleuri (chi hu) . dysfunction of the throat. . stomatitis. . and a submerged. . . . . . . . . which contains Radix et Rhizoma Rhei (da huang). . and other signs of yang deficiency. . . . . . . . . and a floating.3g Radix Platycodi Grandiflori (jie geng) . . . . . . Today it is generally prepared as a decoction.9g Fructus Forsythiae Suspensae (lian qiao). . . . . . . . irritability.6g Radix . . . . hepatitis. and hematemesis associated with pulmonary tuberculosis. . . . . .5g Radix Scrophulariae Ningpoensis (xuan shen) . and forceful pulse. . This condition reflects the battle raging between the powerful pathogenic influences and a Internal Dispersing Decoction with Coptis 4 $L* & XI n2i shii huiing liiin tang Source: Colbction of Writings on the Mechanism of Illness. . . .6g Radix Glycyrrhizae Uralensis (gan cao) . vomiting and diarrhea with sweating. . . . . cholecystitis. 15g Wine-fried Rhizoma Coptidis (jiu chao huang lian) .3g Bombyx Batryticatus (jiang can) . . . . . . a red tongue with a powdery-white o r yellow coating. . . . . . . redness. . . . . . MODIFICATIONS: 6 For trigeminal neuralgia. VARIATION: Universal Benefit Decoction to Eliminate Toxin pii ji xiiio dii yin This formula. and alleviates pain. add Buthus martensi ( p a n xie). . . . . . . .6g Fructificatio Lasiosphaerae seu Calvatiae (mabo) . . . . . . .9g Fructus Gardeniae Jasminoidis (zhi zi) . . . . . swelling. . . . . . . burning pain. constipation. .6g Radix et Rhizoma Rhei (da huang) . . . . and constipation. . a submerged.3g Radix Isatidis seu Baphicacanthi (ban lan gen) . . . Scolopendra subspinipes ( w u gong) and Periostracum Cicadae ( c h t u i ) . . dysentery. . . . . thirst. . . . Actions: Clears heat. .5g Preparation: The source text advises to grind the ingredients into powder and take as a draft. . . . . . . . . . . . I t is most commonly seen in children and is usually contracted during the winter or spring. . . . eliminates fire toxin. and tenderness that characterize this disorder. . . . . . thin pulse. . . . . . . . This is acute. . . conjunctivitis. . . . . . and disperses wind-heat.- Formulas that Clear Heat and Relieve Toxicity formula. has purgative and heat-clearing functions and can be used in treating any condition of heat excess with high fever. devised during a period of widespread epidemics in China. . . . . Source: Precious Mirror of Health (Wei sheng bao jian) Prepared Aconite Decoction to Drain the Epigastrium p y $ . . . . . It is characterized by a sudden onset and severe fire toxin. . INDICATIONS: Strong fever and chills. . T h e head is the meeting place of the body's yang qi and is the first area to be attacked by seasonal toxin. . . . add 3g of Radix Lateralis Aconiti Carmichaeli Praeparata ( f u zi). . . take with Frigid Extremities Powder (si ni sun). . . . swelling. . . .g $5 fi 5 xi2 x i n tting Source: Discussion of Cold-induced Disorders (Shang han lun) For focal distention due to damp-heat. massive febrile disorder of the head (dh toti wgn) due to a seasonal epidemic toxin associated with wind-heat and damp-phlegm. . . fever. . . . . reduces swelling. . . . . . . . . . .1. . . . . . . . . . . . . . . With the appropriate presentation. . . . . . . aversion to cold.

. add Cortex Moutan Radicis (dan pi). .pi) . . . . . . . . . . . .6-12g Fructus Forsythiae Suspensae (lian qiao) . acute tonsillitis. . it was not until the Jin and Yuan dynasties. . and Radix Glycyrrhizae Uralensis ean cao) clear heat from the throat and relieve the toxic fire. . . . . . . . . Acrid and cool Fructus Arctii Lappae (niu bang zi). . . . and add Herba Schizonepetae Tenuifoliae (jing jk). . . . head. stubborn. suppurative parotitis. .6-12g Rhizoma Coptidis (huang lian) . . . . and throat). . . . the tongue coating will be yellow. . Bulbus Fritillariae Thunbergii (xiang bei mu). and more precisely in the writings by adherents of the warm-febrile school during the Q ~ n dynasty. . add Radix et Rhizoma Rhei (da huang). . . The use of wine serves to direct the actions of these herbs upward. dryness. add Radix et Rhizoma Rhei (da huang) (source text). . The battleground is the upper burner (the dwelling of the Lungs. Spica Prunellae Vulgaris (xia ku cao) and Fasciculus Vascularis Luffae (si gua luo). . .9-12g Radix Rehmanniae Glutinosae (sheng di huang) . . . . . add Fructus Meliae Toosendan (chuan lian zi) and Radix Gentianae Longdancao (long dan cao). . . . regulates the qi to ensure the free flow of blood and qi and thereby prevent the pathogenic influences from accumulating. . . . Radix Bupleuri (chi h) and Rhizoma Cirnicifugae (sheng ma) serve as envoys by raising the yang. . . MODIFICATIONS: * For constipation. and a floating. dispersing wind-heat. . . . . . . . Radix Ledebouriellae Divaricatae dfangfeng). If Cornu Rhinoceri (xi jiao) is used. . .3-6g Herba Lophatheri Gracilis (dm zhu ye) . Fructus Forsythiae Suspensae (lian qiao). and lymphadenitis with or without lymphangitis. . . . . . * For more obvious exterior symptoms with less severe internal heat.Clear E p i d e m i c s and Overcome Toxin Decoction robust host. Herba Menthae Haplocalycis (bo he). . . . . If less severe. . suppurative otitis media. . . . . . . hence the dysfunction of the throat. .6-12g Radix Platycodi Grandiflori (jie geng) . . . . . .9-15g Cortex Moutan Radicis (dan. . Radix Platycodi Grandiflori Cjie geng). . . . . . . . the fever and chills are therefore both strong. . . . . CAUTIONS & CONTRAINDICATIONS: Because most of the herbs in this formula are bitter or acrid and have dispersing properties. . g that the etiology and pathogenesis of this disease was clearly understood.60-120g Radix Anemarrhenae Asphodeloidis (zhi mu). . . . . . With the appropriate presentation. . .3-6g Preparation: Cook Gypsum (shi gao) first for 15-20 minutes. . . . * For hard. . . is used to clear and drain the toxic heat from the upper burner. . omit Radix Bupleuri (chi hu)and Herba Menthae Haplocalycis (bo he). . .3-9g Fmctus Gardeniae Jasminoidis (zhi zi). . . . . . . reduce the dosage of Radix Scutellariae (huang gin) and Rhizoma Coptidis (huang lian). . . . The severe heat also causes thirst. . . . . and conducting the other ingredients to the head. . There are two groups of deputies. . . Herba Menthae Haplocalycis (bo he) and Folium Mori Albae (sang ye). . . . and face. . Radix Isatidis seu Baphicacanthi (ban lan gen).6-12g Radix Glycyrrhizae Uralensis (gan cao) . ANALYSIS OF FORMULA: This condition requires 81 two strategies: relieving the toxic fire (the primary treatment principle) and dispersing wind-heat. redness of the tongue and its powderywhite coating. . . . . . . .3-6g Cornu Rhinoceri (xi jiao) . . and Bombyx Batryticatus (jiang can) disperse wind-heat from the upper burner. . . . . . . . . . They are also effective in dispersing stagnation due to fire. . . . . . the assistant. . * For concurrent orchitis.6-12g Radix Scrophulariae Ningpoensis (xuan shen). . . *When the exterior symptoms have disappeared and the internal heat is severe. Radix Scrophulariae Ningpoensis (xuan shen). . . . it should be used with caution in treating cases with yin deficiency. . . Radix Paeoniae Rubrae (chi shao). . wine-fried Radix Scutellariae (jiu chao hang qin) and wine-fried Rhizoma Coptidis (jiu chao huang lian). . . . . . it should be taken in powdered form and followed by the strained decoction. . Pericarpium Citri Reticulatae (chen pi).6-12g Radix Paeoniae Rubrae (chi shao) . This helps to reduce toxic swelling. . . . . . * For internal heat with constipation. . Cornu Bubali (shui niu jiao) may be substituted for Cornu Rhinoceri (xi jiao) . .6-12g Radix Scutellariae (huanp qin) . and add Flos Lonicerae Japonicae (jin yin ha) and Indigo Pulverata Levis (qing hi). . . cellulitis of the head and face. . . . . Fructificatio Lasiosphaerae seu Calvatiae (ma bo). . Heart. rapid pulse. . A relatively large dosage of the chief herbs. . . . . . . . localized swelling. Fructus Immaturus Citri Aurantii (zhi shi) and pure Mirabilitum (xuan mingfen). . . . . . this formula may be used in treating such biomedically-defined disorders as epidemic parotitis. Clear Epidemics and Overcome Toxin Decoction Source: Achievements Regarding Epidemic Rashes (Yi zhen yi de) Gypsum (shi pao) . COMMENTARY: Although early observations of this disorder were recorded in the Yellow Emperor's Inner Chsic. .

(The small dosage is one-half the medium dosage. . . MODIFICATIONS: * For constipation. it is strongly recommended. "medium". and rapid pulse (indicating a more severe condition) requires a large dosage. add Radix et Rhizoma Rhei (da hang) and Mirabilitum (mang xiao). . and drains fire. . When fire enters the blood level it disturbs the Heart and Liver. large. Radix Glycyrrhizae Uralensis (gun cao). It focuses on the functions of White Tiger Decoction (bai hu tang). * For dark-purple rashes. . . . . . . add Folium Daqingye (da qing ye) and Radix Isatidis seu Baphicacanthi (ban lan gen). . Intense fever and strong thirst are signs of vigorous heat in the qi level. a floating. . stabbing headache is due to fire toxin rising to the head. In some formulations up to 120g of Gypsum (shi gao) are used. Severe. . A submerged. thin. .9g Radix Scrophulariae Ningpoensis (xuan shen) . Actions: Clears heat. . . and the large dosage is one-and-one-half to two times the medium dosage. clears heat and relieves toxicity. . . Radix Rehmanniae Glutinosae (sheng di huang). The tongue is dark-red. With the appropriate presentation.82 Formulas that Clear Heat and Relieve Toxicity with a dosage of 30-120g and cooked with the Gypsum (shi gao). . . . add Radix Arnebiae seu a ) . thin. . which manifests as rashes. Rhizoma Coptidis (huang lian). (xi jiao di huang tang). thereby eliminating the toxic fire. . CAUTIONS & CONTRAINDICATIONS: Contraindicated in cases with yang deficiency or Spleen and Stomach weakness. and rapid pulse (indicating a less severe condition) requires a small dosage. . * For very high fever. . large. . . . . * For tremors caused by heat injuring the sinews. and Coptis Decoction to Relieve Toxicity (hang lian jie du tang). .9g Cornu Rhinoceri (xi jiao) . * For swollen parotid glands. . . extreme irritability. ANALYSIS OF FORMULA: The first group of ingre- dients. and the pulse is rapid and either submerged and thin or floating and large. .9-159 . . . . ASSOCIATED FORMULA: Transform Blotches Decoction INDICATIONS: Intense fever. and Herba Lophatheri Gracilis (dan zhu ye). . . . . . dry heaves. . The source text lists the dosage for the first four ingredients as "small". . . add Herba cum Radice Violae Yedoensitis (zi hua di ding) and Radix et Rhizoma Rhei Recens (sheng da huang). in severe cases it causes incoherent or delirious speech. .) The pulse signs determine the appropriate dosage: a submerged. this formula may be used in treating such biomedically-defined disorders as meningitis. scarlet fever. For variations in the dosage of the ingredients. . . . . . add Indigo Pulverata Levis (qing dai) and Flos Lonicerae Japonicae (jin yin ha). . The second group. . Flos Carthami Tinctorii ( h g h Semen Persicae (tao ren) and Radix Angelicae Sinensis (dang gui). and rapid pulse is a sign that fire toxin has broken through all the barriers in the superficial levels of the body. . . . vomiting of blood. . . . *For soreness in the joints and a lower back that feels bruised. . and Radix Scrophulariae Ningpoensis (xuan shen). . This is severe fire in the qi and blood levels. the pulse will become thin. and "large". Cortex Moutan Radicis (dan Pi). relieves toxicity. Gypsum (shi gao).30g Radix Anemarrhenae Asphodeloidis (zhi mu) . . omit Radix Platycodi Grandiflori (jie geng) and add Flos Chrysanthemi Morifolii (ju hua) and Radix Gentianae Longdancao (long dan cao). . . . . . clears heat from the qi level. Cornu Rhinoceri (xi jiao). . and nosebleed. strong thirst. The dosage specified above corresponds to the medium dosage. . . . . . Radix Anemarrhenae Asphodeloidis (zhi mu). If the fire toxin is not relieved. . . . which causes extreme irritability. . . Because this substitution is effective and the rhinoceros is an endangered species. . severe and stabbing headache. Fire at this level also incites the reckless movement of blood. and rapid pulse occurs when intense fire toxin constrains the pulse. . rash. . . COMMENTARY: This formula is a variation of the combination of White Tiger Decoction (bai h u tang). d e 31 i~ hu8 ban tang Source: Systematic Difjiirentiation o f Warm Diseases (Wen bing tiao bian) Gypsum (shi gao). . . a floating. . the lips are dark and scorched. . . . . clears heat from the blood level. and septicemia of various origins. Fructus Gardeniae Jasminoidis (zhi zi). Radix Paeoniae Rubrae (chi shm). * For a swollen face. . and Fructus Forsythiae Suspensae (lian qiao). The third group. . delirious speech. Radix Scutellariae (huang qin). see the commentary below. .12g Radix Glycyrrhizae Uralensis (gun cao) . . encephalitis. or nosebleed. add Cortex Phellodendri (hang bai) and Caulis Mutong (mu tong). . . acute necrosis of the liver. and in severe cases. A dark-red tongue with dark. . . scorched lips are signs of intense fire toxin in the qi and blood levels. Rhinoceros Horn and Rehmannia Decoction.3-6g Nonglutinous rice (geng mi). cools the blood. typhoid fever. Radix Platycodi Grandiflori (jie geng) and Herba Lophatheri Gracilis have an ascending action that conducts the actions of the other ingredients upward. Lithospermi (zi cao). .

3g Spina Gleditsiae Sinensis (zao jiao ci). . . . . . . . INDICATIONS: Early-stage sores and carbuncles with red. . Radix Ledebouriellae Divaricatae (fangfeng) and Radix Angelicae Dahuricae (bai zhi). . It is regarded as a "sage-like" herb in treating sores and carbuncles because it not only relieves the toxic heat in both the qi and blood levels. This formula calls for the use of the branch-roots of Radix Angelicae Sinensis (dung gui wei). hot. . . The source text advises to take Cornu Rhinoceri (xi jiao) in powdered form with the strained decoction three times daily and once at night. . .3g Bulbus Fritillariae Thunbergii ( z h bei mu) . and painful skin lesions. clear heat and transform phlegm. Radix Angelicae Sinensis (dang gui) and Radix Paeoniae Rubrae (chi shao) invigorate and strengthen the flow of blood in the channels. promotes the movement of qi. Radix Trichosanthis Kirilowii (tian huafen) also enters the blood where it reduces the swelling from blood stasis. and a thin tongue coating. . . transform the phlegm. . reduces swelling and promotes the discharge of pus. . . . Bulbus Fritillariae Thunbergii (zh bei mu) and Radix Trichosanthis Kirilowii (tian h f e n ) . . . . . and secondarily to invigorate the blood. and dissipate the clumping. . . . . and indirectly reinforces the actions of the other ingredients in treating this condition. mild chills. which in turn causes the fluids to simmer. and Gummi Olibanum (ru xiang) and Myrrha (mo yao) eliminate blood stasis and alleviate pain. . . . . . . . Source: Revised Fine Formulm for Women Uiao zhu f u ren liang fang) Flos Lonicerae Japonicae (jin yin hua) . They also serve to focus the actions of the other ingredients on the sores. The remaining envoy. . . thirst. .3g Radix Angelicae Dahuricae (bai zhi) . dispel wind and reduce superficial swelling. . invigorates the blood. Actions: Clears heat and relieves fire toxin. mild chills. . . headache. . T h e Golden Mirror of Medicine describes it as a n "exalted medicine for sores. . .'' If the sore is not completely formed. and a rapid. .3. Modern practitioners have extended the use of this formula to the treatment of internal abscesses and dysenteric disorders. . . . forceful pulse. . . . . open and vent stagnation in the channels to expel the pus and thereby accelerate the healing process. . sweet and cool Flos Lonicerae Japonicae (jinyin h ) .or blood-level symptoms. . . . . . . COMMENTARY: This formula is used for early-stage yang sores that develop rapidly. . . . T h e other assistants. The battle between the strong pathogenic influence and the strong normal qi produces a rapid. headache. conditions Sublime Formula for Sustaining Life xiiin fang hu6 ming yin The name is deriued from t h belief that this formula can bring one back from the edge of death. . Radix Glycyrrhizae Uralensis (gan cao). . . . and assists in relieving toxicity. . . . . The battle between heat and the normal qi in the exterior gives rise to fever. usually accompanied by fever. . is very effective in relieving toxicity. Fire toxin or phlegm-fire causes the clumping of stagnant qi and blood in the relatively superficial levels of the body. . and a rapid pulse. . . This directly affects the stagnant qi. . . .9g Radix Glycyrrhizae Uralensis (gan cao) . harmonizes the actions of the other ingredients. . . . . and alleviates pain. .3g Gummi Olibanum (ru xiang) . it will perforate (which accelerates the healing process). but as the disorder progresses. .3g Myrrha (mo yao). (See method of preparation for the principal formula above).3g Radix Angelicae Sinensis (dang gui) . dark-red blotches on the skin. T h e clumping in the channels between the levels of . . swollen. .S Radix Ledebouriellae Divaricatae (fang feng) . it will subside.3g Pericarpium Citri Reticulatae (chen pi) . . . . At first the tongue coating will be white. One of the deputies. . . Two of the assistant ingredients. The chief ingredient. it will turn yellow. Squama Manitis Pentadactylae (chuan shanjia) and Spina Gleditsiae Sinensis (zao jiao ci). . Dosage is adjusted according to the relative proportion of qi. .3g Squama Manitis Pentadactylae (chuan shan jia) . overindulgence in rich or greasy foods. . . The dregs may be applied topically. . 83 the skin and flesh forms sores or carbuncles that are characterized by inflammation and pus. but also dissipates the clumping. For fever that worsens at night. a thin tongue coating (either white or slightly yellow). regulate the qi. if it is completely formed. .9g Preparation: Cook the herbs in one part water and one part wine to strengthen the blood-invigorating action of the formula. . Two of the envoys. . . . . . .6-12g Radix Paeoniae Rubrae (chi shao) . . . . . forceful pulse. . ANALYSIS OF FORMULA: T h e primary strategy in treating sores and carbuncles from fire toxin is to clear the heat and relieve the toxicity. . . . which have a stronger blood-invigorating action than other parts of the plant. Pericarpium Citri Reticulatae (chen pi). or trauma with transmission of toxic qi. Another group of deputies works on the blood. This is a fire toxin or phlegm-fire of various origins including the transformation of a pathogenic influence in the channels. and a premier formula for external disorders. . . . .Sublime Formula for Sustaining Lije Clears qi-level heat and cools the blood. . . . . . . . . .3g Radix Trichosanthis Kirilowii (tian hua fen).

. . . . add the following herbs to direct the actions of the formula to particular parts of the body: Five-Ingredient Decoction to Eliminate Toxin wii w2i xxiiio dii yi. . .6g Preparation: Decoction. . . . . . & C O N T R A I N D I C A T I O N S : Side-effects are rare and generally limited to nausea and vomiting. . .9g types of boils and carbuncles with localized erythema. . . .6g Herba cum Radice Violae Yedoensitis (zi hua di ding) . . . . . . . . . . . and should be modified where there is Spleen deficiency. Patient should bundle up to promote sweating. . . . acute appendicitis. . . . . . . . . . With the appropriate presentation. . . . . . . . . . . . . . . CAUTIONS MODIFICATIONS: 9 To strengthen the ability of the formula to clear heat and relieve toxicity. . . For qi deficiency. omit Radix Angelicae Dahuricae (bai zhi) and Pericarpium Citri Reticulatae (chen pi). a red tongue with a yellow coating. . Prepare with 2-3 tablespoons of rice wine. . . or with prolonged use. . deep-seated lesion. omit Squama Manitis Pentadactylae (chuan shunjia) and Spina Gleditsiae Sinensis (zao jiao ci). .e. . . . . . Herba cum Radice Violae Yedoensitis ( z i hua di ding) and Fructus Forsythiae Suspensae (lian qiao). .9g Herba Taraxaci Mongolici cum Radice (pu gong ying) . . . . . . . . It should not be prescribed in cases with ulcerated carbuncles or yin sores. . . expels pus.3g Spina Gleditsiae Sinensis (zao jiao ci) . relieves toxicity. . .3g Gummi Olibanum (ru xiang). . .n Source: Golden Mirror (Yi zong jin jian) of the Medical 3adition * Flos Lonicerae Japonicae (jin yin hua) . redness and pain. . . . . . For heat in the blood. . . This is fire toxin due to externally-contracted heat from a warm-febrile disease or seasonal pathogenic influence accumulating in the organs or channels. . increase the dosage of Radix Trichosanthis Kirilowii (tian hua fen). . . . . . . .6g Herba Begoniae Fimbristipulatae (zi bei tian kuei) . . .84 Formulas that Clear Heat and Relieve Toxicity Radix Glycyrrhizae Uralensis (gan cao) . . .9g Sclerotium Poriae Cocos ( f u ling) . . .3. . 9 If the sores are small and superficial. .3g Radix Codonopsis Pilosulae (dang shen) . this formula may be used in treating such biomedically-defined disorders as acute mastitis. . .9g Pericarpium Citri Reticulatae (chn Pi). heat. .. which produces more accumulation. . . . . . . . . and reduce the dosage of Pericarpium Citri Reticulatae (chen Pi) so that the formula is not too drying. . add Herba Taraxaci Mongolici cum Radice (pu gong ying). . . . . . . . . . . swelling. . . . . . . . . . . . slight heat. .6g Flos Chrysanthemi Indici (ye ju hua) . . . . and add Radix Scrophulariae Ningpoensis (xuan shen). . T h e presence of fever and chills reflects the battle between . . . . . . . and pain accompanied by fever. . . . . add Cortex Moutan Radicis (mu dan pi). . . . . . . . Especially useful for deeprooted and hard lesions. . . and reduces swelling. . . .3g Bulbus Fritillariae Thunbergii (zhe bei mu) . 9 For sores and carbuncles. . . which in turn generates more heat. . multiple carbuncles. .9g Clears heat. . .3. . . . .3. . . . . . . For high fever and severe thirst due to injury to the fluids. . . . . . . . . and uncertain ulceration). . . Today the dosage is generally increased 3-4 times. and a rapid pulse. . .3g Radix Angelicae Sinensis (dang gui wei) . . . . . . the fire toxin deepens and gradually forms a very hard. . . . . reduces swelling. . . . purulent lesions. . . . . . . . . . . . .9g Rhizoma Atractylodis Macrocephalae (bai zhu) .3. Actions: Clears heat. . . . . . . add Radix Astragali Membranacei ( h a n g qi).3g Radix Angelicae Dahuricae (bai zhi) . relieves toxicity. . . chills. which also present with blood stasis and heat toxin. . . . . .9g Radix Astragali Membranacei (huang qi) . . . . and tonifies the qi. . infected wounds. . It occurs most often in those who overindulge in rich or spicy foods. . . . . which are said to resemble nails or chestnuts. . . . . . . half-yin and halfyang sores characterized by swellings with no head. . As this cycle continues.. . . invigorates the blood. . . . . INDICATIONS: Head: Radix Ligustici Chuanxiong (chuan xiong) Neck: Radix Platycodi Grandiflori (jie geng) Chest: Pericarpium Trichosanthis (gua lou pi) Flanks: Radix Bupleuri ( c h i hu) Back: Radix Gentianae Qinjiao (qin jiao) Upper extremities: Rhizoma Curcumae Longae (+ng h n s ) Lower extremities: Radix Achyranthis Bidentatae (niu xi) ASSOCIATED F O R M U L A : Flush and Harmonize Decoction -# $0 :. .3g Radix Paeoniae Rubrae (chi shao) . and other localized. . . . . . For qi deficiency with yin-yang sores (i. . . . cools the blood. . . . The dregs may be applied topically. injury to the Spleen and Stomach qi.sn chang hi tiing Source: Standards of Patterns and Treatments in External Medicine (Wai b zhng zhi zhun sheng) Flos Lonicerae Japonicae (jin yin hua) . Heat causes stagnation. .

. . . .localized. . . which focuses on invigorating the blood and reducing swelling. . . . . .60g Radii Glycyrrhizae Uralensis (gan cao) . . . . relieves toxicity. . . @ For breast abscess. . . . and acute pyelonephritis. . . @ F o r dark-red and painful sores. . . . relieves toxicity. . Honeysuckle Decoction to Relieve Toxicity its&&&% y h huii jie' dii tiing Source: Collection of Personal Experiences Concerning Skin Lesions (Yang ke xin de ji) MODIFICATIONS: @ For high fever and other signs of severe heat. . . . . . superficial. . . .To si mi20 yiing iin tiing Although there are only four herbs in this formula. . . relieve toxicity. and cool the blood and are therefore useful in treating purulent lesions. . .i5-30g Flos Lonicerae Japonicae (jin yin hua) .9-12g Fructus Forsythiae Suspensae (lian qiao) . Clears heat. CAUTIONS & C O N T R A I N D I C A T I O N S : Contraindicated for yin-type boils.6-9g Spica Prunellae Vulgaris (xia ku cao) . . . . . . . .sores. The focus is on cooling the blood. T h e other herbs clear heat. which exfiessesfaith in this formula's ability to relieve the condition and prevent relapse. . . . With the appropriate presentation. and cools the blood. . . @ For acute pyelonephritis.90g Radix Scrophulariae Ningpoensis ( m a n shen) . . For sores and carbuncles (such as mastitis) with obvious exterior symptoms. . . and releases the exterior. . . . ANALYSIS O F FORMULA: Flos Lonicerae Japonicae ASSOCIATED F O R M U L A S : Reduce Inflammation and Relieve Toxicity Pill . . . . . . mastitis. add Rhizoma Coptidis (huang lian) and Fructus Forsythiae Suspensae (lian qiao). . . It is one of the principal substances in the materia medica for treating . . . T h e red tongue with a yellow coating and the rapid pulse indicate that there is more heat than stagnation of qi and blood. traditionally known as 'sores turning yellow. . . . .i2-24g Radix Ledebouriellae Divaricatae (fang feng) . . 12-24g The source text does not specify dosage. @ For septicemia. . . . . .Four-Valiant Decoction for Well-Being the pathogenic influence and the normal qi in the superficial levels of the body. I n contrast to Sublime Formula for Sustaining Life (xianfang huo ming yin). . . .15-30g Cornu Rhinoceri (xi jiao) . . . . the emphasis of this formula is on clearing heat and relieving toxicity. . . hi). . . . . . @ For concurrent damp-heat rash. .30g . . . add Fructus Trichosanthis (gua lou). add Cortex Moutan Radicis (dan pi) and Radix Paeoniae Rubrae (chi shao). . . . the chief herb. . . . . . . . appendicitis. . add Radix Ledebouriellae Divaricatae (fangfeng) and Periostracum Cicadae (chan Flos Lonicerae Japonicae (jin yin hua) . . . . . . . . . . . .3-6g The source text does not specify dosage. . purulent infections. their dosage is h g e and the effect is so distinct that patients experience a strong sense of well-being once the condition is relieved. . . . . add Rhizoma Imperatae Cylindricae (bai rnao gen) and Stylus Zeae Mays ( y u mi Four-Valiant Decoction for Well-Being YD 8$j$ -. . . . Flos Lonicerae Japonicae (jin yin hua) . . .12-24g Cortex Moutan Radicis (dan pi). add Cortex Dictamni Dasycarpi Radicis (bai xian Pi). . . . erysipelas. . . . Source: New Compilation (Yan fang xin bian) of Time-tested Formulas xu). . . . . . . this formula may be used in treating such biomedically-defined disorders as multiple furuncles. . conjunctivitis. . . For purulent skin lesions with signs of intense fire toxin due to wind-damp-heat. . . . . . . . . . Fructus Kochiae Scopariae (di f u z i ) and Zaocys dhumnades (wu shao she). . .90g Radix Angelicae Sinensis (dang gui). .9-12g Radix Glycyrrhizae Uralensis (gan cao). . .15-30g Herba cum Radice Violae Yedoensitis (zi hua di ding) . . . . . drains fire. . The Chinese character meaning valiant is a homonym for everlasting (yo'ng). .9-12g Rhizoma Coptidis (huang lian) . . . COMMENTARY: This formula serves as the foundation for many formulas that are used in treating . . . . . . . . . . . . . . urinary tract infection. . . . . . Source: Medical Mirror of Past and Present (Gu jin yi jian) Herba Taraxaci Mongolici cum Radice (pu gong ying). . . . . Use with caution in cases with Spleen deficiency. . . . . . . . clears heat from both the qi and blood levels and disperses swelling. . . .' add a large dosage of Folium Daqingye (da qing ye) and Herba Scutellariae Barbatae (ban zhi lian). Clears heat. . .$j % # P A xiiio y6n jig dii w6n (jin yin hua). . .3-6g Sclerotium Poriae Cocos Rubrae (chifu ling) . . Wine invigorates the blood which helps reduce this type of swelling. .i5-30g Fructus Forsythiae Suspensae (lian qiao) . . . . . . . . . * For severe swelling. Bulbus Fritillariae Thunbergii (zhe bei mu) and Pericarpium Citri Reticulatae Viride (qing pi). . .

. qi deficiency. add Cortex Phellodendri (huang bai) and Radix Aristolochiae Fangchi (gwmngfang ji). . . .90g Radix Achyranthis Bidentatae (niu xi) . . . . Radix Scrophulariae Ningpoensis (xuan shen). . * For pronounced swelling. harmonizes the actions of the other herbs and strengthens the formula's ability to relieve toxicity. The source text prescribes a minimum 10-day course of treatment. . . or the improper use of yang tonics. erysipelas. and separates and drains out damp-heat. . . . Toxin and stasis together produce putrefaction. COMMENTARY: T h e effectiveness of the formula requires strict adherence to the prescribed dosage. add Gummi Olibanum (ru xiang) and Myrrha (moyao). Actions: Clears heat. . . Externally-contracted damp-cold painful obstruction impedes the circulation of blood. the bones become malnourished and stagnation develops. . . . . red tongue. thirst. . For damp-heat disorders with toxin affecting the lower extremities. This condition may be attributed to long-standing Kidney deficiency. and gangrene (in conjunction with surgery). which generates heat. . For abscess (including mastitis and Intestinal abscess) with strong fever and chills in patients with qi and blood deficiency. There may be a rotten smell to the lesion together with copious discharge. Tonifies and augments the qi and blood. . . . . . T h e envoy. . CAUTIONS & CONTRAINDICATIONS: Contraindicated in cases with cold. . . . other disorders with thrombosis in the limbs. thirst. and nourishes the yin. . . . . . . a red tongue. relieve toxicity. . . add 60g of Radix Salviae Miltiorrhizae ( d m shen). overindulgence in rich. . This is sloughing ulcer (tuojii) which is due to obstruction by fire toxin leading to stasis of blood in the sinews and blood vessels. . . . . or spicy foods. . and alleviates pain. and extremely painful. . . and increased pain. . . .150g Radix Astragali Membranacei (huang qi) . . . greasy. A reduction in dosage will reduce its effectiveness. *For extreme pain. . . . . Accompanying symptoms include fever. . generates flesh. . . . . More than one factor is usually involved. . . . . .15g Herba cum Radice Violae Yedoensitis (zi hua di ding) . . . . .30g Flos Lonicerae Japonicae (jin yin hua) . It is reinforced by the deputy. add Cortex Moutan Radicis (dan pi) and Radix Rehmanniae Glutinosae (sheng di huang). and relieves toxicity. . . . . . . . . invigorates the blood and breaks u p stasis. . . . . . . Five-Miracle Decoction a* 3 warii shin tiing Source: Profound Purpose from the Heauenly Abode (Dong tian ao zhi) Sclerotium Poriae Cocos (fu ling) . It should only be used in cases of severe fire toxin with blood loss or injury to the yin. Severe obstruction and the ensuing lack of nourishment leads to a darkening of the skin color. . .30g Grind the ingredients into powder and take 6g twice a day as a draft. a moderation of the swelling. and toxic rash in the popliteal region. . .5g Radix Glycyrrhizae Uralensis (gan cao) . . . . INDICATIONS: Ulcerated sores that won't heal on a limb that is dark-red. . With the appropriate presentation.Formulas that Char Heat and Relieve Toxicity Preparation: Decoction. . . slightly swollen and warm to the touch. or blood deficiency. and take in the evening. Radix Angelicae Sinensis (dang gui).30g Semen Plantaginis (che qian zi) . and rapid pulse are indicative of heat. With chronic Kidney deficiency. Radix Glycyrrhizae Uralensis (gan cao). . . . this will lead to constraint. . .37. warmth (due to restricted local circulation). . relieves toxicity. . 6 For severe heat. . . ASSOCIATED FORMULAS: Miraculous Powder for Supporting the Interior $9 &as 4k she'n xiiio tu6 l i siin Source: Imperial Grace Formulary of the Tai Ping Era (Tai ping hui min he ji ju fang) Herba Lonicerae Japonicae (ren dong cao). Heat and toxin combine to produce hot. . . . nourishes the in. T h e fever. . Clears heat. . . externally-contracted damp-cold painful obstruction. . relieves toxicity. . . relieves toxicity. . red. . and painful lesions. this formula may be used in treating such biomedically-defined disorders as thromboangiitis obliterans. . . T h e assistant herb. . . . . including abscess. . .240g Grind into powder and take 6g as a draft cooked in oneand-a-half cups of wine until reduced to half a cup. ANALYSIS OF FORMULA: Flos Lonicerae Japonicae (jin yin hua) is the chief herb in the formula because of its ability to clear heat. . and reduce swelling. MODIFICATIONS: 4 To strengthen the actions in opening up the channels and invigorating the blood. which drains fire. l50g Radix Angelicae Sinensis (dang gui) . . invigorates the blood. . . . and a rapid pulse. swollen. if left untreated. . . .

. . this formula may be used in treating such biomedically-defined disorders as acute tonsillitis and pharyngitis. When dampheat or a damp-warm-febriledisease invades the body. . .5g Pre~aration: Grind the ineredients into a fine ~owder. . . . . . . Actions: Relieves fire toxin. COMMENTARY: This formula is very effective in treating sore throat. . and septicemia from peripheral wounds. and lyrnphangitis. . The red tongue and rapid pulse reflect the presence of heat. . . . . Damp-heat constrains the qi level of the Lungs. . . ." producing a pustular lesion of the throat accompanied by swelling and pain which makes swallowing difficult. . . . Honeysuckle. . . . . a red tongue with a thick white or yellow coating. . . . . . both highly aromatic substances. . acute localized infection. . Realgar (xiong huang) relieves toxicity and breaks up clumps. slippery. . . . . . This is painful obstruction of the throat (ho6 bi) due to damp-heat collecting in the Lungs. Forsythia. Available in prepared form. . . . . . . Secretio Bufonis (chan su) is very effective in reducing swelling and alleviating pain. it often begins by attacking the Lungs. . .159Fructus Forsythiae Suspensae (lian qiao) . . Classical texts refer to this condition as 'milk moth' (rii t!). . .3g Secretio Moschus (she xiang) . . . . . . Forsythia.4. .5g Secretio Bufonis (chan su) . . and possibly floating pulse. . . . . . and alleviates pain. . . . INDICATIONS: Unilateral or bilateral pustular tonsillitis with severe sore throat and difficulty in swallowing. . . . . SECTION 4 FORMULAS THAT CLEAR HEAT FROM THE ORGANS When heat excess develops in an organ it will manifest in signs and symptoms which are characteristic of pathology of that organ and its associated channel. . . . . and the extent of its involvement. which results in obstruction of the throat. . . ANALYSIS O F F O R M U L A : Calculus Bovis (niu hang) and Margarita (zhen zFaL)clear heat and transform phlegm. . . . . . . . and form into millet-size or smaller pills. . . Actions: Clears heat. . . . With the appropriate presentation. . . Today it is usually prepared as a decoction with the addition of 18g of Rhizoma Phragmitis Communis (lu gen). In such cases the internally-generated heat rises and mixes with the externally-contracted heat. . and a rapid. the choice of formula is based upon the organ affected.4. . . . penetrate the tissues and strengthen the ability of the other ingredients to relieve toxicity and reduce swelling. . . Recently it has also been used in treating hepatitis and asthma. . . . . INDICATIONS: Severe sore throat with great difficulty in swallowing. . . . and drains heat from the Lungs to improve the functioning of the throat. . . . . . .3g Borneo1 (bing pian) . . . . . . . . If the damp-heat only penetrates to a relatively superficial level. while the thick tongue coating and slippery pulse indicate dampness. . . and Puffball Powder yin qiiio rnii b6 sEin Source: Systematic Differentiation of Warm Diseases (Wen bing tiao bian) Flos Lonicerae Japonicae (jin yin hua) . . . . . . . including carbuncles. Source: Handbook of Taditional Chinese Medicinal Preparations (Zhong yao zhi ji shou ce) Calculus Bovis (niu huang) . a serious condition caused by phlegm and severe fire toxin rising to the throat.9g Fmctificatio Lasiosphaerae seu Cdvatiae (mabo) . . . " mix with wine. . aphthous stomatitis. . .Honeysuckle. . . .189Rhizoma Belamcandae Chinensis (she gan) . .5g Margarita (zhen zhu) . . the tongue coating will . Borneol (bing pian) and Secretio Moschus (she xiang). . In treating such disorders. . . . . . . lymphangitis. While this type of disorder often occurs in the broader context of an externally-contracted disease. . Damp-heat attacking the blood level of the Lungs causes sore throat. . . relieves toxicity. . . . . . . .3g Realgar (xiong huang) .309Fructus Arctii Lappae (niu bang zi) . CAUTIONS & CONTRAINDICATIONS: Contraindicated during pregnancy. . . this pill is thought to have a miraculow. . . . . . . hence the name. 9g Preparation: The source text advises to grind the ingredients into powder and cook 18g with Rhizoma Phragmitis Communis Recens (xian lu gen) just until it releases its aroma. . . . Adult dosage is 5-10 pills. . . . It is common in patients with chronic heat in the Spleen and Stomach when the throat is invaded by wind-heat. This causes the flesh and membranes of the throat to "scorch and stew. almost divine effect on the body. reduces swelling. . . . . . . . . it is said to be at the organ level because its manifestations are clearly those of a particular organ. And Puffball Powder Six-Miracle Pill A*& liii she'n wiin Composed of six ingredients. . .4. . . . Its use has been expanded to include many other conditions due to toxin. . . . . . .

stops coughing. . . . . . . Together these two herbs make a powerful combination for stopping the wheezing by directing the rebellious Lung qi downward. @ For concurrent purulent stomatitis.F m h that Clear Heat from the Organs be white and the pulse will float. . . . . . For less interior heat and more exterior symptoms. . labored breathing. and Licorice Decoction mi. . As a warm herb.xing shi giin tiing Source: Discusion of Cold-induced Disorders (Shang han lun) Herba Ephedrae (ma h u n g ) . . . . . thirst. They are very effective in treating qi-level throat disorders that manifest as obstruction. . . the envoy. clear heat to improve the functioning of the throat. Actions: Facilitates the flow of Lung qi. yellow tongue coating. . Apricot Kernel. . Flos Lonicerae Japonicae (jin yin hua) and Fructus Forsythiae Suspensae (lian qiao). Two of the deputies. . . 12g Gypsum (shi gao) . . rapid pulse.' which is manifested in sweating. which drains heat from the Lungs and controls the diaphoretic action of Herba Ephedrae (ma huang). a yellow tongue coating. . Heat in the Lungs causes the fluids to 'steam. . ANALYSIS OF FORMULA: The chief herbs. . INDICATIONS: Fever with or without sweating. . COMMENTARY: The use of this formula should be confined to cases with signs of heat in the Lungs and severe swelling and pain in the throat.48g Semen Pruni Armeniacae (xing ren) . relieves toxicity and reduces swelling. . . and calms wheezing by directing rebellious qi downward. The presence or absence of sweating indicates the extent to which the Lungs have been affected. the dosage of Herba Ephedrae (ma hang) is reduced and that of Gypsum (shi gao) is increased. not only clear heat and relieve toxicity. . . . MODIFICATIONS: @ For severe obstruction and moderate pain. . The fever. Rhizoma Phragmitis Communis (lu gen). This is heat lodged in the Lungs where it obstructs the flow of qi. add 18g of talcum (huashi) and i5g of Radix Platycodi Grandiflori (jie geng) (source text). @ For signs of heat toxin. . wheezing. . thirst. . scarlet fever. COMMENTARY:This formula is a variation of Zphedra Decoction (ma huang tang). . and rapid pulse are all indicative of heat. .6g ents.50 pieces (18g) Honey-fried Radix Glycyrrhizae Uralensis (zhi gan cao) . . add Folium Daqingye (da qinbye) and Radix Isatidis seu Baphicacanthi (ban lan gen). . . . it must be balanced by the other chief ingredient. take with Guide Out the Red Powder (dm chi san). . . and the dosage of all ingredients is reduced by about one-half. . . The dosage of these two ingredients must be adjusted according to the condition. . . . if it penetrates deeper. coughing. the dosage of Herba Ephedrae (ma huang) is increased and that of Gypsum (shi gao) is reduced. Another deputy. Fructificatio Lasiosphaerae seu Calvatiae (ma bo). However. the tongue coating will turn yellow and the pulse will no longer float. . facilitates the circulation of Lung qi and thereby controls the wheezing. . . . while simultaneously draining dampness. Today this is not done. . . . and labored breathing reflect obstruction of the Lung qi. . . It may be caused either by externallycontracted wind-heat. . Its use is an example of treating constrained fire by dispersing it (huo' yzi j c i zhi). Preparation: The source text advises to cook Herba Ephedra (ma h u n g ) for a short time before adding the other ingredients. T h e deputy. nasal flaring and pain. moistens the Lungs. . . this formula may be used in treating such biomedically-defined disorders as acute tonsillitis. Gypsum also clears heat from the Stomach (to relieve thirst) and muscles (to relieve fever and spontaneous sweating). . coughing. For rather severe Lung heat (with relatively profuse sweating). in more severe cases the heat will deplete the fluids and there will be little or no sweating. . . . Semen Pruni Armeniacae (xing ren). ANALYSIS OF FORMULA: One of the chief ingredi- Ephedra. . The assistant. and measles. . . Honey-fried Radix Glycyrrhizae Uralensis (zhi gan cao). it works synergistically with the other deputies on the throat. CAUTIONS & CONTRAINDICATIONS: This formula should be used with caution in cases with Spleen and Stomach deficiency. and harmonizes the actions of the other ingredients. with Gypsum (shi gao) substituted for Ramulus Cinnamomi Cassiae (gui zhi). . . . . Gypsum. clears heat from the Lungs and moistens the upper burner. . assists Herba Ephedrae (ma huang) in facilitating the flow of Lung qi. but also transform dampness by facilitating the flow of Lung qi. . Fructus Arctii Lappae (niu bang zi) and Rhizoma Belamcandae Chinensis (she gan). clears heat. . . . . and a slippery. . . . . Available in prepared form. Wheezing. Gypsum (shi gao). It is a good example of how the substitution of one . It attacks the throat pain which occurs when the disorder affects the blood level of the Lungs. With the appropriate presentation. . . Herba Ephedrae (ma hang). . . . . . . or wind-cold that transforms into heat.

. . and moves water. .4. . . . . For wind edema with aversion to drafts. . . . add Fructus Perillae Frutescentis (su zi) and Semen Descurainiae seu Lepidii (ting li zi). . MODIFICATIONS: * For severe heat. .2g Rhizoma Zingiberis Officinalis Recens (sheng jiang). . . . add Herba seu Flos Schizonepetae Tenuifoliae (jing jk). . . Induces sweating. . I n the Discussion of Cold-induced Disorders this formula is prescribed for greater yang-stage disorders "after sweating. . yiie **. . . . .15 pieces Decoction. bronchial pneumonia. 1 piece Fine green tea (xi cha). . . . Because of its ability to treat a complex condition in a gentle manner (i. . . . . . . Induces sweating. . . . and Gypsum Decoction ingredient can significantly alter the actions of a formula. . . this formula may be used in treating such biomedically-defined disorders as upper respiratory tract infection. . Today this is not done and the dosage of all ingredients is reduced by one. .6g Fructus Zizyphi Jujubae (da zao) . . .9g Radix Glycyrrhizae Uralensis (gan cao) . . . . add Rhizoma Pinelliae Ternatae (ban xia). . . . . . . . . bronchiolitis. . .9g Radix Glycyrrhizae Uralensis (gan cao) . This formula is indicated for more severe conditions than Maidservant from Yue Decoction (yue bi tang). . . . and a floating pulse. . . . . .1. . . . add Flos Lonicerae Japonicae (jin yin hua). disseminates the Lung qi. . and diphtheria. disseminates the Lung qi. reduced urination.to two-thirds. . . . . .15 pieces Decoction. . . . . . . . 1% Gypsum (shi gao). . slight fever. . . . . . . . . . disseminates the Lung qi. . . . . . . Fructus Trichosanthis (gua lou). . . * For sinusitis. . . . . . . . . This formula is used for a wide variety of Lung disorders. . lobar pneumonia.to two-thirds. . . . . . . generalized edema. . slight but continuous sweating. . . . . . Radix Scutellariae (huang qin) and Herba cum Radice Houttuyniae Cordatae ( y u xing cao). . . . . . . . . . irrespective of the color of the tongue coating or the presence of fever or sweating. . Later generations of practitioners have used this formula in treating cough with viscous and difficult-to-expectorate sputum. . a red tongue. . . . . .. . . . Pericarpium Citri Reticulatae (chen pi). . . . . . . .'' Commentators have explained the last phrase as meaning that there is no significant heat in the exterior because it has entered the interior. . Apricot Kernel. . . . . . . . and there is sweating and wheezing without great heat. . . . Maidservant from Yue Decoction plus Atractylodes &*nu % yiie bi jiii zhG tang R CAUTIONS Source: Essentials from the Golden Cabinet Uin gui yao lue) Herba Ephedrae (ma huang) . . . . . . . . * For stubborn asthma. For wind edema with edematous orbits.cook Herba Ephedra (ma huang) for a short time before adding the other ingredients. . . .e. . . . . . . . . . . . . . . . . . . . it may be used in treating children with frequent and poorly controlled urination (the main complaint) accompanied by coughing and wheezing. * For wheezing and coughing with copious sputum. . . . . . pneumonitis from measles. fever and chills. the dosage of Herba Ephedrae (ma huang) is larger than in the principal formula. . pertussis. . . . .l2g Fructus Zizyphi Jujubae (da zao) . . . . . . when it is inappropriate to use Cinnamon Twig Decoction (gui zhi tang). .48g Rhizoma Zingiberis Officinalis Recens (sheng jiang) . . . . . . Today this is not done and the dosage of all ingredients is reduced by one. sore and heavy limbs. . . For example. . . . generalized edema that begins in the face. as a mild diaphoretic). . and a floating and slippery or submerged pulse. . . . . . .4g Clears heat from the Lungs. . . labored breathing. .3g Radix Glycyrrhizae Uralensis (gun cao) . . Since this is an acute condition and edema is the primary symptom. . and moves water. . . . . . . . & CONTRAINDICATIONS: Contraindicated for wheezing due to cold and in cases where the pathogenic influence lingers due to normal qi deficiency. 1% Gypsum (shi gao). With the appropriate presentation. this formula was named after the maidservants of southern China (ylie) who were traditionally known to possess qualities of consideration and gentleness. . .PO Maidservant from Yue Decoction bi tang Source: Essentials from the Golden Cabinet Uin gui yao lue) . .Ephedra. . Fructus Forsythiae Suspensae (lian q h ) . . . . The source text advises to cook Herba Ephedra (ma huang) for a short time before adding the other ingredients. . . . . . . . . . ASSOCIATED F O R M U L A S : Five-Tiger Decoction 3jLXJ wii hii tang Source: Collected Treatises o f [Zhang]Jing-Yue uing yw quan shu) Herba Ephedrae (ma huang) . . . . . Licorice. . . . .1g Gypsum (shi gao) . . .2. . This is an example of focusing treatment o n the upper burner for disorders of the lower burner. . . . . . Fructus Immaturus Citri Aurantii (zhi shi) and Rhizoma Zingiberis Officinalis Recens (sheng jiang). . . . The source text advises to. Herba Menthae Haplocalycis (bo he)and Semen Sojae Praeparata ( d m dou chi). . .48g Rhizoma Zingiberis Officinalis Recens (sheng jiang) . . . .6g Rhizoma Atractylodis Macrocephalae (bai zhu).5g Semen Pruni Armeniacae (xing ren) . . . . . . . . . . . . . bronchial asthma. . add Lumbricus (di long). * For chills and no sweating. . . . . 89 Herba Ephedrae (ma huang) . . . . 3 slices Fructus Zizyphi Jujubae (da zao) . . . . . . . . . . . . . .2. and a rapid pulse. .

. . . wheezing. With the appropriate presentation. Actions: Drains heat from the Lungs and calms wheezing. characterized by a high. . dry-fried Cortex Mori Albae Radicis (chao sang bai pi).3g Nonglutinous rice (geng mi) . or damp-phlegm. . and fever all worsen in the afternoon when the Lung qi is at its nadir (the most yin time for the Lungs). little or difficult-to-expectorate sputum. . . drains constrained heat from the Lungs and thereby stops the coughing and wheezing. It should not be confused with the hot skin associated with a yang brightnessstage disorder. the use of bitter and cold herbs should be avoided. . and red tongue with a yellow coating are all indicative of heat. which manifests as coughing and wheezing. cook with the rice. Constrained heat also injures the yin of the Lungs. . neither of which is severe. wheezing. . . .e. . .. . If there is more heat from constraint than from yin deficiency. This so-called 'steaming' heat is thought to emanate from the skin itself. . T h e assistants. and fever with skin that feels hot to the touch. this focuses more superficially on the Lung channel. . . rapid pulse. In contrast to the principal formula. . and stops coughing and wheezing. . This is smoldering fire due to constrained heat in the Lungs. . pleurisy.90 Formulas that Clear Heat from the Organs ANALYSIS OF FORMULA: The chief herb. substitute Sclerotium Poriae Cocos (fu ling) for nonglutinous rice. . . . . . . pulmonary tuberculosis. . . . . This is due to wind-cold invading the body at B-13 (fei shu). . and to further protect the Spleen and Stomach. . . For labored breathing with heaving of the chest. pertussis. COMMENTARY: This formula is very effective in treating smoldering heat and Lung deficiency. and take before meals. @ For severe heat.. . T h e modern physician. It is often used in children with symptoms that alternate between excess and deficiency. . and a red tongue with a yellow coating. * For cough due to dryness. . .30g Cortex Lycii Radicis (di gu pi) . all of which worsen in the late afternoon. . which corresponds to the Lungs). and pneumonitis from measles. a sensation of fullness in the chest. . For this reason. .15-30g Preparation: The source text advises to grind the herbs into powder. . There is also a dry mouth. . The Lungs govern the skin. . . . add Radix Scutellariae (huang qin) and Radix Anemarrhenae Asphodeloidis (zhi mu). metal. protect the Stomach from the cold properties of the other herbs. . the dosage of the chief herb is increased. and nasal flaring. honey-fried Radix Glycyrrhizae Uralensis (zhi gun cao) and nonglutinous rice. wheezing. . .30g Honey-fried Radix Glycyrrhizae Uralensis (zhi gan cao). they also help the mother (i. Zhou Zi-Fang. . This has been a popular formula through the ages. recommends it for treating inverted menses (nosebleed during menstruation) and other upper respiratory tract bleeding. . . . . INDICATIONS: Coughing. clearsounding cough and the absence of sputum. wind-heat. Bulbus Fritillariae Cirrhosae (chuan bei mu) and Radix Adenophorae seu Glehniae (sha shen). It is assisted by the deputy. smoldering heat in the Lungs causes the skin to feel hot to the touch with light pressure. Source: Craft of Medicinal Treatment for Childhood Disease Patterns (Xiao er yao zheng zhi jue) Dry-fried Cortex Mori Albae Radicis (chao sang bai pi) . add Semen Descurainiae seu Lepidii (ting li zi) and Radix et Rhizoma Cynanchi Baiqian (bai qian). . This should be distinguished from conditions of Kidney yin deficiency where there is fever only in the afternoon. . . . . It is contraindicated for coughing and wheezing due to wind-cold. Cortex Lycii Radicis (di gu pi). . . . CAUTIONS & CONTRAINDICATIONS: This formula is often modified to protect the Spleen from injury by the cold-natured herbs in the formula. which originates in the flesh and feels hot at all levels of pressure. . pneumonia. I n terms of the mother-son method. * For obstruction due to phlegm. which sugpsts its action in draining heat from the Lungs. . Available in prepared form. . Today it is usually taken as a decoction with the dosage reduced by two-thirds. . . . . . T h e dry mouth. White may refer in the Lungs' corresponderne to the metal phase and the color white. . . if there is more heat from yin deficiency. . . earth. Semen Pruni Armeniacae (xing ren).e. Drain the White Powder $3 c xi2 b& s i k * This formula is also called Drain the Lungs Powder. a thin. . the coughing. . the dosage of the deputy is increased. with many variations devised by famous physicians. . . . . Constrained heat causes the Lung qi to rebel. after which it transforms into heat and obstructs the Lung channel. thin and rapid pulse. . . this formula may be used in treating such biomedically-defined disorders as bronchitis. add Pericarpium Trichosanthis (gua lou pi). which also clears heat from deficiency. which corresponds to the Spleen and Stomach) to nurture the child (i. Because a child's organs are very delicate. MODIFICATIONS: * For mild phlegm.

. . . . . Reed Decoction In Chinese. Actions: Clears heat from the Lungs. . 1 Preparation: Decoction. . . yellow coating. and blood stasis produces Lung abscess. . . .6g Bulbus Fritillariae Cirrhosae (chuan bei mu) . . coughing of blood or blood-streaked sputum. . . and a slippery. moves the fluids. . . . . . yellow sputum. and a sense of fullness and distention in the chest. . . .30g Semen Benincasae Hispidae (dong gua ren) . . . . . .5g Caulis Bambusae in Taeniis (zhu ru) . . . . . . @ coughing that causes pain in the chest and flanks. . . . . . . . . . .6g Cortex Lycii Radicis (di gu pi) . . . . . . For Lung abscess with phlegm in the chest characterized by coughing. .12 pieces The source text advises to cook Fructus Zizyphi Jujubae (da zao) in three cups of water until two cups remain. . . . . . o ting li dii G Drain the White Powder from the Standards 5 3 l-3 -& xi2 b 6 i siin Source: Standardr of Patterns and Treatments (Zheng zhi zhun sheng) Cortex Mori Albae Radicis (sang bai pi) . . . . . . . an inability to rotate or bend the trunk. . . . . . . . . . . . . and calms wheezing. . drives out phlegm. wheezing. . drives out blood stasis. . . .3g Bulbus Fritillariae Thunbergii (zhe bei mu) . . . . . . . . . . . .24g Semen Persicae (tao ren) . . . .9-12g Fructus Zizyphi Jujubae (da zao) . . mild chest pain. . .9g Cortex Lycii Radicis (di gu pi) . . . . .4. . . 15g Cortex Moutan Radicis (dan pi) . . a red tongue with a greasy. . . . . . . . . .3g Honey-fried Radix Glycyrrhizae Uralensis (zhi gan cao) . . . . . is added. . Today usually prepared as a regular decoction. . . . This is cooked until only one cup of liquid remains. . . accompanied by phlegm and blood stasis. . . . . Carapax Amydae Sinensis (bie jia) and Radix Stellariae Dichotomae (yin c h i hu). scaly skin. more commonly known as lu gen. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . transforms phlegm.9g Mulberry Leaf and Moutan Decoction to Drain the White *+5$%?iI sang diin x i i b 6 i tang Source: Revised Popular Guide to the Discussion of Cold-induced Disorders (Chong ding tong su shang han lun) Cortex Mori Albae Radicis (sang bai pi). Drains the Lungs. In the source text. . . . . . . wei jing is another name for Rhizoma Phragmitis Communis. . . . . . . . .3g Semen Trichosanthis (gua lou ren) . . which has been stewed and then pounded into a pill the size of a bullet. . . . This herb is discarded and Semen Descurainiae seu Lepidii (ting li zi). . . . . VARIATION: Drain the White Powder from the Wondrous Lantern 5% xi? b& siin Source: Wondrous Lantern for Peering into the Origin and Development of Miscellaneous Diseases (Za bing yuan liu xi zhu) Add Radix Ginseng (ren shen). . . . add Herba Artemisiae Annuae (qing hao). . . . . This formula focuses on draining phlegm and fluids from the Lungs. . . . . . . INDICATIONS: Cough with foul-smelling sputum (which may be streaked with blood). drains and protects the Lungs. . . . . . . . . . . . slight fever. . . transforms phlegm and pus. . . .30g Semen Coicis Lachryma-jobi (yi yi ren) . . . the presentation includes superficial edema of the entire body (including the face and ears). . . . . For Liver fire scorching the Lungs characterized by 1' . . 2 pieces Clears the Liver. . . . . . . . Heat toxin obstructs the dissemination of Lung qi. . . . . and discharges pus. . . . . . . .8g Fructus Zizyphi Jujubae (da zao) . . and Radix Scutellariae (huang qin) for coughing and wheezing due to heat from Lung qi deficiency. . . .$ A $. . . . . . ASSOCIATED F O R M U L A S : * Descurainia and Jujube Decoction to Drain the Lungs 9. . . 3 pieces Drains heat from the Lungs. . . . . .4. . . This is Lung abscess due to heat toxin obstructing the Lungs. . For early-stage Lung abscess with coughing of dark-green or blood-streaked sputum that worsens in the morning. . rapid pulse. . . . . .9g Nonglutinous rice (geng m i ) . . 12g Folium Mori Albae (sang ye) . . . . . . . . . . . . . . . . . . . . . . . . The combination of heat. and in severe cases. . . Heat injures the collaterals of the Lungs and produces blood-streaked . . which leads to the coughing up of foul-smelling. . Sclerotium Poriae Cocos ( f u ling). . nasal congestion with a clear discharge. . . . Radix Anemarrhenae Asphodeloidis (zhi mu). . . . and a loss of taste and smell. . . . . . .9g Honey-fried Radix Glycyrrhizae Uralensis (zhi gan cao) . . . . . . . . . . and stops coughing. . . . . .Reed Decoction 91 For heat from deficiency with afternoon fevers. .%#J% x i i 9 i tang Source: Essentials from the Golden Cabinet g i n gui yao he) Semen Descurainiae seu Lepidii (ting li zi). . . . . . . dry. . . . . . . .3g Radix Platycodi Grandiflori (jie geng) .5g Rhizoma Zingiberis Officinalis Recens (sheng jiang) . . . . . Source: Thousand Ducat Formulas (Qian jin yao fang) Rhizoma Phragmitis Communis (lu gen) . . . . . . . . phlegm. . .1.

. and red. . Other applications include Lung heat disharmony with coughing. . It also leaches out dampness and helps the Intestines to function properly. . Source: Craft c $ Medicinal Treatment for Childhood Disease Patterns (Xiao er yao zheng zhi jue) Gypsum (shi gao) . a red tongue. . The assistant. It is also used during recuperation from a febrile disease when the patient has a slight fever and cough with thick sputum that is difficult to expectorate. For measles with coughing. . . With the appropriate presentation. fever. add Semen Descurainiae seu Lepidii (ting li zi). which leads to thirst and frequent hunger.92 Formulas that Clear Heat f r o m the Organs a For lingering heat and persistent cough with copious sputum during recuperation from a febrile disease. and red rashes. the chief ingredients. fever. INDICATIONS: Mouth ulcers. . bad breath. this formula may be used in treating such biomedically-defined disorders as bronchitis. Rhizoma Phragmitis Communis (lu gen). . pneumonia. . why then is tongue thrusting regarded as a sign of Spleen dysfunction? A branch of the Spleen channel reaches the root of the tongue and spreads throughout its underside. invigorates the blood and eliminates blood stasis. . Heat in the Spleen may also cause the tongue to become hot and dry. thirst.90g especially important in treating Lung abscess. add Fasciculus Vascularis Luffae (si gua luo). Some modern practitioners use it for eye disorders due to upward-blazing of heat toxin. For marked pus in the sputum. thus Spleen fire is manifested in oral symptoms. . yellow coating and a slippery. one of For excessive sputum. Yellow refers to the Spleen and Stomach's correspondence to the earth phase and the color yellow. which suggests its action in draining fire from the Spleen and Stomach. . . One of the deputies. Today it is prepared as a decoction with a reduction in dosage. rapid pulse. and take as a draft in 3-6g doses. . . clears and transforms phlegm-heat. dry mouth and lips. Actions: rains smoldering fire from the Spleen. add Radix Scutellariae Baicalensis ( h a n g qin). This formula can be used in treating both early-stage (without pus) and advanced-stage (with pus) Lung abscess. and red rashes (such as measles). If this is true. . . and a rapid pulse.2lg Radix Glycyrrhizae Uralensis (gun cao) . this formula is contraindicated during pregnancy. CAUTIONS & CONTRAINDICATIONS: Because of the descending actions of Semen Persicae (tao ren) and Semen Coicis Lachryma-jobi ( y i yi ren). Cortex Mori Albae Radicis (sang bai Pi) and Bulbus Fritillariae Cirrhosae (chuan bei mu). . pertussis. . clears heat from the Lungs and disperses pus from the upper parts of the body. Radix Trichosanthis Pericarpium (gua lou pi) and Folium Eriobotryae Japonicae (pi pa ye). Semen Benincasae Hispidae (dong gua ren). Heat transfers easily from the Spleen to the Stomach (its paired organ). It may then thrust out of the mouth in an effort to cool and moisten itself. This is smoldering fire in the Spleen. bronchiectasis. . The other deputy. The stasis of blood prevents nourishment and moisture from reaching the skin. . add Flos Lonicerae Japonicae (jin yin hua) and Herba cum Radice Houttuyniae Cordatae ( y u xing cao). Bulbus Fritillariae Cirrhosae (chuan bei mu) and Radix Glycyrrhizae Uralensis (gan cao). . COMMENTARY: The expulsion of phlegm and pus is Drain the Yellow Powder xi2 huiing siin This formula is also called Drain the Spleen Powder. . frequent hunger. and eliminates pus. . Simply clearing the heat and regulating the qi is inadequate. Both Semen Persicae (tao ren) and Semen Benincasae Hispidae (dong gua ren) have a mild laxative effect which provides another outlet for the phlegm through the stool. I 1 / Preparation: The source text advises to grind the ingredients into a powder. The Spleen 'opens' through the mouth.3g Radix Ledebouriellae Divaricatae (fangfeng) . Semen Persicae (tao ren). . which becomes dry and scaly. ANALYSIS O F FORMULA: Gypsum (shi gao). toast lightly with honey and wine. . . ANALYSIS O F FORMULA: The chief herb. it stimulates the tongue and causes it to thrust outward. add Radix Platycodi Grandiflori (jie geng). dry. thereby providing an outlet for the phlegm (dampness) and heat through the urine. . . a For pronounced heat in the Lungs. which reduces the clumping and thereby breaks up the abscess. sputum and mild chest pain. . thirst. MODIFICATIONS: . . When heat disrupts the function of the channel.120g Folium Agastaches seu Pogostemi (huo xiang ye). Heat in the Spleen can also cause the tongue to become hot. Also for tongue thrusting in children. The tongue is regarded as the 'sprout' of the Heart. clears heat from the Lungs and is especially useful in treating Lung abscess. The combination of heat and phlegm produces a red tongue with a greasy. and asthmatic bronchitis. . Semen Coicis Lachryma-jobi ( y i y i ren). . resolves dampness. . . . . . A red tongue and a rapid pulse are signs of heat. . drains fire from the Spleen and . . . thirst. 15g Fructus Gardeniae Jasminoidis (zhi zi) .

. . . . Cortex Moutan Radicis (dan fii) and Radix Rehmanniae Glutinosae (sheng di huang) cool the blood and nourish the yin. . which manifests as sores and swelling in the mouth and bad breath. drains heat from the three burners through the urine. lips. add Rhizoma Coptidis (hang lian).Jasminoidis (zhi zi). The large dosage of the deputy. The large dosage of the envoy. This is a very effective formula in treating tooth- a Clear the Stomach Powder Source: Secretsfrom the Orchid Chamber (Lang shi m i cang) . If the condition is treated simply as a case of Stomach fire to be cleared and drainid.3g (3-6g) Cortex Moutan Radicis (dan Pi) .0. disperses the smoldering Spleen fire in accordance with the principle of treating constrained fire by dispersal. . there will be no improvement. What is needed are substances that gently clear and disperse. the pure products of digestion are unable to rise. . these three ingredients not only clear and drain. and take cool. and rapid pulse are all signs of heat in the Stomach. . but also raise and disperse the smoldering fire without injuring the Spleen and Stomach yang. and the slippery. facial swelling. . . For mouth ulcers or tongue thrusting the dosage of Radix Ledebouriellae Divaricatae (fang feng) is often reduced. . . and other herbs that clear heat are added.1. The deputy. COMMENTARY: The composition of this formula provides an insight to the proper treatment of smoldering heat (fire). . The formula is also used in treating yellowing of the sclera due to Spleen heat. and for a swollen. is a common place for conditions of excess to develop. prepare as a draft. painful tongue. which causes toothache and headache. the red tongue with little coating. With the appropriate presentation. . . Actions: Drains Stomach fire. Rhizoma Cimicifugae (sheng ma). the other chief ingredient. . acting in concert. MODIFICATIONS: @ For severe heat.0. . raises and disperses the heat and relieves toxicity. this formula may be used in treating the biomedically-defined disorder of aphthous ulcers. drain fire. It also assists the deputy in dispersing the smoldering fire. . Folium Agastaches seu Pogostemi (huo xiangye). . Fructus Gardeniae. The sensitivity to changes in temperature. However. . fever. Today it is usually prepared as a decoction with the increase in dosage specified in parentheses. . or jaw. their dosage is relatively small. The painful areas respond favorably to cold. INDICATIONS: Toothache (especially when the pain extends into the head). The yang brightness Stomach channel. . and harmonize the actions of the other ingredients in the formula. . or (paradoxically) of cold foods. and nourishes the yin. bad breath. Although these are the chief ingredients. Cold substances that drain heat from the middle burner play a very small role. tonic herbs. . which contains an abundance of qi and blood. Rhizoma Coptidis (huang lian). . ANALYSIS OF FORMULA: The chief herb. This channel and the yang brightness Large Intestine channel supply the mouth and teeth.9g (6-12g) Preparation: The source text advises to grind the ingredients into powder. Radix Ledebouriellae Divaricatae (fangfeng). a red tongue with little coating. . COMMENTARY: The source text notes that the cause of this disorder is the improper use of hot. The remaining ingredients are regarded as assistants. . . When heat accumulates in the middle burner. CAUTIONS & CONTRAINDICATIONS: Contraindicated in cases with Stomach yin deficiency and tongue thrusting due to congenital qi deficiency. and worsen with heat. and a slippery.Lag (3-6g) Rhizoma Cimicifugae (shng ma). and enters the Heart to relieve irritability. thereby restoring the qi mechanisms of the Spleen and Stomach. attacks the Stomach fire and drains the accumulation of heat. . Also indicated for bleeding and sores of the gums. . and the turbid products are unable to descend. add Sclerotium Poriae Cocos Rubrae (chifu ling) and Medulla Junci Effusi (deng xin cao). Fire also causes the flesh to fester. . . The accumulation of heat blocks the flow of qi in the channel and gives rise to rebellious fire. Bleeding of the gums @is caused by fire that has injured the blood vessels. * For irritability and restlessness. Radix Glycyrrhizae Uralensis (gan cao). . . enables it to harmonize the middle burner. This is to prevent their cooling and descending actions from further constraining or bottling-up the smoldering fire. a dry mouth. and rapid pulse. large. . . . cools the blood. large. The assistant ingredient. . Today the accumulation of heat in the Stomach is usually attributed to overconsumption of rich or fried foods.5g (6-9g) Radix Rehmanniae Glutinosae (shng di huang) . This is heat accumulation in the Stomach. 93 Rhizoma Coptidis (huang lian) . . aromatically revives the Spleen.Cbar the Stomach Powder Stomach. and the dispersing action of this herb is omitted. Radix Angelicae Sinensis (dang gui) reduces swelling and alleviates pain by harmonizing the blood. . . which constrains the yang qi and causes its transformation into fire.9g (6-12g) Radix Angelicae Sinensis (dang gui) . . .

Heat in the Stomach may therefore cause toothache. loose teeth. . . periodontal disease. * For heat in the Large Intestine with constipation.'>. . . . . .3g Rhizoma Coptidis (huang lian). . . and thirst are also symptoms of heat. this focuses more on clearing vigorous Stomach heat. $ Radix Rehmanniae Glutinosae Conquitae (shu di huang) . the other deputy. . a few of which are mentioned below. . . . . . The teeth are associated with the Kidneys and are situated along the yang brightness channel.3-6g @ . . . . irritability and fever.. and alleviating irritability. . . ANALYSIS O F F O R M U L A : Gypsum (shi gao) clears Jade Woman Decoction Y. which. . . . I N D I C A T I O N S : Toothache. . . : . . . . and large pulse. .. qxng we'i tang Source: Golden Mirror of the Medical Tradition (Yi zong jin jian) Gypsum (shi gao) . . . . . which enables water to restrain fire. . . Irritability. A red tongue with a yellow coating and a floating. . and thirst.Formulas that Clear Heat from the Organs ache. . fire-draining actions of this formula. . . . . . also known as the Jade Woman. . . In contrast to the principal formula. Radix Achyranthis Bidentatae (niu xi) .4. j > nourishes the yin. . Take either warm or cool. . . which causes fire to descend. . This is Stomach heat with yin deficiency due to vigorous Stomach fire injuring the Kidney yin. For this reason.3g Radix Rehmanniae Glutinosae (sheng di huang) . f. and large pulse are signs of Stomach heat. . Tuber Ophiopogonis Japonici ( m i men dong). . .'?. . . . . an important ingredient of the formula. . . . .6-9g ?@. . The second theory is that the name refers to the handmaiden of the Bodhisattva Kwanyin.$ . which nourishes the Kidney yin. rather than dispersing it. . is very effective in moistening the Stomach. . and a floating. .5g Clears fire from the Stomach and cools the blood. just like the yin-nourishing. CAUTIONS & C O N T R A I N D I C A T I O N S : Contraindicated in cases with toothache due to wind-cold. Bleeding gums result when heat injures the channels which supply the teeth. The third theory is based on the ancient texts of akhemy. % . omit Radix Angelicae Sinensis (dang gui) and add Radix Scrophulariae Ningpoensis (man shen) and Radix Trichosanthis Kirilowii (tian hua fen). It is an important substance for treating toothache due to Stomach fire. . and thus complements the action of Radix Rehmanniae Glutinosae Conquitae (shu di hang). . . . The first is that it refers to Gypsum (shi gao). .<*. . . gingivitis. . slippery. . . Kwanyin relieves the sorrows and cools the passions of the world. . . .3-6g s. . I ". . . . . . . .fi+ ? $ .3g Rhizoma Cimicifugae (sheng ma). . swollen gums. . A dry tongue and deficient pulse are indicative of Kidney yin deficiency. . . . Radix Rehmanniae Glutinosae Conquitae (shu di huang) nourishes Kidney water insufficiency. . . or tooth and gum problems due to Kidney deficiency. . nil jiiin &a4 The origin of this name is unclear. Preparation: Decoction. . . but there are three theories. . Radix Achyranthis Bidentatae (niu xi).15-30g vigorous fire requires a strategy that directs the fire downward. . . . .. . . . . . . . $\.?: . generating fluids. is cold and yin in nature. deficient. . . trigeminal neuralgia. .. . It can be modified for treating many types of oral problems. .)?>:. It nourishes the yin primarily in the middle and upper burners. this formula may be used in treating such biomedically-defined disorders as stomatitis. For bleeding gums and bad breath due to vigorous Stomach fire. . . . Radix Anemarrhenae Asphodeloidis (zhi mu). . . one of the deputies. . Radix Achyranthis Bidentatae (niu xi) serves as the envoy. . . . ASSOCIATED F O R M U L A : Clear the Stomach Decoction . . . Tuber Ophiopogonis Japonici (mai men dong). . while Kidney deficiency may cause the teeth to loosen. . glossitis. . . . a dry. and bleeding of the gums due to Stomach fire. .'?A Actions: Drains heat from the Stomach and .9-30g Radix Anemarrhenae Asphodeloidis (zhi mu) . . . . .8 'g. . . I $ :: . . F . . . . thirst with a desire to drink cold beverages. These are the chief ingredients in the formula. . red tongue with a yellow coating. like jade. frontal headache. . . . fever. It conducts the heat downward and thereby stops the overflow of blood into the oral cavity. 1% Radix Scutellariae (huang qin) .%<i . . . . . fire from the Stomach and thereby relieves the fever. Stomach heat will travel through the channel and cause headache (usually frontal). . . . . . . irritability. . . and idiopathic halitosis. helps Gypsum (shi gao) clear heat from the Stomach and also nourishes the yin. COMMENTARY: A condition of yin deficiency with Source: Collected Treatises of [Zhang]Jing-yue Wing yue p a n shu) Gypsum (shi gao) . . .. . slippery. . . . gums.. With the appropriate presentation. This formula likewise treats problem associated with the Kidney yin. . . is used instead of Rhizoma Cimicifugae (sheng ma). . bleeding MODIFICATIONS: Q For strong thirst with a desire for cold beverages. . . . add Radix et Rhizoma Rhei (da huang).3g Cortex Moutan Radicis (mu clan pi). which refer to the Kidneys as the Jade Woman. . . The formula may also be used in treating certain forms of wasting and thirsting disorder. . . . . .

.v.15-30g Caulis Mutong (mu tong) .Guide Out the Red Powder This formula nourishes the yin and drains fire excess from the Stomach. the proponents of heat from deficiency argue that the absence of %: . 1 and Small Int&ine channels. . . There has been considerable debate over whether this formula was intended for treating heat from excess or deficiency. thirst with a desire to drink cold beverages. gingivitis. . the secretion of body fluids is disrupted and painful urinary dysfunction ensues. . add Fructus Ligustri Lucidi (nu zhen zi) and Herba Ecliptae Prostratae (han lian cao). . They would not have been included had the formula been intended for treating heat from deficiency. the collaterals become scorched and leak blood into the urine. . . . which is the 'sprout' of the Heart. . . . sores develop in the mouth and tongue. . . The tips of Radix Glycyrrhizae Uralensis @an cao shao) serve as the envoy by treating painful urinary dysfunction. Heat in this channel causes thirst with a desire for cold beverages. Actions: Clears the Heart and promotes urination. or even clearly visible blood in the urine. . .. which nourishes the Kidney yin and drains fire from deficiency in the Kidneys. On the other side. * Where bleeding is the primary symptom. . a red tongue. . . Caulis Mutong (mu tong).:y:. $ huan~). . Herba Lophatheri Gracilis (dan zhu ye). . . which leach out fluids. Radix Guide Out the Red Powder . . . . . The deputy.\?. Phellodendron. and a rapid pulse. . Radix Rehmanniae Glutinosae (sheng di huang) . and clears heat and promotes urination through the Small Intestine channel below. and the tips of Radix Glycyrrhizae Uralensis (gan cao xiao) into ?$$ . . The proponents of heat from excess argue that the presence of Caulis Mutong (mu tong) and Herba Lophatheri Gracilis (dm zhu ye). and painful urination. Today it is usually prepared as a decoction with the dosage specified. . . . . . the assistant. When heat travels up the Heart channel to the mouth. the presence of heat in the Heart channel disturbs the spirit and causes irritability and a sensation of heat in the chest. .:' :: +mk d6o chi d n color red correspond. 95 a red face..3-6g Tips of Radix Glycyrrhizae Uralensis (gan cao shao) . . stomatitis. When heat transfers to the Small Intestine channel (linked to the Heart channel in an interior-exterior relationship). rough.. . scanty. . Because the Heart is located in the chest and controls the spirit. . &. . This contrasts with Anemarrhena. double the dosage of Gypsum (shi gao) and Radix Achyranthis Bidentatae (niu xi). . and Rehmannia Pill (zhi bai di huang wan). INDICATIONS: Irritability with a sensation of heat in the chest. . . . this formula may be used in treating such biomedically-defined disorders as toothache. . Beneficial Formulas Of Amazing Effect. . this formula is contraindicated in cases with diarrhea. . .. . ANALYSIS OF FORMULA: The chief herb.. .. . * For profuse sweating and severe thirst.. .Caulis Mutong (mu tong). add Radix Adenophorae seu Glehniae (sha shen) and Herba Dendrobii (shi hu). enters the Heart to cool the blood. .3-6g Herba Lophatheri Gracilis (dun zhu ye) . The red tongue and rapid pulse are signs of heat. Its use in treating urinary problems due to heat transferred from the Heart to the Small Intestine was first mentioned in an anonymous work of the Qing dynasty. .This formula conducts heat out of the Heart channel through . possibly sores around the mouth. Also used for dark. . . . . is used to alleviate irritability by clearing heat from the Heart. can also injure the yin.. Source: Craft of Medicinal lieatment for Childhood Disease Patterm (Xiao er yao zheng zhi jue) " Rehmanniae Glutinosae (sheng di huang).3-6g powder and take 9g as a draft after meals with a ! i .. which controls the fire in the Heart. . When the heat transferred into the Small Intestine channel is severe.<.. . . Th zhu ye). ... %fi . CAUTIONS & CONTRAINDICATIONS: According to the source text.'L . and redness in the face.. . .$ -% iLr:)::. ..Ai... . . G . . . MODIFICATIONS: * For severe yin deficiency with mild fire in the Stomach. . Available in prepared form. It also enters the Kidneys to nourish the yin and generate fluids (strengthening the Kidney water). . in addition to relieving toxicity and harmonizing the actions of the other herbs in the formula. Preparation: The source text advises to grind equal : . + ! amounts of Radix Rehmanniae Glutinosae (sheng di . . 1 > :-:. . This is heat in the Heart and Small Intestine channels. . and glossitis. and add Rhizoma Imperatae Cylindricae (bai mao gen) and Cortex Moutan Radicis (dm pi) * For a dark-purple tongue with no coating. .. . . add Fructus Schisandrae Chinensis (wu wei zi). small amount of Herba Lophatheri Gracilis (dan . . to the Heart the Small Intestine.. .. . . With the appropriate presentation. COMMENTARY: The source text prescribes this formula for children with heat in the Heart characterized by irritability and thirst. . . clears heat from the Heart channel above.>. The Heart channel has an internal pathway which travels up the esophagus and into the throat and mouth.

. Fructus Gardeniae Jasminoidis (zhi zi). VARIATION: Drain the Epigastrium a n d Guide Out the Red Decoction 5% n. . . this ingredient serves as the chief herb. . hearing loss. . . . . Actions: Drains fire excess from the Liver and Gallbladder. . . . . . . . . . . In the Golden Mirror o f the Medical Tradition it is noted that this formula is most appropriate in treating Kidney deficiency with heat in the Heart that is not from excess. . The Gallbladder and Triple Burner are both lesser yang channels. Because these are the two primary functions of the formula. . . irritability. . The other deputy. . . . . . . . . . . . . nightmares. or foulsmelling leukorrhea. . cystitis. . . combine with Five-Ingredient Powder with Poria (wu ling san). . Radix Scutellariae ( h a n g gin) and Fructus Gardeniae Jasminoidis (zhi zi). The Gallbladder channel (paired with the Liver channel in an exterior-interior relationship) starts at the outer canthus of the eyes and crosses the lateral aspect (including the frontal and occipital areas) of the head. This leads to fire blazing upward to the head where it manifests in the symptoms described above. . . water metabolism is disturbed and internal dampness is generated. It promotes urination without injuring the yin. . The Liver channel traverses the hypochondria and the external genitalia. . . This is heat excess in the Liver andlor Gallbladder channels. . . swollen and pruritic external genitalia. . . . . . CAUTIONS & CONTRAINDICATIONS: Use with caution in cases with Spleen and Stomach deficiency. . . A disturbance in one of the lesser yang channels usually affects the other. add Herba Ecliptae Prostratae ( h n lian cao) and Rhizoma Imperatae Cylindricae (bai mao gen). . urethritis. .3-9g Radix Scutellariae (huang qin) . 9 For ulcerated sores around the mouth.dizziness. and a red tongue with a yellow coating. Available in prepared form. Radix Bupleuri ( c h i hu). . . In women.3-6g Preparation: Decoction. rapid. . . . The mechanism is described as conducting heat out of the Heart. .6-12g I ' nature of Radix Gentianae Longdancao (long dan cao) makes it extremely effective in draining heat excess from the Liver and Gallbladder. assist the chief herb in draining fire and eliminating dampness. . Radix Bupleuri . ANALYSIS OF FORMULA: The very cold and bitter 16ng diin xi2 giin tiing Source: Analytic Collection of Medical Formulas (Yi fang ji jie) Radix Gentianae Longdancao (long dan cao) . -$ : i f . . . . . A damp or humid climate can also induce dampness in the body. this formula may be used in treating such biomedically-defined disorders as stomatitis. . . rather than simply clearing it. and glomerulonephritis.6-12g Caulis Mutong (mu tong) . red and sore eyes..9-15g Radix Angelicae Sinensis (dang gui) . A wiry. . and in eliminating damp-heat from the lower burner. . . including tongue thrusting in children. .9-15g Rhizoma Alismatis Orientalis (ze xie) . . the menstrual cycle will be shortened and the blood will turn reddishpurple. . . and Radix Rehmanniae Glutinosae (sheng di huang) are usually fried in wine to produce draining with dispersion. When the Triple Burner channel is affected. . dampness in the lower burner causes foul-smelling leukorrhea and other disorders of the external genitalia. . . In both cases. . and forceful pulse. . . Also for difficult and painful urination with a sensation of heat in the urethra. . . Dosage is not specified in the source text. . xi2 xZn dGo chi tiing 1 .3-9g Radix Rehmanniae Glutinosae (sheng di huang) . Radix Gentianae Longdancao (long dun cao). . . . . Rhizoma Coptidis (huang lian). . . . short temper. swelling in the ears.6-12g Radix Bupleuri ( c h i hu) .6-12g Fructus Gardeniae Jasminoidis (zhi zi). . . . . . would certainly have been included had the formula been intended for treating heat from excess. . disperses heat due to constrained Liver and Gallbladder qi. When heat excess enters these channels it becomes constrained and cannot drain out.96 Formulas that Clear Heat from the Organs Radix Glycyrrhizae Uralensis (gan cao) . . . . * For blood in the urine. . . . rapid. . . . . . 4 Tradition (Yi zong jin jian) Add Rhizoma Coptidis (huang lian) and Medulla Junci Effusi (deng xin cao) and omit Herba Lophatheri Gracilis (dan zhu ye) for more severe symptoms. . @ : : ! i% %.3-6g Semen Plantaginis (che qian zi) . . and drains fire without encroaching on the Stomach. . a bitter taste in the mouth. . and clears and drains damp-heat from the lower burner. . With the appropriate presentation. . . and its corresponding sensory organ is the eyes. which treats heat excess in the Heart channel. . add Herba Dendrobii (shi hu) and Radix Anemarrhenae Asphodeloidis (zhi mu). headache. and forceful pulse and a red tongue with a yellow coating are signs of heat excess in the Liver channel. MODIFICATIONS: a For yin deficiency. Two of the deputies. a wiry. Source: Golden Mirror of the Medical Gentiana Longdancao Decoction to Drain the Liver 32 i s 4 'h INDICATIONS: Pain in the hypochondria.

There are three criteria for diagnosing heat in the Liver channel (the condition for which this formula is indicated): a wiry. . . . restlessness and irritability. and cause it t o descend without injuring the normal qi. . * For severe headache and painful. . pyelonephritits. . . . . . . For constrained Liver fire characterized by red. . . . Similarly. . MODIFICATIONS: * For pale-red leukorrhea and a wiry. this formula may be used in treating such biomedically-defined disorders as migraine headache. . Caulis Mutong ( m u tong). . Because the Liver stores the blood. . It is an excellent formula for treating the symptoms and underlying mechanisms associated with Liver and Gallbladder disorders. . suppurative otitis media. It should therefore not be taken long-term or in large doses. . .30g Fructus Gardeniae Jasminoidis (zhi zi) . . dark urine. . and Radix Angelicae Sinensis (dang gui). . . . which is used in treating constrained Liver qi with some symptoms of heat. which nourishes the blood without causing stasis. .9g Herba Artemisiae Yinchenhao (yin chen h o ) . intercostal neuralgia. . . . excessive pulse. . . . . . Clear the Gallbladder and Drain Fire Decoction $-jp 3 . CAUTIONS & CONTRAINDICATIONS: This formula can harm the Spleen. . .9g Radix et Rhizoma Rhei (da huanz) [add near end] . drain heat from the upper burner and eliminate damp-heat from the lower burner by promoting urination. . . . central retinitis. gallstones.15g Rhizoma Pinelliae Ternatae (ban xia) . . urethritis. . . because the cold. add Cortex Moutan Radicis (dan Pi) and Cacumen Biotae Orientalis (ce bai ye). . . heat in the Liver channel can easily injure the yin and blood. . conjunctivitis. constipation. . . . . . . .9g Tuber Curcumae ( y u jin) . . . . Tremors or convulsions may also be present. . One-half to one pill is dissolved in a decoction made from a small amount of Herba Lophatheri Gracilis ( d m zhu ye).9g Radix Aucklandiae Lappae (mu xiang) . herpes zoster. . COMMENTARY: This formula can be used in treating a wide variety of complaints. . . . dispel the pathogenic qi. . . . In contrast to the principal formula. K 5% qiing diin xi2 huii tiing Source: Combined Chinese and Western Medical Treatment of the Acute Abdomen (Zhong xi yi jie he zhi liao ji fu zheng) Radix Bupleuri ( c h i hu). . . . . . Radix Bupleuri ( c h i hu) also focuses the actions of the other herbs on the Liver and Gallbladder channels. . T h e herbs in this formula cool heat without causing stasis. . . . . rapid pulse. . . . bitter nature of some of the ingredients can also easily injure the Stomach. * For coughing up blood due to Liver fire injuring the Lungs (the fire of wood attacking metal). . .309. .15g Radix Scutellariae (huang qin) .99Radix Gentianae Longdancao (long dun cao) . . drying herbs in the formula. . . * For tremors. . . .30g Radix Ledebouriellae Divaricatae ( f a n g j n g ) . Clears the Liver and drains fire. . . or dissolved into the aforementioned decoction. uveitis. . . . .Gentiana Longdancao Decoction to D r a i n the L i v e r ( c h i hu) and Radix Scutellariae (huang gin) form the classic combination for clearing lesser yang-channel heat. . a red tongue or red dots along the sides of the tongue. . . . acute glaucoma. Semen Plantaginis (che quLn zi). . . .30g Radix Gentianae Longdancao (long dan cao) . . . .30g Radix et Rhizoma Notopterygii (qiang huo) . . . . . . . eczema. cystitis. . add honey. this focuses on draining fire from the Liver and treating wind due to constrained fire. . . . . . . . . . . . . . . . Radix Glycyrrhizae Uralensis (gan cao) is used as an envoy to harmonize the middle burner and regulate the actions of the other herbs in the formula. . . .9g Mirabilitum (mang xiao) [dissolve is strained decoction]. . . . . . .9g . . . orchitis. . . This situation is not helped by the bitter. . . . . . . . and swollen eyes. . herpes simplex. . . . . . . add Radix Paeoniae Rubrae (chi shao) and Stamen The source text advises to grind equal amounts of the herbs into powder. . . . . Two assistants are therefore added to protect the yin and blood: Radix Rehmanniae Glutinosae (sheng di huang). add Flos Chrysanthemi Morifolii ( j u hua) and Folium Mori Albae (sang ye). . . . . . . 97 Nelumbinis Nuciferae (lian xu). and dark urine or urinary difficulty. which supplements the yin. . The use of this formula should be distinguished from that of Augmented Rambling Powder (jia wei xiao yao sun). and form into pills the size of a chicken head. . red eyes. .30g Radix et Rhizoma Rhei (da huang) . and Rhizoma Alismatis Orientalis (ze xie). .30g Radix Ligustici Chuanxiong (chum xiong) . . nor in cases with Spleen deficiency or injury to the fluids. That formula is indicated for a condition that lacks the full force of heat excess. . . . add Ramulus cum Uncis Uncariae (gou teng) and Bulbus Fritillariae Cirrhosae (chuan bei mu). . . . . . . . With the appropriate presentation.30g Fructus Gardeniae Jasminoidis (zhi zi) . . corneal ulcers. . . and hyperthyroidism. . . . . . . . . . T h e assistant ingredients. . Today it is usually made into 6g pills with water and taken twice a day with warm water. sore. . . . . . . and a flooding. . ASSOCIATED FORMULAS: Drain the Green Pill 33-4 JL xi2 qiing w6n Source: Craft of Medicinal Treatment fir Childhood Disease Patterns (Xiao er yao zheng zhi jue) Radix Angelicae Sinensis (dang gui) . rapid pulse. . . . . . pelvic inflammatory disease. epididymitis. . .

. . The red tongue with a yellow coating and the wiry. .3g Fructus Gardeniae Jasminoidis (zhi zi) . . . . . . . . . . Also for clumping of fire toxin characterized by severe headache.5g Secretio Moschus (she xiang) . . . . . . . rough urination. . . . . . whose dosage is six times that of the deputy. . . . a dry mouth. . irritability. . . insomnia. delirious speech. The commentaries cite its connection with the traditional concept of the abdomen's energetic anatomy. and manic behavior. . . As the heat in the Stomach is drained downward. . . . . . . . . Indicated for more severe conditions which require relieving toxicity and purging of fire excess. .5 Radix Ligustici Chuanxiong (chuan xiong) . This formula is designed to treat the fire excess-type of acute cholecystitis. . . . . . .3g Fructus Forsythiae Suspensae (lian qiao). the upward rebellion of qi is directed downward. . . . . . . and rapid or a flooding. . . . . . . . . . . and strengthens the Spleen. . . . . . . dark urine. . . . . restlessness. . . . . . tinnitus. . hearing loss. . . . . . . . . . .6g Fructus Arctii Lappae (niu bang zi) . . . . . . . . . .30g Rhizoma Coptidis (huang lian). drains fire from the Liver and clears heat from the Stomach. . in which the area corresponding to wood (Liver) is situated to the left and is controlled by metal (Lungs). . . . . . . . . . . . . . . . . belching. .15g Radix et Rhizoma Rhei (da huang) . . epigastric focal distention. . the chief herb. . spreads the Liver qi. . . bad breath. directs rebellious qi downward. . a bitter taste in the mouth. . slippery. . . .4. promotes the movement of qi and releases constraint by dispersing the Liver. . . Left Metal Pill Tangkuei. . . . . . . . . . . . . . abdominal distention. . . . . . . . . a bitter taste in the mouth. . For early-stage sores along the lesser yang channel on the head. . . . . Both of these herbs thereby "kill two birds with one stone. . . . . Actions: Clears Liver heat. . alternating fever and chills. Source: Teachings of [Zhu] Dan-Xi (Dan xi xin fa) Ginger juice-fried Rhizoma Coptidis (huang lian) . . . . . . . . Bupleurum Decoction to Clear the Liver %q$q3 5 chiii hii qing giin tiing Source: Golden Mirror of the Medical Tradition (Yi zong jin jian) Radix Bupleuri (chai hu) . . . .15g Fructus Gardeniae Jasminoidis (zhi zi) . . . coughing of viscous. . . . and Aloe Pill % 93 &&ik The origin of this name is unclear. . . . . .15g Radix Aucklandiae Lappae (mu xiang) . . . . . . . .30g Cortex Phellodendri (huang bai) . . Today it is usually prepared as a decoction with the dosage specified in parentheses. . . and a wiry. . . . . COMMENTARY: This is a very effective formula. . . . rapid pulse. .180g (15-18g) Fructus Evodiae Rutaecarpae (mu zhu yu) . . . . . . . .30g Herba Aloes (lu hui) . . . . and resolves dampness. . INDICATIONS: Hypochondrial pain. and a wiry. . . . . .3g Radix Glycyrrhizae Uralensis (gan cao) . . . . . . . . . . . . . . . . . . . . . . . dry coating. . cold Rhizoma Coptidis (huang lian). a red or dark-red tongue with a yellow. . the deputy. . and stops vomiting. . . . . The mechanism underlying this condition is described in Basic Qmtions (chapter 74): "All that rebels and rushes upward is associated with fire. vomiting. . vertigo.4. . vomiting and acid regurgitation are associated with heat. . . . . acrid Fructus Evodiae Rutaecarpae (wu zhu yu). . .3g Drains fire. flushed cheeks. . . . . . . .4. The principal formula is more focused on draining dampness and treating damp-heat. .30g Radix Scutellariae (huang qin) . . . . . . . . .30g Radix Gentianae Longdancao (long dan cao) . . gnawing hunger. . . rapid pulse reflect the presence of heat in the Liver and Stomach. . a dry mouth. . . rapid pulse. . . An alternative explanation is that the formula drains fire to protect the Lungs. . indeterminate diing gui 16ng hui wiin Source: Teachings of [Zhu] Dan-Xi (Dan xi xin fa) Radix Angelicae Sinensis (dang gui) . rapid pulse. . .6g Radix Paeoniae Rubrae (chi shao) . . . . . .5g Radix Trichosanthis Kirilowii (tian hua fen) . . . .5g Radix Scutellariae (huang qin) . unblocks the interior. . . . . . thus. . . and a wiry. acid regurgitation. This is heat in the Liver channel causing Liver and Stomach disharmony. . . It is also very effective in directing rebellious Stomach qi downward. and acid regurgitation are due to Liver heat disturbing the Stomach qi. . . . . thick sputum. .4. a red tongue. Indeterminate gnawing hunger. .Formulas that Clear Heat from t h Organs Spreads Liver qi. . . 3 g Radix Ledebouriellae Divaricatae (fang feng). .5g Radix Rehmanniae Glutinosae (sheng di huang) . . . .4. . . . . . Hot. . . . Drains Liver and Gallbladder fire excess characterized by headache. For unremitting pain in the hypochondria. . . . relieves toxicity. vomiting. a red tongue with a yellow coating. . . .15-30g (2-3g) Preparation: The source text advises to grind the herbs into powder and form into pills with water.5g Radix Angelicae Sinensis (dang p i ) . . . . . Take in 2-3g doses 2-3 times a day. . . Often there is also constipation and dark. . . . . . . . . . Pain is localized along the Liver channel. . . . . . Take 6g twice a day with warm water or dissolve in a decoction made from Rhizoma Zingiberis Officinalis Recens (sheng jiang). .5g Grind the herbs into powder and form into pills with water or honey. . . . . . . . .1. ANALYSIS O F FORMULA: Bitter. the qi will follow.'' The principle . focal distention. . . . . .4. Gentiana Longdancao.'' The hot nature of the deputy is moderated by the cold nature of the chief herb. .

. . . It serves as the chief herb in this formula because of its ability to clear damp-heat and relieve fire toxin. peptic ulcer. which is the 'child' of the Liver (wood) in the generative cycle of the five phases. this formula may also be used in treating hernial disorders with a similar presentation.Pulsatilla Decoction 99 of treatment can be explained in terms of the five phases.9g Cortex Phellodendri (huang bai) . and a wiry. Grind Rhizoma Coptidis (huang lian) and Radix Aucklandiae Lappae (mu xiang) and form into pills with vinegar. . With the appropriate presentation. . For red-and-white dysenteric disorders with focal distention and a stifling sensation in the chest and diaphragm due to damp-heat. Also used for hot dysenteric disorders. abdominal pain.130g Fry Rhizoma Coptidis (huang lian) with Fructus Evodiae Rutaecarpae (wu zhu yu). a burning sensation around the anus. . . The difference between Gentiana Longdancao Decoction to Drain the Liver (long dan xie gun tang) and Left Metal Pill (zuojin wan) is reflected in the differences between their chief herbs. .6g Rhizoma Coptidis (huang lian) . and relieves dysenteric disorders.9g Preparation: Decoction. Take 9-12g with food. i. promotes the movement of qi. and alleviates dysenteric disorders. In fact. .60g Fructus Evodiae Rutaecarpae (mu zhu yu) . especially from the Stomach and Intestines. . . . rapid pulse. . but is unable to harmonize the functions of the Stomach. . . . INDICATIONS: Abdominal pain. . diarrhea containing more blood than pus. ing sensation around the anus. . The presence of dampheat is reflected in the consistency of the stools and especially by the presence of pus. Clears heat. a burn- MODIFICATIONS: v For severe distention. . . . . . . Radix Gentianae Longdancao (long dan cao) is more effective than Rhizoma Coptidis (huang lian) in draining fire from the Liver. . . this formula may be used in treating such biomedically-defined disorders as gastritis. . This causes tenesmus. . ANALYSIS OF FORMULA: Radix Pulsatillae Chinensis (bai tou weng) is the principal herb in the materia Aucklandia and Coptis Pill xiiing lihn whn Source: Imperial Grace Formulary of the Tai Ping Era (Tai ping hui min he ji ju fang) medica for treating dysenteric disorders. For pronounced acid regurgitation. tenesmus. . . . . . esophageal reflux. . transforms dampness. add Fructus Meliae Toosendan (chuan lian zi). . . . Rhizoma Coptidis (huang lian) . These two deputies assist the chief herb in clearing damp-heat. . drain the 'child'. . . . . . . . rapid pulse. add 0 s Sepiae seu Sepiellae (hai piao xiao) and Concha Arcae (wa leng zi). . . . blood and pus in the stools. . . acid regurgitation. This is a hot dysenteric disorder due to heat toxin searing the Stomach and Intestines. a red tongue with a yellow coating. . . Today the dosage of Radix Pulsatillae Chinensis (bai tau weng) is usually increased 2-3 times. . Because the Liver channel courses through the groin and lower abdomen. and astringent Cortex Fraxini (qin pi) serves as the assistant by restraining the diarrhea and enhancing the actions of the other herbs. Available in prepared form. . . . . then discard the latter herb. thirst. and hiatal hernia. . . . in cases of excess. .e. . . . . . CAUTIONS & CONTRAINDICATIONS: Contraindicated in cases with acid regurgitation due to Stomach cold from deficiency.300g Radix Aucklandiae Lappae (mu xiang) . . . For LiverISpleen disharmony with stomach pain. . . Cold. Cortex Phellodendri (huang bai) clears dampheat from the lower burner. . . Rhizoma Coptidis (huang lian) drains heat from the Heart (fire). . . Here. cools the blood. . . Available in prepared form. . and thereby relieve the dysenteric diarrhea. Pulsatilla Decoction & & % i % b& t6u wEng tiing Source: Discussion of Cold-induced Disorders (Shang han lun) Radix Pulsatillae Chinensis (bai tou weng) . relieves toxicity. . ASSOCIATED FORMULAS: Fifth and Sixth Heavenly Stem Pill *!3& wii jZ whn Source: Imperial Grace Formulary of the Tai Ping Era (Tai ping hui min he ji ju fang) Rhizoma Coptidis (huang lian) Fructus Evodiae Rutaecarpae (wu zhu yu) Radix Paeoniae Lactiflorae (bai shao) Grind equal amounts of each herb into powder and form into pills with flour. . . . Actions: Clears heat. Bitter. . if too much of the herb is prescribed it can easily induce nausea and vomiting. especially in the blood level. . . . a red tongue with a yellow coating. . bitter. .9g Cortex Fraxini (qin pi) . and diarrhea. and a wiry. . . .. . Spreads the Liver qi and harmonizes the Spleen. . . . cold Rhizoma Coptidis (huang lian) clears damp-heat. .

Radix Sanguisorbae Officinalis (di yu).9g Rhizoma Coptidis (huang lian). . . The source text notes that the appropriate use of this formula depends on the pulse type. . . . . leukorrhea. . 2 SECTION 5 FORMULAS THAT CLEAR HEAT FROM DEFICIENCY Heat from deficiency can occur for many reasons. . . . . . . . . or more yin pulse). .6g Rhizoma Coptidis (huang lian). . . . . .6g Radix Scutellariae (huang qin) . . Many of the materia medica books of the Ming and Qing periods note that the chief herb. . . . . . Both this formula and Peony Decoction (shao yao tang) (see chapter 6 ) are used to treat damp-heat dysenteric disorders. . . .100 Formulas that Clear Heat from Deficiency ASSOCIATED FORMULAS: COMMENTARY: The source text recommends this formula for treating terminal yin-stage dysenteric disorders due to heat. . . . and abdominal pain. . .. The use of this formula has been expanded to the treatment of other conditions due to heat toxin or damp-heat in the lower burner.6g Radix Glycyrrhizae Uralensis (gan cao) . . . . . For this reason. urinary tract infection. . . . steaming bone . this formula may be used in treating such biomedically-defined disorders as acute bacillary dysentery. . This is interpreted to mean that the pathogenic influence enters through the upper and middle burners (reflected in the right. .6g Clears heat. . . .9g Today the dosage of Radix Pulsatillae Chinensis (bai tou weng) is usually increased 2-3 times. * For hot. . . . . Herba Agrimoniae Pilosae (xian he cao). . . * For amebic dysentery. . . . . add Pericarpium Punicae Granati (shi liu Pi). add Radix Aucklandiae Lappae (mu xiang).6g Cortex Phellodendri (huang bai) . . . Chronic injury to the Liver and Kidneys may present with similar symptoms including tidal fever. . . . . MODIFICATIONS: * For concurrent signs of an exterior condition such as chills and fever. CAUTIONS & CONTRAINDICATIONS: Because this formula contains herbs that are bitter and cold in nature. . and enriches the yin. . . .$ Tq l& . . . . and alleviates dysenteric disorders. . Cortex Moutan Radicis (mu dan pi) and Flos Carthami Tinctorii (hong ha). add Radix Puerariae (ge gen). * For bacillary dysentery. It is therefore used for conditions with less heat and toxicity (less blood in the stool). add Caulis Mutong (mu tong). urgency. . . and pain. . . For damp warm-febrile diseases leading to hot dysenteric disorders characterized by tenesmus. add Flos Chrysanthemi Morifolii ( j u hua). but more qi stagnation (abdominal pain and tenesmus). . . . it can easily injure the Spleen yang. . . . acute enteritis. . . . . some modern practitioners use the herb for acute eye disorders due to damp-heat. . . . . . . . . . . . . Rhizoma Imperatae Cylindricae (bai mao gen) and Herba Lysimachiae (jin qian cao). . Radix Pulsatillae Chinensis (bai tou weng). . and painful eyes. . . . . . . When it arises during the final stage of a warm-febrile disease when the heat has depleted the yin or settled into the deep. Pulsatilla Decoction plus Licorice and AssHide Gelatin 4 7 2 h v 4. . . . . . diarrhea. . . . . . . . * For severe tenesmus. . . . . but has ingredients that promote the movement of qi. . . . . Flos Lonicerae Japonicae (jin yin hua) and Fructus Forsythiae Suspensae (lian qiao). add Cortex Fraxini (gin pi). . . . * For urinary frequency. or more yang pulse). . . . Clears heat. . . . . . . That formula has less heatclearing and toxicity-relieving functions.6g Gelatinum Corii Asini (e jiao) [add to strained decoction] .6g Cortex Fraxini (qin pi) . For hot dysenteric disorders in cases with blood or yin deficiency. . is beneficial to the eyes. . ulcerative colitis. and small on the left. . . . . and is contraindicated in cases with Spleen yang deficiency. . . . relieves toxicity. . . . Radix Scutellariae ( h a n g qin).9g Radix Paeoniae Lactiflorae (bai shao) . . . . . yin regions of the body. . . nourishes the blood. . The severity of the disorder requires the use of rather large doses of especially strong herbs. . . . swollen. . . . . . . . . . and acute conjunctivitis. it is characterized by fever at night which cools by morning. . .9g Cortex Fraxini (qin pi). . . . . . resolves dampness. .47 $$ 3 j jiii we'i bhi t6u w%ngtiing Source: Systematic Diflerentiation of Warm Diseases (Wen bing tiao bian) Radix Pulsatillae Chinensis (bai tou weng) . . . . . It should therefore not be used long-term. . amebic dysentery. Radix Paeoniae Lactiflorae (bai shao) and Semen Arecae Catechu (bang lung). . . The source text recommends this formula for post partum patients. . . . . . . .9g Cortex Phellodendri (huang bai) . . . With the appropriate presentation. . . . j j 3 bhi tBu wEng jiii giin cGo % j G o tiing Source: Essentialsfrom the Golden Cabinet g i n gui yao he) Radix Pulsatillae Chinensis (bai tou weng) . . . This is regarded as a very serious condition in which the damp-heat or toxin penetrates to the blood level. and Radix Aucklandiae Lappae (mu xiang). Augmented Pulsatilla Decoction +F+. . but becomes lodged in the lower burner (reflected in the left. which should be big on the right. . . . . . . . . .

. emaciation with no loss of appetite. MODIFICATIONS: 4 For Lung consumption.12g Radix Anemarrhenae Asphodeloidis (zhi mu). . since they will cause further injury to the yin. Nor should bitter. and a fine. are the chief ingredients in the formula. add Rhizoma Imperatae Cylindricae (bai mao gen). This is heat smoldering in the yin regions of the body. . .6g Cortex Moutan Radicis (mu dan pi). . 15g Herba Artemisiae Annuae (qing hao) [add near end]. Cortex Moutan Radicis (mu dan Pi) cools the Liver blood. . INDICATIONS: Night fever and morning coolness with an absence of sweating as the fever recedes. and a red tongue with a yellow coating. formulas that tonify the yin should be prescribed (see chapter 8). The fact that the patient does not lose his appetite indicates that the problem is not in the qi level. it is added to the preparation at the end. The assistant. The famous modern physician. fatigue. In contrast to the Great Tonify the Yin Pill (da buyin wan). . and a thin. . yellow urine. Nevertheless. . For this reason. The red tongue with little coating. The deputies. . . . . . COMMENTARY: Although this formula was origin- of Warm Diseases (Wen bing tiao bian) Carapax Amydae Sinensis (bie jia) . and the fine. It is coupled with the aromatic Herba Artemisiae Annuae (qing hao). fevers of unknown origin. emaciation. It usually occurs during the later stages of a warm-febrile disease when the heat has depleted the yin and fluids. . and rapid pulse. The formulas which are used in treating this type of disorder consist of herbs that clear heat from deficiency and enrich the yin. . add Radix Cynanchi Baiwei (bai wei) and Cortex Lycii Radicis (di gu pi) 4 For heat in the five centers. . . cold herbs that clear heat be prescribed. . . it is unwise to nourish the yin alone since this will only serve to trap the heat inside. If the signs of deficiency are more pronounced than those of heat. . add Radix Adenophorae seu Glehniae (sha shen) and Herba Ecliptae Prostratae (han lian cao). . and Herba Artemisiae Annuae (qing hao) vents heat from the lesser yang channel. . . and also in cases with spasms or convulsions. used this formula for treating tidal fevers with Liver yin deficiency characterized by afternoon fever. which would normally occur as a fever recedes. drains heat from the yin and assists Herba Artemisiae Annuae (qing hao) in venting and dispersing the heat. . this formula focuses more on the problems associated with externally-contracteddisorders with remnants of heat. . Qin Bo-Wei. Carapax Amydae Sinensis (biejia) enters the Liver to enrich the yin. . add Radix Cynanchi Baiwei (bai wei) and Ramulus Nelumbinis Nuciferae (lian geng). . CAUTIONS & CONTRAINDICATIONS: Contraindicated in the early stages of a warm-febrile disease when the pathogenic influence is still in the qi level. and that the digestive system is relatively unaffected. 4 For blazing fire from deficiency. this formula may be used in treating such biomedically-defined disorders as the advanced stages of various infectious diseases. This very effective combination of substances. . Because the yin and fluids are depleted.Artemisia Annua and Soft-Shelled Turtle Shell Decoction 101 disorder. chronic nephritis. The only proper course is to simultaneouslynourish the yin and vent the heat. . and post-surgical fevers. Artemisia Annua and Soft-Shelled Turtle Shell Decoction q'ing h6o 5% jig tiing Source: Systematic Diflerentiation which vents the heat and expels it from the body. . . the body. weak. rapid pulse reflect injury to the yin. In Qin's view. unremitting low-grade fever. 4 For fevers of unknown origin due to yin deficiency. . it can also be effectively used in treating fever of various etiologies provided that the presentation is primarily one of yin deficiency with lingering heat. . . or a chronic. a red tongue with little coating. Salty. . . ANALYSIS O F FORMULA: Once heat has settled in ally intended to treat injury to the yin from a febrile disease. . . . Cortex Moutan Radicis (mu dan Pi). . assist Carapax Amydae Sinensis (bie jia) in nourishing the yin and clearing heat from deficiency. Radix Rehmanniae Glutinosae (sheng di hang) and Radix Anemarrhenae Asphodeloidis (zhi mu).6g Radix Rehmanniae Glutinosae (sheng di huang) . injury to the yin and blood causes a general loss of nourishment and thus emaciation. . the body is unable to generate sweat. With the appropriate presentation. sweating. cold Carapax Amydae Sinensis (biejia) directly enters the yin regions to enrich the yin and reduce the fever from deficiency.9g Preparation: Decoction. @ For summertime night fever and morning coolness in children. Herba Artemisiae Annuae (qing hao) should not be exposed to high temperatures for prolonged periods since this may destroy its active properties. Night fevers that recede in the morning indicate heat smoldering in the yin regions of the body. Actions: Nourishes the yin and vents heat. . . It is therefore thought to focus on the yang. one of which focuses on the yin and the other on the yang. which shares an exterior-interior relationship with the Liver channel. rapid pulse. .

. . . . .45g Radix Paeoniae Rubrae (chi shao) . Long-term deficiency at the nutritive level. . . . . . . . . a red tongue with little coating. and a faint. . . nourishes the blood. . 15g Radix Angelicae Sinensis (dang gui) . . . . . . . . which allows the fire from deficiency to blaze upward where it manifests as red lips and dark-red cheeks. . which disturbs the internal harmony of the body. . ASSOCIATED FORMULAS: Pi) and Radix Cynanchi Ginseng and Astragalus Powder "+&X& re'n s f i n hu6ng q i slin Source: Precious Mirror of Health (Wei sheng bao jian) Radix Ginseng (ren shen) . . Honey-fried Carapax Amydae Sinensis (zhi bie jia) . .45g Tuber Asparagi Cochinchinensis (tian men dong) . . heat in the five centers.30g Cortex Lycii Radicis (di gu Pi) . . . . .30g Honey-fried Carapax Amydae Sinensis (zhi bie jia) . . . . . rapid pulse. . Cool the Bones Powder Source: Standards of Patterm and Treatments (Zheng zhi zhun sheng) Radix Stellariae Dichotomae b i n c h i hu) . . . . . . chronic low-grade fever. .90g Honey-fried Carapax Amydae Sinensis (zhi bie jia) .30g Radix Asteris Tatarici (zi wan) . . . . . . . . and a thin. . . . . . . rapid pulse. .459.30g Radix Gentianae Qinjiao (qin jiao) . . . . the patient often experiences a sensation of heat deep in the body (at the level of the bones). Today it is usually prepared as a decoction with a doubling of the dosage. . The deficient yin is unable to contain the fluids during the night (yin). . T h e deficient yin cannot control the yang. Radix Anemarrhenae Asphodeloidis (zhi mu). T h e same process may also disturb the spirit and cause irritability and insomnia. . . . . . . . chronic low-grade fever. . Radix Gentianae Qinjiao (qin jiao) . . . . . . . . . . when further injured by blazing fire. .45g Radix Platycodi Grandiflori (jie geng). rapid pulse. a sensation of heat in the bones but the flesh is not warm to the touch. . . . emaciation. . . . . . .75g Cortex Mori Albae Radicis (sang bai pi) . . . . .90g Honey-fried Radix Glycyrrhizae Uralensis (zhi gan cao) . . coughing. a dry throat. . . irritability. . It is therefore called steaming bone disorder. . . . which store the true yin and are associated with the bones. . leads to emaciation and lethargy. . Today it is usually prepared as a decoction with a slight reduction in dosage. . . . . T h e Kidneys. . . . spontaneous sweating. . . . . . afternoon fever. . . . . In contrast to the principal formula. . . . .60g Radix Rehmanniae Glutinosae (sheng di hwmng) . . . . . . . . . which is attributed to improper or unsuccessful treatment of an externally-contracted disorder in a patient with underlying yin deficiency. clears heat. . a pale tongue with a dark-red tip. . . . . . . . . . . Grind the ingredients into powder and take in 9g doses twice a day as a draft on an empty stomach. . . . . . . . . . . insomnia. . . . . . red lips. stops coughing. . . . . . . . . . . . . . It was specifically designed for treating wind consumption @ng ldo). are affected by this condition. . . .45g Radix Bupleuri ( c h i hu) . . Radix Glycyrrhizae Uralensis (gan cao) . dark-red cheeks. . . . . . . . Actions: Clears heat from deficiency and alleviates steaming bone disorder. . . Rhizoma Picrorhizae (hu huang lian) . . . . . . . . . . . . . . . . . . . . Enriches the yin. . afternoon fever. . lethargy. . . . while the flesh itself is not warm to the touch. . disorder. INDICATIONS: Afternoon tidal fever or unremitting. . . and a deficient. . . . . red lips and cheeks. . generalized weakness. . . . . reduced appetite.15g Radix Anemarrhenae Asphodeloidis (zhi mu) . . . . . . . . . . . . . . This is steaming bone disorder due to Liver and Kidney yin deficiency. . . . . . . . .60g Radix Anemarrhenae Asphodeloidis (zhi mu) . . . . . . . . . For Lung consumption characterized by night sweats. . . . .15g Grind the ingredients into a coarse powder and take in 15g doses with five leaves of Herba Artemisiae Annuae (qing hao) and one piece of Fructus Pruni Mume (wu m i ) . . . . blood. . . . . . . . Preparation: The source text advises to take as a draft between meals. . . Enriches the yin. . . . . . . . . . . . augments the qi. . . . . Herba Artemisiae Annuae (qing hao) . . . When fire from yin deficiency occurs at this level. . . . . . May also be prepared as a decoction by reducing the dosage of the ingredients by approximately 90 per cent. . . . . . coughing with sticky yellow sputum or sputum laced with blood. scanty sputum. and transforms phlegm. . . .Formulas that Clear Heat from D e f i c i e n c y add Cortex Lycii Radicis (di gu Baiwei (bai wei). and alleviates steaming bone . . .75g Radix Astragali Membranacei (huang qi) . . . a dry throat. . . . emaciation. . . . . . . . l05g Cortex Lycii Radicis (di gu Pi) . . . T h e primary manifestations include afternoon tidal fever or unremitting. . . . . . . . . . strengthens the Spleen. . . . . . night sweats. . . . . . . . For consumptive deficiency ( x i lab) characterized by lethargy. . . . clears heat.60g Sclerotium Poriae Cocos Cfu ling) . . . . . . . .60g Rhizoma Pinelliae Ternatae (ban xia) . . I t is at this time that the blazing fire from deficiency forces the fluids out of the body in the form Gentiana Qinjiao and Soft-Shelled Turtle Shell Powder a g g ~ # ~ q i n jiiio biz jCi slin Source: Precious Mirror of Health (Wei sheng bao jian) Radix Bupleuri (chi hu) . . . . this focuses on treating yin. thirst. . . . . . . . . Yin deficiency gives rise to fire. . . . . . . . . Cortex Lycii Radicis (di gu pi) . . . . . and qi deficiency with smoldering heat leading to steaming bone disorder and consumption from deficiency that affects the Lungs and Spleen. . . . .30g Radix Gentianae @njiao (qin jiao) .

7. . . . Radix Paeoniae Lactiflorae (bai shao) and Radix Rehmanniae Glutinosae (sheng di huang) (source text). . . . . .7. . .5g . . . the periods will resume their regular cycle. @ ASSOCIATED FORMULAS: Clear the Menses Powder :* % #k qZng jZng s z n Source: Women's Diseases According to Fu Qing-Zhu (Fu qing zhu nu ke) Cortex Moutan Radicis (mu dan pi) . salty and cold honeyfried Carapax Amydae Sinensis (zhi bie jia). . and Cortex Lycii Radicis (di gu Pi). which enriches the yin and clears heat from Kidney deficiency. .6g Radix Rehmanniae Glutinosae Conquitae (shu di huang) . . . . and conducts heat at the level of the bones outward to the level of the muscles and the exterior. . .5g Radix Scutellariae (huang qin). . .3g Cortex Phellodendri (huang bai) . . red tongue with a yellow coating. . . This formula eliminates heat to prevent further injury to the yin and blood. . . . . . . . . . Radix Glycyrrhizae Uralensis (gan cao). a red face. . . . . . . . . . . . which makes them a particularly useful combination for treating steaming bone disorder without sweating. . T h e second group of deputies includes Herba Artemisiae Annuae (qing hao). . Yin deficiency also prevents the upper parts of the body from receiving moisture. which clears heat from the blood level. since the latter would injure the yin. a red tongue with little coating. which clears heat from deficiency. . . I n cases with more pronounced yin deficiency and less severe tidal fever. . . . . Radix Paeoniae Lactiflorae (bai sho) . . . . . . . . These are the principal substances for clearing heat from deficiency. . . . . . . or use Great Tonify the Yin Pill (da bu yin wan). . . . anchors the errant yang. . COMMENTARY: This formula is commonly used in 103 huang) for Rhizoma Picrorhizae (hu huang lian).Cool the Bones Powder of sweat. . . .6g Sclerotium Poriae Cocos Cfu ling) . . constipation. . . and Radix Gentianae Qinjiao (qin jiao). . . . . .60g Radix Anemarrhenae Asphodeloidis (zhi mu) . . . and heat from deficiency from the Liver and Kidneys below. thick. sweet and slightly bitter Radix Stellariae Dichotomae (yin chai hu). . . . . .60g Radix Bupleuri (chi hu) . . . . . . . . . . . . . add Radix Angelicae Sinensis (dang gui). . . . . . . Lycium Root Bark Decoction ~ % & k di gii pi yin Source: Master Shen's Book for Revering Lije (Shen shi zun sheng shu) Cortex Lycii Radicis (di gu Pi) . . rapid pulse. although the yin must be nourished to ensure any lasting benefit. . and are especially useful in alleviating steaming bone disorder with sweating. . . . . . . . . The substances that perform this function are different from the bitter. . . . . . . . . T h e red tongue with little coating and the thin. . . which clears lingering heat from the Lungs above. . . . . . . .7. . When the blood becomes tranquil. . . low voice. . . yellow urine. . . . . .6g Cortex Lycii Radicis (di gu pi) .5g Radix Ginseng (ren shen) . . add Gelatinum Corii Asini (e jiao). . 15g Herba Artemisiae Annuae (qing h o ) .5g Carapax Amydae Sinensis (bie jia). . . . . T h e chief ingredient. . The envoy. . . . . the primary focus should be on clearing the heat from deficiency. . reduces the fever from deficiency without any of the draining tendencies that could further injure the yin. . May also be prepared as a decoction. . enriches the yin. .5g treating steaming bone disorder with relatively severe heat from deficiency characterized by tidal fever. emaciation. dry mouth. giving rise to thirst and a dry throat. * For coughing. . . rapid pulse are classic signs of heat from yin deficiency. . . . . . . . . . . . . . These herbs vent heat externally. . There are two groups of deputies. . . The first includes Radix Anemarrhenae Asphodeloidis (zhi mu). . night sweats. . . . substitute Radix Rehmanniae Glutinosae (sheng di Honey-fried Radix Glycyrrhizae Uralensis (zhi gan cao) . . . . . . . harmonizes the actions of the other herbs and protects the Spleen and Stomach. . . . irritability and a stifling sensation in the epigastrium and abdomen. . T h e distinction of this formula is that it utilizes most of the major substances that specifically clear heat from deficiency. Rhizoma Picrorhizae (hu hang lian). For heat from deficiency leading to early menstruation with profuse. . . . . . . T h e formula's broad application is due to the combined actions of the chief and deputy ingredients. . . . .5g Grind the ingredients into powder and take as a draft. and dark-red or purplish-red flow. MODIFICATIONS: * For blood deficiency. . . this formula may be used in treating such biomedically-defined disorders as tuberculosis and fevers of unknown origin. . . . . add Radix Astragali Membranacei (huang qi) and Radix Codonopsis Pilosulae ( h n g shn). . T h e assistant ingredient. . . . . . . . . . . Clears heat and cools the blood. . . . . which drains fire without injuring the qi or blood. . For a pale and wan complexion. Tuber Ophiopogonis Japonici ( m i men dong) and Fructus Schisandrae Chinensis ( w u wei zi) (source text). . . . . . .7. . . . . . . . and conducts the actions of the other herbs into the yin (deep) levels of the body. . . and a slippery. . . . . . and a rapid pulse. cold substances that clear heat excess. . . especially from the Liver and Gallbladder. . and shallow breathing.7. . . . . . . . . . With the appropriate presentation. . .1. . . . . . . ANALYSIS O F FORMULA: In this particular condition.

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104

Formulas that Relieve Summerheat

Sclerotium Poriae Cocos Rubrae (chi fu ling). . . . . . . . l 5 g Grind the ingredients into powder and take 6g as a draft with one piece of Rhizoma Zingiberis Officinalis Recens (sheng jiang) and one piece of Fructus Pruni Mume (wu m i ) . Clears heat and nourishes the yin. For steaming bone disorder in children characterized by irritability in the diaphragm and palpitations. Also used for the later stages of cold-induced disorders when the fever has not completely resolved.

SECTION 6

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Flos Lonicerae Japonicae Recens (xian jin yin hua) . . . . . . . . . . . . . . . . . . . . . . . . . .6g ,5?f . , % , Flos Dolichoris Lablab Recens (xian bian dou hua) . . . . . . . . . . . . . . . . . . . . . . . . .6g , Mirabilitum Praeparata Citrulli (xi gua shuang) . .6g ?:$ Pericarpium Luffae Acutangulae (si gua pi) . . . . .6g !)$ . . , , : . , ,$~t, 2, Folium Nelumbinis Nuciferae Recens .$>..," <!:+:I (xianheye) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .6g +!$! Herba Lophatheri Gracilis Recens (xian dan zhu ye) . . . . . . . . . . . . . . . . . . . . . . . . . .6g q: ,,<&, Preparation: Decoction. 3;;;
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Actions: Resolves summerheat and clears the Lungs.

FORMULAS THAT RELIEVE SUMMERHEAT
The formulas in this section relieve summerheat, a yang pathogenic influence. Although summerheat is especially prevalent in late summer (Basic Qwtions, chapter 31), like other pathogenic influences it may also appear before or after its associated season. The effects of summerheat on the body are similar to those of heat. By causing high fever and profuse sweating (the interstices and pores stay open more in the summer), summerheat injures the qi and fluids, thereby producing thirst and irritability. Because the summer season is often accompanied by increased humidity, summerheat often occurs with dampness. During hot spells, the greater consumption of cold beverages and exposure to drafts (attempts to "cool off ') are also conducive to invasion by cold, usually of the exterior. The various hybrids of summerheat therefore require formulas which not only relieve summerheat, but also release the exterior, clear heat, resolve dampness, or augment the qi. Because dampness often accompanies summerheat, most of these formulas contain herbs that dry dampness or promote urination. If relieving summerheat is the primary strategy, the dosage of those herbs which resolve dampness should be relatively low to avoid further injury to the fluids; if drying dampness is the primary focus, the dosage of those herbs which relieve summerheat should not be too high, since the cold, sweet nature of such herbs can generate more dampness.

INDICATIONS: Fever, mild thirst, unclear head and vision with light-headedness and slight distention of the head, and a pink tongue with a thin, white coating. This is mild summerheat injuring the qi level of the Lung channel, or a summerheat-warmth which sweating has not fully released, leaving remnants of the pathogenic influence in its wake. The fever, mild thirst, and normal tongue reflect a mild, relatively superficial condition. The presence of a slight degree of dampness is reflected in the head symptoms. The location of these symptoms in the head, the most yang region of the body, is further evidence that this condition is confined to the superficial levels of the body. ANALYSIS O F F O R M U L A : Cool, aromatic Flos Lonicerae Japonicae Recens (xian jin yin ha), one of the chief herbs, relieves summerheat and clears heat. The other chief herb, aromatic Flos Dolichoris Lablab Recens (xian bin dou ha),clears and disperses summerheat. Mirabilitum Praeparata Citrulli (xi gua shuang), a deputy, helps the chief herbs relieve summerheat and clear heat. Pericarpium Luffae Acutangulae (si gua pi) specifically clears and vents the collaterals of the Lungs. Folium Nelumbinis Nuciferae Recens (xian he ye), an assistant, reinforces the relieving and dispersing actions of the chief herbs. The other assistant, Herba Lophye), clears the Heart hatheri Gracilis Recens (xian dan z and promotes smooth functioning of the water pathways. This herb also prevents summerheat from entering the Heart, and opens the way for the pathogenic influence to exit the Lungs, which are the upper source of the water pathways. COMMENTARY: Fresh, aromatic herbs are used to relieve summerheat and eliminate the accompanying dampness. Not only is this because fresh herbs are more aromatic than the dried variety, but in China such herbs are usually fresh during the summer season. Only small quantities of these herbs are used to gently relieve the summerheat, dispel the heat, and resolve the slight dampness in this mild, superficial condition. This formula may be taken as a tea during the summer to prevent injury from summerheat.

Rl Clear the Collaterals Decoction
qTng luti yin
This formula clears the pathogenic influence from the collaterals of the Lungs, hence its name.

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Source: Systematic Differentiation of Warm Diseases (Wm bing tiao bian)

S i x - b o n e Powder

105

MODIFICATIONS: * For a nonproductive cough with a clear, high pitch, add Radix Glycyrrhizae Uralensis (gan cao), Radix Platycodi Grandiflori Cjie geng), Tuber Ophiopogonis Japonici (mai men dong) and Semen Pruni Armeniacae (xing ren). @ For summerheat in the exterior and dampness in the interior indicated by fever and chills with a lack of thirst and vomiting of blood, add Semen Pruni Armeniacae (xinz ren), Talcum (hua shi) and Semen Coicis Lachryma-jobi (yi yi ren).

generates fluids, thereby enabling the formula to perform its tasks without injuring the fluids. COMMENTARY: This formula may also be used for hot or stony painful urinary dysfunction. It is almost always used as a component of a larger prescription. It was also originally known as Benefit the Basal Powder (yi yuan san) owing to its ability to expel summerheat without injuring the basal or source qi. Today this name refers to a variation of the principal formula (see below). Zhang Xi-Chun, author of Records of Heart-felt Experiences in Medicine with Reference to the West, noted that this formula is especially well-suited for use in southern China, a very humid region where conditions of darnpsummerheat are common. I n northern China, where the climate is much dryer, disorders associated with dryness are more common. With the appropriate presentation, this formula may be used in treating such biomedically-defined disorders as upper respiratory tract infection or urinary tract infection. CAUTIONS & CONTRAINDICATIONS: Because this formula may injure the qi and fluids, use with caution in treating weak, elderly, or yin-deficient patients. Contraindicated in cases with copious, clear urine, or summerheat without dampness. MODIFICATIONS: * For dry-summerheat, substitute Gypsum (shi gao) for Talcum (hua shi) with half the dosage. * For severe summerheat, add Mirabilitum Praeparata Citrulli ( x i gua shuang) and H e r b a Lophatheri Gracilis (dan zhu ye). @ For severe thirst with a red tongue, add Tuber Ophiopogonis Japonici (mai men dong), Radix Adenophorae seu Glehniae ( s h shen), Herba Dendrobii (shi hu) and Radix Anemarrhenae Asphodeloidis (zhi mu). * For injury to the qi and fluids, add Radix Panacis Quinquefolii (xi yang shen). @ For stony painful urinary dysfunction, add Herba Lysimachiae Cjin qian cao), Endothelium Cornei Gigeriae Galli Cji nei jin) and Spora Lygodii Japonici ( h i jin s h ) . For bloody painful urinary dysfunction, add Rhizoma Imperatae Cylindricae (bai mao gen) and Herba Cephalanoplos (xiao ji). @ For cystitis or urethritis, add Cortex Phellodendri ( h a n g bai). VARIATIONS:

Six-to-One Powder 2 - #
liii yT s6n
The name is derivedfrom the ratio this formula.

of the two ingredients in

Source: Direct Investigations of Formulas for Cold-induced Disorde~s(Shang han zhi ge fang lun) Talcum (hua shi) Radix Glycyrrhizae Uralensis (gan cao) Preparation: Grind six parts Talcum (hua shi) and one part Radix Glycyrrhizae Uralensis (gan cao) into powder and take 9-18g with warm water, or prepare as a decoction by placing the ingredients in a cheese cloth bag. The source text advises to use honey-fried Radix Glycyrrhizae Uralensis (zhi gan cao). Actions: Clears summerheat, resolves dampness, and augments the qi. INDICATIONS: Fever, sweating, thirst, irritability, urinary difficulty, a thin, yellow, and greasy tongue coating, and a soggy, rapid pulse. Summerheat (a yang pathogenic influence) easily disturbs the Heart (a yin organ), causing fever and irritability. It also causes sweating and easily injures the fluids, leading to thirst. Urinary difficulty arises from a combination of summerheat injuring the qi, and dampness obstructing the interior; together these processes interrupt the transformation of Bladder qi. The tongue signs reflect relatively mild damp-summerheat, as does the soggy (damp) and rapid (summerheat) pulse. ANALYSIS OF FORMULA: To properly treat summerheat, it requires an outlet. If accompanied by dampness, summerheat can be relieved by promoting urination. The chief ingredient, cold, bland Talcum (hua shi), clears summerheat and drains damp-heat through the urine. The deputy, Radix Glycyrrhizae Uralensis (gan cao), harmonizes the middle and has a mild ability to clear heat and relieve toxicity. This combination not only promotes urination but also

Peppermint Powder
j6 sii s6n

9 4 3i &

Formulas that Relieve Summerheat
Source: Direct Imestigations of Formulas for Cold-induced Disorders (Shang han zhi ge fang lun) Add one part Herba Menthae Haplocalycis (bo he) for concurrent exterior conditions with aversion to cold and wind, headache with a sensation of distention in the head, and cough. INDICATIONS: Fever, headache, irritability, thirst, urinary difficulty with reduced urine, or in severe cases, sudden turmoil disorder (simultaneous vomiting and diarrhea) during the summer. This is summerheat with internal stagnation of water and dampness. Summerheat causes fever and headache. I t injures the qi and fluids, which causes irritability and thirst. The internal ascent of dampness leads to stagnation and the obstruction of the qi mechanism, which causes urinary difficulty with reduced output of urine. When damp-summerheat is severe, injury to the Spleen and Stomach may occur; this disrupts their ascending and descending functions, and can lead to sudden turmoil disorder. ANALYSIS OF FORMULA: The chief ingredients, Talcum (h shi) and Radix Glycyrrhizae Uralensis (gun cao), effectively relieve summerheat and resolve dampness. Two of the deputies, Gypsum (shi gao) and Calcitum (han shui shi), which are very cold in nature, strengthen the heat-clearing actions of the formula. The other deputy, Cortex Cinnamomi Loureiroi ( g u n gui), assists in the transformation of qi in the lower burner. The assistants, Sclerotium Polypori Umbellati (zhu ling), Sclerotium Poriae Cocos ( f u ling), and Rhizoma Alismatis Orientalis (ze x i . ) , promote urination and expel dampness. Rhizoma Atractylodis Macrocephalae (bai zhu) strengthens the Spleen. Together these ingredients restore the ascending and descending functions of the qi mechanism, transform the Bladder qi, and alleviate sudden turmoil disorder. COMMENTARY: This is a modified combination of Six-to-One Powder (liu yi sun) and Five-Ingredient Powder with Poria (wu ling sun). It is generally prescribed for a somewhat more severe condition of summerheat (located at a slightly deeper level) than the heat for which Six-to-One Powder (liu yi sun) is indicated.

Benefit the Basal Powder

& +L& yi yuhn stin
Source: Categorized Discussion of Formulas for Cold-induced Disorders (Shang han zhi ge lun fang) Add one part Cinnabaris (zhu sha) and two parts Succinum (hu po) for stony painful urinary dysfunction, or palpitations with anxiety, insomnia, or dream-disturbed sleep.

Jasper Powder

g3*
bi yic stin
Source: Collection of Methods Related to the Man$stations and Root of Cold-induced Disorders (Shang han biao ben xinfa lei cui) Add one part Indigo Pulverata Levis (qing dai) for summerheat with red eyes, sore throat and/or mouth and tongue sores.

Cinnamon and Poria Sweet Dew Decoction
g u i ling giin lii yin
Sweet dew is associated with the long summer, the season corresponding to summerheat.
Source: Formulas from the Discussion Illuminating the Yellow EmfierorJsBasic Questions (Huang di su wen xuan ming 1un fang) Talcum (hua shi) . . . . . . . . . . . . . . . . . . . . . . . . . . .60g Radix Glycyrrhizae Uralensis (gan cao) . . . . . . . .60g Gypsum (shi gao) . . . . . . . . . . . . . . . . . . . . . . . . . .60g Calcitum (han shui shi) . . . . . . . . . . . . . . . . . . . . . .60g Cortex Cinnamomi Loureiroi ( p a n gui) . . . . . . .60g Sclerotium Polypori Umbellati (zhu 1in.g). . . . . . .l5g Sclerotium Poriae Cocos (fu ling). . . . . . . . . . . . .30g Rhizoma Alismatis Orientalis (ze xie) . . . . . . . . .30g Rhizoma Atractylodis Macrocephalae (bai zhu) .15g Preparation: Grind the ingredients into powder and take 9g with water. u & l l y one piece of Rhizoma Zingiberis Officinalis Recens (sheng jiang) is added. Today Cortex Cinnamomi Cassiae (rou gui) is usually substituted for Cortex Cinnamomi Loureiroi (guan gui) and the formula is generally prepared as a decoction with a proportionate reduction in the dosage of each ingredient. Actions: Expels summerheat, clears heat, transforms the qi, and resolves dampness.

Clear Summerheat and Augment the Qi Decoction
-.

.

qZng shii y3 q i tiing
Source: Warp and Woof of Warm-febrik Diseases (Wen re jing wei) Radix Panacis Quinquefolii (xi yang shen) . . . .4.5-6g Pericarpium Citrulli Vulgaris (xi gua pi) . . . .24-30g Ramulus Nelumbinis Nuciferae (lian geng) . . .12-15g Herba Dendrobii (shi hu) . . . . . . . . . . . . . . . . .12-15g Tuber Ophiopogonis Japonici (mai men dong). . .6-9g Herba Lophatheri Gracilis (dan zhu ye). . . . . .4.5-6g Radix Anemarrhenae Asphodeloidis (zhi mu). . . . . . . . . . . . . . . . . . . . . . . . . . . . . .4.5-6g Rhizoma Coptidis (huang lian). . . . . . . . . . . . . . .2-3g

Clear Summerheat and Augment the Qi Decoction
Radix Glycyrrhizae Uralensis (gun cao) . . . . . . .2-3g Nonglutinous rice (geng mi) . . . . . . . . . . . . . . .12-15g Preparation: Decoction. The source text does not specify dosage. Actions: Clears summerheat, augments the qi, nourishes the yin, and gen&ates fluids.

107

INDICATIONS: Fever, profuse sweating, irritability, thirst, scanty and dark urine, a desire to curl up, shortness of breath, apathy, and a deficient, rapid pulse. This is summerheat injuring the qi and fluids. When summerheat penetrates to the interior there is fever, irritability, dark, scanty urine, and a rapid pulse. The heat 'steaming' internally forces open the interstices and pores and causes profuse sweating. Summerheat, a yang pathogenic influence, is very apt to injure the fluids, which is compounded by profuse sweating. This results in thirst with a desire to drink, a desire to curl up, shortness of breath, apathy and a deficient pulse.
ANALYSIS OF FORMULA: One of the chief herbs in

is used in place of Gypsum (shi gao). This formula is also known as Master Wang's Decoction to Clear Summerheat and Augment the Qi (wang shi qing shuyi qi tang) to distinguish it from its associated formulas (see below). With the appropriate presentation, this formula may be used in treating such biomedically-defined disorders as upper respiratory tract infection, heatstroke, and fevers of unknown origin. CAUTIONS & CONTRAINDICATIONS: Because of the large number of cloying, yin-nourishing herbs, this formula should not be used without considerable modification in cases with damp-summerheat. It is also inappropriate for conditions in which the pathogenic influence has already been resolved. MODIFICATIONS: @ For mild summerheat with severe injury to the fluids, omit Rhizoma Coptidis (huang lian). e For a greasy, white tongue coating, omit Radix Anemarrhenae Asphodeloidis (zhi mu) and Tuber Ophiopogonis Japonici (mai men dong), and add Sclerotium Poriae Cocos ( f u ling). 9 For unremitting fever in children during the summer, qi deficiency, and insufficient fluids, omit Rhizoma Coptidis (huang lian) and Radix Anemarrhenae Asphodeloidis (zhi mu), and add Radix Cynanchi Baiwei (bai wei) and Cortex Lycii Radicis (di gu pi). ASSOCIATED FORMULAS: Master Li's Decoction to Clear Summerheat a n d Augment the Qi

this formula is Radix Panacis Quinquefolii (xi yang shen), which augments the qi, generates fluids, nourishes the yin, and clears heat. In this it is aided by Herba Dendrobii (shi hu) and Tuber Ophiopogonis Japonici (mai men dong), which nourish the yin of the Lungs and Stomach. The other chief herb, Pericarpium Citrulli Vulgaris (xi gua Pi), is an important substance for clearing heat and releasing summerheat. It is aided by Ramulus Nelumbinis Nuciferae (lian geng), which has similar functions. The assistants include Herba Lophatheri Gracilis (dan zhu ye) and Radix Anemarrhenae Asphodeloidis (zhi mu), which clear heat and resolve irritability and thirst. Bitter, cold Rhizoma Coptidis (huang lian) is especially effective in quelling fire. Here it is used to assist in clearing heat and expelling summerheat. The other assistants, Radix Glycyrrhizae Uralensis (gan cao) and nonglutinous rice, augment the qi and nourish the Stomach. Not only do these ingredients assist in treating the underlying condition, they also prevent the cloying nature of the yin-nourishing herbs and the cold nature of the heatclearing herbs from upsetting the Stomach. COMMENTARY: According to the great Qingdynasty physician, Y e Tian-Shi, summerheat develops in the yang brightness stage. The presence of fever is an indication of heat in the yang brightness-stage. While White Tiger plus Ginseng Decoction (bai hu jia ren s h n tang) focuses on clearing heat, this formula focuses on replenishing the fluids, and may be regarded as a modification of Lophatherus and Gypsum Decoction (zhu ye shi gao tang). Because of the close relationship between summerheat and the Heart, Rhizoma Coptidis (huang lian), which enters the Heart channel,

* ~*a-pBt;%
li shf qfng shii y 3 qi tEng

Source: Discussion of the Spleen and Stomach (Pi wei lun) Radix Astragali Membranacei (huang qi) . . . . .3g (9-12g) Radix Ginseng (ren shen) . . . . . . . . . . . . . . . . .1.5g (3-4.5g) Rhizoma Atractylodis (cang zhu) . . . . . . . . . . . .3g (4.5-6g) Rhizoma Atractylodis Macrocephalae (bai zhu) . . . . . . . . . . . . . . . . . . . . . . . . . . . .1.5g (4.5-69) Tuber Ophiopogonis Japonici (mai men dong) . . . . . . . . . . . . . . . . . . . . . . . .0.9g (9-12g) Fructus Schisandrae Chinensis (wu wei zi) . . .0.9g (3-6g) Radix Puerariae (ge gen) . . . . . . . . . . . . . . . . . .0.6g (6-9g) Pericarpium Citri Reticulatae (chen pi). . . . . . .1.5g (3-6g) Pericarpium Citri Reticulatae Viride (qing pi) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .0.9g (3-6g) Radix Angelicae Sinensis (dung gui) . . . . . . . . .0.9g (6-9g) Rhizoma Cimicifugae (sheng ma) . . . . . . . . . . . . .3g (3-6g) Rhizoma Alismatis Orientalis (ze xie). . . . . . . . 1.5g (6-9g) Cortex Phellodendri (huang bai) . . . . . . . . .0.6-0.9g (6-9g) Massa Fermentata (shen qu) . . . . . . . . . . . . . . . .1.5g (6-9g) Honey-fried Radix Glycyrrhizae Uralensis (zhi gun cao) . . . . . . . . . . . . . . . . . . . . . . . . . . .0.9g (2-3g) Radix Panacis Quinquefolii (xi yang shen) is usually substituted for Radix Ginseng (ren shen). The modern dosage (in parentheses) is larger than the dosage recommended

108

Formulas that Relieve Summerheat

in the source text. Clears summerheat, augments the qi, strengthens the Spleen, and dries dampness. For dampsummerheat with qi deficiency characterized by fever, headache, thirst, spontaneous sweating, a desire to curl up, loss of appetite, a sensation of fullness in the chest and a heavy body, loose stools, dark, scanty urine, a greasy tongue coating, and a deficient pulse. In contrast to the principal formula, this focuses more on tonifying the qi and strengthening the Spleen, rather than nourishing the yin and generating fluids. Available in prepared form.

Source: Discussion o f Seasonal Diseases (Shi bing Eun) Talcum (hua shi) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .9g Radix Glycyrrhizae Uralensis (gan cao) . . . . . . . . . . . .2.4g Herba Artemisiae Annuae (qing hao). . . . . . . . . . . . . .4.5g Semen Dolichoris Lablab (bai bian dou) . . . . . . . . . . . . .3g Fructus Forsythiae Suspensae (lian qiao). . . . . . . . . . . . .9g Sclerotium Poriae Cocos (fu ling) . . . . . . . . . . . . . . . . . .9g Medulla Tetrapanacis Papyriferi (tong cao) . . . . . . . . . . .3g Mirabilitum Praeparata Citrulli (xi gua shuang). . . 1 piece Relieves summerheat and leaches out dam~ness.For externally-contracted summerheat and dampness in the upper burner characterized by fever and chills, sweating, light-headedness, coughing, and a thin, slightly greasy tongue coating.

Master Lei's Decoction to Clear, Cool, and Remove Summerheat

%3'$*&&%

COMPARATIVE TABLES O F PRINCIPAL FORMULAS

FORMULAS THAT CLEAR HEAT FROM THE QI LEVEL
COMMON INDICATIONS: fever, irritability, thirst, red tongue, rapid pulse

I

FORMULA NAME White Tiger Decoction (bai hu tang)

DIAGNOSIS Blazing heat in the yang brightness channel stage Qi-level heat lingering in the Lungs and Stomach Qi-level heat lingering in the superficial aspects of the yang brightness stage

INDICATIONS High fever with profuse sweating, a red face, severe thirst and irritability, a flooding, forceful or slippery, rapid pulse Vomiting, parched mouth, lips, and throat, choking cough, stifling sensation in the chest, deficient pulse Insomnia with tossing and turning in bed, stifling sensation in the chest with a soft epigastrium, slightly yellow tongue coating, slightly rapid or strong, floating pulse at the distal position

REMARKS Also for headache, toothache, or bleeding of the gums and nose from the same etiology.
-

Lophatherus and Gypsum Decoction (zhu ye shi gao tang) Gardenia and Prepared Soybean Decoction (zhi zi dou chi tang)

Also for summerheat with a similar presentation.

This is a form of heat from constraint.

FORMULAS THAT CLEAR HEAT FROM THE NUTRITIVE LEVEL AND COOL THE BLOOD
COMMON INDICATIONS: fever (that worsens at night), irritability, a dry, scarlet tongue, a thin, rapid pulse

FORMULA NAME Clear the Nutritive Level Decoction (sins r;ns tans) Rhinoceros Horn and Rehmannia Decoction (xi jiao di huang tang)

DIAGNOSIS Heat entering the nutritive level

INDICATIONS High fever, severe irritability, restlessness

REMARKS Depending on the level of penetration the patient may be thirsty, delirious, or have some faint and indistinct erythema. Some patients become delirious.

Heat entering the blood level

Fever, various types of bleeding (including vomiting of blood, nosebleeds, blood in the stool or urine, and rashes), black and tarry stools, abdominal distention and fullness, thirst with an inability to swallow, prickles on the tongue

FORMULAS THAT CLEAR HEAT AND RELIEVE TOXICITY
COMMON INDICATIONS ($st

4): fever, rapid pulse, red tongue, swellings of some type

FORMULA NAME Coptis Decoction to Relieve Toxicity (huang Zian jie du tang) Drain the Epigastrium Decoction (xie xin tang)

(

DIAGNOSIS Fire toxin obstructing all three burners

INDICATIONS High fever, irritability, dry mouth and throat, dark urine, constipation, insomnia, forceful pulse, red tongue with yellow coating Flushed face, red eyes, irritability, dark urine, constipation, forceful pulse, red tongue with greasy, yellow coating

REMARKS Also for dysenteric disorders or jaundice due to damp-heat. Focuses on draining heat. Also for epigastric focal distention, jaundice, diarrhea, and dysenteric disorders. Focuses on purging. This is called massive febrile disorder of the head (dh to6 wi%).

Damp-heat with interior clumping

Decoction of Universal Benefit to Eliminate Toxin (plji xiao du yin)

Epidemic toxin with wind-heat and dampphlegm

Strong fever and chills, redness, swelling, and burning pain of the head and face, thirst, powdery-white or yellow tongue coating, a floating, forceful pulse Intense fever, strong thirst, dry heaves, severe and stabbing headache, extreme irritability, rash, nosebleed, dark-red tongue, dark and scorched lips, either a submerged, thin or floating, large pulse

Clear Epidemics and Overcome Toxin Decoction (qing wen bai du yin)

Severe fire in the qi and blood levels

COMMON INDICATIONS (next 4): primarily for external sores and/or abscesses with fever, red tongue, rapid pulse
-

FORMULA NAME Sublime Formula for Sustaining Life (xianfang huo ming yin)

DIAGNOSIS Fire-toxin or phlegmfire

INDICATIONS Early-stage sores and carbuncles with red, swollen, hot, and painful skin lesions, usually accompanied by mild chills, headache, thin tongue coating (either white or slightly yellow), forceful pulse Localized erythema, swelling, heat, and pain accompanied by chills and a yellow tongue coating

REMARKS Also for internal abscesses and dysenteric disorders due to blood stasis and heat toxin. Focuses on invigorating the blood. Especially for deep-rooted and hard lesions. Focuses on relieving toxicity.

Five-Ingredient Decoction to Eliminate Toxin (WU wei xiao du yin) Four-Valiant Decoction for Well-Being (si miao yong an tang)

Fire-toxin from externally-contracted heat

This is called sloughing ulcer
(tuo jii).

sinews and blood vessels Severe fire toxin and phlegm in the throat

the touch, and extremely painful

Six-Miracle Pill (liu shen wan)

Unilateral or bilateral pustular tonsillitis with severe sore throat and difficulty in swallowing

Also for carbuncles, acute localized infection, and lymphangitis.

FORMULAS THAT CLEAR HEAT FROM THE ORGANS
COMMON INDICATIONS FOR HEAT IN THE LUNGS: fever, coughing and wheezing andlor sore throat, red tongue with a yellow coating, rapid pulse

FORMULA NAME Honeysuckle, Forsythia, and Puffball Powder (yin qiao ma bo san) Ephedra, Apricot Kernel, Licorice, and Gypsum Decoction (ma xing shi gan tang) Drain the White Powder (xie bai san)

DIAGNOSIS Damp-heat collecting in the Lungs

INDICATIONS Severe sore throat with great difficulty in swallowing, thick white or yellow tongue coating, slippery and possibly floating pulse Fever with or without sweating, thirst, wheezing, difficult-to-expectorate sputum, labored breathing, nasal flaring and pain, rapid pulse Skin that feels hot to the touch, a dry mouth, little or difficult-to-expectorate sputum (ail symptoms worsen in the late afternoon), thin pulse Cough with foul-smelling sputum (which may be streaked with blood), slight fever, mild chest pain, dry, scaly skin, greasy tongue coating, slippery pulse

I

REMARKS This is called painful obstruction of the throat (hibi). Especially useful in children.

Heat lodged in the Lungs

Smoldering fire due to constrained heat in the Lungs

Especially useful in children. Also for inverted menses.

Reed Decoction (wei jing tang)

Lung abscess from heat-toxin obstructing the Lungs

Also for eye disorders due to upward-blazing of heat toxin.

COMMON INDICATIONS FOR HEAT IN THE SPLEEN & STOMACH (first 3): oral lesions or bleeding, dry mouth, red tongue

FORMULA NAME Yellow Powder (xie huang san) Clear the Stomach Powder (qing wei san)

DIAGNOSIS the Spleen Heat accumulation in the Stomach

INDICATIONS Mouth ulcers, bad breath, thirst, frequent hunger, rapid pulse Toothache (especially when the pain extends into the head), facial swelling, bleeding and sores of the gums, swollen and painful mouth, fever, bad breath, a slippery, rapid, and large pulse Toothache, loose teeth, bleeding gums, frontal headache, irritability, fever, thirst, yellow tongue coating, floating, slippery, deficient, and large pulse

I

REMARKS Also for tongue thrusting and yellowing of the sclera.

nu jian)

yin deficiency

Also for wasting and thirsting disorder.

Red Powder (dao chi san)

and Small Intestine channels

Irritability with a sensation of heat in the chest, thirst with a desire to drink cold beverages, red face, possibly sores around the mouth, red tongue, rapid pulse

Also for dark, scanty, rough, and painful urination, or even blood in the urine.

COMMON INDICATIONS FOR HEAT IN THE LIVER (first 2): hypochondriac pain, bitter taste in the mouth, red tongue

with a yellow coating, a wiry, rapid pulse FORMULA NAME Gentiana Longdancao Decoction to Drain the Liver (long dan xie gan tang) DIAGNOSIS Heat excess in the Liver and/or Gallbladder channels INDICATIONS Headache, dizziness, red and sore eyes, short temper, dark urine REMARKS Also for ear pain, difficult and painful urination with a sensation of heat in the urethra, swollen and pruritic external genitalia, or foul-smelling leukorrhea.

111

FORMULAS THAT CLEAR HEAT FROM T H E ORGANS, cont.
FORMULA NAME
(ZUO jin wan)

DIAGNOSIS Liver and Stomach disharmony from heat in the Liver

INDICATIONS Indeterminate gnawing hunger, epigastric focal distention, vomiting, acid regurgitation, belching, dry mouth

REMARKS Also for hernial disorders.

Pulsatilla Decoction (bai tou weng tang)

Dysenteric disorder from heat toxin searing the Stomach and Intestines

Abdominal pain, tenesmus, burning sensation around the anus, diarrhea containing more blood than pus, thirst, red tongue with a yellow coating, a wiry, rapid pulse

Also for acute eye disorders from damp-heat.

FORMULAS THAT CLEAR HEAT FROM DEFICIENCY
COMMON INDICATIONS: emaciation, red tongue with little coating, a thin, rapid pulse

FORMULA NAME
Artemisia Annua and Soft-Shelled Turtle Shell Decoction (qing hao bie jia tang) Cool the Bones Powder (qing gu sun)

DIAGNOSIS Heat smoldering in the yin regions of the body

INDICATIONS Night fever and morning coolness with an absence of sweating as the fever recedes

REMARKS Also for tidal fever with Liver yin deficiency.

Liver and Kidney yin deficiency leading to steaming bone disorder

Afternoon tidal fever or unremitting, chronic low-grade fever, sensation of heat in the bones but the flesh is not warm to the touch, irritability, insomnia, lethargy, red lips, dark-red cheeks, night sweats, thirst, dry throat

Focuses on clearing heat rather than tonifying the yin.

FORMULAS THAT RELIEVE SUMMERHEAT
COMMON INDICATIONS: fever, sweating, thirst

FORMULA NAME
Clear the Collaterals Decoction (qing luo yin) Six-to-One Powder (liu yi san)

DIAGNOSIS Mild summerheat injuring the qi level of the Lung channel Summerheat with dampness in the interior Summerheat with internal stagnation of water and dampness Summerheat injuring the qi and fluids

INDICATIONS Unclear head and vision with light-headedness and slight distention of the head, pink tongue with a thin, white coating Irritability, urinary difficulty, a thin, yellow, and greasy tongue coating, a soggy, rapid pulse Headache, irritability, or urinary difficulty with reduced urine

REMARKS Taken as a tea to prevent injury from summerheat.

I

Also for painful urinary dysfunction.

Cinnamon and Poria Sweet Dew Decoction ( p i ling gan lu yin) Clear Summerheat and Augment the Qi Decoction (qing shu yi qi tang)

Also for sudden turmoil disorder.

Profuse sweating, irritability, thirst, scanty and dark urine, desire to curl up, shortness of breath, a deficient, rapid pulse

Focuses on replenishing the fluids.

They are contraindicated during pregnancy. and should only be used when absolutely necessary after childbirth or loss of blood. With the exception of those that moisten and lubricate the intestines. thereby forcing open the obstruction to the orderly flow of qi. their use should be discontinued as soon as they take effect. or fluids (including water) in the interior. Because their harshness can easily injure the Stomach qi. A SECTION 1 FORMULAS THAT PURGE HEAT ACCUMULATION Heat accumulation is a condition of interior excess characterized by fever. Major Order the Qi Decoction dii che'ng q i tiing This formula treats heat accumulation in the Stomach and Intestine by carrying the Stomach qi downward. a yellow tongue coating. is the strongest of the formulas of Cold-induced Disorders (Shang han lun) . the formulas in this chapter utilize the downward-draining method ( x i h f i ) to break up and expel accumulations of heat. constipation. thereby serving as laxatives to remove accumulation through the stool. abdominal pain which increases upon pressure. and a pulse which is strong and excessive. Many of the formulas contain ingredients which unblock the bowels. Foods which are greasy or otherwise difficult to digest increase the risk of injuring the Stomach qi and should therefore be avoided when taking these formulas. and should never be used long-term. These formulas should not be used when there is an exterior condition. Formulas which treat heat accumulation are mainly comprised of herbs that drain downward and promote the movement of qi. Others contain ingredients that have a cathartic effect upon the accumulation of fluids.CHAPTER THREE Formulas that Drain Downward MONG THE EIGHT methods of treatment. all of them contain harsh ingredients that must be prescribed with care. or in the weak or elderly. cold.

which obstruct the orderly. a tense and firm abdomen. delirious speech. bitter. cold Mirabilitum ( m a y xiao). . and a submerged. The other assistant ingredient. a hot sensation in the sternum and epigastrium. disseminates the qi and relieves the sensation of fullness. . . excessive pulse. The heat and turbidity of the fluids cause the stool to dry out. The heat and dry stool then combine to form clumps. . the constipation associated with conditions of interior excess should be treated by purging. and the heat should be treated by cooling. Actions: Vigorously purges heat accumulation. . . . and heaviness which is focused in the epigastrium. Dryness refers to the dry stool which accumulates in the Intestines and causes parts of the abdomen to become tense and firm. This heat can be due to externally-contracted cold that transforms into heat. . and profuse sweating from the palms and soles. focal distention. which is forced out as prohse sweating through the pdms and soles. there may be tidal fevers. and the other abdominal symptoms mentioned. the deputy ingredient. abdominal pain which increases upon pressure. This has been interpreted to mean that because the qi in the yang brightness level of the body is strongest during this time. . . The first is that the dry stool absorbs and thus depletes the fluids. . . . dry stool. . . in that case. In severe cases the coating will become black with prickles. For this reason. These symptoms can also be viewed as four types of abdominal disharmony: focal distention. dryness. . The second explanation is suggested by a passage in Discussion. of Cold-induced Disorders (chapter 193) where it is noted that pathogenic influences at the yang brightness stage tend to resolve between 3 and 9 p. the original dosage of Cortex Magnoliae Officinalis (hou Po) is used. delirious speech. focal distention and abdominal fullness. dissipates clumps and reduces focal distention. . . . COMMENTARY: The principal pattern for which this formula is indicated includes focal distention. INDICATIONS: Severe constipation and flatulence. Fullness refers to the visible distention which is resistant to palpation. excessive pulse. it is then that the body's normal qi and the pathogenic influence struggle for dominance. This results in severe constipation and flatulence. it has also been used for lesser yin-stage disorders. Dryness also accounts for the submerged. This is a yang brightness organ-stage disorder which is characterized by heat accumulating in the interior and taking form. . . . Although the . There are two explanations for the tidal fever. . . or to externally-contracted heat. black tongue coating with prickles. abdominal fullness. . constipation. . Focal distention refers to the sensation of obstruction. . as well as some types of diarrhea and other disorders. yellow tongue coating indicates dryness in the interior.) with fever. Today it is prepared as a decoction with the ingredients treated as described in brackets above. the use of this formula should be discontinued. cold. and an excessive pulse. it can also be used for earlystage heat collapse (rkju.5 pieces (12-15g) Cortex Magnoliae Officinalis (hou Po).m. which appears in relatively severe cases. thereby injuring the yin. . sweating from the head. . Its propulsive action is aided by the stool-softening action of salty. . . a dry. Upward-blazing interior heat disturbs the spirit and causes delirious speech. cold extremities. . Heat in the yang brightness stage can transform the fluids into steam. The assistant ingredient. . . Mirabilitum (mang xiao) is added to the strained decoction which is then brought to a boil. yellow or dry. fullness. . . disorientation. When heat enters this stage it injures the fluids. . In Essentials from the Golden Cabinet it is recommended for internal blood stasis accompanied by spasms. . hence the fever is strongest during this time. . . and purging Radix et Rhizoma Rhei (da huang) serves as the chief ingredient in the formula. A dry. . . . and hardness. . Cortex Magnoliae Officinalis (hou Po). distention. In severe cases. . Hardness refers to the heat which accumulates and takes form resulting in constipation and abdominal pain that increases upon pressure. which become viscous and turbid. and symptoms of excess. .9-12g Fructus Immaturus Citri Aurantii (zhi shi). Fructus Immaturus Citri Aurantii (zhi shi). downward movement of qi through the Intestines. . . . Once diarrhea has been induced. scanty and dark urine. ANALYSIS OF FORMULA: In traditional Chinese medicine.24g Preparation: The source text advises to cook Fructus Immaturus Citri Aurantii (zhi shi) and Cortex Magnoliae Officinalis ( h u Po) in ten cups of water until five cups remain and then add Radix et Rhizoma Rhei (da huang) and continue cooking until two cups remain. The other signs and symptoms are associated with severe heat. Today most practitioners use 6-12g of Radix et Rhizoma Rhei (da huang) and 12-15g of Cortex Magnoliae Officinalis (hou Po) unless there is severe focal distention. it is most frequently discussed in connection with this pattern. Nonetheless. thirst. 1% Mirabilitum (mang xiao) [dissolvein strained decoction]. a sensation of fullness in the abdomen. Although the formula is mentioned nineteen times in Discussion of Cold-induced Disorders for a variety of conditions. With the appropriate presentation. Dosage is based on the source text. Both herbs assist in the expulsion of stool by moving the qi.F o r m u h that Purge Heat Accumlation Radix et Rhizoma Rhei (da huang) [add near end] .

rather than drained downward o r purged (see chapter 2). Also for nosebleed. MODIFICATIONS: @ For high fever. . .6g Mirabilitum (mang xiao). . . . . which has the mildest purgative action. . . . . . . . . . . . . Moderately purges clumped heat. and hardness. rapid pulse. . . . . . . . . . . . . . . it should be used only when absolutely necessary. this is not indicated for severe symptoms such as delirious speech. . . and take in two divided doses. . . . . . . . . . wherein the heat should be cleared. treats cases without focal distention or fullness. 1% Radix Glycyrrhizae Uralensis (gun cao) . Drains qi downward and unblocks the bowels. . Regulate the Stomach and Order the Decoction (tiao wei cheng qi tang). . cook until three cups remain. and a slippery. . . . . . . . 5 pieces (12-15g) Radix et Rhizoma Rhei (da huang) . For heat clumping in the Intestines (indicated by constipation) and fire rising to disturb the Stomach (indicated by vomiting). . .3g Unblocks the bowels. . . early-stage dysentery. . and hardness without dryness. Contraindicated during pregnancy. . . . . . . . . . acute cholecystitis. Major Order the Q i Decoction (da cheng qi tang). . . abdominal pain that does not increase upon pressure. . . . . add Radix Anemarrhenae Asphodeloidis (zhi mu) and Gypsum (shi gao). For weak patients. Then add the last herb. . . . . . acute pancreatitis. . and pneumonia (especially in children). . . . . 1% Radix Glycyrrhizae Uralensis (gun cao) . For relatively mild yang brightness organ-stage disorders characterized by tidal fever. . Following the same rationale. roundworm in the bile duct. an 'old-looking' (dirty and dry) yellow tongue coating. treats focal distention. . rapid pulse. . severe thirst. .24g Fmctus Immaturus Citri Aurantii (zhi shi) . 3 pieces (6-9g) Cook in four cups of water until slightly over two cups . . . .Major Order T h e indications vary considerably. . . harmonizes the Stomach. . . purges. add Semen Raphani Sativi (lai ju zi). treats focal distention. . . @ For severe abdominal distention. Minor Order the Q i Decoction (xiao cheng qi tang). For mild constipation due to yang brightness-stage heat characterized by the absence of focal distention and abdominal fullness. . . and petechiae (subcutaneous bleeding) due to heat in the Stomach and Intestines. swollen gums and throat. fullness. . abdominal fullness. For qi stagnation causing constipation and unremitting pain and fullness in the epigastrium and abdomen. . . not as strong as the former. . . . but with irritability and a slippery. . dryness. and take in three divided doses. . add Semen Persica (tao ren) and Radix Paeoniae Rubrae (chi shao). . . . and dissolve Mirabilitum (mang xiao) in the strained decoction. . . Regulate the Stomach and Order the Qi Decoction $ q % a%* C O N T R A I N D I C A T I O N S : This is a very strong formula which may cause vomiting o r severe diarrhea. . CAUTIONS & Q i Decoction 117 remain. . constipation. . . . Minor Order the Qi Decoction A< % 5% ching q i tiing Source: Discussion of Cold-induced Disorders (Shang han lun) xiiio Radix et Rhizoma Rhei (da huang) . . . . . . * Rhubarb and Licorice Decoction ASSOCIATED F O R M U L A S : k&+fq. . and a rapid and forceful pulse (a concurrent yang brightness channel a n d organ-stage disorder). . . . . . . . Mildly purges clumped heat. .12g Cortex Magnoliae Officinalis (hou po) . . . . . . . . . . focal distention. . . . . . . . . . . . . . . . . . All of the formulas that 'order the qi' use Radix e t Rhizoma Rhei (da huang) to cleanse heat accumulation from the Stomach and Intestines. ti60 we'i ching q i tiing Source: Discussion of Cold-induced Disorders (Shang han lun) Radix et Rhizoma Rhei (da huang) .6g Fructus Immaturus Citri Aurantii (zhi shi) . For signs of blood stasis. . some practitioners use this formula to treat closed-type wind-stroke. uncomplicated intestinal obstruction. . 12g Cook the first two ingredients in approximately 12 cups of water until five cups remain. Also for early-stage dysenteric disorders. . . the strongest of the group. this formula may be used in treating such biomedically-defined disorders as acute uncomplicated appendicitis. Three-Substance Decoction with Magnolia Bark l$t+-%l% h5u p5 siin wii tiing Source: Essentials from the Golden Cabinet g i n gui yao he) Cortex Magnoliae Officinalis (hou Po) . . I t is important to distinguish the principal pattern from a yang brightness channel-stage disorder. . . . . With the appropriate presentation. fullness.% d 2 huiing giin ctio tiing Source: Essentials from the Golden Cabinet g i n gui yao lue) Radix et Rhizoma Rhei (da huang) . . postoperative constipation and distention. . . each of these presentations shares the same underlying mechanism: heat excess accumulating in the Stomach and Intestines where it injures the fluids and forms clumps that obstruct the downward flow of qi. . . . . . and then with the addition of tonic herbs. and stops vomiting. . In contrast to the 'order the qi' formulas. . .9-12g Cook Radix et Rhizoma Rhei (da huang) with Radix Glycyrrhizae Uralensis (gun cao). . . . . . . . .

. . . . . . the heat must be drained and the stasis of blood broken up. . or a diet which is high in greasy. The clumping of heat and stasis of blood in the Intestines manifests as pain (usually in the lower right quadrant of the abdomen) that increases upon pressure. .Formulas that Purge Heat Accumulation Revised Major Order the Qi Decoction 2 5 k. . . This condition is also commonly attributed to damp-heat accumulating in the Intestines.15-30g Fructus Immaturus Citri Aurantii (zhi shi) . . One of the deputies. . . and the second by enema 1-2 hours later. . disperses clumping. . which putrifies the qi and blood in the Intestines and eventually forms an abscess. . . drains heat. . . . .9-15g Semen Benincasae Hispidae (dong gua ren). . promotes the movement of qi. . . . . . . . . The first dose is usually administered by nasogastric tube. .30g Tuber Ophiopogonis Japonici ( m i men dong). . source text. . . . . yellow. . . . it can be differentiated from painful urinary dysfunction because urination is normal. . . . a condition of excess with interior clumping of heat and blood. . As early as the Vital Axis (chapter 68) it was linked to poor dietary habits. . .24g Radix et Rhizoma Rhei (da huang) . . and unblocks the bowels. There may also be pain in the groin (resembling painful urinary dysfunction without urinary difficulty) which is relieved by flexing the hip and knee (usually on the right) and intensified by extending the hip. Binging or overeating in general. . . . . intermittent fever followed by chills and sweating. Gradually. . .3g Semen Persica (tao ren) . guarding of the abdominal musculature. . . . breaks up blood stasis. a thin. . INDICATIONS: Lower abdominal distention and pain Increase the Fluids and Order the Qi Decoction &&&kij. . . . . . . . . . . . . . . Available in prepared form. . . . constraint gives rise to heat. there may be a mass in the lower right quadrant of the abdomen. . .9g Radix Paeoniae Rubrae (chi shao) . zzng ye' che'ng qqi tang Source: Systematic Diflerentiation of Warm Diseases (Wen bing tiao bian) Radix Scrophulariae Ningpoensis (xuan shen) . . and a slippery. . . . .4. . .:$ $2 fang dii che'ng q i tang Source: Combined Chinese and Weshrn Medical Zeatment of the Acute Abdomen (Zhong xi yi jie he zhi liao ji fu zheng) Cortex Magnoliae Officinalis (hou Po) . . . . as the qi and blood continue to putrify. Today 12-18g of Radix et Rhizoma Rhei (da huang) and 9g of Cortex Moutan Radicis (mu dan pi) are used. . . . . . . . Also for constipation due to yin deficiency which has not responded to Increase the Fluids Decoction (zeng ye tang) (see chapter 5). .R-@i. . . . . . . and greasy tongue coating. Purges the interior. . . . .15g Mirabilitum (mang xiao). .12g Mirabilitum (mang xiao) [dissolve in strained decoction]. . . 15-30g Semen Raphani Sativi ( h i fu zi) . . . raw. . . or cold foods in particular. . intermittent fever followed by chills and sweating. . and invigorates the blood. which similarly obstructs the flow of qi and blood. . . . . . . . softens the stool and aids in draining heat downward. . and reduces swelling. . rapid pulse reflect the clogging of the Intestines by heat. . The yellow. . .9-12g Cortex Moutan Radicis (mu dan pi). . . generates fluids. . . . . .9g Mirabilitum (mang xiao) . . . . . . This pattern is one of early-stage Intestinal abscess. . . can lead to stagnation and obstruction of the Stomach and Intestines. . . In addition. . . . . and irregular. . Rhubarb and Moutan Decoction 4 43 4jdii huiing mil diin tiing Source: Essentialsfrom the Golden Cabinet Uin gui yao he) Radix et Rhizoma Rhei (da huang). ANALYSIS O F FORMULA: The pain associated with early-stage abscess is attributed to an interruption in the normal flow through the Intestines caused by accumulation of heat and stasis of blood. . . . . . Obstruction of any kind constrains the flow of qi and blood. . For yang brightness organ-stage disorders with yin deficiency where there is severe constipation. . . . Actions: Drains heat. . . . . the abscess will form a palpable mass. . Dosage is based on the (usually on the right) that increases upon pressure with rebound tenderness. . .9-15g Add Radix et Rhizoma Rhei (da huang) near the end and dissolve Mirabilitum (mang xiao) in the strained decoction.15-30g Preparation: Cook Radix et Rhizoma Rhei (da huang) with the other herbs.15g Radix et Rhizoma Rhei (da huang) . . .15g Semen Persica (tao ren). . . Enriches the yin. . . . . rapid pulse. . . greasy tongue coating and the slippery. . To restore normal flow. . .24g Radix Rehmanniae Glutinosae (sheng di huang) . . which tends to enhance its blood-moving action. . For uncomplicated intestinal obstruction with yang brightness organ-stage symptoms and more severe signs of qi stagnation. Radix et Rhizoma Rhei (da hang. . . with rebound tenderness. . . . performs both actions quite well. . T h e chief ingredient. . which manifests as irregular. . . . . . . . Although the pain may extend to the genitals. . . . . . . . . . . rich.5g Add Radix et Rhizoma Rhei (da huang) near the end and dissolve Mirabilitum (mang xiao) in the strained decoction. . Mirabilitum (mang xiao). The ebb and flow of the struggle between the body's normal qi and the pathogenic influences disturbs the nutritive and protective qi. . . . . . . . .). . . . . .

. . . . rapid pulse.) Source: Imperial Grace Formulary of the Tai Ping Era (Tai ping hui min he ji jufang) Radix et Rhizoma Rhei (da huang) . . Fructus Meliae Toosendan ( c h n lian zi) and Radix Aucklandiae Lappae ( m u xiang). . . It should be used with extreme caution in the weak and elderly. rapid pulse. . . . moistens the Intestines. . . . . . . . . . . .3% . . . . . . .300g Fructus Gardeniae Jasminoidis (zhi zi) . . used this formula. add Radix Angelicae Sinensis (dang gui) and Radix Salviae Miltiorrhizae (dan shen). . . . . . . . . . . . . For blood deficiency.6g Semen Persicae (tao ren) . . . . lochioschesis. and Baijiangcao Powder -% 2 i . . . With the appropriate presentation. . . . . . For early-stage Intestinal abscess with stagnation of dampness and stasis of blood characterized by colicky abdominal pain or abdominal fullness with loss of appetite. .9g Cortex Moutan Radicis (mu dan pi) . . . breaks up the stasis of blood and has a mild moistening and laxative effect. omit Mirabilitum (mang xiao) and add Radix Scrophulariae Ningpoensis (xuan shen) and Radix Rehmanniae Glutinosae (sheng di h a n g ) . . . . . Cool the Diaphragm Powder This formula cools the diaphragm by clearing heat from the upper burner and draining heat from the middle burner. . . . . . . Semen Benincasae Hispidae (dong gua ren). add Radix Pseudostellariae 119 Heterophyllae ( h i er shen). . . The other assistant. . . it may be used for such biomedicdy-defined disorders as acute uncomplicated appendicitis. . . . .Herba Taraxaci Mongolici cum Radice (flu gong ying) and Herba Hedyotidis Diffusae (bai hua she she cao). Prepared Aconite. a red tongue. . . . . . . . . . .600g Radix Glycyrrhizae Uralensis (gun cao) .3009- . . invigorates the blood. . . Also for post partum abdominal pain or post-menstrual pain with the same etiology. For more severe pain. . . mesenteric lymphadenitis. Modern clinical research supports the view that purgatives may be used for Intestinal abscess at either itage. scaly skin (due to internal constraint leading to stagnation of the nutritive qi in the interior which results in dry blood on the surface). (The upper and middle burners straddle the diaphragm. .6g Benefits dampness. . ASSOCIATED FORMULAS: Coicis. . . . there is localized hardness and heat. in fact. . for conditions with pus. . . with modifications. . . . . . For fully-formed Intestinal abscess without fever. .300g Fructus Forsythiae Suspensae (lian qiao) . Semen Persica (tao ren). . . and a thin. . . . . . . . . . provided that the pattern is one of heat excess.5% yi $ re'n t6ng Source: Standards of Patterns and Treatments (Zheng zhi zhun sheng) Semen Coicis Lachryma-jobi ( y i yi ren) .15-18g Expels pus and reduces swelling.200g Herba Menthae Haplocalycis (bo he). cools the blood and eliminates masses due to blood stasis. and a rapid pulse. . . Cortex Moutan Radicis (mu dan Pi). . . . . add Rhizoma Coptidis (huang lian). Radix Paeoniae Rubrae (chi shao) and Herba cum Radice Violae Yedoensitis (zi h a di ding). g. . . . .I. . CAUTIONS & CONTRAINDICATIONS: This formula is unsuitable for necrotic appendicitis. . pelvic inflammatory disease. an assistant ingredient. . . . . .600g Radix Scutellariae (huang qin). . . . . .?& #L yi $fi zi biii jiiing sZn Source: Essentialsfrom the Golden Cabinet g i n gui yao lue) Semen Coicis Lachryma-jobi ( y i yi ren) . . . . . . . . . . . . . . MODIFICATIONS: a For high fever. . . . and relieves pain. add Rhizoma Corydalis Yanhusuo (yan h suo). . . appendicitis during pregnancy. . . . For qi deficiency. . . . T h e other deputy. . 9 For a palpable mass in the lower abdomen. In fully-formed abscess (after pus has formed) there is a diminution in heat and pain. 6-9g Herba Baijiangcao (bai jiang cao) . and the pulse is tight. Many physicians have. appendicitis with peritonitis.600g Mirabilitum (mang xiao) . The source text prohibits the use of purgatives in treating Intestinal abscesses with pus and a flooding.24-30g Radix Lateralis Aconiti Carmichaeli Praeparata ( j u z i ) . . and infection after vasectomy. eliminates heat. and the pulse is either slippery and rapid or tight. add Flos Lonicerae Japonicae ( j i n yin hua). . taut skin around the abdomen that is soft to the touch. . .9g Semen Trichosanthis (gua lou ren) . . . . . Coicis Decoction from the Standards 3 4. . . . . especially in the Intestines. . . or appendicitis due to parasites. . . . add Radix Angelicae Sinensis (dang gui). . . . . expels pus. .Cool the Diaphragm Powder thereby unclogging the Intestines. and urinary difficulty. the tissues are more relaxed. and reduces abscesses. appendicitis in infants. . . For rough dysenteric diarrhea. For Intestinal abscess with pus. COMMENTARY: I n early-stage Intestinal abscess (before pus has formed) the pain is quite severe. . . . . This formula can be used in treating other conditions with heat and blood stasis in the lower burner. . . What exactly this means has been debated for centuries. . including certain post partum disorders and red-andwhite leukorrhea. . . .

mouth and tongue sores. and is contraindicated during pregnancy and for patients who are very weak. mouth and tongue sores. Mirabilitum (mang xiao). The large dosage of . and dispersing Herba Menthae Haplocalycis (bo he) aids in releasing heat from the upper burner and alleviates the attendant head and throat symptoms. swollen tongue. Herba Lophatheri Gracilis (dm z h he) clears heat from the Lungs and Heart. Spleen. sore throat. and a swollen tongue. It is basically a variation of Regulate the Stomach and Order the Qi Decoction (tho wei cheng qi tang). A dry coating indicates dryness. Radix et Rhizoma Rhei (da hang). May also be prepared as a decoction with a proportionate reduction in dosage. Fructus Forsythiae Suspensae (lian qiao) helps to clear heat from the Lungs and to relieve toxicity. may cause delirious speech. flushed face. Its formulation is believed to be based on a passage in chapter 74 of Basic Questions: "Internal hot pathogenic influences should be treated with salty. With the appropriate presentation. and Radix Glycyrrhizae Uralensis (gan cao). and some gynecological disorders. redness covering the body of the tongue and a yellow coating indicates that heat is firmly established in both the upper and middle burners. scanty urine. sore throat. Dryness due to heat clumping in the yang organs interrupts the smooth flow of qi and causes constipation and dark. COMMENTARY: This formula is used to treat heat and the accumulation of heat in the upper and middle burners. collapsed sores. constipation. cholelithiasis. type B encephalitis. All of these herbs clear the unformed heat above. The downward-draining action of Regulate the Stomach and Order the Qi Decoction (tiao wei cheng qi tang) also helps to guide the heat out from below. Heart. Cool. scanty urine. tongue. delirious speech (in severe cases). Heat in the Stomach and Intestines injures the fluids and prevents them from rising to the mouth. INDICATIONS: Sensation of heat and irritability in the chest and abdomen. The small amount of honey and Radix Glycyrrhizae Uralensis (gan cao) protects the Stomach and prevents the abdominal pain that sometimes accompanies the use of purgatives. meningitis. hypertension. and Fructus Gardeniae Jasminoidis (zhi zi) clears heat from all three burners through the urine. Heat in the Lungs. in severe cases. drain the formed accumulation of yang-brightness heat below. The dosage of Radix et Rhizoma Rhei (da hang) and Mirabilitum (mang xiao) should therefore be reduced or omitted altogether once the constipation has been alleviated. acrid. or white coating. acute conjunctivitis.120 Formulas that Purge Heat Accumulation Preparation: Grind the ingredients into powder and take 6-12g as a draft 2-3 times a day with a small amount of honey and 3g of Herba Lophatheri Gracilis (dan zhu ye). Heat in the chest and diaphragmatic regions produces a sensation of heat and irritability that. or the middle and lower burners. The use of only one of these strategies will not alleviate the condition. red lips. draining the heat and reducing the accumulation. A rapid pulse indicates heat. this formula may be used in treating such biomedically-defined disorders as upper respiratory tract infection. and unformed or blazing heat in the upper burner. pediatric pneumonia. and reduced energy. which treats heat accumulation in the Stomach and Intestines. red tongue body or edges with a dry. dark. cholecystitis. Application of this formula has been extended to the treatment of childhood convulsions. the constituents of Regulate the Stomach and Order the Qi Decoction (tiao wei cheng qi tang). while a slippery pulse indicates clumping due to the accumulation of heat and dryness in the interior. or upon the appearance of mild abdominal pain. This pattern is one of formed or accumulated heat in the middle burner. and a rapid. yellow. and Liver manifests as signs of inflammation in their corresponding sensory organs (the nose. Some practitioners use it for any type of skin disorder due to the accumulation of heat in the upper and middle burners. Heart fire blazing upward produces a flushed face. thirst. nosebleed. red eyes. patch-like rashes. tonsillitis. Commentators differ on the relative importance of each herb in the formula depending on which of the formula's actions is considered to be primary. ANALYSIS OF FORMULA: In this pattern there is both unformed heat above and formed accumulation below. mouth. This formula is appropriate only for conditions of heat excess in the upper and middle burners. furuncles. possibly slippery pulse. and eyes respectively). pus in the stool.'' This formula has a weaker purgative effect than the 'order the qi' formulas. which causes thirst. Actions: Drains fire and unblocks the bowels by clearing the upper burner and draining the middle burner. Radix Scutellariae (hang gin) clears heat from the Lungs and Liver. red lips. Red tongue edges with a white coating indicates that heat is lodged primarily in the upper burner. which requires a strate<gy of simultaneously -. cold [substances] assisted by [those that are] bitter and sweet. CAUTIONS & CONTRAINDICATIONS: The use of this formula can easily injure the Spleen and Stomach qi. and pox where the heat turns into such intense fire that it produces extremely dark.

hence its designation as major. . add Ramulus cum Uncis Uncariae (gou teng) and Cornu Antelopis ( l i n g y a y jiao). . and take in 3-6g doses.30g Gypsum (shi gao). . For constipation due to accumulation of dryness and heat in the Intestines with disturbance of the spirit (indicated by restlessness. . . . . add Radix Bupleuri ( c h i hu) and Fructus Meliae Toosendan (chuan lian zi). severe constipation. add Herba Artemisiae Yinchenhao In the source text. Drains fire and unblocks the bowels. . .18g Mirabilitum (mang xiao) . . . . . . In this condition the pathogenic influence is vigorous in the interior (indicated by the submerged.0. add Rhizoma Coptidis Major Sinking Into the Chest Decoction fen). . .60g Radix Platycodi Grandiflori (jie geng) . The deputies. Because heat has not accumulated below. . . . . . . . hardness. @ For childhood convulsions. .30g Grind the ingredients into a coarse powder and take as a draft in 9g doses. dissolve Mirabilitum (mang xiao) in the strained decoction. @ ASSOCIATED FORMULAS: Clear the Heart and Cool the Diaphragm Powder % !L>4 $ I q k g xZn l i h g ge' sZn Source: Warp and Woof of Warm-febrileDiseases (Wen re jing wei) Fructus Forsythiae Suspensae (lian qiao). trium or the entire abdomen with severe pain that becomes unbearable upon even the slightest amount of pressure. . . This pattern is referred to as clumping in the chest ( j i i xiong zhdng) and arises when heat and internal accumulation of water and fluids clump in the chest. its effects will be felt before morning (and vice versa). . This formula is used for the more severe type.0-1. . . . . and the pain becomes unbearable upon even the slightest pressure. and forceful pulse. . . Radix Scrophulariae Ningpoensis ( m a n s h n ) and Tuber Ophiopogonis Japonici (mai men dong). . . . .6g Radix et Rhizoma Rhei (da huang). a very dry tongue coating. . * For jaundice. . .30g Radix Glycyrrhizae Uralensis (gan cao) . . . . irritability. . . . . . . . . . . . swollen and macerated throat. . . . . . Cools the diaphragm and drains heat. .15-18g Herba Aloes (lu hui) . Radix et Rhizoma Rhei (da h a n g ) and . . * Pill Requiring a Change of Clothes gEng yt wtin Source: Wide-ranging Notes from the First-awakened Studio (Xian xing zhai yi xue guang bi ji) Cinnabaris (zhu sha) . but the normal qi is strong (indicated by the forceful pulse). . . . these symptoms may extend to the lower abdomen. . . . . . . . . ANALYSIS OF FORMULA: The chief ingredient. Clumping inhibits the distribution of fluids throughout the body. . . . .30g Herba Menthae Haplocalycis (bo he) . . Actions: Drains heat and drives out water by flushing downward. . . . .120g Radix Scutellariae (huang qin) . This manifests as severe constipation in the lower parts of the body. red. . . . thirst. . . . and a submerged. . . . . .5g of Radix Euphorbiae Kansui (gun sui) are generally used. . Cook Radix et Rhizoma Rhei (da huang) separately. . and pain in the epigastrium. .30g Fructus Gardeniae Jasminoidis (zhi zi) . cathartic and toxic Radix Euphorbiae Kansui (gun sui). . . . (yin c h n hao) and Tuber Curcumae ( y u jin). tight pulse). . . .3-0. . thus requiring a change of clothing. . . . . . . . . The formula's name is derived from its strong purgative properties: when taken at night. there is fullness. . Tidal fever at dusk is a sign of heat clumping in the interior. . . . . and insomnia). . . . . . . . . thirst. . . . and take warm with powdered Radix Euphorbiae Kansui (gan sui). . . . tidal fever at dusk. Today 9-12g of Radix et Rhizoma Rhei (da huang) and 1. . two types of Sinking into the chest' disorder are described. . and a red tongue with a yellow coating. add Radix Rehmanniae Glutinosae (shng di huang). . in more severe cases. . . . . . . . . For heat toxin collecting in the qi level of the upper burner characterized by unremitting fever. form into pills with a small amount of wine. . the use of purgatives is not required. . . . add Radix Trichosanthis (tian hua For severe mouth sores. and as thirst and a very dry tongue coating above. . . . . . There may also be shortness of breath and irritability.M a j o r S i n k i n g Into the Chest Decoction MODIFICATIONS: @ 121 For severe thirst. . . . .9-12g Preparation: Decoction. . . Its etiology is most commonly attributed to the improper use of purgatives in the treatment of an exterior condition. . . INDICATIONS: Fullness and hardness of the epigas- * For yin deficiency. . tight. . . drives out the accumulation of water and fluids in the chest and abdomen by flushing downward. . . interrupting the flow of qi in the trunk. . Source: Discussion of Cold-induced Disorders (Shang han lun) Radix Euphorbiae Kansui (gun sui) . . . . . . .21-24g Grind the ingredients into a fine powder. . . . In relatively mild cases. . . For qi stagnation with distention and pain in the chest. . . . . @ (huang lian). . . . . . . . . . . short temper. . .

watery. . . . . . . . Some sources recommend adding Radix Platycodi Grandiflori (jie geng) near the end. . or nephritis. . . These include externally-contracted disorders of over six-days duration in which pathogenic heat enters the interior and clumps in the chest (Discussion of Cold-induced Disorders). . . Dryness with vigorous heat in the interior is reflected in the dry. . . delirious speech. . They moisten and soften hard. . Qi and blood deficiency (due to constitutional weakness. it intensifies and injures the fluids. . . . form into pills with 250g of honey. Contraindicated during pregnancy or for very weak patients. . . painful abdominal distention. . . . . . . . . . . . . and firmness with pain that increases upon pressure. which focuses on manifestations below the diaphragm. Major Sinking Into the Chest Pill AjwwL d2 x2n xi6ng whn Source: Discussion of Cold-induced Disorders (Shang han lun) Radix et Rhizoma Rhei (da huang) . . . . Injury to the fluids results in a dry tongue and mouth with thirst. . watery. . .6g Radix Angelicae Sinensis (dang gui) . thirst. . which is also reflected in the abdominal distention. shortness of breath. 2 pieces Radix Glycyrrhizae Uralensis ( . contracted extremities. . . . this formula has a stronger purgative effect and drives out fluids instead of breaking up clumps of qi. . . Actions: Purges heat from the interior and supports the normal qi. As heat (due to cold transforming into heat or a warm-febrile disease) accumulates in the interior. . . . fever. In contrast to the principal formula. . . . . dry stool. . . Green. . . . . yang brightness-stageheat causes fever and delirious speech. yellow or black tongue coating. . . . . . COMMENTARY: Besides the improper use of purgatives. In this name it refers to the formula's effect in stimulating the Stomach qi and promoting the distribution off luids. . . . . there may be hallucinations and "grabbing at the air" or impaired consciousness with frigid. . . and take in 6-12g doses with warm water. . . fullness. . . For clumping in the chest with hardness. . . . combine with Major Order the Qi Decoction (da cheng qi tang).3g Rhizoma Zingiberis Officinalis Recens (sheng jiang) . . . and assist the chief ingredient in driving out the heat and fluids clumped in the chest by way of the stool. . . . . . . . INDICATIONS: Green.9g Radix Platycodi Grandiflori (jie geng) . . ASSOCIATED FORMULA: Yellow Dragon Decoction * & 5% huiing l6ng tiing The color yellow corresponds to the earth and refers to this formula's effect on the central digestive processes controlled by the earth organs. . . . the Stomach and Spleen. . it should be used for acute conditions only. . . . . . . and foul-smelling diarrhea reflects the body's unsuccessful attempt to eliminate the accumulation. black tongue coating. cirrhosis. . .3g Preparation: Decoction. . It should be taken just long enough to obtain results. . . . fullness. . Compared to Major Order the Qi Decoction (da cheng qi tang). or clumping of heat left untreated) . . . and foul-smelling diarrhea. .1759 Mirabilitum (mang xiao) . . . This is heat excess in the interior with qi and blood deficiency. . . .9g Mirabilitum (mang xiao). . 1% Fructus Immaturus Citri Aurantii (zhi shi). . and pain. and should be stopped after a few doses. .3g Radix Ginseng (ren shen) . . . . .9g Fructus Zizyphi Jujubae (da zao) . . . . . Some patients present with constipation or firm. . . . . . other etiologies for clumping in the chest have been identified. this formula may be used in treating such biomedically-defined disorders as exudative pleurisy. . Zhang Zhi-Fu). . . .175g Radix Euphorbiae Kansui (gan sui) . . . . . .Formulas that Purge Heat Accumulation Mirabilitum (mang xiao). . . . . and the accumulation of phlegm-dampness in the diaphragm and chest with clumping of heat in the Stomach and Intestines (according to the modern physician. . . . . . . . .175g Semen Pruni Armeniacae (xing ren) .6g Cortex Magnoliae Officinalis (hou Po). . this formula focuses on manifestations above the diaphragm by incorporating herbs that aid the Lungs. . . . . This leads to internal clumping of heat and fluids which disrupts the qi mechanisms of the yang organs. . . . With the appropriate presentation. . . . . MODIFICATIONS: For acute pancreatitis or intestinal obstruction. . . . a n cao) . . . CAUTIONS & CONTRAINDICATIONS: Because of the strength of this formula and the toxicity of its chief ingredient. Vigorous. stiffness of the upper back and neck. . . . . . a dry tongue and mouth. . . yellow or dry. . while draining and dispersing the clumps due to heat in the trunk. Source: Six Texts on Cold-induced Disorders ( S h g han liu shu) Radix et Rhizoma Rhei (da huang) . form a particularly powerful combination for cleaning out the Intestines. The dragon is said to stimulate the clouds and produce rain. . .30g Grind the ingredients into powder. . . . . . and a deficient pulse. . peritonitis. .250g Semen Descurainiae seu Lepidii (ting li zi) . . and sweating. . . . . lethargy. . abdominal pain that increases upon pressure. . . . . . . . . . Drains heat and drives out accumulation of water. . . a dry. In severe cases. . .

2 Decoction. . . . . . . . COMMENTARY: This formula. adjust and regulate the nutritive and protective qi. .5g Radix et Rhizoma Rhei (da huang) . which makes them particularly useful for treating constipation due to febrile disease. . It also harmonizes the actions of the other ingredients. . yellow or black tongue coating. .39Radix Scrophulariae Ningpoensis (xuan shen) . and the most important aspect of the formula is the draining of heat accumulation. . protect the normal qi. . . Enriches the yin. T h e chief ingredients. . . and focuses more on nourishing the yin. . impaired consciousness and cold. . . . . Radix Platycodi Grandiflori (jie geng).15g Tuber Ophiopogonis Japonici ( m i men dong). dry mouth and throat. . T h e other assistants. . which disseminates the qi. . . . . . . cracked lips. fatigue. . Order the Qi Decoction (da cheng qi tang). . unblocks the flow of qi in the Lungs. . old age. and fluids. . . . SECTION 2 FORMULAS THAT MOISTEN THE INTESTINES AND UNBLOCK THE BOWELS The formulas in this section induce bowel movement by lubricating the Intestines. . The tonifying herbs serve an auxiliary function by preventing further injury to the normal qi. . . . . . . T h e former tonifies the source qi while the latter tonifies the blood. . . . . . and thus the Large Intestine (paired organs). . . . bland. a variation of Major x%njiii huiing 16ng tang Source: Systematic Diflerentiation o f Warm Diseases (Wen bing tiao bian) Radix Rehmanniae Glutinosae (sheng di huang) . . . . augments the qi. and purges. . . . assists the other tonifying ingredients in supporting the normal qi and strengthening the Spleen and Stomach. . this herb possesses a n ascending action which helps to counteract the downward-draining action of the chief ingredients. .Hemp Seed Pill is reflected in the lethargy. This is a very acute condition. . 15g Radix Angelicae Sinensis (dang gui) . . . shortness of breath. In contrast to the principal formula. acute indications of heat accompanied by signs and symptoms of qi and blood deficiency such as fatigue. and thereby hasten recovery. As the condition worsens. In addition. . . . . . . . . there may be hallucinations and. T h e deputies. . . . . . For heat accumulation in the interior with qi and yin deficiency characterized by constipation. . . . shortness of breath. Radix et Rhizoma Rhei (da huang) and Mirabilitum (mang xiao). Fructus Immaturus Citri Aurantii (zhi shi). abdominal distention.150-250g Fructus Immaturus Citri Aurantii (zhi shi). . . . . . . .150-250g Radix et Rhizoma Rhei (da huang). .150-250g Radix Paeoniae (shao yao) . and deficient pulse. . and childbirth. .4. . regulate the disparate actions of the other ingredients. and the deficient pulse. . . . . in the most severe cases (when the normal qi is near exhaustion). . The assistant ingredient. Radix Ginseng (ren shen) and Radix Angelicae Sinensis (dang gui).150-250g Cortex Magnoliae Officinalis (hou Po) . . . . . The other deputies. are an especially powerful combination for draining heat and unblocking the bowels. . which reduces distention and fullness. . . yellow or black tongue coating with cracks. . . qi. . . . . . . the dry. . ANALYSIS O F FORMULA: This formula is designed ASSOCIATED FORMULA: 123 Newly-Augmented Yellow Dragon Decoction $+ $0 -& % 5% to drain heat accumulation while preventing further injury to the normal qi. debility. . . .4. . . . . . . . shortness of breath. . . . contracted extremities. . . .9g Mirabilitum (mang xiao) . . . . . . . . . . MODIFICATIONS: @ For elderly or very weak patients. . . .6g Radix Ginseng (ren shen) . . .5g Stichopus Japonicus (hai shen) . . . This allows the clumping to be eliminated without causing a collapse of the middle qi. . hardness and fullness. . . . . . and oily nature. . . . . . aid the chief ingredients in expelling stool by moving the qi. . . .15g Radix Glycyrrhizae Uralensis (gan cao) . and Cortex Magnoliae Officinalis (hou Po). it has a weaker purgative effect. They contain substances of a sweet. . . . . . . . . . . . and a dry. . omit Mirabilitum (mang xiao). . Rhizoma Zingiberis Officinalis Recens (sheng jiang) and Fructus Zizyphi Jujubae (da zao). . . . . . Hemp Seed Pill R3+& Source: Discussion o f Cold-induced Disorders (Shang han lun) Semen Cannabis Sativae (huo ma ren). . Radix Glycyrrhizae Uralensis (gun cm). drains heat.500-600g Semen Pruni Armeniacae (xing ren) . T h e distinguishing characteristics of this condition are severe. T h e envoy. Delirious speech is a sign of a yang brightness-stage disorder and is also a manifestation of heat injuring the spirit. . . Add ginger juice before taking. . . . . . . . .300-500g . treats a form of yang brightness organ-stage disorder.

. The submerged. yellow tongue coating. . . . . . . .3g Semen Pruni (yu li ren) . . . this formula only lubricates and is used for conditions without excess. directs qi downward and moistens the Intestines. . add Fructus Pruni Mume (wu m i ) . * For intestinal obstruction from roundworms. . and adding herbs that nourish and moisten. take with Tonify the Middle and Augment the Q i Decoction (bu zhong yi qi tang). . also plays an active role as the envoy by moistening the Intestines. Fructus Immaturus Citri Aurantii (zhi shi). * For hemorrhoids. . post partum. . . . . . . . . . promotes the movement of qi. * For severe debility. . make it a relatively mild laxative. . . or purgative properties. One of the deputies. nourishes the yin and harmonizes the interior. . . . . . and unblocks the bowels. . A . dispersing. the remaining fluids seep into the Bladder. May also be prepared as a decoction with a proportionate reduction in dosage. . .8g Semen Pini (song zi ren) . .30g Semen Biotae Orientalis (bai zi ren) . . Available in prepared Actions: Moistens the Intestines. Instead. . . . In contrast to the principal formula which lubricates and drains heat and treats conditions with both excessive and deficient asnects. or for constipation due solely to blood deficiency. . Semen Cannabis Sativae (huo ma ren). causing frequent urination. The excess in the Stomach binds the fluid-depleted Spleen. .3. . it should not be used without modification for treating the very weak. . . . . . . These modifications. breaks up accumulation (especially in the Intestines). however. . The normal dosage is 12g taken with warm water on an empty stomach. INDICATIONS: Constipation with hard stool that is difficult to expel. . . this formula may be used in treating such biomedically-defined disorders as habitual. With the appropriate presentation. used as a medium in forniing the pills. When yin deficiency is accompanied by dryness in the Intestines. . . . . rapid or floating. 120g The source text advises to make a paste from the seeds m and roll in a powder made from ~ & i c a r ~ i uCitri Reticulatae (chen pi). removes fullness and distention. . MODIFICATIONS: * For severe injury to the fluids. Form into small pills with honey and take 50 pills with rice gruel on an empty stomach. . Take in 9g doses 1-2 times a warm water. Honey. which is then unable to distribute fluids to the extremities. COMMENTARY: This formula. The third assistant. . another assistant. . ANALYSIS OF FORMULA: The chief herb. an assistant. . Careful diagnosis is still important. Radix Paeoniae Lactiflorae (bai shao). . . For constipation due to old age or childbirth. . . . . . . Today all the ingredients are ground into powder and formed into pills with honey. . . . Semen Arecae Catechu (bing lang) and Pericarpium Citri Reticulatae (chen Pi). . causing constipation with hard stool that is difficult to expel. and hemorrhoids.Formulas that Moisten the Inbtines and Unblock the Bowels Preparation: Grind the herbs into powder and form into pills with honey. . increase the dosage of Radix et Rhizoma Rhei (da huang) and add Mirabilitum (mang xiao). and a submerged. . and the preference for prescribing the formula in pill form. Radix Paeoniae Lactiflorae (bai shao) is the type of Radix Paeoniae (shaoyao) used. ASSOCIATED FORMULA: Five-Seed Pill Source: Effectiue Formulas from Generations of Physicians (Shi yi de xiao fang) Semen Persicae (iao ren) . . drains heat. frequent urination. because the formula is not appropriate for all types of chronic constipation. . The dry. . is a purgative. . is made by reducing the dosage of those herbs that strongly disperse and purge. a dry. . . yellow tongue coating reflects the depletion of fluids and slight heat in the interior. . . Heat and dryness in the Stomach depletes the fluids in the Spleen. . Contraindicated during pregnancy. . indicating interior stagnation. Radix et Rhizoma Rhei (da huang). The Intestines then become dry. . . a variation of Minor Order the Qi Decoction (xiao cheng qi tang). * For bleeding hemorrhoids. . . . .3g Pericarpium Citri Reticulatae (chen pi) . . * For deficiency of the middle qi. . The other deputy. This is heat-induced dryness in the Stomach and Intestines. . choppy pulse. Cortex Magnoliae Officinalis (hou Po). CAUTIONS & CONTRAINDICATIONS: Because most of the herbs in this formula possess draining. . omit Radix et Rhizoma Rhei (da huang) and add a small amount of Folium Sennae (&n xie ye). . . . * For severe heat accumulation with a yellow tongue coating and a rapid pulse. or post-surgical constipation. Semen Pruni Armeniacae (xing ren). .15g Semen Pruni Armeniacae (xing ren) . . . . add Flos Sophorae Japonicae Immaturus ( h i hua mi) and Radix Sanguisorbae Officinalis (di yu). . rapid pulse is a classic indication of yin deficiency. . . . a floating. . . . add Semen Biotae Orientalis (bai zi ren) and Semen Trichosanthis (gua lou ren). add Semen Persicae (tao ren) and Radix Angelicae Sinensis (dang gui). moistens the Intestines and unblocks the bowels. . . choppy pulse may also appear. . . .

.5-3g Preparation: Decoction. . . .9g Radix Angelicae Sinensis (dang gui). . . . moistens the Intestines. .37. . Take 15g daily. INDICATIONS: Constipation. . . . Radix Rehmanniae Glutinosae (sheng di huang) nourishes the yin. . . blood stasis. . . . dry mouth with a n unquenchable thirst. Benefit the River [Flow] Decoction rmula is derivedfrom its function of Source: Collected Treatises of [Zhang] Jing-Yue Uing yue quan shu) Herba Cistanches (rou cong rong) . . . . T h e qimoving action of Fructus Citri seu Ponciri (zhi ke) reinforces the laxative effect of the formula. and wind (due to blood deficiency). It is also frequently seen after childbirth when the loss of blood injures the yin and depletes the fluids. T h e combination of these herbs is especially effective in cases of constipation with yin deficiency. . . and is indicated for more severe conditions. . . The water is not moved from the Bladder. . . . . The Kidney yang is the foundation of the yang for the entire body. . . and unblocks the bowels. . . . . . . the process of warming and transforming the water is weakened. .9-15g Radix Achyranthis Bidentatae (niu xi). . . .309Semen Cannabis Sativae (huo ma ren) . . . . . . . and prevents the cloying nature of the other herbs from injuring the Spleen and Stomach. . . . . . Actions: Warms the Kidneys. Because its actions are mild it does not always work quickly. .15g Rootlets of Radix Angelicae Sinensis (dung gui wei) . . . . Its functions include controlling the process that transforms and circulates water through the body. . . . . . . . . a d d Radix Anemarrhenae Asphodeloidis (zhi mu) and Rhizoma Polygonati Odorati ( y u zhu). The generation of wind further desiccates the Intestines. . COMMENTARY: This formula may be used in treating many types of constipation associated with debility. This is constipation due to desiccated Intestines (chng ku). .5g Fructus Citri seu Ponciri (zhi ke) . . . . . . . . . clear and copious urine. . . . . . . . . . ANALYSIS OF FORMULA: Semen Cannabis Sativae (huo ma ren) and Semen Persicae (tao ren) contain a n abundance of oils which moisten the Intestines and unblock the bowels. . . . This formula is stronger than the principal formula. For constipation (usually severe) from injury to the Spleen and Stomach due to windheat entering the Intestines. .3g Rhizoma Cimicifugae (shng ma) . . . a common condition among the elderly and debilitated. . . . With the appropriate presentation. . . . . . . . MODIFICATIONS: @ For heat signs. . . . .4. When the Kidney yang and qi are deficient. . . This type of constipation includes aspects of blood deficiency. . . . . . . . 15g Semen Persicae (tao ren) . . . . 15g Radix et Rhizoma Notopterygii (qiang huo) . harmonizes the blood. . . and a thin pulse. . . . Radix Angelicae Sinensis (dang gui) nourishes the blood and moistens the desiccated Intestines. . . . . and a cold sensation in the back. . . . or from improper diet or overwork. thereby aggravating the constipation. resulting in clear and copious urine.6g Rhizoma Alismatis Orientalis (ze xie) . the Spleen and Stomach 3 4 4% -ft riin cKng wiin Source: Discussion of t h Spken and Stomach (Pi wei lun) Radix et Rhizoma Rhei (da huang) . this formula may be used in treating such biomedically-defined disorders as post partum and habitual constipation. . Moistens dryness. . . . but may require extended use for maximum effect. . . . .Moisten the Intestines Pill from Master Shen's Book ASSOCIATED FORMULA: Moisten the Intestines Pill from Discussion of :a1 1%+L riin chiing wiin Source: Master ShnJsBook for Reuering Lij ( S h n shi zun shng shu) Semen Cannabis Sativae (huo ma ren) . .30g Fructus Citri seu Ponciri (zhi ke) .9g Preparation: Grind the ingredients into powder and form into pills with honey. . INDICATIONS: Constipation. the root of this condition. This is constipation due to Kidney yang and qi deficiency. . This same disruption in the normal circulation of water in . . . . .1. a dry tongue. . . lower back pain. . . . .6-9g Radix Angelicae Sinensis (dang gui) . . . The other signs and symptoms are characteristic of yin deficiency with depleted fluids. It should not be prescribed in cases that require purging. . .5g Grind the ingredients into powder and form into pills with honey. . . . Actions: Moistens the Intestines and unblocks the bowels. . lusterless skin and nails. . and disperses wind. . . . . . . . .159Semen Persicae (tao ren) . . . .9g Radix Rehmanniae Glutinosae (shng di huang) . . . . . .

is used to raise the clear yang as a subtle inducement to the descent of the turbid yin. Radix Angelicae Sinensis (dang pi). this formula may be used in treating such biomedically-defined disorders as atonic constipation. and wiry pulse. . . greasy tongue coating. . there is pain and a sensation of cold in that part of the body. relaxes the Intestines and directs the qi downward. add Semen Cannabis Sativae (huo ma ren). it obstructs and constrains the flow of qi in the yang organs. a deputy herb. and chronic arthritis. A small amount of Rhizoma Cimicifugae (sheng ma). . warms the lower back. producing a feeling of cold. . cold in the extremities. . @ To increase the moistening action in the Intestines. Severe constraint from cold may lead to clumping. . For these conditions. cold hands and feet. . . It also has a descending nature which focuses the actions of the formula on the lower burner. When cold accumulates in the middle burner. . and a submerged. strengthens the lower back and Kidneys. . Rhubarb and Prepared Aconite Decoction Source: Essentials from the Golden Cabinet Uin gui yao lue) Radix Lateralis Aconiti Carmichaeli Praeparata (fu zi) . and a submerged. add Radix Ginseng (ren shen) (source text). . . constipation. which causes the qi to rebel upward and produces pain in the hypochondria. COMMENTARY: This formula may be used for Kidney yang and qi deficiency (common in the elderly or debilitated). . or Kidney deficiency with blood and fluid deficiency (common after childbirth). . disperses cold. This is cold accumulation in the interior. The focus of this formula is thus on warming the Kidneys and moistening the Intestines to facilitate the passage of stool. @ For severe deficiency. . . This is different from the chills due . abdominal fullness and distention. it facilitates movement and guides the actions of the other herbs downward. The source text notes that constipation due to deficiency should not be treated with harsh purgatives like Mirabilitum ( m a y xiao) and Radix et Rhizoma Rhei (da huang). and moistens the Intestines to unblock the bowels. Because the lower back is the residence of the Kidneys. . one ascendingland the other descending. omit Rhizoma Alismatis Orientalis (ze xk) and add Fructus Lycii Chinensis (gou qi zi) and Cortex Eucommiae Ulmoidis (du zhong).Formulas that Moisten the Inkstines and Unblock the Bowels the lower burner dries out the Intestines and leads to constipation. SECTION 3 FORMULAS THAT WARM THE YANG AND GUIDE OUT ACCUMULATION The formulas in this section are used in treating accumulation due to cold excess in the interior characterized by constipation. . . Herba Cistanches (rou cong rong). @ For severe lower back pain. especially in the hands and feet. has a descending nature which drains turbidity from the Kidneys. . omit Fructus Citri seu Ponciri (zhi ke) (source text). the assistant herb. . but should be treated with tonics. Fructus Citri seu Ponciri (zhi k e ) . . . the other deputy. the regulation of the Kidney qi mechanism is enhanced. . unblocks the bowels. . tight pulse. . . Rhizoma Alismatis Orientalis (ze xie).9g Herba Asari cum Radice (xi xin) . hypochondriac pain. Actions: Warms the interior. thus helping to unblock the bowels. Deficiency of Kidney yang also deprives the Kidneys of proper nourishment and warmth. (3 pieces) 6-12g Radix et Rhizoma Rhei (da huang) . It also prevents the moistening property of the chief herb from causing stagnation. chills. . low-grade fever. It also interferes with the spreading of yang qi through the body. Radix Achyranthis Bidentatae (niu xi).6g Preparation: Decoction. . With the appropriate presentation. . abdominal pain that responds favorably to warmth. MODIFICATIONS: @ For pronounced qi deficiency. . causing abdominal pain and constipation. . . an envoy. Together with Radix Achyranthis Bidentatae (niu xi). is ideally suited for this condition as it warms and tonifies the Kidney yang. . the other envoy. degenerative joint disease. . . the province of the terminal yin (Liver) channel. . both warming and purging substances must be used together. . nourishes and harmonizes the blood and moistens the Intestines. In combination with Fructus Citri seu Ponciri (zhi ke). . tight. add Radix Scutellariae Baicalensis (huang gin) (source text). INDICATIONS: Abdominal pain. @ For severe Kidney deficiency. . . Cook Radix et Rhizoma Rhei (da huang) with the other herbs. @ For fire. and alleviates pain. ANALYSIS OF FORMULA: The chief herb. . a white. . . . add Radix Rehmanniae Glutinosae Conquitae (shu di huang) (source text).

Herba Asari cum Radice (xi xin).309Rhizoma Zingiberis Officinalis (gun jiang) . For this reason.9g Decoction.6g Rhizoma Zingiberis Officinalis (gun jiang) . . T h e white. . uneven breathing. . . . 1% Radix Ginseng (ren shn) . . . yet there are no other signs of heat. . ANALYSIS OF FORMULA: This formula uses a combination of warming and purging substances: warming substances for interior cold. . . . ASSOCIATED FORMULA: Warm the Spleen Decoction ? & @% . Actions: Harshly purges cold accumulation. The deputy herb. which may give rise to a lowgrade fever. . . With the appropriate presentation. . . . . . . . . . . and uncomplicated intestinal obstruction. T h e cold. . and none of the explanations are completely satisfactory. . . those with both pus and blood in the stool) associated with this pattern. . . the assistant. . .e. . . . The source text advises to take in either powdered or pill form (made with honey). It also enters the Liver channel at the blood level where it assists in the treatment of hypochondriac pain. . . dirty tongue coating. .. wiry pulse. . . . . . @ For severe distention and a thick. and secondarily on the accumulation. . . and a submerged. . . . . . . ulcerative colitis.Three-Substance P i l l for Emergencies 127 to a n exterior condition in which all parts of the body are equally cold. such as Major Order the Q i Decoction (da cheng qi tang). . This is sudden onset of severe cold accumulation. . . . . . Also for chronic red-and-white dysenteric disorders (i. ." rough. . . . bitter nature of Radix et Rhizoma Rhei (da h n ~is)counterbalanced by the acrid. . . uncomplicated appendicitis. greasy tongue coating and the submerged. . .5g doses (reduce for children) with rice water or warm. . . . . This leads to a sudden. abdominal pain. . . . . warm nature of the other herbs. . . . . * For general debility or rather mild accumulation. . and wiry pulse are indicative of cold excess in the interior. a cyanotic complexion. . use treated Radix et Rhizoma Rhei (zhi dQ hang). . uremia. is a powerful substance for expelling cold and dispersing accumulation or clumping. . Add Radix et Rhizoma Rhei near the end. . draining substances for accumulation. there may also be loss of consciousnesswith the mouth tightly closed.30g Preparation: Grind the ingredients into powder and take in 0. . . Others regard it as an indication that the exterior has not been completely released. Warms and tonifies the Spleen yang and purges cold accumulation. add Cortex Cinnamomi Cassiae (rou gui) and Fructus Foeniculi Vulgaris (xiao hui xiang). . It is also cooked with the other herbs. . . . n o bowel movements. . . . . is used here to cleanse the Intestines and purge stagnant accumulation. T h e accumulation of qi leads to stagnation in the Intestines. . . . . For Spleen cold from deficiency with accumulation of cold characterized by constipation. . . tight. this formula focuses primarily on the Spleen deficiency. is the most effective substance in the materia medica for warming the yang and dispelling cold. which is attributed to cold food stagnating in the Stomach and Intestines where it completely obstructs the flow of qi. . . excruciatingly sharp pain in the epigastrium and abdomen. 6g Radix Glycyrrhizae Uralensis (gun cao) . . . . . Radix et Rhizoma Rhei (da huang). I n this case. . . . . INDICATIONS: Sudden epigastric and abdominal pain and distention with pain so intense that it feels "as if an awl is piercing the abdomen. MODIFICATIONS: @ For severe abdominal pain. The chief herb. . Administer with a nasogastric tube for those patients who are unable to open their mouths. . add Fructus Immaturus Citri Aurantii (zhi shi) and Massa Fermentata (shen qu). add Ramulus Cinnamomi Cassiae (gui zhi) and Radix Paeoniae Lactiflorae (bai shao).6-1. . As a variation of Frigid Extremities Decoction plus Ginseng (si ni jia ren shen tang). this formula may be used in treating such biomedically-defined disorders as chronic dysentery. . . tight pulse. because the cold is severe. boiled water. . . . Three-Substance Pill for Emergencies Source: Essentialsfrom the Golden Cabinet Uin gui yao lue) Semen Croton Tiglii (ba d m ) . its dosage is higher than usual. . .30g Radix et Rhizoma Rhei (da huang) . COMMENTARY: There is disagreement concerning the pathogenesis of the fever in this pattern. the dosage of this herb is much lower than in formulas in which it serves as the chief herb. . cold extremities. . and . . . Some believe that it is a manifestation of heat from constraint in the Intestines. . This is a more subtle and complex action than merely draining fire through the stool. * For cold hernial disorders with severe back and groin pain. acrid and hot Radix Lateralis Aconiti Carmichaeli Praeparata ( f u zi).6g Radix Lateralis Aconiti Carmichaeli Praeparata ( f i z i ) . . and directs the actions of the other herbs into the Intestines. yet there are no other signs of a n exterior condition. I n severe cases. wEn pi tang Source: Thousand Ducat Formulas (Qian jin yao fang) Radix et Rhizoma Rhei (da huang) . and a submerged. . . . . . a bluish-purple tongue with white coating. .

characterized by difficulty in urination and defecation. There are generally 5-6 bowel movements after each dose. and toxic properties of the chief herb. . If the patient becomes weak from the effects of the formula. Actions: Purges and drives out congested fluids. T h e other assistant. Take. . . warm and acrid Rhizoma Zingiberis Officinalis (gan jiang). SECTION 4 FORMULAS THAT DRIVE OUT EXCESS WATER T h e formulas in this section are used in treating conditions of excess due to accumulation of water and fluids that obstruct the interior and gather in the chest and abdominal cavities. and often vomiting. tight pulse are indicative of cold excess in the interior. It is contraindicated for weak and pregnant patients and in cases of acute abdominal pain due to heat or summerheat. acrid substances can disperse the accumulation of cold. . . . . . . The source text advises to give the patient warm rice gruel if taking the formula does not induce diarrhea. . For coldphlegm leading to cold excess clumping in the chest characterized by a sensation of extreme fullness and hardness in the chest (possibly extending to the lower . They reduce and eliminate accumulation by unblocking the passage of urine and stool. and disperses clumping. followed by borborygmus and abdominal pain that diminishes after a watery bowel movement. purgative substances which are toxic. . . fishy-smelling sputum. shortness of breath. . cleanses the Stomach and Intestines and moderates the hot. . 1 part Bulbus Fritillariae (bei mu). it may be stopped by taking cool rice porridge. . . and coughing up of turbid. . . . Should produce discomfort in the epigastrium about one hour after administration. . . and thereby protect the Stomach qi. . these formulas are contraindicated during pregnancy. . CAUTIONS & CONTRAINDICATIONS: Semen Croton Tiglii (ba dou) is a toxic substance that should be used with extreme caution. and only harsh purgatives can expel the excess. If the diarrhea becomes severe. and harsh purgative. Ten-Jujube Decoction shi Go tiing The name of this formula is a tribute to the importance of the ten jujubes which are taken to moderate the harsh.in 0. It also revives the Spleen yang. . . . It should only be used in true emergencies. . a white. wiry White Powder w # c b6i siin Source: Discussion of Cold-induced Disorders (Shmg han lun) Radix Platycodi Grandiflori (jie geng) . headache. or cold rice gruel if the diarrhea does not stop. ANALYSIS OF FORMULA: I n this condition only very hot. . . If there are fewer (1-2). is a hot. cold and bitter Radix et Rhizoma Rhei (da hang). The deputy. . COMMENTARY: This is an extremely harsh formula which will induce diarrhea. . . . . another dose may be taken a day or two later. With the appropriate presentation. and a submerged. 3 parts Semen Croton Tiglii (ba dou) . prescribe easily-digested foods (such as rice gruel or oatmeal) and tonics. which is manifested in the abdominal distention and the rough. It is less harsh a purgative than the principal formula. . there may be loss of consciousness with the mouth tightly closed. T h e combination of cold and severe stagnation produces a cyanotic complexion and a bluish-purple tongue. .0g doses with warm water. acute pancreatitis. I n extreme cases. . assists the chief herb in dispelling cold. Semen Croton Tiglii (ba dou).5-1. expels water. acrid. Warmly downward drains. ASSOCIATED FORMULA: abdomen). . INDICATIONS: Cough with pain in the chest and hypochondria. slippery tongue coating. dry heaves. and uncomplicated appendicitis. . transforms phlegm. constipation. vertigo.5-lg doses (may be placed in gelatin capsules) in the early morning on an empty stomach with a warm decoction made from ten pieces of Fructus Zizyphi Jujubae (da zao). . . Both the bluish-purple tongue and the submerged. and should be used with extreme caution in treating weak patients. 3 parts Grind the ingredients into powder and take in 0. and is more effective in treating phlegm and those conditions localized in the chest. this formula may be used in treating such biomedically-defined disorders as food poisoning. downward-draining action of the other herbs. Because they contain harsh. . uneven breathing. . T h e chief herb. acrid. . uncomplicated intestinal obstruction. Source: Discussion (Shang han lun) of Cold-induced Disorders Radix Euphorbiae Kansui (gan sui) Radix Euphorbiae seu Knoxiae (jing da ji) Flos Daphnes Genkwa (yuan hua) Preparation: Grind equal measures of each herb into powder. Begin with low dosage.Formulas that Drive Out Excess Water obstruction of the bowels. . The qi mechanism becomes rebellious and chaotic. which is a life-threatening condition. hard focal distention in the epigastrium.

Harsh purgatives are required to purge the congested fluids from the body. T h e white. This causes the qi to rebel. Since these are toxic substances which easily injure the normal qi. Obstruction of the middle burner causes the Stomach qi to rebel. . Take in 1-3g doses at bedtime with warm water. The Teachings of [Zhu] Dan-Xi recommends that Ten-Jujube Decoction (shi zao tang) be prepared in pill form so that it is easier to take. uremia from systemic lupus erythematosus. Radix Euphorbiae seu Knoxiae (jing d a j i ) drains fluids and dampness from the organs. a loss of desire for food and drink. a tightening sensation in the sinews and bones that evolves into a burning.Vase1 and EhiCle Pill 129 pulse. whereas the principal formula focuses on congested fluids in the chest and hypochondria with pain in these areas. manifested as hard focal distention in this region. fullness in the chest. this formula may be used in treating such biomedically-defined disorders as exudative pleurisy. a condition of excess characterized by generalized edema that is worse in the lower part of the body. unrelenting and severe headache. For phlegm lurking above and below the diaphragm that obstructs the qi mechanism characterized by sudden. CAUTIONS & CONTRAINDICATIONS: This formula should be used with extreme caution in weak or pregnant patients.30g . a sticky. Vessel and Vehicle Pill Because this formula is an extremely harsh and powerjul purgative. and Formulm Related to the Unification of the Three Etiologies (San yin ji yi bing zheng fang lun) Radix Euphorbiae Kansui (gan sui) Radix Euphorbiae seu Knoxiae (jing daji) Semen Sinapis Albae (bai jie zi) Grind equal amounts of each herb into powder and form into small pills. COMMENTARY: This is a very strong formula that should be used only when absolutely necessary. There are three such ingredients in this formula: Radix Euphorbiae Kansui (gun sui) expels fluids and dampness from the channels. congested fluids (xu& yin) clogging up the chest and hypochondriac regions. The word mucus in the formula's name refers to heavy fluids in general. May also be chest pain extending to the back that makes breathing difficult. Patterns. and ascites from cirrhosis. wiry pulse indicates accumulation in the interior and pain. slippery tongue coating is a sign of congested fluids. may extend to the back. the congested fluids collect into clumps. nephrotic syndrome. and the submerged. this formula should be taken in turn with another that strengthens the Spleen and augments the qi: one purges while the other tonifies. . There may also be cold and painful extremities. slippery pulse. If this pattern appears with an exterior condition. In cases with weakness. coughing up of thick. k6ng xi& diin Source: Discussion due to a clogging u p of the entire interior of the body. cold rice porridge should be taken. and a rattling sound in the throat at night or excessive salivation. producing dry heaves. and difficult urination and defecation. excruciating pain in the thorax. producing cough and shortness of breath. greasy tongue coating. . and Flos Daphnes Genkwa (yuan hua)reduces and eliminates congested fluids from the chest and hypochondria. ASSOCIATED FORMULA: Control Mucus Special Pill gx4of Illnesses. . I n relatively mild cases with an exterior condition. While both this and the principal formula treat obstruction of the interior by fluids. When the qi is halted in the epigastrium. it cannot be effectively treated with herbs ordinarily used to transform and leach out congested fluids. or phlegm and congested fluids in particular. Congested fluids are yin in nature and follow the qi. the exterior must be resolved first. sticky sputum. wheezing. Fructus Zizyphi Jujubae (da zao) is added to augment the qi. This is suspended. Obstruction of the flow of qi also produces chest and hypochondriac pain which. Dispels phlegm . ANALYSIS O F FORMULA: Because this condition is With the appropriate presentation. and moderate the harshness and toxicity of the other ingredients. and edema. abdominal distention. If severe diarrhea occurs. . piercing pain. Radix Glycyrrhizae Uralensis (gun cao) is often used to moderate the toxicity of other ingredients. . . However.and expels congested fluids. . in severe cases. and lower back. this formula focuses on the congested fluids and phlegm in the chest and diaphragm with associated widespread pain. protect the Stomach. This formula is also used for edema due to obstruction from accumulation of congested fluids. neck. Source: Collected Teatises o f [Zhang] Jing-Yue Uing yue quan shu) Radix Euphorbiae Kansui (gan sui) . Minor Bluegreen Dragon Decoction (xiao qing long tang) may be used to treat both. and a wiry. lethargy with a desire to sleep. T h e rising of congested fluids disturbs the clear yang and causes headache and vertigo. it is not used here because it is traditionally believed to increase the toxicity of the particular herbs in this formula. abdominal distention. the stools function as a 'vessel and vehicleJfor the removal of accumulation from the body.

30g Radix et Rhizoma Rhei (da huang) . . . . . borborygmus.60g Pericarpium Citri Reticulatae Viride (qing pi) . . ASSOCIATED FORMULA: Stephania. . qi-moving ingredients makes this an extremely powerM formula which should be prescribed only in cases of emergency for persons of otherwise robust health. . . . .30g Semen Zanthoxyli Bungeani (chuan jiao zi) . . promotes urination. . . . Radix Aucklandiae Lappae ( m u xiang) unblocks the flow of qi in the three burners and guides out stagnation. . . . . INDICATIONS: Ascites and distention in a robust patient accompanied by thirst. . Calomelas (qingfen) expels water. . leading to more distention. The resulting turbidity. . . . . The water and heat accumulate and clog the entire abdomen. . . . . this is indicated for less severe conditions of excess with no heat signs. . . dryness of the mouth and tongue. . Semen Arecae Catechu (bing lang) directs the qi downward. thirst. . . formulas which regulate and tonify the Spleen and Kidney should be prescribed to promote full recovery. . and a hard abdomen. . it may be taken again (usually with a reduced dosage) 1-2 days later. . . . . This is water and heat accumulation in the interior obstructing the qi mechanism. are harsh expellants which purge water from the chest and abdomen. . . . . After the acute condition has resolved. Descurainia. . . . . . . . The chief ingredients. . Semen Pharbitidis (qian niu zi) and Radix et Rhizoma Rhei (da huang). . . . . . ANALYSIS OF FORMULA: This is a severe. . . . constipation. Flos Daphnes Genkwa (yuan hua). . . . Take in 3-6g doses on an empty stomach in the early morning with warm water. .15g Radix Aucklandiae Lappae (mu xiang). . . This causes edema and ascites. . . . acute condition in a person of otherwise robust health. . . . . . Otherwise this formula should not be taken more than once. . If the condition improves and the patient remains strong. .120g Radix et Rhizoma Rhei (da huang) . Actions: Promotes the movement of qi and harshly drives out water and heat accumulation. and forceful pulse. COMMENTARY: T h e combination of harsh purgatives and strong. . . . CAUTIONS & CONTRAINDICATIONS: This formula is contraindicated during pregnancy and in persons who are weak. . .Formulas that Drive Out Excess Water Flos Daphnes Genkwa (yuan hua). . . . . whose actions are more direct. . and breaks u p clumping in the abdomen. . The deputies. . Pericarpium Citri Reticulatae (chen pi) promotes movement of the Lung and Spleen qi. . . .. or schistosomiasis. The constraint caused by the obstruction to the flow of qi by water or dampness produces heat. expel water accumulation. Radix Euphorbiae Kansui (gan m i ) . With the appropriate presentation. and a submerged. . . . lacking a n outlet for drainage. . . 15g Semen Arecae Catechu (bing land . . . . . . . . To reduce the ascites and distention.30g Semen Descurainiae seu Lepidii (ting li zi) . Pericarpium Citri Reticulatae Viride (qing pi) spreads the Liver qi and breaks up clumping in the abdomen.30g Radix Euphorbiae seu Knoxiae (jing d a j i ) . . . . 3 g Preparation: Grind the ingredients into powder and form into pills with water. . labored breathing. . . . . . . labored breathing. . the accumulation of water and heat must be harshly purged and driven out of the body. unblocks the bowels. . . and reinforces the actions of the chief and deputy ingredients. .30g Semen Pharbitidis (qian niu zi) . Zanthoxylum. . . . . . . The pulse signs reflect the accumulation of fluids and heat in the interior. helping to smooth the flow of qi in the thoracic and diaphragmatic regions. this formula may be used in treating such biomedically-defined disorders as ascites from cirrhosis. . . Semen Pharbitidis (qian niu zi) also drains water through the urine. a hard abdomen. . . purge heat from the Intestines. In contrast to the principal formula. thereby supporting the chief and deputy ingredients. .15g Calomelas (qing fen) . . . . . .30g Form into pills with honey and take one pill (6-9g each) after meals three times daily. . . and edema with dyspnea. rapid. and Rhubarb Pill z*x%*k jz'jiiio li huhng wiin Source: Essentials from the Golden Cabinet Uin gui yao h e ) Radix Stephaniae Tetrandrae (han fang ji) . the dosage and duration of administration must be carefully regulated. .15g Pericarpium Citri Reticulatae (chen pi) . . . . The assistant ingredients work indirectly to restore the proper flow of qi. Traditional texts discourage the use of Radix Glycyrrhizae Uralensis (gan cao) with this formula as it is incompatible with some of its ingredients. and no deficiency of normal qi. . . and impedes the excretion of urine and stool. . . . Drives out water and scours out congested fluids. For accumulation of water in the Stomach and Intestines with qi stagnation characterized by abdominal distention. obstructing the qi in the Stomach and Intestines. . . . . . produces further clogging and severe stagnation of qi. . Because the formula contains some extremely toxic substances. . scanty urine. . This in turn prevents the proper dissemination of fluids. . . . ascariasis. . .and Radix Euphorbiae seu Knoxiae (jing da ji). and interact synergistically with the chief ingredients. . . . .

131

COMPARATIVE TABLES OF PRINCIPAL FORMULAS

FORMULAS THAT PURGE HEAT ACCUMULATION
COMMON INDICATIONS (first 4): constipation, fever

FORMULA NAME
Major Order the

DIAGNOSIS Yang brightness organ disorder with desiccated stool in the Intestines (middle and lower burners) Early-stage Intestinal abscess from interior clumping of heat and blood (lower burner) Heat and clumping in the diaphragmatic region (upper and middle burners) Clumping of heat and fluids in the chest and epigastrium

INDICATIONS Focal distention, fullness, dryness, hardness, a dry, yellow or dry, black tongue coating with prickles, a submerged, excessive pulse

REMARKS Also for a variety of problems due to heat excess accumulating in the Stomach and Intestines, where it forms clumps.

Qi Decoction (dacheng qi tang)

Rhubarb and Moutan Decoction (da huang mu dan tang)

Lower abdominal distention and pain that increases upon pressure with rebound tenderness, a thin, yellow, and greasy tongue coating, a slippery, rapid pulse Irritability, sensation of heat in the chest, red face, sore throat, nosebleeds, oral ulcerations, yellow or white tongue coating, a rapid, slippery pulse Hardness, fullness, and pain from the epigastrium to the lower abdomen that becomes unbearable with even the slightest pressure, very dry tongue coating, a submerged, tight, and forceful pulse

Also for other conditions due to heat and blood stasis in the lower burner.

Cool the Diaphragm Powder (qing ge san)

Relatively weak purgative. Also for skin disorders.

Major Sinking Into the Chest Decoction (da xian xiong tang)

Very strong purgative that focuses on fluids.

Yellow Dragon Decoction ( h u n g long tang)

Heat excess in the interior with blood and yin deficiency

Green, watery, and foul-smelling diarrhea, abdominal pain that increases upon pressure, fever, a dry, yellow, or black tongue coating, deficient pulse

FORMULAS THAT MOISTEN THE INTESTINES AND UNBLOCK THE BOWELS
COMMON INDICATIONS: constipation

FORMULA NAME
Hemp Seed Pill (ma ti ren wan)

DIAGNOSIS Stomach heat binding the Spleen

INDICATIONS Hard stool that is difficult to expel, frequent urination, a dry, yellow tongue coating, a submerged, rapid or floating, choppy pulse Lusterless skin and nails, parched mouth with an unquenchable thirst, dry tongue, thin pulse Clear and copious urine, lower back pain and cold

REMARKS Requires modification for very weak patients.

Moisten the Intestines Pill from Master Shen's Book (run chang wan) Benefit the River [Flow] Decoction ( j i chuan jian)

Desiccated Intestines

May require extended use.

Kidney yang deficiency

FORMULAS THAT WARM THE YANG AND GUIDE OUT ACCUMULATION
H COMMON INDICATIONS: constipation, abdominal pain, white tongue coating, a submerged, tight pulse

FORMULA NAME Rhubarb and Prepared Aconite Decoction (da huang fu zi tang) Three-Substance Pill for Emergencies (san wu bei ji wan)

DIAGNOSIS Cold accumulation in the interior

INDICATIONS Hypochondriac pain, chills, cold hands and feet, greasy tongue coating, wiry pulse

REMARKS May also be low-grade fever.

Sudden, severe cold accumulation

Sudden, severe pain and distention, cyanotic complexion, bluish-purple tongue

Only used in emergencies.

FORMULAS THAT DRIVE OUT EXCESS WATER
H COMMON INDICATIONS: constipation, distention, submerged pulse

FORMULA NAME
I

DIAGNOSIS
I

INDICATIONS
I

REMARKS Pain may extend to the back.

Ten-Jujube Decoction
(shi zao tang)

Suspended, congested fluids clogging the interior Water and heat ~ccumuiation

Cough with pain in the chest and hypochondria, hard focal distention in the epigastrium, white tongue coating, wiry pulse Ascites and distention, scanty urination, a rapid, forceful pulse

7 1
Vessel and Vehicle Pill @hou che wan)

Only used in emergencies.

CHAPTER FOUR

fiormulas that Harmonize

MONG THE EIGHT methods of treatment, the formulas in this chapter belong to the harmonizing method (hk $3). Although the major harmonizing formulas date back to the late Han-dynasty texts, Discussion of Cold-induced Disorders and Essentials from the Golden Cabinet, formal use of the term did not appear until the Jin-Tartar period with the publication of Clarification of the Theory of Cold-induced Disorders, by Cheng Wu-Ji. Originally referring to lesser yang-stage disorders, this category has since been expanded to include formulas that treat disharmonies of the Liver and Spleen, Gallbladder and Stomach, and Stomach and Intestines. The patterns for which harmonizing formulas are used involve complex processes in different levels of the body, as well as the presence of heat or cold. Treatment of such patterns therefore requires a certain degree of sophistication. The lesser yang stage is most often associated with the Gallbladder, as that organ's channel is a lesser yang channel. Over the years, formulas that regulate and harmonize the relationship

A

between the Gallbladder and its paired yin organ, the Liver, were brought into this category. And because disorders of the Liver and Gallbladder often adversely affect the Spleen and Stomach, formulas that harmonize the relationship between wood (LiverIGallbladder) and earth (SpleenIStomach) were also included. Finally, this category encompasses formulas that regulate and harmonize heat and cold complexes in the Stomach and Intestines. Harmonizing formulas should not be used in treating exterior conditions, as this will cause such conditions to advance to a deeper level. It is also important to remember that the presence of alternating fever and chills is not necessarily indicative of a lesser yangstage disorder. This symptom may also appear in cases of severe organ deficiency or deficiency of both qi and blood. The use of harmonizing formulas will only aggravate these problems. Many cases of LiverISpleen disharmony are due to emotional factors such as difficulty in coping with the stresses of life. In such cases, proper counseling is essential for full recovery.

136

Formulas that Harmonize Lesser Yang-stage Disorders

SECTION 1

FORMULAS THAT HARMONIZE LESSER YANG-STAGE DISORDERS
The lesser yang stage is generally considered to be between the exterior greater yang and the interior yang brightness stages of the six stages of disease. The in-between nature of this stage (characterized as 'halfexterior, half-interior') means halfway between the exterior and the interior, and does not refer to concurrent exterior-interior conditions where the pathogenic influence is lodged in both the exterior and the interior. The dispersing and draining methods utilized in treating greater yang and yang brightnessstage disorders respectively cannot be used in treating lesser yang-stage disorders. Identifying the type of fever will help to differentiate the stage - of the disorder: simultaneous fever and chills indicates a greater yang-stage disorder; fever without chills indicates a yang brightness-stage disorder; alternating fever and chills indicates a lesser yang-stage disorder. The Gallbladder (which corresponds to the leg lesser yang channel) is the organ most closely associated with this stage. A dry throat, bitter taste in the mouth, and sensation of fullness in the hypochondria are symptoms which occur along the course of the leg lesser yang channel. Formulas that treat other externally-contracted conditions with similar signs and symptoms (e.g., heat in the Gallbladder and heat in the membrane source), although not regarded as purely lesser yang-stage disorders, are also included in this section.

Today usually prepared as a decoction in the usual manner. Two-to-three times the dosage of Radix Codonopsis Pilosulae (dang shen) is commonly substituted for Radix Ginseng (ren shen). Today most practitioners reduce the dosage of Radix Bupleuri ( c h i hu) and Rhizoma Pinelliae Ternatae (ban xia) to 12g, honey-fried Radix Glycyrrhizae Uralensis (zhi gan cao) to 6g, and Fructus Zizyphi Jujubae (da zao) to 4 pieces. Available in prepared form. Actions: Harmonizes and releases lesser yang-stage disorders.
INDICATIONS: Alternating fever and chills, dry throat, bitter or sour taste in the mouth, dizziness, irritability, sensation of fullness in the chest and hypochondria (often experienced as difficulty in taking deep breaths), heartburn, nausea and vomiting, reduced appetite, a thin, white tongue coating, and a wiry pulse. This is the lesser yang stage of the six stages of disease, or the half-exterior, half-interior aspect of the eight parameters of disease. At this level the struggle between the pathogenic qi, which is trying to penetrate deeper into the body, and the normal qi, which is trying to force it out, is expressed by three major groups of symptoms. The half-exterior aspect is reflected in the alternating chills and fever and the sensation of fullness in the chest and hypochondria due to heat in the lesser yang channels. The half-interior aspect is reflected in the heat rising upward with a bitter or sour taste in the mouth, a dry throat, and dizziness. The third group of symptoms is associated with the Gallbladder, which is the organ that corresponds to the lesser yang. In this pattern, the Gallbladder qi attacks the Stomach, resulting in heartburn, nausea, vomiting, and reduced appetite. The wiry pulse indicates Liver and Gallbladder involvement. Sometimes the pulse is thin, which is indicative of the stage between the greater yang (floating) and yang brightness (overflowing) stages of disease. ANALYSIS O F FORMULA: The chief herb, Radix

Minor Bupleurum Decoction

4%

* 04
J

: $

xi50 chdi hii tiing
Source: Discussion o f Cold-induced Disorders (Shang han lun) Radix Bupleuri ( c h i hu) . . . . . . . . . . . . . . . . . . . .24g Radix Scutellariae (huang qin). . . . . . . . . . . . . . . . .9g Rhizoma Pinelliae Ternatae (ban xia) . . . . . . . . .24g Rhizoma Zingiberis Officinalis Recens (sheng jiang) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .9g Radix Ginseng (ren shen) . . . . . . . . . . . . . . . . . . . . .9g Honey-fried Radix Glycyrrhizae Uralensis (zhi gan cao). . . . . . . . . . . . . . . . . . . . . . . . . . . . . .9g Fructus Zizyphi Jujubae (da zao). . . . . . . . .12 pieces Preparation: The source text advises to decoct the above ingredients in approximately 12 cups of water until 6 cups remain. The ingredients are removed and the strained decoction is further decocted until 3 cups remain. This is taken warm in three equal doses over the course of one day.

Bupleuri ( c h i hu), is the most important herb for venting lesser yang-stage disorders. When combined with the deputy, Radix Scutellariae (huang qin), which drains heat from the Liver and Gallbladder (the interior aspect of the lesser yang stage), it vents the pathogenic influence and thereby releases lesser yangstage disorders. Radix Bupleuri ( c h i hu) also spreads the Liver qi with an ascending, cooling action (contrary to most cooling, which causes things to descend). This combination therefore drains the heat without causing it to sink deeper into the body. One of the assistants, Rhizoma Pinelliae Ternatae (ban x i . , warms and transforms phlegm and turbidity in the middle burner. When combined with another

Minor Bupleurum Decoction
assistant, Rhizoma Zingiberis Officinalis Recens (sheng jiang), it harmonizes the middle burner, directs rebellious qi downward, and stops nausea and vomiting. The remaining assistants, Radix Ginseng (ren shen), honey-fried Radix Glycyrrhizae Uralensis (zhi gan cm), and Fructus Zizyphi Jujubae (da zao), support the normal qi and thereby prevent the pathogenic influence from penetrating into the interior. Honey-fried Radix Glycyrrhizae Uralensis (zhi gan cm) and Fructus Zizyphi Jujubae (da zao) also moderate the acrid, dry properties of Rhizoma Pinelliae Ternatae (ban xia) and Rhizoma Zingiberis Officinalis Recens (sheng jiang). The combination of Rhizoma Zingiberis Officinalis Recens (shengjiang) and Fructus Zizyphi Jujubae (da ulo) mildly regulates the nutritive and protective qi, and assists Radix Bupleuri (chi hu) in releasing the half-exterior aspects of this condition. COMMENTARY: In the Discussion of Cold-induced Disorders, the common methods of treating externallycontracted diseases are inducing sweating (to release the exterior) and purging or inducing vomiting (to expel interior accumulations). However, for the condition described above, these approaches are inappropriate. The pathogenic influence is lodged too deeply in the interior to be released by sweating, which would only injure the fluids and the normal qi. Yet the condition is not deep enough to justify purging, which would injure the yin and could lead to palpitations with anxiety. And because there is no excess in the chest, inducing vomiting would injure the yang of the chest and could lead to palpitations. Therefore a different, harmonizing approach is necessary. This formula, with its many applications, is mentioned over 30 times in Discussion of Cold-induced Disorders and Essentials from the GoMen Cabinet. Chapter 101 of Discussion of Cold-induced Disorders underscores the wide applicability of this formula. There it states that in patients with injury from cold or wind attack, only one of the symptoms of the Minor Bupleurum Decoction ( c h i hu tang) pattern is needed to make the diagnosis. Another disorder for which this formula is prescribed in these books is heat entering the chamber of the blood. This condition is characterized by alternating fever and chills, dry throat, and discomfort in the hypochondria in women. This is commonly due to colds contracted after childbirth or during menstruation. Clinically, the therapeutic scope of this formula has been greatly expanded over the centuries to include a wide variety of problems associated with the presentation above, but which have not necessarily progressed through the stages of an externallycontracted disorder. Today it is thought that any condition which possesses the salient characteristics of this presentation can be regarded as a lesser yang condition. These conditions are not located in a set

137

place in the body and their presentations are typically unpredictable. Modern physicians have used this formula and its modifications in treating a myriad of problems including childhood diarrhea, habitual constipation, renal colic, acute rheumatic fever, malaria, and gastritis from reflux of bile. There is a large discrepancy between the dosage of Radix Bupleuri (chi hu) prescribed in the source text and that used by most modern practitioners. In part, this is due to a fear of that herb passed on to later generations by the famous physician and chief architect of the warm-febrile disease school, Y e Tian-Shi. Y e believed that it was a dangerous herb that "plunders the yin," and should therefore be used sparingly. This is a source of fierce debate today, and many practitioners believe that while a relatively large dosage of the herb is quite safe for most patients, it should be used with caution in patients with yin deficiency. With the appropriate presentation, this formula may be used in treating such biomedically-defined disorders as upper respiratory tract infection, influenza, bronchitis, pulmonary tuberculosis, epidemic parotitis, jaundice, malaria, acute viral hepatitis, post partum fever, acute pyelonephritis, cholecystitis, lymphadenitis, and intercostal neuralgia. CAUTIONS & CONTRAINDICATIONS: This formula has an ascending action which can injure the qi and cause headache, dizziness, and bleeding of the gums if taken long-term. These side-effects can be reduced or eliminated if the formula is prepared according to the directions in the source text. For the same reason, unless considerably modified, it is contraindicated in patients with excess above and deficiency below, Liver fire, or bleeding of the gums. Use with caution in cases of ascendant Liver yang, hypertension, or vomiting of blood due to yin deficiency. Patients with relatively weak normal qi may experience fever and chills while taking this formula because the pathogenic influence is vented from the lesser yang stage via the greater Yaw. MODIFICATIONS: * For pronounced thirst, omit Rhizoma Pinelliae Ternatae (ban xia) and add Radix Trichosanthis Kirilowii (tian hua fen). * For abdominal pain, omit Radix Scutellariae (huang gin) and add Radix Paeoniae Lactiflorae (bai sho). * For rough, scanty, dark, and painful urination, add Herba Lysimachiae (jin qian cao) and Herba Hedyotidis Diffusae (bai hua she she cao). * For fever, aversion to wind, headache, a stifling sensation in the chest, constipation, loss of appetite, dark urine, irritability, thirst, a yellow tongue coating, and a tight pulse, add Semen Cannabis Sativae (huo

Formulas that Harmonize Lesser Yang-stage Disorders

ma ren) and Fructus Immaturus Citri Aurantii (zhi shi).
For fever, coughing of yellow sputum, and chest pain, add Radix Platycodi Grandiflori (jie geng), Fructus Trichosanthis (gua Lou) and Bulbus Fritillariae Cirrhosae (chuan bei mu). For malarial disorders, add H e r b a Artemisiae Annuae (qing hao) and Radix Dichroae Febrifugae (chang shan). For vertigo, add Flos Chrysanthemi Morifolii ( j u hua), Ramulus cum Uncis Uncariae (gou teng) and Semen Cassiae (jue ming zi). For coughs that are more severe around midnight, alternating fever and chills, and a bitter taste in the mouth, add Rhizoma Zingiberis Officinalis (gan jiang), H e r b a cum Radice Asari (xi xin) and Fructus Schisandrae Chinensis ( w u wei zi). This application was pioneered by the Qing-dynasty physician, Chen Xiu-Yuan, who also used it to treat coughs that did not respond to other treatment. * For urinary tract infection with chills, fever and urgent, frequent urination, take with Six-Ingredient Pill with Rehmannia (liu wei di huang wan). This was developed by the famous twentieth-century physician, Yue Mei-Zhong.

* *

*

Radix Bupleuri (chi hu) . . . . . . . . . . . . . . . . . . . . . . . . 8g Radix Scutellariae (huang qin) . . . . . . . . . . . . . . . . . . . . .3g Radix Ginseng (ren shen) . . . . . . . . . . . . . . . . . . . . . . . . .3g Honey-fried Radix Glycyrrhizae Uralensis (zhi gan cao) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .3g Rhizoma Zingiberis Officinalis Recens (sheng jiang) . . . . . . . . . . . . . . . . . . . . . . . . . .. . . . . . . .3g Rhizoma Pinelliae Ternatae (ban xia) . . . . . . . . . . . . . . .3g Fructus Zizyphi Jujubae (da zao) . . . . . . . . . . . . . . 4 pieces Mirabilitum (mang xiao) . . . . . . . . . . . . . . . . . . . . . . . . . .6g Harmonizes and releases the lesser yang, softens hardness, and drains downward. For constipation and fullness in the chest and hypochondria with vomiting and alternating fever and chills (fever more pronounced in the afternoon). Often caused by inappropriate purging which injures the Stomach yin.

Bupleurum, Bitter Orange, and Platycodon Decoction

2% -&a. : 4

ch6i hii zhi jii tiing
Source: Comprehensive Medicine According to Mmter Zhang (Zhang shi yi tong) Radix Bupleuri (chi hu) . . . . . . . . . . . . . . . . . . . . . . . .4.5g Fructus Citri Aurantii (zhi ke) . . . . . . . . . . . . . . . . . . .4.5g Ginger-fried Rhizoma Pinelliae Ternatae (jiang ban xia) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .4.5g Rhizoma Zingiberis Officinalis Recens (sheng jiang) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .3g Radix Platycodi Grandiflori (jie geng) . . . . . . . . . . . . . .3g Radix Scutellariae (huang qin). . . . . . . . . . . . . . . . . . . .4.5g Pericarpium Citri Reticulatae (chen pi) . . . . . . . . . . . .4.5g Harmonizes and releases the lesser yang and promotes the smooth flow of qi in the chest and diaphragm. For alternating fever and chills, headache in the lateral aspect of the forehead, diminished hearing, vertigo, fullness and pain in the chest and hypochondria, a white tongue coating, a wiry, slippery pulse on the right, and a wiry, floating, and large pulse on the left.

*a

ASSOCIATED FORMULAS:

Bupleurum and Cinnamon Twig Decoction

%&I*&%
ch6i hii gui zhz tiing
Source: Discussion of Cold-induced Disorders (Shang han lun) and Essentials from the Golden Cabinet Uin gui yao lue) Ramulus Cinnamomi Cassiae (gui zhi) . . . . . . . . . . . .4.5g Radix Scutellariae (huang qin). . . . . . . . . . . . . . . . . . . .4.5g Radix Ginseng (ren shen) . . . . . . . . . . . . . . . . . . . . . . ..4.5g Radix Glycyrrhizae Uralensis (gan cao) . . . . . . . . . . . . .3g Rhizoma Pinelliae Ternatae (ban xia) . . . . . . . . . . . . .6-9g Radix Paeoniae (shao yao) . . . . . . . . . . . . . . . . . . . . . ..4.5g Radix Bupleuri ( c h i hu). . . . . . . . . . . . . . . . . . . . . . . . .12g Rhizoma Zingiberis Officinalis Recens (sheng jiang) .4.5g Fructus Zizyphi Jujubae (da zao) . . . . . . . . . . . . . . 6 pieces Today Radix Paeoniae Lactiflorae (bai shao) is the form of Radix Paeoniae (shao yao) that is commonly used. Releases the muscle layer and exterior and harmonizes and releases lesser yang-stage disorders. For lesser yangstage disorders where the exterior has not been completely released, and joint pain with a 'crackling' sensation (due to wind in the joints). May also be used for epigastric pain due to Liver and Spleen disharmony (increase the dosage of Radix Paeoniae Lactiflorae [bai shao] by 2-3 times). Available in prepared form.

Bupleurum, Cinnamon Twig, and Ginger Decoction

s. $4 & & + g 3,

ch6i hii gui zhx giin jiiing tiing Source: Discussion of Cold-induced Disorders (Shang han lun) Radix Bupleuri (chi hu) . . . . . . . . . . . . . . . . . . . . . . . .24g Ramulus Cinnamomi Cassiae (gui zhi) . . . . . . . . . . . . .9g Rhizoma Zingiberis Officinalis (gan jiang). . . . . . . . . . .6g

Bupleurum Decoction plus Mirabilite % 44 &J % 3-if 5%
ch6i hii jiii mhng xitio tang Source: Discussion of Cold-induced Disorders (Shang han lun)

Radix Trichosanthis Kirilowii (tian hua fen) . . . . . . . . . 12g Radix Scutellariae (huang qin) . . . . . . . . . . . . . . . . . . . . .9g Concha Ostreae (mu li) . . . . . . . . . . . . . . . . . . . . . . . . . .6g Honey-fried Radix Glycyrrhizae Uralensis (zhi gan cao) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . ..6g The method of preparation in the source text is the same as that for the principal formula. Harmonizes .and releases the lesser yang, disperses clumping, warms the interior, and dispels cold. Generally used for lesser yang-stage

Major Bupleurum Decoction
disorders with congested fluids characterized by a sensation of fullness with clumping in the hypochondria, urinary difficulty, thirst, sweating from the head, alternating fever and chihs, and a sensation of irritability in the chest. Also used for malarial disorders with chills predominant, or chills without fever. Available in prepared form.

139

Bupleurum Decoction to Clear Dryness

+ i j $ @ %
c E i hii qZng z5o tang Source: Discussion of Epidemic Warm Diseases (Wen yi lun) Radix Bupleuri (chi hu) . . . . . . . . . . . . . . . . . . . . . . .6-12g Radix Scutellariae (huang qin) . . . . . . . . . . . . . . . . . .4.5-9g Honey-fried Radix Glycyrrhizae Uralensis (zhi gan cao) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .3-6g Rhizoma Zingiberis Officinalis Recens (sheng jiang) . . . . . . . . . . . . . . . . . . . . . . . . . . . . .2-4 slices Fructus Zizyphi Jujubae (da zao) . . . . . . . . . . . .4-6 pieces Pericarpium Citri Reticulatae (chen Pi) . . . . . . . . . . . .6-9g Radix Trichosanthis Kirilowii (tian h u a f n ) . . . . . . . .9-12g Radix Anemarrhenae Asphodeloidis (zhi mu). . . . . .9-12g The source text does not specify dosage. Harmonizes and releases the lesser yang, clears heat, and generates fluids. For heat entering the membrane source that has been improperly treated, causing incomplete clearing of heat and injury to the fluids.

Bupleurum and Four-Substance Decoction

?$ t;l w & !I 3 8
chiii h G si wii tiing Source: Collection of Writings on the Mechanisms of h t s s , ,Suitability of Qi, and the Safguarding of Liji as Discussed in Basic Qustions (Su wen bing ji qi yi bao ming ji) Radix Bupleuri ( c h i hu) . . . . . . . . . . . . . . . . . . . . . . . .24g Radix Scutellariae (huang qin) . . . . . . . . . . . . . . . . . . . . .9g Rhizoma Pinelliae Ternatae (ban xia) . . . . . . . . . . . . . . .9g
Honey-fried Radix Glycyrrhizae Uralensis (zhi gan cao) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .9g Radix Ginseng (ren shen) . . . . . . . . . . . . . . . . . . . . . . . . .9g Radix Paeoniae Lactiflorae (bai shao) . . . . . . . . . . . . . .45g Radix Rehmanniae Glutinosae Conquitae (shu di huang) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .45g Radix Angelicae Sinensis (dang gui) . . . . . . . . . . . . . . .45g Radix Ligustici Chuanxiong (chuan xiong) . . . . . . . . . .45g The source text advises to grind the herbs into powder and take as a draft in 9-12g doses. Today it is prepared as a decoction with a proportionate reduction in dosage. For externally-contracted pathogenic influences which penetrate to the terminal yin stage, characterized by pain extending from the chest to the back and alternating fever and chills, with the symptoms often becoming worse at night. There may also be a pale tongue with dark-purple spots, and a wiry, thin pulse, which are signs of both blood deficiency and stasis. Also used for chronic consumptive disorders with alternating (slight) fever and chills, and colds contracted during menstruation.

Major Bupleurum Decoction

~ $ 3 4
dii chiii hii tiing Source: Discussion of Cold-indwed Disorders (Shang han lun)
Radix Bupleuri (chi hu) . . . . . . . . . . . . . . . . . . . .24g Radix Scutellariae (huang qin) . . . . . . . . . . . . . . . . .9g Fructus Immaturus Citri Aurantii (zhi shi) . . . .6-9g Radix et Rhizoma Rhei (da huang) . . . . . . . . . . . .6g Radix Paeoniae Lactiflorae (bai shao) . . . . . . . . . .9g Rhizoma Pinelliae Ternatae (ban xia) . . . . . . . . .24g Rhizoma Zingiberis Officinalis Recens (sheng jiang) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 15g Fructus Zizyphi Jujubae (da zao). . . . . . . . .12 pieces Preparation: The source text advises to decoct the ingredients in approximately 12 cups of water until six cups remain. The ingredients are removed and the strained decoction is further decocted until three cups remain. This is taken warm in three equal doses over the course of one day. Today usually prepared as a decoction in the usual manner. The above dosage is based on the source text. Today most practitioners use 12-15g of Radix Bupleuri (chi hu) and Rhizoma Pinelliae Ternatae (ban xia), 6-9g of Rhizoma Zingiberis Officinalis Recens (shengjiang), and four pieces of Fructus Zizyphi Jujubae (da zao). Available in prepared form. Actions: Harmonizes and releases the lesser yang, and drains internal clumping due to heat.
INDICATIONS: Alternating fever a n d chills, fullness

Bupleurum and Calm the Stomach Decoction

*?%
ch6i ping tiing
Source: Enumeration of Formulas Omitted from the Inner Classic (Neijing shi yi fang lun) Radix Bupleuri (chi hu) . . . . . . . . . . . . . . . . . . . . . . . . .6g Radix Scutellariae (huang qin). . . . . . . . . . . . . . . . . . . .4.5g Rhizoma Pinelliae Ternatae (ban xia) . . . . . . . . . . . . . . .3g Radix Glycyrrhizae Uralensis (,an cao) . . . . . . . . . . . .1.5g Radix Ginseng (ren shen) . . . . . . . . . . . . . . . . . . . . . . . . .3g Pericarpium Citri Reticulatae (chen Pi) . . . . . . . . . . . . 1.5g Rhizoma Atractylodis (cang zhu) . . . . . . . . . . . . . . . . .4.5g Cortex Magnoliae Officinalis (hou Po) . . . . . . . . . . . . . .3g Harmonizes and releases the lesser yang, expels darnpness, and harmonizes the Stomach. For malarial disorders due to dampness with alternating fever and chills (chills predominant), generalized body aches, a sensation of heaviness in the limbs, loss of appetite, and a soggy pulse.

i n t h e chest a n d hypochondria (with o r without pain), a bitter taste i n t h e mouth, nausea, continuous vomiting, h a r d focal distention o r fullness a n d pain i n t h e epigastrium, b u r n i n g d i a r r h e a o r n o bowel movements, despondency, slight irritability, a yellow tongue coating, a n d a wiry, forceful pulse.

140

F o m h that Harmonize Lesser Yang-stage Disorders
beris Officinalis Recens (sheng jiang) and Fructus Zizyphi Jujubae (da zao) mildly regulates the nutritive and protective qi, and assists in the release of the pathogenic influence.
COMMENTARY: This formula also appears in Essen-

This is a concurrent lesser yang and yang brightness-stage disorder. The alternating fever and chills, sensation of fullness in the chest and hypochondria, bitter taste in the mouth, vomiting, and wiry pulse are indicative of a lesser yang-stage disorder. The sensation of firm masses or distention and pain in the epigastrium, absence of bowel movements or hot, burning diarrhea, yellow coating on the tongue, and forceful pulse are indicative of a yang brightness organstage disorder. It is not uncommon to find a flooding or excessive pulse. The symptoms of uncontrolled vomiting, despondency, and irritability will be more severe than the occasional vomiting and irritability associated with a purely lesser yang condition. In terms of organ-pattern differentiation, this condition is viewed as heat excess in the Gallbladder and Stomach. One of the key symptoms from this perspective is the continuous vomiting. This reflects the concept that vomiting is not an intrinsic problem of the Stomach, but only occurs when the Stomach is attacked by Gallbladder qi.
ANALYSIS O F FORMULA: The chief herb, Radix

Bupleuri (chi hu), vents the lesser yang. When combined with the deputy, Radix Scutellariae (huang qin), its ability to clear heat from the Liver and Gallbladder is strengthened. Another deputy, Fructus Immaturus Citri Aurantii (zhi shi), a strong regulator of qi movement, breaks up qi stagnation and reduces focal distention and fullness in the chest and abdomen. When combined with Radix Bupleuri (chi hu),its ability to facilitate the flow of qi is greatly strengthened. The third deputy, Radix et Rhizoma Rhei (da huang), drains heat excess from the Gallbladder and Stomach through the Intestines, transforms blood stasis, and facilitates the flow of bile. When combined with Fructus Immaturus Citri Aurantii (zhi shi), it drains the clumping of heat in the interior. One of the assistants, Radix Paeoniae Lactiflorae (bai sho), nourishes the blood, softens the Liver, and treats abdominal pain and distention. In concert with Fructus Immaturus Citri Aurantii (zhi shi) and Radix et Rhizoma Rhei (da huang), it treats the pain from excess in the abdomen. The other assistant, Rhizoma Pinelliae Ternatae (ban xia), harmonizes the middle burner and directs the rebellious Stomach qi downward. When combined with one of the envoys, Rhizoma Zingiberis Officinalis Recens (sheng jiang), it effectively stops the vomiting. The other envoy, Fructus Zizyphi Jujubae (da zao), strgngthens the ability of Radix Paeoniae Lactiflorae (bai shao)to soften the Liver and reduce abdominal spasms. This combination also protects the yin from injury by pathogenic heat, and from the harsh draining properties of Radix et Rhizoma Rhei (da huang) and Fructus Immaturus Citri Aurantii (zhi shi). The combination of Rhizoma Zingi-

tials from the Golden Cabinet. Used for concurrent lesser yang and yang brightness organ-stage disorders, it is based on two formulas which separately treat each of these single-stage conditions: Minor Bupleurum Decoction (xiao chi hu tang) for lesser yang-stage, and Major Order the Qi Decoction (da cheng qi tang) for yang brightness organ-stage disorders. Radix Ginseng (ren shen) and honey-fried Radix Glycyrrhizae Uralensis (zhi gan cao) are omitted to prevent the tonifying and cloying properties of these herbs from obstructing the flow, thereby aggravating the problems of vomiting and defecation. Since the abdominal pain is more severe than the distention, Cortex Magnoliae Officinalis (hou $0) and Mirabilitum (mang xiao) are omitted, and Radix Paeoniae Lactiflorae (bai shao), which reduces spasms and alleviates pain, is added. Although purging is generally inappropriate for lesser yang-stage disorders, concurrent lesser yang and yang brightness organ-stage conditions require the use of purgatives to attack the interior aspect of the problem. This formula may be used to treat either diarrhea (due to accumulation of heat in the Intestines) or constipation. It may also be used for Liver and Gallbladder fire causing headache, tinnitus, diminished hearing and vision, red eyes, manic behavior, or palpitations with anxiety if the presentation also includes epigastric fullness and pain, a bitter taste in the mouth, a red tongue with yellow coating, and a fast, wiry pulse. In contrast to Bupleurum Decoction plus Mirabilite (chi hu jia mang xiao tung), this formula focuses more on disorders of excess with hard focal distention of the epigastrium and an absence of injury to the Stomach qi. With the appropriate presentation, this formula may be used in treating such biomedically-defined disorders as acute gastroenteritis, gastrointestinal flu, dysentery, cholecystitis, cholelithiasis, acute pancreatitis, hepatitis, pleurisy, peritonitis, migraine headache, trigeminal neuralgia, malignant hypertension, and malaria (especially with fever predominant).
MODIFICATIONS:
@ For marked chest and epigastric pain and distention, add Radix Aucklandiae Lappae (mu xiang), Tuber Curcumae (yu jin) and Herba Artemisiae Yinchenhao (yin chen). For severe abdominal pain, add Rhizoma Corydalis Yanhusuo ban hu suo), Radix Linderae Strychnifoliae (wuyao) and Rhizoma Cyperi Rotundi (xiangfu). For uncontrolled, continuous vomiting, add
@ @

Artemisia A n m and Scutellaria Decoction to Clear the Gallbladder
Rhizoma Coptidis (huang lian) and Fructus Evodiae Rutaecarpae (wu zhu yu). For manic behavior due to Liver fire, add Indigo Pulverata Levis (qing dai), Fructus Gardeniae Jasminoidis (zhi zi), Cortex Moutan Radicis ( d m Pi) and Mirabilitum (mang xiao). For acute jaundice, add Fructus Gardeniae Jasminoidis (zhi zi) and Cortex Phellodendri (huang bai). For marked chills, add Herba Ephedrae (ma huang), Fructus Forsythiae Suspensae (lian qiao) and Semen Phaseoli Calcarati (chi xiao dm). For acute cholecystitis, add Flos Lonicerae Japonicae Cjin yin h a ) , Fructus Forsythiae Suspensae (lian qiao), Herba Taraxaci Mongolici cum Radice (Pu gong ying) and Herba cum Radice Violae Yedoensitis

141

*

* * *

Radix Bupleuri ( c h i hu). . . . . . . . . . . . . . . . . . . . . . . . .15g Radix Scutellariae (huang qin) . . . . . . . . . . . . . . . . . . . . .9g Rhizoma Picrorhizae (hu huang lian) . . . . . . . . . . . . . . . .9g Radix Paeoniae Lactiflorae (bai shao) . . . . . . . . . . . . . .15g Radix Aucklandiae Lappae (mxiang) [add near end] . . . . . . . . . . . . . . . . . . . . . .9g Rhizoma Corydalis Yanhusuo b a n hu suo). . . . . . . . . . .9g Radix et Rhizoma Rhei (du huang) [add near end] . . .15g Mirabilitum (mang xiao) [add to strained decoction] . .9g Clears and drains heat excess, spreads the Liver qi, promotes the movement of qi, and alleviates pain. For stabbing, diffuse pain in the epigastrium that extends to the back, loss of appetite, alternating fever and chills, pain in the abdomen, and constipation. This presentation most commonly occurs during acute pancreatitis. Although there are many formulas by this name in modern China (all of which are used to treat acute pancreatitis), this is the best known.

* For gallstones, add Herba Lysimachiae Cjin qian cao), Folium Pyrrosiae (shi wei) and Spora Lygodii Japonici ( h i jin sha). * For pancreatitis, take with Pinellia Decoction to
Drain the Epigastrium (ban xia xie xin tang). * For intercostal neuralgia, take with Minor Sinking into the Chest Decoction (xiao xian xiong tang).
ASSOCIATED F O R M U L A S :

(zi h a di ding).

Artemisia Annua and Scutellaria Decoction to Clear the Gallbladder

$$ *&

qg 3%

"P

hiio qin qTng dtin tiing
Source: Revised Popular Guide to the Discussion of Coldinduced Disordm (Chong ding tong xu shang han iun) Herba Artemisiae Annuae (qing hao). . . . . . . .4.5-6g Radix Scutellariae (huang qin) . . . . . . . . . . . . .4.5-9g Caulis Bambusae in Taeniis (zhu ru) . . . . . . . . . . .9g Fructus Citri Aurantii (zhi ke) . . . . . . . . . . . . . . .4.5g Pericarpium Citri Reticulatae (chen pi). . . . . . . .4.5g Rhizoma Pinelliae Ternatae (ban xia) . . . . . . . . .4.5g Sclerotium Poriae Cocos Rubrae (chifu ling) . . . .9g Jasper Powder (bi yu san) . . . . . . . . . . . . . . . . . . . .99Preparation: Decoction. The last ingredient is a powder made up of six parts Talcum (hua shi), one part Radix Glycyrrhizae Uralensis (gan cao), and one part Indigo Pulverata Levis (qing h i ) . It is discussed in chapter 2, and should be placed in a cheese cloth bag and cooked with the other ingredients. Actions: Clears Gallbladder heat, harmonizes the Stomach qi, and transforms phlegm.

Seven-Substance Decoction with Magnolia Bark

/5 4 2 #6 3
h5u p5 qT wii tang
Source: Essentialsfrom the Golden Cabinet

gin gui yao

he)

Cortex Magnoliae Officinalis (hou po) . . . . . . . . . . . . .24g Radix Glycyrrhizae Uralensis (gan cao) . . . . . . . . . . . . .9g Radix et Rhizoma Rhei (du huang) . . . . . . . . . . . . . . . . .9g Fructus Immaturus Citri Aurantii (zhi shi) . . . . . . . . . .9g Rarnulus Cinnamomi Cassiae (gui zhi) . . . . . . . . . . . . .6g Rhizoma Zingiberis Officinalis Recens (sheng jiang) . . 15g Fructus Zizyphi Jujubae (da zao) . . . . . . . . . . . . .12 pieces Dosage is based on the source text. Today 15g of Cortex Magnoliae Officinalis (hou Po), 6g of Radix Glycyrrhizae Uralensis (gan cao), 12g of Rhizoma Zingiberis Officinalis Recens (sheng jiang), and four pieces of Fructus Zizyphi Jujubae (da zao) are used. Releases the muscles and the exterior, promotes the movement of qi, and unblocks the bowels- For externally-contracted disorders where the exterior is not yet resolved, but an interior excess has already developed. Manifestations include a sensation of fullness in the abdomen, fever, no bowel movements, and a floating, rapid pulse. In contrast to the principal formula, this is indicated for concurrent greater yang and yang brightness-stage disorders, focusing on the interior aspect.

INDICATIONS: Mild chills alternating with pro-

Clear the Pancreas Decoction

$j @ , 3%
qTng yi tiing
Source: Combined Chinese and Western Medical qeatment of the Acute Abdomen (Zhong xi yi jie he zhi liao ji fu zheng)

nounced fever, a bitter taste in the mouth, a stifling sensation in the chest, spitting u p bitter or sour fluids (or vomiting yellow, brackish fluids, or, in severe cases, dry heaves), thirst with o r without a desire to drink, distention and pain in the chest and hypochondria, a red tongue with a thick, greasy coating that can be yellow or white (or a combination of both), and a pulse that is soggy, wiry, or slippery on the right and wiry on the left. This is damp-heat and turbid phlegm in the lesser yang channels battling the protective and nutritive qi to penetrate deeper into the body. T h e alternating

while this formula focuses on draining the half-interior aspects of the lesser yang. greasy coating which turns white and yellow. whose chief ingredient is Radix Bupleuri (chi hu). greasy tongue coating and fullness in the chest and diaphragm. Rhizoma Pinelliae Ternatae (ban xia). drain damp-heat through the urine. acute hepatitis. ANALYSIS O F FORMULA: The chief ingredients. Gallbladder heat attacking the Stomach leads to nausea or spitting of sour or bitter fluids. expels phlegm. but it focuses more on venting the pathogenic influence. brackish fluid. and pyelonephritis. directing rebellious qi downward. Rhizoma Coptidis (huang lian) and Rhizoma'Alismatis Orientalis (ze xie). *For acute jaundice with severe dampness. * For severe vomiting. coronary artery disease. One of the deputies. and expels dampness (see chapter 2). Fructus Citri Aurantii (zhi ke). transforming turbid dampness.Formulas that Harmonize Lesser Yang-stage Disorders fever and chills (fever stronger). pneumonia. * For tinnitus and diminished hearing due to darnpheat obstructing the lesser yang channel. add Cortex Magnoliae Officinalis (hou Po) and Herba Agastaches seu Pogostemi (huo xiang). Caulis Bambusae in Taeniis (zhu ru). a soft and rapid pulse. drains heat from the Gallbladder and Stomach and stops the vomiting. It resembles Sweet Dew Special Pill to Eliminate Toxin (gan lu xiao du dm) (see * For a thick. Turbid phlegm in the Stomach causes a white. thick. Cortex Moutan Radicis (dan pi) and Concha Ostreae (mu li). bitter taste in the mouth. Tuber Curcumae (yu jin) and Radix et Rhizoma Rhei (da huang). The mixed tongue coating and pulse indicate Gallbladder and Stomach disharmony. add Succinum (hu PO). Herba Artemisiae Annuae (qing hao) is added to vent the exterior aspect. add Haematitum (hi zhe shi). add Rhizoma Acori Graminei (chang @). and transforming phlegm. * For night sweats due to damp-heat in the Liver and Gallbladder. * For phlegm-heat in the Lungs. Bitter Orange. * For heat-predominant conditions with little dampness. The use of Herba Artemisiae Annuae (qing hao) as the chief ingredient gives this formula a milder dispersing action than Minor Bupleurum Decoction (xiao chai h u tang). With the appropriate presentation. bronchiectasis. Ramulus cum Uncis Uncariae (gou teng) and Rhizoma Alismatis Orientalis (ze xie). stifling sensation in the chest. Fructus Gardeniae Jasminoidis (zhi zi). COMMENTARY: This is a combination of Warm the Gallbladder Decoction (wen dan tang). Herba Artemisiae Annuae (qing hao) also vents the exterior aspect of the lesser yang. the middle pulse on the right will be slippery. add Folium Mori Albae (sang ye). harmonizing the Stomach. In this it is similar to Bupleurum. If the Stomach qi is strongly affected. acute gastritis. omit Rhizoma Pinelliae Ternatae (ban xia). add Flos Lonicerae Japonicae Gin yin ha). this formula may be used in treating such biomedically-defined disorders as acute gallbladder conditions. which clears heat. MODIFICATIONS: Herba Artemisiae Annuae (qing hao) and Radix Scutellariae (huang qin). Bile entering the Stomach causes vomiting of a yellow. Rhizoma Phragrnitis Communis (lugen) and Semen Benincasae Hispidae (dong gua ren). Talcum (huashi). * For a strong fever. and a yellow tongue coating. or the general character of the pulse will be soggy. and regulates the Gallbladder and Stomach (see chapter 16). but that formula is better at venting the half-exterior aspects of the lesser yang. and Jasper Powder (biyu sun). Mhitke's disease. or dry heaves. The presence of heat is also reflected in the red tongue body. relieves toxicity. It also contains stronger herbs for regulating the flow and transforming qi. The other deputies. Reach the Membrane Source The actions of this formula reach the leuel of the membrane transform turbidity. drain damp-heat from the Liver and Gallbladder. * For palpitations with anxiety and insomnia due to phlegm-heat. A wiry pulse indicates Liver and Gallbladder disharmony. Fructus Forsythiae Suspensae (lian qiao) and Folium Daqingye (da qing ye). The assistant ingredients. and clearing heat. and distention and pain in the chest and abdomen reflect the presence of damp-heat in the lesser yang. Sclerotium Poriae Cocos Rubrae (chifu ling). and Pericarpium Citri Reticulatae (chen pi). and Platycodon Decoction (chi hu zhi jie tang). Flos Chrysanthemi Morifolii GU hua). chapter 6) in its treatment of damp-heat leading to qirelated disorders. and Radix Scutellariae (huang qin) to clear the interior aspect. which clears heat. and then just yellow as the heat becomes more severe. hypertension. add Herba Artemisiae Yinchenhao (yin chen). Radix Glycyrrhizae Uralensis (gan cao). and Indigo Pulverata Levis (qing dai). and release epidemic Source: Discussion of Epidemic W a r m Diseases (Wen yi lun) . add Herba cum Radice Houttuyniae Cordatae (yu xing cao). assist Caulis Bambusae in Taeniis (zhu ru) in draining Gallbladder and Stomach heat.

A rapid pulse indicates heat. .3g Semen Arecae Catechu (bing lang) . requires an appreciation of the complexity of this condition. Cortex Magnoliae Officinalis (hou Po). . and prevents heat from injuring the yin and fluids. . half-interior [level] of the body.5g . . . and subside when the pathogenic influence is at rest. clears heat. @ For fever and chills (chills predominant). . and a wiry. 143 ' Preparation: Decoction. half-interior disorder caused by an epidemic pathogenic influence entering the membrane source (md yuhn). a thick. . INDICATIONS: Alternating fever and chills (both strong) occurring 1-3 times a day at irregular intervals. . . . . another deputy. .'' It is believed by some that the anatomical substrate of the membrane source is the greater omenturn. The battle between the strong pathogenic influence and the strong normal qi results in intense fever and chills that appear at irregular intervals. The sweating method cannot be utilized because the pathogenic influences are not lodged in the exterior. and add Herba Eupatorii Fortunei (pei hn) and Herba Artemisiae Yinchenhao (yin chen). . add Radix Puerariae (ge gen) (source text). . .6g Radix Scutellariae (huang qin). The three chief herbs in the formula effectively address this complex pattern. the third deputy. The constrained qi generates heat which causes irritability and a wiry pulse. add Radix Bupleuri (chi hu) (source text).3g Radix Glycyrrhizae Uralensis (gan cao) . headache ensues. and regulates the qi. With the appropriate presentation. and comprises part of the half-exterior. nourishes the yin. . . . . omit Semen Arecae Catechu (bing lang) and add Fructus Gardeniae Jasminoidis (zhi zi) and Radix Cynanchi Baiwei (bai wei). which is constrained by turbidity. When the clear yang is unable to rise. .3g Radix Anemarrhenae Asphodeloidis (zhi mu). . clear the heat. . The envoy.Reach the Membrane Source Decoction Fructus Amomi Tsao-ko (cao guo) . . Alternating fever and chills in epidemic or maIariaI disorders are almost always accompanied by turbid dampness. is at the half-exterior. also an aromatic herb. rapid pulse. . while a tongue with dark-red edges and a thick. . and an extremely thick tongue coating (indicating that dampness predominates). It is the gateway to the Triple Burner and. headache. foul. . and brucellosis. It is particularly useful for treating damp-heat in the Stomach and Gallbladder. . while others take it to be the pleura and peritoneum. expels dampness. . COMMENTARY: The membrane source (md yuhn) refers to the membrane found between the viscera and the wall of the trunk. . add Radix et Rhizoma Notopterygii (qiang huo) (source text). . .L5g Cortex Magnoliae Officinalis (hou P o ) . diminished hearing. . pasty coating indicates severe halfexterior. e For back and neck pain. . MODIFICATIONS: @ For pain in the hypochondria. . irritability. acrid. . drying properties of the other herbs from injuring the yin and blood. Radix Glycyrrhizae Uralensis (gan cao) . harmonizes the actions of the other herbs in the formula. The proper method of treatment is to transform the turbidity at the level of the membrane source. causing a stifling sensation in the chest and nausea or vomiting. This leads to a disruption of the qi mechanism in the chest and epigastrium. Semen Arecae Catechu (bing hng) disperses dampness and reduces stagnation by facilitating the flow of qi. prevents the acrid. According to thewarp and Woof of Warm-febrile Diseases. half-interior damp-heat. . Radix Scutellariae (huang qin). . Purgatives cannot be used because there is no excess in the Stomach. . . . The strong. "The membrane source is connected to the muscles externally and is close to the stomach internally. thereby hastening the elimination of the pathogenic influences from the interior. and pasty coating. . . . It is a concept of great importance to adherents of the warm-febrile disease school. foul. . . . . . clears heat and dries dampness. . Fructus Amomi Tsao-ko (cao guo) is an aromatic herb that transforms turbidity and thereby stops the vomiting and vents the pathogenic influences lurking in the half-exterior. by expelling dampness and benefiting the qi. . malaria. Radix Paeoniae Lactiflorae (bai shao).3g Radix Paeoniae Lactiflorae (bai shao) . ANALYSIS OF FORMULA: Appropriate treatment membrane source. . Radix Anemarrhenae Asphodeloidis (zhi mu). marked distention. and a bitter taste in the mouth. and aromatic properties of these herbs enable them to reach and open up the . . transforms turbidity. and transform the dampness. the functions of the Spleen are strengthened. . . . a stifling sensation in the chest. a deputy herb. . . At the same time. halfinterior level. e For conditions that worsen in the afternoon and evening (indicating that heat predominates). . Actions: Spreads the qi and penetrates to the membrane source. a sensation of heaviness in the limbs. . in fact. . . omit Radix Paeoniae Lactiflorae (bai shao) and Radix Anemarrhenae Asphodeloidis (zhi mu). The source text recommends that the decoction be taken warm in the afternoon. nausea or vomiting. this formula may be used in treating such biomedically-defined disorders as influenza. . . a tongue with deep-red edges. half-interior aspect of the body. .1. @ For pain in the orbital and frontal areas with dry nasal passages and insomnia. . This is a half-exterior. .

. . loss of appetite.3g Cortex Magnoliae Officinalis (hou Po). For phlegm-dampness obstructing the membrane source characterized by focal distention and fullness in the chest and epigastrium. . . Today it is prepared as a decoction with a small amount of wine. and a wiry. . . . . . . . . . . which may result from either of two processes. . . . . . . . . . For alternating fever and chills (fever predominant) or fever without chills. cough with sputum that is difficult to expectorate. . . . a pasty sensation in the mouth. . its transporting function is diminished. . . .5g Semen Arecae Catechu (bing lang) . . . . . . . . alternating chills and fever. . . . . . and is taken two hours before the onset of an attack (if the attacks are regular). . . and clears the Spleen. . . phlegm. . . . .6g Folium Nelumbinis Nuciferae (he ye). it can move transversely and violate the Spleen and Stomach. abdominal distention. . . . . . If the internal disharmony is related to emotional or psychological problems. . . . . . . . white tongue coating. . . . . . . . . . . . Conversely. . . . . .9-15g Transforms phlegm and dampness. . . but with the addition of lesser yang signs and symptoms. . . . . . . .5g Cortex Magnoliae Officinalis (hou Po) .5g Pericarpium Citri Reticulatae (chen pi) . The most common symptoms of this disharmony are a stifling sensation in the chest. . .9-12g Radix Scutellariae (huang qin) . . . . a thick. . . . . . . . . . unremitting attacks of alternating fever and chills. . . drains heat. . . pasty tongue coating. transforms phlegm. . . . .5-6g Cortex Magnoliae Officinalis (hou Po). . &$+g+k jig nu2 qi biio yin Seven-Treasure Decoction to Check Malarial Conditions . . . when the Spleen qi is deficient. . . . . . . . and large pulse at the distal position. . . . . . . . . .lg Radix Scutellariae (huang qin). Dries dampness and expels . . . . Radix Dichroae Febrifugae (chang shan) . It is important to remember that these formulas are not intended primarily for conditions of deficiency. . . . . .1. .6-9g Radix Bupleuri ( c h i hu) . The qi-moving aspect of these formulas is generally not as strong as that of the formulas in chapter 9. .9-12g Rhizoma Atractylodis Macrocephalae (bai zhu) . .4. . . .8g Semen Arecae Catechu (bing land . 1. . . . . Dries dampness. The presentation is characterized by intense.1. . . . . . .4. . . . . . . . . . . . . . . thirst. . and in severe cases. . dizziness or vertigo. . This condition is similar to that for which the principal formula is indicated. . . . foul. floating. reduced appetite. . irritability.9-12g Sclerotium Poriae Cocos ( f u ling). . . . . FORMULAS THAT REGULATE AND HARMONIZE THE LIVER AND SPLEEN The formulas in this section are used when there is an imbalance between the functions of the Liver and Spleen. . slippery pulse. . . . . . . . a dry tongue. . . . . . . . . . diarrhea. . When the Liver qi (which is normally spread smoothly throughout the body) is constrained. . For patients with internal phlegm-dampness who contract a malarial pathogenic influence. .5g Radix Platycodi Grandiflori (jie geng) . vents conditions at the level of the membrane source. . . . . . . and take with five pieces of Rhizoma Zingiberis Officinalis Recens (sheng jiang). . . . . SECTION 2 Clear the Spleen Decoction -$$ $f qZng $< tcing Source: Formulas to Aid the Liuing (Ji sheng fang) Pericarpium Citri Reticulatae Viride (qing pi) . . . . . . . . and a rapid.5-3g The source text advises to grind equal amounts of the herbs into a coarse mixture. . . . focal distention. . .1.9-12g Rhizoma Pinelliae Ternatae (ban xia) . . . . . hypochondriac pain. . . . wiry pulse. . . . . and a wiry. . .2. slippery. . . . . a greasy. . . prepare 12g of the mixture as a decoction. . . . . . . . . . . . .1. . . . .5g Fructus Amomi Tsao-ko (cao guo) . .4. . . . . . epigastric and abdominal distention and pain. . . . . . . . . . . . . . but they also address the blood deficiency aspect of Liver disharmony. . . . l . . . . . the patient will become fatigued. . . . . .3g Fructus Amomi Tsao-ko (cao guo) . . . . .1.5g Pericarpium Citri Reticulatae Viride (qing pi) . . .5g Honey-fried Radix Glycyrrhizae Uralensis (zhi gan cao) . . . . . 1.9-12g Fructus Amomi Tsao-ko (cao guo) . . . . . this in turn constrains the spreading of Liver qi.5g Honey-fried Radix Glycyrrhizae Uralensis (zhi gan cao) . . . . . . . . . . . The effects of this formula are milder than those of the principal formula. . . . . . . . . . . . prepared in a bowl of water with a tablespoon of wine.5g The source text advises to coarsely grind equal amounts of the herbs and take in 15g doses as a draft. . . .5g Pericarpium Citri Reticulatae Viride (qing pi) . irritability.4. . . . . . . .4. . . intermittent fever and chills. dark urine. . . . . . . . . . . . . . .Formulas that Regulate and Harmonize the Liver and Spleen ASSOCIATED FORMULAS: Bupleurum Decoction to Reach the Membrane Source Source: Collected Formulas (Yang shi jia cang fang) of the Yang Family *+~&z%+k c E i hii dii yuiin yin Source: Revised Populur Guide to the Discussion of Cold-induced Disorders (Chong ding tong su shang han lun) Radix Bupleuri ( c h i hu) . . . . . if they are used in those circumstances. . . .9-12g Radix Glycyrrhizae Uralensis (gan cao) . . a bitter taste in the mouth. . the best results will be achieved if the patient receives counseling in addition to herbal therapy.

12-24g Honey-fried Radix Glycyrrhizae Uralensis (zhi gan cao) . . Yet it encompasses different types of cold.9-12g Radix Paeoniae Lactiflorae @ai shoo). This combination is . and is therefore the chief herb. may be cold. . This herb has a descending action.or hot-type collapse is identified as the condition for which this formula is most commonly indicated. .9-12g Fructus Immaturus Citri Aurantii (zhi shi) . which is most commonly due to heat entering the interior where it constrains the yang qi. Source: Discussion of Cold-induced Disorders (Shang han 1un) Radix Bupleuri (chi hu) . the primary focus of the formula is to regulate the qi by venting the heat and releasing the constraint. They note that the source text does not distinguish whether the condition is due to heat or cold. In 1 Preparation: The source text advises to grind equal I due to constraint and stagnation of the qi mechanism. . There may also be abdominal pain and/or severe diarrhea. spreads the Liver qi. . and a warm body. in contrast to the chief herb which disperses. . . . the entire area distal to the elbow and knee. Its meaning was subsequently expanded to include certain conditions with symptoms of cold hands and feet. . Although yang. The difference between these two presentations was clearly explained by the Ming-dynasty physician. Available in prepared form. . . . . This is a pattern where the yin contains the yang and 'frigid extremities' results from the qi being unable to disseminate and flow freely. The assistant is Radix Paeoniae Lactiflorae (bai shao).6-9g amounts of the herbs into powder and take in 6-9g doses. This results in a . Radix Bupleuri (chi hu) performs both of these functions well. . which nourishes the Liver and preserves the yin. belching. With yin. . . . . The wiry pulse and sensation of irritability and fullness in the chest and abdomen reflect interior constraint.~riiid Extremities Powder 145 1 Frigid Extremities Powder @&# I si ni siin This formula is used in treating frigid extremities due to the yang qi being constrained in the interior. There are many terms. The term collapse (jui) from the Inm Chsic is one of them. . These formulas are generally used for chronic conditions in which the patient feels cold (chills). which literally means 'four rebellions. . easily differentiated in Chinese. Li ZhongZi: "While it is said that this pattern is called 'frigid extremities. . There may also be vomiting. Cold extremities due to yang-type collapse may be distinguished by the sensation of cold occurring at only the very tips of the extremities. where the entire limb is cold). reduced appetite. . . a bitter taste in the mouth. The combination of the assistant herb with the envoy herb. . the use of this formula is confined to the treatment of frigid extremities due to lesser yin-stage disharmony with a wide range of signs and symptoms (see modifications below).very effective in disseminating the Liver qi without injuring the Liver yin. Later generations of physicians extended the use of this formula to the treatment of rebellious Liver qi disturbing the Stomach. The tongue signs reflect the presence of heat. while the chief herb has an ascending action. inchding the type for which this formula is indicated where only the tips of the fingers and toes are cold to the touch. . Similarly. and the entire hands and feet (not just the tips) are cold. and the pulse not submerged nor faint. .or hot-type collapse (ydngjul). . forceful pulse. This originally referred to a variety of conditions with sudden or temporary loss of consciousness. hence the name. INDICATIONS: Cold fingers and toes (although the body is warm) sometimes accompanied by a sensation of irritability and fullness in the chest and epigastrium. . . honey-fried Radix Glycyrrhizae Uralensis (zhi gan cao). and a wiry.or cold-type collapse. .' the extremities must not be extremely cold. and regulates the Spleen. . This inhibits the spreading of yang qi to the extremities. . . Today it is usually prepared as a decoction with the dosage specified above. moderates the acute or colicky pain. . and therefore in the smooth dispersion of the heat due to constraint. releases constraint. . The deputy is Fructus Immaturus Citri Aurantii (zhi shi). . . . This herb holds things in.' narrowly means ice-cold limbs. . . . . the fingertips slightly warm [to the touch]. ANALYSIS OF FORMULA: Because this condition is ' 1 stronger qi-regulating function. which drains stagnation from the middle burner and thereby aids the transporting and transforming functions of the Spleen. characterized by hypochondriac pain and distention (sometimes with epigastric pain and fullness). some commentators strongly disagree. . or even the entire limb. This is yang. This presentation often occurs in children. . . Actions: Vents pathogenic influences. . . The envoy serves the function of harmonizing the various actions of the other herbs in the formula. a red tongue with a yellow coating. COMMENTARY: In the source text. . . causing cold fingers and toes (in contrast to devastated yang. which becdme problematic when rendered in English. and a wiry pulse." There is another group of formulas mentioned in Discussion of Cold-induced Disorders for treating cold extremities that are based on Tangkuei Decoction for Frigid Extremities (dang gui si ni tang). . the term frigid extremities (si ni). . . .

. .30g Rhizoma Cyperi Rotundi (xiang fu) . @ For abdominal pain. @ For epigastric pain with acid regurgitation. . the treatment principle focuses on regulating and harmonizing. . . . . . @ For breast abscess. . Moutan and Phellodendron Powder for Frigid Extremities diin huiing s i ni siin Source: New Explanations of Medical Forrnular (Yi fang xin jie) Radix Bupleuri (chi hu). .4. . . peptic ulcer. . I . . . . . . . . . . . hepatitis. . . add Pericarpium Trichosanthis (gua lou pz). severely diminished hearing where the patient "cannot even hear thunder" due to emotional upset or an externally-contracted condition. and is related to an explanation suggested in a passage from chapter 5 of Basic Questions: "The clear yang firms up the four limbs. . . Rhizoma Cyperi Rotundi (xiangfu) and Rhizoma Corydalis Yanhusuo (yan hu suo). . . . . . . . . cholecystitis. . intestinal obstruction. . . take with TwoMarvel Powder (er miao san). . . . .5g Spreads the Liver qi. . . and alleviates pain. . . take with Artemisiae Yinchenhao Decoction (yin chen hao tang). Radix Salviae Miltiorrhizae (dan shen). . . omit Fructus Imrnaturus Citri Aurantii (zhi shi) and add Rhizoma Atractylodis Macrocephalae (bai z h ) . . . . . .6g Radix Bupleuri (chai hu) . . For acute icteric hepatitis. . .4.5g Honey-fried Radix Glycyrrhizae Uralensis (zhi gan cao) . . . . . . . . they argue that the pathological mechanism involves the Spleen's control of the limbs. . Excrementum Trogopteri seu Pteromi (wu ling zhi) and Radix Salviae Miltiorrhizae (dan shen). . this formula may be used in treating such biomedically-defined disorders as gastritis. add Fructus Pruni Mume (wu m i ) and Cortex Meliae Radicis (ku lian gen pi). take with Left Metal Pill (zuo jin wan). Sclerotium Poriae Cocos (& ling) and Radix Angelicae Sinensis (dang gui). . . . add Pericarpium Citri Reticulatae Viride (qing pi). Radix Linderae Strychnifoliae (wu yao). With the appropriate presentation. . . . . add Sclerotium Poriae COCOS ( j u ling) (source text).30g Radix Ligustici Chuanxiong (chuan xiong) . . they conclude that this condition arises in a person with a deficient Spleen who contracts a pathogenic influence that enters the lesser yin. . @ For intestinal obstruction. . . . .5g Rhizoma Cyperi Rotundi (xiang fu) . 15g Grind the ingredients into powder and take in 9g doses followed by warm water twice a day. . . cholelithiasis. . . add Radix Angelicae Sinensis (dang gui). . Radix Paeoniae Rubrae (chi shao) and Herba Lysimachiae (jin qian cao). @ For intercostal neuralgia. Instead. . For constraint and clumping of the Liver qi with hypochondriac pain and alternating fever and chills. . . . . add Herba Artemisiae Yinchenhao (yin chen hao). . . . . . . .5g Fructus Citri Aurantii (zhi ke) . For acute. .r a condition whose underlying pathology was associated with heat. . . Tuber Curcumae (yu jin). add Fructus Crataegi (shan zha). . For pinpoint fixed pain due to blood stasis. Bulbus AUii (xie bai) and Tuber Curcumae (yu jin). . . . . add Radix et Rhizoma Rhei (da hang). . .4. 1% *+. .5g Radix Paeoniae Lactiflorae (bai shao) . . . . . . . harmonizes the blood. . . . . This constrains the yang qi and prevents it from reaching the extremities. which would be inappropriate f0. @ For blood deficiency with hypochondriac pain and irregular menstruation. . Fructus Hordei Vulgaris Germinantus (mai ya) and Endothelium Cornei Gigeriae Galli (ji nei jin). @ For painful menstruation. . Available in prepared form. . since there are no strong heat symptoms. . . . . MODIFICATIONS: @ For cough. and fibrocystic breasts. . . . && . . . However. . . . . . The constrained yang qi generates heat. . . . add Pollen Typhae (pu huang). mastitis. . @ @ ASSOCIATED FORMULAS: % Bupleurum Powder to Spread the Liver &+L A? chiii hic shii giin siin Source: Collected Treatises of [Zhangl Jing-Yue Uing yue quan shu) Pericarpium Citri Reticulatae (chen pi). . Also for premenstrual syndrome or dysmenorrhea. I . . . * Unblock the Qi Powder &%* tGng qi sZn Source: Corrections of Errors among ~hjsicians (Yi lin gai cuo) Radix Bupleuri (chi hu) . . @ For palpitations. . . . . . . . For urinary difficulty. . . . . . @ For food stagnation with abdominal pain. .4. . . . . . . . . @ For damp-heat leukorrhea with lower abdominal pain and soreness of the lower back. . add Ramulus Cinnamomi Cassiae (gui zhi) (source text). most of the modified formulas listed in the source text contain warming herbs. . . . . . . . @ For biliary tract disorders. . @ For roundworms. . . . . .Formulas that Regulate and Harmonize the Liver and Spleen addition. . . . . add Radix Lateralis Aconiti Carmichaeli Praeparata ( f u zi) (source text)." Thus.6g Radix Ligustici Chuanxiong (chuan xiong). . Spreads and regulates the Liver qi and opens up the sensory orifices. . . . . . . . . . . add Fructus Schisandrae Chinensis (WUwei zi) and Rhizoma Zingiberis Officinalis (gan jiang) (source text). .

. . . . and a dry mouth and throat. . Actions: Spreads the Liver qi. . . . Liver qi constraint is indicated by pain along the Liver channel. . . . resulting in Spleen deficiency. . . vertigo. feverishness and bruxism. . . often results in blood deficiency. hysteria. . . 147 Radix Paeoniae Lactiflorae (bai shao) . . . . . .(9g) Radix Angelicae Sinensis (dang gui). . ." which includes many stories about soaring above a restricted world view. .3g Sclerotium Poriae Cocos ( f u linl) . . . . . . . . . which is known as constrained Liver qi. . . . . . . . . . There may also be alternating fever and chills. This is Liver constraint with blood deficiency. . work together to nourish the blood and soften the edginess that results from Liver constraint. . . . . palpitations with anxiety. depends upon the yang to carry out its spreading function. . . . . . . Radix Angelicae Sinensis (dang gui) and Radix Paeoniae Lactiflorae (bai shao). . . .1. . . cold hands and feet. INDICATIONS : Hypochondriac pain. . . . a surplus of qi may ensue. . . I n women this can manifest as distended breasts. For early-stage appendicitis with right lower quadrant pain (along the Liver channel). .12g Cortex Phellodendri (huang bai). . When the Liver qi is constrained its control over the Spleen becomes excessive. . . . the Gallbladder. I n some patients. . . . . . . fever and chills. . . Liver constraint and blood deficiency causes headache. . . .3og (9g) Sclerotium Poriae Cocos ( f u ling). . . . "Rambling Without a Destination. Slightly aromatic Radix Angelicae Sinensis (dang gui) affects . . . Fatigue and reduced appetite are symptoms of Spleen deficiency. . . . .1. . . . spreads the Liver qi. . . This is known as transverse rebellion of Liver qi violating the Spleen. . . . . . . fatigue. Conversely. . . . . . . T h e deputies. Available in prepared form. . nourishing herbs must also be included. . a bitter taste in the mouth. Rambling Powder The name of this formula was derivedfrom the title of the first chapter of Zhuang Zi. . pale-red tongue. . . . . . .30g (9g) this formula is on spreading the Liver qi to relieve Liver constraint. . . . But if the supply of Liver blood is insufficient. .5g Radix Glycyrrhizae Uralensis (gan cao) . and irregular menstruation or distended breasts. . . . . vertigo. . . . . . I% The dosage of Radix Paeoniae Lactiflorae (bai shao) depends on the severity of the abdominal pain.129Radix Glycyrrhizae Uralensis (gan cao) . . . . . refers to reducing constrained qi. . . . . Originally used in treating children for heat from deficiency in the Liver channel with spasms. . . .Rambling Powder Radix Paeoniae Lactiflorae (bai shao) . .4g Ramulus cum Uncis Uncariae (gou tend . . . . and lead to lesser yang-stage signs and symptoms such as alternating fever and chills and a bitter taste in the mouth. . . . . .(9g) Rhizoma Atractylodis Macrocephalae (bai zhu). .5g Taken as a draft. . and a wiry. . constraint of the Liver may affect its related channel. . Deficiency of the Spleen. reduced appetite. . . . Calms the Liver and regulates the Liver blood and qi. . .309. . . . .2. . . . . Available in prepared form. . . . and relieves spasmodic pain. . . .5g of Rhizoma Pinelliae Ternatae (ban xia). . refers to shaking constrained blood. . . Similarly. abdominal distention. . . . . . . a yin organ which stores blood. yzio. a homonym for shake. . . The relationship between the Liver and Spleen is very close. reduced appetite. . . . . . . this formula releases constraint and encourages the freef low Of Liver qi. . a homonym for reduce. . and restless sleep due to the Liver (wood) overcontrolling the Spleen (earth). . . headache. .3g Radix Ligustici Chuanxiong (chuan xiong). . . Another interpretation is that the first character.30g (9g) Honey-fried Radix Glycyrrhizae Uralensis (zhi gan cao) . . . dry mouth and throat. . . effectively relieves Liver constraint. . allowing for openmindedness and afree or rambling spirit. . . T h e tongue and pulse signs reflect the constrained Liver qi and blood deficiency. . .3g Radix Bupleuri ( c h i hu) . . . . .12g Cortex Moutan Radicis (mu dan pi) . T h e chief herb. fever. . blood deficiency (regardless of origin) can lead to Liver constraint. . or spitting of sputum and saliva.30-75g Fructus Immaturus Citri Aurantii (zhi shi) . . Clears heat. . xiao.15g (6g) Preparation: Grind the ingredients into powder and take as a draft in 6-9g doses with 6g of roasted Rhizoma Zingiberis Officinalis Recens (wei jiang) and 3g of Herba Menthae Haplocalycis (bo he). May also be prepared as a decoction with the dosage indicated in parentheses. . . especially in the hypochondria. . . . . deficient pulse. . . . and night terrors. . whose function is to transform nutrients into blood and qi. . . . . . . . ANALYSIS O F F O R M U L A : Although the focus of Restrain the Liver Powder 34 H 4 k y i giin sGn Source: Synopsis of Caring for Infants (Bao ying cuo yao) Dry-fried Rhizoma Atractylodis Macrocephalae (chao bai zhu) . . and signs and symptoms similar to those for which the principal formula is indicated. . . Radix Bupleuri ( c h i hu). .309. strengthens the Spleen. . . . and nourishes the blood. T h e Liver. Source: Imperial Grace Formulary of the Tai Ping Era (Tai ping hui min he ji jufang) Radix Bupleuri ( c h i hu) . invigorates the blood. . . . . Its use has subsequently been expanded to cover a wide variety of chronic deficiency disorders with spasmodic movement including seizure disorders. . . . . . . . . . . usually with the addition of 3g of Pericarpium Citri Reticulatae (chen pi) and 4. . and the second character. . .3g Radix Angelicae Sinensis (dang gui) . . . . . . . . . . . .

peptic * For more severe hypochondriac pain with distention. . . and Rhizoma Acori Graminei (shi chang pu) was devised by Wei Wen-Gui to treat various ophthalmological disorders including glaucoma. painful extremities and trunk. deficient pulse. and central retinitis. . . . this formula may be used in treating such biomedically-defined disorders as hepatitis. * For enlarged liver and spleen. . . For Liver constraint with Spleen deficiency that transforms into heat characterized by irritability. . . which recommends it for such disorders as blood deficiency with fatigue. . . . * For pain over the liver with fatigue and reduced appetite. . . . . . . . . fever. . . palpitations. . Add Semen Plantaginis (che qian zi) to focus the formula on the treatment of difficult. . Radix et Caulis Jixueteng (ji xue teng).3g Sclerotium Poriae Cocos (fu ling) . . optic nerve atrophy. .5g Fructus Gardeniae Jasminoidis (zhi zi) . . . . making it an important herb in the treatment of Liver constraint and blood deficiency. tonifies the Spleen and. . add Cortex Moutan Radicis (mu dan pi). . dizziness and heaviness of the head. and increased menstrual flow or uterine bleeding. With the appropriate presentation. . . recommended Augmented Rambling Powder (jia wei xiao ym sun) with Spica Prunellae Vulgaris (xia ku cao). . . * For vaginal discharge. Fructus Citri Sarcodactylis (fo shou). . . Roasted Rhizoma Zingiberis Officinalis Recens (weijiang). . . . . . . an envoy. .3g Radix Paeoniae (shao yao) . Its wide application was noted in the source text. . . Radix Salviae Miltiorrhizae (dm shen) and Rhizoma Cyperi Rotundi (xiang fu). . which is widely used in internal medicine and in the treatment of women's disorders. lower abdominal pressure. and malarial fever and chills. . dry mouth. pale-red tongue.5g Decoction. . red eyes. . . . . . disharmony of the nutritive and protective qi with phlegm cough. fibrocystic breasts. reduced appetite. . . when combined with Radix Paeoniae Lactiflorae (bai shao). painful urination. . . .L5g Honey-fried Radix Glycyrrhizae Uralensis (zhi gan cao) . . cortical blindness. . omit roasted Rhizoma Zingiberis Officinalis Recens (wei jiang) and Herba Menthae Haplocalycis (bo he). . . tremities Powder (si ni san). moderates the spasmodic abdominal pain.1. Rhizoma Atractylodis Macrocephalae (bai z h ) and Sclerotium Poriae Cocos (fu ling). . . Two of the assistant herbs. functional uterine bleeding. . . . The other assistant. . . . red cheeks. . . Carapax Amydae Sinensis (bie jia) and Concha Ostreae (mu li). . . when used in small doses enhances the chief herb's ability to relieve Liver constraint. . honey-fried Radix Glycyrrhizae Uralensis (zhi gan cao). palpitations. and Fructus Ligustri Lucidi (nu zhen zi) for treating hypertension. It is also recommended for treating "virgin girls with weak blood and yin deficiency. . omit Rhizoma Atractylodis Macrocephalae (bai zhu) and add Rhizoma Cyperi Rotundi (xiangfu). pleurisy. . . strengthen the Spleen and thus its transforming and transporting functions. periumbilical and abdominal pain. . . . . A modification of this formula based on Augmented Rambling Powder (jia wei xiao yao san) with Flos Chrysanthemi Morifolii (ju h a ) . Herba Menthae Haplocalycis (bo he). . .3g Dry-fried Rhizoma Atractylodis Macrocephalae (chao bai zhu) . blood deficiency. night sweats. . . . . . COMMENTARY: This is a variation of Frigid Ex- ulcer. . . . Radix Salviae Miltiorrhizae (dan shen) and Radix Codonopsis Pilosulae (dang shen). acute retrobulbar neuritis. . . . . . . . . . . . reduced appetite. The famous twentiethcentury physician. Spreads the Liver qi. . . . . . . . . It may be used for any condition with Liver constraint. . . * For intense. nourishes the blood. . . . anemia. Yue Mei-Zhong. and to disperse the heat due to that constraint. . . . . add 0 s Sepiae seu Sepiellae ( h i piao xiao). menopausal syndrome. . . $ i g& jiii wii xiiio yiio stin Source: Summary of Inkral Medicine (Nei ke zhai yao) Radix Angelicae Sinensis (dang p i ) . contention between the blood and heat with irregular menstruation. pelvic inflammatory disease. . . . optic nerve atrophy. . . .1. . Fructus Lycii Chinensis (gou qi zi). Ramulus Sangjisheng (sangji sheng). strengthens the Spleen. . . . . add Flos Lonicerae ) and Rhizoma Guanzhong ( g u n Japonicae (jin yin h zhng). . painful urination. tidal fever. . omit honey-fried Radix Glycyrrhizae Uralensis (zhi gan cao) and add Semen Vaccariae Segetalis (wang bu liu xing). and clears heat. . * For fibrocystic breasts.Formulas that Regulaft!and Harmonize the Liver and S p L n the qi of the blood. . . . . . . .'' The scope of this formula has been expanded even further in modern China. . harmonizes the Stomach and prevents the development of rebellious qi. and wasting of the limbs that slowly progresses to a steaming bone condition. . difficult. . . . neurasthenia. . and Spleen deficiency characterized by hypochondriac pain. . . The other envoy.3g Cortex Moutan Radicis (mu dan pi). and a wiry. dry mouth and throat. . fatigue. . . . . . and central retinitis.3g Radix Bupleuri (chi hu) . . . fixed pain due to blood stasis. . . Take with a small amount of Rhizoma Zingiberis Officinalis Recens (sheng jiang) and Herba Menthae Haplocalycis (bo he). an increased desire to sleep. . and add Rhizoma Cyperi Rotundi (xiangfu). . Available in prepared form. ASSOCIATED FORMULAS: MODIFICATIONS: Augmented Rambling Powder i h 4. . . . . heat in the five centers. chronic gastritis. Tuber Curcumae (yu jin) and Rhizoma Sparganii Stoloniferi (san leng). a short tern2er with possible tidal fever and sweating. . .

. . . . . . . . . T h e pain is caused by the transverse rebellion of Liver qi. . . . T h e combination of these two herbs works very well to control wood and nurture the earth. . . ANALYSIS O F F O R M U L A : Rhizoma Atractylodis n . . .5-9g) Radix Ledebouriellae Divaricatae (fang feng) . . . . . . . . .12g Radix Notoginseng (san qi) [powdered] . . and loose stools. . . . .overactive Liver and alleviates pain. . . .5g The source text advises to grind the ingredients into powder and take as a draft in 6 s doses with one piece of Rhizoma Zingiberis Officinalis Recens (sheng jiang) and a small amount of Herba Menthae Haplocalycis (bo he). . reduced appetite. . although the first is sometimes given prominence. . and regulates menstruation.45g (4. . . Unless properly treated.. Today these herbs are usually omitted. . .60g (6-24g) Dry-fried Pericarpium Citri Reticulatae (chao chen pi) . . . . . . . . . . . . . . . . . . . .5g Radix Paeoniae Lactiflorae (bai shao) . . Radix Paeoniae Lactiflorae (bai shao) softens the. . . For the same presentation as the principal formula. . . irritability. . . . . . . reflects Liver constraint and Spleen deficiency. Spreads the Liver qi. . . . . For severe Liver qi constraint with clumping and Spleen deficiency leading to blood deficiency and blood stasis characterized by intense hypohondriac pain. .1. . . . . . . . . . . T h e tongue coating is unremarkable because the internally-generated dampness is directed downward and therefore does not affect the tongue. . . . . . I n cases where a deficient Spleen interacts with an overcontrolling Liver. . . . white tongue coating. . . I2 g Rhizoma Atractylodis Macrocephalae (bai zhu) . . . . . .90g (9-12g) Dry-fried Radix Paeoniae Lactiflorae (cho bai shao). . Because of the mutual relationship between the Liver and Spleen. they are both regarded as chief herbs. . . . fatigue. . . . . . thereby stopping the pain and diarrhea associated with this condition. regulates the Spleen. . . nourishes the blood.. . . INDICATIONS: Recurrent problems of b o r b o r y p u s . . . . .159Radix Glycyrrhizae Uralensis (gan cao) . . . . Commonly used for chronic hepatitis and early stages of cirrhosis. . This type of tongue rules out damp excess and turbidity accumulating in the Intestines as the cause of the painful diarrhea. . which indicates a collapse of the Spleen qi. . and a wiry. . Pain before defecation with relief upon evacuation indicates constraint. . Radix Rehmanniae Glutinosae Conquitae (shu di huang) is substituted for Radix Rehmanniae Glutinosae (sheng di huang). a thin. Diarrhea. . . . . . . . thin pulse. .30-60g (3-6g) Preparation: Grind the ingredients into powder and take in powder or pill form. . . . . . . . . . . . .>I$ . . . . . . . . Spread the Liver and Regulate the Spleen Decoction ilk 5 2 4fF1 s hii gEn li pi tcing * z l Source: New Explanations of Medical Formulas (Yi fang xin jie) Radix Bupleuri ( c h i hu). . and nourishes and invigorates the blood. . is caused by the Spleen's inability to transport nutrients upward. . . a stifling sensation in the epigastrium. . using this herb to nurture the Spleen (earth) will have the effect of controlling the Liver (wood). . the resulting turbidity thereupon descends. . . . This is painful diarrhea due to Spleen deficiency with an overcontrolling Liver. moderate or wiry. . . . . . . . . Pericarpium Citri Reticulatae . T h e deputy. . . . .l2g Radix Salviae Miltiorrhizae ( d m shen) . . . . .1. . . . . strengthens the Spleen. . . . . . . . . . . A wiry pulse. . . .5g Radix Angelicae Sinensis (dang gui) . . . . . . . Diarrhea t6ng xi2 ytio fang Source: Collected Treatises of [Zhangl Jing-Yue Uing yue quan shu) Macrocephalae (bai zhu) strengthens the Spleen and dries dampness. . rapid pulse.15g Rhizoma Alismatis Orientalis (ze xie). . . the presence of either Spleen deficiency or an overcontrolling Liver can lead to the development of the other. May also be prepared as a decoction with the dosage indicated in parentheses. . . . . . Actions: Spreads the Liver qi and tonifies the Spleen. . . . .& Important Formula for Painful 1 :i~? % . . insomnia. . . . . . . .Importunt Formula for PainJiLl Diarrha 149 Black Rambling Powder Y1 --& L -& & . but with more severe blood deficiency characterized by premenstrual cramps or excessive menstrual bleeding. . . . . . . which is either thin or moderate.9g Radix Rehmanniae Glutinosae (sheng di huang) . . hi% xi60 yho sZn Source: Six Texts on the Essentials of Medicine (Yi xue liu shu) Radix Bupleuri (chi hu) . . . . . .12g Rhizoma Cyperi Rotundi (xiang fu) . .9g Radix Polygoni Multiflori (he shou wu) . . . . . . . . . . . . . . .4. . and unless there are clear heat signs. . . . . . . . . abdominal pain. . . . . 3g Spreads the Liver qi. . . T h e combination of the descent of the turbidity and the transverse rebellion of Liver qi leads to borborygmus (regarded as a form of wind in the abdomen). . . Dry-fried Rhizoma Atractylodis Macrocephalae (chao bai zhu). . . . and a wiry. . . . . . . . . . . As such. .9g Radix Codonopsis Pilosulae (dang shen) . . . . .. . . . . . . . diarrhea with pain (which starts with the urge to defecate and subsides after completion). . deficient or wiry.5g Sclerotium Poriae Cocos (fu ling) . .4. . . . . this close relationship also makes it easy for the condition to become recurrent. . . . .

. and transposed. 4 For urinary difficulty. . It is also more useful in treating borborygmus. add Radix Pulsatillae Chinensis (bai tau weng) and Radix Scutellariae ( h a n g qin). Because of their complexity. exterior-releasing herb. Qin Bo-Wei. 4 For blood and pus in the stool. 15th-century text by Zhu Zhen-Heng. add Radix Codonopsis Pilosulae (dang shen) and Radix Glycyrrhizae Uralensis (gun cao). add Rhizoma Atrac- tylodis (cang zhu). these conditions must be treated with formulas that harmonize the various conflicting processes. with symptoms of abdominal pain and later diarrhea. . It is also mentioned in an unnamed. and colitis. . MODIFICATIONS: 4 For chronic diarrhea. . substitute Radix Puerariae (ge gen) for Radix Ledebouriellae Divaricatae (fang feng). while focusing the actions of all the herbs on these two organs. this formula may be used in treating such biomedically-defined disorders as acute gastroenteritis. bacillary dysentery. the pathogenesis of this disorder is that the deficient Spleen condition with abdominal distention usually occurs first. Regardless of which of the two organs is more affected. originally known as Atractylodes Macrocephala and Peony Powder (bai zhu shao yao san). double the dosage of Radix Paeoniae Lactiflorae (bai shao) and add Pericarpium Citri Reticulatae Viride (qing pi) and Rhizoma Cyperi Rotundi (xiang fu). It harmonizes the functions of the middle burner and transforms dampness. abdominal pain and distention. Source: Discusion of Cold-induced Disorders (Shang han lun) Rhizoma Pinelliae Ternatae (ban xia) . add Semen Arecae Catechu (bing lung) and Radix Aucklandiae Lappae ( m u xiang).9g . . i XI biin xi6 xi? xfn tiing Although the literal translation of this formula's name is Pinellia Drain the Heart Decoction. It enters the Liver and Spleen channels and helps relieve the overcontrol of the Spleen by the Liver. add Talcum (hua shi). By transposed he meant that the right (Spleen) pulse is stronger than the left (Liver) pulse. the patient feels more comfortable after each bowel movement. The principal reason is that Radix Ledebouriellae Divaricatae (fangfeng) enters both the Liver and Spleen channels and has an anti-diarrhea effect. the word heart actualLy refers to the area below the heart-the epigastrium-and not the heart itself. . Qin noted that the pulse is usually wiry. COMMENTARY: This formula. leading to symptoms of fullness and focal distention in the epigastrium. vomiting. 9 For porridge-like diarrhea. borborygmus. . thin. This causes the Liver to overcontrol the Spleen. . if paradoxical sign of the Liver overcontrolling the Spleen. . 4 For severe qi deficiency. 4 For diarrhea in children due to indigestion.Formulas that H a r m o n i z e the Stomach a n d Intestines ( c h n Pi). is attributed by Zhang Jie-Bing to Liu Cao-Chuang. add Fructus Crataegi (shan zha). Radix Ledebouriellae Divaricatae (fang feng) serves as both an assistant and envoy. Pinellia Decoction to Drain the Epigastrium 3 6 5% . is aromatic. add Rhizoma Cimicifugae (sheng ma) (source text). which is more commonly associated with treating Liver constraint. . and the problem is recurrent. which is very important here. *For diarrhea due to hypothyroid conditions. The diarrhea is marked by a few distinguishing characteristics: it is relatively meager in volume. It also helps Rhizoma Atractylodis Macrocephalae (bai zhu) strengthen the Spleen and eliminate dampness. . This formula eliminates focal distention and fullness in the epigastrium. add Semen Plantaginis ( c h qian zi). SECTION 3 FORMULAS THAT HARMONIZE THE STOMACH AND INTESTINES The formulas in this section are used in treating conditions in which pathogenic influences have invaded the Stomach and Intestines and formed complexes of heat and cold with simultaneous excess and deficiency. hyperthyroidism. 4 For severe abdominal pain. and add Concha Ostreae ( m u li) and Spica Prunellae Vulgaris (xia k u cao). which cites painful diarrhea as the primary indication. There has been some discussion regarding why this herb is used instead of Radix Bupleuri ( c h i hu). which is a common. Because Radix Ledebouriellae Divaricatae (fang feng) is an acrid. warm. The ascending and descending functions of these organs are thereby disrupted. For tenesmus. According to the famous twentieth-century physician. . nausea. 4 For watery diarrhea. this condition often recurs during times of stress and Liver constraint. this formula can also be used for the above presentation together with mild exterior wind-cold. Sclerotium Poriae Cocos (fuling) and Rhizoma Zingiberis Officinalis (gan jiang).9g Rhizoma Zingiberis Officinalis (gan jiang) . irritable bowel syndrome. and diarrhea. double the dosage of Radix Paeoniae Lactiflorae (bai shao). With the appropriate presentation. .

. . ANALYSIS OF FORMULA: Stomach qi disharmony due to a cold-heat complex is the primary mechanism of this pattern. borborygmus with diarrhea. . . . disperses clumping. which leads to cold. . . and focal distention of the epigastrium. The cold-heat complex in the middle burner is a condition of simultaneous excess and deficiency brought on by clumping. T h e simultaneous presence of excess and deficiency causes contention in the Intestines which is manifested as borborygmus. . where it produces clumping in the epigastrium and focal distention. An epigastrium that is soft to the touch is of particular diagnostic significance in selecting this formula over the two other primary formulas from Discussion of Cold-induced Disorders that treat sinking of pathogenic influences due to inappropriate purging. are required.Pinellia Decoction to D r a i n the Epigastrium Radix Scutellariae (huang qin). . . . the dosage of Rhizoma Pinelliae Ternatae (ban xia) is usually increased by 3g. If this occurs together with a cold-heat complex. . This is taken warm in three equal doses over the course of one day. . In this manner they work with the chief herb to stop the vomiting. . Whenever the Spleen and Stomach are disturbed there can be an obstruction of the ascending and descending functions of these organs. . . this formula is recommended for vomiting. .3g Radix Ginseng (ren shen) . There is only slight pain. The disruption of the digestive function leads to reduced appetite. acrid and bitter Rhizoma Pinelliae Ternatae (ban xia). yellow. . and harmonizes the actions of the other ingredients. . The wiry.12 pieces Honey-fried Radix Glycyrrhizae Uralensis (zhi gan cao) . . . The ingredients are removed and the strained decoction is further decocted until three CUDS remain. . . borborygmus. . . The envoy. . Only four pieces of Fructus Zizyphi Jujubae (da zao) are used. The epigastrium is soft. . and that of honeyfried Radix Glycyrrhizae Uralensis (zhi gan cao) is reduced by the same amount. . . . honey-fried Radix Glycyrrhizae Uralensis (zhi gun cao).9g Preparation: The source text advises to decoct the ingredients in approximately ten cups of water until six cups remain. INDICATIONS: Epigastric focal distention. . The dosage is reduced to prevent middle burner distention (see Cinnamon Twig Decoction [gui zhi tangl in chapter 1). . . COMMENTARY: This is a variation of Minor Bupleurum Decoction (xiao chai hu tang). Today it is usually prepared as a decoction in the usual manner. the assistant and envoy herbs are able to tonify without increasing the stagnation in the middle burner or aggravating the focal distention. dry heaves or frank vomiting. . rapid pulse reflects internal clumping and heat. . This causes dry heaves or vomiting above. greasy tongue coating. . and eliminates focal distention. and diarrhea below. . and palpation will reveal no masses or areas of hardness. . . . This type of focal distention is most commonly due to improper purging of an exterior or half-exterior. . . . . blockage. . . and eliminates focal distention. . reduced appetite. Clumping in the epigastrium also produces a sensation of fullness. . Actions: Harmonizes the Stomach. the heat in turn injures the Stomach qi. In Essentials from the Golden Cabinet U i n gui yao he). . . Later physicians have used it in treating patients with Spleen and Stomach deficiency that develop cold-heat complex due to an externally-contracted pathogenic influence. directs rebellious qi downward. . Minor Sinking into the Chest Decoction (xiao xian xiong tang) is indicated for focal distention (with or without masses) in the chest and epigastrium that is painful to the touch. and bitter herbs. Radix Ginseng (ren shen) and Fructus Zizyphi Jujubae (da m). This condition is not always caused by improper purging. . . . Available in prepared form. prevents the Spleen from raising the clear yang. Purging aggravates the Stomach deficiency and causes the pathogenic influence to sink into the interior. The rising of the turbid yin and clumping 151 of the pathogenic influences in the middle burner is also reflected in the yellow. . bitter and cold Radix Scutellariae (huang qin) and Rhizoma Coptidis (huang &an) drain heat. . . helps the assistant herbs tonify the middle qi. . . . .9g Rhizoma Coptidis (huang lian) . which generates heat. . . The term focal distention (pi) refers to a focused. more severe condition in which the entire abdomen is hard. stops the vomiting. . . and a wiry. localized sensation of discomfort. The thin. For this reason. half-interior condition in a patient with underlying Stomach deficiency. rapid pulse. and greasy tongue coating. . . which disperse clumping. . The chief herb. The deputies treat the cold-heat complex: acrid and warm Rhizoma Zingiberis Officinalis (ganjiang) expels cold. . . which direct the qi downward. greasy quality of the coating is due to concurrent excess and deficiency. This complex disrupts the ascending and descending functions of the Spleen and Stomach. a thin. acrid herbs. . The assistants. focal distention in the epigastrium and the other symptoms described above will ensue. fullness and tightness with very slight or no pain. . benefit the middle burner qi and prevent the dispersing actions of the chief and deputy herbs from injuring the normal qi. . enters the Stomach channel and disperses clumps. and interferes with the Stomach's function of directing the turbid yin downward. or no pain at all. . . . . Because of the presence of the chief and deputy herbs. . . Major Sinking into the Chest Decoction (da xian xiong tang) is indicated for a deeper. . . . . . .9g Fructus Zizyphi Jujubae (da zao). . . . and distention. .

. . . . . . . . . . a n d indigestion o r gastric ulcers d u e t o hypersecretion of acid. . a thin. very loud borborygmus.3g Rhizoma Pinelliae Ternatae (ban xia) . . . . . Available in prepared form. . . . . . . . . Available in prepared form. . $ h z . . slight irritability. Fructus Zizyphi Jujubae (da zao) a n d honey-fried R a d i x Glycyrrhizae Uralensis (zhi gun cao). . . . . . . and expels water. . . . and Arcane Essentials from the Imperial Library. . Fresh Ginger Decoction to Drain the Epigastrium . . Licorice Decoction to Drain the Epigastrium 44hY giin czo xi? xKn tiing Source: Discussion of Cold-induced Disorders (Shang han lun) For more severe Stomach qi deficiency characterized by undigested food in the stool and irritability. . . . . . . . There may also be fever and slight chills along with borborygmus and diarrhea. . . . it is included in other classical texts. abdominal pain. . . ASSOCIATED FORMULAS: * . . . . .12 pieces Regulates cold and heat. . . . . . . . . . and diarrhea. . . . characterized by firm epigastric focal distention. . . . . . . . a white. . . . chronic gastritis. . . . . VARIATION: Rhizoma Zingiberis Officinalis Recens ( h n g jiang) . . . dizziness. . . . . . . . .% huiing lien tiing Source: Discussion of Cold-induced Disorders (Shang han lun) Rhizoma Coptidis (huang lian). . this is for conditions with less intense heat and perhaps some remnant of an exterior condition. . . . . . Thousand Ducat Formulas. . . . . . . . . . . . . . . . . . . . . . disperses clumping. . . . . . . chronic hepatitis. . . . . . . .Fornullas that Harmonize the Stomach and Intestines distended. . . . . . . . . . . . . .6g Rhizoma Pinelliae Ternatae (ban xia) . . . this formula m a y b e used i n treating such biomedically-defined disorders a s acute gastroenteritis. . . . . . . . . . . . . fullness and pain in the epigastrium. .-1 & . . and directs rebellious qi downward. .9g Radix Scutellariae (huang qin) . . .in tiing Source: Discussion of Cold-induced Disorders (Shang han lun) COMPARATIVE T A B L E S OF P R I N C I P A L F O R M U L A S FORMULAS THAT HARMONIZE LESSER YANG-STAGE DISORDERS COMMON INDICATIONS: intermittent chills and fever. . . . nausea. . . . . . . forceful pulse . Also known as heat excess in the Stomach and Gallbladder. . .9g Ramulus Cinnamomi Cassiae (gui zhi) . Available in prepared form. . For water and heat complexes or Stomach deficiency with food stagnation and suspended fluids lingering internally.9g Rhizoma Zingiberis Officinalis (gan jiang) . . . . . . . wiry pulse FORMULA NAME Minor Bupleurum Decoction (xiao chai hu tang) Major Bupleurum Decoction (da chai hu tang) DIAGNOSIS Lesser yang disorder INDICATIONS I REMARKS Wide-ranging application including heat in the chamber of the blood. . . . nausea and vomiting. 3 s h h g jiiing xi? x. . . . . .9g Fructus Zizyphi Jujubae (da zao) . MODIFICATIONS: @ For damp-heat aggregating i n t h e middle b u r n e r with vomiting a n d focal distention. . . . . . . . . . . . . . . . yellow tongue coating. . . . . . . . . . . . . . . . stifling or full sensation in the chest and hypochondria.9g Rhizoma Coptidis (huang lian) . . . W i t h t h e appropriate presentation. . .9g Fructus Zizyphi Jujubae (da zao) . . Sour taste in the mouth. 3 g Radix Ginseng (ren shen) . . . . a n d so painful that it cannot b e a r t o b e touched. . . For heat in the chest and cold in the Stomach characterized by a stifling sensation and irritability in the chest. . the sound of fluids in the hypochondria. . . . . . . reduces focal distention. . . .12 pieces Harmonizes the Stomach. . burning diarrhea or no bowel movements. . greasy tongue coating. early-stage cirrhosis. . . . . . . . increase the dosage of honey-fried Radix Glycyrrhizae Uralensis (zhi gan zao) to 12-15g. .s Coptis Decoction & 52. . omit R a d i x G i n seng (ren shen). . . . . . . . .9g Honey-fried Radix Glycyrrhizae Uralensis (zhi gan cao) . . .12g Rhizoma Zingiberis Officinalis (gan jiang) . . . . . . . . R h i z o m a Zingiberis Officinalis (gan jiang). . . . . .9g Radix Ginseng (ren shen) . a n d a d d F r u c t u s I m m a t u r u s C i t r i A u r a n t i i (zhi shi) a n d R h i z o m a Zingiberis Officinalis Recens (sheng jiang). . . bitter taste in the mouth. . . .9g Honey-fried Radix Glycyrrhizae Uralensis (zhi gan cao) . . Although Radix Ginseng (ren shen) is omitted in the source text. among them Essentials from the Golden Cabinet. . . . . . . . . . . . harmonizes the Stomach. dry heaves with a foul odor. and a wiry pulse. . . . . white tongue coating Concurrent lesser yang and yang brightness disorders Continuous vomiting. In contrast to the principal formula. .

foul. cont. a thin. deficient pulse Recurrent problems of borborygmus. Important Formula for Painful Diarrhea (tong xie yao fang) Spleen deficiency with an overcontrolling Liver FORMULA THAT HARMONIZES T H E STOMACH AND INTESTINES FORMULA NAME Pinellia Decoction to Drain the Epigastrium (ban xia xie xin tang) DIAGNOSIS Heat and cold complex in the middle burner INDICATIONS Epigastric focal distention. a tongue with deep-red edges and a thick. reduced appetite. distention and pain in the chest and hypochondria. spitting bitter or sour fluids. and wiry on the left Alternating fever and chills occurring 1-3 times a day at irregular intervals. or slippery on the right. Reach the Membrane Source Decoction (da Yuan $4 Epidemic malarial disorder (damp-heat) Also known as severe halfinterior. white tongue coating. diarrhea with pain. . a thin. dry mouth and throat. fullness. thirst. greasy coating that may be yellow andlor white. and tightness. wiry. red tongue with a yellow coating. may also be abdominal pain andlor severe diarrhea Headache. Rambling Powder (xiao yao san) Liver constraint with blood deficiency Especially useful in women. rapid pulse I REMARKS A form of internal clumping. dry heaves or frank vomiting. and greasy tongue coating. red tongue with thick. and pasty coating. pulse that is soggy. yellow. headache. abdominal pain. irritability and fullness in the chest and epigastrium. wiry. fatigue. a rapid pulse REMARKS A form of Gallbladder and Stomach disharmony. borborygmus with diarrhea. FORMULA NAME Artemisia Annua and Scutellaria Decoction to Clear the Gallbladder (hao qin qing dan tang) DIAGNOSIS Damp-heat and turbid phlegm in the lesser yang channels INDICATIONS Mild chills alternating with pronounced fever. reduced appetite. vertigo. irritability. wiry pulse -- FORMULA NAME Frigid Extremities Powder (si ni san) DIAGNOSIS Rebellious Liver qi disturbing the Stomach INDICATIONS Cold fingers and toes (although the body is warm). half-exterior damp-heat. moderate or thin pulse REMARKS This is known as yang-type collapse. bitter taste in the mouth.FORMULAS THAT HARMONIZE LESSER YANG-STAGE DISORDERS. pale-red tongue. FORMULAS THAT REGULATE AND HARMONIZE T H E LIVER AND SPLEEN COMMON INDICATIONS: hypochondriac or abdominal pain.

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CHAPTER FIVE

Formulas that Treat Dryness

RYNESS, O N E OF T H E six excesses, may be external or internal. Treatment of external dryness requires herbs that have a gentle, dispersing action; internal dryness requires herbs that enrich the yin and moisten dryness. Although they share certain similarities, the differenc between these two types of dryness are sufficient to warrant separate discussion. External dryness refers to externally-contracted dryness. The prevalence of dryness in northern China typically corresponds to the beginning of autumn, as dampness recedes. As winter approaches, the occurrence of dryness in turn recedes, and cold becomes the predominant pathogenic influence. Dryness itself easily transforms into heat or fire. Therefore, depending on variations in the autumn weather, diseases from dryness are classified either as cool-dryness or warmdryness. Dryness was of particular interest to the warmfebrile school of traditional Chinese medicine. Yu Gen-Chu, a leading practitioner of the Qing dynasty, discussed the different types of external dryness in his
'

D

ook, Revised Popular Guide to the Discussion of Cold-induced Disorders: In the depth of autumn, [the air] begins to cool and the west wind is fierce. The externally-contractedcondition that people usually get at this time is wind-dryness, a type of cool-dryness. This condition is milder than the wind-cold of winter. If [in autumn] there are many sunny days and no rain, then the autumnal yang 'basks in the sun'. Warmdryness is commonly contracted at this time, which is a type of hot-dryness. It is more severe than the windwarmth disease (fing wFn) of spring. The seasonality of dryness in northern China does not, of course, necessarily correspond to its occurrence in other parts of the world. Moreover the widespread use of central heating and air conditioning in modern times has become a common cause of dryness irrespective of the season or locale. Externally-contracted dryness easily injures the Lungs and depletes the fluids. I n its early stages, in addition to such exterior symptoms as fever and chills, there may also be a dry mouth, sore throat, and either a nonproductive cough or one with scanty sputum.

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Formulas that Gently Disperse and Moisten Dryness
Internal dryness arises from the loss of an organ's essence and depletion of the fluids. It is most commonly associated with improper sweating or purging of a serious illness, severe vomiting, excessive urination, overindulgence in sex, or overconsumption of spicy foods. The clinical presentation of internal dryness is rather complex and will vary depending on the depth of the condition and which organs are affected. T h e Lungs, Spleen, Kidneys, and Large Intestine are most commonly involved. Internal dryness may also be understood from the perspective of the three burners: dryness in the upper burner leads to a hacking cough; dryness in the middle burner produces vomiting and belching, with an inability to keep food down; dryness in the lower burner causes dry stools or wasting and thirsting disorders. Because of the complex relationships among the various organs and body regions, and between the exterior and interior, differentiation of external and internal dryness is not always a simple matter. External dryness may affect the interior, the organs may affect each other, and the different parts of the body may interact on many levels. Such differentiation is especially difficult with the Lungs since external dryness almost immediately injures this organ. Formulas that treat dryness contain many enriching, cloying substances that can easily obstruct the qi. They also encourage the development of dampness and therefore should not be used for patients with a damp constitution. It is important that they be used with caution (and appropriate modification) in cases with diarrhea due to Spleen deficiency, or where there is marked qi stagnation.

Apricot Kernel and Perilla Leaf Powder
xing sii s6n
Source: Systematic Diflerentiation of Warm Diseases
(Wen bing tiao bian)

Folium Perillae Frutescentis (zi su ye) . . . . . . . . . .6g Radix Peucedani (qian hu). . . . . . . . . . . . . . . . . . . .6g Semen Pruni Armeniacae (xing ren). . . . . . . . . . . .6g Radix Platycodi Grandiflori (jie geng) . . . . . . . . . .6g Fructus Citri Aurantii (zhi ke) . . . . . . . . . . . . . . . .6g Pericarpium Citri Reticulatae (chn pi) . . . . . . . . .6g Sclerotium Poriae Cocos ( f u ling). . . . . . . . . . . . . .6g Rhizoma Pinelliae Ternatae (ban xia) . . . . . . . . . .6g Rhizoma Zingiberis Officinalis Recens (shng jiang) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .6g Fructus Zizyphi Jujubae (da zao) . . . . . . . . . 2 pieces Radix Glycyrrhizae Uralensis (gan cao) . . . . . . . . .3g Preparation: The source text advises to grind the herbs into powder and take as a draft. Today it is usually prepared as a decoction. Available in prepared form. Actions: Gently disperses cool-dryness, disseminates the Lung qi, and transforms congested fluids.
INDICATIONS:

SECTION 1

FORMULAS THAT GENTLY DISPERSE AND MOISTEN DRYNESS
The formulas in this section are used in treating externally-contracted cool-dryness and warm-dryness. Dryness itself directly injures the Lungs. Although there are significant differences between these two patterns, both are marked by a cough with little sputum. Cool-dryness is distinguished by chills, headache, and a dry mouth and throat; warm-dryness by fever, headache, thirst, and irritability.

Slight headache, chills without sweating, cough with watery sputum, stuffy nose, dry throat, a dry, white tongue coating, and a wiry pulse. This is externally-contracted cool-dryness interfering with the disseminating and descending functions of the Lungs. Headache and chills without sweating indicates cool-dryness attacking the exterior. When cool-dryness attacks the Lungs it disrupts their ability to facilitate the circulation of fluids. This results in the internal accumulation of fluids, and produces a type of congested fluids characterized by cough with watery sputum. Since the nose is the sensory orifice of the Lungs and the throat is part of the Lung system, dryness in the Lungs can lead to a stuffy nose and a dry throat. The dry, white tongue coating indicates cool-dryness. The wiry pulse indicates cool-dryness and congested fluids.
ANALYSIS O F F O R M U L A : The chief herbs in this

formula are bitter Semen Pruni Armeniacae (xing ren), which disseminates the Lung qi and stops the coughing, and acrid Folium Perillae Frutescentis (zi su ye), which releases exterior cold by promoting moderate sweating. The deputy herb, Radix Peucedani (qian hu), assists the chief herbs by directing the qi downward and releasing the exterior. Another deputy, Radix Platycodi Grandiflori (jie geng), causes the Lung qi to descend and stops the coughing. A third deputy, Fructus Citri Aurantii (zhi ke), moves the qi, expands

Mulberry Leaf and APicot Kernel Decoction the chest, and stops the coughing by regulating the qi. In order to address the problem of congested fluids (a type of phlegm), the qi of the middle burner (the source of phlegm) must be regulated and the phlegm expelled. The assistant herbs, Pericarpium Citri Reticulatae (chen Pi), Sclerotium Poriae Cocos (fu ling), and Rhizoma Pinelliae Ternatae (ban xia), regulate the qi of the middle burner and expel phlegm. The envoys, Rhizoma Zingiberis Officinalis Recens (sheng jiang), Fructus Zizyphi Jujubae (da zao), and Radix Glycyrrhizae Uralensis (gun cao), harmonize the actions of the other herbs and regulate the nutritive and protective qi. They thereby contribute both to the release of the exterior and the regulation of the middle qi.
COMMENTARY: This formula is based on the prin-

159

Fructus Pyri (li pi). . . . . . . . . . . . . . . . . . . . . . . . . .3g Preparation: Decoction. Dosage is based on the source text. Today the dosage is increased 2-3

INDICATIONS: Moderate fever, headache, thirst, a

ciple stated in chapter 74 of Basic Questionr: "For a dry pathogenic influence, internally treat with bitter and warm [herbs] and use sweet and acrid [herbs] adjunctively." It is especially useful in treating coughs due to colds contracted during the autumn. A peculiarity of this condition is that while it affects the protective qi (superficial) level of the Lungs, the fluids are already injured. This formula is very effective in treating relatively superficial conditions with cough during any time of the year. A variation of this formula, Ginseng and Perilla Leaf Decoction (shn su yin), is used for windcold disorders with qi deficiency (see chapter 1). With the appropriate presentation, this formula may be used in treating such biomedically-defined disorders as acute and chronic bronchitis, bronchiectasis, and emphysema.
MODIFICATIONS:
e For absence of sweating and a very wiry or tight pulse, add Radix et Rhizoma Notopterygii (qiang huo) (source text). * For diarrhea and a sensation of fullness in the abdomen, add Rhizoma Atractylodis (cang zhu) and Cortex Magnoliae Officinalis (hou to) (source text). @ For headache involving the supraorbital ridge, add Radix Angelicae (bai zhi) (source text).

dry, hacking cough or one with scanty, thick, and sticky sputum, a red tongue with a thin, dry, and white coating, and a floating, rapid pulse (especially on the right). This is warm-dryness injuring the Lung qi at a relatively superficial (exterior) level. Because the Lungs are responsible for respiration and control the skin, they are the organ most influenced by the external environment. When the weather is dry, dryness will affect the Lungs first. At a relatively exterior level, this leads to moderate fever and headache. Disruption in the flow of Lung qi and the scorching effect of warm-dryness causes a dry, hacking cough. Dryness also depletes the Lung fluids, which manifests as thirst, a red tongue, and a dry tongue coating. The floating, rapid pulse indicates a relatively superficial disorder. It is especially floating on the right (qi) side.
ANALYSIS OF FORMULA: The treatment of warm-

Mulberry Leaf and Apricot Kernel Decoction

*d%
siing xing tiing
Source: Systematic Di8erentiation o f W a r m Diseases
( W e n bing tiao bian)

dryness attacking the Lungs requires the use of cool, acrid herbs to release warm-dryness from the upper burner, and cool, moistening herbs to make the Lung qi descend. One of the chief herbs, Folium Mori Albae (sang ye), clears dryness from the upper burner. Its deputies, Fructus Gardeniae Jasminoidis (zhi zi) and Semen Sojae Praeparata (dan dou chi), release constrained heat. This combination prevents the pathogenic influence from penetrating further into the body and helps release it from the exterior. The other chief herb, Semen Pruni Armeniacae (xing ren), which causes the Lung qi to descend, is assisted by its deputy, Bulbus Fritillariae Thunbergii (zhe bei mu), which cools and transforms the stagnation that might otherwise cause phlegm to form. The combination of the two chief herbs is very effective in gently dispersing warm-dryness and moistening the Lungs. The assistants, Radix Adenophorae seu Glehniae (sha shn) and Fructus Pyri (li pi), nourish the yin and clear heat. Together they have a cooling and moistening effect.
COMMENTARY: The important indications for this

Folium Mori Albae (sang ye). . . . . . . . . . . . . . . . . .3g Fructus Gardeniae Jasminoidis (zhi zi) . . . . . . . . .3g Semen Sojae Praeparata (dun dou chi) . . . . . . . . . .3g

formula include a dry, hacking cough, a thin, dry, white tongue coating, and a floating, rapid pulse. It may also be used for conditions at this level that affect the collaterals of the Lungs with coughing of blood, and in

160

Fmmulas that Gently Disperse and Moisten Dryness
chest and pain in the hypochondria develops. The presence of dryness is reflected in the hacking, dry cough, dry nasal passages, parched throat, irritability and thirst, and dry tongue without coating. The injury to the Lungs from warm-dryness also causes a mild deficiency of qi, which is reflected in the deficient and big pulse, and yin, which is reflected in the rapid pulse.
ANALYSIS OF FORMULA: One of the chief herbs,

the treatment of respiratory problems caused by working in dry environments. With the appropriate presentation, this formula may be used in treating such biomedically-defined disorders as upper respiratory tract infection, pharyngitis, pertussis, bronchitis, and bronchiectasis.
CAUTIONS
&

CONTRAINDICATIONS: Contrain-

dicated in cases with injury to the yin.
MODIFICATIONS:

increase the dosage of Fructus GardeniaeJasminoidis (zhi zi) and add Cortex Moutan Radicis ( d m pi) and Herba Artemisiae Annuae (qing hao). * For marked sore throat, add Fructus Arctii Lappae (niu bang zi) and Radix Scrophulariae Ningpoensis ( x w m shen). * For thick, yellow sputum, add Pericarpium Trichosanthis (gua lou pi) and Fructus Aristolochiae (ma dou ling).

* For nosebleed,

&* : + fq ?& i
qTng 20 jiii $i tiing

Eliminate Dryness and Rescue the Lungs ~ e c o c t i o n

Source: Precepts for Physicians (Yi men fa lu) Folium Mori Albae (sang ye). . . . . . . . . . . . . . . . . .9g Gypsum (shi gao) . . . . . . . . . . . . . . . . . . . . . . . . . .7.5g Tuber Ophiopogonis Japonici (mai men dong). . .3.6g Gelatinum Corii Asini (e jiao) [dissolve in strained decoction] . . . . . .2.4g Semen Sesami Indici (hei zhi ma). . . . . . . . . . . . . .3g Semen Pruni Armeniacae (xing ren) . . . . . . . . . .2.lg Honey-fried Folium Eriobotryae Japonicae (mi zhi pi pa ye). . . . . . . . . . . . . . . . . . . . . . . . . . .3g Radix Ginseng (ren shen). . . . . . . . . . . . . . . . . . . .2.lg Radix Glycyrrhizae Uralensis (gan cao) . . . . . . . . .3g Preparation: Decoction. Radix Adenophorae seu Glehniae (sha shn) or Radix Pseudostellariae Heterophyllae (hai er shen) is usually substituted for Radix Ginseng (ren shen) with 2-3 times its dosage. Available in prepared form. Actions: Clears dryness and moistens the Lungs. INDICATIONS: Headache, fever, hacking cough,

Folium Mori Albae (sang ye), clears and disperses dryness from the Lungs. Gypsum (shi gao), the other chief herb, clears heat from the Lung and Stomach channels and thereby relieves thirst. The relatively small dosage of Gypsum (shi gao) prevents this ingredient from inhibiting the spreading action of Folium Mori Albae (sang ye). The two chief herbs interact synergistically to treat warm-dryness in the Lungs. The deputies, Tuber OphiopogonisJaponici ( m i men dong), Gelatinum Corii Asini (e jiao), and Semen Sesami Indici ( h i zhi ma), moisten the Lungs and nourish the Lung yin. These herbs work to counterbalance the heat-clearing and Lung qi-disseminatingactions of the other ingredients with a moistening action. Semen Pruni Armeniacae (xing ren) and honey-fried Folium Eriobotryae Japonicae (mi zhi Pi pa ye) , two of the assistants, cause the Lung qi to descend and also moisten the Lungs. The other two assistants, Radix Ginseng (ren shen) and Radix Glycyrrhizae Uralensis (gan cao), augment the qi and harmonize the middle, thereby supplementing the 'mother' (Spleen) to benefit the 'child' (Lungs). Radix Adenophorae seu Glehniae (sha shen) or Radix Pseudostellariae Heterophyllae ( h i er shen) are usually substituted for Radix Ginseng (ren shen) because they are less expensive, and also because they directly nourish the Lung yin and possess a mild, qi-tonifying action. Radix Glycyrrhizae Uralensis (gan cao) is also regarded as an envoy because it harmonizes the actions of the other herbs in the formula.
COMMENTARY: This formula was devised by the

wheezing, a dry and parched throat, dry nasal passages, a sensation of fullness in the chest, hypochondriac pain, irritability, thirst, a dry tongue without coating, and a deficient, big, and rapid pulse. This is warm-dryness attacking the Lungs and causing the Lung qi to rebel, which is reflected in the headache, fever, cough, and wheezing. When the Lung qi is unable to spread, a sensation of fullness in the

early Qing-dynasty physician, Yu Chang, owing to his belief that there was no formula which adequately addressed conditions of dryness in the Lungs. Successful treatment of such conditions requires a certain degree of sophistication. Acrid, aromatic substances are inappropriate because they can injure the Lung qi. Bitter, cold herbs are also inappropriate because they can deplete the yin and the fluids. Only a combination of ingredients like those in this formula can adequately address all aspects of this condition. This formula is usually prescribed for disorders caused by exposure to dry environmental conditions, including seasonal and indoor dryness. It is stronger than Mulberry Leaf and Apricot Kernel Decoction

Lily Bulb Decoction to Preserve the Metal
a n g ) , and is intended for less superficial (sang xing t conditions with a stronger dry pathogenic influence. Sometimes patients with acute-onset hemiplegia will have signs and symptoms of dryness invading the Lungs. This formula may be helpful for such patients. With the appropriate presentation, this formula may be used in ireating such biomedically-defined disorders as upper respiratory tract infection, influenza, acute and chronic bronchitis, pulmonary tuberculosis, pneumonia, and pertussis.
CAUTIONS & CONTRAINDICATIONS: This formula contains rich, cloying substances and should therefore be used with caution in patients with Spleen and Stomach deficiency. Although the formula contains tonifying herbs, its principal application is in cases where the pathogenic influence has not been eliminated. It should not be used for cases of deficiency in the absence of exterior signs. MODIFICATIONS: For profuse, thick, and sticky sputum, add Bulbus Fritillariae Cirrhosae (chuan bei mu) and Semen Trichosanthis ( p a lou ren). * For blood-streaked sputum, add Radix Rehmanniae Glutinosae (shng di huang) and Cacumen Biotae Orientalis (ce bai ye). For constipation, add Semen Persica (tao ren) and Semen Cannabis Sativae (huo ma ren). For hot Lung atrophy, add Cortex Mori Albae Radicis (sang bai pi), Rhizoma Phragmitis Communis (lu gen), Indigo Pulverata Levis (qing dai) and Gecko (ge jie). SECTION 2

FORMULAS THAT ENRICH THE YIN AND MOISTEN DRYNESS
The formulas in this section treat internal dryness with yin deficiency, primarily of the Lungs and Stomach. T h e most common symptoms of this disorder include cough with scanty sputum, nausea and vomiting, a dry mouth, wasting and thirsting disorder, and constipation. This condition is often caused by internal disharmonies, but may also appear as the sequelae of externally-contracted dryness. It is important to properly differentiate the two. Prescribing a formula that enriches the yin and moistens dryness for a condition in which the pathogenic influence is still active in the exterior may cause the pathogenic influence to linger, or may exacerbate the condition. Conversely, the use of herbs that disperse externally-contracted dryness where the condition is actually one of internal dryness with yin deficiency will aggravate the. injury to the qi and yin.

*

Lily Bulb Decoction to Preserve the Metal

* *

6&a&%
b6i ht gii jh tiing

This formula acts to preserve and stabilize the function of the ~un&, which are associated with the metal phase, and one of its chief herbs is lily bulb (bai he), hence the name.
Source: Analytic Collection o f Medical Formulas (Yi fang ji jie) Bulbus Lilii (bai he) . . . . . . . . . . . . . . . . . . . . . . . . .3g Radix Rehmanniae Glutinosae (sheng di huang). . .6g Radix Rehmanniae Glutinosae Conquitae (shu di huang) . . . . . . . . . . . . . . . . . . . . . . . . . . . . .9g Tuber OphiopogonisJaponici ( m i men dong). . .4.5g Radix Scrophulariae Ningpoensis (xuan shen) . .2.4g Bulbus Fritillariae (bei mu) . . . . . . . . . . . . . . . . . . .3g Radix Platycodi Grandiflori (jie geng) . . . . . . . .2.4g Radix Angelicae Sinensis (dang gui). . . . . . . . . . . .3g Radix Paeoniae Lactiflorae (bai shao) . . . . . . . . . .3g Radix Glycyrrhizae Uralensis (gan cao) . . . . . . . . .3g Preparation: Decoction. Today most practitioners use 2-3 times the specified dosage, and some texts advise to increase the dosage of Bulbus Lilii (bai he) to 24 grams. Bulbus Fritillariae Cirrhosae (chuan bei mu) is generally the species of Fritillariae used. Available in prepared form. Actions: Nourishes the yin, moistens the Lungs, transforms phlegm, and stops coughing. INDICATIONS: Coughing with blood-streaked sputum, wheezing, a dry and sore throat, hot palms

ASSOCIATED FORMULA: G l e h n i a and Ophiopogonis Decoction

: 3 -9& i 2 $ 5 6
shii shen m&i m m i n dong tiing Source: Systematic Differentiation of Warm Diseases (Wen bing tiao bian)
Radix Adenophorae seu Glehniae (sha shen) . . . . . . . . .9g Tuber Ophiopogonis Japonici ( m i men dong). . . . . . . . .9g Rhizoma Polygonati Odorati (yu zhu) . . . . . . . . . . . . . .6g Folium Mori Albae (sang ye). . . . . . . . . . . . . . . . . . . . .4.5g Radix Trichosanthis Kirilowii (tian huafen) . . . . . . . .4.5g Semen Dolichoris Lablab (bai bian dou). . . . . . . . . . . .4.5g Radix Glycyrrhizae Uralensis (gan cao) . . . . . . . . . . . . .3g Clears and nourishes the Lungs and Stomach, generates fluids, and moistens dryness. For injury to the Lungs, Stomach, and fluids from dryness characterized by a dry throat, thirst, a hacking cough with scanty sputum, and a red tongue with little coating. Similar in function to the principal formula, except that it treats relatively mild conditions where only the yin and fluids have been injured, and not the qi. Available in prepared form.

162

Formulas that Enrich the Y i n and Moisten Dryness

and soles, night sweats, a red tongue with little coating, and a thin, rapid pulse. This is internal dryness of the Lungs due to Lung and Kidney yin deficiency. Yin deficiency generates internal heat which rises to cause a dry and sore throat. Yin deficiency may be caused either by a chronic disorder of the Lungs which injures the yin and fluids, or by any condition which injures the Kidney yin. Heat from deficiency 'steams' the delicate, uppermost organ (the Lungs), and interferes with the regulation of Lung qi, producing coughing and wheezing. Heat from deficiency also 'scorches' the collaterals of the Lungs, leading to blood-streaked sputum. The other signs and symptoms are classic indications of heat from deficiency.
ANALYSIS OF FORMULA: Bulbus Lilii (bai he), one

improves the condition of the throat. COMMENTARY: This formula and Tonify the Lungs Decoction with Ass-hide Gelatin (bufei e jiao tang) have similar functions. Lily Bulb Decoction to Preserve the Metal (bai he gu jin tang) possesses stronger yinnourishing actions; Tonify the Lungs Decoction with Ass-hide Gelatin (bufei e jiao tang) focuses on clearing heat and stopping the bleeding. This formula and Eliminate Dryness and Rescue the Lungs Decoction (qing zao jiufei tang) are also similar in that they both moisten and nourish the Lung yin. However, this formula only nourishes the Lung and Kidney yin and treats fire from deficiency. Eliminate Dryness and Rescue the Lungs Decoction, (qing m j i u j i tang), which augments the qi and has a slight exterior-releasing function, addresses injury to the qi and yin. Both this formula and Fritillaria and Trichosanthes Fruit Powder (bei mu gua lou san) treat Lung dryness with phlegm. However, Fritillaria and Trichosanthes Fruit Powder (bei mu gua lou san) primarily transforms phlegm and is used when the phlegm is severe, the dryness is not intense, and the yin is not yet deficient. This formula focuses on moistening the Lungs and is used when the dryness is more severe than the phlegm, and the yin is already deficient. With the appropriate presentation, this formula may be used in treating such biomedically-defined disorders as chronic bronchitis, bronchiectasis, pharyngitis, spontaneous pneumothorax, cor pulmonale, silicosis, and pulmonary tuberculosis. CAUTIONS & CONTRAINDICATIONS: Most of the herbs in this formula are of a sweet, cold, and cloying nature. For this reason, it should be used with caution or modified (using herbs that strengthen the Spleen and regulate the qi) in cases with Spleen deficiency or food stagnation. Failure to do so may result in indigestion or diarrhea. It should not be used for patients with exterior conditions. MODIFICATIONS: * For copious sputum, add Semen Trichosanthis (gua lou ren) and Cortex Mori Albae Radicis (sang bai pi). *For coughing up profuse blood, omit Radix Platycodi Grandiflori (jie geng), which has an ascending action, and add Rhizoma Imperatae Cylindricae (bai mao gen) and Herba Agrimoniae Pilosae (xian he cm). For pronounced fever and dark-yellow sputum, add Radix Anemarrhenae Asphodeloidis (zhi mu) and Herba cum Radice Houttuyniae Cordatae (yuxing cao). * For lung cancer with yin deficiency, add Herba cum Radice Houttuyniae Cordatae (yu xing cao), Radix Paeoniae Rubrae (chi shao), Bungarus multicinctus (bai hua she) and Herba Scutellariae Barbatae (ban zhi lian).

of the chief herbs in the formula, moistens and nourishes dryness in the Lungs, and clears heat. Another of the chief herbs, Radix Rehmanniae Glutinosae (sheng di huang), strongly enriches the yin and tonifies the Kidneys. It also performs the important function of cooling the blood to stop the bleeding. Radix Rehmanniae Glutinosae Conquitae (shu di huang), the third chief herb, is a very powerful tonic for the Liver and Kidney yin. In concert with Radix Rehmanniae Glutinosae (shng di huang), it is also especially helpful in treating fire due to yin deficiency. One of the deputies, Tuber Ophiopogonis Japonici (mai men dong), is an important herb for tonifying the yin, especially that of the upper burner. It also potentiates the actions of Bulbus Lilii (bai he) on the Lungs, and the yin-tonifying actions of the other chief herbs. The other deputy, Radix Scrophulariae Ningpoensis (xuan shen), helps the Kidney water to ascend to the Lungs, and is very useful in clearing fire from deficiency and treating steaming bone condition. Bulbus Fritillariae Cirrhosae (chuan bei mu), one of the assistants, moistens the Lungs, transforms phlegm, and stops coughing. Another assistant, Radix Platycodi Grandiflori (jie geng), facilitates the movement of Lung qi and stops coughing, especially when combined with Bulbus Fritillariae Cirrhosae (chuan bei mu). The other assistant herbs, Radix Angelicae Sinensis (dang gui) and Radix Paeoniae Lactiflorae (bai shao), nourish the blood to support the yin. In ancient materia medica, Radix Angelicae Sinensis (dang gui) was considered to be useful in stopping coughing. Another way of viewing the actions of Radix Paeoniae Lactiflorae (bai shao) and Radix Angelicae Sinensis (dang gui) is that by calming the Liver they protect the Lungs from violation. The envoy, Radix Glycyrrhizae Uralensis (gan cm), harmonizes the actions of the other herbs and, in combination with Radix Platycodi Grandiflori (jie geng),

Toni,fy the Lungs Decoction w i t h Ass-Hide Gelatin

163

Tonify the Lungs Decoction with Ass-Hide Gelatin

and benefit the Lungs. This combination cultivates the earth (Spleen) to generate metal (Lungs) in order to tonify the Lungs, and prevents the other herbs from disrupting the digestive process.
COMMENTARY: This formula was originally known

Source: Craft o j Medicinal Treatment for Childhood Disease Patterns (Xiao er yao zheng zhi jue) Gelatinum Corii Asini (e jiao) . . . . . . . . . . . . . . .45g Fructus Aristolochiae (ma dou ling). . . . . . . . . . . . 15g Semen Pruni Armeniacae (xing ren). . . . . . . . . . . .6g Fructus Arctii Lappae (niu bang zi). . . . . . . . . . .7.5g Nonglutinous Rice (geng mi). . . . . . . . . . . . . . . . .30g Honey-fried Radix Glycyrrhizae Uralensis (zhi gan cao) . . . . . . . . . . . . . . . . . . . . . . . . . . . .7.5g Preparation: The source text advises to dry-fry Gelatinum Corii Asini (e jiao) with wheat bran, pound it and form into balls with glutinous rice flour, grind the other ingredients into powder, and take as a draft in 3-6g doses. Today it is prepared as a decoction with proportioned doses of Gelatinum Corii Asini (e jiao) dissolved in water and added to the decoction. Available in prepared form. Actions: Nourishes the yin, tonifies the Lungs, controls coughing, and stops bleeding.
INDICATIONS: Coughing with wheezing, a dry and

as Ass-hide Gelatin Powder (e jiao san) or Tonify the Lungs Powder (bufei san). T h e use of Fructus Arctii Lappae (niu bang zi) in the formula, and the presence of a floating pulse in the presentation, has led some commentators to identify this as a formula for treating externally-contracted conditions with Lung yin deficiency. Most clinicians, however, do not share this view.
MODIFICATIONS:
@ For blood-streaked sputum with severe heat signs due to Liver fire violating the Lungs, add Indigo Pulverata Levis (qing dai) and Fructus Gardeniae Jasminoidis (zhi zi).

ASSOCIATED FORMULAS:

Moonlight Pill
yui huh whn

A4-

Source: Medical Revelations (Yi xue xin wu) parched throat, scanty or blood-streaked sputum, a red tongue with little coating, and a floating, thin, and rapid pulse. This is Lung yin deficiency with vigorous heat, which disrupts the flow of Lung qi and results in coughing with wheezing. T h e dry throat and cough with scanty sputum is due to the scorching of the fluids. Heat also scorches the collaterals of the Lungs, leading to blood-streaked sputum. T h e tongue signs indicate heat due to yin deficiency. T h e floating, rapid pulse indicates heat in the Lungs, the most superficial of the yin organs. T h e tongue signs and the thin pulse also indicate that this is not an externally-contracted exterior condition, which would present with no change in the color of the tongue body (or only a red tip), and some coating would remain.
ANALYSIS O F FORMULA: This formula treats both the manifestation (heat) and the root (Lung yin deficiency) of t h e disorder. T h e chief ingredient, Gelatinum Corii Asini (ejiao), nourishes the yin and tonifies the Lungs, stops the bleeding, and nourishes the blood. The deputy ingredients treat the manifestations: Fructus Aristolochiae (ma dou ling) clears heat and stops the coughing; Semen Pruni Armeniacae (xing ren) causes the Lung qi to descend and calms the wheezing; Fructus Arctii Lappae (niu bang zi) spreads the Lung qi and unblocks areas of congestion in the throat. T h e assistants, nonglutinous rice and honey-fried Radix Glycyrrhizae Uralensis (zhi gan cao), tonify the Spleen

Tuber Asparagi Cochinchinensis (tian men dong) . . . . .30g Tuber Ophiopogonis Japonici ( m i men dong). . . . . . . .30g Radix Rehmanniae Glutinosae (sheng di huang) . . . . . .30g Radix Rehmanniae Glutinosae Conquitae (shu di huang) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .30g Radix Dioscoreae Oppositae (&an yao) . . . . . . . . . . . .30g Radix Stemonae (bai bu) . . . . . . . . . . . . . . . . . . . . . . . .30g Radix Adenophorae seu Glehniae (sha shen) . . . . . . . .30g Bulbus Fritillariae Cirrhosae (chuan bei mu) . . . . . . . . .30g Gelatinum Corii Asini (e jiao) . . . . . . . . . . . . . . . . . . . .30g Sclerotium Poriae Cocos ( f u linl) . . . . . . . . . . . . . . . . . 15g Iecur Lutrae (fa gan). . . . . . . . . . . . . . . . . . . . . . . . . . . . 15g Radix Notoginseng (san qi) . . . . . . . . . . . . . . . . . . . . . .15g Flos Chrysanthemi Morifolii Albae (bai ju hua). . . . . .60g Folium Mori Albae (sang ye) . . . . . . . . . . . . . . . . . . . . .60g Make a paste with the addition of honey, and form into pills. Take in 15g doses three times a day. Enriches the yin, moistens the Lungs, controls coughing, and stops bleeding. For Lung and Kidney yin deficiency characterized by chronic cough or consumptive cough with tidal fever, heat in the five centers, emaciation, dry and nonproductive cough or cough with blood-streaked sputum, a dry mouth and throat, a sensation of fullness in the chest with reduced appetite, shortness of breath, laconic speech, difficult bowel movements, scanty urine, a red and dry tongue, and a thin, rapid pulse. In contrast to the principal formula, this possesses a stronger tonifying effect on the yin of the Lungs and Kidneys, and is particularly useful in treating Lung consumption.

Sweet Dew Decoction
giin 1 2 yZn

164

Formulas that Enrich the Yin and Moisten Dryness This is 'white throat' (bcii ho'u) or diphtherial disorder, which usually develops in persons with constitutional yin deficiency and internal clumping of heat who contract epidemic toxin (yi dzi). Epidemic toxin further injures the deficient fluids, and hot epidemic toxin fumes upward, causing the distinctive symptom of a white, curd-like membrane in the throat that is difficult to scrape off. This membrane interferes with breathing and causes it to become raspy. The fever, tongue, and pulse signs are characteristic of heat with yin deficiency. The sore and swollen throat, dry nasal passages, and parched lips are due to hot epidemic toxin and heat (from Kidney and Lung yin deficiency) rising upward. This type of deficiency can also disrupt the qi mechanism of the Lungs, which produces coughing. ANALYSIS OF FORMULA: The chief herbs, Radix Rehmanniae Glutinosae (sheng di huang) and Radix Scrophulariae Ningpoensis (xuan shen), work synergistically to nourish the yin, clear heat from deficiency, cool the blood, and relieve toxicity. Two of the deputies, Tuber OphiopogonisJaponici (mi men dong) and Radix Paeoniae Lactiflorae (bai shao), assist the chief herbs in nourishing the yin. Tuber Ophiopogonis Japonici (mi men dong) acts on the Lungs; Radix Paeoniae Lactiflorae (bai shao) preserves and protects the yin. The other deputy, Cortex Moutan Radicis (mu dan Pi), cools the blood, reduces swelling, and supports the actions of the chief herbs. The assistant herb, Bulbus Fritillariae Cirrhosae ( c h n bei mu), moistens the Lungs, stops the coughing, and clears and transforms phlegm-heat. Herba Menthae Haplocalycis (bo he) is added to help disperse the pathogenic influence and aid the throat. Radix Glycyrrhizae Uralensis (gan cao) relieves toxicity, improves the condition of the throat, and harmonizes the actions of the other herbs in the formula. COMMENTARY: The etiology of this condition is described in the source text: "This disorder arises from the Lungs and Kidneys in people with deficiency, or in those who have contracted a prevalent dry qi, or who eat too many spicy and hot foods." With the appropriate presentation, this formula may be used in treating such biomedically-defined disorders as diphtheria, tonsillitis, pharyngitis, and tumors of the nose and throat. CAUTIONS & CONTRAINDICATIONS: Diphtheria is a very serious, even life-threatening disease, and extreme care must be exercised in its treatment. In China this condition is treated with a combination of traditional Chinese and modern medicine, especially in cases with breathing difficulties. MODIFICATIONS: For severe constitutional yin deficiency, add Radix

Source: Imperial &ace Formulary of the Tai Ping Era (Tai ping hui min he ji ju fang) Radix Rehmanniae Glutinosae (sheng di huang) . . . . . . .9g Radix Rehmanniae Glutinosae Conquitae (shu di huang) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .9g Herba Dendrobii (shi hu) . . . . . . . . . . . . . . . . . . . . . . . . .9g Tuber Asparagi Cochinchinensis (tian men dong) . . . . .12g Tuber Ophiopogonis Japonici ( m i men dong). . . . . . . . 1% Radix Scutellariae (huang qin) . . . . . . . . . . . . . . . . . . . . .9g Herba Artemisiae Yinchenhao (yin chen hao). . . . . . . . .9g Fructus Citri Aurantii (zhi ke). . . . . . . . . . . . . . . . . . . . .9g Folium Eriobotryae Japonicae (pi pa ye) . . . . . . . . . . .24g Radix Glycyrrhizae Uralensis (gun cao) . . . . . . . . . . . . . 6g The source text advises to coarsely grind equal amounts of the ingredients and take in 6g doses as a draft. Today it is usually prepared as a decoction with the dosage specified above. Nourishes the yin, clears heat, disseminates the Lung qi, and resolves dampness. For yin deficiency with yang brightness-channel dampness characterized by swollen gums with or without pus, mouth ulcers, bad breath, sore throat, and a dry, red tongue with a yellow, greasy coating. Primarily nourishes the yin, and secondarily clears heat and drains dampness. The use of this formula has been expanded recently to include treatment of some eye disorders (the Stomach channel terminates near the eyes), as well as other conditions with yin deficiency and damp-heat.

Nourish the Yin and Clear the Lungs Decoction
yiing y T n q h g @i tiing
Source: Jade Key t o Many Towers (Chong lou yu yao) Radix Rehmanniae Glutinosae (sheng di huang). . .6g Radix Scrophulariae Ningpoensis (xuan shen) . .4.5g Tuber Ophiopogonis Japonici ( m i men dong). . .3.6g Dry-fried Radix Paeoniae Lactiflorae (chao bai shao) . . . . . . . . . . . . . . . . . . . . . . . . . . .2.4g Cortex Moutan Radicis (mu dan Pi) . . . . . . . . . .2.4g Bulbus Fritillariae (bei mu). . . . . . . . . . . . . . . . . .2.4g Herba Menthae Haplocalycis (bo h) . . . . . . . . .1.5g Radix Glycyrrhizae Uralensis (gun cao) . . . . . . .1.5g Preparation: Decoction. Today the dosage is increased 2-3 times. Bulbus Fritillariae Cirrhosae (chuan bei mu) is generally the species of Fritillariae (bei mu) used. Available in prepared form. Actions: Nourishes the yin, clears the Lungs, and relieves toxicity.

INDICATIONS: Development of a white, curd-like membrane in the throat that is difficult to scrape off, swollen and sore throat, fever, dry nasal passages, parched lips, raspy breathing resembling wheezing, a red and dry tongue, and a rapid, usually thin pulse. There may also be coughing.

Ophiopogonis Decoction
Rehmanniae Glutinosae Conquitae (shu di huang) (source text). * For severe dryness, add Tuber Asparagi Cochinchinensis (tian men dong), Radix Anemarrhenae Asphodeloidis (zhi mu) and Rhizoma Phragrnitis Communis (lu gen). * For severe swelling and pain in the throat, add Rhizoma Belamcandae Chinensis (she gan), Radix Platycodi Grandiflori (jie geng), Bombyx Batryticatus (jiang can) and Fructificatio Lasiosphaerae seu Calvatiae ( m bo). * For marked exterior signs, add Folium Mori Albae (sang ye) and Periostracum Cicadae (chan tui). *For more pronounced fever, add Fructus Forsythiae Suspensae (lian qiao), Flos Lonicerae Japonicae (jin yin hua) and Radix Isatidis seu Baphicacanthi (ban Ian gen).

165

scorching of the Lung yin causes shortness of breath and depletes the fluids. The depletion of the fluids leaves only saliva or a thick, viscous sputum that becomes lodged in the throat and causes a dry, uncomfortable sensation. The dry mouth, and the tongue and pulse signs, are classic indications of heat from deficiency leading to internal dryness.
ANALYSIS OF FORMULA: Following the classical

Ophiopogonis Decoction

Source: Essentialsfrom the Golden Cabinet Uin gui yao he) Tuber Ophiopogonis Japonici

(mai men dong). . . . . . . . . . . . . . . . . . . . . . . . .15-18g Radix Ginseng (ren shen) . . . . . . . . . . . . . . . . . . . . .6g Nonglutinous rice (geng mi) . . . . . . . . . . . . . . . .9-15g Fructus Zizyphi Jujubae (da zao). . . . . . . . .12 pieces Radix Glycyrrhizae Uralensis (gan cao) . . . . . . . . .6g Rhizoma Pinelliae Ternatae (ban xia) . . . . . . .4.5-9g
Preparation: Decoction. Today 3-4 pieces of Fructus Zizyphi Jujubae (da zao) are used. Available in prepared form. Actions: Benefits the Stomach, generates fluids, and directs rebellious qi downward.

INDICATIONS: Coughing and spitting of saliva, wheezing, shortness of breath, a dry and uncomfortable sensation in the throat, a dry mouth, a dry, red tongue with little coating, and a deficient, rapid pulse. This is a form of Lung atrophy (fei wii). Although the symptoms are primarily related to the Lungs, the condition is actualiy caused by heat from deficiency in the Stomach, which rises in rebellion and scorches the Lung yin. It may also be understood by reference to the theory of the five phases, wherein the 'mother' (Stomach) transmits the problem to the 'child' (Lungs). The Lungs are the most delicate of the yin organs and serve as a canopy for the trunk. They depend on the earth (SpleenIStomach) for nourishment and for some of its fluids. If, over an extended period of time, the Lungs do not receive proper nourishment or moisture, they shrivel up or 'atrophy.' The rebellious qi from the Stomach prevents the Lung qi from descending properly, and results in coughing and wheezing. The

precepts of moistening dryness and tonifying the 'mother' for deficiency, the focus of this formula is primarily to moisten and nourish the Stomach yin, and only secondarily to direct the rebellious qi downward. The chief herb, Tuber Ophiopogonis Japonici ( m i men dong), clears heat from deficiency from the Stomach, and generates fluids in the Stomach and Lungs. It is therefore very useful in the treatment of Lung atrophy. Some sources recommend a dosage of as much as 45g of this herb. The deputy, Radix Ginseng (ren shen), augments the qi, generates fluids, and revives the qi and yin. Tuber Ophiopogonis Japonici ( m i men dong) and Radix Ginseng (ren shen) form a particularly powerful combination for reviving the qi and yin of the Lungs and Stomach. The remaining ingredients are regarded as assistants. Nonglutinous rice, Fructus Zizyphi Jujubae (da zao), and Radix Glycyrrhizae Uralensis (gan cao) work synergistically with the chief and deputy herbs to assist the Stomach qi and generate fluids. While honey-fried Radix Glycyrrhizae Uralensis (zhi gan cao) has a relatively stronger action in tonifying the Stomach, its unprepared form is used here because it also improves the condition of the throat. Rhizoma Pinelliae Ternatae (ban xia) facilitates the flow of Stomach qi and directs the qi downward. The warm, acrid, drying nature of this herb is moderated by the moistening herbs in the formula, and by its relatively low dosage. In fact, adding a small amount of this acrid, dispersingherb to the formula will assist in the distribution of nourishment from the middle burner to the upper burner, and redirect the qi, thereby facilitating the replenishment of fluids in the Lungs. COMMENTARY: This formula may be regarded as a modification of Lophatherus and Gypsum Decoction (zhu ye shi gao tang). The ingredients in the title of that formula are omitted, and the dosage of Tuber Ophiopogonis Japonici ( m i men dong) is increased. Nevertheless, the use of these formulas is quite different: Lophatherus and Gypsum Decoction (zhuye shi gao tang) treats heat that is retained in the qi level, and clears heat from the Lungs and Stomach; Ophiopogonis Decoction (mai men dong tang) focuses on generating fluids and nourishing the Stomach yin. The source text recommends this formula for rebellious fire with rising qi and dysfunction of the throat.

166

Formulas that Enrich the Yin and Moisten Drjness

However, the application of the formula has been greatly expanded over time. Its most common use now is based on Emergency Formulas to Keep up O n e ' s Sleeue, in which it is prescribed for Lung atrophy with incessant coughing and spitting of saliva, a dry throat, and thirst. It is also often used in the treatment of belching, nausea, or vomiting due to Stomach yin deficiency. With the appropriate presentation, this formula may be used in treating such biomedically-defined disorders as gastritis, peptic ulcer, esophageal reflux, acute or chronic pharyngitis, chronic bronchitis, and pulmonary tuberculosis.
CAUTIONS

Increase the Fluids Decoction
zZng ye' tiing
The source text 1ihn.s the condition for which this formula is indicated to "the boat [that] stops because there is no water." Boat refers to the bowels, and water to the fluids that are needed to moue the bowels. In effect, this formula "increases the fluids to float the boat."

Source: Systematic Diflerentiation
(Wen bing tiao bian)

of Warm Diseases

sr CONTRAINDICATIONS: Use with caution in cases with high fever and irritability, where the pathogenic influence remains in the exterior, and the qi and yin have yet to be affected. Contraindicated in cases with dampness, or Lung atrophy due to cold from deficiency.
MODIFICATIONS: e For severe depletion of the fluids, add Radix Adenophorae seu Glehniae (sha s h n ) and Rhizoma Polygonati Odorati ( y u zhu). e For tidal fever, add Radix Stellariae Dichotomae (yin c h i hu) and Cortex Lycii Radicis (di gu pi). e For severe cough, add Bulbus Fritillariae Cirrhosae ( c h n bei mu) and Semen Trichosanthis (gua lou
ren).

Radix Scrophulariae Ningpoensis (xuan shen) . . .30g Tuber Ophiopogonis Japonici (mai men dong) . . .24g Radix Rehmanniae Glutinosae (sheng di huang). .24g Preparation: Decoction. According to the source text, this formula should only be prescribed for acute conditions. If one dose does not induce bowel movement within 12 hours, prescribe Increase the Fluids and Order the Qi Decoction (zeng ye cheng qi tang). Actions: Generates fluids, moistens dryness, and unblocks the bowels. INDICATIONS: Constipation, thirst, a dry, red tongue and a thin and slightly rapid, or a weak, forceless pulse. This is dry Intestines due to injury to the fluids, usually from a warm-febrile disease. When a warmfebrile disease persists for a long time or occurs in a patient with constitutional yin deficiency, heat will begin to clump at the yang brightness level. This depletes the fluids (especially in the Large Intestine) and leads to constipation. As they become depleted, the fluids are unable to rise to the mouth, causing thirst and a dry tongue. T h e tongue and pulse signs reflect heat from yin deficiency. ANALYSIS OF FORMULA: T h e large dosage of the chief herb, Radix Scrophulariae Ningpoensis (xuan shen), nourishes the yin, generates fluids, moistens dryness, and clears heat. O n e of the deputies, Tuber Ophiopogonis Japonici ( m i men dong), assists in enriching and moistening the yin. The other deputy, Radix Rehmanniae Glutinosae (sheng di hang), nourishes the yin and clears heat. COMMENTARY: T h e source text recommends this formula for treating the deficient type of yangbrightness heat instead of Order the Qi Decoction (chng qi tang), which isused for the excessive type. Although this is a simple formula, it is still able to attack the clumped heat and prevent further injury to the yin. Over the years the use of this formula has been expanded to include any constipation due to yin deficiency, regardless of etiology. Based on the functions of its individual ingredients, the formula is also commonly used for nutritive-level heat with signs of dryness in the middle burner. It is worth noting that this formula is not a

ASSOCIATED FORMULA:

Augmented Ophiopogonis Decoction
jh"

4f.

4

l i

jiii we'i mhi min d6ng tiing Source: Records of Heartfelt Experiences in Medicine with Reference to the West (Yi xue zhong zhong can xi lu) Tuber Ophiopogonis Japonici (mai men dong). . . . . . . .15g Radix Ginseng (ren shen) . . . . . . . . . . . . . . . . . . . . . . . . 12g Rhizoma Pinelliae Ternatae (ban xia) . . . . . . . . . . . . . . .9g Radix Dioscoreae Oppositae (shan yao). . . . . . . . . . . . .12g Radix Paeoniae Lactiflorae (bai shao). . . . . . . . . . . . . . .9g Radix Salviae Miltiorrhizae ( d m shen) . . . . . . . . . . . . . .9g Radix Glycyrrhizae Uralensis (gan cao) . . . . . . . . . . . . .6g Semen Persicae (tao ren) . . . . . . . . . . . . . . . . . . . . . . . . . .6g Fructus Zizyphi Jujubae (da zao) . . . . . . . . . . . . . . 3 pieces Benefits the Stomach, regulates the penetrating vessel, and directs rebellious qi and blood downward. For inverted menses (nosebleed or vomiting of blood during menstruation). The author of this formula explained its efficacy by referring to the relationship of the penetrating vessel to the yang brightness Stomach channel, with which it connects superiorly. When the Stomach is deficient, its qi cannot move downward properly to anchor the qi of the penetrating vessel. This leads to an upward rebellion or 'gushing' of the penetrating vessel's qi. The blood follows the qi upward, and inverted menses results.

-+3

. . . . . Fructus Psoraleae Corylifoliae (bu gu zhi) and Nidus Vespae (lu feng fang). . this is indicated for conditions with more severe depletion of fluids (caused by purging and sweating). . . .159Radix Anemarrhenae Asphodeloidis (zhi mu). . . take with Regulate the Stomach and Order the Qi Decoction ( t h wei chng qi tang). moistens dryness. . add Radix Adenophorae seu Glehniae (sha shen). . and the tongue is dry with a scanty coating. . but the mouth and throat are dry. Source: Records of Heartjilt Experiences in Medicine with Reference to the W e s t (Yi xue zhong zhong can xi lu) Radix Dioscoreae Oppositae (shan yao) . Cortex Moutan Radicis (mu dan pi). .4. hyperthyroid conditions. . .9g Tuber Ophiopogonis Japonici (mai men dong). and supports the Spleen's function of dispersing the fluids throughout the body. . take with Sophora Japonica Flower Powder (huai hua san).15g Radix Rehmanniae Glutinosae (sheng di huang) . . . In contrast to the principal formula. tonifies the Spleen. . There is no fever and the pulse is not rapid. . ASSOCIATED FORMULA: bi~l Preparation: Decoction.4. . and refers to this formula's ability to repair the mechanism by which the body replenishes its f luids. . . . . . and the Spleen cannot hold in substances. which prevents the proper spreading of the fluids. Endothelium Cornei Gigeriae Galli (ji neijin) supports the transforming and transporting functions of the Spleen to encourage the production of fluids from food. thin. reduces thirst by raising the Spleen qi. . . . .5g Rock candy (bing tang) . and a deficient. Radix Dioscoreae Oppositae (shan yao). . ANALYSIS O F FORMULA: One of the chief ingre- Benefit the Stomach Decoction Sf% y 3 we'i tiing Source: Systematic Dijjrentiation of W a r m Diseases (Wen bing tiao bian) Radix Adenophorae seu Glehniae (sha shen) . . Actions: Augments the qi. . . treat thirst by enriching the yin and moistening dryness. . . sequelae of infectious diseases. . . With the appropriate presentation. . . Rhizoma Polygonati Odorati (yu zhu) and Herba Dendrobii (shi hu). while the thin pulse reflects the deficiency of yin. * For toothache. Radix Trichosanthis Kirilowii (tian huafen). which depletes the body fluids.9g Endothelium Cornei Gigeriae Galli (ji nei jin) . Radix Puerariae (ge gen) raises the clear yang of the . . . Lassitude. . It is not strong enough for conditions with severe dryness. These herbs work synergistically with each other. . irritable bowel syndrome. . and a deficient. Radix Anemarrhenae Asphodeloidis (zhi mu) and Radix Trichosanthis Kirilowii (tian hua fen). The Kidneys have lost their power to grasp. . Recently it has also served as the foundation for formulas designed to treat the oral sideeffects associated with radiation therapy. . INDICATIONS: Excessive thirst that is not quenched by a substantial intake of fluids. . . Radix Adenophorae seu Glehniae (sha shen). .6g Radix Puerariae (ge gen) . The remaining ingredients serve as assistants. . and chronic pancreatitis. . stabilizes the Kidneys to stop frequent urination.30g Radix Astragali Membranacei (huang qi). . . . . .5g Fructus Schisandrae Chinensis (wu wei zi) . . . . . the Stomach is dry. copious. . Persistent thirst is due to qi deficiency. This is one type of waiting and thirsting disorder due to yin deficiency. .3g Benefits the Stomach and generates fluids. . * For bleeding hemorrhoids.9g * For a peeled tongue with a shiny coating and parched mouth and lips due to severe Stomach yin deficiency. . Increase the Fluids and Order the Qi Decoction (zeng ye chng qi tang) is a better choice. add Flos Chrysanthemi Morifolii C j u ha). and alleviates thirst. *For oral side-effects of radiation therapy with dryness that is worse at night. . . and Cortex Moutan Radicis (mu dan pi). 15g Rhizoma Polygonati Odorati (yu zhu) . Jade symbolzzes that which is precious. . . .Jade Fluid Decoction purgative. . and the qi is too weak to spread the fluids. . a dry tongue. . . The other chief ingredient. * For signs of more severe clumped heat. which injures the Stomach yin. e' :. . . MODIFICATIONS: Jade Fluid Decoction . generates fluids. . weak pulse reflect the deficiency of qi. irritability. or turbid urine. hemorrhoids. and weak pulse. Radix Astragali Membranacei (huang qi). . . and moistens the Lungs and generates fluids to reduce the thirst. aphthous ulcers. . . . . add Radix Achyranthis Bidentatae (niu xi). The Kidneys are deficient. in such cases. . The deputy ingredients. shortness of breath. but promotes evacuation of the bowels by clearing heat and replenishing the fluids. . . frequent. and to Stomach dryness. . Radix Dioscoreae Oppositae (shan yao). lassitude. . For qi-level or yang brightness-stage warm-febrile diseases where sweating occurs after the condition has been purged. . . and less severe heat signs. This causes the fluids to flow into the Bladder. producing turbid or copious urination. dients. . . .lz.189Radix Trichosanthis Kirilowii (tian huajn). . and a rapid and thin pulse. . .. . shortness of breath. . . this formula may be used in treating such biomedically-defined disorders as habitual constipation. . .

thirst. dry and parched throat. Dry Lung atrophy (upper and middle burners) Also for belching or vomiting from deficient Stomach yin. The formula is designed for a rather complex presentation which almost always appears in advanced-stage conditions. red tongue with little coating. fever. and rapid pulse Also for acute-onset hemiplegia. shortness of breath. wiry pulse Fever. scanty or blood-streaked sputum. big. It contains only a few ingredients. a floating. Fructus Schisandrae Chinensis (wu wei zi) acts to preserve the yin. thin and slightly rapid pulse or one that is weak and without strength For relatively acute conditions.168 Formulas that Enrich the Yin and Moisten Dryms a condition roughly analogous to diabetes. a sensation of fullness in the chest. a deficient. Diptherial disorder (upper burner) White. rapid pulse REMARKS For relatively superficial conditions. May also have coughing of blood. Spleen and helps to convey the fluids to the organs. white tongue coating. yet they are carefully and precisely balanced to effectively address a wide array of problems. watery sputum. and stabilize the essence of the Kidneys. usually a thin pulse Coughing and spitting of saliva. rapid pulse FORMULA NAME Preserve the Metal Decoction with Lily Bulb (bi he gu jin tang) Tonify the Lungs Decoction with AssHide Gelatin (bu fei e jiao tang) Nourish the Yin and Clear the Lungs Decoction (yang yin qing fei tang) Ophiopogonis Decoction (mi men dong tang) I DIAGNOSIS Internal dryness of the Lungs (upper burner) Lung yin deficiency with vigorous heat (upper burner) INDICATIONS Cough with blood-streaked sputum. night sweats. wheezing. FORMULAS THAT ENRICH T H E YIN AND MOISTEN DRYNESS I COMMON INDICATIONS: (first 4): dry. stuffy nose. wheezing. swollen and sore throat. thin pulse I REMARKS Focuses on nourishing the yin. a floating. . I Focuses on clearing heat and stopping bleeding. wheezing. red tongue with white coating. COMMENTARY: This formula is commonly used in the treatment of wasting and thirsting disorder.Apricot Kernel and Perilla Leaf Powder (xing su san) Mulberry Leaf and Apricot Kernel Decoction (sang xing tang) Eliminate Dryness and Rescue the Lungs Decoction (qing zao jiu fei tang) DIAGNOSIS Cool-dryness INDICATIONS Chills without sweating. generate fluids. sticky sputum. parched lips. hypochondriac pain. irritability. curd-like membrane in the throat that is difficult to scrape off. but more importantly. dry throat. Dryness attacking the Lungs Fever. hot palms and soles. With the appropriate presentation. dry and red tongue. hacking cough or one with scanty. dry and uncomfortable sensation in the throat. not only does this help reduce the flow of urine. thin pulse Cough with wheezing. it prevents further injury to the Kidneys. this formula may be used in treating the biomedicallydefined disorder of diabetes mellitus. COMPARATIVE TABLES OF PRINCIPAL FORMULAS FORMULAS THAT GENTLY DISPERSE AND MOISTEN DRYNESS COMMON INDICATIONS: cough. deficient pulse Also for purulent tonsillitis. dry and sore throat. Increase the Fluids Decoction Ye tang) Dry Intestines (lower burner) Constipation. hacking cough. dry tongue (thin or no coating) FORMULA NAME .

cont. a deficient. FORMULA NAME Jade Fluid Decoction (F r e tang) DIAGNOSIS Wasting and thirsting disorder (lower burner) INDICATIONS Excessive thirst. shortness of breath. dry and red tongue.FORMULAS THAT ENRICH T H E YIN AND MOISTEN DRYNESS. frequent and copious urination or turbid urine. . thin. and weak pulse REMARKS For relatively advanced conditions. lassitude.

.

.

.

but otherwise have left it simply as water. overindulgence in alcohol. and the Spleen. jaundice. nausea. The two organs most susceptible to dampness are the Kidneys. The word water (shui) is often used in connection D with dampness. The latter usage is reflected in the adage. these are conditions of deficiency which most commonly arise from internally-generated disharmonies. . or superficial edema. are also susceptible to dampness. diarrhea. "Dampness is the permeation of water. and sometimes specifically to edema or to an accumulation that is more distinct and localized than dampness. while water is the accumulation of dampness. stiffness and pain in the joints. Darnpness can also be externally contracted from living in a damp environment. painful urinary dysfunction.CHAPTER SIX Formulas that Expel Dampness AMPNESS IS A YIN pathogenic influence which has a heavy. we have translated shui as edema when it refers specifically to that condition. Internally-generated dampness is usually associated with improper eating habits. To a lesser extent the Lungs. vomiting. Manifestations of externally-contracted dampness include chills and fever. Because it is not uncommon for conditions of dampness to present with both externally-contracted and internally-generated aspects. or getting wet from rain or sweat. which controls it. Damp disorders progress slowly and linger in the body." In this text. Manifestations include generalized and focal abdominal distention. a feeling of distention in the head and heaviness in the body. and therefore . or edema of the lower extremities. Problems with those organs which are most intimately connected with the process of water metabolism in the body often result in damp disorders. and obsessive deliberation or other emotional behavior that injures the Spleen. which govern the ascending and descending aspects of water metabolism known as the water pathways (shui dad). Sometimes this word refers to the fluids in general. sluggish nature. it must therefore be approached carefully in each case to gain a full understanding of its etiology and the underlying constitution of the patient. which are said to govern water. Generally. The Triple Burner and the Bladder also have important connections with water metabolism.

The principal patterns of externally-contracted dampness are damp-heat and wind-dampness. strong thirst but with vomiting immediately after drinking. . Diarrhea may also appear in cases due to dysfunction of water metabolism. . It may also be taken as a powder without wine in 3-6 grams doses 1-3 times a day. . strengthens the Spleen. irritability and floating pulse indicate an exterior condition. or pregnancy with edema or other signs of dampness. .2. If the qi is obstructed in the Triple Burner. Since urination is the principal vehicle for expelling dampness from the body. . When the flow in the channels is open.4g Sclerotium Poriae Cocos ( f u ling) . Although this causes strong thirst. if the Bladder does not function smoothly and urination becomes difficult. and coughing. . The value of such herbs in treating dampness is succinctly stated in the Systematic Dflerentiation of Warm Diseases: "When the qi [mechanisms] are transformed. ." For example. and possible vomiting and diarrhea due to sudden turmoil disorder. . and promotes the transforming functions of qi. .2. . the qi mechanisms of the Triple Burner can be affected by the backflow. . and a floating pulse. the formulas in this chapter are comprised of acrid. diarrhea. The pathogenic influences attack and disrupt the functions of the Bladder. urinary difficulty. . shortness of breath. Furthermore. . the Bladder. . first treat the blood. painful urinary dysfunction. Five-Ingredient Powder with Poria wii ling s5n Source: Discllrsion o f Cold-induced Disorders (Shang han lun) Rhizoma Alismatis Orientalis (ze xie) . The most common signs of dampness affecting urination include edema. it can be taken with hot water (as a powder) or very warm (as a decoction). &#k SECTION 1 FORMULAS THAT PROMOTE URINATION AND LEACH OUT DAMPNESS The formulas in this section are used when dampness clogs the water pathways. generalized sensation of heaviness. If the treatment strategy includes inducing slight sweating. fever. . Actions: Promotes urination. . fluids cannot be transported downward INDICATIONS: . and the pathogenic influence which predominates. 2 . . .edema. a greater yang-stage disorder in which the pathogenic influences have not been released from the exterior. . . . vomiting frothy saliva. irritability. 3 throbbing pulsations just below the umbilicus. or sweet. . . Winddampness is marked by pain (usually of the joints) and is sometimes accompanied by edema. . hence the adage. . vertigo. bland substances that leach out dampness.2. Here it is also important to distinguish whether wind or dampness predominates. and atrophy disorder. . . drains dampness. . Because Dampness is a heavy. and take a small spoonful three times a day followed by warm water. .3g Sclerotium Polypori Umbellati (zhu ling) . but have penetrated to the greater yang organ.3g Ramulus Cinnamomi Cassiae (gui zhi). ensuring the free flow of healthy blood is an important aspect of treatment. The first group of symptoms (the original indications for this formula) are manifestations of water buildup (xli hi). The headache. urination is an effective method for leaching out dampness. It is always important to carefully distinguish both the level (burner) at which the process is active. warms the yang. when the Bladder qi is obstructed by dampness these herbs can regulate the Bladder qi and thereby provide an avenue for water and dampness to exit the body. . Disruption of Bladder function also leads to water retention. promoting 1 . because these conditions lodge primarily in the channels. the wind has no place to lodge. . . . Manifestations of damp-heat include jaundice. and warm substances that dry dampness. . . . Today the formula is generally prepared as a decoction with the dosage increased about four times. aromatic. . which interferes with the upward transportation and downward elimination of fluids.FormuLx that Promote Urination and Leach Out Dampness with dampness. . . . there is no force behind the metabolism of water.Headache. . and to treat accordingly. . and painful urinary dysfunction. . these formulas must be modified with Spleenstrengthening herbs to protect the normal qi. these formulas often include qi-regulating herbs. Available in prepared form. mix with white wine. dampness will likewise be transformed. sluggish pathogenic influence that readily hinders and obstructs the qi mechanisms. ." In general. . it should not be cooked for more than 20 minutes. . . . Dampness in the exterior is discussed in chapter 1. . resulting in urinary difficulty. . urinary difficulty. primarily those associated with urination. They should be used with extreme caution in cases of yin deficiency and depleted fluids.5g Preparation: The source text advises to grind the ingredients into powder. . . . . . . . . If prepared as a decoction. which are generally conditions of excess. "When treating wind [disorders]. fever. l. urinary obstruction. . . In patients with debility brought on by disease. . .3g Rhizoma Atractylodis Macrocephalae (bai zhu) .

when the yang of the middle burner is deficient. This causes a throbbing pulsation below the umbilicus. The third group of symptoms reflects retention of congested fluids in the lower burner. 175 Macrocephalae (bai zhu). They are caused by pathogenic influences (heat. and cold Rhizoma Alismatis Orientalis (ze xie). The stagnation produced by congested fluids leads to an upward rebellion (vomiting) of frothy saliva. the Bladder. leaches out dampness and promotes urination. This is known as water rebellion disorder (shui ni zhing). one of the assistants. there may also be coughing. thus facilitating the movement and 'steaming' of the fluids by the Kidney yang. And where an accumulation of fluids known as pathogenic water (shui xii) invades the Lungs and causes coughing and wheezing. Because the water and dampness are not properly transformed by the Spleen and transported to the Bladder. Because it enhances the transformation and transportation of fluids. The chief and deputy ingredients act synergistically to drain dampness. manifested as urinary difficulty or edema. This causes internal accumulation of water and dampness which overflows into the muscles and skin and produces edema and a sensation of heaviness. bland. which is characterized by a sensation of heaviness in the extremities and urinary difficulty. thereby aiding in the transformation and transportation of fluids. Both water and blood buildup (xh xu. If the congested fluids encroach on the Lungs.] are mentioned in Discussion of Cold-induced Disorders. This gives rise to the simultaneous vomiting and diarrhea which are characteristic of sudden turmoil disorders. In this respect it serves as an envoy to the Kidneys and Bladder. Within the formula certain ingredients work in pairs to reinforce particular actions. The Spleen has an aversion to dampness and the retention of fluids inhibits the Spleen qi's ability to transform and transport fluids. providing the key link between the upper and lower burners. strengthens the Spleen qi. The basic strategy is to restore to the qi its function of regulating fluid metabolism. The other deputy. the pathogenic influence which has invaded the Bladder is considered to be heat. This formula may therefore be used in treating other problems than those described above. Its dosage is relatively large. It is also useful in treating damp painful obstruction. Ramulus Cinnamomi Cassiae (gui zhi) serves as both an assistant and envoy ingredient in this formula. Ramulus Cinnamomi Cassiae (gui zhi) is therefore used to warm the fire of the gate of vitality. is particularly effective in leaching out dampness in cases of deficiency by promoting urination. ANALYSIS O F FORMULA: The chief ingredient. which is likened to "adding firewood under the cauldron. One of the deputies.Fiue-Ingredient Powder with Poria and are vomited up. This is because the Spleen serves as a pivot in the water pathways of the Triple Burner. there is vertigo. it also helps the Spleen qi to raise up dampness. The second group of symptoms refers to a pattern of Spleen deficiency which can be described in terms of the five phases as earth failing to transport water. the Kidneys and Bladder may be unable to transform them. bitter Sclerotium Polypori Umbellati (zhu ling). Sclerotium Poriae Cocos (fu ling) and Rhizoma Atractylodis Macrocephalae (bai zhu) strengthen the Spleen and promote urination. When the retention of dampness impedes the circulation of fluids. Rhizoma Atractylodis to all of the conditions for which this formula is indicated is the severe accumulation of water in the Bladder and the inability of the qi to transform fluids. The cold nature of Rhizoma Alismatis Orientalis (ze xie) enables it to enter the Bladder directly and eliminate this type of heat. This disrupts the normal function of the Stomach and Intestines. The effects of the Spleen's failure to transform and transport water may be felt throughout the Triple Burner. irrespective of its original nature in the exterior. and assisting the yang. strengthening the Spleen. or cold that has transformed into heat) entering the greater yang organ. In addition to these problems with water metabolism. In these patterns. and promote urination. When the ascent of clear yang is obstructed. and Ramulus Cinnamomi Cassiae (gui zhi) and Sclerotium Poriae Cocos (fu ling] warm and transform the water and fluids. COMMENTARY: The primary mechanism common sweet. unblock the yang. Sclerotium Poriae Cocos (fu ling). unblock and regulate the urinary pathways. and thus the resolution of dampness. eliminates dampness and promotes urination. and thereby prevents the clear yang from ascending and the turbid yin from descending. it can be utilized when the Small Intestine fails in its task of separating the clear from the turbid. there may also be diarrhea and urinary difficulty. As an assistant it also helps to dispel pathogenic influences from the exterior and thereby releases the exterior aspects of the greater yang-stage disorder. and drain heat from the Bladder." Not only does this assist the Bladder in transforming and discharging urine. the use of this formula will promote urination and thereby eliminate the water and relieve the coughing and wheezing. external pathogenic influences more easily penetrate to the interior. Water buildup occurs when the pathogenic influence enters the qi level of the Bladder and prevents . Sclerotium Poriae Cocos (fu ling) and Sclerotium Polypori Umbellati (zhu ling) promote urination.

. . . .5g Augments the qi. I . . . . neurogenic bladder syndrome. . . . acute gastroenteritis. . . . . . . . MODIFICATIONS: e For severe edema. .4. gastrectasis. . . . . .3g Gelatinum Corii Asini (e jiao) . . thirst. . . .3g Sclerotium Poriae Cocos (fu ling). chiin ze' tiing Source: Secret Text of Extraordinarily Eflectiue Beneficial Formulas from across the Seas (Qi xiao hai shang liang fang mi ben) Rhizoma Alismatis Orientalis (ze xie). . . . . . . I n cases of urinary difficulty with yin deficiency. . . Artemisia Yinchenhao and Five-Ingredient Powder with Poria xr f3J *.3g Rhizoma Alismatis Orientalis (ze xie) . . . . . . . dark stool. . . ASSOCIATED F O R M U L A : Spring Pond Decoction #$* % . this formula may be used in treating such biomedically-defined disorders as acute or chronic nephritis. and urinary difficulty.3g Tuber Ophiopogonis Japonici ( m i men dong) . Polyporus Decoction #*% zhii ling tiing Source: Discussion (Shang han lun) of Cold-induced Disorders Four-Ingredient Powder with Poria a&& s i ling siin Source: Displays of Enlightened Physicians (Ming yi zhi zhang) Omit Ramulus Cinnamomi Cassiae (gui zhi) for uncomplicated cases of dampness injuring the Spleen and Stomach characterized by loose stools and urinary difficulty. . . . . . * For damp-heat diarrhea. omit Rhizoma Atractylodis Macrocephalae (bai z h ) and Ramulus Cinnamomi Cassiae (gui zhi). add Cortex Mori Albae Radicis * For cold-damp painful obstruction accompanied by thirst and urinary difficulty. . . . . At this level. . . promotes urination. . . . . the dosage and duration of use of this formula must be carefully limited. . . . . .176 Formulas that Promote Urination and Leach Out D a m w s the qi from carrying out its transforming function. diarrhea. . . I n cases with deficiency. . . add Rhizoma et Radix Notopterygii (qiang h o ) . . . . when the pathogenic influence enters the blood level of the Bladder. . Mdnidre's disease. ascites from liver cirrhosis. gastroptosis. .3g Radix Ginseng (ren shen) . . . . . . .6g Sclerotium Poriae Cocos ( f u ling) . . and acute lower abdominal pain. This leads to urinary difficulty with either normal bowel movements or diarrhea. . . infectious hepatitis. Today Radix Codonopsis Pilosulae (dang shen) is substituted for Radix Ginseng (ren shen) with 2-3 times its dosage. chronic renal failure. . . . .3g Preparation: Prepare the first four ingredients as a decoction and dissolve one-half of the Gelatinum Corii Asini (e jiao) into the strained liquid. . . . . . and hydrocele. . . . take with Five-Peel Decoction (wu pi yin). .6g Rhizoma Atractylodis Macrocephalae (bai zhu) . . . .5g Radix Bupleuri ( c h i hu) . .6g Ramulus Cinnamomi Cassiae (gui zhi) . . . . * For concurrent edema and qi obstruction due to excessive water retention. . . and urinary difficulty. . . . However. . . . . . . . . . . .9g Sclerotium Polypori Umbellati (zhu ling) . . . . . . . . Peach Pit Decoction to Order the Q i (tao he cheng qi tang) is indicated (see chapter 10). . . Calm the Stomach and Poria Decoction $ & ? ? I we'i ling tiing Source: Teachings of [Zhu] Dan-Xi (Dan xi xin fa) Take with Calm the Stomach Powder (ping wei san) for epigastric distention and pain. . Today 2-3 times the original dosage is generally used. and reduced appetite. . . acute enteritis. . . . . . . *For both exterior signs and edema. . For lingering summerheat characterized by fever. . . CAUTIONS & CONTRAINDICATIONS: I n cases with Spleen or Kidney qi deficiency. . .4. . . . Sclerotium Polypori Umbellati (zhu ling). . . . With the appropriate presentation. . . . . . this formula should be modified to protect the yin from further injury. this formula is often combined with others that tonify and nourish the Spleen and Stomach to prevent injury t o the normal qi. . . . . . genitourinary infections. . and add Herba Artemisiae Yinchenhao (yin chen hao) and flos Lonicerae Japonicae (jin yin h a ) . . . . . .3g Talcum (hua shi) . . . congestive heart failure. . . vertigo. . . . . irritability.*&* fin c h i n wii ling siin Source: Essentials from the Golden Cabinet Uin gui yao he) Combine two parts powdered Herba Artemisiae Yinchenhao (yin chen hao) with one part of this formula for jaundice due to damp-heat (dampness predominant) with urinary difficulty and a slightly pale skin tone. it obstructs the lower burner and causes incontinence of urine. . . and releases lingering summerheat. . . . . . . . . a bland taste. . . VARIATIONS: (sang bai pi). . Pericarpium Citri Reticulatae (chen pi) and Pericarpium Arecae Catechu (dafu Pi). Symptoms of overdose may include dizziness. take with Maidservant from Yue Decoction (yue bi tang).

The use of this formula has been extended to the treatment of hot or bloody painful urinary dysfunction with lower abdominal fullness and pain. add Radix Adenophorae seu Glehniae (sha shen) and Radix Trichosanthis Kirilowii (tian hua fen). and harmonizes the Stomach. MODIFICATIONS: * For severe thirst from yin deficiency." With the appropriate presentation. & &$I s u n shi zhii ling tang Source: Master Shen's Book for Revering Life (Shen shi zun sheng shu) Omit GeIatinum Corii Asini (e jiao) and add Rhizoma . nausea. Injury to the fluids and obstruction of the water pathways causes thirst with a desire to drink (in contrast to thirst without a desire to drink. VARIATION: Polyporus Decoction from Master Shen % . and to stabilize the yin without causing the retention of pathogenic influences. Rhizoma Alismatis Orientalis (ze xie). promotes water metabolism. & . The other chief ingredient. and Rhizoma Alismatis Orientalis (ze xie). The difference is that the former treats a condition where the disease is still active in the exterior by focusing on unblocking the flow of yang to encourage the transformation of qi. there will be coughing. Vigorous heat due to yin deficiency agitates the Heart and leads to irritability and insomnia. The combination of these four ingredients clears heat and promotes flow in the water pathways. * For bloody painful urinary dysfunction. hence the use of Ramulus Cinnamomi Cassiae (gui zhi) and Rhizoma Atractylodis Macrocephalae (bai zhu). benefits the Spleen. there will be nausea. If the disturbance of the water pathways affects the flow of qi in the Lungs. Polyporus Decoction (zhu ling tang) drains vigorous heat. this is due to the use of Gelatinum Corii Asini (e jiao). and aids the chief ingredients in promoting urination. which is characteristic of damp-heat). Sclerotium Polypori Umbellati (zhu ling). which would further injure the yin. and nourishes the yin. Sclerotium Polypori Umbellati (zhu ling).Five-Ingredient Powder with Poria Available in prepared form. 177 eat ANALYSIS OF FORMULA: Treatment should focus on the acute problem of urinary difficulty. resulting in diarrhea. Herba Dianthi (qu mai) and Herba Cephalanoplos (xiao ji). dry skin. * For hot painful urinary dysfunction. clears heat. hence the use of talcum (ha shi). this formula may be used in treating such biomedically-defined disorders as upper or lower urinary tract infection and hemorrhagic shock. Heat also injures the yin (fluids) and disturbs the water pathways. while the latter treats pathogenic influences which have transformed into heat in the interior by clearing the heat and nourishing the yin. one of the chief ingredients. gives rise to fever. this is injury from cold entering the yang brightness or lesser yin stage where it transforms into heat. add Rhizoma Imperatae Cylindricae (bai mao gen). and is therefore very effective in resolving the clumping of water and heat. Both formulas contain Sclerotium Poriae Cocos (fuling). and a dark-red. When fluids cannot be eliminated through the urine they are eliminated through the stool. It is also common for this pattern to develop in patients with constitutional yin deficiency and invasion of heat into the lower burner. sunken eyes. dry tongue. According to the source text. This difference was succinctly described by Wang Ang in Analytic Collection of Medical Formulas: "Five-Ingredient Powder with Poria (wu ling sun) drains vigorous dampness. resulting in urinary difficulty. If the disturbance affects the middle burner. which leads to clumping of water and heat. the organ corresponding to the leg lesser yin channel). add Fructus Gardeniae Jasminoidis (zhi zi) and Herba Polygoni Avicularis (bian xu). The heat battles with the water (controlled by the Kidneys. promotes urination. which is better able to maintain this delicate balance than such substances as Radix Rehmanniae Glutinosae Conquitae (shu di huang). In large part. or insomnia. fever which worsens at night. strongly reinforces the proper functioning of the water pathways and thereby promotes urination. There may also be diarrhea. Sclerotium Poriae Cocos (fu ling). while also clearing the heat and nourishing the yin. Actions: Promotes urination. clears heat and unblocks painful urinary dysfunction. The deputy. irritability. The chief ingredients work together synergistically. COMMENTARY: What is special about this formula is its ability to promote urination without injuring the yin. Both Five-Ingredient Powder with Poria (wu ling sun) and Polyporus Decoction (zh ling tang) treat urinary difficulty due to disturbances of the water pathways by promoting urination. cough. talcum-(hua shi). Recently it also has been used in treating diarrhea in infants caused by damp-heat and injury to the yin characterized by reduced urination. Gelatinum Corii Asini (e jiao) is a moist substance that enriches the yin (without causing retention of the pathogenic influences) and prevents excessive urination. The assistant. INDICATIONS: Urinary difficulty accompanied by fever and thirst with a desire to drink. unblocks the deep parts of the water pathways that involve the Kidneys.

. . . . . .309Cortex Mori Albae Radicis (sang bai pi) . This leads to internally-generated dampness that further disrupts its transporting function and prevents the proper elimination of fluids. The dispersing and descending actions of these herbs restores the water metabolism function to the Lungs and facilitates the smooth flow of fluids into the Bladder. labored and heavy breathing. . This formula. . For urinary obstruction with pain and rigidity in the area below the umbilicus. the transportation of the fluids. ANALYSIS OF FORMULA: Effective treatment of this condition requires that the Spleen be strengthened to prevent dampness from spreading through the tissues. . . . I n traditional Chinese medicine. ASSOCIATED FORMULA: Polyporus Decoction from Comprehensive Recording zhii ling tiing Source: Comprehensive Recording of Sage-like Benefit from the Zheng He Era (Zheng he shengji zong lu) Sclerotium Polypori Umbellati (zhu ling) . . . and a submerged and moderate ~ u l s e . is inhibited when the Spleen is deficient. . . . This is skin edema (pi shui). . promotes urination. . The stagnation of fluids prevents the water pathways from fully opening and causes urinary difficulty. The development of edema may be attributed to various pathological mechanisms: the invasion of wind disrupting the Lungs' ability to disseminate and move the qi downward. . . . .15g Preparation: Grind equal amounts of the ingredients into a coarse powder and take 6-9g as a draft. and Spleen deficiency with vigorous dampness and qi stagnation. . The generalized sensation of heaviness is indicative of dampness. Distention and fullness in the epigastrium and abdomen is indicative of qi stagnation. greasy tongue coating. .9g Pericarpium Arecae Catechu (da fu pi) . The pulse and tongue signs reflect the presence of internal dampness. . . the ingredients have been presented in what appears to be the most logical order. . . The latter mechanism is the one for which this formula is indicated. . this formula (with modifications) may be used in treating such biomedically-defined disorders as edema from pregnancy. . . . a white. . . That formula focuses on strengthening the Spleen and tonifying the qi. One of the primary functions of the Spleen. . . reduces edema. assistant. . . . . . . but the deficiency is mild. and strengthens the transporting function of the Spleen. . Pericarpium Citri Reticulatae (chen pi) and Pericarpium Arecae Catechu (dafu Pi) perform this function by eliminating qi stagnation. . . . focuses on resolving dampness and regulating the qi. . . . Grind the ingredients into powder and take in 9g doses as a draft before meals with 2-3g of Medulla Junci Effusi (deng xin cao). . . . .30g Caulis Mutong (mu tong) . .30g 16% which spread through the tissues causing generalized edema.Formulas that Promote Urination and Leach Out Dampness Cimicifugae (sheng ma) for severe diarrhea with urinary difficulty. . It is indicated where the dampness and qi stagnation are relatively strong. . It is interesting to note that the peel. and that the water pathways be opened to provide an exit for the surplus fluids. or 'skin' of the herbs is used to treat skin edema. . . . . . . .6g Cortex Poriae Cocos ( f u ling Pi) . . If the smooth flow of qi is reestablished. . . . . and fullness in the epigastrium and abdomen. . Cortex Poriae Cocos (fu ling Pi) leaches out dampness. the peel or rind is considered to be especially effective in moving water just below the skin. . . . . COMMENTARY: The focus of this formula is on leaching out dampness and promoting urination. . Cortex Zingiberis Officinalis Recens (sheng jiang Pi) transforms dampness and disperses edema. . Five-Peel Powder Source: Zeasury Classic (Zhong zang jing) Cortex Mori Albae Radicis (sang bai pi) . . . Drains and leaches out lower burner dampness. deputy. . . these herbs interact very closely and it serves no clinical purpose to assign a greater importance to one herb over another. With the appropriate presentation. urinary difficulty. The dampness and surplus of fluids floods the upper source of the fluids (the Lungs) and causes labored and heavy breathing. . For this reason. however. . . Actions: Resolves dampness. . . . . INDICATIONS: Generalized edema with a sensation of heaviness. Cortex Mori Albae Radicis (sang bai pi) promotes urination by directing the Lung qi downward and opening up the water pathways. and strengthens the Spleen. . .15g Pericarpium Citri Reticulatae (chen pi) . . . . It is used for cases of skin edema where the deficiency of the Spleen and the protective qi is significant. . distention. . . . and there is not much stagnation. . rind. Kidney yang deficiency leading to the accumulation of fluids and dampness. Both this formula and Stephania and Poria Decoction (fangjifu ling tang) treat skin edema. . . and envoy) of the herbs in this formula varies depending on the source. regulates the qi. .15g Cortex Zingiberis Officinalis Recens (sheng jiang pi) . . May also be prepared as a decoction with the dosage specified. In fact. . . . the fluids will follow. . . Available in prepared form. however. The hierarchy (chief.

Available in prepared form. . 15g Cortex Poriae Cocos (fu ling pi) . . This leads to a reduction in the transformation of qi in the Bladder and causes urinary difficulty. . . . . . For edema. . . . 15g Cortex Lycii Radicis (di gu Pi) . . X % fhng j z 'huhng q i tiing (Jin gui yao he) Source: Essentials from the Golden Cabinet Radix Astragali Membranacei (huang qi) . . . resolves dampness. .8g Radix Stephaniae Tetrandrae (han fang ji). . . Herba Plantaginis (che qian cao) and Radix Astragali Membranacei (huang qi). Today it is usually prepared as a decoction with 3-4 times the specified dosage of each ingredient. . a pale tongue with a white coating.15g Cortex Glycyrrhizae Uralensis Radicis (gan cao pi). . . add Epicarpium Benincasae Hispidae (dong gua Pi). . urticaria. . . . and reduces swelling. . . . . . . . . urinary difficulty. Folium Perillae Frutescentis (zi suye). For damp-heat lodged in the lower burner with edema below the waist. . . Although the source text simply provides for Radix Fangji (fang ji). . . add Semen Raphani Sativi (lai fu zi) and Cortex Magnoliae Officinalis (hou Po). . . . . .3g Rhizoma Atractylodis Macrocephalae (bai zhu) 2. . . Herba seu Flos Schizonepetae Tenuifoliae (jing jie) and Radix Angelicae Dahuricae (bai zhi). and a floating pulse. . . . . . . Actions: Augments the qi. Sweating and an aversion to wind are indicative of unstable protective qi.5g doses as a draft with the remaining ingredients.1.3. add Rhizoma Zingiberis Officinalis (ganjiang) and Radix Lateralis Aconiti Carmichaeli Praeparata ( f u zi). Radix Stephaniae Tetrandrae (han fang ji) is much more commonly used than Radix Aristolochiae Fangchi (guang fang ji). . add talcum (hua shi). . Exterior deficiency or unstable . .Stephania and Astragalus Decoction protein-deficiency edema. Superficial edema and a floating pulse indicate that the condition is lodged in the superficial aspects of the body.15g Cortex Zingiberis Officinalis Recens (shengjiang pi) . . . . . . . . This is wind-dampness or wind edema ($ng shuz') caused by deficiency in the exterior and an invasion of wind and dampness. promotes urination. . . 4 pieces Fructus Zizyphi Jujubae (da zao) . . . . . . superficial edema. . add Radix Stephaniae Tetrandrae (han fang ji) and Semen Plantaginis (che qian zi). . . . add Radix Codonopsis Pilosulae (dang shen) and Rhizoma Atractylodis Macrocephalae (bai zhu). When wind-dampness invades the body. . 15g Pericarpium Citri Reticulatae Viride (qing pi). . . * For internal damp-cold. . .3g Honey-fried Radix Glycyrrhizae Uralensis (zhi gan cao) . and menopausal edema. add Radix et Rhizoma Rhei (da huang) and Fructus Immaturus Citri Aurantii (zhi shi). . . . MODIFICATIONS: For externally-contracted wind with edema above the waist. The heavy sensation in the body is due to dampness in the channels. . Spleen-tonifying herbs should be added for cases with severe Spleen deficiency. . . . VARIATIONS: 2 Ye 4% pi $n +k Source: Formulas to Aid the Living (Ji shengfang) Pericarpium Arecae Catechu (dafu Pi) . For constipation due to accumulation in the Stomach and Intestines. . . . . For severe abdominal distention. a heavy sensation in the body. . Semen Plantaginis ( c h qian zi) and Semen Coicis Lachrymajobi ( y i yi ren). . congestive heart failure. strengthens the Spleen. it attacks the greater yang channels. . For marked signs of Spleen deficiency. add Radix Ledebouriellae Divaricatae (fang jing). . . . . . . . . . . ascites from cirrhosis. . CAUTIONS & CONTRAINDICATIONS: Although this is a relatively mild formula. a 1% #k ASSOCIATED FORMULA: Seven-Peel Decoction INDICATIONS: Sweating. . . . I piece Preparation: Grind the first four ingredients into powder and take in 1. . . add Stylus Zeae Mays (yu mi xu). Stephania and Astragalus Decoction i $t $ . . For chronic glomerulonephritis. . . . Five-Peel Decoction wii pi $n Source: Imperial Grace Formulary of the Tai Ping Era (Tai Ping hui min he ji jufang) Substitute Cortex Acanthopanacis Gracilistyli Radicis (wu jia pi) and Cortex Lycii Radicis (di gu Pi) for Pericarpium Citri Reticulatae (chen pi) and Cortex Mori Albae Radicis (sang bai pi) to focus on the lower burner and nourish the Kidneys. *For edema due to pregnancy. . . . . For dampness lodged in the lower burner with edema below the waist. . and reduces edema. . strengthens the Spleen. . . . .15g Pericarpium Citri Reticulatae (chen pi). . . For skin edema with more emphasis on the treatment of abdominal distention and fullness. . which contributes to superficial edema. . . . . . . . . . . . l 5 g Regulates the qi. .5g Rhizoma Zingiberis Officinalis Recens (sheng jiang) . . . . . . a larger dosage (between 30-60g) of the ingredients may be prescribed.

also control the exterior. @ For chronic nephritis. . . With the appropriate presentation. These symptoms require the use of aromatic herbs that cut through the turbidity and revive the Spleen. acute glomerulonephritis. . a heavy sensation in the body. add a small amount (I-3g) of Herba Ephedrae (ma huang). . unblocks the channels. and relieves pain. . SECTION 2 FORMULAS THAT TRANSFORM DAMP TURBIDITY When dampness lingers in the interior. Rhizoma Atractylodis Macrocephalae (bai zhu). .9g Radix Astragali Membranacei (huang qi) . Radix Astragali Membranacei (huang qi). . . . . acrid. . ANALYSIS O F FORMULA: When pathogenic influCAUTIONS & CONTRAINDICATIONS: Contrain- dicated for acute. . bitter Radix Stephaniae Tetrandrae (han fang ji). promotes urination. . sweating. However. . . strengthens the Spleen and resolves dampness. * For vigorous cold. unblocks the yang. and promotes urination. . skin. diarrhea. it assists Radix Astragali Membranacei (huang qi) in stabilizing the exterior (protective qi). . releases the exterior. belching. which control the qi. . . . MODIFICATIONS: @ For abdominal pain. . the envoys. The deputy. By combining these herbs. For fullness and pain in the chest and abdomen.6g Augments the qi. . . . and chronic nephritis. . @ For severe dampness with a sensation of heaviness in the lower back and legs. reduced appetite. . and body hair. this treats superficial edema and focuses more on the exterior and the muscle levels. one of the chief herbs. . The other chief herb. COMMENTARY: This formula exemplifies the simultaneous treatment of the manifestation (winddampness) and root (exterior deficiency). . stagnation and turbidity ensue. add Sclerotium Poriae Cocos ( f u ling) and Rhizoma Atractylodis (cang zhu). . . . . . . edema (usually of the lower extremities) in women with constitutional deficiency. the Spleen is the source of qi and blood production. The cardinal signs and symptoms of wind-dampness at this level and in this type of patient are the same as those of wind edema: a floating pulse. and aversion to wind. add Herba cum Radice Asari (xi xin). . The pale tongue with a white coating also reflects the deficiency of Lung and Spleen qi. and fatigue. . . if there is superficial edema and the exterior is not released. the edema will persist. vomiting. . . . . acid regurgitation. . For wheezing. . ascites. A commonly-used formula. ASSOCIATED FORMULA: Stephania and Poria Decoction ~ L & & $ fiing jrfi ling tang Source: Essentialsfrom the Golden Cabinet Uin gui yao he) Radix Stephaniae Tetrandrae (han fang ji) . . . . In contrast to the principal formula.9g Sclerotium Poriae Cocos (fu ling) . Fructus Citri seu Ponciri (zhi ke) and Folium Perillae Frutescentis (zi su ye). and Radix Stephaniae Tetrandrae (hanfang ji) in resolving dampness. its application has been expanded to include acute invasion of wind-dampness without edema. . . . . helps tonify the Spleen. when the protective qi (which circulates in the exterior) is unstable. @ ences are lodged in the exterior. . the appropriate strategy is to release the exterior. .9g Ramulus Cinnamomi Cassiae (gui zhi) . regulates and harmonizes the nutritive and protective qi to assist in the stabilization of the exterior and the strengthening of the qi and blood. . and damp-predominant painful obstruction with a heavy sensation in the body and limbs accompanied by numbness. excess-type edema. producing symptoms of epigastric and abdominal distention and fullness. honey-fried Radix Glycyrrhizae Uralensis (zhi gan cao). . it is also necessary to strengthen and stabilize the protective qi. expels dampness. This can be a relatively rapid process. 1% Radix Glycyrrhizae Uralensis (gan cao) . . . and the edema is alleviated without injuring the normal qi. . . . is the principal substance in the materia medica for stabilizing and strengthening the protective qi. . The assistant. add Pericarpium Citri Reticulatae (chen Pi). Damp turbidity severely interferes with the transporting function of the Spleen. The combination of Rhizoma Zingiberis Officinalis Recens (sheng jiang) and Fructus Zizyphi Jujubae (da zao).Formulas that Tranrform Damp Turbidity protective qi is generally related to Lung and Spleen qi deficiency: the Lungs. . their functions of tonifying the qi and promoting urination are reinforced. add Radix Paeoniae Lactiflorae (bai shao) (source text). This twin strategy is the focus of the formula. this formula may be used in treating such biomedically-defined disorders as rheumatic heart disease. . take with Five-Ingredient Powder with Poria (wu ling san).

. . . . which exacerbates the diarrhea. . . . The combination of the deputy and assistant herbs revives the Spleen and improves the appetite. . which encumbers the Spleen and produces turbid dampness. The assistant herb. some practitioners now use the formula as the foundation for prescriptions which are designed to treat coronary artery disease with a similar presentation. . . T h e Spleen is responsible for transforming food into nutrients and for transporting those nutrients throughout the body. . . Pericarpium Citri Reticulatae (chen pi). . The swollen tongue reflects deficient qi. . . The moderate or slippery quality of the pulse reflects dampness encumbering the Spleen. In the source text. vomiting. . giving rise to distention and fullness throughout the abdomen. . This causes the turbid yin to rise. fatigue. . . . . . .1560g (9-12g) Honey-fried Radix Glycyrrhizae Uralensis (zhi gan cao) . . The failure of the Spleen's transporting function prevents the Stomach from receiving and passing the fluids downward. The encumbrance of the Spleen allows dampness to flow into the Intestines. . . May also be prepared as a decoction with the dosage specified in parentheses. and is adverse to dampness and stagnation. . . Actions: Dries dampness. The cardinal symptoms are distention and fullness in the epigastrium and abdomen. Honey-fried Radix Glycyrrhizae Uralensis (zhi gan cao). belching. . . . a heavy sensation in the limbs. Cortex Magnoliae Officinalis (hou Po). . ANALYSIS OF FORMULA: T h e chief herb. acrid. . and greasy coating. white. a sensation of fullness in the chest and shortness of breath were among the indications for this formula. and a moderate or slippery pulse. and a thick. For this reason. . a heavy sensation in the limbs. peptic ulcer disease.1560g (9-12g) Pericarpium Citri Reticulatae (chen pi). . bitter and warm Rhizoma Atractylodis (cang zhu). Dampness causes the qi to stagnate. Available in prepared form. With the appropriate presentation. nausea and vomiting. a swollen tongue with a thick. and harmonizes the Stomach. .2500g (12-15g) Cortex Magnoliae Officinalis (hou Po) . infantile indigestion. . It prefers dryness and the smooth flow of qi. . Because of the importance of these functions in treating this condition. . . . . easily-fatigued. gastric neurosis. . . or to Spleen deficiency. This in turn causes the qi of the middle burner to stagnate. . . and greasy tongue coating. regulates the qi and thereby transforms the dampness. . COMMENTARY: This is the most representative and popular formula for the treatment of dampness (specifically damp-cold) stagnating in the middle burner. The symptoms of loss of taste and appetite. would have been used in place of Rhizoma Atractylodis (cang zhu). This is damp-cold stagnating in the Spleen and Stomach. white. promotes the movement of qi. which is better suited for strengthening the Spleen. loss of taste and appetite. . . INDICATIONS: Distention and fullness in the epigastrium and abdomen. CAUTIONS & CONTRAINDICATIONS: This formula contains warm. and acid regurgitation. dispels dampness and disperses fullness. and the tongue coating the presence of damp-cold and turbid dampness. . . an increased desire to sleep. . . . regulating the qi transforms dampness. . add Rhizoma Zingiberis Officinalis Recens (sheng jiang) and Fructus Zizyphi Jujubae (da zao). . . its dosage is rather large. . T h e deputy. and loose stool or diarrhea indicate that the Spleen yang is unable to function. . . and take as a draft in 6-9g doses on an empty stomach. and to induce labor. drying herbs which easily injure the . . Overconsumption of raw or cold foods leads to dampness. an envoy. . . . this formula may be used in treating such biomedically-defined disorders as acute and chronic gastroenteritis. and enhances their Spleenstrengthening properties. . . It harmonizes the actions of the other herbs. The other envoys. acid regurgitation. loose stool or diarrhea. . Rhizoma Zingiberis Officinalis Recens (sheng jiang) and Fructus Zizyphi Jujubae (da z a o ) . mildly regulate and harmonize the relationship between the Spleen and Stomach. increased desire to sleep. Most commentators have argued that if the formula were designed to treat dampness due to Spleen deficiency. For a formula in which this substitution is made to focus more on the deficient aspects of the presentation. Over the years there has been a debate in the literature about whether the dampness for which this formula is indicated is primarily due to excess (as described above). see modifications below. tonifies the Spleen.Calm the Stomach Powder 181 Calm the Stomach Powder ping w2i s S E i n Source: Imperial Grace Formulary of tht Tai Ping Era (Tai ping hui min he ji ju fang) Rhizoma Atractylodis (cang zhu) . . . improves the Spleen's transporting function. Rhizoma Atractylodis Macrocephalae (bai zhu). is perhaps the best substance in the materia medica for dispelling dampness and strengthening the transporting function of the Spleen. which is characterized by nausea. It assists the deputy in directing rebellious qi downward and eliminating distention.900g (3-6g) Preparation: Grind the ingredients into powder. It works synergistically with the chief herb to dry the dampness and strengthen the Spleen. .

. . . . . . . . directs rebellious qi downward. . . . . . For externally-contracted sudden turmoil disorder characterized by fever and chills.1. . . greasy tongue coating. . . . . . . . . . . .2. . . . . . . . . . . diarrhea. . . 4% Eliminate Dampness Decoction by Combining Calm the Stomach and Five-Ingredient Powder with Poria d ?$3% w *%I chii sh%wei ling tting Source: Golden Mirror o f the Medical Tradition (Yi zong jin jian) . . . . * For damp-heat with a bitter taste in the mouth. . . . . . . . . . . . . and a yellow. .4g Sclerotium Polypori Umbellati (zhu ling) . . . . In contrast to the principal formula. . . . . . *For food stagnation with severe distention and constipation. . . and abdominal distention and fullness.9-12g Fructus Hordei Vulgaris Germinantus (mai ya) . . . . . . . . . . . . . an aversion to eating. . . . . add Cortex Cinnamomi Cassiae (rou gui) and Rhizoma Zingiberis Officinalis (gan jiang). . . . . . .9g Medulla Junci Effusi (deng xin cao) . . and alleviates pain. . . . For food stagnation characterized by abdominal distention and pain. . . 1 piece Promotes urination. . . . . . .4g Fructus Amomi (sha ren) . . For stones in the common bile duct. . . MODIFICATIONS: Cyperus and Amomum Powder to Calm the Stomach %87%k xiiing shci ping we'i siin Source: Golden Mirror of the Medical Tradition (Yi zong jin jian) Rhizoma Cyperi Rotundi (xiangfu) . .3-6g Rhizoma Atractylodis (cang zhu) . . . . . . . pitting edema and ascites. . . . .3g Cortex Magnoliae Officinalis (hou $0) . . Strengthens the Spleen. . . .6-9g Fructus Citri seu Ponciri (zhi h) . . . . . . and diarrhea that does not relieve the abdominal pain. . vomiting. . . . . . . . . . . . . . .2. . . . promotes the movement of qi. transforms turbidity. firm focal distention in the epigastrium. . . . Pericarpium Arecae Catechu (da fu Pi) and Fructus Citri seu Ponciri (zhi ke).3g Pericarpium Citri Reticulatae (chen pi). .3g Sclerotium Poriae Cocos (fu ling) . . . scanty. . . . . The source text does not specify dosage. . moves the qi.3g Rhizoma Atractylodis Macrocephalae (bai zhu) . . add Herba Artemisiae Yinchenhao ( y i n chen hao). . . . . . . .9-12g Radix Paeoniae Lactiflorae (bai shao) . . . . . . . . .2. . . . . . . . . . . . . . . . . . . . . and guides out stagnation. . . . and add Radix Astragali M e m b r a n a c e i (huang qi) a n d R a d i x Dioscoreae Oppositae (shan yao). . . . . . . . . . . . . . . . . . . . . . . . substitute Rhizoma Atractylodis Macrocephalae (bai zhu) for Rhizoma Atractylodis (cang zhu). . . . . . yellow urine. a dry throat with no thirst. . . . . * * * Separate and Reduce Decoction PL * * 7) ASSOCIATED FORMULAS: Rectify the Qi Powder Worth More than Gold %*&iEL* bii huiin j k zhe'ng q i sZn Source: Imperial Grace Formulary of the Tai Ping Era (Tai ping hui min he ji jufang) Cortex Magnoliae Officinalis (hou po) Rhizoma Atractylodis (cang zhu) Herba Agastaches seu Pogostemi (huo xiang) Rhizoma Pinelliae Ternatae (ban xia) Pericarpium Citri Reticulatae (chen pi) Radix Glycyrrhizae Uralensis (gan cao) Grind equal amounts of the ingredients into powder and take in 3-6g doses as a draft before meals with Rhizoma Zingiberis Officinalis Recens (sheng jiang) and Fructus Zizyphi Jujubae (da zao). For severe damp-cold with generalized cold and pain. . . . . . . For abdominal fullness and drumlike distention. .lg Radix Aucklandiae Lappae (mu xiang) . . .5-3g Decoction.5-3g Rhizoma Zingiberis Officinalis Recens (sheng jiang) . . . Dries dampness.3g Pericarpium Arecae Catechu (da fu pi) . . . . . . . . . . . . .2. . add Mirabilitum (mang xiao) and Fructus Immaturus Citri Aurantii (zhi shi). . l . For delayed labor o r fetal death with a similar presentation. . . . . . . . . . . . .4g Rhizoma Alismatis Orientalis (ze xie) . . . . . . . . . . Fructus Gardeniae Jasminoidis (zhi zi) and Tuber Curcumae ( yu jin) .1 piece Rhizoma Zingiberis Officinalis Recens (sheng jiang). . . . . . .3g Rhizoma Cyperi Rotundi (xiang fu) . . . .4g Fructus Immaturus Citri Aurantii (zhi shi) . . . . . . . vomiting of sour fluids. For more Spleen deficiency marked by a loss of appetite with less distention and fullness. . . . . . . . . . .9-12g Radix Glycyrrhizae Uralensis (gan cao) . .0. . . . . . . . . add Semen Raphani Sativi ( h i fu zi). . . . . . .182 Formulas that Transform Damp Turbidity yin and the blood. . . add Rhizoma Pinelliae Ternatae (ban xia). . . Source: Women's Diseases According to Fu Qing-Zhu (Fu qing zhu nu ke). . add Radix Scutellariae (huang qin) and Rhizoma Coptidis ( h a n g lian). . . . . . . . . and should therefore only be used with significant modification for patients with yin or blood deficiency. $n xitio tang Source: Restoration of Health from the Myriad Diseases (Wan bing hui chun) Rhizoma Atractylodis (cang zhu) . reduces food stagnation. . . . For severe vomiting. . .3-6g Fructus Amomi (sha ren) . . . . . .9-12g Fructus Crataegi (shan zha) . . . and constipation. . .12-15g Pericarpium Citri Reticulatae (chen Pi) . .2. . . I t should also be used with caution during pregnancy. . . and stops vomiting. . this has a stronger ability to transform turbid dampness and to regulate the qi. . . . . . .

. . . . .60g (9g) Pericarpium Arecae Catechu ( d a f u pi) . Internal stagnation of dampness in the middle burner weakens the Spleen's transporting a n d transforming functions. .6og (1%) Sclerotium Poriae Cocos ( f u ling). . . Pericarpium Citri Reticulatae (chen pi) regulates the qi. . . . Both herbs act upon the qi mechanism in the middle and lower burners. .to lower-back region. . which causes headache.3g Sclerotium Poriae Cocos Rubrae (chifu ling). . . . . . . . . a white. This condition usually corresponds to herpes zoster which erupts in the mid. . soggy ppulse. vomiting. consisting of Folium Perillae Frutescentis (zi suye) and Radix Angelicae Dahuricae (bai zhi). . . . . . regulates the qi. . . . . . . . . . . . . . .1 Preparation: Grind the ingredients into powder and take in 3-6g doses as a draft with 3-6g of Rhizoma Zingiberis Officinalis Recens (sheng jiang) and one piece of Fructus Zizyphi Jujubae (da zao). . . . . .3g Clears heat and dries dampness in the lower burner. . . . consisting of Cortex Magnoliae Officinalis (hou po) and Pericarpium Citri Reticulate (chen pi). . . This causes abdominal pain. . . . transforms dampness. . It also disrupts the normal ascending and descending functions of the middle burner. . . . .3g Fructus Gardeniae Jasminoidis (zhi zi) . . leading to a sensation of fullness and stifling oppression in the chest. . . . This is externally-contracted wind-cold with concurrent internal injury due to stagnation. . . . .$L%& This formula releases the exterior and tramforms dampness in order to rectgy and restore the normal qi. Radix Platycodi Grandiflori (jie geng). . . It disperses wind-cold. . .Agastache Powder to Rectqy the Q i Rhizoma Atractylodis (cang zhu) . . .609-(9g) Pericarpium Citri Reticulatae (chen pi) . . . . . . acrid and aromatic Herba Agastaches seu Pogostemi (huo xiang). Pericarpium Arecae Catechu (dafu pi). . . but focuses on the lower burner. . . ANALYSIS OF FORMULA: T h e chief herb. . . . . . . .30g (6g) Radix Angelicae Dahuricae (bai zhi) . regulates the qi. . .60g (9g) Honey-fried Radix Glycyrrhizae Uralensis (zhi gan cao) . . .3g Sclerotium Polypori Umbellati (zhu ling) . . . . . . T h e internal stagnation obstructs the qi mechanism in the middle burner. . . .3g Talcum (hua shi) . . soggy ppulse. . . . .3og (9g) Radix Platycodi Grandiflori (jie geng) . Radix Angelicae Dahuricae (bai zhi) is very effective in treating headache. .3g Pericarpium Citri Reticulatae (chen pi). . . . functions like Cortex Magnoliae Officinalis (hou Po). T h e assistants Rhizoma Atractylodis Macrocephalae (bai zhu) and Sclerotium Poriae Cocos (fu ling) form a powerfd combination for strengthening the Spleen and transforming dampness. . . . . . May also be prepared as a decoction over a relatively high flame for a short period of time (about 10-20 minutes) with the dosage specified in parentheses. . . . . diarrhea. . . pain in the epigastrium and abdomen.3g Caulis Mutong (mu tong) . . . . . . exterior-releasing herb that also harmonizes the middle burner. . . . . Actions: Releases the exterior. . greasy tongue coating and a moderate.3g Radix Ledebouriellae Divaricatae (jang feng). headache. . . the most yang aspects of which traverse the head. . . . . . . are the first to be affected by wind-cold. promotes the Agastache Powder to Rectify the Qi %$. . . and diarrhea. . . . . . . . INDICATIONS: Fever and chills. . Available in a variety of prepared forms. and a moderate. Another assistant. revives the Spleen. . . . . Source: Imperial Grace Formulary of the Tai Ping Era (Tai Ping hui min he ji ju fang) Herba Agastaches seu Pogostemi (huo xiang) . . . Rhizoma Pinelliae Ternatae (ban xia). Externally-contracted wind-cold constricts the protective qi (producing chills) and battles with the normal qi (producing fever). T h e greater yang channels. . . . and stops vomiting. . . . . . . Internal stagnation of dampness causes a loss of taste. .3g Cortex Magnoliae Officinalis (hou Po) . . . . a sensation of fullness and stifling oppression in the chest. . . . . . . . . . . . . .3g Khizoma Alismatis Orientalis (ze xie). and harmonizes the functions of the middle burner.3g Cortex Cinnamomi Cassiae (rou gui) . . . .9Og (1%) Cortex Magnoliae Officinalis (hou po). . . hence the name. . . . . . . reinforces the actions of the chief herb in the middle burner.3g Dry-fried Rhizoma Atractylodis Macrocephalae (chao bai zhu) . . . . . transforms dampness. . . . . . nausea. . 183 vomiting. . .9g Radix Glycyrrhizae Uralensis (gan cao). T h e first. which focuses on the upper burner. . . . Cortex Magnoliae Officinalis (hou po) moves the qi and promotes proper water metabolism to expand the chest and reduce the sensation of fullness and stifling oppression. . . . In China. There are two distinct groups of deputy herbs.9g Medulla Junci Effusi (deng xin cao) . .30g (6g) Rhizoma Pinelliae Ternatae (ban xia) . . 75g (39. . . . . . . . . . . . . . . . . . . . . . . . . . . greasy tongue coating. . . transforms turbid dampness. . . . . . . . . . . . . For fire papules that encircle the waist. . . . . . . borborygmus. T h e last of the assistants. . .0. . harmonizes the Stomach and stops vomiting. . Folium Perillae Fmtescentis (zi s u ye) is a strong. . . . . . and abdominal pain. . . . . . . . . . . . . . . . . . . and harmonizes the middle burner. . . . loss of taste.0. . . the more fast-acting liquid preparations are preferred. . . and produces a white. . . . . nausea and . . . . . helps the chief herb dispel externally-contracted cold. . and harmonizes the middle burner. addresses all the major aspects of this condition.30g (9g) Rhizoma Atractylodis Macrocephalae (bai zhu) . . . . . . . and reinforce the actions of the chief herb. . . . . . . One of the assistants. . . . . . . . . . . . .60g (9g) Folium Perillae Frutescentis (zi su ye) . . . . T h e second group. . . borborygrnus. .

. with an emphasis on the middle burner. . The envoys. . @ For food stagnation. . discussed under the previous formula. Folium Perillae Frutescentis (zi su ye). . the actions of the other herbs and regulate the Spleen and Stomach. Both this formula and Elsholtzia Powder (xiang ru san) (see chapter 1) treat externally-contracted windcold in the summertime with internal accumulation of dampness. . . which strengthens the actions of the chief herb. . and Radix j i egeng) produce an ascending Platycodi Grandiflori ( action. . Rectify the Qi Powder Worth More than Gold (bu huanjin zheng qi sun). . . Chen Xiu-Yuan. .Formulas that Transform Damp Turbidity proper functioning of the Lungs and the diaphragm. This formula is commonly used in treating such disorders. . especially if the aspect of turbid dampness is pronounced and there are few manifestations of an exterior condition. The first three modifications treat conditions with some heat signs. . . . . . and Pericarpium Arecae Catechu (da fu Pi) cause the turbid.6g Cortex Magnoliae Officinalis (hou Po) . . and add Massa Fermentata (shen qu) and Endothelium Cornei Gigeriae Galli (ji nei jin). . . it is different from the pathogenic qi which injures the channels [and enters through the skin]. do not use strong sweating [herbs] to release the exterior. . disorientation. Sclerotium Poriae Cocos (fu ling). . . . . . . intestinal flu.6g Cortex Poriae Cocos (fu ling pi) . . Its ability to transform dampness is accordingly stronger than is its ability to release exterior conditions. can also be used in treating this disorder. Therefore. CAUTIONS & CONTRAINDICATIONS: Because this formula contains warm and drying herbs. . . substitute Rhizoma Atract~lodis (cang zhu) for Rhizoma Atractylodis Macrocephalae (bai zhu). . this formula may be used in treating such biomedically-defined disorders as influenza. Conversely. . The other two treat damp-cold. . . . Agastache Powder to Rectify the Q i (huo xiang zheng qi san) is indicated for severe internal accumulation with only mild exterior symptoms. Rhizoma Zingiberis Officinalis Recens (sheng harmonize jiang). Herba Agastaches seu Pogostemi (huo xiang). . . . . . . However.6g Semen Pruni Armeniacae (xing ren) . . omit Radix Glycyrrhizae Uralensis (gan can) and Fructus Zizyphi Jujubae (da 2 4 . . . . . Each of the five associated formulas from the Systematic Difjerentiation of Warm Diseases listed below contains Herba Agastaches seu Pogostemi (huo xiang). These herbs regulate the middle burner. COMMENTARY: Acute conditions in which there is a simultaneous onset of vomiting and diarrhea are known as sudden turmoil disorders (hud ludn). Rhizoma Pinelliae Ternatae (ban xia). rebellious qi to descend. transform turbid dampness." This formula includes all of the herbs that comprise Calm the Stomach Powder (ping wei san) and Two-Cured Decoction (er chen tang). . .4. . . . . scanty urination. The cardinal symptoms are abdominal pain. . . . . greasy tongue coating. .3g Massa Fermentata (shen qu) . . . 4 For brief. . . and treat dampness constrained in the Triple Burner.69Pericarpium Citri Reticulatae (chen pi). . . . . it should not be used without significant modification in cases with wind-heat or fire due to deficiency. add Caulis Mutong (mu tong) and Rhizoma Alismatis Orientalis (ze xie). vomiting and diarrhea. . nonspecific acute colitis. and acute gastroenteritis. and madness with delirious speech or loss of voice. Pericarpium Arecae Catechu (da fu Pi). MODIFICATIONS: 4 For severe wind-cold. . . ASSOCIATED FORMULAS: First Modification of Rectify the Qi Powder -a&&&& yt jiii jiiin zhing qi siin Source: Systematic Difjirentiation o f Warm Diseases (Wen bing tiao bian) Herba Agastaches seu Pogostemi (huo xiang) . . explained the treatment strategy in this manner: "The qi of [any one of] the four seasons that does not arrive at its proper time enters through the mouth and nose. and Pericarpium Citri Reticulatae (chen Pi) promote the movement of qi internally. .5g . . . . . . but aromatic substances that promote the proper flow of qi. and Fructus Zizyphi Jujubae (da 4. The herbal groupings in this formula have been carefully matched and balanced. This formula is also used for mild cases of miasmic malarial disorder (shiin lhn zhdng nu?). 4 For severe dampness with a very thick. . increase the dosage of Folium Perillae Frutescentis (zi su ye). With the appropriate presentation. the focus of Elsholtzia Powder (xiang ru san) is on releasing the exterior where the primary symptoms are chills and fever. . which is thought to be contracted from the mists of the mountains and forests. and the internal accumulation is relatively mild. and Radix Angelicae Dahuricae (bai zhi) release the exterior. Such mists are considered to be damp and hot in nature. Manifestations include intermittent fever and chills. honey-fried Radix Glycyrrhizae Uralensis (zhi gan cao). The early nineteenth-century physician. Pericarpium Citri Reticulatae (chen pi). . . and Sclerotium Poriae Cocos (fu ling). Folium Perillae Frutescentis (zi su ye). Cortex Magnoliae Officinalis (hou Po). . . . Note that the associated formula. . together with signs of an exterior condition. Radix Angelicae Dahuricae (bai zhi). especially during the summertime when dampness is the predominant aspect. Cortex Magnoliae Officinalis (hou Po). . . .

. . . . . . . . . . Strengthens the Spleen. . . . . body aches. . . . . . . . . . . . . . . . . . . . . . . . . . . . . and a white. . .9g Cortex Magnoliae Officinalis (hou Po) .6g Pericarpium Citri Reticulatae (chen pi) . . . . . and clears and drains damp-heat. . . . . . . . .5g Strengthens the Spleen. . . . . . . . . . . . . . Fourth Modification of Rectify the Qi Powder 92 f i u $ j. . . . . . . benefits the Stomach. . . . . . . .6g Pericarpium Arecae Catechu (da fu pi) . . . . . .3g Fructus Crataegi (shan zha) . warms and transforms cold and dampness. . . . . . . . . . . . .9g Pericarpium Citri Reticulatae (chen pi). . . . . . . For darnpcold obstructing the middle burner and injuring the Spleen and Stomach characterized by a stifling sensation in the epigastrium and diarrhea. . . . . . 15g Massa Fermentata (shen qu) . . . . . . . 2 $* 3 liii hi tang Source: Investigations of Medical Formulas (Yi fang kao) Radix Ginseng (ren shen) .3g Rhizoma Pinelliae Ternatae (ban xia) . . Third Modification of Rectify the Qi Powder Harmonize the Six Decoction L+:&z%* siin jiii ji6n zhe'ng qi sEn Source: Systematic Differentiation of Warm Diseases (Wen bing tiao bian) Herba Agastaches seu Pogostemi (huo xiang) . . . . . For summertime conditions due to improper diet that causes dampness which injures the Spleen and Stomach and disrupts the harmonious functioning of the yang organs.6g Cortex Magnoliae Officinalis (hou Po) .6g Sclerotium Poriae Cocos Rubrae (chi fu ling). .1. . . . . . . . . . . . . . . diarrhea. . . For a stifling sensation in the epigastrium with loose stools. . . . . Warms the middle burner and transforms dampness. . .6g Herba Agastaches seu Pogostemi (huo xiang) . . . . . . . and reduces food stagnation. . . . . . . .6g Semen Pruni Armeniacae (xing ren) . . .E q. .5g Fructus Oryzae Sativae Germinantus (gu ya) . . . . . causing an overabundance of yin and subsequent generation of cold characterized by a white. . . . . regulates the qi.2. .# . . wii jig ji6n zhe'ng qi s6n Source: Systematic DiJerentiation (Wen bing tiao bian) of Warm Diseases Herba Agastaches seu Pogostemi (huo xiang) . The result is sudden turmoil disorder characterized by vomiting. . . . . . . .5g Semen Coicis Lachryma-jobi (yi yi ren) . . . . . . . . . . . a white tongue coating. . . . . and harmonizes the functions of the six yang organs.4g Radix Glycyrrhizae Uralensis (gan cao) .3g Rhizoma Atractylodis (cang zhu) . . . . . . . .4. . transforms dampness.. . . . . . . . . . . . . . . . . . .6g Fructus Amomi (sha ren) .fy the Fructus Hordei Vulgaris Germinantus ( m i ya) . this focuses on strengthening the Spleen and regulating the ascending and descending functions of the middle burner. . . . . . . . . . . . . . . . . . . . . . . .9g Cortex Poriae Cocos ( f u ling pi) . . . . Spreads and facilitates the flow of qi in the middle burner. . . Regulates the qi. . . . . causes the pure to ascend and the turbid to descend. and an indistinct pulse. . . . . . . . . . . . . . . . . .6g Rhizoma Atractylodis Macrocephalae (bai zhu) .6g Medulla Tetrapanacis Papyriferi (tong cao) . . . .5g Herba Artemisiae Yinchenhao (yin chen hao) . . . . . . . slippery tongue coating and a moderate pulse on the right (qi) side. . . . . . . . . For food stagnation and dampness constraining and obstructing the middle burner (causing a loss of control over the ascending and descending functions) characterized by epigastric and abdominal distention and fullness. . . . . .4. . .9g . . . In contrast to the principal formula. . . . .6g Semen Dolichoris Lablab (bai bian dou) . . . . . . . . . . and gummy stools with irregular bowel movements. .Agastache Powder to Recti. . . . . . . .4. . . .6g Decoction. . . . . . . . . . . . . . . . . . . . . . . . .9g Radix Stephaniae Tetrandrae (han fang ji) . . . .5g Sclerotium Poriae Cocos ( f u ling) . . . . . For long-term internal constraint from dampness which has transformed into damp-heat characterized by a stifling sensation in the epigastrium and a yellow tongue coating. . . . . . . . . . . . . . . .4. . . . . . . . .5g Fructus Amomi Tsao-ko (cao guo) . . . . . . . .6g Cortex Poriae Cocos ( f u ling pi) . .4. . . . . . . . . .4. transforms dampness. . . . . . . . . . . . . . . . . . . . . . . . Second Modification of Rectify the Qi Powder Z&Q*t-& Fifth Modification of Rectify the Qi Powder H 3. .4. . . . .3g Decoction.5g Semen Pruni Armeniacae (xing ren) . . .5g Cortex Magnoliae Officinalis (hou Po) . . . .6g Pericarpium Citri Reticulatae (chen pi) . . . slippery tongue coating. . . . $ n 4% e'r jiii ji6n zhe'ng qi sEn Source: Systematic Differentiation of Warm Diseases (Wen bing tiao bian) Herba Agastaches seu Pogostemi (huo xiang) . . . . . . . . . . . . . . . . . . . . . . . .6g Pericarpium Arecae Catechu (da fu pi) . . . . . . .9g Cortex Magnoliae Officinalis (hou Po) . . . . . . .6g Fructus Chaenomelis Lagenariae (mu gua) . . . . . . . . . . . . .9g Talcum (hua shi) . . . . . .9g Decoction. . . .9g Semen Glycines Germinatum (dou juan) . . . . . . . . . . . . . . .6g Sclerotium Poriae Cocos ( f u ling) . . . . . . . and facilitates the flow of qi in the channels. . . . . 15g Decoction. . . . . For dampness obstructing the qi level of the middle burner. . . . . Q i 185 Pericarpium Citri Reticulatae (chen pi) . . . . . . . . .9g Cortex Magnoliae Officinalis (hou Po) . . . . . si jiii ji6n zhe'ng qi s6n Source: Systematic Differentiation of Warm Diseases (Wen bing tiao bian) Herba Agastaches seu Pogostemi (huo xiang) . . . . transforms dampness. . . . . . . Transforms dampness. . . . .6g Decoction. . . a sensation of fullness and distention in the diaphragmatic region. . . . . . . . .

. . . acrid substances which unblock the flow of Lung qi should be used. . . and Job's tears or pearl barley (yi yi ren).9g Semen Coicis Lachryma-jobi ( y i yi ren). . aromatic Fructus Amomi Kravanh (bai dou kou). . . . . COMMENTARY: This condition is most common during the late summer or early autumn. there are three ways that this condition can be misdiagnosed. and is often found in patients with constitutional Spleen deficiency and dampness. . . cardamom seed (bai dou kou). . l 5 g Fructus Amomi Kravanh (bai dou kou) . . a heavy sensation in the body. example ANALYSIS OF FORMULA: This is a good of how to match a formula to a specific clinical presentation. and a yellow. . . and soggy pulse. it sequesters the heat in the deeper levels of the body. a heavy sensation in the body.6g Cortex Magnoliae Officinalis (hou Po). . . . Working together. transforming and drying dampness (middle burner). the pulse suggests otherwise. and taking one cup three times a day. leaches out dampness through the urine. a white tongue coating. an absence of thirst. and soggy pulse. . . dampness can also be transformed. . . . Semen Coicis Lachrymajobi (yi yi ren).18g Preparation: The source text advises to prepare as a decoction by cooking eight cups of liquid down to three cups. .6g Talcum (hua shi) . confusion. and Talcum (huashi). . . . which causes headache. . 18g Medulla Tetrapanacis Papyriferi (tong cao) . and also clear heat. It can affect all three burners. headache. with disastrous consequences. . and clearing heat. facilitates the flow of Lung qi and thus allows it to descend. with the dosage of the ingredients reduced by one-half to two-thirds. a stifling sensation in the chest. . . The chief ingredient for the middle burner. . . . . . . generalized pain. Today it is prepared as a decoction in the standard fashion (2-3 cups cooked down to one cup). INDICATIONS: Headache. Herba Lophatheri Gracilis (dan zhu ye). a stifling sensation in the chest. white tongue coating. and a wiry. FORMULAS THAT CLEAR DAMP-HEAT Conditions of damp-heat develop from the invasion of damp-heat from the exterior. afternoon fever. Three-Nut Decoction siin re'n tiing The three nuts i n this formula are apricot kernel (xing ren). This manifests as fever in the afternoon. . Medulla Tetrapanacis Papyriferi (tong cao). or from dampness which transforms into heat in the interior. These ingredients effectively treat epigastric and abdominal distention due to dampness or phlegm.6g Rhizoma Pinelliae Ternatae (ban xia) . . In order to dispel damp-heat from the qi level. resolve dampness by promoting urination. . . . Also. This is an early-stage damp warm-febrile disease or summerheat warm-febrile disease in which dampness predominates and the pathogenic influences are lodged in the protective and qi levels. . . and clears damp-heat. it can 'weigh down' the heat and make it more difficult to clear. .F o r m u h that Clear Damp-Heat SECTION 3 yang from dampness. . . . combines with heat. it also prevents the clear yang from rising. and loss of appetite.6g Herba Lophatheri Gracilis (dan zhu ye) . Source: Systematic Differentiation of Warm Diseases (Wen bing tiao bian) Semen Pruni Armeniacae (xing ren) . Actions: Disseminates the qi. The predominance of dampness is reflected in the pale-yellow complexion. Semen Pruni Armeniacae (xing ren). . . transforms turbid dampness and revives the Spleen. . . . . thin. facilitates the qi mechanisms. the chills here are caused by constriction of the .The chief ingredient for the upper burner. dampness and heat will rise up and veil the sensory orifices causing irritability. It also treats the upper burner by spreading the qi in the chest. and are much milder than the chills associated with exterior cold. . . . loss of appetite. . greasy tongue coating. . paleyellow complexion. . . . or the 'yin within the yang' time of day. and heavy and painful body sensations could also be regarded as indications of an exterior cold condition. . . . If it is misdiagnosed as an exterior condition due to cold and a formula which induces sweating is prescribed. According to the source text. the ingredients of this formula clear damp-heat from the qi level by unblocking the Lung qi (upper burner). . . . draining dampness (lower burner). . . Dampness lodged in the flesh and muscles causes a heavy sensation in the body and generalized pain. It also treats the middle burner by strengthening the Spleen. a yin pathogenic influence. When dampness combines with heat. The Lungs control the upper source of water. When dampness. . Although the chills. . . . The chief ingredient for the lower burner. chills. and diminished visual and aural acuity. . When the Lungs' function of transforming the fluids is restored. . . but tends to collect (like dampness) in the lower burner. . . T h e assistant ingredients. . The primary symptoms of damp-heat include fever that worsens in the afternoon. . Fructus Amomi Kravanh (bai dou kou) is supported by two deputies with drying properties. Cortex Magnoliae Officinalis (hou $ 0 ) and Rhizoma Pinelliae Ternatae (ban xia).

. . . . . If afternoon fever is mistaken for an indication of yin deficiency for which cloying herbs that nourish the yin are prescribed. . the dampness and heat are equally severe. . . . . . . . . . thirst. . . . . . . . .4. . . and postoperative fever of various etiologies. . and Poria Decoction % R615 hu6 p6 xi2 ling tiing Source: Bases of Medicine (Yi yuan) Herba Agastaches seu Pogostemi (huo xiang) . . . . . . . . and weaker at clearing heat. . . . . . . . . . . . . . fever of unknown origin. .1. . . . . * For malarial disorders. . and a grayish-white tongue coating. .6g Rhizoma Pinelliae Ternatae (ban xia) . . . . . . . . . . . . . . With the appropriate presentation. . severe diarrhea. .12g Fructus Amomi Kravanh (bai dou kou). Agastache. . .5g Semen Sojae Praeparatum (dan dou chi). dark urine. . . . . . . add Radix Peucedani (qian hu) and H e r b a Agastaches seu Pogostemi (huo xiang). . . . nausea. This formula is also known as Universal Benefit Special Pill to Relieve Toxicity (pu ji jie du dan).6g Talcum (hua shi) . . . . . . . . . . . . . . . . . . .9g Radix Scutellariae (huang qin) . . Fructus Gardeniae Jasminoidis (zhi zi) and Radix Scutellariae (huang gin). . . . . . . . . . thin tongue coating. . .3g Clears heat and summerheat and resolves dampness. . . . . . . . . . . . ASSOCIATED FORMULAS: Apricot Kernel and Talcum Decoction &&%z% xing r i n hu6 shi tiing Source: Systematic Differentiation of Warm Diseases (Wen bing tiao bian) Semen Pruni Armeniacae (xing ren) . . . this is the time ofyear when the 'sweet dew' falls. . . . . . . . . . . . . . . and a moderate pulse. soggy pulse. . . . . . . . which is often difficult to resolve. . . . . . . . . . .5g Sclerotium Poriae Cocos Rubrae (chi fu ling). . . . T h e modern physician. . . . . . . . . . . . . . add Herba Artemisiae Annuae (qin. . . . Wang De-Jun. . . . . scanty urine. . . . . . . . . . . . . . . lassitude. MODIFICATIONS: Scutellaria and Talcum Decoction -&4&qW3 huiing q i n hu6 shi tiing Source: Systematic Differentiation of Warm Diseases (Wen bing tiao bian) Radix Scutellariae (huang qin) . . . . . . . . . . a white.3g Pericarpium Citri Reticulatae (chen pi) . . .9g Medulla Tetrapanacis Papyriferi (tong cao) . . . . .3g Sclerotium Polypori Umbellati (zhu ling) . . . .9g Cortex Magnoliae Officinalis (hou $0) . . . undulant fever. . . . a n d biliary ascariasis. . . . . . . Sweet Dew Special Pill to Eliminate Toxin giin lii xiiio d 6 diin This formula was originally used for conditions contracted in the 'long summer' or early autumn. . . . . . . . . . . . . . . add Herba Artemisiae Yinchenhao (yin chen hao). . ha4 and Fructus Amomi Tsao-ko (cao guo). Pinellia. . For smoldering damp-heat or damp-summerheat in all three burners characterized by tidal fever. . .120g (6-9g) . . .9g Cortex Poriae Cocos (fu ling pi) . the condition will progress to a deeper level where it will stubbornly resist treatment. . . . . .9g Talcum (hua shi) . Primarily for early-stage damp warm-febrile disorders with distinct exterior signs characterized by fever and chills.5g Cortex Magnoliae Officinalis (hou $0) . . . . . a pale-yellow and overly-moist tongue coating. . .3g Releases the exterior and transforms dampness. . little or no thirst. . . . For severe headache and aversion to cold. . . . . . a pasty sensation in the mouth. . . . . * For severe fever.9g Clears heat and resolves dampness. . . . . . . . . . . . . and a moderate. . . . . . . . . . . . . . . . sweating.300g (12-15g) Herba Menthae Haplocalycis (bo he) . . . . .4. . . . In this condition. . . . . . . . . . .6g Rhizoma Coptidis (huang lian). Magnolia Bark. . . . . . . . . . . . . . . . this formula may be used in treating such biomedically-defined disorders as enteric fever. . . . . . . . . . . . .4.9g Rhizoma Alismatis Orientalis (ze xie) . .5g Rhizoma Pinelliae Ternatae (ban xia) . a stifling sensation in the chest. . . . . . . . . body aches. . . . a stifling sensation in the chest. . the Spleen yang will collapse causing severe diarrhea. . pyelonephritis. For damp warmfebrile diseases in the middle burner characterized by fevers that apparently resolve with sweating but then recur. . . . add Herba Agastaches seu Pogostemi (huo xiang) and Folium Perillae Frutescentis (zi su ye). . this is stronger at resolving dampness and releasing the exterior. In contrast to the principal formula. . . . . . . . . . . . .3g Medulla Tetrapanacis Papyriferi (tong cao) . . .120g (12-15g) Radix Scutellariae (huang qin). .9g Semen Pruni Armeniacae (xing ren) . and a red tongue. . . . . .9g Semen Coicis Lachryma-jobi (yi yi ren) . . . According to the Chinese lumr calendar. * For a more severe stifling sensation in the chest and focal distention in the epigastrium. . .6g Tuber Curcumae (yu jin) . . . . .4. . . . . . . . . . . .Sweet Dew Special Pill to Eliminate Toxin If the stifling sensation in the chest and loss of appetite are misdiagnosed as symptoms of accumulation for which purgatives are prescribed. . . . . . . . .8g Sclerotium Polypori Umbellati (zhu ling) .6g Fructus Amomi Kravanh (bai dou kou) . . . . . . .9g Pericarpium Arecae Catechu (da fu pi) . . . . . Source: Warp and W o o f of Warm-febrileDiseases (Wen re jing wei) Fructus Forsythiae Suspensae (lian qiao). . . recommends this formula for a wide range of conditions with qi obstruction due to damp-heat including morning sickness. . . . . .

reduced appetite. . Dark. . some believe that it is more effective in treating conditions in which heat is the predominant factor. and by opening the flow in the lower parts of the body. . achy limbs. . the pathogenic influences first attack these organs. . . and Rhizoma Belamcandae Chinensis (she gan) and Bulbus Fritillariae Cirrhosae ( c h n bei mu). . . It may also be used in treating damp-heat stagnating in the Triple Burner characterized by persistent low-grade fever. transforms turbidity. . The third group of herbs is used for this purpose: Herba Agastaches seu Pogostemi (huo xiang). . the damp-heat has an avenue through which to exit. . . scanty urine. Depending on the level of penetration and whether dampness or heat is preponderant. . The first clears heat. . . . dampness may confine the heat internally and cause jaundice. . . . which also helps clear the consciousness. . . . . . mild leptospirosis. . . . The soggy. . . . or a seasonal epidemic disorder. . . . . . abdominal distention. . . and deficiency disorders of the middle qi are in the greater yin. . . and relieves toxicity. . the tongue coating may be white or yellow. . . . . rapid pulse is indicative of damp-heat. greasy tongue coating. .Formulas that Clear Damp-Heat Rhizoma Belamcandae Chinensis (she gan). dry tongue coating. . . . . . . . . The problem is in the qi level. Caulis Mutong (mu tong). . . . cholecystitis. . . MODIFICATIONS: @ For enteric fever. . Diarrhea with difficulty in passing stool indicates that the pathogenic influences are in the Stomach or Intestines.150g (6-9g) Talcum (hua shi) . . . Severe damp-heat in the qi level can also lead to unremitting fever. achy limbs. . . . . observed of this kind of condition: "Most damp-heat patterns reside in the yang brightness and greater yin because excess disorders of the middle qi are in the yang brightness. . simultaneous bitter and sweet tastes in the mouth. . In conditions of damp-heat. . infectious hepatitis. . . jaundice. rapid pulse. . The resulting smoldering damp-heat causes fever. . enteric fever. . Both conditions are caused by pathogenic influences entering the body through the mouth and nose. . . . . Heat surging upward. . improve the functioning of the throat. and lethargy. . . . . a white. . this formula may be used in treating such biomedically-defined disorders as gastroenteritis. . . Today it is usually prepared as a decoction with the dosage specified in parentheses. There may also be vomiting and diarrhea. cloying properties of dampness. and Herba Artemisiae Yinchenhao (yin chen hao). Radix Sophorae flavescentis (ku shen) . . . a stifling sensation in the chest." In China this formula is usually prescribed for conditions occurring between summer and autumn. . which also aids in releasing the exterior aspects of the body. when the middle burner is obstructed by the thick. Although most practitioners use this formula for conditions in which both heat and dampness are present. which drain heat from the Lungs. and mild cases of type B encephalitis. However. In the second group are substances which drain damp-heat from the lower burner. . . . and transform phlegm. . . . devised by Ye TianShi (1665-1775). . . . and Herba Menthae Haplocalycis (bo he). . . while constipation indicates that the damp-heat is in the upper burner or the lesser yang channel. . . abdominal distention. . ANALYSIS OF FORMULA: The herbs in this formula can be divided into three major groups. . add Radix Sanguisorbae Officinalis (di yu). . Included in this group are Talcum ( h a shi). . . clears heat. With the appropriate presentation. . a sensation of heaviness in the body. . Actions: Resolves dampness. . . .150g (9-12g) Herba Artemisiae Yinchenhao (yin chen hao) . . . . . causing a stifling sensation in the chest. This group includes Fructus Forsythiae Suspensae (lian qiao). In severe cases. . Radix Scutellariae ( h n g qin). . greasy or yellow. By clearing the upper parts of the body. . the presence of either constipation or diarrhea with difficulty in passing stool are clues for locating the disorder. and a yellow. This is the early-stage of a damp warm-febrile disease. . . greasy or dry. . . . pyelonephritis. . . . . . . . . 120g (9-12g) Rhizoma Acori Graminei (shi chang pu) . Xue Sheng-Bai. . . bowel dysfunction. . . and a soggy. was not written down until after his death. Since the nose is linked to the Lungs and the mouth to the Stomach. Smoldering damp-heat also constrains the clear yang and disrupts the qi mechanism. . causes a swollen throat. and Fructus Amomi Kravanh (bai dou kou). . swollen throat. INDICATIONS: Fever. it is necessary to use aromatic substances to eliminate the turbidity and revive the Spleen. . . . . or unremitting fever. . . . which clear heat from the upper and relatively exterior aspects of the body. . . . the qi can flow freely. . . . .450g (18-21g) Caulis Mutong (mu tong). The famous Qing-dynasty physician. Rhizoma Acori Graminei (shi chang pu). especially when accompanied by dampness.180g (4-6g) Fructus Amomi Kravanh (bai dau kou).120g (10-12g) Preparation: The source text advises to grind the ingredients into powder or form into pills and take in 9g doses twice a day with water. dark. . COMMENTARY: This formula. and possibly vomiting and diarrhea.120g (9-12g) Bulbus Fritillariae Cirrhosae (chuan bei mu). sweating. scanty urine and diarrhea reflect the preponderance of heat. lethargy. . .330g (24-30g) Herba Agastaches seu Pogostemi (huo xiang) .

. Working together. . . greasy tongue coating are classic signs of damp-heat. . . . . urinary difficulty.Yen). . . . . . a yellow. . . . Radix et Rhizoma Rhei Conquitae (shu da huang) may be used. Rhizoma Pinelliae Ternatae (ban xia). Fructus Gardeniae Jasminoidis (zhi zi) and Semen Sojae Praeparatum (dm dou chi). in this type of condition. The condition is characterized by vomiting and diarrhea. . and dry heaves (sometimes with diarrhea). * For infectious hepatitis. .3g Cortex Magnoliae Officinalis (hou Po). . and reduces jaundice. . . . . . . . . and harmonizes the middle burner. Rhizoma Phragmitis Communis (lu gen) is classified as an assistant herb which aids in clearing and transforming damp-heat. . . The last deputy. Another deputy. . . . is one of the most effective herbs for transforming dampness and promoting the movement of qi. Depending on how much of a purgative action is required.3g Rhizoma Phragmitis Communis (lu gen) . . . . . Actions: Clears heat. * For pyelonephritis. . . Today the dosage is commonly doubled. and a slippery. harmonizing the Stomach. Dark. and a stifling sensation in the chest and epigastrium. The combination of two of the deputy herbs. dark. . . thirst. . . . . Coptis and Magnolia Bark Decoction Source: Discussion (Huo luan lun) of Sudden Turmoil Disorders Ginger juice-fried Rhizoma Coptidis (huang lian) . . .3g Rhizoma Pinelliae Ternatae (ban xia) . Available in prepared form. . transforms dampness. focal distention and a stifling sensation in the chest and epigastrium. . . 189 clears the constrained heat from the chest and epigastrium. Cortex Magnoliae Officinalis (hou Po). . . . . The other chief herb. . . fin chin hiio tiing Source: Discussion (Shang han lun) of Cold-induced Disorders Herba Artemisiae Yinchenhao (yin chen hao) .9g Semen Sojae Praeparatum (dan d Rhizoma Acori Graminei (shi chang pu) . It does not treat the diarrhea directly because this is unnecessary. l a g Fructus Gardeniae Jasminoidis (zhi zi) . . regulates the qi. . This is yang-type or damp-heat jaundice due to dampness and static heat accumulating in the interior. This pattern leads to a 'steaming' effect that causes . . thirst (with the ability to take only sips). . . INDICATIONS: Whole-body jaundice with color that . . . . . . This is sudden turmoil disorder due to an aggregation of damp-heat smoldering in the body. This causes the clear and turbid fluids to become intermingled with resulting disruption of the ascending and descending functions of the Spleen and Stomach. increase the dosage of Herba Artemisiae Yinchenhao (yin chen hao) and add Fructus Gardeniae Jasminoidis (zhi zi). the diarrhea will stop. . irritability. these two herbs transform dampness which. .9g m chi) . .9g Radix et Rhizoma Rhei (da huang) . . thereby stopping the vomiting. rapid pulse. . . transforms dampness and revives the Spleen. . especially when neither heat nor dampness predominates. one of the chief herbs. . Herba Polygoni Avicularis (bian xu). . . the rest of the herbs. . aromatic Rhizoma Acori Graminei (shi c h g pu). other symptoms include fever.' slight abdominal distention. once the damp-heat is resolved and the qi is regulated.6g Preparation: Decoction. facilitates the clearing of heat.Artemisia Yinchenhao Decoction and Rhizoma Coptidis (huang lian). it also focuses on the middle burner. . . resolves dampness. . resembles a 'fresh tangerine. . . . Despite its relatively large dosage. add Herba Dianthi (qu mi). The use of this formula has been expanded to treat many types of conditions with dampness obstructing the middle burner and generatingheat. greasy tongue coating.6g Fructus Gardeniae Jasminoidis (zhi zi) . scanty urine and a yellow. Radix et Rhizoma Rhei (da huang) may be cooked with . Actions: Clears heat. . . . In addition to the indications listed above.60g Preparation: Decoction. or Radix et Rhizoma Rhei (da huang) may be added near the end of the decocting process. . . Cortex Phellodendri (huang bo) and Radix et Rhizoma Rhei (da b n 9 ) . . . and stopping the vomiting. . COMMENTARY: This formula focuses on clearing and transforming damp-heat and regulating the ascending and descending functions of the middle burner. . Folium Pyrrosiae (shi wei) and Rhizoma Imperatae Cylindricae (bai mao . greasy tongue coating. . scanty urine. . ANALYSIS OF FORMULA: Rhizoma Coptidis (huang lian). . . assists Cortex Magnoliae Officinalis (hou po) in drying dampness and is very effective in directing the rebellious Stomach qi downward. Artemisia Yinchenhao Decoction INDICATIONS: Simultaneous vomiting and diarrhea. . and a yellow. . effectively clears heat and dries dampness in the middle burner.

. These three herbs act synergistically to drain damp-heat and encourage the fading of jaundice. Damp-heat collecting internally prevents the fluids from ascending and produces this particular type of thirst. . . . . COMMENTARY: This is a very effective formula for the treatment of jaundice. For yin-type or damp-cold jaundice with more Kidney yang deficiency characterized by a dull complexion with a dark-yellow sheen. . leukemia. .5g Radix Lateralis Aconiti Carmichaeli Praeparata ( f u z i ) . . cholelithiasis. . . The tongue and pulse signs reflect the presence of both dampness (greasy and slippery) and heat (yellow and rapid). . One of the distinguishing features of this condition is sweating from the head only. . . . which is unable to be released externally. . . resolves dampness. add Herba Eupatorii Fortunei (tei lan). . . thin. add Caulis Barnbusae In Taeniis ( z h ru). especially those types in which heat is the predominant factor. . and reduces jaundice. .5g Quick-fried Rhizoma Zingiberis Officinalis (pao jiang) . ASSOCIATED FORMULAS: Artemisia Yinchenhao Decoction for Frigid Extremities Artemisiae Yinchenhao (yin chen hno). the herb should be replaced with a mild laxative that is suitable for this condition. . . . . . . .4. . add Herba Lysimachiae (jin qian cao). add Fructus Forsythiae Suspensae (lian qiao) and Flos Chrysanthemi Indici (ye ju h a ) . drains damp-heat through the urine. . . reinforces the yang. and weak pulse. .Formulas that Clear Damp-Heat the entire body to turn a bright-orange color. . If this leads to rebound constipation. . . Fructus Gardeniae Jasminoidis (zhi zi). . . . Radix et Rhizoma Rhei (da h n g ) can easily injure the normal qi if taken long-term. . Its ability to benefit the Gallbladder assists Herba Artemisiae Yinchenhao (yin chen h) in reducing jaundice. . . cirrhosis. lethargy. ANALYSIS OF FORMULA: The chief herb.5g 3 ?k x ?H a . . e For difficult and irregular bowel movements with loose stools. vomiting. . this formula may be used to treat yang-brightness heat in the interior with jaundice. *For fever and chills. The rather large dosage of this herb increases its efficacy. The assistant. . reduced appetite. . . purges heat through the bowels. . .3g Today the dosage is usually doubled. and a submerged. . . and more specifically. . . including two of the associated formulas discussed below. cholecystitis. this formula may be used in treating such biomedically-defined disorders as acute hepatitis. . not from the neck or any other part of the body.3g Radix Glycyrrhizae Uralensis (gan cao) . . . . . . . . . and leptospirosis. . can be used in treating all types of jaundice. malaria. . such as Radix Gentianae Qinjiao (qin jiao) and Semen Benincasae Hispidae (dong gua ren). It is used as the foundation for many formulas that treat jaundice. . . * For cholelithiasis. . . . hepatic necrosis. Fructus Meliae Toosendan (chuan lian zi). . . and reduced appetite. . . . . .1. . Artemisia Yinchenhao. Rhizoma Cyperi Rotundi (xiang fu) and Radix Paeoniae Lactiflorae (bai shao).6g Rhizoma Zingiberis Officinalis (gan jiang) . . . The accumulation of dampness causes slight abdominal distention and urinary difficulty. . . . Rhizoma Pinelliae Ternatae (ban xia) and Massa Fermentata (shen qu). . With the appropriate presentation. this formula is contraindicated for yin-type 3-& & 2i. . Radix et Rhizoma Rhei (da hang). . CAUTIONS & CONTRAINDICATIONS: Unless modified.4. Atractylodes. . Its use should therefore be discontinued as soon as the bowel movements become smooth. . . . . . frigid extremities. add Radix Bupleuri ( c h i hu). . . . . . add Radix Gentianae Longdancao (long dan cao). Radix et Rhizoma Rhei (da huang) should be used with extreme caution during pregnancy. . . Radix Isatidis seu Baphicacanthi (ban lan gen) and Radix et Rhizoma Polygoni Cuspidati (hu zhang). . Herba jaundice or jaundice in which dampness predominates (see associated formulas). According to the source text. The deputy. . And its ability to invigorate the blood encourages the smooth flow of blood through the Liver and hastens its recovery. . . . . . typhoid fever. MODIFICATIONS: e For high fever and other signs of severe heat. but especially jaundice due to damp-heat. Its ability to clear heat strengthens the actions of the other herbs. . This is attributed to damp-heat steaming upward. *For hypochondriac pain and other signs of constrained Liver qi. . clears heat from the three burners. .J bfl yin chin si ni tiing Source: Comfirehensiue Medicine According to Master Zhang (Zhang shi yi tong) Herba Artemisiae Yinchenhao (yin chen hao) . The importance of Radix et Rhizoma Rhei (da hang) in this formula should not be overlooked.3g Rhizoma Atractylodis Macrocephalae (bai zhu) . . . . a n d Prepared Aconite Decoction yin che'n zhii fii tiing Source: Medical Reuelations (Yi xue xin wu) Herba Artemisiae Yinchenhao (yin chen hao). . Warms the interior. * For nausea.

. and a sensation of fullness and bursting pain in the epigastrium and abdomen. .Separate and Reduce Fullness in the M i d d l e Pill Radix Lateralis Aconiti Carmichaeli Praeparata ( f u z i ) . . . . firmness with a sensation of fullness and bursting pain in the epigastrium and abdomen. . The transporting function of the Spleen may be impeded by injury from externally-contracted pathogenic influences. and Rhizoma Pinelliae Ternatae (ban xia). . T h e tongue and pulse signs are likewise indicative of damp-heat. . hence the name. . . . . .5g Cortex Cinnamomi Cassiae (rou gui) . . . . . . . . . . . . . . . . . . Separate and Reduce Fullness in the Middle Pill zh6ng mtin fin xiiio wiin This formula reduces fullness in the middle burner by separating the various imbalances and addressing each individually. . . . . . . . . overindulgence in sex. . . Take in 6-9g doses 2-3 times a day with warm water. . and especially fluids. . . . . . . INDICATIONS: Abdominal distention. . . but also enriches the yin to prevent it from being further injured by the progress of the disorder or the actions of the other herbs. . Radix Anemarrhenae Asphodeloidis (zhi mu). . . .9g Honey-fried Radix Glycyrrhizae Uralensis (zhi gan cao)3g Warms and strengthens the Spleen. which in turn leads to qi stagnation and eventually blood stasis. . . Rhizoma Coptidis (huang lian). . . . . . . . . which inhibits the normal physiological processes and generates heat. . Dampheat lodged in the lower burner leads to dark-yellow urine. . . The large dosage of the qi-regulating herb. descending ones in order to drain stagnation from the epigastrium and thereby separate the dampness from the heat. .0. . . . . drains heat. . . . . . . . a bitter taste in the mouth. . 12g Rhizoma Alismatis Orientalis (ze xie) . .3g Radix Ginseng (ren shen) . . . . . . . . . . . . . . . . . . . fever. . . unbinding .30g Dry-fried Fructus Immaturus Citri Aurantii (chao zhi shi). 159Rhizoma Curcumae Longae (jiang hung). . . . . . . . . . . . . . another member of this group.3g Dry-fried Radix Scutellariae (chao huang qin) . . . . . . resolves dampness. . . . . . . . . rapid pulse. . . . focuses the formula on removing the obstruction to the flow of qi in the middle burner. . The ANALYSIS O F FORMULA: . . . . . . . . . Fructus Amomi (sha ren) . . . primarily clears yang brightness-stage heat. coupled with Fructus Immaturus Citri Aurantii (zhi shi). They are aided in this purpose by Rhizoma Curcumae Longae (jiang h n g ) . . . . . Cortex Magnoliae Officinalis (hou PO). . . . . . . 191 Gardenia and Phellodendron Decoction *--ska% zhr ii bhi pi tEng Source: Discussion of Cold-induced Disorders (Shang han lun) Fructus Gardeniae Jasminoidis (zhi zi) . . . .herbs with bitter. . .15g Dry-fried Radix Anemarrhenae Asphodeloidis (chao zhi mu) . . . . a bitter taste in the mouth. . . This group combines acrid. . . . . . . . . . . 6g Honey-fried Radix Glycyrrhizae Uralensis (zhi gan cao) . . . . . . . . . . . . .5g Sclerotium Polypori Umbellati (zhu ling). For fever and jaundice as the sequela of a cold-induced disorder in cases where there is more heat than dampness.) T h e clumping of dampness and heat produces an accumulation of turbidity in the middle burner manifested as abdominal distention and firmness. . . . . . warming herbs promote the movement of qi and harmonize the Stomach. . . . . . . The disruption of this function prevents the smooth flow of qi. . . . . . .3g Clears heat. . . . Stagnation of the fluids generates dampness. . .99. . . . . . (This is a n example of heat from constraint. . . . . transforms dampness.3g Honey-fried Radix Glycyrrhizae Uralensis (zhigancao) . . . greasy tongue coating. a yellow. . . T h e upward-steaming of damp-heat and the lingering turbid fluids produces irritability. . . constipation or foul-smelling diarrhea. . . . . . .6g Rhizoma Atractylodis Macrocephalae (bai zhu) . . while damp-heat in the Stomach and Intestines causes constipation or foul-smelling diarrhea. . . . . . . Rhizoma Zingiberis Officinalis (gun jiang). . . . .6g Preparation: Grind the ingredients into a fine powder and steam into small pills. . . . .3g Pericarpium Citri Reticulatae (chen pi) . . . Actions: Strengthens the Spleen. . . . . . . . . . . . . . . . . . This is drum-like abdominal distention (gii zhhng) due to heat. . . .15 pieces (9-15g) Cortex Phellodendri (huang bai) . . . and reduces jaundice. blood. . . and thirst with no desire to drink (an important indication of this pattern).6g Rhizoma Pinelliae Ternatae (ban xia). . . . . These three bitter. . . . . . . . . . This formula is composed of three major groups of herbs. . . 1. . . 3 g Sclerotium Poriae Cocos (fu ling). . . . . fever. . and resolves dampness. . improper diet. . . . . . . . . emotional problems that generate internal disharmonies. . . . . . irritability. and reduces jaundice. . . or Liver constraint. . 15g Rhizoma Zingiberis Officinalis (ganjiang) . . . . T h e second group includes Radix Scutellariae (huang qin). . . . . Source: Secrets from the Orchid Chamber (Lan shi mi cang) Cortex Magnoliae Officinalis (hou Po). . .36g Dry-fried Rhizoma Coptidis (chao huang lian) . dark-yellow urine. . . . regulates the qi. For yin-type jaundice with more Spleen yang deficiency. and a wiry. . Obstruction of the middle burner from stagnation leads to a pathological intermingling of the clear and the turbid.

. .6g Rhizoma Alismatis Orientalis (ze xie). . while gross abdominal distention is a symptom of heat. . . . . . . . . . . . . ASSOCIATED FORMULA: third group. . .6g Rhizoma Coptidis (huang lian) . . . . . The combination of Sclerotium Poriae Cocos (fu ling). . . . . . . . . . . . . . . . . . . FourIngredient Powder with Poria (si ling sun) (this chapter). . . and Calm the Stomach Powder (ping wei sun) (this chapter). This is a complex formula which is actually an amalgamation of five constituent formulas: FourGentleman Decoction (si jun zi tang) (chapter 8). . This has led to much controversy. . . . however. . Warms the middle. . . . . . and Sclerotium Poriae Cocos (fu ling). . Rhizoma Curcumae Ezhu (e zhu) and Radix Salviae Miltiorrhizae (dm shen). . . Rhizoma Alismatis Orientalis (ze xie). . . . . .6g Rhizoma Zingiberis Officinalis Recens (sheng jiang) . . . . . . . . . . . .6g Radix Bupleuri (chi hu) .15g Grind the ingredients into a coarse powder and take warm as a draft in 3-9g doses before meals. . . . .6g Rhizoma Zingiberis Officinalis (pn jiang). .15g Cortex Magnoliae Officinalis (hou $0) . and vomiting immediately after eating. . . . . Rhizoma Atractylodis Macrocephalae (bai zhu). . . .15g Rhizoma Pinelliae Ternatae (ban xia) . . . .6g Pericarpium Citri Reticulatae Viride (qing pi) . . 15g Sclerotium Poriae Cocos (fu ling) . . . . .15g Rhizoma Cimicifugae (sheng ma) . . . The list of ingredients in the source text includes Rhizoma Zingiberis Officinalis (gunjiang). . . . they not only assist in resolving the acute problem. . . Eight-Herb Powder for Rectification This formula combines eight herbs which expel pathogenic influences and rectify the function o f the lower burner. Herba Dianthi (qu mai) and Herba Polygoni Avicularis (bian XU). . rough urination. . . . Two-Cured Decoction (er chen tang) (chapter 16). . . . . . . . . . . . . . . . . . . . . . .9-15g Herba Dianthi (qu mai) . . . . . they serve to regulate and revive (with the qi-tonifying herbs) the Spleen.6-12g Fructus Gardeniae Jasminoidis (zhi zi) . . . Separate and Reduce Fullness in the Middle Decoction -p % .3-9g Treated Radix et Rhizoma Rhei (zhi da huang) . . . . . . . . . . With the appropriate presentation. . are qi-regulators like those in the first group. . . . . . . . . . . . . . . . .6g Fructus Cubebae (bi cheng qie) . . . . and a choppy pulse.6-9g . . . this formula may be used in treating the biomedically-defined disorder of ascites. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . MODIFICATIONS: * For jaundice due to damp-heat in the Spleen and Stomach. . . . . . . . Pericarpium Citri Reticulatae (chen pi) and Fructus Amomi (sh ren). . . . . . . . . .15g Fructus Evodiae Rutaecarpae (wu zhu yu) . . . .6g Radix Ginseng (ren shen) .15g Semen Alpiniae Katsumadai (cao dou kou) . . . . Radix Ginseng (ren shen). . Drain the Epigastrium Decoction (xk xin tang) (chapter 2). . a dark-purple tongue. . . . . . . . . . . . . . yet the instructions for preparation mention Rhizoma Zingiberis Officinalis Recens (shengjiang) instead. . . . . . For drumlike abdominal distention due to cold characterized by a lack of urination or bowel movement. . . . . . and reduces fullness. . . The remaining herbs. . . Today the consensus is that Rhizoma Zingiberis Officinalis (gun jiang) is more appropriate in the context of this formula. . . . . May also be used for hernial disorders due to cold. . . but also help the patient back on the road to health. . 15g Radix Astragali Membranacei (huang qi) . . It should not be used without modification for conditions due to cold. . . . . . . . . Source: Imperial Grace Formulary o f the Tai Ping Era (Tai ping hui min he ji ju fang) Caulis Mutong (mu. . . . . . . . . . . . . . . . Thus. . . which is the basic formula for tonifymg the Spleen qi (see chapter 8). . add Talcum (h shi). . . and add Herba Artemisiae Yinchenhao (yin chen hao). add Rhizoma Sparganii Stoloniferi (sun leng). . . . . 15g Radix Aucklandiae Lappae (mu xiang) .6-12g Herba Polygoni Avicularis (bian xu) . . . . . . . . . . . . . . . . . and honey-fried Radix Glycyrrhizae Uralensis (zhi gun cao) is known as FourGentleman Decoction (si jun zi tung). or running piglet disorder. . . b L 74 s a zh6ng miin $n xi60 tiing Source: Secrets from the Orchid Chamber (Lan shi m i cang) Radix Aconiti Carmichaeli (chuan wu) . 15g Cortex Phellodendri (huang bai). . . . . . . . . . . . moves the qi. . . . . . leaches out dampness through the urine. . . . . . . . . . . . . . .3-6g Talcum (hua shi) . . . . . . . . . . . . . . . CAUTIONS & CONTRAINDICATIONS:This formula should only be used for distention due to damp-heat.6g Radix Angelicae Sinensis (dang p i ) . . . Here. tong) . . . . . . . . . . . . . + For painful. . . . . COMMENTARY: The pathological mechanisms underlying this condition were first described in Basic Questions (chapter 74) where it is noted that fullness and swelling from dampness are symptoms of the Spleen. . hence the name. . . . irritability. . .12-30g Semen Plantaginis (che qian zi) . Sclerotium Polypori Umbellati (zhu ling). . . omit Radix Ginseng (ren shen) and Rhizoma Zingiberis Officinalis (gun jiang).192 Formulas that Clear Damp-Heat *For dark-purple blood vessels showing on the abdomen. . . . . . . . . Radix et Rhizoma Rhei (da huang) and Fructus Gardeniae Jasminoidis (zhi zi). . . . . .6g Fructus Alpiniae Oxyphyllae (yi zhi ren) . . . . . . . . . . . . .6g Herba Ephedrae (ma huang). . . . . . .

scanty. . CAUTIONS & CONTRAINDICATIONS: Long-term use of this formula may cause weakness.3-6g Radix Glycyrrhizae Uralensis (gan cao) . . greasy tongue coating. and stomatitis. This is hot or bloody painful urinary dysfunction caused by the clumping of damp-heat in the lower burner. . Talcum (hua shi) and Herba Polygoni Avicularis (bian xu). With the appropriate presentation. increase the dosage of Herba Polygoni Avicularis (bian xu). Available in Actions: Clears heat. . and Radix et Rhizoma Rhei (da huang) drains heat through the stool. Radix Glycyrrhizae Uralensis (gan cao). * For stony painful urinary dysfunction. does not nourish the yin at all. while both this formula and Guide Out the Red Powder (dao chi san) can be used to treat hot painful urinary dysfunction. For example. sweet or rich foods. the use of this formula may be inappropriate. urinary tract calculi. this formula may be used in treating such biomedically-defined disorders as glomerulonephritis. dark urine that is scanty. or during pregnancy. clears heat. rapid pulse. . since urinary tract infection (usually a type of painful urinary dysfunction) is not always caused by damp-heat or other forms of excess. 193 irritability. and a loss of appetite.3-9g Preparation: The source text advises to grind equal amounts of the ingredients into powder and take as a draft in 9g doses with 1. and add Rhizoma Imperatae Cylindricae (bai mao gen) and Herba Cephalanoplos (xiao ji). This formula strongly unblocks painful urinary dysfunction. one of the envoys. and a slippery. but has a much weaker effect on painful urinary dysfunction. add Herba Lophatheri Gracilis (dan zhu ye) and Radix Rehmanniae Glutinosae (sheng di huang) . and is very effective in clearing the obstruction caused by damp stagnation. or overconsumption of alcohol. . There is commonly a history of overindulgence in spicy. Not only does this herb strengthen the transforming function of the Bladder qi. their mode of action and indications are quite different. The urine will become dark-red if there is injury to the blood vessels. Medulla Junci Effusi (deng xin cao). . However. a yellow. nosebleed. MODIFICATIONS: * For bloody painful urinary dysfunction. INDICATIONS: Dark. scorched lips. Zhu Dan-Xi. . and painful urination. modified this formula by adding Radix Aucklandiae Lappae (mu xiang). The presence of heat with accumulation of dampness in the lower burner is reflected in the dry mouth and throat. Spora Lygodii Japonici ( h i jin sha). focuses on the upper burner (irritability and mouth sores). and Herba Polygoni Avicularis (bian xu). and thereby assist the chief ingredient in unblocking the painful urinary dysfunction. . harmonizes the actions of the other ingredients and relieves the abdominal pain. . *For urinary retention. or throat. Semen Plantaginis (che qian zi). In severe cases. and unblocks painful urinary dysfunction. . The assistant ingredients indirectly treat the painful urinary dysfunction by draining heat: Fructus GardeniaeJasminoidis (zhi zi) drains heat from the three burners through the urine. ANALYSIS OF FORMULA: T h e chief ingredient. its acrid. The other envoy. urethritis. The great Yuan-dynasty physician. promotes urination. The combination of Radix Glycyrrhizae Uralensis (gan cao) and Talcum (hua shi) also helps to alleviate irritability. tongue. difficult. difficult to pass. If especially severe. a dry mouth and throat.5-3g of Medulla Junci cao). increase the dosage of Caulis Mutong (mu tong). The deputies. nourishes the yin. cystitis. . cold Caulis Mutong (mu tong). . turbid. Today it is usually prepared as a decoction with the dosage specified. * For stomatitis. Folium Pyrrosiae (shi wei) and Radix Achyranthis Bidentatae (niu xi). Herba Dianthi (qu mi). lightheadedness. add Herba Lysimachiae (jin qian cao). promotes urination. and painful. It should not be used without significant modification in treating conditions of cold from deficiency. bitter. and add Cortex Phellodendri (huanz bai) and Cortex Cinnamomi Cassiae (rou gui). eye redness and pain.Eight-Herb Powder for Rectification Medulla Junci Effusi (deng xin cao) . the patient may be unable to urinate and will experience lower abdominal distention and pain. Talcum (hua shi). prostatitis. palpitations. COMMENTARY: According to the source text. add Rhizoma Dioscoreae Hypoglaucae (bei xie) and Rhizoma Acori Graminei (chang pu). Sometimes the tips of Radix Glycyrrhizae Uralensis (gan cao shao) are used to strengthen the diuretic action of this formula. severe thirst. . Guide Out the Red Powder (dao chi san). guides heat downward. . Today most formulas for urinary tract infection are based on this formula. and sores in the mouth. this formula is also indicated for heat in the Heart channel characterized by a parched throat. The tongue and pulse signs are typical of damp-heat. and focuses on the lower burner symptoms (urinary retention together with lower abdominal distention and pain). clear damp-heat by promoting urination. on the other hand. . there may be urinary retention and lower abdominal distention and pain. * For cloudy painful urinary dysfunction. . warm nature also prevents the cold properties of the other ingredients from injuring the yang qi. Damp-heat in the Bladder manifests as turbid.

60g Semen Abutiloni seu Malvae (dong kui zi) . .. . . . . reduced appetite. For bloody painful urinary dysfunction characterized by rough. . . . . . . . . . . f$$ . .5g (1. . . .. . .9g Note that the type of jin qian cao used here is that which . T h e presence of damp-heat is also reflected in the greasy. . . . . . . ... . . . . . . . . . ..5-3g) 'A .:/Ai k. . . . . . and not the more commonly-used Herba Lysimachiae. Clears heat. 6 g (4. a dry mouth with no desire to drink. . slightly yellow tongue coating. . . INDICATIONS: Abdominal pain.30g Caulis Mutong (mu tong) . Damp-heat in the lower burner causes scanty. For painful urinary dysfunction due to damp-heat in the lower burner characterized by urgent.6g (4. T h e struggle between the normal qi and blood and the pathogenic influences brews in the Intestines and transforms into pus. . .30g (15-20g) . . . . . Promotes urination and expels stones.:d . . . . . . . . . . . . 15g (6-9g) Radix Glycyrrhizae Uralensis (gun coo) . . . . .. . . scanty urine. Radix Paeoniae (shao yao). . Five-Ingredient Powder for Painful Urinary Dysfunction A*% wii lin siin Source: Imperial Grace Formulary of the Tai Ping Era (Tai ping hui min he ji ju fang) Sclerotium Poriae Cocos Rubrae (chifu ling). and i the . .60g Fructus Gardeniae Jasminoidis (zhi zi) . . . . . T h e damp-heat scorches the collaterals of the Intestines. I ">' Augmented Five-Ingredient Powder for Painful Urinary Dysfunction $$ AQ*~*& $!. . . . . . . . . . . . . . . . . : jiii we'i wii lin siin Source: Golden Mirror of the Medical Tradition (Yi zong jin jian) Sclerotium Poriae Cocos Rubrae (chi fu ling). . . . . This is damp-heat lodged in the Intestines where it causes the q i and blood to stagnate. . . . . . . . . . .:c2~v ii.*. . . and a slippery.. . . . . . . .15g Decoction. . . . . . .30g Rhizoma Alismatis Orientalis (ze xie). a red tongue with a yellow coating. . . . > . . Actions: Regulates and harmonizes the qi and blood. dark. . a greasy. diarrhea with pus and blood (equal amounts). . or with multiple tiny stones. . . . . . . . this focuses on stony painful urinary dysfunction. . . Clears heat and resolves dampness. d ' ? . . . +. burning. . sh&oy5o t h g Source: Collection of Writings on the Mechanism of Illness. . . . . . .60g Grind the ingredients into a fine powder and take in 6g doses as a draft. . :+i~ . . a burning sensation around the anus. . . . . . . . . rough urination with burning pain. . .30g Talcum (hua shi) . . . . . . . and unblocks painful urinary dysfunction.G: . .. producing abdominal pain and tenesmus. . . Safguarding of Lij as Discussed Suitability of Q in the Basic Questions (Su wen bing ji qi yi bao ming ji) Radix Angelicae Sinensis (dang gui) . . . . . ..12g Herba Lygodii Japonici (jin sha kng) . . . . .. $i . . and a rapid pulse. . . . .<: !. . . . . . . . . .189Radix Angelicae Sinensis (dang gui) . . . . 15g Radix Glycyrrhizae Uralensis (gun cao) . . . . . . . . . 15g (6-9g) Radix Scutellariae (huang qin) . . clears heat. . 15g (9-12g) Radix et Rhizoma Rhei (da huang). . . .. . dark urine and a burning sensation around the anus. . . . . . . . 1% Fresh Endothelium Cornei Gigeriae Galli (sheng ji nei jin) .60g Fructus Gardeniae Jasminoidis (zhi zi) . . . . . . . . . . Preparation: Grind the ingredients into a coarse %% powder and take warm in 15g doses as a draft after meals. . . . The name of this formula is derived from the fact that three of the ingredients' names contain the word gold (jin). . . Lactiflorae (bai shao) and substitute Cortex Cinnamomi Cassiae (rou gui) for Cortex Cinnamomi Loureiroi (guan gui). . . . . . .60g Radix Rehmanniae Glutinosae (sheng di huang) . .i. . slightly yellow tongue coating. . . . . a stifling sensation in the chest. . which is from Sichuan. . . .. . . difficulty with defecation. . . and painful urination. . which is expelled through the stool. . . . . . . . . . . anuria or oliguria due to stones in the urinary tract. . . $ ! . . . . . which manifests as blood in the stool. .30g Semen Plantaginis (che qian zi) . . . . . . . . .9g Herba Dianthi (qu mai) . tenesmus.5g) Radix Aucklandiae Lappae (mu xiang) . . . . . . . 15g Radix Paeoniae Rubrae (chi shao) . . .'. . . . . .15g Radix Glycyrrhizae Uralensis (gun cao) . .5g) Semen Arecae Catechu (bing lang) . Most modern formulations use Radix Paeoniae j~!i'. . . . . The source text does not specify dosage. . .. . . Today it is usually prepared as a decoction with the dosage specified in parentheses. a dirtyyellow complexion. .7. painful urination that is red or the color of red bean juice (or cola). . . . . . . . . .5g) Rhizoma Coptidis (huang lian) . . . . cools the blood. . . .$$. rapid pulse. . . . . This condition is frequently associated with food poisoning or the contraction of a n epidemic toxin. . . . . . . . . . . In contrast to the principal formula. G?. . . . .. .\?. Stagnation obstructs the flow of q i in the Intestines. + ! . . . . . . . . . . . . .9g (6-9g) Cortex Cinnamomi Loureiroi (guan gui) . . . . . .fi$ . . . . . . . . . . . . . . . . . . . . . . . . . .30g Folium Pyrrosiae (shi wei) . .:dr LA & . . ..15g Radix Paeoniae Rubrae (chi shao) . and relieves toxicity. . . . . . .Formulas that Clear Damp-Heat ASSOCIATED FORMULAS: is native to Guangdong province. . . . s i$ . . . . . Three-Gold Decoction 5 2 i5 siin j f n ttiing Source: Shyuang Hospital o f the Shanghai College of Traditional Chinese Medicine Herba Desmodii Styracifolii (jin qian cao) . .. .18g Radix Angelicae Sinensis (dang gui) . . . . .6g (4. For painful urinary dysfunction during pregnancy ( z i lin) characterized by frequent. ..

omit Radix Glycyrrhizae Uralensis (gan cao) and add Fructus Crataegi (shan zha) and Massa Fermentata ( s h n qu). and alleviates dysenteric diarrhea.T w o . add Cortex Moutan Radicis ( m u d m pi) and Radix Sanguisorbae Officinalis (di yu). Where the cause is heat toxin. omit Cortex Cinnamomi Cassiae (rou gui). . nor should it be used for chronic dysenteric disorders due to cold from deficiency. . from the Inner Classic to explain the rationale of this formula: "When the stool contains pus and blood. . . . . . . . COMMENTARY: The source text quotes a passage more pronounced and there is thus more blood than pus in the stool. *For severe heat toxin. It enters the blood level and assists the blood-harmonizing herbs in moving the blood. the latter restrains the former from increasing the fire in the body. . it moderates the spasms and relieves abdominal pain. One of the distinguishing characteristics of a damp-heat dysenteric disorder is the roughly equal amount of blood and pus. the tenesmus will disappear by itself. . . With the appropriate presentation. Radix Paeoniae Lactiflorae (bai shao). . . . . this formula may be used in treating such biomedically-defined disorders as bacillary or amebic dysentery. a bitter taste in the mouth. bitter properties of the other herbs from either injuring the yang or constraining the pathogenic influences in the interior. . and a rapid pulse. . . . . . . . They complement the actions of the chief herb and Radix Angelicae Sinensis (dang gui).'' This formula is used primarily for dysenteric disorders caused by damp-heat. . harmonizes the middle. . Today usually only four pieces of Fructus Zizyphi Jujubae (da zao) are used. . . . . . 9 For severe bleeding. . . . this is not used in treating tenesmus caused by severe qi stagnation. . . while Pulsatilla Decoction (bai tou weng fang) (see chapter 2 ) is used for dysenteric disorders caused by heat toxin scalding the Stomach and Intestines. Using both of these herbs has the effect of combining clearing with draining. . . . . . . . . promote the movement of qi and help eliminate stagnation. . Radix Glycyrrhizae Uralensis (gan cao). add Flos Lonicerae Japonicae (jin yin hua)and Radix Pulsatillae Chinensis (bai tou weng). Cortex Cinnamomi Cassiae (rou gui) serves two purposes in this formula. and ulcerative colitis. the heat is much Two-Marvel Powder e'r miiio szn This formula is considered to be a 'marvel' for its simplicity (composed of only two hrbs) and its singular effectiveness.M a r v e l Powder ANALYSIS O F FORMULA: The primary emphasis 195 of this formula is to regulate the qi and blood. which reinforces the action of Radix et Rhizoma Rhei (da huang) in draining heat through the stool. The chief herb. . . . when combined with the deputy. . . . . . . The assistants Rhizoma Coptidis ( h a n g lian) and Radix Scutellariae ( h a n g qin) resolve heat toxin in the Intestines by clearing heat and drying dampness. . . . . when the blood is moving normally. . . which means that it prevents the cold. whose focus is to regulate the blood. For dysenteric disorders due to heat entering the interior characterized by fever.9g Radix Paeoniae Lactiflorae (bai shao). . Radix Angelicae Sinensis (dang gui). . the pus in the stool will resolve by itself. . The combination of Cortex Cinnamomi Cassiae (rou gui) with Radix et Rhizoma Rhei (da h a n g ) is particularly adroit. It also acts as an opposing assistant. . . The use of Radix et Rhizoma Rhei (da h a n g ) with the qi-moving herbs is an example of using herbs that promote flow for disorders of flow. and thereby transforming into smoldering damp-heat.12 pieces Clears heat. The other two deputies. ASSOCIATED FORMULA: Scutellaria Decoction +% 33 huhng qin tiing Source: Discussion of Cold-induced Disorders (Shang han lun) Radix Scutellariae (huang qin) . . dysenteric diarrhea. CAUTIONS & CONTRAINDICATIONS: This formula should not be used during the early stages of this disorder where there are also exterior symptoms. . regulates the nutritive qi and the blood. abdominal pain. . when the qi is regulated. In contrast to the principal formula. .6g Honey-fried Radix Glycyrrhizae Uralensis (zhi gan cao) . the bleeding will stop when the qi moves. . While both herbs work synergistically to invigorate the blood. 9 For heat that has injured the fluids with a dry tongue coating. . . Source: Teachings of [Zhu] Dan-xi (Dan xi xin fa) . . . . Radix Aucklandiae Lappae ( m u xiang) and Semen Arecae Catechu (bing lung). . acute enteritis. When combined with the other deputy. however. . Radix Glycyrrhizae Uralensis (gan cao) also serves as an assistant herb which harmonizes the functions of the Stomach and protects its qi from the harsh actions of the other herbs. . a red tongue with a yellow coating. .6g Fructus Zizyphi Jujubae (da zao) . MODIFICATIONS: 9 For a thick tongue coating and a slippery pulse (indicating food stagnation).

. MODIFICATIONS: * For pain in the lower back and lower extremities as the major complaint. hot. greasy tongue coating. Bitter and warm Rhizoma Atractylodis (cang zhu) dries dampness. resulting in weakness or atrophy. hepatitis. . . . Damp-heat in the sinews and bones of the lower burner causes pain in the lower back and extremities with red. and is very effective in the treatment of atrophy disorders due to damp-heat. yellow. and gonococcal arthritis. . . . . . . . . . *For leukorrhea as the major complaint. . . It may also be prepared as a decoction with the dosage specified. These are different presentations of damp-heat lodged in the lower burner. . Today it is prepared as a decoction with an appropriate reduction in dosage. Among these complaints are pain in the lower back or extremities (especially the sinews or bones). . . . . grind into powder. .120g Rhizoma Atractylodis (cang zhu) . rheumatoid arthritis. . . With the appropriate presentation. . . Semen Phaseoli Calcarati (chi xiao d m ) and Semen Arecae Catechu (bing * INDICATIONS: For a wide variety of complaints accompanied by scanty. . For damp-heat lodged in the lower burner with numbness or burning pain in the feet. . . hng. . gouty arthritis. . . . COMMENTARY: This formula is commonly used as the foundation for larger and more complex formulas. . . red. . . . Clears heat and dries dampness. . Fructus Chaenomelis ~ a ~ e n a r i(mu a e gua) and Cortex Acanthopanacis Gracilistyli Radicis ( w u jia pi). . .9-12g Rhizoma Atractylodis (cang zhu) . add Sclerotium Poriae Cocos Rubrae (chi& ling) and Semen Euryales Ferocis (qian shi). . . . . . . . . .30g * . . . . . . . . . . . . and take 70 pills on an empty stomach with ginger juice or salted water. .196 Formulas that Clear Damp-Heat Cortex Phellodendri (huang bai) . . . add Radix Gentianae Longdancao ( h g dan cao). . . . . . . . Clears heat and resolves dampness. and painful feet or knees. .240g Rhizoma Atractylodis (cang zhu) . . . . . .240g Semen Coicis Lachryma-jobi (yi yi ren) . .). . .120g Cortex Phellodendri (huang bai) . Today when this is done the normal dosage is 3-6g. . . . . yellow urine and a yellow. add Semen Coicis Lachryma-jobi ( y i yi ren). Actions: Clears heat and dries dampness. . . . . There may also be weakness in the lower back and extremities. add Radix Achyranthis Bidentatae (niu xi). . . mix with flour and form into tiny pills. For atrophy disorder as the major complaint. . . . . . and painful joints. * For sores on the lower extremities as the major complaint.4 . . . . . . . . . yellow. . . . ANALYSIS OF FORMULA: Cortex Phellodendri (huang bai). . . . . . . . . For leg qi as the major complaint. . . . . beriberi. this formula may be used in treating such biomedically-defined disorders as urinary tract infection. . and sores on the lower extremities due to dampness. . . CAUTIONS & CONTRAINDICATIONS: This formula should not be used without modification in cases with Lung heat or Liver and Kidney deficiency. . foul-smelling vaginal discharge. . . For atrophy disorder characterized by severe numbness and weakness in the {ower extremities with painful and swollen feet. . 4 ) jiii we'i e'r miAo wiin Source: Medical Mirror of Past and Present (Gu jin yi jian) Rhizoma Atractylodis (cang zhu) . . . . swollen. . . . vaginitis.180g Radix Achyranthis Bidentatae (niu xi) . . . . hot. . and take twice a day with ginger juice. .6-9g Preparation: The source text advises to fry equal amounts of both herbs. . . . . . . . .60g The source text advises to grind the ingredients into powder. .120g The source text advises to grind the ingredients into powder and take in 6-9g doses 2-3 times daily. .120g Radix Achyranthis Bidentatae (niu xi) . . . . . . . Augmented Two-Marvel Pill 3. . y& siin mi20 wiin Source: True Lineage of Medicine (Yi xue zheng chuan) Cortex Phellodendri (huang bai). . . Darnp-heat lodged in the genital region causes a thick. treats damp-heat in the lower bkrner. . . T h e urine and tongue signs reflect damp-heat in the lower burner. . a thick. Today it is more commonly prepared as a decoction with an appropriate reduction in dosage. . . . . . . . ASSOCIATED FORMULAS: Three-Marvel Pill 52 1 . . . swollen. weakness or atrophy of the lower extremities. . . . . . . It may also interfere with the nourishment of the sinews and bones. . . and foul-smelling leukorrhea. . cervicitis. Semen Coicis Lachryma-jobi (yi yi ren) and Semen Phaseoli Calcarati (chi xiao dou). . . . . Together they form an elegant and powerful formula for drying and clearing damp-heat lodged in the lower burner. . . . . Four-Marvel Pill hfl* dt si milio wiin Source: Convenient Reader of Established Formulas (Cheng fang bian du) Cortex Phellodendri (huang bai) . .30g Branch-rootlets of Radix Angelicae Sinensis (dangguiwei) .60g Radix Cyathulae Officinalis (chuan niu xi) . . . add Herba Siegesbeckiae (xi xian cao) and Cortex Acanthopanacis Gracilistyli Radicis ( w u jia Pi). . . . . a bitter and cold herb. . . . . .

Today it is usually prepared as a decoction in the normal manner. . . .9Og Radix Paeoniae Lactiflorae (bai shao) . a yellow tongue coating. . slippery tongue coating. . . . .True Warrior Decoction Radix Stephaniae Tetrandrae (han fangji) . When the true yang (stored in the Kidneys) is deficient. . . . For a sensation of heaviness and discomfort in the extremities with atrophy and loss of strength accompanied by slight edema and numbness. . There will often be a sensation of heat that begins at the dorsum of the foot and slowly progresses up the leg to the waist. For this reason. . a white. urinary difficulty. . . INDICATIONS : Abdominal pain which is aggravated by cold.9g Rhizoma Zingiberis Officinalis Recens (shenl jiang) . . Also for externally-contracted disorders with sweating that does not reduce the fever. . . a heavy sensation in the head. . which has many etiologies. . The Spleen governs the transformation and transportation of water and dampness. . . . . .6g Sclerotium Poriae Cocos ( f u ling). . . The Kidneys are the yin organ associated with water and fire. . . . . . . and lower abdominal numbness. . . . . . . . . . Symptoms include urinary difficulty. and a submerged. . . . Source: Discussion of Cold-induced Disorders (Shang han lun) Radix Lateralis Aconiti Carmichaeli Praeparata ( f u z i ) . thin. . . . Deficient Spleen yang can give rise to similar problems. . . shivering and trembling with an unsteady appearance. thin. True Warrior Decoction zhEn wil tiing According to Chinese folk tradition. . . For profuse. . . . and a submerged. and forceless pulse. . . the 'true warrior' is the spirit of the north who manages fire and water. . this formula contains astringent herbs to control the unremitting. . or with the failure of the yang to transform water. . The first presentation is Kidney yang deficiency. . tends to settle in the lower parts of the body where it causes cloudy painful urinary dysfunction or leg qi. . Take in 3-9g doses 1-2 times daily with water. . . . loose stools. . . . . which thereupon accumulates as pathogenic water in the lower burner where it causes urinary difficulty as well as abdominal pain that is aggravated by cold. . and a soft. palpitations. . . . . . profuse discharge. . . . . . . This formula. a white.9g Preparation: The source text advises to decoct in eight cups of water until three cups remain. and deep aching and heaviness in the extremities. . then take in three divided doses. . . . . . There may also be generalized edema. . . . Clears heat and resolves dampness. . . . slippery tongue coating. dizziness. . with retention of pathogenic water. . . . Available in prepared form. . . 9g Rhizoma Atractylodis Macrocephalae (bai zhu). palpitations in the epigastrium. . . The inability of the Spleen yang to transport water leads to various problems associated with the retention of pathogenic . . . vomiting. . . . . . . Should be taken on an empty stomach. . . Cure Discharge Pill yii diii w6n Source: Shanghai Municipal Standards for the Manufacture of Chinese Prepared Medicines (Shang hai shi zhong yao cheng yao zhi ji gui fan) Cortex Ailanthi Altissimae (chun gen pi). .30g Honey-fried Plastrum Testudinis (zhi gui ban) .309Rhizoma Dioscoreae (bei xie) . . .30g Charred Rhizoma Alpiniae Officinari (liang jiang hui) 18g Charred Cortex Phellodendri (huang bai hui) . . . . Available in prepared form. . . . . . . . . . or Spleen and Kidney yang deficiency. . . . . rapid pulse. . .30g Grind the ingredients into powder and cook in wine. . . . b9h SECTION 4 FORMULAS THAT WARM AND TRANSFORM WATER AND DAMPNESS T h e formulas in this section are used in treating patterns of dampness or pathogenic water associated with cold. . . Damp-cold. . . . . the water becomes pathogenic by overflowing and causing edema. . a pale or dark swollen tongue with tooth marks. . . . . . . . . . . . which warm the yanl and promotes urination. . . and forceless pulse. Clears and transforms damp-heat and stops vaginal discharge. Actions: Warms the yang and promotes urination. red-andwhite vaginal discharge due to damp-heat.9g Radix Paeoniae Lactiflorae (bai shao) . fishy-smelling. dizziness. . . . . . Although this is a condition of excess. . . viscous. The Kidneys are the root of the body's yang qi and support the generative and transformative processes of the other organs. . the Kidney qi loses its ability to transform water. .12g Grind the ingredients to a fine powder and form into pills with 10-20 percent (by weight) being ground glutinous rice. . . or stagnating and giving rise to dampness. edema. They control the process of water metabolism and urination. . Kidney yang deficiency is often accompanied by Spleen yang deficiency. . . coughing. . . is named after that spirit. . . . When the Kidney yang is deficient and its qi loses the ability to transform water. . . then form into tiny pills. . . . . .

warms and dispels the pathogenic water and thereby strengthens the actions of the deputy herbs. * For palpitations due to source qi deficiency. omit Radix Paeoniae Lactiflorae (bai shao) and add Rhizoma Zingiberis Officinalis (gan jiang). omit Sclerotium Poriae Cocos (fu ling). Thus. rheumatoid arthritis. because this formula is also indicated for cases in which the protective yang qi is depleted by excessive sweating. Its binding nature is moderated by the other herbs in this formula. ANALYSIS O F FORMULA: COMMENTARY: Water is a yin pathogenic factor which requires the assistance of yang in order to be properly transformed. and when it attacks the middle burner. Although water is governed by the Kidneys. Rhizoma Zingiberis Officinalis Recens (shengjiang). Sclerotium Poriae Cocos (fu ling) also drains the dampness that has been retained through the urine. * For frequent urination. the continuous loss of fluids causes the body to wither and severely depletes the yang qi. strengthen the Spleen and promote urination. intestinal tuberculosis and other causes of chronic diarrhea.cing generalized edema with deep aching and heaviness in the extremities. which restores the Kidney yang and thereby enables the Kidneys to resume their function of transforming water. and chronic bronchitis.F o r m h that Warm and Tramjbrm Water and Dampness water and dampness. which is manifested as shivering and trembling and an unsteady appearance. The second presentation is externally-contracted wind-cold at the greater yang stage. Water and darnpness prevent the clear yang from ascending and the urbid yin from descending. it disrupts the Lung qi and produces coughing. prodv. Thus. * For palpitations. preserves the yin and alleviates pain. and also helps prevent injury to the yin by checking the drying action of the herbs which drain dampness. Radix Paeoniae Lactiflorae (bai shao). add Fructus Schisandrae Chinensis (wu wei zi). it reinforces the formula's action of promoting urination. Moreover. M6niGre's disease. This deprives the sinews and flesh of nourishment. the source yang must be strengthened in order to reduce the diffusion of yin. it is also controlled by the Spleen. MODIFICATIONS: Because Kidney yang deficiency is the root of the condition. its ability to relax spasms and stop pain is useful in treating the abdominal pain from stagnation which is caused by the congealing of internal dampcold. primary hyperaldosteronism. it causes epigastric palpitations. arguing that in patients with yang deficiency and the overflow of water its binding properties might cause the retention of water. this formula may be used in treating such biomedically-defined disorders as chronic nephritis. However. slippery tongue coating. primary hypertension. thin. Internal accumulation of damp-cold obstructs the flow of water and qi and causes abdominal pain. In this case. or coughing with . Radix Paeoniae Lactiflorae (bai shao) serves to restrain the sweating in the same manner as it does in Cinnamon Twig Decoction (gui zhi tang). With the appropriate presentation. warms the Stomach. hypothyroidism. and forceless pulse are signs of yang deficiency with internal retention of pathogenic water and dampness. This veils the sensory orifices and produces dizziness and a heavy sensation in the head. It disseminates the Lung qi. wheezing. and will therefore not cause the pathogenic influences to accumulate or stagnate. The other assistant. and the channels and extremities of warmth. it disturbs the Spleen and Stomach and causes vomiting and diarrhea. its ability to promote urination is mentioned in several ancient texts. an assistant herb. one must also address its manifestations (the retention of water and dampness) by using herbs that strengthen the Spleen and benefit dampness. * For coughing. and Sclerotium Poriae Cocos ( f u ling) thus reinforce the earth (SpleenIStomach) to control the water (Kidneys). congestive heart failure. thereby indirectly assisting the chief herb in warming and strengthening the Kidney yang. In the Intestines this may cause loose stools. Rhizoma Atractylodis Macrocephalae (bai zFaL) and Sclerotium Poriae Cocos @ ling). Some commentators have questioned the use of Radix Paeoniae Lactiflorae (bai shao). when it attacks the Lungs. the white. It prevents the dry. this formula focuses on warming and strengthening the Kidney yang. * For more pronounced Spleen yang deficiency with diarrhea. and the submerged. liver cirrhosis or other chronic hepatic disorders and other causes of edema and ascites. They may flood or spill over into the flesh and skin. Rhizoma Zingiberis Officinalis Recens (sheng jiang). When sweating does not deviate the fever. The pale or dark swollen tongue with tooth marks. When pathogenic water ascends and affects the Heart. in addition to treating the source or root of the problem. In addition. chronic enteritis. hot herbs that promote urination from injuring the yin. Rhizoma Atractylodis Macrocephalae (bai zhu). add Radix Ginseng (ren shen). and assists the chief herb by dispelling the dampness that has overflowed into the flesh and skin. The deputies. The chief herb is therefore the very hot and acrid Radix Lateralis Aconiti Carmichaeli Praeparata (fu zi). Herba cum Radice Asari (xi xin) and Rhizoma Zingiberis Officinalis (gan jiang). including the Divine Husbandman's Classic of the Materia Medica. rheumatic valvular heart disease.

. strengthens the Spleen. . . . Source: Discussion 199 of Cold-induced Disorders (Shang han lun) * Radix Lateralis Aconiti Carmichaeli Praeparata ( f u zi) . . . . . . . scanty urine. . . . .El severe below the waist. . . Semen Cuscutae Chinensis (tu si zi) and Herba Epimedii (yin yang huo). cold extremities. . . . . Semen Trigonellae Foeni-graeci (hu lu ba) and Cornu Cervi (lu jiao). absence of thirst. . dispels cold. add Fructus Trichosanthis (gua lou ren). . . . . add Radix Codonopsis Pilosulae (dang shen). plus the additional herbs. .30g Pericarpium Arecae Catechu (dafu pi) . . aversion to cold. . semi-liquid. . .30g Radix Aucklandiae Lappae (mu xiang). . . . ( . . add Cortex Magnoliae Officinalis (hou Po). chest and abdominal fullness and distention. . . . thin pulse. . . add Ramulus Cinnamomi Cassiae (gui zhi) and Radix Codonopsis Pilosulae (dang shn). . add Radix Ginseng (ren shen). . . . . Ramulus Cinnamomi Cassiae (gui zhi) and Radix Salviae Miltiorrhizae (dm shen). . . . faint. . . . . . . . For urinary difficulty. l2g Radix Ginseng (ren shen) . . . Radix Astragali Membranacei (huang qi). . . . . . For yang deficiency with internal damp-cold and stagnation in the channels due to congealed damp-cold characterized by aching bones and joints. . . . . . . Radix Astragali Membranacei (hang qi) and Fructus Schisandrae Chinensis (wu wei zi). . . . . . slow or submerged. 15g Preparation: The source text advises to grind the ingredients into powder and take as a draft in 12g doses with five slices of Rhizoma Zingiberis Officinalis Recens (sheng jiang) and one piece of Fructus Zizyphi Jujubae (da zao). @ For vomiting due to retention of pathogenic water in the Stomach with no signs of lower burner dysfunction. Bolster the S ~ l e e n Decoction shi pi yin Source: Effective Formulas from Generations of Physicians (Shi yi de xiao fang) Radix Lateralis Aconiti Carmichaeli Praeparata ( f u z i ) . . . . . While the principal formula focuses on reducing edema. . . . cold extremities. . . . . . . For unremitting spontaneous sweating due to yang deficiency and instability of the exterior. . and a submerged. . . . . . . . . add Radix Codonopsis Pilosulae (dang shen). . . Radix Morindae Officinalis (ba ji tian). . . . . Rhizoma Alismatis Orientalis (ze xie) and Radix Aristolochiae Fangchi (guang fang ji). . . . . . . loss of appetite. . . . . and a submerged. assists the yang. . . promotes the movement of qi. . . . . Often used for coldpredominant painful obstruction. . . For edema due to chronic nephrotic syndrome.30g Cortex Magnoliae Officinalis (hou Po). . . a thick. . .30g Honey-fried Radix Glycyrrhizae Uralensis (zhi gan cao) . . omit Radix Lateralis Aconiti Carmichaeli Praeparata ( f u zi) to avoid irritation of the Stomach. . . .30g Rhizoma Atractylodis Macrocephalae (bai zhu). . . It fortifies the source yang and dispels damp-cold. take with Five-Ingredient Powder with Poria (wu ling sun) or Stephania and Astragalus Decoction (fang ji huang qi tung). . . . Actions: Warms the yang. . . . . For chronic bronchitis with Spleen and Kidney yang deficiency. . . . For edema due to chronic heart failure with yang deficiency. . .9g Warms the channels.30g Fructus Chaenomelis Lagenariae (mu gua) . . . . . . INDICATIONS: Generalized edema that is more * * * * * ASSOCIATED FORMULA: Prepared Aconite Decoction j Z Zi tiing 7 4 A. . . *For improper purging which has injured the Spleen yang and caused abdominal distention. . slow pulse. Fructus seu Semen et Pericarpium Amomi (sha ren). add Herba cum Radice Asari (xi xin) and Fructus Schisandrae Chinensis (wu wei zi). substitute Rhizoma Zingiberis Officinalis (gunjiang) for Rhizoma Zingiberis Officinalis Recens (sheng jiang). . and transforms dampness. and edema. . . . . . . . . * For leukorrhea due to damp-cold. a n d increase the dosage of Rhizoma Zingiberis Officinalis Recens (sheng jiang). . . . . . . . . and forceless or a choppy. . . * For rheumatoid arthritis. 30g Rhizoma Zingiberis Officinalis (ganjiang) . and promotes urination. greasy tongue coating. . . . . .Bolster the Spleen Decoction copious. . For painful obstruction of the chest. . add Semen Plantaginis (che qian zi).30g Fructus Amomi Tsao-ko (cao guo) . . . .30g Sclerotium Poriae Cocos (fu ling).6g Sclerotium Poriae Cocos (fu ling) . .9g Radix Paeoniae Lactiflorae (bai shao) . . Bulbus Allii (xie bai). . . . . a heavy sensation in the body. . . . For ascites due to liver cirrhosis with Spleen and Kidney yang deficiency. . . . . 2 pieces (12-15g) Rhizoma Atractylodis Macrocephalae (bai zhu). . . . . . . . . . . this focuses on treating body aches. add Ramulus Cinnamomi Cassiae (gui zhi) and Radix Codonopsis Pilosulae (dang shen). . Today it is usually prepared as a decoction with one-fifth the specified dosage of the ingredients. . . . . . This formula is more warming and tonifying than the principal formula. a white. Semen Alpiniae Katsumadai (cao dou kou) and Rhizoma Alismatis Orientalis (ze xie). . . . . . . . . . . . aching and heaviness in the extremities. . . watery sputum. . unformed stools. . slippery tongue coating. . . . Cortex Eucommiae Ulmoidis (du zhong). . . . . . . . .

It is thus a very effective formula for treating yin-type edema. an assistant herb. . it is used in almost every case involving a cold. Aromatic Fructus Chaenomelis Lagenariae (mu g w ) . In this condition. In addition. but the cold must also be dispelled. transforms dampness.200 Formulas that Warm and Tramform Water and Dampness circulation of qi is restored. transform dampness. When the yang qi is deficient. semi-liquid. It is therefore very effective in overcoming the stagnation from the accumulation of yin (water). honey-fried Radix Glycyrrhizae Uralensis (zhi gan cao). MODIFICATIONS: This is yin-type edema due to Spleen and Kidney yang deficiency. is acrid and very hot in nature. This is almost always pitting edema. revives the Spleen. Many texts mistakenly attribute this formula to Formulas to Aid the Living. which is therefore listed as the source text. Pericarpium Arecae Catechu (dafu pi) also promotes the movement of qi. The deputies. Tuber Curcumae (yu jin) and Pericarpium Citri Reticulatae (chen Pi). Radix Lateralis Aconiti Carmichaeli Praeparata (fu zi). The incapacity of the yang qi to transform water leads to internal accumulation of water and dampness. Sclerotium Poriae Cocos (fu ling) and Rhizoma Atractylodis Macrocephalae (bai zhu). guide out stagnation. and promotes urination to strengthen the Spleen's transporting and transforming functions. Cortex Magnoliae Officinalis (hou PO). Radix Aucklandiae Lappae (mu xiang). True Warrior Decoction (zhen wu tang) focuses on warming the Kidneys. benefit the Spleen. and the Spleen yang's ability to transform and transport water and dampness. and a submerged. The accumulation of water and dampness obstructs the qi mechanism. add Rhizoma Alismatis Orientalis (ze xie) and Sclerotium Polypori Umbellati (zhu ling). It is thus a very important formula for treating fluid retention due to yang deficiency characterized by abdominal pain and shivering. regulate and harmonize the other herbs. ANALYSIS O F FORMULA: Radix Lateralis Aconiti Carmichaeli Praeparata (fu zi) and Rhizoma Zingiberis Officinalis (ganjiang) serve as the chief herbs in this formula. there is no mention of this formula in any text extant before Effective Formulas from Generations of Physicians. and harmonize the middle burner. Rhizoma Zingiberis Officinalis Recens (sheng jiang). the Spleen's ability to transform and transport is impeded by the accumulation of fluids. and Fructus Zizyphi Jujubae (da zao). Once the For scanty urine and severe edema. It tends to travel throughout the body unblocking and promoting the movement of yang qi in all twelve channels. the stagnant qi must be addressed by promoting both the movement of qi and urination. focuses on warming the Spleen. producing chest and abdominal fullness and distention and a heavy sensation in the body. *For ascites due to liver cirrhosis. Not only must the deficiency be tonified. unformed stools. COMMENTARY: This formula not only warms and tonifies the Spleen. It promotes the movement of qi and transforms stagnation. Loss of appetite. which governs the extremities. and reduces edema. promotes urination. Together these herbs work synergistically to warm and nourish the Spleen and Kidneys. It is the nature of water to descend. With the appropriate presentation. thin pulse are manifestations of Spleen and Kidney yang deficiency and obstruction due to the accumulation of dampness. and circulate the fluids. dampness will be transformed. rheumatic valvular heart disease. scanty urine. when it accumulates. and intestinal tuberculosis. to warm the extremities. promotes urination. This seriously impairs the digestive function. The envoys. direct the qi downward. and relaxes spasms. preserves the yin. it causes edema that is more severe below the waist. Rhizoma Zingiberis Officinalis (ganjiang) warms and promotes the movement of Spleen yang to invigorate the transporting processes in the middle burner. add Radix Codonopsis Pilosulae (hng shen). slow or submerged. it impedes the ability of the Spleen. Bolster the Spleen Decoction (shi pi yin). and Fructus Amomi Tsao-ko (cao guo). it also treats retention of fluids. Although both this formula and True Warrior Decoction (zhen wu tang) warm the Spleen and Kidneys and support the yang in circulating the fluids. this formula may be used in treating such biomedically-defined disorders as chronic nephritis. greasy tongue coating. Rhizoma Alismatis Orientalis (ze xie). each has a different focus. on the other hand. Pericarpium Arecae Catechu (da fu pi). absence of thirst. The other assistants. chronic enteritis. It also tonifies the vital fire of the Kidneys. Because its action is confined primarily to the middle burner. It warms the yang. cirrhosis or other chronic hepatic disorders. However. a thick. Its ability to support the yang and dispel cold is slightly stronger than True Warrior Decoction (zhen wu tang). congestive heart failire. on the other hand. and is therefore an important formula for treating yang deficiency edema characterized by chest and abdominal fullness and distention. It is very hot in nature but is not toxic. deficient Stomach pattern. supporting the yang and curbing the yin. strengthen the Spleen and resolve dampness by promoting urination.

. . and a yellow. * For qi deficiency of the middle burner. . . . This leads to frequent urination. acute exacerbations of chronic pyelonephritis. warm and acrid Rhizoma Acori Graminei (shi chang pu). . .6g Cortex Phellodendri (huang bai) .4. . Actions: Warms the Kidneys. . . For damp-heat seeping into the Bladder which causes cloudy painful urinary dysfunction with cloudy urine that continues to drip after completion. . .5g Sclerotium Poriae Cocos ( f u ling) . . .9g Rhizoma Acori Graminei (shi chang pu). COMMENTARY: With the appropriate presentation.5g Semen Plantaginis (che qian zi) . . Today it is usually prepared as a decoction with the dosage specified. . chronic pelvic inflammatory disease. Fructus Ligustri Lucidi (nu zhen zi).9g Radix Linderae Strychnifoliae (wu yao) . . The flow of water requires the movement of qi. . Source: Effective Medical Formulas Arranged by Category by Doctor Zhu (Lei bian zhu shi ji pan yi fang) this formula may be used in treating such biomedicallydefined disorders as chronic prostatitis. and trichomoniasis. . . greasy tongue coating.4. . . . . . This is cloudy painful urinary dysfunction (gao lin) due to cold from deficiency in the lower burner which causes turbid dampness to pour downward.3g Rhizoma Atractylodis Macrocephalae (bai zhu) . . and thus fails to assist the Bladder in retaining the urine. . When the Kidney qi is deficient and weak. . . . . . . . It is also unable to separate the clear from the turbid in water. .3g Radix Salviae Miltiorrhizae (dan shen) .1.1. . . . and transforms and separates the turbid from the clear. warms the Kidneys and promotes the movement of qi and the transformation of water. . . warms the Kidney yang and thereby reduces the frequency of urination. drains dampness.5g Rhizoma Acori Graminei (shi chang pu) . treats cloudy urine by draining dampness and transforming turbidity. *For leukorrhea due to damp-cold. . Sclerotium Poriae Cocos (fu ling) and honey-fried Radix Glycyrrhizae Uralensis (zhi gan cao). . . Rhizoma Atractylodis (cang zhu) and Sclerotium Poriae Cocos (ju ling). . . . . ANALYSIS OF FORMULA: Warming the Kidneys assists the Bladder in properly storing and releasing the urine. At this time of day the yang increases. . turbid urine due to an accumulation of damp-heat in the Bladder. . ASSOCIATED FORMULA: Dioscorea Hypoglauca Decoction to Separate the Clear from Medical Revelations bai xi2 fin q k g yin Source: Medical Revelations (Yi xue xin wu) Rhizoma Dioscoreae Hypoglaucae (bei xie) . add Radix Codonopsis Pilosulae (dung shen). . while the empty stomach increases absorption and thus the laxative effect of the formula. . . INDICATIONS: Frequent urination with cloudy. . . . . thereby restoring its ability to separate the clear from the turbid. . The chief herb. The increase in yang assists the body in dispelling damp-cold. . . it is unable to stabilize or restrain the water. . . the yin diminishes. . . hence the turbid appearance of the urine. . Powder to Take at Cock's Crow jZ ming sEin This formula should be taken at daybreak or when the 'cock crows'. . . nephrotic syndrome. . . . 12g Fructus Alpiniae Oxyphyllae (yi zhi ren) . . which in turn alleviates dampness and discharges the turbid water. . . . . Rhizoma Dioscoreae Hypoglaucae (bei xie). resolves dampness. add Sclerotium Poriae Cocos (ju ling) and Radix Glycyrrhizae Uralensis (gun cao). . or greasy urine. . . Semen Cuscutae Chinensis (tu si zi). Herba Lysimachiae Cjin qkn cao) and Semen Plantaginis (che quln zi). . Fmctus Alpiniae Oxyphyllae (yi zhi ren). add Radix Lateralis Aconiti Carmichaeli Praeparata (fu zi).Powder to Take at Cock's Crow 201 Dioscorea Hypoglauca Decoction to Separate the Clear 3$**$& This formula is so named because it treats cloudy painful urinary dysfunction by strengthening the transforming function of the qi. . and the stomach is empty. . . . . The other assistant. . . . . . an assistant. . . Rhizoma Atractylodis Macrocephalae (bai zhu). . . Radix Linderae Strychnifoliae (wu yao). . milky (resembling rice water). . . . . .9g Preparation: The source text advises to grind equal amounts of the ingredients into powder and take as a draft in 12g doses with a small amount of salt. . . . and separates the clear from the turbid.5g. . . transforms turbidity and eliminates dampness and cold from deficiency in the Bladder. . . Source: Teachings of [Zhu] Dan-xi (Dan xi xin fa) Rhizoma Dioscoreae Hypoglaucae (bei xie). CAUTIONS & CONTRAINDICATIONS: This formula should not be used in treating cloudy painful urinary dysfunction characterized by milky. . The deputy. . . . MODIFICATIONS: * To strengthen the actions of draining dampness and transforming turbidity. Cortex Cinnamomi Cassiae (rou gui). . dense. Clears heat. add Semen Cuscutae Chinensis (tu si zi). . . . . * For chronic prostatitis with chyluria.

omit Pericarpium Citri Reticulatae (chen pi). . . "When the qi moves. which effectively ameliorates the edema and pain of damp leg qi. The other deputy. . The draft should be prepared by twice cooking the ingredients over a low flame. . If disruption in the flow of qi becomes severe. . ANALYSIS OF FORMULA: Semen Arecae Catechu (bing lung). . . . and take with Three-Marvel Pill (san miao wan). . moderate pulse due to wind-dampness. COMMENTARY: Leg qi is generally divided into two types. . . * For damp-cold leg qi rushing upward to the Heart with palpitations. The other chief herb. It is also used for acute invasion of wind-dampness that pours downward characterized by fever and chills. . and an almost imperceptible pulse. a cold and stifling sensation in the chest. and dampheat. . . . The liquid from both decoctions is combined into a single daily dose. . * For damp-heat lodged in the lower burner. disperses cold and causes the turbidity to descend. there may also be a stifling sensation in the chest and nausea. Rhizoma Zingiberis Officinalis Recens (sheng jiang). Available in prepared form. . damp and dry. . and add Lignum Aquilariae (chen xiang).30g Fructus Evodiae Rutaecarpae (wu zhu yu). Together the herbs in this formula open the upper burner. . one of the deputies. . Actions: Promotes the movement of qi. body aches and pain. . INDICATIONS: Heavy and weak feet and calves with difficulty in walking.30g Folium Perillae Frutescentis (zi su ye) . this formula may be used in treating such biomedically-defined disorders as beriberi and filariasis. these herbs benefit the flow of Lung qi. . Pericarpium Citri Reticulatae (chen pi). Damp leg qi is indicated by swelling of the legs. unblocks and disseminates the Lung qi. omit Fructus Evodiae Rutaecarpae (wu zhuyu) and Rhizoma Zingiberis Officinalis Recens (sheng jiang). Disruption in the flow of qi and blood results in numbness. . Fructus Chaenomelis Lagenariae (mu gua). . . Sometimes the obstruction of the channels will force the qi upward. clear the lower burner. indirectly resolving the dampness. warms and disperses cold and thereby helps treat the leg qi. there are different subtypes of damp leg qi including wind-dampness. . which is essential to proper water metabolism. Fructus Evodiae Rutaecarpae (wu zhu yu). . . . Cold and dampness cause heaviness and weakness which makes it difficult to walk. also has a descending action. . . relaxes the sinews. regulates the qi and strengthens the Spleen. causes turbidity to descend. This formula is designed for leg qi due to winddampness or damp-cold. one of the assistants. When combined with Fructus Chaenomelis Lagenariae (mu gua). . In addition. dampness will move [out]. . directs rebellious qi downward. . and invigorates the collaterals. . . . .6g Pericarpium Citri Reticulatae (chen pi) . aversion to wind. . . . 7 pieces (36-45g) Fructus Chaenomelis Lagenariae (mu p a ) . These herbs work together to drive dampness out through the stool. Folium Perillae Frutescentis (zi su ye). . CAUTIONS & CONTRAINDICATIONS:This formula should not be used without significant modification in cases of leg qi due to dryness or damp-heat. it transforms dampness. . In severe cases. . and a submerged. it treats the nausea and stifling sensation in the chest due to the upsurge of leg qi. . cold. MODIFICATIONS: * For spontaneous sweating.Formulas that Warm and Tram$rm Water and Darn*~ Semen Arecae Catechu (bing lung) . . and is most effective if taken during the early stages." The envoy. depending on the relative strength of dampness (which causes numbness) and cold (which causes cold and pain). . . damp-cold. rebellious qi will develop. . . Radix Lateralis Aconiti Carmichaeli Praeparata (fu zi) and Rhizoma Pinelliae Ternatae (ban xia). or pain. . cold. and superficial swelling of the sinews and vessels. causing ascending spasms. . disperses wind-cold. reducing the dosage of the ingredients by approximately two-thirds. . causing a stifling sensation in the chest and nausea. and transforms damp-cold. . Cortex Cinnamomi Cassiae (rou gui). . . . it is used here to expel the obstruction from dampness.15g Preparation: The source text advises to grind the ingredients into a coarse powder and take upon waking as a draft on an empty stomach. or pain (or both) in these areas. . . and spread the middle qi to produce a warming and ventilating action that facilitates the elimination of turbidity. . Radix Platycodi Grandiflori (jie geng). slow pulse due to damp-cold. There may also be numbness. Folium Perillae Frutescentis (zi su ye) and Radix Platycodi Grandiflori (jie geng).9g Radix Platycodi Grandiflori (jie geng) . dry leg qi by withering of the flesh. . . or ascending spasms. . . The use of these three herbs illustrates the maxim. The other assistant. . . . . This is damp leg qi which is caused by damp-cold settling in the legs and feet where it obstructs the channels and interrupts the smooth flow of qi and blood. With the appropriate presentation. . severe leg and foot pain. When combined with Pericarpium Citri Reticulatae (chen pi). add Ramulus Cinnamomi Cassiae (gui zhi) and Radix Ledebouriellae Divaricatae (fang feng). . . add Cortex Cinnamomi Cassiae (rou gui) and Radix Lateralis Aconiti Carmichaeli Praeparata (fu zi). . . . . .15g Rhizoma Zingiberis Officinalis Recens (sheng jiang) . * For absence of sweating. . Today it is usually prepared as a decoction. . . and a floating. . one of the chief herbs. .

. preferably before meals. add Rhizoma Atractylodis (cang zhu). .9g Honey-fried Radix Glycyrrhizae Uralensis (zhi gun cao) . . where profuse sweating can easily injure the yang and the fluids. . first treat the blood. CAUTIONS & CONTRAINDICATIONS: Use with caution in patients with constitutional yin deficiency. MODIFICATIONS: For hot. Focusing less on releasing the exterior. . Today it is usually prepared as a decoction with 2-3 times the specified dosage. Notopterygium Decoction to Overcome Dampness Source: Clarijying Doubts about Injury from Internal and Exte~nal Causes (Nei wai shang bian huo lun) Radix et Rhizoma Notopterygii (qiang huo) . chills. it is indicated for conditions with mild exterior symptoms and relatively severe generalized pain and heaviness. . . . when the blood moves. l." the most superficial of the channels. and a floating pulse. . . rheumatic fever. expel wind and dampness from the exterior aspects of the greater yang channel. . Rhizoma et Radix Ligustici (gao ben) and Radix Ledebouriellae Divaricatae (fang fend. . . . especially its ability to treat headache. . . . controls the exterior level of the body. I n addition to herbs that expel winddampness. and reinforce the actions of Radix et Rhizoma Notopterygii (qiang huo). . . and floating pulse indicate an exterior condition. mild fever. fever. Radix Glycyrrhizae Uralensis (gun cao). add Radix Lateralis Aconiti Carmichaeli Praeparata (fu zi).1. Radix Ligustici Chuanxiong (chuan xiong). . . and whether cold or heat is also involved. . . T h e deputies. This should promote mild sweating. . . . . . Together they are very effective in treating systemic wind-dampness. COMMENTARY: Most practitioners use relatively small doses of this formula to produce a mild sweat. T h e other chief herb. This is wind-dampness in the superficial aspects of the body. . also treats the headache. . .0. Since the condition is superficial. the wind will be extinguished. .5g Preparation: The source text advises to grind the ingredients into a coarse powder and take as a draft. . . Cortex Phellodendri (hang bai). the exterior and muscle levels. or for any condition with heat. INDICATIONS: Heavy and painful head. The formula is also frequently used in treating headaches. . . . the presence of which is indicated by pain and sometimes numbness. . These conditions are generally known as painful obstruction (bi). one of the chief herbs. . back o r generalized pain. . . . This formula is more effective than Nine-Herb Decoction with Notopterygium (jiu wei qiang huo tang) (see chapter 1) in treating systemic wind-dampness. T h e envoy.3g Rhizoma et Radix Ligustici (gao ben) . treats the headache and invigorates the blood. . The greater yang channel. . expels wind-dampness from the upper reaches of the greater yang channel.5g Radix Ledebouriellae Divaricatae (fangfeng) . a generalized sensation of heaviness. . which helps relieve the generalized heaviness and pain. the purpose of which is explained in an adage from Convenient Reader of Established Formulas: "To treat wind. a white tongue coating. ANALYSIS OF FORMULA: Radix et Rhizoma Notopterygii (qiang huo). this formula may be used in treating such biomedically-defined disorders as upper respiratory tract infection.Notopterygium Decoction to Overcome Dampness SECTION 5 203 FORMULAS THAT DISPEL WIND-DAMPNESS T h e formulas in this section are used in treating externally-contracted wind-dampness. The nature and location of the pain varies depending on the level of penetration of the pathogenic influences. Wind and dampness clog the interstices and pores and move upward to attack the head. . expels wind-dampness from the lower reaches of this channel. harmonizes the actions of the other herbs. . . . difficulty in rotating or bending the trunk. Radix Aristolochiae Fangchi (guang fang ji) and Semen Coicis Lachryma-jobi (yi yi ren). Actions: Expels wind and overcomes dampness. . . and difficulty in moving the trunk. . .1. and muscular headache. .5g Fructus Viticis (man jing zi) . these formulas contain herbs that invigorate the blood. it does not affect the tongue and the coating remains a normal white. @ For severe cases. When wind and dampness enter this channel there may be a generalized sensation of heaviness and pain. . . . where they cause heaviness and pain. or who live in a damp environment. T h e other assistant. The chills. It is commonly found in persons who have caught cold after sweating profusely. Radix Angelicae Pubescentis (du huo). . .1. . back pain. . One of the assistants. . Fructus Viticis (man jing zi). . . .3g Radix Angelicae Pubescentis (du huo) . . . . . This is especially important when treating conditions such as wind-dampness. painful joints. . With the appropriate presentation. .5g Radix Ligustici Chuanxiong (chuan xiong) .

. . and Caulis Piperis Futokadsurae ( h i feng teng). . . . Today the dosage is increased 2-3 times. . . . Gummi Olibanum (ru xiang). . . -3g Ramulus Mori Albae (sang zhi) . . . .2. . ANALYSIS O F FORMULA: T h e chief herbs. . . . . . . . . . . . . . . Radix Aucklandiae Lappae (mu xiang). and bursitis. . . . . . . . Actions: Removes wind-dampness and alleviates painful obstruction. . . . the white tongue coating.9g Radix Ligustici Chuanxiong (chuan xiong) . . . . . Another assistant. . . . . gouty arthritis. . add Radix Aristolochiae Fangchi (guangfang ji). .45g Radix Angelicae Sinensis (dung gui) . . add Radix Achyranthis Bidentatae (niu xi) and Fructus Chaenomelis Lagenariae (mu gua). . . . . T h e deputies. . this formula may be used in treating such biomedically-defined disorders as osteoarthritis. . together relieve painful obstruction in both the upper and lower parts of the body. . This is painful obstruction (bi). . . MODIFICATIONS: and diminishes with warmth. . . . rheumatoid arthritis. . . . . . . . Two of the assistants. . . . and overcomes dampness. . T h e assistant and juiin bi tiing Source: Selected Formulas (Bai yi xuan fang) Radix et Rhizoma Notopterygii (qiang huo) . . T h e presence of cold is evidenced by the response to temperature change. . * For damp-predominant painful obstruction.5g Preparation: Decoction. .3g Radix Angelicae Pubescentis (du huo) . . . . possibly accompanied by a sensation of heaviness and numbness in the limbs. revives the Spleen and is therefore helpful in treating dampness.1. . . . . . . . . With the appropriate presentation.204 lFormulas that Dispel Wind-Dampness Remove Painful Obstruction Decoction from Medical Revelations Source: Medical Revelationr (Yi xue xin wu) Radix et Rhizoma Notopterygii (qiang huo) . . . . For painful obstruction due to invasion of wind-cold-dampness in patients with qi deficiency characterized by a generalized sensation of . . . . . . and approximately a 90 percent reduction in the dosage of the other ingredients. ASSOCIATED FORMULA: Remove Painful Obstruction Decoction from Selected Formulas a*% et Rhizoma Notopterygii (qiang huo) and Radix Angelicae Pubescentis (du huo). . . . . especially the shoulders. . . . . . . . . . .4g Cortex Cinnamomi Cassiae (TOU gui) . (gui zhi). . .4g Radix Aucklandiae Lappae (mu xiang) .45g Radix Ledebouriellae Divaricatae (fang feng). . a thick. . . T h e presence of wind is manifested in the changing position of the pain. . . . . . . and a slow. . . .45g Honey-fried Radix Glycyrrhizae Uralensis (zhi gan cao) . . It may be modified to focus the actions on whichever pathogenic influence is predominant. . . . .45g Rhizoma Curcumae Longae Cjiang huang) . honey-fried Radix Glycyrrhizae Uralensis (zhi gan cao). . . . . . . . improves the circulation of the yang qi and helps direct the actions of the other herbs toward the extremities. .5g Honey-fried Radix Glycyrrhizae Uralensis (zhi gun cao) . . . white tongue coating. . . . . Radix e For wind-predominant painful obstruction. effectively expel winddampness. . . . . . . e For cold-predominant painful obstruction. . . . . . Radix Gentianae Qinjiao (qin jiao). and cold.9g Radix Angelicae Sinensis (dang gui). . . . l . . and the slippery pulse. . Rhizoma Atractylodis (cang zhu) and Semen Coicis Lachrymajobi (yi yi ren). prevents injury to the normal qi and harmonizes the actions of the other herbs. . . .lg Gummi Olibanum (TUxiang) . .2. . . and Rarnulus Cinnamomi Cassiae (gui zhi) is substituted for Cortex Cinnarnomi Cassiae (mu gui). . as this improves fluid metabolism. e For pain primarily in the lower extremities. . . . Ramulus Cinnamomi Cassiae. .45g Radix Paeoniae Rubrae (chi shao) . . . . . . . . add Radix Ledebouriellae Divaricatae (fang feng). . invigorate the blood. which helps expel wind-dampness and stop the pain. .3g Radix Gentianae Qinjiao (qin jiao) . Radix Angelicae Sinensis (dang gui) and Radix Ligustici Chuanxiong (chuan xiong). . This is joint pain due to local obstruction of qi from the effects of wind. . . . . 15g The source text advises to coarsely grind the ingredients and take as a draft with five pieces of Rhizoma Zingiberis Officinalis Recens (sheng jiang). . . . e For pain primarily in the upper extremities. . . . . INDICATIONS: Joint pain that increases with cold envoy herb. . . dispels wind. . . . . .2. . . . . . Today it is taken as a decoction with 3g of Rhizoma Zingiberis Officinalis Recens (sheng jiang). . . T h e numbness is caused by a combination of wind and dampness. . . . . . . Yet another assistant. . . . The other envoy. . Rarnulus Mori Albae (sang zhi). . . . .9g Caulis Piperis Futokadsurae (haifeng tend . . . . COMMENTARY: This is an important formula for I treating relatively early-stage painful obstruction. dampness. . . add Radix Lateralis Aconiti Carmichaeli Praeparata (fu zi). Tonifies and harmonizes the protective and nutritive qi. . . . possibly slippery pulse. breaks u p blood stasis and helps treat localized pain. . add Radix Clematidis (wei ling xian). . . .45g Honey-fried Radix Astragali Membranacei (mi zhi hung qi) .

Herba Ephedrae (ma hang). Radix Ledebouriellae Divaricatae (fangfeng). . Two other deputies. and it is now most commonly prescribed for those conditions listed above.6g Radix Anemarrhenae Asphodeloidis (zhi mu). . dizziness. . . promotes movement (in areas with painful obstruction). .6g Preparation: Decoction. which is indicated for hot painful obstruction with symptoms of systemic heat. . . and Radix Lateralis Aconiti Carmichaeli Praeparata (jizi) has each been identified as the chief herb in the formula. . Warm. . . . .69Radix Lateralis Aconiti Carmichaeli Praeparata (juzi) . warms the channels and relieves pain. . . Depending on the point of view. which is thought to occur in patients with constitutional Liver and Kidney deficiency who contract wind-cold-dampness. Rarnulus Cinnamomi Cassiae (gui zhi). . . . wind-dampness tends to accumulate in the lower extremities where it causes edema and other problems with the joints. . . headache. . ANALYSIS OF FORMULA: The chief herb. . 15g Radix Glycyrrhizae Uralensis (gun cao) . and Anemarrhena Decoction heaviness in the body. . INDICATIONS: Swollen and painful joints (especially of the lower extremities) that are warm to the touch and worsen at night. . . . . . I t should also be . At this stage there is a predisposition toward internal dampness. difficulty in moving. Radix Lateralis Aconiti Carmichaeli Praeparata (fu zi). absence of sweating. slippery pulse. . acrid Rhizoma Zingiberis Officinalis Recens (sheng jiang). This condition is called pan-arthralgia (li jid). . Peony. . . This formula is widely used in treating painful obstruction and can be modified for either hot or cold conditions.12g Herba Ephedrae (ma huang) . . dizziness. . The other assistant. . . . The combination of the chief herb and Radix Paeoniae Lactiflorae (bai shao) is a common one that harmonizes the functions of the protective and nutritive qi. . . Another deputy. In concert with the other envoy. . . . . . Radix Paeoniae Lactiflorae (bai shao) is generally the form of Radix Paeoniae used. . . . The use of this formula has been expanded over the years. 205 Cinnamon Twig. . . Heat from constraint tends to worsen at night when the yin is waxing. The less common pairing of Radix Anemarrhenae Asphodeloidis (zhi mu) with the chief herb effectively resolves heat from constraint in the joints. . numbness in the extremities. Actions: Unblocks the flow of yang qi. . . dispels wind. . one of the assistants. .Cinnamon Twig. . . . . . . . 15g Radix Ledebouriellae Divaricatae (fang feng) . Rhizoma Atractylodis Macrocephalae (bai zhu). . . severe swelling of the feet. manifested in headaches and dizziness. . . emaciation. . . . This formula should be distinguished from White Tiger plus Cinnamon Twig Decoction (bai h jia gui zhi tang). . . . . . . . . . . Peony. Rhizoma Atractylodis Macrocephalae (bai zhu). . . . . strengthens the formula's function of expelling wind and dampness. When the constraint becomes long-term. . At this level of disease. . The wiry pulse is a sign of pain and constraint. . . . a white. . . . . . . Available in prepared form. . and upper back. . Radix Anemarrhenae Asphodeloidis (zhi mu). . the heat from constraint is confined to the affected joints and does not produce systemic heat signs. . . however. . In fact. . strengthens this effect and relieves the relatively superficial swelling. . . a white tongue coating. reduced range of motion in the affected joints. . . . Whether the formula was intended primarily for hot or cold disorders has been a subject of debate for more than fifteen-hundred years. shortness of breath. . . . weight loss. . . clear heat and prevent injury to the yin by recurrent painful obstruction. honey-fried Radix Glycyrrhizae Uralensis (zhi gan cao). . 12g Rhizoma Zingiberis Officinalis Recens (sheng jiang) . . and Anemarrhena Decoction gui zhT shho y6o zhX mil tiing Source: Essentialsfrom the Golden Cabinet gin gui yao he) Ramulus Cinnamomi Cassiae (gui zhi) . Radix Anemarrhenae Asphodeloidis (zhi mu) and Radix Paeoniae Lactiflorae (bai shao). greasy tongue coating. . This causes swollen. . one of the envoys. . . . Herba Ephedrae (ma huang). . it harmonizes the actions of the other herbs and regulates the functions of the middle burner. . . a deputy. . COMMENTARY: The source text recommends this formula for aches and pains in all the joints. . . . l2g Radix Paeoniae (shao yao) . . . . chills. warms and unblocks the channels. greasy tongue coating and a slippery pulse. . Available in prepared form.9g Rhizoma Atractylodis Macrocephalae (baizhu) . . This is recurrent wind-cold-damp painful obstruction in which localized constraint generates heat. . . It may also obstruct the ascent of the clear yang. and overcomes dampness. . . strengthens the spreading and mobilizing actions of the other herbs. . . . painful joints that are warm to the touch. . . works with the chief herb to unblock the flow of yang qi and leach out dampness. . Rarnulus Cinnamomi Cassiae (gui zhi). . . . and a wiry. This can lead to a loss of appetite and weight. . in its chronic stage it is quite difficult to differentiate hot from cold painful obstruction because one often transforms into the other. . . and a moderate pulse. . shoulder. . . stiffness in the neck. indicated by a white. and mild nausea.

increase the dosage of Radix Lateralis Aconiti Carmichaeli Praeparata (fu zi) and Herba Ephedrae (ma huang). . . . 4 For qi and yin deficiency. . . . A gray or yellow. . . 3g Disperses swelling in the exterior and treats dry blood in the interior. . . . The dosage of Semen Phaseoli Calcarati (chi xiao dou) is often increased 2-3 times. . a lusterless. . The remainder of the herbs are regarded as assistants. . . . . . . . . This is painful obstruction due to the containment of damp-heat in the channels. . . add Radix Rehmanniae Glutinosae (sheng di huang) and Radix Achyranthis Bidentatae (niu xi). .9g Talcum (hua shi) . . . . . increase the dosage of Rhizoma Atractylodis Macrocephalae (bai zhu). . . Available as a prepared medicine with the substitution of Rhizoma Atractylodis Macrocephalae (bai zhu) for Rhizoma Atractylodis (cang zhu). . . . . . . and add Ramulus Mori Albae (sang zhi) and Ramus Lonicerae Japonicae (ren dong teng). . . . Radix Aristolochiae Fangchi (guangfang ji) is generally used. fever and shaking chills. These three herbs serve as the deputies in this formula. . 15g Excrementum Bombycis Mori (can sha) . . . . . . . . . . . The lusterless. At the same time. . . . . . and the scanty. Fructus Forsythiae Suspensae (lian qiao) is very effective in clearing . . . ANALYSIS OF FORMULA: Radix Aristolochiae Fangchi (guang fan^ ji) dispels damp-heat in the upper burner by venting the heat externally. . . . With the appropriate presentation. . MODIFICATIONS: Disband Painful Obstruction Decoction xuiin bi tiing Source: Systematic Differentiation (Wen bing tiao bian) of Warm Diseases For severe pain and restricted movement that responds favorably to warmth. . 15g Semen Phaseoli Calcarati (chi xiao dou) . and a gray or yellow and greasy tongue coating. .9g Fructus Forsythiae Suspensae (lian qiao) . mobility. . Actions: Clears and resolves damp-heat. . .15g Semen Pruni Armeniacae (xing ren) . . . . unblocks the channels. . . . . . connective tissue disorders. . . . . . . . . . . . . . . . . . . . . . Semen Coicis Lachryma-jobi (yi yi ren) and Excrementum Bombycis Mori (can sha) both strengthen the Spleen. Its effect on all three burners together with its ability to treat painful obstruction distinguishes it as the chief herb in the formula. . .9g Preparation: Decoction. . . . .9g Semen Coicis Lachryma-jobi ( y i yi ren) . . . . . . . . . INDICATIONS: Heat and pain in the joints. . . dark urine. and treat painful obstruction.9g Rhizoma Pinelliae Ternatae (ban xia) . . which leads to shaking chills. the only ones available to the editors.9g Rhizoma Atractylodis (cang zhu) . . . . . . . . increase the dosage of Radix Paeoniae (shao yao) and Radix Anemarrhenae Asphodeloidis (zhi mu). and disbands painful obstruction. . 9 For a heavy sensation throughout the body which is especially severe in the affected joints. . and gouty arthritis. and numbness and difficulty in moving the joints. . . . . greasy tongue coating indicates that both dampness and heat are strong. . . . . . . 4 For pronounced heat in the joints. . . resolve dampness. . . . . . . . . The 'steaming' of dampheat which is confined in the channels causes fever and prevents the yang qi from circulating. Damp-heat obstructing the joints causes heat and pain in the joints with reduced mobility. . .6g Radix Paeoniae Lactiflorae (bai shao) .F o r m u h that Dispel Wind-Damfmas distinguished from White Tiger plus Atractylodis Decoction (bai hu jia cang zhu tang). . . . . . it disperses superficial swelling and drains damp-heat through the urine. . . Rhizoma Pinelliae Ternatae (ban xia) dries dampness and transforms turbidity. . .9g Fructus Gardeniae Jasminoidis (zhi zi) . yellow complexion is a sign of constrained dampness. . . . . . . . . . . . . @ Radix Fangji (fang ji). . . . Commonly used for pain and swelling of the joints that has not responded to treatment (or was improperly treated) at the acute stage. . . . this formula may be used in treating such biomedically-defined disorders as rheumatoid arthritis. . . . .15g Semen Coicis Lachryma-jobi ( y i yi ren). . usually accompanied by fever. . . . . It also has some ability to dry dampness and strengthen the Spleen. .24g Rarnulus Cinnarnomi Cassiae (gui zhi) . . . .9g Honey-fried Radix Glycyrrhizae Uralensis (zhi gan cao) . . . . . . . .6g Radix Angelicae Sinensis (dang gui) . . scanty. . . . . reduced ASSOCIATED FORMULA: Coicis Decoction from the Enlightened Physicians %% P $3 9yi rGn tting Source: Displays of Enlightened Physicianr (Ming yi zhi zhang) Herba Ephedrae (ma huang). Semen Pruni Armeniacae (xing ren) regulates the Lungs' function in water metabolism. For swelling and pain in the joints (usually of the hands and feet). . . substitute Radix Paeoniae Rubrae (chi shm) for Radix Paeoniae Lactiflorae (bai shao). . . . . . The dosage and actions are drawn from Japanese sources. . . which helps resolve the underlying cause of this condition. . . . . . . . 4 For symptoms that worsen at night. which is indicated for damp painful obstruction that has transformed into systemic heat. . . dark urine indicates vigorous heat. . . . . . . . . yellow complexion. . . and is beginning to show chronic signs. . . . . . .

. . . Ramulus Sangjisheng (sang ji sheng). . . . Kidney yang deficiency is often involved. . . . Radix Ledebouriellae Divaricatae ( j m g j n g ) . weak pulse. . bones.6g Radix Ledebouriellae Divaricatae (fang jng) . which is manifested in the aversion to cold and attraction to warmth. . . . . . . which is indicated by the fixed pain. . . . . . Talcum (huashi). . which is treated with warm. . . . . Angelica Pubescens and Sangjisheng Decoction ~&3f?k?5 dii hu6 ji shzng tting Source: Thousand Ducat Formulas (@an jin yao fang) Radix Angelicae Pubescentis (du huo) . Another deputy. . There may also be paresthesias or numbness. INDICATIONS: Heavy and painful sensations at fixed locations in the lower back and lower extremities accompanied by weakness and stiffness. .6g Radix Gentianae Qinjiao (qin jiao) . Radix Rehmanniae Glutinosae (sheng di huang). . discussed above. . . . Fructus Gardeniae Jasminoidis (zhi zi). Cortex Cinnamomi Cassiae (rou gui) warms and unblocks the channels. . . . when damp-heat obstructs the channels. . . Radix Achyranthis Bidentatae (niu xi) also serves as an envoy and directs the actions of the other herbs toward the lower extremities. . . . . . . . . . tonifies the middle qi and harmonizes the actions of the other herbs in the formula. . . . . Actions: Expels wind-dampness. . This formula is particularly well-suited for that purpose and is therefore commonly used in treating hot painful obstruction. . The remaining ingredients serve as assistants. It is often prescribed together with Two-Marvel Powder (er miao sun). . . . . . . . gouty arthritis.6g Radix Rehmanniae Glutinosae (sheng di huang). a different strategy is required which addresses the damp-heat in the channels as well as in all the burners. . . . .6g Radix Achyranthis Bidentatae (niu xi).6g Sclerotium Poriae Cocos ( f u ling). and slow pulse. . . COMMENTARY: Most painful obstruction is caused by wind-dampness in the channels. . This is painful obstruction with Liver and Kidney deficiency. . shortness of breath. and Radix Paeoniae Lactiflorae (bai shao) serve the important function of nourishing and invigorating the blood. palpitations. . . the sinews and expels wind and dampness. . . . The relaxes third deputy. The knees are the province of the sinews and are therefore associated with the Liver. It thereby opens up the lower back and is an important herb for treating lower back pain. . . Cortex Eucommiae Ulmoidis (du zhong). . acrid substances that dispel wind and dry dampness. . Rhizoma Curcumae Longae (jiang huang) and Cortex Erythrinae ( h i tong Pi).9g Herba cum Radice Asari (xi xin). . . . . .6g Radix Ligustici Chuanxiong (chuan xiong) . with twice its dosage. . and cold from the lower burner. . and a thin. .6g Radix Paeoniae Lactiflorae (bai shao) . . .Angelica Pubescens and Sangjisheng Decoction 207 relatively superficial heat. . . an aversion to cold and attraction to warmth. The lower back and lower extremities are the province of the Kidneys. . . Chronic painful obstruction can lead to deficiency in these organs. . Today the normal dosage of Ramulus Sangjisheng (sang ji sheng) is 15-30g. . . These herbs are more fully discussed under Four-Substance Decoction (si w u tang) in chapter 8. . . . . . especially chronic ones. . . . . .6g Preparation: Decoction. . Available in prepared form. . . this formula may be used in treating such biomedically-defined disorders as rheumatic fever. . Radix Angelicae Pubescentis (du hw). . . add Ramulus Mori Albae (sang zhi). the Spleen must be strengthened. and connective tissue disorders. and Radix Achyranthis Bidentatae (niu x i ) expel wind-dampness and tonify the Liver and Kidneys.6g Honey-fried Radix Glycyrrhizae Uralensis (zhigancao) . .6g Cortex Cinnamomi Cassiae (rou gui). . . . and Semen Phaseoli Calcarati (chi xiao d m ) assist the chief herb in clearing heat and draining dampness through the urine. . . dampness. Radix Codonopsis Pilosulae (dang shen) is usually substituted for Radix Ginseng (7en shen). ANALYSIS OF FORMULA: The chief herb. . . shortness of breath. . . . Radix Ginseng (ren shen) and Sclerotium Poriae Cocos ( f u ling) serve this purpose. . .6g Radix Angelicae Sinensis (dang gui). white tongue coating. . . expels wind and overcomes dampness. scatters cold in the channels and scours out winddampness from the sinews and bones to stop the pain.expels wind. . . . . . . . . disperses painful obstruction. . and thin. . . . and fortifies the yang. but Radix Dipsaci Asperi (xu duan) is often substituted for this herb. . . one of the deputies. . . MODIFICATIONS: For severe pain. . Individuals with Liver and Kidney deficiency are especially prone to problems with the joints in the lower extremities. Radix Angelicae Sinensis (dang gui). . . . weak. With the appropriate presentation.6g Ramulus Sangjisheng (sang ji sheng) . rheumatoid arthritis. . pale tongue. . . . and sinews. . . . Herba cum Radice Asari (xi xin). . . . . . . Radix Gentianae Qinjiao (•÷injiao). . . Radix Ligustici Chuanxiong (chuan xiong). slow pulse. However.6g Cortex Eucommiae Ulmoidis (du zhong) . . This condition is commonly due to cold-predominant painful obstruction. When treating conditions with dampness. The envoy.6g Radix Ginseng (ren shen) . and tonifies deficiency. The source text advises to coarsely grind the ingredients. . a pale tongue with a white coating. honey-fried Radix Glycyrrhizae Uralensis (zhi gun cao). . . .

. . . . . . . . . in the sinews [it] causes contractions with an inability to extend the joints. . and there is also pain due to wind-damp painful obstruction. . . . . . . . . . . ." This formula treats lower-body painful obstruc.30g Radix Ledebouriellae Divaricatae (fangfeng). . . . . . . . omit Radix Ginseng (ren shen).5g Honey-fried Radix Glycyrrhizae Uralensis (zhi gan cao) . . . .D a m e s Herba cum Radice Asari (xi xin). . . . . . .9g Radix Ligustici Chuanxiong (chuan xiong). . . . . . . . . . . . . . . add Radix Notoginseng (sun qi). . The pathological mechanism of painful obstruca s i c Questions: tion was first described in chapter 43 of B "Painful obstruction in the bones causes heaviness. . . . . . . .9g Tonifies the Liver and Kidneys. Often accompanied by chills and fever. . . . . . . . . . . add Radix Aristolochiae g and Rhizoma Atractylodis (cang Fangchi ( p a n ~ f a n ji) zhu) .9g Radix Angelicae Pubescentis (du huo) . . MODIFICATIONS: Major Gentiana Qinjiao Decoction A&%<% dii q i n jiiio tang Source: Collection of Writings on the Mechanism of Illness. . augments the qi. . . . . .5g Cortex Eucommiae Ulmoidis (du zhong) . . . . . . .