T h e Tr a d i t i o n a l C h i n e s e M e d i c i n e

FORMULA STUDY GUIDE
Qiao Yi
with Al Stone Chief editor: Peter Holmes Assistant editors: Bea Ferigno, Laurel Redmon and Heather McIver

Snow Lotus Press

Boulder

This book is dedicated to my husband, Li Sun

Important Notice
The information contained in this book is for educational purposes only. It is not intended to diagnose, treat or prescribe, and does not purport to replace the services of a duly trained doctor or practitioner. Cover design by Peter Holmes FIRST EDITION Copyright © 2000 Snow Lotus Press, Inc. All rights reserved. No part of this book may be reproduced or transmitted in any form or by any means, electronic or mechanical, without written permission from the publisher. ISBN 1-890029-40-8 10 9 8 7 6 5 4 3 2 1 Published by Snow Lotus Press, Inc. P.O. Box 1824 Boulder, Colorado, U.S.A.
303/443-9289

www.snowlotus.org Manufactured in the United States of America

Contents Classification of the Formulas by Treatment Categories 7 Acknowledgements 12 Making Best Use of this Book 13 Introduction The Essential Principles of Chinese Herbal Medicine Herb Actions Based on the Nature of Plant Parts and Tastes 15 Special Methods of Decocting Chinese Herbs 16 The Seven Combining Effects of Herbs 16 Incompatible and Antagonistic Herbs 17 The Principles of Formula Writing 18 The Eight Methods of Herbal Treatment 19 Formulas to Release the Exterior Introduction to Exterior Syndromes 22 The Formulas 23 Review and Discussion 36 Formulas to Clear Heat Introduction to Heat Syndromes 44 The Formulas 48 Review and Discussion 58 Formulas to Purge Introduction to Yang Ming Organ Syndromes 64 The Formulas 65 Review and Discussion 71 Formulas to Harmonize Introduction to Shao Yang Syndromes 76 The Formulas 77 Review and Discussion 83 Formulas to Expel Damp Introduction to Damp Syndromes 88 The Formulas 90 Review and Discussion 101 Formulas to Transform Phlegm Introduction to Phlegm Syndromes 106 The Formulas 109 Review and Discussion 117 3 15 Chapter 1 21 Chapter 2 43 Chapter 3 63 Chapter 4 75 Chapter 5 87 Chapter 6 105 .

Chapter 7 Formulas to Warm the Interior Introduction to Cold Syndromes 122 The Formulas 126 Review and Discussion 132 Formulas to Tonify Introduction to Deficiency Syndromes 136 The Formulas 138 Review and Discussion 151 Formulas to Regulate the Qi Introduction to Qi Dysfunction Syndromes 158 The Formulas 159 Review and Discussion 168 Formulas to Invigorate the Blood Introduction to Blood Stagnation Syndromes 174 The Formulas 175 Review and Discussion 168 Formulas to Stop Bleeding Introduction to Bleeding Syndromes 188 The Formulas 189 Review and Discussion 194 Formulas to Stabilize and Astringe Introduction to Leakage and Discharge Syndromes 198 The Formulas 199 Review and Discussion 206 Formulas to Calm the Mind Introduction to Mind Disharmony Syndromes 210 The Formulas 211 Review and Discussion 214 Formulas to Expel Wind Introduction to Wind Syndromes 218 The Formulas 219 Review and Discussion 224 Formulas to Reduce Food Stagnation Introduction to Food Stagnation Syndromes 228 The Formulas 228 Review and Discussion 232 121 Chapter 8 135 Chapter 9 157 Chapter 10 173 Chapter 11 187 Chapter 12 197 Chapter 13 209 Chapter 14 217 Chapter 15 227 4 • The Formula Study Guide .

Low-Grade 248 Fever. Tidal 249 Headache 250 Hypochondriac Pain 252 Insomnia 253 Memory Loss 254 Menstrual Disorders 256 Nausea and Vomiting 258 Palpitations 260 Sweating Syndrome: Spontaneous Sweating 261 Sweating Syndrome: Night Sweats 262 Sweating Syndrome: Sweating by Location 263 Tinnitus and Deafness 264 Urinary Pain 265 Wheezing and Breathlessness 266 Comprehensive Examination Primary Formula Questions 270 General Formula Questions 300 Case Study Questions 317 Answers to the Primary Formula Question 354 Answers to the General Formula Questions 355 Answers to the Case Study Questions 355 Bibliography Index 232 234 269 357 358 Contents • 5 .Shang Han Lun Formulas According to the Six Stages Symptom Differentiation Charts Abdominal Pain 234 Cough 236 Diarrhea 238 Dizziness and Vertigo 240 Edema 242 Emotional Conditions 243 Epigastric Pain 244 Fatigue 246 Fever.

Classification of the Formulas by Treatment Categories * Formulas marked with an asterisk are the Primary formulas referenced by the California State Board Examination Formulas to Release the Exterior Release External Wind-Cold Ma Huang Tang * Gui Zhi Tang * Da Qing Long Tang Xiao Qing Long Tang Ge Gen Tang * Jiu Wei Qiang Huo Tang Chuan Xiong Cha Tiao San Release External Wind-Heat Cang Er Zi San Sang Ju Yin * Yin Qiao San * Chai Ge Jie Ji Tang * 24 Ephedra Decoction Cinnamomum Decoction Major Bluegreen Dragon Decoction Minor Bluegreen Dragon Decoction Pueraria Decoction Nine-Herb Notopterygium Decoction Ligusticum and Camellia Regulating Powder 30 Xanthium Powder Morus and Chrysanthemum Decoction Lonicera and Forsythia Powder Bupleurum and Pueraria Release the Muscle Layer Decoction 34 Release the Exterior with Internal Deficiency Ren Shen Bai Du San * Panax Expel Toxin Powder Ma Huang Xi Xin Fu Zi Tang Ephedra. Asarum and Aconitum Decoction Jia Jian Wei Rui Tang Modified Polygonatum Decoction Formulas to Clear Heat Clear Heat from the Qi Level Bai Hu Tang * White Tiger Decoction Zhu Ye Shi Gao Tang Lopatherum and Gypsum Decoction Clear Heat and Toxin Huang Lian Jie Du Tang * Xie Xin Tang Coptis Relieve Toxin Decoction Drain the Epigastrium Decoction 48 50 6 • The Formula Study Guide .

Clear Heat from the Organs Ma Xing Shi Gan Tang * Xie Bai San Xie Huang San Qing Wei San Yu Nu Jian Dao Chi San Long Dan Xie Gan Tang * Zuo Jin Wan Bai Tou Weng Tang Clear Empty Heat Qing Hao Bie Jia Tang * Qing Gu San 50 Ephedra. Prunus. Gypsum and Glycyrrhiza Decoction Drain the White Powder Drain the Yellow Powder Clear the Stomach Powder Jade Woman Decoction Guide Out the Red Powder Gentiana Drain the Liver Decoction Left Metal Pill Pulsatilla Decoction 57 Artemisia and Amyda Decoction Cool the Bones Powder Formulas to Purge Purge Heat Accumulation Da Cheng Qi Tang * Xiao Cheng Qi Tang * Tiao Wei Cheng Qi Tang * 67 Major Order the Qi Decoction Minor Order the Qi Decoction Regulate the Stomach and Order the Qi Decoction 70 70 Moisten the Intestines and Unblock the Bowels Ma Zi Ren Wan Hemp Seed Pill Warm the Yang and Lead Out Accumulation Da Huang Fu Zi Tang Rheum and Aconitum Decoction Formulas to Harmonize Harmonize the Shao Yang Xiao Chai Hu Tang * Da Chai Hu Tang 78 Minor Bupleurum Decoction Major Bupleurum Decoction 79 Harmonize the Liver and Spleen Si Ni San * Frigid Extremities Powder Xiao Yao San * Easy Wanderer Powder Tong Xie Yao Fang Painful Diarrhea Formula Harmonize the Stomach and Intestines Ban Xia Xie Xin Tang * Pinellia Drain the Epigastrium Decoction 82 Treatment Classification • 7 .

Chapter 2 FORMULAS TO C L E A R H E AT 48 49 50 50 Bai Hu Tang Zhu Ye Shi Gao Tang Ma Xing Shi Gan Tang Xie Bai San 52 52 53 54 54 Xie Huang San Qing Wei San Yu Nu Jian Dao Chi San Xie Xin Tang Zuo Jin Wan 53 Huang Lian Jie Du Tang Long Dan Xie Gan Tang 56 56 Bai Tou Weng Tang Qing Gu San 57 55 Qing Hao Bie Jia Tang 57 43 .

dry stool. external heat heat between the exterior and interior full heat heat syndromes empty heat internal heat by wen bing stages wei (defensive) qi (Qi) ying (nutritive) xue (Blood) by zang fu location Heart Lung Liver Kidney etc. CHARACTERISTICS • Heat or fire is a Yang pathogenic factor. red eyes. thirst with desire for cold water. soles. In some heat syndromes.Introduction to Heat Syndromes DEFINITION Heat syndromes are pathological conditions that involve physiological hyperactivity. insomnia. sudden tinnitus and/or deafness. hot palms. They manifest as symptoms of heat. swollen bleeding gums. malar flush. dry mouth and constipation. the body temperature is normal. burning urination. Heat ascends. bitter taste in the mouth. sternum • Kidney fire: similar symptoms to heat from Kidney Yin deficiency. bad breath. or as the experience of being hot. thirst • Liver fire: dizziness. • Heat tends to irritate the Heart and Mind. causing thirst. however. Fever is just one of many symptoms seen in heat syndromes. afternoon hot spells or fever. which occurs with sweat. such as fever and inflammation. which results in upper body symptoms such as oral sores. blurred vision. Small Intestine. Figure 4. anger. It tends to burn and flare upward. tinnitus. • Pathogenic heat often injures the fluids and consumes the Qi. nosebleed and mental disturbances. Gallbladder and Bladder PATHOGENESIS Heat causes a sensation of warmth or fever. Heat also has a quickening effect that can cause a rapid pulse. • Heat tends to generate Liver wind and disturb the Blood. bleeding and restlessness. thirst. because elevated body temperature in itself is not synonymous with a heat syndrome—they are two entirely different concepts. Large Intestine. congested red eyes and face. but more severe • Heat and damp found in the Spleen. in severe cases delirium or mania • Lung heat: loud coughing. irritability. night sweats. dark scanty urine • Stomach heat: easily hungered. restlessness.1 Classification of heat syndromes SYMPTOMATOLOGY 1. Organ (zang fu) syndromes presenting heat • Heart fire: irritability. headache. Its drying nature damages the Yin and fluids. agitation. loud panting. 44 • The Formula Study Guide . constipation • Kidney Yin deficiency with empty heat: dizziness. swelling or ulceration of the tongue and lips.

thirst. sexual overactivity (which consumes Kidney Essence and creates heat) TREATMENT PRINCIPLE AND CONSIDERATIONS Clear pathogenic heat • Differentiate between excess (full) and deficiency (empty) heat syndromes. Clear Heat • 45 .. qi.3). Also identify the location and stage of heat. purpura no deep red thin fever at night none mild possible night sweats delirium. delirium erythema.2. fever slight slight slight none none no normal or red tip floating exterior Qi Stage Ying Stage interior Xue Stage fever. Heat in the wei. tongue red. coma erythema.2 and 4.. improper diet. pulse rapid high fever none severe profuse possible restlessness none no red with yellow coating forceful fever at night none mild possible night sweats restlessness. ying and xue stages Wei Stage Syndrome location Common symptoms Fever Chills Thirst Sweating Mental symptoms Skin signs Bleeding Tongue color Pulse: rapid and . The treatment method chosen depends directly on these essential primary differentiations (see tables 4. purpura yes deep red with prickles thin Table 4.2 Differentiation of heat by stages according to the wen bing theory ETIOLOGY • Exogenous: pathogenic heat • Endogenous: disorders of the seven emotions (which transform into heat).

pulse rapid high fever low-grade tidal fever Fever D i f f e r e n c e s Heat feelings Tongue Pulse Other Sweating Thirst Red face whole face thirst with desire for cold water day time sweating whole body malar flush thirst with desire for warm water night sweating five centers heat (chest. delirium. etc. urine dark and scanty. Excess (full) heat versus deficiency (empty) heat Excess/Full Heat abrupt onset. sweating. short duration. rapid and thin emaciation. vertigo.3. unconsciousness. soles) red with scanty coating red with yellow coating rapid and forceful red eyes. palpitations. thirst. insomnia. constipation. chronic duration slow pathological changes Characteristics Common symptoms fever. red complexion.3 Differentiation of excess (full) heat and deficiency (empty) heat 46 • The Formula Study Guide . palms. tongue red. etc. feeling of heat. Table 4. severe symptoms and rapid pathological changes Deficiency/Empty Heat slow onset.

• Formulas that clear heat are contraindicated in cases of persistent exterior conditions Clear Heat • 47 . • For the same reason. without strength pale with white coating loose (diarrhea) clear and copious cold D i f f e r e n c e s Thirst Feverishness Pulse large and forceful Tongue Stool Urine Extremities red with yellow coating hard (constipation) dark and scanty warm Table 4. heat-clearing formulas should not be prescribed in large doses or taken over long periods of time. feverishness.4 Differentiation of true heat and false heat The Formulas DEFINITION Formulas that clear internal heat use cool or cold herbs as king ingredients. and should be discontinued as soon as the heat has been cleared. FUNCTIONS AND INDICATIONS To clear pathogenic heat. CAUTIONS AND CONTRAINDICATIONS • The majority of herbs in these formulas are cold by nature and may injure the Spleen and Stomach. pulse large redness of the whole face thirst with preference for cold water feverishness with dislike of warmth or heat intermittent malar flush. heat-clearing formulas are contraindicated in cases of Yang deficiency with fever. True heat versus false heat False Heat and True Cold True Heat Common symptoms Red face red face. when purgative herbs are appropriate (see Chapter 3).4. and in patterns of true cold with false heat (see table 4. thirst. superficial skin redness thirst with preference for warm or hot water feverishness with liking for warmth and warm environment large and deep.4) • Heat-clearing formulas should not be used for treating yang ming organ syndromes (constipation with heat). Consequently. clear heat toxin and cool the Blood in various internal hot conditions.

profuse sweating. bleeding of the gums and nose. other symptoms may include headache.” which are: a great fever. generates fluids. relieves thirst and irritability clears heat. a great sweat. harmonizes the formula . herbs that generate fluids and moisten dryness are often added to heat-clearing formulas. rapid Note: The key indications for use of this formula are the so-called “four great symptoms. • Tongue: red with dry yellow coating • Pulse: forceful (you li).• Heat tends to consume the fluids and create dryness. FUNCTIONS Clears heat from the Qi level Generates fluids and relieves thirst INDICATIONS Full heat in the Qi level or yang ming channel causing four great symptoms • Symptoms: high fever with severe thirst. For both these reasons. and the bitter. cold. Anemarrhenae Jing Mi Fr. flooding or slippery. Oryzae Zhi Gan Cao Rx. a great thirst and a great pulse. heavy labored breathing. irritability. dislike of heat. generates fluids. TREATMENT CLASSIFICATION • Clear heat from the Qi level • Clear heat from the nutritive (ying) and Blood (xue) levels • Clear heat and toxin • Clear summer-heat • Clear heat from the organs • Clear empty heat Clear Heat from the Qi Level B AI H U TANG Shi Gao Gypsum Zhi Mu Rz. dry. delirium or coma. protects the Stomach from cold herbs tonifies the Qi. toothache. descending nature of many heat-clearing herbs may create further dryness. a red face. Glycyrrhizae praep. relieves thirst tonifies the Qi. CAUTIONS AND CONTRAINDICATIONS Because this formula is very cold. it is contraindicated in the following conditions: • Exterior syndromes • Syndromes of true cold with false heat • Fever caused by Spleen and Stomach Qi deficiency 48 • The Formula Study Guide White Tiger Decoction clears heat.

nasal pain and flaring of the nostrils. harmonizes the formula FUNCTIONS Clears heat from the Lung. erythema or skin purpura in the course of febrile diseases. epistaxis. drains fire in all three warmers. jaundice with damp-heat. insomnia. relieves thirst moistens the Lung. the following considerations apply: • Use only in patients with a strong constitution. irritability. red tip or border • Pulse: slippery. Gypsum and Glycirrhiza Decoction circulates Lung Qi. Prunus. Ephedra. dysentery with fever. carbuncles. and never use long-term • Contraindicated in patients presenting damage to the fluids or the Yin Clear Heat from the Organs M A X ING S HI G AN TANG Ma Huang Hb. Glycyrrhizae praep. wheezing. rapid. promotes urination FUNCTIONS Clears heat and toxin from all three warmers INDICATIONS Fire toxin obstructing all three warmers • Symptoms: high fever. hematemesis. delirium. coughing. Coptidis Huang Qin Rx. flooding CAUTIONS AND CONTRAINDICATIONS Because this formula is very bitter and cold. focusing on the upper warmer clears heat. also floating with external wind-heat present CAUTIONS AND CONTRAINDICATIONS • Contraindicated in dyspnea caused by wind-cold invasion • Contraindicated in deficient-type dyspnea 50 • The Formula Study Guide . deep-rooted boils and sores • Tongue: red. Gardeniae Coptis Relieve Toxin Decoction clears heat. labored or difficult breathing. circulates Lung Qi and stops wheezing Releases the exterior and dispels wind-heat INDICATIONS Lung heat with or without external wind-heat causing wheezing • Symptoms: persistent fever with or without sweating. focusing on the lower warmer clears heat and toxin. stops coughing and wheezing. stops coughing and wheezing clears heat from the Lung and Stomach. yellow scanty urine. forceful. slight dislike of wind or cold • Tongue: red tip or border with thin white or yellow coating. drains damp. dry mouth and throat. Scutellariae baicalensis Huang Bai Cx.Clear Heat & Toxin H UANG L IAN J IE D U TANG Huang Lian Rz. dry with yellow coating • Pulse: rapid. thirst. Pruni armeniacae Shi Gao Gypsum Zhi Gan Cao Rx. Phellodendri Shan Zhi Zi Fr. releases external wind-cold descends Lung Qi. Ephedrae Xing Ren Sm. focusing on the middle warmer clears heat.

Xing Ren. Zhi Gan Cao Shi Gao Gui Zhi diaphoretic to release exterior. Xing Ren Zhi Mu. dislike of heat red with dry yellow coating forceful. rapid yang ming — Symptoms different Tongue Pulse Channel stage involved Pathogenesis full heat invades the Lung. Zhi Gan Cao Ma Huang. profuse sweating. coughing. Jing Mi clears heat from the Lung circulates Lung Qi to stop wheezing and cough. from tai yang to yang ming thereby obstructing Lung Qi Table 4. coughing exogenous pathogens transform into heat that lodges in the Lung and obstructs Qi flow no sweating chills and fever.Ma Xing Shi Gan Tang Ingredients common different common Ma Huang Tang Ma Huang. resulting in Lung Qi rebellion Symptoms different cardinal Pathogenesis Table 4. flooding. dyspnea. rapid. slippery tai yang and yang ming high fever. body aches cold closes the skin pores and inhibits the Lung. fever.5 Comparison of Ma Xing Shi Gan Tang and Ma Huang Tang Ma Xing Shi Gan Tang Ingredients common different common Bai Hu Tang Shi Gao. dyspnea. exogenous pathogen (wind-cold or wind-heat) transforms into heat or exogenous heat lodges in Qi level or exogenous pathogens transfer and lodges in the Lung. possible sweating. releases the exterior generates fluids Functions different common different common Indications full heat accumulating in the Lung exterior syndrome fever.6 Comparison of Ma Xing Shi Gan Tang and Bai Hu Tang Clear Heat • 51 . slippery. thirst wheezing. dislike of wind or cold color normal with possible red tip with thin white/yellow coating floating. circulates Lung Qi to stop wheezing clears heat from the Lung strongly promotes sweating to release the exterior Functions different common wheezing and dyspnea sweating wheezing.

a feeling of heat in the bones. relieves thirst nourishes the Yin. Stellariae Hu Huang Lian Rx. emaciation. malar flush. Picrorrhizae Di Gu Pi Cx. cools the Blood nourishes the Yin. relieves steaming bone syndrome clears heat. clears empty heat nourishes the Yin. cools the Blood clears empty and full heat. Artemisiae annuae) should be added 10 minutes before the end of cooking time Artemisia and Amyda Decoction clears empty heat. cools the Blood. clears heat. cools and invigorates the Blood Q ING G U S AN Yin Chai Hu Rx. nourishes the fluids and relieves steaming bone disorder INDICATIONS Liver and Kidney Yin deficiency with empty heat causing steaming bone syndrome • Symptoms: low-grade tidal fever in the afternoon or evening. clears empty heat harmonizes the formula FUNCTIONS Clears empty heat. irritability. relieves steaming bone syndrome clears heat. night sweats. palms and soles). dry mouth • Tongue: red with scanty coating • Pulse: thin.Clear Empty Heat Q ING H AO B IE J IA TANG Qing Hao Hb. FUNCTIONS Nourishes the Yin and clears empty heat INDICATIONS Yin deficiency with empty heat during late-stage febrile disease • Symptoms: low-grade fever at night with normal temperature in the morning. dries damp. Artemisiae annuae Bie Jia Carapax Amydae Zhi Mu Rz. Rehmanniae recens Mu Dan Pi Cx. cools the Blood clears empty heat nourishes Kidney Yin. though the flesh is not warm to touch. Anemarrhenae Bie Jia Carapax Amydae Gan Cao Rx. clears empty and full heat nourishes the Yin. Gentianae macrophyllae Zhi Mu Rz. possibly afternoon tidal fever • Tongue: red with scanty coating • Pulse: thin. Radicis Lycii Qing Hao Hb. rapid CAUTIONS AND CONTRAINDICATIONS • Contraindicated in Qi-stage heat • Contraindicated with a tendency present for spasms or seizures caused by Yin deficiency • Qing Hao (Hb. Anemarrhenae Sheng Di Huang Rx. radicis Paeoniae suffr. weak CAUTIONS AND CONTRAINDICATIONS This formula is stronger for clearing empty heat than for tonifying the Yin Clear Heat • 57 . rapid. no sweating after the fever subsides. Artemisiae annuae Qin Jiao Rx. insomnia. cools the Blood. five centers heat (heat feeling in the sternum. lethargy. normal appetite. clears empty heat. emaciation. clears empty heat from the Liver and Kidney clears empty heat. Glycyrrhizae Cool the Bones Powder clears heat. thirst.

and Intestines Clear Empty Heat Qing Hao Bie Jia Tang • Yin deficiency with empty heat during later-stage febrile disease Qing Gu San • Liver and Kidney Yin deficiency with empy heat causing steaming bone syndrome Table 4. Shan Zhu Yu. Mu Dan Pi Sheng Di Huang to clear heat nourishes the Yin. Ze Xie. Bie Jia Sheng Di Huang. Zhi Mu.8 Summary of formulas that clear heat 58 • The Formula Study Guide . tinnitus. fire) Xie Bai San • Lung heat and Qi stasis Xie Xin Tang • Heart fire with hematemesis Zhu Ye Shi Gao Tang • Qi-level heat with Qi and fluids deficiency during later-stage febrile disease Xie Huang San • Spleen-Stomach fire LongDanXieGanT ang • Liver/Gallbladder fire or damp-heat Qing Wei San • Stomach fire or yang ming channel heat Zuo Jin Wan • Liver fire burning the Stomach Yu Nu Jian • Stomach fire with Yin/fluids deficiency causing dryness Bai T Weng T ou ang • toxic heat in the St.7 Comparison of Liu Wei Di Huang Tang and Qing Hao Bie Jia Tang Clear Heat from the Qi Level Bai Hu Tang • Qi-level/yang ming channel heat causing four great symptoms Clear Heat and Toxin Huang Lian Jie Du Tang • fire toxin in all three warmers Clear Heat from the Organs Ma Xing She Gan T ang • Lung heat (with external wind-heat) Dao Chi San • Heat in the Heart chann. night sweats lower back and knee aches. Fu Ling Shu Di Huang to nourish the Yin nourishes Liver and Kidney Yin primary hot flashes. Shan Yao. no sweating after fever subsides emaciation Ingredients others Di Huang Functions Symptoms others pulse tongue Signs thin and rapid red body with scanty coating Kidney and Liver Yin deficiency to nourish the Yin late-stage febrile disease with heat smoldering in the body's Yin regions to clear empty heat Indications Therapeutic emphasis Table 4.Liu Wei Di Huang Wan king Shu Di Huang Mu Dan Pi. (with S. light-headedness Qing Hao Bie Jia Tang Qing Hao.I. clears empty heat low-grade fever at night.

bleeding gums regurgitation Xie Bai San wheezing Xie Xin Tang hematemesis or epistaxis Yu Nu Jian thirst for cold water Table 4.Heat Syndromes Excess Qi-Level Heat Bai Hu Tang four great symptoms symptoms in all three warmers Deficiency Heat in the Organs Qing Hao Bie Jia Tang Toxic Heat Huang Lian Jie Du Tang Bai Tou Weng Tang symptoms in the lower warmer nocturnal low-grade fever Qing Gu San afternoon low-grade fever Zhu Ye Shi Gao Tang mild fever.8 Symptomatology of heat-clearing formulas Clear Heat • 59 . thirst Lung Ma Xing She Gan Tang wheezing from wind-heat Heart Dao Chi San dark painful urination Liver Long Dan Xie Gan Tang temple headache Spleen Xie Huang San severe thirst Stomach Qing Wei San Zuo Jin Wan toothache.

What role does Ma Huang (Hb. Why are they used in Long Dan Xie Gan Tang (Gentiana Drain the Liver Decoction)? 2. Sheng Di Huang (Rx. six channel differentiation (shang han). How and why does Long Dan Xie Gan Tang (Gentiana Drain the Liver Decoction) treat Liver fire flaring upward. Angelicae sinensis) are Yin and Blood tonics. four level differentiation (wen bing) and eight principle differentiation (ba gang)? 4. Rehmanniae) and Dang Gui (Rx. Gypsum and Glycyrrhiza Decoction)? 5. based on the following systems: organ differentiation (zang fu). Which are the king herbs in Qing Hao Bie Jia Tang (Artemisia and Amyda Decoction)? What are their functions? 6.Review and Discussion Study Questions 1. For which syndrome is this formula used. radicis Paeoniae suffruticosae) in Qing Hao Bie Jia Tang (Artemisia and Amyda Decoction)? 3. What is the function of Mu Dan Pi (Cx. Ephedrae) play in Ma Xing Shi Gan Tang (Ephedra. and damp-heat flowing downward in the Liver channel? 60 • The Formula Study Guide . Bai Hu Tang (White Tiger Decoction) can be used according to a variety of systems of syndrome differentiation. Prunus.

Sheng Di Huang (Rx. According to zang fu theory. From the eight principles perspective. a dry red tongue with dry yellow coating. Yang syndromes. 3. Bupleuri) in the formula. to prevent Blood stasis. and a rapid. promote urination and clear damp-heat in the Liver channel. Bai Hu Tang (White Tiger Decoction) addresses a syndrome characterized by high fever with severe thirst. Ze Xie (Rz. it goes to the Blood level. Mu Dan Pi (Cx. Mu Tong (Cs. This syndrome can be interpreted in different ways. To soothe and regulate the Liver Qi. Plantaginis) are included to clear heat. it addresses interior. Ma Xing Shi Gan Tang (Ephedra. flooding or slippery pulse. dry Chai Hu can consume Liver Yin. They are needed in Long Dan Xie Gan Tang (Gentiana Drain the Liver Decoction) for three reasons: a. The bitter. Bitter. excess heat or dampheat in the Liver channel may easily damage the Blood or Yin. These patients typically present sweating. however. Gypsum and Glycyrrhiza Decoction) is the correct formula for treating an exterior syndrome that has affected the interior in the form of heat accumulating in the Lung. The Liver stores the Blood. Prunus. wheezing. radicis Paeoniae suffruticosae) is included in Qing Hao Bie Jia Tang (Artemisia and Amyda Decoction) to cool and invigorate the Blood. profuse sweating. coughing and dyspnea. and second. thereby assisting Qing Hao (Hb. Rehmanniae) and Dang Gui (Rx. it treats Qi level heat. c. but with additional Lung heat with Qi rebellion. Their strong diuretic action. It is given to patients who present an exterior condition that has been released. b. and to protect the Liver Yin from possible damage from the Chai Hu (Rx. Alismatis) and Che Qian Zi (Sm. this formula treats full heat in the Lung and Stomach. According to the wen bing theory. irritability. Bai Hu Tang Organs Six channels Four levels Eight prinicples full heat in the Lung yang ming channel syndrome pathogenic heat in the Qi level interior full heat Yang syndrome Table 4. To nourish the Liver Blood and Liver Yin. 2. Clear Heat • 61 . it addresses the yang ming channel syndrome. excess. can damage the Yin. to clear heat from the Blood. depending on the system of differentiation used. Akebiae). heat. Artemisiae annuae).Answers & Explanations 1. pungent and cool. Mu Dan Pi specifically acts first.9 Bai Hu Tang schematic 4. In the shang han system of differentiation. While this formula as a whole clears empty heat. as the many cold herbs in this formula may cause Blood stasis. To prevent injury to the Yin from the herbs in the formula that clear heat and drain damp. Angelicae sinensis) both tonify the Blood and nourish the Yin.

S Y M P T O M D I F F E R E N T I AT I O N R E F E R E N C E C H A RT S 233 .

pulse also weak sweating. some shivers. irritability. rapid Chai Ge Jie Ji Tang External wind-heat acute headache with severe distended pain. dislike of wind. pain may extend to nape of neck and back regions (tai yang areas). thirst with desire to drink cold water. dizziness. chills and fever. nausea. worse from exposure to wind. fever. red complexion and eyes. pulse also somewhat moderate Formula Ge Gen Tang Ma Huang Tang Ren Shen Bai Du San Gui Zhi Tang full type E x t e r i o r External wind-cold empty type Tai yang syndrome with yang ming and shao yang syndromes acute headache. insomnia. boring and tight. vomiting. possibly radiating to ear. body aches. dry throat. fever and slight chills. pulse wiry Sang Ju Yin Yin Qiao San mixed Shao yang syndrome Xiao Chai Hu Tang 250 • The Formula Study Guide . dry nose.Headache Differentiation Symptoms pulse also tight no sweating coating greasy white. bitter taste in mouth. pulse floating acute frontal (yang ming) and occipital headache. pain is violent. pulse floating. possible alternating chills and fever. pulse floating and rapid temporal (shao yang) headache. relieved by warmth. sore throat. tongue coating thin yellow. hypochondriac pain and distension. dislike of wind.

empty headache. five centers heat. tongue purple with dark lateral spots. wiry Symptom Differentiation Reference Charts • 251 . restlessness. irritability. slippery dull. sputum expectoration. slippery persistent headache that is a slight ache or dull. low energy. body heaviness. tongue dusky. pulse slow. pain worse from blood loss such as menstruation. twitching. pulse weak and empty slight headache with dizziness. tinnitus. thin. tongue pale. darkness around eyes. tongue pale. dislike of cold. worse from cloudy or rainy weather. dislike of light. tongue coating white. heavy headache. pain at temples and around eyebrows. weak back and knees. poor appetite. tongue purple. vomiting after drinking. tongue red cold limbs. pulse weak. possible numbness or hemiplegia. empty pain. deep night sweats. hemiplegia thirst. hair loss.Liver Yang rising Liver Liver fire Liver Qi stagnation E x c e s s I n t e r i o r D e f i c i e n c y Blood stagnation Wind-damp-cold with Blood stagnation in the channels Wind-phlegm throbbing headache. empty chronic dull. dry heaves. difficult urination. restlessness. tongue red. dislike of cold. constipation Tian Ma Gou Teng Yin Long Dan Xie Gan Tang Si Ni San Xiao Yao San Xue Fu Zhu Yu Tang modified Xiao Huo Lou Dan Ban Xia Bai Zhu Tian Ma Tang Wu Ling San headache worse from emotional stress. low sex drive. pulse wiry. pulse rough. possibly accompanied by dizziness and nausea. worse from emotional stress. pulse wiry. spermatorrhea. Kidney Yang def. worse in the morning or after exertion. full feeling of heat rushing to head. fatigue. worse in the afternoon or evening. pulse empty. five centers heat. fatigue. pulse slippery headache. oppressive feeling in chest. red eyes and face. wiry chronic persistent headache or migraine. pulse floating. dizziness or vertigo. nausea. thirst. loose stool. fixed pain. numbness. insomnia. chest and hypochondriac fullness and distension. Wu Zhu Yu Tang Kidney deficiency Kidney Yin def. frequent attacks. low-pitched tinnitus. dizziness. tongue pale Water-damp accumulation Qi deficiency Bu Zhong Yi Qi Tang Blood deficiency Si Wu Tang modified Liu Wei Di Huang Wan modified Jin Gui Shen Qi Wan mod. distended. insomnia. fever. cold limbs. Liver/Stomach empty cold vertex (jue yin) headache accompanied by a feeling of cold. pulse wiry chronic persistent headache with sharp. spitting of clear fluids. spasms. bitter taste. yellow urine.

b. Astragali) Zhi Gan Cao (Rx. Shan Zha (Fr. Forsythiae) Ban Xia (Rz. dispel cold and improve digestion harmonize the Stomach and Intestines to improve digestion reduce food stagnation. and his pulse to be rapid and slippery. Spleen Qi deficiency with damp in the middle warmer Food stagnation with heat accumulation Stomach and Intestines disharmony Spleen and Stomach Qi deficiency with cold The correct treatment principle for his condition is: a. warm the middle warmer. Which of the following herb sets should NOT be used for him? a. age 10 Josh’s complaint is that an hour after eating dinner last night he began feeling discomfort and pain in the epigastrium. Crataegi) Lai Fu Zi (Sm. b. After having diarrhea this morning. along with fetid belching. Lian Qiao (Fr. Chen Pi (Pc. d. What is your diagnosis for Josh? a. 1. Ban Xia Xie Xin Tang (Pinellia Drain the Epigastrium Decoction) Li Zhong Wan (Regulate the Middle Pill) Ping Wei San (Calm the Stomach Powder) Bao He Wan (Preserve and Harmonize Pill) 4. Huang Qi (Rx. Pinelliae) d. Raphani) b. c. d. b. Examination reveals his tongue to be red with a greasy yellow coating. c. Glycyrrhizae praeparata) Comprehensive Exam • 317 . acid regurgitation and abdominal fullness and bloating. c. Which is the appropriate formula for this boy? a. Citri reticulatae) Shen Qu (Massa fermentata) c. d.Case Study Questions CASE STUDY #1 — QUESTIONS 1-4 Josh. Josh’s symptoms were reduced. regulate the Stomach and clear heat tonify the Spleen/Stomach and improve digestion 3. 2.

which for the past five years she has controlled with the use of corticosteroid cream. When she scratches. feels a bitter taste in her mouth and likes drinking cold water. Jing Jie (Hb. age 35 Sue has chronic eczema. She often feels dizzy and nauseated. Zhi Mu (Rz. 5. Cannabis) CASE STUDY #3 — QUESTION 8-11 Linda. rapid and slippery. with some blistering and scaling. 6. Angelicae sinensis) Huo Ma Ren (Sm. Atractylodis macrocephalae) Shu Di Huang (Rx. Anemarrhemae) Mu Tong (Cs. age 48 Linda complains of having palpitations and problems with sleeping for the past month. Her tongue has a greasy yellow coating. Arctii) b. c. d. c. Your diagnosis for Sue is: a. damp-heat in the Liver channel Blood and Qi deficiency wind-damp-heat invading the skin protective Qi deficiency Which of the following formulas is the best choice for her? a. her pulse is floating. 318 • The Formula Study Guide . b. b. and her pulse is wiry and slippery. Two days ago she had a flare-up of her condition after eating some spicy seafood. d. a yellowish exudate comes out. Akebiae) d. Which of the following herb sets are NOT in the formula you chose? a. Schizonepetae) Niu Bang Zi (Fr. Long Dan Xie Gan Tang (Gentiana Drain the Liver Decoction) Xiao Feng San (Eliminate Wind Powder) Si Wu Tang (Four Substances Decoction) Wu Pi San (Five Peel Powder) 7. Her tongue is red and coated with yellow moss. Dang Gui (Rx. Bai Zhu (Rz. Her menstrual cycle has also been irregular for the past year. The eczema on both of her elbows is now very itchy.CASE STUDY #2 — QUESTIONS 5-7 Sue. Rehmanniae praeparata) c. On examination you find Sue’s elbows to be red and dry.

Ma Zi Ren Wan (Hemp Seed Pill) treats constipation caused by which of the following? a. d. Aconiti praeparata) the same as Fu Zi (Rx. d. b. Cang Er Zi San (Xanthium Powder) Sang Ju Yin (Morus and Chrysanthemum Decoction) Yin Qiao San (Lonicera and Forsythia Powder) Ma Huang Tang (Ephedra Decoction) A patient presents severe dislike of cold. 2. Which of the following formulas is best for treating nasal sinusitis? a. d. Chuang Xiong Cha Tiao San (Ligusticum and Camellia Regulating Powder) treats headache because it performs which of the following? a. c.General Formula Questions 1. d. c. Asarum and Aconitum Decoction) 3. c. the dosage of Da Huang (Rz. a slight fever without sweating. Stomach excess and Spleen deficiency Spleen excess and Stomach deficiency Spleen and Stomach deficiency Stomach and Intestines excess 300 • The Formula Study Guide . Ren Shen Bai Du San (Panax Expel Toxin Powder) Ma Huang Tang (Ephedra Decoction) Jia Jian Wei Rui Tang (Modified Polygonatum Decoction) Ma Huang Fu Zi Xi Xin Tang (Ephedra. d. b. expells cold to relieve pain dispels wind to relieve pain soothes Liver Qi to relieve pain nourishes the Blood to relieve pain 4. c. a pale face. b. c. c. Aconiti praeparata) does not matter 6. a pale tongue with thin white coating and a deep. Xiao Qing Long Tang (Minor Bluegreen Dragon Decoction) treats which of the following? a. Which formula would you choose for this patient? a. weak pulse. b. cold limbs. d. b. Rhei) should be which of the following? a. b. In Da Huang Fu Zi Tang (Rhubarb and Aconitum Decoction). a headache. external wind-cold with internal heat external wind-cold with internal phlegm-fluids accumulation external wind-cold with internal damp-heat external wind-cold with internal Qi stagnation 5. less than Fu Zi (Rx. Aconiti praeparata) more than Fu Zi (Rx.

C O M P R E H E N S I V E E X A M I N AT I O N PRIMARY FORMULA QUESTIONS GENERAL FORMULA QUESTIONS CASE STUDY QUESTIONS 317 354 355 270 300 ANSWERS TO THE PRIMARY FORMULA QUESTIONS ANSWERS TO THE GENERAL FORMULA QUESTIONS ANSWERS TO THE CASE STUDY QUESTIONS 355 Comprehensive Exam • 269 .

Glycyrrhizae) c. c.Primary Formula Questions 1. Xiao Yao San (Easy Wanderer Powder) Ban Xia Xie Xin Tang (Pinellia Drain the Epigastrium Decoction ) Xiao Chai Hu Tang (Minor Bupleurum Decoction) Si Ni San (Frigid Extremities Powder) 3. Platycodi) Gan Cao (Rx. d. Menthae arvensis) Ju Hua (Flos Chrysanthemi) Lu Gen (Rz. Phragmitis) d. Gui Zhi Tang (Cinnamomum Decoction) treats all of the following symptoms EXCEPT: a. Forsythiae) Bo He (Hb. Phragmitis) Bo He (Hb. Jin Yin Hua (Flos Lonicerae) Lian Qiao (Fr. c. Forsythiae) Niu Bang Zi (Fr. Platycodi) Lu Gen (Rz. Phragmitis) 4. 2. Jie Geng (Rx. Forsythiae) Gan Cao (Rx. Which of the following herb sets is common to Yin Qiao San (Lonicera and Forsythia Powder) and Sang Ju Yin (Morus and Chrysanthemum Decoction)? a. Arctii) Jie Geng (Rx. dislike of wind headache sweating tight pulse Which of the following formulas is best for treating pi syndrome (abdominal distension without palpable mass) caused by heat or cold accumulation in the middle warmer? a. d. b. b. Mori albae) Jie Geng (Rx. In which type of patient is Ren Shen Bai Du San (Panax Expel Toxin Powder) contraindicated? 270 • The Formula Study Guide . Forsythiae) Bo He (Hb. Lian Qiao (Fr. Platycodi) b. Glycyrrhizae) Lu Gen (Rz. Menthae arvensis) Ju Hua (Flos Chrysanthemi morifolii) Sang Ye (Fm. Menthae arvensis) Lian Qiao (Fr. Lian Qiao (Fr.

A week ago. he developed a constant high fever. his pulse is weak and deep. His tongue is pale with little coating. b. He has had no bowel movement now for about four days. Gan Jiang (Rz. decoct Hou Po (Cx. Today he complains of hot sensations and intense irritability. formulas to warm internal cold formulas to clear heat formulas to drain downward formulas to harmonize 9. c. d. shortness of breath and coughing with expectoration of yellowish sputum. d. high fever. Which formula category would you choose for this patient? a. c. his cheek bones look red. Which formula category would you choose for this patient? a. the Yang deficiency patient the Yin deficiency patient the protective/wei Qi deficiency patient the patient with damp stagnation Which is the right way to decoct Xiao Cheng Qi Tang (Minor Order the Qi Decoction)? a. his pulse is rapid and forceful. Which of the following herbs belongs in Wu Zhu Yu Tang (Evodia Decoction)? a. c. sweated profusely and experienced thirst. Magnoliae officinalis) first decoct Da Huang (Rz. Aurantii immaturus) first decoct all of them at the same time 6. d. c. Glycyrrhizae) Yi Tang (Maltose) Da Zao (Fr. b. Li Zhong Wan (Regulate the Middle Pill) treats all of the following syndromes EXCEPT: a. b. a patient experienced symptoms of fear of cold. c. d. formulas to release external wind-heat formulas to clear heat formulas to drain downward formulas to harmonize 8. sore throat and cough. A lung cancer patient has been hospitalized now for about a week with a severe wasting condition. abdominal pain caused by empty cold in the middle warmer bleeding caused by Yang deficiency chronic infantile convulsions with drooling saliva headache caused by cold in the jue yin channel Comprehensive Exam • 271 . b. After taking two packs of Ma Huang Tang (Ephedra Decoction). d. headache. d. His tongue is red with thick yellowish coating. Zizyphi jujubae) 7. Zingiberis officinalis) Gan Cao (Rx. b. c. 5. Rhei) last decoct Zhi Shi (Fr.a. b.

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