Author: Zhang Zhong-Jing, 張仲景
Year: c. 220
Source: Essentials from the Golden Cabinet (Jin Gui Yao Lue, 金匱要略)
Category: Formulas that Drain Downward
Pattern: Cold accumulation in the interior causing stagnation of Qi and clumping of fluids
Key Symptoms: Acute abdominal pain, hypochondriac pain, chest pain
Secondary Symptoms: Chills, low grade fever, cold hands and feet
Tongue: Greasy, white coating
Pulse: Submerged, tight and wiry
Abdomen: Pain and tenderness in the hypochondrium and abdomen
Ingredients
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Zhi Fu Zi
| 9-12g | |
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Pinyin: Fu Zi
Chinese: 附子
Pharmaceutical: Radix Aconiti Lateralis Praeparata
Taxonomy: Aconitum carmichaeli
English: Wolf's-bane Root / Monkshood Root / Aconite Root |
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Tastes: Pungent, sweet, hot, toxic
Meridians Entered: Heart, Kidney and Spleen |
Actions & Indications:
- Restores Devastated Yang and rescues from rebellion
Devastated Yang with diarrhoea containing undigested food, chills, cold extremities and a faint almost imperceptible pulse (often as a result of severe vomiting, diarrhoea or sweating)
- Warms Ming Men Fire and assists Heart, Kidney and Spleen Yang
Heart Yang Deficiency
Spleen Yang Deficiency
Kidney Yang Deficiency
- Disperses Cold and Dampness, warms the channels and stops pain
Wind-Damp-Cold Bi
Cold blocking the organs, channels, bones and Blood vessels
Yin flat abscesses
Gu Parasites /
chronic inflammatory disease (Fruehauf, 2015)
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Standard Dosage: 3-15g in decoction. Fire Spirit practitioners prescribe doses of 60-200g per day (Fruehauf, 2009).
Cautions: It is contraindicated for heat syndrome, yin-deficiency leading to hyperactivity of yang and the pregnant because of its pungent, hot, dry and drastic properties. It must be soaked and decocted for about half and hour to one hour until numbing taste disappears for oral use. Over-dosage and incorrect processing must be avoided.
This herb is prohibited from use in the UK under the banned and restricted herbal ingredients list issued by the MHRA. It is generally substituted with various Yang tonics depending on the presentation although none can imitate its powerful cardiovascular effects making them ineffective substitutes for rescuing devastated Yang. External use is permitted at 1.3% or below. |
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Da Huang
| 9g | |
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Pinyin: Da Huang
Chinese: 大黄
Pharmaceutical: Radix et Rhizoma Rhei
Taxonomy: Rheum palmatum
English: Chinese Rhubarb Root |
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Tastes: Bitter, cold
Meridians Entered: Large Intestine, Spleen, Stomach, Liver and Heart |
Actions & Indications:
- Drains Heat and purges accumulations
Intestinal Heat Excess, with high fever, profuse sweating, thirst, constipation, abdominal distention and pain, delirium, a yellow tongue coat and a full pulse
Yang-Ming Fu Stage
Qi Level Heat in the Intestines
- Drains Fire
Fire from Excess with intense fever, sore throat, and painful eyes and constipation
Fire toxin sores due to Xue Level Heat, especially with constipation
- Clears Heat, transforms Dampness and promotes urination
Damp-Heat with oedema, jaundice, painful urinary dysfunction and acute, hot dysenteric disorders
- Drains Heat from the Blood
Bloody stool either from hemorrhoids or Heat in the Intestines
Chaotic movement of hot Blood with hemoptysis or epistaxis with constipation
It can be powdered and administered orally for bleeding in the upper digestive tract
- Invigorates the Blood and dispels Blood Stasis
Blood Stasis with amenorrhea, fixed abdominal masses or fixed pain
Blood Stasis due to traumatic injury
Intestinal abscess
- Clears Heat and reduces Fire toxicity
Topically or internally for burns or skin lesions (Chuang Yung) due to Heat
- Clears Heat and eliminates Phlegm
Chronic Accumulation of Phlegm-Heat with cough, dyspnea, mania, disorientation and other symptoms of Phlegm Misting the Heart
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Standard Dosage: 10-15g in decoction. Excessive decoction will reduce the purgative action. Therefore it should be added at end to achieve this purpose and over-decocted to eliminate this action.
Cautions: It should be used with caution in case of spleen and stomach deficiency for its bitter and cold property which is easily to damage stomach qi. It is contraindicated to women during pregnancy, menstruation or lactation for it has actions of activating blood and resolving stasis, and can make the purged substances follow lactating out. |
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Xi Xin
| 6g | | |
Pinyin: Xi Xin
Chinese: 细辛
Pharmaceutical: Herba cum Radix Asari
Taxonomy: Asarum sieboldii
English: Chinese Wild Ginger |
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Tastes: Pungent, warm, slightly toxic
Meridians Entered: Lung, Kidney and Heart |
Actions & Indications:
- Releases Exterior Wind and Cold
As an adjunctive for any exterior Wind-Cold especially with Dampness in Lung or underlying Yang Deficiency
Frequently used for Wind-Cold when the dominant symptoms are head and body aches
- Disperses Wind-Cold and Internal Cold and alleviates pain
Pain due to Wind and/or Cold anywhere in the body, particularly headache, painful obstruction, abdominal pain or headache due to obstruction of Fluids and Blood by Cold, often with anhydrous Wind-Cold-Damp Bipain
- Warms the Lungs and transforms Phlegm and Thin Mucus (circulates water)
Cough and Qi which surges upward and fullness in the chest in the chest with continuous cough from clumped Qi in the chest and diaphragm marked by copious, watery sputum due to Phlegm-Damp or Wind-Cold with congested fluids
- Disperses and unblocks the Qi of the nasal orifices (clears the orifices of the head)
Nasal congestion
Oral pathology
Loss of consciousness
- Promotes healing of oral ulcerations
Oral lesions or ulcerations
- Relieves toothache
Toothache
- Aids fasting
Mentioned in the Shen Nong Ben Cao Jing as part of the superior class of herbs which can, with protracted taking, make the body light and prolong life. This may suggest it was part of supplementing the diet when engaging in an "avoiding grain" (Bigu 辟穀) fasting regime to cultivate life (Yangsheng 養生).
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Standard Dosage: 1-3g in decoction.
Cautions: Traditionally contraindicated for headache due to hyperactivity of yang caused by yin deficiency and dry cough caused by lung dryness hurting yin. It is incompatible with Li Lu.
While not prohibited in the UK, the RCHM has enacted a voluntary ban by use due to possible fears of aristolochic acid. It is usually substituted with Gui Pi (Cinnamon Bark), or Rou Gui, or Gui Zhi and Qiang Huo for channel problems, Zi Su Ye and Bai Qian for lung issues, Gao Ban and Bai Zhi for treating the head and Cong Bai and Bai Zhi for the sinuses. |
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Subsitutions:
For legal reasons most of this formula may be difficult to obtain. Fu Zi may be substituted with Rou Gui and Gan Jiang, while Xi Xin may be substituted with Wei Ling Xian.
Preparation: Decoction.
Actions: Warms the interior, disperses Cold, unblocks the bowels, alleviates pain
Contraindications: Interior Heat excess patterns
Notes:
One liang is taken as 3g in modern sources but in Eastern Han times it was equivalent to 13.875g. This means that the dosages in classical formulae could have been more than 4x what is given today making them far higher than recommended safe dosages today but prompts consideration of what an effective dose may be (He, 2013).
Research Links:
Reference Notes: (click to display)
Most formulas are found in Scheid, Bensky, Ellis & Barolet (2009): Chinese Herbal Medicine: Formulas & Strategies and Chen & Chen (2015) Chinese Herbal Formulas and Applications. Others are from translations of primary sources. It is recommended that the original material is cross-referenced for mistakes and additional information.
Substitutions have been taken from Ken Lloyd & Prof. Leung (2004): Mayway UK Substitution List or the above publications and are intended as suggestions to help navigate the tight restrictions in the UK quickly. More applicable substitutions may be appropriate in specific situations.
Individual herb information has initially been sourced from TCM Wiki and American Dragon for basic data and then updated manually with my own notes.
These pages are intended to assist clinicians and are not intended for self-diagnosis or treatment for which a qualified professional should be consulted.