Author: Zang Xi Chun / Zang Shou Fu, 張錫純 / 張壽甫
Year: 1918-1934
Source: Essays on Medicine Esteeming the Chinese and Respecting the Western (Yi Xue Zhong Zhong Can Xi Lu, 醫學衷中參西錄)
Category: Formulas that Clear Heat
Pattern: Cold Damage or Warm-Heat disease with Heat entering the Stomach causing rebellion of stomach Qi
Key Symptoms: Fever, thirst, sweating with a feeling of fullness and a stifling oppression in the epigastrium
Secondary Symptoms: Headache, aversion to heat, irritability, red face, toothache, bleeding gums and other Yangming channel symptoms
Tongue: Likely to be red
Pulse: Flooding, forceful or slippery, rapid
Ingredients
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Shi Gao
| 30-90g | |
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Pinyin: Shi Gao
Chinese: 石膏
Pharmaceutical: Gypsum Fibrosum / Calcium Sulphate
Taxonomy: CaSO4
English: Gypsum / Plaster of Paris |
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Tastes: Pungent, sweet, cold
Meridians Entered: Lung and Stomach |
Actions & Indications:
- Clears Heat in the Qi Stage, drains Fire, relieves irritability and quenches thirst
Heat in the Qi Stage or Yangming Heat with high fever, no chills, irritability, intense thirst, profuse sweating, restlessness, encephalitis, a flooding, big pulse and a red tongue with a yellow coat
- Clears Excess Heat from the Lungs
Lung Heat with cough, wheezing, fever and a thick viscous sputum
- Clears Blazing Stomach Fire
Stomach Fire with headache, toothache or swollen gums
- Heals eczema, burns and ulcerated sores and wounds
Sores and wounds (topically or internally)
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Standard Dosage: 15-60g in decoction.
Cautions: Mineral products are prohibited from use in the UK under the Medicines Act 1968 ch. 67 which restricts herbalists to the use of plant products only.
Conventional replacements include Huang Lian and Zhi Mu but its actions are difficult to substitute in many cases and the patient may have to rely on OTC mineral based antacids from the pharmacy such as sodium bicarbonate and calcium carbonate which have a similar effect of binding and neutralising the stomach acid, then using herbal medicines as an adjunctive treatment. Another possibility would be to use sodium alginate that is often found in antacid medications and extracted from seaweed. |
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Zhi Mu
| 45g | |
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Pinyin: Zhi Mu
Chinese: 知母
Pharmaceutical: Rhizoma Anemarrhenae
Taxonomy: Anemarrhena asphodeloides
English: Anemarrhena Rhizome |
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Tastes: Bitter, sweet, cold
Meridians Entered: Lung, Stomach and Kidney |
Actions & Indications:
- Clears Heat and drains Fire (Clears Heat from the Qi Stage, from the Lungs and from the Stomach)
Heat in the Qi Stage with high fever, irritability, restlessness, thirst and a rapid, flooding pulse.
Lung Heat and Dryness with cough and expectoration of thick, yellow Phlegm
Yang Ming Heat
Stomach Heat
- Nourishes Yin and moistens Dryness
Lung and Kidney Yin Deficiency with night sweats, steaming bone disorder, irritability, afternoon or low grade fever, Five Sole Heat and bleeding gums
(Stomach Yin Deficiency)
Kidney Heat with spermatorrhea, nocturnal emissions and an abnormally elevated sex drive
- Generates Fluids, clears Deficiency Fire and quenches thirst
Oral ulcers and inflammation, steaming bones and Xiao Ke (diabetes) due to Yin Deficiency
- Ameliorates the Dryness of tonifying or warming herbs
For use with herbs such as Rx. Astragali Huang Qi, Ram. Cinnamomi Gui Zhi, Rx. Aconiti Lateralis Preparata Zhi Fu Zi when there is concern that these herbs may be too drying
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Standard Dosage: 5-15g in decoction.
Cautions: It is not suitable for deficiency cold syndrome. Being cold and moist in property, it is prohibited to be used for those who have a spleen-deficiency diarrhea. |
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Zhi Ban Xia
| 24g | |
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Pinyin: Ban Xia
Chinese: 半夏
Pharmaceutical: Rhizoma Pinelliae
Taxonomy: Pinellia ternata
English: Pinellia Rhizome |
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Tastes: Pungent, warm, toxic
Meridians Entered: Lung, Spleen and Stomach |
Actions & Indications:
- Dries Dampness and transforms Phlegm
Cold-Phlegm in the Lungs (cough with copious sputum)
Especially effective for Damp-Phlegm of the Spleen (Cold-Damp Stagnation)
- Descends Rebellious Qi and stops vomiting (harmonizes the Stomach)
Vomiting due to Phlegm-Damp in the Stomach (Tan Yin), Cold thin mucus, Stomach Deficiency, Stomach Heat or pregnancy
- Dissipates nodules and reduces Stagnation (clumps)
Phlegm in the chest (nodules, pressure, distention, pain)
Phlegm nodules in the neck (goiter, scrofula)
Focal distension in the chest and epigastrium
Obstruction caused by Phlegm anywhere in the body
- Treats sores, skin ulcerations and carbuncles and reduces swelling (external)
Topically as a powder for sores, skin ulcerations and carbuncles
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Standard Dosage: 3-10g in decoction.
Cautions: Contraindicated to Wu Tou. Use with cautions during gestation.
Must be processed before use as raw Ban Xia is toxic. Ingesting the raw form can cause severe irritation of the mouth, pharynx, and gastrointestinal tracts, and has toxic effects on the nervous system. Symptoms of toxicity include a dry mouth, numbness of the tongue, gastric discomfort, burning sensations and swelling of the mouth, tongue, throat and salivation. In serious cases ingesting Ban Xia can result in hoarseness, spasms, dyspnoea and asphyxia.
Processing can be done with ginger and alum (Jiang Ban Xia) to make a warming herb best suited for Cold-Damp and thin Phlegm conditions, or with liquorice (Fa Ban Xia) to make a more neutral herb that is less drying and can be used for Damp-Heat conditions too. |
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Zhu Ru
| 18g | | |
Pinyin: Zhu Ru
Chinese: 竹茹
Pharmaceutical: Caulis Bambusae in Taeniam
English: Bamboo Shavings |
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Tastes: Sweet, lightly cold
Meridians Entered: Lung, Heart and Stomach |
Actions & Indications:
- Clears Heat and transforms Hot Phlegm
Lung Heat with viscous sputum a stifling sensation in the chest or hemoptysis (Phlegm-Heat in the Lungs)
Gallbladder Fire harboring Phlegm and Phlegm-Heat
- Clears Heat and stops vomiting
Stomach Heat with bad breath, vomiting bitter or sour fluid, aversion to Heat, a greasy, yellow tongue coat (due to either Excess or Deficiency)
- Cools the Blood and stops bleeding
Blood Heat bleeding
- Calms the fetus
Restless fetus
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Standard Dosage: 6-10g in decoction.
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Subsitutions:
In the UK Shi Gao must be substituted but no other substances really suffice in this instance, especially since the decoction already contains Zhi Mu which is the only thing that can occasionally take its place in other formulae.
Preparation: Decoction. Cook in 5 cups and boil down to make 3 caps. Take 1 cup warm. Do not take again if condition improves significantly within 2 hours. If not take another, and then the third if necessary 2 hours later.
Actions: Clears Stomach Heat and regulates the Stomach Qi.
Contraindications: Cold disorders. Should be discontinued if signs of headache, stiffness in the neck, icy-cold limbs, subjective sensations of cold or impairment of mental faculties occur
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.