Author: Zhang Zhong-Jing, 張仲景
Year: c. 220
Source: Discussion of Cold Damage (Shang Han Lun, 傷寒論)
Category: Formulas that Warm Interior Cold
Pattern: Shaoyin disorder with true Cold in the Interior and false Heat in the Exterior, or severe Heart Yang deficiency
Key Symptoms: Diarrhoea with undigested food in the stool, cold extremities, no aversion to cold
Secondary Symptoms: Flushed face, dry retching, pain in the throat
Pulse: Faint, hidden or almost imperceptible.
Ingredients
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Zhi Gan Cao
| 6g | |
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Pinyin: Gan Cao
Chinese: 甘草
Pharmaceutical: Radix Glycyrrhizae
Taxonomy: Glycyrrhiza uralensis seu glabra seu inflata
English: Liquorice Root |
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Tastes: Sweet, slightly cold
Meridians Entered: Heart, Lung and Spleen (and all 12 meridians) |
Actions & Indications:
- Tonifies the Spleen and augments Qi
Spleen Qi Deficiency with shortness of breath, lassitude and loose stools
Qi and Blood Deficiency with an irregular pulse and/or palpitations
Heart Qi Deficiency or Heart Yang Deficiency
- Moistens the Lungs, resolves Phlegm and stops coughing
Lung Heat or Cold
Productive or non-productive coughing
- Moderates spasms and alleviates pain
Painful muscle spasms of the abdomen and legs
- Clears Heat and relieves Fire Toxicity
Raw for Toxic Heat with sore throat or carbuncles and sores (Chuang Yung)
- Antidote for many toxic substances (internal and topical)
Poisoning
Bites (after washing the wound, chew Gan Cao and apply a thick layer on the bite wound, changing whenever it dries out; Bao Xiang-Ao, 1846, New Compilation of Proven Formulas)
- Moderates and harmonizes the harsh properties of other herbs and guides the herbs to all twelve channels
Often added in small doses to harmonise formulas
- Tonifies the Qi while suppressing Parasites
Gu Sydnrome (Fruehauf, 1998)
Chronic inflammatory disease (Fruehauf, 2015)
- 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: Typically 1.5-9g in decoction. Large doses can be up 30g.
Cautions: It is contraindicated for combining with Hai Zao, Da Ji, Gan Sui and Yuan Hua because of "eighteen antagonisms". It is also contraindicated in cases of dampness obstruction in middle energizer and edema because it can help dampness obstruct qi, and it is prohibited from long-term usage in large dosage (more than 20g/day) and should be avoided or used with extreme caution in patients with high blood pressure because it may raise aldosterone levels in the blood causing retention of sodium.
The NHS recommends avoiding during pregnancy. |
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Sheng Fu Zi
| 12-24g | |
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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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Gan Jiang
| 9-12g | | |
Pinyin: Gan Jiang
Chinese: 干姜
Pharmaceutical: Rhizoma Zingiberis
Taxonomy: Zingiber officinale
English: Dried Ginger |
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Tastes: Pungent, hot
Meridians Entered: Spleen, Stomach, Kidney, Heart and Lung |
Actions & Indications:
- Warms the Middle and expels Cold
External Cold affecting the Spleen and Stomach Spleen and Stomach Yang Deficiencies
- Dispels Wind-Dampness seeping into the Lower Jiao
Lower Jiao Wind-Cold-Damp Bi
- Rescues Devastated Yang and expels Interior Cold
Devastated Yang with a very weak pulse and cold limbs
- Warms the Lungs and transforms thin mucus
Lung Cold with expectoration of thin, watery or white sputum
- Warms the channels (unblocks the pulse) and stops bleeding
Haemorrhage due to Deficiency Cold, especially uterine bleeding (only if the bleeding is chronic and pale in colour with cold limbs, ashen white face and a soggy thin pulse)
- Aids fasting
Mentioned in the Shen Nong Ben Cao Jing as part of the middle class of herbs which can, with protracted taking, remove foul smell and enable one to communicate withe Spirit Light (Shen Ming 神明). 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: 3-10g in decoction.
Cautions: It is contraindicated for yin deficiency with internal heat and haemorrhage due to blood heat. |
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Subsitutions:
In modern practice Sheng Fu Zi is always replaced with the less toxic Zhi Fu Zi. In the UK both have to be replaced although no useful substitute can be made in this context making the inclusion of this formula for reference only. For a less severe presentation using the maximum amount of Gan Jiang to warm the middle and adding Gui Zhi to warm the extremities may be possible but this would not be a Shaoyin Cold Inversion pattern.
Preparation: Decoction.
Actions: Restores the Yang and unblocks the pulse
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.