Author: Wang Tao, 王燾
Year: 752
Source: Arcane Essentials from the Imperial Library (Wai Tai Mi Yao, 外台秘要)
Category: Formulas that Clear Heat
Pattern: Severe obstruction of all three Jiao by Heat Toxin disturbing the Shen.
Key Symptoms: High fever, irritability, dry mouth and throat, incoherent speech, insomnia, dark urine
Secondary Symptoms: Any number of symptoms due to Damp-Heat Toxins including severe bloating with constipation, or sticky diarrhoea, red, swollen or weeping sores and swellings, including haemorrhoids
Tongue: Red with yellow coating
Pulse: Rapid and forceful
Ingredients
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Huang Lian
| 9g | |
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Pinyin: Huang Lian
Chinese: 黄连
Pharmaceutical: Rhizoma Coptidis
Taxonomy: Coptidis chinensis
English: Coptis Rhizome / Goldthread Rhizome |
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Tastes: Bitter, cold
Meridians Entered: Heart, Stomach, Large Intestine and Liver |
Actions & Indications:
- Clears Heat and drains Dampness
Damp-Heat in the Stomach or Intestines with diarrhoea or dysenteric disorder
Stomach Heat with vomiting and/or acid regurgitation
- Drains Fire and resolves Fire toxicity
Heat with Blazing Fire (Toxic Heat) with high fever. irritability, disorientation, delirium, a red tongue and a rapid, full pulse
Heat from Excess with toxicity: painful, red eyes and a sore throat
Boils, carbuncles and abscesses (Chuang Yung)
- Clears Heat and stops bleeding
Blood Heat with epistaxis, hematuria, hemafecia and hemoptysis
- Clears Heat topically
Infected wounds, red and painful eyes, ulcerations of the tongue and mouth (topical)
- Clears Heart Fire (sedative)
Heart Fire
Lack of communication between the Heart and Kidneys
- Drains Stomach Fire
Stomach Fire
- Aids fasting
Mentioned in the Shen Nong Ben Cao Jing as part of the superior class of herbs which can, with protracted taking, improve memory. 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: 2-10g in decoction.
Cautions: It is contraindicated for deficiency-cold syndrome. Because its taste is extremly bitter and dryness, overdosage and long-time taking will impair spleen and stomach, yin and fluids. |
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Huang Qin
| 6g | |
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Pinyin: Huang Qin
Chinese: 黄芩
Pharmaceutical: Radix Scutellariae baicalensis
Taxonomy: Scutellaria baicalensis
English: Baical Skullcap Root |
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Tastes: Bitter, cold
Meridians Entered: Lung, Stomach, Gallbladder, Large Intestine and Bladder |
Actions & Indications:
- Clears Heat and dries Dampness
Damp-Heat in the Stomach or Intestines with diarrhoea or dysenteric disorder
Damp-Warmth with fever, a stifling sensation in the chest and thirst with no desire to drink
Damp-Heat in the Lower Jiao with painful urinary dysfunction
Damp-Heat jaundice (auxiliary), infectious hepatitis
- Drains Fire and detoxifies
Heat and Fire especially in the Upper Jiao (Lung) with high fever, irritability, thirst, cough and expectoration of thick, yellow sputum
Upper respiratory tract infection
Hot sores and swellings (topical or internal)
- Cools the Blood and stops bleeding
Xue Stage Heat or Blood Heat causing bleeding with epistaxis, hemoptysis, hematemesis and hemafecia
- Clears Heat and calms the fetus
Fetal restlessness due to Heat
- Calms ascending Liver Yang
Liver Yang Rising with headache, irritability, red eyes, flushed face and bitter taste
Hypertension (high blood pressure)
Gallbladder Heat
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Standard Dosage: 5-15g in decoction.
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Huang Bai
| 6g | |
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Pinyin: Huang Bai
Chinese: 黄柏
Pharmaceutical: Cortex Phellodendri
Taxonomy: Phellodendron amurense seu chinense
English: Amur Corktree Bark |
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Tastes: Bitter, cold
Meridians Entered: Liver, Gallbladder, Large Intestine, Kidney and Bladder |
Actions & Indications:
- Drains Damp-Heat especially from the Lower Jiao
Thick, yellow vaginal discharge, foul smelling diarrhoea or dysenteric disorder
Damp-Heat in the Lower Jiao
Hot Leg Qi with red, swollen, painful knees, legs or feet
Damp-Heat jaundice
- Drains Kidney Fire (False Heat, Deficiency Heat)
Kidney Yin Deficiency with Empty Fire Rising (steaming bone disorder, night sweats, afternoon fevers and sweating, occasionally with nocturnal emissions and spermatorrhea)
- Drains Fire and relieves Fire toxicity
Toxic sores and Damp-skin lesions (internally and topically)
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Standard Dosage: 6-10g in decoction.
Cautions: It is contraindicated for deficiency-cold syndrome. Overdosage and long-time taking will impair spleen and stomach. |
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Zhi Zi
| 6-12g | | |
Pinyin: Zhi Zi
Chinese: 栀子
Pharmaceutical: Fructus Gardeniae
Taxonomy: Gardenia jasminoides
English: Gardenia Fruit |
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Tastes: Bitter and cold
Meridians Entered: Heart, Liver, Stomach and Lung |
Actions & Indications:
- Clears Heat, reduces Fire and eliminates irritability in the San Jiao
Excess Heat in the Heart, Stomach and Liver with high fever, irritability, restlessness, a stifling sensation in the chest, insomnia or delirious speech, eye problems, anger, jaundice
- Clears Heat and resolves Dampness (Drains Damp-Heat)
Damp-Heat in the Lower Jiao with painful urinary dysfunction (Lin Syndrome)
Damp-Heat in the Liver/Gallbladder with jaundice
Damp-Heat in the San Jiao
Damp-Heat in the Gallbladder and San Jiao channels of the face affecting the nose and eyes or causing sores in the mouth or facial region
- Cools the Blood and relieves toxicity (stops bleeding by astringing)
Heat in the Blood with epistaxis, hematemesis, hemafecia or hematuria (partially charred)
- Reduces swelling and invigorates the Blood
Blood Stagnation due to trauma (topical)
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Standard Dosage: 5-15g in decoction.
Cautions: Being strongly bitter in flavor and cold in nature, it is not good for deficiency-cold syndrome because it can easily impair spleen and stomach. It is contraindicated in case of loose stool due to spleen deficiency. |
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Subsitutions:
At present the dosage of Huang Lian is often reduced to 3-4.5g.
Preparation: Decoction. Some Japanese sources recommend to let the liquid cool in order to enhance its cooling effects.
Actions: Drains fire and resolves Toxicity from Upper Jiao, Middle Jiao and Lower Jiao.
Contraindications: It can easily injure the Yin and so should only be used in robust patients and not for long term or for patients with Heat in the Ying and Xue levels.
Notes:
Ploberger (2017), in Westliche und traditionell chinesische Heilkräuter, offers the following alternative using western herbs:
| Herba Fumariae | (Fumitory) | 5g | (Emperor) |
| Herba Urticae | (Nettle leaves) | 5g | (Minister) |
| Radix Gentianae | (Gentian root) | 3g | (Minister) |
| Herba Violae tricolores | (Wild Pansy) | 8g | (Minister) |
| Radix Taraxaci | (Dandelion root) | 7g | (Minister) |
| Herba Equiseti | (Horsetail) | 8g | (Assistant) |
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.