Author: Zhang Zhong-Jing, 張仲景
Year: c. 220
Source: Discussion of Cold Damage (Shang Han Lun, 傷寒論)
Category: Formulas that Clear Heat
Pattern: Heat constraint with stagnation of Qi
Key Symptoms: Irritability and abdominal distention after purging with a sense of incomplete emptying of the bowel although stools may not necessarily be hard.
Secondary Symptoms: Nausea, fullness and belching.
Ingredients
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Zhi Zi
| 9-12g | |
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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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Hou Po
| 12g | |
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Pinyin: Hou Po
Chinese: 厚朴
Pharmaceutical: Cortex Magnoliae
Taxonomy: Magnolia officinalis
English: Magnolia Bark |
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Tastes: Bitter, pungent, warm
Meridians Entered: Spleen, Stomach, Lung and Large Intestine |
Actions & Indications:
- Promotes the movement of Qi in the Middle Jiao and resolves Stagnation
Abdominal, epigastric, and/or chest fullness, bloating, loss of appetite, poor digestion, constipation
Plum Pit Qi, a feeling of a lump in throat, usually considered psychosomatic today (globus hystericus). Hou Po has modern indications as neuroprotective and also features in formulas like Da/Xiao Cheng Qi Tang which deal with neuropsychiatric symptoms like delirium.
- Promotes the movement of Qi downward, dries Dampness and transforms Phlegm
Dampness or Phlegm Obstructing the Middle Jiao with distention, fullness, nausea and diarrhoea
- Descends Rebellious Qi, reduces Phlegm and calms wheezing
Cough and wheezing due to Phlegm congesting the Lungs
- Expels Wind, scatters Cold and regulates the Blood
The Shen Nong Ben Cao Jing places in the middle class of woods and says "It mainly treats Wind-stroke, Cold damage, headache, Cold and Heat, fright qi, blood Bi and dead muscles."
- Removes the Three Worms
The Shen Nong Ben Cao Jing also says that it "removes the Three Worms." These may refer to difficult to treat metabolic disorders caused by overindulgence and should be accompanied by fasting, meditation and exercise regimes.
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Standard Dosage: 3-10g in decoction.
Cautions: It should be used with cautions for the syndrome of qi deficiency and fluid consumption, and in pregnant women. Due to some of the anticoagulant effects of its constituents it should be used with caution in conjunction with blood thinners. |
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Zhi Shi
| 6-9g | | |
Pinyin: Zhi Shi
Chinese: 枳实
Pharmaceutical: Fructus Aurantii Immaturus
Taxonomy: Citrus aurantium
English: Immature Seville Orange / Immature Bitter Orange / Immature Sour Orange |
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Tastes: Pungent, bitter, slightly cold
Meridians Entered: Spleen, Stomach and Large Intestine |
Actions & Indications:
- Breaks up Stagnant Qi, reduces accumulation, descends Qi, unblocks the bowels and removes Stagnant Food
Qi Stagnation and accumulation with epigastric or abdominal pain and distention or indigestion with focal distention or gas
Food Stagnation
- Transforms Phlegm, reduces distention and resolves hardenings
Turbid Phlegm Obstructing the Qi with focal distention and fullness in the chest and epigastrium
- Expels Wind, alleviates itching, breaks up bindings, regenerates flesh and invigorates the Qi
Listed in the Shen Nong Ben Cao Jing as a medium class wood which "treats great Wind within the skin giving rise to tormenting itching as if [caused by] flax seeds, eliminates cold and heat and heat binding, stops dysentery, promotes the growth of the muscles and flesh, disinhibits the five viscera, boosts the qi, and makes the body light."
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Standard Dosage: 3-10g in decoction.
Cautions: It should be used with cautions for pregnant women. |
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Preparation: Decoction.
Actions: Clears Heat, alleviates irritability, reduces fullness and distention
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.