San Bi Tang

Source: Fine Formulas for Women (1237)

Category: Formulas that Expel Dampness

Pattern: Liver and Kidney Deficiency with Qi and Blood Stagnation and Wind-Damp Bi

Key Symptoms: Tremors of the hands and feet, weakness and pain in the Sinews and bones

Ingredients

Xu Duan

30g

Du Zhong

30g

Fang Feng

30g

Rou Gui

30g

Pinyin: Rou Gui Chinese: 肉桂 Pharmaceutical: Cortex Cinnamomi Taxonomy: Cinnamomum cassia English: Cinnamon Bark
Tastes: Pungent, sweet, hot Meridians Entered: Kidney, Spleen, Heart and Liver
Actions & Indications: Warms the Kidneys, Spleen and Heart and strengthens Yang and Ming Men Fire Kidney Yang Deficiency and Deficiency of Ming-Men Fire with aversion to Cold, cold limbs, weak back, impotence and urinary frequency Spleen and Kidney Yang Deficiency with abdominal pain and Cold, reduced appetite and diarrhoea Kidney Unable to Grasp Qi Heart Yang Deficiency, particularly with chest Bi Disperses deep Cold, warms the channels, unblocks the channels and vessels and alleviates pain Deep Cold causing Qi Stagnation or Blood Stasis with Cold in the Blood causing amenorrhea or dysmenorrhea, Cold-Damp Bi, Yin-type boils (chronic sores that are usually concave and ooze a clear fluid) and sores or abscesses that do not heal It enters the Blood aspect and, in small amounts, enhances the Blood moving action of other substances Leads the Fire back to its source Upward Floating of Deficient Yang (False Heat, True Cold or Heat Above and Cold Below) with flushed face, wheezing, severe sweating (the sweat pours out like oil), weak and cold lower extremities and a deficient and rootless pulse Any condition with Heat in the Upper body (dry mouth, sore throat, or teeth which is worse at night) and Cold in the Lower body (Lower back pain, cold lower extremities, diarrhoea and weakness in the proximal portion of the pulse) Assists in the generation of Qi and Blood Chronic Qi and Blood Deficiency (auxiliary) Aids fasting Mentioned in the Shen Nong Ben Cao Jing as part of the superior class of herbs which can, with protracted taking, enable one to communicate with spirits, make the body light, and prevent forgetfulness. 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).
Standard Dosage: 1-5g in decoction. It should be decocted later. Cautions: It is contraindicated for syndrome of yin deficiency with fire effulgent, haemorrhage due to blood heat and pregnant women. It is incompatible with Chi Shi Zhi (nineteen incompatibilities).

Xi Xin

30g

Pinyin: Xi Xin Chinese: 细辛 Pharmaceutical: Herba cum Radix Asari Taxonomy: Asarum sieboldii English: Chinese Wild Ginger
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).
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.

Ren Shen

30g

Fu Ling

30g

Dang Gui

30g

Pinyin: Dang Gui Chinese: 當歸 Pharmaceutical: Radix Angelicae sinensis Taxonomy: Angelica sinensis English: Chinese Angelica Root / Tang-Kuei / Dong Quai Root
Tastes: Sweet, Pungent, Warm Meridians Entered: Heart and Liver
Actions & Indications: Tonifies the Blood and regulates the menses Blood Deficiency, especially when affecting the Heart and Liver with pale, ashen complexion, lusterless nails, tinnitus, blurred vision and palpitations Blood Deficiency associated irregular menstruation, amenorrhea and dysmenorrhea Invigorates and harmonizes the Blood and disperses Cold (stops pain due to Blood Stasis) Blood Stasis causing abdominal pain and carbuncles and pain due to Blood Stasis from traumatic injury, especially when accompanied by Deficiency Cold Postpartum menstruation Pregnancy (use with caution) Blood Deficiency with chronic Wind-Damp-Bi Moistens the Intestines and unblocks the bowels Dry Intestines due to Blood Deficiency Reduces swelling, expels pus, generates flesh and alleviates pain Sores and abscess (Chuang Yung), internally and topically Stops coughing and treats dyspnea Used adjunctively for coughing Tonifies the Blood while suppressing Parasites Gu Sydnrome (Fruehauf, 1998) Chronic inflammatory disease (Fruehauf, 2015)
Standard Dosage: 6-12g in decoction. Cautions: It is contraindicated in cases of Damp-Heat stagnating in the Middle, Lung Heat with Phlegm Fire, and Yin deficiency with effulgent Yang because it is warm and sweet in properties. In addition, it should be used with caution in cases of loose stool because it can moisten intestines to smooth stool. Many sources recommend using caution, avoiding or only taking under guidance of a TCM physician during pregnancy as it can cause uterine contractions. However, there are no studies supporting this and the only scientific literature seems to suggest that Z-Ligustilide has anti-spasmodic activities that alleviate dysmenorrhoea by inhibiting uterine contractions (Du et al., 2006; Dietz et al., 2016). Caution is also advised in breast cancer patients due to its oestrogen stimulating activity. This based upon Lau et al (2005) who found it may stimulate breast cancer growth in vitro, however Yue et al, (2019) demonstrated that it is not that stimulatory in breast cancer both in vitro and in vivo through a series of tests, although they suggested it should still be used with caution in estrogen receptor-positive breast cancer. Conversely, a large population study in Taiwan by Wu et al (2014) found it reduced the subsequent risk of endometrial cancer in breast cancer survivors taking tamoxifen, especially in those of reproductive age.

Bai Shao

30g

Gan Cao

30g

Pinyin: Gan Cao Chinese: 甘草 Pharmaceutical: Radix Glycyrrhizae Taxonomy: Glycyrrhiza uralensis seu glabra seu inflata English: Liquorice Root
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).
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.

Qin Jiao

15g

Chuan Xiong

15g

Du Huo

15g

Huang Qi

30g

Pinyin: Huang Qi Chinese: 黄芪 Pharmaceutical: Radix Astragali Taxonomy: Astragalus membranaceus English: Astragalus Root / Mongolian Milkvetch Root
Tastes: Sweet, warm Meridians Entered: Lung and Spleen
Actions & Indications: Tonifies Qi and Blood Postpartum fever due to Qi and Blood Deficiency Recovery from severe Blood loss Strengthens the Spleen and raises the Yang Qi of the Spleen and Stomach Spleen Qi Deficiency with anorexia, fatigue and diarrhoea Central Qi Sinking (prolapse) Lung and Spleen Qi Deficiency Qi Failing to contain Blood Qi and Blood Deficiency Fever from Qi Deficiency Tonifies Wei Qi, stabilizes the Exterior and tonifies the Lungs (aids circulation of moisture downward from the face) Wei Qi Deficiency with spontaneous sweating Lung Qi Deficiency with frequent colds or shortness of breath Excessive sweating associated with Qi, Yang or Yin Deficiency Dampness in the head Promotes urination and reduces oedema Spleen Deficiency oedema or superficial oedema with reduced urination (It can be used as a stand-alone herb for this) Promotes the discharge of pus, generates flesh and expels toxins Chronic ulcerations and sores that either have trouble forming pus or have formed pus but are not draining well Generates Body Fluids Wasting and thirsting disorder (消渴 Xiao Ke) Bi Syndrome with numbness of the limbs and paralysis Relieves numbness and pain Numbness and pain due to Deficiency of Qi and Blood Tonifies the Qi while suppressing Parasites Gu Sydnrome (Fruehauf, 1998) Chronic inflammatory disease (Fruehauf, 2015)
Standard Dosage: 10-15g in decoction. Large dosages of up to 30g can be used for severe debilitation, Blood deficiency or unhealing sores (e.g. Dang Gui Bu Xue Tang). Cautions: It is contraindicated in cases of exterior excess with excessive pathogen, internal obstruction, yin deficiency with yang hyperactivity, early stage of sores and ulcers of excessive pathogen and no deficiency of heathy qi, because it can tonify qi, raise yang and strengthen superficial.Caution with patients on immunosuppressents due to its immune modulating effects.

Chuan Niu Xi

30g

Subsitutions:
In the UK Xi Xin must be substituted. The usual substitution would be Qiang Huo and Gui Zhi.

Preparation: Ground into a coarse powder and prepared as a 15g draft by boiling in two cups of water with 3 slices of Sheng Jiang and 1 piece of Da Zao. Taken on an empty stomach. More often today it is taken as a decoction with one-third to one-half of the dosages.

Actions: Tonifies Liver and Kidneys, augments the Qi, nourishes the Blood, expels Wind, overcomes Dampness

Research Links:

American Dragon

TCMWiki

Journal of Chinese Medicine

National Resource Centre for Chinese Materia Medica, China

TCM-ID Integrated Database, East China Normal University

TCM-ID Information Database, National University of Singapore

Pubmed

Science Direct

Google Scholar

Bai Du (Chinese)

A+ Medical Encyclopedia (Chinese)

Reference Notes: (click to display)

These pages are intended to assist clinicians and are not intended for self-diagnosis or treatment for which a qualified professional should be consulted.

Herb Formulas Notebook

Three Painful Obstruction Decoction