Shen Xiao Tai Yi Gao - 神效太醫膏 - Wonderously Effective "Tai Yi" [great medicine] Ointment

Author: Xue Ji, 薛己

Year: 1548

Source: Categorised Essentials of Repairing the Body (Zheng Ti Lei Yao, 正體類要)

Category: Formulas that are Applied Externally

Pattern: Toxic Heat from Blood stasis caused by abscesses or wounds

Key Symptoms: Abscesses, eruptions on the back and wounds from caning, especially if festering.

Ingredients

Xuan Shen

37.5g

Bai Zhi

37.5g

Dang Gui

37.5g

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.

Rou Gui

37.5g

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).

Chi Shao

37.5g

Da Huang

37.5g

Pinyin: Da Huang Chinese: 大黄 Pharmaceutical: Radix et Rhizoma Rhei Taxonomy: Rheum palmatum English: Chinese Rhubarb Root
Tastes: Bitter, cold Meridians Entered: Large Intestine, Spleen, Stomach, Liver and Heart
Actions & Indications: Drains Heat and purges accumulations Intestinal Heat Excess, with high fever, profuse sweating, thirst, constipation, abdominal distention and pain, delirium, a yellow tongue coat and a full pulse Yang-Ming Fu Stage Qi Level Heat in the Intestines Drains Fire Fire from Excess with intense fever, sore throat, and painful eyes and constipation Fire toxin sores due to Xue Level Heat, especially with constipation Clears Heat, transforms Dampness and promotes urination Damp-Heat with oedema, jaundice, painful urinary dysfunction and acute, hot dysenteric disorders Drains Heat from the Blood Bloody stool either from hemorrhoids or Heat in the Intestines Chaotic movement of hot Blood with hemoptysis or epistaxis with constipation It can be powdered and administered orally for bleeding in the upper digestive tract Invigorates the Blood and dispels Blood Stasis Blood Stasis with amenorrhea, fixed abdominal masses or fixed pain Blood Stasis due to traumatic injury Intestinal abscess Clears Heat and reduces Fire toxicity Topically or internally for burns or skin lesions (Chuang Yung) due to Heat Clears Heat and eliminates Phlegm Chronic Accumulation of Phlegm-Heat with cough, dyspnea, mania, disorientation and other symptoms of Phlegm Misting the Heart
Standard Dosage: 10-15g in decoction. Excessive decoction will reduce the purgative action. Therefore it should be added at end to achieve this purpose and over-decocted to eliminate this action. Cautions: It should be used with caution in case of spleen and stomach deficiency for its bitter and cold property which is easily to damage stomach qi. It is contraindicated to women during pregnancy, menstruation or lactation for it has actions of activating blood and resolving stasis, and can make the purged substances follow lactating out.

Sheng Di Huang

37.5g

Huang Dan

750g

Ma You

1kg

Subsitutions:
Huang Dan is no longer used because of toxicity, even in external use. The ointment should be thickened with approx 200g beeswax.

Preparation: Place the herbs and the sesame oil in a copper wok and boil until the herbs turn black. Filter to remove the dregs and slowly add the thickening agent. Drip some into water and rub between the fingers until the correct degree of hardness has been obtained.

Actions: Clears Heat and cools the Blood, invigorates the Blood

Notes:
A version of this formula is used in pre-prepared plaster form in the China Medical University Hospital in Taichong, Taiwan. It was called "Hung Hui (浤匯 - The Sound of Water Swirling) Detumescent Emplastra" and contained:

Bai Zhi 14mg
Chi Shao 14mg
Xuan Shen 14mg
Rou Gui 14mg
Da Huang 14mg
Wu Bei Zi 14mg
Sheng Di Huang 14mg
Huang Dan 289mg
Xue Yu Tan 7mg
Ru Xiang 4mg
Bo He 3mg
A Wei 2mg
Mo Yao 2mg
Ma You to make up to 1g

Indicated for rheumatic pain, pain and soreness of the bone and tendon and pain from injury.

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

神 效 太 醫 膏  Shen Xiao Tai Yi Gao

Wonderously Effective "Tai Yi" [great medicine] Ointment