Su He Tang - 苏荷湯 - Perilla and Menthol Decoction

Author: Lu Shunde, 路順德

Year: Qing Dynasty

Source: New Methods for the Treatment of Gu Syndrome (Zhi Gu Xin Fang, 治蠱新方)

Category: Formulas that Expel Parasites

Pattern: All types of Gu Syndrome with Internal sweltering of Excess Fire

Key Symptoms: Bloating, swelling, madness, depression and epilepsy
Secondary Symptoms: Flu-like symptoms, coughing or other signs of Qi counterflow, dark urine, patient usually gets worse after ingesting tonics.

Abdomen: Tight abdominal wall

Ingredients

Bo He

30g

Zi Su Ye

30g

Bai Zhi

30g

Chai Hu

18g

Pinyin: Chai Hu Chinese: 柴胡 Pharmaceutical: Radix Bupleuri Taxonomy: Bupleurum chinense (Nan Chai Hu) seu scorzoneraefolium (Bei Chai Hu) English: Hare's Ear Root / Thorowax Root
Tastes: Bitter, pungent, slightly cold Meridians Entered: Liver and Spleen
Actions & Indications: *Resolves Shaoyang* disorders and reduces fever (harmonizes the Exterior and Interior)** Shaoyang Stage with alternating chills and fever, a bitter taste,dizziness, tinnitus, flank pain, irritability, vomiting and a stifling sensation in the chest Deficiency Heat (auxiliary) Gallbladder Fire The Shen Nong Ben Cao Jing says "It weeds out the stale to bring forth the new." Spreads Liver Qi and relieves Stagnation Liver Qi Stagnation with dizziness, vertigo, chest and flank pain, emotional instability and menstrual problems Disharmony between the Liver and Spleen with epigastric and flank pain, a stifling sensation in the chest, abdominal bloating, nausea and indigestion Liver/Gallbladder Disharmony The Shen Nong Ben Cao Jing says "It mainly treats bound qi in the heart, abdomen, intestines, and stomach, food stagnation, cold and heat, and evil qi." Raises Yang Qi (specifically the Clear Qi of the Stomach and Gallbladder) Spleen and Stomach Yang Deficiency, Qi collapse (prolapse) with hemorrhoids, vaginal discharge, bleeding or exhaustion Disperses Wind-Heat and resolves Phlegm and congestion Wind-Heat *Guides herbs to the Shaoyang* aspects of the head** Shaoyang headaches Releases the Exterior and Drives Out Snakes Relieves the symptoms of Gu Sydnrome while suppressing parasites (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, brighten the eyes and boost the Essence. 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: Up to 3g to raise sinking Qi, 6-9g to relieve Liver Qi stagnation, 12-24g to release the exterior. Cautions: Anyone who has syndromes of yin deficiency with yang hyperactivity, stirring of liver wind, yin deficiency with effulgent fire and qi going upward adversely, this herb should be used with cautions.

30g

24g

15g

30g

21g

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.

Bei Sha Shen

24g

He Shou Wu

30g

(unprocessed)

Sheng Di Huang

24g

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

15g

Chuan Xiong

15g

Preparation: Decoct in water. If San Qi (Radix Notoginseng) 6g is added, the results will be enhanced. It is important to gradually work up to the full daily amount over a period of 5-6 doses, since otherwise the internal toxin might flare up and cause restlessness, distress, vomiting or diarrhoea. Treatment should be sustained over a period of 3-9 months, during which it should be modified at regular intervals, although it may be interrupted by brief intermissions.

Actions: Kills parasites, clears Heat and detoxifies poisons, expels Wind and Dampness, tonifies the Lungs and Spleen, nourishes Blood and Yin, dredges the Liver, Regulates the Qi, settles the Spirit.

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

苏 荷 湯  Su He Tang

Perilla and Menthol Decoction