Author: Zhang Zhong-Jing, 張仲景
Year: c. 220
Source: Discussion of Cold Damage (Shang Han Lun, 傷寒論)
Category: Formulas that Regulate Blood
Pattern: Blood stagnation in the lower Jiao causing Blood accumulation and Heat, Yin Wei Mai Heat pain with Taiyin pattern.
Key Symptoms: Acute lower abdominal pain that is aggravated by pressure, constipation but smooth urination, facial flushing, mental agitation
Secondary Symptoms: Headache, dizziness, tinntitus, night-time fevers, irritability, restlessness, insomnia, thirst, delirious speech, dysmenorrhoea, amenorrhoea, dark or black stools
Tongue: Dry body, white coating, visible and enlarged sublingual veins
Pulse: Submerged and full, choppy
Abdomen: Generally strong, hardness and distention in the lower abdomen with resistance to pressure, hypertonicity of rectus abdominus
Ingredients
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Tao Ren
| 12g | |
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Pinyin: Tao Ren
Chinese: 桃仁
Pharmaceutical: Semen Persicae
Taxonomy: Prunus persica
English: Peach Seed |
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Tastes: Bitter, sweet, neutral, lightly toxic
Meridians Entered: Heart, Liver, Lung and Large Intestine |
Actions & Indications:
- Breaks up Blood Stasis and invigorates Blood circulation
Menstrual disorders, abdominal pain, traumatic injury, flank pain, Lung abscess and Intestinal abscess with fixed abdominal masses associated with Blood Stasis
- Moistens the Intestines and unblocks the bowels
Constipation due to dry Intestines
- Drains abscesses
Lung and Intestinal abscesses
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Standard Dosage: 5-10g in decoction.
Cautions: Prohibited for pregnant women. Use with cautions for loose stool. Not overuse because of its toxicity. |
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Da Huang
| 12g | |
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Pinyin: Da Huang
Chinese: 大黄
Pharmaceutical: Radix et Rhizoma Rhei
Taxonomy: Rheum palmatum
English: Chinese Rhubarb Root |
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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
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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. |
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Gui Zhi
| 6g | |
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Pinyin: Gui Zhi
Chinese: 桂枝
Pharmaceutical: Ramulus Cinnamomi
Taxonomy: Cinnamomum cassia
English: Cinnamon Twig |
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Tastes: Pungent, sweet, warm
Meridians Entered: Lung, Heart, Kidney, Liver |
Actions & Indications:
- Releases the Exterior, assists Yang, adjusts the Ying and Wei and releases the muscle layer
Taiyang Wind Strike (Taiyang Zhongfeng, 太阳中风) - a weak person who catches cold easily with spontaneous sweating, aversion to drafts, fever and chills, nasal congestion, stiff and aching head and muscles
- Warms the channels and collaterals to relieve pain
Wind-Cold-Damp Bi
- Unblocks Yang and transforms Qi and thin mucus
Edema due to Cold-Phlegm or Yang Qi Deficiency with urinary dysfunction, dizziness and palpitations
- Assists Heart Yang and warms and facilitates the flow of Yang Qi in the chest
Palpitations due to Yang Obstruction in the chest due to Stagnation or Deficiency
Listless chest Yang with upward movement of Phlegm and thin mucus and disorderly descent of Lung Qi with shortness of breath, chest and back pain and palpitations
Heart and Spleen Yang Deficiency
- Warms and facilitates the flow of Qi through the channels and collaterals and Blood through the vessels
Wind-Cold-Damp Bi
Blood Stasis due to Cold, causing amenorrhea or dysmenorrhea with or without abdominal masses
- Warms the Middle and directs Turbid Yin downward
Middle Jiao Yang Deficiency
Heart and Spleen Yang Deficiency (patient usually craves sweets)
- 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, prevent forgetfulness, and render the face bright and efflorescent, thus forever looking charming, like a child's face. 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: 3-10g in decoction for exterior conditions, or up to 15g for Bi Syndromes.
Cautions: This herb induces heat, damages the yin and moves blood. It is prohibited for those with warm pathogens, yin deficiency with effulgent fire, or reckless movement of the blood due to heat in the blood. Use with caution in pregnant women. |
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Mang Xiao
| 6g | |
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Pinyin: Mang Xiao
Chinese: 芒硝
Pharmaceutical: Natrii Sulfas
Taxonomy: Na2SO4·10H2O
English: Glauber's Salt / Mirabilite |
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Tastes: Salty, bitter, cold
Meridians Entered: Stomach and Large Intestine |
Actions & Indications:
- Purges accumulations, guides out Stagnation, softens hardness and moistens Dryness
Heat in the Stomach and Intestines with constipation and hard knots
- Clears Heat and drains Fire
Heat in the Stomach or Lungs especially accumulated Phlegm or clumping in the Intestines
- Clears Heat and reduces swelling
Red, swollen, painful eyes
Painful, ulcerated, swollen mouth or throat (topical)
Red, swollen skin lesions (topical)
Mastitis (topical) (promotes lactation)
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Standard Dosage: 10-15g dissolved into decoction at end.
Cautions: Use with caution for women during lactation for its milk regurgitation action. It is contraindicated to pregnant women.
Mineral products are prohibited from use in the UK under the Medicines Act 1968 ch. 67 which restricts herbalists to the use of plant products only. It is generally substituted with Yu Li Ren. If the osmotic laxative effects of salts are required then Epsom salts (magnesium sulfate) are more commonly available in the UK, although they still come under the same laws and would have to be included as lifestyle advice, to be sourced and dosed by the patient, not prescribed and given by the herbalist. |
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Zhi Gan Cao
| 6g | | |
Pinyin: Gan Cao
Chinese: 甘草
Pharmaceutical: Radix Glycyrrhizae
Taxonomy: Glycyrrhiza uralensis seu glabra seu inflata
English: Liquorice Root |
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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).
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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. |
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Subsitutions:
In the UK Mang Xiao must be replaced with Yu Li Ren.
Preparation: Decoction.
Actions: Drains Heat, breaks up Blood stasis
Contraindications: Pregnancy, deficiency patterns, chronic diarrhoea, exterior pathogens (should be released first)
Notes:
Extraordinary Vessel attributions come from Li Shi-Zhen's (1577-8) Exposition on the Eight Extraordinary Vessels (Qi Jing Ba Mai Kao), trans. Chace & Shima (2009). The text only states "Cheng Qi Tang" potentially meaning any of the decoctions that end in this name.
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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).
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Ploberger (2017), in Westliche und traditionell chinesische Heilkräuter, offers the following alternative using western herbs:
| Flos Arnicae | (Arnica flowers) | 6g | (Emperor) |
| Radix et Rhizoma Rhei | (Rhubarb root) | 8g | (Emperor) |
| Ramulus Cinnamomi | (Cinnamon bark) | 2g | (Minister) |
| Folium Rosmarini | (Rosemary) | 3g | (Minister) |
| Herba Equiseti | (Horsetail) | 6g | (Assistant) |
| Radix Glycyrrhizae | (Licorice) | 2g | (Assistant & Envoy) |
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.