Author: Li Gao / Li Dong Yuan, 李杲 / 李東垣
Year: 1276
Source: Secrets from the Orchid Chamber (Lan Shi Mi Cang, 蘭室秘藏)
Category: Formulas that Expel Dampness
Pattern: Heat in the lower Jiao and obstructing the Qi transformation of the Bladder
Key Symptoms: Urinary obstruction, rough and painful urination, absence of thirst
Secondary Symptoms: Pain in the lower abdomen, headaches, wheezing, palpitations
Tongue: Yellow, greasy coating
Pulse: Slippery, rapid
Abdomen: Rebound tenderness in the lower abdomen
Ingredients
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Huang Bai
| 30g | | (wine fried)
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Pinyin: Huang Bai
Chinese: 黄柏
Pharmaceutical: Cortex Phellodendri
Taxonomy: Phellodendron amurense seu chinense
English: Amur Corktree Bark |
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Tastes: Bitter, cold
Meridians Entered: Liver, Gallbladder, Large Intestine, Kidney and Bladder |
Actions & Indications:
- Drains Damp-Heat especially from the Lower Jiao
Thick, yellow vaginal discharge, foul smelling diarrhoea or dysenteric disorder
Damp-Heat in the Lower Jiao
Hot Leg Qi with red, swollen, painful knees, legs or feet
Damp-Heat jaundice
- Drains Kidney Fire (False Heat, Deficiency Heat)
Kidney Yin Deficiency with Empty Fire Rising (steaming bone disorder, night sweats, afternoon fevers and sweating, occasionally with nocturnal emissions and spermatorrhea)
- Drains Fire and relieves Fire toxicity
Toxic sores and Damp-skin lesions (internally and topically)
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Standard Dosage: 6-10g in decoction.
Cautions: It is contraindicated for deficiency-cold syndrome. Overdosage and long-time taking will impair spleen and stomach. |
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Zhi Mu
| 30g | | (wine fried)
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Pinyin: Zhi Mu
Chinese: 知母
Pharmaceutical: Rhizoma Anemarrhenae
Taxonomy: Anemarrhena asphodeloides
English: Anemarrhena Rhizome |
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Tastes: Bitter, sweet, cold
Meridians Entered: Lung, Stomach and Kidney |
Actions & Indications:
- Clears Heat and drains Fire (Clears Heat from the Qi Stage, from the Lungs and from the Stomach)
Heat in the Qi Stage with high fever, irritability, restlessness, thirst and a rapid, flooding pulse.
Lung Heat and Dryness with cough and expectoration of thick, yellow Phlegm
Yang Ming Heat
Stomach Heat
- Nourishes Yin and moistens Dryness
Lung and Kidney Yin Deficiency with night sweats, steaming bone disorder, irritability, afternoon or low grade fever, Five Sole Heat and bleeding gums
(Stomach Yin Deficiency)
Kidney Heat with spermatorrhea, nocturnal emissions and an abnormally elevated sex drive
- Generates Fluids, clears Deficiency Fire and quenches thirst
Oral ulcers and inflammation, steaming bones and Xiao Ke (diabetes) due to Yin Deficiency
- Ameliorates the Dryness of tonifying or warming herbs
For use with herbs such as Rx. Astragali Huang Qi, Ram. Cinnamomi Gui Zhi, Rx. Aconiti Lateralis Preparata Zhi Fu Zi when there is concern that these herbs may be too drying
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Standard Dosage: 5-15g in decoction.
Cautions: It is not suitable for deficiency cold syndrome. Being cold and moist in property, it is prohibited to be used for those who have a spleen-deficiency diarrhea. |
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Rou Gui
| 1.5g | | |
Pinyin: Rou Gui
Chinese: 肉桂
Pharmaceutical: Cortex Cinnamomi
Taxonomy: Cinnamomum cassia
English: Cinnamon Bark |
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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).
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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). |
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Preparation: Decoction.
Actions: Clears Heat, enriches the Yin, opens urinary painful obstruction, promotes urination
Contraindications: Deficiency Cold patterns
Notes:
Absence of thirst is the key clinical marker that differentiates this pattern from others.
Can also be used to treat other signs of Heat in the lower extremities and in the upper body if they are due to Fire flaring up from the lower Jiao.
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.