Author: Sun Si Miao, 孫思邈
Year: 650
Source: Important Formulas Worth a Thousand Gold Pieces (Bei Ji Qian Jin Yao Fang, 備急千金要方)
Category: Formulas that Clear Heat
Pattern: Heat in the Blood Level
Key Symptoms: Fever, various types of bleeding (vomiting of blood, nosebleed, blood in the stool or urine and rashes), black tarry stools, abdominal distention and fullness, thirst with an inability to swallow
Secondary Symptoms: Delirium
Tongue: Scarlet with prickles
Pulse: Thin, rapid
Ingredients
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Xi Jiao
| 3g | | (30-120g of Shui Niu Jiao is normally used instead)
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Pinyin: Xi Jiao
Chinese: 犀角
Pharmaceutical: Cornu Rhinocerotis Asiatici
English: Rhinoceros Horn |
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Tastes: Sour, salty, cold
Meridians Entered: Liver and Heart |
Actions & Indications:
- Clears Heat from the Ying and Xue stages, relieves Fire toxicity, cools the Blood, clears skin blotches and stops bleeding
Ying or Xue Stage Heat or Blood Heat with a very high fever and chaotic movement of Blood (erythema, purpura, epistaxis, hematemesis, convulsions and delirium)
- Clears the Heart and calms the Shen
Shen disturbance
- Clears Heat and extinguishes Liver Wind (arrests tremors)
Warm-Heat pathogen diseases when the Heat enters the Ying or Xue levels with unremitting high fever, loss of consciousness, delirium, convulsions or manic behavior
- Aids fasting
Mentioned in the Shen Nong Ben Cao Jing as part of the middle class of animal parts which can, with protracted taking, make the
body light. 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: 2.5-10g in decoction, or as pills or powder.
Cautions: Due to its endangered status it is contraindicated from use. It is generally substituted with Shui Niu Jiao. Since animal 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, this is also prohibited. It is generally substituted with Huang Lian and Xuan Shen in 3:1 ratio.
Traditional contraindications include pregnancy. It is incompatible with Wu Tou and Lei Wan. |
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Sheng Di Huang
| 24g | |
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Pinyin: Sheng Di Huang
Chinese: 生地黃
Pharmaceutical: Radix Rehmanniae
Taxonomy: Rehmannia glutinosa
English: Chinese Foxglove Root / Rehmannia Root |
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Tastes: Sweet, bitter, cold
Meridians Entered: Heart, Liver, Stomach and Kidney |
Actions & Indications:
- Clears Heat and cools the Blood
Ying Stage Heat with high fever, thirst and a scarlet tongue
Xue Stage Heat
Hemorrhage due to Blood Heat
- Nourishes Yin, generates fluids, increases saliva and treats wasting and thirsting
Yin Deficiency with Heat signs
Injury to fluids
Throat pain due to Yin Deficiency
Wasting and thirsting disorder (消渴 Xiao Ke - diabetes)
- Cools Heart Fire
Heart Fire
- Calms the Spirit agitated by Parasites damaging the Yin
Gu Sydnrome (Fruehauf, 1998)
Chronic inflammatory disease (Fruehauf, 2015)
- Breaks up Blood Stasis, expels Cold and Hot Bi, replenishes Bone Marrow and promotes the growth of Muscles and Flesh
Broken bones or severed sinews from falls and a damaged center (Shen Nong Ben Cao Jing)
- 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 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: 10-15g in decoction.
Cautions: It is contraindicated in cases of diarrhea, abdomen distention due to spleen deficiency. |
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Shan Yao
| 9g | |
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Pinyin: Shan Yao
Chinese: 山药
Pharmaceutical: Rhizoma Dioscoreae
Taxonomy: Dioscorea polystachya syn. batatas
English: Chinese Yam / Shu Yu |
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Tastes: Sweet, neutral
Meridians Entered: Spleen, Lung and Kidney |
Actions & Indications:
- Tonifies the Spleen, nourishes Stomach Yin and stops diarrhoea
Spleen or Stomach Deficiency with diarrhoea, fatigue, spontaneous sweating and anorexia
- Tonifies Lung Qi and nourishes Lung Yin
Lung Qi and/or Yin Deficiency with chronic cough
- Tonifies Kidney Yin and astringes Jing
Kidney Qi Deficiency with spermatorrhea, urinary frequency and vaginal discharge
消渴 Xiao Ke due to Qi and Yin Deficiency
- Aids fasting
Mentioned in the Shen Nong Ben Cao Jing as part of the superior class of herbs which can, with protracted taking, sharpen the ears and eyes, make the body light, make one free from hunger 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). Despite being a starchy vegetable, this may still have been an appropriate addition to a ketogenic diet as the starches are mostly resistant and many of its other compounds have been shown to have blood glucose reducing effects, making it a potential important source of this essential nutrient group while engaging in a low carbohydrate diet.
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Standard Dosage: 5-30g in decoction. Very large doses, up to 500g have been used in trials for diabetes management.
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Mu Dan Pi
| 6g | | |
Pinyin: Mu Dan Pi
Chinese: 牡丹皮
Pharmaceutical: Cortex radicis Moutan
Taxonomy: Paeonia suffruticosa
English: Tree Peony Root Bark / Moutan Peony Root Bark |
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Tastes: Bitter, pungent, light cold
Meridians Entered: Heart, Liver and Kidney |
Actions & Indications:
- Clears Heat and cools (and harmonizes) the Blood
Xue Stage Heat with epistaxis, hemoptysis, hematemesis or subcutaneous bleeding
Menorrhagia due to Blood Heat
- Clears Deficiency Fire
Yin Deficiency Heat signs especially in the aftermath of Warm Febrile Disease with fever at night and coolness in the morning (most appropriate when the is no sweating)
- Invigorates the Blood and dispels Blood Stasis
Blood Stasis with amenorrhea, abdominal masses, lumps or bruises due to trauma
Liver Blood Stagnation
- Clears Liver Fire
Liver Fire with headache, eye pain, flank pain, flushing and dysmenorrhea
- Drains pus and reduces swelling
Non-draining sores (topical)
Intestinal abscesses (internal)
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Standard Dosage: 6-12g in decoction.
Cautions: It is contraindicated in cases of profuse menstruation and pregnant women. |
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Subsitutions:
Xi Jiao is prohibited by international law and its alternative, Shui Niu Jiao, must also be replaced in the UK too. The best substitution is probably Xuan Shen and Huang Lian in a 3:1 ratio.
Preparation: Decoction.
Actions: Clears Heat, resolves Fire Toxicity, cools the Blood, nourishes the Yin, dispels Blood stasis, stops bleeding
Contraindications: Bleeding due to Yang deficiency
Notes:
This formula is always going to generate controversy due to its use of rhino horn. These were considered magical creatures in ancient China, the equivalent of a unicorn, whose horns could detect and detoxify poison. It seems unlikely it was ever intended for widespread use. Given the symptoms indicated it seems like the Tang dynasty physicians were pharmacologically helpless against such a severe presentation and resorting to magical cures.
Whatever the origin of this formula it should no longer be used. Patients with the original presentation should be in emergency care. It remains in use as the other ingredients and the substitutions can be useful as a base in disorders of Blood level Heat with similar presentations such as frequent nosebleeds or bleeding skin conditions with red tongue and rapid pulse.
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.
