Author: Zhang Zhong-Jing, 張仲景
Year: c. 220
Source: Discussion of Cold Damage (Shang Han Lun, 傷寒論)
Category: Formulas that Warm Interior Cold
Pattern: Middle Jiao deficient and Cold due to consumptive illness, Chong Mai counterflow due to Cold Damage.
Key Symptoms: Spasmodic abdominal pain (often focused in either the epigastrium or around the umbilicus) that improves with heat or pressure, lustreless complexion, reduced appetite
Secondary Symptoms: Low grade fever, spontaneous sweating, night sweats, palpitations, irritability, aversion to cold, cold extremities with soreness and nonspecific discomfort, alternating diarrhoea and constipation, dry mouth and throat, increased urination, bedwetting in children
Tongue: Normal or pale, thin white coating
Pulse: Thin, wiry and moderate, or large and deficient
Abdomen: Distended but with weak muscle tone, visible peristaltic movements, hypertonicity of rectus abdominis, pencil line of tension above and below the umbilicus
Ingredients
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Yi Tang
| 30g | |
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Pinyin: Yi Tang
Chinese: 饴糖
Pharmaceutical: Maltosum
English: Maltose / Barley Malt Sugar |
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Tastes: Sweet, warm
Meridians Entered: Spleen, Stomach and Lung |
Actions & Indications:
- Strengthens the Spleen and tonifies Qi
Overexertion injuring the Spleen with shortness of breath and reduced appetite.
- Tonifies the Middle Jiao and alleviates pain and coldness
Middle Jiao Deficiency Cold with Excess salivation, a pale tongue with a white coat and a deep, slow pulse
- Moistens the Lungs and stops coughs
Lung Qi Deficiency with dry, nonproductive coughs with labored, slow breathing and a weak voice
- Coats foreign objects
Treats obstruction of the throat by fish bones or other objects
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Standard Dosage: 30-60g in decoction.
Cautions: It is contraindicated in case of damp-heat accumulation with vomiting. |
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Gui Zhi
| 9g | |
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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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Bai Shao
| 18g | |
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Pinyin: Bai Shao
Chinese: 白芍
Pharmaceutical: Radix Paeoniae Alba
Taxonomy: Paeonia lactiflora
English: White Peony Root |
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Tastes: Bitter, sour, sweet, slightly cold
Meridians Entered: Spleen and Liver |
Actions & Indications:
- Nourishes the Blood and regulates menstruation
Liver Blood Deficiency with menstrual dysfunction, vaginal discharge and uterine bleeding accompanied by a pale face, a lusterless complexion and dull, lusterless nails
Anemia
Breast distention and premenstrual syndrome
- Astringes Yin and adjusts the Ying and Wei
Yin Deficiency sweating Sweating due to Yin Collapse
Disharmony between the Liver and Spleen
Disharmony between the Ying and Wei with non-productive sweating
- Calms Liver Yang and Liver Wind and alleviates pain
Liver Qi Stagnation with Liver Yang Rising
Liver Wind with Yin and Blood Deficiency
Bi syndrome due to Blood Deficiency with pain and spasms
- Softens the Liver and relieves pain
Diarrhoea, borborygmus and abdominal pain
Dysenteric disorders with tenesmus
- Tonifies the Blood while suppressing Parasites
Gu Sydnrome (Fruehauf, 1998)
Chronic inflammatory disease (Fruehauf, 2015)
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Standard Dosage: 10-30g in decoction.
Cautions: Caution with anticoagulants as it may slow clotting time. May also slow the absorption of phenytoin. |
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Zhi Gan Cao
| 6g | |
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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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Sheng Jiang
| 9g | |
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Pinyin: Sheng Jiang
Chinese: 生姜
Pharmaceutical: Rhizoma Zingiberis Recens
Taxonomy: Zingiber officinale
English: Fresh Ginger |
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Tastes: Pungent, warm
Meridians Entered: Lung, Spleen and Stomach |
Actions & Indications:
- Releases the Exterior, induces perspiration and disperses Cold
Wind-Cold
- Warms the Middle and stops vomiting
Cold in the Stomach especially with vomiting
- Warms the Lungs and stops coughing
Cough due to Wind-Cold Cough due to Lung Deficiency with Phlegm
- Reduces the toxicity of other herbs and seafood
Herb toxicity or seafood poisoning
- Adjusts the Ying and Wei - normalizes the flow of Qi at the center
Taiyang Zhong Feng - Wind-Cold with Deficiency
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Standard Dosage: 3-10g in decoction.
Cautions: It should be used with caution for yin deficiency with internal heat and heat exuberance because it helps promote fire and injure yin. |
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Da Zao
| 4pcs | | |
Pinyin: Da Zao
Chinese: 大枣
Pharmaceutical: Fructus Jujubae
English: Jujube Berry / Black Date / Chinese Date |
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Tastes: Sweet, warm
Meridians Entered: Spleen, Stomach and Heart |
Actions & Indications:
- Tonifies the Spleen and Stomach and augments Qi
Spleen and Stomach Deficiency with weakness, shortness of breath, lassitude, anorexia and loose stools
- Nourishes the Blood and calms the Spirit
Blood Deficiency
Restless Organ Syndrome with wan complexion, irritability and severe emotional debility
- Moderates and harmonizes the harsh properties of other herbs
Added to formulas with to counter harsh, drying and draining herbs by fortifying the Spleen, nourishing Blood and settling the Spirit.
- 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: 10-30g in decoction.
Cautions: It is used with cautions in cases of damp-phlegm or food stagnation because it can help dampness produce heat, and induce distention in middle energizer. |
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Preparation: Decoction.
Actions: Warms and tonifies the middle Jiao, moderates spasmodic abdominal pain
Contraindications: Heat from Yin deficiency, abdominal distension from excess patterns
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). It should be preceded by Fang Feng Bai Zhu Mu Li Tang or Gan Cao Gan Jiang Tang.
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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).
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.