Author: Zhang Zhong-Jing, 張仲景
Year: c. 220
Source: Discussion of Cold Damage (Shang Han Lun, 傷寒論)
Category: Formulas that Expel Dampness
Pattern: Kidney, or Spleen and Kidney Yang deficiency with retention of pathogenic water, or Taiyang Cold Damage moving into Shaoyin
Key Symptoms: Sensations of internal cold or cold extremities, exhaustion, deep aching and heaviness in the extremities
Secondary Symptoms: Dizzness, palpitations, coughing and vomiting, abdominal pain aggravated by cold, oedema, loose stools, urinary difficulty, generalised twitching
Tongue: Pale or dark, swollen and tooth-marked body with white, slippery coating
Pulse: Submerged, thin, forceless
Abdomen: Splashing sounds in the abdomen, pulsations in the upper abdomen or around the umbilicus, pencil-line tension above or below the umbilicus
Ingredients
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Zhi Fu Zi
| 9g | |
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Pinyin: Fu Zi
Chinese: 附子
Pharmaceutical: Radix Aconiti Lateralis Praeparata
Taxonomy: Aconitum carmichaeli
English: Wolf's-bane Root / Monkshood Root / Aconite Root |
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Tastes: Pungent, sweet, hot, toxic
Meridians Entered: Heart, Kidney and Spleen |
Actions & Indications:
- Restores Devastated Yang and rescues from rebellion
Devastated Yang with diarrhoea containing undigested food, chills, cold extremities and a faint almost imperceptible pulse (often as a result of severe vomiting, diarrhoea or sweating)
- Warms Ming Men Fire and assists Heart, Kidney and Spleen Yang
Heart Yang Deficiency
Spleen Yang Deficiency
Kidney Yang Deficiency
- Disperses Cold and Dampness, warms the channels and stops pain
Wind-Damp-Cold Bi
Cold blocking the organs, channels, bones and Blood vessels
Yin flat abscesses
Gu Parasites /
chronic inflammatory disease (Fruehauf, 2015)
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Standard Dosage: 3-15g in decoction. Fire Spirit practitioners prescribe doses of 60-200g per day (Fruehauf, 2009).
Cautions: It is contraindicated for heat syndrome, yin-deficiency leading to hyperactivity of yang and the pregnant because of its pungent, hot, dry and drastic properties. It must be soaked and decocted for about half and hour to one hour until numbing taste disappears for oral use. Over-dosage and incorrect processing must be avoided.
This herb is prohibited from use in the UK under the banned and restricted herbal ingredients list issued by the MHRA. It is generally substituted with various Yang tonics depending on the presentation although none can imitate its powerful cardiovascular effects making them ineffective substitutes for rescuing devastated Yang. External use is permitted at 1.3% or below. |
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Bai Zhu
| 6g | |
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Pinyin: Bai Zhu
Chinese: 白朮
Pharmaceutical: Rhizoma Atractylodes macrocephalae
Taxonomy: Atractylodes macrocephala
English: Largehead Atracylodes Rhizome |
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Tastes: Sweet, bitter, warm
Meridians Entered: Spleen and Stomach |
Actions & Indications:
- Tonifies the Spleen and augments Qi
Spleen and Stomach Deficiency with diarrhoea, fatigue, a sallow complexion and lack of appetite
Spleen Yang failure to rise
- Dries Dampness and promotes water metabolism
Spleen Damp or accumulation of fluids affecting the digestion
Edema and reduced urination due to Spleen Deficiency (failure to transform and transport)
Tan Yin, masses, swelling
Auxiliary for Damp painful obstruction
- Stabilizes the Exterior and stops sweating
Qi Deficiency with spontaneous sweating (Wei Qi Deficiency)
With appropriate herbs, other types of sweating
- Calms the fetus
Restless fetus disorder due to Spleen Qi Deficiency
With appropriate herbs, other types of Restless Fetus Disorder
- 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, prolong life and make one free from hunger. 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: 6-12g in decoction.
Cautions: Use with cautions in cases of yin deficiency with fluid injury by dryness-heat pathogen. |
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Fu Ling
| 9g | |
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Pinyin: Fu Ling
Chinese: 茯苓
Pharmaceutical: Poria
Taxonomy: Poria cocos syn. Wolfiporia extensa
English: China-Root / Hoelen / Tuckahoe / Indian Bread |
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Tastes: Sweet, bland, neutral
Meridians Entered: Heart, Spleen, and Kidney |
Actions & Indications:
- Strengthens the Spleen and harmonizes the Middle Jiao
Spleen Deficiency Dampness with anorexia, diarrhoea and epigastric distention
- Strengthens the Spleen
Phlegm Dampness due to Spleen Deficiency with thin mucus in which Phlegm moves upward manifesting as palpitations, headache, dizziness and a thick, greasy tongue coat
- Promotes urination and leaches out Dampness
Urinary difficulty, diarrhoea or oedema due to Stagnation of Fluids or Dampness
- Quiets the Heart, calms the Spirit and soothes the nerves
Palpitations, insomnia or forgetfulness due to either Spleen and Heart Insufficiency or Internal Obstruction of Turbid Phlegm
- Aids fasting
Mentioned in the Shen Nong Ben Cao Jing as part of the superior class of herbs which can, with protracted taking, quiet the Hun, nourish the Shen, 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).
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Standard Dosage: 9-15g in decoction.
Cautions: It is contraindicated for spermatorrhea due to deficiency-cold. |
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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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Bai Shao
| 9g | | |
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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Subsitutions:
Fu Zi cannot be used in the UK but no substitute can effectively replace it in this context.
Preparation: Decoction.
Actions: Warms the Yang, promotes urination
Notes:
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.