Author: Zhang Zhong-Jing, 張仲景
Year: c. 220
Source: Essentials from the Golden Cabinet (Jin Gui Yao Lue, 金匱要略)
Category: Formulas that Clear Heat
Pattern: Jaundice from Heat accumulating in the Interior due to improper diet during convalescence or excessive consumption of alcohol.
Key Symptoms: Jaundice with distress and irritability, or relapse of fever and constipation after illness.
Secondary Symptoms: Sometimes accompanied by generalised pain.
Ingredients
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Zhi Zi
| 9-12g | |
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Pinyin: Zhi Zi
Chinese: 栀子
Pharmaceutical: Fructus Gardeniae
Taxonomy: Gardenia jasminoides
English: Gardenia Fruit |
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Tastes: Bitter and cold
Meridians Entered: Heart, Liver, Stomach and Lung |
Actions & Indications:
- Clears Heat, reduces Fire and eliminates irritability in the San Jiao
Excess Heat in the Heart, Stomach and Liver with high fever, irritability, restlessness, a stifling sensation in the chest, insomnia or delirious speech, eye problems, anger, jaundice
- Clears Heat and resolves Dampness (Drains Damp-Heat)
Damp-Heat in the Lower Jiao with painful urinary dysfunction (Lin Syndrome)
Damp-Heat in the Liver/Gallbladder with jaundice
Damp-Heat in the San Jiao
Damp-Heat in the Gallbladder and San Jiao channels of the face affecting the nose and eyes or causing sores in the mouth or facial region
- Cools the Blood and relieves toxicity (stops bleeding by astringing)
Heat in the Blood with epistaxis, hematemesis, hemafecia or hematuria (partially charred)
- Reduces swelling and invigorates the Blood
Blood Stagnation due to trauma (topical)
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Standard Dosage: 5-15g in decoction.
Cautions: Being strongly bitter in flavor and cold in nature, it is not good for deficiency-cold syndrome because it can easily impair spleen and stomach. It is contraindicated in case of loose stool due to spleen deficiency. |
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Dan Dou Chi
| 9-12g | |
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Pinyin: Dan Dou Chi
Chinese: 淡豆豉
Pharmaceutical: Semen Sojae Preparatum
Taxonomy: Glycine max
English: Fermented Soybean |
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Tastes: Pungent, bitter and cool
Meridians Entered: Lung and Stomach |
Actions & Indications:
- Releases the Exterior
Wind-Cold or Wind-Heat
Yin Deficiency with superimposed Exterior disorders
- Eliminates irritability, harmonizes the Middle Jiao and relieves stuffy sensations in the chest
Irritability, restlessness, insomnia, stifling sensations in the chest and insomnia following a febrile disease
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Standard Dosage: 10-15g in decoction.
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Zhi Shi
| 6-9g | |
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Pinyin: Zhi Shi
Chinese: 枳实
Pharmaceutical: Fructus Aurantii Immaturus
Taxonomy: Citrus aurantium
English: Immature Seville Orange / Immature Bitter Orange / Immature Sour Orange |
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Tastes: Pungent, bitter, slightly cold
Meridians Entered: Spleen, Stomach and Large Intestine |
Actions & Indications:
- Breaks up Stagnant Qi, reduces accumulation, descends Qi, unblocks the bowels and removes Stagnant Food
Qi Stagnation and accumulation with epigastric or abdominal pain and distention or indigestion with focal distention or gas
Food Stagnation
- Transforms Phlegm, reduces distention and resolves hardenings
Turbid Phlegm Obstructing the Qi with focal distention and fullness in the chest and epigastrium
- Expels Wind, alleviates itching, breaks up bindings, regenerates flesh and invigorates the Qi
Listed in the Shen Nong Ben Cao Jing as a medium class wood which "treats great Wind within the skin giving rise to tormenting itching as if [caused by] flax seeds, eliminates cold and heat and heat binding, stops dysentery, promotes the growth of the muscles and flesh, disinhibits the five viscera, boosts the qi, and makes the body light."
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Standard Dosage: 3-10g in decoction.
Cautions: It should be used with cautions for pregnant women. |
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Da Huang
| 3g | | |
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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Preparation: Decoction.
Actions: Clears Heat, alleviates irritability, unblocks the bowels and reduces accumulation.
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.