Author: Zhang Zhong-Jing, 張仲景
Year: c. 220
Source: Discussion of Cold Damage (Shang Han Lun, 傷寒論)
Category: Formulas that Clear Heat
Pattern: Xu Fan, Deficiency Vexation or Formless Heat lingering at the Qi level with Qi deficiency
Key Symptoms: Shortness of breath, fever, irritability, insomnia with tossing and turning in bed, a stifling sensation in the chest, hunger with no desire to eat
Tongue: Slightly yellow coat
Pulse: Slightly rapid pulse
Abdomen: Soft epigastrium
Ingredients
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Zhi Zi
| 9g | |
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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
| 6-9g | |
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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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Gan Cao
| 6g | | |
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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Preparation: Decoction.
Actions: Clears Heat and alleviates restlessness and irritability, tonifies Qi
Contraindications: Use with caution in patients with long lasting Spleen deficiency and loose stools
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.