5 Clear heat in the Zang-fu (organ network) (9)
Liver
Long Dan Xie Gan Tang
Decoction of Chinese Gentiana Combination to Purge Liver Fire
龙胆泻肝汤
Indications:
Flaring up of fire in the liver and gallbladder, or damp-heat in the lower jiao.
Functions:
1.To clear excessive fire in the liver and gallbladder.
2. To clear damp-heat in the lower jiao.
1) Excessive fire in LV / GB → head, eyes and ears,
+ LV Qi stagnation, causing:
Bitter taste in the mouth, red, swelling pain in the eye, swollen ear, tinnitus, deafness, headache, hypochondriac pain, or
2) Damp-heat in LV / GB → lower jiao, causing:
Swelling or itching in the genital organs, yellow leucorrhea, turbid urine, painful urination
Longdancao: extremely bitter/cold, clear and push downward LV/GB fire in the middle jiao + clear and remove damp heat in the lower jiao
Huangqin, Zhizi: bitter/cold, clear fire and dry dampness
Zexie, Mutong, Cheqianzi: eliminate heat/dampness through urination
Danggui, Shengdihuang: prevent yin damage
Chaihu: (Hi, guys follow me to LV/GB!)
Gancao: harmonize
Composition:
Chinese gentiana (Longdancao) 6 g
Scutellaria (Huangqin) 9 g
Capejasmine fruit (Zhizi) 9 g
Alisma (Zexie) 12 g
Clematis stem (Mutong) 9 g
Plantain seed (Cheqianzi) 9 g
Chinese angelica (Danggui) 3 g
Fresh rehmannia (Shengdihuang) 9 g
Bupleurum (Chaihu) 6 g
Licorice (Gancao) 6 g
Applications: Acute conjunctivitis, acute media otitis, acute icteric hepatitis, acute cholecystitis, hypertension, acute urethritis, acute prostatitis, orchitis, acute pelvic inflammation and swollen genital organs.
Method Used: decoction
Liver-Stomach
Zuo Jin Wan
Pills of Coptis and Evodia Fruit
左金丸
Indications:
LV fire attacks ST
Functions:
1. To clear fire in the liver.
2. To descend the perversion of Qi and stop vomiting.
LV qi Stagnation → Hypochondriac distention and pain
LV qi →fire → ST qi↑→ Nausea, vomiting and acid regurgitation, belching
Heat → Dry mouth, red tongue with yellow coating, wiry and rapid pulse
Formula Analysis:
Huanglian: bitter/cold, clear HT (son) for suppressing LV
Wuzhuyu: pungent/warm, “adverse adjuvant”, restricts the coldness of Huanglian, also enters LV to bring down qi and harmonize ST
Composition: 6 : 1
Coptis (Huanglian) 180 g
Evodia fruit (Wuzhuyu) 15-30 g
Method Used: pills or decoction
Yu Nu Jian
The Fair Maiden Decoction of Rehmannia and Gypsum Combination
玉女煎
Indications:
Excessive fire in ST and Yin deficiency in KI (toothache, headache, diabetes)
Functions:
To clear heat in the stomach and replenish Yin
Formula Analysis:
shi gao: clear stomach heat
shud di huang: nourish kidney yin
zhi mu: bitter, cold, moistening — assists shi gao in clearling stomach heat
mai men dong: sweet and cold, moistening — assist shu di huang to nourish kidney yin
gan cao: detoxify and harmonizing all herbs
Niu xi: nourish kidney yin and bring down heat
Composition:
Gypsum (Shigao) 15-30 g
Prepared rehmannia (Shudihuang) 9-30 g
Anemarrhena (Zhimu) 4.5 g
Ophiopogon root (Maimendong) 6 g
Achyranthes (Niuxi) 4.5 g
Applications: Periodontitis, acute stomatitis, diabetes
Method Used: decoction
Lung
Ting Li Da Zao Xie Fei Tang
Ting Li Zi & Da Zao to drain the Lungs soup
葶苈大枣泻肺汤
Functions:
Drives out Phlegm-fluids from LU, brings down the LU qi and calms wheezing
Indications:
Retention of phlegm–fluid in the chest, manifested by:
Cough, wheezing, fullness and distension in chest, whole body edema, nasal congestion with clear discharge, loss of taste and smell
Formula Analysis:
Ting Li Zi – pungent, bitter, very cold, purges Phlegm–fluids from LU
Da Zao – sweet, warm, tonifies the Spleen, restricts the bitterness and coldness of Ting Li Zi
Composition:
Ting Li Zi (semen descurainiae seu lepidii)…9-12g
Da Zao (fructus Zizyphi jujubae)…12 pieces
Method Used: decoction
Review — Ting Li Zi
Meridians: Lung and urinary bladder
Functions:
- To reduce phlegm in the lungs and soothe asthma;
- To promote urination and reduce edema
Indications
- Retention of phlegm fluid in the lungs manifested as cough with profuse sputum, asthma, fullness and distension in the chest and hypochondriac region, asthma in which patient cannot lie flat and edema of the face.
- Edema or dysuria.
Question:
What is the distinguished difference between Tinglizi and other herbs for stopping cough / soothing asthma (ig, Xingren, Baibu, Zhiyuan, Kuandonghua, Suzi, Sangbaipi, Pipaye, Madouling, Baiguo)?
Note: Ting Li Da Zao Xie Fei Tang is a formula mainly for eliminating phlegm fluid rather than clearing LU heat.
Heart & Small Intestine
Dao Chi San
Powder of Fresh Rehmannia and Clematis Stem to Conduct the Fire Downward
导赤散
Functions:
- To clear heat in the heart and replenish Yin.
- To promote urination.
Indications: excessive heat in the heart channels, manifested by: irritability, thirst and prefer cold drink, flushed face, tongue and mouth ulcers; or painful and difficult urination with darkish red urine.
Analysis of formula:
Sheng di huang — cool blood and replenish Yin so as to reduce HT fire
Mutong – clear heat in HT, clear SI and promote urination
Gancao — reduce fire and stop urethra pain
Zhuye – clear heat in HT and relieve irritability,
promote urination and conduct heat downward
Composition:
Fresh rehmannia (Shengdihuang) 10 g
Clematis stem (Mutong) 10 g
Licorice (Gancao) 10 g
Bamboo leaf (Zhuye) 10 g
Method Used: decoction or powder
Applications: Acute urinary tract infection and ulceration of the oral cavity.
Modifications:
- Severe ulceration of the mouth and tongue. Add: Coptis (Huanglian).
- Severe urinary tract infection. Add: Small thistle (Xiaoji), Capejasmine fruit (Zhizi) and Plantain seed (Cheqianzi).
Questions: In this formula,
1) Which herb is best at relieving irritability due to HT heat?
2) Which herb is best at promoting urination?
Lung
Xie Bai San
Drain the White powder
泻白散
Functions: clears Lung Heat, stops cough and calms breath
Indications: cough due to heat stagnating in LU, manifested by: shortness of breath (tendency to have asthma), heat steaming sensation of skin (worsen in the afternoon), red tongue with yellow coating, thin and rapid pulse.
Analysis of formula:
Sang Bai Pi – sweet, cold, purges lung and clear stagnated heat, resolve phlegm
Di Gu Pi – sweet, bland, cold, purges remained LU fire and clear deficiency heat
Zhi Gan Cao + Geng Mi – benefits ST for aiding LU qi
Composition:
Chao Sang Bai Pi (dry fried cortex mori albae radicis)…30g
Di Gu Pi (cortex lucii radicis)…30g
Zhi Gan Cao (honey fried radix glycyrrhizae uralensis)…3g
Geng Mi (non-glutinous rice)…15-30g
Method Used: decoction or powder
Notes:
1) This formula is designed originally for children.
2) Heat steaming sensation of skin is caused by yin damage.
Questions:
1) Why don’t use Huangqin and Huanglian to clear lung heat?
2) Why is Digupi used?
Stomach
Qing Wei San
Powder to Clear Heat in the Stomach
清胃散
Functions:
- To clear heat in the stomach.
- To cool the blood.
Indications: Upward attack of ST heat along Yangming meridian, manifested by toothache, which prefers cold rather than heat, headache, flushed face; or swelling, bleeding and ulceration of the gums; offending smell in the mouth, thirst, red tongue with yellow coating, wiry and large rapid pulse.
Analysis of formula:
Huanglian — To clear heat
Shengdihuang + Mudanpi — To clear heat and cool the blood
Danggui — To nourish the blood, invigorate blood circulation and relieve swelling
Shengma – To guide others in Yangming meridian; to disperse fire; to help Huanglian clear fire in the upper
Composition:
Coptis (Huanglian) 3-5 g
Fresh rehmannia (Shengdihuang) 12 g
Moutan bark () 9 g
Chinese angelica (Danggui) 6 g
Cimicifuga (Shengma) 6 g
Method Used: decoction or powder
Applications: Stomatitis, periodontitis and trigeminal neuralgia
Modifications:
- Gum bleeding. Add: Achyranthes (Niuxi).
- Severe swollen gum. Add: Lonicera flower (Jinyinhua).
Questions:
1) Why is Shengma used?
2) Which herb is king?
3) What kind of toothache does this formula indicate?
Large Intestine
Shao Yao Tang
芍药汤
Functions: regulates & harmonizes Qi & blood, clears Heat, detoxify
Indications: Damp-heat dysentery, manifested by:
diarrhea, pain, and tenesmus (always wanting to go to defecate but not producing significant amounts of stool), difficulty with bowel movements, pus and blood in the stool, burning anus (ring of fire), T- greasy yellow coat, P- rapid (soft or slippery)
Analysis of formula:
Bai Shao Yao + Gan Cao — regulate Blood and Ying
+ Gan Cao — moderates spasm
Huang Lian + Huang Qin — clear heat and dry damp
+ Da Huang — purge Heat (bring heat downward)
Bing Lang + Mu Xiang — move Qi and relieve stagnation
Rou Gui – warm, adverse adjuvant
Composition:
Bai Shao Yao (radix paeoniae la ctiflorae)…15-20g
Dang Gui (radix angelicae sinensis)…6-9g
Gan Cao (radix glycyrrhizae uralensis)…4.5g
Huang Lian (rhizoma coptidis)…6-9g
Huang Qin (radix scutellariae)…9-12g
Da Huang (radix and rhizoma rhei)…6-9g
Mu Xiang (radix aucklandiae lappae)…4.5g
Bing Lang (semen arecae catechu)…4.5g
Rou Gui (cortex cinnamomi cassiae)…1.5-3g
Method Used: decoction
Question:
1) Which herb is used in heaviest dosage in this formula? Why?
2) What is the mostly common used method for treating diarrhea / dysentery?
3) Why is Da Huang used?
4) Why is Rou Gui used?
5) What is Gan Cao’s function?
Bai Tou Weng Tang **
白头翁汤
Functions: clear Heat & detoxify bowels, cool blood & stop dysentery
Indications: dysentery due to heat, manifested by:
Intestinal pain, tenesmus, burning anus, more blood than pus mixed with stool, thirst with preference to drink, T- red with yellow coat, P- wiry rapid.
Analysis of formula:
Blood/pus/stool mixture ← ST/LI qi/blood ← toxic heat
Bai Tou Weng *** – clear toxic heat in blood, cool blood
Huang Lian – bitter, cold, clear heat in ST/LI
Huang Bai – clear heat in the lower jao
Qin Pi – cold, bitter, astringent, clear toxic heat, astringe diarrhea
Composition:
Bai Tou Weng (radix pulsatillae chinensis)…6g
Huang Lian (rhizoma coptidis)…9g
Huang Bai (cortex phellodendri)…9g
Qin Pi (cortex fraxini)…9g
Method Used: decoction
Questions:
Why is Qinpi not used in Shao Yao Tang?
Why are Mu Xiang and Bing Lang used in Shao Yao Tang?