half interior/half exterior
disharmony between LV and SP
cold/heat in the upper/lower
GB – LV – SP/ST
Shaoyang
LV—SP
ST—Intestine
1 Harmonizing Shao yang
和解少阳(2)
pathogenic factors → half interior/half exterior
Chaihu/Qinghao + Hunagqin + herbs replenishing qi or invigorating qi
Xiao Chai Hu Tang
小柴胡汤
harmonizes & releases Shaoyang stage disorders (Liver Gallbladder)
Chai Hu…12g (light, ascending, disperse pathogens out from exterior)
(King)
+
Huang Qin…9g (bitter, cold, clear heat in Shaoyang)
Ban Xia…12g
Ren Shen…9g
Zhi Gan Cao…6g
Sheng Jiang…9g
Da Zao…4 pieces
Indications:
Shaoyang syndrome — alternating fever and chills, chest and hypochondriac fullness, poor appetite, irritability, vomiting, bitter taste in the mouth, dry throat, dizziness, P- wiry.
Note:
A special point of this formula is to strengthen qi and expel the pathogen at the same time, in order to prevent the pathogen from entering the deeper region (Yangming/ST).
Question: Why does Chaihu combine with Huangqin?
Hao Qin Qing Dan Tang
蒿芩清胆汤
Clear GB damp/heat, regulate ST & dissolve phlegm
Qing Hao…4.5-6g (bitter, pungent, cold)
Huang Qin…4.5-6g
Zhu Ru…9g
Ban Xia…4.5g
Chen (ju) Pi…4.5g
Zhi Qiao…4.5g ? — zhi shi
(Chi) Fu Ling…9g (promote urination and clear damp heat)
Bi Yu San…9g [Niuyi San (= hua shi, gan cao) + Qing dai]
Indications:
Mild chills alternating with pronounced fever, bitter taste in the mouth, fullness in the chest and hypochondria, vomiting sour/bitter gastric juice or sticky phlegm, or retching, T- red with a white coating, P- wiry slippery
Note:
Wen Dan Tang + Qing Hao, Huang Qin + Bi Yu San →Hao Qin Qing Dan Tang
2 Harmonizing Liver and Spleen (3)
LV qi stagnation → SP/ST
SP def → LV
Soothe LV qi/nourish blood: Chaihu, Zhiqiao, Chenpi, Danggui, Baishao, Xiangfu
Replenish SP: Baizhu, Gancao, Fuling
Si Ni San
四逆散
Clear pathogenic factors, release Liver Qi, regulate Spleen
Zhi Gan Cao…6-9g
Chai Hu…9-12g ↑
Zhi Shi…9-12g ↓
Bai Shao…12-24g: + chai hu
Indications: Shaoyin syndrome with cold fingers and toes, or palpitation, or difficulty in urination, or diarrhea ??????
Questions:
1) What causes cold fingers and toes?
— SP qi deficiency + pathogen entering Shaoyin and obstructing yang qi → so yang qi can not go to four extremities.
2) Which herb is the king?
3) What is the advantage from the combination of Zhishi and Chaihu?
— the clear yang↑, the turbid yin↓,
4) What is the advantage from the combination of Baishao and Chaihu?
— harmonize LV (nourishing LV blood + dispersing LV)
Note:
This formula is also used for Liver Qi stagnation overacting on the Stomach.
(Why?)
Xiao Yao san
逍遥散
Soothe LV Qi, relieve depression, strengthen Spleen, and nourish blood
Chai Hu …30g [soothe Liver Qi]
Bai Shao…30g [nourish Blood]
Dang Gui…30g [nourish Blood, aromatically affects the Qi of the Blood]
Bai Zhu…30g [strengthen Spleen]
Fu Ling…30g [strengthen Spleen]
Zhi Gan Cao…15g [harmonizes mid Jiao]
Shengjiang…appropriate
Bohe …appropriate
The ginger helps stop the Stomach Qi from rebelling, and the Bo He helps Chai Hu to soothe the Liver Qi.
Indications:
Syndrome of LV Qi stagnation with Blood deficiency and SP qi deficiency — hypochondriac pain, alternate chills and fever, headache, vertigo, dry mouth and throat, fatigue, poor appetite, irregular menstruation, breast distension, P- wiry/weak.
Questions:
1) What use Bohe?
2) Why is Danggui used? Fragrant –promote qi; sweet—soothe “urgency”
3) Why Baizhu + Fuling?
4) Why Danggui + Shaoyao
associate formula of xiao yao san
** jia wei xiao yao san (other name: dan zhi xiao yao san)
dan pi, zhi zi + xiao yao san ——– heat + LV stg, SP/LV def (qi/blood)
Tong Xie Yao Fang
痛泻要方
Tonifies Spleen, soothes Liver Qi
(Chao) Bai Zhu…90g — dry dampness and tonify SP
(Chao) Bai Shao…60g — nourish blood, soothe LV (sour)
(Chao) Chen Pi…45g — regulate qi and invigorate SL
Fang Feng…30-60g — disperse LV, activate SP
Indications: SP deficiency, LV overacting on SP — recurrent abdominal pain, borborygmus, diarrhea, T- thin white coating, P- wiry/retarded.
Note:
1) SP↓, LV attacks SP →disharmony of ascending (the clear) and descending (the turbid)
2) Pain – LV; diarrhea — SP
3) for diarrhea and abd pain (not relieved after bowels)
3 Harmonizing Stomach and Spleen (1)
pathogens attacking ST/intestine → mixed heat and cold → disharmonized descending and ascending
Ganjiang, Huangqin, Huanglian, Banxia → pathogens
Renshen, Gancao → def SP/ST
Ban Xia Xie Xin Tang
半夏泻心汤
Harmonizes ST, redirect rebel Qi, disperse clumping, eliminates distension
Huang Qin…9g
Huang Lian…3g
Ban Xia…9g
Gan Jiang…9g
Ren Shen…9g
Zhi Gan Cao…9g
Da Zao…12 pieces
Indications: Disharmony of ST qi – epigastric fullness, vomiting or retching, borborygmus, diarrhea, T- thin yellow greasy coat, P- wiry rapid.
Note:
1) cold + heat → ST; disharmony of ascending and descending
2) bitter/cold – descending → heat
pungent/warm – dispersing → cold accumulation
sweet/warm → deficiency
tai yang: ma huang t
shao yang: xiao chai hu t
ban xia xie xin tang
yang ming: da cheng qi tang? —- SP qi def cold