1. Clear heat in qi level
Bai Hu Tang
White Tigar Decoction 白虎汤
Composition:
Shi gao 30 g, Zhi mu 9 g, Jing mi 9 g, Gan cao 3 g
Functions:
To clear heat and promote the production of body fluids
Indications:
Excessive heat in the Yangming channels (or excessive heat in the Qi systems)
High fever(1 big), aversion to heat, flushed face; profuse sweating (2 big); irritability, excessive thirst (3 big), preference drinking; forceful or slippery and rapid pulse (4 big)
Shigao: strongly clear excessive heat
Zhimu: clear heat; nourish body fluid
Jinggmi: nourish fluid; protect stomach
Gancao: hormanize
Questions:
What are the “Four Bigs” ? — (fever, sweat, pulse, thirst)
What are the properties of shi gao? (pungent-dispersing?, extremely cold, sweet)
Zhu Ye Shi Gao Tang
Decoction of Bamboo Leaf and Gypsum Combination 竹叶石膏汤
Composition:
Bamboo leaf (Zhuye) 15 g
Gypsum (Shigao) 30 g
Ginseng (Renshen) 15 g
Ophiopogon root (Maimendong) 9 g
Pinellia tuber (Banxia) 9 g
Licorice (Gancao) 5 g
Oryza (Jingmi) 15 g
Indications:
Deficiency of Qi and body fluids due to febrile diseases in which the remaining heat is not eliminated
Manifestations:
Low grade fever
Profuse sweating
Irritability
Dry mouth
Red tongue with little coating
Nausea
Functions:
- To clear heat and promote the production of body fluids.
- To tonify Qi and harmonize the stomach.
Zhuye 15 g: clear heat
Shigao 30 g: clear heat
Renshen 15 g: tonify qi
Maimendong 9 g: nourish body fluid
Banxia 9 g: stop nausea/vomiting
Gancao) 5 g
Jingmi 15 g
Exercise:
True or false?
1) Bai Hu Tang —- excessive heat in the interior?
2) Zhu Ye Shi Gao Tang —- def of both qi and body fluid?
3) Zhu Ye Shi Gao Tang —- excessive heat in the later stage of febrile disease?
4) Zhu Ye Shi Gao Tang —- four “big”s
5) Bai Hu Tang – Ren Shen + Mai Men Dong → nourish qi and yin?
2 Clear heat in the ying & blood portion/level
Qing Ying Tang
Decoction to Dispel Pathogenic Heat from Yin System
清营汤
Indications:
Pathogenic heat entering the Ying (nutrient) system.
Functions:
- To dispel pathogenic heat from Ying (nutrient) system.
- To nourish Yin and invigorate blood.
Fever worsening at night
Irritability
Insomnia ← excessive heat in Ying
Delirium & disturbing the mind
Rapid pulse
Thirst
Dull macula on skin ← heat in Ying (not entering blood system)
Deep red tongue with dry coating ← (heat in Ying (not entering blood system)
Xijiao / Sheng di huang — To dispel heat in the Ying system, cool the blood and release toxins
Xuan shen / Mai men dong — To replenish Yin and clear heat
Jinyinhua / Lianqiao / Huanglian / Zhuye — To clear heat and release toxins
(push heat out of ying and go back to qi system and move out of body)
Dan shen — To invigorate blood and disperse stagnation
Composition:
Rhinoceros horn (Xijiao) 2 g
Fresh rehmannia (Shengdihuang) 15 g
Scrophularia (Xuanshen) 9 g
Ophiopogon root (Maimendong) 9 g
Lonicera flower (Jinyinhua) 9 g
Forsythia (Lianqiao) 6 g
Coptis (Huanglian) 5 g
Bamboo leaf (Zhuye) 3 g
Red sage root (Danshen) 6 g
Method Used: decoction
Xi Jiao Di Huang Tang
Decoction of Rhinoceros Horn and Rehmannia Combination 犀角地黄汤
Indications:
Extravasation of blood syndrome due to exogenous pathogenic heat in the blood system
Functions:
- To clear heat and release toxins.
- To cool the blood and remove stagnation.
Vomiting with blood
Nosebleed
Bloody urination excessive heat in blood system
Purplish black macula
Deep red tongue with dry coating
Rapid pulse
Xijiao, Shengdihuang → To clear heat, cool the blood, release toxins and stop bleeding.
Mudanpi, Chishao → To clear heat, cool the blood, remove blood stasis.
Composition:
Rhinoceros horn (Xijiao) 1.5-3 g
Fresh rehmannia (Shengdihuang) 30 g
Red peony (Chishao) 12 g
Moutan bark (Mudanpi) 9 g
Method Used:
Rhinoceros horn (Xijiao) is ground into powder and added to the decoction.
Exercise:
True or false?
Xi Jiao Di Huang Tang is indicated for syndrome of heat invading ying system.
Qing Ying Tang has a better effect in stopping bleeding than Xi Jiao Di Huang Tang.
Difference between qing ying tang and xi jiao di huang tang?
Qyt: early stage when heat entering ying level + no sign of bleeding;
Xjdht: heat leading bleed (blood level)
3 Clear the heat and detoxify
Liang Ge San
凉膈散
Indications: Heat in the upper & middle Jiao
Functions: To drains Fire, unblocks bowels by clearing upper & middle Jiao
Heat in the chest and diaphragm → irritability
Heat in the Stomach and intestines → thirst, dry lips, mouth, sore throat, constipation, and dark scanty urine
Heart Fire → cankers, red lips, disturbed spirit (irritable, insomnia, delirious speech).
Heat in the Lungs or Liver → dry bloody nasal passages, red dry eyes, headaches, and dry hacking coughs
Heat → T- red, yellow or dry coating, P- rapid
Lian Qiao → toxic heat
Huang Qin → heat in the HT and chest
Zhi Zi → three jao fire
Bo He → dispersing heat
Da Huang, Mang Xiao → purging fire downward
Gan Cao → harmonizing
Composition:
Lian Qiao (fructus forsythiae suspensae)…1200g
Huang Qin (radix scutellariae)…300g
Zhi Zi (fructus gardeniae jasminoidis)…300g
Bo He (herba mentae haplocalycis)…300g
Da Huang (radix and rhizoma rhei)…600g
Mang Xiao (mirabilitum)…600g
Gan Cao (radix glycyrrhizae uralensis)…600g
Method Used: decoction or powder
Huang Lian Jie Du Tang
Decoction of Coptis Combination to Release Toxins
黄连解毒汤
Indications: Excessive toxic heat syndromes
(Excessive heat disturbing in Sanjiao)
Functions: To reduce fire and release toxins.
1) Heat disturbing mind; Fever, irritability, insomnia, cloudy mind; or
2) Bleeding: Epistaxis, vomiting with blood, macula ; or
3) Damp-heat: Jaundice, dysentery; or,
4) Toxic fire: Boils, carbuncles; and
Common symptoms:
Brown urine
Red tongue with yellow coating
Rapid and forceful pulse
Clear
| Huanglian → heart+ middle jiao
Huangqin → Lung–upper jiao Huangbai → lower jiao Zhizi → upper/middle/lower jiao |
← fire |
Composition:
Coptis (Huanglian) 3-9 g
Scutellaria (Huangqin) 6 g
Phellodendron (Huangbai) 6 g
Capejasmine fruit (Zhizi) 9 g
Method Used: decoction
Pu Ji Xiao Du Yin
Universal Anti-Toxin Decoction
普济消毒饮
Indications:
(Da tou wen) Flushed swollen face and head due to invasion by exogenous pathogenic heat and toxic factors
Functions:
- To dispel wind.
- To clear heat and release toxins.
Fever/chills ← Wind heat and toxic factors invading the exterior.
Flushed swollen face and head ← Epidemic wind / heat attacking the face and head.
Sore throat, thirst and dry throat ← Injury of body fluids by heat.
Red tongue with white or yellow coating ← Excessive heat.
Superficial, rapid and forceful pulse ← Exogenous pathogenic wind and heat.
Huangqin / Huanglian: clear / reduce toxic heat in the face and head
Niubangzi / Lianqiao / Bohe / Jiangcan:
cool/pungent, disperse wind/heat in the face and head
Xuanshen / Mabo / Banlangen: strengthen clearing toxic heat
Gancao / Jiegeng: benefit throat
Jupi/chen pi: disperse stagnated wind heat
*Shengma / Chaihu: 1) disperse stagnated wind heat (“stagnated fire should be dispersed”)
2) guide Huangqin / Huanglian to the head
Composition:
Scutellaria (Huangqin) 15 g
Coptis (Huanglian) 15 g
Arctium fruit (Niubangzi) 3 g
Forsythia (Lianqiao) 3 g
Mentha (Bohe) 3 g
White stiff silkworm (Jiangcan) 2 g
Scrophularia (Xuanshen) 6 g
Puff-ball (Mabo) 3 g
Isatis root (Banlangen) 3 g
Licorice (Gancao) 6 g
Platycodon (Jiegeng) 6 g
Citrus Peel (Jupi) 6 g
Cimicifuga (Shengma) 2 g
Bupleurum (Chaihu) 6 g
Applications: Carbuncles, furuncles, boils and swelling on face and head, epidemic parotitis, acute tonsillitis and acute submaxillary lymphadenitis
Method Used: decoction
4 Clear heat in both the Qi and blood (1)
Qing Wen Bai Du San (Yin)
清瘟败毒散
Indications: severe Fire in the Qi and Xue levels
Functions: clear Heat, detoxify, cool blood, drains Fire
high fevers and excessive thirst ← Qi level Heat
headache and rashes with general malaise ← Fire toxin
irritability, various bleeding, and rashes ← Heat in the Xue level
T- dark red (lips are also dark red), P- rapid and thin or floating and large
delirious speech and altering of consciousness —- severe condition
Bai Hu Tang (without Jingmi) → clear heat and protect body fluid
Xi Jiao Di Huang Tang → clear heat, cool the blood, and release toxins.
Huang Lian Jie Du Tang (without Huangbo) → clear heat / fire in three jiao
Xuan Shen/Lian Qiao → clear “floating and scattering heat”
Jie Geng/Dan Zhu Ye → guide herbs going upward
Composition: Modified combination of Bai Hu Tang, Xi Jiao Di Huang Tang, and
Shi Gao (gypsum)…60-120g
Zhi Mu (radix anemarrhenae asphodeloidis)…6-12g
Gan Cao (radix glycyrrhizae uralensis)…3-6g
Huang Lian (rhizoma coptidis)…6-12g
Huang Qin (radix scutellariae)…3-9g
Zhi Zi (fructus gardeniae jasminoidis)…6-12g
Xi Jiao (cornu rhinoceri)…9-12g
Sheng Di Huang (radix rehmanniae glutinosae)…9-15g
Mu Dan Pi (cortex moutan radicis)…6-12g
Chi Shao (radix paeoniae rubrae)…6-12g
Xuan Shen (radix scrophulariae ningpiensis)…6-12g
Lian Qiao (fructus forsythiae suspensae)…6-12g
Jie Geng (radix platycodi grandiflori)…3-6g
Dan Zhu Ye (herba lophatheri gracilis)…3-6g
Method Used: decoction