2 Blood tonic (4)
Blood deficiency: head, color, mind, menstruation, pulse, tongue
Herbs: Shudihuang, Danggui, Shaoyao, Erjiao, etc.
Possible side effects: produce dampness, impede spleen qi
Si Wu Tang (four ladies?)
Four Substance Decoction
四物汤
Indications: Chong/Ren meridians deficiency (Blood deficiency and stagnant blood)
—- Irregular menstruation with scanty flow, dysmenorrhea, amenorrhea, lower abdominal or periumbilical pain, and PMS
—- Dizziness, fatigue, tinnitus, blurred vision, palpitations, and pale nails and complexion
—- Painful and hard abdominal masses, threatened miscarriage, and lochioschesis.
T- Pale, purple, or dusky tongue, P- wiry and thin, or choppy and thin
Now: basic formula for
all kinds of blood deficiency
most kinds of irregular menstruation
Functions: nourish blood and invigorate blood
Shudihuang 12g—-sweet/slightly warm (moist/greasy), nourish blood not moving
Danggui 10g —- nourish and invigorate blood moving
Baishao 12g —- astringe yin and nourish blood not moving
Chuanxiong 8g —- regulate qi within blood moving
Applications: Irregular menstruation and anemia
Cautions:
This formula is heavy and cloying and should not be used in cases with loose stool, poor appetite, and indigestion due to Spleen Qi/Yang deficiency
Do not use in cases of acute or severe blood loss.
Question:
Which herb in this formula most easily impedes SP qi? Why?
Dang Gui Bu Xue Tang
Decoction with Chinese Angelica Combination to Tonify Blood
当归补血汤
Functions: To tonify Qi and promote the production of blood.
Indications: Blood deficiency and floating of Yang due to fatigue and deficiency of source Qi.
—- Hot sensation of the body, red face, thirst, desiring to drink, surging, big and deficient pulse; or anemia and heat manifestation in post-labor or menstruation period, headache
Huangqi 30g – in heavy dosage, replenish/invigorate SP/LU qi, (qi produces blood)
Danggui 6g – sweet, pungent, warm, nourish blood, harmonize ying
Applications: Anemia, uterine bleeding, post-partus bleeding and fever and purulent abscesses.
Cautions: 1. Heat manifestation here is due to the deficiency of blood leading to the failure of Yang, so heat here should not be regarded as a sign of common fever. Cold or cool herbs should be avoided as such formulas may worsen the disease. 2. This formula is contraindicated for a person with Yin deficiency manifested by afternoon fever.
Question:
A patient has hot sensation of the body, red face, thirst, desiring to drink, and surging, big and deficient pulse. Which formula do you prefer? Why? Should you have to ask more questions for symptom in order to get detailed information about the syndrome?
a) Baihu Tang
b) Qinghao Biejia Tang
c) Danggui BuXie Tang
Gui Pi Tang
Decoction to Strengthen the Spleen and Heart
归脾汤
Functions: To tonify Qi and blood, strengthen the spleen and heart.
Indications:
1) Spleen and heart deficiency (Qi and blood deficiency) due to fatigue or over-thinking.
—- Palpitation, forgetfulness, insomnia, lassitude, poor appetite, night sweating, fever, sallow complexion, pale tongue with thin and white coating, thready and weak pulse;
2) Qi deficiency and weakness of the spleen which fail in controlling the blood
—- Qi deficiency and weakness of the spleen which fail in controlling the blood, functional uterine bleeding, etc.
Ren shen 15 g, Huang qi 30 g, Bai zhu 30 g, Gan cao 8 g —- Warm/tonify SP qi
Dang gui 3g —- Nourish LV, replenish blood
Fu ling (Fu shen)30 g, Suan zao ren 30 g, Long yan rou 30 g —- Sweet, nourish HT, tranquilizing mind
Yuan zhi 3 g —- Communicate HT and KI, tranquilizing mind
Mu xiang 15 g —- Regulate qi, activate SP; Prevent damp generation and impairment of SP
Method Used: Once the herbs are mixed, six grams of Fresh ginger (Shengjiang) and three pieces of Jujube (Dazao) are added to the herbs which are then cooked with water by decoction.
Applications: Irregular menstruation, functional uterine bleeding, anemia and neurasthenia.
Questions:
In Guipi Tang, which herb is used for preventing generation of dampness?
In Buzhong Yinqi Tang, which herb is used for regulate/active SP qi?
- Chenpi (Jupi)
- Xiangfu
- Muxiang
In both Guipi Tang and Buzhong Yinqi Tang, herbs as Renshen, Huangqi, Baizhu and Gancao are used for tonify SP qi?
Zhi Gan Cao Tang
Decoction of Baked Licorice Combination
炙甘草汤 (加减复脉汤)
Functions: To tonify Qi and replenish Yin.
Indications:
1) Palpitation and intermittent pulse due to Qi and blood deficiency.
—- Palpitation, intermittent pulse, fatigue, shortness of breath, pale tongue without coating.
2) Consumptive lung disease – dry cough, or little sputum mixed with blood, thin body, shortness of breath, irritability, insomnia, spontaneous sweating or night sweating, dry mouth, constipation, or fever, weak and rapid pulse.
Zhigancao 12 g, Renshen 6 g, Dazao 5-10 pcs —- Tonify qi of SP/HT
Sheng di huang 30 g, Mai men dong 10 g, E jiao 9 g, Ma zi ren 10 g —- Sweet, moist, nourish yin, and HT blood, moisten LU and generate fluid
Sheng jiang 9 g, Gui zhi 9 g, Wine 10ml —- Pungent, warm, promote yang qi, activate blood
Herbs tonifying qi + herbs nourishing yin —- warm, but not dry, promote qi/blood circulation, unblock bl vessels
Method Used: Except for the Donkey-hide gelatin (Ejiao), all the other herbs are cooked with water by decoction. Then the Donkey-hide gelatin (Ejiao) is added to a cup of boiling water. Finally, these two decoctions are mixed with 10 ml of white wine.
Applications: Arrhythmia.
Modifications: Severe Qi deficiency. Add: Astragalus (Huangqi).
Cautions: Prolonged use of this formula may cause edema. In cases where edema exists, the dosage of Baked licorice (Zhigancao) should be reduced.
Questions:
- Why is wine used in this formula?
- Is Zhigancao in this formula used for harmonizing others?
- What is main symptom that this formula is indicated?
3 Both Qi and blood tonic (3)
Ba Zhen Tang
Decoction of Eight Treasure Ingredients
八珍汤
ba zhen tang = Sijunzi Tang + Siwu Tang
Functions: To tonify Qi and blood.
Indications: Qi def and blood def
Method Used: Three slices of Fresh ginger (Shengjiang) and two pieces of Jujube (Dazao) added to the eight treasure ingredients are cooked with water by decoction.
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Shi Quan Da Bu Tang
十全大补汤
Ba Zhen Tang + Huangqi/Rougui
Functions: To warm and tonify qi and blood
Indications: Qi def / blood def + (KI) yang def
Ren Shen Yang Rong (Ying) Tang
人参养荣(营)汤
dang gui, bai shao, shu di huang
ren shen, fu ling, bai zhu, gan cao
huang qi, rou gui (or gui zhi), ju pi, wu wei zi, yuan zi
Ren Shen Yang Rong (Ying) Tang = shi quan da bu (Chuanxiong (is removed) + Wuweizi/Yunzhi/Chenpi
Functions: To tonify Qi/blood, to nourish HT and tranquilized mind
Indications: constitutional weakness due to consumptive disease