Indication: deficiency cold in the middle jiao (SP/ST)
caused by: SP/ST yang def + external cold
Herbs: Ganjiang, Wuzhuyu, Shujiao, Shengjiang + herbs invigorating qi / spleen
Li Zhong Wan
Pills to Regulate the Middle Jiao (Spleen and Stomach)
理中丸
Indications:
Deficiency cold of the spleen and stomach, such as:
(a) stomach and intestine disorders;
(b) loss of blood due to spleen Yang deficiency;
(c) infantile convulsions;
(d) obstruction in the chest.
Manifested mainly by: nausea, vomiting, diarrhea, no thirst, abdominal pain, poor appetite
Functions:
- To warm the middle jiao (spleen and stomach) and dispel cold.
- To tonify Qi and strengthen the spleen.
Analysis of formula:
Ganjiang – pungent, hot, warm SP/ST and dispel cold
Renshen – tonify primary qi and invigorate SP qi
Baizhu – tonify SP and dry damp
Gancao – benefit SP qi and harmonize all ingredients
Composition:
Ganjiang 5 g
Renshen 6 g
Baizhu 9 g
Gancao 6 g
Method Used: decoction or pills
Applications: Indigestion, chronic diarrhea, functional uterine bleeding, bloody stool due to gastroduodenal ulcer and angina pectoris.
Modifications:
- Loss of blood due to Yang deficiency + Ejiao, Aiye and Lujiaojiao
- Pain in the chest + Danshen, Gualou, Yujin and Zhiqiao
Question:
Which herb is the king, Ganjiang or Renshen? Why?
How to warm spleen yang?
Xiao Jian Zhong Tang
Minor Decoction to Restore the Normal Function of the Middle Jiao
小建中汤
Indications:
Abdominal pain due to weakness and coldness in the spleen and stomach
Manifested by:
1) paroxysmal pain in the epigastrium (relieved by warmth and pressure), pale tongue proper with thin and white coating, thready, wiry and retarded pulse; or
2) palpitation, irritability, pale complexion; or
3) four limbs soreness, fever of hands and feet, dry throat/mouth
Functions:
- To warm and tonify the middle jiao (spleen and stomach).
- To dispel cold and stop pain.
Analysis of formula:
Yitang – invigorate SP qi, nourish SP yin, warm the middle, moisten LU, soothe LV, stop pain
Guizhi — warm yang qi
Baishao — nourish the blood and pacify LV
Gancao – benefit qi
Gancao + Dazao — To tonify SP/ST, harmonize ying / wei,
Composition:
Yitang (Maltose) 30 g
Guizhi 9 g
Baishao 18 g
Gancao 6 g
Shengjiang 10 g
Dazao 12 pcs
Applications: Gastric and duodenal ulcers
Method Used: decoction, 5 herbs first, then Yitang is added.
Questions:
1) What is the significance of Gancao combined with Guizhi?
2) What is the significance of Gancao combined with Baihsao?
3) Which herbs are combined to show the principle — “the pungent and sweet can be transformed into yang ” and “the pungent and sweet can be transformed into yin”?
4) What is the difference between compositions of Guizhi Tang and Xiao Jian Zhong Tang?
Da Jian Zhong Tang
Major construct the middle soup
大建中汤
Indications:
Yang def in the middle jiao, excessive internal cold, manifested as:
very severe abdominal pain, does not tolerate touch, epigastrium also feels cold, may be severe vomiting (can’t keep food down), borborygmus, T- white slippery coat, P- thin tight, or slow wiry.
Functions:
Warms & tonifies mid Jiao deficiency, redirects rebel Qi, relieves pain
Analysis:
Chuan Jiao – pungent/hot, warm SP/ST, disperse cold/damp, bring down qi, stop pain
Gan Jiang – pungent/hot, warm SP/ST, disperse cold/damp, stop pain and vomiting
Ren Shen + Yi Tang – warm and tonify SP/ST
Composition:
Chuan Jiao 3-9g
Gan Jiang 12g
Ren Shen 6g
Yi Tang (maltose)…18-30g (add to the strained decoction)
Method Used: decoction
Question:
After taking this formula, it better to take porridge, why?
Comparison
Xiao Jian Zhong Tang:
pungent /sweet + sour/sweet, yang def/yin def, mild, abdonman
Da Jian Zhong Tang:
pungent/sweet, yang def cold, strong, stomach
Wu Zhu Yu Tang
Decoction of Evodia Fruit Combination
吴茱萸汤
Indications:
Vomiting due to deficiency cold of SP / ST and perversion of Qi, Manifested by:
Vomiting immediately after intake of food, stifling sensation and fullness in the epigastric region, epigastric pain, acid regurgitation
Functions:
- To warm and tonify the spleen and stomach.
- To conduct perversion of Qi downward and stop vomiting.
Analysis:
Wuzhuyu — pungent, bitter, dry, hot, warm ST and dispel cold, bring down ST qi
Renshen – tonify primary qi, benefit yin
Shengjiang + Dazao – disperse cold, nourish SP
Composition:
Wuzhuyu 3 g
Renshen 6 g
Shengjiang 18 g
Dazao 4 pcs
Applications: Acute and chronic gastritis, neurotic headache, Meniere’s syndrome and migraine.
Method Used: decoction
Cautions: This decoction may induce further vomiting. It should be taken cold and more frequently.
Others: yangmin, jieyin, shaojin deficiency cold
2 Restore yang and save critical reverse
Yang depleted
Extreme cold in the interior and exterior, or deficiency yang floating up
Fuzi, Ganjiang, Rougui
Si Ni Tang
Decoction to Treat Cold Limbs
四逆汤
Indications:
1) Syndrome of excessive Yin and declined Yang, manifested as: cold limbs, aversion to cold, curled up sleep, fatigued and sleepy, no thirst, vomiting, diarrhea, abdominal pain, pale tongue with white coating, thready and forceless pulse;
2) Excessive Yin and collapsed Yang, manifested as: profuse sweating, cold limbs, listlessness, coma, pale complexion, cyanosis on the lips and nails, weak, thready and fading pulse, pale tongue and white coating.
Functions:
To restore the Yang after collapse
Analysis:
(Sheng) Fuzi – extremely pungent, extremely hot, toxic, replenish “gate fire”, search and disperse cold in 12 meridians (in the exterior and interior) → restore Yang and dispel cold
Ganjiang – pungent, hot, warm yang, expel cold in middle jiao
Gancao – detoxify Fuzi, harmonize
Composition:
Raw Aconite (Sheng Fuzi) 5-10 g
Dried ginger (Ganjiang) 6-9 g
Licorice (Gancao) 6 g
Applications: Coma
Method Used: First, cook Fuzi an hour earlier
Modifications: Severe coma. Add: Ginseng (Renshen).
Note: 1) Representative formula for recuperation from collapse.
2) Fuzi + Ganjiang: “no Ganjiang, no hot effect of Fuzi”
Hui Yang Jiu Ji Tang
Restore and revive the Yang soup
回阳救急汤
Indications:
Yang depleting, cold attacking three yin, manifested as chills, like to curl up, cold extremities, vomiting, diarrhea, abdominal pain, lethargy, constant desire to sleep, pale tongue with white coat, deep faint or imperceptible pulse, may also be cyanosis of lips and fingernails.
Functions:
To restore yang and save life, to replenish qi and revive pulse
Sini Tan + Rou Gui – warm primary yang, dispel cold
Liujunzi Tang – replenish SP/ST
Wu Wei Zi – combine with Renshen to replenish qi and restore pulse
She Xiang – activate 12 meridians, combine with Wuweizi, disperse/astringe, lead others herbs to all the body.
Composition:
Shu Fu Zi 9g
Gan Jiang 6g
Zhi Gan Cao 6g
Rou Gui 3g
Ren Shen 6g
Chao Bai Zhu 9g
Fu Ling 9g
Chen Pi 6g
Ban Xia 9g
Wu Wei Zi 3g
She Xiang ( Take 0.1g just before taking the decoction)
Applications: Periodontitis, acute stomatitis, diabetes
Method Used: decoction
Questions:
1) Shu Fuzi is used in which formular, Sini Tang or Hui Yang Jiu Ji Tang?
2) What is the significance of combination of Wu Wei Zi and She Xiang?
3) What is the significance of combination of Wu Wei Zi and Ren Shen?
3 Warm up channels and disperse cold (2)
Mechanism:
yany def + yin blood def + exterior cold → obstructing meridains
Herbs:
warm yang/dispel cold+warm meridians/dispel cold+nourish blood/dredge collaterals
Dang Gui Si Ni Tang
Decoction of Chinese Angelica Combination to Treat Cold Limbs
当归四逆汤
Indications:
Yang def and blood def, and external cold attack, manifested as:
Cold limbs, cold pain, pale tongue with white coating, deep, thready and fading pulse
Functions:
- To warm meridians and dispel cold.
- To nourish the blood and dredge meridians
Danggui – pungent, bitter, sweet, warm, to nourish the blood and activate blood circulation
Baishao — to nourish the blood
Guizhi + Xixin — to warm the meridians and dispel (internal and external) cold
Gancao + Dazao — To tonify Qi and strengthen SP for production of Qi and blood
Tongcao — To invigorate the blood circulation and remove blood stagnation
Composition:
Chinese angelica (Danggui) 12 g
White peony (Baishao) 9 g
Cinnamon twigs (Guizhi) 9 g
Asarum (Xixin) 1.5 g
Licorice (Gancao) 5 g
Jujube (Dazao) 8 pcs
Ricepaper pith (Tongcao) 3 g
Applications: Thromboangiitis, athetosis, frostbite, dysmenorrhea and chronic rheumatoid arthritis
Method Used: decoction
Huang Qi Gui Zhi Wu Wu Tang
Astragalus cinnamon twig five substance soup
黄耆桂枝五物汤
Indications:
Blood bi syndrome, manifested as: numbness of muscle, P- faint, choppy tight.
Functions: Invigorate qi, warm meridians, remove obstruction
Composition:
Huang Qi (radix astragali membranacei)…12g
Gui Zhi (ramulus cinnamomi cassiae)…9g
Bai Shao Yao (radix paeoniae)…9g
Sheng Jiang (rhizome zingiberis officinalis recens)…12g
Da Zao (fructus jujubae)…12 pieces
Method Used: decoction