Author: Qian Yi, 錢乙
Year: 1119
Source: Craft of Medicines and Patterns for Children (Xiao Er Yao Zheng Zhen Jue, 小兒藥證真訣)
Category: Formulas that Open the Sensory Orifices
Pattern: Phlegm-Heat entering the Pericardium
Key Symptoms: Fever, impaired consciousness, childhood convulsions, irritability and restlessness
Secondary Symptoms: Wheezing, nausea, night crying, vomiting milk, diarrhoea, abdominal pain, excessive secretion of mucus and saliva, sounds of mucus in the throat
Ingredients
Tian Zhu Huang
| 30g | |
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Pinyin: Tian Zhu Huang
Chinese: 天竺黄
Pharmaceutical: Concretio Silicea Bambusae
English: Bamboo Sugar / Tabasheer
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Tastes: Sweet, cold
Meridians Entered: Heart and Liver
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Actions & Indications:
- Clears and transforms Phlegm-Heat
Phlegm-Heat in the Lungs with difficult-to-expectorate sputum
- Clears Heat, cools the Heart and settles convulsions and tremors
Spasms and convulsions due to Phlegm-Heat
Wind-Stroke with Phlegm obstruction and gurgling sounds in the throat
Childhood convulsions and spasms associated with Phlegm-Heat
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Standard Dosage: 3-6g in decoction.
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Xiong Huang
| 3g | |
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Pinyin: Xiong Huang
Chinese: 雄黃
Pharmaceutical: Realgar
Taxonomy: As2S2
English: Realgar
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Tastes: Pungent, warm, toxic
Meridians Entered: Liver, Stomach and Large Intestine
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Actions & Indications:
- Relieves toxicity and kills Parasites
Scabies, ringworm and Damp rashes (topical)
Any kind of skin itch (topical)
Abscesses, suppurative inflammation, ulcerations, and snakebite (topical)
Intestinal parasites especially when there are signs of accumulation
Particularly effective against roundworms
Gu Sydnrome (Fruehauf, 1998)
- Dries Dampness, expels Phlegm, stops malarial disorders and settles Wind
Wheezing
Seizures Malarial disorders
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Standard Dosage: Due to toxicity no dose is permissible today. Traditionally 0.05-0.1g internally or a small amount applied as powder in external applications.
Cautions: This substance is toxic due to its arsenic content and so should not be used. Traditional usage requires it be refined with water, and just for temporary use. For external application, it is not suitable for a large scale use or for a long time. It is contraindicated for the pregnant women. Avoid being calcined by the fire. |
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Zhu Sha
| 15g | |
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Pinyin: Zhu Sha
Chinese: 朱砂
Pharmaceutical: Cinnabaris
Taxonomy: HgS
English: Cinnabar / Vermilion / Mercury (II) Sulfide / 丹 Dan / 朱雀 Zhu Que (Red Raven)
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Tastes: Sweet, cold, toxic
Meridians Entered: Heart
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Actions & Indications:
- Sedates the Heart and calms the Spirit
Restlessness, palpitations, anxiety, insomnia and convulsions associated with a disturbed Spirit
Heart Fire (with appropriate herbs)
Phlegm Fire Disturbs the Heart (with appropriate herbs)
Heart Blood Deficiency (with appropriate herbs)
- Expels Phlegm and sedates jitteriness and convulsions while stopping tremors
Seizures, childhood convulsions and other problems due to Phlegm-Heat Blocking the Pericardium and Heart
Wind-Phlegm dizziness
Lung Heat
- Clears Heat, relieves toxicity and prevents putrefaction
Topically for carbuncles, mouth sores, sore throat and snakebite
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Standard Dosage: No dosage is permissible due to mercury toxicity. 0.1-0.5g in powder or pills is traditional.
Cautions: Prohibited from use today due to its mercury content, it is generally omitted or substituted with Hu Po. Historically it was sometimes confused with Xue Jie, so this could also make a potential substitute in the right circumstances.
Zhao, Li & Wang (2022) claim that grinding and washing was a traditional method of removing the toxicity but any amount of mercury toxicity is unacceptable today.
Traditional contraindications include overdose and taking for a long period of time, or calcinification. |
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She Xiang
| 15g | |
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Pinyin: She Xiang
Chinese: 麝香
Pharmaceutical: Moschus
English: Musk
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Tastes: Pungent, warm
Meridians Entered: Heart, Liver and Spleen
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Actions & Indications:
- Strongly opens the Orifices and Luo vessels, revives the Spirit and unblocks closed disorders
Ying Stage Heat Attacks the Pericardium due to a Warm pathogen disease with convulsions, delirium, stupor and fainting Closed disorders (Yang Obstruction, Yin Obstruction, Phlegm Obstruction) Tetanic collapse Seizures
- Invigorates the Blood, dissipates masses, reduces swellings, detoxifies, opens the channels and alleviates pain
Severe problems due to Blood Stasis including fixed palpable masses, toxic sores and carbuncles Obstructions of the channels and collaterals due to traumatic injury or painful obstruction Coronary artery disease
- Hastens delivery and facilitates the passage of stillborns (induces abortion)
Labor Dead fetus or placenta fail to descend
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Standard Dosage: 0.03-1g as pills or powder. Should not be decocted.
Cautions: Animal products are prohibited from use in the UK under the Medicines Act 1968 ch. 67 which restricts herbalists to the use of plant products only. It is generally substituted with Shi Chang Pu and Ru Xiang. |
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Dan Nan Xing
| 120g | | |
Pinyin: Dan Nan Xing
Chinese: 胆南星
Pharmaceutical: Arisaema Cum Bile
Taxonomy: Arisaema consanguineum
English: Bile prepared Jack-in-the-Pulpit Rhizome
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Tastes: Bitter, cold
Meridians Entered: Heart, Liver and Lung
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Actions & Indications:
- Clears Heat, dissolves Phlegm, calms Wind and stops convulsions
Muscle spasms and cramps, infantile convulsions, seizures, facial paralysis, tetanus and stroke
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Standard Dosage: 3-6g in decoction.
Cautions: This herb is prohibited from use in the UK due to its being processed in cow bile making it partially an animal product. The unprepared from (Tian Nan Xing) can be used with its Phlegm-Heat resolving actions being enhanced by adding Zhu Ru, or it can be substituted with Tian Zhu Huang. |
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Subsitutions:
Most of this formula needs to be substituted in the UK. The standard substitutions would be:
Xiong Huang == no standard replacement. Things like Chong Lou, Yu Jin, Zhi Zi and Zhu Li would complement the other substitutions and the overall focus of the formula
Zhu Sha == Hu Po
She Xiang == Shi Chang Pu + Ru Xiang
Dan Nan Xing == Tian Zhu Huang or Tian Nan xing + Zhu Ru
Preparation: Ground into a fine powder and made into pills with licorice juice and taken with warm water. Dosage ranges from 1/4 of a pill for infants of 3 months of less to 3-5 for an adult.
Actions: Clears Heat, transforms Phlegm, opens the sensory orifices and calms the Shen
Research Links:
Reference Notes: (click to display)
Most formulas are found in Scheid, Bensky, Ellis & Barolet (2009): Chinese Herbal Medicine: Formulas & Strategies and Chen & Chen (2015) Chinese Herbal Formulas and Applications. Others are from translations of primary sources. It is recommended that the original material is cross-referenced for mistakes and additional information.
Substitutions have been taken from Ken Lloyd & Prof. Leung (2004): Mayway UK Substitution List or the above publications and are intended as suggestions to help navigate the tight restrictions in the UK quickly. More applicable substitutions may be appropriate in specific situations.
Individual herb information has initially been sourced from TCM Wiki and American Dragon for basic data and then updated manually with my own notes.
These pages are intended to assist clinicians and are not intended for self-diagnosis or treatment for which a qualified professional should be consulted.