Author: Zhang Zhong-Jing, 張仲景
Year: c. 220
Source: Discussion of Cold Damage (Shang Han Lun, 傷寒論)
Category: Formulas that Expel Dampness
Pattern: Yang deficiency with Internal Cold-Dampness in the Interior and obstruscting the Channels
Key Symptoms: Generalised body pain, aching of bones and joints, aversion to cold, especially at the back, cold extremities, no thirst
Secondary Symptoms: Also used for abdominal distention and pain that is cool to the touch with aversion to cold and fever during late pregnancy.
Tongue: White slippery coating
Pulse: Submerged, faint and forceless or choppy and slow (first presentation). Wiry (second presentation).
Ingredients
Bao Fu Zi
| 12-18g | | (2pc)
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Pinyin: Fu Zi
Chinese: 附子
Pharmaceutical: Radix Aconiti Lateralis Praeparata
Taxonomy: Aconitum carmichaeli
English: Aconite Root / Monkshood Root
| |
Tastes: Pungent, sweet, hot, toxic
Meridians Entered: Heart, Kidney and Spleen
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Actions & Indications:
- Restores Devastated Yang and rescues from rebellion
Devastated Yang with diarrhoea containing undigested food, chills, cold extremities and a faint almost imperceptible pulse (often as a result of severe vomiting, diarrhoea or sweating)
- Warms Ming Men Fire and assists Heart, Kidney and Spleen Yang
Heart Yang Deficiency
Spleen Yang Deficiency
Kidney Yang Deficiency
- Disperses Cold and Dampness, warms the channels and stops pain
Wind-Damp-Cold Bi
Cold blocking the organs, channels, bones and Blood vessels
Yin flat abscesses
Gu Parasites /
chronic inflammatory disease (Fruehauf, 2015)
|
Standard Dosage: 3-10g in decoction.
Cautions: It is contraindicated for heat syndrome, yin-deficiency leading to hyperactivity of yang and the pregnant because of its pungent, hot, dry and drastic properties. It must be soaked and decocted for about half and hour to one hour until numbing taste disappears for oral use. Over-dosage and incorrect processing must be avoided.
This herb is prohibited from use in the UK under the banned and restricted herbal ingredients list issued by the MHRA. It is generally substituted with various Yang tonics depending on the presentation although none can imitate its powerful cardiovascular effects making them ineffective substitutes for rescuing devastated Yang. External use is permitted at 1.3% or below. |
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Bai Zhu
| 12g | |
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Pinyin: Bai Zhu
Chinese: 白朮
Pharmaceutical: Rhizoma Atractylodes macrocephalae
Taxonomy: Atractylodes macrocephala
English: Largehead Atracylodes Rhizome
| |
Tastes: Sweet, bitter, warm
Meridians Entered: Spleen and Stomach
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Actions & Indications:
- Tonifies the Spleen and augments Qi
Spleen and Stomach Deficiency with diarrhoea, fatigue, a sallow complexion and lack of appetite
Spleen Yang failure to rise
- Dries Dampness and promotes water metabolism
Spleen Damp or accumulation of fluids affecting the digestion
Edema and reduced urination due to Spleen Deficiency (failure to transform and transport)
Tan Yin, masses, swelling
Auxiliary for Damp painful obstruction
- Stabilizes the Exterior and stops sweating
Qi Deficiency with spontaneous sweating (Wei Qi Deficiency)
With appropriate herbs, other types of sweating
- Calms the fetus
Restless fetus disorder due to Spleen Qi Deficiency
With appropriate herbs, other types of Restless Fetus Disorder
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Standard Dosage: 6-12g in decoction.
Cautions: Use with cautions in cases of yin deficiency with fluid injury by dryness-heat pathogen. |
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Ren Shen
| 6g | |
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Pinyin: Ren Shen
Chinese: 人參
Pharmaceutical: Radix Panax ginseng
Taxonomy: Panax ginseng
English: Ginseng Root
| |
Tastes: Sweet, slightly warm
Meridians Entered: Spleen, Lung and Heart
|
Actions & Indications:
- Powerfully tonifies Yuan Qi
Extreme collapse of Qi or abandoned conditions that manifest in shallow breathing, shortness of breath, cold limbs, profuse sweating and an almost imperceptible pulse (after blood loss, overly profuse sweating or other problems related to severe fluid loss - it can be used alone in these emergencies)
Collapse of Yang
Collapse of Yin
- Tonifies Spleen and Stomach Qi
Lethargy, anorexia, chest and abdominal distention, chronic diarrhoea and, in severe cases, prolapse of the Stomach, uterus or rectum
- Tonifies Lung Qi
Lung Qi Deficiency with wheezing, shortness of breath and labored breathing on exertion
- Generates Body Fluids and stops thirst
Wasting and thirsting disorder (Xiao Ke) and high fevers with profuse sweating which injures Qi and fluids
- Tonifies Heart Qi and calms the Spirit
Heart Qi and Blood Deficiency with palpitations, anxiety, insomnia, forgetfulness and restlessness
- Treats impotence
With Kidney Yang tonics for impotence
- Tonifies Qi in Deficiency patients with Exterior conditions
Exterior disorder with Interior Deficiency
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Standard Dosage: 5-10g in decoction, 10-30g for exhaustion syndrome due to Qi deficiency.
Cautions: Antagonizing to Li Lu; the warm nature of sun-dried raw Ren Shen is weaker than that of Hong Shen. |
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Fu Ling
| 9g | |
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Pinyin: Fu Ling
Chinese: 茯苓
Pharmaceutical: Poria
Taxonomy: Poria cocos syn. Wolfiporia extensa
English: China-Root / Hoelen / Tuckahoe / Indian Bread
| |
Tastes: Sweet, bland, neutral
Meridians Entered: Heart, Spleen, and Kidney
|
Actions & Indications:
- Strengthens the Spleen and harmonizes the Middle Jiao
Spleen Deficiency Dampness with anorexia, diarrhoea and epigastric distention
- Strengthens the Spleen
Phlegm Dampness due to Spleen Deficiency with thin mucus in which Phlegm moves upward manifesting as palpitations, headache, dizziness and a thick, greasy tongue coat
- Promotes urination and leaches out Dampness
Urinary difficulty, diarrhoea or oedema due to Stagnation of Fluids or Dampness
- Quiets the Heart, calms the Spirit and soothes the nerves
Palpitations, insomnia or forgetfulness due to either Spleen and Heart Insufficiency or Internal Obstruction of Turbid Phlegm
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Standard Dosage: 9-15g in decoction.
Cautions: It is contraindicated for spermatorrhea due to deficiency-cold. |
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Bai Shao
| 9g | | |
Pinyin: Bai Shao
Chinese: 白芍
Pharmaceutical: Radix Paeoniae Alba
Taxonomy: Paeonia lactiflora
English: White Peony Root
| |
Tastes: Bitter, sour, sweet, slightly cold
Meridians Entered: Spleen and Liver
|
Actions & Indications:
- Nourishes the Blood and regulates menstruation
Liver Blood Deficiency with menstrual dysfunction, vaginal discharge and uterine bleeding accompanied by a pale face, a lusterless complexion and dull, lusterless nails
Anemia
Breast distention and premenstrual syndrome
- Astringes Yin and adjusts the Ying and Wei
Yin Deficiency sweating Sweating due to Yin Collapse
Disharmony between the Liver and Spleen
Disharmony between the Ying and Wei with non-productive sweating
- Calms Liver Yang and Liver Wind and alleviates pain
Liver Qi Stagnation with Liver Yang Rising
Liver Wind with Yin and Blood Deficiency
Bi syndrome due to Blood Deficiency with pain and spasms
- Softens the Liver and relieves pain
Diarrhoea, borborygmus and abdominal pain
Dysenteric disorders with tenesmus
- Tonifies the Blood while suppressing Parasites
Gu Sydnrome (Fruehauf, 1998)
Chronic inflammatory disease (Fruehauf, 2015)
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Standard Dosage: 10-30g in decoction.
Cautions: Caution with anticoagulants as it may slow clotting time. May also slow the absorption of phenytoin. |
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Subsitutions:
In the UK Fu Zi must be substituted. Rou Gui and Xian Mao are the standard choice for joint pain and Rou Gui and Gan Jiang for abdominal pain.
Preparation: Decoction. The source text advises using 8 cups of water and boiling until 3 remain, then straining, dividing into 3 doses and taking them during the course of 1 day. The Fu Zi is decocoted for 30-60 minutes before the other herbs until no numbing sensation of the tongue can be tasted.
Actions: Warms the Channels, assists the Yang, dispels Cold, transforms Dampness
Notes:
One liang is taken as 3g in modern sources but in Eastern Han times it was equivalent to 13.875g. This means that the dosages in classical formulae could have been more than 4x what is given today making them far higher than recommended safe dosages today but prompts consideration of what an effective dose may be (He, 2013).
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.