Xi Xin San - 細辛湯 - Thin Pungent Decoction.

Author: Unknown, attributed to Sun Si Miao, 孫思邈

Year: Maybe composed in the Song - Ming Dynasty, published ~1579

Source: Essential Subtleties on the Silver Sea (Yin Hai Jing Wei, 銀海精微)

Category: Formulas that Release the Exterior

Pattern: Eye Screen after a Severe Illness (大患後生翳 Da Huan Hou Sheng Yi) due to Wind-Evil harming the Liver .

Key Symptoms: Sudden severe eye swelling and pain and intolerable roughness, chills and fever, restlessness when sitting or lying, sometimes walking around all night until daybreak, photophobia, copious tears and runny nose, groaning day and night, loss of flavour to food and drink.
Secondary Symptoms: If not cured after 14 days, a screen develops resembling yellow purulent scratch marks and they experience pulling pain in the brain.

Ingredients

Pinyin: Da Huang Chinese: 大黄 Pharmaceutical: Radix et Rhizoma Rhei Taxonomy: Rheum palmatum English: Chinese Rhubarb Root
Tastes: Bitter, cold Meridians Entered: Large Intestine, Spleen, Stomach, Liver and Heart
Actions & Indications: Drains Heat and purges accumulations Intestinal Heat Excess, with high fever, profuse sweating, thirst, constipation, abdominal distention and pain, delirium, a yellow tongue coat and a full pulse Yang-Ming Fu Stage Qi Level Heat in the Intestines Drains Fire Fire from Excess with intense fever, sore throat, and painful eyes and constipation Fire toxin sores due to Xue Level Heat, especially with constipation Clears Heat, transforms Dampness and promotes urination Damp-Heat with oedema, jaundice, painful urinary dysfunction and acute, hot dysenteric disorders Drains Heat from the Blood Bloody stool either from hemorrhoids or Heat in the Intestines Chaotic movement of hot Blood with hemoptysis or epistaxis with constipation It can be powdered and administered orally for bleeding in the upper digestive tract Invigorates the Blood and dispels Blood Stasis Blood Stasis with amenorrhea, fixed abdominal masses or fixed pain Blood Stasis due to traumatic injury Intestinal abscess Clears Heat and reduces Fire toxicity Topically or internally for burns or skin lesions (Chuang Yung) due to Heat Clears Heat and eliminates Phlegm Chronic Accumulation of Phlegm-Heat with cough, dyspnea, mania, disorientation and other symptoms of Phlegm Misting the Heart
Standard Dosage: 10-15g in decoction. Excessive decoction will reduce the purgative action. Therefore it should be added at end to achieve this purpose and over-decocted to eliminate this action. Cautions: It should be used with caution in case of spleen and stomach deficiency for its bitter and cold property which is easily to damage stomach qi. It is contraindicated to women during pregnancy, menstruation or lactation for it has actions of activating blood and resolving stasis, and can make the purged substances follow lactating out.

Che Qian Zi

Mu Tong

Sheng Di Huang

Gan Cao

Pinyin: Gan Cao Chinese: 甘草 Pharmaceutical: Radix Glycyrrhizae Taxonomy: Glycyrrhiza uralensis seu glabra seu inflata English: Liquorice Root
Tastes: Sweet, slightly cold Meridians Entered: Heart, Lung and Spleen (and all 12 meridians)
Actions & Indications: Tonifies the Spleen and augments Qi Spleen Qi Deficiency with shortness of breath, lassitude and loose stools Qi and Blood Deficiency with an irregular pulse and/or palpitations Heart Qi Deficiency or Heart Yang Deficiency Moistens the Lungs, resolves Phlegm and stops coughing Lung Heat or Cold Productive or non-productive coughing Moderates spasms and alleviates pain Painful muscle spasms of the abdomen and legs Clears Heat and relieves Fire Toxicity Raw for Toxic Heat with sore throat or carbuncles and sores (Chuang Yung) Antidote for many toxic substances (internal and topical) Poisoning Bites (after washing the wound, chew Gan Cao and apply a thick layer on the bite wound, changing whenever it dries out; Bao Xiang-Ao, 1846, New Compilation of Proven Formulas) Moderates and harmonizes the harsh properties of other herbs and guides the herbs to all twelve channels Often added in small doses to harmonise formulas Tonifies the Qi while suppressing Parasites Gu Sydnrome (Fruehauf, 1998) Chronic inflammatory disease (Fruehauf, 2015) Aids fasting Mentioned in the Shen Nong Ben Cao Jing as part of the superior class of herbs which can, with protracted taking, make the body light and prolong life. This may suggest it was part of supplementing the diet when engaging in an "avoiding grain" (Bigu 辟穀) fasting regime to cultivate life (Yangsheng 養生).
Standard Dosage: Typically 1.5-9g in decoction. Large doses can be up 30g. Cautions: It is contraindicated for combining with Hai Zao, Da Ji, Gan Sui and Yuan Hua because of "eighteen antagonisms". It is also contraindicated in cases of dampness obstruction in middle energizer and edema because it can help dampness obstruct qi, and it is prohibited from long-term usage in large dosage (more than 20g/day) and should be avoided or used with extreme caution in patients with high blood pressure because it may raise aldosterone levels in the blood causing retention of sodium. The NHS recommends avoiding during pregnancy.

Preparation: Divide into equal amounts and take, boiled in water, after meals.

Actions: Clears Heat, Cools and Nourishes the Liver to Subdue Wind

Notes:
Xi Xin Tang also means "Asarum Decoction" but seems an unusual moniker for this formula as it does not contain Xi Xin.

Research Links:

American Dragon

TCMWiki

Journal of Chinese Medicine

National Resource Centre for Chinese Materia Medica, China

TCM-ID Integrated Database, East China Normal University

TCM-ID Information Database, National University of Singapore

Pubmed

Science Direct

Google Scholar

Bai Du (Chinese)

A+ Medical Encyclopedia (Chinese)

Reference Notes: (click to display)

These pages are intended to assist clinicians and are not intended for self-diagnosis or treatment for which a qualified professional should be consulted.

Herb Formulas Notebook

細 辛 湯  Xi Xin San

Thin Pungent Decoction.