Transcript CHINESE MATERIA MEDICA - Acupuncture and Massage College

Class 7: Yin and Yang Tonics
Fayi Wu
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Herbs
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Fructus Corni (Shanzhuyu) MM: pp 855-858
Radix Dioscoreae (Shanyao) MM: pp 723-726
Cortex Moutan radicis (Mudanpi) MM: pp 126-128
Fructus Lycii (Gouqizi) MM: pp 759-761
Flos Chrysanthemi (Juhua) MM: pp 58-61
Rhizoma Anemarrhena (Zhimu) MM: pp 92-95
Cortex Phellodendri (Huangbai) MM: pp 138-141
Tuber Ophiopogonis (Mai men dong) MM: pp 822-825
Fructus Schizandrae (Wu wei zi) MM: pp 858-862
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Shan zhu yu (Fructus Corni)
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Categories: Herbs that stabilize and bind
Taste and Property: sour, slightly warm
Meridian tropism: Liver and kidney
Actions: augments the liver and kidneys, secures the primal qi,
prevents abandonment
Applications:
 For leakage of fluids due to weak essence with such symptoms
as urinary frequency, incontinence, spermatorrhea, and
excessive sweating.
 For excessive sweating, especially in cases of devastated yang
and collapsed qi, as in shock. Also used when sweating was
mistakenly induced as a treatment.
 For liver and kidney deficiency
 For deficiency patterns of excessive uterine bleeding and
prolonged menstruation
Dosage: 6~12g
Attention: contraindicated in cases with urinary pain and
difficulty, or where there is damp-heat
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Shan Yao (Rhizoma Dioscoreae)
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Categories: Herbs that tonify qi
Taste and Property: Sweet and neutral
Meridian tropism: Spleen, lung and kidney
Actions: supplement qi, nourish yin, tonify the spleen, the lung
and the kidney
Applications:
 Deficiency of the spleen qi marked by poor appetite and diarrhea
 Cough or asthma due to lung deficiency
 Kidney deficiency marked by emission, frequent urination and
leukorrhea: This herb can both tonify the kidney and astringe
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Emission due to kidney deficiency:
Frequent urination due to kidney deficiency:
Leukorrhea:
Diabetes: Used at a large dosage (250g/day), to be taken as tea
Dosage: 10-30g, or up to 60-250g
Attention: This herb can not be used for patients with abdominal
fullness due to dampness or retention of food
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Mu dan pi (Cortex Moutan radicis)
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Categories: Herbs that cool the blood
Taste and Property: acrid, bitter and slightly cold
Meridian tropism: Heart, liver and kidney
Actions: clears heat, cools the blood, invigorates blood and
removes blood stasis
Applications:
 For heat entering the blood level during a warm-heat pathogen
disease with nosebleed, blood in sputum or vomit or
subcutaneous bleeding,
 For yin deficiency patterns such as steaming bone disorder
 For liver blood stasis patterns with amenorrhea, abdominal
masses, lumps, or bruises due to traumatic injury
 For liver fire, used with zhi zi, i.e. jia wei xiao yao san
 Used topically for firm, non draining sores or internally for
intestinal abscess
Dosage: 6~12g
Attention: inappropriate for cold in the blood, or women who are
pregnant or have excessive menstrual bleeding
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Ju hua (Flos Chrysanthemi)
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Categories: Herbs that release the exterior
Taste and Property: Sweat, slightly bitter, slightly cold
Meridian Tropism: Lung and liver
Actions: disperses wind heat, resolves toxin, brightens eyes
Applications:
 Wind heat exterior pattern, used together with Bo He, Sang Ye,
Jie Geng for wind heat exterior pattern marked by cough, i.e.
Sang Ju Yin
 Red, swollen and painful eyes due to wind heat in the eyes or
upward attack of liver fire, often used together with Sang Ye,Xia
Ku Cao, Chan Tui.
 Vertigo of eyes due to deficiency of both the liver yin and the
kidney yin, often used together with Gou Qi Zi, Shu DI Huang,
etc., i.e. Qi Ju Di Huang Wan
 Calm hyperactivity of the liver yang, often used together with Shi
Jue Ming, Bai Shao Yao and Gou Teng, i.e.
Dosage: 6-12g
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Zhi Mu (Radix Anemarrhenae)
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Categories: Herbs that clear heat
Taste and Property: Bitter, sweet and cold
Meridian Tropism: Lung, stomach and kidney
Actions: Clear heat and purge fire, nourish yin and moisten dryness
Applications
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Excessive heat of the lung and stomach in epidemic febrile diseases,
Cough due to lung heat or yin deficiency marked by thick phlegm
Exuberance of fire due to yin deficiency marked by bone heat, tidal fever,
night sweating and restlessness
Diabetes due to yin deficiency, often used together with Tian Hua Fen and
Wu Wei Zi
Dosage: 6-12g.
Contraindication: Being cold and moist, this herb is not suggested for
loose stool due to spleen deficiency.
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Gou Qi Zi (Fructus Lycii)
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Categories: Herbs that tonify Yin
Taste and Property: Sweet and neutral
Meridian Tropism: Liver, Kidney and Lung
Actions: Nourish liver and kidney, improve vision, and moisten the lung
Applications:
 Deficiency of the liver blood and the kidney yin. This herb is a
very good herb for this condition
 Cough due to yin deficiency, used with Zhi Mu, Mai Dong and Bei
Mu
Dosage: 5-15g
Attention: Not suggested for patient with accumulation of dampness in
the middle jiao or with phlegm, retained water or fire.
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Huang bai (Cortex Phellodendri )
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Categories: Herbs that clear heat and dry dampness
Taste and Property: bitter and cold
Meridian tropism: kidney, bladder and large intestine
Actions: clear heat, dry dampness, directs fire down, resolves toxin,
clear deficiency heat
Applications:
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For damp-heat in the lower jiao: thick, yellow vaginal discharge, foul smelling
diarrhea, or dysenteric disorder, also for damp-heat pouring downward: red
swollen, and painful knees, leg or feet.
For empty fire: steaming bone disorder, night sweats, afternoon fevers and
sweating, nocturnal emissions and spermatorrhea
For fire toxin-generated sores and damp lesions of the skin
Dosage: 3~12g
Attention: inappropriate for cold from deficiency in the spleen and
stomach
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Mai Men Dong (Ophiopogonis, Radix )
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Categories: Herbs that tonify yin
Taste and Property: Sweet, slightly bitter and cold
Meridian Tropism: Heart, lung, and stomach
Actions: Moistens lungs and nourishs Yin, augments the stomach Yin
and generates fluids, clears the heart and eliminates irritability
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Applications:
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dry cough or epistaxis due to lung yin deficiency, Er Dong Gao
Heat impairing yin or diabetes, Sha Shen, Sheng Di huang, Yu Zhu
Insomnia or irritability due to yin deficiency, Tian wang bu xin dan
Dosage: 6-15g.
Attention: Deficiency cold of the spleen and stomach
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Wu wei zi (Fructus Schizandrae)
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Categories: Herbs that stabilize and bind
Taste and Property: sour, sweet and warm
Meridian tropism: heart, kidney and lung
Actions: contains leakage of lung qi, enriches the kidneys, constrains
essences, stop diarrhea, generates fluids and inhibits sweating, quiets the spirit
Applications:
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For chronic cough and wheezing due to lung deficiency or lung and kidney deficiency,
Gan Jiang, Xi Xin
For nocturnal emissions, spermatorrhea, vaginal discharge, and urinary frequency due
to kidney deficiency, Wu Wei Zi Gao
For excessive sweating, Sheng Mai San
For irritability, palpitations, dream-disturbed sleep and insomnia due to injury to yin and
blood
Dosage: 3~6g
Attention: contraindicated where an exterior disorder has not been cleared, or
there is heat from excess in the interior, or in the early stages of a cough or rash
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Formulas
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Liu Wei Di Huang Wan, Qi Ju Di Huang Wan,
Zhi Bai Di Huang Wan, Ba Xian Chang Shou
Wan, Ming Mu Di Huang Wan FS: pp 263265
Zuo Gui Yin FS: pp 266-267
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Liu wei di huang wan (Six
ingredient pill with rehmannia)
Categories: Formulas that tonify yin
Ingredients: Shu di huang, Shan zhu yu,
Shan yao, Fu ling, Mu dan pi, Ze xie
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Actions and indications of the formula
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Actions
 Enrich the yin and nourish the kidneys.
Indications
 Kidney yin deficiency in children characterized by an open
anterior fontanel, lack of spirit. Soreness and weakness in
the lower back, vertigo, tinnitus, diminished hearing, night
sweats, spontaneous and nocturnal emissions. hot palms
and soles, a chronic dry and sore throat, toothache, or
wasting and thirsting disorder. A red tongue with little
coating, a rapid and thin pulse.
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Analysis of Formula
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Monarch: Shu di huang
 enrich the kidney yin and essence.
Deputy: Shan zhu yu, shan yao
 Shan zhu yu: nourish the liver and restrain the leakage of
essence.
 Shan yao: stabilize the essence by tonifying the spleen
Assistant: ze xie, mu dan pi, fu ling
 Ze xie: clear and drain the overabundance of kidney fire, prevent
the rich, cloying properties of the chief herb from congesting the
mechanisms of the kidneys.
 Dan pi: clear and drain liver fire and is used here to
counterbalance the warm properties of Shan zhu yu.
 Fu ling: a bland herb that leaches out dampness from the spleen.
Paired with Shan yao to strengthen the transportive functions of
the spleen. Prevent the formula from clogging up the digestive
process.
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Modern application and modifications
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Modern application:
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Neurasthenia, pulmonary tuberculosis, diabetes mellitus, hyperthyroidism,
chronic nephritis, urinary tract infection, hypertension, functional uterine
bleeding, optic neuritis, optic nerve atrophy, and central retinitis
Modifications:
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Qi Ju Di Huang Wan: Add Gou qi zi and Ju hua. for dry or painful eyes,
diminished visual acuity, night blindness, photophobia
Zhi Bai Di Huang Wan: Add Zhi mu and Huang bai. for yin deficiency with
vigorous fire, consumptive heat, or steaming bone disorders. Also for urinary
difficulty and lower back pain from damp-heat in the lower burner in patients
with underlying kidney yin deficiency.
Ba Xian Chang Shou Wan (Eight immortal pill for longevity): Add Mai men
dong, Wu wei zi. For lung and kidney yin deficiency with cough with blood,
tidal fever, and night sweat.
Ming mu di huang wan: add sheng di, chai hu, dang gui, wu wei zi. For
diminished vision due to liver and kidney deficiency.
Shen qi wan: add fu zi, rou gui
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Zuo Gui Yin (Restore the left
decoction)
Categories: Formulas that tonify yin
Ingredients: Shu di huang, Shan zhu yu,
Shan yao, Fu ling, Gou qi zi, Zhi gan cao
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Actions and indications of the formula
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Actions
 Enrich the yin and nourish the kidneys.
Indications
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Soreness and weakness in the lower back, night sweats,
spontaneous and nocturnal emissions. Dry mouth and
throat. A peeled, shiny tongue, a rapid and thin pulse
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Analysis of Formula
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Monarch: Shu di huang
 enrich the kidney yin and essence.
Depute: Shan zhu yu, shan yao, gou qi zi
 Shan zhu yu: nourish the liver and restrain the leakage of
essence.
 Shan yao: stabilize the essence by tonifying the spleen
 Gou qi zi: nourish liver blood
Assistant: fu ling, zhi gan cao
 Fu ling: a bland herb that leaches out dampness from the spleen.
Paired with Shan yao to strengthen the transportive functions of
the spleen. Prevent the formula from clogging up the digestive
process.
 Zhi gan cao: augment qi and strengthen spleen.
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Formula Comparisons
Formula
Ingredient
Zuo gui yin
Shu di huang, shan yao, shan zhu yu, fu ling
Gou qi zi, zhi gan cao
Actions
Liu wei di huang wan
Ze xie, dan pi
Nourish the yin and enrich the kidney
Little heat
Mild action of clearing heat
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Herbs
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Ramulus Cinnamomi (Gui zhi) MM: pp 8-11
Aconite (Fu zi) MM: pp 673-677
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Gui Zhi (Ramulus Cinnamomi )
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Categories: herbs that release exterior
Taste and Nature: Pungent, sweet and warm
Channel tropism: Heart, lung and bladder
Actions: induces sweating, releases exterior, warm the channel, and unblock
yang qi
Application:
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Treat exterior syndrome of deficiency type with symptoms of wind-cold type
Relieve pain by dispersing wind cold from the channels and collaterals, applicable to
pain or soreness in the shoulder and lumbar region
Assist yang to promote flow of yang qi and remove obstruction from the collaterals,
applicable to phlegm syndrome, abdominal pain due to yang deficiency and
dysmenorrhea due to accumulation of cold in the collaterals
Dosage: 3-9g for oral use
Contraindications: Pregnancy ,Menorrhagia, Deficiency heat syndrome.
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Fu Zi (Prepared Aconite)
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Categories: herbs that warm interior
Taste and Property: Pungent and hot
Meridian Tropism: Heart, kidney and spleen
Actions: Rescue yang from collapse, Tonify fire and assist yang, Disperse cold
and relieve pain
Applications
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Collapse of yang: Marked by cold sweating, cold limbs, feeble and indistinct pulse
Fu Zi can assists the heart yang to promote flow of qi and blood in the vessels and
tonify the kidney yang to supplement fire to rescue the depleting yang. Often used
together with Gan Jiang and Gan Cao, i.e. Si Ni Tang
Yang deficiency patterns: Yang deficiency of the kidney, the spleen and the heart can
all be treated with this herb.
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Kidney Yang deficiency: Marked by aversion to cold, cold limbs, soreness and weakness of the
loins and knees, impotence and frequent urination.
Spleen yang deficiency with excess of cold marked by cold pain in the abdomen, and loose
stool
Heart yang deficiency: Palpitation, shortness of breath, cardialgia due to CHD
Arthralgia: More suitable for exuberance of cold dampness marked by pain of the
joints of all over the body, often used together with Gui Zhi and Bai Zhu, i.e. Fu Zi Gan
Cao Tang
Dosage: 3-15g. It should be decocted first for 30-60m to reduce its toxicity
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Formulas
Jin Gui Shen Qi Wan FS: pp 275-278
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Jin Gui Shen Qi Wan (Kidney Qi
Pill from the Golden Cabinet)
Categories: formulas that tonify yang
Ingredients: Shu di huang, Shan zhu yu,
Shan yao, Fu ling, Mu dan pi, Ze xie, Fu zi,
Gui zhi
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Actions and indications of the formula
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Actions
 Warm and tonify Kidney Yang .
Indications
 Lower back pain, weakness of the lower
extremities, a cold sensation in the lower half of
the body, dyspnea, A pale swollen tongue with a
thin white and moist coating, empty pulse, Difficult
urination with edema or excessive urination with
incontinence.
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Analysis of Formula
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Liu wei di huang wan:
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Fu zi:
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tonify the source of fire, dispel cold, eliminate dampness
Gui zhi:
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tonify kidney yin
benefit the joints, warm the channels, and unblock the
vessels. Warm the bladder and promote urination by
assisting in the transformation the organ’s qi.
Together they assist yang and enhance the
metabolism of water.
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Modern application and modifications
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Modifications
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Replace Gui zhi with Rou gui in order to accentuate the
warming and tonification of the lower burner, which leads
the fire back to its source in kidneys. treating wheezing,
severe sweating, weakness and cold of the lower
extremities, and a deficient, rootless pulse.
Modern application:
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Nephritis, chronic urethritis, diabetes mellitus,
hypothyroidism, neurasthenia, arthritis, chronic bronchial
asthma.
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