Transcript Harmonizing, Dryness and Dampness Formulas

Harmonizing, Dryness
and Dampness
Formulas
HBR class 9
Formulas that
Harmonize
*Minor Bupleurum Decoction
(xiao chai hu tang)
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C:
Chai Hu
D:
Huang Qin
A:
Ban Xia, Sheng Jiang, Ren Shen, Zhi Gan
Cao, Da Zao
Pattern: Lesser Yang Disorder
Indications: Alternating fever and chills, dry throat,
bitter or sour taste in the mouth, dizziness, irritability,
sensation of fullness in the chest and hypochondria
(often experienced as difficulty in taking deep breaths),
heartburn, nausea and vomiting, reduced appetite, a
thin, white tongue coating, and a wiry pulse.
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CAUTIONS AND CONTRAINDICATIONS: has an
ascending action which can injure the qi and cause
headache, dizziness, and bleeding of the gums if taken
long-term.
Contraindicated in patients with excess above and
deficiency below, Liver Fire, or bleeding of the gums.
Caution in cases of ascendant Liver yang, hypertension, or
vomiting of blood due to yin deficiency.
Patients with relatively weak normal qi may experience
fever and chills while taking this formula because the
pathogenic influence is vented from the lesser yang stage
via the greater yang.
Major Bupleurum Decoction
(da chai hu tang)
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C: Chai Hu
Huang Qin, Da Huang, Zhi Shi, Sheng Jiang, Da Zao,
Bai Shao Yao, Ban Xia, Zhi Gan Cao
Pattern: Concurrent lesser yang and yang brightnessstage disorder.
Indications: Alternating fever and chills, fullness in the
chest and hypochondria (with or without pain), a bitter
taste in the mouth, nausea, continuous vomiting, hard
focal distention or fullness and pain in the epigastrium,
burning diarrhea or no bowel movements, despondency,
slight irritability, a yellow tongue coating, and a wiry,
forceful pulse.
*Frigid Extremities Powder
(si ni san)
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C:
Chai Hu
D:
Zhi Shi
A:
Bai Shao
E:
Zhi Gan Cao
Pattern: Rebellious Liver qi disturbing the Stomach (or
yang-type collapse)
Indications: Cold fingers and toes (although the body
is warm) sometimes with a sensation of irritability and
fullness in the chest and epigastrium, a red tongue
with a yellow coating, and a wiry pulse. There may
also be abdominal pain and/or severe diarrhea.
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MODIFICATION / ASSOCIATED FORMULA
Bupleurum Powder to Spread the Liver (chai hu
shu gan san)
Chai Hu, Bai Shao, Xiang fu, Chuan xiong, Zhi Ke,
Chen pi, Zhi Gan Cao
Spreads the Liver qi, harmonizes the blood, and
alleviates pain. For constraint and clumping of the
Liver qi with hypochondriac pain and alternating fever
and chills. Also for premenstrual syndrome or
dysmenorrhea.
*Rambling Powder
(xiao yao san)
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C:
Chai Hu
D:
Dang Gui, Bai Shao
A:
Bai Zhu, Fu Ling, Zhi Gan Cao
E:
Wei Jiang, Bo He
Pattern: Liver Constraint with Blood Deficiency
Indications: Hypochondriac pain, headache, vertigo, a
bitter taste in the mouth, dry mouth and throat, fatigue,
reduced appetite, pale-red tongue, and a wiry,
deficient pulse. There may also be alternating fever
and chills, and irregular menstruation or distended
breasts.
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MODIFICATION / ASSOCIATED FORMULA
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Augmented Rambling Powder (jia wei xiao yao san)
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Chai Hu, Dang Gui, Shao Yao, Bai Zhu, Fu Ling, Mu Dan
Pi, Zhi Zi, Zhi Gan Cao
Spreads the Liver qi, strengthens the Spleen, nourishes the
blood and clears heat.
For Liver constraint with Spleen deficiency that transforms
into heat characterized by irritability, a short temper with
possible tidal fever and sweating, red eyes, dry mouth,
palpitations, lower abdominal pressure, difficult painful
urination, and increased menstrual flow or uterine bleeding.
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MODIFICATION / ASSOCIATED FORMULA
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Black Rambling Powder (hei xiao yao san)
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Chai Hu, Dang Gui, Bai Shao, Fu Ling, Sheng Di Huang,
Gan Cao
Spreads the Liver qi, strengthens the Spleen, nourishes
the blood and regulates menstruation.
For the same presentation as the principal formula, but
with more severe blood deficiency characterized by
premenstrual cramps or excessive menstrual bleeding,
and a wiry deficient or wiry rapid pulse.
Important Formula for Painful
Diarrhea (tong xie yao fang)
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C: Bai Zhu
Bai Shao Yao, Chen Pi, Fang Feng
Pattern: Painful diarrhea due to Spleen deficiency with
an overcontrolling Liver.
Indications: Recurrent problems of borborygmus,
abdominal pain, diarrhea with pain (which starts with
the urge to defecate and subsides after completion), a
thin, white tongue coating, and a wiry, moderate or
wiry, thin pulse.
*Pinellia Decoction to Drain the
Epigastrium (ban xia xie xin tang)
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C:
ban xia
D:
gan jiang, huang qin, huang lian
A:
ren shen, da zao
E:
zhi gan cao
Pattern: Heat-Cold Complex in the Middle Burner
Indications: Epigastric focal distention, epigastric fullness
and tightness with very slight or no pain, dry heaves or
frank vomiting, borborygmus with diarrhea, reduced
appetite, a thin, yellow, and greasy tongue coating, and
a wiry, rapid pulse.
Gan Cao Xie Xin Tang
(Licorice Decoction to Drain the Epigastrium)
Gan Cao Xie Xin Tang (Licorice Decoction to Drain the Epigastrium)
Ingredients:
Ban Xia Xie Xin Tang(Pinellia Decoction to Drain the Epigastrium)
Increase the dosage of the gan cao to 12-15g
Pattern: strengthens, regulates the stomach, relieves focal distention,
and stops vomiting; for severe Stomach Qi Deficiency with ColdHeat Complex Syndrome.
Indications:
For inappropriate purgation with severe stomach qi deficiency.
Sheng Jiang Xie Xin Tang
(Fresh Ginger Decoction to Drain the Epigastrium)
Ingredients:
Ban Xia Xie Xin Tang(Pinellia Decoction to Drain the Epigastrium)
Minus dried ginger to 3g, adds 12g fresh ginger
Pattern:
regulate the Stomach, reduce focal distention, dispel clumping and purge
water; for Water Heat Complex, or Stomach Deficiency with Food
Stagnation.
Indications:
For water and heat bound together
Formulas that Treat
Dryness
Apricot Kernel and Perilla
Leaf Powder (xing su san)
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C:
Xing Ren, Zi Su Ye
Qian Hu, Jie Geng, Zhi Ke, Chen Pi, Fu Ling, Ban Xia,
Sheng Jiang, Da Zao, Gan Cao
Pattern: Externally-contracted cool-dryness interfering
with the disseminating and descending functions of the
Lungs.
Indications: Slight headache, chills without sweating,
cough with watery sputum, stuffy nose, dry throat, a
dry, white tongue coating, and a wiry pulse.
Mulberry Leaf and Apricot Kernel
Decoction (sang xing tang)
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C: Sang Ye, Xing Ren
Zhi Zi, Dan Dou Chi, Zhe Bei Mu, Sha Shen, Bei Sha
Shen, Li Pi
Pattern: Warm-dryness injuring the Lung qi at a relatively
superficial (exterior) level.
Indications: Moderate fever, headache, thirst, a dry,
hacking cough or cough with scanty, thick, and sticky
sputum, a red tongue with a thin, dry, and white coating,
and a floating, rapid pulse (especially on the right).
Eliminate Dryness and Rescue the
Lungs Decoction (qing zao jiu fei tang)
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C: Sang Ye, Shi Gao
Mai Men Dong, E Jiao, Hei Zhi Ma, Xing Ren, Pi Pa Ye,
Ren Shen, Gan Cao
Pattern: Warm-dryness attacking the Lungs.
Indications: Headache, fever, hacking cough, wheezing,
a dry and parched throat, dry nasal passages, a
sensation of fullness in the chest, hypochondriac pain,
irritability, thirst, a dry tongue without coating, and a
deficient, big, and rapid pulse.
Lily Bulb Decoction to Preserve the
Metal (bai he gu jin tang)
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C: Bai He, Sheng Di Huang, Shu Di Huang
Mai Men Dong, Xuan Shen, Chuan Bei Mu, Jie Geng,
Dang Gui, Bai Shao, Gan Cao
Pattern: Internal dryness of the Lungs due to Lung and
Kidney yin deficiency.
Indications: Coughing with blood-streaked sputum,
wheezing, a dry and sore throat, hot palms and soles,
night sweats, a red tongue with little coating, and a thin,
rapid pulse.
Ophiopogonis Decoction
(mai men dong tang)
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C: Mai Men Dong
Ren Shen, Jing Mi, Da Zao, Gan Cao, Ban Xia
Pattern: Lung atrophy (fei wei).
Indications: Coughing and spitting of saliva, wheezing,
shortness of breath, a dry and uncomfortable
sensation in the throat, a dry mouth, a dry, red tongue
with little coating, and a deficient, rapid pulse.
Increase the Fluids Decoction
(zeng ye tang)
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C: Xuan Shen
Mai Men Dong, Sheng Di Huang
Pattern: This is dry Intestines due to injury to the fluids,
usually from a warm-febrile disease.
Indications: Constipation, thirst, a dry, red tongue, and
a thin and slightly rapid, or a weak, forceless pulse.
Formulas that Expel
Dampness
*Five-Ingredient Powder with
Poria (wu ling san)
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C:
Ze Xie
D:
Fu Ling, Zhu Ling
A:
Bai Zhu
E:
Gui Zhi
Pattern: Taiyang-sage Water Buildup (Xu Shui)
Indications: (1) Headache, fever, irritability, strong thirst
but with vomiting immediately after drinking, urinary
difficulty, and a floating pulse;
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Indications, continued:
(2) edema, generalized sensation of heaviness,
diarrhea, urinary difficulty, and possible vomiting and
diarrhea due to sudden turmoil disorder;
(3) throbbing pulsations just below the umbilicus,
vomiting frothy saliva, vertigo, shortness of breath, and
coughing.
COMMENTARY: The basic strategy is to restore to the
qi its function of regulating fluid metabolism. This
formula may therefore be used in treating other
problems than those described above.
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CAUTIONS AND CONTRAINDICATIONS: In patients
with Spleen or Kidney qi deficiency, the dosage and
duration of use of this formula must be carefully
limited.
Symptoms of overdose may include dizziness, vertigo,
a bland taste, and reduced appetite.
In cases with deficiency, this formula is often combined
with others that tonify and nourish the Spleen and
Stomach to prevent injury to the normal qi.
In cases of urinary difficulty with yin deficiency, this
formula should be modified to protect the yin from
further injury.
*Polyporus Decoction
(zhu ling tang)
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C:
Zhu Ling, Fu Ling
D:
Ze Xie
A:
Hua Shi, E Jiao
Pattern: Injury from cold entering the yang brightness
or the lesser yin stage where it transforms into heat.
Indications: Urinary difficulty accompanied by fever
and thirst with a desire to drink. There may also be
diarrhea, cough, nausea, irritability, or insomnia.
*Five-Peel Powder (wu pi
san)
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Sang Bai Pi, Sheng Jiang Pi, Fu Ling Pi, Chen Pi, Da
Fu Pi
Pattern: Skin edema (pi shui).
Indications: Generalized edema with a sensation of
heaviness, distention, and fullness in the epigastrium
and abdomen, labored and heavy breathing, urinary
difficulty, a white, greasy tongue coating, and a
submerged and moderate pulse.
Add Spleen-tonifying herbs for SP deficiency.
*Calm the Stomach Powder
(ping wei san)
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C:
Cang Zhu
D:
Hou Po
A:
Chen Pi
E:
Zhi Gan Cao, Sheng Jiang, Da Zao
Pattern: Damp-Cold Stagnating in SP/ST
Indications: Distention and fullness in the epigastrium and
abdomen, loss of taste and appetite, heavy sensation in
limbs, loose stool or diarrhea, easily-fatigued, increased
desire to sleep, nausea & vomiting, belching, acid
regurgitation, swollen tongue with thick white greasy
coating, moderate or slippery pulse.
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CAUTIONS AND CONTRAINDICATIONS: This
formula contains warm, drying herbs which easily
injure the yin and the blood, and should therefore only
be used with significant modification for patients with
yin deficiency or blood deficiency.
It should also be used with caution during pregnancy.
*Agastache Powder to Rectify the Qi
(huo xiang zheng qi san)
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C:
Huo Xiang
D:
Hou Po, Chen Pi, Zi Su Ye, Bai Zhi
A:
Ban Xia, Da Fu Pi, Bai Zhu, Fu Ling, Jie Geng
E:
Zhi Gan Cao, Sheng Jiang, Da Zao
Pattern: Externally-contracted wind-cold with
concurrent internal injury due to stagnation.
Indications: Fever and chills, headache, fullness and
stifling oppression in the chest, pain in the epigastrium
& abdomen, nausea & vomiting, borborygmus,
diarrhea, loss of taste, white, greasy tongue coating,
moderate, soggy pulse.
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CAUTIONS AND CONTRAINDICATIONS: Because
this formula contains warm and drying herbs, it should
not be used without significant modification for
conditions of wind-heat or fire due to deficiency.
*Eight-Herb Powder for
Rectification (ba zheng san)
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C:
Mu Tong
D:
Hua Shi, Che Qian Zi, Qu Mai, Bian Xu
A:
Zhi Zi, Da Huang
E:
Deng Xin Cao, Gan Cao
Pattern: Hot or bloody painful urinary dysfunction caused
by the clumping of damp-heat in the lower burner.
Indications: Dark, turbid, scanty, difficult, and painful
urination, a dry mouth and throat, a yellow, greasy tongue
coating, and a slippery, rapid pulse. In severe cases,
there may be urinary retention and lower abdominal
distention and pain.
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CAUTIONS AND CONTRAINDICATIONS: Long-term
use of this formula may cause weakness, lightheadedness, palpitations, and a loss of appetite.
It should not be used without significant modification in
treating conditions of cold from deficiency, or during
pregnancy.
Artemisia Yinchenhao
Decoction (yin chen hao
tang)
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C:
Yin Chen Hao
Shan Zhi Zi, Da Huang
Pattern: Yang-type jaundice or damp-heat jaundice
due to dampness and static heat accumulating in the
interior.
Indications: Whole-body jaundice with color that
resembles a fresh tangerine, slight abdominal
distention, urinary difficulty, thirst (with the ability to
take only sips), a yellow, greasy tongue coating, and a
slippery, rapid pulse.
Shao Yao Tang (Peony Decoction)
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C:
bai shao yao:
D:
dang gui, gan cao, bing lang, mu xiang
A:
huang lian, huang qin, rou gui
Pattern: Damp-heat lodged in the intestines where it
causes the qi and blood to stagnate.
Indications: Abdominal pain, tenesmus, difficulty with
defecation, diarrhea with pus and blood, a burning
sensation around anus, dark, scanty urine, a greasy,
slightly yellow tongue coating, and a rapid pulse
Er Miao San
(Two-Marvel Powder)
Ingredients:
C: Huang Bai: clear Damp heat in the lower jiao
D: Cang Zhu: Dries the dampness
Pattern: Clears Heat and Dries Dampness
Indications: Damp-Heat in Lower Jiao
1. Painful obstruction syndrome (Damp-Heat Pattern of Bi Syndrome)
2. Atrophy disorder: Weakness, sores or atrophy of the lower extremities,
accompanied by scanty yellow urine.
3. Vaginal discharge: Thick, yellow or bloody, foul-smelling vaginal discharge.
*True Warrior Decoction
(zhen wu tang)
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C:
Fu Zi
D:
Bai Zhu, Fu Ling
A:
Sheng Jiang, Bai Shao
Pattern: Retention of Pathogenic Fluids with Kidney
Yang (or Spleen and Kidney Yang) Deficiency
Indications: Abdominal pain which is aggravated by
cold, urinary difficulty, and deep aching and heaviness
in the extremities.
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Indications, continued:
There may also be generalized edema, loose stools,
dizziness, a heavy sensation in the head, palpitations,
coughing, vomiting, a pale or dark swollen tongue with
tooth marks, a white, slippery tongue coating, and a
submerged, thin, and forceless pulse.
Also for externally-contracted disorders with sweating
that does not reduce the fever, palpitations in the
epigastrium, dizziness, shivering and trembling with an
unsteady appearance, a white, slippery tongue
coating, and a submerged, thin, and forceless pulse.
Shi Pi Yin
(Bolster the Spleen Decoction)
Shi Pi Yin (Bolster the Spleen Decoction)
Ingredients:
Chief:
Gan Jiang: Warms and moves the spleen yang, moves and transforms waterdamp
Fu Zi: Warms the kidney and assists yang, transforms qi and moves water
Assistant:
Bai Zhu: fortifies the spleen and dries damp
Fu Ling: Drains damp by bland dispersion
Auciliary:
Mu Gua: Dispels damp and disperses water, Arouses the spleen and
harmonizes the stomach
Shi Pi Yin
(Bolster the Spleen Decoction)
Auciliary:
Hou Po: Moves qi and eliminates fullness, bitter, warm, dry, and damp
Mu xiang: moves qi and relieves pain, harmonizes the spleen and stomach
Da Fu Zi: Move qi and disperse water
Cao Guo Ren: Acrid, hot, dry, and hard
Sheng Jiang, Da Zao: boost qi and harmonize the stomach
Guilding herb:
Gan Cao: Harmonizes all the medicinals
Pattern:
Warms and fortifies the spleen, move qi, and drains water.
Indications:
Yang deficiency and edema.
Dioscorea Hypoglauca Decoction to
Separate the Clear (bei xie fen qing yin)
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C:
Bei Xie
Yi Zhi Ren, Wu Yao, Fu Ling, Shi Chang Pu, Gan Cao
Pattern: Cloudy painful urinary dysfunction (gao lin) d/t
cold from deficiency in the lower burner.
Indications: Frequent urination with cloudy, dense,
milky (resembling rice water), or greasy urine.
Note: There is a similarly-named formula for DampHeat
*Angelica Pubescens and Sangjisheng
Decoction
(du
huo
ji
sheng
tang)
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Du Huo
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D:
Xi Xin, Fang Feng, Qin Jiao
A:
Sang Ji Sheng, Du Zhong, Niu Xi, Rou Gui, Dang
Gui, Chuan Xiong, Sheng Di Huang, Bai Shao, Ren Shen,
Fu Ling
E:
Zhi Gan Cao
Pattern: Painful obstruction with Liver-Kidney Deficiency
Indications: Heavy and painful sensations at fixed
locations in the lower back and lower extremities
accompanied by weakness and stiffness, an aversion to
cold and attraction to warmth, palpitations, shortness of
breath, a pale tongue with a white coating, and a thin,
weak, slow pulse.
Notopterygium Decoction to Overcome
Dampness (qiang huo sheng shi tang)
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C:
Qiang Huo, Du Huo
Fang Feng, Gao Ben, Chuan Xiong, Man Jing Zi, Zhi
Gan Cao
Pattern: Wind-dampness in the superficial aspects of
the body, the exterior and muscle levels
Indications: Heavy and painful head, a generalized
sensation of heaviness, back pain or generalized pain,
difficulty in rotating or bending the trunk, mild fever,
chills, a white tongue coating, and a floating pulse.
Remove Painful Obstruction Decoction
from Medical Revelations (juan bi tang)
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C:
Qiang Huo, Du Huo
Qin Jiao, Sang Zhi, Hai Feng Teng, Dang Gui, Chuan
Xiong, Ru Xiang, Mu Xiang, Rou Gui, Gan Cao
Pattern: Joint pain due to local obstruction of qi from
the effects of wind, dampness, and cold.
Indications: Joint pain that increases with cold and
diminishes with warmth, possibly accompanied by a
sensation of heaviness and numbness in the limbs, a
thick, white tongue coating, and a slow, possibly
slippery pulse.
Cinnamon Twig, Peony, and
Anemarrhena Decoction (gui zhi shao
yao zhi mu tang)
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C:
Gui Zhi, Ma Huang
Fu Zi, Zhi Mu, Bai Shao, Bai Zhu, Fang Feng, Sheng Jiang,
Gan Cao
Pattern: Recurrent wind-cold-damp painful obstruction in
which localized constraint generates heat.
Indications: Swollen and painful joints (especially of the
lower extremities), joints that are warm to the touch and
worsen at night, reduced range of motion in the affected
joints, chills, no sweating, weight loss, headache,
dizziness, a white, greasy tongue coating, and a wiry,
slippery pulse.