Chinese Herbal Medicine
Practitioner Use Clinical Guide
Frequently Asked Questions
The protocols given here are very effective and have been developed, refined and tested in a busy modern clinic, catering to the needs of a variety of patients. In order to achieve good, and in many cases remarkably swift clinical results, they require the use of high dosages for several weeks. In patients who have poor digestion, it is advisable to begin the treatment below the recommended dosages, gradually increasing the dose, while making sure that the patient is able to tolerate the medicines without gastro-intestinal upset.
As with all protocols, those given here should be applied flexibly, with due consideration given to the aetiology and pathogenesis of each patient's individual condition. Thus, both the dosages as well as formula combinations should be prescribed appropriate to each patient's individual requirements.
Although each patient is unique and each disease state is also unique, there are some broad general guidelines that may be applied in our approach to designing a treatment regimen, specifically in regards to prognosis. The approximate course of treatment will vary according to the duration of the patient's condition:
- Chronic conditions: 1 – 3 years, or ongoing
- Sub-acute conditions: 3 – 6 months
- Acute conditions: 2 – 4 weeks
It is also important to bear in mind that once treatment of the acute stage symptoms has been successfully completed, it is often necessary to focus on the underlying imbalances that caused the condition. In this way, the treatment results can be consolidated, preventing recurrence of the condition. Thus, the second stage of treatment (for the underlying factors) may need to continue for 3 – 6 months or more depending on the age of the patient, the history of the illness and the patient's lifestyle.
Key Herbal Formulas For Modern Practice
This is a variant of the original Ban Xia Hou Po Tang, which was recorded in the 'Synopsis of Prescriptions of the Golden Cabinet' (jin gui yao lue fang lun) by Zhang Zhong-jing (circa 150 – 219 CE). The formula was originally described under gynaecological disorders for the major presenting symptom of a sensation in the throat as if a piece of roasted meat was stuck there, referred to as 'plum-pit qi' (mei he qi). In Western medicine this is known as 'globus hystericus'.
The formula has several synergistic therapeutic actions: a) moves the Qi and resolves constraint, b) harmonises the Stomach and redirects the Qi downward, c) resolves Phlegm and breaks up 'clumping' (i.e. bound pathogens – in this case stagnant Qi and Phlegm). In this way, the formula addresses the physical sensations of plum-pit qi in the throat (actions b and c), while also resolving the emotional stress that has contributed to the disorder (actions a and c).
This variant has been enhanced with the addition of Curcuma tuber (yu jin) and Amomum fruit (sha ren). While both herbs promote the movement of Qi, the former enters the Liver channel and helps to resolve constrained Liver Qi (i.e. Qi stagnation due to emotional strain), while the latter acts mainly on the middle Jiao, drying Damp and harmonising the Spleen and Stomach.
This is an ancient Phlegm resolving formula that precedes the other commonly used Phlegm formulas, such as Er Chen Tang (Citrus and Pinellia F) and Wen Dan Tang (Bamboo & Hoelen F.), by about 1,000 years. In resolving Phlegm and constrained Qi, this formula is suitable for treating stubborn and persistent emotional problems, such as depressed mood. The key physical signs and symptoms for its use include the feeling of something being stuck in the throat and not being able to move it down by swallowing or bring it up by coughing; a white greasy tongue coat and a wiry-slippery pulse.
Herbs
- Pinellia ternata, tuber (ban xia)
- Magnolia officinalis, stem bark (hou po)
- Poria cocos, fruit. body (fu ling)
- Perilla frutescens, leaf (zi su ye)
- Curcuma longa, tuber (yu jin)
- Zingiber officinale, rhiz. (sheng jiang)
- Amomum villosum, fruit (sha ren)
Actions
- Moves Qi
- Redirects Qi downward
- Resolves Phlegm
Syndromes
- Plum-pit Qi
- Qi-Phlegm
Signs & Symptoms
Indications & Combinations
[restrict]- Laryngitis (chronic)
- Pharyngitis (chronic)
- Globus hystericus
- Gastro-oesophageal reflux
- Chronic gastritis
- Oesophageal spasm
- Chemotherapy side effects (gastrointenstinal)
This is a modern empirical formulation that was developed by doctors at the Shuguang Hospital of the Shanghai College of Traditional Chinese Medicine to treat hypertension occurring in menopausal women. This formula aims at balancing the endocrine functions by tonifying the Kidney and reducing Fire. It treats the pattern of lower Jiao deficiency (i.e. Kidney deficiency) and upper Jiao excess (i.e. excess Fire in the upper body), and is directed towards menopausal women with both Kidney Yang and Kidney Yin deficiency with deficiency Heat or Fire that leads to various types of inflammatory disorders. Through the combined therapeutic actions of tonifying the Kidney Yang, nourishing the Kidney Yin and reducing Fire, this formula provides a very strong treatment in stubborn conditions.
Although there are only few ingredients, they work synergistically to give a focused action with good clinical efficacy.
Up until fairly recently, the general approach to treating problems due to menopause has been to nourish the Kidney Yin and reduce the deficiency Heat (or Fire) with Liu Wei Di Huang Wan and its variants. However, in recent years the trend within TCM has been to also treat Kidney Yang deficiency, as this may also lead to deficiency Fire and inflammation. This newer approach, to address both the Kidney Yin and Kidney Yang deficiency provides much better clinical efficacy in a shorter time frame.
Thus, Er Xian Tang addresses the main syndrome-pattern that underlies menopause-related disorders, and its effect on reducing hypertension in these women is far superior to other approaches (e.g. settling the rising Yang and calming the Spirit).
Herbs
- Epimedium sagittatum, herb (yin yang huo)
- Curculigo orchioides, rhiz. (xian mao)
- Eucommia ulmoides, stem bark (du zhong)
- Angelica polymorpha, root (dang-gui)
- Morinda officinalis, root (ba ji tian)
- Phellodendron amurense, stem bark (huang bai)
- Anemarrhena asphodeloides, rhiz. (zhi mu)
Actions
- Tonifies Jing
- Tonifies the Kidney
- Clears Deficiency-Heat
- Regulates the Chong and Ren Channels
Syndromes
- Kidney Jing deficiency
- Kidney Qi deficiency
- Deficiency-Heat
Signs & Symptoms
Indications & Combinations
[restrict]- Hot flushes in menopause
- Premature menopause with amenorrhea
- Essential hypertension
Huang Lian Jie Du Wan is from the Tang dynasty and was first recorded in 'Medical Secrets of an Official' (wai tai mi yao), by Wang Tao, 752 CE. This is a simple formula with a small number of ingredients, which gives it a very focused therapeutic action, resulting in great clinical efficacy. Specifically, it acts to clear Heat-Toxin.
This is a unique formula with special value in TCM as it may be used for both externally contacted disorders as well as those due to internal injury. In addition, although it is a bitter-cold medicine, it is generally well tolerated by patients compared with other bitter-cold formulas, and can be safely taken at high dosage without upset for up to one week treatment period.
Herbs
- Coptis chinensis, root (huang lian)
- Scutellaria baicalensis, root (huang qin)
- Phellodendron amurense, stem bark (huang bai)
- Gardenia jasminoides, fruit (shan zhi zi)
Actions
- Drains Fire
- Clears Damp-Heat
- Clears Heat-Toxin
Syndromes
- Excess Heat
- Damp-Heat
- Heat-Toxin
Signs & Symptoms
Indications & Combinations
[restrict]- All types of infection due to attack by Heat-Toxin, such as tooth ache or inflammation of the gums due to flourishing Fire in the Heart; erysipelas; furuncle (boil); carbuncle; dysentery.
- Suppression of reflux and treatment of stomach ulcers. It not only relieves symptoms of acid reflux, it also destroys Helicobacter.
- Assists in the reduction of blood pressure in hypertension.
- Regulates the blood sugar and blood lipids in the treatment of blood sugar disorders and dyslipidemia.
- Improves blood flow in the brain and assists in recovery post stroke.
This formula is from the Ming dynastic period, and was recorded in 'Records of Heart-felt Experiences in Medicine with Reference to the West' (yi xue zhong zhong can xi lu) by Zhang Xi-chun, circa 1935. It is the best formula for activating the Blood to dispel stasis and alleviate pain; it is indicated for all painful conditions due to Qi stagnation and Blood stasis. According to TCM theory, pain arises when there is obstruction to the normal free movement of the Qi and Blood.
This formula can be used for all types of pain in all bodily locations, especially in the abdomen, limbs, eyes, ears, nose and throat, as well as gynaecological and paediatric conditions. It treats pain both in the Channel (jing -luo) system as well as the internal organs (zang-fu).
This is a focused formula with only five ingredients and in addition to pain it effectively targets swellings and masses (ji-ju) due to Qi and Blood stagnation.
Herbs
- Salvia miltiorrhiza, root (dan shen)
- Boswellia carterii, sap resin (ru xiang)
- Commiphora myrrha, sap resin (mo yao)
- Angelica polymorpha, root (dang-gui)
- Glycyrrhiza uralensis, root (gan cao)
Actions
- Activates the Blood and dispels Stasis
- Unblocks the collaterals and alleviates pain
Syndromes
- Blood Stasis obstructing the collaterals
Signs & Symptoms
Indications & Combinations
[restrict]- Gout, arthritis
- Acute traumatic injuries of the joints and muscles and ligaments
- Endometriosis and severe menstrual pain
- Internal organ pain, e.g. angina, biliary colic, nephritic colic
- Uterine fibroids, ovarian cysts (adjuvant treatment to help reduce the size of the lesion and alleviate pain)
The original formula has been enhanced with the addition of Fallopia (a.k.a. Polygonum) multiflora stem (ye jiao teng), Albizia flower (he huan hua), and Polygala root (yuan zhi), as these herbs act to calm the Spirit and settle the emotions.
The original Suan Zao Ren Tang is the earliest recorded formula with the actions of calming the Spirit and alleviating irritability. Later generations of Chinese physicians have developed further uses for this formula and have used it as a basis for treating various types of insomnia due to other causes, such as Heart-Kidney disharmony with Yin deficiency, Heart and Spleen disharmony, etc.. Thus, we can see Zhang Zhong-jing's genius in designing a formula that has been used by subsequent herbal physicians as the essential building block for clinical prescribing in a wide range of clinical presentations of insomnia.
In terms of prepared formulas, if we accurately interpret the patient's signs and symptoms, then by skillfully combining an appropriate formula, stubborn cases of insomnia and associated emotional irritability may be effectively treated.
Herbs
- Ziziphus jujuba var. spinosa, seed (suan zao ren)
- Fallopia multiflora, stem (ye jiao teng)
- Poria cocos, hyphae (fu ling)
- Anemarrhena asphodeloides, rhiz. (zhi mu)
- Ligusticum wallichii, rhiz. (chuan xiong)
- Albizia julibrissin, flower (he huan hua)
- Polygala sibirica, root (yuan zhi)
- Glycyrrhiza uralensis, root (gan cao)
Actions
- Tonifies Liver Blood
- Clears Deficient-Heat
- Calms the Spirit
Syndromes
- Liver-Heart Blood deficiency
- Liver Yin deficiency with deficient Heat
Signs & Symptoms
Indications & Combinations
[restrict]- Insomnia
- Anxiety
- Stress
The following formulas, used in combination with Jin Gui Suan Zao Ren Tang, have worked well in clinical practice:
- Heart-Kidney disharmony with Yin deficiency: plus Tian Wang Bu Xin Wan
- Heart and Spleen disharmony with Qi and Blood deficiency: plus Gui Pi Wan
- Phlegm: plus Wen Dan Tang
- Blood stasis: plus Tao Hong Si Wu Wan
This formula is from the Qing Dynasty, text ‘Analytic Collection of Medical Formulas’ (yi fang ji jie) by Wang Ang (1682). It is especially suitable for treating conditions due to Heat, specifically excess Heat. It also clears lower Jiao Damp-Heat and Liver Gallbladder Damp-Heat.
The key clinical features for the use of this formula are: headache, hypochondrial pain, tinnitus or hearing loss, jaundice with a bitter taste in the mouth, atrophy of the tendons, sweating, swollen and sore penis, gonorrhoea and hematuria.
It is particularly effective in allergic conditions, characterised by Yang hyperactivity and effulgent Fire, as this formula is designed to reduce the hyperactive Yang and drain Fire. However, it should only be used short term to avoid damage to the Stomach by the bitter-cold herbs.
Herbs
- Rehmannia glutinosa, root (sheng di huang)
- Plantago asiatica, seed (che qian zi)
- Gentiana scabra, root (long dan cao)
- Bupleurum falcatum, root (chai hu)
- Alisma plantago aquatica, rhiz. (ze xie)
- Gardenia jasminoides, fruit (shan zhi zi)
- Scutellaria baicalensis, root (huang qin)
- Angelica polymorpha, root (dang-gui)
- Clematis armandii, stem (chuan mu tong)
- Glycyrrhiza uralensis, root (gan cao)
Actions
- Drains Fire from the Liver and Gallbaldder
- Clears Damp-Heat from the Triple Jiao
Syndromes
- Liver and Gallbladder Fire
- Damp-Heat in the Triple Jiao (especially the lower Jiao)
Signs & Symptoms
Indications & Combinations
[restrict]- Acute allergic reaction to food or medicine. It usually works within 20 minutes, provided that a large dose is given as soon as possible.
- Toxic insect bites, which cause severe rash or festering sores. Treat promptly and with high doses.
- Epistaxis (nose bleeding) in children. It is generally fast acting for stopping the bleeding. Treat promptly and with high doses.
- Retrograde menstruation. It is fasting acting for stopping the bleeding. Treat promptly and with high doses
- Acne, seborrheic dermatitis, hair loss due to seborrheic dermatitis.
- Hyperthyroidism (symptoms during the acute period, such as angry outbursts, palpitation, insomnia, frequent hunger and excessive sweating)
- Failure of the sperm to liquefy (generally these patients have Yang excess condition)
- Female hypersexuality
- Shingles (herpes zoster) and post herpetic neuralgia
- Priapism
- Acute and chronic middle ear infection (clinical effect is better than antibiotic if given promptly and in high doses)
- Allergic dermal conditions of the male and female genitalia; infections of the female genitalia, vulvovaginitis
- Cystitis
- Urinary tract infections
- Scrotal eczema
- Eye conditions, such as: hordeolum chalazion, iriditis, acute conjunctivitis, acute glaucoma (best result during the acute stage)
- Eczema and dermatitis
This formula was devised by Dr Zhang Xi-zhong from the Ming dynasty. It acts to soften masses and disperse nodules and lumps. It also tonifies the Qi (to protect the health Qi from the effects of the strong dispersing herbs) and regulates the Blood. It also promotes the Liver's spreading function and nourishes the Yin. The formula's overall action is to disperse Phlegm nodules by breaking up the Blood to dispel stasis and resolving Phlegm. It has the dual actions of dispersing and tonifying (i.e. attacking the pathogens and nourishing the health Qi).
It has a strong anti-inflammatory action and may also be used for lumps that are due to inflammation as well as tumours.
Herbs
- Prunella vulgaris, herb top flowering (xia ku cao)
- Scrophularia ningpoensis, root (xuan shen)
- Astragalus membranaceus, root (huang qi)
- Sargassum fusiforme, whole plant (hai zao)
- Gentiana scabra, root (long dan cao)
- Fritillaria cirrhosa, bulb (chuan bei mu)
- Sparganium stoloniferum, rhiz. (san leng)
- Curcuma zedoaria, rhiz. (e zhu)
- Citrus reticulata, fruit peel (chen pi)
Actions
- Clears Heat
- Resolves Phlegm
- Breaks up Blood Stasis to soften and resolve masses
Syndromes
- Phlegm-Heat Stagnation
- Qi Stagnation and Blood Stasis
Signs & Symptoms
Indications & Combinations
[restrict]- Growths, and other proliferative lesions of the soft tissues, inflammatory swellings of the knee joint, such as Bakers cyst and degenerative arthritis.
- Uterine fibroids
- Ovarian cysts; polycystic ovarian syndrome (PCOS
- Endometriosis
- Amenorrhea or oligomenorrhoea
- Lipomas – single or multiple (3 – 6 months course of treatment)
- Blocked nose (e.g. due to sinusitis or nasal polyp), generally one week course of treatment at high dosage to unblock the nose
- Gout
- Deep venous thrombosis - use together with Xue Fu Zhu Yu Tang, three months course of treatment
- Simple thyroid nodules (several months course of treatment
- Prostate enlargement with difficult urination
- Cervical spondylitis, hyperosteogeny (lipping and bone spurs of vertebrae, e.g. cervical or lumbar), bony spur on the heel bone. Combine with Huo Luo Xiao Ling Dan, Qing E Jian Gu Zhuang Yao Wan and Xue Fu Zhu Yu Tang for more rapid clinical improvement
- Traumatic injury with swelling and bruising (combine with Tao Hong Si Wu Wan for rapid recovery)
Qi Bao Mei Ran Dan was originally developed by Shao Ying-jie during the Ming dynasty, and was first recorded in the 'Analytic Collection of Medical Formulas' (yi fang ji jie) by Wang Ang, 1682. The formula was prescribed for Zhu Hou-chong (1507-1567), the emperor Shizong, who had been unable to produce any children. With the help of this formula the emperor was not only able to father several sons, but also ruled for over 45 years and lived until the age of 60, both quite rare achievements for an emperor during that period. As a result, this formula became very well known, and it was recorded in the Compendium of Materia Medica (ben cao gang mu) by Li Shi-zhen, during the Ming period, as well as Wang Ang's book in the subsequent dynastic period.
In the history of TCM, this is the first formula that was developed to nourish the Kidney Essence. It helps to restore fertility and normal hair growth by nourishing the both the Liver Blood and Kidney Essence (as Essence and Blood are able to mutually generate one another).
In contemporary times with our ageing population, this formula fulfils the need for health maintenance and prevention of physical and mental degeneration (e.g. dementia) in these people. This formula strengthens both the Yin as well as the Yang aspects of the health Qi: it nourishes the Kidney and Liver Yin, replenishes the Kidney Essence, tonifies the Qi and nourishes the Blood. It is particularly effective in nourishing and promoting the brain, the hair and the sexual functions. It is one of the best tonifying and nourishing formulas.
Herbs
- Fallopia multiflora, root (he shou wu)
- Poria cocos, fruit. body (fu ling)
- Angelica polymorpha, root (dang-gui)
- Cuscuta hygrophilae, seed (tu si zi)
- Astragalus membranaceus, root (huang qi)
- Lycium barbarum, fruit (gou qi zi)
- Achyranthes bidentata, root (huai niu xi)
- Rehmannia glutinosa, root (shu di huang)
- Cullen corylifolium, seed (bu gu zhi)
- Panax ginseng, root (ren shen)
- Anemone altaica, rhizome (shi chang pu)
- Polygala sibirica, root (yuan zhi)
Actions
- Tonify Jing
- Tonify Kidney and Liver Yin
- Tonify Blood
- Tonify Qi
Syndromes
- Kidney Jing deficiency
- Kidney-Liver Yin deficiency
- Qi deficiency
- Blood deficiency
Signs & Symptoms
Indications & Combinations
[restrict]- Infertility in males and females
- Hair loss (scalp, both sexes and facial hair in males), early greying of the hair
- Fatigue, energy decline, muscular weakness
- Decline of thyroid function (generally subclinical hypothyroidism, lethargy, puffiness, aversion to cold, increased need for sleep, anorexia and a dull, pale complexion)
- Memory loss (even in cases with rapid decline)
- Mild cognitive impairment
- Anemia
- Chronic fatigue syndrome
This formula was originally recorded in the 'Treatise on Cold-induced Diseases' (shang han lun), by Zhang Zhong-jing (circa 150 – 219 C.E.). It was originally devised for use during the course of a Cold-induced disorder, Greater Yang (tai yang) stage, in cases where the patient had been given diaphoretic medicines inappropriately. The sweating thus induced, instead of releasing and expelling the exogenous pathogen, has caused the patient's body Fluids and Blood to become depleted. This would give rise to the characteristic symptoms of irritability, slight chills, muscular spasms in the lower limbs, and lack of a tongue coat.
The formula contains only two herbal ingredients and their combined action is to tonify the Qi, nourish the Yin-Blood and harmonise the Liver and Spleen. Paeonia root (bai shao) nourishes the Liver Blood, with Glycyrrhiza root (gan cao) tonifies the Spleen Qi and regenerates the body Fluids. Thus, it is effective for patients with blockage (bi) (= pain) due to depletion of the Liver Blood and body Fluids.
In contemporary TCM clinical practice, this is the key formula for treating muscular spasms, in both smooth muscle (internal organs) and striated (skeletal) muscle.
Herbs
- Paeonia lactiflora, root (bai shao)
- Glycyrrhiza uralensis, root (zhi gan cao)
Actions
- Tonifies Blood
- Soothes the Liver
- Relieves spasms and pain
Syndromes
- Liver Blood deficiency
- Liver-Spleen disharmony
Signs & Symptoms
- Muscular cramps and spasms
- Abdominal pain
- Tongue: pale with little coating
- Pulse: thready and wiry
Indications & Combinations
[restrict]- Acute pain due to spasm of internal organs, such as stomach, intestines, gallbladder, ureter, urinary bladder, uterus and blood vessels.
- Muscular injury due to overstrain
- Acute wry neck (torticollis) due to incorrect size or position of the pillow
- Acute lower back pain due to lumbar strain
- Gastrocnemius spasm
- Hiccups
- Stubborn cough
This is a variant of a formula from the 'New Compilation of Time-tested Formulas' (yan fang xin bian) by Bao Xiang-ao, 1846, in which were recorded various simple, proven and secret recipes of the time. In contemporary TCM practice, this is the most commonly used formula from the original book.
The original contained only four ingredients, hence the name (si = four; miao = wonderful, remarkable (herbs); yong an = well-being). This formula has come to be used in a very broad range of clinical applications in contemporary TCM clinics. It was originally used for gangrenous lesions and ulcerated lesions of the subcutaneous tissues, such as carbuncles. Patients were treated with a course of ten packs of this formula at a high dosage, to be taken daily. This formula's therapeutic actions are threefold:
- clears Heat Toxin and cools the Blood
- activates the Blood and dispels stasis to relieve pain
- nourishes the Yin
Because of the small number of ingredients in the formula, it is easy to prescribe it in large doses, as this is how the original formula was designed to be taken.
In contemporary TCM, its applications include a variety of persistent or stubborn infections or inflammations. This formula is particularly effective in infections that do not respond to antibiotics.
Herbs
- Lonicera japonica, flower (jin yin hua)
- Scrophularia ningpoensis, root (xuan shen)
- Angelica polymorpha, root (dang-gui)
- Paeonia veitchii, root (chi shao)
- Glycyrrhiza uralensis, root (gan cao)
Actions
- Clears Heat-Toxin
- Cools the Blood
- Activates the Blood and dispels Stasis
- Nourishes the Yin and moistens the skin
Syndromes
- Blood-Heat Toxin
- Blood Stasis
Signs & Symptoms
Indications & Combinations
[restrict]- Stubborn gum disease
- Tooth pain
- Dental abscess
- Post herpetic neuralgia (after shingles lesions have resolved)
- Stubborn gout (red swollen and painful lesion/s) with difficulty in standing due to the pain)
- SLE (rash and arthralgia due to Wind, Damp and Heat)
- Stubborn eczema
- Atopic dermatitis
- Psoriasis (pustular type)
- Mastitis
- Cystitis
- Cholecystitis
- Pyelonephritis
- Osteomyelitis
This formula is from Song dynasty, and was first recorded in the 'Formulary of the Tai Ping Welfare Dispensary Bureau' (tai ping hui min he ji ju fang). It is the essential formula for activating the Blood and dispelling stasis. It can treat conditions due to Blood stasis together with Blood deficiency. The formula's original use was for regulating menstruation. However, in China there is a very popular medicine called 'Tai Tai Oral Liquid', which is an adaption of this formula, and has proven very effective for a wide variety of disorders.
Herbs
- Rehmannia glutinosa, root (sheng/shu di huang)
- Angelica polymorpha, root (dang-gui)
- Paeonia lactiflora, root (bai shao)
- Paeonia veitchii, root (chi shao)
- Ligusticum wallichii, rhiz. (chuan xiong)
- Prunus persica, seed (tao ren)
- Carthamus tinctorius, flower (hong hua)
Actions
- Nourishes Blood
- Activates the Blood and dispels Stasis
Syndromes
- Blood Stasis
- Blood deficieny
Signs & Symptoms
Indications & Combinations
[restrict]- Insomnia. This formula may be used by men, women, children and the elderly. It may be taken during the day and will not affect alertness. This formula is generally more effective than other formulas that are used for the treatment of insomnia.
- Female hormone support during the menopausal transition. This is the best formula for treating the decline in female hormones that occurs in menopause (main symptoms: whole body aches, hot flushes, loss of libido). However, it should not be used in women with breast cancer that is stimulated by hormones.
- Lumps and swellings, post trauma swelling, bruises
- Whole body aches, moving pains. This formula is more often effective for pain relief than Shao Yao Gan Cao Wan or Huo Luo Xiao Ling Dan.
- Constipation (especially in patients with mood disorders, and menopausal disorders) due to decline of intestinal secretory function (i.e. dry intestines)
This formula is from Song Dynastic period, and was first described in the 'Three Causes and One Treatment for Diseases'( san yin fang) by Chen Yan (a.k.a. Chen Wu-ze), circa 1161-74.
It is a famous formula used to dry Damp and resolve Phlegm. It is used in conditions due to disharmony between the Gall Bladder and Stomach, characterised by interior obstruction due to Phlegm-Heat.
This formula's action on the middle Jiao (i.e. promotes the Stomach Qi to descend, and harmonises Stomach and Gallbladder), means it can be used to in the treatment of almost every disease.
The formula is very effective for a variety of disorders due to Phlegm-stagnation syndrome.
Herbs
- Phyllostachys nigra, stem wood (zhu ru)
- Poria cocos, fruit. body (fu ling)
- Pinellia ternata, tuber (ban xia)
- Citrus aurantium, fruit (zhi shi)
- Citrus reticulata, fruit peel (chen pi)
- Glycyrrhiza uralensis, root (gan cao)
- Ziziphus jujuba, fruit (hong zao)
- Zingiber officinale, rhiz. (sheng jiang)
Actions
- Clears Phlegm-Heat
- Regulates the Qi and harmonises the Stomach
- Clears the Gallbladder
Syndromes
- Phlegm-Heat
- Gallbladder Qi invasion of the Stomach
Signs & Symptoms
Indications & Combinations
[restrict]- This is the strongest formula for mood disorders, such as depression, anxiety, irritability, insomnia, obsessive-compulsive disorder, palpitations and globus hystericus. Patients do not develop tolerance to WDT when taken long term. Moreover, because it resolves the underlying causes of stagnation, the conditions treated do not recur. In contrast to Western medication, WDT has no toxicity at all. If the pharmaceutical drug is not helping, it can be replaced with WDT.
- Nervous system regulation: Hypertension, low blood pressure, insomnia, narcolepsy, smoking, alcohol addiction, drug withdrawal, jet lag and low blood pressure. (It is effective for most difficult or complex diseases that are due to Phlegm).
- Severe nausea and vomiting, e.g. in morning sickness, Meniere's disease, chemotherapy side effects, gastric reflux.
- Asthma or chronic cough, due to Phlegm, with thick sputum obstructing the bronchi.
This formula is from the 'Golden Mirror of Medicine' (yi zong jin jian), 1742 CE. It is a simple formula with a clear-cut single action: clearing Heat Toxin (or Fire Toxin), i.e. it clears Heat and resolves Toxin, cools the Blood and reduces swelling. This is the main formula for clearing Heat-Toxin, for sores and ulcers, and skin lesions with inflammation and pus (e.g. hard furuncle and deep-rooted boil). It can be used for various kinds of toxic swellings, including infections and insect bites. While this formula does have a cooling action, it is not overly Cold and its use will not cause Stomach problems.
Herbs
- Taraxacum mongolicum, herb (pu gong ying)
- Lonicera japonica, flower (jin yin hua)
- Begonia fimbristipula, herb (tian kui zi)
- Chrysanthemum indicum, flower (ye ju hua)
- Viola yedoensis, herb (zi hua di ding)
Actions
- Clears Heat and resolves Toxin
- Cools the Blood and reduces swelling
Syndromes
- Heat-Toxin (localised)
Signs & Symptoms
Indications & Combinations
[restrict]- Carbuncle or furuncle (early stage)
- Cellulitis, erysipelas
- Acute lymphangitis
- Mastitis
- Appendicitis
- Conjunctuivitis
- Urinary Tract Infections
- Acute Pyelonephritis
- Abscess
- Bacterial infections (especially those where the organisms are resistant to antibiotics)
- Mycoplasma
L-form bacterial infection
Acne with pustules - Trachoma and red pterygium (i.e. with inflammation)
- Frequent urination
- Nasal infections (with thick, greenish discharge)
- Sinusitis (especially deep seated conditions that have been treated with antibiotics without success)
- Auto-immune disorders (whole body aches) and fibromyalgia. In the treatment of auto-immune disorders, this formula provides better clinical results than Western anti-inflammatory drugs.
Xiao Chai Hu Tang was first recorded in the 'Treatise on Cold-induced Diseases' (shang han lun), by Zhang Zhong-jing (circa 150 – 219 C.E.). It was originally used to treat Shao Yang syndrome (shao yang bing zheng) in acute febrile diseases due to invasion by exogenous Cold. The formula's original actions are to harmonise the Shao Yang , which is characterized by eight specific symptoms: bitter taste in the mouth; dry throat; blurred vision; alternating sensations of heat and cold; chest or hypochondrial fullness and discomfort; loss of appetite; irritability; nausea and vomiting (including vomiting in pregnancy). To these eight symptoms we can add a ninth: wiry pulse.
In summary, Xiao Chai Hu Tang is a commonly used formula that has powerful clinical actions on a variety of complex conditions, outside of its use in the treatment of Shao Yang stage disorders due to externally contacted Cold pathogens.
Herbs
- Codonopsis pilosula, root (dang shen)
- Scutellaria baicalensis, root (huang qin)
- Bupleurum falcatum, root (chai hu)
- Pinellia ternata, tuber (ban xia)
- Glycyrrhiza uralensis, root (gan cao)
- Zingiber officinale, rhiz. (sheng jiang)
- Ziziphus jujuba, fruit (da zao)
Actions
- Harmonises and releases Shao Yang stage disorders
- Harmonises the Gallbladder and Stomach
Syndromes
- Shao Yang stage pathogen
- Gallbladder Qi invasion of the Stomach
Signs & Symptoms
Indications & Combinations
[restrict]- Shao Yang stage (half exterior, half interior) of externally contacted Cold disorder (i.e. early stage of common cold or 'flu). Note that for the initial stages (i.e. pathogens at the exterior) with sore throat and fatigue, use Yin Qiao San promptly in a large dose: this will resolve the disorder and prevent it developing further. If there is sore throat, productive cough with clear or white sputum (i.e. sputum not yellow), temperature is not elevated, the pathogen is half exterior and half interior, then give Xiao Chai Hu Wan at a large dose for several days to control the disease. If there is a severe cough with yellow sputum, fever, the pathogen has penetrated to the interior, treat with large dose of Heat- clearing, Toxin resolving formula such as Wu Wei Xiao Du Yin or Huang Lian Jie Du Tang. It is important to be careful and treat this stage promptly, especially in the very young and the elderly, to prevent further development.
- Disorders related to the costal and hypochondrial areas: viral hepatitis, gall stones, cholecystitis, malaria, typhoid fever, costochondritis, intercostal neuralgia and pleurisy). For these types of disorders this formula gives remarkable clinical results.
- Recurring symptoms: The Qi of the Shao Yang channel is strongest between 3:00 am and 9:00 am. Any symptoms that tend to recur or worsen during these times may be quickly relieved with this formula.
This formula is from the Qing dynasty and was developed by Wang Qing-ren (a.k.a. Wang Xun-chen) and recorded in his 'Correction of Errors among Physicians' (yi lin gai cuo), published in 1830. In this work, Wang Qin-ren also recorded four other formulas that 'drive out' (zhu yu) Blood stasis*. However, Xue Fu Zhu Yu Tang is the most frequently used as it has much broader clinical applications. Moreover, it is one of the few TCM formulas that may be effectively used in emergencies. The original use for this formula, as described by Wang, was to treat Blood stasis in the chest with the following clinical signs: chest oppression, sweating at dawn, sensation that food was passing down on the right side of the chest after swallowing, thirst, irritability, dream disturbed sleep, hiccough brought on by drinking water, insomnia, childhood night terrors/crying, palpitations, restless sleep, dry retching, feverishness at night time (before sleeping), etc..
In contemporary clinical practice this formula is generally used to provide effective treatment for Blood stasis above the diaphragm as it can act on the large blood vessels. In many cases where Blood stasis is the main problem, the patient will be taking Western medications that thin the blood, prevent coagulation or dilate the coronary arteries (e.g. aspirin, warfarin, heparin, and vasodilating agents such as Nitroglycerine). Experienced practitioners have not found any interaction between these drugs and the formula, specifically in connection with over-anticoagulation and the induction of bleeding.
This formula may be used with great efficacy in acute conditions that are due to Blood stasis.
Herbs
- Rehmannia glutinosa, root (sheng di huang)
- Paeonia veitchii, root (chi shao)
- Achyranthes bidentata, root (huai niu xi)
- Angelica polymorpha, root (dang-gui)
- Ligusticum wallichii, root (chuan xiong)
- Prunus persica, seed (tao ren)
- Bupleurum falcatum, root (chai hu)
- Citrus aurantium, fruit (zhi ke)
- Carthamus tinctorius, flower (hong hua)
- Platycodon grandiflorus, root (jie geng)
- Glycyrrhiza uralensis, root (gan cao)
Actions
- Activates the Blood and dispels Stasis
- Alleviates pain
Syndromes
- Blood Stasis
Signs & Symptoms
Indications & Combinations
[restrict]- Acute vertigo, especially with horizontal nystagmus. I have found it to be very effective in these conditions
- Numbness and/or pins and needles sensation in the arm, regardless of whether or not the root cause is cervical spondylosis or peripheral neuritis
- Precordial pain, palpitations, shortness of breath, irregular or slow heart beat
- Bronchitis with productive cough. The formula helps resolve Phlegm in the chest
- Various eye problems and disorders of vision such as floaters, inflammatory lesions and visual snow
- Tinnitus and sudden decline of hearing in one ear
- Gynecological disorders, such as dysmenorrhea, endometriosis, uterine fibroids, ovarian cysts, scanty menstrual flow
- Migraine headache (particularly headache due to blood stasis)
- Insomnia
- Parkinson's disease (when due to Blood stasis), stroke, encephalomyelitis, encephalomalacia (note: Parkinson's disease due to Qi deficiency does not respond well to TCM treatment). This treatment can improve the symptoms and slow down the progress of the disease.
This is a variant of a formula that was originally recorded in the 'Treatise on Cold-induced Diseases' (shang han lun), by Zhang Zhong-jing (circa 150 – 219 C.E.). The original was intended to be used for Bright Yang syndrome (yang ming bing zheng) with jaundice due to Damp-Heat stagnation. The original text advised that three doses of the formula be taken so as to induce diuresis and drain the Damp-Heat via the urine. This will produce a deep reddish colored urine ('like the juice of the honey-locust') and after one night's sleep the jaundice will be resolved.
Subsequent generations of physicians in China have expanded the use of this formula to include many different types of disorder due to Damp-Heat. Moreover, this variant has been enhanced with seven additional herbs in order to broaden the therapeutic scope for treating various Liver and Gallbladder diseases, as well as certain metabolic disorders – all due the accumulation of Damp-Heat.
Note: as this formula is very cooling, it is not suitable in patients with deficient and/or Cold conditions (e.g. of the Spleen-Stomach). In these patients it should be combined with formulas that resolve Phlegm and soothe the Liver.
Herbs
- Artemisia frigida, herb (yin chen hao)
- Lysimachia christinae, herb (jin qian cao)
- Taraxacum mongolicum, herb (pu gong ying)
- Gardenia jasminoides, fruit (shan zhi zi)
- Abrus cantoniensis, herb (ji gu cao)
- Alisma orientale, rhiz. (ze xie)
- Crataegus pinnatifida, fruit (shan zha)
- Curcuma longa, tuber (yu jin)
- Rheum palmatum, root & rhiz. (da huang)
- Citrus aurantium, fruit (zhi shi)
Actions
- Clears Damp-Heat
- Soothes the Liver
- Drains the Gallbladder
Syndromes
- Damp-Heat in the Liver and Gallbladder
Signs & Symptoms
Indications & Combinations
[restrict]- Liver and Gallbladder diseases: liver damage by drugs, acute and chronic hepatitis, fatty liver, cholecystitis.
- Gall stones, kidney stones, bladder stones
- Dyslipidemia, overweight, obesity, uremia, chronic pancreatitis
- Acne
- Hair loss due to excessively oily scalp (seborrheic alopecia)
- Polycystic ovarian syndrome
The main action of this formula is to warm-tonify the Kidney Yang and enrich the Kidney Essence. Thus, it is the main formula for treating male sexual function in cases with depletion of the Kidney Yang and Essence. In addition, it also warms and tonifies the Spleen Yang, nourishes the Kidney Yin, tonifies the Qi and activates the Blood. These therapeutic actions, combined together, make this an outstanding formula in the clinic, as it has a fairly broad range of clinical applications in cases with deficiency of the Kidney Yang.
Herbs
- Epimedium sagittatum, herb (xian ling pi)
- Astragalus membranaceus , root (huang qi)
- Rehmannia glutinosa, root (shu di huang)
- Dioscorea oppositifolia, root (huai shan yao)
- Eucomia ulmoides, stem bark (du zhong)
- Poria cocos, fruiting body (fu ling)
- Angelica polymorpha, root (dang-gui)
- Paeonia lactiflora, root (bai shao)
- Cornus officinalis, fruit (shan yu rou)
- Morinda officinalis, root (ba ji tian)
- Lycium barbarum, fruit (gou qi zi)
- Acanthopanax gracilistylus, root (ci wu jia)
- Cynomorium songaricum, stem (suo yang)
- Polygala sibirica, root (yuan zhi)
- Ligusticum wallichii, root (chuan xiong)
- Schisandra chinensis, fruit (wu wei zi)
- Panax ginseng, root (ren shen)
- Cinnamomum cassia, stem bark (rou gui)
Actions
- Warm-tonifies the Kidney Yang
- Tonifies Jing
- Tonifies Qi
- Tonifies Blood
Syndromes
- Kidney Yang deficiency
- Kidney Jing deficiency
- Qi deficiency
- Blood deficiency
Signs & Symptoms
Indications & Combinations
[restrict]- Impotence, premature ejaculation
- Abnormal uterine bleeding (e.g. bleeding due to fibroids, functional uterine bleeding, heavy menstrual bleeding)
- Assisting patients to wean off corticosteroid type of drugs. For those patients in the process of reducing drug treatment or after stopping the drug treatment for SLE or arthritis, it may prevent recurrence of symptoms and assist in the transition.
- Early stage diabetes, impaired glucose tolerance status
- Chronic fatigue syndrome (virus positive or negative). This formula may provide a rapid improvement in energy and vitality
- Hashimoto's thyroiditis (in patients with long term use of Thyroxin but antibody remains high, this formula will help to reduce the antibody)
- Parkinson's disease (to reduce symptoms such as trembling and numbness and slow the progression of the disease)
- Blood cell abnormalities, such as low granulocytes, low white cells, anemia due to blood loss, low hemoglobin due to blood loss, thrombocytopenia (this formula helps the bone marrow to produce blood)
- Chronic respiratory conditions, e.g. asthma, hay-fever, sinusitis
- Raynaud's disease (with aversion to cold and cold extremities)
- Conditions due to hormone deficiency