Chapter Ten Formnlae for Resuscitation
This group of formulae is mainly composed of oromatic herb taking effects on openning orifices ta treat loss uf consciousness.
Unconsciousness is an excess syndrome caused by the misting of heart orifice due to exuberance uf the evil-gilt is usually mauifested as unconsciousness, tighu ly closed bands and clenched jaws, coarse breathing and forceful pnlsa. According to different causes of disease, closure syndrome can be divided into heat closure syndrome and cold-closure syndrome. The former is caused by warm poison sinking into the perieardium, while the latter is due to dysfunctional activtiy of qi caused by accumulation of cold-evil, or phlegm-turbidity covering the heart-orifice.
According to the principle of “treating stagnated syndrome with herbs for the openning and dispersing” Gram Chapter 74 in the Plain Qnestions). Unconsciousness syndrome should he treated by opening orifice. Heat-closure syndrome should be treated by clearing away heat and opening orifice, called “cold opening” . While cold-closure syndronie should be treated with warm-natured herbs for qpening orifice, called “warm opening”. Formulae of resuscitation in this chapter are divided into formulae to resosciste with cold property and formulae to resusei ate with worm property.
Formulae for resuscitation are used only for closure syndrome due to exuberance of both the evil-qi and vital energy, bot not for prostration syndrome mani fested as profuse sweating, cold limbs, feeble breating, enoresis, eyes closed and mouth opened, etc. For ease with coma and delirium in Yangming ftc-viscera syn dromw, purgative therapy with cold property should be applied, and it is also not advisable to use the method of opening orifice. Even for coma and delirium caused by Yengming ftc-viscera syndrome accompanied with the evil qi sinking into the pericardium, this method is not suitahle to use singly. Only h55d on situation by combining opening orifice with purgation, can the therapy tally with the syn drnme. In addition, formulae for resoseeitatinn ore chiefly composed of the herbs which have strong aromatic odor and stimulation on the sense organs, and longterm administration may lead to consumption of the genuine qi. Therefore, thim group of formulae is used only in emergency for symptomatic relief, not for long
term use. For this reason, they crc usoelly made into holus, pills and powder, arid are not advisahlc for use in decoctinn, heacuse their volatile active compositions will he volatilized and the efficacy will be decreased.
Section 1 ColdNatured Formulae for Resuscitation
These formulae are osed for heat-closure syndrome caused by warm-hcat-poi son evil sinking into the pcricardiom with high fever, loss of consciousness, delirium, spasm and coma, etc. or they arc also suitable for sudden falling down and loss of consciousness marked by symptoms with hcat properties doe 10 attack of fotid-qi. In these conditions, the method of clearing away heat for resoscitation shoold he prescribed. The commonly used aromatic herbs for resuscitation are musk, borneol, cow bezoaro and henzoin. The heat clearing and datoxicating herbs soch as rhioocetos horn, coptis root and hawksbill shell, etc. ,can be used together as principal herbs. lf there is closure syndrome with riot of heart—spirit, cinnabar, amber, niagnetite and nacrc should he added to these formulae to relieve convulsion and tranquilize the mind; If there is exuberance of heat-evil searching body fluid into phlegm, arisaema with bile hat rylicated silk worm, bamboo juice and fritillary bulb, etc. should be added to clearing away heat and resolving phlegm; If there is extreme heat causing wind antelops’s horn, scorpion and uncaria stem, etc. should be added to clear away heat to stop wind;If there is constipation due to exuberance of heat, rhubarb and mirahilite should he added to purge fire and ease defecation. The representative formulae arc Peacaful Palace Bezoar Bolos, Violet Snow Pillets and Real Treasure Pillets.
Peaceful Palace Bovine GalFstone Bolus
an gong ida huáng wan
SOURCE; Treatise on Differentiation and Treatment of Warm Diseases
Bovine gall stone lOOg
Curcnma root lOOg
Coptic root lOOg
Scntellaria root lOOg
Capajasmine fruit lOOg
Rhinoceros horn bog
Gold foilf appropriate amoont)
DIRECTIONS: Grind the above-mentioned iogredionts into fine powder, mix them with honey to make into boluses, with each weighing three grams, coaled with gold foil(or gold foil is oot used for coating) ,enveloped with wax shell. Take one bolus each time with warm boiled water. For coma ease, give nasal feeding, one or twice a day, twice to three times a day for critical eases. Half dose for children.
EFFECTS: Clearing away heat and toxins and sweeping away phlegm to clear orifice.
INDICATIONS: Syndrome of heal evil sinking into perieardiom occurring in the course of warm-diseases of phlegm heat covering the heart-orifice manifested as high fever, coma and delirium, or sturring of speech due to inflexible tongue, cold limhs, coma due to apoplexy, infantile convulsion due to interior blockage of heat evil.
ANALYSIS OF FORMULA: It is representative formula for heat and toxins as well as phlegni to open the orifice. Bovine gall-stone can clearing away heat, toxins and phlegm to open the orifice and arrest wind to calm down ennsulsinn. Musk opens orifices and awakens the mind. Both are principal herbs. Rhinoceros horn as the assistant herb clears the heart, cools the blood and eliminates toxins and helps principal herbs in clearing away heat in the perieardium; Cuptie root, scutellaria root and capejasmine fruit porgc the fire and toxin and induce the heat downward to assist the principal herbs in clearing away the fire evil in the periear •diom;Borneo and curconia root assist musk tu open the orifices and awaken the mind and resolve the turbid-qi with aromatic property. Cinnabar, pearl and gold foil are adjovant herbs with the effects of tranquilizing the mind, and they help ho vine gall-stone clear away tl phlegm and toxins. Honey has the effect on harmo nizing the stomach, playing the role of the dispatcher herb.
In clinical practice, this formula is used for coma doe to phlegm-heat occurring most commonly in encephalitis B, epidemic meningitis, toxic pneumonia, toxic dysentery, uremia, cerebmovascular accident, toxic hepatitis, hepatie coma and others.
Violet Snow Pillet
SOURCE: Formulae of Peaceful Benevolent Dispensaty
Rhinoceros horn 500g
Antelope’s horn 500g
Dotchmanspipe root SOOg
Eagle wood 500g
Scropholaria root SOOg
Boghance rhizome 500g
Roasted licorice root 240g
Nitcr(or Mirabilite) 96g
Cinnahar(refining powder with water) 90g
Gold(It was omitted starting from Effective Formulae.
DIRECTIONS: Grind the ahove ingredients into fine powder take 0. 9 to 1. 5 grams each time with cold boiled water, once or twice a day.
EFFECTS: Clearing away heat and openning orifices, relieving convolsion and tranquilizing the mind.
INDiCATIONS: Syndrome of heat evil sinking into the pericardiom occurring in the course of warm heat disease manifested as high fever, restlessness, loss of consciouseness, delirium, convulsion, thirst with parched lips, dark brown urine, constipation, infantile convulsion due to high fever.
ANALYSIS OF FORMULA: It is a common formula to clear away heat and blockage of orifices and relieve convulsion, Gypsum, is pungent and sweet in flavor and very cold in praperty. It reduces fever and purges the fire, and is good at clear ing away the heat in qi phase and relieving heavy thirst. Calcite assists gypsum in purging •fire. Talc produces the effects of clearing away heat, excreting urination and inducing heat downward. Rhinoceros horn being salty in flavor and cold in
property clears the heart, cools the blood, purges toxins and tranquilizes the mind. Antelope’s horn is good at purging the liver-fire and is the key herh for cooling the liver to stop wind. Musk opens orifices with its aromatic nature. The above- mentioned herbs play the main role in the formula. Serophularia ruot clears away heat and nourish yin. Magnetite, cinnabar tranqoilize the mind with their heavy property. Dutehmanspipe rout, cloves and eagle wood promute the circulation of qi and assist musk in npenning orifices. Bugbance rhizome and licorice runt clear a way’heat and poison. Glaober’s salt and niter purge heat to relieve constipation just like taking away the horning wood from under the boiler. These ingredients are assistant herbs. The joint use of all the ingredients produce the effects of clearing away heat and apenning orifices and stopping wind lo relieve convulsion.
Encephalitis B, epidemic eerebruspinal meningitis, morbid pneumonia, infan tile measles, typhus and scarlet fever manifested by cuma, delifiom, convulsion and purple maculae and papollae cnn be treated with the formula.
Real Treasure Pillets
zhi boo dan
SOURCE: Formnolae of Peaceful Benevolent Dispensary
Rhinoceros horn(ground) 30g
Hawksbill shell(gruund) 30g
Cinnabar(refined powder with water) 30g
Realgar(refined puweder with water) 30g
Burneol(grnund) 7. 5g
Musk(gruund) 7. 5g
Bavine gall-stone 15g
Gold foil(half •for ingredient and half for coating) 50 pieces
Silver foil 50 pieces
DIRECTIONS: Grind the above-mentioned herbs into fine powder and then mix them with honey to make into boloses, each weighing 3 grams. Take one bolos to be groaned for oral administratio) with warm boiled water, once a day, half bolos for children.
EFFECTS: Clearing away heat and openning orifices, resolving turbid qi and detoxicating.
INDICATIONS: Heatstroke,apoplexy arid closure synnclrome due to phlegm heat occurring in the course of warm-disease marked by coma and delirium, fever and restlessness, abundant expectoration, harsh respiration, red tongue with yellow, thick and greasy coating, slippery and rapid pulse, and infantile cunvulsiun manifested as the above syndrome.
ANALYSIS OF FORMULA: It is a key formula which is used for both sweep ing away phlegm to open orifices and clearing away heat and toxins. Musk has aromatic odor and remarkable effect of stimulating all the orifices. Beozoin opens orifices, remuves fetid odor and resulves turbid-qi by its aroma. Borneol has strung aromatic odor and effect of opcnning orifices. They work together as the principal herbs, Bovine gall stone clears the heart, poisons and phlegm to open orifices. Rhi noccros hum clears the nutrient phase and cools the blood, it goad at clearing a way heat evil in the pericardium. Hawksbill shell clears away heat and toxins and relieves convulsion. Realgar clears phlegm and toxins. All of them are assistant herbs. Cinnabar, Amber, gold foil and silver fail as adjuvant and dispatcher herbs tranquilize the mind hy their heavy properties.
This formula has stranger resuscitation effects with aromatic nature, and is very effective for coma due to stagnation of phlegm-heat.
The Real Treasure Pillet is used for oral administration with Ginseng IDecoc tion in original formula. It aims at strengthening the action of replenishing vital. energy. This formula is suitable for weakeness of the genuine-qi with feeble pulse. Another method in original formula is to be taken after being soaked in vir gin boy urine and fresh ginger juice in order to increase the actions of removing phlegm and stnpping vomiting and nourishing yin to purge fire, and it is therefore suitable for heat closure syndrome with pulse of excess type.
This formula contains quite a lot of herbs with pungent flavor and dry nature, which consume yin fluid, therefore, it is not indicated to coma and delirium caused by yang exuberance due to yin deficiency, and it has to be token with great care in pregnant woman.
In clinical practice, this formula is usually used for encephalitis B, epidemisc cerebrospinal meningitis, cerebrovascular accident, heat stroke hcpatic coma and other diseases rrianifested by the above symptomes.
Section 2 warm-Natured Formulae for openning orifices
fhses formulae are indicated to wind-stroke, direct cold-attack, phlcgm-syn212
cope and others belonging to cold-closure syndrome. When cold dampness and phlegm-turbidity go up and block the clear-orifices and disturb mental activities, it results in falling down in aLt, loss of consciousness, aphasia, lock-jaw, white tongue coating and slow pulse. Openning orifice method with warm property should be prescribed. Aromatic herbs for openning orifices such as storax, musk, bomneol and benzoin are usually used as the main part of formula which combine with cloves, eagle wood, Sandal wood and dutehmanspipe root promote the flow of qi Long pepper and asoruni herb can he added to warm meridians to dispel cold-evil. The representative formulae are Storax Pill and Purple Gold Troehe.
sü he xidng wan
SOURCE: Prescription of Peaceful Benevolent Dispensary
Bighead atractylodes rhizome 60g
Dutchmanspipe root 60g
Rhinoceros horn 60g
Nutgrass flatsedge rhizome(stir fried, remove the hair) 60g
Cinnabar(groond, refined with waler) 60g
Myrohalan froit(roasted in ashes) 60g
White sandal wood 60g
Benzoin(ground into powder, deeoeted io a liter of linieless liquor into extract) 60g
Eagle wood 60g
Long pepper BOg
Oriental sweetgom resin(mixed with the extract Benzoinom) 30g
Olibanom(ground alone) 30g
DIRECTIONS: Grind the above-mentioned ingredients into fine powder and then mix them with honey to make into boluses, each weighing 3 grams. Take one bolos each time with warm boiled water. Half dosage for children.
• EFFECTS: Openning orifices with aromaties and activating qi to stop pain.
INDICATIONS: Wind-stroke, direct cold attack, attack of pestilent factors, phlegm syncope, qi syneope and others belonging to closure syndronie marked by
falling down in a fit, lock-jaw, loss of consciousness, or sudden pain in the chest and abdomen and fainting caused by qi stsgnation due to direct cold-attack.
ANALYSIS OF FORMULA: Oriental sweetgum resin, musk, borneol and henzoin are used as principal herbs to open orifices. Nutgrass flatsedge rhizome, dutchmanspipe root, cloves, eagle wood, olibanum, and white sandal wood as assistant herbs activate qi and relieve stasis, expel cold and resolve the turbid evil, reg ulate qi and the blood. Long pepper as adjuvant herbs expels cold to alleviate pain and warms the middle to activate qi. Rhinoceros born is used for clearing away heart-heat and toxins. Cinnabar tranquilizes the mind. Bighesd atrsctylodes rhizome invigorates the spleen to eliminate dampness and harmonizes the middle to re solve the turbid-evil. Myrohalan fruit has the effect of astringing qi. It combines with various aromaties to prevent excessive effect of pungent and aromatic herbs from causing consumption of the genuinc-qi.
In clinical practice, this formula is often used for cerebrovascular accident, hysterical syncope, epilepsy, concussion of brain during the stage of coma, angina pectoris at the time of attack and others manifested as cold-closure syndrome.
This chapter introduced four common formulae for resuscitation, they are divided into two categories: cold-natured formulae for resuscitation and warm-natured formulae for resuscitation on the basis of their effects and indications.
1 . Cold-natured formulae for resuscitation
Peaceful Palace Bovine Gall-stone Bolus, Violet Snow Pillet and Real Treasure Pillet are collectively known as “Three Treasures”, and they are commonly used representative formulae for resuscitation with cold properties. All of them arc indicated to syndrome uf heat penetrating the pericardium, but they are slight different in clinical usc. The first one is good at clearing away best and toxins, upenn;ng orifice and tranquilizing the mind, and is suitable for syndrome of heat sinking into the pericardium marked by coma and delirium; The last one has stronger effect of openning orifice, so it is indicated to all the cuma due to heat closure; As far as the second one is concerned, its effect of clearing away heat and toxins is less than that of the first one, whilst its effect of upenning orifice is inferior to the last one. It stresses on arresting wind to relieve convulsion, and it is, therefore, suitable fur syndrome uf extreme heat causing wind with coma and convulsion.
2. Warm-natured formulae for resuscitation
Starax Pill is the representative formula, and is indicated for syndrome of
cold—closurc. It is good at activating qi to rclicve pain, ihos, it has good effect for pain in the chest and shdomen caosed hy qi stagnation and cold accomolat ion.