| Chapter Thirteen Formulae of Eliminating Dampness and Diuretic
This group of formulae is mainly composed of dampness-eliminating herbs, with the effects of diuresis and removing dampness, treating stranguria and dispel ling the turbid and is used for damp diseases, is generally known as dampness-eliminating formulae.
The dampness belnngs to yin-evil and is characterized by heaviness, turbid ness, stickness and stagnancy. Damp diseases may last long period of time. The damp and namer share different names hut pertain to the same category, and the damp is mild water and water is the accumulatinn of dampness. Damp diseases are usually caused by two kinds of pathogenic factors: The first is exogenous damp ness. It may occur most commonly in case of deficient genuine qi induced by prolonged raining, frequent exposure to water or living in damp conditions and places, or wearing clothes damped by sweat. Its clinical manifestations include a version to cold, fever, distending pain of the head, heaviness of the body, arthralgia, or facial edema,jouridice. The second is eudogenous damp. The condition may appear when internal injury of the spleen and stomach due to indulgence in taking raw and cold food, or ovcreating fat and delicious food and drinking wine lead to weakness of the middle-yang and failure of the spleen in transportation, marked by stuffy chest and abdomen, vomiting, diarrhea, jaundice stranguria with turbid urine, and edema of ankle. Fur there is exterior interior relationship between the sruface of body and viscera, exterior damp may transmit to the internal organs, and endogenous damp may overflow the muscle and skin. Thus, exogenous damp and endogenous damp can influence each other in causing diseases.
As far as the human body is concerned, wamer metabolism is dominated by the kidney, controlled by the spleen, regulated by the lung, transformed by the urinary bladder end maiteged by the triple jiao. Therefore, weakness of the spleen may lead to formation of endogenous damp; deficiency of the kidney may cause flooding of water-damp; failure of the luog qi in dispersion may impair its regulating water ways;dysfunction of the urinary bladder may cause dysuria;obstruction of transformative function of qi in the triple jiao may lea[i to failure of it in water excre tiun. All of the conditions are related to damp diseases. Therefore, it is necessary
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to pay close attention to function of the viscera when using dampness elinunoting formulae.
According to the principles of that “Dryness can dispel dampness”and “Dis charging method can resolve stagnatinn”in tile “ten kinds of formulae” ,(lamp diseases should he treated hy methods of eliminating dampness and diurcsis. Since damp evil usually work together with wind, cold, summer heat or heat to creates disorders. Constitutions of the patient are different in deficiency and excess, sturd— mess and weakness. The affected parts are different from the upper and the low er, the exterior and the interior, and the diseases also differ in cold transformation and heat-transformation. Therefnre, this type of formulae is divided into six kinds:formulae for drying dampness and resolving the turbid, formulae for clear ing away heat and excreting dampness, formulae for facilitating diuresis to remuve dampness, formulae for warming and resolving water-dampness, formulae fur excreting the water by purgatiun and formulae for expelling wind and dampness.
Damp is characterized by heaviness and turbidity, stickness and stagnancy, and it is apt to disturh functional activities of qi, therefore, some herbs for regula ting qi are usually added to the formulae to get the result that “Transformative function of qi can lead to dispersioni of dampness”.
This type of formulae is mainly composed of herbs with pungent and aromat ic flavor and warm and dryness properties, or herbs of sweet and tasteless flavor with effects of excreting dampness, which tend to consume the body fluids. So they should he used carefully to eases of insufficiency of the body fluids, weak constitution due to illness and pregnant wumen.
Section 1 Formulae for Drying Dampness and
Resolving the Turbidity
This group of formulae is mainly used fur syndromes caused by damp-ob struction in the middle jtho and disharmony between the spleen and stomach. Since the spleen duminates transportal ion and transformation, the stumach domiuates receiving food, accuniulatiun uf dump-turbidity in the middle can lead to dis turbance in ascending and descending due to disharmuny between the spleen and stomach, marked by stuffy chest, nausea, vomiting, poor appetite, muse stool, tired limbs, white and greasy tongue costing, soft, moderate pulse. Fur this condition, drying dampness and resolving the turbid therapies shuuld be used. Herbs fur drying dampness with bitter warm flavur, such as magnnlia bark, atractylodes rhizn
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me, and tangerine peel, etc and aromatic hcrbs for resolving damp torbidity soch as agastache, eupatoriom, amomom fruit and notmeg, etc. ,are often taken as prin cipal ingredients to form formulae.
For ease of heavy damp torbidity with dysoria, poria, coix seed and water plantsin can he added to the formula to excrete water-dampess. If dampness is transformed into heal, seotellaria root, coptis root and eapejasmine froit shoold he added to clear heat and dry dampness. If damp syndrome accompanied by synip tums of cold, dry ginger, evudia fruit and gslangal rhizome should be added to warm the middle and dispel cold. if damp syndrome accompanied by symptoms of wind cold, perilla leaf, schizanepeta and dahuria angelica root can be added to disperse the exterior evil. The main representative forrnolae are Stomach-Calming Powder and Agastaehes Genoine Qi Powder.
Stomach-Calming Powder
ping wet sen
SOURCE:Prescriptions of Peaeefol Benevolent Dispensary
INGREDIENTS:
Atraetylodes (rough bark discarded, soaked in rice washed water for two days) 15g
Magnolia bark (rough bark removed, ginger joiee prepared, parched) 9g
Tangerine peel Pg
Licorice root (parched) 4g
DIRECTIONS: Grind the herbs into fine powder. Take S to 5 grams each time with the decoetion of fresh ginger and Chinese dates. Or, deeoct all the above herbs (including fresh ginger and Chinese dates) in water for oral administration.
EFFECTS:Drying dampness and strengthening spleen, activating qi and har monizing the stomach.
INDICATIONS: Stagnation of dampness in the stomach and spleen manifested by abdominal distention, anorexia, tastelessness, nausea, vomiting, erocaUan, acid regurgitation, tiredness, lassitude and sleepiness, frequent diarrhea, white, greasy and thick tongue coating and slow pulse.
ANALYSIS OF FORMULA: It is a representative formula fur drying damp ness and strengthering the spleen. Atractylodes, being bitter in flavor and warm- dryness in property is used as a principal herb in large dose with effect of invigor ating the spleen to dispel dampness. Magnolia hark being bitter in flavor and warm in property as an assistant herb, activates qi, relieves fullness and eliminates
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dampness. Tangerine peel is used to regulate qi, resolve the turbid, awaken the spleen and harmonize the middle. Fresh ginger and Chinese date regulate the the spleen and stomach, They are used as adjuvant herbs. Licorice root as a dispatcher herb, being sweet in flavor and mild in property harmonizes the middle, coordinates the effects of the other herbs in the formula.
This formula can he used to treat syndrome of obstruction of dampness in the middle-jiao involved in acute or chronic gastroenteritis, gastrointestinal disfunction, poptic ulcer hepatitis and others.
Agastaches Genttine-Qi Powder
huô xiãng zhèng qi san
SOURCE: Prescriptions of Peaceful Benevolent Dispensary
INGREDIENTS:
Shell of areea nut 30g
Dahurian angelica root 30g
Perilla leaf 30g
Puns 30g
Pinellia tuber 60g
Bighead atractylodes rhizome 60g
Tangerine peel 60g
Magnolia hark (rough hark removed, fried with ginger juice) 60g
Platyeodon root 60g
Agastaehe 90g
Roasted licorice 75g
DIRECTIONS: Grind the herbs into fine powder. Take 6 grams each time with the deeoetion of fresh ginger and Chinese dates for oral administration. Or deeuet the above herbs in water fur oral administration, with the dosage proportionally adjusted. They can be also made into bolus or medicinal water.
EFFECTS: Relieving exterior syndrome by resolving dampness, regulating qi and harmonizing the middle.
INDICATIONS: Exterior syndrome due to wind cold with internal injury due tu damp-turbidity narked by fever, chills, headache, stuffy chest, abdominal pain, nausea, vomiting, borborymus and diarrhea, whitish and greasy tongue coating, or mountainous miasma.
ANALYSIS OF FORMULA: It is a common formula to relieve exterior syndrome and resolve dampness. Agastache with pungent flavor and aromatic smell is
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used in large dose as a principal herb, and it can not only dispcl wind-cold but also resolve the turbid and awaken the spleen to harmonize the middel, and expel the turbid to stop vomiting. Perilla leaf and dahurian arigelica root being pungent in flavor arid aromatic in property regulate qi to smooth the chest. Pinellia tuber low ers the adverse qi to stop vomiting and dries dampncss to harmonize the stomach. Magnolia bark being bitter in flavor and warm in property dries dampness and activates qi to relieve stuffiness. They are all used as assistant herbs. Tangerine peel regulates qi and dries dampness. Poria and bighead atractylodes rhizome strength en the spleen and excrete dampness. Shell of areca nut activates qi and dispels dampness. Platycodon root disperses the long to activate c1i, and is helpfol in relieving the exterior syndrome and resolving dampness. They act as adjovant herbs. Fresh ginger and Chinese dates harmonize the spleen and stomach. Licorice coor dinates thc effects of the other herbs and assists the thcse two herbs in benefiting qi and harmonizing the middle. They are used together as dispatcher herbs.
Today this formula is often used to treot acute gastroenteritis manifested in exterior syndrome doe to wind-cold accompanied by injury of the spleen and stom ach caused by dampness evil.
ASSOCIATED FORMULA:
Six Harmony Deeoetion(lià he tang)
SOURCE: Textual Research on Medical Formula
INGREDIENTS:
Amomom fruit 3g
Pinellia tuber 6g
Apricot kernel 6g
Ginseng 6g
Bighead atractylodes rhizome 6g
Agastaehe 6g
White hyacinth bean Gg
Poria 6g
Chaenomeles fruit 4. 5g
Magnolia bark 3g
Licorice root 2g
DIRECTIONS:Decoet all the herbs in water for oral administration.
EFFECTS:Strengthening rhe spleen and dispersing dampness, sending up the lucid qi and sending down the turbid.
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INDICATIONS: injury of spleen and stomach due to dampness and improper diet in summer marked by vomiting, diarrhea, strffy chest, white aod watery coat ing.
Section 2 Formulae for Clearing Away Heat
and Excreting Dampness
This kiod of formula is indicated for exogenous attack due tu damp-warm or for febrile disease due to summer-heat and damp-warm disease, jaundice, heatstrangury and flaccid blockage syndrome etc. , caused by internal exuberance af damp heat and downward flow of damp heat. Dampness belungs tu yin evil, while heat to yang evil,eombination of dampness and heat is just like oil mixed with the flour, which is characterized by unresolvable accumulation, stickiness and prutrue— ting course of disease. Damp-heat may be caused by exogenous attack or by internal injury, and its changes often center on the spleen and stomach. Although the patterns of damp heat syndrome are various, they are nuthing more than three categories Syndrome with more dampness than heat, syndrome with more heat than dampness and syndrome with dampness equal to heat. If dampness is more promi nent than heat, resulving dampness is taken as principal therapy, apricot kernel, platyeodon root and agastaehe are often used to disperse the upper jiao; Nutmeg magnolia bark and pinellia tuber are prescribed to invigorate the middle-jiao;coix seed, puria and tale are applied to ooze dampness in the lower-jiao, so that the heat evil is isolated from damp evil, and then some herbs for clearing away and cx crating dampness can be added tu the furmula to eliminate heat. If dampness is equal to heat, the method of resolving dampness and clearing away heat should be used. If heat is more prominent than dampness, therapy of clearing away heat is taken as principal one. l\’leanwhile to resolve dampness is the second. For jaundice due to damp heat, oriental wormwood, capejasmine fruit and phellodendron hark are usually used as principal herbs to excrete dampness and eliminate jaundice. For diarrhea due to damp-heat, seutellaria root, eoptis toot, silkworm dropping and pulsatilla root can he chosen as principal herbs to clear the intestines, dry damp ness, detoxieate and arrest dysentery. For heat-strangury and blood-strangury due to damp heat in the lower jiao, Chinese pink herb, prostrate knotweed, pyrrosia leaf and plantain seed can be chosen as principal herbs to induce diaresis far stran— guria. For flaccid-blockage syndrome due to damp-heat, atraetylodes rhizome and phellodendron bark can be chosen as principal herbs to clear away heal and dry
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dampness.
For the ease with constipation, rhuharh can he added to the formola to redoce heat and induce defecation. If fomigation of damp heat leads to sore throat, forsythia fruit, belameanda rhizome and peppermint can be added to the formula to clear the throat. For flaccid—blockage syndrome with arthritic extrernilies, large leaf gentian root, tetrandra root, futokadsora stem and Chinese starjasioine can be added to the formula to clear collaterals and relieve pain. The main representative formulae are Oriental Wormwood Decoction, Decoction of Three Kinds of Kernel, Sweet Dew Detoxicating Pillet and Eight Corrections-Powder, Coptis and Magnolia Dececlion and Two Wonderful Herbs Powder. -
Oriental Wormwood Decoction
yin chén han tang
SOURCE; Treatise on Cold-Attack
INGREDIENTS:
Oriental wormwood 30g
Capejasmine fruit 15g
Rhubarb 9g
DII{ECTIONS:Decnct all the herbs in water for oral adrninistraion.
EFFECTS:Clearing away heat and excreting dampness to clear jaundice.
INDICATIONS:iaundice due to damp-heat marked by bright yellow coloration of the skin and eyes,just like orange color, slight fullness sensation in the abdomen, thirst, disturbance in urination, yellow and greasy tongue coating and deep, rapid pulse.
ANALYSIS OF FORMULA: It is a basic formula to treat jaundice doe to damp heat. Oriental wormwood is used in large dosage as a principal herb in this formula. It is good at clearing away stagnated heat in the liver and gallbladder and excreting dampness to clear jaundice. Capejasmine fruit as an assistant herb clears obstruction in the triple jioo, disperses heat and dries dampness via dioresis. Rhubarb as an adjuvant herb purges heat, induces defecation, clears the intestines and stomach and benefits the gallbladder, relieves damp heat via bowel naovement.
This formula is used for yang type jaundice characterized by bright yellow eyes and skin just like orange color.
Today it is widely used for syndrome of yang type jaundice in acute infectious icteric hepatitis, cholecystitis, clmlelithiasis, leptospirosis, etc.
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Three Kinds of Kernels Decoction
san rén tang
SOURCE:Treatise on Differentiation and Treatment of Warm Diseases
INGREDIENTS:
Apricot kernel lOg
Talc 18g
Rice paper pith 6g
Pound cardamon seed Gg
Lophatherum 6g
Magnolia bark 6g
Cuix seeds 18g
Pinellia tuber log
DIRECITONS:Decocl all the herbs in water for oral administration.
EFFECTS: Promoting the functional activities of qi, clearing away beat and excreting dampness.
INDICATIONS: Initial stage of damp-heat disease or febrile disease due to summer-heat with dampness which cause accumulation of the evil qi in the qi phase marked by headache, aversion to cold, pain and fatigue, slight yellow complexion, oppressive fullness of the chest, poor appetite, afternoon fever, dry mouth without a desire to drink, white and greasy tongue coating, taut, thready and soft pulse.
ANALYSIS OF FORMULA:This formula is used for the first stage of damp- heat disease which causes accumulation of the evil-qi in the qi phase when damp ness is greater than heat. Apricot kernel soothes the long-qi to regulate the upper source of water. Round cardamon seed activates qi, resolves dampness and strengthens the middle-jiao. Coix seed being sweet and tasteless in flavor and cold in property, excretes damp-heat to clear the lower-jiao. These three herbs are used together as principal herbs to make the triple-jiao unobstructed and damp- heat separated. Pinellia tuber and magnolia bark strengthen the spleen and dispel dampness, activate qi and relieve fullness of the abdomen. Talc, rice paper pith and lnphathernm clear heat and excrete dampness, they are used together as assistant and adjuvant herbs.
Today this formula is often used to treat the above syndrome wiih more dampness than heat involved in acute gastroenteritis, acute hepatitis, influenza, pyclitis, typhoid fever and others.
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For treatments of the above syndrome, Treatise on Differentiation and Treatment of Warm-Diseases pointed out the following admonitions: The first, it is not allowed to be sweated, as “diaphoresis may lead to unconsciousness, deafness, or closed eyes and dislikeness of speaking.” The second, it is inadviseble to purge, as
“purgation may cause severe diarrhea”. The third, it is inadvisable to nourish, as “nourishment may prolong the coure of the disease. “All of these are really bril liant expositions.
Sweet Dew Detoxication Pullet
gãn là xido dá dan
SOURCE: Compendium on Warm-Diseases
INGREDIENTS:
Talc 450g
Oriental wormwood 330g
Scurellaria root SOOg
Grassleeved sweetflag rhizome 180g
Fritillary bulb 150g
Akebie stem 150g
Agastache 120g
Belamcanda rhizome 120g
Forsythia fruit 120g
Peppermint 120g
Round Cardamon seed 120g
DiRECTIONS: Grind the above herbs into fine powder. Take 9 grams each time with boiling water, twice a day. Or make paste pills by refining the powdered herbs with medicated leaven. The pills are to be taken, 9 grams each time with warm boiled water, twice a day. Or dccocted them in water for oral administration, with its dosage decreased proportionally according to the original formula.
EFFECTS: Excreting dampness, resolving turbidity, clearing heat end removing poison.
INDICATIONS: Damp werm disease and scusunel pestilence occurring in the qi phase marked by fever, lassitude, chest oppression, abdominal distention, tired limbs, swelling of throat, jaundice, swelling of lower check, vumiriog, dierrhea, scanty dark urine, or srronguria with turbid urine, white tongue coating, or thick greasy coating or dry yellowish coating, soft end rapid pulse.
ANALYSIS OF FORMULA: This is a common formula indicated for syndrome
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with dampness equal to heat at the first stage of damp-warm disease. Talc, orien tsl wurmwood and scutellaria rout are used in large dose in the formula. Among them, the first one removes damp-heat to eliminate summer-heat, the second one clears away heat and excretes dampness to reduce jaundice, the third one clears a- way heat and poison to dry dampness, they are used together as principal herbs. Grassleaved sweetflog rhizome, agastache sod round cardamon seed as assistant herbs, resolve the turbid with their aromatic nature and awaken the spleen and dispel dampness. Peppermint and forsythia fruit disperse and expel the exterior with their lightness and clearness, and clear away heat and poison. Fritillary bulb and belameanda rhizome remove poison to treat throat. Akebis stem clears away heat and being diuretic, induces damp—heat downward and eliminates it via orina tion. All the above herbs act as adjovant ones.
Today, this formola is oaosally used for syndrome with dampness equal to heat involved in iniestinol typhoid, infectious hepatitis, cholecystitis, acute gastro enteritia and leptospirosis and the others.
Coptis and Magnolia Decoction
lMn pô yin
SOURCE: Treatise on Cholera
INGREDIENTS:
Prepared magnolia bark 6g
Coptis rant (parched with ginger juice) 3g
Grasaleavcd sweetflag rhizome 3g
Prepared pinellia tuber 3g
Prepared soybean 9g
Capejosminc fruit (parched) 9g
Reed rhizome 60g
DIRECTION5:Decoct all the above herbs in water for oral administration.
EFFECTS:Clearing away heat and resolving dampness, regulating qi and har monizing the middle.
INDICATIONS:Syndrome of damp-heat lodged in the middle jiao marked by vomiting, diarrhea, stuffy chest and abdomen, yellow and greasy tongue coating, scanty dark urine and rapid pulse.
ANALYSIS OF FORMUT4A: It is a common formula for treatment of syn drome with dampness equal to hcat marked by vomiting and diarrhea. Coptis root being bitter in flavor and cold in property purges fire, dries dampneas and is de264
toxicating. Magnolia bark bitter in flavor and warm in natore aedvates qi and re lieves folloess. The two herbs are used together as principal herbs with the effects of pungent opening and bitter descending. Capejasmine fruit clears away heat in the triple—jiao and assiers coptis root in porging heat. Pinellia tuber dries dampness and invigorates the spleen and assists magnolia bark in eliminating dampness. They are assistant herbs in the formula. Grassleaved sweetflag rhizome re solves dampness by irs aromatics. Prepared soybean dissipates heat and relieves anxiousness. Reed rhizome clears away heat, resolves dampness and harmonizes the stomach to arrest vomiting. They are used together as adjovant and dispatcher herbs.
This formala can he used for syndrome of damp heat lodged in the middlejiaa involved in typhoid fever, para-typhoid fever and baeillary dysentery.
Eight corrections Powder
ba zhêng can
SOURCE: Prescriptions of Peaceful Benevolent Dispensary
INGREDIENTS:
Plantain seeds 500g
Chinese pink herb 500g
Prostrate knot weed 500g
Tale 500g
Capejasmine fruit 500g
Roasted lieariee rant 500g
Akebia stem 500g
Rhubarb (coated with flour paste and then roasted after removal of the coat and then baked) 500g
Rush pith 3g
DIRECTIONS:Crind the herbs into powder, and then deeoet 6 to 9 grams in water for oral administratian;Or all the above herbs are directly decacted in water for oral administration, with the dosage adjosted in proportion to the original far— mole.
EFFECTS: Clearing away heat and purging fire, inducing diuresis to treat strangoria.
INDICATIONS: Heat straagoria, blaod-strangaria doe to downward flaw of damp heat marked by cloudy and dark urine, frequent and orgent micturitian, borning pain in the urethra, dribbling urination, ar retention of urine, spasmatic
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destention and fullness of the lower abdomen, dryness of mooth and throot, yellowish and greasy tongue coating, slippery and rapid poise.
ANALYSIS OF FORMULA: It is a common formula for treatnien of heat stranguria and blood strangoria. Chinese pink herb and prostrate knotwced as principal herbs are good at clearing away heat and excreting dampness, dropping fire and treating stranguria. Plantain seed, akebia stem, talc und rosh pith as oasis tant herbs clear away damp heat and treat stranguria to benefit the orifices. Cape- jasmine fruit purges damp-heat from the triple jiao. Rhubarb purges heat and lowers fire. These two herbs act as adjuvant herbs. Roasted licorice coordinates the effects of the other herbs in the formula, playing the role of dispatcher herbs.
T his formula treats stranguria by its bitter flavor and cold property, and it is only indicated for stranguria syndrome with excess fire. It is contraindicated in prolonged stranguria syndrome with weak constitution and in pregnant women.
Today it is often used for cystitis, urethritis, acute prostatitis, infection or stone in urinary system, pyelonephritis and the other manifested as syndrome of damp-heat in the lower-jiao.
Two Wonderful Herbs Powder
èr miào san
SOURCE: Danxi’ s Experiential Therapies
INGREDIENTS:
Phellodendron bark (parched) 15g
Atractylodes rhizome (soaked in rice-washed water and parched) 15g
DIRECTIONS:Ground them into fine powder. The above two herbs are used in same dose. Take 3 to 5 grams each time with boiled water or fresh ginger de coction. Or make the fine powder into pills. All herbs can also he decuctcd in water for oral administration.
EFFECTS:Clearing away heat and drying dampness.
INDICATIONS: Syndrome of downward flow of damp-heat marked by tired legs, congestion, swelling and pain uf the knees and feet, or morbid leukorrhea due to damp-heat, or wet-sores in the lower part of the body, scanty dark urine, yellowish and greasy tongue cuating.
ANALYSIS OF FORMULA: It is a cummun furmula for treatment of syn drume of downward flow of damp heat. Phellodendron bark clears heat and dries dampness with its bitter and cold properties, and it enters the lower jiao. Atractyindes rhizome is goad at drying dampness as it has bitter and warm properties.
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The combination of these two herbs results in clearing away hcat and drying dampness.
In clinical practice, it is nsnally modificd according to conditions of illness. For flaccid syndrome due to damp-heat, siegesbeckia herb, acanthopanax bark and pyrnla can be added to the formula to dispel wind-dampness and strenihen the tendons and bones. For clamp heat beriberi, coix seed, chaennmeles fruit and areca seed can be added to theiormula to cxcrete danipness and resolvc the turbidity. For morbid leukorrhea due to damp-heat, euryale seed, ailanthus bark and red po na could be addcd to the formula to strengthen the spleen, ooze dampness and ar rest morbid lcuorrhea. For damp-sorcs in the lower part, gentian root, coix seed and red bean could be added to clear damp-heat and poison from sores.
ASSOCIATED FORMULAE:
(1) Three Wonderful Herbs Pills (san mido wda)
SOURCE:’Jrthox Medical Book
INGRED1ENTS:
Phellodendron hark (parched with wine) 120g
Atractylodes rhizome (soaked in rice-washed water and parched) 180g
Achyranthes root 60g
DIRECTIONS:Grind the above herbs into powder and make into paste pills as big as the seed of Chinese parasol for oral administration 6 to 9 grams each time with wsrm hailed water or light salt ginger decoction two to three time a day be fare meal. The herbs can also he decocted in water for oral administration with the dose reduced proportionally to the original formula.
EFFCTS:Clearing away heat and drying dampness.
INDICATIONS: Syndrome of sinking of damp-heat marked by numbness of feet with scorching sensation.
(2) Four Wonderful Herbs Pills(tf micio man)
SOURCE: Set fermulae fur Easy Reading
INGREDIENTS:
Phellodendron bark 240g
Cuix seed 240g
Atractylodes rhizome 120g
Achyranthes rout I 20g
DiRECTIONS: Grind the herbs into fine powder first and then make intc small pills with water, Take 6 to 9 grams each time with warm boiled water.
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EFFECTS: Clearing heat and dampness.
INDICATIONS:Syndrome of sinking of damp-heat marked by numbness, I la eidity, swelling sad pain nf the feet.
Notes:Three Wonderful Herbs Pill is Two Wonderful Herbs Pill plus achyranthes root which can dispel wind-dampness and tonify the liver and kidney and guide the effect of all herbs downward. This is why it is good at treating syndrome of dampness in the lower-jiao with numbness pain and weakness of the feet. If enix seed is added to Three Wonderful herbs Pill the formula is called Foor Wonderful Herbs Pill. This formula increases the functions of removing dampness and heat. Thus it is indicated for syndrome of sinking of damp-heat with symptoms of numbness, flseidity swelling and pain of the feet.
Section 3 Formulae for Inducing Diuresis
to Remove Dampness
This group of formulae is indicated for syndrome af overabundance of water- dampness marked by disturbance in urination, edema, stranguria, reterntion of u rine and diarrha. The spleen dominates transformation of dampness. The urinary bladder is in charge of transformative function of qi and excreting water. Failure of the spleen in transporting dampness may lead to flooding of water-dampness, resulting in general edema and disturbance in micturition. if the exteriar evil is not relieved, it may enter the urinary bladder and impair the transformative function of qi, causing disturbance in micturition edema, diarrhea and vomiting after drinking water. If wind-evil attacks the exterior and water evil stagnates in the surface of the body, there will be wind dampness, wind edema. Accordance with the principle of “Dampness has to he removed by promoting dioresis”, the method of re moving dampness by diuresis should ha osed. Poria, water plantain, Polyporus selerotium and tetrandra root are often chosen as principal herbs.
If there is exterior-evil accompanied by failure of the orinary bladder in trans forming qi, cinnamon twig should he added to the formula to expel the exterior-evil and to assist the urinary bladder in transforming qi. If accumulation of water and heat creates impairment of yin, donkey-hide gelatin can be added to nourish yin and moisturize dryness. If wind edema leads to unconsolidation of superficial qi,astragalus root and highead atractylodes rhizome should be added to replenish qi, consolidate the exterior, invigorate qi and strengtheo the spleen. If stagnation of water and dampness disturbs functional activities of qi, tangerine peel, magnolia
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bark, aucklandia root arid shell of areca nut are usually chosen to the formula to activate qi and excrete dampness. The main representative formulae are Poria Powder with Five Herbs,Polyporus Selerotium Decoction and Five Kinds of Peels Powder and so on.
Poria Powder with Five Herbs
wü lIng san
SOURCE: Treatise on Cold- Attack
INGREDIENTS:
Polyporus Selerotiom 9g
oriental water plantain rhizome 15g
l3ighead atractylodes rhizome 9g
Poria 9g
Cinnamon twig 6g
DIRECTIONS:C rind all the herbs into fine powder. Take 3 to 6 grams each time with boiling waler. or, decoct in water for oral administration.
EFFECTS: Removing dampness by dioresis and warming yang to promote transformative function of qi.
INDICATIONS: Syndrome of accumulation of water-dampness accompanied by the exterior evil marked by headache, fever, heavy thirst with desire for drink ing, vomiting after drinking water, disturbance in mictorition, whitish tongue coating, and floating, pulse, or edema, diarrhea and vomiting, or salivation, dizziness and shortness of breath with cough.
ANALYSIS OF FORMULA: This furmula is often used for fluid-retention with distuhanee in urination. Oriental water plantain rhizome with sweet and tasteless flavor and cold property is usd as a principal herbs in large dose and it directly acts on the urinary bladder to expel dampness by diuresis. Poria and Polyporus selerotium as assistant herbs increase the effects of expelling excessive water. Bighead atractylodes rhizome invigorates the spleen to dry dampness. Cinna mon twig being pungent in flavor and warm in property can relieve the exterior syndrome of Taiyang externally and assist the. urinary bladder to transfurmo rji in ternally. It acts as adjuvant herbs.
‘Today this formula can be used for edema in acute or chronic nephritis, acute gastroenteritis and retention of urine belonging to the syndrome of ‘fluid-reten tion.
ASSOCIATED FORMULAE:
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(1) Poria Powder with Four Herbs (si flog sOn)
SOURCE: Guidance of famous Physicians
INC REDIENTS:
Bighead atractyludes rhizome 9g
Poria 9g
Umbellate pore fungus 9g
Oriental water plantain rhizome 15g
EFFECTS: Expelling dampness by diuresis.
INDICATIONS:Overabondanee of dampness doe to the spleen deficiency with scanty dark urine and loose stool.
(2) Weiling Deeoetion(roOl flog tang)
SOURCE: Danxi’ s Experiential Therapies
INGREDIENTS: It is a combination of Poria Powder with Five Herbs and Stomach Calming Powder.
DIRECTIONS:Deeoei all the herbs with fresh ginger and Chinese dates in water for oral administration.
EFFECTS: Expelling dampness and harmonizing the stomach.
INDICATIONS:Injory of the spleen and stomach due to cold diet in between summer and autumn marked by diarrhea with undigested food, edema, abdominal distention and disturbance in mieturition.
(3) Oriental Wormwood Plus Poria Powder with Five Herbs (ytn ehOn zoO ling são)
SOURCE: Synopsis of prescriptions from the Golden Chamber
INGREDIENTS:
Oriental wormwood powder lOg
Poria Powder with Five Herbs 5g
DIRECTIONS: Mix the herbs and take 4 to 6 grams each time after meal, three time a day.
EFFECTS:Expelliag dampness and fading jaundice.
INDICATIONS: Jaundice doe to damp heat marked by pattern with more dampness then heat, disturbance in urination.
Notes:If Poria Power with Five Herbs omits cinnamon twig, it is called Poria Powder with Four Herbs. This formula is good at expelling dampness and indica ted for syndrome of retention of water dampness marked by disturbance in micto rition. Weiling Deeoction consists of Poria Powder with Five Herbs and Stomach-
270
Calming Powder. It has tha effects of activating qi and excreting water, drying dampness and harmonizing the stomach, and it is usually used for syndrome of retention of water-dampness marked by abdominal distention, edema, disturhance in mieturitiun or diarrhea. If oriental wormwood is added to the formula it is called Oriental Wormwood Plus Poria Powder with Five Herhs. This formula can excretes dampness, clears away heat and eliminates jaundice, and is osed for jaundice marked by pattern with greater dompness than heat, disfurhanee in micturition.
Polyporus Decoction
zhü (Ing tang
SOURCE:Treatise on Cold Attack
INGREDIENTS:
Polyporus selerotium 9g
Poria 9g
Oriental water plantain rhizome 9g
Donkey hide gelatin 9g
Tale 9g
DIRECTIONS: Deeoet all the herbs except donkey-hide gelatin in water for o ral administration. Donkey-hide gelatin should be taken after being melted by the finished deeoetion in two separate doses.
EFFECTS: Diuresis, clearing away heat and nourishing yin.
INDiCATIONS: Aceumlation of water and heat with impairment of yin fluid marked by disturbance in mietorition, fever, thirst, or insomnia with restlessness, or cough, nausea, vomiting, diarrhea, or pain in mieturition, harnoturia, distention in the lower abdonien, red tongue with white coating, thready and rapid pulse.
ANALYSIS OF FORMULA:It is a common formula for diuresis, eleaing heat and nourishing yin. Poria and polyporus sclerotium are principal herbs with the effects of diuresis, invigorating the spleon and soothing the stomach. Oriental water plantain rhizome dispels damp-turbidity. Tale facilitates diuresis to treat stran guria and clears away heat to nourish yin. They are assistant herbs. Donkey-hide gelatin as adjuvant herb nourishes yin to clear away heat, and prevent the other herbs from inpairing yin-fluid. The combination of the five herbs results in facilitaing diaresis without impairment of yin and nourishing yin without retaining the evil-qi, and gets the water-dampness dispelled, heat-evil cleared away so that yin fluid will be restored.
In clinical practice, this formula is used for urinary infection and nephritis
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manifested by disturbance in micturition accompanied by yin deficiency with heat. Poria Powder with Five herbs arid this formula ore both ettribotable to for
molac of dioretic, so their fonctions are similar. They can be osed for disturbance in micturition. However the former has dioretic herbs to excret dampness combined with connamon twig which activates yang, promotes transformative fonctinn of qi and facilitate dinresis, so i is indicated for syndrome of water eccomoletion doe to failure of the orincry bladder in transforming qi. The letter has diuretic herbs to excrct dampness combined with dondey-hide gelatin which nourishes yin, clears away heat and facilitates diuresis, so it is used for accurnolation of water and heat accompanied by impairment of yin marked by disturbance in micturiation
Five Kinds of Peels Powder
Wa ph são
SOURCE:Huatuo’s Visceral Classic
INGREDIENTS:
Ginger slices 9g
Mulberry hark 9g
Tangerine peel 9g
Shell of areca nut 9g
Poria peel 9g
DIRECTIONS:Decoct all the above herbs in water for oral administration.
EFFECTS: Excreting dampness to subduce edema and regulating . qi to strengthen the spleen.
INDICATION:General subcutaneous edema, tired limbs or the whole body, distention of chest and abdomen, dyspnea, oliguria and edema during pregnancy, whitish and greasy tongue coating, and deer), moderate pulse.
ANALYSIS OF FORMULA: It is a common formula for treatment of general edema. Poria peel in the formula induces diuresis and excretes dampness, and strengthens the spleen to promote the functions of transportation and transformation at the same time. Ginger being pungent in flavor disperses fluid-retention. Mulberry bark descends the lung qi to clear and regulate water passage. Shell of areca nut activates water qi to relieve distention of the ahdnTnen. Tangerine peel soothes the stomach-qi and resolves damp turbidity. The combination of the five herbs produces the effects of regulating qi and invigorating the spleen and excreting dampness to relieve edema.
This formula promotes normal water flow and eliminates edema. If the
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spleen qi is very deficient, bighead atractylodes rhizome and astragalus root should be added to the formula to replenish qi and strengthen the spleen. If edema accompanied by wind-evil is in the tipper body, ledebouriella ruot and riotopterygium ruot should be added to the formula tu dispel wind and dampness. If edema is in the lower budy, this formula is often combined with Puria Powder with Five Herbs to increase the effects of diuresis and relieving edema.
It is shuuld be treated by the modified furmula that edema of acute or chronic nephritis, edema of heart failure, edema during pregnancy, edema of abrupt onset and menopausal syndrome, etc manifested in general edema syndrumc due tu spleen deficiency and excessive dampness can.
Tetrandra and Astragalus Decoction
fling fl Iuzdng qI tang
SOURCE:Synopsis of prcscriptiuns from the Golden Chamber
INGREDIENTS:
Tetrandra root 12g
Astragalus 15g
Roasted licorice rout 6g
Bighead atractylodes rhizome 9g
Fresh ginger 4 pcs.
Chinese date I pea.
DIRECTIONS:Decoct all the above herbs in water fur ural administration.
EFFECTS:Replenishing qi and dispelling wind, invigorating the spleen and diuresis.
INDICATTONS:Wind edema or wind-dampness syndrome manifested by perspiration, aversion to wind, tired body, uliguria, pale tongue with white coating end floating pulse.
ANALYSIS OF FORMULA: lt is a common formula fur treatment of wind e dema or wind dampness syndrome belonging to exterior deficiency. Tetrandre ruot in the formula dispels wind, induces diuresis, remuves dampness and stops pain, Astragalus is used in lurge duse to replenish qi, consolidate the exterior, promote diuresis and relieve edema. The cumbinetion of these two herbs results in invigorating the genuine-qi to eliminate the evil qi. They act as principal herbs. Bighead atractylodes rhizome as on assistant herb strengthens the spleen and excretes dampness ,assists tetrandra root in promoting diuresis end estragalus in consolidating the exterior. Fresh ginger end Chinese date acting as odjuvant herbs hermo
273
nize nutrienttqi and defense-qi, invigorate the spleen and regulate the stomach. Roasted licorice root is used as dispatcher herbs with the effects of replenishing qi, strengthening the splean and moderating othar herhs.
This formula is often used for chronic nephritic edema, it is often used with Poria Powdar with Five Herbs.
Today this formula is usually used for acute or chronic nephritis, cardiac edema, rheumatic arthritis and nephrotic syndrome manifested as wind edema or wind dampness syndrome.
Section 4 Formulae for Warming and
Resolving Waterdampness
This kind of formulae is indicated for retention of phlegm and fluid, edema due to dampness transforming intu cold and failure of yang-qi in warming and evaparating water. The spleen is in charge of transportation and transformation of dampness. The kidney controls urination arid defecation. Yang deficiency of the spleen and kidney leads to failure of qi in transforming function and transformation of cold from dampness. Accumulation of water dampness may lead to fluid-retention. Obstruction of water passage may cause defficulty in urination and ede ma. Deficiency of rhe kidney can give rise to downward flow of dampness turhidi ty, resulting in clondy urine. Stagnation of cold-dampness in the feet may lead ta heriheri. Se this group of formulae is mainly composed of herbs that warm the interior and dispel colrl such as cinnamon twig, dried ginger and evodia fruit, etc.
and those which induce dioresis and dispel dampness, such as poria, bighead atrac— tylodes rhizome, wolly yam and areca seed, etc.
Internal retention of water dampness is apt ta disturb functional activity of qi. Therefore, some herbs for regulating qi, such as tangerine peel, magnolia bark, aucklandia root, shell of areea not and lindera root, are usually added to this kind of formulae to strengthen the effects of diurcsis and dispelling dampness. Water cold due to yang deficiency is often accompanied by insufficiency of genuine yin, an the basis of using dried ginger and prepared aconite root with large dose,white peony root, chaenonieles fruit and schisadra fruit, however, are usually chosen to prevent impairing yin by the damiaess-eliminating herbs. The representative formulae are Decoction of Pane, Cinnanman, Bighead Atractylades and Licorice, Spleen Reinforcing Decoctinn, Wally Yam l)ecnctinn far Clearing Turbid Urine.
274
Poria Cinnamon, Bighead Atractylodes and Licorice Decoctioa
Ilug gui aM gao tang
SOURCE: Treatise o’i Cold Attack
INGREDIENTS:
Poria 12g
Cinnamon twig 9g
Bighead atractylodes rhizome 6g
Roasted licorice root 6g
DIRECTIONS:Deeoet all the above herbs in water for oral administration.
EFFECTS:Warming and Resolving phlegm and fluid retention, strenthening the spleen and dispelling dampness.
INDICATIONS:Syndrome of phlegm and floid tetention doe to deficiency of middle-yang marked by stuffy chest and hypoehondrioni, dizziness, palpitation, or eoogh, shortness of breathe, white and watery coating of tongue and toot and slip pery polae.
ANALYSIS OF FORMULA:It is a common formula for treatment of phlegm and floid. retention of phlegm and fluid retention. Poria as a principal herb in the formola is used in large dose with the effects of strengthening the spleen and excreting dampness. Cinnamon twig as an assistant herbs warms yang to promote transformative function of qi, and meanwhile, lowers the adverse qi. The eembina tion of these rwu herbs, one being diuresis and the other being of warmer nature, eon warm, and resolve retention of cold phlegm-and-fluid. Since dampness comes from the spleen, deficiency of the spleen may lead to formation of dampness. Thus, bighead atractylodes rhizome is used as an adjuvant herb to strengthen the spleen and dry dampness and to assist the spleen in transporting and transforming water-dampness. Roasted licorice root as a dispatcher herb replenishes qi and harmonizes the middle. The combination of these four herbs, functioning in warming without hot nature and promoting diuresis without purgation, results in warming yang to resolve fluid retention and strengthening the spleeu to excrete dampness.
This formula is often used fur chronic bronchitis, bronchial asthma, eangas tive heart failure and chronic nephritis manifested as edema due to yang deficiency.
ASSOCIATED FORMULA
Licorice, Dried Ginger, Poria and Bighead Atruetylades Daeaetion (gao edo gun jioag f ml flag bdi zhrl tang)
275
SOURCE: Synopsis of Prescriptions from the Golden Chamber
iNGREDIENTS:
Licorice root fig
Dried ginger 12g
Poria 12g
Bighead atractylodes rhizome fig
DIRECTIONS: Dccoct all the herbs in water for oral adnunistration, three times a day.
EFFECTS:Warming the earth (spleen) to dispel dampness.
INDICATIONS:Kidney stagnation doe to downward attack of cold-dampness marked by lired body, cold fooling and pain in the lower body, normal food intake and urine.
Notes: This formola is Poria, Cinnamon, Bighead Atractylades and Licorice Decoction minos cinnamon twig hot pbs dried ginger. Poria and dried ginger in the formula are osed in large dose to warm the middle and dispel dampness. It is mainly used for kidney-stagnation syndrome doe to downward attack of cold dampness. Decoction of Poria, Cinnamon, Bighead Atractylodes and Licorice is indicated for retention of phlegm and fluid due to deficiency of the middle-yang. So more attention should be paid to the difference between them in clinical practice.
Spleen-Reinforcing Decoction
xiii pi yin
SOURCE: Effective Formulae Handed Down for Generations
INGREDIENTS:
Magnolia bark (bark removed, parched with ginger juice) fig
Bighead atractybodes rhizome fig
Chaenamcbcs fruit fig
Aucklandia rant fig
Tsaoko fig
Shell of areca nut fig
Prepared acunite runt fig
White pnria fig
Dried ginger (baked) fig
Roasted licorice root 3g
Fresh ginger 5 pcs.
Chinese (late I pcs.
276
DIRECTIONS:Decoct all the above herbs in water for oral administration.
EFFECTS: Warming yang and strengthening the spleen, activationg qi and diuresis.
INDICATIONS:Edema due to yang deficiency marked by serioos edema in the lower body, cold hands and feet, no thirst, stutty chest and abdomen, distention, fatigue,poor appetite,oliguria and loose stool,thick and greasy coating of tongue, deep and slow pulse.
ANALYSIS OF FORMULA: It is a common formula for treatment of edema due to deficiency of yang. Dried ginger in the formula warms spleen yang, and transforms water dampness. Prepared aconite root warms kidney yang, promotes transformative function of qi and induces diuresis. The combination of these two herbs can warm the spleen and kidney and strengthen yang to restrain yin. They are used as principal herbs. Bighead atractylodcs rhizome invigorates the spleen and dries dampness. Poria being tasteless in flavor excretes dampress via urination. Chaenomeles fruit as assistant herb dispels dampness, induces diuresis, a wakens the spleen and barmonizes the stomach;and it can also astringes yin with sour flavor and prevent impairing yin by dampness eliminating herbs. Magnolia bark being hitter in flavor and warm in property dries dampness., activates qi and eliminates fullness. Aucklandia root activates qi to stop pain and regulates the spleen and stomach. Shell of areca nut activates qi and induces diuresis. Tsaoko being pungent in flavor and hot in property worms the middle and dries dampness. Fresh ginger and Chinese date benefit qi and harmonize the stomach. All the above herbs are used together as adjuvant herbs. Roasted licorice rout moderates the properties of all herbs in the formula as a dispatcher herbs. This formula is special for warming and tonifying the spleen-yang, and it reflects the principle of treating desease from the “rout” . To reinforce function of the spleen is the basis of treating water-dampness, thus known as “spleen-reinforcing”.
In clinical practice this formula can he used for edema of chronic nephritis and heart failure manifested as syndrome of yang deficiency.
Wolly Yam Decoction for Clearing Turbid Urine
bi xiè fin qing yin
SOURCE: Danxi’ s Experiential ‘I’herapies
INGREDIENTS:
Bitter cardamon 9g
Wolly yam 9g
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Crassleaved sweetflag rhizome 9g
Lindera root 9g
DIRECTIONS: Decoct all the herbs with o little salt in water for oral administration.
EFFECTS:Warming the kidney, exeereting dampness and resolving the tor bidity.
INDICATIONS: Deficiency-cold of the lower jiao doe to downward flow of damp-torhidity marked by cloody orine, frequent orination, or orine jost like chyme, coagulation of orine like ereom, whitish tongoe coating and deep poise.
ANALYSIS OF FORMULA: It is a common formola for treatment of eloody orine and chyloid strangoria dde to deficiency-cold of the lower-jioo and downward flow of damp torbidity. WoHy yam in the formula is good at excreting dampness and separating clear and the torbid, acting as a principal herb. Fonctioning as assistant barbs, bitter cardamon warms the kidney and concentrates urine, lindera root warms the kidney and activates qi. Grassleaved sweetflag rhizome as an adju vant herb resolves the turbid to treat stranguria. Salt being salty flavor goides the potency of all herbs to act on the kidney, playing a role of dispatcher herb.
in clinical practice this formola can be used to treat chyluria and chronic prostatitis manifested as syndrome of cold dampness due to deficiency of the kid ney.
Bat ii is contraindicated in cloudy urine and chyloid strangoria due to overa bundance of damp-heat in the urinary bladder.
Section 5 Formulae for Diuresis by Purgation
This group of foumulac is indicated for interior excess syndrome doe to over exuberance of fluid-retention. Hydrothorax, ascitic fluid and edema may occur most commonly in cases such as improper food intake, ovarstrain, internal injury due to improper food intake, overstrain, internal injury due to excess of seven e motions, failure of the spleen in transportation and transformation, disturbance of the tripic jiaa, retention of water-dampness. However, only interior excess syn drome due to stagnation of dampness transforming into heat is marked by reple tion of both the body and qi, difficulty in urination and defecation, can the method of promoting diuresis by purgation be used. Drastic hydragogues such as knoxia root, gcnkwa flower and kansoi root arc frequently chosen as principal herbs.
Accumulation of water may lead to stagnation of qi, while flow of qi may
• 278
bring about water circulation. Therefore, some herbs for regulating qi such as green tangerine peel, tangerine peel, aucklandia root and areca seed etc are usually used in formulae for purging waler. Since purgign power of drastic bydragagues is too strung, and it frequently impairs the genuine-qi, this is why this kind of herbs is often tu he taken with Chinese date decuct ion so as to replenish qi and prutect the stomach. The representative formulae are Ten jujubes Decoction and Boat and Cart Pills.
Tcn Jujubes Decoction
skI ado tang
SOURCE:Treatisa on Cold-Attack
INGREDiENTS:
Chinese date lOpcs.
kansui rout
Knuxia rant
Genkwa flower
(The three herbs listed above are used in the same dose.
DIRECTIONS: Grind the above three herbs into fine powder and take 1. 5 to 3 grams of puwder after being rruxed with Chinese date decoctiun before meal in the early morning, once a day. After fluid retention being purged, it can bs taken with millet porridge to nuuriah and protect the stomacb-qi.
EFFECTS: Purging fluid-retention.
INDICATIONS: Suspended fluid-retention marked by pain in the chest and hypuchundrium when cuugbing, or being unable to breathe because of chest and back pain, epigastric stuffiness and rigidity, snrtness of breath, retching, headache, dizziness, watery tongue coating and deep and taut pulse.
It is alan used fur ascitic fluid like drum pertaining to excess syndrome mani
•fested by distention and fullness in the abdomen, or asthma, difficulty in micturitinn and defecatinn, white tongue coating, and deep and taut pulse.
ANALYSIS OF FORMULA: It is a drastic formula for fluid-retention. Kansui runt in the formula is good at dispelling water-dampness in the meridians. Knnxia rant is gund at purging water retention of the viscera. Genlcwa flower is every ef feet ive far remuving latent fluid-retention and hypochnndriac phlegm in the chest and hypnchondrium, These three herbs have a very strong purgative action, and each has its special effect. The combination of the three herbs produces the effect of inter reinforcement and purges fluid retention in the chest and abdumen. Be-
279
cause the three herbs have toxicity and are apt to impair the genuioe qi, Chinese date is used to replenish qi and protect the stomach, and meanwhile it can moderate the strong purgative action and toxicity of the other herhs so that the formola has the effect of purging the evil without impairment of the genuine qi.
This formula is also called Three Sage Powder in the General Collection for Holy Relief. Later on, its form was modified into pills, named Ten Jojobes Pills in Danxi’s Experiental Therapies, it is comvenient to take it. This is a method of “gaining the moderate action with drastic purgative herbs.
This formula has potent action and toxicity, overdose should be avoided and attention shoold he paid to its usage and indications. They shoald he dispensed, accordign to the actual conditions. The combined use of Ten Jojuhes Decoction and foomola far strengthening the spleen and tonification can achieve the result of purging out the evil-qi and reivfarcing the genuine-qi.
In clinical practice, it can be used for hydrothorax, ascites and general edema with stronger constitution involved in exudative pleurisy, liver cirrhosis and chronic nephritis.
Boat and Cart Pills
zhou the wan
SOURCE :Jingyue’s Complete Works
INGREDIENTS:
Morning glory seeds (ground into powder) l2Og
Kansui root (wrap it in flour paste and roast) 30g
Genkwa flower (parched whh vinegar) 30g
Knaxia root (parched with vinegar) 30g
Rhubarb 60g
Green tangerine peel lEg
Tangerine peel 1 5g
Aocklandia root lEg
Aroca seeds 15g
Caloniel 3g
DIRECTIONS: Grind the shove-mentioned herbs into fine powder and make into pills for nra] administration. Take 6 to 9 grams with warm boiled water before meal in the early morning, once a day.
EFFECTS:Activating qi and removing water retention.
INDICATIONS:Syndrome of accamolation of water and heat due to obstroe280
tion of functional activities of qi marked by edema, distention thirty, coarse hreath ing, stuffiness and hardness in the abdomen, constipation and oligonia, deep and rapid poise with forcefulness.
ANALYSIS OF FORMULA: This formula is formed froni modification of Ten J ujubes Deeoetion and is a drastic one to remove water-retention. Kansui root, genkwa flower and knoxia root in the formula as principal herbs purge water re tention in the chest, hypochondrium, ahdumen and meridians. Rhubarb and morning glory seed are assistant herbs which clear the stomach and intestines, and purge the water and heat. The combination of the principal and assistant herhs re moves water and heat downward and eliminates them through urination and defecation. As retention of water-dampness disturbs the functional activities of qi, green tangerine peel soothes the liver qi to resolve the hardness; tangerine peel regulates qi and resolve dampness ; areca seed activates qi and guides water downward; aucklandia root regulates qi and removes stagnation. All of these herbs make qi flow freely, water circulate smoothly and edema resnlved. Caluniel being moving without retaining in nature is used in a little dose to remove water-retention and defecation and to assist the other herbs in separating and eliminating wa ter and heat. The herbs above mentioned are used together as assistant and adju vant herbs. The joint use of all herbs in the formula produces strung purgative action of removing water retention, and its effect is prompt as if the boat is sailing a long with the current and ihe chart is running on the road dowuward. Thus, ii is named Boat and Chart Pills.
This formula is only indicated for the cases with repletion of both body and qi and is contraindicated in weak constitutiun and pregnancy. Cslnmel, genkws flow er, knoxia root and kansui root in the formula have drastic toxicity and caution should he paid to its dosage, so it is not suitable for long term use
Section 6 Formulae for Expelling Wind and Dampness
This group of formulae is mainly indicated for blockage-syndrome due to cx ogenuus uttack of wind, cold and dampness eviL marked by headache, pantalgia, numbness and pain in the lower back and knees. The nature of wind is rapid changeability and movability. Cold is characterized by contraction and stagnation. Dampness is characterized by heaviness and turbidity. When the three evils invade into the skin and meridians, they may give rise to obstruction of qi and blond, resulting in the symptoms mentioned above. Expelling wind and dampness should
281
he used for the treatment. Notopterygium root, pubescent root, ledebooriella root and large leaf gentian root, etc. are frequently used to form the formulae.
In accordance with the principle of that “when treating wind-disease, the blood should he regulated first, and when the blood is in normal circulation the wind will extinguish itself”, some herbs for promoting blood circulation such as chuanxiong rhizome and Chinese angelica root, etc. arc commonly added to the formula to promote blood circulation and collatterals. If hlockage syndrome is accompanied by deficiency of the liver and kidney, eucommia bark, dipsecus root, loran thus mulberry mistletoe, and achyraothes root, etc. can be added to the formula to replenish the liver •and kidney. For the case complicated with deficiency of the blood, prepared rehmannia root and white peony root can be added to the formula to nourish the blood and yin. For the case with deficiency of qi, ginseng, astragalus root, poria and highead atractylodes rhizome, etc. should he added to the formula to tonify qi and strengthen the spleen. For the case with symptoms of cold, cinoa mon hark and wild ginger can be added to the formula to warm the meridians and expel cold. The main representative formulae are Notopterygiom Damp Expelling Decoction and Pubescent Angelica and Loranthos Decoction.
Notopterygium Damp-Expelling Decoction
qiäng huó shèng shi tang
SOURCE: Differentiation on Endogenoos and Exogenous Diseaeses
INGREDIEN Ii’S:
Notopterygiom root 6g
pubescent angelica root 6g
Ligosticom root 3g
Ledebooriella root 3g
Raasted licorice root 3g
Choanxiong rhizome 3g
Chastetree fruit 2g
DIRECTIONS:Decoct all the herbs in water for oral administration.
EFFECTS: Expelling wind and dampness, stopping pain and relieving the exterior syndrome.
INDICATIONS: Attack of wind dampness in the exterior marked by headache, tired body, pain in the shoulder, hack and lower back, and difficulty in turning and side bending, or slight aversion to wind add cold, white tongue coating, end floating poles.
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ANALYSIS OF FORMIJLA: it. is a common fornuila for treatment of wind- dampness attack in the exterior. Notopterygium root being pungernt in flavor and warm in property relieves the exterior syndrome and is good at dispelling wind- dampness from the upper part of the body. Pubescent angeliea root tends to dispel wind dampness from the lower part of the body. The combination uf these two herbs eon expel wind dampness of the whole body, so they are used as principal herbs for treatment of arthralgia. Ledebouriella root expels wind and removes dampness, and it has rhe effect of moistening without drying. Ligustieum rout dis perses wind, cold and damp evils and is good for stopping parietal headache. The combined use of these two as assistant herbs can assist the prioeipal herbs in strengthening the effect of expelling wind-dampness. Chuanxiong rhizome promotes blood circulation and dissipates blood stasis. Chastetree fruit dispels wind and relieve pain. Both act as adjuvont herbs. Roasted licorice root as a dispatcher herb coordinates the effects of the other herbs in the formula.
‘Ihis formula is one for relieving the exterior syndrome by dispelling wiod and dampness with pungent and warm herbs. After taking it, the person may have slight sweating. Thus, it is euntraindieated in patients with wind heat syndrome due to exogenous attack or those suffering from common cold with perspiration.
This furniula can be used for eummon clod, rheumatic arthritis and seiatie neuralgia
ASSOCiATED FORMULA
Blockage-Relieving Deeoetion(juan H tang)
SOURCE:One hundred and One Selected Formulae
INGREDIENTS:
Notopterygium root 9g
Turmeria 9g
Ghiaese angeliea root (soaked in wine) 9g
Astragelus taut (honey haking) 9g
Red peony rout 9g
Ledehouriella root 9g
Roasted licorice root 3g
DIRECTIONS:Decoel all the herbs in water for oral administration.
EFFECTS: Replenishing qi, regulating nutrient qi end expelling wind and dampnesss.
INDICATIONS: Blockage syndrome due to wind dempness accompanied by
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deficiency of both notrient-qi and defense-qi marked by pain of nape, shoulder and arms, heaviness and numbness of the hands and feet.
Notes Both this formula and Notopterygium Damp-Expelling Decoetion can be used for blockage syndrome due to wind-dampness, however. The former trends to replenish qi and regulate nutrient qi, so it is suitable for pain of nape, shoulder and arms, numbness of the hands and feet. The latter stresses on dispel ling wind and dampness, and it is effective for attack of wind dampness in the exterior marked by headache.
Pubescent Angeilca and Loranthus Decoction
dü hud jj shëng Mug
SOUI{CE:Essential Formulae Worth a Thousand Gold for Emergency
INGREDIENTS:
Pubescent angelico root 9g
Loranthus mulberry mistletoe 6g
Eucomnoa bark 6g
Achyranthes root 6g
Wild ginger 6g
Large leaf gentiao root 6g
Poria 6g
Cinnamon bark 6g
Ledabouriella root 6g
Chuanxiong rhizome 6g
Ginseng 6g
Licorice root 6g
Chinese angehea root 6g
White peony root 6g
Dried rebmonnia rout. 6g
DIREC’I’IONS:Decoct all the herbs in water for oral administration.
EFFECTS: Dispelling wind-dampness, stopping pain of blockage-syndrome, tonifying the liver and kidney and replenishing qi and blood.
INDICATIONS: Chronic blockage syndrome with deficiency of the liver and kidney and insufficiency of both qi and blood marked by cold and pain of loin and knees, limitation of movement, soreness, weakness or nombnats of the limbs and joints, preference to warmth and intolerance of cold, palpitation, shortness of breath, pale tongue with whitish coating, and thready and feeble pulse.
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ANALYSIS OF FORMULA: This is a common formula for treatment of chronic blockage syndrome with deficiency of the liver and kidney and insufficiency of hoth qi and blood. Pohescent angelica root as a principal herb in the formula is used io large dose to dispel wiod and dampness and ease joints movement, and it expels windeold and damp evils from lower jiao,muscles and joints.LedebourielIa root and large-leaf gentian root assist the principal herb in expelling wind and dampness. Cinnamon bark and wild ginger warm and activate meridians, dispel cold and wind-dampness from the moscle and joints to rlieve pain. The combination of the foor herbs has the effects of expelling wind, cold and damp evils and easing the muscles and tendons. They act as assistant herbs. Loranthus molberry mistletoe, achyranthes root and eocommia bark tonify the liver and kidney, strengthen tendons and bones and expel wind and dampness at the same time. Ginseng, poria and licorice root invigorate the spleen and reinforce qi. Chinese angelica root, white peony root, dried rebmannia root and choanxiong rhizome noorish the blood and promote blood circulation. Licorice root also coordinates the effects of the other herbs. The combination of the herbs in the formula results in the double roles of both expelling the evil qi and strengthening the genuine so as to expel the evil-qi without impairment of the genuine qi and strengthen the genu me qi without retaining the evil qi. These herbs nrc combined to get the qi and blood enriched, the liver and kidney strengthened so that wind-dampness will be dispelled and arthralgia will be cured.
This formula can be used for chronic arthropothy, chronic lumbago, sciatica and chronic rheumatic arthritis pertaining to defficiency of liver and kidney and insufficiency of both qi and blood.
In Summary
This chapter consists of nineteen formulae. They are divided into some formulae. for drying dampness and resolving the turbidity, some for clearing heat and dampness, some for diuresis to remove dampness, some for warming and resolving water-dampness, some for diuresis with purgation and some for expelling wind and dampness.
1. Formnlae for drying dampness and resoLving the turbidity
This kind of formula used for syndrome of disharmony between the spleen and stomach due to internal overabundance of damp turbidity. Stomach Calming Powder has the effects of drying dampness to strengthen the spleen and activating qi to harmonize the stomach, and is indicated for syndrome uf encumbrance of the
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spieen and stomach by dampness marked by distention and pain in the abdomen, and whitish, thick and greaay coating of tongoe, etc. Agastaches Gennine Qi Powder can dispel wind cold exteriorly and resolve damp-torbidity interiorly, and ii is indicated for syndrome eaosed by endogenoos dampness nod exogenons cold mani fested by fever, chili, headache, follness of the abdomen, abdominal pain, vomiting and diarrhea, etc. It is a common formula for the cholera in sommer.
2.Formulae for clearing heat and excreting dampness.
This kind of formulae are indicated for disorder which occur most commonly in cases such as damp-heat due to exognous attack, internal exuberance of damp- heat and downward flow of dampness. Oriental wormwood Deeoetion is an imnportant formula to treat jaundice due to damp heat. It clears away heat dampness to elinunmite jaundice, and is suitable for jaundice doe to damp heat marked by bright yellow coloration of the skin and eyes, slight fullness of the abdoinea and disturbance in urination. Three Kinds of Kernels Decoction clears heat and dampness, however, it emphasizes on excreting dampness than clearing away heat. So it is in dicated for initial stage of damp-heat disease, belonging to syodronme with more dampness than heat doe to the evil-qi lodged in the qi phase. Sweet Dew Detuxieating Pillet stresses equally on both clearing away heat and dampness, it is there fore used fur damp-warm disease and seasonal pestilence occurring in the qi phase. Coptis and Magnolia Decoction is good at clearing away heat and dampness and resolving the turbidity, and is indicated fur vomiting and diarrhea due to cholera. Eight Correetios Powder clears away heat and induces diuresis for stranguria, and is every effective for heat-stranguria. Two wonderful Herbs Powder dries dampness and clears away heat, and is mainly indicated for syndrome of downward flow of damp-heat marked by weakness of lower legs, damp-sores, etc.
3. Formulae for indeing diuresis to remove dampness
This group uf formulae are indicated for syndrome of overabundance of water-dampness. Both Poria Powder with Five Herbs and Polypnrus Decor-lion are attributable to formulae of diuretic, which are used fur disturbance in micturitioa. In addition to the effect of diuresis, the former can also warm yang and promote transformative function of qi to relieve the exterior syndrome, arid it is therefore used for syndrome of water accumulation involved meridian and fmc-viscus of Tainyang simultaneously. The latter can clear away hert and nourish yin, and therefore ii is indicated for syndrome of water end heat accumulation with impair ment of yin due to heat-evil. Five Kinds of Peels Powder has the effects of
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strengthening the spleen, regulating qi and inducing diuresis to alleviate edema. It is used for subcutaneous edema syndrome marked by general edema hut nu aver sion to wind. Tetrandra and Astragalus Deeoetion can consolidate the exterior, dispel wind, invigorate the spleen and induce diuresis, and it is indicated for wind— edema or wind dampness marked by perspiration, aversion to wind, tired body and floating pulse, pertaining to deficiency of the exterior wirh overabundance of dampness.
4. Formulae for warming and resolving water-dampness
This kind of formula indicated for retention of phlegm and fluid, edema and disturbance in mieturition, etc. due to transforming from dampness into heat, failure of yang in transporting and transforming water dampness. Poria, Cinnamon, Bighead Atraetylndes and Licorice Deeoetion invigorates the spleen, excretes dampness, warms yang and resolves fluid retention, and is a principal formula to treat retention of phlegm and kidney-retention. It warms yang to induce diuresis, but it lays stress on warming the spleen and activating qi to relieva flatulence. Therefore it is used for edema due to yang deficiency. Wolly Yam Deeoetion for Clearing Turbid Urine warms the kidney, excretes dampness and resolves the turbidity, therefore it is used far cloudy ruina due to yang deficiency and frequent un nation.
5. Formulae for diuresis by purgation
‘l’his kind of formule is mainly indicated fur interior excess syndrome due to over-exuberance of fluid retention. Both Ten jujuhes Deeoetion and Boat and Cart Pills are the drastic formula fur purging fluid-retention. But the former uses Chinese date to invigorate the spleen and support the genuine qi except purgation, it is indicated for suspended fluid retention and excess syndrome with edema and ab dominal distention. The latter, can also promote flow of qi, and its effect of purging fluid retention is stronger than the former. It is therefore used for excess syndrome with edema and aseites.
6. Formulae for expelling wind and dampness
This kind of formula is mainly indicated for blockage syndrome due to wind, cold and dampness evils. Notapterygium Damp-Expelling Deeoction expels wind and dampness, and it is mainly used for shoulder and back pain caused by wind dampness. Pubescent Anggelica and Lorani bus Deeoetion dispels wind dampness, stops pain due to blockage syndrome, replenishes the liver and kidney and tonifies qi and blood, and it is mainly used to treat chronic blockage syndrone with defi
ciency of the liver and kidney and impairment of qi and blood marked by pain of the loin and knees.
  
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