| Chapter Five Heat Clearing Formulae
Heat clearing formulae are mainly composed of heat-clearing herbs which have effects uf clearing away heat and purging fire,(•learirig the outnent phase and cooling blood, clcaring away heat and poison, and clearing away deficient heat. They are all used to treat the interior heat syndromes arid pertain to clearing ther apy of the eight therapies.
The causes ol interior heat syndromes are cnmpieate. in brief, there are two large aspects, i. e. exogenous attack and internal injury. When the exogenous six climatic evils enter the interior, they all can transform into heat. The internal inju ry of seven emotions, or excessiveness of five emotions, partially exuberance of visceral qi, all can lead to excessiveness of heat. According to the different de grees, they can be divided into warm, heat and •fire. Warm is less than heat which is less than fire in degree. However, they are the same thing with different names. Besides, the aunooer—heat also belongs to the warm category, so the formulae for clearing away summer-heat is included in this chapter.
The scope of interior heat syndromes is vevy extensive. It includes the qi, nutrient and blood phases in exogenous warm diseases, heat-poison and sores in sur gery, heat syndromes of viscera in internal medicine, and interior heat doe to yin deficiency in the later stage of warm diseases or overstrain, etc.
Depending upon the principles that “heat syndromes should be treated with cooling therapy” and “warm syndromes should be treated with clearing therapy”, the interior heat syndromes sha old he treated with heat clearing therapy. Because there are the differences among causes disease, locations and disease conditions, the heat-clearing formulae are correspondingly divided into six categories, i. e. far mulae for clearing away heat from the qi stage, formalae for clearing the nutrient stage and cooling blood, formulae for clearing away heat and poison, farniulue for clearing owoy viacerol beet, furoiulae for clearing away summer-heat and formulae fur clearing away deficient heat. The other foroiolaa for clearing away heat to open orifice, clearing away heat to quench wind, clearing away heat to relieve the exteri— or, and purging heat to relieve constipation, are discussed in chapter ten, one, arid two respectively.
It is suitable to apply these formulae to the condition that the exterior syn96
drome has already relieved but fever is still there or there is exuberant interior heat without coagulated excessive evils. Applying heat—clearing formulae in clinic, the first thing is tu differentiate the deficiency or excessiveness of heat syndromes. The excessive heat should be treated with hitter cold herbs directly, while the deficient heat should he nonrished with sweet-cold herbs. If the heat is nut re lieved yet with repeated application of heat clearing or fire purging herbs, it is due to the consumption of yin. In such conditions, the therapy should be changed at once to nourish yin for strengthening water. Secondarily, it is necessary to differentiate the true or false conditions of heat syndromes. For the heat syndrome with pseudo cold symptoms, the heat-clearing formulae are suitable; but for the cold syndrome with pseudo-heat symptoms, the heat-clearing formulae cannot be used. The interior warming and yang-restoring formulae should be used instead. Besides, there is another type of exuberant heat evil,to which when the heat-clearing formulae are applied, vomiting happens immediately after taking the decoetion. At this time, small amount of fresh ginger juice should be added to the heat clearing formulae, or the cooling decoction should be taken hot. This is the contrary ad] uvent therapy called “using herbs of hot nature to treat heat syndromes”.
Heat pertains to yang evils and the exuberant heat can injure yin, so, to pre serve yin and body fluid is the important principle for treating heat syndromes. However, the yin nourishing herbs have the shortcoming uf keeping evil qi if he ing used too early. In addition, herhs with cool and cold natures can injure yang and the stomach-qi, so the functions of the spleeu and stomach should be protected at any time (luring the treatment.
Section 1 Formulae for Clearing Heat from the Qi Stage
Formulae for clearing heat from the qi stage are suitable to interior heat syn dromes due to heat in the qi phase. They can be applied to all interior heat trans formed from the exterior evils without synptone of heat in the exterior or the blood stage end without the interior accumulation syndromes. Qi is the basic sub stence of life activities of human body as well as the motive power of the visceral function The acquired qi comes from the inhaled air and food essence, so it has the most close relationship to the lung and stomach. Whenever the evil enters into the qi phase and leads to exuberance of interior heat, the basic features are fever without chill, thirst, red tongue and yellow coating. In them, hoot symptom of Yang ming is the most common one. Fever without chill is due to the struggle between
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the genuine and evil with the exuberant stomach heal afLer the evil leaves the cx tenor; the steaming interior heat brings about profuse sweating; thirst is caused by heat injuring the body fluid; slippery rapid or surging large pulse reflects the exuberant intecior heat. So it should be treated by clearing away heat and purging fire to relieve vexation and thirst. For the condition of warm-evil invading the qi stage preliminarily manifested by fever, slight thirst,deep vexatioo, thin and white coating, it is chiefly treated by capejasminc fruit cooperating with prepared soybean to clear heart for relieving vexation; For the exuberant heat of Yangming manifested by sthenic fever, profuse sweating, irritable thirst and surging large pulse, ii is mainly treated with gypsum, calcite, anemarrhena rhizome and bamboo leaf to clearing away heat for promoting production of body fluid..
Because haat in the qi stage is apt to cunsume body fluid and qi, dendrohium stem,ophiupogon root,trichosanthes root and reed rhizome are used together to clear away heat and promote production of body fluid while pilose asiabell root, ginseng, round grain rice and licorice root are used together to nourish the stomach-qi. If stomach foils in descending and leads to retching, pinellia tuber and bam boo shavings should he added to lower the rebellious qi for relieving vomiting. The representative formulae are White Tiger Decoetion, Lophatherum and Gypsum Deeoetion, etc.
White Tiger Decoction
bái Jul tang
SOURCE: Treatise on Cold Attack
iNGREDIENTS:
Gypsum SOg
Anemarrhcna rhizome 9g
Roasted licorice root 3g
Round-groin rice 9g
DIRECTIONS:Dceoet all herbs in water for oral use until the rice is well- done.
EFFECTS:Cleoring heat and promoting generation of body fluid.
INDICATIONS: Exuberant heat in the qi stage of Yangming manifested by sthenie fever, flushed face, irritable thirst with desire for drinking, profuse swea ting, aversion to heat, surging, large and forceful pulse or slippery rapid pulse.
ANALYSTS OF FORMULA:This is a representative formula for syndrome of exuberant heat in the qi stage uf Yangming. Being pungeni end sweet flavors and
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extremely cold nature, specially clearing pathogenic evil of the long aod stomach, gypsom is the main herb ro relieve muscles for expelling hear and to promote geo eration of body fluid for qoenching rhirst. With biller flavor sod cold nature, aoemorrhcna rhizome os the ossistant herb helps gypsum clear the excessive heat of the qi stoge as well ss replenishing the injured yin, As the adjovcnr sod dispstcher herbs, licorice root and round-grain rice can reinforce the stomach for pre serving body fluid and injury of the middle from the extremely cold of gypsum.
The four kinds of symptoms, i. e. heavyfever, profuse sweating, serious irritable thirst and surging large poIse, are the main reasons for applying this formula. However, in clinic, it is not necessary to he limited in these four kinds of symp toms. It can be applied to various conditions pertaining to non-figured exuberant heat.
In the present clinic, this formula has a certain therapeutic effects in lobar pneumonia, epidemic encephalitis B, gingivitis, rheumatic arthritis pertaining to heat in the qi phase.
ASSOCIATED FORMULAE:
(1) Ginseng plus White Tiger Decoction fbdi hd jia ceo shea tang) , (Trea tise on Cold-Attack)
Gypsum 30g, anemarrheaa rhizome 9g, roasted licorice root 3g, round-grained rice 9g,ginseng 6g.
The above herbs should be decocted in water for oral administration until the rice is well-done. Effects: clearing heat and reinforcing qi to promote generation of body fluid. Indications: syndrome of both injury of qi and body fluid due to exo berant heat in the qi stage or summer-heat disease manifested by profuse sweating with slight chill of the back, fever, thirst,large but feeble pulse.
(2) Cassia Twig plus White Tiger Decoctionfbái hd jia gal zhz tang) , (Synopsis of the Golden Chamber)
Gypsum 30g, anemarrhena rhizome 9g, roasted licorice root 3g, round grained rice 9g, cassia twig 5’-9g.
The above herbs should he dacocted in water for oral use. Effects: clearing heat and activating collaterals to relieve pain. Indications: warm-malaria marked by fever without chill, pain of joints, fregucnt vomiting; or syodrome of wind damp-heat blockage manifested by srhenic fever, husky breath, restlessness, swelling and pain of joints, thirst, white coating, taut and rapid pulse.
(3) Arractylodes plus White Tiger Decoction (lull ha 110 cCng zhil tang)
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(Lifesaving Book of Classified Syndromes):
Gypsom 30g, anemarrhena rhizome 9g, roasted licorice root 3g, roorid grain rice 9g, atractylodes rhizome 9g.
The above herbs shoold be decocted in water for oral administration. Effect:
clearing heat and dampness. Indications: damp warm diseases manifested by fever, stuffiness of chest, profuse sweating, red tongue with white greasy coating. Recently, it is osed to treat rheomatic fever.
NOTES: All the above three formulae are modified from White Tiger Decoction. The Ginseng plus White Tiger Decoction is one for clearing heat and purging fire as well as reinforcing qi and promoting generation of body fluid, so it is suit able to syndrome of injury of qi and body fluid due to exuberant heat of Yengming or summer-heat. Cassia Twig plus White Tiger Decoction is one for clearing heat and dredging collaterals, harmonizing tile nutrient and defensive qi, so it is used to treat warm-malaria or blockage syndrome of damp-heat with symptoms pertaining to White Tiger Decoction. Atractylodes pius White Tiger Decoction is one for clearing heat and drying dampness, so it is applied to damp-warm diseases marked by stuffiness of chest, white and greasy coating with symptoms pertaining to White Tiger Decoction.
Lophatheriun and Gypsum Decoetion
zhá ye shI gao tang
SOURCE: Treatise on Cold-Attack
INGREDIENTS:
Bamboo leaf 15g
Gypsum SOg
Pinellic tuber 9g
Ophiopogon root 15g
Ginseng 5g
Licorice root 3g
Round grain rice lOg
DIRECTIONS: Decuct the above herbs in water for oral administration until the rice is well done.
EFFECTS:Clearing heat and promoting generation of body fluid, reinforcing qi and harmonizing stomach.
INDICATIONS: After suffering from cold attack, warm disease, or summer heat disease, the remaining beat exists with injury of both qi and body fluid mani100
fested by fever, profuse sweating, distress of chest, nausea or vomiting, dryness of muuth with desire [or drinking, or insomnia due to deficient vexation, weakness, shortness of breath, feeble and rapid pulse, red tongue with less coating.
ANALYSIS OF FORMULA:This formula is based on White Tiger Decoction by removing anemarrhene rhizome and adding bamboo leaf, ginseng, ophiopogon root and pinellia tuber, so that the extremely cold formula is changed into clearing end tonifying formula. As the main herbs, gypsum and bamboo leaf can clear the remaining heat of Yongming to relieve vexation. Ginseng and ophiopogon root act as the assistant herbs to reinforce qi and to promote generation of body fluid. Pincllia is the adjuvani herb to lower rebellious qi for relieving vomiting. As the dispatcher herbs, licorice root and round grain rice harmonize the middle and nourish the stomach. The nature of pinellia tuber is warm, but when it cooporates with the herbs generating body fluid and nourishing yin, in which especially the dosage of ophiopogon root is as twice as that of pinellia tuber, its warmness and dryness are moderated. Thos, it is possible for pinellia tuber to lower the rebel lious qi end assist the spleen in transporting the body fluid.
Capejasmine and Prepared Soybean Decoction
zhi zi chI’ tang
SOURCE:Treatise on Cold Attack
INGREDIENTS:
Capejasmina fruit 9g
Prepared soybean 9g
DIRECTIONS:Capajasmine should be decocted prior to prepared soybean in water for oral administration.
EFFECT: Clearing heat for relieving vexation.
INDICATIONS: Fever, vexation, insomnia due to deficient vexation, congestion of chest and epigastrium with epigastric upset, hunger hut poor appetite, red tongue with slight yellow coating.
ANALYSIS OF FORMULA:Capcjasminc fruit with bitter flavor and cold na turc as the main herb clears heat for relieving vexation. With the property of as cending and dispersing, prepared soybean as the assistant herb disperses the stagnated heat from chest.
ASSOCIATED FORMULAE:
(1) Licorice root plus Capejasmine and Prepared Soybean Decoction f’zhz zi gan cáo chi tang) , (Treatise on Cold Attack)
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On the basis of Capejasmine and Prepared Soybean Decoctinn licorice root is added for shortness of breath.
(2) Fresh Ginger pios Capejasmine and Prepared Soybean Decoction frht zi sheng jiaog clii tang) , (Treatise oh Cold—Attack):
On the basis of Capejasniine and Prepared Soybean Deeoetion fresh ginger is added fur vomiting.
(3) Capejasmine and Magnolia Decoction fzht zi hod o tang) (Treatise on Cold At tack)
On the basis of Capejasmine and Prepared Soybean Decoction prepared soybean is removed and magnolia hark and nnripened bitter orange are added for vexation, abdominal distention with insomnia.
(4) Capejasmine and Dry Ginger Decoctinn(zhi zi gao jidng tang) (Treatise on Cold Attack)
On the basis of Capejasmine and Prepared Soyhean Decoction prepared soybean is removed end dry ginger is added for treating lever with slight. vexation alter erroneous purgetion.
Section 2 Formulae for Clearing the Nutrient Stage
and Cooling Blood
The formulae for clearing the notrient stage end cooling blond are indicated to syndromes due to heat entering the nutrient end blood phases in the warm diseases. The notrient qi conies froni the food essence and travels within vessels to nourish the whole body. The pathogenic heat entering the notrient stage end injuring the notrient yin leads to fever aggravated at night and thread rapid pulse;heat steaming in the nutrient stage is responsible of crimson tongue and dryness of mouth without thirst as well as the obscure macole and papule hecause the nutrient qi is corresponding to the heart qi, heat in the nutrient stage will disturb the heart—spirit, so there appear vexation, insomnia, or sometimes delirium. If the pathogenic heat in the nutrient stage dose not he expelled in time, it would inevitably enter the hlnod stage to consume and disturb blood. In addition to that the heat syndrome of nutrient phase is aggravated, there will he various bleeding such as hemoptysis, epiataxis, hemafecin, herneturia, macole and papule, etc. Heat in the blood phase even results in wind syndrome marked by cunvulsinn and spasm. Therefore, it should he treated by therapies of clearing the nutrient stage and conling blond. Herbs each as rhinoceros horn, rehmannia root, moutan bark and
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red peony root are usually used as the main ones Jo clear the nutrient phase anrl to cool blood. For heat in the nutrient stage, honeysuckle flower, forsythia fruit, homhoo leaf and so on can he used to dispel heat through the qi phase. For heat in the blood stage consuming and disturbing blood, muutan hark, red peony root, red sage root and so an can he used to cool blood and dissipate stasis on order to stop bleeding hot no stasis.
Yin and body fluid arc easily injured when hcat eoters the nutrient and blood stages, so scrophularie root, ophiopogon root and dendrobium stem can ha used to elcar heat and nourish yin;for heat in the blood stage leading to wind syndrome, antelope’s horn, uncaria stem and abalone sheh can be used together to clear the liver and quench wind; if there is coma doe to closure of orifice, Peaceful Palace Bovine Gall-Stone Pills and Violet Pellets should be applied simultaneously. The representative formulae are Decoction for Clearing Ying-Stage and Rhinoceros Horn aral Rehmannia dacoction.
Decoction for Clearing Ying-Stage
qing yIng tang
SOURCF:Differentiatian on Warm Diseases Item by Item
INGREDIENTS:
Rhinoceros horn Zg
Rehmanme root BIg
Scropholeria root 9g
Bamboo leaf 3g
Ophiopogon root 9g
Red sage root 6g
Coptis root 5g
Honeysuckle flower Pg
Forsythia fruit 6g
D1RECTIONS:Dceoct the above herbs in water for oral administration.
EF’FECTS: Clearing thc nutrient stage end dispelling heat, nourishing yin end eerivating blood.
INDICATIONS: Ileet entering the nutrient stage manifcsted by fever eggrevoted at night, vexation and insomnio, occasional delirium, opening or closing eyes, thirst or without thirst, obscure macole end papole, thread rapid pulse, crimson end dry tongue.
ANALYSIS OF FORMULA:This is a representative fornioletnr treeting heat
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in the nutrient stage. Being salt flavor and cold nature, rhinoceros horn can clear the nutrient stage and poison and cool blood for dissipating stasis as well as clear ing the heart for calming mind; being sweet flavor and cold nature, rehmannia root can clear the nutrient stage for cooling blood and nourish yin for promoting generation of body fluid. Both of them act as the main herbs. As the assistant herbs, scropholaria root and ophiopogon root clear heat and noorish yin. As the ad] ovant herbs, coptis root clears the heart-fire; bambao leaf clear the heart for relieving vexation; honeysuckle flower and forsythia froit clear heat and poison. They can help the main herbs dispel heat through the qi stage. Red sage root activates blood and dissipates stasis to prevent coagulation of blood and heat.
In the present clinic, this formula is often applied to epidemic encephalitis B, epidemic cerebraspinal meningitis, hematoscpsis and cerebrovascolar accident with the ahovemeotioned symptoms.
Buffalo barn 30 to 60g is used ia place of rhinoceros barn in present clinic.
ASSOCIATED FORMULA:
Palace-Clearing Decoction (qiag gOng tang) , (Differentiation on Warm Dis ease Item by Item)
Scraphularia root 9g, lotus seed 2g, bamboa leaf 6g, forsythia fruit 6g, rhinoc eros horn 2-5g,ophiopogon root 9g.
The abave herbs shanld be decocted in water far oral administration. Effects:
clearing heart to expel poison, nourishing yin to promote generation of body fluid. Indications : evil sinking into the pericardiom due to erroneously application of diaphoresis for the warm diseases manifested by fever with cama or delirium.
NoTES : This formula stressel on treating the light case of coma and delirium due to heat sinking into perieardiom while Decoctiao for Clearing Ying-Stage stresses oa clearing away heat in the nutrient phase.
Rhinoceros Horn and Relirnannia Deeoction
xijido dl haáng tang
SOURCE: Essential formulae Worth A Thousand (fald for Emergency
INGREDIENTS:
Rhinoceros horn 1. 5’--3g
Rehmannia root 30g
red peony root 12g
Mootan hark 9g
DIRECTIONS: Decact the above herbs in water for oral administration.
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EFFECTS: Clearing heat and poison, cooling Idood and dissipating stasis.
INDICATIONS: Syndromes of heat in the blood phase:
(1) Heat damaging blood vessels manifested by hemoptysis, epistaxis, he mafecia, hematuria, etc.
(2) Blood stagnation or old stasis manifested by forgetfulness mania, with water in manth hut no desire to swallow it, pain of chest, abdominal distention, dark smooth stool;
(3) Ileat disturbing the nutrient stage manifested by coma, mania or deliri— om, dark purple macole, crimson tongue with prickle-like coating.
ANALYSIS OF FORMULA: This is a representative formula for heat in the blood stage. Being salt flavor and cold nature, rhinoceros horn can clear the nutrient stage and cool blood as well as clearing the heart for relieving poisou ; rehrnan nia rout can clear heat and cool blood as wall to nourish yin for promoting genera tion of body fluid. They act as the main herbs. Red peony root and mouton bark can strengthen the power of clearing heat and cooling blood, and prevent stagnation of blood. They both act as the assistant and adjovant herbs.
In the presaut clinic, ibis forniola is used to treat acute yellow atrophy, liver necrosis, urinaemia, porpora, acute leukemia, aplastic aueniia, heroatosepsis with symptoms of high fever and bleeding.
ASSOCIATED FORMULA:
Antipyretic and Antitoxic Decnctionzng wen baz rid yin) , (A View of Pestilent Rashes)
Gypsu 180—240g(Iarge dosage), 6O—I2Og(mild dosage), 24—36g(small
dosage) , rehoiannia root 18 30g (large dosage), 9 1 5g(rnild dosage) , 6 12g
(small dosage) ,rhinoceros horn 18’—24g(large dosage), 9-I5g(mild dosage), 6
—12g(small dosage) , coptis root 12-48g(large dosage), 6—42g(miid dosage), 3 4. 5g (small dosage), capejasmine fruit, platycodon root, scutelloria root,
aoemarrhena rhizome, red peony root, scropholaria root, forsythia froit, licorice root, mnutao bark, bamboo leaf(proper dosage according to particular conditions)
The gypsum shoold be decocted in water to the boiling point for several dozens of times before it is mixed and re-deeocted with other herbs. Effects; clearing heat and poison, cooling blood for preserving yin. Endications: various syndromes of fire or heat manifested by high fever, vexation, thirst with desire of drinking, retching, severe headache, coma, mania, delirium, or macole, hcmoptysis, epistaxis, crimson tongue with chapped lips, deep, thread and rapid pulse, or deep rapid
.JQ5,
poise, or floating, large and rapid pulse
NOTES:This formola is a modification of Rhinoceros Horn and Rehmaooia Decoction, White Tiger Decoetion and Coptis Deroction for treating syndromes doe to spread of heat poisoo ood intense heat in hoth qi and blood stages.
Section 3 Formulae for Clearing Heat and Poison
Formulae for clearing heat and poison are indicated to syndromes due to pestilence, warm-poison, exuberance of fire, heat or poison manifested by swollen head, erosion of month with sore throat,or sores and carbuncle with swelling and feverish pain, red tongue, rapid pulse, and also restlessness or mania, hemoptysis, epstaxis, macole and papole, etc. Accumulated fire or heat transforms into poison which leads to retention and stagnation of qi sod blood in meridians. As a resolr, the exuberant heat brings about putrefaction of flesh which becomes pustule, then carbuncle, gangrene, foronele and the like. The wind—heat or pestilent poison aceu molating in the upper jieo or attacking on the head leads to swollen head, sore throat with erosion of mooth;the exuberant fire-poison spreading the triple-jiooo is responsible of high fever, coma or mania, or hemoptysis, episraxis, macole and papule, etc. So it should be treated with large dose ol bitter cold herbs to purge fire and to expel poison. For the spread of fire evil in the triple-jzoo, the main herbs in common use are seutellaria root, eoptis root, phellodendron boric, cepejos— mine fruit, gypsum, etc ; for carbuncle and sores, th main herbs in common use are honeysuckle flower,forsythia fruit, dandelion herb, tokyo violet herb, wild chrys a nthemom flower, isotis root, etc.
For the wind heat or pestilent poison attacking on the head, or the beginning of sores, it can be used together with eimieifuga rhizome, screpholaria root, plotye odoo root, peppermint and puffball to clear and soothe the throat; and with sehi— zencpeta, ledehouriella root and dohorian angelica root to disperse wind aod to re .-,olve accomolation;for carbuncle and sores with stagnation of qi and blood, it con he used together with Chinese angelica root, red peony root, Irsokioceose, myrrh, bovint gallstone, fritillary holb, triehosanthes root, tangerine peel and wine to cc tivate blood for dissipating stasis and activate qi for relieving pain as well as resolve phlegm arid accumulation; for the imperforatc abscess, it can lie osed with psngolio scales and Chinese hooeyloeost spins to expel poison and to promote per— foretioo. The representative formolee are Coptis Detoxieeting Decoetion, Everyone’s Detoxiesting Deeoctioo, Cod’s Life Saving Deeoction, etc.
it)tt
Coptis Detoxicating Decoction
huáng han jiè dü tang
SOURCE: The Medical Secrets of an Official
INGREDIENTS:
Coptis root 3--9g
Scutellaria root 6g
Phellodendron bark 6g
Capejasminc fruit 9g
DIRECTIONS: Decoct the above herbs in water for oral administration.
EFFECTS: Purging fire and expelling poison.
INDICATIONS: Syndromes of exuberant heat of the triple-jiao due to excessive heat and fire poison manifested by high fever, restlessness, dryness of mouth and throat, paraphasia, insomnia; or heat diseases riiarked by hemoptysis and epistaxis ; or exuberant heat leading to maculc,fever and dysentery; or jaundice due to damp heat; or carbuncle, gangrene, furuncle in surgery; dark urine, red tongue withc yellow coating, strong rapid polse.
ANALYSIS OF FORMULA: This formula is set up for exuberant heat and fire in the triple—jiao. As the main herb, coptis root can porge the heart fire and clear the middle-jiao. Scutellaria root clears fire of the opper-jiao; phellodendron bark clears fire of the lower jiao; capejasmine fruit purges fire of the triple-jiao for inducing heat nut through urine. They are ali the assistant and midjuvant herbs.
In clinic, this formula has good therapeutic effects against septecemia, pyosep, dysentery, toxic dysentery, pneumonia, urinary infection, epidemic encephalitis, encephalitis B, and forunde the above mentioned symptonis.
ASSOCIATED FORMULA:
Heart-Purging Decoctionfriè :rzfl tang)
Rhubarb 6g, coptis root 3g, scutellaria root 9g. The above herbs should he demeted iii water for oral administration. Effects: purging fire and poison, drying dampness to resolve stitffiness. Indications: internal exuberance of fire leading to bleeding such as hemoptysis and epistaxis; or internal accumulation of dam-heat resulting in jaundice with chest stuffiness and irritable fever; or pushing-up of accumulated heat manifested by conjunctive congestion with swollen eyelids, oral olceration ;or sores in surgery with symptoms of irritable and feverish sensation of chest, constipation, etc.
NOTES:Both this formula and Coptis Detoxicating Decoction can be used to
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treat syndrome of exoberant heat of the triple jiao. In this formola, rhoharh as the main herb in the cooperation with scotcllaria root and coptis root porge fire and heat as well as resolve dampness with their hitter flavor and cold oatore, so it is spccial for syndrome of exoberant fire of the heart and stomach.
Everyone’s Detoxicating Decoction
pájixiaodá yin
SOURCE: Dongyoan’s Effective Formulae
INGREDIENTS:
Scotellaria root 15g
Coptis root 15g
Tangerine peel 6g
Licorice root Gg
Seropholoria root 6g
Bopleurum root 6g
Platycodon root Gg
Forsythia froit 3g
Isatis root 3g
Poff ball 3g
Aretiom fruit 3g
Peppermint 3g
Batrytieated Silkworm 2g
Cimicifoga rhizome 2g
DIRECTION:Deeoct the above herbs in water for oral administration.
EFFECTS:Dispersing wind evil, clearing heat and poison.
INDICATIONS: Infectious swollen head due to wind-heat or pestilent poison accumulating the opper jiao manifested by chill and fever, flushed swollen face with severe pain, difficulty of eyes to open, sore throat, dryness of mouth and throat, red tongue with yellow coating, strong rapid pulse.
ANALYSTS OF FORMULA: This is a good formula far infectious swollen head. Coptis rout and scutcllaria rout act as the main herbs to purge heat poison of the upper-jiao. Arctium fruit, peppermint, forsythia fruit and batryticated silkworm act as the assistant herbs to disperse wind-heat with their pungent flavors and cool natures. As the adjuvant herbs, acrophularia root, iaatia root, puff ball, platycodon root and licorice root clear heat and poison as well as aoothcing throat; tangerine peel regulates qi for resolving coagulation. Cimicifuga rhizome and hop
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leurum root are tbe dispatcher herbs to lift yang for expelling beat and fire as well as guiding the other herbs to the head. Adding ginseng for the deficicnt casc and rhubarb for cnnstipation are two common modifications in clinic.
In the present clinic, this formula has definite effects against epidemic parotitis, acote tonsillitis, parotitis porulenta, and facial phlegmon.
God’s LifeSaving Decoction
xiãn fang Iwo ming yin
SOURCE:Revised Effective formulae for Wnmen
INGREDIENTS:
Dahurian angelica root 3g
Fritillary bulb 3g
Ledebouriella root Sg
Red peony root 3g
Chinese angalica root 3g
Licorice root 3g
Chinese honeyloeust spine 3g
Pangolin scales Sg
Triehosanthes root 3g
Frankincense 3g
Myrrh 3g
Honeysuckle flower 9g
Tangerine peel 9g
DIRECTIONS:Decoet the above herbs in water or with rice wine fur oral ad rrunisl ration.
EFFECTS: Clearing heat and poison, resolving swelling and mass, activating blood for relieving pain.
INDICATIONS:The beginning of sores manifested by local swelling with severe pain, or fever, chill, thin white or yellow coating, strong rapid pulse.
ANALYSIS OF FORMULA: It is a representative formula for carbuncle end sores pertaining to yang syndrome. Being pungent and sweet flavors, honeysuckle flower acts as the main herb to disperse end clear away heat and poison as well as to clear the qi phase for cooling blood, which is goud for all kind of carbuncle and sores. As the assistant herbs, ledehouriella root and dahurian engelica root are to disperse wind evil for the beginning of carbuncle and sores ;Chinese angeliea rout,
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red peony root, frankincense, myrrh ami tangerine peel to activate blood for dissipating stasis and to activate qi for dredging collaterals as well as to resolve swelling for relieving pain. As the adjuvant herbs, fritillary hoib and trichosanthes root clear heat and resolve phlegm as well tn resolve swelling arid mass; pangolin scales and Chinese honeylocust spine resolve hardness and drain pus. Licorice root clears heat and poison; rice wine activates blond for resolving swelling and guides all herbs to the suffering location. They both act as the dispatcher herbs. This formula can be applied to non suppurative sores as well as suppurative sores.
However, this formula is only suitable to sores before perforation. For the perforated sores, or sores pertaining to yin syndrome, this formula is prohibited. Besides,it should be cautious for the cases with deficiency of the spleen and stomach or insufficiency of qi and blood.
Four Powerful Herbs Decoction
si tniâo yóng an tang
SOURCE:New Compilation of Proved Formulae
INGREDIENTS:
Honeysuckle flower 30g
Scrophularia rout 3Pg
Chinese angelica rout f5g
Licorice root lOg
DIRECTIONS:Decuct the above herbs in water for oral administration.
EFFECTS: Clearing heat and poison, activating blood for relieving pain.
INDICATIONS: Gangrene of finger or toe due to exuberant heat-poison manifested by local purplish redness with slight feverish sensation and swelling, severe pain. iritable fever with thirst, or ulceration with dripping of pus, red tongue, rapid pulse.
ANALYSIS OF FORMULA: this is an effective formula for gangrene of finger or toe due tu exuberant heat-poison with consumption of yin-blood. Iloneysuckle flower acts as the assistant herb, scrophulario root purges fire and poison as well to clear away heat and nourishes yin. Chinese nngelica root is thc adjuvant herb to activate and nourish hluud for resolving stasis and swelling. Licorice root acts as the dispatcher herb to expel fire-poison and harmonize all the components.
Bovine Gall-Stone Pills
xihnáng wan
SOURCE: Surgery Life-Saving Collection
110
INGREDIENTS:
Bovine gall-stone ig
Musk 3g
Frankincense 30g
Myrrh 30g
Cooked glutinous millet 30g
DIRECTIONS:The above herbs should be ground and mixed together to be manufactured in form of pills. Takin 9 gram of the pills with rice wine each time.
EFFECTS:Cleariug heat nad poison, resolving phlegm and mass, activating blood for resolving stasis.
INDICATIONS: Breast cancer buho, serofula, sobeutaneous nodole, multiple abscess, pulmonary abscess, small intestine abscess, etc.
ANALYSIS OF FORMULA:Being hitter flavor and cold nature with aromatic property, bovine gall stone acts as the main bert) to clear away heat and expel phlegm for resolving mass and swelling. With pungent flavor and warm nature and as the assistant herb, musk can activate blood for reliving pain. The eaopara tion of musk and bovine gall stone plays the rule of resolving phlegm and mass hut avoiding the disadvantage of assisting the fire-poison. Frankincense and myrrh act as the adjuvant herbs to activate blood far relieving pain, subduing swelling and promoting granulation. The cooked glutinous millet can harmonize the stomach qi while rice wine can activate qi and blood to clear collaterals. They act as the dispatcher herbs.
In the present clinic, this formula is used in lymphonodids, lymphoid tuberculosis, cystic hyperplasia of breast, mammary cancer, multiple abscesses and medul— itis with symptoms of feverish swelling and pain, red tongue, slippery rapid pulse. But it should be cautious when epplying to deficiency uf both qi and blood after perforation with dripping of pus.
Section 4 Formulae for Clearing Visceral Heat
Formulae for clearing visceral heat are suitable to syndromes of fire or heat due to partial exuheramo heat evil in a certain viseus. There are various causes far the visceral heat syndromes, such as internal injury of the seven emotions, exeessivcness of the five emotions, overeating of rich food, exogenous evils entering the interior, etc. I—Teat pertains to yang evil, so the clinical symptoms are manifested mainly by the hyperactivity of visceral functions, such as fever, aversion to heat,
ill
thirst with desire for cool drinking, vexetion, yellow orine, red tongoe, and rapid pulse, etc. Bot hecaose of the different functions of viscere, the clinical manifestations sre different. For examples, flamiog—’up of the heart fire is manifested hy irritable feverish sensation of chest, oral ulceration, flushed face and so on; exuberance of the liver arid gallbladder fire is manifested by irritability easy to he an— gery, distending pain of hypoehondrium, oral bitter taste, conjunctival congestion, headache with tinnitus, and so on; failure of the lung in dispersing and descending due to exuberant heat in the Long Meridian is marked by asthma and cough;exu berance of the stomach-fire is manifested by swollen cheek, ulcerative gums, toothache ; damp-heat of the large intestine is manifested by diarrhea with abdomi nal pain, or dysentery; damp-heat of the gallbladder is marked by scanty dark a rine, frequent or difficulty and pain in urination. Generally, there are no excessive fire of the spleen and kidney. Clearing away heat and purging fire are the main therapies. However, herbs should be chosen respectively according to the different visceral functions. For instances, the exuberant heat of the Heart Meridian should he treated mainly with captis rout, rehmaania root, capejasmine fruit and lotus seed to clear away the heart fire;exeessive fire of the liver and gallbladder he treated mainly with gentian root, prunella spike and natural indigo tn clear away the liver-fire;exuherant heat of the lung be treated chiefly with gypsum, scutellaria root, mulberry bark and anemarrhena rhizome to clear away the lung heat; exuberant fire of the stomach he treated chiefly with gypsum and eoptis root to etear a way the stomach fire; the large intestinal heat be mainly with eoptis root, seutel lana root, phelludendron bark and pulsatilla root to clear intestine and to dry dampness; damp heat of the gallbladder be treated mainly with tale, bamboo leaf and akehia stem to clear away heat and to facilitate diurisis.
If the exuberant heat injures yin, it can be used with rehmannia rout, uphiupugun root and scrophularia rout to clear away heat and to nourish yin; for constipation due to exuberant heat, it can be used with rhubarb and rnirabilite ; fur exuberant heat with qi stagnation, it can be’ used with Chinese angelica rout, white peony rout, aueklandia root and areca seed to activate qi and to harmonize blood. The representative formulae are Fire-Inducing Powder; Centian Liver Purging Decuctiun, Stomach-Clearing Powder, Blue-Purging Pills, White Purging Powder, Fairy Deeoetion, Peony Decuetion, Pulsatilla Deeuetiun, etc.
Fire-Inducing Powder
ddo chI tan
SOURCE: Key to Pediatric Therapeutics
112
INGREDIENTS:
Rehmaonia root 9g
Akebia stem 9g
Licorice root 9g
Bamboo leaf 9g
DIRECTIONS: Decoct the above herbs in water for oral administration.
EFFECTS:Cleaning heart for cooliog blood, exereetiog water to treat sirangoria.
INDICATIONS: Exuberant beat nf the Heart Meridian manifested by irritable feverish sensation of chest, thirst with desire for cool drinking, floshed face, oral ulceration; or transferring of the heart-heat to the small intestine marked by scanty dark urine or difficulty and pain in mictoritioo.
ANALYSIS OF FORMULA:This is a formula for clearing away the heart-fire and facilitating diurisis. Rehamonia root acts as the main herb to clear the heart for cooling blood as well as nourishing the kidney-essence. As the assistant herb, bamboo leaf can clear the heart for relieving vexation and induce heat out through urine. Akehia stem is the ad] uvaot herb to clear away the heart-heat and to facilitate diurcsis. As the dispatcher herb, licorice root clears heat-poison and relieves painful urination as well as harmonizing all the components.
Gentian Liver-Purging Decoction
lông thin xiè gdn Mug
SOURCE Collection of Formulae with Notes
INGREDIENTS:
Gentian root 9g
Bopleururo root 6g
Scotelloria root 9g
Capejasmine fruit Og
Water plantain 12g
Plantain seed 9g
Akebia stem 9g
Chinese angclica rout 3g
Rehmanoia root 9g
Licorice root 6g
DIRECTIONS:Decoct the above herbs in water for oral administration.
EFFECTS: Purging the excessive fire of the liver arid gallbladder, deoriog a
113
way damp-heal in the lower jiao.
INDICATIONS: Flaming-op of the excessive fire of the liver and gallbladder manifested by headache with c:onjunctiva congestion, hypochondriac pain, oral hit ter taste, deafness with bulge of ear; or downward flow of damp beat manifested by itch and swelling of volva, impotence, polyhidrosis aroond die external genitals, strangoria with torbid urine, or leukorrhagia in woman.
.ANALYSIS OF FORMULA: This is an effective formola for the excessive fire of the liver and gallbladder with downward flow of damp heat. Being bitter flavor and cold nstiire, acting on the liver and gallblralder, gentian stem is the main herb, which is good at porging the excessive fire of the liver and gallbladder and dispel ling damp—heat in the lower jiuo. As the assistant herbs, scotellaria root can clear heat and dry dampness; capejasminc froit is dioretic which porges fire from the triple jioo and removes dampness. As the adjuvant herbs, water plantain, akebia stem and plantain seed clear heat and dampness to induce evils out; rehmannia root nourishes yin and promotes generation of body fluid; Chinese angelica root and bupleuroni root nourish blood and soothe the liver. Licorice root is the dispatcher herb to harmonize all the components.
In the present dude, this formula is usually applied to migraine, hyperten sian, acute conj octivitis, acute otitis media, rhinitis pertaining to flaming up of the excessive fire of the liver and gallbladder; or acute icterohepatitis, acute cholecystitis, herpes zoster, and inflammation io die ufinary and reproductive system such as acute pycloncphritis, acute cystitis, orethritis, volvitis, testitis, acute pelvic in flammation pertaining to interior accumulation of dam-heat of the liver and gall bladder or downward flow of damp-heat.
Since mast of herbs in this formula ore hitter flavor and cold nature which can injure the spleen and stomach, long term use is nat suggested.
ASSOCIATED FORMULA:
Clunese Aogelica, G-cntian and Aloes Pills (clang gui lông ho1 rodiz)
Chinese angelica root, gcntian root, ocpejasniine fruit, captis root, phcllodcndron bark, scotellaria root, rhubarb, aloes, natural indigo, socklandia root. musk.
The above herbs should he ground and mixed with honey arid made iota pills which should lie taken with fresh ginger decoction. Effects:clearing the liver and purging heat and stasis. Indications: excessive fire of the liver and gallbladder manifested by headache with flushed face, conjunctival congestion with swelling eyelids, disteding pain of chest and hypochondrium, constipation, dark urine, rest
114
lessness, or oven spasm, strong taut pulse.
NOTES: Both this formula and Gentian Liver Purging Decoction have the effects of clearing the liver and purging heat. This formula stresses on purging fire directly with the extremely hitter flavor and cold nature as wcH as inducing fire out through urine and stool, so it specializes in purging the excessive fire of the liver and gallbladder; while herhs of Centian Liver-Purging Decuction includes tunificatian within reduction and dispersing within nourishing, so it has a curnparatively modeate effect and is mainly to clear away damp heat.
Blue-Purging Pills
xiè qing wan
SOURCE: Key to Pediatric Therapeutics
INC REDIENTS:
Chinese angelica root
Burnout
Chuanxiong rhizome
Cape] asmine fruit
Rhubarb
Notupterygium root
Ledebouriella root
(With equal dosage uf the above herhs.
DIRECTIONS : Docuct the above herbs in water with some bamboo leaf, honey and granulated sugar fur oral administratiun.
EFFECTS:Clcaring the liver and purging fire.
INDICATIONS: Stagnation of the liver-fire manifested hy insomnia and easy in he angry, conjunctival congestion with swelling eyelids, dark urine and cunsti patiun, forceful surging pulse; or infantile acute convulsion marked by high fever and spasm.
ANALYSIS OF FORMULA: Being extremely hitter flavor and cold gentian rout as the main herb specially purges the excessive fire of the liver and gallblad der. Rhubarb can purge heat to relieve cunstipatiun;cape]asmine fruit can clear the triple—jiuu and facilitate diuresis. They act as the asistant herb to induce heat out thrnugh urine and stuul. As the adjuvant herbs, ehuanxiung rhizunie activates blood fur dispersing wind and soothing the liver;Chinese angelica root nourishes bluud fur gentling the liver;lcdehnuriella ruut and nutuptarygiurn rout disperse the liver wind and the stagnated fire;hambuu leaf clears the heart and facilitates diu
115
resis. Honey and granulated sugar are die dispatchers to harmonize all the compo nents.
White—Purging Powder
xiè bat son
SOURCE: Key to Pediatric Therapeutics
INGREDIENTS:
Wolfherry hark 30g
Molherry hark 30g
Licorice rout 3g
Round grsined rice 15g
DIRECTIONS:Deeoct the above herbs in water for oral administration.
EFFECTS:Cleariog away the lung heat to relieve asthma and cough.
INDICATIONS:Accumulation of lung heat manifested by cough or asthma, feverish skin which is aggravated in the afternoon, red tongue with yellow coat ing, thread rapid pulse.
ANALYSIS OF FORMULA: This is a formula for clearing away the lung heat. Being sweet flavor and cold nature, acting on the lung, mulberry bark is the main herb to clear thhe lung and to resolve phlegm for relieving asthma. Being sweet flavor and cold nature, wolfberry bark is the assistant herb to clear away the hidden heat from the lung as well as expeling the deficent heat. As the adju vant and dispatcher herbs, round grained rice and licorice root can harmonize the middle and reinforce qi as well as invigoraing the earth to generate the metal. Thie formula cannot lie applied to asthma and cough due to exogenous attack of wind- cold and cough pertaining to deficient cold.
Reed Rhizome Decoction
wèijIng (dug
SOURCE: Essential Formulae Worth A Thousand Gold for Emergency
INGREDIENTS:
Reed rhizome 30g
Coix seed 30g
Waxgourd• seed 24g
Peach kernel 9g
DIRECTIONS:Decoct the above herbs in water for oral administration.
EFFECTS: Clearing the lung, resolving phlegm, expelling stasis and promo
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dog pus discharge.
INDICATIONS:Pulmunary ahscess manifested by cough with stinking or pa rulent sputum, nuld fever and chest pain, squamous and dry skin in ihe area of chcst and hypochondrium, red tongae with yellow greasy coating, slippery rapid pulse.
ANALYSIS OF FORMULA: This is a common formula for pulmonary abscess. Being sweet flavor and cold nature, reed rhizome is the main herb to clear a- way the lung heat and is osed as the key herb fur pulmonary abscess. As the assis tant herb, waxgoord seed cau clear away heat, resolve phlegm, excrete dampness and drain pus. As the adjuvant and dispatcher herbs, peach kernel activates blood to resolve stasis and accomolation; coix seed clears the long, drains pos arid facilitates dioresis to induce heat auL through urine. This formula can be used in unripe pulmonary abscess to resolve it or in ripe pulmonary ahscess to drain the pus.
In addition, this formula can be modified according to symptoms to treat bronchitis, pneumonia and whooping cough pertaining to the lung-heat.
Stomach-Clearing Powder
qing wet san
SOURCE: Secret Records of the Orchid Chamber
INCREDIENTS:
Chinese angelica root 6g
Coptis rout 3’--6g
Rehmannia root 6g
Moutan bark log
Cimicifuga rhizume 6g
DIRECTIONS:Decoct the above herbs in water fur oral adnunistrution.
EFFECTS:Clearinng the stomach and cooling blood.
INDICATIONS:Accumulated heat in the stomach manifested by headache ra diated froni toothache with aversion to heat and predilection for cold, feverish check ; or ulceration in the gum ; or gingival atrophy with oozing of blood ; or swelling and soreness of the tongue, lips and cheeks;or hot and foul breath, dryness of muuth and tongue, red tongue with yellow coating, slippery, large and rapid pulse.
ANALYSIS OF FORMULA:Being bitter flavor and cold nature, coptis root as the main herb specially clears away heat and fire from the heart and stumuoch. As the assistant herbs, rebmannia root cools blood and nourishes yin; moutan bark cools blood and dissipates stasis. Chinese angelica rooi us the adjuvuot herb noun
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shes and harmonizes blood to relieve swelling and pain. As the dispatcher herb, eirnicifnga rhizome can disperse fire poison as well as goiding herbs to the Yangming Meridian. This formula is particularly fur toothache. It con he applied to the syndrome of stomach heat and blood heat with fire stagnation by means of modifi cations. For constipation, rhubarb could he added to induce beat downwards.
In the preseot clinic, it is applied to stomatitis, periodontitis and trigeminal neuralgia pertaining to flaming-up of the stomach-fire.
Fairy Decoction
yã nil jian
SOURCE: Jingyue’s Complete Works
INGREDIENTS:
Gypsum I5-3Og
Prepared rehmannia root 9—’3Og
Ophiopogon root 6g
Anemarrheoa rhizome 4. 5g
Cyathula root 4. 5g
DIRECTIONS: Decoct the above herbs in water for oral administration.
EFF’ECTS: Clearing the stomach and nourishing yin.
INDICATIONS: Syndrome of the stomach-heat with yin deficiency manifested by fever with thirst, toothache, heabaehe, odontoseisis with gingival hemorrhage, red tongue with yellow and dry coating; or consumptive-thirst marked by eating much yet ever feeling hungry.
ANALYSIS OF FORMULA: This is a common formula for toothache and gingival hemorrhage due to exuberance of the stomach fire with deficiency of ihe kid nay water. Gypsum is the main herb to purge the stomach-fire and promote generation of body fluid and quench thirst. Prepared rehmennia root is the assistant herb to strengthen the kidney—yin for restraining fire. As the adjuvant herbs, anemarrhena rhizome can help gypsum clear the stomach and quench thirst; ophin pogon root can assist prepared rehmannia in nourishing yin to moisten dryness. Cyathulo root acts as the dispatcher herh to strengthen not only the liver and kidney Ian alsn hnnes and tendons, as well as conducting the blood heat downwards.
Peony Deeoctioa
sháo ydo tang
SOURCE: Life Saving Collection Based on Pathological Mechanism of the
118
Plain Questions
INGREDIENTS:
White peony root 1L--’20g
Chinese angelica root 9g
Coptis root 9g
Areea seed 5g
Aucklaridia root 5g
Licorice root 5g
Rhobarb 9g
Seorellaria root 9g
Cinnamon hark 2’—’5g
DIRECTIONS:Decoct the above herbs in water for oral administration.
EFFECTS:Clearirig away heat and poison, harmonizing blood and qi.
INDTCATIONS:Damp heat dysentery manifested by abdominal pain with pus and blood diarrihea, tenesmos, horning sensation in the anos, scanty dark urine, yellow greasy coating.
ANALYSIS OF FORMULA: This is a common formula for treating heat dys eutery with abdominal pain. White peony root acts as the main herb to harmonize qi and blood for relieving abdominal pain. As the assistant herbs, scotcllaria root and eoptis root clear awey heat and dry dampness to relieve dysentery; rhubarb cEo clear away heat and dry dampness, purge retention, as well as cooling blood to stop bleeding. As the adjuvant herbs, Chinese augelica root harmonizes and activates blood; cinnamon hark strengthens the effect of activating blood with its warm property; aueklandia root and areea seed activate qi for dispersing stagnation and resolving accumulation. Licorice root is the dispatcher herb to harmonize all the components and relieve spasm and pain by cooperating with white peony root.
This formula is often used in baeillary dysentery, amebie dysentery, allergic colitis and acute enteritis pertaining to damp-heat.
ASSOCIATED FORMULA:
Scutellaria Deeoctiouhudog jin long) , (Treatise on Cold-Attack)
Scutellaria rout 9g, white peony root fig, Roasted licorice root 3g, Chiuese date 4 pea.
The above herbs should he decocred in water for oral administratien. Effects:
clearing away heat fur relieving dysentery, harmonizing the middle for reliveing pain. Indicadrious: abdonunal pain with diarrhea, fever, oral bitter taste, or dyaen
119
tery with abdominal cramp and fever, red tongue, taut and rapid pulse.
NOTES: Buth this formula anrl Peony Decoction can be used to treat heat dysentery with abdominal pain. Peony Decoetion has powerful effect on clearing away heat and drying dampness as well as harmonizing qi and blood, so it is usually applied tu damp-heat dysentery marked by pus and blood diarrhea with tenesmus; while Seutellaria Daeoctiun is inferior in clearing away heat and drying dampness as well us harmonizing qi and bluod, so it is usually applied to damp heat diarrhea marked by mucous in stoul.
Pueraria, Seutellaria and Coptis Decoetion
gé gën huáng qIn hudng han tang
SOURCE: Treatise on Cold Attack
INC REDIENTS:
Pueraria root 15g
Roasted licorice root Sg
Coptis root 9g
Seutellaria root 9g
DIRECTIONS:Deeoet the above herbs in water for oral administration.
EFFECTS: Relieving the exterior and clearing away heat.
INDICATIONS:Non-raliaf of the exogenous exterior syndrome with heat evil entering the interior manifested by fever with foul diarrhea, burning sensation in the anus, irritable feverish sensation of chest and epigastrium, dry mouth and thirst, asthma with sweating, yellow coating, rapid pulse.
ANALYSIS OF FORMULA:This is a representative formula for fever with diarrhea. Being bitter flavor and cool nature, pulsatilla root acts as the main herb to relieve the exterior and lift the lucid yang of the spleen and stomach for relieving diarrhea so as to treat both the exterior and the interior. As the assistant herbs, seutellaria root and eoptis root can clear away heat and dry dampness to relieve diarrhea. Licorice root is the dispatcher herb to harmonize the middle for relieving spasm as well as to harmonizing all the components. Thus the formula is used for relieving both the exterior and interior.
In clinic, this formula can be used in acute anteritis, haeillary dysentery, ume— hie dysentery with the abovemention symptoms.
Pulsatilla Decoetion
bái tóu wëng tang
SOURCE:Treatise on Cold-Attack
120
INGREDIENTS:
Pulsatilla root 15g
Phelludendron bark 12g
Coptis root 6g
Ash bark 12g
DIRECTIONS: Decoct the above herbs in water for oral administration.
EFFECTS:Clearing away beat and poison, cooling blood to relieve dysentery.
INDICATIONS: Heat dysentery manifested by abdominal cramps with tenesmus, horning sensation in the anos, diarrhea with more blood and icss moeus, thirst with desire for drinking, red tongue with yellow coating, taut rapid poise.
ANALYSIS OF FORMULA: This is a chief formula far heat dysentery with tenesmus. Being bitter flavor and cold natore, polsatillla root acts as the main herb to clear sway heat and poison as well as cooling blood for relieving dysentery. As the assistant and ad] avant herbs, captis root, phelladendran hark arid ash hark are to purge fire and poison as well to dry dampness for relieving dysentery. For dys eatery doe to pestilent poison and blood heat marked by diarrhea with porple blood and pus, rehmannia root and mouton hark cao he used cooperatively to nourish yin and cool blood.
Section 5 Formulae for Clearing SummerHeat
Summer-heat-clearing formulae are indicated to syndromes due to attack of summer-heat. As one kind of fire-heat evils, summer-heat is characterized by quick transmission and attacking on the qi phase. So, at the beginning, it is manifested by high fever, irritable thirst, profuse sweating and sa on. Because the exuberant summer heat can consume qi and injure yin very easliy, it is usually accompanied by symptoms of fatigue and feeble pulse. hammer is a rainy season, so the summer-heat is often accompanied by dampness marked with irritable thirst with desire for drinking, stuffiness of chest and epigastrium, nausea or vomiting with di arrhea, disuria, etc. If enjoying the cool and taking cool drinking too much in hot summer season without avoiding wind and cold, it is also often accompanied by the extuerior cold. Far the simple summer heat sufferer, it should be treated hy clear ing away the summer-heat. The light case should be treated mainly with honeysuckle flower, watermelon endocarp and bamboo leaf; the heavy case chiefly with gypsum and anemarrhena rhizoirre, such as Collateral Clearing Decoctiun and White Tiger Decoction (seen in the section of clearing away heat from the qi
121
phase) . For cases accompanied by the exterior cold, it should he treated by clear ing away summer heat and relieving the exterior, such as Elscholtzia Powdcr(seen in exterior-rclicving formulae) . For cases accompanied by dampness, it is usually treated with talc, gypsum, puria and waler plantain, such as Six-To-Onc Puwder, Cassia Twig and poria sweet Dew Powder. Fur cases accompanied by deficiency of qi and yin, it should be treated mainly with American ginseng, inseng, ophio pogun root and dendrobium stem, such as Summer Heat Clearing and Qi-Tonifying Decoctiun.
The key of applying sumnier heat clearing formulae is to grasp the existence or absence of complications, the primary and secondary symptoms and the degree of seriousness. If the summer heat disease is accumpanied by dampness with heavier summer heat and lighter dampness, then the dampness is easily transformed into heat, so herbs with warm and dry pruperiies should he chosen carefully in order to avoid injury uf the hndy fined. If the dampness is heavier than summer heat, then summer-heat would be encumbered by dampness, so herbs with sweet and greasy properties and cold nature should be applied cautiously in order to prevent from stasis of dampness evil.
Collateral-Clearing Decoction
qing tad yin
SOURCE: Differentiation on Warm Diseases Item by Item
INGREDIENTS:
Lntns leaf 6g
Honeysuckle flower Dg
Watermelon endocarp hg
Hyacinth bean flower hg
Towel gourd peel hg
Bamboo leaf 6g
DIRECTIONS: Decoct the above herbs in water for oral administration.
EFFECT: Clearing summer heat.
INDICATIONS: Summer-host iujoring the lung in the qi phasc manifested by fever, slight thirst, dizziness with slight fullness of head, pink tongue with thin white coating.
ANALYSIS OF FORMULA: Being sweet flavnr and cool nature, watermelon endocarp is the main herb to clear away heat, to promote generation of body fluid and to induce dinresis. As the assisent herbs, hyacinth bean flower can clear away
122
summer-heat arid resolve dampness;honeysuekle flower clears summer-heat by its puhgent flavor and cool nature. As [lie adjovant herbs, lotus leaf clears sommerheat and lifts the lucid yang; bamboo leaf clears heart arid induces diaresis to dis perse summcr-heat arid dampness out throogh urine. Towel gourd peel acts as the dispatcher herb to clear the long collaterals and clear away summer-heat.
This formula can be taken in summer instead of ordinary tea to prevent cam nier—heat diseases.
Six-To-One-Powder
flu yl san
SOURCE: Formalae Applied to Cold-Attack
INC RED1ENTS:
Tale 180g
Licorice root 30g
DIRECTIONS: Grind the above twa herbs into fine powder. Taking 9 gram of the powder each time with lukewarm water. Or wrapping the powder in silk cloth and decoeting it with other herbs.
EFFECTS: Clearing away sornmer-heat and excreting dampness.
INDICATIONS: Attack of sommer-heat evil manifested by fever, vexation, thirst, disarm, or vomiting arid diarrhea; or admpr-heat of the gallladder marked by scanty dark urine or difficolty and pain in rnicturition, stranguria or sandy strangoria.
ANALYSIS OF FORMULA: This is a common formula for syndrome of samrner-heet and dampness. Being sweet flavor arid cold nature, talc as the main herb clears heat arrd indacea diuresi.s to disperse damp-heat oat through urine. As the assistant herb, licorice root can purge fire and harmonize the middle as well as mitigating the coldness of tale.
ASSOCIATED FORM ULAE:
(1) Primordial Qi-Tanifying Powder fyi yuan são) , (Formulae Applied to Cold-Attack)
On the basis of Six-To-One Powder cinnabar and rash pith are added for clearing heart. Effects: clearing away summer—heat and calming the mind. lt is aced to treat syndrome of aammer heat and dampness marked by palpitation or severe jialpitation, insomnia or dreamful sleep.
(2) Green jade Powder (hi yã san) , (Formulae Application to Cold-Attack)
On the basis of Six-To-One Powder natural indigo is added for clearing away
•123
summer heat. It is applied to syndrome of summer heat and dampness accompanied by stagnated heat in the liver and gallbladder.
(3) Peppermint Powder(jz se san) ,(Formulae Applied to Cold Attack):
On the basis of Six To One Powder peppermint is added for dispersing wind and clearing away summer-heat. It is used to treat syndrome of summer-heat and dampoess complicated with symptoms of slight chill, disteoding headache and cough.
Cassia Twig and Poria Sweet Dew Powder
gui lIng gdn là san
SOURCE: Formulae and Expositions
INGREDIENTS:
Poria 30g
Licorice root 6g
Bighead atractyludes rhizume 12g
Water plantain 15g
Cinnamon bark 3g
Gypsum 30g
Calcite 30g
‘I’alc 30g
Agarie 15g
DIRECTIONS: Decoet the above herbs in water for oral administration.
EFFECTS: Clearing away summer-heat and promoting the transformative function of qi to disperse dampnsec.
INDICATIONS: Attack of summer heat and dampness manifested by fever, headache, irritable thirst with desire fur drinking, disuria, vomiting and diarrhea.
ANALYSIS OF FORMULA:This formula is set up for syndrome of both exuberance of summer heat and dampness. It is composed of Six To-One Powder and Poria Powder with Five Ilerbs(scen in dampness-dispersing formulae) by adding gypsum and calcite. Being the extremely cold nature, gypsum and calcite are to clear away summer heat; talc to clear away heat and to facilitate diuresis for indo cing dampness out through urine. They together act as the main herbs. As the assistant herbs, poria, agarie and water plantain can facilitate dioresis to remove dampness. Being pungent flavor and hot nature, cinnamon bark is to strengthen the transformative function of the gallbladder qi; highead airactylodes rhizome to strengthen the spleen and dry dampness in order to recover the functions of as
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cending and descending. They act as the adjuvant herbs. Licorice root is the dis
patcher herb to reinforce qi and harmonize the middle and all ihe components. Because of the powerful effect of clearing away summer-heat and dispersing
dampness, this formula is more suitable to cass due to heavier summer heat and dampness.
Snrnrner-Heat-Clcaring and Qi-Tonifying Decoction
qing shã yl qI tang
SOURCE: Compendium on Warm Disecses
INGREDIENTS:
American ginseng 5g
Dendrohium stem 15g
Ophiopogon root 9g
Coptis root 3g
Bamboo leaf 6g
Lotus petiole lSg
Anemarrhena rhizome 6g
Licorice rout 3g
Round (irained rice 15
Watermelon endocarp SOg
DIREC’I’IONS: Decuct the above herbs in water for oral administration.
EFFECTS: Clearing away summer-heat and reinfurcoing qi, nourishing yin far promoting gencratiun of body fluid.
INDICATIONS: Attack of summer heat with injury of both qi and body fluid marufested by fever, profuse sweating, vexation, thirst, scanty dark urine, short ness of breath, fatigue with tired mind, feeble and rapid pulse.
ANALYSIS OF FORMULA: This is a cummon formula br summer heat inju ring qi and body fluid. Being sweet flavor and cool natucr, American ginseng can tonify qi and promote generation of body fluid as well as nourishing yin;watermclon enducarp can clear away summer-heat and induce diuresis as well as promote generation of body fluid for quenching thirst. They both act as the main herbs. As the assistant herbs, lotus petiole clears summer-heat arid dampness; dendrobium stem and uphiupugun rout help American ginseng nourish yin •for clearing away heat. As the adjuvant herbs, coptis ruut and bamboo leaf can purge fire and clear the heart to assist in relieving the exterior; anemarrhena rhizome is to nourish yin for lowering fire. Licorice root and round grained rice act as the dispatcher herbs
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to strengthen the stomach and harmonize the middle.
This formula includes some more graasy herbs for nourislung yin, so it is nnt advisable to be applied to summer-heat diseases acconpanied by dampness.
Section 6 Formulae for Clearing Away the Deficient Heat
Formulae for clearing away the deficient heat are suitable to the late stage of febrile diseases with remaining of pathogenic heat and injury of yin fluid. Heat staying in the yin phase is marked by fever at night but being normal in the morn ing, red tungue with less coeting. Syndrome nf deficient heat due to injury of the liver and kidney is marked by hectic fever or persistent fever. For the remaining of pahogenic heal at the late stage of febrile diseases, it should be treated by nourishing yin and expelling heat. herbs in common use are sweet wormwood, large leaf gentian rout and fresh-water turtle shell for clearing the interior and expelling the exterior. For injury of the liver and kidney marked by hectic fever, it should he treated by nourishing and clearing away heat. Herbs in cummon use are stellaria root, wolfbcrry bark, picrorhiza rhizome and mautan bark for clearing away ihe deficient heat to treat the ‘branch” arid anemarrhena rhizome, rehmannia root, prepared rehmannia root and Chinese angelica root for nourishing yin and blond to treat the “root”. the representative formulae are Sweet Wormwood and Turtle Shell Decnction, Large leaf Centian and Tortle Shell Powder, Chinese Angclica end Six Yellow Herbs Dccoction, crc.
Sweet Wormwood and Turtle Shell Decoction
qing han bie fbi tang
SOURCE:Differentietion on Warm Diseases Item by Item
INGREDIENTS;
Sweet wormwood 6g
Fresh water tattle shell 15g
Rebmannia root 12g
Anemarrhena rhizome 6g
Mootan bark 9g
DIRECTIONS:Decoct the above herbs in water for oral administration.
EFFECTS:Noorishing yin and clearing away heat.
INDICATIONS: Consumption af yin fluid with hidden evil in the yin phase at the late stage of febrile diseases manifested hy fever at night and normal in the
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morning, absence of sweat after disappear of fever, red tongue with less coating, threed rapid pulse.
ANALYSTS OF FORMULA: This is a representative formula for clearing away the deficient heat. Being salt flavor and cold nature, fresh water turtle shell acts on the yin phase directly to nourish yin and to clear away heat; sweet wormwood can expel evil through the exterior with its aromatic property. they both act as the main herbs. As the assistant and adjuvant herbs, rehmannia rout is to nourish yin, to clear away heat and to promote generation of body fluid; enemerrhene rhizome nnuishe’a yin and luwers fire for helping fresh—water turtle shell nourish yin and clear away heat;moutan bark can help sweet wormwood clear away the hidden fire from the yin phase.
Bouc-Clearing Powder
qing gd san
SOURCE: Standards of Syndromes and Treatment
iNGREDIENTS:
Stellaria rout 5g
Picrurhiza rhizome 3g
Large leaf gentiao root 3g
Fresh—water turtle shell 3g
Wolfberry bark 3g
Sweet wormwood 3g
Anemarrhena rhizome 3g
Licorice root 2g
DIRECTIONS:Decoct the ohove herhs in water fur oral administration.
EFFECT:Abating hectic fever due to deficient heat.
INDICAT1ONS:Consumption syndrome manifested by hectic fever or persistent low fever, crimson lip and flushed cheek, emaciation with night sweating, red tongue with less coating, thread and rapid pulse.
ANAlYSIS OF FORMULA:This is a common formula for hectic fever. Being sweet flavor and slight cold nature, stellaria root acts as the main herb to clear a- way the deficient heat. As the assistant herbs, anemarrhaoa rhizome is to nourish yin for moistening dryness as well as clearing away the deficient fire in the lung and kidney; pierorhiza rhizome to clear away heat frummi the blood phase; wolfberry bark to clear away the lung-heat; sweet wormwood and large leaf gentian root to expel the hidden heat through the exterior. Fresh water turtle shell is the adju127
vant herb to noorish yio for calming yang as well as to guiding herhs to the yin phase. Licorice root acts as the dispatcher herb to harmonize all the components.
Modifications: Adding Chinese angelica root, white peony root and rehmannia for heavier deficiency of blood; adding donkey-hide gelatin, ophiopogon root and schisandra froit for cough.
ASSOCIATED FORMULA:
Large leaf Gentian and Tortle Shell Powder qfn jido He jiri são)
Wolfharry hark 30g, bopleorom root 30g, fresh-water turtle shell 30g, large leaf gentian root 1 5g, anernarrhena rhizome 15g, Chinese angelica root 15g, black plom l5g, sweet wormwood 6g.
The above herbs should he decocted in water for oral administration. Effects:
nourishing yin and blood, clearing away heat to abate hectic fever. Indications:
Consomption Syndrome manifested by hectic fever, night sweating, emaciation, crimson lip and flush cheek, lassitode, coogh, tidal fever in afternoon, thread and rapid pulse.
Chinese Angelica and Six yellow Herbs Decoction
ddng gal ha huáng tang
SOURCE: Secret Records of the Orchid Chamber
INGREDIENTS:
Chinese angelica root 12g
Rehmannia root 12g
Prepared rehmannia root 12g
Coptis root l2g
Scotellaria root l2g
Phelodcndron bark 12g
Astragalos root 24g
DIRECTIONS:Dccoct the above herbs in water for oral administration.
IfFFECTS:Nourishing yin and clearing away heat, consolidating the exterior to stop sweating.
INDICATIONS: Jlcat syndrome with yin deficiency maniftstcd by fever, night sweating, hectic cheek, vexation, dryness of mouth and lips, constipation and dark urine, red tongoe, rapid polse.
ANALYSIS OF FORMIJLA:This is a common formula for night sweating doe to yin deficiency. Chinese angelica root, rehmannia root and prepared rchmannia rnot act as the main herbs to nourish yin and blond and to tonify the liver and kid-
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ncy. As the assistant herbs, eoptis roots, eutellaria root and phellodendron bark can clear away heat an porge fire to preserve yin and relieve vexation. Astragalos root is the adjuvant herb to reinforce qi and consolidate the exterior for stopping sweating.
Becaose this formula has a powerful effects on nourishing yin and purging fire, it is not advisable to be applied to the cases with deficiency of the spleen and stomach.
In Summary
1 . Formulae for clearing away heat from the qi stage
Both White Tiger Decoction and Lophatherum and Gypsum Decoetion are used to treat the meridian syndrome of Ynagming with heat in the qi stage. The former is marked by high fever, profuse sweating, extreme thirst, surging and large pulse. Large dosage of gypsum is used as the main herb to clear away the excessive heat from the qi stage with its pungent and sweet flavors and extremely cold nature. Meanwhile anemarrhena rhizome is used cooperatively to strengthen the effect of clearing away heat and purging fire; The latter is derived from White Tiger Decoction and suitable to the cases due to the remaining heat with injury of both qi and yin at the late stage of febrile diseases, so anemarrhena rhizome is removed because of its bitter flavor and cold antore, bamboo leaf, ophiopogon root and pinellia tuber are added to clear away heat, to nourish yin and to harmonize the stomach for lowering rebellious qi. Thus, formula with extremely cold nature is changed into that for clearing and reinforcing. Capejasmine Fruit and Prepared Soybean Decoction can clear away heat for relieving vexation, so it is suitable to the cases doe to stagnated heat in chest.
2. Formulae for clearing the mttrieat phase and cooling blood
Decoction for Clearing Ying-Stage is the representative formola for heat in the nutrient stage. Though the main purpose is to clear the nutrient stage and to cool hlnod, honeysuckle flower, forsythia fruit and bamboo leaf are osed coopera tively to expel heat in the nutrient stage through the qi phase. Rhinoceros horn and Rehmannia Decoction is the representative formula for heat in the blood stage. At the sonic time of cooling blood arid dispelling poison, mouton bark and red peony root arc cooperated to cool blood and to dissipate stasis for the purpose of stopping bleeding without remaining of stasis.
3. Formulae for clearing heat and poison
Coptis Detoxicating Decoction can counteract fire-poison of the triplc-jiao di
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reetly by its extremely bitter flavor and cold natore. Meanwhile cooperating with eapejasmine frut to induce fire evil of the triple—jioo out through urine. Sn it is in dieated to exuberant heat in the triple-jioo without injury of the body fluid. Everyone’s Detoxieating Deenetiun is the main formula for infectious swollen head. Being emphasized on clearing away heat poison of the opper-jiao with large dosage of seutellari root and euptis root, a great amount of herbs with pongent fla vor and cool nature are cooperated to disperse evils and to soothe throat. Mean time with eimieifuga rhizome and bupleorom root to lift yang for dispersing fire. So it is stressed on that “fire stagnation should be dispersed”. God’s Life-Saving Deeoetion is the main formula for carbuncle and sores due to heat poison and called as “the first formula” in surgery by physicians in successive dynasties. Because herbs for clearing away heat-poison, (lispersing wind, activating blood and promoting ulceration are collected in this formula, it is suitable to the beginning stage of sores due to heat poison with or without suppuration. Four Powerful Herbs Decoetion is special for gangrene of finger or toe due to exuberant heat-poison with emphasis on herbs for clearing away heat poison, nourishing yin and blood as well as activating blood and dissipating stasis. Bovine Gall-Stone Pills stresses on activating blood and resolving stasis as well as expelling poison so it is suitable to serofula, breast cancer and multiple abscess in physically strong patient marked by red tongue and rapid pnlse. Because of the large dosage of herbs with aromatic, warm and try properties, it is not suitable to the eases with yin deficien ey.
4. Formulae for clearing away the visceral heat
Fire-Inducing Powder is used to treat syndrome due to heat transformed into the small intestine from the heart, so rehmannia root is the main herb to clear the heart and to nourish yin, meanwhile cooperating with herbs for purging fire and inducing diuresis to disperse heat out through urine. Both Gentian Liver-Purging Deenetion and Blue-Purging Pills can clear the liver-fire. Gentian Liver-Purging Deeoetion is mainly applied to syndrome doe to excessive fire of the Liver Meridi an with downward flow of damp-heat. Gentian root acts as the main herb to purge the liver fire and excrete damp-heat, by cooperating with hupleurum root for soothing liver, Chinese angeliea root and rebmannia root for nourishing yin and blood, so as to purge the liver fire without damaging the liver and to excrete dampness without injuring yin. Blue-Purging Pills is chiefly to purge the excessive fire of the liver and gallbladder so as to make heat evil out through stool end u130
rine. Both Reed Rhizome Deeoetion and White Purging Powder can clear the lung for relieving cough. Reed Rhizome Decoction is a special formula for pulmonary ahseess hecause of its effect of expelling stasis and promoting discharge of pus. While White-Purging Powder is suitable to asthma and cough due to the lung beat with injury of yin, especially to the condition of not too serious injury of the genu inc qi and not too exuberance of the incubative fire. Both Stomach-Clearing Powder and Fairy Deeoetion have the effect of clearing the stomach-fire. StumachClearing Powder is meinly to purge fire and cool blood by cooperating with small dosage of cimieifuga rhizome as the guiding herb for the Yangming Meridian, so it is suitable to symptoms of toothache, gingival atrophy due to stomach-fire. Fairy Decoction is applied to pyogenic gingivitis and gingival hemorrhage due to defi ciency of water and exuberance of fire. In this formula, emphasis is laid on both clearing away heat and nourishing yin, also with cyathula root to inivgorate the kidney and to conduct heat downward. Pueraria, Scutellaria and Cuptis Decoctiun, Peony Decoctiun and Pulsatilla Decoetiun all can dry dampness for relieving diar rhea. Pueraria, Scutellaria and Capris Decocrion is applied to heat dysentery cam plicated by the exterior syndrome; Peony Decoctian is mainly to harmonize qi and blood,so it is suitable to abdominal cramp with tenesmus due to damp-heat;while Pulsatilla Deauction stressesd on claaring away heat, so it is suitable tn cases who are attalked more from heat than dampness.
5. Formulae for clearing away summer-heat
Collateral-Clearing Dacoction is a formula with pungent flavor and cool nature and it is only suitable to the light case doe to summer heat injuring the lung in the qi phase. Bath Six Ta One Powder and Cassia Twig and Puria Sweat Dew Powder have the effects clearing away summer-heat and dispersing dampness. The former is composed of six portions of tale and one portion of licorice rout to clear away summer-heat and disperse dampness without injuring the body fluid, so it is the basic formula far summer heat complicated by dampness;While the latter has a predaniinant effect an clearing and dispersing, so it is suitable to the case with heavier condition. Summer-Heat-Clearing and Qi-Tunifying Deeuetian is suitable to summer-heat diseases with injury of both qi and body fluid hot no complication of dampness-evil, so herbs far tonifying qi and promoting production of body fluid are cooperated within the herbs far clearing away summer-heat.
6. Formulae for clearing away the deficient heat
Sweet Wormwood and Turtle Shell Decaction is mainly to noorish yin and
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expel heat with sweat warmwood eoaperated by fresh-water turtle shell, sa it is suirabla to fever at night but being normal in the morning due to hidden evil in the yin phase at the late stage aI febrila diseases. Bone Clearing Powder stresses on clearing away interior heat in the yin phase, so it is special for hectic and tidal fe ver. Chinese Angelica and Six Yellow Herbs Decoetion can nourish yin and purge fire, and it is good for night sweating. But it cannot be applied tu loose stool due to the spleen deficiency.
  
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