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Chapter Six Interior Warming Formulae

The interior warming fnrmulae are mainly composed of herbs which have the effects of warming the middle to dispel cold, restoring yang to rescue collapse, and warming meridians to expel cold. They are used for the interior cold syndromes and pertain to warming therapy ol the eight therapies.
There arc two kinds of causes for the interior cold syndromes, i.e. directly at tacking of cold on the interior and cold originated from the interior. For examples, constitutional yang deficiency leads to generation of the interior cold; the exogenous cold directly attacks on the interior including viscera and meridians; erroneous purgation inj ores yang qi. The interior cold syndronces are characterized by chill without fever, preference for warm and lying crookedly, oral tastelessness without thirst, clear urine, deep and slow pulse or loose pulse. For the parts of viscera and meridians attacked by cold evil are different, the iaterior cold syndromes can be divided into deficiency of cold of the middle jiao, exhaustion of the heart and kidney-yang, and attacking of cold on meridians.
Based on the principle that “cold syndrome should he treated by hot-natured herbs”, the interior cold syndromes should be treated by therapy af warming the interior and dispelling cold. According to the different locations of diseases, this kind of formulae are divided into three categories, i. e. formulae for warming the middle to dispel cold, formulae for restoring yang to rescue collapse, and formulae for warming meridians to expel cold.
When applying the interior warming formulae, it should he careful to differentiate the true or false cold and heat. The interior warming formulae are never be applied to heat syndromes with pseudo cold symptoms. In cases of extreme exuberance of cold, if vomiting happens immediately after takiag hot-natured herbs, the hot-natured decoction can be taken coolly, or small amount cold-natured herbs can be added to the formulae as the contrary adjuvant. The interior warming formulae are mainly composed of herbs with pungent flavor and warm or hut nature, so that deduction of dosage is obliged to apply theni to patients of constitutional exuberance of fire, blood loss and injury of yin even if manifested by the interior cold syndromes.
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Section 1 Formulae for Warming the Middle to Dispel Cold
Formulae for warming the middle to dispel cold are indicated to deficient cold syndrome of the middle jiao. The spleen and stomach are located in the middlejioo with the functions of dominating transportation and transformation as well as ascending and descending of qi. The internal exuberance of yin cold with yang deficiency of the middle leads tu abdominal pain with preference fur warming and pressing, cold limbs, pale tongue with white euating, deep slow pulse or taut and tight pulse. Failure of the spleen in lifting the lucid yang is respunsible for diar rhea. Failure of the stomach in descending results in vornitiug, acid regurgitation and poor appetite. Therefore, the treatment should be warming the middle to dis pel cold. The main herbs br warming the middle to dispel cold are dry ginger, evodia fruit, pricklyash peel, galangul rhizome and malt sugar, etc.
The yang deficiency of the middle-jiao is usually complicated by qi deficiency, so that pilose asiabell root, highead atractylodes rhizome and licorice root are used together to reinforce the middle-qi. Failure of the spleen in transporting is often complicated by dampness-evil, so that poria, magnolia bark and tangerine peel can be used tugether to dry dampness and to strengthen the spleen. For the heavier cold evil leading to severe abdominal pain, small dosage of prepared acuuite lat eral root could he added to warm the kidney and spleen. The spleen deficiency brings about lack of production of qi arid blood so as to lead to bloud deficiency, Chinese angelico rout and white peony rout euuld he used together to gentle the liver and to nourish blood. Fur the stomach cold with rebellious qi marked by vomiting and acid regurgitation, fresh ginger, pinellia tuber and amomum fruit could be used to harmonize the stumseb and lower rebellion. The representative formulae are Middle Regulating Pills, Evodia Decoction, Minor Middle Strengthening Decoction, Major Middle-Strengthening Decoction, etc.
Middle-Regulating Pills
ii thong wan
SOURCE:Treatise on Cold-Attack
INGREDIENTS:
Ginseng 6g
Dry ginger 5g
Roasted licorice root 6g
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Bighead atractylodes rhizome 9g
DIRECTIONS: Grind the above herbs into powder then mix with honey to make into from of pills as large as yolk. Taking one pill with lukewarm water each time. Or the above herbs could be deeoctad in water for oral odrninist ration.
EFEECTS: Warming the middle to dispel cold, reinforcing the spleen-qi.
INDICATIONS:
(1) Deficient cold of the middle-jiao manifested by diarrhea without thirst, vomiting, abdominal distention and pain, anorexia, and cholera.
(2) Yang deficiency and blood loss.
(3) Chronic infantile convulsion, sleepy and sialorrhea after recovery from ill ness, and chest congestion, etc. due to deficient cold of the middle jiao.
ANALYSIS OF FORMULA:This is a representative formula for deficient cold of the spleeo and stomach. Being pungent flavor and hot nature, dry ginger nets as the main herb to warm the middle for dispelling cold and relieving pain. As the as sistant herb, ginseng reinforces the middle qi. Bighead atractylodes rhizome is the ad] uvant herl) to dry dampness and to strengthen the spleen qi for recovering the normal ascending and descending. Licorice root acts as the dispatcher herb to toni fy the middle qi and to harmonize all the components.
In the present clinic, this formula has affirmative effects on treating acute of chronic gastroentcritis, gastric and duodenal ulcer, gastroptosia, chronic colitis, chronic bronchitis, ascariasis, mcnorrhogia perlaining to deficient cold of the spleen and stomach.
ASSOCIATED FORMULAE:
(1) Cassia Twig and Ginseng Decoction(hrif zhz ceo then tang) , (Treatise on Cold Attack)
Cnssin twig 6g, Roasted licorice root 9g, bighead otractylodes rhizome 9g, ginseng 6g,dry ginger 5g.
The above herbs should be decocted in water for oral administration. Effccts:Wnrming the interior and relieving the exterior, reinforcing qi for relicving stuffioess.
Indications: Not relief of the exterior syndrome after applying several purga tion to the Taiyang diseases manifested by fever with persistent diarrhea, stuffiness and hardness of epigastrium.
(2) Aconite Middle-Regulating Pills ( zi If zhOog who) , (Formulae of Peaceful Benevolent Dispensary)
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Ginseng 30g, bighead atractylodes rhizome 30g, dry ginger 30g, Roasted licorice root 30, prepared aconite lateral root 30g.
The abovc hcrbs should be ground into fine powder, then mix with honcy to be made into farm of pills.
Effects: Warming yang to dispel cold, strengthening the spleen qi.
Indications: Deficient cold of the spleen and stomach with attack of wind—cold marked by epigastric pain vomniting and diarrhca with spasm.
(3) Unrippen Bitter Orange Middle-Regulating Pills (vhf shi if zhOog wan) (Formulae of Peaceful Banevnlen Dispensary)
On the basis of Middle-Regulating Pills unrippen bitter orange and pane are added. It can regulate the middle-jiao for relieving stuffiness and fullness as well as expel fluid retention for relieving abdominal pain.
(4) Cuptis Middle-Regulating Decoction (isuáng han if zhoog tang) , (Syndrome-Cause-Pulse Treatment)
On the basis of Middle-Regulating Decuction cuptis root is added. It is used mainly tu treat deficient cold of the spleen and stomach marked by vomiting with acid regurgitation, taut and slow pulse.
(5) Middle Regulating and Phlegm Resolving Pills (if zhoog huh tdn who) (Miseellonea of Famous Physicians)
On the basis of middle Regulating Pills pinellia tuber and poria are added and prepared with ginger.
Effects: Strengthening the spleen qi to resolve phlegm.
Indications: Deficient cold of the spleen and stomach with internal retention of phlegm manifested by vumiting, poor appetite, or loose bowel with undigested food, cough with expectoration of phlegm and saliva.
Evodia Fruit Decoction
wá thu yá tang
SOURCE: Treatise on Cold-Attack
INC REDIENTS:
Evodia fruit 3g
Ginseng 6g
Chinese daie 4pes
Fresh ginger 18g
DIRECTIONS:Deeoet the above herbs in water for oral administration.
EFFECTS: Worming the middle and tonifying deficiency, lowering rehellioa to
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relieve vomiting.
INDICATiONS:
(1) Deficient cold of the stomach manifested by nausca after meal, fullness of chest, epigastralgia, gastric discomfort with acid regurgitation.
(2) Jueyin headache with retching and vomiting of saliva.
(3) Shaoyin diseases marked by vomiting and diarrhca, cold limbs dysphoria.
ANALYSIS OF FORMULA: This formula is set up for deficient cold of thc liver end stomach. Being pangent flavor and hot nature and acting on thc liver, spleen arid stomach, evudia fruit is the main herb to warm the liver and stomach as well as lowering the rebellious qi. Fresh ginger is the assistant herb to warm the stomach and relieve vomiting. As the adjuvant herb, ginseng is to tonify the mid die qi Chinese date to harmonize the middle for relieving spasm. This formula is indicated to stuffiness of epigastrium with pale tongue, white greasy coating and slow pulse. It is prohibited for acid regurgitation pertaining to heat type.
This formula can he applied to chronic gastritis, neurotic headache, Meriiere’s disease pertaining to deficient cold of the liver and stomach.
Minor Middle-Strengthening Decoction
xiáo jtdn thông tang
SOURCE: Treatise on Cold-ATtack
INGREDIENTS:
White peony root l8g
Cassia twig 9g
Roasted licorice root 6g
Fresh ginger lOg
Chinese date 4pcs.
Malt sugar 30g
DIRECTIONS: Decuct the above herbs in water for oral administration with the exception of malt sugar which should be infused in the decoction.
EFFCTS: Warming the middle to tonify deficiency, harmonizing the interior to relieve spasm.
INDICATIONS: Consumption syndrome manifested by abdonunal spasm and occasinal pain which can be assuaged by warming and pressing, pale tongae with white coating, thread, taut and loose pulse; or palpitation with vexation and pale complexion; or fever with sbdnnunal pain and poor appetite due to the yang defieeney.
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ANALYSIS OF FORMULA: This formula is composed of Cassia Twig Deeoe tioo plus malt sugar with double dosage uf white peony root. Being sweet flavor and warm nature, acting on spleen,malt sugar is the main herb to warm the middle and tonify deficiency for harmonizingthe interior hnd relieving spasm. By cam bination with malt sugar, eassia twig can warm the middle and tonify deficiency; white penny rout can harmonize the interior and relieve spasm. The combination of eassia twig and white peony root can also harmonize yin and yang, so that they both act as the assistant herbs. Fresh ginger and Chinese date act as the adjuvant herbs to nourish the source of generation and transformation as well as harmonizing the nutrient and defensive qi. Licorice root is the dispatcher herb which can not only help malt sugar reinforce qi, but also nourish yin and harmonizing yang hy cooperating with cassia twig and white peony root as well as harmoing all the components.
This formula can he applied to gastric and doodenal ulcer, ehrdnic hepatitis and neuroasthema with the above mentioned symptoms.
ASSOCIATED FORMULAE:
(1) Astragalos Middle-Strengthening Decoction (hudng qi jidn zhong tang) , (Synopsis of the Golden Chamber)
9 gram of astragalos root is added to minor middle Strengthening Deeoetion. The directions are the same as that of Minor Middle Strengthening Deeoetion.
Effects:Warming the middle and reinforcing qi to harmonize the interior and to relieve spasm.
Indications: All the deficient manifestations due to consumption with abdominal pain and spasm.
(2) Chinese Angeliea Middle-Strengthening Deeoetionfdang gut jidn v/tong tang) , (A Sopplement to the Essential Formulae Worth A Thousand Gold):
12 gram of Chinese angelica root is added to Minor Middle-Strengthening De coetion. The directions are the same as that of Minor Middle-St rengihening lie coetion.
Effects: Warming the middle and tonifying deficiency to relieve spasm and pain.
indications: Deficient syndrome after delivery manifested by persistent ah dominal pain with shortness of breath, or eramping of the lower abdomen, abdominal pain radiating to the hack, anorexia.
NOTES: Astrogalos Middle Strengthening Deeoetion is applied to all defi
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ciencies which are more seriaos than those indicated by Minor Middle Strengthening Decoction. Astragalos root is used to strengthen the effect on reinforcing qi and tonifying deficiency. While Chinese Angelica Middle Strengthening Decoction stresses on noorishing and harmonizing blood, it is suitable te abdominal pain af ter delivery due to the internal deficiency of the notrient qi.
Major MiddleStrengthening Decoction
dd
f Ida zhong tang
SOURCE: Synopsis of the Golden Chomber
INGREDIENTS:
Pireklyash peel 3g
Dry, ginger 4. 5g
Ginseng Og
DIRECTIONS:Decoct the above three herbs in water for oral administration. Add 30 gram of malt sugar being infused in the decactian.
EFFECTS: Warming the middle and tanifying deficiency fur lowering rebel lion and relieving pain.
INDICATIONS: Exhnustion of the middle-yang with internal exuberance of yin-cold manifested by severe pain of chest, vomiting with anorexia, abdominal cold sensation, abdominal pain with rejection to pressing, white slippery coating, thread and tight pulse, even cold limbs and deep sited pulse, or bowel rumbling.
ANALYSIS OF FORMULA: Being sweet flavor and warm nature, acting on spleen,malt sugar acts as the main herb to warm yang and to tunify deficiency for relieving spasm and pain. As the assistant herbs, priekyosh peel can warm the middle and lower rebellion to relieve pain and to resolve mass; dry ginger can warm the middle tu dispel cold and harmonize stomach to relieve vomiting. Ginseng is the dispatcher herb to reinforce the middle qi and to support the genuine qi.
In the present clinic, this formula is applied to enterocele, stricture of kites— tines, peritonitis, appendicitis arid pancreatitis pertaining to internal exuberance of yin cold.
Magnolia Middle-Warming Decoction
hdu pô wën zhöng tang
SOURCE: Differentiation on Endogenuos and Exogenous Diseases
INGREDIENTS:
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Magnolia bark 30g
Tangerine peel 30g
Roasted licorice 15g
Poria l5g
Katsumadai seed 15g
Aucklandia root 15g
Dry ginger 5g
DIRECTIONS: Decoet the above herbs in water with three slices of fresh ginger for oral administration.
EFFECTS: Warming the middle and regolationg qi, drying dampness for relieving fullness.
INDICATIONS: Syndrome of cold-dampness of the spleen and stomach mani fested by fullness of epigastrium and abdomen; or attack of cold on stomach marked by adventitious epigastrie pain.
ANALYSIS OF FORMULA: Being pungent and bitter flavors, magnolia hark acts as the main herb to dry dampnes, warm the middle and lower qi. As the assistant herbs, tangerine peel can regulate qi and dry dampness;katsumadai seed acts on the spleen and stomach to dry dampness and warm stomach; aoeklandia root eon activate qi to relieve pain;dry ginger can warm the middle to dispel cold. Poria disperses dampness to strengthen spleen; fresh ginger lowers rebellion and to har monize the stomach. They both act as the adjovant herbs. Licorice is the dispatcher herb to harmonize all the components.
In clinic, it is applied to chronic enteritis, leokorrhea in women pertaining to coagulation of cold-dampness.
Section 2 Formulae for Restoring Yang to Rescue Collapse
Formolae for restoring yang to rescue collapse are indicated to syndromes due to exhaustion of the heart and kidney yang or direct attack of exogenoos cold on the interior. The kidney yang is the root of yang-qi of the whole body, which can warm op all Ihe viscera. The heart is the monarch of the hody, which dominotes blood and stores mind. Exhaustion of the heart and kidney-yang with inter nal exuberance of yin cold leads to mental fatigue, chill, lying crookedly, and cold limbs ; Deficiency of yang-qi and failing to drive blood eireolatiomi are responsible for pale complexion and faint pulse; Exhaustion of the kidney-yang and failing to warm the spleen hring about lienteric diarrhea, in this case, it shoold be treated by
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restoring yoog to reseoe collapse. The main herbs are prepared aconite lateral root, dry ginger and cinnamon bark for warming yang to dispel cold with their cx tremely pungent flsvors and hot nature. If exhaostion of the kidney-yang is accompanied with failore of the kidney in receiving qi and phlegm exuberance in chest, sulphur and black tin can be used as the main herbs Eu werni the kidney for receiving qi. Fnr the sudden collapse of yang-qi marked by cold limbs with sweating, faint pulse, ginseng can be combined to tonify the primnrdial qi for restore pulse. For the deficiency of the kidney-yang failing ta evaporate water so as to cause internal retentinn of water evil, poria and bighead atractylodes rhizome can be combined to warm yang for excreting water. For syndrome of exuberant yin repelling yang due to yin exuberance and yang deficiency manifested by faint pulse, hectic cheek, restlessness, fever, retching, etc. ,pig’s bile can he added tn the yang restoring formulae to nourish yin and to eunduer the deficient yang back to the interior. The representative fnrmulae are Cold Limbs Decoction, Divine Black Bird Deenetion, etc.
Cold Limbs Decoetion
sl in tang
SOURCE: Treatise an Cold Attack
INGREDiENTS:
Prepared aennite lateral runt 5 —‘lOg
Dry ginger 6-’—’9g
Rnasted licorice 6g
DIRECTIONS: Deeoct the above herbs in water for oral administration.
EFFECT: Restoring yang to rescue collapse.
INDICATIONS:
(1) Shanying diseases with symptoms of cold limbs, chill, lying crookedly, vnmiting without thirst, abdominal pain and diarrhea, mental fatigue and drnwsi ness,whita and greasy coating, feeble and thread pulse.
(2) Depletion of yang due tu errunaaus use of purgative to Taiyang diseases.
ANALYSIS OF FORMULA This is a representative formula fur restoring yang to rescue collapse. Being extremely pungent flavor and hot nature, prepared acanite lateral rout as the main herb warms and restores the kidney-yang to rescue collapse. As the assistant herb, dry ginger warms up the spleen-yang and helps prepared acanite lateral root strengthen the kidney-yang. As the adjuvant and dispatcher herb, licorice promotes transfnrmatinn of yang by combination with pro
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pared aconite lateral root and dry ginger and buffers the extremely hot nature of prepared aconite lateral rout and dry ginger tu prevont injury or yin.
ASSOCIATED FORMULAE:
(1) Ginseng plus Cold Limbs DecoctionG/ ni jio ceo s/ten tong) , (Treatise on Cold-Attack):
Add 3 gram of ginseng on the basis of Cold Limbs Decoction. Thc directions are the same as that of Cold Limbs Decoction.
Effects:Restoring yang and reinforcing qi to rescue collapse and consolidate prostration.
Indications: Cold limbs, chill, lying crookedly, feeble pulsc and diarrhea. The above symptoms aften exist diarrhea is stopped.
(2) Poria Cold Limbs Decoction(fd lIng sI of taug), (Treatise on Cold-Attack)
Add 18 gram of poria and 3 grani of ginseng on the basis of Cold Limbs Dccoction. The directions are the same as that of Cold Limbs Decoction.
Indications: Cold attack after diaphoresis remaining of illness and restlessness.
(3) Spring Onion Decoction(btii tong tang) ,(Treatise an Cold-Attack):
Chinese onion stalk 9g, dry ginger 3 5g, prepared aconite lateral runt 5 l0g.
Decoct the above herbs in water fur oral use.
Effects: activating yang to break yin.
Indications: Shaoyin diseases with diarrhea and feeble pulse.
(4) Pig’s Bile plus Spring Onion Decoction(bdi tong jia zhu dOn vhs tang) (Treatise on Cold-Attack)
Add 20 ml of pig’s bile and 50 nil of human urine to Spring Onion Decoction. The above three herbs should be decocted id water for oral use after naxing with pig’s bile and human urine.
Effects: Breaking yin to restore yang fur connecting the superiority and infe riority.
Indications: Shaoyin diseases with symptoms of unceasing diarrhea even after application of Spring Onion Decoction with cold limbs, retching, vexation and feeble pulse.
NOTES: All the above four formulae are modified frum Cold Limbs Decocdon. Ginseng plus Cold Limbs Decoction is indicated to the syndromes as indica142
tcd by Cold Limbs Decoctioo but complicated by exhaustion of yin-fluid. In this case ginseng is added to restore yin, yang and qi in order to promote generation of body fluid. Poria cold Limbs Decoction is indicated to injury of both yin and yang marked by restlessness after diaphoresis and purgation. In this case poria and ginseng are combined to nourish yin on the basis of restoring yang by Cold Limbs Decoction. Chinese Onion Decoction is applied to syndromes due to yin cold in the lower part with exhaustion of yang-qi, so licorice is removed from Cold Limbs Dccoction and Chinese onion stalk is added to activate yang for dispelhng cold evil. If the exoberant yin expelling yang exteriorly manifested by hectic cheek, retching and vexation, Pig’s Bile plus Chinese Onion Decoction could be applied. Herbs with bitter flavors and cold nature arc used in yang-warming formulae as the counter adjuvant to prevent cold evil rejecting the hot-natured herbs.
Ginseng and Aconits Decoction
then (dog
SOURCE: Key to Classification of Traumatism
INGREDIENTS:
Ginseng 9g
Prepared aconite lateral root fig
DIRECTIONS: Decoct the above two herbs in water for oral administration.
EFFECTS: Restoring yang to consolidate prostration.
INDICATIONS: Sudden collapse of yang qi manifested by cold limhs, faioting with shortness of hresth, sweating, feeble pulse.
ANALYSIS OF FORMULA: This is a representative formula for restoring yang to consolidate prostration. Ginseng is the main herb to reinforce the primor dial qi as well as the spleen and lang-qi. Being extremely pungent flavor and hot nature, prepared aconite lateral root as the assistant herb warms and tonifies the primordial yang as well as activating all the twelve regular meridians. The combination of ginseng and prepared aconite lateral root can srrengthen the heart-yang, reinforce the lang and spleen-qi, invigorate the kidney-yang so as to tonify yang and qi simultaneousl in critical cases.
ASSOCIATED FORMULAE:
(1) Astragalus and Aconite Decoetionfql fd tang) , (Wei’s Formulae Hand ad Down by Family):
Prepared aconite lateral root, astragalus root.
The above two herbs should be decocted in water for oral administration.
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Effects:Reinfurcing qi and strengthening yang to consolidate the exterior.
Indications: Spontaneous sweating due to yang deficiency.
(2) Atractylodes and Aconite Deeoetion(zhd ffc tang) , (The Golden Mirror of Medicine)
Prepared aeonite lateral root, bighead atractylodes rhizome.
The above two herbs shoold be deeoeted in water for oral administration.
Effects: Warming the spleen yang to dispel cold and to dry dampness.
Indications: Pain of limbs and body doe to attack of cold dampness.
Divine Black Bird Decoction
zhen wii tang
SOURCE: Treatise on Cold-Attack
INGREDIENTS:
Poria 9g
White peony root 9g
Bighead atractylndes rhizome 6g
Fresh ginger 9g
Prepared aconite lateral root 9g
DIRECTIONS: Decoct the above herbs in water for oral administration.
EFFECTS: Warming yang to excrete water.
INDICATIONS:
(1) Deficiency of the spleen and kidney yang with internal retention of water evil manifested by disoria, heaviness and, pain of limbs, ahdomioal pain with diarrhea, or edema, absence of thirst, white coating, deep pulse.
(2) After inducing perspiration by diaphoretie therapy to Taiyang diseases, there are still fever, epigastric palpitation, vertigo, muscular twitching with body shivering.
ANALYSIS OF FORMULA: This is a representative formula for warming yang to excrete water. Being extreniely pongent flavor and hot nature, prepared aeonite lateral met is the main herb to warm the kidney yang for activating the transformative function of qi. As the assistant herbs, bighead atractylodes rhizome is to dry dampness and strengthen the spleen; poria to disperse dampness; fresh ginger to diserse the lung and warm the middle. All the three herbs can help prepared aconite lateral root warm yang to excrete water. White peony root as the ad juvant and dispatcher herb astringes yin to prevent injury of yin doe to facilitating diurisis.
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in the present clinic, this formula is used for nephrogenic edema, cardiac ede me, edema due to chrome hepatitis, hypothyroidism and prostatic hyperplasia per— teining to deficiency of the spleen and kidney-yang.
ASSOCIATED FORMULA:
Aeonite Deeoetion (fzi zi tang) , (Treatise an Culd-Attack)
Prepared aeonite lateral root 15g, poria 9g, ginseng 6g, bighead atraetylodes rhizome 12g,white peony root 9g.
The above herh should he deeoeted in water far ural administration.
Effects: Strengthening yang to warm meridians, expelling cold and resolving dampness.
Indications: Yang deficiency with cold-dampness invading the interior marked by painful body and joints, chill with cold limbs, deep and faint pulse.
NO’I’ES: There is only one different herb between Aconita Daeoetion and Divine Black Bird deeoetion. In Aeonite’Deeoetion, ginseng is used to warm and rein force yang for dispelling cold danipness by combination with prepared aconite mt eral root and bighead atraetylodes rhizome, so it is applied to painful body and joints due to cold dampness invading the interior; While in Divine Black Bird Beeuetion, fresh ginger is used to warm yang for excreting water, So it is indicated to syndrome of yang deficiency with water retention.
Section 3 Formulae for Warming Meridians to Expel Cold
Formulae for warming meridians to expel cold are indicated to painful blockage syndromes of yin gangrene due to cold coagulating in meridians. On the basis of deficiency of yaog-qi and nutrient blood, cold attacking on meridians with hampered blood flow leads to cold limbs and painful body. Cold evil invading the inta nor with phlegm coagulating in moseles, tendons, hones sod blood vessels briogs about yin gangrene. So it can be treated by therapies of dispersing with pungent- warm herbs, nourishing blood and activating vessels. Herb used as the main com ponents are Chinese angaliea root, prepared rehmannia root, antler gelatin for warming and reinforcing the nutrient-blood and cinnamon bark, baked ginger, eassia twig, epliedra for warming meridians to expel cold.
For the exuberance of yin-cold, it can be combined with prepared aeonite lat eral root, evodia fruit and asarom herb to warm yang and activate vessels for dis pelling cold and relieving pain. Fur the qi deficiency, pilose asiaheli root and astragalus root can be combined to reinforce the middle-qi. The representative for
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mulae are Chinese Angelica Cold Limbs Decoetion and Yang-Harmonizing Decoction.
Chinese Angelica Cold Limbs Decoction
dang gui si nI tang
SOURCE: Treatisc on cold Attack
INGREDIENTS:
Chinese angelica rool 1 2g
Cassia Twig 9g
White peony root 9g
Asarum herb L 5g
Rieepaper pith 3g
Chinese date 8 pes.
DIRECTIONS: Deeoet the above herbs in water for oral administration,
EFFECTS: Warming meridians to expel cold, nourishing blood and activating vessels.
INDICATIONS:
(1) Deficiency of yang qi and blood with exogenous attack of cold-evil mani fested by cold limbs, pale tongue with white coating, thread pulse or deep thread pulse.
(2) Cold invading meridians manifested by pain of waist,thigh, leg and foot. ANALYSIS OF FORMULA: This formula is chiefly for the “root” of blood
deficiency. Being sweet flavor and warm nature, Chinese angelica root as the main herb nourishes and activates blood. As the assistant herbs, caaaia twig and white peony root can activate yang-qi and nourish yin-qi to harmonize the nutrient and dcfenaivc qi. As the adjiivant herbs asarum herb is to dispel cold for relieving pain; ricepaper pith to activate blood vessels. Chinese date and licorice as the dispatcher herbs reinforce the spleen and stomach as well as harmonizing all the components.
In the present clinic, this formula is used fur thrumboangitis obliterans per taming to blood deficiency with cold in meridians.
There are three formulae named by “cold limbs”, i. e. Cold Limbs Powder, Cold Limbs Decoctian and Chinese Angelica Cold Limbs Dccoction. Though they are all named by “cold limbs” ,their effects, components and indications are different. It should be careful to distinguish them in clinical application.
ASSOCIATED FORMULA:
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Five Herbs Decoction Including Astragalus and Cassia Twig (hudng qi gui zhz mu wd tang,) (Synopsis of the Golden Chamber)
Astragalus root 12g, white peony root 9g, cassia twig 9g, fresh ginger 18g, Chioese date 4 pcs.
The above herbs should be decucted in water for oral administration.
Effects: Reinforcing qi and warming meridians to treat blockage syndrome.
Indications: Blood blockage syndrome marked by numbness of body, feeble, oneven and tight pulse.
NOTES: This formula is composed of Cassia Twig Deeoetion by removing lie once and adding astragalus root with double dosoge of fresh ginger. It is a com mon formula for blood blockage syndrome marked by obstinate numbness without pain. The emphasis is laid do reinforcing qi and activating yang, while Chinese An geliea Cold Limbs Deeoetion stresses on nourishing blood and activating vessels.
Yang-harmonizing Decoction
yang he tang
SOUREC : Surgery Life Saving Collection
INGREDIENTS:
Prepared rebmannia root 30g
Cinnamon bark 3g
Ephedra 2g
Antler gelatin 9g
White mustard seed 6g
Baked ginger 2g
Licorice 3
DIRECTIONS: Decoct the above herbs in water with rice wine for oral adnuoistration.
EFFECTS: Warming yang and nourish blood, dispelling cold and clearing stasis.
INDICATIONS: Yin gangrene due to yang dificiency with cold coagulation such as bone necrosis, gangrene of finger or toe, multiple abscess, subcutaneous nodule, and arthroncus of knee. The general clinical features are swelling without apparent boundary, aching pain without hot, normal skin color, absence of thirst, pale tongue with white coating,deep thread pulse.
ANALYSIS OF FORMULA: This is a well-known formula for yin gangrene in surgery. Prepared rehrnannia root as the main herb warm and tonifies the liver
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and kidney as well as naurishing yin and blood. Antler gelatin is the assistant herb to tonify kidney and replenish essence as well as streogtheing tendons and bones. As the ad] avant herhs, ephedra is to disperse and activate yang—qi; white mustard seed to expel phlegm and dampness. The combination of these two herbs can pro mote flow of qi and blood so as to prevent from stagnation clue to the reinfarcement of prepared rehmannia and antler gelatin. Baked ginger and cinnamon hark can effect on the blood phase to warm meridians and to etcpel cold. Licorice is the dispatcher herb to clear away heat and poisoo as well to harmonize all the components.
In the present clinic, this formula is used for bone tuberculosis, peritoneal tu bereulosis, periostitis, chronic medulitis, throroboangitis ohliterans, rheumatoid ar— thritis and deep abscess of muscle pertaining to yin gangrene due to blood deficiency with cold coagulation.
In Snmmary
There are totally 10 formulae in common use for warming the interior. According to their different effects, they are divided into formulae for warming the middle to dispel cold, formolae for restoring yang to rescue collapse, and formulae for warrrung meridians to expel cold.
1 Formulae for warming the middle to dispel cold
This category of formolae is mainly for syndromes of deficient cold of the noddle jioo. Taking dry ginger as the main herb to warm the middle and to expel cold and by combination with ginseng and bigheas atractylodes rhizome to rein force the spleen qi, Middle Regolating Pills is the representative formula for deficient cold of the middie-jioo. Though Evodia Decoction can be used for the deficient cold syndromes of Yangming, Joeyin and Shaoyin Meridians, the key is the liver cold invading the stomach marked by vomiting, so evodia fruit is taken as the main herb and large dosage of fresh ginger is used. Minor Middle Strengthening Decoetion is composed of Cassia Twig Decoction plus malt sogar with doable dos age of white peony root. As the main herb, melt sager can combine with cassia twig to produce yang through the combination of pungent and sweet flavors and also can combine with white peony root to prodoce yin through the combination of sour cad sweet flavors. So this formula enrphaszes an assisting the transformative source, harmonizing the nutrient and defensive qi, warming the middle yang, and nourishing yin blood. It is the represena0ve forrnala far warming the middle and tonifying deficiency to harmonize the interior and relieve spasm. Major Middle148

Strengthening Decoction has more powerful effects on warming end reinforcing than those of Minor Middle Strengthening Decoctinn heeaose of using malt sugar combining with prieklyash peel and dry ginger to warm yang and to expel cold for lowcring rebellion and relieving pain, so it is applied to syndrome doe to yang defi ciency with yin exuberance. Magnolia Middle-Warming Decoction is mainly for syndrome doe to cold—dampness encumbering the middle with qi stagnation, and it is composed of herbs with pungent flavor, warm natore and aromatic property to dry dampness and activate qi so as to strengthen the spleen and relieve (listentinri and pain.
2. Formulae for restoring yang to rescued collapse
This category of formulae is applied to exhaostion of the heart and kidney- yang with internal exuberance of yin-cold. Cold Limbs Deeoction is the chief for mole for restoring yang to rescue collapse, in which, there is not only prepared aeonite lateral root to warm and restore the kidney yang, hat also dry ginger to warm and strengthen the spleen-yang, so that it is indicated to critical eaese doe to internal exuberance of yin-cold tendency of yang depletion. Ginseng and Aconite Decoction emphasizes on both warming yang and reinforcing qi, so it is usually applied to syndrome due to sodden collapse of yang qi. Divine Black Bird l)ecoetioo is a formula for warming yang to excrete water through combination of prepared aconite lateral root and bighead atrsetylodes rhizome. To this formula, fresh ginger is to disperse water anrj cold; white peony root to prevent from injury of yin.
3. Formulae for warming meridians to expel cold
‘Ihis category of formulae is mainly for syndromes of yang deficiency and blood insufficiency with cold in meridians. Chinese Aogeliea Cold Limbs Deeoetioo is composed of Cassia Twig Deeoetion by removing fresh ginger and adding Chinese angelica root, rieepaper pith and asarum herb with doable dosage of Chinese date. It is the representative formula for warming yang and nourishing blood to expel cold and to activate vessels. Yang Harmonizing Decoction is the representa tive formula for yin gangrene, and its main purpose is to replenish essence and to noorish blood for strengthening tendons and hones. In this formula, epheclra is to disperse and activate yang qi while white mustard seed to dissolve phlegm and coagulation so as to prevent from too greasiness of prepared rehmnanmns root and antler gelatin.

 



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