Introduction to

Chinese Herbology

 

    Created by

    Bob Damone, M.S., L.Ac. and

    Todd Luger, B.S., M.Ac.O.M., L.Ac.

    

     Syllabus, Instructions and other Course Links

TABLE OF CONTENTS:

Acknowledgements Release Exterior Downward Draining Calm the Spirit, Nourish Heart
History Herbs that Clear Heat Transform Phlegm Heavy Settling Agents
Drain Fire
Introduction Cool Blood Relieve Cough and Wheezing Calm the Liver and Extinguish Wind
Herb Properties Dry Dampness Stop Bleeding Open the Orifices
Functions Heat Toxin Move Blood Expel Parasites
Pao Zhi Deficiency Heat Warm the Interior MAJOR TEXTS
Vacuity Patterns
Contraindications

Drain Dampness

Supplement Qi

Nei Jing

Form and Dosage Aromatic Transform Dampness Supplement Yang Shang Han Lun
Herb Combining Dispel Wind Damp Supplement Blood Shen Nong Ben Cao Jing
Formula Composition Regulate Qi Nourish Yin Ben Cao Gang Mu
Formula Modification Relieve Food Stagnation Stabilize and Bind  



Acknowledgements

 

    The contents of this reader are primarily derived from both the required and recommended resources listed on the syallbus. The Online Reader has many hot links to other Internet based resources. The reader also has audio files of Chinese herb names.  To hear the sound with a file, just click on any linked pinyin.  To see photos, click on the linked chinese characters.  Syllabi, study questions and other materials for PCOM Herbs 1 can be found on the school's secure server.

    The primary sources for the reader and linked resources are listed below.

    Chinese Herbal Medicine: Materia Medica, Bensky, Clavey and Stoger, Eastland Press, 2004. (BC)

    Fundamentals of Chinese Medicine, Wiseman and Ellis, Paradigm Publications.Brookline: 1995. (WE)

    Flow Charts - All flow charts and diagrams were produced by Bob Damone

    Chinese Herbal Medicine: Formulas and Strategies, Bensky and Barolet, Eastland Press, 1990.

    Dui Yao, Sionneau, Blue Poppy Press, 1997

    Pao Zhi, Flaws, Blue Poppy Press, 1995

    A Practical Dictionary of Chinese Medicine, Wiseman and Ye, Paradigm Publications, 1998

    The Illustrated Chinese Materia Medica, Yen, Taipei, 1992

    Wenlin Software for Learning Chinese - source for reader sounds

    Traditional Chinese Herbal Science CD-ROM by Roger Wicke

    Herb photographs are provided via links to Traditional Chinese Medicine and Acupuncture Health Information Organization

    All web authoring was done by Todd Luger

 

History of Chinese Herbal Medicine

    

Chinese medicine has its historical roots in three different traditions

        Demonology-     

            Disease caused by evil spirits

            Treatment lies in influencing spirit world through incantations, spells, preparation of charms, dances, etc.

        Magic Correspondence

            Disease caused by magical relationships among phenomena

            Treatment lies in using these magical relationships to one’s own advantage

                     Ex: use a venomous animal’s natural enemy to counter its poison

        Systematic Correspondence

            Disease caused by unhealthy relationship with nature

            Treatment lies in establishing balance with nature

            Yin/yang and five phases

    

Major texts and their contributions

         Formulas for Fifty-two Diseases ( Wu Shi Er Bing Fang, 2 nd century B.C.E. )

            Pharmacy text unearthed at Ma Wang Dui in 1973

            The text itself dates from before the second century B.C.E

            Clearly reflects the influence of demonology and magic correspondence on early Chinese medicine

            

         Yellow Emperor's Canon of Internal Medicine( Huang Di Nei Jing, Later Han 25- 220 C.E.)

            Based on naturalistic observation rather than shamanism or magic

            Medicine based on natural rules and relationships of nature

            The spirit world was stressed less and the readily seen, observed, and understood world stressed more.

            Philosophy of Chinese medicine laid down

            Only 12 prescriptions and 28 individual medicinals mentioned; not a major work specific to the field of Herbology

             However, prescriptions mentioned are based on organization of tastes, mentioned in chapter 22 of the Su Wen

MORE RESOURCES

 

Shen Nong's Classic of the Materia Medica  (Shen Nong Ben Cao Jing, Later Han Dynasty, 100 C.E.)

         Legendary author- Shen Nong introduced agriculture, animal husbandry, tasted "the hundred herbs.” He is the legendary patron of herbal medicine

        Edited and reconstructed from several editions by Tao Hong Jing 452-536 CE), somewhere between 492 and 500 CE.

         Divides herbs into three basic categories, 364 medicinals in total, about 1/2 of which were mentioned in Wu Shi Er Bing Fang

                a. Superior- nourishes life, correspond to heaven, nontoxic

                b. Neutral- cultivates personality or modifies temperament, may be toxic, may be used to treat disease        

                c. Inferior– specifically treat disease or severe symptoms short term, usually somewhat toxic

        Mentions taste and temperature for each herb and carefully notes toxicity (Du), and medicinal effects.

        Medicinals act because they have certain properties that can be perceived with the normal senses not because they have a particular magical component or spiritual power. Clearly a more rational approach overall. However, about 15%  were used for chasing away demons.



     Shang Han Lun and the Jin Gui Yao Lue (On Cold Damage and The Classic of Prescriptions from the Golden Chamber, 200 B.C.E.-200 C.E.)

        Most celebrated classics of medicinal prescriptions (103 formulas in Shang Han Lun ), authored by Zhang Zhong Jing later edited by Wang Shu He

        Introduced the six channel pattern identification for the diagnosis and treatment of diseases caused by exterior wind and cold

        Zhang identified the diagnosis with an herbal formula, i.e., Gui Zhi Tang Pattern

        Major source of prescriptions. 20% of the prescriptions in Bensky text are from these texts

       Period of great development of the Ben Cao Tradition ensued

     The Grand Materia Medica ( Ben Cao Gang Mu , 17 th century C.E.)

        The life work of Li Shi Zhen

        Vast work in many volumes

        Collected information from all over the empire

     The Great Dictionary of Chinese Medicinals ( Zhong Yao Da Ci Dian, 1977)

        Contains entries for 5,767 medicinal substances

[table of contents]



Introduction to Chinese Medicinals



Nomenclature

         

Pinyin

Latin pharmaceutical - plant parts

 

     The Four Temperatures 四气

        Hot, Cold, Warm, Cool, Neutral qualifications used include slightly cold and slightly warm

        Vary somewhat from text

        Opposite temperature is used to treat disease

The Five Tastes   五味

     Acrid - scatters, moves Qi and blood, break up accumulations, upbears (Yang). Used for exterior disorders and obstruction of qi and blood

     Sweet- supplements and augments or boosts, harmonizes the middle, relieves pain and spasms, generates fluids. Used for various vacuity conditions

     Sour- astringes, prevents loss of qi and fluids, secures astriction, and stops perspiration. Used for Vacuity perspiration, vacuity diarrhea

     Bitter - draining, drying, opens channels, descends, harmonizing. Used for bound stool due to binding of heat. Damp conditions

     Salty- softens accumulations, purges, and laxative, descends

     * Astringent - similar usage to the sour flavor stores or retains Essence, stops diarrhea, stops hemorrhage

     * Aromatic- disencumbers the spleen and transforms dampness, opens the orifices (not really a taste?)

     * Bland- disinhibits Dampness, percolates dampness, fluids. Used for edema, inhibited urination

    It is important to note that the four temperatures and the five tastes must be integrated in practice; they do not stand alone.

    Examples

        bitter and cold medicinals

            bitter and warm medicinals

            bitter and acrid medicinals

    Medicinals with the combined qi and tastes of sweet and cold and sweet and warm are used for different purposes.

 

Upbearing, Downbearing, Floating, and Sinking 升降浮沉

     Sheng - upbearing (ascends), often are acrid, sweet, warm, and hot; ex: raise yang

     Jiang - downbearing (descends), often are sour, bitter, salty, cold, and cool; ex: laxative, sedative

     Fu - floats; ex: resolves the exterior (overlaps with upbearing)

     Chen - sinks, drains and disinhibits, ex: diuretic  (overlaps with downbearing)

 

 Examples

    For vomiting and coughing, dyspnea, etc. we don't use floating medicinals but sinking ones

    For diarrhea, flooding and leaking, center qi fall avoid downbearing too heavily

    For resting perspiration and thief perspiration avoid floating medicinals

    For unresolved exterior diseases avoid sinking

          Note : One medicinal may be both upbearing and downbearing

 

Staying and Moving

    The effects of some medicinals are more static and less dynamic; they remain or “stay” in one region

        Examples: Gan Jiang (Zingiberis Radix) and Rou Gui (Cinnamomi Cortex)

    The effects of other medicinals are more dynamic and active; they “move” through different regions or activate movement of qi and/or blood and fluids, etc.

        Examples: Sheng Jiang (Zingiberis Rhizoma recens), Gui Zhi (Cinnamomi Ramulus)

 

Entering channels

        First applied around 1100 CE

        Further refined to describe substances able to guide other herbs to particular organs and regions of the body

    Refers to either the organ function or the course of the channel

    Represents a link between the herbal tradition and the acumoxa tradition

 

[table of contents]

Functions and Categories

        Developed out of combining a medicinal's qi and taste and empirical clinical experience with TCM theory

    Our focus is mostly in this area.

        Functions: actions

        Indications: symptoms/signs

        Pattern explained by pathomechanisms, etiology

        Treatment principles derived from patterns

        Herb categories correlated with treatment principles

   

 Ten major groups with basic qualities (8 classic plus settle and secure)

            sweating

            emesis

            purgation

            harmonization

            clearing/cooling

            warming

            supplementing

            reducing/draining

            settling

            securing

 

[table of contents]

 

Pao Zhi 炮制

 

        Pao Zhi is a general term for defining a group of methods of preparing the medicinals in the Materia Medica.  There are two general terms used in Chinese:

         a.) Sheng (生) - uncooked, but not crude or fresh. May involve special preparation methods that do not involve cooking or heating

         b.) Shu (熟) - involves cooking or heating

        Objectives of Pao Zhi methods (For specific examples see Sionneau, pp.8-9)

        a.) Lessening toxicity

        b.) Modifying the energetic properties (Qi, flavor, action)

        c.) Reinforcing therapeutic effects

        d.) Modifying the tropism

        e.) Dissipating disagreeable odors or flavors

        f.) Facilitating storage, pharmaceutical production, and assimilation

        g.) Washing and eliminating foreign, non-medicinal substances

 

 

Specific Pao Zhi methods and their purposes

 

    1) Mechanical methods- cutting, slicing, scraping, sifting, pulverizing, defatting

    2) Using water- rinsing and washing, moistening, soaking, Aqueous Triturating

    3) Using fire- cooking, steaming, baking, steaming, roasting, charring, etc.

 

Pao Zhi Methods Using Fire

 

    1) Chao - Stir - Frying-

        A) Reinforce inherent actions, lessen toxicity, awakens the spleen

        B) With or without dry adjutants- bran, rice, etc.

    2) Zhi - mix-frying with liquid adjuvants

        A) Honey- moistening, supplementing

        B) Wine- clear channels, wind, pain, upbearing

        C) Vinegar- quickens blood, astringes

        D) Ginger juice- reduces counterflow-producing tendencies in stomach, floats and disperses

    3) Duan- calcining or high temperature baking

        A) Makes it brittle and easier to pulverize, reduces acidity,

        B) Enhances astringent action

    4) Pao

          A) High temperature frying until dark brown can stop bleeding, toxicity, and moderates harshness

 

Pao Zhi Methods Using both water and fire

    

Steaming, Zheng- modifies nature or property, lessens toxicity,

  Scalding (Dan Fa)- eliminates non-medicinal parts, facilitates storage and drying

 

[table of contents]

 

Contraindications of Medicinals

 

    According to Traditional Theory and Experience

         Pregnancy

        Qi and taste runs counter to therapeutic goals

        Qi and taste may damage the correct

    Drug/Herb interactions - basic ideas

        a)  don't take any herbs and drugs at the same time

        b)  don't combine herbs and drugs with similar effects

        c)  keep abreast of documented drug/herb interactions via Medline, etc.

    Toxicity – Aristolochic Acid, ban xia, fu zi

 

[table of contents]



Typical Forms of Administration

 

    Tang

            a. The most common method today

            b. Readily absorbed

            c. Most appropriate to acute disorders

            d. Most easily tailored to individual

            e. No aluminum, non-metal best, or coated

            f. Mention variations on this in modern times as in powder extracts DOWNLOAD MOVIE

            g. Mention issues with extractable components - re: pharmacognosy

            h. Discuss drafts (Zhu san) as alternative (see san)

            i.  Cooking times for light and heavy herbs

     San

            a.  Between tang and wan in terms of strength

            b. Watch dosage in formula text

     Wan

            a.  Preparation

            b. Mild in terms of action and speed of effect, for long-term use usually

            c. Nowadays concentrates are used which change things somewhat

     Jiu

            a. Steeped in wine, maybe with heat

            b. Usually for wind-dampness, vacuity conditions, cold

            c. Tinctures and issues in herb preparation and delivery     methods.

 

 

Dosage

 

    Textbook range - daily decoction, if not otherwise indicated

        For our purposes:

             Low dosage range: 1-5 grams

            Medium dosage range: 6-15 grams

            High dosage range: 15- 30 grams or more

        

    Traditional formularies may list dosages appropriate for pills or powders

        Must make adjustments for decoction

        

    Modern products, pharmacology, active ingredients, comparative analysis, unanswered questions

[table of contents]



Principles of Herb Combining; Polypharmaceutics; Traditional Synergistics

 

    Chinese herbs mostly used in combination

    There are several methods of combining herbs to produce a desired clinical result.

    These methods of combination were laid out in the Shen Nong Ben Cao Jin:.

 

     1.   Mutual Accentuation (xiang xu 相须 ) two or more herbs with similar functions may be used together to achieve a single therapeutic goal, (i.e. Da Huang & Mang Xiao)

     2. Mutual Enhancement (xiang shi 相使 ) Two or more herbs with different functions may be combined to reach a therapeutic goal, (i.e. Huang Qi & Fu Ling, Huang Qin & Da Huang)

     3. Mutual Counteraction- (xiang wei 相畏 ) Reduction of toxicity or side effects of one herb by another; emphasis is on the toxic substance i.e. Sheng Ban Xia is counteracted by Sheng Jiang

     4. Mutual Suppression- (xiang sha 相杀 ) reverse of mutual counteraction. One substance reduces the undesirable side effects of another, but the emphasis is on the substance that performs the action. For example Sheng Jiang suppresses the toxicity of Ban Xia

     5. Mutual Antagonism- (xiang e 相恶 ) Two substances may minimize or reduce each other's original therapeutic effects  

     6. Mutual Incompatibility- (xiang fan 相反 ) Two substances which, when used together causes side effects produced by neither alone

     7.   Single Effect- (dan xing) Use of a single medicinal substance to treat a patient (i.e. use of Ginseng as a single treating Collapse of Qi

 

 

Formula Composition; hierarchy of ingredients

  

  1) Chief

        Principal ingredients directed towards the primary disease and or s/s being addressed by the formula.  Formula often named after it

        Examples: Gui Zhi in Gui Zhi Tang, Ma Huang in Ma Huang Tang, Zhi Gan Cao in Zhi Gan Cao Tang, Cang Er Zi and Xin Yi Hua in Cang Er Zi San, Shi Gao in Bai Hu Tang

   2) Deputy

        1) Aids the chief

        2) Directed towards coexisting pattern, disease or s/s

         Examples :  Gui Zhi and Xing Ren in Ma Huang Tang, Zhi Mu in Bai Hu Tang,  

   3) Assistant

        1) Aids the chief and deputy in treating the primary pattern or disease

        2) Moderates or eliminates harmful effects of chief or deputy, e.g. Chai Hu and Bai Shao used together

        3) Has effect opposite to the chief ingredient for mixed picture diseases, e.g. Huang Lian and Gan Jiang in Ban Xia Xie Xin Tang, Zuo Jin Wan

   4) Envoy  (AKA messenger, guide, courier)

        1) Focuses the action of the formula on a given channel or area of the body

        2) Harmonizes and integrates the actions of the other ingredients

[table of contents]

 

 

Formula Modification

 

    Very Common

    Example:  Gui Zhi Jia Hou Po Xing Zi Tang

    Taking the formula Gui Zhi Tang and adding the herbs Fang Feng and Xin Yi Hua for nasal congestion, or adding Qiang Huo and Fang Feng to the formula Bu Zhong Yi Qi Tang for wind damp in the upper body combined with spleen qi deficiency and sinking of qi

    Can also subtract an ingredient, as in Yue Ju Wan where you can remove Zhi Zi if the patient lacks heat s/s and has cold s/s

    Can be loosely based on a traditional formula, using the classical formula as a template and branching off.

    Add an ingredient to base formula and get a completely different action: Yi Tang in Gui Zhi Tang focuses formula internally

 

[table of contents]

 

 

 

Release Exterior Medicinals

 

Flavors: Acrid
Temp: Cool or warm
Channels: Lung

 

 

Introduction to Release Exterior Medicinals

    

Define Externally Contracted Diseases

        Wind Cold- Six Channel Pattern Identification

             六经辨证 ( liu4 jing1 bian4 zheng4 )

Taiyang Stage

             Cold damage: Ephedra Decoction ( 麻黄汤 ma2 huang2 tang1 )

             Wind strike: Cinnamon Twig Decoction ( 桂枝汤 gui4 zhi1 tang1 )

        Wind Heat- Four Aspects

             Defense ( wei4 ) : Lonicera and Forsythia Powder ( 银翘散 yin2 qiao4 san3 )

             Qi ( qi4 )

             Construction ( ying2 )

             Blood ( xue4 )

    Signs and Symptoms

    Basic Pathomechanisms

    Treatment Principles and Formulas

 

 

 

麻黄 ma2 huang2, Ephedrae Herba

(photo)

    

   Induces sweating and releases the exterior - colds

   Disseminates and facilitates lung qi, calms wheezing, stops coughing - asthma

   Promotes urination and reduces edema (due to exterior invasion)

   Warms and disperses cold (wind cold damp) pathogens - bi syndrome

   Cautions and contraindications - hypertension, sweating, vacuity

    Dosage - low to medium

(IET) Impaired depurative downbearing of the lung: A pathomechanism
that involves a disturbance of the lung's functions of governing
depurative downbearing and regulation of the waterways. The
lung governs the qi of the whole body. If, for any reason, lung qi is
inhibited, there may be signs such as cough, nasal congestion, and qi
counterflow; if the movement and distribution of water is affected, there
may be signs such as inhibited urination, puffy swelling, and panting
and cough.

 

 

桂枝 gui4 zhi1, Cinnamomi Ramulus

(photo)

 

    Releases the exterior and assists the yang - wind cold

    Warms and unblocks channels and collaterals - bi syndrome

    Warms yang and transforms thin mucus - edema due to yang vacuity

    Assists heart yang and unblocks yang qi of the chest - chest pain

    Warms the channels, vessels and collaterals - menstrual pain

    Cautions and contraindications - dryness, heat

    Dosage - low to medium

 

Formula for Cold Damage

 

     Ephedra Decoction ( 麻黄汤 ma2 huang2 tang1 )

    ephedra ( 麻黄 ma2 huang2 , Ephedrae Herba)

    cinnamon twig ( 桂枝 gui4 zhi1 , Cinnamomi Ramulus)

    apricot kernel ( 杏仁 xing4 ren2 , Armeniacae Semen)

    mix-fried licorice ( 炙甘草 zhi4 gan1 cao3 , Glycyrrhizae Radix Preparatae)

 

 

Formula For Wind Strike

 

    Cinnamon Twig Decoction ( 桂枝汤 gui4 zhi1 tang1 )

     cinnamon twig ( 桂枝 gui4 zhi1 , Cinnamomi Ramulus)

     white peony ( 白芍药 bai2 shao2 yao4 , Paeoniae Radix Alba)

     fresh ginger ( 生姜 sheng1 jiang1 , Zingiberis Rhizoma Recens)

     jujube ( 大枣 da4 zao3 , Jujubae Fructus)

     mix-fried licorice ( 炙甘草 zhi4 gan1 cao3 , Glycyrrhizae Radix Prep)

 


薄荷 bo4 he2, Menthae Herb

(photo)

 

    Disperses wind heat, clears and benefits the head, eyes and throat

    Vents rashes - unexpressed measles

    Allows constrained liver qi to flow freely

    Cautions and contraindications - sweating, qi vacuity

    Dosage - low

 

柴胡 chai2 hu2, Bupleuri Radix

(photo)

 

   Resolves lesser yang disorders and reduces fever - alt chills and fever, ribside pain, nausea, wiry pulse  

    Spreads liver qi and relieves constraint - emotions, GI, menses 

    Raises the yang qi  

    Cautions and contraindications - liver fire or yang rising

    Dosage - low to medium

     Abstracts

[table of contents]

 

Medicinals that Clear Heat

 

Flavor: Bitter
Temperature: Cold
Channels: Many

 

 

Etiology of Heat

 

 

Four Aspects (Wei, Qi, Ying, Xue)

    Review Overall System Briefly

    Establish Basic Definition of Qi4 Aspect Heat

    

    Formula for Great Heat in the Qi4 Aspect (Not Required)

    

     White Tiger Decoction ( 白虎 bái hǔ tāng )

     gypsum ( 石膏 shí gāo , Gypsum Fibrosum)

     anemarrhena ( 知母 zhī mǔ , Anemarrhenae Rhizoma)

     non-glutinous rice ( 粳米 gēng mǐ , Oryzae Semen)

     mix-fried licorice ( 炙甘草 zhì gān cǎo , Glycyrrhizae Radix Prep)

 

Qi4 Aspect Heat

   Qi Aspect Heat

        Brief Historical Comments

        Pathomechanisms

         Symptoms and Signs: Four Greatnesses 四大 ( sì dà )

            heat (fever), thirst, pulse, sweating

       

 

 Medicinals that Clear Heat and Drain Fire

Flavor: Bitter
Temperature: Cold
Channels: Many

 

 

石膏 shi2 gao1, Gypsum Fibrosum

(photo)

    

Clears heat and drains fire - qi level heat

Clears heat from the lungs - cough, sputum

Clears blazing stomach fire

Topical use

Cautions/contraindications: cold vacuity  

Dosage:  high

 

 

知母 zhi1 mu3, Anemarrhenae Rhizoma

(photo)

 

    Clears heat and drains fire - qi level heat, lung and stomach heat

    Enriches yin and moistens dryness - heat effusion and nightsweats

    Generates fluids and clears heat - waste and thirsting disease (xiao ke) = late stage type 2 diabetes   

   C/C: cold vacuity;  

    Dosage:  medium

 

[table of contents]

 

Medicinals that Clear Heat and Cool the Blood

 

Flavor: Bitter
Temperature: cold
Channels: Liver, Heart, Kidney

 

 

Four Aspects (Wei, Qi, Ying, Xue)

    

    Review Overall System Briefly    

    Establish Basic Definition of Blood Aspect Heat

    Discuss Blood Aspect Heat as Serious Infectious Disease or Sepsis 

    Clinical significance for contemporary practitioner

 

Blood Aspect Heat

 

    Blood Aspect Heat

        Brief Historical References

        

        Pathomechanisms

        

        Symptoms and Signs

 

 

 

shui2 niu2 jiao3, Bubali Cornu

    

    Clears heat, relieves fire toxin, and cools the blood- heat causes blood to move frenetically

    Clears heat and arrests tremor- extreme heat engenders wind

    Cautions and Contraindications - cold vacuity

    Dosage - high

    

    The historical species is Endangered! DO NOT USE Use Xi Jiao (Rhinocerotis Cornu)

 

 

 

 

生地黄 sheng1 di4 huang2, Rehmanniae Radix

(photo)

    

    Clears heat and cools the blood- heat damages fluids, heat causes blood to move frenetically due to internal or external causes

    Nourishes yin and engenders fluids- fever, waste and thirsting

    Cautions and Contraindications - damp, phlegm

    Dosage- medium

 

[table of contents]

 

Medicinals that Clear Heat and Dry Dampness

 

Flavor: bitter
Temperature: cold
Channels: many, esp. yang

 

 

Damp Heat Signs and Symptoms

    

    Etiology

    

    General signs and symptoms

    

    Specific Zang Fu Patterns

    

    Pathomechanisms of Damp Heat Disease

    

    Treatment Principles

 

 

The Three Yellows 三黄    

     黄芩 huang2 qin2 , Scutellariae Radix

     黄连 huang2 lian2 , Coptidis Rhizoma

     黄柏 huang2 bai3 , Phellodendri Cortex

       Similarities and differences

    

    Areas of action

    

    Cautions and contraindications - spleen/stomach vacuity cold for all

 

 

黄芩 huang2 qin2, Scutellariae Radix

(photo)

    

    Clears heat and dries dampness - GI diseases

     Clears heat and resolves toxicity - lung infections, skin lesions

     Clears heat and stops bleeding - heat stirs blood

     Clears heat and calms the fetus - heat stirs fetus

     Sedates ascendant liver yang - heat causes yang to rise

    C/C: spleen vacuity cold

     Dosage: low to medium, abstracts

 

 

 

黄连 huang2 lian2, Coptidis Rhizoma

(photo)

    

    Clears heat and drains dampness - GI disease

    Drains fire and resolves fire toxicity - upper body spirit or mouth symptoms, also skin lesions    

    Clears heat and stops bleeding    

    Clears heat topically

    Dosage - low to medium

 

 

 

黄柏 huang2 bai3, Phellodendri Cortex

(photo)

 

    Drains damp heat - lower jiao    

    Drains kidney fire - vacuity fire    

    Drains fire and resolves fire toxicity - skin    

    Cautions/Contra - spleen vacuity    

    Dosage - low to medium

 

[table of contents]

 

 

Medicinals that Clear Heat and Toxin

 

Flavor: bitter
Temperature: cold
Channels: many

 

 

 

    Definition in TCM (Wiseman and Ye)

热毒 re4 du2 , heat toxin: 1. Any substance that is harmful to the body when eaten or when entering the body through a wound or through the skin, such as lacquer toxin or pitchtoxin. The toxin of animals is called venom. 2. Any virulent evil qi, e.g.,toxic qi, which denotes scourge epidemic qi; occasionally, a disease caused by this, e.g., seasonal toxin.)

 

Pestilential qi: Any disease evil that is highly contagious

    

    Pathomechanisms

        Depressed heat

        Heat toxin

        Blood stasis

        Swelling

        Rotting of the flesh

    

   S/S: Redness, swelling, pain, pus

 

(IET) Heat toxin in externally contracted heat (febrile) diseases, sores (yang patterns), cinnabar toxin, maculopapular eruption, pulmonary welling abscess, dysentery with blood and pus in the stool, and heat strangury with painful urination and reddish urine. Such patterns are characterized by scorching heat, heat effusion (fever), swelling and distention, pain,suppuration, and putrefaction.


Representative TCM Diseases: 

        yong1 : welling-abscess

        外痈 wai4 yong1 , external welling-abscess

        内痈 nei4 yong1 , internal welling-abscess


 

Huang Lian Jie Du Tang
Coptis Decoction to Relieve Toxicity

 

     黄芩 huang2 qin2 , Scutellariae Radix

     黄连 huang2 lian2 , Coptidis Rhizoma

     黄柏 huang2 bai3 , Phellodendri Cortex

     山栀子 shan1 zhi1 zi3 , Gardeniae Fructus

 

 

 

金银花 jin1 yin2 hua, Lonicerae Flos

(photo)

 

 

    Clears heat and resolves fire toxicity - throat, intestines, breast, eyes, skin    

    Vents and disperses externally contracted wind heat - sore throat, headache    

    Clears damp heat from the lower burner- damp heat dysentery, heat Strangury

    Dosage - medium to high.  

    C/C:  none

 

 

 

连翘 lian2 qiao2 , Forsythiae Fructus

(photo)

 

        Clears heat and resolves toxicity - wind heat and skin lesions

        Reduces abscesses and dissipates clumps

        Cautions and Contraindications: None at normal dosage, which is medium

 

 

Yin Qiao San   银翘散

 

    Releases exterior, clears heat

    Used for wind heat

    Esp. in throat conditions and fever

    Includes lian qiao, jin yin hua, bo he and gan cao - all used for sore throat

 

[table of contents]

 

 

Medicinals that Clear Deficiency Heat

 

Flavor: bitter
Temperature: cold
Channels: many

 

 

 

Qing Hao, Artemisia Annua Herbae

(photo)

Clears Summer Heat, especially with no sweating, low heat effusion (fever), constriction in the chest and vertigo. 

Clears Vacuity-Heat heat effusion (fever) in conditions of Vacuity of Blood or of Yin; especially useful during recuperation from Warm Disease.

Cools Blood Heat and stops bleeding, especially for rashes and nosebleeds.

 

[table of contents]

 

 

 

 

Medicinals that Drain Dampness

 

Flavor: bland, bitter
Temperature: neutral to cold
Channels: spleen, kidney, bladder

 

 

 

Etiology of Dampness

 

 

 

 

茯苓 fu2 ling2, Poria

(photo)

 

    Promotes urination and leeches out dampness- external and internal

    Strengthens the spleen and harmonizes the middle burner- splenic TT failure

    Strengthens the spleen and transforms phlegm- lung, stomach

    Quiets the heart and calms the spirit- palpitations, insomnia

    Cautions and contraindications - yin vacuity, sinking qi

    Dosage- medium

 

[table of contents]

 

 

Aromatic Medicinals that Transform Dampness

 

Flavor: acrid, aromatic, bitter
Temperature: warm
Channels: spleen, stomach

 

 

 

厚朴 Hou4 Po4 Magnoliae Officinalis Cx

(photo)

 

    Promotes movement of qi in the middle burner, transforms dampness, and resolves stagnation- dampness obstructing Sp/St, food stagnation

    Promotes the movement of Qi downward, dries dampness and transforms phlegm - cough and wheeze, bloating, GI

    Cautions and contraindications- pregnancy

    Dosage- low to medium

 

Ping Wei San  平胃散

    Hou Po/magnolia officinalis cx

    Cang Zhu/atractylodis rz.

    Chen Pi/citri reticulatae pericarpium

    Gan Cao/glycyrrhizae rx

    Sheng jiang/zingiberis rz recens   

Basic formula for all cold damp diseases

 

[table of contents]

 

 

Herbs that Dispel Wind Damp

 

    Flavor:  Acrid

    Temp:  Warm

    Channels:  many, esp. yang

    C/C: yin xu, qi xu, dryness

 

These herbs treat Bi Syndrome

 

 

 

Du2 Huo2  Angelicae Pubescentis Radix

(photo)

    

    Dispels wind dampness and alleviates pain- guiding herb for lower back and legs - acrid flavor

    Disperses wind cold dampness and releases the exterior- external contraction with body pain

    Shao Yin channel headache and toothache- channel theory connection to throat and tongue

    Cautions and contraindications- dryness, internal wind

    Dosage- low to medium

 

[table of contents]

 

Herbs and Formulas that Regulate Qi

 

Flavor: acrid
Temperature: warm
Channels: spleen, stomach, lung

 

 

Etiology of Qi Stagnation

 

 

 

 

 

 Chen2 Pi2  Citri Reticulatae Pericarpium

(photo)

    

    Regulates qi, adjusts the middle, and relieves the diaphragm - digestive sx

    Dries dampness and transforms phlegm - cough and GI sx

    Prevents stagnation - combined with tonics

    Dosage - low to medium

    C/C: qi and yin vacuity, heat repletion

 

[table of contents]

 

 

Herbs that Relieve Food Stagnation

 

    Flavor:  sweet

    Temperature:  warm

    Channels:  spleen and stomach

 

 

Define Food Stagnation

        Discuss etiology & Pathomechanisms

    Identify Two Types of Food Stagnation

        Mild Case- Food Damage

            Treatment principle- dissolve and conduct out food- Shan Zha

        Severe Case- GI Accumulation

            Attack and purge using offensive precipitants- Da Huang

  

 

 

山楂 Shan1 Zha1 Crataegi Fructus

(photo)

 

    Reduces food stagnation and transforms accumulations - meat and greasy foods    

    Transforms blood stasis and dissipates clumps - chest and abdominal pain    

    Stops diarrhea- when charred    

    Empirical use- coronary artery disease, hypercholesterolemia, hypertension

 

[table of contents]

 

 

 

Downward Draining Medicinals

 

    Three different types under this heading

         All enter LI channel

        

        Attacking and Purging- Da Huang

        Bitter, cold

        Draining Fire- GI heat bind, heat toxin, depressed upper body fire

        

        Moist lubricants, emollients- Huo Ma Ren

        Sweet, neutral

        

        Cathartics- Gan Sui

         Bitter, cold - Expelling water rheum, Attacking phlegm

 

 

 

 Da4 Huang2  Rhei Radix et Rhizoma

(photo)

 

    Drains heat and purges accumulations-GI heat bind of qi aspect, yang ming bowel fever

    Drains fire - upper body sx

    Clears heat, transforms damp, promotes urination - strangury, dysentery

    Invigorates blood and dispels stasis- trauma,

    Clears heat and reduces fire toxin - skin lesions

    Cautions and Contraindications - qi vacuity, pregnancy

    Dosage and cooking time

 

(JSD) When rhubarb is used raw, its strength of draining precipitation is fierce (so offensive precipitation formulas often use raw rhubarb, while invariably noting add at end). When stir-fried with wine (or steeped in wine, or washed with wine) it reaches the upper part of the body and expels heat with downward movement.Washing with wine also help its draining power making it suitable for symptoms such as red eyes, toothache, mouth sores, and burning heat in the chest. When decocted, its draining power is harmonious and moderate, making it suitable for elderly people with weak health. Char-fried it is used for accumulation and stagnation in the large intestine accompanied by precipitation of blood with the stool because it has a blood-stanching effect.

 

 

火麻仁 Huo3 Ma2 Ren2, Cannabis Semen

(photo)

 

    Nourishes and moistens intestines-elderly, post partum women, chronically ill, aftermath of heat disease

    Nourishes yin- Yin vacuity with insufficiency of fluids to moisten intestines

    Clears heat and promotes healing of sores- nourishes the skin

    Cautions and contraindications - n/v, diarrhea due to moistness

    Dosage: medium

 

 

甘遂 Gan1 Sui4  Kansui Radix

(photo)

 

    Drains water downward and drives out thin mucus - thoracic and abdominal evil water (ascites)

    Drives out phlegm - seizures

    Clears heat and reduces swelling- topical use in dermatology

    Cautions and contraindications

 

[table of contents]

 

 

Medicinals that Transform Phlegm

 

Flavor: acrid
Temperature: warm or cold
Channels: lung

 

 

Phlegm Etiology

 

 

 

 

 

Phlegm Patterns

 

 

 

 

 

 

Qian2 Hu2 (peucedani rx)

(photo)

 

    Directs qi downwards and transforms phlegm -  phlegm heat cough

    Disperses and Scatters wind heat - external cough (acrid flavor)

    C/C: yin vacuity, cold damp phlegm

    Dosage - low to medium

 

 

 Zhi4 Ban4 Xia4 (pinelliae rz prep)

(photo)

 

    Dries damp, transforms phlegm, descends rebellious qi - lung dz, spleen damp patterns

    Descends rebellious qi - GI, vomiting

    Dissipates nodules and reduces clumps - phlegm obstruction or lumps anywhere

    C/C: yin  vacuity, fire excess, bleeding

    Dosage - low to medium

    Representative Rx:  Er Chen Wan

 

[table of contents]

 

 

 

Medicinals that Relieve Cough and Wheezing

 

Flavor: variable
Temperature: variable
Channels: Lung

 

 

Etiology of Cough

 

 

 

 

 

杏仁 Xing4 Ren2 Armeniacae Semen

(photo) 

    

    Stops coughing and calms wheezing    

    Moistens the intestines    

    Dosage- low to medium    

    C/c:  diarrhea, yin vacuity, careful with dose

 

[table of contents]

 

 

 

Regulate Blood

 

 

Herbs that Stop Bleeding

 

Flavors, temperatures and channels vary

 

 

Etiology of Bleeding in TCM:

 

 

 

三七 San1 Qi1 , Notoginseng Radix

(photo)

    

    1. Stops bleeding and transforms blood stasis

    a. Internal bleeding- hematuria, hematemesis, hemafecia, epistaxis

       Also used for bleeding due to blood stasis, since it also quickens the blood

    b. External bleeding- when trauma severs the network vessels and blood escapes

    2. Reduces swelling and alleviates pain

    Dosage - low to medium

    C/c: pregnancy

 

[table of contents]

 

 

Herbs that Move Blood

 

flavors: acrid

temperature: cool or warm

channels: ht, lv

 

Etiology and Pathomechanisms of Blood Stasis

 

 

 

 

 

赤芍 Chi4 Shao1 Yao4, Paeoniae Radix Rubra

(photo)

 

    1. Invigorates the Blood and Dispels Blood Stasis

    a. Gynecological applications

    b. Traumatic injury

    c. To help ripen or promote the development of pus

    2. Clears heat and cools the Blood

    a. Blood aspect heat

    b. Heat induced bleeding

    c. Gynecological applications- abnormal bleeding disorders when blood moves recklessly due to heat

     d. Eyes - wind fire eye (conjunctivitis)

    Dosage - medium

More Information

 

 

川芎 Chuan1 Xiong1, Chuanxiong Rhizoma

(photo)

    

     1. Invigorates blood and promotes movement of qi-

    a. Gynecological applications

    b. Used for combined patterns of qi stagnation and blood stasis

    2. Expels wind and alleviates pain-

    a. Externally contracted wind causing pain-

    b. Used for impediment (bi zheng)

    Dosage - low to medium

    C/c: liver yang or fire rising

 

[table of contents]

 

 

Medicinals that Warm the Interior

 

flavors: acrid

temperature: hot

channels: kd, ht, sp

 

 

Etiology and Pathomechanisms for Cold Disease

 

 

 

 

 

 

附子 Zhi4 Fu4 Zi3, Aconiti Radix Lateralis Praeparata

(photo)

    

        Revives the yang and rescues from rebellion

        Used for devasated yang qi and abundant yin

        Warms the fire and assists yang

        Used for yang vacuity patterns in general- Zang Fu involved can be heart, spleen or kidneys

        Disperses cold, warms the channels, alleviates pain - bi syndrome

        Dosage - low to medium

        C/C: heat, yin vacuity, pregnancy

 

[table of contents]

 

 

Vacuity Patterns

 

 

 

 

Medicinals that supplement Qi

 

Temperature: Warm
Flavor: Sweet
Channels: Spleen, Lung
C/C: qi stagnation, heat, exterior

 

 

 

人參 Ren Shen, Ginseng Radix

(photo)

 

     1. Powerfully tonifies the primal qi (yuan qi)

    a. For qi or yang desertion- especially red Korean ginseng. Used in high dosages

    2. Tonifies and augments lung qi

    a. Lung qi vacuity cough, sob, sweating, low voice

    3. Strengthens spleen and tonifies stomach qi

    a. Spleen and stomach vacuity patterns

    b. Center qi fall

    4. Generates fluids and alleviates thirst

    a. White ginseng is used here

    b. Xiao ke disease

    c. When fluids and qi have been injured by heat disease

     5. Benefits the heart qi and calms spirit

    a. Heart qi vacuity patterns with shyness, depression, spiritual fatigue, anxiety with palpitations, etc

 

Notes   

Abstracts

 

 

党参 Dang Shen (Codonopsis Radix)

(photo)

Eric Brand on dosage: "I finished my survey of the core materia medica textbooks with regard to Dang Shen. The "21st century" zhong yao xue text by ren min wei sheng publishing house (part of the latest 7th edition textbookseries) lists 10-30 g. The 5th edition teacher's book (published inTaiwan by zhuyin, but it is just a traditional character reprint ofthe PRC edition published by ren min wei sheng) lists 6-30 g. Thepharmacopeia (the PRC text that specifies the standard species for each drug) lists 9-30 g. Basically, all the key modern texts list 10-30 g, with the exceptionof the 5th edition teacher's book, which goes as low as 6 g. The factthat some texts use 9 g and some use 10 g at the low end of the dose range is likely due to a desire for round numbers and rounding from the original dosage of 3 qian (9.375 g in PRC, or 11.25 g everywhere else)."

Commonly used as a substitute for Ren Shen due to its lower cost and easier cultivation.  Similar functions for spleen and Lung.  No affect on heart or kidneys.  Generates fluids.

 

 

 

 

白朮 Bai Zhu, Atractylodis Macrocephalae Rhizoma

    

    1. Tonifies spleen and augments the qi

    a. Spleen vacuity patterns with internally engendered dampness

    2. Dries dampness and promotes water metabolism

    a. See above

    3. Stabilizes the exterior and stops sweating

    a. Used when there is qi vacuity spontaneous sweating

     4. Calms fetus

    a. For threatened miscarriage due to failure of spleen qi to contain the fetus

     Dosage - low to medium   C/C :  yin vacuity, thirst

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Notes

 


甘草 Gan Cao (Glycyrrhizae Radix)

(photo)

    

    1. Supplements spleen qi

    a. Zhi Gan Cao better for this function

    2. Moistens lung and stops cough

    a. Used when dryness consumes lung fluid

    3. Clears heat and fire toxin

    a. Used for welling abscess and sore throat due to fire toxin

    4. Moderates spasms and alleviates pain

    a. For yin and blood insufficiency failing to nourish the sinews

    5. Moderates and harmonizes characteristics of other herbs

    6. Antidote to toxic substances

    Dosage low to medium

    C/c:  hi BP, bloating, dampness

 

 

    Si Jun Zi Tang (Four Gentlemen Decoction)

    Ren Shen (Ginseng Rx)                  6-15g.

    Bai Zhu (Atractylodis Macrocephalae Rz)    6-12

    Fu Ling (Poriae)                      6-15

    Zhi Gan Cao (Glycyrrhizae Rx prep)     3-5

 

[table of contents]

 

 

Medicinals that Supplement Yang

 

Temperature: Warm
Flavor: Sweet
Channels: Kidney, Liver
C/C: heat

 

     

鹿茸 Lu Rong, Cervi Cornu

(photo)

    

Tonifies kidney and fortifies yang

Warms the yang, Regulates the chong and ren - discharge, bleeding, infertility

Tonifies the governing vessel, augments essence and blood, and strengthens the sinews and bones - retardation, failure to thrive

Tonifies and nourishes qi and blood

Dosage - low   C/C:  yin vacuity, fire , yang rising

More Information

 

[table of contents]

 

Medicinals that Supplement Blood

 

Temperature: Warm
Flavor: Sweet
Channels: Liver, Heart
C/C: damp, phlegm, dampheat

 

 

 

熟地黄 Shu Di Huang, Rehmanniae Radix Preparatae

(photo)

    

    Tonifies blood - all blood diseases

    Nourishes yin - nightsweats, vacuity heat

    Strongly enriches yin  and relieves wasting and thirsting

    Nourishes blood and tonifies essence

    C/C: dampness and phlegm

    Dosage - medium to high

More Information

     Abstracts


當歸 Dang Gui, Angelicae Sinensis Radix

(photo)

    

    Tonifies blood and regulates menses

    Invigorates and harmonizes blood and disperses cold

    Moistens intestines and unblocks the bowels

    Reduces swelling, expels pus, generates flesh, and alleviates pain

    Dosage - medium

    C/c:  diarrhea, bloating

 

 

   Si Wu Tang  (Four Substance Decoction)

    Dang Gui (Angelicae Sinensis Rx)            6-12g.

    Chuan Xiong (Chuanxiong Rx)         6-10

    Bai Shao (Paeoniae Rx)                             6-15

    Shu Di Huang (Rehmanniae Rx Prep)       6-30    

 

[table of contents

 

 

 

Medicinals that Nourish Yin

 

Temperature: Cold
Flavor: Sweet
Channels: Kidney, Lung, Stomach
C/C: damp, phlegm

 


麦门冬 Mai Men Dong, Ophiopogonis Radix

(photo)

    

    Moistens the lung and nourishes yin    

    Augments stomach yin and generates fluids    

    Clears the heart and eliminates irritability

    Moistens the Intestines

    Dosage - medium

    C/c: dampness, loose stool, cold phlegm

 

[table of contents]

 

 

Astringent Flow Chart

 

 

 

 

 

 

Herbs that Stabilize and Bind

 

Temperature: Warm

Flavor: Sour

Channels:  Spleen, Lung, Kidney

C/C: excess, heat, exterior

 

 

 

 

山茱萸 Shan Zhu Yu, Corni Fructus

(photo)

    

    Stabilizes the kidneys and retains essence

    Stops excessive sweating and supports that which has collapsed

    Tonifies liver and kidneys

    Stabilizes menses and stops bleeding

    Dosage - medium

    C/c: dampheat, strangury

 

   

   Liu Wei Di Huang Wan  (Six-Ingredient Pill with Rehmanniae)

    Shu Di Huang (Rehmanniae Rx. Prep.)     6-30g.

    Shan Zhu Yu (Corni Fr.)                6-10

    Shan Yao (Dioscoreae Rz)            6-15

    Fu Ling (Poriae)                    6-15

    Ze Xie (Alismatis Rz. )                6-12

    Mu Dan Pi (Moutan Cx. )                6-12

 

[table of contents]

 

 

Herbs that Calm the Spirit and Nourish the Heart

 

 

    Temperature: neutral

    Flavor: Sweet

    Channels:  heart, liver

    C/C: none

 

 

Etiology and Pathomechanisms of Disturbances of the Spirit

 

 

 

 

 

酸棗仁 Suan Zao Ren Zizyphi Spinosae Semen

(photo)

    

    Nourishes heart yin, augments liver blood, and quiets the spirit    

    Prevents abnormal sweating    

    Dosage - medium to high    

    C/c:  diarrhea, heat excess

More Information

 

 

 

Heavy Settling Agents

 

temp:  cold

taste:  sweet, astringent

channels:  ht, lv

 

 

龍骨 Long Gu Fossilia Ossis Mastodi

(photo)

    

    Settles anxiety and calms the spirit    

    Calms the liver and anchors floating yang    

    Prevents leakage of fluids    

    Used topically for chronic sores

    Dosage - high

    C/c:  spleen qi vacuity, dampheat, external illness

More Information

 

[table of contents]



 

Calming the Liver and Extinguishing Wind

 

Temperatures:  Cool and cold

Channels:  Lv, Ht

 

 

Etiology and Pathomechanisms of Internal Wind

 

 

 

 

 

 

    These medicinals primarily calm the liver and settle yang

        They are used for:

       Internal Stirring of Liver Wind – spasms, convulsions, tetany, numbness

      One must ascertain the underlying cause of the wind and combine these medicinals with those in other categories

        

      Hyperactive Ascendancy of Liver Yang- symptoms in the head including dizziness, tinnitus, and vertigo

        Other categories to combine with depending on the case:

            Clear heat and drain fire, calm spirit, supplement blood, supplement yin

 

 

 

鈎籐 Gou Teng, Uncariae Ramulus cum Uncis

(photo)

    

    Extinguishes wind and alleviates spasms    

    Drains liver heat and pacifies yang    

    Releases exterior wind-heat    

    Dosage - medium to high

    C/c:  vacuity

 

[table of contents]

 

The Method of Opening the Orifices

 

 This method generally uses pungent,  aromatic agents to open the sensory orifices and consciousness

 Primarily used when there is sudden loss of consciousness to resuscitate the patient in conditions such as stroke,  seizure,  angina pectoris,  or cloudiness of the mind from heat disease entering the pericardium

    Also used to eliminate distention and oppression in the chest and abdomen caused by phlegm and dampness

    Mostly used in pill form owing to the urgent need of the substance as well as prohibitive costs in some cases

 

        Primarily an emergency symptomatic treatment taking three major forms:

    1)  Clearing the heart and opening the orifices

    2)  Transforming phlegm and opening the orifices

    3)  Expelling dampness and opening the portals

    

         General Contraindications:  pregnancy,  desertion of yang

 

 

 

麝香 She Xiang Moschus

 

    

    Vigorously opens the orifices, revives the spirit, and unblocks closed disorders

    Invigorates blood, dissipates clumps, reduces swelling, and alleviates pain

    Hastens delivery and facilitates the downward passage of stillborns

    Dosage - low

    C/c:  yin  vacuity heat, pregnancy, allergies, hypertension, renal failure

 

[table of contents]

 

 

Medicinals that Expel Parasites

 

    A basic understanding of parasitic disease was gained early in the history of Chinese medicine

         “ Inch white worm is a result of eating uncooked beef.”

         ( Zhu Bing Yuan Hou Lun, Chao Yuan Fang 610c.e.)

    Parasites are now listed as neutral or miscellaneous causes of disease

    In modern CM, the term parasites mostly refers to cases of worms

        Hookworm, pinworm, roundworm, and tapeworm

 

 

    Symptoms and signs of parasites

 Peri-umbilical pain, vomiting, change in appetite or deranged appetite, itching in various locations including the anus and perineum, the nose, and the ears.

        Enduring cases will present with s/s of qi and blood vacuity

        In modern times, stool and other lab exams confirm the diagnosis

 

 

    Choice of medicinal depends on the parasite involved

    Combined with other categories

        Food stagnation

        Attacking precipitants (purgatives)

        Clearing heat

        Warm supplementation

        Warm interior

        Specialized methods exist including taking timing of therapy into consideration

            i.e., first take strong parasite formula soon followed by purgative formula

 

 

大蒜 Da Suan Alli Sativae bulbus

    

    Kills parasites - for most parasites, especially hookworm and pinworm

    Relieves toxicity

    Prevents influenza and food poisoning from shellfish

    Dosage - medium

    C/c:  yin vacuity heat

 

[table of contents]