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
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
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
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
Introduction to Chinese Medicinals
Nomenclature
Pinyin
Latin pharmaceutical - plant parts
Hot, Cold, Warm, Cool, Neutral qualifications used include slightly cold and slightly warm
Vary somewhat from text
Opposite temperature is used to treat disease
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
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
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
Contraindications of Medicinals
According to Traditional Theory and Experience
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
Typical Forms of Administration
Tang 汤
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 散
a. Between tang and wan in terms of strength
b. Watch dosage in formula text
Wan 丸
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 酒
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.
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
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
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
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 )
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 ( 卫 wei4 ) : Lonicera and Forsythia Powder ( 银翘散 yin2 qiao4 san3 )
Qi ( 气 qi4 )
Construction ( 营 ying2 )
Blood ( 血 xue4 )
Signs and Symptoms
Basic Pathomechanisms
Treatment Principles and Formulas
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
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
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
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
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 汤 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
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
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
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
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
水 牛 角 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
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
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
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
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
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
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
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:
痈 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
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
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
Medicinals that Clear Deficiency Heat
Flavor:
bitter
Temperature: cold
Channels: many
Qing Hao, Artemisia Annua Herbae
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.
Medicinals that Drain Dampness
Flavor:
bland, bitter
Temperature: neutral to cold
Channels: spleen, kidney, bladder
Etiology of Dampness
茯苓 fu2 ling2, Poria
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
Aromatic Medicinals that Transform Dampness
Flavor:
acrid, aromatic, bitter
Temperature: warm
Channels: spleen, stomach
厚朴 Hou4 Po4 Magnoliae Officinalis Cx
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
Flavor: Acrid
Temp: Warm
Channels: many, esp. yang
C/C: yin xu, qi xu, dryness
These herbs treat Bi Syndrome
独 活 Du2 Huo2 Angelicae Pubescentis Radix
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
Herbs and Formulas that Regulate Qi
Flavor:
acrid
Temperature: warm
Channels: spleen, stomach, lung
Etiology of Qi Stagnation
陈 皮 Chen2 Pi2 Citri Reticulatae Pericarpium
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
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
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
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
大 黄 Da4 Huang2 Rhei Radix et Rhizoma
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
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
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
Medicinals that Transform Phlegm
Flavor:
acrid
Temperature: warm or cold
Channels: lung
Phlegm Etiology
Phlegm Patterns
Qian2 Hu2 (peucedani rx)
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)
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
Medicinals that Relieve Cough and Wheezing
Flavor:
variable
Temperature: variable
Channels: Lung
Etiology of Cough
杏仁 Xing4 Ren2 Armeniacae Semen
Stops coughing and calms wheezing
Moistens the intestines
Dosage- low to medium
C/c: diarrhea, yin vacuity, careful with dose
Herbs that Stop Bleeding
Flavors, temperatures and channels vary
Etiology
of Bleeding in TCM:
三七 San1 Qi1 , Notoginseng Radix
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
Herbs that Move Blood
flavors: acrid
temperature: cool or warm
channels: ht, lv
Etiology and Pathomechanisms of Blood Stasis
赤芍 药 Chi4 Shao1 Yao4, Paeoniae Radix Rubra
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
川芎 Chuan1 Xiong1, Chuanxiong Rhizoma
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
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
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
Temperature:
Warm
Flavor: Sweet
Channels: Spleen, Lung
C/C: qi stagnation, heat, exterior
人參 Ren Shen, Ginseng Radix
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
党参 Dang Shen (Codonopsis Radix)
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
甘草 Gan Cao (Glycyrrhizae Radix)
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
Medicinals that Supplement Yang
Temperature:
Warm
Flavor: Sweet
Channels: Kidney, Liver
C/C: heat
鹿茸 Lu Rong, Cervi Cornu
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
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
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
當歸 Dang Gui, Angelicae Sinensis Radix
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
Temperature:
Cold
Flavor: Sweet
Channels: Kidney, Lung, Stomach
C/C: damp, phlegm
麦门冬 Mai Men Dong, Ophiopogonis Radix
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
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
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
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
Nourishes heart yin, augments liver blood, and quiets the spirit
Prevents abnormal sweating
Dosage - medium to high
C/c: diarrhea, heat excess
temp: cold
taste: sweet, astringent
channels: ht, lv
龍骨 Long Gu Fossilia Ossis Mastodi
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
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
Extinguishes wind and alleviates spasms
Drains liver heat and pacifies yang
Releases exterior wind-heat
Dosage - medium to high
C/c: vacuity
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